Hostname: page-component-76fb5796d-wq484 Total loading time: 0 Render date: 2024-04-29T02:57:57.381Z Has data issue: false hasContentIssue false
  • English
  • Français

The effect of the level of dietary protein, carbohydrate and fat on urea kinetics in young children during rapid catch-up weight gain

Published online by Cambridge University Press:  09 March 2007

Alan A. Jackson ,
J. Doherty ,
M.-H. de Benoist ,
J. Hibbert  and
C. Persaud
Alan A. Jackson
Affiliation:
Department of Human Nutrition, University of Southampton, Bassett Crescent East, Southampton SO9 3TU Tropical Metabolism Research Unit, University of the West Indies, Mona, Kingston 7, Jamaica
J. Doherty
Affiliation:
Tropical Metabolism Research Unit, University of the West Indies, Mona, Kingston 7, Jamaica
M.-H. de Benoist
Affiliation:
Tropical Metabolism Research Unit, University of the West Indies, Mona, Kingston 7, Jamaica
J. Hibbert
Affiliation:
Tropical Metabolism Research Unit, University of the West Indies, Mona, Kingston 7, Jamaica
C. Persaud
Affiliation:
Department of Human Nutrition, University of Southampton, Bassett Crescent East, Southampton SO9 3TU Tropical Metabolism Research Unit, University of the West Indies, Mona, Kingston 7, Jamaica
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The kinetics of urea metabolism were measured in children recovering from severe malnutrition. For a period of up to 10 d they received one of four diets which provided 711 kJ (170 kcal)/kg per d. Two groups received a diet with a high protein: energy (P:E) ratio of 10.6% (HP), enriched with either fat (HP/F) or maize starch and sucrose (HP/C). Two groups received a diet with a low P:E ratio of 8.8% (LP), enriched with either fat (LP/F) or maize starch and sucrose (LP/C). The rate of weight gain on the HP diets was significantly greater than on the LP diets. There was no difference in urea production between any of the four diets: HP/F 1.23 (SE 0.12), HP/C 1.37 (SE 0.14), LP/F 1.64 (SE 0.22), LP/C 1.15 (SE 0.15) mmol nitrogen/kg per h. On the HP diets urea excretion was 0.77 (SE 0.07) mmol N/kg per h. 61 % of production. There was significantly less urea excreted in the urine on diet LP/C than on LP/F (0.36 (SE 0.05) and 0.64 (SE 0.04) mmol N/kg per h respectively). A significantly greater percentage of the urea production was hydrolysed on the LP diets (61 %) compared with the HP diets (39 %), with the consequence that 50% of urea-N produced was available for synthetic activity on the LP diets compared with 30% on the HP diets. The increase in the urea hydrolysed on the LP diets was equivalent in magnitude to the decreased intake of N, so that overall intake plus hydrolysis did not differ between the LP and the HP diets. Crude N balance was similar on diets HP/F, HP/C and LP/C, but was significantly reduced on diet LP/F. These results show that there is an accommodation in urea kinetics during rapid catch-up weight gain, which becomes evident when the P:E ratio of the diet falls to 8.8%. It is proposed that, for a P:E ratio of 8.8%, protein is limiting for catch-up growth. When the intake has a P:E ratio of 8.8% the pattern of urea kinetics can be modified by the relative proportions of fat and carbohydrate in the diet. The measurement of urea kinetics provides a useful approach to the definition of the adequacy of the protein in the diet.

Keywords

Urea kineticsGrowthUndernutrition
Type
Nitrogen Metabolism
Information
British Journal of Nutrition , Volume 64 , Issue 2 , September 1990 , pp. 371 - 385
Copyright
Copyright © The Nutrition Society 1990

References

Ashworth, A. (1975). Regulation of weight and height during recovery from severe malnutrition. Proceedings 9th International Congress of Nutrition, vol. 2, pp. 280–285 [Chavez, A., Bourges, H. and Basta, S., editors]. Basel: Karger.Google Scholar
Chan, H. & Waterlow, J. C. (1966). The protein requirement of the infant at the age of about one year. British Journal of Nutrition 20, 775–782.CrossRefGoogle Scholar
Cummings, J. H. (1981). Dietary fibre. British Medical Bulletin 37, 65–70.CrossRefGoogle ScholarPubMed
Golden, M. H. N., Golden, B. E. & Jackson, A. A. (1981). Method of trace element balance in young children. In Trace Element Metabolism in Man and Animals, pp. 69–72 [McCHowell, J., Gawthorne, J. M. and White, C. C., editors]. Canberra: Australian Academy of Science.CrossRefGoogle Scholar
Hamill, P. V. V., Drizd, T. A., Johnson, C. L., Reed, R. B., Roche, A. F. & Moore, W. M. (1979). Physical growth: National Center for Health Statistics percentiles. American Journal of Clinical Nutrition 32, 607–629.CrossRefGoogle ScholarPubMed
Harper, A. E., Benevenga, N. J. & Wohlhueter, R. M. (1970). Effects of ingestion of disproportionate amounts of amino acids. Physiological Reviews 50, 428–458.CrossRefGoogle ScholarPubMed
Jackson, A. A. (1983). Amino acids: essential and non-essential? Lancet i, 1034–1037.CrossRefGoogle Scholar
Jackson, A. A. (1985). Nutritional adaptation in disease and recovery. In Nutritional Adaptation in Man, pp. 111–126 [Blaxter, K. and Waterlow, J. C., editors]. London: John Libbey.Google Scholar
Jackson, A. A. (1990). Protein requirements for catch-up growth. Proceedings of the Nutrition Society 49 (In the Press).CrossRefGoogle ScholarPubMed
Jackson, A. A., Golden, M. H. N., Jahoor, P. F. & Landman, J. P. (1980). The isolation of urea nitrogen and ammonia nitrogen from biological samples for mass spectrometry. Analytical Biochemistry 105, 14–17.CrossRefGoogle ScholarPubMed
Jackson, A. A., Landman, J. P. & Picou, D. (1981). Urea production rates in man in relation to the dietary intake of nitrogen and the metabolic state of the individual. In Nitrogen Metabolism in Man, pp. 247–251 [Waterlow, J. C. and Stephen, J. M. L., editors]. Barking, Essex: Applied Science Publishers.Google Scholar
Jackson, A. A., Landman, J. P., Stevens, M. C. G. & Serjeant, G. R. (1988). Urea kinetics in adults with homozygous sickle cell disease. European Journal of Clinical Nutrition 42, 491–496.Google ScholarPubMed
Jackson, A. A., Picou, D. & Landman, J. P. (1984). The non-invasive measurement of urea kinetics in normal man by a constant infusion of 15N15N-urea. Human Nutrition: Clinical Nutrition 38C, 339–354.Google Scholar
Jackson, A. A., Picou, D. & Reeds, P. J. (1977). The energy cost of repleting tissue deficits during recovery from protein energy malnutrition. American Journal of Clinical Nutrition 30, 1514–1517.CrossRefGoogle ScholarPubMed
Kaplan, A. (1965). Urea nitrogen and ammonia nitrogen. In Standard Methods of Clinical Chemistry, vol. 5, pp. 245–256 [Meites, S., editor]. New York: Academic Press.Google Scholar
Levenson, S. M., Crowley, L. V., Horowitz, R. E. & Malm, O. J. (1959). The metabolism of carbon labelled urea in the germ free rat. Journal of Biological Chemistry 234, 2061–2062.CrossRefGoogle Scholar
Liu, H. Y. & Anderson, G. J. (1967). A method for the long term quantitative and fractional collection of urine. Journal of Pediatrics 70, 276–279.CrossRefGoogle Scholar
MacLean, W. C. & Graham, G. G. (1980). The effect of energy intake on nitrogen content of weight gained by recovering malnourished children. American Journal of Clinical Nutrition 33, 903–909.CrossRefGoogle Scholar
Moran, B. J. & Jackson, A. A. (1990). 15N-urea metabolism in the functioning human colon: luminal hydrolysis and mucosal permeability. Gut 31, 454–457.CrossRefGoogle ScholarPubMed
Nissim, I., Yudkoff, M., Yang, W., Terwilliger, T. & Segal, S. (1981). Rapid gas chromatography-mass spectrometric analysis of [15N]urea: application to human metabolic studies. Clinica Chimica Acta 109, 295–304.CrossRefGoogle ScholarPubMed
Picou, D. & Phillips, M. (1972). Urea metabolism in malnourished and recovered children receiving a high or low protein diet. American Journal of Clinical Nutrition 25, 1261–1266.CrossRefGoogle ScholarPubMed
Rudman, D., Millikan, W. J., Richardson, T. J., Bixler, T. J. II, Stackhouse, J. & McGarrity, W. C. (1975). Elemental balances during intravenous hyperalimentation of underweight adult subjects. Journal of Clinical Investigation 55, 94104.CrossRefGoogle ScholarPubMed
Shetty, P. S. & Kurpad, A. V. (1986). Increasing the starch intake in the human diet increases fecal bulking. American Journal of Clinical Nutrition 43, 210–212.CrossRefGoogle ScholarPubMed
Tanaka, N., Kubo, K., Shiraki, K., Koishi, H. & Yoshimura, H. (1980). A pilot study on protein metabolism in Papua New Guinea Highlanders. Journal of Nutritional Science and Vitaminology 26, 247–259.CrossRefGoogle ScholarPubMed
Walser, M. & Bodenlos, L. J. (1959). Urea metabolism in man. Journal of Clinical Investigation 38, 1617–1626.CrossRefGoogle ScholarPubMed
Walser, M., George, J. & Bodenlos, L. J. (1954). Altered proportions of isotopes of molecular nitrogen as evidence for a monomolecular reaction. Journal of Chemical Physics 22, 1146.CrossRefGoogle Scholar
Waterlow, J. C. (1961). The rate of recovery of malnourished infants in relation to the protein and calorie levels of the diet. Journal of Tropical Pediatrics 7, 16–22.CrossRefGoogle Scholar
Wellcome Trust Working Party (1970). Classification of infantile malnutrition. Lancet ii, 302–303.Google Scholar