Fernando Monckeberg

Lipid transport in kwashiorkor.

1. In an attempt to elucidate the pathogenic mechanism of the fatty liver of kwashiorkor some aspects of lipid metabolism were studied in ten patients with kwashiorkor and nine with marasmus, so classified according to the clinical and laboratory findings. 2. Plasma lipid levels, especially those of triglycerides, were low in patients with kwashiorkor; they showed a marked rise very early during treatment. 3. The changes in the plasma lipid levels occurred mainly in the serum lipoprotein fraction of density 4. The findings support the suggestion that the primary mechanism in the production of the fatty liver of kwashiorkor is an impairment in the synthesis of lipoprotein of very low density, probably due to the rate-limiting synthesis of its protein moiety. 5. In patients with marasmus no modifications in lipid metabolism were detected by the methods used.

Metabolism of serum albumin in marasmic infants

By means of studies with I 131 -labeled human serum albumin, the serum albumin half-life of marasmic infants has been shown to be longer than that of normal infants. It is suggested that reduced catabolism of body proteins may contribute to the survival of the infant during prolonged periods of inadequate calorie and protein intake.

Chilean Experience with Fortified Children’s Formulas

In this paper we have described all the steps needed to develop an efficient program for distributing childrens fortified formulas. The easiest steps are to develop the formulas on an experimental and laboratory basis. The real obstacles lie in implementation at the national level. All that has been described applies to experience in Chile, which we consider very successful because of the acceptance of the program as well as spectacular advances in preventing malnutrition. The figures for 1977 show that combining all degrees of malnutrition in the under six age group, the prevalence is now 12.2% compared to nearly 60% found 10 years ago. This progress is due, not only to the specific program, but also to the many others that constitute the national food and nutrition policy (CONPAN, 1976). This success is due to the persistent, skilled effort of many professional and technical staff members. It is impractical to acknowledge all individual contributions here. The National Food and Nutrition Council, the National Health Service, Universities, Research Bodies, and private enterprizes have all contributed to this joint effort. The purpose of this presentation is that this experience may benefit other countries with similar problems.

Definition of the Nutrition Problem — Poverty and Malnutrition in Mother and Child

Adequate food is essential for every being, but man, up to this time, has not been able to satisfy this need equally well for all of the world’s population. Malnutrition and hunger are still his inseparable companions, as they have been since the beginning of history (1). During the last decades, man’s knowledge has developed tremendously, and, for the most part, he has applied it for his benefit. No one can deny that he has accumulated sufficient information to provide enough food for humanity. In spite of this, many millions of children and adults continue to suffer from undernourishment and hunger. In fact, the gap seems to be widening between those who are able to produce abundant food and those who cannot.

El hígado graso en el Kwashiorkor

Una de las caracteristicas mas notables de ladesnutricion proteica Infantil (Kwashiorkor) es lahepatomegalia debido a la infiltration grasa del hi-gado. Este es un signo comunmente utilizado paradiferenciar el kwashiorkor del otro tipo de des-nutricion Infantil, marasmo.El 50 o mas por ciento del peso humedo delhigado puede ser grasa en el kwashiorkor. Aunque el contenido lipidico del higado ha sido exa-minado quimicamente solo en contadas ocasiones,hay acuerdo universal en que el exceso de lipidoshepaticos esta constituido practicamente en su to-talidad pro trigliceridos. Utilizando una adaptationpara micro-cantidades de un metodo para deter-minar trigliceridos (1) pudimos establecer que,en efecto estos constituyen practicamente toda lagrasa hepatica en ninos con kwashiorkor (Ta-bla 1).Se han eleborado diversas hip6tesis para ex-plicar patogenesis del higado graso en el kwashior-kor. Es notable que las observaciones de los dis-tintos investigadores son bastantes similares, a pc-sar de lo cual las conclusiones sacadas de estosmismos datos son muy diferentes.Bronte-Stewar (2) sugirio que uno de losfactores principales en la infiltration grasa del hi-gado seria una deficiencia de acidos grasos esen-ciales. Schendel y Hansen (3) observaron que, enefecto, en el plasma de pacientes de kwashiorkoren recuperacion habia un patron de acidos grasosreminisccnte de la deficiencia de acidos grasosesenciales, pero interpretaron cste dato como elresultado de la gran demanda producida por elgran aumento en las nccesidades de transporte delipidos que se produce durante la recuperacion del