Oscar Pineda

Calcium metabolism in children recovering from severe protein-energy malnutrition

Twenty preschool children with severe edematous protein-energy malnutrition (PEM) were studied during the first 45 days of recovery. All children received 4 g/kg/day of protein and 150 kcal/kg/day of energy from a milk-based recovery formula, providing 130-140 mg/kg/day of calcium (Ca). Children were randomized to two treatment groups, one receiving intact milk formula and the other a lactose-free preparation. Both groups showed a high efficiency of intestinal calcium absorption, sustained even after the normalization of weight for height and lean body mass. The presence or absence of lactose in the diet did not affect intestinal calcium absorption, and increased stool volume in the early period of recovery in the children receiving intact milk was not associated with higher fecal Ca losses. Urinary Ca excretion was within the range reported for healthy children under a normal diet. These results suggest that therapeutic amounts of calcium should be delivered to children with PEM well beyond the normalization of body weight and lean body mass.

Milk, lactose and ethanol as dietary factors in cataractogenesis in Guatemala. A case-control study

We performed a case-control study in 46 Guatemalan adults aged 26 to 79 years with a recent history of cataract extraction and 46 controls matched for sex, age (±5 years), and altitude of residence (±400m). The aetiological variables studied included: (i) effect of lactose digesting capacity as reflected by chance in breath hydrogen concentration; (ii) effect of the tolerance to a 240 ml challenge of milk containing 12 g of lactose; (iii) effect of usual lactose consumption; and (iv) effect of ethanol consumption. Adjusted relative risks, calculated using the matched-pair method, were 4.2 for a history of milk consumption, and 16.0 for a history of ethanol use. Non-suggestive associations were found for the milk tolerance challenge test and for lactose digesting capacity according to breath hydrogen concentration. We concluded that, in a Guatemalan population, ethanol is a more important risk factor than milk exposure, but both can influence cataract risk.