Context: Severe acute malnutrition (SAM) accounts for approximately 1 million child deaths per year. High mortality is linked with comorbidities, such as diarrhea and pneumonia.
Objective: The aim of this systematic review was to determine the extent to which carbohydrate malabsorption occurs in children with SAM.
Data sources: The PubMed and Embase databases were searched. Reference lists of selected articles were checked.
Data extraction: All observational and controlled intervention studies involving children with SAM in which direct or indirect measures of carbohydrate absorption were analyzed were eligible for inclusion. A total of 20 articles were selected for this review.
Data synthesis: Most studies reported carbohydrate malabsorption, particularly lactose malabsorption, and suggested an increase in diarrhea and reduced weight gain in children on a lactose-containing diet. As most studies reviewed were observational, there was no conclusive scientific evidence of a causal relationship between lactose malabsorption and a worse clinical outcome among malnourished children.
Conclusion: The combined data indicate that carbohydrate malabsorption is prevalent in children with SAM. Additional well-designed intervention studies are needed to determine whether outcomes of SAM complicated by carbohydrate malabsorption could be improved by altering the carbohydrate/lactose content of therapeutic feeds and to elucidate the precise mechanisms involved.
Keywords: F-75; carbohydrate malabsorption; disaccharidase deficiency; lactose intolerance; malnutrition..
© The Author(s) 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute.