Carbohydrate malabsorption in acutely malnourished children and infants: a systematic review

Nutr Rev. 2016 Jan;74(1):48-58. doi: 10.1093/nutrit/nuv058. Epub 2015 Nov 17.


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..

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Child
  • Child Nutrition Disorders / complications*
  • Diarrhea / etiology
  • Diet
  • Dietary Carbohydrates / metabolism*
  • Humans
  • Infant
  • Lactose / metabolism*
  • Lactose Intolerance / etiology*
  • Malnutrition / complications*
  • Weight Gain / drug effects


  • Dietary Carbohydrates
  • Lactose