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

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

Matilda A Kvissberg  1 , Prasad S Dalvi  1 , Marko Kerac  1 , Wieger Voskuijl  1 , James A Berkley  1 , Marion G Priebe  1 , Robert H J Bandsma  2
Affiliations

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

Matilda A Kvissberg et al. Nutr Rev. 2016 Jan.

Abstract

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..

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Figure 1
PRISMA flow diagram of the literature search and selection process
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