Treatment and prevention of kwashiorkor.

Recent research carried out on kwashiorkor in Kampala, Uganda, is discussed. The first essential in both the treatment and the prevention of this disease being a diet rich in protein (preferably animal protein, to ensure an adequate intake of vitamin B(12) and a satisfactory mixture of amino-acids), methods of incorporating sufficient protein into children's diets were investigated.For the treatment of severe cases, two high-protein diets-one based on animal protein, the other on plant protein-gave good results. In the first, the protein was obtained from dried skimmed milk and a calcium caseinate preparation known as Casilan; in the second, it was supplied by soya. Some vitamin B(12), which is lacking in the soya itself, was added to the second diet in order to ensure satisfactory weight gains.With regard to prevention, the author points out that although it is theoretically simple there are serious practical difficulties. The best sources of protein-milk, meat, and fish-are unfortunately, at present, too expensive for general consumption in Uganda. Therefore, the best possible use of plant protein must be made for the time being. In this connexion, the author recommends investigating the value of sunflower, which grows more easily in Uganda than soya. He feels that soya, sunflower, and maize could probably be combined to provide a mixture of amino-acids which-though not as perfect as that found in animal proteins-would be very satisfactory.