Volume 90, Issue 6, December (2003), pp. 1123-1132 © The Author 2003
doi:10.1079/BJN2003990

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Nutritional status of preschool Senegalese children: long-term effects of early severe malnutrition

Nicole Idohou-Dossou¹, Salimata Wade¹, Amadou T. Guiro¹, Cheikh S. Sarr¹, Babou Diaham¹, Djibril Cissé¹, Jean-Pierre Beau †¹, Philippe Chappuis², Daniel Hoffman³, Daniel Lemonnier^4
1Equipe de Nutrition et Alimentation, Laboratoire de Physiologie, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop de Dakar, Sénégal
²Laboratoire de Biochimie et de Biologie Moléculaire, Hôpital Lariboisière, Paris, France
³Department of Nutritional Sciences, Rutgers University, The State University of New Jersey, 96 Lipman Dr., New Brunswick, NJ 08901, , USA
⁴GRPN, Pédiatrie, CHU Charles Nicolle, Rouen, France

 (Received 6 November 2002–Revised 17 July 2003–Accepted 30 July 2003)

The prevalence of malnutrition remains high in many developing countries. However, data relating to the long-term effects of severe malnutrition, specifically, serum levels of biochemical indicators of nutritional status, are still scarce in the literature. Hence the present study aimed to investigate the nutritional, biological and growth status of Senegalese preschool children previously hospitalised for severe malnutrition. The study involved twenty-four 7-year-old children who had suffered from marasmus 5 years earlier, twenty-four siblings living in the same household, and nineteen age-matched children living in the centre of Dakar. The siblings were of similar age to the post-marasmic children. Anthropometry, serum biochemical indicators of nutritional status, growth factors, and haematological and mineral parameters were measured. The prevalence of stunting and wasting was the same in the post-marasmic children as in the siblings. Body-fat and fat-free-mass (FFM) deficits in both groups were corroborated by abnormally low concentrations of transthyretin, osteocalcin, insulin-like growth factor (IGF)-1, and insulin-like growth factor-binding protein (IGFBP)-3. FFM was positively and significantly correlated with concentrations of IGF-1 and IGFBP-3. In the post-marasmic children, height for age was also correlated with IGF-1. Of the post-marasmic children, 53 % had Fe-deficiency anaemia, as did 35 % of the siblings and 29 % of the controls. No significant associations were found between the serum concentrations of Ca, Cu, K, Mg, Na, P, Se, Zn and growth retardation. At 5 years after nutritional rehabilitation, the post-marasmic children remained stunted with nutritional indices significantly lower than the control children. However, these children were doing as well as their siblings except for minor infections.

Keywords:
Stunting, Biochemical markers, Mineral status, Anaemia, West Africa

Abbreviations:
Apo A1, apolipoprotein A1, Apo B, apolipoprotein B, FFM, fat-free mass, ht/age, height for age, IGF, insulin-like growth factor, IGFBP, insulin-like growth factor-binding protein, MUAC, mid-upper arm circumference, wt/age, weight for age, wt/ht, weight for height