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Statistically will only meet the requirements of 50% of the population. cShould meet the requirements of 97.5% of the population. F, female; M, male.

Statistically will only meet the requirements of 50% of the population. cShould meet the requirements of 97.5% of the population. F, female; M, male.

An increase in the protein:energy ratio is necessary for infants and children who are wasted or stunted and who need to grow at an increased velocity in order to catch up. Malnutrition during the first year of life, whether a result of a poor environment or because of conditions such as malabsorption or cystic fibrosis, is more serious than wasting and stunting later in childhood. Although the potential for catch-up growth remains until the end of puberty, deficits during early life can lead to permanent impairment of cognitive function. Estimates of requirements for malnourished infants and children should be based on the height age (i.e., the age at which the child's measured height falls on the 50th centile) because estimations based on normal requirements for chronological age are likely to be difficult to achieve and may lead to obesity. The increase in protein requirement for catch-up growth is proportionally greater than the increase in energy requirement and is dependent on age and growth velocity. For example, a child aged 1 year who is growing at twice the normal rate has a 5% increase in energy requirements and a 32% increase in protein requirements. When designing regimens for infants and children who need to catch up, a protein:energy ratio of at least 10% and possibly up to 15% is necessary. Ratios less than this will result in changes in body composition, with greater amounts of fat and water and lower amounts of lean tissue being deposited.

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