Principles of Treatment of Protein Deficiency

The dietary treatment of protein deficiency depends on the cause of the deficiency and must depend upon a sound understanding of the underlying disorder. In most instances, isolated protein deficiency due to deficient intake is rare and most deficits include both macronutrients and micronutrients. In this situation, isolated repletion of protein or amino acids alone is inadequate and may even cause harm. This is well illustrated by the great 'protein fiasco' of the past when attempts to provide high protein supplements to malnourished children were found to be both inadequate and deleterious. Similarly, high protein supplements in pregnancy have been shown to actually increase rates of adverse pregnancy outcomes. Thus, the mainstay of treatment in such states of global deficiency includes balanced energy-protein and micronutrient supplementation.

In other instances, protein supplementation is critical. For example, in children with nephrotic syndrome, the daily intake of protein should be increased to 3-4 g kg-1 day-1 so that hepatic synthesis of albumin can compensate in part for the urinary losses. In other acute circumstances, infusion of albumin can be used to acutely correct deficits and circulatory abnormalities. However, in states of metabolic adaptation, care should be used in increasing protein intakes. For example, in cases of cirrhosis, the protein intake should be restricted to 20 g day-1 to reduce the risk of precipitating hepatic encephalopathy.

See also: Amino Acids: Chemistry and Classification; Metabolism; Specific Functions. Protein: Synthesis and Turnover; Requirements and Role in Diet; Digestion and Bioavailability; Quality and Sources.

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