Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
권호 표지

Marasmus and Kwashiorkor by Nutritional Ignorance Related to Vegetarian Diet and Infants with Atopic Dermatitis in South Korea

아토피피부염 영아의 영양장애 사례보고와 채식주의에 관한 고찰

  • 정상진 (성균관대학교 의학연구소) ;
  • 한영신 (성균관대학교 의학연구소) ;
  • 정승원 (성균관대학교 의학연구소) ;
  • 안강모 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 박화영 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 이상일 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 조영연 (삼성서울병원 병원 영양계) ;
  • 최혜미 (서울대학교 식품영양학과)
  • Published : 2004.09.01
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Abstract

Infants and children with food related Atopic Dermatitis (AD) need extra dietary efforts to maintain optimal nutrition due to food restriction to prevent allergy reactions. However, nutrition ignorance and food faddism make patients even more confused and practice desirable diet more difficult. The objective of this study was to report the AD patients' malnutrition cases in Korea. We report on 2 cases of severe nutritional deficiency caused by consuming macrobiotic diets which avoid processed foods and most animal foods, i.e. one of vegetarian diet. Case 1, a 12-month-old male child, was admitted with severe marasmus. Because of a history of AD, he was started on mixed grain porridge at 3 months without any breast milk or formula feeding. His caloric intake was 66% and protein intake was 69% of the recommended dietary allowance. Patient's height and weight was under 3th percentile. On admission the patient was unable to crawl or roll over. Case 2, a 9-month-old AD female patient, was diagnosed with kwashiorkor and rickets. She was also started on mixed grain porridge at 100 days due to AD. Her caloric intake has been satisfied recommended dietary allowance until 7 months, however, she conducted sauna bath therapy and reduced both energy and protein intake at 8 months. The amount of protein intake for case 2 was higher than recommended dietary allowance, but, sauna therapy and severe AD with intakes of low guality protein may increase patient's protein requirement resulting in kwashiorkor. Case 2 patient's height and weight was on 3th percentile. Both cases showed low intake of calcium, iron, zinc, vitamin A, vitamin E and especially very low intake of vitamin B$_{12}$ and vitamin D. Allergy tests for certain foods had not done prior to admission for both cases. They followed the dietary advise operated by macrobiotic diet internet site. In conclusion, AD infants' parents and caregivers should contact a pediatrician trained as a specialist in allergy for accurate diagnosis. For infant patients, breast or formula feeding including hypoallergenic formula should be continued until their one year of age. When certain foods need to be restricted or to follow special diets such as vegetarian diet, consultation with pediatrician and dietitian is needed.d.

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