Malnutrition Among Ceylonese Adults

Abstract

Ninety-six patients (eighty-four female and twelve male) suffering from a syndrome thought to be due to malnutrition were studied in Ceylon. The chief symptoms were anorexia, nausea, frequent loose bowel movements or diarrhea, weight loss asthenia, undue sensitivity to cold, blurring of vision, amenorrhea in women, loss of libido in men, and mental changes. The patients were dull, apathetic and underweight, and had characteristic skin and hair changes, edema of the ankles and face, hepatomegaly, atrophy of breasts and uteri in women, testicular atrophy and gynecomastia in men. The patients had subsisted for long periods on a deficient diet low in protein, especially animal and fish protein, which contamed about 1,500 to 2,000 calories daily, 75 per cent of which was derived from carbohydrate sources. The illness was often precipitated by pregnancy in women or some intercurrent infection. Investigation showed hypo-albuminemia, hypocholesterolemia, decreased blood urea, flat glucose tolerance curves and gross abnormalities in endocrine function. Liver biopsy performed in fifty patients revealed varying degrees of fatty infiltration and fibrosis, some of these patients had complete nodular cirrhosis. Treatment consisted of a high-protein balanced diet; ninety patients recovered, four died of liver failure and two of an intercurrent infection.