RESUMO
A randomized clinical trial was completed to compare the efficacy of a mixed diet composed of locally available foods versus a lactose-free, soy-based formula for the management of young Mexican children with acute diarrhea and dehydration. A total of 87 patients between 5 and 36 months of age received either a blended mixed diet containing rice, chicken, carrots, beans, and vegetable oil (group MD) or a soy formula (group SF) immediately after standard oral rehydration therapy. The initial clinical characteristics of the patients in each group were similar, as were their stool outputs during the first 6-hour period of rehydration before the diets were offered. There were six treatment failures, all of which were in group SF (p < 0.01). The stool outputs of children in group MD and in group SF were 82 +/- 55 versus 112 +/- 88 gm/kg per day, respectively, on day 1 (p = 0.037), and 48 +/- 33 versus 66 +/- 55 gm/kg per day on day 2 (p = 0.109). The duration of diarrhea among those in group MD was significantly reduced compared with those in group SF (29 vs 67 hours; p < 0.001). We conclude that the mixed diet resulted in improved clinical outcomes compared with the lactose-free, soy protein isolate formula.
Assuntos
Diarreia/dietoterapia , Proteínas Alimentares/administração & dosagem , Hidratação , Alimentos Fortificados , Glycine max , Alimentos Infantis , Oryza , Administração Oral , Peso Corporal , Pré-Escolar , Terapia Combinada , Diarreia/microbiologia , Diarreia/fisiopatologia , Diarreia/terapia , Diarreia Infantil/dietoterapia , Diarreia Infantil/microbiologia , Diarreia Infantil/fisiopatologia , Diarreia Infantil/terapia , Humanos , Lactente , Masculino , Soluções para Reidratação/uso terapêutico , Índice de Gravidade de Doença , Fatores de Tempo , Aumento de PesoRESUMO
The safety and efficacy of a rice-based oral rehydration salt (ORS) solution for the treatment of acute diarrhea in infants < 6 months of age was compared to those of a standard glucose-based ORS solution. A total of 97 infants aged 1-6 months who had a history of acute diarrhea for 120 h or less and showed signs of mild to moderate dehydration and no complications was recruited. Subjects were assigned to two treatment groups and received either standard glucose-based ORS solution or rice-based ORS solution until cessation of diarrhea. There was no significant difference between the two treatment groups with regard to the main outcome variables, including total stool output (84 [95% confidence interval (CI), 56-126] vs. 106 (95% CI, 76-148) g/kg], total ORS solution intake [171 (95% CI, 149-197) vs. 187 (95% CI, 161-218) ml/kg], or duration of diarrhea (35 +/- 31 vs 38 +/- 32 h). In addition, the fact that there was no difference between treatment groups in the presence of reducing substances in the stools suggests that rice was digested and absorbed by these infants. The results of our study support the conclusion that for infants < 6 months of age, rice-based ORS solution is safe and as efficacious as standard glucose-based ORS solution in the treatment of acute diarrhea.