The effectiveness of carnitine supplements in children with malnutrition
An important indicator of a child’s health is physical development, violations of which are usually accompanied by a decrease in the level of adaptive resources and anti-infection protection of the body. Another well-known postulate is that weight loss with poor nutrition is a consequence of protein deficiency.
Without disputing these provisions, we draw attention to the fact that leading nutritionists strongly emphasize not only the importance of protein, but also the role of a balanced diet and high-quality diet, especially in young children, with various ingredients essential for their normal growth and development. Among them, not only proteins, fats and carbohydrates are obligatory, but also macro- and microelements, vitamins and vitamin-like substances. The latter include carnitine, the significance of which for the human body has been proven in numerous experimental and clinical studies of Russian and foreign scientists. In particular, it was found that a decrease in carnitine content and changes in the ratio of acylcarnitine and free carnitine can cause metabolic disorders in the mitochondria, inhibiting the Krebs cycle, oxidation of fatty acids, pyruvate metabolism and gluconeogenesis processes.
In a series of studies, S. Winter, V.S. Sukhorukova, E.V. Neudakhina et al. Have also been shown that carnitine deficiency is often detected as a factor / condition in children with malnutrition. There is convincing scientific evidence for the role of carnitine deficiency in primary mitochondrial diseases, such as Bart syndrome, Cairns-Sayre syndrome, Pearson syndrome, MELAS syndrome (Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes – mitochondrial encephalomyopathy, lactic acidosis, Root syndrome, Rhodophobia, insult epilepsy with ragged red fibers – myoclonic epilepsy with torn muscle fibers) and others. Even more impressive is the list of secondary disorders in which manifestations of carnitine deficiency are necessarily formed (preterm Nost, artificial feeding, anemia, stress, immune deficiency, a slowdown in mental and physical development, and others.). In this regard, one of the promising directions for solving the problem of a balanced diet for children with body weight deficiency and reduced appetite is the use of biologically active food supplements (BAA) with a high content of various biologically significant substances (such as L-carnitine, B vitamins, coenzyme Q10 , biotin) necessary to ensure the energy processes of the body.
The aim of our study was to study the effectiveness and tolerability of dietary supplements “Kidz (syrup) with carnitine” in the treatment of children with reduced body weight and decreased appetite.
Material and methods
The study involved 60 children with reduced body weight (less than 25% of centile on the centile table “body weight / height”) and decreased appetite at the age of 1.5 to 5 years. All patients were randomized into two groups in a 1: 1 ratio. Children from the 1st group (the study group) took 90 ml of dietary supplement “Kidz (Kidz) syrup with carnitine” for 90 days (children aged 1.5 to 3 years) or 5 ml (children aged from 3 to 5 years) 1 r. / day in the morning, with food. Children of the 2nd group (comparison group) underwent only standard diet therapy, without the addition of dietary supplements with carnitine.
The criteria for non-inclusion in the study were:
the presence of severe, clinically significant mental, neurological, endocrinological (including diabetes mellitus, impaired carbohydrate metabolism), a history of cardiovascular, liver, and kidney diseases;
acute (at the time of inclusion in the study) and / or chronic infectious diseases (tuberculosis, viral hepatitis, HIV, etc.);
congenital malformations of the digestive system, peptic ulcer of the digestive system, acute and chronic gastritis, gastroduodenitis and enteritis, pancreatitis, short bowel syndrome.
Along with a detailed collection of anamnestic data, all children underwent a physical examination with measurement of height and body weight, determination of percentiles according to the tables “body weight / age”, “height / age”, “body weight / height”, and also measured the thickness of the skin fold using caliperometry. The child’s appetite, as well as the presence and severity of the following symptoms were evaluated on a visual analogue scale (VAS): sleep disturbances, headaches, fatigue, decreased performance, decreased exercise tolerance, difficulty concentrating.
In dynamics, all children underwent a similar initial examination 30, 60, 90 days after the start of dietary supplement intake. In addition, we evaluated the tolerance of dietary supplements with carnitine by the presence of allergic reactions and other side effects (gastralgia, dyspepsia, myasthenia gravis, etc.).
Statistical data processing was performed using the SPSS Statistics 17.0 program. Analysis of the results and evaluation of the effectiveness parameters was carried out according to the final values of the indicators before and after a 3-month course of therapy.