In a recent communication,1 the view was expressed that the changed level of the basal metabolism in the marasmic infant is ascribable entirely to the relatively high content of active metabolic tissue in its organism coincident with the failure to lay down body fat. The basal rate was shown to be essentially the same per kilogram of active protoplasm in the emaciated as in the well nourished infant. In addition, previously reported studies2 did not give evidence of derangement of the intermediary carbohydrate metabolism in marasmus. Emaciated infants metabolized approximately the same proportion of ingested dextrose per kilogram of active protoplasm, in the three to four hours following a meal rich in dextrose, as normal control infants.
The possibility remained that an abnormal response to the ingestion of food might lead to an excessive "cost of digestion" and thus play a rôle in the causation of marasmus. If
LEVINE SZ, WILSON JR, GOTTSCHALL G. THE RESPIRATORY METABOLISM IN INFANCY AND IN CHILDHOOD: X. THE RESPIRATORY EXCHANGE IN MARASMUS: SPECIFIC DYNAMIC ACTION OF FOOD IN NORMAL AND IN MARASMIC INFANTS. Am J Dis Child. 1928;36(4):740–755. doi:10.1001/archpedi.1928.01920280091008
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