LETTERS
Reply
Dr.
EDITOR
805
Mann
Sir:
We appreciate Dr. Mann’s helpful comments. The formula he suggests is nearly identical to one proposed by WHO as a single oral glucose-electrolyte fluid for all ages (I). The availability of any medicinal or simple staple in the poor areas of the world is highly capricious (a shortage of even table salt now exists in Bangladesh); in the more advantaged areas pediatricians are chary of allowing mothers to mix up their own salt formula. For these reasons we believe distribution of standard, premixed powder packages (commercially or through national and international agencies) ought to be encouraged. In the meanwhile, local formulations such as one suggested by Dr. Mann must suffice.
Amino Dear
THE
acid
Dr. R. A. Phillips’ contributions to the world are well known in his researches on cholera and intestinal physiology. It was he who first suggested the use of oral glucoseelectrolyte fluids in diarrheal disease (2). We applaud Dr. Mann’s suggestion. Norbert Hirschhorn, M.D. Kevin M. Denny Management Cambridge,
Sciences Massachusetts
for Health
References I. Editorial: Oral glucose-electrolyte therapy diarrhea. Lancet 1: 79, 1975 2. PHILLIPS, R. A. Water and electrolyte diarrhea. Federation Proc. 23: 705, 1964.
for acute losses
in
fortification
Sir:
In a recent article entitled “Lysine supplementation of wheat proteins. A review,” Vaghefi, Makdani and Mickelsen (1) conclude that “No conclusive answer is available to amino acid fortification due to the fact that no well-documented reports are available involving reasonably large numbers of children who received a large proportion of their protein from wheat.” The writers undoubtedly did not realize that such a study has been underway in Tunisia since 1969 conducted by the Tunisian National Institute of Nutrition, U.S.A.I.D., and the Department of Nutrition of Harvard University School of Public Health. This study involves some 3,200 pre-
school children from three well-matched areas. As Rosenfield (2) reported, it would be premature to evaluate amino acid fortification prior to the conclusion of our current study in Tunisia. M. T. El Ghamry, Ph.D. Department of Nutrition Harvard School of Public Health Boston, Massachusetts 02115 References 1. VAGHEFI, Lysine
Am. 2.
S. B., D. D. MAKDANI supplementation
J. Clin.
ROSENFIELD,
nutrition.
of
wheat
Nutr. 27: 1231-1246, D. Protein-calorie Am. J. Clin. Nutr. 28:
0. MICKELSEN. A review. 1974. alleviation of mal1, 1975.
AND
proteins.
Downloaded from https://academic.oup.com/ajcn/article-abstract/28/8/805/4732977 by Washington University in St. Louis user on 15 February 2019
Dear
to
TO
Reply
Dr.
EDITOR
805
Mann
Sir:
We appreciate Dr. Mann’s helpful comments. The formula he suggests is nearly identical to one proposed by WHO as a single oral glucose-electrolyte fluid for all ages (I). The availability of any medicinal or simple staple in the poor areas of the world is highly capricious (a shortage of even table salt now exists in Bangladesh); in the more advantaged areas pediatricians are chary of allowing mothers to mix up their own salt formula. For these reasons we believe distribution of standard, premixed powder packages (commercially or through national and international agencies) ought to be encouraged. In the meanwhile, local formulations such as one suggested by Dr. Mann must suffice.
Amino Dear
THE
acid
Dr. R. A. Phillips’ contributions to the world are well known in his researches on cholera and intestinal physiology. It was he who first suggested the use of oral glucoseelectrolyte fluids in diarrheal disease (2). We applaud Dr. Mann’s suggestion. Norbert Hirschhorn, M.D. Kevin M. Denny Management Cambridge,
Sciences Massachusetts
for Health
References I. Editorial: Oral glucose-electrolyte therapy diarrhea. Lancet 1: 79, 1975 2. PHILLIPS, R. A. Water and electrolyte diarrhea. Federation Proc. 23: 705, 1964.
for acute losses
in
fortification
Sir:
In a recent article entitled “Lysine supplementation of wheat proteins. A review,” Vaghefi, Makdani and Mickelsen (1) conclude that “No conclusive answer is available to amino acid fortification due to the fact that no well-documented reports are available involving reasonably large numbers of children who received a large proportion of their protein from wheat.” The writers undoubtedly did not realize that such a study has been underway in Tunisia since 1969 conducted by the Tunisian National Institute of Nutrition, U.S.A.I.D., and the Department of Nutrition of Harvard University School of Public Health. This study involves some 3,200 pre-
school children from three well-matched areas. As Rosenfield (2) reported, it would be premature to evaluate amino acid fortification prior to the conclusion of our current study in Tunisia. M. T. El Ghamry, Ph.D. Department of Nutrition Harvard School of Public Health Boston, Massachusetts 02115 References 1. VAGHEFI, Lysine
Am. 2.
S. B., D. D. MAKDANI supplementation
J. Clin.
ROSENFIELD,
nutrition.
of
wheat
Nutr. 27: 1231-1246, D. Protein-calorie Am. J. Clin. Nutr. 28:
0. MICKELSEN. A review. 1974. alleviation of mal1, 1975.
AND
proteins.
Downloaded from https://academic.oup.com/ajcn/article-abstract/28/8/805/4732977 by Washington University in St. Louis user on 15 February 2019
Dear
to
TO
