Chronic Energy Deficiency: Consequences and Related Issues

Table of contents

Beat Schürch & Nevin S. Scrimshaw, Editors
International Dietary Energy Consultancy Group
Background papers and working group reports presented at an I/D/E/C/G meeting of August 3-7, 1987, in Guatemala City.

The International Dietary Energy Consultancy Group (I/D/E/C/G) has been established for the study of dietary energy intake in relation to the health and welfare of individuals and societies. Its specific objectives are:

1. The compilation and interpretation of research data on functional and other consequences of deficiency, change or excess of dietary energy.

2. The identification of related research needs and priorities, and the promotion of needed research.

3. The publication of scientific and policy statements and other information on the significance of chronic deficiencies and excesses of dietary energy.

4. The identification and promotion of appropriate and practical means of corrective action.

The digitalization of this publication was made possible by a grant from the Nestlé Foundation



Research relating to energy adaptation in man

1. General introduction
2. The Sukhatme-Margen hypothesis
3. Is energy balance regulated in man?
4. The time basis of energy regulation
5. Altered metabolic rate
6. Other Sukhatme analyses
7. Problems in testing the Sukhatme-Margen hypothesis
8. The reproducibility of metabolic rates in man
9. Adaptation to underfeeding

9.1. The range of adaptation
9.2. The response to semistarvation

10. Overfeeding studies

10.1. Early studies
10.2. Prolonged overfeeding

11. Attempts to test the Sukhatme-Margen hypothesis(es)
12. Concluding remarks

Seasonality in energy metabolism

1. Introduction
2. Reasons of seasonal variations in energy metabolism
3. Seasonal body weight fluctuations

3.1. Children
3.2. Adults

4. Seasonal fluctuations of energy expenditure

4.1. Basal metabolic rate (BMR)
4.2. Physical activity and energy expenditure

5. Conclusions
6. Research priorities

Chronic energy deficiency and the effects of energy supplementation

1. Introduction
2. Definitions and descriptions

2.1. Chronic energy deficiency
2.2. Energy supplementation
2.3. Targets of supplementation
2.4. The effects of supplementation

3. Approaches to the study of the effects of energy supplementation
4. Supplementation studies

4.1. The INCAP study
4.2. The Gambian studies
4.3. The Bacon Chow Study, Taiwan
4.4. Conclusions

5. Some possible explanations for the small effects

5.1. Are the recipients really malnourished?
5.2. Are the target groups being energy-supplemented?
5.3. Are the target groups appropriate?
5.4. Are the outcome variables appropriate?

6. Contemporary models
7. Gaps in our knowledge
8. Concluding comments

A critical view of three decades of research on the effects of chronic energy malnutrition on behavioral development

1. Background
2. The main-effect model
3. Deficiencies of the main-effect model

3.1. Outcomes of primary and secondary malnutrition
3.2. Effects of the environment and experience
3.3. Outcomes of monofocal and multifocal interventions

4. Suggestions for future research

Effects of chronic energy deficiency on stature, work capacity and productivity

1. Studies in adults

1.1. Malnutrition and VO2 max
1.2. Endurance
1.3. Productivity and physical work capacity

2. Studies in children

2.1. Anthropometry, sexual maturation and body composition in boys
2.2. Growth of work capacity

3. Men and boys

3.1. Body size, composition and VO2 max
3.2. Energy cost of load-carrying
3.3. Efficiency of economy of submaximal work in malnutrition
3.4. Reduced physical activity in chronic energy deficiency
3.5. Work performance in large and small individuals

4. Productivity, earning and nutrition in developing countries
5. Summary

The energy requirements of pregnancy and lactation

1. Introduction
2. Background
3. Methodology

3.1. Selection of subjects
3.2. Body weight and body fat
3.3. Energy intake
3.4. Basal metabolic rate (BMR)
3.5. Standardized exercise test
3.6. Normal daily activity pattern
3.7. Daily energy expenditure
3.8. Frequency of measurements

4. Results and discussion
5. Conclusion on pregnancy data
6. Lactation

Methodology of field studies related to socioeconomic effects of chronic energy deficiency

1. Introduction
2. Conceptual framework
3. Study designs
4. Human capital studies

4.1. Methodological aspects
4.2. Analytical limitations

5. Economic behavioral studies

5.1. Methodological aspects
5.2. Analytical limitations

6. Participation of the community in research
7. Concluding remarks

Pregnancy, lactation and childhood: Report of working group 1*

1. Introduction
2. Pregnancy

2.1. New information
2.2. Policy implications
2.3. Needs for research

3. Lactation

3.1. New information
3.2. Policy implications
3.3. Needs for research

4. Children

4.1. Energy supply and physical growth of infants and children
4.2. Energy supply and physical activity of children
4.3. Chronic energy deficiency and development
4.4. Causes of inadequate energy intakes in children

5. Conclusion

Work capacity, work performance: Report of working group 2*

1. Definitions

1.1. Physical work capacity
1.2. Work performance
1.3. Chronic energy deficiency (CED)

2. Summary of existing knowledge
3. Priority studies
4. Relationship of the proposed research activities to developing countries
5. Recommendations for continuing obligations

Social and economic development: Report of working group 3*

1. Introduction
2. Designs for studying the effects of low energy intake on behavior

2.1. Naturalistic designs
2.2. Experimental designs

3. Types of variables
4. Proposed future activities with IDECG support

List of participants