The winged bean (Psophocarpus palustris Desv.) in the treatment of kwashiorkor

Abstract

1. A feeding trial with children suffering from kwashiorkor was conducted in which the winged bean (Psophocarpus palustris Desv.) was used as the major source of protein in the diet.

2. Seventy-two children who had been admitted to hospital with moderate or severe kwashiorkor were included in the study. The experimental diet, prepared from a mixture of two parts of the winged beans and three parts of maize flour, enriched with a small amount of skim milk, was given to twelve children with moderate and twenty-four children with severe kwashiorkor. Equal numbers of children with similar clinical, somatometric and biochemical measurements received a control diet in which most of the protein was provided by skim milk. Both groups of children had a supplementary meal of ‘poto-poto’of negligible protein content, which supplied an extra 100–120 kJ per kg per d. The diets were introduced after the children had overcome the most acute phase of the illness during which a routine diet based on skim milk and calcium caseinate had been given. Both diets supplied 4 g protein and 435 kJ per kg body-weight and were given to the children, on the average, for 30 d.

3. The experimental diet was well accepted and tolerated, and all children made good clinical progress. The rates of gain in weight were slightly less in the experimental groups than in the children who received the control diet. Although the differences were not statistically significant, they were more marked in children whose weights were between 61 and 75% of standard (classified as second degree kwashiorkor). With both diets, mean daily weight gains were significantly higher in children with severe kwashiorkor than in those with moderate kwashiorkor.

4. The increase in total serum protein and the decrease in the amino acid ratio determined 2 weeks after admission were more marked in children given the control diet. At the end of the experimental period, however, the differences between the groups in these two measurements, as well as in values for haemoglobin concentration, protein fractions and the hydroxyproline index were no longer significant.

5. The high nutritive value and the pleasant, sweet taste, even in the raw state, are the main advantages of the winged bean. These should outweigh the disadvantage that its skin is tough and more difficult to remove than that of the soya bean.