Doctors generally interpret a low level of a blood protein called transferrin to mean a child or elderly person suffers from malnutrition.

Recent findings from nutritional research indicate low transferrin can point to another culprit: infection due to poor sanitation. Inadequate water and sewer sanitation facilities can be sources of intestinal flu and bacterial and other infections.

Nutritionist Farook Jahoor of the Children’s Nutrition Research Center in Houston, Texas, led the study. The center is a cooperative facility of USDA’s Agricultural Research Service and Baylor College of Medicine.

Jahoor was part of a research team that included Terrence Forrester and John Morlese of the University of the West Indies in Jamaica. They examined infected and severely malnourished children at the university’s Tropical Metabolism Research Unit in Kingston, Jamaica. Their finding that infection can lower transferrin--and mislead health workers--is as important for agencies serving America’s poor as for those conducting international relief efforts.

Study findings were published this summer in Journal of Nutrition.

Scientists have long known that many children worldwide suffer from protein-energy malnutrition, or PEM. They get enough calories to survive, but their diets are low in protein. Infections can tip the nutritional scales against these children. They reduce the children’s appetites and “tax” available calories to fight illness, leading to malnutrition.

This infection connection can be sneaky. A child will seem healthy until a repeated--but undiagnosed--infection uses up stored nutrients. Then classic hunger symptoms develop, possibly confounding the pediatrician and parents. According to the Houston research center’s study, transferrin levels now used are not a good indicator of protein nutritional status.

Scientific contacts: Farook Jahoor, ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, phone (713) 798-7084, fax (713) 798- 7119, fjahoor@bcm.tmc.edu.