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Lysine requirements of chronically undernourished adult Indian men, measured by a 24-h indicator amino acid oxidation and balance technique^1,2,3

¹ From the Department of Physiology and Division of Nutrition (AVK, TR, JV, and RK) and the Department of Biochemistry (JG), St John’s Medical College, Bangalore India, and the Laboratory of Human Nutrition, Massachusetts Institute of Technology, Cambridge (MMR and VRY).

Background: In earlier studies with well-nourished subjects that used a 24-h indicator amino acid oxidation or balance approach, we concluded that the 1985 FAO/WHO/UNU requirement for lysine (12 mg · kg^-1 · d^-1) was inadequate for healthy South Asian subjects and proposed a tentative requirement of 30 mg · kg^-1 · d^-1.

Objective: We assessed whether chronic undernutrition, with low habitual dietary protein and lysine intakes, leads to changed lysine requirements.

Design: Twenty-seven otherwise clinically healthy, chronically undernourished Indian men were studied during 2 randomly assigned 7-d diet periods supplying 12 and 30, 18 and 36, or 24 and 42 mg lysine · kg^-1 · d^-1, based on an L-amino acid diet. The subjects’ leucine intake was 40 mg · kg^-1 · d^-1. At 1800 on day 6, a 24-h intravenous [¹³C]leucine tracer-infusion protocol was conducted to assess leucine oxidation and daily leucine balance at each test lysine intake.

Results: A breakpoint was not identified in the lysine intake–leucine oxidation or balance response over the range of intakes studied. Mixed-models linear regression analysis indicated a mean requirement of 44 mg lysine · kg^-1 · d^-1 (95% CI: 36, 63) for the lysine intake–leucine balance relation.

Conclusions: The mean lysine requirement in chronically undernourished men is estimated to be higher than the value of 30 mg · kg^-1 · d^-1 proposed for well-nourished individuals. This may be related to body-composition differences. It also suggests that these subjects have not elicited a metabolic adaptation in response to their habitually low lysine intakes by substantially improving their efficiency of dietary lysine utilization.

Key Words: Chronically undernourished adults • lysine requirements • indicator amino acid oxidation • indicator amino acid balance • Indian men

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