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Amylase-Treated Rice Flour Oral Rehydration Solution with Enhanced Energy Density. Ii. in Vivo Studies of Tolerance, Energy Intake, and Rehydration Efficacy in the Initial Treatment of Dehydrated Diarrhoeic Children

In a companion paper we described the feasibility of liquefying high concentrations of rice flour with amylase to produce enhanced oral rehydration solutions (ORS) with suitably lower viscosities to remain drinkable. This offers a means of orally rehydrating patients, while eliminating much or all of the caloric deficit imposed by conventional, dilute, glucose-based ORS. To explore whether humans would tolerate these solutions, 63 dehydrated diarrhoeic children were randomly assigned to one of three four-hour oral treatments: ORS with 5% rice flour, 10% rice flour incubated with -amylase, or 15% rice flour incubated with -amylase. The sodium and potassium concentrations of the solution as well as the osmolality and viscosity were within the desired ranges. On average, the children consumed 70 ± 26%, 90 ± 28%, and 80 ± 45% of the respective ORS, equivalent to intakes of 8 ± 4, 23 ± 9, and 33 ± 18 kcal/kg/4 hours, respectively. The mean increases in weight in four hours were 1.1%, 2.7%, and 1.6%, respectively. The concept of enhanced energy content of ORS based on amylasetreated rice flour appears to be ready for exploration in clinical field trials.