Background: We showed previously by the 24-h direct amino acid balance (DAAB) method that the leucine requirement of well-nourished Western and South Asian subjects is approximately 40 mg x kg(-1) x d(-1).
Objective: It is not known whether this estimated leucine requirement is applicable in chronic undernutrition; therefore, we assessed the leucine requirement in Indian men with chronic, but stable, undernutrition.
Design: We studied 26 chronically undernourished men during 2 randomly assigned 7-d diet periods consisting of an L-amino acid diet (n = 20) and supplying either 14 and 30 (n = 10) or 22 and 40 (n = 10) mg leucine x kg(-1)x d(-1) or consisting of the subjects' habitual cereal-and-lentil-based diets (n = 6). The 24-h DAAB was estimated on day 6 by using a [13C]leucine tracer infusion. The splanchnic uptake of leucine was determined at an intake of 40 mg x kg(-1) x d(-1) by administering [2H3]leucine orally.
Results: By using mixed-models linear regression of leucine balance against leucine intake, we estimated a zero leucine balance at a leucine intake of 39.6 mg x kg(-1) x d(-1). The splanchnic first-pass uptake of [2H3]leucine was 22.7% and 11.5% of the intake in the fasted and fed phases, respectively. The subjects were in neutral leucine balance with their habitual cereal-and-lentil-based diets.
Conclusion: On the basis of the 24-h DAAB approach, a mean leucine requirement of 40 mg x kg(-1) x d(-1) is proposed for healthy and for chronically undernourished Indian adults.