The Encyclopedia Of Nutrition And Good Health - K pps

K
378
kabob
Chunks of seasoned meat grilled or
roasted on skewers. The name comes from the
Turkish sis kebab, meaning “skewered, roasted
meat.” Traditionally, marinated mutton or lamb is
skewered with pork fat or mutton fat. American
variations of ingredients include veal, meatballs,
and vegetables like onions, peppers, mushrooms,
and tomatoes. (See also
BARBECUED MEAT.)
kale (Brassica oleracea acephala) A dark green,
leafy vegetable of the cabbage family that is closely
related to the European wild
CABBAGE. There are
many different leaf forms of kale, from curly to
plain, and colors range from bluish-green to red-
brown and purple. Kale withstands the stress of
cold weather and severe frosts, and gardens can
provide fresh greens into autumn.
Kale holds its texture when cooked, making it a
useful ingredient in soups, meat loafs, stews, and the
like. Eaten raw, it can be used in mixed salads. Kale
can be blanched, steamed, sauteed, or microwaved.
Like other leafy greens, kale contains high levels of
BETA-CAROTENE (provitamin A). One cup, cooked
(130 g), provides: 42 calories; protein, 3.5 g; carbo-
hydrate, 7.3 g; fiber, 3.7 g; calcium, 94 mg; potas-
sium, 296 mg; vitamin A, 962 retinol equivalents;
thiamin, 0.07 mg; riboflavin, 0.009 mg; niacin, 0.70

mg; vitamin C, 53 mg. (See also
CHARD; SPINACH.)
karaya gum A FOOD ADDITIVE that serves as a
thickening agent and is not absorbed by the
INTES-
TINE. Karaya GUM, obtained exclusively from the
sterculia tree in India, prevents fats and oils from
separating in whipped products and salad dressing
and in the meat juices in sausages. It also improves
the texture of ice cream and has been used as a
LAXATIVE. Karaya gum is unique in that it expands
to up to 100 times its dry volume when wet.
Some individuals are allergic to karaya gum, but
it is presumably safer than other thickening agents
since little of it is absorbed. However, long-term
safety studies have not been performed. The ques-
tion of whether this gum binds nutrients and pre-
vents their absorption has not been resolved. (See
also
BULKING AGENTS.)
kasha Roasted BUCKWHEAT; a coarse or finely
ground, hulled
GRAIN that can be cooked like RICE.
The roasting process conveys a nutlike flavor.
Buckwheat is not a grass, therefore it is not related
to the cereal grains. Individuals who are allergic to
GLUTEN can often tolerate buckwheat. In the United
States, buckwheat is most commonly eaten as an
ingredient in pancakes. Kasha is also an eastern
European dish. Russian kasha refers to small buck-

wheat pancakes. Polish kasha is a sweet pudding
prepared either with
BARLEY
or with SEMOLINA.
kava (Piper methysticum, kawa) A plant native to
South Pacific islands, where the root of the plant is
often ground into the fine paste and used in a tradi-
tional ceremonial beverage. It has been sold in the
United States as an herbal supplement to ease gen-
eralized anxiety, sleeplessness, and anxiety during
menopause. In 2002 the U.S.
FDA issued a consumer
advisory warning that kava-containing products had
been associated with liver-related injuries, including
hepatitis, cirrhosis, and liver failure in patients tak-
ing normal doses for as little as 1 to 3 months. It is
therefore not recommended; kava is banned in
Switzerland and Germany is considering a ban.
kefir Fermented milk. A traditional beverage of
the Middle East and southern Russia. Originally,
kefir was prepared from camel’s
MILK; now cow’s
milk is fermented instead of camel’s milk. The fer-
mentation process produces LACTIC ACID, which
gives kefir its tangy flavor. Fermentation also pro-
duces a low level of
ALCOHOL (generally about 1
percent). One cup provides 150 calories; protein,
9.3 g; carbohydrate, 8.8 g; fat, 4.5 g; calcium, 350
mg; potassium, 205 mg; vitamin A, 155 mg; thi-

amin, 0.45 mg; riboflavin, 0.44 mg; niacin, 0.30
mg. (See also
YOGURT.)
kelp See SEAWEED.
keratin A PROTEIN that is the major constituent of
skin, hair, nails, and the protein matrix of tooth
enamel. Keratin is a highly insoluble protein, clas-
sified as a structural protein. Its role in protecting
the body is passive only. Alpha keratin occurs in
mammals and consists of highly coiled protein
chains that form insoluble fibers. This protein con-
tains high levels of the sulfur-containing
AMINO
ACID
, CYSTEINE. The cysteine sulfur atoms of adja-
cent keratin chains cross-link with each other,
making keratin resistant to stretching and con-
tributing to water insolubility and strength of hair.
For this reason, keratin also resists digestion. Ker-
atin in skin is softer than in hair and nails because
it has less sulfur content, and therefore less cross-
linking. Toxic
HEAVY METALS bind to keratin in hair,
and mineral analysis of hair samples can reveal the
accumulation of toxic elements like
LEAD, CAD-
MIUM
, or MERCURY. (See also HAIR ANALYSIS.)
ketchup (catsup) In North America, a thick
tomato sauce used to flavor

MEAT, FISH, HAMBURGERS,
FRENCH FRIES, and HOT DOGS. Ketchup is made of
tomato puree,
SALT, VINEGAR, and a variety of spices,
Typical ketchup contains 25 percent
SUGAR and rep-
resents one of the hidden sources of this sweetener,
though it is not considered sweet. One tablespoon
(17 g) contains 18 calories; protein, 0.3 g; carbohy-
drate, 4.3 g; sodium, 156 mg; and trace levels of vit-
amins. (See also
CONDIMENT; FOOD PROCESSING.)
keto acid A class of weak ACIDS with a carbon
atom skeleton. The keto acids are more highly oxi-
dized acids than
FATTY ACIDS and appear as inter-
mediates in metabolic pathways of the body, which
oxidize fatty acids and
CARBOHYDRATES for energy
production. Keto acids contain a keto group, an
oxidized carbon atom found in a class of organic
compounds called ketones.
Typical keto acids of cellular
METABOLISM in-
clude:
PYRUVIC ACID (three carbon atoms), produced
from the single sugar
GLUCOSE by GLYCOLYSIS, the
major pathway of glucose degradation. Alpha keto-
glutaric acid (five carbon atoms) and

OXALOACETIC
ACID
(four carbon atoms) are intermediates of the
KREB
’S CYCLE, the central energy-producing path-
way of the cell. Oxaloacetic acid is important for
several reasons. It is both the starting point and the
end point of the
KREB’S CYCLE. Furthermore,
oxaloacetic acid can be converted to glucose for
BLOOD SUGAR
.
Keto acids are produced in the degradation of
certain
AMINO ACIDS by removal of their amino
groups (nitrogen-containing groups). Thus, the
amino acid
ALANINE yields pyruvic acid; ASPARTIC
ACID
yields oxaloacetic acid; and GLUTAMIC ACID
yields alpha ketoglutaric acid. The process is
reversible so that an addition of an amino group to
pyruvic acid forms alanine; to oxaloacetic acid,
forms aspartic acid; an addition to alpha ketoglu-
taric acid forms glutamic acid. Because these amino
acids are readily synthesized by the body from
common keto acids, they are not essential to the
diet. (See also
AMINO ACID METABOLISM; CARBOHY-
DRATE METABOLISM

; GLUCONEOGENESIS.)
ketogenic Refers to compounds converted to
KETONE BODIES
, a kind of metabolic acid, during
their chemical breakdown for energy production.
Ketogenic compounds include free
FATTY ACIDS and
the amino acid
LEUCINE. Most amino acids are both
ketogenic and “glycogenic”; that is, their complex
structures are broken down into both ketone bod-
ies and the sugar
GLUCOSE. Excessive accumulation
of ketone bodies may acidify the body, leading to
imbalances. (See also
ACIDOSIS; AMINO ACID METAB-
OLISM.)
ketone bodies The water-soluble products of
excessive fat breakdown. Ketone bodies represent
ACETOACETIC ACID, BETA HYDROXYBUTYRIC ACID, and
ACETONE, which are synthesized by the liver. They
accumulate in the blood during prolonged fasting,
STARVATION, crash DIETING, and ALCOHOLISM. Each of
these conditions promotes high rates of fat degra-
ketone bodies 379
dation. Fatty acids cannot be completely oxidized
for energy under these conditions and are instead
converted to ketone bodies. The accumulation of
ketone bodies in the blood and their excretion in
the urine indicates a potentially hazardous meta-

bolic imbalance. (See also
ACIDOSIS; FAT METABO
-
LISM
; KETOSIS.)
ketosis The accumulation of KETONE BODIES in
the blood due to incomplete oxidation of
FATTY
ACIDS
. Excessive fat breakdown can occur during
uncontrolled diabetes,
ALCOHOLISM, crash DIETING,
and with high-fat, low-carbohydrate diets. Pro-
longed high levels of ketone bodies (
ACETOACETIC
ACID
and BETA HYDROXYBUTYRIC ACID), can acidify
the blood (
ACIDOSIS). Furthermore, ketone body
excretion in the urine can lead to excessive water
loss (starvation diuresis).
DEHYDRATION is poten-
tially hazardous. Ketosis causes disturbances in
ELECTROLYTES (dissolved minerals like SODIUM,
POTASSIUM, and CHLORIDE) in body fluids. Imbal-
anced electrolytes can alter heart function and ner-
vous system responses. Severe ketosis can cause
coma and, ultimately, death.
kidneys Organs that regulate the amounts of key
ingredients in blood, including

WATER, the pH (acid-
ity) and the levels of minerals (
ELECTROLYTES
), and
in excreted waste products. By regulating water
excretion in urine, kidneys also regulate
BLOOD
PRESSURE
. There are two kidneys, located close to
the backbone at the back of the abdomen. Each is
about 4 in. (10 cm) long and each contains approx-
imately one million filtering units called
NEPHRONS,
resembling small tubes. The nephrons filter a huge
amount of fluid; about 425 gallons (1,930 liters) per
day for adults. However, only a very small fraction,
(2 liters) is excreted as urine, because most of the
water, and most of the other useful blood con-
stituents, are reabsorbed and recycled.
Nephrons are supplied with blood from the
kidney artery, and a small cluster or “tuft” of capil-
laries (glomerulus) feeds each nephron. The glo-
merulus acts as a filter under pressure. The filtrate,
the fluid emerging from the glomerulus, contains
small molecules like water, salts (dissolved miner-
als,
SODIUM, POTASSIUM, CHLORIDE), GLUCOSE, UREA
(the end product of protein degradation), and cre-
atinine (the waste product of muscle metabolism).
Larger particles like proteins and cells are retained

in the blood by the glomerulus.
The filtrate passes through the convoluted
tubules of the nephron, where most of the sodium
chloride is reabsorbed into the blood. The tubules
help regulate the sodium content and the pH of the
blood by exchanging electrolytes like
AMMONIA,
potassium, and chloride. The final product is urine.
Glucose at normal blood concentrations is com-
pletely reabsorbed by the kidneys into the blood. In
DIABETES MELLITUS
the blood sugar concentration
may be so high that more glucose appears in the fil-
trate than can be reabsorbed, and thus it passes into
the urine (glucosuria). Because water follows the
glucose, frequent urination accompanies glucose in
the urine and may cause
DEHYDRATION. Certain
metabolic acids called
KETONE BODIES may accumu-
late in the bloodstream with
ALCOHOLISM, untreated
diabetes, crash
DIETING, and other situations. Once
their levels exceed the kidney threshold, ketone
bodies are excreted in the urine. This, too, can cause
dehydration and electrolyte imbalances that further
compromise the patient’s health.
Urine represents the concentrated waste; 99
percent of the water has been reabsorbed by the

time urine reaches the ureters, which are tubes
that drain into the bladder. The kidneys regulate
water balance. If there is too much fluid in the
body, the kidneys excrete more water as urine.
When there is too little fluid, they retain more
water and urine becomes more concentrated. Envi-
ronmental temperature also affects kidney function
because sweating increases water losses, prompting
the kidneys to retain more water. Kidneys add
potassium and hydrogen ions, ammonia, and bicar-
bonate to the filtrate to control blood pH.
HORMONES regulate kidney function. Water
retention can be regulated by a pituitary hormone,
ANTIDIURETIC HORMONE (ADH). Release of this hor-
mone is stimulated when the brain (
HYPOTHALA-
MUS) detects a low blood-water concentration.
ADH increases water loss from cells, allowing more
water to pass back into the blood.
ALDOSTERONE,a
hormone from the adrenal glands, regulates
sodium excretion. If the sodium level drops, for
example from sweating or
DIARRHEA, aldosterone
levels increase, salt reabsorption from the filtrate
increases, and water is retained.
380 ketosis
The kidneys also process hormones. VITAMIN D is
activated by the kidneys; they convert calcidiol
(25-hydroxyvitamin D) to the hormone calcitriol

(1,25 dihydroxyvitamin D). They also produce ery-
thropoietin, a hormone that stimulates
BONE mar-
row to produce
RED BLOOD CELLS
, and renin, a
hormone that controls blood pressure. (See also
BLADDER INFECTIONS; GLOMERULAR FILTRATION; KID-
NEY STONES
.)
kidney stones Mineralized particles occurring in
the kidney and upper urinary tract. Most kidney
stones contain
CALCIUM as carbonate, phosphate, or
oxalate. In the United States, they are quite com-
mon and more prevalent than stone formation in
the gallbladder. An estimated 10 percent of men
and 15 percent of women over 30 years of age will
eventually develop kidney stones.
A kidney stone is formed when the concentra-
tion of mineral salts in urine increases to the point
of saturation, at which time the mineral will spon-
taneously crystallize.
DEHYDRATION and increased
calcium in urine favor stone formation. High uri-
nary calcium can reflect a high intake of
VITAMIN D,
too much
ALUMINUM or MILK, overactive THYROID
(hyperthyroidism), lengthy immobilization, or kid-

ney disease. Calcium oxalate stones are more likely
with vitamin B
6
deficiency; with high consumption
of foods like
SPINACH rich in the organic acid OXALIC
ACID
; intestinal disease (particularly of the ileum);
fatty stools; and abnormal metabolism of certain
organic acids.
Possible Causes
Certain metabolic diseases, such as parathyroid
malfunction and certain diseases of the bone, can
cause kidney stones.
MILK ALKALI SYNDROME is asso-
ciated with an increased risk. Many toxic metals,
especially
CADMIUM, increase the risk of stone for-
mation. In addition, several dietary factors are
often linked. Inadequate water intake prompts the
formation of insoluble salts. Inadequate
VITAMIN K
could promote stone formation because the vita-
min assists in the synthesis of a protein that inhibits
stone formation.
INSULIN insensitivity and OBESITY
increase the risk of stone formation. Certain foods
contain high oxalic acid levels; therefore, reduced
intake of
COCOA, tea, spinach, chard beet leaves,

RHUBARB, and PARSLEY decreases the risk. Consum-
ing more
FIBER-rich foods, like fruit and vegetables,
is likely to decrease the risk of kidney stones.
VITA-
MIN B
6
deficiency is also linked to oxalate-stone for-
mation.
URIC ACID occasionally forms stones, a
process favored by the excessive consumption of
nucleic acid-rich foods like yeast and organ meats,
and by certain anticancer drugs.
The prevention of kidney stones relies on
dietary changes:
• Drinking plenty of water. Adequate water is
needed to keep salts dissolved.
• Avoiding sugar, refined carbohydrate, and
excessive animal protein, salt, and caffeine.
These tend to increase the level of calcium in
urine.
• Avoiding cola soft drinks. These contain phos-
phate, which promotes stone formation.
• Avoiding over-consumption of aluminum con-
taining antacids.
• Minimizing alcohol consumption. High alcohol
consumption favors dehydration.
• Emphasizing magnesium-rich foods. Magne-
sium deficiency is linked to kidney stone forma-
tion, so eating foods with a high magnesium

content—barley, wheat bran and other whole
grains, avocados, bananas and lima beans—or
supplements can reduce the risk.
• Citric acid keeps calcium solubilized, and citric
acid supplementation has been used to reduce
the incidence of kidney stones.
(See also
GALLSTONES.)
Burtis, William J. et al. “Dietary Hypercalciuria in
Patients with Calcium Oxalate Kidney Stones,” Amer-
ican Journal of Clinical Nutrition 60, no. 3 (September
1994): 424–429.
kilocalorie A measure of
ENERGY content fre-
quently used in nutrition. The term
CALORIE is fre-
quently used synonymously with kilocalorie
although strictly speaking it should be capitalized
(Calorie). The prefix “kilo” means 1,000. Thus, one
kilocalorie (abbreviated kC.) is the amount of heat
required to increase the temperature of 1,000 g(1 l)
of water by 1° C (from 15.5° C to 16.5° C), while a
calorie (small c.) refers to heating 1 g of water by 1°
C. The caloric content of foods and daily energy
kilocalorie 381
requirements are given in kilocalories. A small calo-
rie is one-thousandth of a kilocalorie. However, the
international standard for energy content is based
on the
JOULE; 1 kilocalorie equals 4.18 kilojoules.

kiwi fruit
(Actinidia chinensis) An egg-sized fruit
that originated in China and is now cultivated in
New Zealand, France, Israel, and California. Kiwi
fruit has a thin, brown, hairy skin. The fruit is pale
green with a tangy taste and is eaten raw, used in
fruit salads and tarts or as a garnish with meat and
fish. Each raw fruit (46 g, peeled) provides 46 calo-
ries; protein, 0.8 g; carbohydrate, 11.3 g; fiber, 1.16
g; calcium, 15 mg; potassium, 80 mg; vitamin C, 31
mg; thiamin, 0.02 mg; riboflavin, 0.01 mg; niacin,
0.06 mg.
kohlrabi (Brassica oleracea, var. caulorapo) A
stem vegetable of the
CABBAGE family. Its bulbous
stalk (resembling a turnip) distinguishes its appear-
ance from other members of the cabbage family.
Kohlrabi was popular in the Middle Ages in central
and eastern Europe. Currently, kohlrabi is grown
in California. Kohlrabi is a source of
VITAMIN C, CAL-
CIUM, and IRON. Small stems are more tender than
the more mature vegetable. It is cooked like a
turnip or celery root. Cooked, sliced kohlrabi (1
cup, 165 g) provides 48 calories; protein, 3 g; car-
bohydrate, 11.4 g; fiber, 2.3 g; calcium, 50 mg; iron,
0.66 mg; potassium, 561 mg; vitamin C, 89 mg; thi-
amin, 0.07 mg; riboflavin, 0.03 mg; niacin, 0.64
mg. (See also
CELERIAC.)

kombu See SEAWEED.
konjac (Amorphophallus konjac) A tuber culti-
vated in the Far East that is a traditional ingredient
in Japanese cooking. The tuber is processed to yield
a light-colored flour. Konjac has been used to make
noodles (shiritaki noodles) and heat-stable gels
such as mitsumame, a fruit dessert. The flour is
used in food processing as a thickener for soups,
sauces, and desserts. Konjac flour provides a form
of
FIBER, a complex carbohydrate called GLUCOMAN-
NAN that forms viscous solutions in water. When
added to processed foods, konjac helps other plant-
based thickeners like
CARRAGEENAN, XANTHAN GUM,
and
CORNSTARCH work more efficiently. (See also
FOOD ADDITIVES; PASTA; THICKENING AGENTS.)
kosher Foods permitted by Jewish law. Jewish
dietary laws, known as kashruth, define the fitness
and appropriateness of foods. Acceptable and unac-
ceptable foods fall into three food groups: Milchig
refers to dairy products and
MILK; fleishig refers to
MEAT
, fowl, and products derived from them; and
pareve refers to foods that can be eaten with either
milk or meat. These neutral foods are
FRUITS, VEG-
ETABLES

, GRAINS, FISH
, and EGGS. Acceptable fish
have fins and scales;
SHELLFISH are excluded.
Domestic fowl are permitted, as are animals with a
split hoof that chew cud, a group that includes cat-
tle, goats, sheep, and deer. Pigs (pork) are not
acceptable.
CONVENIENCE FOOD is not kosher unless
certified by rabbinical authority, signified by the
name and insignia on the package.
BREAD must be
baked by observant Jews under rabbinical supervi-
sion. Bread is normally a pareve food.
All meat and fowl must be killed according to
prescribed methods. Kosher slaughter involves the
use of a sharp knife to quickly sever the carotid
arteries, jugular bone, and windpipe of a live ani-
mal by a trained slaughterer (schochet). Kosher
slaughter of poultry must also be done by hand.
Some Jews follow a stricter interpretation of rules
concerning acceptability. Glatt kosher meat means
the organs, especially the lungs of kosher-killed
animals, have been inspected for blemishes or
defects. Glatt kosher meat and must be soaked and
salted within 72 hours of slaughter.
GRAPE JUICE and WINE, traditionally used in reli-
gious ceremonies, must be prepared by observant
Jews. To be kosher, grape juice must be properly
separated and heated. If grape-flavored sodas with

real fruit juice are not prepared in this way, the
soda is not kosher. The Union of Orthodox Jewish
Congregations of America has published guidelines
regarding the kosher status of food and beverage
ingredients.
Jews who keep kosher may not eat insects. This
poses a problem for fresh produce, especially green,
leafy vegetables, which may require inspection.
Aphids are a common problem, and fresh produce
from health food stores and roadside outlets
requires inspection.
382 kiwi fruit
The Passover holiday has additional kosher
requirements extending over an eight-day period.
Many products, kosher for the rest of the year, are
not kosher for Passover. Leavened grain and
related materials are avoided to commemorate the
departure of the Jews from Egypt. Legumes, corn,
rice, and mustard are not eaten during Passover by
Jews of European ancestry.
To separate meat and dairy, the kosher kitchen
employs two sets of pots, pans, dishes, utensils, and
table linen to be used separately for dairy and
meat. Pareve foods can be prepared and eaten with
either set. The utensils are washed and stored sep-
arately. Currently, an estimated 500,000 families in
the United States and perhaps 50,000 families in
Canada abide by kosher dietary laws. Some non-
Jewish groups, such as Seventh Day Adventists and
Muslims, sometimes purchase specific kosher foods

to meet their religious needs, and some consumers
consider the kosher seal an indicator of quality.
(See also
EATING PATTERNS.)
Kreb’s cycle (citric acid cycle, tricarboxylic acid
cycle) A branch of metabolism consisting of a
coordinated sequence of enzymes that operate in a
cyclic fashion to oxidize the major fuels of the body
to produce
ENERGY
. The Kreb’s cycle is a major
METABOLIC PATHWAY and produces approximately 90
percent of the body’s energy production by oxidiz-
ing
FATTY ACIDS
, AMINO ACIDS, and CARBOHYDRATES
to carbon dioxide. The Kreb’s cycle occurs in MITO-
CHONDRIA
, particles in the cell’s cytoplasm that
function as cellular powerhouses.
Prior to entering the Kreb’s cycle, fuel molecules
are broken down to
ACETIC ACID, a two-carbon mol-
ecule that is attached to a carrier molecule called
COENZYME A. The product, ACETYL COENZYME, feeds
into the Kreb’s cycle. The acetic acid unit (two car-
bon atoms) combines with a simple acid with four
carbon atoms,
OXALOACETIC ACID, to create CITRIC
ACID

(six carbon atoms), the first true product of
the Kreb’s cycle. Subsequent oxidations release
carbon dioxide and regenerated oxaloacetic acid,
which can again react with incoming acetyl COA to
continue the cycle.
Certain B complex
VITAMINS support energy pro-
duction from food in part because they assist the
Kreb’s cycle. They include
NIACIN, RIBOFLAVIN, PAN-
TOTHENIC ACID, and THIAMIN. B vitamins must first
be converted to a
COENZYME or enzyme helper to
catalyze chemical reactions performed by the cycle.
Thus, coenzyme A is the coenzyme form of pan-
tothenic acid.
The Kreb’s cycle is coupled with other pathways
supporting energy production by mitochondria, the
cell’s powerhouses. Coenzymes of niacin and
riboflavin, as well as
COENZYME Q, carry electrons
from the oxidations of the Kreb’s cycle to the ter-
minal
ELECTRON TRANSPORT CHAIN, which reduces
OXYGEN
to form WATER
and simultaneously forms
ATP, the cell’s energy currency. When the Kreb’s
cycle slows down, this slowdown inhibits glucose
oxidation, allowing it to be shunted to storage

mechanisms by the liver. (See also
CARBOHYDRATE
METABOLISM
; FAT METABOLISM.)
Barron, John T., Stephen I. Kopp, and June Tow. “Fatty
Acid, Tricarboxylic Acid Cycle Metabolites and Energy
Metabolism in Vascular Smooth Muscle,” American
Journal of Physiology 267 (August 1994): Part 2,
H764–H769.
kudzu (Pueraria lobata) A fibrous root vegetable,
native to subtropical Asia; kudzu is used as a source
of complex carbohydrate. It is chopped into cubes
and cooked with soups in order to thicken them,
and is available in Asian food markets. The food
value, in 100 g (raw) is: calories, 120; protein, 2.1
g; carbohydrate, 27.8 g; fiber, 0.7 g; and essentially
no fat. (See also
STARCH.)
kumquat (Fortunella spp.) A small CITRUS FRUIT,
with a sweet rind and a sour pulp. Kumquats are
about the size of a quail’s egg and have a thin,
orange-red skin that is eaten with the fruit.
Kumquats originated in China and are now culti-
vated in Australia, the Far East, Florida, and Cali-
fornia. Kumquats can be eaten raw with skins, in
jam and in baked goods like cakes. Nutrient content
of one fruit (raw, 20 g) provides 12 calories; protein,
0.17 g; carbohydrate, 3.1 g; fiber, 0.7 g; vitamin C,
7.1 mg; thiamin, 0.02 mg; riboflavin, 0.02 mg.
kwashiorkor A severe malnutrition disease

caused by a chronic protein-deficient diet. Kwash-
iorkor is the classic protein deficiency disease in
kwashiorkor 383
which caloric intake may be adequate, but con-
sumption of too little
PROTEIN causes serious MAL-
NUTRITION. Protein and ENERGY are required for
growth and maintenance of the body. People con-
suming too little food to supply either will degrade
their own body protein and fat. Thus, protein
malnutrition and energy malnutrition overlap.
Symptoms include
EDEMA, apathy, decreased resis-
tance to disease, delayed development, depig-
mented hair, and scaly skin. Symptoms in children
include bloated belly,
DIARRHEA, fatty liver, and
ANEMIA
.
Kwashiorkor is more common in developing
tropical and subtropical nations. In low socioeco-
nomic regions of Africa, the Near East, Asia, and
Central and South America, the disease often be-
gins with the birth of a second child. The weaned,
first-born child must then rely on cereals, often a
protein-deficient diet within the community. This
does not supply enough amino acids to maintain a
child, nor to support growth. It can be prevented by
diets providing adequate protein and energy to
meet the child’s growth requirements. (See also

BALANCED DIET
; HUNGER, WORLD
; STARVATION.)
384 kwashiorkor