do escore-Z peso/estatura (p=0,026). Nao houve associacao significativa entre realizacao de terapia nutricional e melhora do estado nutricional (p=0,37). A melhora doescore-Z peso/estatura esteve relacionada a ingestao de energia maior que a recomendacao normal para a idade (p<0,001). CONCLUSAO: As criancas acompanhadas neste estudo tiveram melhora significativa do estado nutricional, tornando-se evidente a importancia do acompanhamento nutricional durante a internacao. Termos de indexacao: crianca, dietoterapia, estado nutricional, hospitalizacao. ABSTRACTOBJECTIVE: This study aimed at evaluating the nutritional evolution of hospitalized children with infectious diseases, who were put under nutritional orientation. METHODS: Evaluate the effect of therapeutic nutritional orientation on 125 children between 6 and 36 months of age, who were admitted at the Pediatric Infectology Ward of the Hospital Sao Paulo, Sao Paulo, Brazil, between March 2001 and December 2002. The evaluations of nutritional status and energetic intake were based on data obtained from inquiry-forms on feeding-patterns and anthropometric measurements. RESULTS: Of the children being evaluated, 53,6% (67) were male. The mean age was 17 months, and the average period spent in the hospital was 10 days. At admission, 24,8% (31) of the children were undernourished and 10,0% (23) were overweight or obese. The diagnosis of acute diseases affected 69,6% (87) of the children. Nutritional support was provided for 21.6% (27) of the children, out of which, 81.5% (22) received nutritional support orally. The undernourished group presented a significant improvement of the Z-score of Weight over Height Z W/H (p=0.001); the eutrophic group had no significant change of the Z-score Weight over Height (p=0.651), and the group overweight/obese showed a significant reduction of the Z-score Weight over Height (p=0.026). No significant associations were found between nutritional support therapy and improvement of the nutritional status (p=0.37). The children who had an energy intake higher than the one recommended for their age, had a significant improvement of the Z-score Weight over Height (p<0.001). CONCLUSION: The children followed up in this study had their nutritional condition significantly improved, making it evident that nutritional orientation, or diet therapy, can improve the treatment of hospitalized children. Indexing terms: child, dietotherapy, nutritional state, hospitalization. INTRODUCAO A interacao sinergica entre desnutricao e infeccao e reconhecida ha muito tempo com base em observacoes clinicas e em dados epidemiologicos. Como resultado final ocorre a potencializacao de cada uma isoladamente e adicionadas entre si, sendo que a desnutricao compromete as defesas imunologicas do hospedeiro, facilitando a instalacao de processos infecciosos e, por outro lado, as infeccoes reiteradas comprometem o estado nutricional, tornando-se um circulo vicioso1,2. Alteracoes na relacao nutricao e imunidade decorrente de processo infeccioso podem favorecer a desnutricao por meio de infeccoes intestinais capazes de alterar a absorcao e a biodisponibilidade de nutrientes, de processo febril que acarreta aumento do requerimento energetico e de infeccoes cronicas que aumentam a glicogenese e a lipogenese, alterando o metabolismo de carboidratos, lipideos, proteinas, niveis de micronutrientes e balanco eletrolitico, alem de acarretar alteracoes hormonais que interferem no metabolismo de nutrientes3-5. Em geral, a resposta metabolica do hospedeiro durante a infeccao independe da sua etiologia. No entanto, a intensidade dessa resposta relaciona-se com a virulencia do