Preschool child feeding, health and nutritional status in Gualaceo, Ecuador

Anthropologic, survey, dietary recall and anthropometric techniques were used to study the correlates of nutritional status of preschool children under five years of age in Gualaceo Ecuador. A widespread stunting was found among the children. Nutritional status was worst among infants comprised between 12 and 23 months old but it improved between April and August, thus suggesting seasonality changes of nutritional status. The correlates of nutritional status (expressed as Z score of weight-for-age) were dietary diversity, birth-spacing, fertility, migration, household income, material goods owned, and parental education. A regression model with these variables predicted 63% of the variability in weight-for-age. The prediction of height-for-age was similar, but only predicted 43% of the variability in height-for-age. Correlates of dietary diversity, birth-spacing, fertility, and migration were child age, maternal age and arm circumference, parental education, use of birth control, household food expenditure, material goods owned, and the raising of animals. Parental education was a correlate of dietary diversity, fertility and migration. Parental education was related to change in weight-for-age in the longitudinal subset. Pre-harvest time and a pathway of illness leading to decreased dietary diversity and to decreased nutritional status in April, were suggested as important to preschool child nutritional status. Hot-cold ideology--resulting in food withdrawal during illness and restriction of high-protein and high-calorie foods--appears to be an important mechanism determining preschool child nutritional status. Breast-feeding, sanitary, higienic, birth control, and drinking (alcohol) practices were suggested as areas that could be improved, in order to improve preschool child nutritional status. Communication between parents and western health care providers was also suggested as an area for improvement.     

Soybean products for feeding infants,children and adults under nutritional stress

This review points out the good quality of well-processed soya products. Normal infants, children and adults are able to utilize the protein and other nutrients present in the soya, when fed these products in amounts that will cover their needs. Under nutritional stress, such as in infant malnutrition, soya products such as soya-milk have been shown to help in the children’s recovery. Clinical and biochemical data show that their recovery is similar to that obtained with cow’s milk. Milk- or lactose-intolerant children and adults, who present a public health problem in some developing countries, could benefit from the high nutritive value and low cost of soy milk. Soya products have been shown to decrease cholesterol and other levels of blood lipids. Considering the availability of the several soya products in the market, this possibility has to be further explored. The utilization of soya products in preparing liquid formulas for oral or tube-feeding opens new fields for the treatment of several diseases, insuring at the same time adequate nutrition for the patients. From a practical point of view, in spite of all that is known about soybeans and soybean products, its use as human food, even in countries where it is produced in large quantities, is very low. It seems that local governments are not aware of the importance of soya for the solution to their serious food and nutrition problems. What is known on the subject has to leave the laboratories, research centers and universities and be transferred as food for the mouths of the needy populations. This has to be understood as an urgent duty of national governments. There is no doubt that soya is the cheapest and one of the best-quality foods available to help solve the present hunger problem of the world today.     

Maternal nutritional status and milk volume. Is there a cause-effect relationship?

Studies on human lactation were examined in order to gather some answers about questions concerning the effect of maternal food intake, size, fatness and economic status on milk production. Up to date, evidence in the literature is insufficient to permit definitive answers, but a general conclusion can be drawn: milk volume varies little among mothers with largely variable energy intakes, sizes and economic status. There is a great need for more controlled studies focusing on the relationship between maternal energy balance and milk output. Although many studies have separately addressed the nutritional changes in mothers throughout lactation (1-8) and milk consumption by infants (9-17), very few have correlated maternal nutritional conditions and the volume of milk consumed. This report will consider investigations published from 1975 and on, combining data on maternal nutritional status and milk production in the same individual. The rationale is that around 1975 more accurate and standardized methodology began to be used in related studies. Milk output is estimated by the summary of the differences of body weights of infants obtained before and after each milking episode during 24 hours. Before 1975 the balances used for such a purpose had very poor precision, and this interfered seriously on the inter and intra-personal variability of the measurements. Electronic scales made available after that year gave enough reliability to the procedure. This report is comprised of studies from birth to four months postpartum, when energy supplementation is less common, and quantitatively less important. Nutritional status of the mothers will be analyzed on the basis of four categorizing variables: social and economic status, anthropometry, food intake and body composition.     

Breastfeeding, complimentary feeding practices and childhood malnutrition in the Bolivian Andes

Northern Potosi is one of the poorest parts of Bolivia with the highest indicators of rural poverty, malnutrition and food insecurity in the Bolivian Andes. The objective of this research was to characterize the levels of malnutrition and describe infant feeding practices in Potosi, Bolivia and use this information to develop an effective, gender sensitive and culturally relevant intervention encouraging good infant feeding practices. Standard methods were used to collect anthropometric data. Weight and height data were collected for 400 children under five years of age from 30 communities. In six of these communities, interviews and focus group discussions were conducted with 33 mothers and other families in addition to household observational data that were collected to describe infant feeding practices. Nearly 20% of children were underweight; stunting was widespread as well. 38% of mothers initiated breastfeeding 12 hours or more after birth. 39% of mothers initiated complementary feeding in the first three months following birth. The type of complementary food given to children was usually inadequate. With this research we could see that nutritional deficiencies often begin when the mother starts breastfeeding and when first introduced complementary feeding. Interventions aimed at improving maternal and child nutrition will require changes in parents' behavior, greater recognition and community support of the importance of child feeding, and the inclusion of strategies to reach young people, involve men, and make high quality nutrition promotion more widely available in the communities.     

Energy protein intake during nutritional recovery and nutritional status achieved

Thirty years ago malnourished Chilean children were recovered by CONIN; they were fed ad libitum and this may have favoured the appearance of overweight-obesity (SP/OB). The objective of this study was to evaluate the relationship between energy-calorie intake during nutritional recovery and the appearance of overweight-obesity (SP/OB). The design was a retrospective, analytical study of the universe formed by the 168 clinical records found, of children below 2 years of age, recovered by CONIN between 1977 and 1982. Nutritional status was assessed using the Sempé criteria (applied in the period evaluated) and those of WHO, (currently in use), on admission, after 4 month treatment and on discharge. By Sempé criteria, malnutrition on admission was classified 25% severe, 63% moderate and 12% mild; instead, using WHO standards these figures were 14.9%, 29.2% y 38.1%, respectively; the remaining children were well nourished. On discharge, there was no SP/OB by W/A (Sempé), but by W/H (WHO) 6% and 13.8% were SP/OB after 3 months and on discharge, respectively. Food intake, administered ad libitum, reached a mean of 148 kcals/ kg/d and 4 g prot/kg/d. SP/OB children had greater daily weight gain (30.3 vs 19.2 g/d) than the non-obese children and greater daily weight gain than the mean for age and sex (19.7 vs 8.2 g/dia). The prescribed feeding reached values considered high by currently used criteria; actual intake, administered ad-libitum, was significantly lower and was associated with 13.8% of children with overweight-obesity at the time of discharge.     

Maternal height and growth of Chilean premature infants

The aim of this study was to analyze the association between maternal age and growth of infants born preterm through the first 4 mo. of age. We prospectively studied 80 infant born at the hospital Herminda Martin in Chilean between January and September 1995 with birthweight < 2500 g and gestational age < or = 36 weeks; those born small for date, with congenital malformations or developing chronic diseases were excluded. The modified Graffar was applied to study socioeconomic status and growth, morbidity and type of feeding was monthly registered at Primary Care Centers where they were controlled. The maternal height was categorized as small (< -1 SD, n = 14), normal (> -1 SD and < +1 SD, 147.6-161.8 cm, n = 52) or tall (> +1 SD, n = 14). Sons from tall mothers presented better W/A z score at 4 mo than those from normal or small mothers (0.85 +/- 0.8 vs 0.31 +/- 0.6, p < 0.03 and 0.85 +/- 0.8 vs 0.15 +/- 0.8, p < 0.04). Length gain through the 4 mo was also better of infants with tall mothers (15.3 +/- 1.4 vs 13.7 +/- 2.3 and 13.6 +/- 2.2 cm, ANOVA p < 0.04), reaching better z-scores (0.2 +/- 0.3 vs -0.7 +/- 0.6 and -0.9 +/- 0.9, ANOVA p < 0.0001). The maternal schooling > 8 y was also associated to infant growth: those with tall mothers presented better L/A z-score at 4 mo than those with normal or small mothers (0.27 +/- 0.3 vs -0.89 +/- 0.7 and -0.85 +/- 0.5 p < 0.001). Exclusive breast milk was present in 7% of tall, 25% of normal and 0% of small mothers. No differences in morbidity were observed between groups. We conclude that Chilean infants born preterm from mothers > 1.61 m present a better growth that those with smaller mothers since the first 4 months of age.     

Nitrogen fertilizer effects on sugarcane growth,nutritional status,and productivity in tropical acid soils

Nutrient Cycling in Agroecosystems - Knowing the influence of long-term N fertilization is a key aspect in improving the yield of most crops, including sugarcane (Saccharum spp.). We aimed to...     

Acute and persistent diarrheal disease and its nutritional consequences in Guatemalan infants

For the purpose of better understanding the epidemiology of acute and persistent diarrhea, 130 infants of a marginal urban area in Guatemala City were studied. The subjects were kept under surveillance by weekly home visits, for periods that varied from three to nine months. The diarrhea episodes were detected and microbiological studies were done in fecal material. Additionally, the children were weighed and measured to determine their nutritional status. The infants suffered, on the average, 5.2 episodes per child annually; 9.4% of all the episodes lasted at least two weeks. The children who were less than six months old had more episodes of persistent diarrhea (0.052/child-month) than the older ones (0.017/child-month), with previous diarrhea morbidity and number of infecting enteropathogens being important factors. Furthermore, a child who had already suffered an episode of persistent diarrhea had a higher probability (relative risk = 2.2) of developing an additional one. Adherent E. coli, Cryptosporidium, toxigenic E. coli and Campylobacter jejuni are the pathogens more commonly associated with persistent diarrhea. Diarrheal illnesses have a deleterious effect on nutritional status, especially persistent episodes, which interfere with gain in weight and length of the children.     

Socioeconomic level and nutritional status: a study in schoolchildren

Obesity increased in recent years at different rates among socioeconomic levels (SEL). The purpose of this study was to analyze the association between SEL and nutritional status in schoolchildren attending elementary schools in the six counties that show the highest prevalence of obesity in Santiago, Chile. Within the counties schools were stratified according to obesity and children were randomly selected from each school. Anthropometric assessment was performed in children whilst a socio-demographic survey and a 24 hour recall of food intake were applied to their mothers. We classified the sample according to SEL in two categories (higher and a lower vulnerability). The prevalence of excess weight was 51.1% (24.7% overweight and 26,4% obese) without significant differences among SEL. The most vulnerable group had lower values of body mass index, skinfold thickness, arm circumference and food intake however, these differences were not statistically significant. At the same time, these children were physically more active, showing higher use of community places to play [OR 1.91; 95% CI 1.05-3.48] and walked larger distances from houses to schools OR 6.6; CI 2.5-16.7). Thus, albeit non significant association was detected between SEL and anthropometric indicators nor with food intake, the highest vulnerable group showed a tendency to have lower values and more physical activity.     

Enzymatic modification of the functional, nutritional and sensorial properties of soybeans for special feeding

Production of new protein-based products for special nutrition such as hypoallergenic infant formulas, fortified beverages and nutraceutics, require ideal ingredients. Protein ingredients were developed by enzymatic hydrolysis and methionine synthesis of soy protein. Hydrolysis was done at 4% (w/v) using porcine pancreatic enzymes (4% w/w), 50 degrees C, 6 h and pH 8. After drying powder was resuspended (20% w/v) and incubated with 7.6% (w/w) methionine methyl-ester, 1% (w/w) chymotrypsin and 3 M glycerol, 37 degrees C, 3 h and pH 7. Hydrolysates were fractionated by ultrafiltration (UF) before and after enrichment (E): FI > 10, 10 > FII > 3 and 3 > FIII > 1 kDa. Functional properties, amino acid content, anti-physiological factor activities and antigenicity were assayed for all the UF fractions and the soybean meal. Protein quality bioassay and sensorial test of an non-enriched fraction and an enriched fraction were performed. Functional properties were positively modified by hydrolysis and synthesis by using a minimum time and methionine added for the last reaction. After UF all the fractions under 10 kDa showed 100% solubility (pH 4 and 7), good clarity, acceptable foam capacity and negligible antigenicity and antiphysiological activities. Additionally, methionine enrichment enhanced their nutritional value, upgrading sulfur amino acid requirements for infants and adults. Because functionality and nutritional value FIII-E could be used for hypoallergenic infant formulas, FII-E for fortified soluble formulas and nutraceutics and FI-E for a semi-solid baby food.     

Compost mulch effects on soil fertility, nutritional status and performance of grapevine

Two composts were tested as mulching materials in a vineyard: one was a sewage sludge and bark compost with a low heavy metal content, the other was a municipal solid waste compost with a higher concentration of metals. Both compost mulches increased organic matter content, available phosphorous and exchangeable potassium of soil and improved the porosity and water retention capacity of the soil. They also reduced soil temperature fluctuations, reduced evaporation of soil water, and influenced the levels of some nutrients measured in leaf samples. The data obtained show that the nutrients uptake was more influenced by the physical conditions of the soil (temperature, moisture) than by the availability of nutrients in the soil. The sewage sludge and bark compost did not cause any significant increase in heavy metal levels in soil and plants. In contrast, the municipal solid waste compost led to a notable accumulation of metals in the soil, in the vegetation and in the musts. Both the compost mulch materials had considerable advantages for the soil management on the grapevine rows, by reducing chemical weed control and allowing for the substitution of chemical fertilisers with no loss in vigour, yield or quality of musts.     

Nutritional rehabilitation and evaluation of the nutritional state. Validity of anthropometric measures for following, in hospitalized patients, the course of nutritional status and of body compartments during nutritional recovery

A population suffering from a serious form of malnutrition was examined. The effectiveness of nutritional rehabilitation is demonstrated by the statistically significant changes observed in clinical and laboratory indicators. Several anthropometric measurements related to nutritional status are also compared with total body potassium (TBK) in patients with a positive nitrogen balance during the process of nutritional rehabilitation. It is concluded that weight (W), arm circumference (AC), middle arm muscle circumference (MAMC) and skinfold thickness (ST) measures are useful, and sufficiently accurate and precise to follow the evolution of nutritional status and body compartments.     

Evaluation of nutritional status in children with refractory epilepsy

Background  

children affected by refractory epilepsy could be at risk of malnutrition because of feeding difficulties (anorexia, chewing, swallowing difficulties or vomiting) and chronic use of anticonvulsants, which may affect food intake and energy metabolism. Moreover, their energy requirement may be changed as their disabilities would impede normal daily activities. The aim of the present study was to evaluate nutritional status, energy metabolism and food intake in children with refractory epilepsy.     

Maternal attitudes and child-feeding practices: relationship with the BMI of Chilean children

Background  

Chile has experienced the nutritional transition due to both social and economic progress. As a consequence, higher rates of overweight and obesity have been observed in children. In western countries, researchers have tried to determine pathways by which parents influence their children's eating behavior; up to now findings have been inconsistent. The objective of this study was to evaluate the cross-sectional and retrospective relationship between maternal attitudes and child-feeding practices and children's weight status in children who had been subject of an obesity prevention intervention for two years.     

The nutritional and health status of the Latin American woman

Latin America is a region where countries have various levels of socioeconomic development. Thus, the living standards and health status of its people differ significantly in the midst of a mosaic of social, ethnic, cultural and economic realities. Social inequalities and extreme poverty determine significant differences, not only in the magnitude of health indicators, but also in the type of pathology prevalent. People in the high socioeconomic levels are affected by nutritional diseases characterized by excessive food intake, while people from the low socioeconomic levels are affected by undernutrition and its associated pathology. Undernutrition occurs fundamentally among the age groups at higher risk in the population segments with low income, low food intake, illiteracy and poor access to the health care and preventive medicine centers. Among families exposed to undernutrition, women are usually in worse condition than men. This is due to the long working hours and the increased nutritional requirements caused by frequent gestations and prolonged lactation. It is estimated that one fourth of newborns in Latin America are affected by low birth weight, which has been associated to adolescent mothers, their excessive physical work, anemia, low maternal pregestational weight, low weight gain during gestation, and frequent maternal infections. Nutritional anemia due to iron deficiency is highly prevalent among pregnant women in Latin America. In some countries, the prevalence of folate deficiency during pregnancy appears to have increased significantly in the past 15 years and is becoming a nutritional problem that needs preferential attention. Diets generally are inadequate and, in the case of pregnant and lactating women, usually deficient in calories, protein, iron and folic acid. It is urgent that the health and nutritional status of Latin American women of low socioeconomic condition be given special attention, particularly mothers during gestation and lactation. Otherwise, women will not be able to altogether fulfill their important role in the home and within the family, nor will they successfully participate in the economic development of their countries.     

Diagnosis of hypovitaminosis A and nutritional anemia status in the population of Vale do Jequitinhonha, Minas Gerais, Brazil

A survey was carried out with the purpose of evaluating the nutritional status of the population of Jequitinhonha Valley in regard to vitamin A deficiency and iron-deficiency anemia. A Program--"Programa de Combate à Hipovitaminose A e à Anemia Nutricional Ferropriva em Bols?es de Probreza de Minas Gerais"--is being implanted by the Instituto Nacional de Alimentac?o e Nutri?ao (INAN) aiming to the prevention of such deficiencies. A random sample of 2,357 children from the towns: Turmalina, Minas Novas and Capelinha (Vale do Jequitinhonha), Minas Gerais (1,604 living in the urban and 753 in the rural areas) was submitted to an eye examination. Blood was drawn from a random subsample of these children (157 from the urban area and 107 from the rural area), in oder to detect possible nutritional problems. The following results were observed (preschool and school children, respectively): 1. Hemoglobin: 23.9% and 20% of the population in the urban area, 34.6 and 18.2% in the rural area, had low and deficient values, respectively. 2. Hematocrit: 1.5 and 2.2% of the population in the urban area, 17.3 and 5.5% in the rural area, had low values. 3. Vitamin A: 8.9 and 4.4% of the population in the urban area, 5.8 and 0% in the rural area, had deficient values (less than 10 micrograms/dl); 26.9 and 31.1% in the urban area, 26.9 and 23.6% in the rural area, had low values (10-20 micrograms/dl). These results show the occurrence of nutritional anemia and vitamin A deficiency in the observed children. As to the eye examination this was performed in 2,357 children. A high incidence of conjunctival xerosis (3.16 and 6.04% in the urban area, 7.7 and 12.6% in the rural area, in preschool and school children, respectively), was detected. Five cases of conjunctival xerosis with Bitot spot (0.2%), corneal xerosis (0.08%) and kerotomalacia (0.04%) were observed. The therapeutic effect of 200,000 UI of oral vitamin A was more efficient in preschool children (90.3% of positive reactions) than in school children (25.9% of positive reactions). The causes of the different reactions are now under study.     

Differentiation of the nutritional status of preschool children, according to socioeconomic levels, in a marginal zone

This article informs of a study carried out in an attempt to validate a new methodology to differentiate socioeconomic levels in a low income urban population group, as well as to correlate each level with the degree of malnutrition of preschool children, using the Gómez and Waterlow classifications. The socioeconomic indicators selected were: housing, main occupational activity and educational level of the head of the family, number of members per room, food expenditure per capita, per week, and ownership of a few household articles. A scale was constructed on the basis of the afore-mentioned indicators, and values were assigned on a point system, resulting in three levels: high, medium and low. Weight and height were determined in preschool children. In order to establish correlation of anthropometric data with socioeconomic levels, and to determine if such levels permitted to differentiate the degree of malnutrition, two types of nutritional classifications were used. Of the total of 187 families selected, 46 were evaluated as of high level, 72 medium and 69, low. Analysis of the weight-for-age and weight-for-height in children 24 to 47 months of age, and total preschool children, that is, from 12 to 59 months, revealed significant differences in both classifications, p less than 0.001. The authors conclude that the point scale applied to determine socioeconomic levels, was sufficiently sensitive in distinguishing the degree of malnutrition in preschool children, especially when analyzing the total population; though not significant in a few age groups, this was probably due to the reduced number of same. It is recommended that the Gómez classification be used permanently, particularly in cross-sectional surveys, and the Waterlow classification, because of its rapid diffusion in the world.     

Usage patterns,health, and nutritional status of long-term multiple dietary supplement users: a cross-sectional study

Background  

Dietary supplement use in the United States is prevalent and represents an important source of nutrition. However, little is known about individuals who routinely consume multiple dietary supplements. This study describes the dietary supplement usage patterns, health, and nutritional status of long-term multiple dietary supplement users, and where possible makes comparisons to non-users and multivitamin/mineral supplement users.     

Serum and diet long-chain omega-3 fatty acid nutritional status in Chinese elite athletes

Omega-3 polyunsaturated fatty acids (omega-3 PUFAs) are essential for improving the health and performance of athletes. The present study aimed to evaluate the nutritional status of omega-3 PUFAs in Chinese elite athletes by both dietary intake analysis and serum biomarker detection. A cross-sectional analysis of data from 54 elite athletes (24 men and 30 women) from Shanghai professional sports teams was conducted. A food frequency questionnaire (FFQ) was employed to analyze dietary intake, and gas chromatography–mass spectrometry (GC–MS/MS) was conducted to measure serum biomarkers of PUFAs. Correlation analysis was performed to investigate the relationships of PUFA biomarkers with diet, inflammation and oxidative stress. The results showed that the median intake of EPA + DHA among athletes was 132 mg/d, which is lower than the minimum value recommended by dietary guidelines (250 mg/d). The average serum EPA + DHA was 4.0 ± 1.1%, and the ratio of omega-6/omega-3 was 7.7 ± 1.7. Most (96.3%) of the athletes were below the targeted value of serum EPA + DHA, which is associated with a reduction in cardiovascular risk. Correlation analysis showed that the serum EPA + DHA was positively correlated with the long-term dietary intake of EPA + DHA and negatively correlated with inflammatory markers. In conclusion, the serum circulating EPA + DHA and omega-6/omega-3 ratio are effective biomarkers reflecting the nutritional status of PUFAs in athletes. Omega-3 PUFAs have a potential effect on inhibiting inflammatory markers. Hence, it is necessary for Chinese athletes to improve their suboptimal nutritional status of PUFAs through dietary intervention.