Regional study of nutritional status of urban primary schoolchildren. 1. Manila, Philippines

This multicity study sought to provide baseline information on the nutritional status of urban schoolchildren in order to examine the emerging problem of overweight and obesity in this age group. The study included 1,208 children 8 to 10 years old who were randomly selected from all public and private schools in Manila for weight and height measurements. Nutritional status was assessed by weight-for-age and height-for-age Z scores and BMI percentile cutoff points. On the average, private schoolchildren were taller and heavier and had higher body mass index (BMI) values than public schoolchildren, resulting in a much lower prevalence of undernutrition and a much higher prevalence of overnutrition. These results have important programmatic implications. However, using the World Health Organization (WHO)--recommended cutoff points to define under- and overnutrition gave contrasting results when weight-for-height and BMI were used. There appears to be a need to validate the anthropometric reference standards and cutoff points in children and adolescents to better define nutritional status and ascertain the influence of ethnicity.     

Regional study of nutritional status of urban primary schoolchildren. 3. Kuala Lumpur, Malaysia

A total of 5,995 (7.8% of all 7- to 10-year-old primary schoolchildren in Kuala Lumpur), randomly selected from 166 schools (97.6% of all schools), were measured for their weight and height. The analyses of all weight and height data, including the cutoffs used for defining stunting, underweight, and wasting and for thinness and overweight, were carried out as recommended by the World Health Organization (WHO). The prevalances of stunting (height-for-age Z score < -2 SD), underweight (weight-for-age Z score < -2 SD) and wasting (weight-for-height Z score < -2 SD) among all the children studies were 6.7%, 7.1%, and 4.5%, respectively. Undernutrition among boys was more serious than among girls according to all three indicators. Because it was not possible to analyze the weight-for-height data for most of the children above 8.5 years of age, body mass index (BMI)-for-age was used to determine the prevalences of thinness and overweight for all the children. Based on the reference data, the prevalence of overweight (at or above the 95th percentile) was 9.7% and 7.1% for boys and girls, respectively, and 8.4% overall.     

Impact of a multiple-micronutrient food supplement on the nutritional status of schoolchildren

BACKGROUND:. Multiple-micronutrient deficiencies exist in many developing nations. A system to deliver multiple micronutrients effectively would be of value in these countries. OBJECTIVE:. To evaluate the delivery of multiple micronutrients through the food route. The goal was to test the stability of the supplement during cooking and storage and then to test its bioefficacy and bioavailability in residential schoolchildren 5 to 15 years of age. METHODS: A pre- and post-test design was used to study children 5 to 15 years of age, with an experimental and a control group. The experimental group (n=211) consisted of children from two residential schools, and the control group (n=202) consisted of children from three residential schools. The experimental group received a micronutrient supplement containing vitamin A, vitamin B2, vitamin B6 vitamin B12, folic acid, niacin, calcium pantothenate, vitamin C, vitamin E, iron, lysine, and calcium daily for 9 months. There was no nutritional intervention in the control group. Children in the experimental and control groups were matched by socioeconomic status, age, and eating habits at baseline. All of the children in the experimental and control schools were dewormed at baseline, after 4 months, and at the endpoint. Biochemical measurements (hemoglobin, serum vitamin A, serum vitamin E, serum vitamin B12, and serum folic acid) were measured at baseline, after 4 months, and at the endpoint (after 9 months). The heights and weights of the children were also measured at baseline and endpoint. Serum vitamins A and E were measured in a subsample of 50% and vitamin B12 and serum folic acid measured in a subsample of 25% of the children. RESULTS: In the experimental group, the mean gains in hemoglobin, serum vitamin A, serum vitamin E, serum vitamin B12, and serum folic acid over 9 months were 0.393 g/dL, 6.0375 microg/dL, 1037.45 microg/dL, 687.604 pg/mL, and 1.864 ng/mL, respectively. In the control group, the mean losses in hemoglobin and serum vitamin A over 9 months were 0.9556 g/dL and 10.0641 microg/dL, respectively, and the mean gains in serum vitamin E, vitamin B12, and folic acid were 903.52 microg/dL, 233.283 pg/mL, and 0.0279 ng/mL. The mean gain in all biochemical measurements was significantly higher (p < .05) in the experimental group than in the control group. CONCLUSIONS: Vitamin A, vitamin E, vitamin B12, folic acid, and iron are bioavailable from the multiple-micronutrient food supplement used in this study. This method of micronutrient delivery has been beneficial. We believe the study intervention was beneficial because of small doses of the micronutrients added but delivered many times through meals throughout the day, over a period of 9 months.     

Constraints on good child-care practices and nutritional status in urban Dar-es-Salaam, Tanzania

BACKGROUND: Care is increasingly being recognized as a crucial input to child health and nutrition, along with food security, availability of health services, and a healthy environment. Although significant gains have been made in the fight against malnutrition in Tanzania, the nutritional status of preschool children in urban areas is not improving. OBJECTIVE: To assess child-care practices and the nutritional status of infants and young children with the aim of improvingfeeding practices and child nutritional status. METHODS: A cross-sectional study was undertaken in urban Dar-es-Salaam, Tanzania. The study involved 100 randomly selected mothers of children 6 to 24 months old from households in Ilala Municipality, one of the three municipalities that constitute the Dar-es-Salaam City Council. Data were collected by a structured questionnaire, spot-check observations, and anthropometric measurements. RESULTS: The prevalence rates of stunting, underweight, wasting, and morbidity were 43%, 22%, 3%, and 80%, respectively. The prevalence of exclusive breastfeeding was very low (9%), and most stunted children (88%) were not exclusively breastfed for the first 6 months. The mean age at which complementary foods and fluids were introduced was 3.26 +/- 1.12 months (range, 1 to 5 months). The fluids given were mainly water and thin cereal-based porridge. More than half of the households practiced good hygiene. Most of the psychosocial practices (e.g., caregiver's attention, affection, and involvement in child feeding, hygiene, health care, and training) were performed by mothers, except for cooking and feeding the children and child training, which were done mostly by alternative caregivers. Nearly half of the mothers (44%) worked out of the home. The mean number of working hours per day was long (10.32 +/- 2.13), necessitating the use of alternative caregivers. A negative correlation was found between height-for-age z-scores and the number of hours mothers worked outside the home. CONCLUSIONS: The prevalence rates of chronic malnutrition and morbidity are high, and child-feeding practices are inadequate in this urban population. Maternal employment and educational characteristics constrain good child-care practices, and alternative caregivers are taking a more important role in child care as mothers join the work force. We recommend that formative research be conducted to study the actual practices of caregivers in order to form the basis for a child-care education program. There is also a need to strengthen national health system support for improved child feeding.     

Effect of iodine status and other nutritional factors on psychomotor and cognitive performance of Filipino schoolchildren

BACKGROUND: Until 1998, iodine deficiency was a public health problem in the Philippines. A law entitled "An Act Promoting Salt Iodization Nationwide" (ASIN) has been passed and implemented by the government to eliminate iodine deficiency. The contribution of salt iodization, as well as dietary, health, and environmental factors, to improving the intellectual performance of Filipino schoolchildren remains to be determined. OBJECTIVE: The objectives of the study were to determine the relationship between iodine status and levels of psychomotor and cognitive performance in first-grade children aged 6 to 10 years, and to examine the extent to which dietary, biochemical, health, and environmental factors contribute to children's mental performance. METHODS: Two hundred ninety children in six classroom sections from a public school in Manila were examined by measurement of urinary iodine excretion (UIE) and thyroid palpation. The median UIE level for each section was determined. Sixty-five children classified as iodine deficient (UIE < 90 microg/L with grade 1 goiter, n = 34) and non-iodine deficient (UIE > 100 microg/L without goiter, n = 31) were given psychomotor and cognitive function tests (Bender-Gestalt and Raven's Colored Progressive Matrices). Scores from the two tests were used to determine each child's general ability percentile rank. Other variables examined were dietary intake (% RDA of nutrients ingested based on two nonconsecutive 24-hour recalls); deficiencies in iron, vitamin A, and selenium; parasitic infection; coliform contamination of drinking water; household use of iodized salt; illness in the past 2 weeks; and wasting and stunting. RESULTS: Children whose general ability scores were at or above the 50th percentile had higher UIE levels, but the relationship was not significant. Children from sections with higher median UIE levels had higher percentile ranks for general ability (p = .002). Backward logistic regression showed that the variance in deficient and adequate mental performance was explained by dietary intakes that met > or = 80% of the RDA for energy, protein, thiamin, and riboflavin; the use of iodized salt; child's iodine status; and stunting (R2 = .520, p = .0016). Higher class median UIE was associated with better psychomotor and cognitive performance in children who were tested. Factors that contributed to better performance include higher intakes of energy, protein, thiamin, and riboflavin; household use of iodized salt; normal iodine status; and absence of stunting or chronic malnutrition. CONCLUSIONS: Salt iodization, accompanied by adequate intakes of energy, protein, and foods rich in thiamin and riboflavin, can contribute to improved mental performance in Filipino schoolchildren. Longer-term factors that can contribute to improved performance are achievement of normal iodine status and elimination of protein-energy malnutrition.     

Factual nutrition and several indicators of health status of urban schoolchildren of the regions of Ukraine

Altogether 2334 schoolchildren (first-, fifth- and eighth-graders) were examined for the factual nutrition, health status and physical development. The diet received by the schoolgirls of the above grades and that of the first-grade boys correlated well with the recommended physiological standards, whereas the diet of the eight-grade boys and five-grade boys in particular was slightly lower as compared to those standards. Attention is drawn to an ever increasing number of obese children, which has an adverse effect on the percentage of harmoniously developed children, reducing it to 66.7%. To improve the nutrition of schoolchildren, the authors have developed sets of foods and exemplary menus which have been included into the methodological instructions for organization of schoolchildren's catering in nonspecialized schools of the Ukrainian Soviet Socialist Republic.     

Maternal nutritional status in pastoral versus farming communities of West Pokot, Kenya: differences in iron and vitamin A status and body composition

BACKGROUND: Underweight and micronutrient deficiencies are sequelae of the prevailing harsh living and economic conditions of women in sub-Saharan Africa. There are few data describing maternal nutritional status in these resource-poor settings. Provision of more effective modes of intervention requires that public health and nutrition policy at both the national and the multisectoral levels be based on community-specific nutritional and behavioral practices. OBJECTIVE: This longitudinal study investigated maternal micronutrient status in two remote, semiarid, rural communities that are ethnically similar but have distinctly different pastoral and farming lifestyles. We looked at differences in iron stores, vitamin A levels, and body composition of women in the third trimester of pregnancy and again at 4 months postpartum. METHODS: Complete data were collected from 113 pastoral and 110 farming Pokot women. Anthropometric measurements were taken, and serum ferritin and retinol levels were measured. Infants were weighed within 7 days of birth. RESULTS: Women from the farming community had significantly (p < .05) lower hemoglobin concentrations than women from the pastoral community during the third trimester of pregnancy. Pastoral women had significantly higher serum ferritin concentrations than farming women during the third trimester of pregnancy (p <.05) and at 4 months postpartum. There were no significant differences between pastoral and farming women in the percentage of women with serum retinol levels < 0.70 micromol/L during the third trimester of pregnancy (27.9% [34/113] and 24.2% [31/110], respectively) and at 4 months postpartum (29.2% [33/113] and 30.9% [34/110]) In the farming community, mean infant birthweight was significantly lower (p <. 01) than in the pastoral community and a significantly higher (p < .05) proportion of newborns weighed less than 2.5 kg. At 4 months postpartum, the percentage of body fat was significantly lower in pastoral women than in farming women. CONCLUSIONS: Women from the farming community in West Pokot, Kenya, have lower iron stores during the third trimester of pregnancy than women in the pastoral community. In addition, the mean weight of their newborn infants is lower than that of infants in the pastoral community. These findings may be associated with differences in living conditions, which are usually harsher in farming than in pastoral communities.     

Screening of aflatoxins in duck feedstuffs in West Java,Indonesia

During the period 1979-1985, incoming feed ingredients (some of imported origin) for duck diets were screened for their aflatoxin level. As a result. records of aflatoxin data from 533 corn, 88 rice, 136 rice bran, 47 wheat pollard, 207 soya bean meal. 55 copra meal and 166 fish meal samples were obtained. Aflatoxin B ₁ was the predominant form, the incidence of samples containing it ranging from 69 to 94%; then accompanied by aflatoxin G₁, 37 to 81%: by B ₂, 33 to 70%; by G₂, 13 to 66%. Levels of total aflatoxin > 20 μg kg ^?1 were most frequently encountered in corn (71%) and copra meal (58%), followed by soya bean meal (20%), wheat pollard (15%), rice bran (12%), fish meal (10%) and rice (4%). Most feed ingredients contained aflatoxins < 100 μg kg^?1 except in corn of which 202 samples (38%) had a higher level. Corn is concluded to be the main source of alfatoxin contamination in corn-based mixed feeds.     

Prevalence and molecular characterization of Vibrio cholerae from ice and beverages sold in Jakarta, Indonesia, using most probable number and multiplex PCR

Vibrio cholerae is well recognized as the causative agent of cholera, an acute intestinal infection characterized by watery diarrhea that may lead to dehydration and death in some cases. V. cholerae is a natural inhabitant of the aquatic environment in the tropical regions. Jakarta has the highest percentage of individuals affected by sporadic diarrheal illness compared with other areas in Indonesia. Inadequate safety measures for drinking water supplies, improper sanitation, and poor hygiene can increase the risk of cholera outbreaks. Few studies have been conducted on the prevalence of these bacteria in ice and beverages that are popularly sold and consumed in Jakarta. In this study, we detected and quantified V. cholerae from ice and beverages collected from several areas in five regions of Jakarta. Levels of V. cholerae in both ice and beverages were determined with the three-tube most-probable-number (MPN) method and ranged from < 0.3 to > 110 MPN/ml. The presence of regulatory and virulence gene sequences was determined by using uniplex and multiplex PCR assays. Of 110 samples tested, 33 (30%) were positive for V. cholerae; 21 (64%) were ice samples and the remaining 12 (36%) were beverages. A total of 88 V. cholerae strains were isolated, based on the presence of the toxR gene sequence identified by PCR. Other genetic markers, such as hlyA (59%), ompU (16%), and ctxA (19%), also were found during the search for potential pathogenic strains. The detection and isolation of potentially harmful V. cholerae from ice and beverages in Jakarta indicate that these products pose a health risk from choleragenic vibrios, particularly because of the emergence of classical biotypes of V. cholerae O1 and potentially harmful non-O1 serovars of this species.     

Recognition of cigarette brand names and logos by primary schoolchildren in Ankara, Turkey

OBJECTIVE: To assess the smoking behaviour of primary schoolchildren and their ability to recognise brand names and logos of widely advertised cigarettes, compared with other commercial products intended for children. DESIGN: Cross-sectional survey in classroom settings using a questionnaire designed to measure attitudes towards smoking and the recognition of brand names and logos for 16 food, beverage, cigarette, and toothpaste products. SETTING: Ankara, Turkey. SUBJECTS: 1093 children (54.6% boys, 44.4% girls) aged 7-13 years (mean = 10, SD = 1), from grades 2-5. The student sample was taken from three primary schools--one school in each of three residential districts representing high, middle, and low income populations. MAIN OUTCOME MEASURES: Prevalence of ever-smoking, recognition of brand names and logos. RESULTS: Prevalence of ever-smoking was 11.7% overall (13.9% among boys and 9.1% among girls; p < 0.05). Children aged eight years or less had a higher prevalence of ever-smoking (19.6%) than older children (p < 0.002). Ever-smoking prevalence did not differ significantly across the three school districts. Ever-smoking prevalence was higher among children with at least one parent who smoked (15.3%) than among those whose parents did not (4.8%) (p < 0.001). Brand recognition rates ranged from 58.1% for Chee-tos (a food product) to 95.2% for Samsun (a Turkish cigarette brand). Recognition rates for cigarette brand names and logos were 95.2% and 80.8%, respectively, for Samsun; 84.0% and 90.5%, respectively, for Camel; and 92.1% and 69.5%, respectively, for Marlboro. The Camel logo and the Samsun and Marlboro brand names were the most highly recognised of all product logos and brand names tested. CONCLUSIONS: The high recognition of cigarette brand names and logos is most likely the result of tobacco advertising and promotion. Our results indicate the need to implement comprehensive tobacco control measures in Turkey.     

Women's workload and its impact on their health and nutritional status.

This paper highlights various issues in relation to the workload of women in developing countries and its impact on health and nutritional status. The determining factors in women's workload and work-time and the methods employed for assessment are described. The drawbacks of the methods used and the resulting inconsistencies in the data are reviewed. How women are subjected to different health stresses owing to their productive and reproductive roles has been examined under three categories of work: economic, domestic and agricultural. The interaction of women's workload and health is complex and multifactorial owing to variations in the environment and socio-economic conditions within developing countries. There is a critical need to re-examine the assumptions existing about women's workload in programmes aimed at reducing work-time and workload of women in developing countries.     

Dietary and physical activity patterns of 8- to 10-year-old urban schoolchildren in Manila,Philippines

This report is the second part of a study on the nutrition of urban schoolchildren in the city of Manila; the first part was on nutritional status. The primary purpose of the study was to gather data that will assist authorities in planning and implementing nutrition education programs focused on the growing problem of obesity and overweight in children. The study included 1,208 children 8 to 10 years of age, who were randomly selected from all public and private schools in the city of Manila. Data on the children's dietary and physical activity patterns, together with information on nutrition-related knowledge, attitudes, and preferences of the children and their parents, were gathered by interviews and self-administered questionnaires. There were distinct differences in dietary and physical activity patterns between the two groups of children. Children from private schools, who are generally of higher socioeconomic status than those from public schools, tended to consume more total food, more animal foods, fats, and oils, and more beverages, resulting in higher intakes of calories, protein, iron, and vitamin A than public schoolchildren. Moreover, children from private schools were apparently less physically active, were more likely to be driven to school instead of walking, and were more likely to prefer television and computer games over outdoor games. These differences agree with an earlier report on the nutritional status of the children as determined by anthropometry, which showed a higher proportion of overnutrition and a lower proportion of undernutrition among private schoolchildren than among public schoolchildren. Although the emphasis in public schools should be on prevention and control of undernutrition in children, private schools should begin to look at the emerging problem of overnutrition and the role of physical activity programs in the health of children. The information on the knowledge, attitudes, and preferences of the children and their parents showed that parents or guardians, teachers, and television influence the nutritional practices of schoolchildren. These groups should therefore be the major targets for nutrition education programs meant to improve the nutrition and health of schoolchildren.     

乙二胺四乙酸铁钠(NaFeEDTA)在改善铁营养状况和预防铁缺乏性贫血方面的研究

临床数据表明婴幼儿和少年儿童缺铁性贫血发病率较高,而常用口服铁剂由于其铁腥味、胃肠刺激和生物利用率差等原因,限制了其在特殊人群中的应用。本文重点介绍了新型铁剂乙二胺四乙酸铁钠(NaFeEDTA)的特性、毒理安全性和人体吸收代谢过程等。国内外许多营养专家通过在食物中添加铁营养强化剂NaFeEDTA的方式,明显有效的改善婴幼儿、3～8岁儿童和11～17岁学生等人群的铁营养状况,而对铜、锌、钙等离子代谢没有影响,同时还能促进人体的锌吸收和铅排出;因此,NaFeEDTA被推荐用于改善人群铁营养状况和预防缺铁性贫血的最佳铁剂之一。     

《中国居民营养与健康现状》对中国食品工业发展的思考

2004年10月12日国务院新闻办公室发布了2002年进行的<中国居民营养与健康现状>的调查报告.调查表明,随着国民经济的持续快速发展,最近十年我国城乡居民的膳食、营养状况有了明显改善,城乡居民能量及蛋白质摄入基本得到满足,肉、禽、蛋等动物性食物消费量明显增加,优质蛋白比例上升;儿童青少年生长发育水平稳步提高,婴幼儿平均出生体重达到3309克,低出生体重率为3.6%,已达到发达国家水平;儿童营养不良患病率显著下降;5岁以下儿童生长迟缓率为14.3%,比1992年下降55%,儿童低体重率为7.8%,比1992年下降57%,居民贫血患病率有所下降.这一结果与我国的食物生产和食品工业的发展是相一致的.     

Portuguese bee pollen: palynological study,nutritional and microbiological evaluation

Bee pollen is one of the richest and purest natural foods, used in the folk medicine, clinical practices, and food and pharmaceutical industries. This work aims to characterise, for the first time in Portugal, the palynological origin, nutritional value and microbiological safety of this beehive product. It identified ten botanical families, and the more frequent were Boraginaceae and Ericaceae. We have evaluated the water content, a_w, pH, reducing sugars, ash, carbohydrate, proteins, lipids, fatty acids and energy. The microorganisms studied were the aerobic mesophiles, moulds and yeasts, faecal coliforms, Escherichia coli, Staphylococcus aureus, Salmonella and sulphite‐reducing clostridia. The studied pollens are nutritionally well balanced, and contain high levels of moisture, proteins, fat, energy, ash, carbohydrates, reducing sugars, essential n‐3 fatty acids and good ratios of polyunsaturated fatty acids (PUFA)/saturated fatty acids. In fact, the PUFA represent 66% of the total fatty acids. The samples had good microbiological quality, as none of the samples had toxigenic species.