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Biomedical subjects

N W Solomons

Publications and source records attributed to N W Solomons.

At least 19 recordsLinked to original sources
PubMed1999

Effects of discontinuing coffee intake on iron deficient Guatemalan toddlers' cognitive development and sleep.

Coffee is commonly given daily to toddlers in Guatemala. Possible negative effects of coffee ingestion on cognitive development and sleep patterns were assessed in 132 children 12-24 months of age who had received coffee for > 2 months and were iron deficient on at least one indicator. Children were stratified by initial hemoglobin (A= anemic, Hgb < 10.5 g/dl; NA = 'non-anemic', Hgb > or = 10.5 g/dl) and were randomly assigned to an experimental group (S = substitute consisting of sugar and coloring), and a control group (C = continuation of coffee) (42 C-NA; 53 S-NA; 18 C-A; and 19 S-A). Anemic children were provided Fe supplements for 2-3 months. Compliance was assessed every 2 weeks. After 5 months, testers masked to treatment group and anemia evaluated children with the Bayley Scales of Infant Development II in a central location. Scores were the Mental Development Index (MDI), the Psychomotor Development Index (PDI), and scales from the Behavior Rating Scale (BRS). The child's sleep in the previous 24 h was assessed with a set of standardized sleep questions to the care giver on the first visit and every 2 weeks thereafter. No significant effects of treatment on test scores or BRS ratings were found. In the 24 h period reported on at the final visit, children in the Substitute group slept more during the night and overall (night plus naps) than children in the Coffee group, a difference not found at the first visit. No differences were found in sleep difficulty or number of times waking at night. Women's reported coffee intake per day during pregnancy was associated with lower BRS ratings, even after controlling for SES and child age. The effects of postnatal coffee ingestion in Guatemala were seen for sleep duration, but not for cognitive development. Prenatal coffee ingestion was negatively associated with Behavior Rating Scales and should be investigated further.

Anemia, Iron-Deficiency↗
PubMed1999

Assessment of total body stores of vitamin A in Guatemalan elderly by the deuterated-retinol-dilution method.

BACKGROUND: Deuterated retinol dilution (DRD) gives quantitative estimates of total body stores of vitamin A. OBJECTIVES: In elderly people, we studied 1) the time when an oral dose of deuterated vitamin A equilibrates with body stores, 2) whether serum ratios of deuterated to nondeuterated retinol (D:H) at 3 or 6 d postdosing predicted body stores, and 3) the ability of DRD to detect changes in the size of the body vitamin A pool. DESIGN: A 10-mg oral dose of [2H4]retinyl acetate was administered to 60-81-y-old Guatemalans (n = 47); percentage enrichment of serum retinol with deuterated retinol was determined at 1-3 time points per subject at 3, 6, 7, 14, 20, 21, and 54 d. In subjects from whom blood was obtained at 3 and 21 d (n = 15) and at 6 and 20 d (n = 9), total body stores were calculated by using the formula of Furr et al (Am J Clin Nutr 1989;49:713-6) with 21- or 20-d data and correlated with serum D:H at 3 or 6 d postdosing. Nine subjects received diets containing 982+/-20 microg RE (x+/-SEM) plus 800 microg RE as retinyl acetate supplements for 32 d. DRD, serum retinol, and relative dose response were used to assess vitamin A status before and after the intervention. RESULTS: Deuterated retinol equilibrated with the body pool by 20 d postdosing. Vitamin A supplementation for 32 d increased body stores, although unexplained exaggerated increases were seen in some subjects. An inverse linear relation was found between estimates of body stores and serum D:H at 3 d postdosing (r = -0.75, P = 0.002); at 6 d postdosing, the correlation was weaker. CONCLUSIONS: DRD can detect changes in total body stores of vitamin A, although factors affecting serum D:H need to be elucidated. Serum D:H 3 d postdosing might be used as an early indicator of total body stores of vitamin A, although a predictive equation will need to be developed.

Administration, Oral↗
PubMed1998

Determination of discretionary salt intake in rural Guatemala and Benin to determine the iodine fortification of salt required to control iodine deficiency disorders: studies using lithium-labeled salt.

The use of discretionary salt, which is salt added during cooking and at the table, as a suitable vehicle for iodine intake was assessed by measuring salt consumption using the lithium-marker technique in rural areas of Guatemala and Benin. In both countries, we studied boys aged 6-12 y and their mothers. Subjects used lithium-labeled salt after all unlabeled salt was removed from their households. In Guatemala, 24-h urine samples for 9 mother-son pairs were collected at baseline and on days 7, 8, and 9 during the use of lithium-labeled salt. Total maternal salt intake averaged 5.2 +/- 1.7 g/d (mean +/- SD), of which 77 +/- 24% came from discretionary sources, whereas Guatemalan boys consumed 1.8 +/- 0.6 g salt/d, of which 72 +/- 12% came from discretionary sources. In Benin, urine collection from 13 mother-son pairs took place at baseline and on days 5 and 7. Beninese mothers had a total salt intake of 9.0 +/- 2.9 g/d and their sons had an intake of 5.7 +/- 2.8 g/d; discretionary salt contributed 52 +/- 14% and 50 +/- 13%, respectively, of total salt consumed. Therefore, fortification of household salt appears to be an appropriate method of controlling iodine deficiency in both countries, although fortification of other salt sources could be considered in Benin.

Adult↗
PubMed1998

Fortified foods contribute one half of recommended vitamin A intake in poor urban Guatemalan toddlers.

Vitamin A intake from food sources, not including breast milk, was determined from seven consecutive 24-h recalls for 55 children (mean age 20.8 mo, SD 8.9) from two poor communities of Guatemala City. Not including vitamin A derived from fortified sugar or breast milk, the median daily vitamin A intake was 194 retinol equivalents (RE). Including vitamin A derived from fortified sugar but not including that derived from breast milk, the median total vitamin A intake (25th and 75th percentiles) was 338 RE (146 and 617 RE) of which 78% was preformed retinol and 22% provitamin A. More than 90% of total vitamin A intake from non-breast milk food sources was derived from only 10 items; over half came from three fortified foods: fortified sugar, Incaparina and margarine. Sugar samples from 91 households in 1991 had a median of 3.3 RE/g (range, 0.0-29.9 RE/g), <25% of the target level (13-17 RE/g); nevertheless, fortified sugar provided 25% of these children's total vitamin A intake (81 RE/d) from non-breast milk food sources and their intake approached the level recommended by the FAO/WHO (400 RE/d). These results show that fortified foods make an important contribution towards vitamin A intake in this sample of poor urban Guatemalan toddlers.

Breast Feeding↗
PubMed1998

The street food culture of Guatemala City: a case study from a downtown, urban park.

This study investigated the structure and environment of 31 street food vendors in an urban park in the downtown area of Guatemala City. Vendors were interviewed and observed in order to assess the quality, safety, and accessibility of street food. The street food vending in the park consisted of five types: whole meal, snack, beverage, fruits, and carts. A great variety of typical Guatemalan meals, as well as ready-to-eat fruits and hot dog chapin (hot dog with cabbage and avocado cream), were found in the park. The food preparation and handling revealed inadequacies concerning the hygiene. Circumstances, such as the lack of portable water near the vending site and unhygienic sanitary facilities, supported the transmission of pathogens. The clientele was of all ages, and included female as well as the male purchasers. Typical clients came from the surrounding area, i.e. the employees of civil and private offices, commercial businesses, and the non-food vendors of the park. Comparing the economy of street food with the definition of very poor in Guatemala, the prices on the street were often above the daily money needed for a basic food basket. However, a special clientele were the very poor, such as the street children and handicapped people, who earned their meals by helping out at the vending sites. Mainly female street food vendors were found at the whole meal, snack, and refreshment sites whereas men sold predominantly at the carts. For all of the vendors, it was the main source of income and for many families the only one.

Child↗
PubMed1997

Effects of discontinuing coffee intake on iron status of iron-deficient Guatemalan toddlers: a randomized intervention study.

Coffee is one of the first liquids given to infants in Guatemala. To evaluate whether this practice has an adverse effect on iron status, 160 children 12-24 mo of age who had received coffee for > or = 2 mo and had at least one indicator of iron deficiency were stratified by initial hemoglobin concentration (anemic, or nonanemic, ie, hemoglobin > or = 105 g/L) and randomly assigned to a control (continuation of coffee; coffee) or intervention (provided with a substitute consisting of sugar and coloring; substitute) group for 5 mo. Anemic children were provided with iron supplements for 2-3 mo. Hematologic and anthropometric measurements were made before and after the intervention and dietary and morbidity data were collected every 2 wk. A total of 139 children completed the study: 45 coffee, nonanemic; 56 substitute, nonanemic; 19 coffee, anemic; and 19 substitute, anemic. Compliance with the procedures was good: median coffee intake was 891 mL/wk in the coffee group compared with 18 mL/wk in the substitute group (P = 0.0001). There was no significant effect of discontinuing coffee consumption on changes in hemoglobin, hematocrit, ratio of zinc protoporphyrin to heme or plasma iron, zinc or copper in either nonanemic or anemic children, or plasma ferritin in children who did not take iron supplements. In children who took iron supplements, change in plasma ferritin was significantly greater in the substitute group than in the coffee group (106% compared with 1%, P < 0.05). This implies that coffee interferes with the utilization of supplemental iron. It is likely that the amount and strength of coffee consumed by Guatemalan toddlers are too low to significantly affect the other indexes of iron status.

Anemia↗
PubMed1997

Nutritional status indicators and their interactions in rural Guatemalan elderly: a study in San Pedro Ayampuc.

Anthropometry and body-composition measures, hematologic and biochemical measures of nutritional status, and helminthic infection were studied in the population of elderly persons (> or = 60 y of age) in a rural village in Guatemala that was 65% Mayan (indigenous) and 35% ladino (European). The population had low levels of literacy and formal education. The elderly persons were much shorter and lighter than reference populations. Anemia was present in 18% of the population, and riboflavin and vitamin B-12 deficiencies were detected in 70% and 38%, respectively. Both anthropometric and biochemical-hematologic variables were lower, on average, in the Mayan descendants than in the ladinos. When grouped by body mass index (BMI; in kg/m2), greater BMI signified higher values for almost all biochemical-hematologic measures. Sixty-five percent of the sampled population had mild-to-moderate Ascaris lumbricoides and Trichuris trichiura infections. The lifestyle in rural Guatemala is evolving, and the present findings provide insights into the evolution of nutritional status in the growing number of elderly in the countryside.

Aged↗
PubMed1997

A randomized intervention study of the effects of discontinuing coffee intake on growth and morbidity of iron-deficient Guatemalan toddlers.

Coffee is widely consumed by children in Guatemala. To evaluate whether coffee has an adverse effect on growth or morbidity, 160 children 12-24 mo of age who had received coffee for > or = 2 mo and had at least one indicator of iron deficiency were stratified by initial hemoglobin (Hb) (A = anemic vs. NA = "nonanemic", i.e., Hb > or = 105 g/L) and randomly assigned to a control (C = continuation of coffee) or intervention group (S = provided with a substitute consisting of sugar and coloring) for 5 mo. Anemic children were provided iron supplements for 2-3 mo. Hematological and anthropometric measurements were made before and after the intervention, and dietary and morbidity data were collected every 2 wk. A total of 139 children completed the intervention: 45 C-NA, 56 S-NA, 19 C-A and 19 S-A. Compliance with the intervention was good: median coffee intake was 127 mL/d in group C vs. 3 mL/d in group S (P = 0.0001). There were no significant differences between C vs. S groups in food intake before or after the intervention. In the total sample, there was no effect of the intervention on weight or length gain. However, in children initially consuming more than 100 mL/d of coffee (n = 96), length gain was 22% greater in the S vs. the C group (P = 0.07), and weight gain was 46% greater in the S-A vs. the C-A group (P < 0.05; NS in the NA groups). Total illness prevalence (particularly respiratory illness) was significantly lower in the S-NA vs. the C-NA group (P < 0.05), but somewhat higher in the S-A vs. the C-A group (P = 0.09). Morbidity differences did not explain the effect of the intervention on growth. These results indicate a modest increase in growth associated with discontinuation of coffee consumption by toddlers with initial intakes >100 mL/d.

Anemia, Iron-Deficiency↗
PubMed1997

Identifying areas with vitamin A deficiency: the validity of a semiquantitative food frequency method.

OBJECTIVES: The prevalence of vitamin A deficiency has traditionally been assessed through xerophthalmia or biochemical surveys. The cost and complexity of implementing these methods limits the ability of nonresearch organizations to identify vitamin A deficiency. This study examined the validity of a simple, inexpensive food frequency method to identify areas with a high prevalence of vitamin A deficiency. METHODS: The validity of the method was tested in 15 communities, 5 each from the Philippines, Guatemala, and Tanzania. Serum retinol concentrations of less than 20 micrograms/dL defined vitamin A deficiency. RESULTS: Weighted measures of vitamin A intake six or fewer times per week and unweighted measures of consumption of animal sources of vitamin A four or fewer times per week correctly classified seven of eight communities as having a high prevalence of vitamin A deficiency (i.e., 15% or more preschool-aged children in the community had the deficiency) (sensitivity = 87.5%) and four of seven communities as having a low prevalence (specificity = 57.1%). CONCLUSIONS: This method correctly classified the vitamin A deficiency status of 73.3% of the communities but demonstrated a high false-positive rate (42.9%).

Child, Preschool↗
PubMed1997

Identification and production of local carotene-rich foods to combat vitamin A malnutrition.

OBJECTIVES: To address, with respect to improvement of human vitamin A status by dietary approaches, the three theoretical postulates that: 1) the most practical and economical manner to increase the amount of dietary vitamin A available to low-income persons in low-income nations is through plant sources of provitamin A carotenoids; 2) there will be constraints and limitation to the efficiency of a given intervention approach related to behavioural, cultural, biological and botanical considerations; and 3) the nature of these constraints and limitations must be understood, and then overcome where possible, to maximize the impact of such interventions on the vitamin A status of developing country populations. CONCLUSIONS: We review how local plant sources of provitamin A that would be acceptable for the at-risk populations and outline six settings and scenarios for the processing of carotene-rich foods: 1) cooking for hygiene; 2) long-term preservation; 3) compacting to reduce volume; 4) formulation for specific consumers; 5) improving bioavailability and bioconversion; and 6) to increase 'value added' in commerce. We describe our experiences in Guatemala (with sweet potato flakes), and those of others in the Caribbean, the African Sahel, and East Africa (with solar-drying for preservation of a variety of plants), and in Sri Lanka (with leaf concentrates) in promoting increased carotene-rich food intake, and the lessons learned from their evaluations. This overall approach to combatting endemic hypovitaminosis A in developing countries is evaluated within the constraints of: 1) the volumes of plant-based foods required to satisfy vitamin A requirements; and 2) the controversy over the true bioconversion efficiency of provitamin A from plant sources into the biologically-available active vitamin.

Carotenoids↗
PubMed1997

Micronutrients and urban life-style: lessons from Guatemala.

Guatemala is a nation of 10 million persons, at the northern point of the chain of five Republics derived from Spanish colonies on the Isthmus of Central America. The country is diverse in its ethnicities, its climate and terrain, and its agricultural pursuits. The majority of its population is poor, illiterate, and under-employed. It has had a unique and turbulent political history, and only recently has emerged. The traditional basis of the diet, dating to Mayan times, is maize and beans. Guatemala City, with its population in excess of 2 million inhabitants, having doubled since the Earthquake of 1976, is the only major metropolis. The pattern of dietary selection and the format of eating meals is changing in relationship to the size, congestion, economic evolution, and modernization of the capital city. A wider selection of foods is consumed in the city, but preparation follows the traditions of the rural cuisine. Street vendors play an ever larger role in the feeding of the urban poor. Quantitative data are only available for vitamin A and zinc, and only in certain subsegments of the population. The vitamin A in fortified foods, notably table sugar which is fortified with retinyl palmitate by legal mandate, makes up over one-third of the intake. The maize tortilla is an important sources of calcium, iron, zinc and copper. Average zinc intakes are appropriate, but the biological availability of the metal is low. The intake of iodine is totally dependent upon table salt which is inconsistently fortified. Data on micronutrient status exists for vitamin A, iron, iodine, riboflavin and zinc. With respect to rural areas, no major advantages or disadvantages in the adequacy of micronutrient nutriture can be claimed for the urban population. It is possible that, in the metropolitan area, vitamin A nutriture is slightly better and riboflavin status somewhat poorer than in the countryside. The prospects for future directions in urban lifestyle, in micronutrient status and in their interaction are uncertain. The pressure of growth are straining the ability of the municipal infrastructure and the industrial base to respond with provision of services and employment.

Feeding Behavior↗