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Biomedical subjects

N W Solomons

Publications and source records attributed to N W Solomons.

At least 37 records · Page 2Linked to original sources

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↗

Comparison of three methods for estimating daily individual discretionary salt intake: 24 hour recall, duplicate-portion method, and urinary lithium-labelled household salt excretion.

OBJECTIVE: To compare methods for estimating discretionary salt intake, that is, salt added during food preparation and consumption in the home. SETTING: The study was carried out in a rural Guatemalan village. SUBJECTS: Subjects were selected non-randomly, based on their willingness to cooperate. Nine mother-son dyads participated; the sons were aged 6-9 y. INTERVENTIONS: Three approaches for estimating the discretionary salt consumption were used: 24 h recall; collection of duplicate portions of salt; and urinary excretion of lithium during consumption of lithium-labelled household salt. Total salt intake was assessed from the excretion of chloride over 24 h. RESULTS: The mean discretionary salt consumption based on lithium excretion for mothers was 3.9+/-2.0 g/d (mean +/- s.d.) and for children 1.3+/-0.6 g/d. Estimates from the 24 h recalls and from the duplicate portion method were approximately twice and three times those measured with the lithium-marker technique respectively. The salt intake estimated from the recall method was associated with the lithium-marker technique for both mothers and children (Spearman correlation coefficient, 0.76 and 0.70 respectively). The mean daily coefficient of variation in consumption of discretionary salt measured by the three methods, for mothers and boys respectively, were: lithium marker, 51.7 and 43.7%; 24 h recall, 65.8 and 50.7%; and duplicate portion, 51.0 and 62.6%. CONCLUSIONS: We conclude that an interview method for estimating discretionary salt intake may be a reasonable approach for determining the relative rank-order in a population, especially among female food preparers themselves, but may grossly overestimate the actual intake of salt added during food preparation and consumption.

Adult↗

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↗

Plant sources of vitamin A and human nutriture: how much is still too little?

In a randomized controlled 12-week feeding trial among malnourished, anemic, and largely vitamin A-deficient Ghanaian preschool children, the hypothesis that the ability of provitamin A carotenoids in dark green, leafy vegetables (DGLV) to raise vitamin A status in different formats--with or without fat and with fat plus anthelmintic treatment for intestinal worms--was tested by comparison with a low vitamin A fare and with pure chemical beta-carotene. The 12-week increments in retinol concentrations over baseline ranged from 5% to 44%, but over half of the DGLV-fed population had persistently low circulating retinol. The very modest impact on vitamin A status of these maneuvers to optimize dietary use of provitamin A in DGLV has major implications for public policy to eradicate hypovitaminosis A.

Anthelmintics↗

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↗

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↗

The plasma beta-carotene response to a single meal of carrots in Guatemalan schoolchildren.

Plasma samples were obtained before, and 8 and 24 h after the ingestion of an ad libitum amount of cooked carrots by 23 school children from a peri-urban community in Guatemala City. The single-meal consumption of cooked carrots ranged from a low 122 g to a high of 961 g (mean: 370.5 +/- 237.2 g; median: 268.4 g). The measured beta-carotene content of the carrots was 10.1 mg per 100 g of edible portion; therefore, the range of intake of beta-carotene was 12.4 to 97.0 mg (mean: 37.4 +/- 24 mg; median: 27.1 mg). Changes in plasma beta-carotene levels at 8 h ranged from a decrement of -0.32 mumol/l (-16.98 micrograms/dl) to an increment of 0.79 mumol/l (42.44 micrograms/dl), with a mean of 0.11 +/- 0.24 mumol/l (5.97 +/- 12.82 micrograms/dl). Changes at 24 h were less dramatic than those at 8 h. A regression of the 8-h changes in plasma beta-carotene on the amount of carrot carotene consumed (corrected by body weight) had an r-value of 0.12. Baseline levels of plasma retinol were poor predictors of the plasma beta-carotene response with this sample size (r = 0.10). The magnitude of the plasma response to beta-carotene from carrots appears to be lower than that observed with pure, powdered, crystalline carotenes; moreover, the variability of the post-carrot response seems to be greater--and its association to dosage appears to be weaker--than with the pharmacological beta-carotene.

Biological Availability↗

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↗

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↗

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↗