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Biomedical subjects

N W Solomons

Publications and source records attributed to N W Solomons.

At least 55 records · Page 3Linked to original sources
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

Intestinal helminths and their influence on the indicators of iron status in the elderly.

The intestinal helminthiasis and hematological status was assessed in 100 elderly residents of two low-land communities, one at sea-level and the other at 61; m, equally representative of men and women. These are beth low-income communities. The population showed a 48% helminth infection rate which consisted of hookworm, Trichuris, and Ascaris infection. The prevalence of each of the individual parasites was considered light to moderate and the intensity of infection was generally low in this population. A strong inverse association between intensity of hookworm infection and hemoglobin levels was observed but only at intensities greater than 2,000 eggs/gram feces. Lower intensities of infection had no apparent influence on hematological status. The evaluation of hematological status using hematocrit and hemoglobin showed different prevalences of risk of anemia of 14.1% and 43.8%, respectively. These differences may reflect the chosen cut-off values. Iron deficiency does not appear to be a major problem in this population with only 5% or 11% having absent stores using the low and high cut-off values of circulating serum ferritin, respectively.

Aged↗
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↗
PubMed1996

A comparison of body fat estimates using anthropometry and bioelectrical impedance analysis with distinct prediction equations in elderly persons in the Republic of Guatemala.

Bioelectrical impedance analysis (BIA) has been proposed as a technique to estimate body composition. Its application has extended beyond the clinical setting, however, it remains to be determined if the BIA prediction formulas published to date provide comparable body composition estimates in elderly populations. The objective of this study was to compare the estimates of body fat derived from published prediction equations in a developing country's population such as Guatemala. A total of 234 elderly persons were studied (108 males and 126 females), with ages of 78 +/- 7 and 77 +/- 8 (mean +/- SD) yr, respectively. The height and weight averaged 156.4 +/- 7.9 and 144.0 +/- 7.0 cm, and 54.5 +/- 9.4 and 49.4 +/- 10.6 kg, for males and females, respectively. Measurements included skinfolds (triceps, biceps, subscapular, and suprailiac), and body resistance (BIA). Body fat estimates were derived from four BIA-prediction formulas and three equations based on anthropometry. Mean percent body fat estimates for the overall population obtained from anthropometry and BIA prediction formulas ranged from 22 to 50%. Females had higher estimates compared to males without regard for the method used. Highly significant intermethod correlations were seen, but differences in fat estimation among prediction formulas were noticed and the magnitude of the differences were BIA-formula dependent.

Adipose Tissue↗
PubMed1996

Plant sources of vitamin A and human nutrition: renewed strategies.

The ability of a supplement of local, cooked green leaves to support vitamin A nutriture of anemic, lactating rural Indonesian women was tested using increments in carotenoid and retinol content in plasma and breast milk as indices of bioavailability and bioconversion, respectively. While beta-carotene provided in a simple matrix of a fortified cracker produced substantial improvements in both vitamin A and carotenoid status, an equivalent amount from stir-fried vegetables had a negligible effect.

Biological Availability↗
PubMed1996

[Lactose and its implications in gastroenterology. Nutrition and food sciences].

The development of the practice of dairying allowed humans to become the only species of mammals to consume milk after the time of weaning. Milk contains the sugar, lactose, which requires the enzyme, intestinal lactase, to digest. Adult mammals do not retain ordinarily express this enzyme after early life, but through evolution, some groups of humans-notably those who practice dairying-have evolved to have the persistence of lactase into adulthood. In Meso-America, South America, Asia and most of Africa, the majority of individuals are genetically lactase non-persistent. With milk as an element of the diet, this human polymorphism for lactase produced its implication in gastroenterology, nutrition and food sciences for both those who can digest and those who cannot digest this sugar. Here, we review the issues of terminology, molecular genetics, diagnosis, health consequences, and management of different lactase states at a general and generic level.

Adult↗
PubMed1996

[Dietary pattern and nutrient intake in preschool children from three rural villages in the Province of Santa Rosa, Guatemala].

We present here the results of a nutritional survey to show the pattern of food consumption, as well as nutrient intake, of 303 pre-school children (six to 71 months old) from three rural hamlets of the South-East region of Guatemala. This survey was performed prior to the establishment of a nutritional intervention in the same geographical area. Information was gathered from June through August 1991, by personnel from the Center for Studies of Sensory Impairment, Aging, and Metabolism (CeSSIAM) using two data collection instruments during home visits. Informats were mothers or other caretakers in charge of the children feeding. Data collected were initially converted to individual food item weight, and then, to micronutrients values. These values were used to establish their adequacy to standard requirements for children of these ages. Results showed a pattern in which corn tortilla, and beans were the most commonly consumed food items. Those items were also the relatively most important sources of calories, protein, and iron. Vitamin A intake was low, and it came mainly from plant sources. Nutrients intake was below the recommended dietary allowances, except for protein and iron.

Calcium, Dietary↗
PubMed1995

Blood retinol and beta-carotene levels in rural Guatemalan preschool children.

Plasma retinol and beta-carotene levels were measured in 502 preschool Guatemalan children from five rural hamlets. Their ages ranged from 6 to 78 months (mean: 42.9 +/- 19.2 months); 45% males and 55% females. The mean retinol value in the whole group was 0.9 +/- 0.4 mumol/l (range: 0.1 to 8.4 mumol/l). There was no significant difference between sexes in retinol mean values nor in the incidence of retinol values less than 0.7 mumol/l (22% in males, 18% in females). When grouped by age and community, significant low retinol mean values were found in two hamlets in the youngest age group (12 to 23 months) as compared to the other age-groups (p < 0.05). In the other two hamlets, there were no significant differences among retinol means by age-group. The highest prevalence of deficient retinol values by age-group was in the 12 to 23 months group (40%), and decreased as age increased. The mean value for beta-carotene in the whole group was 0.13 +/- 0.18 mumol/l (range: 0.01 to 2.23 mumol/l). There were no significant differences in beta-carotene means between sexes in the whole group. Stratifying the beta-carotene data by age-groups and community, values were significantly higher in the 48-59 months and 72-83 months groups, as compared with the other age groups in two of the communities (p < 0.05). Significant differences across communities for beta-carotene were found only in the 12 to 23 months group.

Age Factors↗
PubMed1995

Weekly versus daily oral iron administration: are we asking the right questions?

The separation of oral iron doses to conform to cycle of intestinal mucosa turnover has been suggested by some as a method to improve the efficiency of uptake for therapeutic doses of iron. A short-term study in healthy American women failed to confirm a superior absorption of radioiron with a 7-day interval versus everyday administration of a 50-mg iron dose, but the iron status of the experimental subjects may have produced an inappropriate population on which to test a question relevant to Third World populations.

Administration, Oral↗
PubMed1995

Urban nutrition in developing countries.

In developing countries, the past decades have seen a marked demographic shift from rural to urban. By the year 2000, 40% of the population of the Third World will live in urban areas. We have limited specific knowledge of the similarities and differences in diet, nutrition status, and health effects of diet and lifestyle between the traditional rural populations and the emerging urban poor. Such information will be useful for basic descriptive information as well as for assistance in the design and execution of health and nutrition projects for the urban poor.

Child↗
PubMed1995

Alteration of circulating micronutrients with overt and occult infections in anaemic Guatemalan preschool children.

Clinical and laboratory data to define conditions of apparent health, localised infection or inapparent infection were available for 74 anaemic Guatemalan preschool children in the baseline phase of a clinical trial of the effect of iron and vitamin A on haematological status to be correlated with serum levels of four circulating micronutrients--iron, zinc, copper and retinol--known to be influenced by activation of the acute-phase reaction. Upon enrolment, only 29.7% of the children were free of all evidence of infection, 36.5% had one or more localised conditions detected on clinical examination, and 33.8% had an elevated white cell count and/or sedimentation rate, without localising features. These were classified as 'inapparent infections'. With respect to the healthy children, levels of iron, zinc, and retinol declined and copper generally increased in the four categories of clinical infections (acute respiratory infection, dermal infections, conjunctivitis, and 'other') but were also displaced in inapparent infections. Some activation of the acute-phase response in anaemic children may occur in the absence of clinical findings. Care must be taken in interpreting circulating micronutrient levels in relation to nutritional status in such population.

Acute-Phase Reaction↗
PubMed1995

Clinical trial of glucose-oral rehydration solution (ORS), rice dextrin-ORS, and rice flour-ORS for the management of children with acute diarrhea and mild or moderate dehydration.

OBJECTIVE: To assess the effects of glucose (G)-oral rehydration solution (ORS), rice dextrin (RD)-ORS, and rice flour (RF)-ORS on fluid intake, rapidity of rehydration, and stool output of children with acute diarrhea and mild or moderate dehydration. METHODS: The study was a randomized, double-masked clinical trial. One hundred forty-six male infants, ages 3 to 36 months, were randomly assigned to one of three treatment groups. Clinical evaluations and fluid balances were conducted every 2 to 4 hours for 48 hours. Principal outcome variables were ORS consumption, recovery of hydration status, and fecal output. RESULTS: The groups were similar at admission with regard to age, nutritional status, history of the current episode, and clinical status. There were no differences in ORS consumption by treatment group during any period of study. During the first 6-hour period, patients in group RF had less stool output (16 +/- 14 g/kg/body weight) than those in group G (22 +/- 20 g/kg) or RD (21 +/- 19 g/kg; P < .05). After 12 hours of hospitalization, there were no differences by treatment group. Recovery of hydration status, changes in serum sodium and potassium, and duration of diarrhea in the hospital were similar in all three groups. CONCLUSION: There was a 24% to 27% reduction in stool output during the first 6 hours of treatment among children who received RF-ORS compared with those who received G-ORS or RD-ORS, but this effect did not persist after the first 12 hours of therapy. Because this difference was of small magnitude and limited duration, it has minor clinical importance. Thus, we conclude that the three solutions had similar efficacy for children with acute, watery diarrhea and mild or moderate dehydration.

Acute Disease↗