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Biomedical subjects

R Martorell

Publications and source records attributed to R Martorell.

At least 37 records · Page 2Linked to original sources
PubMed1999

Role of intergenerational effects on linear growth.

Current knowledge on the role of intergenerational effects on linear growth is reviewed on the basis of a literature search and recent findings from an ongoing study in Guatemala. Fourteen studies were identified, most of which examined the intergenerational relationships in birth weight. Overall, for every 100 g increase in maternal birth weight, her child's birth weight increased by 10-20 g. The study samples were primarily from developed countries, and birth weight data were extracted from hospital records and/or birth registries. Among the few studies that examined associations between the adult heights of parents and their offspring, correlation coefficients of 0.42-0.5 were reported. None of the studies examined intergenerational relationships in birth length or linear growth patterns during early childhood, preadolescence and/or adolescence. Prospectively collected data from long-term studies being carried out in rural Guatemala provide the first evidence of intergenerational relationships in birth size in a developing country setting. Data were available for 215 mother-child pairs. Maternal birth size was a significant predictor (P < 0.05) of child's birth size after adjusting for gestational age and sex of the child and other potential confounders. Child's birth weight increased by 29 g/100 g increase in maternal birth weight which is nearly twice that reported in developed countries. Similarly, child's birth length increased by 0.2 cm for every 1 cm increase in mother's birth length. The effect of maternal birth weight remained significant even after adjusting for maternal adult size. More evidence from developing countries will help explain the underlying mechanisms and identify appropriate interventions to prevent growth retardation.

Adult↗
PubMed1999

Massive fetomaternal hemorrhage: how long should children with good evolution be controlled? A case report.

We report on a term infant with a severe fetomaternal hemorrhage that caused a serious anemia that was surmounted after several transfusions. After the initial complications, such as persistent pulmonary circulation, severe anemia and thrombocytopenia, the outcome was good. We discuss the importance of a long-term follow-up of affected children, as well as their mothers. No clear parameters for a real prognosis are available. A follow-up is needed in order to detect possible complications in neurological development.

Adult↗
PubMed1998

Obesity in Latin American women and children.

National surveys conducted since 1982 were used to assess maternal and child obesity in Latin American and Caribbean countries and in U. S. residents of Mexican descent. Obesity in women, a body mass index (BMI) >/=30 kg/m2, was 3% in Haiti, 8-10% in eight Latin American countries and 29% in Mexican Americans. Median BMI for Latin American women were near or above the 50th percentile of the general U.S. population; values exceeded the 75th percentile in the case of Mexican Americans. The prevalence of overweight (>1 SD above mean weight-for-height) in children 1-5 y of age ranged from 6% in Haiti to 24% in Peru among 13 countries. Overweight occurred in 24% of Mexican-American children. Prevalences of overweight in children and of obesity in women were greater in urban areas and in households of higher socioeconomic status. Overweight in children increased with higher maternal education; however, in some countries, obesity in women decreased with higher education. No general pattern of change over time was observed in eight countries in overweight in children. Obesity in women increased in the three countries with such data and in Mexican-American women and children. There was a tendency for greater national incomes to be associated with greater obesity levels in women and with lower levels of stunting in children. Levels of obesity in the region indicate a public health concern, particularly among women, considering that studies have identified mortality and morbidity risks associated with obesity in adults.

Adult↗
PubMed1998

Intrauterine growth retardation, body size, body composition and physical performance in adolescence.

Studies about effects of IUGR on growth in childhood as well as on body size, body composition and physical performance in adolescence and adulthood are reviewed. The review is based on 12 studies that distinguished IUGR from other types of low birthweight and compared outcomes of IUGR cases with those of non-IUGR controls. This information is complemented by results of a follow-up study of IUGR cases and controls carried out in Guatemalan adolescents and young adults. In Guatemala as well as in other countries, IUGR newborns showed partial catch-up growth during the first one or two years of life, and then maintained their achieved place in the growth distribution. Guatemalan IUGR cases were shorter, lighter and weaker than non-IUGR controls as adolescents and young adults. The differences in adult body size observed in Guatemala between cases and controls are similar to those found in more affluent countries (i.e. about 5 cm in height and 5 kg in weight).

Adolescent↗
PubMed1998

[Duodenal duplication].

Cystic duplication of the duodenum is a rare anomaly of the gastrointestinal tract. This is a report of a newborn with a cystic duplication of duodenum diagnosed prenatally. It's relevant the few clinical symptoms of a such big mass. The surgical procedure was excision of the cyst, with a good post operative curse.

Duodenum↗
PubMed1997

Acculturation, socioeconomic status, and obesity in Mexican Americans, Cuban Americans, and Puerto Ricans.

OBJECTIVES: This study examined the relationship between acculturation and obesity in United States (US) Hispanics, controlling for socioeconomic status (SES). METHODS: The sample included 3141 Mexican American, 828 Cuban American, and 1211 Puerto Rican adults 18-74 y of age in the 1982-84 Hispanic Health and Nutrition Examination Survey (HHANES). Acculturation was measured by language preference and generation; SES by income and education; and obesity by body mass index (BMI). RESULTS: Mean and standard deviations of BMI (kg/m2) were 25.9 +/- 4.4, 26.0 +/- 4.2, and 25.5 +/- 4.3 in men of Mexican American, Cuban American, and Puerto Rican origin, respectively. For women, the corresponding values were 26.6 +/- 5.8, 25.9 +/- 5.0, and 26.2 +/- 5.9. Linear regression models of BMI which included acculturation, income, education, and other covariates were carried out. Income and education were not associated consistently with BMI. Acculturation, but only among Mexican Americans, was associated with BMI. Specifically, greater preference for English was associated with reduced BMI among women (P < 0.01). Also, men and women of the second (P < 0.001 in both sexes) and third (P < 0.01 in men P < 0.001 in women) generation had greater BMIs. Relative to the first generation, the increase in BMI units was 1.15 +/- 0.34 in men and 1.76 +/- 0.39 in women in the second generation and 0.83 +/- 0.31 in men and 1.83 +/- 0.37 in women of the third generation. CONCLUSIONS: BMI was not associated with SES, an unexpected finding since the relationship is generally negative in women from developed countries. The relationship between BMI and acculturation was weak and conditional. BMI in Mexican Americans appeared to be somewhat more sensitive to the process of acculturation than among Cubans or Puerto Ricans.

Acculturation↗
PubMed1996

Screening for nutrition interventions: the risk or the differential-benefit approach?

The risk approach has been promoted to improve screening for nutrition interventions on the premise that indicators of risk also predict greater response to interventions. This study tested whether the determinants of the risk of poor growth (eg, low length-for-age) at 36 mo of age were the same as the determinants of differential benefit from food supplementation. The sample included 460 Guatemalan children who were exposed to either a high-energy, high-protein drink (atole) or a low-energy, no-protein drink (fresco) during their first 36 mo of life [INCAP (Institute of Nutrition of Central America and Panama) supplementation trial]. Low maternal stature, poor socioeconomic status, inadequate home diet, high diarrhea rates, and low anthropometry scores at 3 or 6 mo were all determinants of the risk of poor growth. Only indicators of child's thinness at 3 or 6 mo of age (low weight-for-age, weight-for-length, or midupper arm circumference) were determinants of differential benefit from supplementation. Thus, the development of screening indicators should be based on analyses of the predictors of differential benefit, not on conventional risk-factor analysis.

Anthropometry↗
PubMed1995

Differential response to early nutrition supplementation: long-term effects on height at adolescence.

BACKGROUND: The classical risk approach to predicting who benefits from an intervention is unsound because it relies on the theoretical assumption that those at risk will necessarily benefit. A better approach to systematically test who benefits from nutrition supplementation is proposed using interactive models. METHODS: Differential effects of nutrition supplementation during early childhood on stature at adolescence were studied in 245 males and 215 females to identify determinants of long-term benefit from food supplementation. Factors studied included family socioeconomic status (SES) and children's home diet and diarrhoea during the first 3 years of life. To determine whether a factor conferred benefit, the statistical significance of the interaction between this factor and the intervention was tested. Data from the INCAP supplementation trial in Guatemala and from the follow-up of the same subjects at adolescence were used. RESULTS: Ordinary least squares (OLS) showed that high rates of diarrhoea in males and poor SES in females were significant determinants of benefit from supplementation at adolescence, and that the effects were mediated by length at 3 years old. Results of two-stage least squares (2SLS) analysis showed that length at 36 months, maturation and maternal height were significant determinants of height at adolescence but SES was not. CONCLUSIONS: Nutrition supplementation in early childhood has long-lasting effects on body size and the larger benefits acquired by some groups of children remain throughout early adulthood. The relevance of these findings for screening and targeting of nutritional interventions is discussed.

Adolescent↗
PubMed1995

History and design of the INCAP longitudinal study (1969-77) and its follow-up (1988-89).

This is an overview of the design and methods of the INCAP longitudinal study (1969-77) and its follow-up study (1988-89). The first study had the objective of assessing the effects of intrauterine and preschool malnutrition on growth and mental development. To achieve this, food supplements were provided to pregnant women and young children residing in four Gautemalan villages. Two villages were given a high-protein, high-energy drink and two were provided a no-protein, low-energy drink. Both supplements contained vitamins and minerals. Longitudinal information was collected during the first seven years of life on physical growth, mental development, attendance and consumption of supplement, home diet, morbidity and on characteristics of the family. Health and nutrition data on mothers also were collected. The INCAP follow-up study was a cross-sectional evaluation of former participants of the first study and was carried out when the subjects were 11-27 y old. The hypothesis of the INCAP follow-up study was that improved nutrition in early childhood leads to enhanced human capital formation in adolescents and adults. Data were collected on physical growth and body composition, maturation, work capacity, intellectual performance and school achievement.

Adolescent↗
PubMed1995

Nutritional impact of supplementation in the INCAP longitudinal study: analytic strategies and inferences.

From 1969 to 1977 a supplementation trial was conducted in Guatemala to ascertain the effects on physical and behavioral outcomes of improved nutrition in pregnant women and in preschool children. This paper reviews different strategies to analyze the effect of the intervention on physical growth. One strategy compares outcomes in two villages that were randomly allocated to receive Atole, a supplement containing high amounts of protein and energy, with values in two other villages that received Fresco, a beverage containing no protein and little energy. Both supplements contained micronutrients. This comparison of village means gives a probability significance statement (P < 0.005) that the difference in growth was because of the supplement intervention, although it does not specify the aspect of the intervention that caused the effect. Complementary strategies increase the credibility that the effect of the supplement was nutritional. Thus, analysis of the dose response with increasing supplement intake within the villages excludes the possibility that the above findings were the result of knowing which villages received which supplement (i.e., measuring biases). A greater effect in those most likely to respond nutritionally also increases the credibility that the mechanism was nutritional. In studying other behavioral and biomedical impacts of this supplementation intervention, analyses for credibility should always be included.

Child Nutrition Disorders↗
PubMed1995

Age differences in the impact of nutritional supplementation on growth.

Supplementary feeding programs are common in developing countries. These programs often cannot demonstrate an impact on child growth, however, possibly because they tend to reach older children. This study examines the impact of nutritional supplementation on annual growth rates in length and weight from birth to 7 y of age in 1208 rural Guatemalan children. A series of multiple linear regression models is used to control for initial body size, diarrheal disease, home diet, socioeconomic status and gender. During the first year of life, each 100 kcal/d (418 kJ) of supplement was associated with approximately 9 mm in additional length gain and 350 g in additional weight gain; the benefit decreased to approximately 5 mm in length gain and 250 g in weight gain during the 2nd y of life. Between 24 and 36 mo of age, supplement only had a significant impact on length. There was no impact of nutritional supplementation on growth between 3 and 7 y of age. Patterns were the same if supplement intakes were expressed as a percent of recommended allowances or growth was expressed as a percent of the expected rate. These impacts of nutritional supplementation on growth coincide with the ages when growth velocities, as well as growth deficits, are greatest in this population.

Age Factors↗
PubMed1995

Patterns of linear growth in rural Guatemalan adolescents and children.

Length and weight data from a longitudinal study of rural Guatemalan subjects birth to 7 y of age and height and weight data from a cross-sectional study of the same subjects when they were 11-24.9 y old are compared to reference data for the USA general population and for Mexican-Americans. At birth, the median length of Guatemalan children is at approximately the 16th percentile of the USA reference or approximately 2 cm shorter. By 6 mo of age, Guatemalan children are shorter, on average, than the 5th percentile of the reference curves and, in absolute terms, are approximately 5 cm below the median; by 3 y, the difference increases to approximately 10 cm. As adults, Guatemalans have about the same absolute level of deficit (approximately 13 cm) as they did at age 3 y. If the general USA population is used for comparison, Guatemalans can be said to grow as expected during adolescence, neither recuperating the growth retardation of early childhood nor falling further behind in size. If the Mexican-American sample is selected instead, it would appear that some catch-up in growth occurs in Guatemalan adolescents. Regardless of the choice of reference population, growth is markedly retarded only in early childhood; adolescence is not a period when growth is significantly constrained.

Adolescent↗