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PubMedDate not supplied

[Nutrition and development in the first semester of life].

OBJECTIVE: To study the psychomotor development of young infants from a poor and underfed rural community and to correlate this with the nutritional conditions of the mother during pregnancy and the child itself. MATERIAL AND METHODS: We studied 82 mother-child pairs from the 5th month of pregnancy to the 6th month of life of the child as to anthropometry and food consumption. The neonatal Brazelton test and the Bayley test at 3 and 6 months were applied to the child. RESULTS: Several of the neonatal psychomotor tests applied to the child correlate positively with the mother's weight and skin folds, as well as with the child's own previous weight and size. This was also true for maternal consumption of animal foods and fruits during pregnancy. A negative correlation was observed with the consumption of corn tortillas and beans. The correlation of several tests applied to the child at six months was positive with its complementary consumption, total energy and several foods, specially egg, milk and fruit around three months of age. CONCLUSIONS: Small variations in nutrition of the mother-child pairs from the poor rural community studied had consequences on the psychomotor development of the infant. These findings point to the need for more applied nutrition programs.

Anthropometry↗
PubMed2003

Body composition in childhood: effects of normal growth and disease.

Body composition in children is of increasing interest within the contexts of childhood obesity, clinical management of patients and nutritional programming as a pathway to adult disease. Energy imbalance appears to be common in many disease states; however, body composition is not routinely measured in patients. Traditionally, clinical interest has focused on growth or nutritional status, whereas more recent studies have quantified fat mass and lean mass. The human body changes in proportions and chemical composition during childhood and adolescence. Most of the weight gain comprises lean mass rather than fat. In general, interest has focused on percentage fat, and less attention has been paid to the way in which lean mass varies within and between individuals. In the general population secular trends in BMI have been widely reported, indicating increasing levels of childhood obesity, which have been linked to reduced physical activity. However, lower activity levels may potentially lead not only to increased fatness, but also to reduced lean mass. This issue merits further investigation. Diseases have multiple effects on body composition and may influence fat-free mass and/or fat mass. In some diseases both components change in the same direction, whereas in other diseases, the changes are contradictory and may be concealed by relatively normal weight. Improved techniques are required for clinical evaluations. Both higher fatness and reduced lean mass may represent pathways to an increased risk of adult disease.

Adipose Tissue↗
PubMed2000

Exploring the clinical nurse specialist role in an AIDS community-based organization.

Although community-based organizations (CBOs) serving persons living with HIV/AIDS have proliferated, the role of advanced practice nurses in these CBOs has not been articulated. This article describes four components of the clinical nurse specialist (CNS) role in a CBO: a nutrition program for ambulatory persons living with HIV disease. The CNS educates clients about strategies to improve and maintain their health and manage complex treatment regimens in daily lives that are often chaotic and limited by severe financial constraints. As a member of a multidisciplinary team, the CNS provides a healthcare perspective in policy development and staff education for a predominantly social service agency.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Malnourished children treated in day-hospital or outpatient clinics exhibit linear catch-up and normal body composition.

The nutritional programming hypothesis proposes that early life malnutrition is related to an increase in body fat later in life. Brazilian boys and girls (n = 94; 4-14 y old) were studied. Malnourished children treated in a Nutrition Recovery Center, were followed up and divided into 2 groups: the Outpatient group (recovered after outpatient care, n = 28), and the Day-hospital group (recovered after day-hospital care, n = 38). They were compared with a Control group (healthy individuals without intervention, n = 28). Nutritional recovery was confirmed by anthropometry. Body composition was evaluated by dual-energy X-ray absorptiometry. Both recovered groups had a greater increase in height-for-age Z-scores than in weight-for-age Z-scores after treatment (P < 0.03). Body fat mass (kg) and the percentage of body fat were significantly lower in recovered groups of girls and boys compared with controls. Among boys, lean mass/height (kg/cm), fat-free mass (kg) and the fat-free mass index (kg/m(2)) were significantly lower in the Outpatient and Day-hospital groups than in Controls, but girls did not differ. Bone mineral content (BMC)/height (g/cm) did not differ between the recovered girls and the girls in the Control group (P < 0.15) or between the boys in the Day-hospital group and those in the Control group (P = 0.06). The Outpatient boys group had lower BMC/height than boys in the Control group (P = 0.02). This study demonstrates that when malnourished children receive adequate treatment, linear catch-up growth occurs and is followed by appropriate gain in lean body mass and BMC.

Adipose Tissue↗
PubMed1998

Volunteer peer counselors increase breastfeeding duration among rural low-income women.

BACKGROUND: The purpose of this demonstration project was to test the effectiveness of a volunteer peer counseling program for promoting breastfeeding in a community. METHODS: The two-year project was conducted in Iowa from September 1994 to September 1996. Both intervention and control groups were rural low-income pregnant and postpartum women who qualified for the Women, Infants and Children's (WIC) nutritional program. The intervention was initiated in two counties with 143 clients, of whom 72 completed the project. The control group was drawn from six counties that had received no significant breastfeeding promotion programs during the previous three years. The intervention was the assignment of trained volunteers with previous successful personal experience with breastfeeding as peer counselors to low-income pregnant women. Both before and after the baby was born, the volunteers taught a series of in-home, one-to-one lessons about healthy diet and breastfeeding, and maintained informal contact to answer questions or help with concerns. RESULTS: Women in the intervention group improved dietary intake when compared with the control group. Knowledge of breastfeeding and good nutrition improved slightly. Eighty-two percent of intervention compared with 31 percent of control group women initiated breastfeeding. Mean duration of breastfeeding for intervention and control group women was 5.7 and 2.5 weeks, respectively. At 4 weeks, 56 percent of intervention and 10 percent of control group women were still breastfeeding. CONCLUSION: A volunteer peer counseling program that provides low-income women with role models, accurate information, support, and encouragement can increase the duration of breastfeeding, and thus contribute to healthier infants.

Adult↗
PubMed2002

Improving the health of infants on Medicaid by collocating special supplemental nutrition clinics with managed care provider sites.

OBJECTIVES: This study tested whether collocation of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics at managed care provider sites improved health care for infants enrolled in Medicaid and WIC. METHODS: Weights and immunization rates were studied for the 1997 birth cohort of African American infants enrolled in WIC and Medicaid in Detroit, Mich. Infants using traditional WIC clinics and health services were compared with those enrolled under Medicaid in 2 managed care organizations (MCOs), of whom about half obtained WIC services at MCO provider sites. RESULTS: Compared with other infants, those who used collocated WIC sites either were closer to their age-appropriate weight or had higher immunization rates when recertified by WIC after their first birthday. Specific benefits (weight gain or immunizations) varied according to the priorities at the collocated sites operated by the 2 MCOs. CONCLUSIONS: Collocation of WIC clinics at MCO sites can improve health care of low-income infants. However specific procedures for cooperation between WIC staff and other MCO staff are required to achieve this benefit.

Black or African American↗
PubMed1985

Improved survival in very short small bowel of infancy with use of long-term parenteral nutrition.

Thirteen children with very short small bowel (less than or equal to 38 cm jejunoileum) beginning in the first month of life were enrolled in a home parenteral nutrition program between 1977 and 1984. Their survival is compared with the collective reported experience with short bowel syndrome before 1972: nine (69%) of 13 have survived, compared with seven (23%) of 30 previously. Five discontinued parenteral nutrition after periods of 4 to 32 months of therapy, and have normal growth and development. Two still receive partial (50% and 60%) parenteral nutrition after 9 and 55 months, respectively, and two still receive total parenteral nutrition after 66 and 68 months of therapy, respectively; all four infants have grown normally, and three are developmentally normal. In the combined categories of 15 to 38 cm jejunoileum without the ileocecal valve and less than 15 cm jejunoileum with and without the ileocecal valve, seven (70%) of 10 have survived, compared with none (0%) of 16 before 1972; three of these discontinued parenteral nutrition. Ultimate survival with normal growth without parenteral nutrition is now possible with as little as 11 cm jejunoileum with an intact ileocecal valve and as little as 25 cm jejunoileum without an ileocecal valve.

Age Factors↗
PubMed2004

An educational intervention to promote appropriate complementary feeding practices and physical growth in infants and young children in rural Haryana, India.

Complementary feeding practices are often inadequate in developing countries, resulting in a significant nutritional decline between 6 and 18 mo of age. We assessed the effectiveness of an educational intervention to promote adequate complementary feeding practices that would be feasible to sustain with existing resources. The study was a cluster randomized controlled trial in communities in the state of Haryana in India. We developed the intervention through formative research. Eight communities were pair matched on their baseline characteristics; one of each pair was randomly assigned to receive the intervention and the other to no specific feeding intervention. Health and nutrition workers in the intervention communities were trained to counsel on locally developed feeding recommendations. Newborns were enrolled in all of the communities (552 in the intervention and 473 in the control) and followed up every 3 mo to the age of 18 mo. The main outcome measures were weights and lengths at 6, 9, 12, and 18 mo and complementary feeding practices at 9 and 18 mo. All analyses were by intent to treat. In the overall analyses, there was a small but significant effect on length gain in the intervention group (difference in means 0.32 cm, 95% CI, 0.03, 0.61). The effect was greater in the subgroup of male infants (difference in mean length gain 0.51 cm, 95% CI 0.03, 0.98). Weight gain was not affected. Energy intakes from complementary foods overall were significantly higher in the intervention group children at 9 mo (mean +/- SD: 1556 +/- 1109 vs. 1025 +/- 866 kJ; P < 0.001) and 18 mo (3807 +/- 1527 vs. 2577 +/- 1058 kJ; P < 0.001). Improving complementary feeding practices through existing services is feasible but the effect on physical growth is limited. Factors that limit physical growth in such settings must be better understood to plan more effective nutrition programs.

Body Height↗
PubMedDate not supplied

Malaria, malnutrition and MSF. Médecins Sans Frontières.

This is a personal account of my brief time in Burundi as a volunteer doctor with Médecins Sans Frontières (MSF) at the beginning of 2001. Burundi is a small nation in central Africa (bounded by the Democratic Republic of Congo, Rwanda and Tanzania) which has suffered from problems between the Hutu and Tutsi "ethnic groups", similar to those for which Rwanda is better known. Unlike Rwanda, the war between government troops and rebel forces continues in Burundi. MSF has been in Burundi since 1992, providing basic healthcare, nutrition programs, surgical services and epidemiological intervention. In late 2000, a malaria epidemic began in Burundi's highland regions where transmission is normally low, and thus the population largely not immune. Malnutrition rates also increased and MSF rapidly expanded its usual program in an attempt to control these new health problems.

Adult↗
PubMed2004

Nuclear and isotopic techniques application used in supporting nutritional studies in Latin America countries.

The global nutrition community recognizes the usefulness of nuclear and isotopic techniques and especially stable isotopes for accurate measurements in key areas of human nutrition and health. Although progress has been made in many Latin America countries in reducing the absolute number of undernourished people, food policy and public health communities have to face the double burden on health. On one side they have to address the prevention of obesity and on the other side they are trying to reduce undernutrition. However, to be successful in development of sustainable nutrition programs, a combination of relevant scientific knowledge and approaches that are practical is required to assure even a reasonable level of success. The objectives of this review are to highlight the role of isotopic techniques in nutritional studies and to review the role of the International Atomic Energy Agency in supporting nutrition interventions in Latin America countries.

Biomedical Research↗
PubMed1992

[Correction of severe malnutrition by cyclic enteral feeding].

This study was designed to evaluate the efficacy and tolerance of cyclic (nocturnal) enteral nutrition in ambulatory malnourished patients. A ternary polymeric diet was administered to a total of 28 women and 23 men (mean age: 58 years) for a nocturnal period of 12-14 hours during 24.5 +/- 1.1 days. This diet provided an average of 28.3 +/- 0.6 kcal/kg ideal body weight/day. The nutritional program was administered as planned and well tolerated in 50 of the 51 patients. Voluntary oral caloric intake improved significantly during the treatment period (18.2 +/- 1.4 kcal/kg ideal body weight/day during the first week of enteral nutrition and 22.7 +/- 1.6 kcal/kg ideal body weight/day during the last week). The global nutritional deficit based on 10 anthropometric and biological parameters improved by an average of 36.8 +/- 2.2 percent. Overall, 71 percent of the patients exhibited a favorable nutritional course. Results were identical regardless of the pathology responsible for malnutrition. The main advantages of cyclic enteral nutrition include the possibility for patients to engage in physical activities and to eat normally during the day.

Adolescent↗
PubMed2004

[Effect of different early nutritional interventions on catch-up growth of rats with intrauterine growth retardation].

OBJECTIVE: About 20 - 50% individuals with intrauterine growth retardation (IUGR) could not achieve catch-up growth and remain small in size till adulthood. There are few reports on the relation between intestinal development and body catch-up growth of IUGR. Studies showed that early "nutritional programming" would results in long-term effects on the body growth and organic function, and gastrointestinal development is closely related to the body development as well. The authors aimed to study the effect of early nutritional interventions on serum IGF1, IGFBP3, intestinal development and catch-up growth of pups with IUGR by using diets with different protein and caloric levels during the first four weeks of life. METHODS: An IUGR rat model was established by maternal nutrition restriction during pregnancy. Thirty-two IUGR female pups were divided randomly into 4 groups (8 pups in each group) and eight normal female pups as control. The groups and interventions were (1) Normal control group (C group); (2) IUGR control group (S group), (3) IUGR low-protein diet group (SL group); (4) IUGR high-protein diet group (SH group); (5) IUGR high-caloric group (SA group). The serum IGF1, IGFBP3, body weight, body length, and intestinal weight, length, intestinal villi height (VH), crypt depth (CD), villi absorbing area (VSA), mucous thickness (MT) were measured at the 4(th) week of life. RESULTS: (1) At the 4(th) week, the serum IGF1 (724.0 +/- 153.5 ng/ml), IGFBP3 (9.69 +/- 3.13 ng/ml), and VH (416.9 +/- 46.3 microm), VSA (115.9 +/- 24.0 x 10(3) microm(2)), MT (583.9 +/- 68.5 microm) in the SH group were significantly higher than those of normal control group (539.4 +/- 198.4 ng/ml, 4.77 +/- 2.98 ng/ml and 322.1 +/- 25.8 microm, 85.8 +/- 17.8 x 10(3) microm(2), 480.0 +/- 61.5 microm) and IUGR control group (P < 0.05). The intestinal weight (1.91 +/- 0.16 g) and length (80.67 +/- 9.47 cm) in the SH group was not significantly different from the normal control group (2.24 +/- 0.22 g and 74.77 +/- 9.06 cm, P > 0.05). The SH group showed the fastest catch-up growth. Their body weights (40.14 +/- 11.03 g) at the 3(rd) week and body lengths (23.61 +/- 0.49 cm) at the 4(th) week of life reached the normal ranges of the control group (44.65 +/- 5.36 g and 23.10 +/- 1.42 cm, P > 0.05). (2) The serum IGF1 (346.7 +/- 85.3 ng/ml), IGFBP3 (1.4 +/- 0.21 ng/ml), body weight (21.41 +/- 3.54 g) and body length (15.96 +/- 1.29 cm) and the most of intestinal indexes in the SL group were markedly lower than other groups at the 4(th) week of life (P < 0.05). CONCLUSION: The serum IGF1 was a sensitive marker to reflect the catch-up growth and nutritional status, and IGF1 was positively correlated with the intestinal development and body growth. When given different nutritional interventions during the first four weeks of life, high protein diet is more helpful for the IUGR catch-up growth by promoting the intestinal development and the absorption of nutrition.

Animal Nutritional Physiological Phenomena↗
PubMed2004

Childhood overweight in a New York City WIC population.

OBJECTIVES: We estimated the prevalence of overweight in a population of young children enrolled in a New York City Special Supplemental Nutrition Program for Women, Infants, and Children. METHODS: Administrative and survey data were collected from a sample of enrolled families. Body mass index (BMI) of 557 children aged 2, 3, and 4 years was compared by sociodemographic and nutrition characteristics. RESULTS: Forty percent of the children were overweight or at risk for overweight (BMI >/= 85th percentile). Compared with other racial/ethnic groups combined, Hispanic children were more than twice as likely (odds ratio = 2.6; 95% confidence interval = 1.8, 3.8) to be overweight or at risk for overweight. Two-year-olds were less likely to be overweight than 3- and 4-year-olds. CONCLUSIONS: Interventions to address childhood overweight should be culturally specific and target very young children.

Aid to Families with Dependent Children↗
PubMed1994

Atwater and USDA nutrition research and service: a prologue of the past century.

A century of scientific investigations into the ways that air reacts with carbon, led to the discovery of the conservation of mass and the energy equivalence of foods. Atwater synthesized existing knowledge, most of it based on his own investigations, to define the caloric equivalence of protein, fat, and carbohydrates; 4, 8.9, 4 per gram. His work was a continuation of a series of government research investments. This year we recognize the Centennial of the first such investment by the United States. The USDA supported research which resulted in Atwater's discovery of energy equivalence continues to guide today's applied nutrition programs.

Calorimetry↗
PubMedDate not supplied

Characterizing nutrient intakes of children by sociodemographic factors.

Data from 1,392 children ages 1 to 10, who were participants in the U.S. Department of Agriculture 1987-88 Nationwide Food Consumption Survey, were examined to determine how their diets compared with current dietary recommendations and to identify those sociodemographic factors associated with the greatest risk for not meeting the recommendations. Vitamin A, vitamin E, vitamin C, calcium, iron, and zinc were the nutrients most often consumed below recommended levels. Percentage of calories from fat and saturated fat and mean sodium intakes were above recommended levels for the majority of the children. Of the total sample, 81 percent met guidelines for cholesterol intakes. Multiple correlation regression analysis was used to determine the effect of the following factors on the children's nutrient intakes: geographic region, degree of urbanization, race, household size and income, age, education, and employment status of the male and female head of household. Age and sex of the child were entered as control variables. Level of urbanization affected the most nutrient intake variables, followed by race. Living in a rural area and being black were significant predictors for higher intakes of total fat, saturated fat, cholesterol, and sodium. Mean annual household income had no significant effect on any of the diet quality measures. Many of the children in the sample, however, participated in Federal food and nutrition programs that provided additional resources for food.

Black or African American↗
PubMedDate not supplied

Studies on the efficacy of a new 20% fat emulsion in pediatric parenteral nutrition.

A new 20% safflower oil emulsion was studied in a small series of pediatric patients. Eight infants and children were evaluated over a 2-week period. The 20% fat emulsion supplied a major portion of daily caloric requirements. No serious side effects or toxicity were noted. No major changes in blood chemistries were observed; however, a statistically significant increase in serum albumin was noted. In addition, 63% of the patients gained weight during the study. This investigation supports the contention that 20% Liposyn is a safe and effective component of a parenteral nutrition program for children.

Body Weight↗
PubMed1998

A controlled trial of health promotion programs in 11-year-olds using physical activity "enrichment" for higher risk children.

OBJECTIVE: To evaluate the short and long term benefits of a school and home based physical activity "enrichment" program for children at higher risk of cardiovascular disease as identified by cluster analysis. STUDY DESIGN: During two 10-week school terms, 800 11-year-olds took part in a randomized controlled trial with the standard physical activity and nutrition program in six schools, the standard program in a further seven schools but with the addition of physical activity enrichment for higher risk children in those schools, and no program in five control schools. Cluster analysis identifying the 29% or so highest risk children used systolic blood pressure, percent body fat, physical fitness, and blood cholesterol. RESULTS: Fitness improved significantly in program schools, particularly with enrichment in higher risk boys. Substantial improvements persisted 6 months later in girls from program schools. At "Enrichment" schools, cholesterol showed significant benefits in higher risk girls and, 6 months later, in both boys and higher risk girls. Sodium intake and, in girls, subscapular skinfolds were lower in "Enrichment" schools when the program ended, but not 6 months later. CONCLUSION: Two-semester health programs with physical activity enrichment for higher risk children can produce benefits sustained for at least 6 months. Improvements extend to lower risk children exposed indirectly to the enrichment. Attenuation of effects on diet and body composition in the longer-term suggest the need for on-going programs.

Anthropometry↗
PubMed1980

A new direction for public health care: changing cafeteria eating habits.

A "Food for Thought" game, an eight-week, media-based nutrition program designed to influence food choices in a cafeteria setting, was conducted in a National Institutes of Health employee cafeteria. Its purpose was to encourage customers to select lower-caloric food during lunch. The effects of the program on food choices and total calories of food purchased each day were measured by time series analyses. During the eight-week intervention period, skim milk purchases increased, and dessert and bread sales, as well as average number of calories purchased per day per person, declined significantly. Some evidence for a maintenance effect over a ten-week follow-up period was obtained. The "Food for Thought" game delivered nutrition education in an upbeat but unobtrusive way. Although people patronize cafeterias to eat, socialize, and relax and not to be educated, this program had only minimal requirements for participation. The result was a high level of interest and involvement. People can "learn while they eat," if careful attention is paid to customer needs and principles of effective communication.

Diet↗