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PubMed2004

[Body composition analysis using bioelectrical and anthropometric parameters].

BACKGROUND: Interest in the study of body composition in childhood is increasing. Bioelectrical impedance analysis (BIA) is an accurate and reliable method. OBJECTIVES: To determine anthropometric parameters, fat-free body mass and fat body mass using BIA and anthropometry, and to establish their relationship. MATERIAL AND METHOD: A total of 365 healthy children (188 boys, 177 girls) aged 6.0 to 14.9 years were studied. Weight, height, arm circumference, skinfolds (bicipital, tricipital, subscapular and suprailiac) and bioelectrical parameters were measured. Body density was calculated from the four skinfold measurements using Brook's formula. Bioelectrical impedance was measured with a BIA-101 S (RJL Systems) using a fixed frequency (50 kHz). Fat-free body mass from BIA was calculated using Deurenberg's equation (FFM = 0.82 x height2/resistance). RESULTS: We present the mean, standard deviation and 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th percentiles of anthropometric variables and fat mass and fat-free mass estimated using BIA. Correlations were found between fat-free mass estimated using BIA and anthropometric variables. The reliability of BIA in estimating fat mass was assessed with intraclass correlation coefficients, which were excellent (0.948 in boys, and 0.945 in girls). CONCLUSIONS: BIA is an easy, low-cost, and highly reliable method, making it a useful technique for studying human body composition. This method shows excellent correlation with anthropometric variables.

Adolescent↗
PubMed2000

Stress fracture in military recruits: gender differences in muscle and bone susceptibility factors.

A total of 693 female U.S. Marine Corps recruits were studied with anthropometry and dual-energy X-ray absorptiometry (DXA) scans of the midthigh and distal third of the lower leg prior to a 12 week physical training program. In this group, 37 incident stress fracture cases were radiologically confirmed. Female data were compared with male data from an earlier study of 626 Marine recruits extended with additional cases for a total of 38 stress fracture cases. Using DXA data, bone structural geometry and cortical dimensions were derived at scan locations and muscle cross-sectional area was computed at the midthigh. Measurements were compared within gender between pooled fracture cases and controls after excluding subjects diagnosed with shin splints. In both genders, fracture cases were less physically fit, and had smaller thigh muscles compared with controls. After correction for height and weight, section moduli (Z) and bone strength indices (Z/bone length) of the femur and tibia were significantly smaller in fracture cases of both genders, but patterns differed. Female cases had thinner cortices and lower areal bone mineral density (BMD), whereas male cases had externally narrower bones but similar cortical thicknesses and areal BMDs compared with controls. In both genders, differences in fitness, muscle, and bone parameters suggest poor skeletal adaptation in fracture cases due to inadequate physical conditioning prior to training. To determine whether bone and muscle strength parameters differed between genders, all data were pooled and adjusted for height and weight. In both the tibia and femur, men had significantly larger section moduli and bone strength indices than women, although women had higher tibia but lower femur areal BMDs. Female bones, on average, were narrower and had thinner cortices (not significant in the femur, p = 0.07). Unlike the bone geometry differences, thigh muscle cross-sectional areas were virtually identical to those of the men, suggesting that the muscles of the women were not relatively weaker.

Absorptiometry, Photon↗
PubMed1996

Changing femoral geometry in growing girls: a cross-sectional DEXA study.

In elderly women, a long hip axis length has been shown to increase the risk of hip fracture. However, to date, few measurements of hip geometry have been reported in children and adolescents. The present cross-sectional dual-energy X-ray absorptiometry (DEXA) study of 200 girls aged 3-16 years was undertaken to determine at what age adult hip geometry is achieved and to examine possible influences of anthropometry and body composition on the development of femur axis length (FAL) and femur width (FW) during growth. Adult values for FAL and FW were achieved by age 15 years. Age, height, lean tissue mass, total body bone mineral content (BMC), weight, FW, neck of femur bone mineral density (BMD), and fat were each strongly associated with FAL (p < 0.001), the highest correlations being with age (r = 0.917) and height (r = 0.906). However, after adjusting for age and height, only lean tissue mass, weight, and fat mass remained significantly associated with FAL, suggesting that bone mineral accrual does not influence variance in FAL. Our results also suggested that fat mass and weight per se tended to have greater influence on FW than on FAL in age- and height-adjusted data. Twin studies indicate that 20% of adult hip axis length is associated with environmental factors. We therefore conclude that any environmental effects of physical activity or nutrition on hip geometry must occur before early teen-age years.

Absorptiometry, Photon↗
PubMed1997

Anthropometric characteristics of healthy Italian nonagenarians and centenarians.

Available anthropometric reference values for elderly people do not include specific norms for over-90-year-old subjects despite their increasing number. In the present study, weight, height and a number of anthropometric variables related to body muscle and fat mass were collected from fifty-seven nonagenarian and forty-one centenarian healthy, non-institutionalized subjects living in an Italian area. Recumbent anthropometry was used to avoid errors associated with impaired mobility. Nonagenarians and centenarian men were taller and heavier than women of corresponding age and had a greater amount of muscle and trunk fat, whereas women showed a marked peripheral adipose distribution. Anthropometric values of both age-groups were generally lower than published norms for 70-89-year-old American and European elderly people. However, differences were less marked when comparing Italian nonagenarians and centenarians with French and British people aged 85 years and over than when comparing Italian subjects with American octogenarians and younger European elderly people. Taken together these findings suggest a dramatic loss of muscle and fat mass in over-90-year-old subjects with respect to younger elderly people. However, changes between successive generations and geographical influences cannot be excluded. The need for local and age-specific norms in nutritional assessment of over-90-year-old people is emphasized. It is also suggested that current anthropometric indices may not be reliable when evaluating the oldest elderly subjects.

Aged↗
PubMed1998

Chronic energy deficiency in women from rural Bangladesh: some socioeconomic determinants.

This paper explores a number of socioeconomic factors thought to explain the wide prevalence of undernutrition among rural Bangladeshi women. The 1992 baseline survey data of the BRAC-ICDDR,B Joint Research Project at Matlab were used. Anthropometry was performed on a random sub-sample of 1462 currently married, non-pregnant women between 15 and 49 years of age. Women's nutritional status was defined in terms of Body Mass Index (BMI = wt in kg/ht in m2). Compared with women from better-off households, the mean weight (41.2 vs 43.0 kg; p < 0.0001), mid-upper arm circumference (MUAC) (22.1 vs 22.7; p < 0.0001), and BMI (18.5 vs 19.1; p < 0.0001) of poor women were consistently lower. However, no significant difference in mean height was found between the two groups. The results showed that women aged more than 35 years are twice as likely to have a BMI < 18.5 compared with younger women. Both years of schooling received and socioeconomic status are found to be important predictors of women's BMI. Women who have received one or more years of formal education are nearly half as likely to suffer chronic energy deficiency (BMI < 18.5) than women with no schooling. Again, better-off women are found to be 0.77 times less likely to have chronic energy deficiency than women from poor households. The implications of these findings in improving the nutritional status of rural Bangladeshi women are discussed.

Adolescent↗
PubMed1988

The relationship between body-image and body-fat in adult women.

Measures of body-fat or adiposity, body-image, and other psychological variables were obtained from a sample of 100 female volunteer subjects. The measures of adiposity included surface anthropometry, underwater weighing and a new electrical impedance method. Body-image measures were derived from two experimental techniques, namely the visual-size estimation (or calliper) method and a distorting-mirror, and also from a self-report body-satisfaction scale (BSS). The main findings were that measures of adiposity were positively and significantly related to each other. But, that by contrast, measures of body-image separated out into three distinct sets, namely: (i) 'mirror' accuracy, (2) 'callipers' accuracy, and (3) 'dissatisfaction/desire for change'. The 'accuracy' measures were found to be unrelated to measures of adiposity or other psychological variables: while the 'dissatisfaction' measures were found to relate to both of these. The implications of these findings for future studies of weight and eating disorder groups are discussed.

Adult↗
PubMed2003

The Atherosclerosis Risk in Young Adults (ARYA) study: rationale and design.

INTRODUCTION: Despite recent advances in treatment, cardiovascular disease (CVD) is still health problem number one in western societies. Aiming at specific prevention strategies for high-risk individuals and shifting the available prevention programs towards younger age groups might increase the success of primary prevention. However, before addressing age-specific prevention programs, more insight in the determinants of early vascular damage and increased cardiovascular risk is warranted as well as insight in determinants increased cardiovascular risk, including vascular damage, at an early age. The Atherosclerosis Risk in Young Adults (ARYA) study was specifically designed to address this issue. OBJECTIVES: The ARYA study started off with studies evaluating (1) whether it is possible to predict cardiovascular risk at young adulthood by routinely measured adolescent data, and (2) evaluating the role of birth characteristics and adolescent characteristics to the development of vascular damage at young adulthood. METHODS: The ARYA study comprises of two cohorts of young adults. The Utrecht cohort includes 750 young adults, aged 27-30 years. The Hague-cohort includes 261 young adults born between 1963 and 1968. Data on birth characteristics, growth in early infancy as well as adolescent anthropometry, blood pressure, lipids, body mass index were obtained from the original medical records of the Municipal Health Service. In 1999/2001, the extent of subclinical vascular damage was measured using carotid wall thickness and aortic stiffness. Also, data on adult cardiovascular risk profile, bone density and central blood pressure were assessed, fasting blood was drawn and timed overnight urine samples were collected. CONCLUSION: The ARYA study is aimed to provide data on early determinants of cardiovascular risk, including vascular damage, at an early age. This knowledge enhances the understanding of atherosclerosis development and CVD risk and is needed to improve the available primary prevention programs.

Adolescent↗
PubMed2005

Coexistence of osteoporosis and cardiovascular disease risk factors in apparently healthy, untreated postmenopausal women.

This study aimed to determine whether apparently healthy, untreated postmenopausal women at risk of osteoporosis relative to nonmenopausal women are concomitantly at risk of cardiovascular disease (CVD) in terms of various aspects of lifestyle, personality, body shape and composition, and blood chemistry. Two homogeneous groups of 30 women having reached menopause for 3-5 years and 30 nonmenopausal controls, all non-estrogen users without apparent CVD risk factors, were compared in a cross-sectional design. Data related to physical activity, dietary intakes, personality type, anthropometry, and skinfold-thickness were collected. Plasma insulin-like growth factor (IGF-1) and serum lipids were measured and used as biochemical predictors of osteoporosis and CVD, respectively. Compared to nonmenopausal controls, postmenopausal women were at greater risk of bone loss given their lower plasma IGF-1, lower physical activity level, and even given their higher serum lipids, as recent literature suggests. Moreover, their dietary calcium intake fulfilled only 70% of the current recommendation, which may reduce protection against osteoporosis and CVD (particularly hypertension) as well. The two groups did not differ regarding energy intake, body weight and frame size, body mass index (BMI), waist circumference, and waist-hip ratio (WHR). However, postmenopausal subjects had more adipose tissue and differed in terms of lifestyle factors (lower dietary lipids and greater alcohol consumption). While neither group was at particular risk of CVD according to waist circumference, WHR, and serum triglycerides, postmenopausal women were at risk according to percent body adiposity and serum cholesterol. This study shows that several risk factors for osteoporosis and CVD can coexist in apparently healthy postmenopausal women after a few years of natural menopause. It emphasizes the need for a timely screening that would stress both heart and bone risk factors.

Adipose Tissue↗
PubMed2001

Genetic variation and obesity in Australian women: a prospective study.

OBJECTIVE: A number of candidate genes have been implicated in the pathogenesis of obesity in humans. This study examines associations between longitudinal changes in body mass and composition and the presence of polymorphisms in the beta-3 adrenergic receptor, tumor necrosis factor-alpha, leptin, and leptin receptor (Lepr) in a cohort of Australian women. RESEARCH METHODS AND PROCEDURES: Healthy white Australian women (n = 335) were randomly selected from the Barwon region of Victoria and underwent baseline anthropometry and double-energy X-ray absorptiometry for assessment of body mass and adiposity. These measurements were repeated again at 2-year follow-up. Genomic DNA was extracted and used for polymerase chain reaction-based genotyping of all polymorphisms. RESULTS: The Pro1019Pro Lepr polymorphism was associated with longitudinal increases in body weight (p = 0.02), fat mass (p = 0.05), and body mass index (p = 0.01) in this study, and individuals homozygous for the A allele at this locus had a greater propensity to gain body fat over time. The largest effects on body composition seemed to be in individuals already obese at baseline. Changes in body weight, fat mass, percent body fat, and body mass index over a 2-year period were not associated with genetic variation in the beta-3 adrenergic receptor (Trp64Arg), tumor necrosis factor-alpha promoter, or leptin genes in non-obese or obese women. DISCUSSION: These results suggest that a Lepr polymorphism is involved in the regulation of body mass and adiposity in obese Australian white women, which may have implications for the treatment of obesity in this population.

Absorptiometry, Photon↗
PubMed1998

Muscle strength and functional mobility in relation to lean body mass in free-living frail elderly women.

OBJECTIVES: (1) To describe body composition of the frail elderly, (2) To relate lean body mass to muscle strength and functional ability, and (3) To assess temporal stability of strength measures and index of functional ability. DESIGN: Cross-sectional study. SETTING: Community-dwelling. SUBJECTS: Thirty frail elderly women (81.5 +/- 7 y) recruited from residences or out-patient facilities. METHODS: Total body fat and fat-free mass (FFM) were determined using multi-frequency bioelectrical impedance analysis and predicted from anthropometry. Handgrip strength, biceps and quadriceps strength, functional capacities (Timed 'Up & Go') as well as self-perceived health and functional status were measured. Reliability was assessed using two separate observations made one week apart by the same examiner. RESULTS: Mean height, weight and body mass index were 1.52 +/- 0.04 m, 60.4 +/- 10.7 kg and 26.0 +/- 4.8 kg/m2 respectively. FFM (34.1 +/- 4.6 kg) was lower than previous reports for autonomous elderly females and associated with all measures of muscle strength (Pearson's r = 0.42-0.62, P < or = 0.02), but not with performance on the Timed 'Up & Go' or self-perceived health and functional status. Strength measures correlated significantly with different subscales of self-perceived functional capacities and were significantly lower among women with a low %FFM (n = 19) and those reporting pain (n = 11) as compared to other women. Excellent temporal stability for muscle and functional measures was observed (ICC = 0.80-0.90). CONCLUSIONS: Muscle strength was strongly related to FFM in free-living frail elderly women especially in the absence of pain.

Adipose Tissue↗
PubMed1999

Nutritional status of adult inpatients in Bujumbura, Burundi (impact of HIV infection).

OBJECTIVE: To determine the prevalence and analyse the characteristics and causes of malnutrition among inpatients in an HIV highly endemic area. DESIGN: Prospective cross-sectional study. SETTING: Department of Internal Medicine, University Hospital, Bujumbura, Burundi. SUBJECTS: 226 adult inpatients. MAIN OUTCOMES MEASURES: Evaluation of nutritional status using anthropometry. Degree of malnutrition defined by the percentage of body weight loss (BWL), calculated by reference to the usual body weight. RESULTS: Among the 226 patients recruited (mean age: 34.4 +/- 11.9 y, M:F sex ratio: 1.72), 102 (45.1%) were HIV seropositive. 62 (60.8%) of these HIV seropositive were AIDS cases. The AIDS defining criterion was 'wasting syndrome' for 25 (40.3%) and opportunistic infection (OI) for 37 (59.7%) including 34 cases of tuberculosis (TB). The nutritional status of 119/226 patients (52.7%) was normal (BWL < or = 10%). Moderate malnutrition (10% < or = BWL < or = 20%) was observed in 47 (20.8%) and severe malnutrition (BWL > 20%) was observed in 60 (26.5%). HIV seroprevalence and, among HIV seropositive subjects, the percentage of AIDS cases increased according to decreasing level of nutrition (Chi2 for trends: P < 0.001 in both instances). The fat free mass mass of malnourished subjects was lower and the fat body mass was higher among HIV seropositive subjects than HIV seronegative subjects. Among HIV seropositive subjects, malnutrition was associated with TB (P < 0.001) and dysphagia (P < 0.05). Among HIV seronegative subjects, malnutrition was associated with decreased food availability (P < 0.003) and TB (P < 0.05). One week after admission, the mortality rate was higher among HIV seropositive subjects (10.8%) than seronegative subjects (2.4%, P=0.009). Other factors associated with death were decreased fat free mass (P < 0.01) and tricipital skinfold thickness (P < 0.04). CONCLUSIONS: The prevalence of malnutrition is high among the inpatients investigated. Main factors are HIV infection and TB. Strategies adapted to the African context should be developed to prevent, detect and treat malnutrition and associated factors, particularly among HIV seropositive subjects.

AIDS-Related Opportunistic Infections↗
PubMed2000

Effects of an energy and micronutrient supplement on growth and development in undernourished children in Indonesia: methods.

OBJECTIVES: To describe the methodologies of a clinical trial on the effects of an energy and micronutrient supplement on the growth and development of undernourished children. DESIGN: This trial included two cohorts of children classified as nutritionally-at-risk who were randomly assigned to three treatments (condensed milk + micronutrients (E); skimmed milk + micronutrients (M); skimmed milk (S)). Supplements were given for a period up to 12 months. SETTING: Six tea plantations in Pangalengan, West Java were the site for this study. SUBJECTS: A 12-month-old (N=53) and an 18-month-old (N=83) cohort were recruited from 24 day-care-centers (DCC). Twenty children that received the S supplement were part of the 12- and 18 month-old cohort. Criteria for case inclusion were absence of chronic disease; length-for-age < or = -1 standard deviation (s.d.) and weight-for-length between -1 and -2 s.d. of the median of the reference of the World Health Organization. VARIABLES: Social variables included assessment of health facilities, childcare, housing, income and parental education. Nutrition and growth variables included dietary intake measured over a 24 hr period every 2 months; hemoglobin and three iron indicators measured at baseline, 6 and 12 months; anthropometry measured every 2 months and skeletal maturation measured every 6 months. Cognition and behavior included the assessment of mental and motor development and the behavior of the child under natural conditions. DATA ANALYSIS: An ANOVA was the statistic most frequently used to test inter-group differences and structural equation modeling was used to test the internal validity of the conceptual model of the study.

Analysis of Variance↗
PubMed2000

Effects of an energy and micronutrient supplement on growth and activity, correcting for non-supplemental sources of energy input in undernourished children in Indonesia.

OBJECTIVES: This paper investigates simultaneously the growth and activity of children that received an early energy and micronutrient supplement, adjusting for all non-supplemental energy intakes. Any additional change in growth and activity after this adjustment was then compared across supplements at three points felt to be representative of the study. DESIGN: Two cohorts of children were randomly assigned to three treatments: E = 1171 kJ + 12 mg iron; M = 209 kJ + 12 mg iron; S = 104 kJ. Supplementation was given for 12 months. SETTING: The sites were six tea plantations in Pangalengan, West Java. SUBJECTS: A 12-month-old (n = 53) and an 18-month-old (n = 83) cohort were recruited from day-care-centers. Twenty children that received S belonged to the 12- and 18-month-old cohorts. Inclusion criteria were: no chronic disease; length-for-age < or = -1 standard deviation (s.d.) and weight-for-length between -1 and -2 s.d. of the median of the reference of the World Health Organization. METHODS: Length was measured with a portable measuring board; a Detecto scale with an accuracy of 0.1 kg was used for the measurement of body weight. Arm and head circumferences were measured using similar fiberglass tapes. Motor activity was assessed through continuous 4 h observations at home and at day care centers. Anthropometry and activity were measured every two months over 12 months. RESULTS: After correcting for non-supplemental sources of energy intake, the effects of the supplement on weight and activity were observed at 2 months; effects on length and activity were observed at 6 months; and effects on weight alone were observed at 12 months.

Anthropometry↗
PubMed2000

The use of the Mini-Nutritional Assessment (MNA) tool in elderly orthopaedic patients.

OBJECTIVE: To assess the use of the Mini-Nutritional Assessment (MNA) in elderly orthopaedic patients. DESIGN: An observation study assessing the nutritional status of female orthopaedic patients. SETTING: The orthopaedic wards of the Royal Surrey County Hospital. SUBJECTS: Forty-nine female patients aged 60-103 y; dietary records were obtained for 41 subjects and 36 subjects gave a blood sample for biochemical analysis. MAJOR OUTCOME METHODS: MNA questionnaire, anthropometry, plasma albumin, transferrin, C-reactive protein (CRP) levels and dietary analyses. RESULTS: The group as a whole had low mean values for body weight, albumin and transferrin and high CRP levels. In addition, the group had mean energy intakes well below the estimated average requirement (EAR) and mean intakes of vitamin D, magnesium, potassium, selenium and non-starch polysaccharides (NSP) were below the lower reference nutrient intakes (LRNI). The MNA screening section categorized 69% of the patients as requiring a full assessment (scored 11 or below), but for the purposes of the study the MNA was completed on all patients. The MNA assessment categorized 16% of the group as 'malnourished' (scored<17 points), 47% as 'at risk' (scored 17.5-23.5) and 37% as 'well nourished' (scored>23.5). Significant differences were found between the malnourished and well nourished groups for body weight (P<0.001), body mass index (BMI) (P<0.001), demiquet (P<0.001) and mindex (P<0. 001). Mean values for energy and nutrient intakes showed a clear stepwise increase across the three groups for all nutrients except sodium, with significant differences for protein (P<0.05), carbohydrate (P<0.05), riboflavin (P<0.05) niacin (P<0.05), pyridoxine (P<0.05), folate (P<0.05), calcium (P<0.05), selenium (P<0.05), iron (P<0.05) and NSP (P<0.05) intakes. Stepwise multiple regression analysis indicated that anthropometric assessments were the most predictive factors in the total MNA score. The sensitivity and specificity of the MNA was assessed in comparison with albumin levels, energy intake and mindex. The sensitivity of the MNA classification of those scoring less than 17 points in comparison with albumin levels, energy intake and mindex varied from 27 to 57% and the specificity was 66-100%. This was compared with the sensitivity and specificity of using a score of less than 23.5 on the MNA to predict malnourished individuals. Using this cut-off the sensitivity ranged from 75 to 100%, but the specificity declined to between 37 and 50%. CONCLUSIONS: The results suggest that the MNA is a useful diagnostic tool in the identification of elderly patients at risk from malnutrition and those who are malnourished in this hospital setting. SPONSORSHIP: Nestlé Clinical Nutrition, Croydon, Surrey.

Aged↗
PubMed2000

Early linear growth retardation and later blood pressure.

OBJECTIVE: To examine the effects of stunting in early childhood on blood pressure in later childhood. DESIGN: A cohort study. SETTING: Kingston, Jamaica. SUBJECTS: Seven to eight year old children, 120 stunted (height for age <-2 s.d. of the NCHS references) and 224 non-stunted (height for age >-1 s.d. of the NCHS references) at age 9-24 months. METHODS: Stunted and non-stunted children were identified at age 9-24 months by house to-house survey of poor neighbourhoods in Kingston, Jamaica. Blood pressure and anthropometry were measured at age 7-8 y. Birth weight was obtained from hospital records (73%) or maternal recall. RESULTS: The stunted children remained shorter and thinner than the non-stunted ones. In multiple regression analysis adjusting for size and pulse rate, the stunted children had higher systolic blood pressure (P<0.05). Birth weight was not a significant predictor of systolic blood pressure. CONCLUSION: Stunting in early childhood may increase the risk of elevated systolic blood pressure in later life. SPONSORSHIP: Nutricia Research Foundation, The Netherlands and the Commonwealth Caribbean Medical Research Council.

Anthropometry↗
PubMed2000

The effect of leprosy-induced deformity on the nutritional status of index cases and their household members in rural South India: a socio-economic perspective.

OBJECTIVES: To determine whether the socioeconomic and nutritional status of cured leprosy patients with residual deformity, and their household members, was lower than that of cured leprosy patients without deformity. DESIGN: Cross-sectional study. SUBJECTS: One hundred and fifty-five index cases with deformity, 100 without deformity. Also 616 household members comprising 48% of the total members enumerated. MEASUREMENTS: Nutritional status was evaluated using anthropometry. Disease characteristics, socio-economic parameters and household information were recorded using a questionnaire. RESULTS: Index cases with deformity had lower community acceptance (P<0.001), and employment (P<0.001) than those cases without deformity. Households of index cases with deformity had a lower income (P<0.01) and a lower expenditure on food (P<0.05). The presence of deformity (odds ratio (OR): 2.1-3.2, P<0.01), unemployment (OR: 2.3-4.3, P<0.01) and female gender (OR: 2.4, P<0. 01) significantly increased the risk of index cases being undernourished, as judged by body mass index (BMI) alone, or BMI and mid-upper arm circumference. A low BMI (<18.5) in the index case significantly increased the odds of other adults (OR 2.2), adolescents (OR 2.9-3.8) and children (OR 2.2) in the household being undernourished. CONCLUSIONS: Cured leprosy index cases with physical deformity are more undernourished than index cases without deformity. This is associated with a reduced expenditure on food, possibly brought on by increased unemployment, and a loss of income. Undernutrition in the index case increases the risk of undernutrition in other members of the family. European Journal of Clinical Nutrition (2000) 54, 643-649.

Adolescent↗
PubMed2000

Nutrient intake of adult women in Jilin Province, China, with special reference to urban-rural differences in nutrition in the Chinese continent.

OBJECTIVES: The objectives of this study were to investigate possible urban-rural differences in food intakes in Jilin province and in continental China as a whole, and to examine possible implications for nutritional status of urban and rural populations. DESIGN: Cross-sectional study. SETTING: Communities. SUBJECTS: In total, 499 adult women in six urban sites and four rural sites, 10 sites in total, including two sites in Jilin province. METHODS: A pair of surveys were conducted in September, 1999, in the provincial capital of Changchun and a farming village in Dehui county, both in Jilin province, in northeast China. Each of 50 adult women per survey site provided a 24 h duplicate food sample and a blood sample, and had an interview on health history including anthropometry and blood pressure measurement. Nutrient intakes were estimated from the food duplicates, using national food composition tables. Results from the two sites were supplemented with data from eight sites where surveys had been conducted following the same protocol, and the pooled material were subjected to analyses for possible urban-rural differences. RESULTS: The Jilin participants consumed daily, on average, about 1600 kcal energy, 44 g protein, and 60 g lipid with a lipid energy ratio (i.e. the ratio of lipid over total nutrients in terms of energy) of 33%. When nutrient intakes were compared between the urban (i.e. Changchun) and rural (Dehui) groups, urban women consumed more energy, protein (especially animal protein) and lipid than rural women. Similar examination of data from six urban and four rural sites, including the present two, showed that adult women in urban areas eat more animal protein and animal fat than their counterparts in villages, and suggested that the observation on urban rural difference in Jilin province can be extrapolated to a nationwide scale. CONCLUSIONS: Urban rural differences in nutrient intakes still persist in 1999 not only in Jilin but in other provinces, typically in the terms of intakes of animal-based foods.

Adult↗
PubMed2002

Energy intake and expenditure of free-living, lactating Colombian women in an urban setting.

OBJECTIVES: To examine the components of energy balance during lactation in a population of economically disadvantaged women in an urban developing country setting in order to better understand the metabolic response to lactation. DESIGN: Cross-sectional comparison of lactating (LACT) and non-pregnant non-lactating (NPNL) women. Body size and composition were assessed via anthropometry, energy intake was measured using estimated diet records and energy expenditure using indirect calorimetry and the Flex-Heart Rate method. SETTING: Low-income neighborhoods of Cali, Colombia. SUBJECTS: Lactating women (n=15) studied at 2.4+/-0.8, 5.5+/-0.8 and 8.9+/-1.2 months postpartum, and NPNL women (n=48) studied in three measurement rounds at 0, 3.5+/-0.6 and 7.1+/-1.0 months. RESULTS: There were no significant differences between LACT and NPNL women in anthropometric dimensions, but LACT women showed decreases in waist-hip ratio, lean body mass and increases in mid-arm circumference and percentage body fat with time. Energy intake was higher in LACT women (P=0.04), but there were no significant between-group differences in energy expenditure variables. CONCLUSION: This group of women met the cost of lactation principally via increased energy intake.

Adult↗