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The prevalence of soil-transmitted helminthic infection, living conditions, and practices relating to personal hygiene were studied in schoolgirls (age 14-18 years) in both an urban area (n = 383) and a rural area (n = 231) of Sri Lanka. The impact of helminthic infection on nutritional status was also studied. The prevalence of Ascaris and Trichuris infection was significantly higher (p < 0.00001) in the urban area than in the rural area and this was associated with poor living conditions and personal hygiene. In contrast, the prevalence of hookworm infection was similar in the two areas. Less than 3 per cent of subjects had moderate or heavy infection. Trichuriasis was the commonest helminthic infection and was associated with significantly lower serum vitamin A concentrations than in uninfected subjects. There was no significant difference in body mass index or haemoglobin concentration between infected and uninfected subjects. Our results show that even mild infection with Trichuris had adverse effects on vitamin A status.

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Serum lipid profiles, anthropometric parameters, dietary habits and smoking practice were determined in 637 adolescent school boys in the 10th to 13th year of school (mean age 16.7 ± 1.3 years), to determine the prevalence of risk factors for cardiovascular disease in later life. They all attended schools in Colombo, the capital city (n=416), and two other cities, Negombo and Kurunegala. Seven percent of the subjects had body mass index (BMI) values above a reference range (for age 14-16, > 23.5 kg/m2; older than 16 years > 24.5 kg/m2). The mean serum total cholesterol concentration was within the reference range (158.9± 27.2 mg/dL: 4.11± 0.70 mmol/L), but 16.5% had values >185 mg/dL. The percentages of subjects with high LDL (low density lipoprotein)cholesterol (>110 mg/dL) and apolipoprotein B (>85 mg/dL) concentrations were 21.9 % and 23.0% respectively, while low HDL (high density lipoprotein) cholesterol (<35 mg/dL) levels were noted in 27.3% of subjects. A significant (p<0.001) positive association was noted between serum total cholesterol concentration and BMI. There was no significant difference in the mean BMI or total cholesterol levels of subjects from the three areas in the age group 15-16.9 years. However, in the age group 17-18.9 years, subjects in the Kurunegala area had a lower prevalence of risk factors ie. significantly lower BMI and serum total cholesterol and apolipoprotein B concentrations than those in other areas. Overall, smoking prevalence was 4.5%, and higher in Colombo than in Negombo and Kurunegala. Further, the mean intake of cholesterol was significantly lower and the fibre intake was higher among subjects in Kurunegala, than those in other areas. Thirty two percent of subjects had a family history of coronary artery disease, hypertension or diabetes and these subjects had significantly higher BMI values than those who did not have a family history of the above diseases, but their lipid patterns were similar. Thus high BMI was a major factor leading to hypercholesterolaemi.

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Iron, zinc and vitamin A status was assessed in 309 plantation workers during pregnancy and in a sub-sample of 108 subjects at 20 to 36 weeks postpartum and the birth weights of their newborn were noted. A significant positive correlation was noted between haemoglobin concentration at 10-26 weeks of gestation of anaemic mothers (n = 180) and birth weights of their new born. Depleted iron stores (serum ferritin < 12 micrograms/l) were noted in 33.3% of subjects at 10-26 weeks of gestation. There was no significant change in serum ferritin concentration at > 32 weeks of gestation. Iron deficiency persisted at 20-36 weeks postpartum. Marginal vitamin A deficiency was also noted, as, 46.2% and 15.6% of the subjects respectively, had low serum vitamin A levels in pregnancy and postpartum. Low serum zinc levels were noted only in pregnancy. Iron supplementation during pregnancy was only effective in preventing further deterioration in iron status and it should be continued for about 12 weeks after delivery.

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Intervention measures against anemia available to plantation workers during pregnancy include fortified food supplements (thriposha) and iron-folate supplements containing 60 mg elemental Fe. The effectiveness of these intervention measures was studied in 195 subjects whose iron and nutritional status were assessed at < 24 and > 32 wk of gestation. Taking thriposha conferred no significant benefit on maternal nutritional status, probably because sufficient amounts were not consumed. An increase in the duration of iron-folate supplementation to > 17 wk caused a significant positive change (P < 0.01) in hemoglobin, whereas an increase in the dose frequency had no significant benefit. Anthelminthic therapy in addition to iron-folate supplements caused a significant positive change in hemoglobin (P < 0.001) and serum ferritin (P < 0.005) compared with no supplementation. Thus, anthelminthic therapy significantly increased the beneficial effects of iron supplementation on hemoglobin concentration and iron status.

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Vitamin A status was assessed in early and late stages of pregnancy in 496 pregnant women living in Colombo, Kurunegala, Kegalle, Badulla and Galle districts, using clinical, dietary and biochemical parameters. Serum vitamin A concentration was determined by a fluorometric method and the retinol binding protein concentration by radial immunodiffusion. The serum vitamin A levels of subjects in the lowest socioeconomic group in Galle and Kegalle districts were significantly lower than those living in Colombo. The percentage of subjects having serum vitamin A levels less than 20 micrograms/dl, increased in late pregnancy in all areas, with the highest value (27.8%) in the Galle district. None of the subjects had severe ocular manifestations of vitamin A deficiency. The higher incidence of subclinical vitamin A deficiency noted among subjects in Galle and Kegalle districts could be attributed at least in part to a low dietary intake of vitamin A and carotenoids.

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Lipid patterns were determined in 167 healthy subjects in the age group 28 to 50 years living in an urban area, a suburban area and two rural areas to determine a possible relationship between their serum lipid patterns and food habits. Total cholesterol, high density lipoprotein (HDL)-cholesterol, and triglyceride concentrations were determined in the sera of fasting subjects, and low density lipoprotein (LDL)-cholesterol concentration was calculated. Risk of coronary heart disease as assessed by the body mass index, ratios of total cholesterol to HDL-cholesterol, and LDL-cholesterol to HDL-cholesterol, was significantly lower in subjects in rural area 2, who were agricultural workers with a high degree of physical activity, subsisting on a diet consisting mainly of plant food, despite a higher consumption of coconut, a saturated fat. It is possible that the hypercholesterolaemic effect of saturated fats was mitigated by the high fibre content of their diets.

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Ninety-three females in the age group 14-18 years were randomly selected from three schools in Colombo. Their iron and nutritional status was assessed using clinical, anthropometric, haematological, and biochemical parameters. Haemoglobin levels less than 12 g/dl were seen in 3.7 per cent of adolescent females. Free erythrocyte protoporphyrin levels greater than 70 micrograms/dl and serum percentage transferrin saturation values less than 16 per cent indicate iron deficiency and were seen in 10 per cent and 14 per cent of the subjects, respectively. Serum ferritin levels less than 12 micrograms/l indicate depleted iron stores and were seen in 59 per cent of the subjects studied. Our results suggest that although overt anaemia was not common among the subjects studied, a large number of subjects belonging to the lower socio-economic groups were in the early stages of iron deficiency and had depleted iron stores. These subjects are, therefore, at risk of developing clinical manifestations of iron deficiency when the demand for iron is increased, as in pregnancy.

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Zinc and vitamin A concentrations in the serum were measured in 40 alcoholics (33 males and 7 females) and 35 healthy, age-matched subjects (31 males, 4 females). Liver zinc concentrations were measured in 15 alcoholics from specimens collected by liver biopsy and compared with the zinc concentrations in liver specimens taken at autopsy from victims of road-traffic accidents. Alcoholics had significantly lower serum concentrations of both zinc and vitamin A compared to the control group of healthy subjects. The depression of zinc and vitamin A levels was related to the severity of the hepatic lesions, the lowest levels being observed among cirrhotics. Liver zinc concentrations were similar in alcoholics and healthy subjects and were not related to plasma zinc concentrations. Serum zinc and vitamin A levels were positively correlated among cirrhotics, but not in other alcoholics or controls. Thus low levels of vitamin A in cirrhotics may have arisen as a result of impaired mobilisation from the liver due to zinc deficiency, or to non-availability of hepatic zinc. Female alcoholics were more severely affected than males with respect to their zinc and vitamin A levels, although they consumed lesser amounts of alcohol and had a shorter duration of alcohol intake. A strong positive relationship existed between zinc and albumin levels in all alcoholics but not in controls. It is possible that the decreased serum albumin levels may have limited the availability of albumin for the transport of zinc in the plasma and this in turn may have resulted in increased urinary excretion of zinc.(ABSTRACT TRUNCATED AT 250 WORDS)

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The nutritional status of 14 patients with metastatic testicular teratomas was measured longitudinally through four courses of treatment with vinblastine and bleomycin, or vinblastine, bleomycin and cis platinum regimens. On each regimen patients lost weight during each course and did not entirely regain it between courses. The nutritional status with respect to retinol and vitamins E, B1 and B6 also fell during each course. The fall in plasma retinol levels was correlated with a fall in the plasma level of retinol-binding protein (RBP). In patients treated with the vinblastine and bleomycin regimen, plasma retinol levels were higher at the beginning of the fourth course than at the start of the treatment, possibly due to improved synthesis of RBP. In contrast, there was no overall improvement in B1 status.

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The administration of large doses of corticosterone to normal adult male rats resulted in a rapid loss of vitamin A from the plasma, liver, adrenals and thymus. Of the organs studied, the thymus appeared to be the most sensitive to treatment. The steroid-mediated depression of plasma and tissue contents of vitamin A was reversed when animals were treated with corticosterone in combination with vitamin A.

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