RESUMEN
Age-stratified path analyses modeled associations between enteric pathogen reservoirs, transmission pathways and height-for-age z-scores (HAZ) to identify determinants of childhood growth in the Kolkata, India site of the Global Enteric Multicenter Study (GEMS). Models tested direct associations of potential pathogen reservoirs with HAZ at 60-day follow-up in separate moderate and severe diarrhea (MSD) case and control cohorts or indirectly when mediated by enteric infections. In the MSD cohort, rotavirus and typical EPEC (tEPEC) infections among children 0-11 months of age and ST-ETEC infections among children 12-23 months of age were associated with lower HAZ. Handwashing after defecating and before cooking reduced impaired growth through reductions in rotavirus and tEPEC infections. Water storage increased rotavirus and ST-ETEC infection risks, resulting in increased impaired growth, but was reduced with reported child feces disposal. The GII norovirus variant was inversely associated with HAZ among children 12-59 months of age in the control cohort. Reported handwashing before the handling of children reduced GII infections and impaired growth. Boiling water and the disposal of children's feces mediated by stored water were positively associated with HAZ. The targeting of pathogen-specific reservoirs and transmission pathways may more effectively improve childhood linear growth in South Asian urban communities.
Asunto(s)
Diarrea , Humanos , India/epidemiología , Lactante , Masculino , Preescolar , Femenino , Diarrea/virología , Diarrea/epidemiología , Recién Nacido , Trastornos del Crecimiento/epidemiología , Trastornos del Crecimiento/virología , Estatura , Estudios de Casos y Controles , Infecciones por Rotavirus/transmisión , Infecciones por Rotavirus/prevención & control , Infecciones por Rotavirus/epidemiología , Heces/virología , Heces/microbiología , Desinfección de las Manos , Rotavirus/aislamiento & purificación , Reservorios de Enfermedades/virologíaRESUMEN
OBJECTIVE: To provide a comprehensive synthesis of the effects of Zn supplementation on childhood body composition and adiposity-related hormone levels. DESIGN: Five electronic databases were searched for randomized controlled trials of Zn supplementation studies published before 28 February 2015. No statistical pooling of results was carried out due to diversity in study designs. SETTING: Community- or hospital-based, from fourteen developing and developed countries. SUBJECTS: Children and adolescents aged 0 to 10 years. RESULTS: Seven of the fourteen studies reported an overall or subgroup effect of Zn supplementation on at least one parameter of body composition, when determined by anthropometric measurements (increased mid upper-arm circumference, triceps skinfold, subscapular skinfold and mid upper-arm muscle area, and decreased BMI). Three out of the fourteen studies reported increased mean value of total body water estimated by bio-impedance analysis and increased fat-free mass estimated by dual energy X-ray absorptiometry and by total body water. Zn supplementation was associated with increased fat-free mass among stunted children. One study found supplementation decreased leptin and insulin concentrations. CONCLUSIONS: Due to the use of anthropometry when determining body composition, a majority of the studies could not accurately address whether alterations in the fat and/or fat-free mass components of the body were responsible for the observed changes in body composition. The effect of Zn supplementation on body composition is not consistent but may modify fat-free mass among children with pre-existing growth failure.
Asunto(s)
Adiposidad , Composición Corporal , Suplementos Dietéticos , Hormonas Peptídicas/sangre , Zinc/administración & dosificación , Antropometría , Índice de Masa Corporal , Niño , Preescolar , Humanos , Lactante , Obesidad , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
BACKGROUND: Micronutrient status may be a contributing factor to the development of childhood obesity in many industrializing countries passing the nutritional transition. The few studies investigating associations between serum concentrations of vitamin B and intake of B vitamins with adiposity, however, have reported inconsistent findings. OBJECTIVE: The aim of the study was to examine associations between serum vitamin B-12 and folate concentrations and intakes of B vitamins with body fat by using data on 1131 Mexican American children 8-15 y of age included in NHANES 2001-2004. METHODS: Children's body mass index (BMI), trunk fat mass (TrFM), and total body fat mass (TBFM) were used as body adiposity (BA) measures. Serum concentrations of folate and vitamin B-12 were measured in blood samples collected from children. Intake of B vitamins was collected according to 24-h dietary recall. Associations of BA with serum concentrations of vitamin B-12 and folate and intake of B vitamins were determined by using linear and multinomial regression models. RESULTS: Serum concentrations of vitamin B-12 and folate were inversely associated with BMI (ß: -2.68, P < 0.01; ß = -1.33, P < 0.01), TrFM (ß:-3.32, P < 0.01; ß: -0.14, P < 0.05), and TBFM (ß:-1.93, P < 0.01; ß: -3.19; P < 0.01). Higher serum concentrations of vitamin B-12 were associated with a reduced risk of obesity (OR: 0.48; 95% CI: 0.31, 0.77; P < 0.001). Thiamin and riboflavin intakes were inversely associated with BMI (ß:-1.35, P < 0.05; ß: -1.11, P < 0.05) and TrFM (ß:-1.26, P < 0.05; ß: -1.37, P < 0.05). CONCLUSION: Similar inverse associations between BA and status of both vitamin B-12 and folate and intake of thiamin and riboflavin suggest that these micronutrients may play a role in adipogenesis and risk of childhood obesity.
Asunto(s)
Adiposidad , Ácido Fólico/sangre , Americanos Mexicanos , Riboflavina/sangre , Tiamina/sangre , Vitamina B 12/sangre , Adolescente , Índice de Masa Corporal , Niño , Estudios Transversales , Femenino , Ácido Fólico/administración & dosificación , Deficiencia de Ácido Fólico/sangre , Deficiencia de Ácido Fólico/epidemiología , Humanos , Modelos Lineales , Masculino , Recuerdo Mental , Micronutrientes/administración & dosificación , Micronutrientes/sangre , Micronutrientes/deficiencia , Análisis Multivariante , Encuestas Nutricionales , Obesidad Infantil/sangre , Obesidad Infantil/epidemiología , Riboflavina/administración & dosificación , Deficiencia de Riboflavina/sangre , Deficiencia de Riboflavina/epidemiología , Tiamina/administración & dosificación , Deficiencia de Tiamina/sangre , Deficiencia de Tiamina/epidemiología , Vitamina B 12/administración & dosificación , Deficiencia de Vitamina B 12/sangre , Deficiencia de Vitamina B 12/epidemiologíaRESUMEN
Mexican-American children have a high prevalence of overweight/obesity. Micronutrient deficiencies may be contributing to the development of greater adiposity in these children. This study investigated the relations between adiposity and serum concentrations of carotenoids, retinol, and vitamin E among Mexican-American children 8-15 y of age included in the 2001-2004 U.S. NHANES. Associations of the outcomes of children's body mass index (BMI), truncal fat mass (TrFM), and total body fat mass (TBFM) with serum concentrations of α-carotene, cis-ß-carotene, trans-ß-carotene, retinol, and α-tocopherol were determined by using linear, quantile, and multinomial regression models. BMI was inversely associated with serum concentrations of α-carotene (ß = -0.88, P < 0.05), trans-ß-carotene (ß = -2.21, P < 0.01), cis-ß-carotene (ß = -2.10, P < 0.01), and α-tocopherol adjusted for total cholesterol ratio (ß = -3.66, P < 0.01), respectively. Similar inverse associations were found with TrFM and TBFM. Higher cis-ß-carotene and α-tocopherol serum concentrations were associated with reduced probability of overweight (OR: 0.57; 95% CI: 0.37, 0.89; P < 0.05; and OR: 0.56; 95% CI: 0.37, 0.86; P < 0.05; respectively) and obesity (OR: 0.39; 95% CI: 0.26, 0.58; P < 0.01; and OR: 0.38; 95% CI: 0.24, 0.60; P < 0.01; respectively). Higher retinol serum concentrations were associated with increased probability of overweight and obesity (OR: 2.01; 95% CI: 1.26, 3.22; P < 0.01; and OR: 2.90; 95% CI: 1.65, 5.09; P < 0.01; respectively). Significant inverse associations were found between serum concentrations of carotenoids and vitamin E and adiposity among Mexican-American children, but serum retinol concentrations were positively associated with adiposity. Future research is needed to understand the causes and consequences of micronutrient status on adiposity and comorbidities.