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BACKGROUND: Family-based strategies to reduce the risk of overweight in childhood are needed in the Caribbean. AIM: To investigate the associations between parental characteristics and risk of overweight and explore possible mechanisms. METHODS: Data from a parenting intervention were analysed. Parental characteristics were obtained by questionnaire at enrolment. At 18 months, 501 infants (82.9% of cohort) had weight and length measured using standardized methods. The association of parents' characteristics with risk of infant overweight was assessed using random-effects logistic regression. Four focus groups among mothers in Jamaica were conducted to explore mechanisms. RESULTS: Overall, 20.6% of infants were 'at risk of overweight'. Fathers were present in 52% of households. Fathers' presence [OR (95% CI) 0.60 (0.37-0.96)] was associated with reduced risk of overweight independent of socioeconomic status. Mothers reported that fathers encouraged healthier practices. CONCLUSION: Fathers may be important agents of change in intervention strategies to prevent childhood overweight.
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The heat shock transcription factor 1 gene (HSF1) plays a key role in the heat stress response. We previously found a single nucleotide polymorphism (SNP) in the 3'-untranslated region (g.4693G>T) of HSF1 that was related to thermo tolerance in Chinese Holstein cattle through association analysis. However, it is not known whether other SNPs also affect thermo tolerance.In this study a novel SNP, g.1451G>T, was identified by DNA sequencing and genotyped using creating restriction site-polymerase chain reaction methodology. The g.1451G>T polymorphic site met Hardy-Weinberg equilibrium (P > 0.05). Association analysis demonstrated that this SNP had no effect on thermo tolerance traits in Holstein cattle. Findings of the study compared to the analysis of g.4693 G>T further indicated that g.4693 G>T may play an important role in thermo tolerance, although the mechanism is not clear. RNA hybrid and Targetscan prediction showed that the minimum free energy hybridization of bta-miR-484 with HSF1 3'-UTR was -31.9 kcal/mol and g.4693 G>T was in the seed sequence of bovine HSF1 that binds to bta-miR-484. Analysis by Luciferase assay indicated that HSF1 expression was directly targeted by bta-miR-484 in HEK 293T cells, and the Rluc/luc ratio of wildtype (GG) was lower than that of the mutant (TT) (P < 0.05). These results suggest that g.4693 G>T affects binding of HSF1 to bta-miR-484.
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Proteínas de Choque Térmico/genética , MicroRNAs/metabolismo , Polimorfismo de Nucleotídeo Único/genética , Regiões 3' não Traduzidas/genética , Animais , Bovinos , MicroRNAs/genética , Ligação ProteicaRESUMO
OBJECTIVES: We aimed to characterize neurological outcomes and determine the prevalence of HIV encephalopathy in a cohort of HIV-infected children in Jamaica. METHODS: Data for 287 HIV-infected children presenting between 2002 and 2008 were reviewed and neurological outcomes characterized. A nested case-control study was conducted between July and September 2009 used 15 randomly selected encephalopathic HIV-infected children aged 7-10 years and 15 matched controls (non-encephalopathic HIV-infected). Their neurocognitive functions were evaluated using clinical assessment and standardized tests for intelligence, short term memory (visuo-spatial and auditory), selective attention, and fine motor and coordination functions. Outcomes were compared using Fisher's exact test and the Mann-Whitney U-test. RESULTS: Sixty-seven (23.3%) children were encephalopathic. The median age at diagnosis of HIV encephalopathy was 1.6 years (interquartile range (IQR) 1.1-3.4 years). Predominant abnormalities were delayed milestones (59, 88.1%), hyperreflexia (59, 86.5%), spasticity (50, 74.6%), microcephaly (42, 61.7%), and quadriparesis (21, 31.3%). The median age of tested children was 8.7 years (IQR 7.6-10.8 years) in the encephalopathic group and 9 years (IQR 7.4-10.7 years) in the non-encephalopathic group. Encephalopathic children performed worse in all domains of neurocognitive function (p<0.05). CONCLUSIONS: A high prevalence of HIV encephalopathy was noted, and significant neurocognitive dysfunction identified in encephalopathic children. Optimized management through the early identification of neurological impairment and implementation of appropriate interventions is recommended to improve quality of life.
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Complexo AIDS Demência/psicologia , Transtornos Cognitivos/virologia , Países em Desenvolvimento , Complexo AIDS Demência/tratamento farmacológico , Complexo AIDS Demência/epidemiologia , Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Estudos de Casos e Controles , Criança , Pré-Escolar , Transtornos Cognitivos/epidemiologia , Humanos , Lactente , Jamaica/epidemiologia , Deficiências da Aprendizagem/epidemiologia , Deficiências da Aprendizagem/virologia , Transtornos da Memória/epidemiologia , Transtornos da Memória/virologia , Microcefalia/epidemiologia , Microcefalia/virologia , Prevalência , Qualidade de Vida , Reflexo AnormalRESUMO
Research conducted by the Child Development Research Group in the Tropical Medicine Research Institute has made significant contributions to the understanding of the importance of early nutrition and the home environment for children's development and the impact of psychosocial stimulation for disadvantaged and/or undernourished children. The work has provided critical evidence that has contributed to the increasing attention given to early childhood development in the work and policies of agencies such as the World Bank, World Health Organization (WHO) and United Nations Children Fund (UNICEF). This review concerns research which documented the impact of malnutrition on children's development and for the first time demonstrated the benefits and necessity of psychosocial stimulation for improvement in development. Subsequent research was critical in establishing the importance of linear growth retardation (stunting) as a risk factor for poor child development. A twenty-two-year study of stunted children has demonstrated benefits through to adulthood in areas such as educational attainment, mental health and reduced violent behaviour from an early childhood home visiting programme that works through mothers to promote their children's development. The group's research has also demonstrated that it is feasible and effective to integrate the stimulation intervention into primary care services with benefits to children's development and mothers'child rearing knowledge and practices. The group is currently conducting a study to provide information needed for scaling-up of parenting programmes through evaluation of a new approach to improving parenting through health centres and a modified home visit programme.
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Desenvolvimento Infantil , Intervenção Educacional Precoce , Criança , Pré-Escolar , Pesquisa sobre Serviços de Saúde , Humanos , Lactente , Jamaica , Desnutrição , Saúde Mental , Poder Familiar , Medicina Tropical , UniversidadesRESUMO
BACKGROUND: Cross-sectional studies have shown associations between stunting and overweight; however, there are few prospective studies of stunted children. OBJECTIVES: To determine whether stunting before age 2 years is associated with overweight and central adiposity at 17-18 years and whether growth in height among stunted children predicts body mass index (BMI) in late adolescence. DESIGN: Prospective cohort study. PARTICIPANTS: One-hundred and three participants stunted by age 2 years and 64 non-stunted participants (78% of participants enrolled in childhood). Participants were measured in early childhood and at ages 7, 11 and 17 years. RESULTS: Stunted subjects remained shorter and had lower BMIs, smaller skinfolds and circumferences than non-stunted subjects. Overweight (BMI >/=25 m(2)) was not significantly different among stunted and non-stunted male subjects (5.2 and 12.5%) but non-stunted female subjects were more likely to be overweight than those who experienced early childhood stunting (11.1 and 34.4%, P=0.013). Centralization of fat (waist to hip ratio (WHR), subscapular/triceps skinfold ratio (SSF/TSF)) did not differ between stunted and non-stunted groups (mean WHR 0.77 and mean SSF/TSF 1.18 in both groups). Stunted subjects with greater increases in height-for-age for the intervals 3-7 and 7-11 years had higher BMI at age 17 years (P=0.04 and P=0.001, respectively). CONCLUSION: Participants stunted by age 2 years were less likely to be overweight than those who were never stunted. This suggests that cross-sectional studies of the association between stunting and overweight may be misleading. Among stunted children, greater linear growth during mid- to late childhood was associated with greater BMI at age 17 years.
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Adiposidade , Transtornos do Crescimento/fisiopatologia , Sobrepeso , Antropometria , Constituição Corporal , Estatura , Índice de Massa Corporal , Feminino , Seguimentos , Crescimento , Transtornos do Crescimento/terapia , Humanos , Lactente , Masculino , Estudos ProspectivosRESUMO
The objective of this study was to identify the factors associated with size and proportionality at birth in a cohort of term infants established to investigate their growth and development. One hundred and forty term low-birth-weight (birth-weight < 2,500 g) infants and 94 normal birth-weight infants (2,500- < 4,000 g) were recruited within 48 hours of birth at the main maternity hospital, Kingston, Jamaica. Birth anthropometry and gestational age were measured, and maternal information was obtained by interview and from hospital records. Controlling for gestational age, variables independently associated with birth-weight were rate of weight gain in the second half of pregnancy, maternal height, haemoglobin level < 9.5 microg/dL, time of first attendance in antenatal clinic, birth order, pre-eclampsia, and consumption of alcohol, with 33% of the variance in birth-weight explained. Birth length was associated only with maternal height and age, while measures of proportionality (ponderal index and head/length ratio) were associated with characteristics of the environment in late pregnancy, including rate of weight gain, weight in late pregnancy, and pre-eclampsia. The variation in maternal characteristics associated with size or proportionality at birth may reflect the times during gestation when different aspects of growth are most affected.
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Peso ao Nascer , Desenvolvimento Embrionário e Fetal , Adulto , Antropometria , Estudos de Coortes , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Jamaica , Estudos Longitudinais , Masculino , Estado Nutricional , Pré-Eclâmpsia/embriologia , Pré-Eclâmpsia/metabolismo , Gravidez , Resultado da Gravidez , Análise de Regressão , Aumento de PesoRESUMO
BACKGROUND: Stunting in early childhood is common in developing countries and is associated with poorer cognition and school achievement in later childhood. The effect of stunting on children's behaviours is not as well established and is examined here. METHOD: Children who were stunted at age 9 to 24 months and had taken part in a 2-year intervention programme of psychosocial stimulation with or without nutritional supplementation were reexamined at age 11-12 years and compared with non-stunted children from the same neighbourhoods. Their school and home behaviours were assessed using the Rutter Teacher and Parent Scales and school achievement was measured using the Wide Range Achievement Test (WRAT) and the Suffolk Reading Scales. RESULTS: No significant intervention effects were found among the stunted groups. Thus data from the four intervention groups were aggregated for subsequent analyses, comparing all 116 stunted children with 80 non-stunted children. Controlling for social background variables, the stunted group had more conduct difficulties (p < .05) as rated by their parents. They also had significantly lower scores in arithmetic, spelling, word reading and reading comprehension than the non-stunted children (all p < .001). Conduct difficulties and hyperactivity were related to poorer school achievement. Controlling for the children's IQ, the stunted children's arithmetic scores remained significantly lower than those of the non-stunted children, but reading and spelling scores were not different. CONCLUSIONS: Previously stunted children had more conduct difficulties at home, regardless of their social background, than non-stunted children. Their educational attainment was also poorer than non-stunted children and these results are suggestive of a specific arithmetic difficulty. Children with behaviour problems performed less well at school.
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Logro , Transtornos do Comportamento Infantil/epidemiologia , Transtornos Cognitivos/epidemiologia , Área Programática de Saúde , Criança , Países em Desenvolvimento , Feminino , Seguimentos , Humanos , Jamaica/epidemiologia , Masculino , Testes Neuropsicológicos , Leitura , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: (1) To determine whether benefits to growth and cognition remain after intervention in growth-restricted children who received psychosocial stimulation and nutritional supplementation in early childhood. (2) To investigate the extent of the differences in IQ and cognition at age 11 to 12 years between growth-restricted and non-growth-restricted children. STUDY DESIGN: Growth-restricted and non-growth-restricted children were identified at age 9 to 24 months, at which time the growth-restricted children participated in a 2-year randomized trial of nutritional supplementation and psychosocial stimulation. Eight years after the interventions ended, the children's growth, IQ, and cognitive functions were measured. RESULTS: There were no significant benefits from supplementation to growth or cognition. Children who had received stimulation had higher scores on the Weschler Intelligence Scales for Children-Revised full-scale (IQ) and verbal scale and tests of vocabulary and reasoning (all P <.05). The growth-restricted children had significantly lower scores than the non-growth-restricted children on 10 of 11 cognitive tests. CONCLUSIONS: Psychosocial stimulation had small but significant long-term benefits on cognition in growth-restricted children. Growth-restricted children had significantly poorer performance than non-growth-restricted children on a wide range of cognitive tests, supporting the conclusion that growth restriction has long-term functional consequences.
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Cognição , Suplementos Nutricionais , Transtornos do Crescimento/terapia , Apoio Social , Criança , Análise Fatorial , Feminino , Seguimentos , Humanos , Lactente , Inteligência , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores SocioeconômicosRESUMO
Three thousand, eight hundred and eighty-two (3,882) children in grades 2-5, attending 16 rural primary and all-age schools in central Jamaica were weighed and their weight-for-age standard deviation scores calculated using the World Health Organization/National Center for Health Statistics (WHO/NCHS) references. Heights were also measured in a random sample of the grade 5 children (n = 793) and height-for-age and body mass index (BMI-kg/m2) calculated. Sixty-nine per cent of the total sample were of normal weight-for-age, 2% were moderately undernourished (weight-for-age > -3 Z-score, < or = -2 Z-score), and a further 24% mildly undernourished (weight-for-age > -2 Z-score, < or = -1 Z-score). Few children were overweight. The frequency distribution of weight-for-age was similar in girls and boys. In the subsample of children in whom heights were measured, 25.8% were < or = -1 Z-score height-for-age, and of these 4.9% were < -2 Z-score. Compared with a survey conducted in a similar rural area in the 1960s, the children's mean weights for age group categories were 1.1 to 3.7 kg heavier. Children who were older than appropriate for their grade were more likely to be undernourished (Odds ratio 3.94, 95% CI 3.21, 4.83), which suggests that undernourished children may be more likely to repeat a grade or start school later.
Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Saúde da População Rural , Constituição Corporal , Criança , Feminino , Humanos , Jamaica , MasculinoRESUMO
Three thousand, eight hundred and eighty-two (3,882) children in grades 2-5, attending 16 rural primary and all-age schools in central Jamaica were weighed and their weight-for-age standard deviation scores calculated using the World Health Organization/National Center for Health Statistics (WHO/NCHS) references. Heights were also measured in a random sample of the grade 5 children (n = 793) and height-for-age and body mass index (BMI-kg/m2) calculated. Sixty-nine per cent of the total sample were of normal weight-for-age, 2were moderately undernourished (weight-for-age > -3 Z-score, -2 Z-score, < or = -1 Z-score). Few children were overweight. The frequency distribution of weight-for-age was similar in girls and boys. In the subsample of children in whom heights were measured, 25.8were < or = -1 Z-score height-for-age, and of these 4.9were < -2 Z-score. Compared with a survey conducted in a similar rural area in the 1960s, the children's mean weights for age group categories were 1.1 to 3.7 kg heavier. Children who were older than appropriate for their grade were more likely to be undernourished (Odds ratio 3.94, 95CI 3.21, 4.83), which suggests that undernourished children may be more likely to repeat a grade or start school later.
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Humanos , Masculino , Feminino , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Saúde da População Rural , Constituição Corporal , JamaicaRESUMO
Hunger during school may prevent children in developing countries from benefiting from education. Although many countries have implemented school feeding programs, few programs have been rigorously evaluated. We conducted a randomized, controlled trial of giving breakfast to undernourished and adequately nourished children. The undernourished group comprised 407 children in grades 2-5 in 16 rural Jamaican schools (weights-for-age < or = -1 SD of the National Center for Health Statistics references) and the adequately nourished group comprised 407 children matched for school and class (weights-for-age >-1 SD). Both groups were stratified by class and school, then randomly assigned to breakfast or control groups. After the initial measurements, breakfast was provided every school day for 1 school year. Children in the control group were given one-quarter of an orange and the same amount of attention as children in the breakfast group. All children had their heights and weights measured and were given the Wide Range Achievement Test before and after the intervention. School attendance was taken from the schools' registers. Compared with the control group, height, weight, and attendance improved significantly in the breakfast group. Both groups made poor progress in Wide Range Achievement Test scores. Younger children in the breakfast group improved in arithmetic. There was no effect of nutritional group on the response to breakfast. In conclusion, the provision of a school breakfast produced small benefits in children's nutritional status, school attendance, and achievement. Greater improvements may occur in more undernourished populations; however, the massive problem of poor achievement levels requires integrated programs including health and educational inputs as well as school meals.
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Serviços de Alimentação , Aprendizagem , Fenômenos Fisiológicos da Nutrição , População Rural , Instituições Acadêmicas , Absenteísmo , Logro , Estatura , Peso Corporal , Criança , Feminino , Humanos , Jamaica , Masculino , Estado NutricionalRESUMO
OBJECTIVES: To describe food consumption during the school day of rural Jamaican children and participation in two government school feeding programmes. To determine factors which were related to these. DESIGN: Cross sectional. SETTING: 16 primary schools in rural Jamaica. SUBJECTS: 415 children in grades 2 and 5 (ages 7 and 10 years). RESULTS: Consumption of sweets, sweet drinks and snacks was high. Mean intakes at lunch were: energy 1537 kJ (SD 756), protein 10.4 g (SD 7.6) and iron 1.5 mg (SD 1.2). The mean energy intake was 17-20% of the daily requirement for this age group. Two types of school feeding programmes were available in the schools, one provided a cooked meal and the other a bun and milk. Median availability of school meals (as a percentage of children enrolled in the schools) over three terms was 24.6% (range 0-85.4%). Twenty per cent of the children participated in one or other programme. Poorer children were more likely to participate in the bun and milk programme (odds ratio 2.1, 95% CI 1.3-3.5) but children with more money to purchase food participated in the more costly cooked meal programme (odds ratio 2.4, 95% CI 1.3-4.6). CONCLUSIONS: Energy intakes at lunch in Jamaican children were somewhat below optimal levels and the reliance on sweets and snacks is an area of concern. Programme characteristics such as meal cost, may affect access to school feeding by poor children.
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Transtornos da Nutrição Infantil/prevenção & controle , Preferências Alimentares , Serviços de Alimentação , Programas Governamentais , Instituições Acadêmicas , Análise de Variância , Criança , Custos e Análise de Custo , Estudos Transversais , Ingestão de Energia , Feminino , Serviços de Alimentação/economia , Humanos , Jamaica , Masculino , Valor Nutritivo , Razão de Chances , Análise de RegressãoRESUMO
OBJECTIVE: We examined whether or not the effect of elevated blood lead levels on children's psychomotor development was modified by their nutritional status. DESIGN: Anthropometry, developmental quotients (DQs), blood lead levels and haemoglobin were measured in lead exposed and unexposed children with different levels of nutritional status. Social background and maternal height and verbal intelligence were also measured. Testers, anthropometrists and interviewers established reliabilities with a trainer before the study began. SETTING: Children were from two suburban areas in Kingston, Jamaica. All measurements on the children were carried out at a research unit. Social background and maternal measurements were carried out at the children's homes. SUBJECTS: The exposed group comprised 58 children (3-6 years) attending the same preschool which was situated in a lead contaminated environment. The unexposed group comprised 53 children attending a nearby preschool without lead contamination. RESULTS: The exposed children had significantly higher blood lead levels and lower DQs, and their homes had poorer facilities than the unexposed children. The deficit in DQ was greater (10.6 points) among children with weight for height less than -1 SD (National Center for Health Statistics references) than among better nourished children (2 points). CONCLUSIONS: Undernourished children exposed to lead may have more serious developmental deficits than better nourished children.
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Transtornos da Nutrição Infantil/sangue , Deficiências do Desenvolvimento/etiologia , Intoxicação do Sistema Nervoso por Chumbo na Infância/sangue , Chumbo/sangue , Criança , Transtornos da Nutrição Infantil/complicações , Proteção da Criança , Pré-Escolar , Feminino , Humanos , Jamaica , Intoxicação do Sistema Nervoso por Chumbo na Infância/complicações , Masculino , Estado Nutricional , Análise de RegressãoRESUMO
OBJECTIVE: To determine whether nutritional status, anaemia and geohelminth infections were related to school achievement and attendance in Jamaican children. DESIGN: A cross-sectional study using a randomly selected sample. SUBJECTS: Eight hundred children aged 9-13 y randomly selected from those enrolled in grade 5 in 16 primary schools in rural Jamaica. RESULTS: The mean height-for-age of the children was -0.37 z-score +/- 1.0 s.d. with 4.9% having heights-for-age < -2 s.d. of the NCHS references. Anaemia (Hb < 11 g/dl) was present in 14.7% of the children, 38.3% were infected with Trichuris trichiura and 19.4% with Ascaris lumbricoides. Achievement levels on the Wide Range Achievement Test were low, with children performing at grade 3 level. In multilevel analyses, controlling for socioeconomic status, children with Trichuris infections had lower achievement levels than uninfected children in spelling, reading and arithmetic (P < 0.05). Children with Ascaris infections had lower scores in spelling and reading (P < 0.05) Height-for-age (P < 0.01) was positively associated with performance in arithmetic. Ascaris infection (P < 0.001) and anaemia (P < 0.01) predicted poorer school attendance. CONCLUSION: Despite mild levels, undernutrition and geohelminth infections were associated with achievement, suggesting that efforts to increase school achievement levels in developing countries should include strategies to improve the health and nutritional status of children.
PIP: The association of nutritional status, anemia, and geohelminth infection with school attendance and performance was investigated in a cross-sectional study of 800 primary school students 9-13 years of age (mean age, 10.8 years) from 4 rural parishes in Jamaica. 4.9% of the children had heights-for-age less than 2 standard deviations of the US National Center for Health Statistics references and 14.7% were anemic; 38.3% were infected with Trichuris trichiura and 19.4% with Ascaris lumbricoides. Multivariate analyses, controlled for socioeconomic status, indicated children with Trichuris infection had significantly lower achievement levels than uninfected children in spelling, reading, and arithmetic, while those with Ascaris infection had significantly lower scores in spelling and reading. Height-for-age was positively associated with performance in arithmetic. Ascaris infection and anemia predicted poorer school attendance. The associations demonstrated in this study are not necessarily causal. However, these findings indicate that efforts to increase school achievement levels in developing countries should include strategies to address the health and nutritional status of rural children.
Assuntos
Anemia/complicações , Ascaríase/complicações , Escolaridade , Estado Nutricional , Tricuríase/complicações , Adolescente , Antropometria , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Jamaica , Masculino , Distribuição Aleatória , População Rural , Fatores SocioeconômicosRESUMO
It is not known whether nutritional supplementation in early childhood has long-term benefits on stunted children's mental development. We followed up 127 7-8-y old children who had been stunted in early childhood and received supplementation, stimulation, or both. At 9-24 mo of age, the children had been randomly assigned to four treatment groups: nutritional supplementation, stimulation, both treatments, and control. After 2 y, supplementation and stimulation had independent benefits on the children's development and the effects were additive. The group receiving both treatments caught up to a matched group of 32 nonstunted children. Four years after the end of the 2-y intervention 97% of the children were given a battery of cognitive function, school achievement, and fine motor tests. An additional 52 nonstunted children were included. Factor analyses of the test scores produced three factors: general cognitive, perceptual-motor, and memory. One, the perceptual-motor factor, showed a significant benefit from stimulation, and supplementation benefited only those children whose mothers had higher verbal intelligence quotients. However, each intervention group had higher scores than the control subjects on more tests than would be expected by chance (supplemented and both groups on 14 of 15 tests, P = 0.002; stimulated group in 13 of 15 tests, P = 0.01), suggesting a very small global benefit. There was no longer an additive effect of combined treatments at the end of the intervention. The stunted control group had significantly lower scores than the nonstunted children on most tests. Stunted children's heights and head circumferences on enrollment significantly predicted intelligence quotient at follow-up.
Assuntos
Deficiências do Desenvolvimento/dietoterapia , Alimentos Fortificados , Antropometria , Criança , Deficiências do Desenvolvimento/psicologia , Humanos , Lactente , Inteligência , Jamaica , Inquéritos e QuestionáriosRESUMO
The long-term benefits of early childhood supplementation and the extent to which catch-up growth occurs following linear growth retardation remain controversial. Stunted children (height-for-age < -2 SD of NCHS references, n = 122) recruited from a survey of poor neighborhoods in Kingston, Jamaica, participated in a 2-yr randomized, controlled trial of supplementation beginning at ages 9-24 mo. A group of 32 non-stunted children from the same neighborhoods was also followed. Four years after the intervention ended, when children were 7 to 8 y old, there were no effects of supplementation on any anthropometric measure. From the end of the trial until follow-up, the children who had been supplemented gained 1.2 cm less (P < 0.05) than the non-supplemented children, approximately the same amount as they had gained during the trial compared with the non-supplemented children. After adjustment for regression to the mean, the height-for-age of stunted children (supplemented and non-supplemented combined) increased from enrollment to follow-up by 0.31 Z-score (95% CI 0.17, 0.46). The height-for-age of the non-stunted children also increased (0.96 Z-score; 95% CI 0.70, 1.22). Our results suggest that some catch-up growth is possible even when children remain in poor environments. Long-term benefits of supplementation to growth may not be achieved when intervention begins after age 12 mo in children who have already become undernourished.
Assuntos
Alimentos Fortificados , Transtornos do Crescimento/dietoterapia , Crescimento , Antropometria , Transtornos da Nutrição Infantil/complicações , Pré-Escolar , Feminino , Humanos , Lactente , Jamaica , Estudos Longitudinais , Masculino , Pobreza , Análise de RegressãoRESUMO
It is frequently assumed that undernutrition in young children leads to poor development through reduced activity. 3 groups of 26 1-year-old stunted children were studied: nutritional supplementation, supplementation with psychosocial stimulation, and controls. 26 nonstunted comparison children were also studied. Activity levels were measured by extensive observation in the homes, and development using 4 subscales of the Griffith's Mental Development Scales. Initially, stunted children were less active than nonstunted ones (p < .01), but after 6 months they caught up regardless of treatment. The mental ages of the stunted children were lower than those of the nonstunted children initially, and improved with either treatment. Initially, activity levels made a significant contribution to the variance in the locomotor subscale only, but not 6 months later. Activity did not predict change in development over 6 or 12 months, nor did change in activity over 6 months predict change in development over 12 months.
Assuntos
Transtornos do Comportamento Infantil/psicologia , Países em Desenvolvimento , Nanismo/psicologia , Alimentos Fortificados , Atividade Motora , Desnutrição Proteico-Calórica/psicologia , Transtornos do Comportamento Infantil/dietoterapia , Terapia Combinada , Nanismo/dietoterapia , Intervenção Educacional Precoce , Feminino , Seguimentos , Humanos , Lactente , Jamaica , Masculino , Desnutrição Proteico-Calórica/dietoterapia , Meio SocialRESUMO
The presence of gamma-aminobutyric acid (GABA) and peripheral and central benzodiazepine receptors in the mammalian pineal gland prompted the examination of GABAergic transmission in dispersed bovine pineal cells. The effect of GABA on 3H-serotonin (5HT) release was examined in bovine pineal cells. GABA, by acting through GABA B receptor subtype, decreased 5HT release and by acting through GABA B, and presumably through GABA A receptor subtypes, inhibited depolarization-induced 45Ca2+ uptake in bovine pinealocytes. GABA, by acting on GABA B as well as on GABA A receptors, prevented the 5HT2- or 5HT1C-mediated stimulatory effect of serotonergic agonists on calcium uptake in pineal cells. GABA augmented 36Cl- uptake by bovine pineal cells. These results are interpreted to indicate that, by regulating the release of 5HT, GABA may modulate the synthesis and action of melatonin.
Assuntos
Cálcio/metabolismo , Cloretos/metabolismo , Glândula Pineal/metabolismo , Serotonina/metabolismo , Ácido gama-Aminobutírico/metabolismo , Análise de Variância , Animais , Bovinos , Antagonistas GABAérgicos , Técnicas In Vitro , Cinética , Glândula Pineal/citologiaRESUMO
The benefits of nutritional supplementation, with or without psychosocial stimulation, on the growth of stunted children were evaluated. Children aged 9-24 mo with lengths less than -2 SD of the National Center for Health Statistics references (n = 129) were randomly assigned to four groups: control, nutritional supplementation, stimulation, and both interventions. A fifth group with lengths greater than -1 SD was also enrolled. Length, weight, head and arm circumferences, and triceps and subscapular skinfold thicknesses were measured on enrollment and 6 and 12 mo later. Multiple-regression analysis was used to determine the effects of the interventions in which age, sex, initial status, initial dietary intake, and several socioeconomic variables were controlled for. Stimulation had no effect on growth and there was no interaction between the interventions. After 12 mo supplemented children had significantly increased length, weight, and head circumference (all P less than 0.01). The effects of supplementation were not cumulative but occurred in the first 6 mo.
Assuntos
Alimentos Fortificados , Transtornos do Crescimento/dietoterapia , Terapia Ocupacional , Ludoterapia , Feminino , Transtornos do Crescimento/reabilitação , Humanos , Lactente , Jamaica , Masculino , Distribuição Aleatória , Análise de RegressãoRESUMO
The effect of melatonin injection on norepinephrine (NE) turnover rate in rat pineal gland was estimated from the decline of tissue NE levels after the injection of the tyrosine hydroxylase inhibitor alpha-methyl-p-tyrosine. The administration of a single injection of 300 micrograms/Kg of melatonin at the beginning of the scotophase induced, 3 hr later, a significant decrease of pineal NE turnover. The possible direct effect of melatonin on pineal NE release was examined in vitro. Exposure of rat pineal explants previously loaded with 3H-NE to 10(-8)-10(-6) M melatonin decreased significantly 3H-NE release triggered by 60 mM K+. This activity of melatonin was revealed only in pineals excised at night (0000 and 0400, i.e., at the fourth or eighth hours of darkness) and not in those excised in the middle (1400) or late light phase of the daily photoperiod (2000). Melatonin did not modify the spontaneous pineal 3H-NE efflux. Melatonin decreased 3H-NE uptake at a low NE concentration (0.5 microM) in a dose-dependent manner (IC50 identical to 10(-10) M). A kinetic analysis of the pineal NE uptake process indicated that melatonin augmented both Vmax and Km of transmitter uptake. These results suggest that endogenously released melatonin may be a regulatory signal for rat pineal sympathetic synapses.