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To determine whether growth faltering during early infancy was attributable to inadequate intake of human milk, the nutrient intakes and growth of 30 Otomi infants from Capulhuac, Mexico, were studied at 4 or 6 mo of age. Growth was monitored monthly from 1 through 6 mo of age. The 2H dose-to-the-mother method was used to measure human milk intake. Energy, protein, lactose, and fat concentrations in milk were analyzed by standard techniques. Mean (+/- SD) human milk intakes were 885 +/- 145 and 869 +/- 150 g/d at 4 and 6 mo, respectively. Protein and lactose concentrations in milk were normal but fat and consequently energy concentrations were abnormally low. Energy intakes averaged 81 +/- 14 kcal.kg-1.d-1 at 4 mo and 72 +/- 14 kcal.kg-1.d-1 at 6 mo. Growth faltering by 6 mo was evidenced by the significant decline in growth velocities and National Center for Health Statistics Z scores. Weight gain at 6 mo was 8.1 +/- 3.5 g/d and length gain was 1.0 +/- 0.34 cm/mo. Weight-for-age and length-for-age Z scores were -0.81 +/- 0.94 and -1.51 +/- 0.83, respectively. Growth velocities were not significantly correlated with nutrient intakes. Growth faltering among the Otomi infants despite energy intakes comparable to those of breast-fed infants in more protected environments may have resulted from an increase in the need for nutrients or from a growth-limiting nutrient, other than energy, in their diet.

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Anthropometry, body composition and dietary intake of 30 lactating Otomi Indians of Capulhuac, Mexico, were studied to identify maternal factors which potentially limit lactation and thereby infant growth. Human milk production, milk composition, and maternal dietary intake, body weight, skinfold thicknesses, and body composition were measured at 4 and 6 months postpartum. The 2H2O dose-to-mother method was used to estimate milk production and maternal total body water (TBW). Fat-free mass (FFM) was calculated as TBW/0.73. Body fat was computed as body weight minus FFM. Human milk samples were analyzed for energy, nitrogen, lactose and fat using standard analytical methods. Maternal diet was assessed by three 24-h intake recalls. Mean (SD) milk production was 885 (146) and 869 (150) g/d at 4 and 6 months, respectively. Milk concentrations of protein nitrogen (1.23 (0.17) mg/g) and lactose (66.6 (2.8) mg/g) were comparable to, but the concentrations of fat (22.2 (6.7) mg/g) and energy (0.54 (0.06) kcal/g) were lower than, values observed in economically privileged populations. Maternal height, weight, and BMI were 1.47 (0.06) m, 50.3 (6.0) kg, and 23.4 (3.1) kg/m2, respectively. Maternal TBW, FFM and body fat were 55.8 (4.6)%, 76.4 (6.3)%, and 23.6 (6.4)%, expressed as a percentage of body weight, respectively. Maternal energy and protein intakes averaged 1708 (338) kcal/d and 40 (10) g/d, respectively. Milk production was negatively correlated with maternal body fat (P = 0.006). Energy and fat concentrations in the milk of the Otomi women were positively related to their weight (P = 0.002), BMI (P = 0.05), and body fat (P = 0.004). Energy concentrations in milk were not related to rates of milk production (r = 0.24; P = 0.23). Nor was milk production or composition significantly associated with maternal dietary intake. Lactation performance of these Otomi women correlated significantly with maternal body size and composition, but not current dietary intake.

PIP: Researchers analyzed data on 30 postpartum women from the Otomi Indian community living in rural Capulhuac, Mexico to examine interrelationships among lactation performance, maternal body size/composition, and dietary intake to learn which maternal factors limit lactation and thus infant growth. Infant food supplementation was minimal. Current diet did not affect milk production or levels of energy and fat in milk. Even though the body mass index (BMI) was lower than the normal range (19.8-26 kg/sq meter) for only 2 women, 8 women had 20% body fat indicating considerable undernutrition. Women consumed a mean of 68% and 80% of energy and protein requirements. Mean energy intakes (kcal/kg/day) at 4 and 6 months postpartum were 33.8 and 35.1 respectively, compared with the recommended 51. Mean protein intakes (g/kg/day) were 0.75 and 0.84 respectively compared with the recommended 1.1 3-day intake records based on memory, estimation of portion sizes, food preparation, and food composition data led to the above energy intake results, but they may not have been accurate since a mean of 35 would not allow much physical activity. Fats and carbohydrates mainly from maize made up 17% and 76% respectively of the Otomi diet suggesting a suboptimal diet. Yet human milk production rates (885 g/day at 4 months and 869 g/day at 6 months) tended to equal or be higher than those of women of higher socioeconomic status (711-925 g/day) and other poor women (525-789 g/day). The greater the levels of maternal body fat the smaller the amount of milk women produced (p=.006). Total nitrogen, protein nitrogen, lactose, and nonprotein nitrogen levels fell within the range of that of privileged women. Fat and energy levels in the milk were lower than those of privileged women, however heavy women (p=.002) with high BMI (p=.05) and body fat (p=.004) levels tended to have high levels of energy and fat in the milk. Energy levels in milk were not linked with milk production. Neither milk production nor composition were related to dietary intake.

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Information on nutritional status of the rural Mexican population is mostly obtained from cross-sectional studies. This investigation evaluates semi-longitudinally the nutritional level of a sample of the rural population of Mexico. A total of 15,552 individuals in 2,587 households from 208 rural communities were evaluated. Body weight and height of rural boys and girls were found to be significantly lower than in their urban counterparts. Severe forms of weight for age or height for age inadequacy were more frequent in females than in males, in smaller communities than in larger ones, and in economically depressed zones than in those with a good economy. Our data showed a lower frequency of mild and moderate forms of possible malnutrition than previous studies (20 vs 50%) using as a criterion weight for age. These differences are explained on the basis of sampling bias.

PIP: The nutritional status of 15,552 individuals of both sexes in 2587 households from 208 rural communities in Mexico was evaluated in a semilongitudinal nationwide study. Research was carried out from March 1982 to February 1983. The communities were randomly selected from among the 3000 with Mexican Institute of Social Security-COPLAMAR primary health care services. The 8 geoeconomic zones identified by Bassols-Batalla were represented. 10 families with at least 1 infant under 1 year old were selected in communities with under 5000 inhabitants, while 20 such families were selected from communities with 5001-20,000 inhabitants. Body weight, height or length, and arm and calf circumferences were measured in all household members in March-April 1982, and again in July-August 1982 and January-February 1983. The proportion of household heads employed primarily in agriculture ranged from 88% in the smaller communities to 32% in the larger. Families in small communities were mainly peasants in subsistence farming, while household heads in larger communities who were employed in agriculture were mostly owners of small plots. 40-54% of the mothers in communities of different sizes had 3 years or less of school attendance. Comparison of growth curves of the rural population with reference data from urban children showed similar median body weight in both groups at 2 years of age. But by age 18, median weight and height, respectively, were 8.6 kg lower and 9 cm shorter for rural boys and 5.5 kg lower and 5 cm shorter for rural girls. The most severe forms of inadequacy in weight for age were more frequent in females than males, in smaller communities than larger, and in the economically depressed zones. Severe inadequacy of height for age was more frequent in the states located on the southern Pacific Coast and the Gulf of Mexico. The frequency of mild and moderate forms of malnutrition according to weight for age was 20%, lower than the rate of 50% estimated in previous published studies. Selection of a broader range of rural communities rather than just the most marginal, and the bias introduced by selecting the sample from among communities with primary health services may explain the lower rate in this study.

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PIP: Infertility is a problem for many couples who wish to conceive and bear children. This paper investigates the relationships of educational status, age, onset of menarche, first sexual intercourse, menstrual cycle, gestational interval, and coital frequency to infertility in 509 Mexican women who were not exposed to any contraceptive method. This study was conducted to gain insight into when infertility studies should commence during the course of a woman's sexual life. Two thirds of the women were married. On average, menarche took place at age 13 years, first intercourse at age 20, and they had sexual intercourse 9 times/month. 68% of women became pregnant within the first 12 months of sexual activity; earliest pregnancy was at age 14 and the latest was at age 44. A significant linear correlation was observed between chronological age and gestational interval with the achievement of first pregnancy significantly related to age and coital frequency. Overall, first pregnancy was achieved in almost 90% of monthly menstruating women. Significant estimated risk of sterility exists for older women and when periods of expectancy for pregnancy are longer than 1 year.^ieng

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