RESUMO
OBJECTIVE: To examine maternal intake of a mildly alcoholic beverage (pulque) during pregnancy and lactation, and its potential effect on postpartum child growth and attained size. DESIGN: A prospective cohort study that followed mothers (during pregnancy and lactation) and their offspring (from birth to approximately 57 months of age). SETTING: Six villages in rural, central Mexico. SUBJECTS: Subjects are 58 mother-child pairs. Pulque intake was measured as part of a dietary assessment that was conducted for 2days/month during pregnancy and early lactation. RESULTS: Most mothers consumed pulque during pregnancy (69.0%) and lactation (72.4%). Among pulque drinkers, the average ethanol intake was 125.1 g/week during pregnancy and 113.8 g/week during lactation. Greater pulque intake during lactation, independent of intake during pregnancy, was associated with slower weight and linear growth from 1 to 57 months, and smaller attained size at 57 months. Low-to-moderate pulque intake during pregnancy, in comparison to either nonconsumption or heavy intake, was also associated with greater stature at 57 months. CONCLUSIONS: Pulque intake during lactation may have adversely influenced postnatal growth in this population. Public health interventions are urgently needed in Mexico to reduce heavy intake of pulque by pregnant and lactating women, and to replace intake with foods that provide the vitamins and minerals present in the traditional alcoholic beverage.
Assuntos
Etanol/efeitos adversos , Crescimento/efeitos dos fármacos , Recém-Nascido/crescimento & desenvolvimento , Lactação/efeitos dos fármacos , Fenômenos Fisiológicos da Nutrição Materna , Gravidez/efeitos dos fármacos , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Antropometria , Desenvolvimento Infantil/efeitos dos fármacos , Pré-Escolar , Feminino , Humanos , Lactente , Lactação/fisiologia , Masculino , Troca Materno-Fetal/fisiologia , México , Leite Humano/química , Gravidez/metabolismo , Saúde da População RuralRESUMO
OBJECTIVES: To document the consumption during pregnancy of pulque, a traditional central Mexican alcoholic beverage, and its relationship to subsequent infant size, physical growth and performance on the Bayley Scales of Infant Development. DESIGN: Prospective cohort study. SETTING: Six villages in rural, central Mexico in 1984-1985. SUBJECTS: Seventy mother-infant pairs. RESULTS: Most women (72.9%) consumed pulque during pregnancy, and 28.6% consumed more than 150 g ethanol week(-1) from the beverage. Individuals who consumed pulque showed no compensating decrease in energy obtained from other foods. Pulque consumption possessed curvilinear relationships with both infant length (at 1 and 6 months) and Bayley mental performance (at 6 months). Heavy pulque intakes were associated with smaller infant size and poorer mental performance. In modest quantities, pulque consumption may have been beneficial due to its micronutrient content. CONCLUSIONS: Intakes of alcohol from pulque were common among pregnant women in these rural, central Mexican villages. Given current scientific knowledge of the adverse effects of ethanol on foetal development, public health interventions are needed to reduce heavy pulque consumption during pregnancy in some areas of rural Mexico.
Assuntos
Desenvolvimento Infantil/efeitos dos fármacos , Cognição/efeitos dos fármacos , Desenvolvimento Embrionário e Fetal/efeitos dos fármacos , Etanol/efeitos adversos , Recém-Nascido/crescimento & desenvolvimento , Troca Materno-Fetal/fisiologia , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Antropometria , Estudos de Coortes , Etanol/administração & dosagem , Feminino , Humanos , Lactente , México , Gravidez , Estudos Prospectivos , Desempenho Psicomotor , Saúde da População RuralRESUMO
Gender differences in nutrient and food intake were examined in Mexican Nutrition CRSP (Collaborative Research Support Program) infants (N = 75), preschoolers (N = 80), and school children (N = 91). No significant gender differences in dietary quality or quantity were seen for infants and preschoolers. For school children, the contribution of various foods to total energy intake (dietary quality) was also quite similar for girls and boys. Equity in dietary quality remained even under conditions of economic and demographic stress. Nevertheless, school girls consumed significantly less energy per day than boys (-300 kcal/d or 1.3 mJ/d), and less of all micronutrients examined. Gender differences in estimated basal metabolic rates of school children were slight (-20 kcal/d), and body composition and size were similar. When energy intakes were expressed as a percent of estimated requirement (calculated from age, sex and weight using WHO/FAO/UNU equations), intakes were adequate and not significantly different between girls (mean = 111%) and boys (mean = 113%). Playground observations showed girls to be less active than boys, which may reflect both cultural and biological influences. Apparently due to this lower activity, school girls consumed less energy, and may have been at much higher risk than boys of micronutrient deficiency. The lower food intakes of girls did not appear to be due to purposeful dietary discrimination, but rather to culturally patterned sex roles involving lower activity.
Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Ingestão de Energia , Comportamento Alimentar/etnologia , Preconceito , Saúde da População Rural , Sexo , Metabolismo Basal , Composição Corporal , Criança , Pré-Escolar , Exercício Físico , Feminino , Identidade de Gênero , Humanos , Lactente , Masculino , México , Inquéritos Nutricionais , Fatores SocioeconômicosRESUMO
OBJECTIVE: To identify the terms used by mothers to refer to diseases, signs and symptoms related to acute respiratory illnesses (ARI), alarming signs which should motivate them to seek medical attention, and to describe common home practices of disease care and treatment. MATERIAL AND METHODS: An ethnographic study was performed in six rural communities of the Mexican central highlands. Interviews were collected from 12 key informers, six mothers of children who had died from ARI and 24 mothers of children younger than five years of age, with several ethnographic techniques to complement information ("triangulation"). RESULTS: The most commonly identified diseases were cold, sore throat, cough, bronchitis, pneumonia and "bronchopneumonia". Key signs to establish diagnosis included nasal discharge, sore throat, cough, head and body ache, fever. "bubbling" chest, general malaise and shortness of breath. Tachypnea was referred to as "strong breathing", "much breathing", "rapid breathing" or "sizzle"; intercostal depression as "the chest sinks", stridor as "chest moan or chest snore", sibilance as "chest snore" and cyanosis as "he turns purple". Home treatments include herbal teas, lemon, green or red tomato or potato applied to the throat externally, as well as creams applied to chest or back. Antibiotic prescription was not common, contrary to antipyretics. Most mothers recognized mild illnesses: severe illnesses were recognized less frequently. When faced with a severe ARI, mothers sought attention firstly at the project clinic, second in frequency with a private physician in the capital of the province and then at the Health Ministry of the district. The reasons to choose these possibilities were mainly proximity and lower costs. CONCLUSIONS: This information can be useful to improve communication with mothers.
Assuntos
Antropologia Cultural , Infecções Respiratórias , Adolescente , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Entrevistas como Assunto , Masculino , México , Mães , Infecções Respiratórias/diagnóstico , População Rural , Terminologia como AssuntoRESUMO
OBJECTIVE: This study was designed to identify determinants of body size perceptions and their relationship to dietary behavior in a multiethnic group of women. DESIGN: A single interview consisting of the Massara and Stunkard body image cards (1979) and questionnaires on sociocultural background, anthropometry, and dieting history were administered to volunteers from the staff of a hospital. SUBJECTS: The sample was a convenience sample of 186 women representing a range of staff positions recruited from Methodist Hospital in Brooklyn, NY; 174 completed the study. Data on 150 women are presented in this article. RESULTS: Height and weight-for-height were stronger predictors of accuracy of perceived body size than ethnicity. Tall, slight women were more likely to overestimate and short, heavy women were more likely to underestimate actual body size. Ethnicity had an interactive effect with height as taller European Americans were more likely to perceive their body size as larger than actual compared with Afro-Caribbeans and African Americans. Women with a history of dieting were more likely to overestimate their size and to view it as different from what is perceived as attractive to others. APPLICATIONS/CONCLUSIONS: Based on the results, we conclude that body size is a stronger predictor of accuracy of perceived body size than ethnicity; and dieters overestimate their body size and believe it to be heavier than their social group would prefer.
Assuntos
Constituição Corporal , Imagem Corporal , Dieta , Etnicidade , Recursos Humanos em Hospital , Negro ou Afro-Americano , População Negra , Região do Caribe/etnologia , Dieta Redutora , Europa (Continente)/etnologia , Feminino , Humanos , Itália/etnologia , Porto Rico/etnologia , Autoimagem , Estados UnidosRESUMO
Acute respiratory infections (ARI) are among the principal causes of mortality of children under 5 years of age. Most deaths are due to pneumonia, which, when timely identified and properly treated, could be avoided. An effective case management scheme, based on early recognition of pneumonia and prompt antibiotic treatment, relies on early recognition of alarm signs by mothers and community health workers. For mothers to understand and act on advice from health workers, language and concepts commonly used by mothers should be utilized. The present study was carried out to compare the relative effectiveness of two different methods to elicit local terms used by mothers to refer to ARI symptoms/signs/treatments. A comparison was made among the terms elicited by a free listing of common terms mentioned by mothers in relation to ARI, and the terms they recognized when looking at a video that showed children with different ARI signs. The video was shown in a community and a clinical setting, in order to identify strengths and weaknesses of showing it in these settings. The video elicited more signs dealing with serious illness, respiratory distress and general malaise, but missed non-visual signs, such as fever, lack of appetite or pain. Also, mothers tended to be distracted by trivial signs, such as skin color. Free listing was easier to administer and elicited more non-life-threatening symptoms/signs, but mothers were more prone to drift away and mention terms not related to respiratory illness. Showing the video in the clinic elicited more medical-related terms, and was easier to show than in the community. In conclusion, choice of either of the two methods depends on the researcher's purpose. Using both methods produced a larger list of terms associated with ARI.
Assuntos
Educação em Saúde/métodos , Idioma , Mães/psicologia , Infecções Respiratórias/diagnóstico , Gravação de Videoteipe , Academias e Institutos , Adulto , Pré-Escolar , Barreiras de Comunicação , Feminino , Humanos , Lactente , México , Pneumonia/diagnóstico , População RuralRESUMO
To determine the prevalence and causes of anemia in rural Mexico, blood samples and longitudinal dietary data were collected from 187 women, some pregnant and then lactating, and from 72 men. Blood was used to measure anemia, mean cell volume, and plasma ferritin, folate and vitamin B-12. Anemia was found in 33% of the men, 54% of nonpregnant, nonlactating women, 35% of pregnant women and 41% of lactating women, and varied by season. Low iron stores (ferritin) accompanied anemia in only 8% of men compared with 38-67% of women. Low meat intake and poor dietary iron bioavailability were associated with anemia in women. There were no cases of low plasma folate. Low plasma vitamin B-12 was common in all groups, and the incidence increased from 15% at 7 mo of pregnancy to 30% at 7 mo of lactation. Vitamin B-12 was lower in the plasma and milk of anemic lactating women than in plasma and milk of non-anemic lactating women and was classified as deficient in 62% of breast milk samples.
Assuntos
Deficiência de Ácido Fólico/epidemiologia , Deficiências de Ferro , Lactação , Complicações na Gravidez , Deficiência de Vitamina B 12/epidemiologia , Adulto , Anemia/epidemiologia , Anemia/etiologia , Dieta , Feminino , Humanos , Estudos Longitudinais , Masculino , México , Pessoa de Meia-Idade , Leite Humano/metabolismo , Gravidez , População Rural , Vitamina B 12/metabolismoRESUMO
Predictors of attained size at 30 mo and growth rate between 18 and 30 mo (eg, diet, maternal size, morbidity, age at weaning, and selected environmental factors) were investigated by using longitudinal data from 67 Mexican children aged 18-30 mo. These children were small because of growth stunting in early infancy. Between 18 and 30 mo they grew on average at the 50th percentile of National Center for Health Statistics references values for weight, and the 25th for length. Size at 30 mo and growth rates were unrelated to energy or protein intakes during the previous year, but positively related to consumption of animal-origin foods. Maternal weight predicted size and growth only for children with larger intakes of animal products. Individual rates of weight and length growth were uncorrelated on average, correlated negatively when animal-product intake was low, and positively only when more animal products were consumed. Integrated weight and length growth, and the influence of maternal size on growth, may be disrupted by poor dietary quality. Different children would be identified as malnourished depending on whether weight or length growth was measured.
Assuntos
Constituição Corporal , Dieta/normas , Transtornos do Crescimento/fisiopatologia , Crescimento , Análise de Variância , Animais , Laticínios , Proteínas Alimentares/administração & dosagem , Ingestão de Alimentos/fisiologia , Escolaridade , Ingestão de Energia , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Carne , México , Morbidade , Mães , Análise de Regressão , Fatores Socioeconômicos , DesmameRESUMO
Large household size is widely regarded as a risk factor for malnutrition in developing countries, particularly for infants and young children. This study examines the extent to which household size is related to nutritional status in school-age children in the Solis Valley in highland Mexico. The relationships of food intake, anthropometric measures, and household size are assessed in a sample of 110 children (7-9 years of age), who were followed longitudinally for a minimum of one year as part of the Collaborative Research Support Program on Food Intake and Human Function. Diets in the valley are characterized by very low intake of animal food products and are heavily dependent on maize, which is primarily home-produced. Growth faltering is pervasive; the mean Z score for height-for-age in the sample is--1.6 of the NCHS reference standard. Children from larger households are significantly shorter and consume diets of poorer quality, as assessed by intake of foods from animal sources. These relationships remain statistically significant in regression analyses that control for household economic status. It therefore appears that the resources available to households in the Solis Valley are inadequate to buffer children in even more advantaged households from the stresses of maintaining large families.
Assuntos
Ingestão de Alimentos , Características da Família , Estado Nutricional , Desnutrição Proteico-Calórica/epidemiologia , Antropometria , Criança , Inquéritos sobre Dietas , Feminino , Humanos , Masculino , México/epidemiologia , Inquéritos Nutricionais , Desnutrição Proteico-Calórica/diagnóstico , Desnutrição Proteico-Calórica/etiologia , Análise de Regressão , Fatores de Risco , Fatores SocioeconômicosRESUMO
This paper reports on a rapid ethnographic assessment methodology (REA) that was developed as an essential component of the dietary management of diarrhea (DMD) program. The DMD program is an interdisciplinary research project that has been developed to design intervention programs to reduce or eliminate the nutritional complications of diarrhea in Peru and Nigeria. Anthropological data gathering was an important component of the intervention design, but time and budgetary constraints required a rapid methodological approach. This paper outlines the REA methodology, describes the advantages and disadvantages of the approach, and discusses future applications for international primary health care interventions.
Assuntos
Características Culturais , Cultura , Países em Desenvolvimento , Diarreia/dietoterapia , Educação em Saúde , Criança , Hidratação , Humanos , Medicina Tradicional , Nigéria , Peru , ProibitinasRESUMO
Enamel hypoplasias, deficiencies in enamel thickness resulting from disturbances during the secretory phase of enamel development, are generally believed to result from nonspecific metabolic and nutritional disruptions. However, data are scare on the prevalence and chronological distributions. of hypoplasias in populations experiencing mild to moderate malnutrition. The purpose of this article is to present baseline data on the prevalences and chronological distributions of enamel hypoplasias, by sex and for all deciduous and permanent anterior teeth, in 300 5 to 15-year-old rural Mexican children. Identification of hypoplasias was aided by comparison to a published standard (Federation Dentaire Internationale: Int. Dent. J. 32(2):159-167, 1982). The location of defects, by transverse sixths of tooth crowns, was used to construct distributions of defects by age at development. One or more hypoplasias were detected in 46.7% (95% CI = 40.9-52.5%) of children. Among the unworn and completely erupted teeth, the highest prevalence of defects was found on the permanent maxillary central incisors (44.4% with one or more hypoplasias), followed by the permanent maxillary canine (28.0%) and the remaining permanent teeth (26.2 to 22.2%) Only 6.1% of the completely erupted and unworn deciduous teeth were hypoplastic. The prevalence of enamel defects on the permanent teeth was up to tenfold greater than that found in studies of less marginal populations that used the FDI method. The prevalence of defects in transverse zones suggests a peak frequency of hypoplasias during the second and third years for the permanent teeth, corresponding to the age at weaning in this group. In the deciduous teeth, a smaller peak occurs between 30 and 40 weeks post gestation. The frequency of defects after three years of age is slightly higher in females than males, suggesting a sex difference in access to critical resources.