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A sample of 471 pre-school children who frequented schools and crêches in a poor district of Manaus (Amazonas), Brazil, were randomly submitted to faecal parasitological tests. Two-hundred-and-forty children from both sexes between the ages of 3 and 7 years with Ascaris lumbricoides and/or Giardia lamblia were selected. The objective of the study was to determine the possible influence of these two intestinal parasites and vitamin A and/or zinc supplementation on the serum retinol levels of primary school children. The children were submitted to clinical and anthropometric examinations, dietary interviews and biochemical examinations of retinol and carotene in the serum and of zinc in the hair. The parasitic incidence was 85.0% and about 54% of the children were polyparasitic. During the pretreatment phase, the retinol and carotene serum levels were 36% and 57%, respectively, below the normal levels. Using the Waterlow classification, the anthropometric analyses revealed that 88% of the children showed normal growth. A significant effect was observed of the anti-parasitic medicine on the serum retinol levels.

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Säo analisadas as dietas e o estado nutricional de 466 crianças abaixo de dois anos de idade, em áreas periurbanas de quatro capitais brasileiras. A principal mistura de alimentos encontrada foi de leite artificial, amido, e açucar (68%), sendo os alimentos da dieta da família pouco utilizados no processo de desmame das crianças. As dietas säo inadequadas quantitativamente, especialmente no segundo ano de vida quando a maioria das crianças (57%) näo conseguiram 80% das suas necessidades energéticas. As dietas foram inadequadas qualitativamente em zinco e ferro, sendo adequadas para proteína, vitamina A e vitamina C, desde que preenchidas as necessidades energéticas. A desnutriçäo mostrou-se mais grave nos locais (Nordeste) e faixas etárias (segundo ano) onde a dieta se apresentou mais inadequada

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1. Zinc metabolism has been studied in a group of undernourished, slum-dwelling, lactating women in Manaus, Brazil, by means of modified metabolic balance techniques and the stable isotope 67Zn. 2. The subjects were found to be consuming a diet which provided an average of 34% of the recommended dietary allowance for lactating women, but six of the seven appeared to achieve Zn balance. In five of the subjects use of 67Zn in a stable isotope dilution manner demonstrated that they were absorbing a high proportion of the dietary Zn (proportional absorption ranged from 0.59 to 0.84), suggesting an adaptation to the chronically low intake. 3. Two subjects had marginally low plasma Zn concentrations, although hair, urine and milk Zn contents were all within accepted normal values. 4. Preliminary findings on the rate of plasma Zn turnover and the size of the exchangeable body Zn pool obtained using 67Zn suggest that these subjects may have a reduction in both.

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Data from a household expenditure survey of 1,200 Manaus families performed by the Amazonas State Government in 1973-74 are analyzed by income group. The per cent frequency of families buying different foods and the daily per capita consumption of each were calculated. The daily per capita intakes of energy, protein, vitamin A, thiamine, riboflavin, nicotinic acid, ascorbic acid, calcium, phosphorus, iron and zinc were estimated and their adequacy evaluated. In contrast to the south and northeast of Brazil, the main bulk of the diet was derived from cereals and fish. The quantities of eggs, meats, fruit and vegetables consumed per person, increased 50-100% as income improved, whereas fish consumption decreased 30%. The nutrients quantitatively most deficient were zinc, vitamin A, calcium, thiamine and riboflavin, with 60-80% of low and middle income families not achieving safe levels of intake for zinc and vitamin A. The beneficial effect of income on the adequacy of calcium, thiamine and riboflavin intake was quantitative. For zinc and vitamin A, increased income was associated with a qualitative improvement in the diet, principally due to the increased consumption of meat and liver. These results are discussed in relation to existing clinical evidence of deficiency states in the region.

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Onze especies de peixes, os mais consumidos pela populacao de Manaus em 1973-74, foram analisados quanto aos seus conteudos de: umidade, cinzas, proteina, gordura, energia e zinco. Os peixes carnivoros como Tucunare, Pirarucu e a Pescada eram magros enquanto Pacu, Sardinha, Curimata, Matrincha e Branquinha foram considerados como gordos. Os peixes representavam alto teor proteico, com razoes proteina/energia muito alem das recomendadas (FNB-USA). As razoes zinco/energia eram altas somente nos peixes menos gordurosos, ou nos peixes carnivoros como Tucanare e Pescada.Estes peixes sao colocados entre os mais caros no mercado de Manaus. Os peixes herbivoros e/ou onivoros como Matrincha, Curimata, Tambaqui e Branquinha apresentaram uma razao zinco/energia abaixo do nivel recomendado. Discutem-se as possiveis importancias desses resultados

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Descreve-se pela primeira vez uma cepa amazonica de Plasmodium falciparum resistente ao Fansidar (pirimetamina mais sulfadoxina) e quinino mais tetraciclina simultaneamente. O paciente, com 13 anos de idade, residia ha cinco anos em Ariquemes, Estado de Rondonia, na Amazonia brasileira. A infeccao foi curada com dose elevada de cloroquina administrada em dose unica intravenosa (IV). E evidenciado o alto valor da cloroquina na cura da malaria falciparum resistente, quando administrada em doses maiores que as usadas nos esquemas convencionais de tratamento

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O estado nutricional relacionado a vitamina "A" foi estudado em 382 operarios de ambos os sexos, de classe socio-economico baixa em qua tro fabricas de Manaus, atraves da utilizacao dos niveis de retinol e caroteno sericos e inquerito alimentar nas ultimas 24 horas. Pode-se constatar que os niveis sericos "abaixo de aceitaveis" de retinol em operarios de tres fabricas foi acima de 15% e o caroteno nos operarios das quatro fabricas foi de 51,1%. Os niveis sericos nao mostraram diferencas significativas por faixa de renda, mas o consumo de vitamina "A" equivalentes em operarios com niveis sericos de retinol alto eram significativamente mais alto do que os com niveis sericos de retinol baixo. A adequacao de consumo de vitamina "A" nas duas fabricas que ofereciam alimentacao foi superior as necessidades recomendadas, enquanto as outras duas apresentaram um deficit de consumo de, aproximadamente, 45%

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Summary In view of the scarcity of literature on food consumption and nutrient intakes in the Amazon Basin, the results of a household expenditure survey conducted in 1,200 families of Manaus in 1973-74 were analyzed. The frequency of families buying different foods and the daily per caput intake of these foods, were calculated. The diet was characterized by low vegetable, low legume, low fruit, high bread, high cassava flour and high fish consumption. Using food composition tables, daily per capita intakes of energy, protein, fat, carbohydrate, calcium, iron, vitamina A, riboflavin, thiamin, niacin and ascorbic, acid were estimated and compared with calculated recommendei intakes per capita. Sufficiences of Vitamin and mineral intake; in the medium wage group, considered the sample most representative of the city as a whole, were vitamin A 70,1%, thiamin 76,7%. riboflavine 77,5%, calcium 91,5% iron 154,2%, niacin 155,0% and ascorbic acid 155,6%. These results are worse than those reported for some state capitals of the north-east of Brazil, where malnutrition is considered to be endemic. These deficiencies need corroboration by analasis of local foods and clinical biochemical studies of the local population. The intake of protein and energy seems sufficient since 201% of protein requirements and 92,1% of energy requirements are met. Using the body mass index in the adult population group, obesity is indicated as not being uncommon, especially in middle aged women. The distribution of energy sources as 61,5% fron carbohydrates, 21,3% from fats and 17,2% fron protein would seem satisfactory in relation to recent recommendations of governments of developed countries, where obesity and atherosclerosis are the major public health problems. Based on the food consumption pattern a programme to stimulate production and consumption of vegetables should probably be the main government priority to improve the local food and nutrition situation.

Resumo Dados de consumo de alimentos e ingestão de nutrientes na Amazônia são escassos. Foram analisados dados já existentes da Primeira Pesquisa sobre Orçamentos Familiares feita entre 1.200 famílias de Manaus, em 1973 e 1974, pela CODEAMA. A dieta caracteriza-se pelo baixo consumo de verduras, legumes, frutas e leguminosas secas, além do alto consumo de peixe, pão e farinha de mandioca. Do ponto de vista quantitativo a dieta parece suficiente ao nível familiar, mas em termos qualitativos é deficiente, com níveis baixos de Vitaminas A e B. Medidas e políticas capazes de melhorar esse quadro em relação aos problemas de Saúde Pública atuais e futuros, são discutidas.

RESUMO

Summary In view of the scarcity of literature on food consumption and nutrient intakes in the Amazon Basin, the results of a household expenditure survey conducted in 1,200 families of Manaus in 1973-74 were analyzed. The frequency of families buying different foods and the daily per caput intake of these foods, were calculated. The diet was characterized by low vegetable, low legume, low fruit, high bread, high cassava flour and high fish consumption. Using food composition tables, daily per capita intakes of energy, protein, fat, carbohydrate, calcium, iron, vitamina A, riboflavin, thiamin, niacin and ascorbic, acid were estimated and compared with calculated recommendei intakes per capita. Sufficiences of Vitamin and mineral intake; in the medium wage group, considered the sample most representative of the city as a whole, were vitamin A 70,1%, thiamin 76,7%. riboflavine 77,5%, calcium 91,5% iron 154,2%, niacin 155,0% and ascorbic acid 155,6%. These results are worse than those reported for some state capitals of the north-east of Brazil, where malnutrition is considered to be endemic. These deficiencies need corroboration by analasis of local foods and clinical biochemical studies of the local population. The intake of protein and energy seems sufficient since 201% of protein requirements and 92,1% of energy requirements are met. Using the body mass index in the adult population group, obesity is indicated as not being uncommon, especially in middle aged women. The distribution of energy sources as 61,5% fron carbohydrates, 21,3% from fats and 17,2% fron protein would seem satisfactory in relation to recent recommendations of governments of developed countries, where obesity and atherosclerosis are the major public health problems. Based on the food consumption pattern a programme to stimulate production and consumption of vegetables should probably be the main government priority to improve the local food and nutrition situation.

Resumo Dados de consumo de alimentos e ingestão de nutrientes na Amazônia são escassos. Foram analisados dados já existentes da Primeira Pesquisa sobre Orçamentos Familiares feita entre 1.200 famílias de Manaus, em 1973 e 1974, pela CODEAMA. A dieta caracteriza-se pelo baixo consumo de verduras, legumes, frutas e leguminosas secas, além do alto consumo de peixe, pão e farinha de mandioca. Do ponto de vista quantitativo a dieta parece suficiente ao nível familiar, mas em termos qualitativos é deficiente, com níveis baixos de Vitaminas A e B. Medidas e políticas capazes de melhorar esse quadro em relação aos problemas de Saúde Pública atuais e futuros, são discutidas.