RESUMO
To assess the possible influence of altitude on childhood growth in the United States, we used data collected by the Centers for Disease Control Pediatric Nutrition. Surveillance System from eight mountain states to determine the height and weight status of children aged 5 years or younger enrolled in various public health programs between 1982 and 1984. The mean birth weight, height-for-age, weight-for-age, and weight-for-height indicators were found to decline significantly with increasing altitude, starting at an elevation greater than 1500 m (p less than 0.001, ANOVA). The reduction in growth was observed for all age groups and all birth weight groups studied. Part of the observed reduction in growth could be attributed to the lower birth weight of children born at higher altitude. However, the reduced growth status persisted after controlling for birth weight, suggesting the presence of an extrauterine growth retardation effect related to altitude.
Assuntos
Altitude , Crescimento , Peso ao Nascer , Estatura , Peso Corporal , Pré-Escolar , Coleta de Dados , Humanos , Lactente , Recém-Nascido , Estados UnidosRESUMO
In some child populations, low height-for-age, suggesting chronic undernutrition, may paradoxically be accompanied by relatively high weight-for-height, suggesting obesity. This growth pattern was investigated with anthropometric assessment and body composition studies using H2(18)O stable isotope dilution in 139 preschool-age Peruvian children. Results suggested low height-for-age (15th percentile National Center for Health Statistics [NCHS]) and high weight-for-height (60th percentile NCHS). Skinfold thicknesses were lower whereas arm muscle areas were more similar to NCHS reference values. Total body water (as percent body weight) was greater than reference values, consistent with lower body fat. Differences in body proportions did not account adequately for the high weight-for-height. The data suggest that the high weight-for-height in these children is not obesity but is associated with lower body fat and greater lean tissue or lean tissue hydration that may reflect dietary, environmental, or genetic influences. Weight-for-height cutoffs for wasting or obesity may require different interpretations for different populations.
Assuntos
Composição Corporal , Estatura , Peso Corporal , Estado Nutricional , Fatores Etários , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Peru , Fatores Sexuais , Dobras CutâneasRESUMO
Total body water (TBW) was measured by 18O dilution in 139 undernourished, preschool Peruvian children with high weight-for-height. Values for TBW as a percent of body weight were relatively high, averaging 67.4 +/- 6.4%. Depending upon the method of calculation, mean values for the sample population for percent fat ranged from 9.4-18.5%. Regression of TBW on lean body mass suggested that hydration of the fat-free body was higher than for normally nourished children of comparable age. Thus, the increased weight-for-height in these children did not result from increased fat tissue, but from increased hydration of the fat-free body. TBW was most highly correlated with height and weight, both with r = 0.95. Equations predicting TBW from either height or weight were significantly different from those developed by other investigators to predict TBW for normal, well-nourished American children.
Assuntos
Estatura , Água Corporal/análise , Peso Corporal , Transtornos do Crescimento/epidemiologia , Antropometria , Pré-Escolar , Feminino , Transtornos do Crescimento/metabolismo , Humanos , Lactente , Masculino , Distúrbios Nutricionais/epidemiologia , Distúrbios Nutricionais/metabolismo , PeruRESUMO
Nutritional status surveillance data based on the clinical diagnosis of malnutrition and on weight-for-age, as well as diarrhoeal disease data for preschool age children attending government health clinics in El Salvador are presented for a 3-year period (1975 - 77). Surveillance results indicated consistently higher rates of clinical malnutrition and weight-for-age deficit in rural children as compared with urban children, and higher malnutrition rates in children 1 - 4 years of age as compared with infants less than 1 year old. Consistent seasonal increases in malnutrition were observed that were most pronounced in older preschool children (1 - 4 years) in rural areas. Seasonal peaks in malnutrition consistently followed 1 - 2 months after the major seasonal peak in diarrhoea at the onset of the rainy season, suggesting that diarrhoea may play a role in the etiology of malnutrition. A secondary seasonal peak in diarrhoea in the cooler, dry season was most prominent in infants but was not related to increased malnutrition. These results indicate that nutritional and health status indicators formed from data collected regularly at health centres can demonstrate consistent age group, urban/rural, and seasonal differences in nutritional status that may be useful in identifying risk groups and in monitoring nutritional changes for planning and evaluation purposes.
Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Inquéritos Nutricionais , Peso Corporal , Pré-Escolar , Diarreia/epidemiologia , El Salvador , Humanos , Lactente , Distúrbios Nutricionais/epidemiologia , População Rural , Estações do Ano , População UrbanaRESUMO
Data are presented to quantify the relationship between nutritional status and diarrheal disease reported in a 1-week period in children in El Salvador. A strong association was observed between reported diarrhea and combined wasting (defined by low weight-for-height) and stunting (defined by low height-for-age). This association held for all age groups studied and was consistently observed in the seasons of low and high prevalence of malnutrition. There were also significant associations between reported diarrhea and wasting alone, low weight-for-age, and low arm circumference. No consistent association was observed between reported diarrhea and stunting or chronic undernutrition as defined by low height-for-age, suggesting that short stature is not, by itself, a risk factor for diarrhea. Previously defined seasonal patterns of malnutrition for El Salvador as a whole were confirmed and appear to affect some geographic subregions more severely than others. Definition of these regional and seasonal patterns of malnutrition and their association with diarrhea has implications for the targeting and timing of nutrition interventions.
Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Diarreia/epidemiologia , Estatura , Peso Corporal , Criança , Pré-Escolar , Diarreia/etiologia , El Salvador , Humanos , LactenteRESUMO
Arm circumference indicators of nutritional status such as simple arm circumference, arm circumference-for-age and arm circumference-for-height have advantages for field use because of their simplicity and low cost. However, these indicators need to be evaluated in terms of their ability to identify children who are manourished by more accepted criteria such as weight-for-age and weight-for-height. This study used sensitivity-specificity analysis to evaluate arm circumference indicators in 3838 children 1 to 4 years of age in a rural area of El Salvador. It was found that simple arm circumference gave sensitivity-specificity results similar to arm circumference-for-age and generally better than arm circumference-for-height in identifying children with low weight-for-age. The three arm circumference indicators gave similar sensitivity-specificity results in identifying children with low weight-for-height. Linear correlations of the arm circumference indicators with weight-for-age and weight-for-height gave results which correspond to the results of sensitivity-specificity analysis, but the information obtained from correlations to was less useful in evaluating the adequacy of the individual arm circumference indicators for screening purposes. Sensitivity-specificity analysis is proposed as useful method for evaluating indicators for use in nutritional surveys and for screening for malnutrition.
Assuntos
Antropometria/métodos , Braço/anatomia & histologia , Distúrbios Nutricionais/epidemiologia , Envelhecimento , Estatura , Peso Corporal , Pré-Escolar , El Salvador , Humanos , Lactente , Programas de Rastreamento/métodosRESUMO
A dietary survey was conducted in a department of El Salvador as part of an assessment of the nutritional status of preschool children. Intake of calories, protein and retinol equivalents were estimated using a 24-hour recall technique. The average daily energy intake for children 1-4 years old was 866 Kcal representing 60% of the 1973 level recommended by the Institute of Nutrition of Central America and Panama (INCAP), for this age group, and 76% of the recommended level on a body-weight basis. Average protein intake per child per day in the same age group was 31.3 g, which represents 110% of the recommended level for the age group, and 136% of the recommended level on a body weight basis. The estimated retinol equivalent intake was 36% of the recommended allowance. In general, the results of the present study were similar to those obtained in the study carried out in El Salvador by INCAP during the period September-November, 1965.
Assuntos
Dieta , Proteínas Alimentares/normas , Ingestão de Energia , Vitamina A/normas , Pré-Escolar , El Salvador , Humanos , Lactente , Inquéritos NutricionaisRESUMO
PIP: An ongoing nutritional surveillance system has 2 advantages: 1) it provides information less expensively than would a nutritional survey; and 2) data can be available on a continuous routine basis within a few weeks or months after collection. Nutritional surveillance systems ideally should 1) be multisectorial in design; 2) be organized within the framework of existing information channels; 3) be based on a standard set of indicators selected after careful assessment of their validity; and 4) be aimed towards vulnerable population groups. This report describes the development of a nutritional status surveillance activity within the Ministry of Health of El Salvador for use in health planning and evaluation. However, the surveillance activity in El Salvador was not multisectorial in design but was developed solely within the health sector because it was felt that nutritional surveillance could best be developed in a step-by-step manner and that monitoring nutritional status within the health sector was a logical first step. Other causal factors in malnutrition can then be added later as resources and opportunities permit to form a more comprehensive surveillance system. Steps in the project development in El Salvador included: 1) recognition of need; 2) evaluation of indicators (e.g., clinical diagnosis indicator and weight-for-age indicator), and; 3) design of surveillance data collection system. It is hoped that in the future, data from other sectors can be combined with the nutritional status data to form what could justifiably be termed a 'nutritional surveillance system'.^ieng
Assuntos
Peso Corporal , Inquéritos Nutricionais , Pré-Escolar , El Salvador , Humanos , Lactente , Saúde da População Rural , Saúde da População UrbanaRESUMO
Clinical nutrition status as well as selected biochemical characteristics, levels of parasitic infection and aspects of family and health history were assessed in rural EI Salvadoran children categorized as severely malnourished by anthropometric measurements. The anthropometric categories used were based on weight-for-age, weight-for-height, height-for-age, and simple mid-upper-arm circumference. Results indicated that 16 of 17 children with less than 80% of expected weight-for-height ("wasted") and all 17 children with arm circumference below 12.5 cm had clinically evident malnutrition. Children with less than 82.5% of expected height-for-age ("stunted") were more frequently anemic than controls and had a higher intestinal parasite burden, but only 3 of 23 were malnourished clinically. Sixteen of 22 children with severe weight-for-age deficit (Gomez grade III) were judged clinically malnourished, but the remaining six were underweight primarily because of short stature and did not appear malnourished clinically. The results illustrated the inability of weight-for-age classification to distinguish between acute and chronic malnutrition. The interrelationships between weight-for-height, height-for-age, and weight-for-age classification are illustrated graphically as a guide to the interpretation of these results.
Assuntos
Peso Corporal , Desnutrição Proteico-Calórica , Envelhecimento , Antropometria , Braço/anatomia & histologia , Proteínas Sanguíneas/metabolismo , Criança , Pré-Escolar , El Salvador , Fezes/parasitologia , Feminino , Transtornos do Crescimento/complicações , Hemoglobinas/metabolismo , Humanos , Lactente , Enteropatias Parasitárias/complicações , Kwashiorkor/sangue , Masculino , Músculos/patologia , Contagem de Ovos de Parasitas , Desnutrição Proteico-Calórica/sangue , Desnutrição Proteico-Calórica/complicações , Desnutrição Proteico-Calórica/patologiaRESUMO
The nutritional status of preschool children in a rural El Salvadoran population was assessed quarterly for 1 year using height, weight and arm circumference measurements in order to define seasonal changes in malnutrition. Seasonal patterns in the incidence of reported malnutrition and diarrheal disease from the local clinic serving the study population and on the national level for EL Salvador were also assessed and were compared with field measurements. Results indicated a similar seasonal increase in both measured malnutrition and in the reported incidence of malnutrition and diarrheal disease occurring at the onset of the rainy season. The results confirm the existence and indicate the magnitude of seasonal changes in malnutrition and diarrheal disease in a preschool population.
Assuntos
Diarreia/epidemiologia , Desnutrição Proteico-Calórica/epidemiologia , Estações do Ano , Estatura , Peso Corporal , Pré-Escolar , Diarreia Infantil/epidemiologia , El Salvador , Humanos , Lactente , Inquéritos NutricionaisRESUMO
Goiter examination was performed on 7,785 children aged 9 to 16 years in four areas of the United States--Michigan, Kentucky, Texas, and Georgia. Urinary iodine and creatinine, thyroxine, protein-bound iodine, and plasma inorganic iodide determinations were made on 377 matched pairs of goitrous and nongoitrous control children. The overall prevalence of goiter was 6.8%. Most children with goiter had palpably but not visibly enlarged thyroids and showed no evidence of clinical or biochemical thyroid abnormalitymmean urinary iodine excretion was 452 mug/gm of creatinine, many times the 50 mug/gm of creatinine level used to define deficiency. Children with goiter and areas with high goiter prevalence tended to have higher rather than lower iodine excretion. These findings are consistent with other data indicating high iodine intakes in the United States and suggest that goiter in American children cannot be assumed to be related to iodine deficiencymthe possible role of high iodine intake in the causation of goiter is discussed.