Identification and production of local carotene-rich foods to combat vitamin A malnutrition.

Objectives: To address, with respect to improvement of human vitamin A status by dietary approaches, the three theoretical postulates that: 1) the most practical and economical manner to increase the amount of dietary vitamin A available to low-income persons in low-income nations is through plant sources of provitamin A carotenoids; 2) there will be constraints and limitation to the efficiency of a given intervention approach related to behavioural, cultural, biological and botanical considerations; and 3) the nature of these constraints and limitations must be understood, and then overcome where possible, to maximize the impact of such interventions on the vitamin A status of developing country populations.

Conclusions: We review how local plant sources of provitamin A that would be acceptable for the at-risk populations and outline six settings and scenarios for the processing of carotene-rich foods: 1) cooking for hygiene; 2) long-term preservation; 3) compacting to reduce volume; 4) formulation for specific consumers; 5) improving bioavailability and bioconversion; and 6) to increase 'value added' in commerce. We describe our experiences in Guatemala (with sweet potato flakes), and those of others in the Caribbean, the African Sahel, and East Africa (with solar-drying for preservation of a variety of plants), and in Sri Lanka (with leaf concentrates) in promoting increased carotene-rich food intake, and the lessons learned from their evaluations.

Bioelectrical impedance spectroscopy (BIS) in young children with acute and semi-acute hydration disorders: potentials and limitations.

This study aimed to evaluate the feasibility and reliability of bioelectrical impedance spectroscopy in young children suffering of acute hydrational disorders. Whole body and segmental measurements were carried out in a group of 42 of children aged 4 to 147 months, using a BIS analyzer (Xitron 4000B). This phase of the study involved several hundred of BIS measurement, which showed the feasibility of using this technique in young children.

Mild human zinc deficiency produces an imbalance between cell-mediated and humoral immunity.

Experimental studies in human volunteers confirm an influence of zinc nutriture on the balance between lymphocyte TH1 elements and functions (cell-mediated immunity) and TH2 elements and functions (humoral immunity).

Aging, physical activity, insulin-like growth factor I, and body composition in Guatemalan women.

Aging is associated with diminished secretion of growth hormone and the major endogenous mediator of growth hormone action, insulin-like growth factor I (IGF-I). Aging is also associated with decreased physical activity. Alterations in body composition characteristic of the aging process (increased fat mass and decreased lean body mass) may be related to the decline in anabolic effects of IGF-I with aging, decreased physical activity, or both.

Nutritional status indicators and their interactions in rural Guatemalan elderly: a study in San Pedro Ayampuc.

Anthropometry and body-composition measures, hematologic and biochemical measures of nutritional status, and helminthic infection were studied in the population of elderly persons (> or = 60 y of age) in a rural village in Guatemala that was 65% Mayan (indigenous) and 35% ladino (European). The population had low levels of literacy and formal education. The elderly persons were much shorter and lighter than reference populations.

Effects of discontinuing coffee intake on iron status of iron-deficient Guatemalan toddlers: a randomized intervention study.

Coffee is one of the first liquids given to infants in Guatemala. To evaluate whether this practice has an adverse effect on iron status, 160 children 12-24 mo of age who had received coffee for > or = 2 mo and had at least one indicator of iron deficiency were stratified by initial hemoglobin concentration (anemic, or nonanemic, ie, hemoglobin > or = 105 g/L) and randomly assigned to a control (continuation of coffee; coffee) or intervention (provided with a substitute consisting of sugar and coloring; substitute) group for 5 mo. Anemic children were provided with iron supplements for 2-3 mo.

A randomized intervention study of the effects of discontinuing coffee intake on growth and morbidity of iron-deficient Guatemalan toddlers.

Coffee is widely consumed by children in Guatemala. To evaluate whether coffee has an adverse effect on growth or morbidity, 160 children 12-24 mo of age who had received coffee for > or = 2 mo and had at least one indicator of iron deficiency were stratified by initial hemoglobin (Hb) (A = anemic vs. NA = "nonanemic", i.

Intestinal helminths and their influence on the indicators of iron status in the elderly.

The intestinal helminthiasis and hematological status was assessed in 100 elderly residents of two low-land communities, one at sea-level and the other at 61; m, equally representative of men and women. These are beth low-income communities. The population showed a 48% helminth infection rate which consisted of hookworm, Trichuris, and Ascaris infection.

Body composition and disease: is there anything new to be learned?

The observation that disease has an effect on the tissues of the human body is as old as medicine, itself, and was not lost on preliterate and pre-technological societies. Primary changes in the amount, proportions or quality of total body mass, specific organs and specific tissues constitute pathologies; conversely, changes in body composition secondary to and conditioned by diseases are myriad. The classification of most of the associations has been roughly addressed.

Plant sources of vitamin A and human nutrition: renewed strategies.

The ability of a supplement of local, cooked green leaves to support vitamin A nutriture of anemic, lactating rural Indonesian women was tested using increments in carotenoid and retinol content in plasma and breast milk as indices of bioavailability and bioconversion, respectively. While beta-carotene provided in a simple matrix of a fortified cracker produced substantial improvements in both vitamin A and carotenoid status, an equivalent amount from stir-fried vegetables had a negligible effect.

A comparison of body fat estimates using anthropometry and bioelectrical impedance analysis with distinct prediction equations in elderly persons in the Republic of Guatemala.

Bioelectrical impedance analysis (BIA) has been proposed as a technique to estimate body composition. Its application has extended beyond the clinical setting, however, it remains to be determined if the BIA prediction formulas published to date provide comparable body composition estimates in elderly populations. The objective of this study was to compare the estimates of body fat derived from published prediction equations in a developing country's population such as Guatemala.

The effects of dairy products on body composition, bone mineralization, and weight in adolescent girls.

Twelve months of a consistent average daily intake of calcium to at least the 1200-mg Recommended Dietary Allowance (RDA) was achieved by 22 adolescent girls. At the end of the year the calcium-enriched group showed no significant differences in body composition, bone mass, or bone density from peers consuming an average of 728 mg of calcium.

Weekly versus daily oral iron administration: are we asking the right questions?

The separation of oral iron doses to conform to cycle of intestinal mucosa turnover has been suggested by some as a method to improve the efficiency of uptake for therapeutic doses of iron. A short-term study in healthy American women failed to confirm a superior absorption of radioiron with a 7-day interval versus everyday administration of a 50-mg iron dose, but the iron status of the experimental subjects may have produced an inappropriate population on which to test a question relevant to Third World populations.

Clinical trial of glucose-oral rehydration solution (ORS), rice dextrin-ORS, and rice flour-ORS for the management of children with acute diarrhea and mild or moderate dehydration.

Objective: To assess the effects of glucose (G)-oral rehydration solution (ORS), rice dextrin (RD)-ORS, and rice flour (RF)-ORS on fluid intake, rapidity of rehydration, and stool output of children with acute diarrhea and mild or moderate dehydration.

Methods: The study was a randomized, double-masked clinical trial. One hundred forty-six male infants, ages 3 to 36 months, were randomly assigned to one of three treatment groups.

The interobserver reproducibility of bioelectrical impedance analysis measurements in infants and toddlers.

Although nomograms to convert readings of resistance (R) and reactance (Xc) into estimates of body composition have begun to emerge for children as well as adults, there has been reluctance to use bioelectrical impedance analysis (BIA) in very young children due to the irritability of children, measurement instability, positioning of electrodes, and, of course, reproducibility of measurements. The precision of completely independent measurements of BIA indices was evaluated by two observers by comparing a series of 40 measurements of R and Xc and 36 measurements for weight in four malnourished children on 10 different days during the course of their nutritional recuperation. For weight, the CV (coefficient of variation) was 3.

The underprivileged, developing country child: environmental contamination and growth failure revisited.

A major public health challenge to human populations in developing countries is poor linear growth and failure to maximize genetic potential in final adult stature. It is now clear that this process occurs in early life, and neither genetics nor dietary intake, or both, is the complete determinant. We suggest that a situation similar to the phenomenon of impaired growth of poultry and livestock reared under unsanitary conditions occurs in children from underprivileged countries.

Plant sources of provitamin A and human nutriture.

Hypovitaminosis A is a problem in many parts of the developing world. Beyond the stop-gap measures of capsule distribution and food fortification, increased consumption of accessible sources of vitamin A, specifically of the carotenoid provitamin A in yellow, orange, and green plants, has been promoted as the sustainable, long-term solution. However, a search of the available literature reveals few examples of human studies to support the effectiveness of this solution.

The effect of zinc supplementation on parasitic reinfestation of Guatemalan schoolchildren.

One hundred thirty children (65-95 mo old) from a low-socioeconomic neighborhood of Guatemala City participated in a randomized, double-blind, controlled trial of zinc supplementation. One group received 10 mg Zn/d (n = 65) and the other group received a placebo (n = 65); 90 +/- 9.2 doses were given over 120-150 d.

Uses of anthropometry in the elderly in the field setting with notes on screening in developing countries.

A field setting can be defined as any setting outside of a fixed, permanent, and sophisticated health facility or research laboratory. The most important applications of anthropometry at field level include biological anthropology, epidemiology, clinical application, and metabolic research. Data collecting in the field setting requires different levels of accuracy and precision; the standardization should also consider intra- and inter-observer variability due to the possibility of more than one observer participating in a given survey.

Preparation effects on tortilla mineral content in Guatemala.

We have previously reported that in Guatemala, the calcium, iron, and zinc contents of tortillas from rural areas are higher that that of tortillas from urban centers. This study examines variation in the calcium, iron, zinc and copper content of tortilla according to the implements used for making tortillas and inquires as to whether preparation effects mediate rural-urban variation in tortilla mineral content. Tortilla samples and information on how the tortillas were prepared were collected from the female heads of a total of 50 households from three rural, two semi-urban and one low income urban community.

The distribution of intestinal helminth infections in a rural village in Guatemala.

Fecal egg count scores were used to investigate the distribution and abundance of intestinal helminths in the population of a rural village. Prevalences of the major helminths were 41% with Ascaris lumbricoides, 60% with Trichuris trichiura and 50% with Necator americanus. All three parasites showed a highly aggregated distribution among hosts.