The status and trend of child growth failure (CGF) burden in children aged < 5 years in China / 公共卫生与预防医学

Objective To analyze the status and trend for the mortality and DALY rates of child growth failure (CGF) in children aged < 5 years in China from 1990 to 2019, so as to provide a scientific basis for CGF prevention and control. Methods The mortality and DALY rates of CGF in children aged < 5 years from 1990 to 2019 were obtained from GBD 2019. The changes of these indicators with the years in China , the United States, Japan, Russia, India and the global were compared and analyzed. Results In 2019, the mortality of child wasting, child stunting and child underweight in children aged < 5 years in China were 9.62/100 000, 1.23/100 000, and 1.29/100 000 respectively, the mortality rates were 867.50/100 000 , 129.23/100 000 , and 112.87/100 000 rescpectively, higher than those of the United States, Japan, and Russia, and far lower than those of India and the global. The disease burden of three types of CGF were all higher in males than females, and higher in children aged < 1 years than children aged 1-4 years. From 1990 to 2019, the mortality and DALY rates of CGF in children aged < 5 years in China decreased from 300.41/100 000 and 26 445.38/100 000 to 10.49/100 000 and 943.57/100 000, respectively. China had the largest drop rate compared with all analyzed countries. As for children aged < 5 years in China, the DALY rate of lower respiratory infection ranked first in all the diseases caused by CGF. Conclusion From 1990 to 2019, the disease burden of CGF in children aged < 5 years has shown a significant decrease in China , but it is still far behind the developed countries. In the future, more attention should be paid to the problems of child growth in hope of reducing the mortality and DALY rates of CGF.

Breastfeeding practices and head circumference in young children: a systematic review

ABSTRACT OBJECTIVE To review observational studies on the association between breastfeeding (BF) practices and head circumference (HC) of children < 2 years old. METHODS A systematic review was conducted using the following electronic databases of health sciences: PubMed, Latin American and Caribbean Literature in Health Sciences (Lilacs), Web of Science and Scopus. We selected observational studies published in any language from January 01, 2010 to November 19, 2021, from different populations that investigated the association between BF practice and HC among healthy children < 2 years old. Titles and abstracts were screened independently by two evaluators. RESULTS From the 4,229 articles identified, 24 were included in this review: 6 cross-sectional, 17 longitudinal, and 1 case-control. The studies varied in their definition of the variables for BF and in reporting its practice, frequency, duration, and feeding method. Regarding HC, the authors analyzed the mean differences, abnormal values (z-score above + 2SD or below -2SD according to the World Health Organization (WHO) growth standards, 2007), and longitudinal growth parameters. The findings of this review suggest that BF may have a positive relationship with HC at the beginning of life. CONCLUSIONS Our findings suggest that BF, especially exclusive BF, may play a protective role against abnormal HC values in young children. However, more robust evidence with standardized BF indicators and WHO growth standards (2007) are required.

Biochemical markers and anthropometric profile of children enrolled in public daycare centers

Abstract Objective: The nutritional status resultant from dietary habits along with socioeconomic conditions and the school environment are directly related to the individual's health condition not only in their childhood but also throughout adulthood. The aim of this study was to evaluate the effects of socioeconomic factors on the anthropometric profile and to analyze a probable association between this profile and biochemical markers in children attending public daycare centers. Methods: It is a transversal study developed in a probability sample of clusters of children from 6 months to 5 years old. Anthropometric and socioeconomic data were gathered at the CMEIs, questionnaires on the nutritional status were applied and blood was collected at the Family Health Units (USFs). Results: Female children are three times more likely to be underweight; in families with five members, it is 1/3 more likely that children of higher-educated parents are overweight. Among the results of the biochemical tests, hypervitaminosis A was a relevant aspect, positively correlating with copper (p=0.005) and zinc (p=0.008). Conclusion: Therefore, since the influence of the family is an important predictor of overweight and its future outcomes related to nutritional deficiencies and inadequate dietary intake, educational interventions are vital as a way to pave the path to prevention.

Fatores associados ao crescimento de crianças filhas de mães com agravo de transmissão vertical

RESUMO Objetivo: Analisar os fatores associados ao crescimento infantil de filhos de mulheres diagnosticadas com agravo de transmissão vertical. Material e Método: Estudo longitudinal, retrospectivo e quantitativo. A amostra foi composta por prontuários de filhos de mulheres com HIV/AIDS, sífilis e toxoplasmose gestacional do ambulatório de alto risco do noroeste do Paraná, Brasil. Para a análise dos dados, realizou-se estatística descritiva e teste Qui-quadrado. Resultados: Analisou-se 136 prontuários de filhos de mulheres com agravo de transmissão vertical, sendo 59,6% com sífilis, 22,8% toxoplasmose e 17,6% HIV. Crianças filhas de mães com toxoplasmose e HIV/ AIDS, apresentaram 2,7 e 4,1 maiores chances, respectivamente, de desenvolver alterações de crescimento na infância. Verificaram-se alterações de crescimento em 61% dos encaminhamentos, os quais foram associados às variáveis de nascimento. Os percentis fora da normalidade apresentaram predominância do diagnóstico nutricional de magreza acentuada. Conclusões: Os fatores associados às alterações do crescimento identificados nesse estudo foram parto cesárea, Apgar no primeiro e quinto minuto inferior a sete, idade gestacional inferior a 36 semanas e etnia não branca. O sexo e peso não apresentaram associação.

ABSTRACT Objective: To analyze the factors associated with child growth in children of women diagnosed with vertical transmission disease. Material and Methods: Longitudinal, retrospective and quantitative study. The sample consisted of medical records of children of women with HIV/ AIDS, syphilis and gestational toxoplasmosis from the high-risk outpatient clinic of northwestern Paraná, Brazil. For data analysis, descriptive statistics and Chi-square test were performed. Results: We analyzed 136 medical records of children of women with vertically transmitted disease, 59.6% with syphilis, 22.8% toxoplasmosis and 17.6% HIV. Children born to mothers with toxoplasmosis and HIV/AIDS had 2.7 and 4.1 greater chances, respectively, of developing growth alterations in childhood. Growth alterations were observed in 61% of referrals, which were associated with birth variables. The non-normal percentiles presented a predominance of the nutritional diagnosis of marked thinness. Conclusions: Factors associated with growth alterations identified in this study were cesarean delivery, Apgar in the first and fifth minutes of less than seven, gestational age less than 36 weeks and non-white ethnicity. Sex and weight were not associated.

RESUMEN Objetivo: Analizar los factores asociados con el crecimiento infantil en niños de mujeres diagnosticadas con enfermedad de transmisión vertical. Material y Método: Estudio longitudinal, retrospectivo y cuantitativo. La muestra consistió de registros médicos de hijos de mujeres con VIH/SIDA, sífilis y toxoplasmosis gestacional de una clínica ambulatoria de alto riesgo en el noroeste del estado de Paraná, Brasil. Para el análisis de datos, se realizó estadística descriptiva y prueba de Chi-cuadrado. Resultados: Se analizaron136 registros médicos de hijos de mujeres con enfermedades de transmisión vertical, 59,6% con sífilis, 22,8% de toxoplasmosis y 17,6% de VIH. Los niños nacidos de madres con toxoplasmosis y VIH/SIDA tenían 2,7 y 4,1 más probabilidades, respectivamente, de desarrollar alteraciones del crecimiento en la infancia. Se observaron alteraciones del crecimiento en el 61% de las derivaciones, las cuales se asociaron a variables de nacimiento. Los percentiles no normales fueron mayores para delgadez acentuada. Conclusiones: Los factores asociados con las alteraciones del crecimiento identificadas en este estudio fueron el parto por cesárea, el Apgar en el primer y quinto minuto de menos de siete, la edad gestacional de menos de 36 semanas y la etnia no blanca. El sexo y el peso no se asociaron.

The importance of encouraging child development

@#Quality child growth and development are important tools in assisting today's children to become the adults of the future. Hence, developmental delays in young children have an impact not only on a child's abilities to learn new skills, but also in the opportunities of the greater community or society. In this regard, parents and caregivers are the most well-equipped to prevent the child from experiencing developmental delays. Children will learn to trust the person who sensitively interacts with them and this trust provides a foundation for future learning, growth, and development. This paper looks at the importance of encouraging child development through the parents or guardians of children, since they are inevitably linked to a child's learning, and they know their own children better than anyone else. Parents and guardians who do not have the skills required to monitor and encourage the development of young children can and should be trained by professionals. This research reveals that training parents and guardians to use the Developmental Surveillance and Promotion Manual in monitoring and encouraging development of young children is a very important way to prevent future developmental delays.

Regional variation in maternal and childhood undernutrition in Bangladesh: evidence from demographic and health surveys.

Background: Undernutrition among mothers and children is currently a major public health and development concern in Bangladesh. In literature relating to nutritional determinants, of particular interest is the geography, as regions with poor nutrition tend to pull down the overall nutritional status of the country. As such, reducing the regional gap can alone reduce overall undernutrition significantly, especially when regional gaps are high. The aim of this study is, therefore, to assess the magnitude of inequalities in undernutrition in children aged under 5 years in Bangladesh and their mothers, and relate this to the administrative divisions of the country. Methods: The Bangladesh Demographic and Health Surveys (1996–1997, 1999– 2000, 2004 and 2007) were the sources of data, and a total of 16 278 mother–child pairs whose records were complete for the required individual and household-level variables were included in the analysis. Maternal nutritional status was measured by the body mass index (BMI). Weight-for-age, height-for-age and weight-forheight z-scores were calculated by use of the World Health Organization (WHO) Child Growth Standards to assess the nutritional status of children aged under 5 years. General linear model, sequential linear and multinomial logistic regression analyses were done to assess the inequalities in maternal and child nutritional status among the six administrative divisions of Bangladesh. Socioeconomic variables that were controlled for were residency, education and occupation of the mothers and their husbands, house type and possession score in the household. Results: Maternal BMI and prevalence of underweight, stunting and wasting in children aged under 5 years were found to vary significantly according to administrative division. Of the six divisions, Sylhet was found to have highest prevalence of undernourished mothers and children. The trends from 1996 to 2007 also established Sylhet as the poorest-performing region overall. Conclusion: The Sylhet administrative division needs specially focused attention from policy-makers if the overall performance of the health, nutrition and population sector is to reach the targets set by the country.

Prevalence of underweight among children under five years in Mongolia / Монголын Анагаах Ухаан

IntroductionOne key target of the United Nations Millennium Development goals is to reduce the prevalence of underweight among children younger than 5 years by half between 1990 and 2015. Child malnutrition is internationally recognized as an important public health indicator for monitoring nutritional status and health in populations. World Health Organization estimated the malnutrition was associated with 54% of child deaths in developing countries. The devastating effects of malnutrition on human performance, health, and survival are well-established and a recent global analysis demonstrated that child malnutrition is the leading cause of the global burden of disease. The importance of assessing population nutritional status every 5 years is widely recognized, and three rounds of National Nutrition Survey were carried out in Mongolia since 1992 with support from UNICEF. The most recent Third National Nutrition Survey was carried out with the purpose of assessing nutritional status of Mongolian children and women six years ago in 2004.ObjectiveTo describe the national prevalence of underweight in children under five.Materials and MethodsThe current cross-sectional survey was conducted in 21 provinces of 4 economic regions of the country and capital Ulaanbaatar city. Household was randomly selected based on local administrative and soum/family hospital registry and enrolled a total of 706 children aged 0-59 months were selected from sampled households. Interviews, anthropometric measurements and clinical examinations were used in the survey. Child growth was assessed based on z-scores calculated using the WHO Child Growth Standard. Low weight-for-age (underweight) can result from either long-term or short-term nutritional deficit.Results4.7% of the surveyed children were underweight. According to the WHO criteria the prevalence of underweight in Mongolian children less than 5 years of age was include “low prevalence rate”. The prevalence of the underweight among children less than 5 years was significantly higher in Rural area than the Urban.Conclusions:1. The national prevalence of underweight remains at “low” level according to WHO classification. 2. Child malnutrition reduction is needed to successfully meet the Millennium Development Goals.3. In rural area the prevalence of underweight among in 0-59 months old children was highest than urban area’s children.4. The prevalence of nutrition deficiencies varies between different regions calling for implementation of interventions specific for local conditions and needs.

The effect of breastfeeding in body composition of young children

INTRODUCTION: the effect of breastfeeding over the body mass components still demands analyses aiming to further investigate the body composition evolution in the after-breastfeeding childhood. OBJECTIVE: analyze the influence of breastfeeding (BF) over the body composition of children under 3 years old. METHODS: 760 children between zero and 3 years old were selected from the data of the longitudinal, home-based study "Saúde das Crianças de São Paulo II" ["São Paulo's Children Health II"] (1995-1997). The outcome variables used were the anthropometric indexes BMI-for-age (Z BI) and triceps skinfold-for-age (Z DI) expressed in Z-scores based on the WHO reference curve. Panel regression models were used in the analyses, with data from the 3 visits, adjusted by: birth weight, mother's educational level and mother's age. RESULTS: there was no association between breastfeeding and Z BI after multiple adjustments. There was inverse association between BF duration and the Z DI index. The interaction between the mother educational level and the BF duration revealed the protective effect of higher educational level over Z DI , when isolated. The mean nutritional indexes showed dose-response effect inversely proportional to the BF duration. CONCLUSION: breastfeeding showed protective effect against the mean body fat increase in children younger than 3 years...

INTRODUÇÃO: o efeito do aleitamento materno sobre os componentes da massa corporal ainda demanda análises que visem a aprofundar a evolução da composição corporal no período infantil posterior ao aleitamento materno. OBJETIVO: analisar a influência do aleitamento materno sobre a composição corporal de crianças menores de 3 anos. MÉTODO: Foram selecionadas 760 crianças entre 0 e 3 anos a partir dos dados do estudo longitudinal de base domiciliar "Saúde das Crianças de São Paulo II" (1995-1997). As variáveis utilizadas como desfecho foram os índices antropométricos IMC-para-idade (Z BI), e dobra cutânea triciptal-para-idade (Z DI), expressos em escores Z da curva de referência da OMS. Nas análises foram utilizados modelos de regressão em painel, com dados das 3 visitas, ajustados por: peso ao nascer, escolaridade da mãe e idade da mãe. RESULTADOS: Não houve associação entre aleitamento materno e Z BI após o ajuste múltiplo. Houve associação inversa entre a duração do AMP e o índice Z DI. A interação entre escolarização materna e duração do AMP revelou o efeito protetor, quando isolado, da maior escolarização sobre o Z DI. As médias dos índices nutricionais apresentaram efeito dose-resposta inversamente proporcional ao aumento na duração do AMP. CONCLUSÃO: o aleitamento materno apresentou efeito protetor contra o aumento médio da gordura corporal em menores de 3 anos...

Utilización de gráficos de crecimiento infantil / Children growth charts utilization

Impresiona un abandono casi total del uso de gráficos de crecimiento en la evaluación nutricional del niño. La introducción de los Cuadernos de Chile Crece Contigo no ha conseguido revertir esta situación. Su distribución está limitada a las maternidades públicas, los gráficos presentan dificultades por su exiguo tamaño y la supervisión es nula. Se decidió cuantificar la utilización de gráficos y evaluar la percepción nutricional de las madres. Se realizaron entrevistas a madres de niños(as) de 12-59 meses, en Consultorios de Lo Espejo, área sur de Santiago, que portaran un carnet de control. Se registraron los datos del paciente, edad y nivel educacional de la madre. Se consultó a la madre sobre el estado nutricional del niño. Luego se le mostraron datos de una niña en 4 formatos diferentes: valores numéricos, desviación estándar, gráfico y porcentaje de la mediana, solicitando definir el estado nutricional del caso e indicar las preferencias sobre las formas de presentación. Se analizaron 109 carnets, 10 de Chile Crece Contigo; de los cuales, uno tenía el gráfico con curva dibujada; de los otros 99, de diseño antiguo, sólo 11 tenían un gráfico impreso y ninguno tenía la curva de crecimiento del niño dibujada. De las madres entrevistadas, 2 eran menores de 20 años y el 65 por ciento completó la enseñanza media. El 83 por ciento definió satisfactoriamente el estado nutricional del hijo(a) y el 60 por ciento lo hizo en relación al caso mostrado, siendo esto último relacionado significativamente con el nivel escolar materno. La forma de presentación de datos preferido fue el de valores absolutos (41 por ciento), seguido del gráfico con un 28 por ciento. Este estudio demuestra el abandono de los gráficos como forma de visualización del crecimiento infantil, herramienta básica tanto para madres como para profesionales y alerta sobre las consecuencias de esta situación en la detección precoz de desvíos nutricionales y el retraso en las medidas correctivas...

Growth charts are barely used in most of public clinics. In many cases have been replaced by booklets without a growth chart. The new “Chile Crece Contigo” booklet has not solved this pitfall. Its distribution is limited to public maternities, and the charts are tiny making difficult its proper use. In this operational study, was intended to quantify the use of growth charts and to assess mother’s perception of children nutritional status. Mothers of children aged 12-59 months were interviewed in Municipal Outpatient Clinics in Lo Espejo, Santiago. After collecting basic child data, mother’s age and educational level, the growth chart was evaluated. Mothers were requested to diagnose their child’s nutritional status. Then, they were presented with a specially prepared set of nutritional data of an imaginary child in four different formats: numeral values, standard deviations, growth chart and percentage of median weight for age, asking them again for their nutritional diagnose and format preferences. Of 109 booklets observed, 10 were “Chile Crece Contigo” format and only one these has a chart completely plotted. Of the other 99 old booklets, only 11had a printed chart on it and not a single one has data plotted. An 83 percent made a correct nutritional assessment of her child and 60 percent in relation with the case exhibited; in this second case it was a significant correlation with educational level. The preferred format was plain numbers with growth charts as second preference. This study confirms the surprising reduction in the use of growth charts, a very valuable aid in monitoring child growth both for mothers and health workers, and should represent a warning for its consequence in early detection of nutritional deviations. Through this study we also intent to promote more investigation on the issue and the design of public policies to extend and improve the use of growth charts in the area and in the country.

Os glicocorticoides e seus efeitos no crescimento e na mineralização óssea / Effects of glucocorticoids on growth and bone mineralization

OBJETIVO: Revisar os mecanismos de ações dos glicocorticoides e sua capacidade de induzir osteoporose e déficits de crescimento. FONTES DOS DADOS: A revisão bibliográfica de artigos científicos foi realizada na base de dados MEDLINE e utilizou as palavras-chave agrupadas nas sintaxes “glicocorticoides”, “mineralização óssea”, “crescimento” e “efeitos colaterais”, nos últimos 10 anos, e das referências destes nos reportamos para as publicações mais antigas, mas com os estudos fundamentais para a compreensão do assunto. SÍNTESE DOS DADOS: Destacam-se ações dos glicocorticoides sobre hormônios e citocinas responsáveis pelo crescimento longitudinal. Os efeitos finais dos glicocorticoides sobre o esqueleto são determinados por ações sistêmicas no metabolismo ósseo e por ações diretas desses esteroides nas células ósseas, levando a mudanças no número e função das mesmas e favorecendo a perda óssea. Discutem-se os mecanismos indutores da recuperação dos canais de crescimento e recuperação da massa óssea após a descontinuação dos glicocorticoides; os métodos diagnósticos do metabolismo e mineralização óssea; assim como medidas terapêuticas e preventivas das alterações óssea induzidas pelos glicocorticoides. CONCLUSÃO: A monitorização de cada paciente é essencial para identificação e potencial reversão dos danos associados ao uso crônico de glicocorticoides.

OBJECTIVE: To review the various mechanisms of glucocorticoid action and the ability of these agents to induce osteoporosis and growth deficits. SOURCES: A review of the scientific literature was conducted on the basis of a MEDLINE search using the keywords and descriptors “glucocorticoids,” “bone mineralization,” “growth,” and “side effects” and limited to articles published in the last decade. The references cited by these articles were used to identify relevant older publications, with an emphasis on landmark studies essential to an understanding of the topic. SUMMARY OF THE FINDINGS: Emphasis was placed on the actions of glucocorticoids on the hormones and cytokines that modulate linear growth. The end effects of glucocorticoids on the skeletal system are the result of systemic effects on bone metabolism and of direct actions on bone cells, which alter bone cell counts and predispose to bone loss. The mechanisms underlying catch-up growth and bone mass recovery after discontinuation of glucocorticoid treatment are discussed, followed by a review of diagnostic methods available for assessment of bone metabolism and mineralization and of measures for prevention and management of glucocorticoid-induced bone changes. CONCLUSION: Patient monitoring on a case-by-case basis plays an essential role in detection and, potentially, reversal of the damage associated with chronic glucocorticoid therapy.

Prevalence of stunting among infants and young children in Mongolia / Монголын Анагаах Ухаан

Introduction. Malnutrition has a negative impact on the physical and intellectual development which can further affect health, living potentials and the quality of life. A lack of a sustained decrease in low birth weight and young child malnutrition is associated with the failure to provide nutritious food in adequate quantities to pregnant and breastfeeding women and children up to two years of age. The most recent estimate from the 2005 MICS survey of the prevalence of wasting is 2.8 percent, stunting is 26.8 percent, and underweight is 7.4 percent among children aged 0-59 months in Mongolia.Goal. To assess the current nutritional status of 0-59 months old children of Mongolia, and identify next steps to improve child nutrition.Materials and Methods. This cross-sectional survey was conducted in 21 aimags of 4 economic regions of the country and in the city Ulaanbaatar. A total of 706 children aged 0-59 months were selected from sampled households. Interviews, anthropometric measurements and clinical examinations were used in the survey.Results. The distribution of length/height-for-age Z-scores of the surveyed children was shifted to the left compared to the WHO Child Growth Standard. The weighted average z-score and its standard deviation was 0.78±1.5, which is characteristic of high proportion of "short" children in Mongolia. Of the surveyed children, 15.6% (95%CI 12.7¬18.9) were stunted about one-third of stunted children had severe stunting. The prevalence of stunting was highest in the Western Region, the differences between this region and all other regions were statistically significant. Rural children had statistically significantly prevalence rates of overall stunting, moderate stunting, and severe stunting compared to their urban counterparts. Underweight and stunting were much more prevalent in children who had a low birth weight. Of those with a low birth weight, 35.5% (95%C118.4- 57.3) were underweight and 54.1% (95%CI 35.3-71.8) stunted, but there were no wasted children.Conclusions:1. In rural area the prevalence of stunting among in 0-59 months old children was highest than urban area's children.2. The prevalence of stunting was highest in the Western Region and remains at "high" level according to WHO classification.3. Underweight and stunting were much more prevalent in children who had a low birth weight4. The high rate of stunting among under five year olds is likely related to dietary behavior, and requires further study and intervention efforts.

Evolução do crescimento e desenvolvimento neuropsicomotor de crianças pré-escolares de zero a dois anos do município de Goiânia (GO) / Evolution of growth and development of children preschoolers zero-two years in the city of Goiânia (GO)

Os objetivos do estudo foram analisar a evolução do crescimento e desenvolvimento de crianças pré-escolares em creches de Goiânia e verificar a associação entre fatores de risco no crescimento e desenvolvimento das crianças. Participaram 39 crianças, de ambos os sexos, de zero a dois anos de idade. As crianças foram avaliadas em três momentos, com intervalo de dois meses entre as avaliações. O crescimento foi avaliado pelas medidas antropométricas de peso e altura e o desenvolvimento foi avaliado pelo Teste de Denver II. A maioria das crianças apresentou crescimento normal. Na primeira avaliação 46 por cento das crianças apresentaram risco para o desenvolvimento, na segunda avaliação 28 por cento de risco e na última avaliação 44 por cento, sendo a linguagem a área mais defasada. Variáveis que tiveram relação com o déficit do crescimento e atraso no desenvolvimento: maior idade materna, menor Apgar 5° minuto, crianças do sexo masculino, menor peso adquirido na gravidez e mães desempregadas

Impact of NGO run mid day meal program on nutrition status and growth of primary school children.

Objective. To study the impact of wholesome mid day meal (MDM) program run by an NGO on the growth of the primary school students in rural area of Mathura district. Methods. This intervention study involved children enrolled in Government run rural primary schools in Mathura district in Uttar Pradesh from March 06 through August 07. A wholesome, nutritionally balanced MDM provided by an NGO for the students in the 6 primary schools was selected as intervention group. Control group consisted of children in 8 schools which received locally prepared MDM by village panchayats. Height, weight, change in height/month, change in weight/month, prevalence of protein-energy malnutrition and prevalence of signs of vitamin deficiencies, were measured. Results. Food was provided for 221 days in one year. Within group and between groups repetitive measures were compared using generalized estimating equation (GEE). Within both intervention and control groups height and weight had significantly increased (p < 0.05), while there was no significant difference between the groups. There was no change in prevalence of malnutrition within either of the groups. Reduction in vitamin A deficiency signs was 38% more in intervention group (p < 0.001). Prevalence of Vitamin D deficiency reduced by 50% more in intervention group. No such differences between groups were observed for vitamin B complex and vitamin C. Conclusions. MDM provided by the NGO has no better impact on growth of the primary school children, however, it reduced prevalence of vitamin deficiency significantly in comparison to the MDM run by Village Panchayats.

Avaliação antropométrica e análise dietética de pré-escolares em centros educacionais municipais no sul de Minas Gerais / Anthropometric evaluation and food intake of preschool children at municipal educational centers, in South of Minas Gerais State, Brazil

Objetivou-se avaliar as condições socioeconômicas, o estado nutricional e o consumo alimentar de pré-escolares assistidos pelos Centros Educacionais Municipais (CEM) de Alfenas (MG). Foi realizado um estudo transversal, com 186 crianças. Avaliou-se o perfil socioeconômico, peso, estatura, idade, sexo e o consumo alimentar pelo instrumento de pesagem direta dos alimentos. Observou-se renda familiar de um a três salários mínimos, ensino fundamental incompleto, casa própria com saneamento básico, quatro a cinco habitantes por domicílio, dos quais, na maioria dois trabalhavam. A média de idade foi de 49,2 ± 12,9 meses. A baixa estatura foi o desvio nutricional mais prevalente (20,5 por cento). 72,6 por cento das crianças apresentaram ingestão energética abaixo da necessidade energética estimada (EER). Ao estratificar por faixa etária, de um a três anos, 78,4 por cento das crianças apresentaram ingestão acima da EER e de quatro a seis anos, 74,1 por cento apresentaram ingestão abaixo da EER. Todas as crianças apresentaram baixo consumo de cálcio e a maioria apresentou consumo abaixo da necessidade média estimada (EAR) para ferro. Apesar de alguns fatores biossocioeconômicos serem favoráveis, os desvios nutricionais e a ingestão inadequada de nutrientes estavam presentes, tornando-se necessária implementação de programa de controle nutricional nos CEM.

The objective of this article is to evaluate socioeconomic conditions, nutritional status and food intake of preschool children assisted at Municipal Educational Centers (CEMs) of Alfenas, Minas Gerais State, Brazil. A transverse study involving 186 children was performed. The socioeconomic profile, weight, height, age, sex and food intake by a direct weighting tool were evaluated. It was observed an income family of one to three minimum wages, incomplete fundamental learning, private house with basic sanitation, four to five inhabitants per house of whom two worked at most. The average age was 49.2 ± 12.9 months. The stunting rates were more prevalent among the children (20.5 percent). The whole, 72.6 percent of children have energy intake below Estimated Energy Intake (EER). However, when stratifying for age group, 78.4 percent of the children from 1 to 3 years old have high energy intake and 74.1 percent from 4 to 6 years old have inadequate energy intake. All children presented consumption below the Adequate Intake (AI) of calcium and most of them below to Estimated Average Requirement (EAR) of iron. Despite some biosocioeconomic factors be favorable to the nutritional status, malnutrition, and inadequate nutrient intake were present, which demanded the implementation of nutritional programs in CEMs.

Relationship of change in body mass to blood pressure among children in Korea and black and white children in the United States

Body mass is a major factor in determining blood pressure levels in children. We compared associations of body mass with blood pressure in 121 white and 91 black children in Bogalusa, Louisiana with that of 370 children in Kangwha, Korea. All children were seven years old at entry into the study and were followed for three years. Korean children were shorter (p< 0.001) thinner (p<0.0001), and had a lower body mass index (p< 0.01) than white or black children. At age seven, systolic blood pressure levels were 2 approximately 5 mm Hg lower, but at age 10, they were 2 approximately 5 mm Hg higher in Korean than white or black children. The increases in blood pressure levels from age seven to ten years were much greater in Korean than black or white children, while changes in height, weight, and body mass index were generally less. Change in blood pressure level was positively associated with change in body mass index for systolic (but not diastolic) levels; however, the association was no stronger for Korean than for U.S. children, except for Korean males vs Bogalusa black males. Cross-cultural studies of other factors, such as diet and physical activity, may explain these differences.

STUDY OF GROWTH INDICES OF CHILDREN IN 9 CITIES / 营养学报

This paper summarized the data of 5 growth indices of 152, 874 children aged 0-7 years in 9 city's urban and suburban areas. The results showed that they were well related to the growth of children. The stature of children was thin-tall in urban and thick-short in suburban. As compared with American and Japanese children data, we found that the body indices of our children were lower. Among 5 growth indices, the Kaup's index seemd to be useful for assessment of child physical development and nutrition.