ABSTRACT
In order to investigate growth following early severe malnutrition, two groups of 40 children and their mothers were studied, one of patients recovered from early protein energy malnutrition (PEM) at a closed center for nutritional recovery and another one of children under the same socioeconomic condition but who had never been malnourished. Both groups were matched for sex and age, and were followed by the same professional team for 9 years. A significant difference in mother's size (154.8 +/- 5.2 vs. 150 +/- 3.6 cm) and in patients size at birth (males 3,453.5 +/- 522.3 vs. 3,018.2 +/- 490.3 and females 3,328.4 +/- 563.4 vs. 2,654.6 +/- 579.6 g) was found in favour of the control group (p < 0.01). There were significant differences in height for age (H/A) and weight for age (W/A) (p < 0.001) but not in weight for height ratios between children for both groups (fig. 1 and 2). No differences were detected in bone age. Growth velocity was similar in both groups of boys (10.40 +/- 2.3 vs. 9.81 +/- 1.40 cm and 12.94 +/- 2.53 vs. 12.80 +/- 1.64 cm from 5 to 7 and 7 to 9 years of age respectively) but it was significantly greater in control girls (11.22 +/- 2.70 vs. 9.30 +/- 1.60 and 15.60 +/- 1.66 vs. 12.80 +/- 2.20 cm 5 to 7 and 7 to 9 years respectively, p < 0.01). These findings show that malnutrition before 2 years of age may produce long term effects on growth in children of low socioeconomic condition specially if, after treatment, they are turned back to the same unfavourable environment.
Subject(s)
Growth , Protein-Energy Malnutrition/physiopathology , Anthropometry , Child Development , Child, Preschool , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , PovertyABSTRACT
Undernutrition is associated with precarious sociocultural conditions. Concerned to break the vicious circle of undernutrition and poverty, Chile has developed programs to solve this problem, among these are the Closed Nutritional Recovery Centers (CNRC), where undernourished infants are treated and their families are educated, in order to improve their quality of life and to sustain, after treatment, the nutritional status achieved by their children at the center. We have followed up for the past 9 years of 283 children who were admitted at age 9.96 +/- 4.97 (mean +/- SD) months, (weight/age 63.05 +/- 8.4% NCHS standards), for treatment in a CNRC. Only 13% of them sustained the nutritional status achieved before discharge, which proceeded at age 13.42 +/- 5.1 months, (weight/age 81.64 +/- 8.9). We also studied, in two transversal points along follow up, the socio-cultural factors that influence nutrition after discharge from the CNRC: father's alcoholism, the presence of another malnourished infant at home, and low socio-economic status at admission were significantly related to bad nutritional long term evolution, while higher educational level and marital stability favored better outcomes.
Subject(s)
Poverty , Protein-Energy Malnutrition/etiology , Anthropometry , Child , Chile , Follow-Up Studies , Humans , Protein-Energy Malnutrition/therapyABSTRACT
Early postnatal malnutrition produces delay in growth and developmental processes, and children from a low socioeconomical level where undernutrition is prevalent are shorter than those from higher socioeconomic levels. We examined the effects of severe and early protein energy malnutrition on growth and bone maturation. We studied 40 preschool children who had been admitted to hospital in infancy with protein energy malnutrition and 38 children from the same socioeconomic level, paired for age and sex, who had never been malnourished. Growth measurements were made over a period of 4-6 years, and bone age was determined in a subgroup through wrist roentgenograms. Results showed a correlation between protein energy malnutrition, birth weight of infants, and mother's height and head circumference. The group with protein energy malnutrition showed a significant delay in stature after four years, especially the girls (p less than 0.001). Weight:height ratio was reduced in boys compared with controls but not in girls. Both groups showed a delay in bone maturation, but there were no significant differences between them. We found a positive correlation between bone age and arm fat area in control boys and between bone age and height for age in boys with protein energy malnutrition. The finding that rehabilitated children were shorter than the control group but had similar bone age at follow up suggests that genetic or prenatal factors were important in their later poor growth, and this suggestion is supported by their smaller birth size and the smaller size of their mothers.
