Schoolchildren have similar predicted prevalences of inadequate intakes as toddlers in village populations in Egypt, Kenya, and Mexico.

OBJECTIVES: To examine the probability of inadequacy of schoolchild nutrient intakes; to compare the predicted adequacy of schoolchild diets to previously published data for toddler diets and to examine the relative adequacy of the diets of sibling pairs. DESIGN: Food consumption data were measured 2 days per month across approximately one year. Mean nutrient intakes were calculated and compared to international standards using a probability approach. SETTING: Villages in Egypt, Kenya, and Mexico. SUBJECTS: 285 school-age children (7-9 years of age) and 255 toddlers (18-30 months of age) including 94 sibling pairs. RESULTS: Within a country, there was a striking similarity between the nutrients predicted to be inadequate in schoolchild and toddler diets across all nutrients except vitamin B12, which was more likely to be inadequate among schoolchildren. Nutrients of concern for both ages in one or more countries included iron, zinc, calcium, riboflavin, and vitamins B12, D, E, and A. For 94 toddler-schoolchild pairs, siblings at high risk of nutrient inadequacy could be identified from an indicator child with a sensitivity of 43-100% and a specificity of 59-100%. CONCLUSIONS: Nutrient adequacy tends to be a household characteristic for these two ages of children. Nutritional interventions that target the household have a high probability of benefitting multiple age groups of children.

PIP: The authors investigated the probability of inadequacy of schoolchild nutrient intakes in order to compare the predicted adequacy of schoolchild diets to previously published data for toddler diets, and to examine the relative adequacy of the diets of sibling pairs. Food consumption data were measured two days per month for approximately one year for 285 children aged 7-9 years and 255 infants aged 18-30 months, including 94 sibling pairs, in villages in Egypt, Kenya, and Mexico. Mean nutrient intakes were calculated and compared to international standards using a probability approach. Within a country, there was close similarity between the nutrients predicted to be inadequate in schoolchild and toddler diets across all nutrients except vitamin B(12), D, E, and A. For 94 toddler-schoolchild pairs, siblings at high risk of nutrient inadequacy could be identified from an indicator child with a sensitivity of 43-100% and a specificity of 59-100%. Nutritional interventions which target the household have a high probability of benefiting multiple age groups of children.

Estimated vitamin intakes of toddlers: predicted prevalence of inadequacy in village populations in Egypt, Kenya, and Mexico.

Vitamin intakes of 255 toddlers (aged 18-30 mo) were estimated from food consumption recorded during 1 y at sites in Egypt, Kenya, and Mexico. Mean intakes were compared with requirements standards by using a probability approach to estimate the prevalence of inadequate intakes. There were predicted inadequacies for vitamin A (32%) and riboflavin (20%) in Egypt, vitamins A (68%) and C (63%) and riboflavin (52%) in Mexico, and vitamin B-12 (44%) in Kenya. Vitamin E was inadequate in all diets, but in relation to polyunsaturated fatty acids only the intake in Mexico was low. No diet provided the recommended amount of vitamin D, but its dietary requirement is uncertain. Correlations among nutrient intakes suggest factors that may contribute to reported associations of consumption of animal products with improved growth or development among these children: provision of vitamin B-12 and available minerals, displacement of fiber and phytate-rich energy sources, and increased energy density.

PIP: Data on 255 children, 18-30 months old, in Kalama village on the Nile delta in Egypt, the Embu district in Kenya, and the Solis Valley in Mexico were analyzed over a 1-year period to study the relationships of energy and animal protein intakes with vitamins, minerals, and two factors that affect bioavailability, dietary fiber and phytate. The researchers used the probability approach to determine the prevalence of inadequate intakes. Estimated intake inadequacies were 32% for vitamin A and 20% for riboflavin in Egypt; 68% for vitamin A, 63% for vitamin C, and 52% for riboflavin in Mexico, and 44% for vitamin B12 in Kenya. All the diets were deficient in vitamin E. Yet, when researchers compared vitamin E in relation to polyunsaturated fatty acids, the vitamin E intake was low only in Mexico. None of the diets had the recommended amount of vitamin D, but actual dietary requirements were unknown. Further, the researchers had no information on solar exposure. Provision of vitamin B12 and available minerals, displacement of fiber and phytate-rich energy sources, and increased energy density were associated with improved growth or development among children ingesting animal products (p 0.05). Intakes of folacin, niacin, and thiamin were negatively related to animal protein intake (p 0.05).

Combined modality treatment for tumoral calcinosis.

Tumoral calcinosis is a rare syndrome marked by periarticular and intramuscular calcifications. We present the case of a 13-year-old black girl who has received treatment since age 2 for tumoral calcinosis with bilateral shoulder involvement.

Estimated mineral intakes of toddlers: predicted prevalence of inadequacy in village populations in Egypt, Kenya, and Mexico.

Intakes of minerals and factors that might affect their bioavailability were estimated for 255 toddlers aged 18-30 mo living in villages in Egypt, Kenya, and Mexico. Mean intakes over 1 y were compared with international-requirement estimates by using a probability approach. The prevalence of iron intakes likely to be inadequate to prevent anemia was estimated as 35% in Egypt, 13% in Kenya, and 43% in Mexico. The prevalence of zinc intakes likely to be inadequate to meet basal requirements was estimated as 57% and 25% in Kenya and Mexico, respectively, but only 10% in Egypt, where the use of yeast-leavened breads was judged to have improved zinc availability. There was no suggestion that estimated copper or magnesium intakes were inadequate, but calcium intakes in Kenya and Egypt were well below recommended amounts. Studies of factors affecting mineral bioavailability in the diets of these countries' populations could suggest dietary changes that might improve effective mineral intake with minimal cost.