Determinants of growth among poor children: nutrient intake-achieved growth relationships.

Seven-day individual weighed dietary intakes and anthropometric measurements were determined in 123 children, 2 to 19 yr of age, from 26 poor families in Lima: each included one child who had been malnourished, six were adopting families. Heights and weights were converted to "ages" based on Boston reference data and local data, then to "quotients" as percentages of actual ages. Mineral and vitamin intakes were expressed as amounts per day and per 1000 kcal, calories and protein as percentages of FAO/WHO recommendations for age and height age and of modified recommendations based on size of Peruvian children. Regression analyses identified common sources of nutrients and greater dependence of intakes on body size than on age. Analysis of covariance for sex identified different nutrient-growth correlations. Polynomial regression analysis identified percentage protein from animal sources and percentage fat calories as having significant quadratic as well as linear correlations with achieved growth. In males, multiple regression analysis identified percentage protein from animal sources and beta-carotene intakes as strongly associated with achieved height and weight, and percentage fat calories as strongly associated with weight quotient/height quotient ratios. In females the correlations were not as strong, possibly because a significant percentage had reached the menarche some time before the survey and were probably no longer growing. Nevertheless, calorie intake, as a percentage of the recommendation for height age, was prominent in the regressions for height quotient and percentage fat calories in that for weight quotient. The very strong association of animal protein intake with male height, despite seemingly generous total protein intakes, is difficult to reconcile with current recommendations. The possible role of vitamin A (as beta-carotene) has potentially important implications for food policies.

Determinants of growth among poor children: relation of nutrient intakes to expenditure for food.

The growth status and the nutrient intakes of 123 children from 26 urban poor families in Peru were related to per capita expenditure for food. Children from six better off families were taller and heavier (p less than 0.001), with no difference in weight for height. They had significantly higher calorie and total protein intakes (as percentage of recommended) and higher intakes of animal protein, fat, calcium, carotene, riboflavin, and vitamin C. When macronutrient intakes were expressed as percentages of recommended calorie intakes, correcting for age and relative size, all of the increase in total protein intake was due to animal protein, vegetable protein remaining constant. Almost all of the increase in adequacy of total calories was due to increasing fat intakes, relatively much less to carbohydrate, and this only among the poor families. In this population, as more money becomes available to purchase food, there is an increase in animal protein and fat intakes, over an almost constant vegetable protein and carbohydrate intake. There is a simultaneous increase in consumption of fruits and vegetables, accounting for increases in the carotene and vitamin C intakes.

Determinants of growth among poor children: effect of expenditure for food on nutrient sources.

The effect of increasing expenditure on the nature and the amounts of foods consumed by children from an urban population was estimated by studying the diets of 111 children from 20 typically poor families and those of 12 children from six economically better off families who had a much more satisfactory growth status. Total calories and protein, fat, and carbohydrate calories were expressed as a fraction of each individual's estimated energy requirement, thus adjusting for sex, age, and size. No important sex differences were found. Calorie intake was 87.2 +/- 17.3% and 111.4 +/- 18.1% of requirement for the two groups, respectively. Differences were found between the groups in protein calories which were totally due to milk and meat. Differences in fat calories were due to milk, meat, and separated fats. There was no significant difference between groups in total carbohydrate calories, although there were shifts in its components with increasing expenditure. Regression analysis of calorie adequacies as a function of per capita expenditure for food, both in the poorer group and in the combined population, were performed and yielded highly significant (p less than 0.001) results. These were due to significant gradual increases in the consumption of milk, meat, separated fats, fruits and vegetables on top of an almost constant consumption of the staple cereals, roots and tubers.

Determinants of growth among poor children. I. Food and nutrient intakes.

One hundred sixty-seven poor families living in Lima had yearly anthropometric and socioeconomic evaluations for up to 16 years. In 26 of these a 7-day individually-weighed food survey was carried out in 1972 to 1974, immediately following a national food consumption survey. Adult males were markedly under-represented in the survey and probably to a lesser degree in the national one. Mean daily intakes of energy (1975 +/- 498 kcal), total protein (41.1 +/- 12.1 g), and animal protein (14.4 +/- 8.1 g) fell between those of the first and second economic deciles of the city in the national survey, which is where mean incomes were estimated to be. Intakes of the few adult males were approximately 50% higher than the family means, those of adult females approximately 12% lower. Nutrient intakes of the few infants in the survey were markedly different from those of the 2- to 19-year-old children, being heavily dependent on cow milk. There were no significant differences in intake between boys and girls. Children over 2 years of age derived almost 50% of energy and protein from cereals (notably wheat and rice), 11.2% of energy from sugar, 4.3% of energy and 11% of protein for legumes, 4.4% of energy and 14.7% of protein from meat, and 13% of energy from separated fats. Total fat represented 21.8% of energy in their diet. These sources of energy and protein were very similar to those found in the lowest two deciles of the national survey from Lima.

[Tolerance and digestibility of Peruvian "common foods" in malnourished infants]. / "Alimentos comunes" peruanos. Tolerancia y digestibilidad en infantes desnutridos.

Six diets were prepared based on commonly used Peruvian foods, mainly of vegetable origin, which were offered to eight infants (mean age: 12.8 +/- 8.2 months) recovering from malnutrition. The purpose of this study was to evaluate the acceptability, tolerance and digestibility of the diets in question. Five were prepared with a potato and wheat base (noodle) and the sixth with a quinua-oats base. The acceptability and tolerance was satisfacotry, allowing maintenance of an adequate calorie and protein intake in all patients except one. On the quinua-oats based diet, the mean apparent absorption of nitrogen and fat was significantly lower (P less than 0.05) than in the case of the other diets. The increase in height coefficient (height age/chronological age X 100) and weight/age proved to be adequate during the study, except in the three youngest patients. The authors consider that this type of diets (potato-wheat based) can be recommended for infant feeding after the first year of life, and that the quinua-oats based diet still needs a more thorough evaluation prior to recommending its use.