Extended composite index of anthropometric failure in Argentinean preschool and school children.

OBJECTIVE: The Composite Index of Anthropometric Failure (CIAF) can only be applied to children under 5 years of age and does not contemplate obesity. The aim of this study was to propose an Extended CIAF (ECIAF) that combines the characterization of malnutrition due to undernutrition and excess weight, and apply it in six Argentine provinces. DESIGN: ECIAF excludes children not in anthropometric failure (group A) and was calculated from a percentage of children included in malnutrition categories B: wasting only; C: wasting and underweight; D: wasting, stunting and underweight; E: stunting and underweight; F: stunting only; Y: underweight only; G: only weight excess; and H: stunting and weight excess. SETTING: Cross-sectional study conducted in Buenos Aires, Catamarca, Chubut, Jujuy, Mendoza and Misiones (Argentina). PARTICIPANTS: 10 879 children of both sexes aged between 3 and 13·99. RESULTS: ECIAF in preschool children (3 to 4·99 years) was 15·1 %. The highest prevalence was registered in Mendoza (16·7 %) and the lowest in Misiones (12·0 %). In school children (5 to 13·99 years) ECIAF was 28·6 %. Mendoza also recorded the highest rate (30·7 %), while Catamarca and Chubut had the lowest values (27·0 %). In the whole sample, about 25 % of the malnutrition was caused by undernutrition and 75 % by excess weight. CONCLUSIONS: The ECIAF summarizes anthropometric failure by both deficiency and excess weight and it highlights that a quarter of the malnutrition in the Argentine population was caused by undernutrition, although there are differences between Provinces (P < 0·05). ECIAF estimates are higher than those of CIAF or under-nutrition.

Craniofacial catch-up growth in intrauterine growth retarded rats following postnatal nutritional rehabilitation.

PURPOSE: The aim of the study was to analyze the effect of postnatal nutritional rehabilitation on the craniofacial growth in rats with intrauterine growth retardation (IUGR). MATERIALS AND METHODS: Wistar rats were assigned to one of the following groups: control, Sham-operated, and IUGR. The IUGR was produced by uterine vessels bending (day 14 of pregnancy). At days 1, 21, 42, 63, and 84 of postnatal life, each animal was X-rayed, and neural and facial length, width and height were measured. Volumetric and morphometric indices were calculated. RESULTS: The decreased maternal-fetal blood flow during the last-third of the gestation period modified cranial size and shape of both sexes at birth. DISCUSSION: Postnatal nutritional rehabilitation is not fully sufficient to reverse the prenatal growth retardation. There are specific responses depending on the sex and the age of the IUGR pups. Regardless of the changes in size, the shape is not modified during all the postnatal period.

[Comparative analysis of growth and sexual maturation in girls of Santa Rosa (La Pampa) and La Plata (Buenos Aires), Argentina]. / Análisis comparativo del crecimiento y la maduración sexual entre niñas de Santa Rosa (La Pampa) y La Plata (Buenos Aires), Argentina.

The aim of this study was to analyze growth in relation to menarche in girls from two Argentinean urban populations. We performed a comparative-descriptive cross sectional study in 2474 schoolchildren between 8.0 and 16.9 years old from Santa Rosa (SR) and La Plata (LP) cities. We registered the presence of menarche and anthropometrics variables of body weight, total and sitting heights, arm circumference, triceps and subscapular skinfolds. Body mass index, subscapular/triceps index and muscle and fat arm areas were calculated. The study group was divided into 4 groups according to the city and menarche. The socio-environmental structured survey indicated significant differences between cities with these variables: tenure status, building materials and services, health care coverage, cash assistance, educational level and parents' occupation, therefore establishing a higher welfare in youngsters of SR. Menarche at a mean age of 12.7 years old was more prevalent in SR (40.6%) than in LP (33.7%) (c2 = 12.9; p < 0.01). The ANOVA indicated significant differences between cities in total and sitting heights and muscle area (p < 0.01), body weight and arm circumference (p < 0.05) which were generally held in the post hoc comparison by age in pre-menarche and post-menarche groups. The presence of a small body size at the expense of lowering in: total height, muscle area and leg length in LP youngsters, associated with a lower prevalence of menarche in this city, it would represents the adaptive cost of a lower welfare environment.

Growth of school children in different urban environments in Argentina.

BACKGROUND: Nutritional transition has been described in various countries, each showing inherent characteristics. Furthermore, different patterns also appear within the same country. AIM: To compare the nutritional status of schoolchildren, of both sexes, living in two Argentine cities with different urban and environment characteristics, from the perspective of nutritional transition. SUBJECTS AND METHODS: The sample comprised 5355 children (6-13 years) living in Puerto Madryn (Chubut) and General Alvear (Mendoza), Argentina. Weight and height were transformed into Z-scores according to NHANES I- II; underweight, stunting and wasting defined by - 2 SD and overweight and obesity calculated according the cut-off proposed by IOTF. Prevalences of nutritional status were estimated. RESULTS: Comparison of the two cities revealed significant χ² values for the indicators of nutritional status analysed. Puerto Madryn had higher prevalences of overweight and obesity. General Alvear exhibited higher stunting and underweight values. CONCLUSIONS: The cities studied are in different stages of nutritional transition. Puerto Madryn is undergoing growing industrialization and urbanization and thus exhibits characteristics typical of an 'obesogenic' environment. General Alvear, a less complex urban centre, where some cultural patterns related to an agrarian way of life appear to have been retained, is situated at a less advanced stage.

Nutritional status, body composition, and intestinal parasitism among the Mbyá-Guaraní communities of Misiones, Argentina.

Indigenous communities in Argentina represent socially and economically neglected populations. They are living in extreme poverty and environmental degradation conditions. New information about health status and socio-environmental features is urgently needed to be applied in future sanitary policies. Present study describes the nutritional status, body composition, and intestinal parasitism among Mbyá-Guaraní children from three communities in the Misiones Province. Anthropometric parameters were analyzed for 178 individuals (aged 1-14). Data were transformed to z-scores using NHANES I and II. Stunting showed the greatest prevalence (44.9%). Children were found to have low arm circumference and low arm muscle area, although with tricipital skinfold value near to the reference. They also tend to have shorter than normal lower limbs. Fecal samples and anal brushes (for Enterobius vermicularis) were collected in 45 children (aged 1-13). Ritchie's sedimentation and Willis' flotation techniques were used to determine parasitoses. Ninety five percent of children were infected with at least one species and 81.4% were polyparasitized. The higher prevalences corresponded to Blastocystis hominis, hookworms (Ancylostoma duodenale/Necator americanus), and Entamoeba coli. Associations occurred between hookworms with B. hominis/E. coli and B. hominis with nonpathogenic amoebas. Thirty nine percent of the children with stunting presented B. hominis, Strongyloides, and hookworms. Our results indicate that this indigenous population is subjected to extreme poverty conditions and is one of the most marginalized in this country. Severe growth stunting and parasitic infection are still quite common among Mbyá children affecting about half of them along with significant changes in body composition and proportions.

Body weight recovery in intrauterine growth-retarded rats treated with growth hormone.

The aim of this work was to analyze the action of growth hormone (GH) on postnatal body weight recovery in intrauterine growth-retarded (IUGR) rats. Wistar rats were assigned to three groups: 1) control; 2) IUGR and 3) sham-operated. Uterine vessels of dams in the IUGR group were partially bent on the 14th day of pregnancy. At weaning, some IUGR pups were randomly selected and injected with GH (3 mg/kg/day), up to the 60th day. A standard diet ad libitum was available to mothers and offspring. The animals were weighed and food intake was recorded weekly. The weight gained velocity and relative food intake (RFI) was calculated. IUGR animals showed significant lower body weights than the control group. GH treatment allowed body weight recovery in IUGR rats. In females, body weight increased 14 days before males, and the former had greater RFI values. In conclusion, our results indicated differences in sexual responses to GH treatment. There is a need for more research on the mechanisms involved in that sexual difference.

Nutritional status in two Mbyá-Guaraní communities from misiones (Argentina).

Growth and nutritional status of children and adults in two Mbyá-Guaraní communities from Argentina, was assessed. Height, weight, sitting height, upper arm circumference, triceps and subscapular skinfold were measured on 120 individuals aged from 2 to 60 between March and May, 2001. Data were transformed to z-scores using United States references (NHANES I and NHANES II). A z-score of less than -2 was used as the cut-off point to determine the prevalence of stunting and wasting respectively. Mean z-scores for weight, height, and upper arm circumference lie below the reference (0 > Z > -3), while in sitting height ratio and muscular area for females they were above the US standard (0 < Z < 2). Skinfold thicknesses and muscular area for males were similar to the reference (2 > Z > -1). Our findings are in agreement with others South American Indian research that the prevalence of stunting (36.7%) is significantly higher than wasting (1.8%). The presence of parasitic infections and nutritional environment previously described in this population could be related to the short stature.

Sexual responses to intrauterine stress: body and brain growth.

The aims of this work were to analyse body and brain growth as produced by deficiencies in the uteroplacental blood supply, and to evaluate sexual responses to intrauterine stress. Intrauterine growth retardation (IUGR) was experimentally induced in pregnant rats by partial obstruction in both uterine vessels at 1,7 and 14 gestational days. The dysfunctions in the placental circulation retarded both somatic and cerebral growth, depending on the period of gestational stress and the sex. Brain weight had a relatively greater resistance than body weight, which is called a "brain sparing" mechanism. The body and brain sexual dimorphism in control pups was inhibited in IUGR pups. This study shows that prenatal stress exposition might modify growth and sexual dimorphism at birth.

Effects of bilateral uterine vessel ligation on skeletal growth in rats.

The aim of the present study was to assess the catch-up growth in the postcranial skeleton of intrauterine growth retarded (IUGR) rats. Male and female Wistar rats were assigned to one of the following groups: controls, sham-operated, IUGR. The IUGR was produced by uterine vessels bending (day 14th of pregnancy). Trunk, pelvis, femur and humerus were measured on Rx of each animal, from I to 84 days of age. Data were processed by repeated analysis of variance and LSD post hoc test. The reduced placental blood flow disturbed the skeletal growth in pups, with the axial skeleton relatively more affected than the bones of the extremities. The catch up only took place in femur length of both sexes. The widths of long bones remained significantly retarded. We concluded that nutritional rehabilitation during the postnatal period might not be enough to allow a complete growth recovery.

Effect of undernutrition on cranial components and somatotroph-lactotroph pituitary populations in the squirrel monkey (Saimiri sciureus boliviensis).

The aim of the present study was to investigate in monkeys the effects of undernutrition on neurocranial and facial components, correlated with a histometric and ultrastructural analysis of somatotroph (growth hormone, GH) and lactotroph (prolactin, PRL) pituitary populations. Twenty Saimiri sciureus boliviensis (Cebidae) of both sexes were employed. The monkeys were born in captivity and when they reached 1 year of age, they were separated into two groups: control and undernourished animals. They were fed ad libitum a 20% and 10% protein diet, respectively. The monkeys were radiographed when they were 3 years old in order to measure the length, width and height of the anterior, middle and posterior components of the neurocranium, as well as those of the masticatory, respiratory and optic components of the face. The volumetric and morphometric indices were then calculated. After the sacrifice, pituitary glands were processed for light and electron microscopy. The quantitative immunohistochemistry revealed a decrease in the volume density and cell density of both GH and PRL cells from malnourished animals when compared to control ones. The ultrastructural study showed changes suggestive of cellular hyperfunction for both types of cells in the former experimental group. Under nutrition also affected the size of the cranial components, with males being more affected than females; brain weight was, however, nonmodified by stress, with the brain/body ratio difference being the same for both sexes. We conclude that in monkeys, experimental undernutrition produces a decrease in the pituitary GH and PRL cell populations, in some way related to changes in the cranio-facial morphometric patterns.

Growth of skeletal components in the young squirrel monkey (Saimiri sciureus boliviensis): a longitudinal experiment.

A functional skeletal criterion, as an extension of the van der Klaauw's cranial theory, was adopted in the present study. The null hypothesis tested was: "The major skeletal components of the platyrrhine body grow linearly, regardless of their functional dependence to different demands." The acceptance of the hypothesis will imply that all Saimiri skeletal growth may be satisfactorily explained by independent variables in a single equation. The rejection will suggest that such skeletal growth patterns have to be explained by variables in several different equations, and perhaps these equations may vary with the effect of sex and undernutrition. Control and undernourished squirrel monkeys were radiographed monthly for 2 years; they were also measured; and their volumetric and morphometric neurocranial, facial, and pelvic indices were calculated. The curves that best described each of the 24-point sequences were obtained. Three main growth patterns were observed: 1) Simple linear (femur length for all groups, and pelvic index for control and undernourished females), for which the simple regression equation explained more than 95% of the variation; 2) Complex linear (pelvic index for control and undernourished males, and neurocranial and facial indices for all of the groups), for which more than 95% of the variation was explained by one of the four four-function type equations; and 3) Noncorrelated with age (neurofacial index for undernourished males, and pelviofemoral index for control females and undernourished males and females), which showed nonsignificant correlations with respect to age. The food intake and the oscillations of the environmental temperature might help to explain the undulating growth trajectory observed in the complex linear components.

Influence of intrauterine blood supply on cranial growth and sexual dimorphism at birth.

Many experimental studies of the effects of placental blood flow on growth exist. Nevertheless, few of them deal with the relationship between impaired uterine blood supply, and cranial growth and sex differentiation. The object of the present study was to investigate the impact of intrauterine growth retardation (IUGR) on sexual cranial dimorphism in the newborn rat. Three experimental groups were employed: (a) control; (b) operated (IUGR), in which both uterine vessels were partially bent in the 15th day of gestation; and (c) sham-operated, identical to (b) but without vessel bending. At birth, pups were weighed, and their bodies and craniums, measured. In the cases of asymmetric distributions, data were logarithmically transformed. A multi-way analysis of variance (ANOVA) and LSD post-hoc tests were used to find out differences between experimental groups and sex. Controls had significant sex differences in body and cranial variables. The prenatal growth of IUGR pups was significantly inhibited. Body and facial variables were more affected than the neurocranial ones. Undernutrition produced body and cranial size changes. Since IUGR affected male more than female growth, sex dimorphism was clearly reduced in all variables which were dimorphic in controls.

Sexual cranial dimorphism in malnourished rats treated with growth hormone.

One hundred and sixty two Holtzman rats of both sexes were malnourished during suckling and post-weaning periods. Some of them received periodic injections of growth hormone. After sampling, at 56 days of age, skulls were cleaned and measured. Differences within and between sexes were estimated by Mahalanobis D2 distances. Normal cranial differentiation between sexes (SCD) was decreased by malnutrition and restored by growth hormone treatment. The effect of the growth hormone on skull size was larger in malnourished males than females. This differential increment between sexes explains how growth hormone acted on the restoration of SCD.

The influence of gonadic hormones on skull differences in rats malnourished during lactation.

One hundred and twenty five Holtzman rats of both sexes were submitted to malnutrition during suckling with or without periodic injections of testosterone enantate in males and estradiol valerianate in females. Ten cranial measurements were made, and morphological differences within and between sexes were calculated by multivariate Mahalanobis D2-distances. Malnutrition delayed the cranial difference between sexes, which was restored by hormonal treatment. Testosterone arrested the skull size difference between sham and malnourished males. Estradiol stimulated the skull size difference between sham and malnourished females. This counteracting effect indicates that at early ages, both hormones stimulate sexual cranial dimorphism when a protein-calorie malnutrition acts on both sexes.

The influence of gonadic hormones on skull differences in rats malnourished during lactation.

One hundred and twenty five Holtzman rats of both sexes were submitted to malnutrition during suckling with or without periodic injections of testosterone enantate in males and estradiol valerianate in females. Ten cranial measurements were made, and morphological differences within and between sexes were calculated by multivariate Mahalanobis D2-distances. Malnutrition delayed the cranial difference between sexes, which was restored by hormonal treatment. Testosterone arrested the skull size difference between sham and malnourished males. Estradiol stimulated the skull size difference between sham and malnourished females. This counteracting effect indicates that at early ages, both hormones stimulate sexual cranial dimorphism when a protein-calorie malnutrition acts on both sexes.

The influence of gonadic hormones on skull differences in rats malnourished during lactation.

One hundred and twenty five Holtzman rats of both sexes were submitted to malnutrition during suckling with or without periodic injections of testosterone enantate in males and estradiol valerianate in females. Ten cranial measurements were made, and morphological differences within and between sexes were calculated by multivariate Mahalanobis D2-distances. Malnutrition delayed the cranial difference between sexes, which was restored by hormonal treatment. Testosterone arrested the skull size difference between sham and malnourished males. Estradiol stimulated the skull size difference between sham and malnourished females. This counteracting effect indicates that at early ages, both hormones stimulate sexual cranial dimorphism when a protein-calorie malnutrition acts on both sexes.

Effects of maternal food restriction during lactation on craniofacial growth in weanling rats.

Adult Holtzman rats were submitted during suckling period to a food restriction with or without protein or carbohydrate restoration. Twenty-one-day-old weanling pups were compared with controls of 9, 13, 17, and 21 days of age. Lateral craniofacial roentgenographies were taken. The length in midsagittal plane of each bone and its angle with respect to the vestibular line were measured in males. In females, the brain and the left masseter muscle were weighed, and the muscle/brain ratios (neuromuscular index) were calculated. Food restriction altered skull size and shape. Size changes were due to arrested lengths in all studied skull bones. Shape variation was evident by orthocephalization changes, reflected in angulation changes of bones belonging to the frontoethmofacial (frontal, nasal, and maxillary bones) and to the occipitointerparietal (interparietal bone) complexes. Partial restorations by both protein or carbohydrate supplementation were found. Nutritional stresses during lactation affected orthocephalization through an altered growth ratio between two soft tissues functionally associated to the craniofacial complex: brain and masticatory muscles.

Influence of food restriction during gestation on craniofacial growth of the weanling rat.

Holtzman rats were subjected to food restriction during gestation or lactation, or both periods (overall stress). At weaning, male pup skulls were measured and female brains and cranial masticatory muscles were weighed and a neuromuscular index was calculated. It was found that gestational protein-calorie malnutrition (PCM) without suckling restoration accounted for about 30% of the growth delay observed under overall stress. That effect disappeared after a normal suckling restoration. Under the same conditions of maternal food restriction in both periods, growth delay in the offspring was greater during lactation than gestation. As in lactation, craniofacial changes during gestational restriction were due to an adjustive response of bone growth to PCM. This response seemed to accrue from an altered relationship between the growth of the brain-less sensitive and highly restorable-and the growth of the masticatory muscles-more sensitive and less restorable. Some degree of delay in orthocephalization would be the skeletal outcome of such adjustive neuromuscular response.

Variations of rat skull bone robusticity evoked by malnutrition.

Weanling Holtzman rats of both sexes were fed a control (25% protein), a 10% protein, and a 2% protein semisynthetic diet. Protein deficit (PD) and protein calorie malnutrition (PCM) were estimated from comparisons between control and 10% protein, and control and 2% protein-fed animals, respectively. Animals were killed when they were 56 days old and their skulls cleaned and disarticulated. Individual bones and incisors were ovendried to constant weight. Total weight (TW), maximal projected length (MPL), and robusticity index (RI) were determined on each bone and incisor. It was found that all the bones and incisors did not behave uniformly. They followed two main patterns: (1) Proportional variation. RI values were not affected by nutritional deficiencies. All basicranial bones and 4 of 10 facial bones followed this pattern. (2) Non-proportional variation. RI values were affected by nutritional deficiencies. This pattern was subdivided into two trends: (2a) PD-diminished RI values. Both upper and lower incisors and 1 of 10 facial bones followed this trend. (2b) PCM, but not PD, decreased RI values. All vault bones and the remaining five facial bones followed this trend. It was concluded that there was a differential robusticity response among cranial base, calvaria, and incisors. This response may be connected with the differences in both histogenetic characteristics of those components and the functional roles they have to perform. The nonvault intramembranous bones showed a nonspecific behavior. This fact precluded the classification of the facial region in some of the previously defined patterns.

Alterations in protein and mineral contents of rat skull bones, evoked by different protein levels of the diet.

Holtzman rats of both sexes were fed one of the following semisynthetic diets; 25% protein (control), 10% protein (slight malnutrition), 5% protein (medium malnutrition), and 2% protein (severe malnutrition). The skulls were cleaned and disarticulated with papain; they were defatted, dried, and the total weight (Tw) of each bone was determined. A gravimetric method of estimating bone protein-mineral ratio was performed. Following a decalcification with EDTA, the protein matrix was weighed (PMw). A protein-mineral index (PMI) was defined as: PMI = 100 (Tw-PMw)/Tw. The nutritional deficiencies imposed affected the protein and/or mineral contents of the bones according to three different patterns. The first pattern was followed by the bones of the vault and the facial region. The second one included the basicranial bones. The third one comprised the incisors. These patterns were associated with the histogenetic characteristics of the bones and teeth. A relationship between these findings and previously ascertained functional craniofacial variations in malnourished rats was found. From the differential behavior of the base, the vault, the masticatory apparatus and the incisors, it was inferred that each of these functional cranial components reacted to the experimentally unbalanced nutrition, according to a specific kind of adaptive mechanism.