Short Stature Is Associated With Overweight but Not With High Energy Intake in Low-Income Quilombola Women.

BACKGROUND: Population exposed to chronic undernutrition in early life seems to be more susceptible to obesity in adulthood due to the development of mechanisms that improve the efficiency of energy use. Therefore, these individuals have relatively reduced energy requirements (thrifty phenotype). OBJECTIVE: To investigate, among women living on severe socioeconomic vulnerability, whether short stature, a marker for undernutrition in early life, is associated with excess body weight but not with a high energy intake. METHODS: This cross-sectional study, carried out between July and November 2008, evaluated 1308 women from all (N = 39) Quilombola communities of Alagoas. Adequacy of energy intake was estimated by the ratio between energetic ingestion and the estimated energy requirement (EER). RESULTS: The prevalence of short stature (≤ 154.8 cm) was 43.0% and 52.4% had excess body weight (body mass index ≥ 25 kg/m2), being that 33.1% were overweight and 19.3% obese. Excess body weight was higher among women with short stature (56.6% vs 49.2%; P = .008), even after adjusting for age, energy intake, and per capita income (prevalence ratio = 1.16; 95% confidence interval = 1.04; 1.28). The ratio of energy intake/EER was independent of women's stature. CONCLUSION: Excess body weight among Quilombola women represents a serious health problem. Short stature was significantly associated with excess body weight but not with a high energy intake. "Thrifty phenotype" may be one of the plausible explanations for this finding.

Diagnosis and prevalence of protein-energy wasting and its association with mortality in Japanese haemodialysis patients.

AIM: The International Society of Renal Nutrition and Metabolism (ISRNM) has proposed the diagnostic criteria for protein-energy wasting (PEW). We studied Japanese haemodialysis (HD) patients to verify the diagnostic method, especially with respect to the body mass index (BMI) criterion, as well as the prevalence of PEW and its association with mortality. METHODS: Japanese patients receiving maintenance HD at three outpatient clinics in Tokyo (n = 210) were enrolled, and prospectively followed-up for 3 years. PEW was diagnosed at baseline, according to the four categories (serum chemistry, body mass, muscle mass and dietary intake) recommended by the ISRNM. For the category of body mass, we select a body mass index (BMI) and set up three thresholds, <18.5, <20.0 and <23.0 kg/m2 , as the diagnostic criterion. The patients who satisfied at least three out of the four categories were diagnosed as PEW. RESULTS: Protein-energy wasting, when the threshold of a BMI among the diagnostic criteria was defined as <18.5 kg/m2 , was recognized as an independent risk factor for mortality. However, PEW was not recognized as a risk factor when the BMI diagnostic criterion was set at <20.0 or <23.0 kg/m2 . Overall, 14.8% of the patients had PEW. The survival rate of PEW patients was significantly lower than that of non-PEW patients (log rank, P < 0.001). CONCLUSIONS: The diagnosis algorithm of PEW proposed by an expert panel of the ISRNM strongly associates with mortality. However, given differences in body size in Japan, we suggest to revise the BMI criterion from <23.0 kg/m2 to <18.5 kg/m2 .

Comparing and Contrasting Three Cultural Food Customs from Nigeria and Analyzing the Nutrient Content of Diets from These Cultures with the Aim of Proffering Nutritional Intervention.

Nigeria is a multicultural country with a diverse cultural food. Most Nigerians' cultural diet is based on staple food accompanied by stew. In the South West and Eastern region (where Yorubas and Igbos are the dominant ethnic groups), staple foods are yam and cassava by-product (garri, fufu and lafun) with vegetables prepared as stew, often over cooked, thereby losing essential micronutrients. In Northern Nigeria (where the Hausas and Fulanis are the dominant ethnic groups), grains such as sorghum, millet form the main diet; these are served with palm oil based soup made with tomatoes and okra. Meat is sometimes added. Among the Hausas, meat is usually reserved for special occasions. Various types of malnutrition prevalent in developing countries such as Nigeria are iron deficiency anemia (ID/A), protein-energy malnutrition (PEM), Vitamin A deficiency (VAD), iodine deficiency disorder (IDD). The proposed long-term measure by the Federal government of Nigeria for the resolution of these various types of malnutrition is dietary diversification. A review of the literature on Nigerian cultural diets identified gaps in knowledge with respect to the nutritional values of Nigerian ethnic diets.

Biosocial comparison of mid-upper arm circumference in the two Koreas.

Anthropometric differences between the two Koreas are of considerable public and scientific interest given the unique socio-political status of North Korea and the fact that the nations share the same genetic ancestry. This study provides new biosocial evidence on these differences by analysing mid-upper arm circumference (MUAC) as a human welfare indicator. This is the first study to compare the nutritional status of adults surveyed inside North Korea with South Koreans. The MUAC measurements of 2793 North Korean women obtained through a household survey conducted in 2002 were compared with those of 1428 South Korean women surveyed around 2003. Comparative analysis was conducted by plotting centiles and calculating mean differences in MUAC by age. This paper finds that the MUAC of the South Koreans was on average 2.8 cm greater than that of their North Korean peers, with MUAC gaps ranging from 1.6 cm to 3.9 cm and becoming more pronounced with age. This research confirms previous studies on height and weight in the two Germanies and in the two Koreas that have shown that biosocial performance is worse in socialist economies as compared with free-market regimes.

Age-sex variation and association of 0AB blood groups with haemoglobin level among the adult Dhimals at Naxalbari in West Bengal, India.

The Dhimals at Naxalbari of the Darjeeling district in West Bengal belong to the Indo-Mongoloid ethnic stock. Dhimal is a comparatively less known small community in North Bengal. The mean age (males = 35.93 +/- 1.14 years and females = 32.59 +/- 1.06 years) of both sexes represent the standard adult population (males = 151 and females = 171). The results show that the haemoglobin levels in both the sexes (males: 9.69 gm/dl and females: 8.82 gm/dl) among the adult Dhimals are very low. This is true in all age groups. The females are found to be more anaemic than males in all ages. Significant sex differences (p < 0.001) in this context were recorded in all ages except among the population of 60 years and above. Young adult females of reproductive ages group (20-39 years) are observed to have a less haemoglobin level (8.86 +/- 0.18 gm/dl) compared to a higher level of haemoglobin (9.29 +/- 0.30 gm/dl) found among the females of over 40 years of age. 50.88 % of the females having a mean haemoglobin level of 7.09 +/- 0.08 gm/dl and 67.56% of the males with a mean haemoglobin level of 10.75 +/- 0.08 gm/dl indicate that larger proportions of the adult Dhimal population are suffering from severe anaemia. Repeated malarial parasite infection is the major reason behind this situation. 49.70% of the total sample of both the sexes is recorded to have B blood group. 47.47% of the male and 53.45% of the female sample with blood group B along with moderately higher proportions of the AB blood group (21.78% in males and 20.22% in females) over comparatively much less frequent A and 0 blood groups in both the sexes indicate a high prevalence of B gene in the Dhimal population. The association of higher mean haemoglobin levels (10.21 +/- 0.14 gm/dl for males and 9.54 +/- 0.14 gm/dl for females) among the individuals of both the sexes with B blood groups compared to lower haemoglobin levels with other blood groups especially 0 and A indicate a selection of the B gene in the Dhimal population for survival.

Age variations in anthropometric and body composition characteristics and undernutrition among female Bathudis: a tribal population of Keonjhar District, Orissa, India.

A cross-sectional study of 183 female Bathudis, a tribal population of the Keonjhar District, Orissa, India, was undertaken to investigate age variations in anthropometric and body composition characteristics and nutritional status. The subjects were categorized into three age groups: < or =30 years, 31-50 years, >50 years. Height, weight, circumferences and skinfolds data were collected. Body mass index (BMI) and several body composition variables and indices were derived using standard equations. The results revealed that there existed significant negative age variations for most of the anthropometric and body composition variables and indices. Correlation studies of age with these variables and indices revealed significant negative correlations. Linear regression analyses revealed that for all variables, age had a significant negative impact. Studies on the nutritional status of these women revealed that with increasing age, there was an increase in the frequency of undernutrition. In conclusion, this study demonstrated that among Bathudi women, age was significantly negatively related with anthropometric and body composition variables and indices. Moreover, with increasing age, the level of undernutrition increased.

A comparison of anthropometric indices of nutritional status in Tukanoan and Achuar Amerindians.

Anthropometric data from a Tukanoan population in the Vaupes region of Colombia and an Achuar population in the Ecuadorian Amazon were compared relative to international references. The Tukanoans exploit an oligotrophic blackwater ecosystem, whereas the Achuar inhabit a resource rich montane ecosystem. Given this ecological distinction, three hypotheses regarding nutritional statuses were proposed: (1) Tukanoans are significantly shorter than the Achuar, indicating a greater degree of stunting; (2) Tukanoans are significantly leaner, indicating a greater degree of wasting; and (3) Tukanaons have significantly lower upper arm muscle area, indicating lower lean body mass. Z-scores for height, weight-for-height, and estimated upper arm muscle area were determined and significant nutritional stress was assumed at z < or = -2.0. Between population differences in z-scores for height-for-age (ZHT), weight-for-height (ZWH), and upper arm muscle area (ZUMA) were examined using analysis of variance with a subsequent Scheffe's test. Between-group differences in the frequencies of individuals with low z-scores (z < or = -2.0) were assessed via chi-squared analysis. Both populations showed stunting in most age groups, but neither showed low ZWH or ZUMA. Significant differences between populations were found only for ZHT in children (females 1.0-4.9 and 5.0-9.9 years, and males 5.0-9.9 years). Tukanoans have significantly higher frequencies of stunting in all age-sex groups except females and males age 30-49.9 years. There were no significant between-population differences in the frequencies of individuals with low ZWH or ZUMA. These differences in nutritional status may reflect differences in resource availability.

Nutritional status and dietary habits of Indian children from Alto Xingu (Central Brazil) according to age.

OBJECTIVE: To evaluate the nutritional status and dietary habits of children of the Alto Xingu, Central Brazil, according to age. SUBJECTS: 172 Indian children (<10 years of age) of Alto Xingu tribes. METHODS: Date of birth, sex, weight, height (NCHS reference) and questionnaire of dietary habits at the time of field work. RESULTS: Of the 103 children less than 5 years of age, 34% presented protein-energy malnutrition (PEM), according to Gomez's criteria, of which only 2% with grade II malnutrition and no child presented severe PEM. In relation to the Z scores for the 172 children studied, it was observed that those younger than 1 year (n=25) presented weight for age (median, M=+0.43) and weight for height (M=+1.33) greater (p<0.05) than the children with ages between 12 and 60 months (n=78) (weight for age, M=-0.54; weight for height, M=+0.29) and between 60 and 120 months (n=69) (weight for age, M=-0.78; weight for height, M=+0.27). The height for age Z scores for the population studied showed a shift to the left in relation to the reference population in the three age groups (<12 months, M=-0.95; 12 to 60 months, M=-1.22 and 60 to 120 months, M=-1.40). The mothers nursed, without exception, to the age of 24 months, and the frequency of breastfeeding decreased progressively to age 42 months. The introduction of solid foods started at the age of 6 months and after the 10th month all the children ate "beiju" (flat bread), fruit and fish. CONCLUSION: The nutritional status of Alto Xingu Indian children, in 1992, is adequate and similar to that previously observed between 1974 and 1980.

The nutritional status of Asian end stage renal failure patients: a cross sectional study.

Nutritional status was assessed in 303 dialysis patients and the results of Asian and non Asian patients was compared. Mid Arm Muscle Circumference (MAMC) was found to be lower [22.7 +/- 2.7 v 24.2 +/- 2.9 (p = 0.008)] and TSF higher [15.9 +/- 7.2 v 13.6 +/- 7.4 (p = 0.078)] in Asians as compared to non Asians. Body Mass Index (BMI), Mid Arm Circumference (MAC) and Serum Albumin were not significantly different in the two groups. Difficulties in assessing and interpreting nutritional status in the Asian dialysis population are discussed and areas for further work are identified.

Nutritional status as indicator for reproductive success in !Kung San and Kavango females from Namibia.

The interaction between nutritional status, estimated by using Body mass index, and fertility outcome was tested in two female samples from Northern Namibia. It turned out, that !Kung San undernourished females had significantly more total and surviving offspring than well-nourished and overweight females of these population. In contrast within the Kavango group well-nourished females had the highest reproductive success. These group specific differences can be interpreted as special reproductive strategies to maximize the reproductive success under different ecological conditions.

Epidemiology of Schistosoma mansoni infection in a low-endemic area in Brazil: clinical and nutritional characteristics

A cross-sectional case-control study designed to evaluate the role of malnutrition in the association between the intensity of Schistosoma mansoni infection and clinical schistosomiasis, was conducted in an area with both low frequency of infection and low morbidity of schistosomiasis in Brazil. Cases (256) were patients with a positive stool examination for S. mansoni; their geometrical mean number of eggs/gram of feces was 90. Controls (256) were a random sample of the negative participants paired to the cases by age, sex and length of residence in the area. The clinical signs and symptoms found to be associated with S. mansoni infection, comparing cases and controls, were blood in stools and presence of a palpable liver. A linear trend in the relative odds of these signs and symptoms with increasing levels of infection was detected. Adjusting by the level of egg excretion, the existence of an interaction between palpable liver and ethnic group (white) was suggested. No differences in the nutritional status of infected and non-infected participants were found

Epidemiology of Schistosoma mansoni infection in a low-endemic area in Brazil: clinical and nutritional characteristics.

A cross-sectional case-control study designed to evaluate the role of malnutrition in the association between the intensity of Schistosoma mansoni infection and clinical schistosomiasis, was conducted in an area with both low frequency of infection and low morbidity of schistosomiasis in Brazil. Cases (256) were patients with a positive stool examination for S. mansoni; their geometrical mean number of eggs/gram of feces was 90. Controls (256) were a random sample of the negative participants paired to the cases by age, sex and length of residence in the area. The clinical signs and symptoms found to be associated with S. mansoni infection, comparing cases and controls, were blood in stools and presence of a palpable liver. A linear trend in the relative odds of these signs and symptoms with increasing levels of infection was detected. Adjusting by the level of egg excretion, the existence of an interaction between palpable liver and ethnic group (white) was suggested. No differences in the nutritional status of infected and non-infected participants were found.

Observaçöes sobre a favela da Cidade Leonor, Säo Paulo. II. Acompanhamento longitudinal clínico e antropométrico de crianças durante o primeiro ano de vida / Cidade Leonor slum, Säo Paulo. II. Longitudinal clinical and anthropometric follow-up of infants during their first year of life

Os autores realizaram seguimento clínico e nutricional de lactentes favelados desde o nascimento até o fim do primeiro ano de vida. De 61 crianças, cuja idade mediana na primeira avaliaçäo era de 47,3 dias, 41 puderam ter seu crescimento acompanhado em consultas periódicas durante o primeiro ano de vida. A avaliaçäo do estado nutricional baseou-se no emprego da relaçäo peso-idade, segundo os critérios de Gomez, e ralaçöes altura-idade e peso-idade, ambas segundo os critérios de Waterlow. Para se definir a duraçäo e o caráter evolutivo dos casos de desnutriçäo, usaram-se os critérios de Seoane e Latham. A aplicaçäo dos critérios de Gomez aos dados obtidos revelou elevada incidência de desnutriçäo (38,6%) e o estudo da adequaçäo estatura-idade mostrou um comprometimento precoce do crescimento (31,1%) já na primeira consulta. A utilizaçäo dos critérios de Seoane e Latham permitiu caracterizar que a maioria das crianças apresentava desnutriçäo aguda, mas, apesar da baixa idade das crianças, em 11% delas a desnutriçäo crônica já estava presente. Esses dados atestam a gravidade das condiçöes nutricionais das crianças que vivem em meio ambiente totalmente ...

[Cidade Leonor slum, São Paulo. II. Longitudinal clinical and anthropometric follow-up of infants during their first year of life]. / Observações sobre a favela da Cidade Leonor, São Paulo. II--Acompanhamento longitudinal clínico e antropométrico de crianças durante o primeiro ano de vida.

In this study, the authors performed a clinical and nutritional follow-up involving infants that live in a slum area of the City of São Paulo. The infants were followed since birth and up to the end of their first year of life. The nutritional status was evaluated considering the following criteria: weight/age, height/age, and weight/height indices. On the first visit, 38.6% of the infants already presented protein-calory malnutrition according to the weight/age index, and 31.1% presented early delay of growth. The application of the Seoane and Latham criteria showed that most infants had acute malnutrition, but chronic malnutrition was already present in 11.0% of the infants followed-up. The results of this study show the negative impact of an unfavorable environment on infants during their first year of life.

Estado nutricional de crianças índias do Alto Xingu e avaliaçäo do uso do perímetro braquial no diagnóstico da desnutriçäo protéico-calórica / Nutritional status of Indian children of Alto Xingu and evaluation of the use of asm perimeter in the diagnosis of protein-calorie malnutrition

Objetivo do estudo; Determinar a prevalência de desnutriçäo protéico-calórica (DPC) em crianças índias do Alto Xingu e avaliar a capacidade diagnóstica do perímetro braquial e do índice de QUAC na identificaçäo da DPC. Local: A populaçäo índia do Alto Xingu preserva grande parte dos seus hábitos e os costumes tradicionais. Pacientes: Foram estudadas prospectivamente 335 crianças índias em pelo menos um ano de sete anos consecutivos, entre 1974 e 1980. Nesse período, foram obtidas 1.278 medidas de peso, estatura e perímetro braquial. Medidas e resultados: A prevalência anual média de DPC (peso-estatura < 90%), segundo a tabela de referência brasileira, foi de 4,1% nas crianças menores de um ano, 7,3% entre um e cinco anos e 7,5% nas crianças com mais de cinco anos de idade. De acordo com a tabela do NCHS, a sensibilidade e a especificidade foram, respectivamente, de 23,5% e 99,3% para o perímetro braquial e 35,3% e 98,3% para o índice de QUAC. Conclusöes: É baixa a prevalência de DPC no Alto Xingu e o emprego do perímetro braquial e do índice QUAC no diagnóstico de DPC deve ficar a situaçöes compatíveis com sua sensibilidade e especificidade (AU) de referência do NCHS, foram constatados, respectivamente, 1,0%, 2,8% e 1,1% de DPC. A sensibilidade e a especificidade do perímetro braquial e do índice de QUAC foram calculadas em relaçäo à adequaçäo peso-estatura. segundo a tabela de referência brasileira, o perímetro braquial apresentou sensibilidade de 8,9% e especificidade de 99,3%, e o índice de QUAC, sensibilidade de 11,1% e especificidade de 98,3%. De acordo com a tabela do NCHS, a sensibilidade e a especificidade foram, respectivamente, de 23,5% e 99,3% para o perímetro braquial e 35,3% e 98,3% para o índice de QUAC. Conclusöes: É baixa a prevalência de DPC no Alto Xingu e o emprego do perímetro braquial e do índice QUAC no diagnóstico de DPC deve ficar a situaçöes compatíveis com sua sensibilidade e especificidade

[Nutritional status of Indian children of Alto Xingu and evaluation of the use of arm perimeter in the diagnosis of protein-calorie malnutrition]. / Estado nutricional de crianças índias do Alto Xingu e avaliação do uso do perímetro braquial no diagnóstico da desnutrição protéico-calórica.

STUDY OBJECTIVE: The purpose of this study was to determine the presence of malnutrition in indian children of Alto Xingu region in Brazil, and to evaluate the usefulness of arm circumference and QUAC index in the diagnosis of protein-energy malnutrition (PEM). SITE: The indian population of Alto Xingu maintains most of its traditional customs. PATIENTS: 335 children were studied prospectively in at least one of seven consecutive years between 1974 and 1980, and 1278 measurements were obtained of weight, height, and arm circumference. MEASUREMENTS AND RESULTS: The annual prevalence of PEM (weight-for-height) less than 90% according to Brazilian reference tables was 4.1% in children aged under 1 year, 7.3% in children from 1 to 5 years of age, and 7.5% in children older than 5. According NCHS tables, however, values of 1.0%, 2.8%, and 1.1% were obtained for the respective age groups. The sensitivity and specificity of arm circumference and QUAC index were calculated in relation to the weight-for-height relation. According to Brazilian reference tables, arm circumference had a sensitivity of 8.9% and specificity of 99.3%, whereas the QUAC index had a sensitivity of 11.1% and specificity of 98.3%. However, according to NCHS tables, slightly different values were obtained. The sensitivity and specificity in this case were 23.5% and 99.3%, respectively, for arm circumference and 35.3% and 98.3%, respectively, for the QUAC index. CONCLUSIONS: The authors concluded that the prevalence of PEM was low in the Alto Xingu and that arm circumference and the QUAC index should only be used in situations suited to their sensitivity and specificity.