Hot beverages and oesophageal cancer in southern Brazil: a case-control study.

There is a cluster of high-incidence areas of oesophageal cancer in south-eastern South America, including Southern Brazil, Uruguay and parts of Argentina. The present case-control study investigated the hypothesis that this may be due to the drinking of maté, a traditional beverage drunk at a very high temperature, and also studied the role of other known risk factors such as alcohol and tobacco. Cases (171) and age- and sex-matched controls (342) were recruited from hospitals in the State of Rio Grande do Sul in Southern Brazil. The crude odds ratio for daily maté drinkers was 1.92 relative to those drinking less frequently than daily (p = 0.006). Other risk factors included the drinking of cachaça (a sugar cane spirit), smoking, rural residence, low fruit consumption and high intake of meats. After adjustment for these variables through conditional logistic regression, the odds ratio associated with daily maté drinking was reduced to 1.47 (90% CI = 0.87-2.50). Although the study failed to provide evidence of a strong association between maté and oesophageal cancer, the cluster of high rates could be explained by relative risks of the magnitude observed. This is due to the fact that approximately 70% of adult males and 50% of females are daily drinkers. In addition, this study revealed that alcohol, tobacco smoking and rural residence are the main risk factors for oesophageal cancer in this population and the fruit consumption confers some degree of protection.

Risk factors for malnutrition in Brazilian children: the role of social and environmental variables.

The article reports the effects of several socioeconomic and environmental indicators on the nutritional status (stunting, underweight, and wasting) of a sample of 802 children aged 12-35.9 months in urban and rural areas of southern Brazil. Of the social variables studied, family income and father's education level were the two risk factors that showed the strongest associations with nutritional status. The mother's education level, employment status of the head of the family, number of siblings, and family's ethnic background also showed some degree of association, but these were less significant when family income was included in the analysis. Environmental variables, particularly the type of housing, degree of crowding, and type of sewage disposal, were also strongly associated with malnutrition. The effects of having access to piped or treated water were only apparent on stunting and wasting.

Is prolonged breast-feeding associated with malnutrition?

The association between duration of breast-feeding and nutritional status was studied in a population-based sample of 802 children aged 12 to 35.9 months in Southern Brazil during 1982. The prevalence of malnutrition (low weight for age, length for age, and weight for length) was smallest in those children breast-fed for 3 to 6 months, but after this age nutritional status appeared to be worse in those breast-fed for longer. Children still being breast-fed at the time of the survey presented with a significantly higher prevalence of low weight for length than those who had been totally weaned, and those receiving breast-plus bottle-feeding presented with intermediate levels. This association could not be explained by a number of possible confounding variables using a multiple logistic regression analysis. These results are also consistent with a controlled trial on supplementary feeding in the Sudan.

PIP: The association between duration of breast feeding and nutritional status was studied in a population-based sample of 802 children aged 12 to 35.9 months in Southern Brazil during 1982. The prevalence of malnutrition (low weight for age, length for age, and weight for length) was smallest in those children breastfed for 3 to 6 months, but after this age nutritional status appeared to be worse in those breastfed longer. Children still being breastfed at the time of the survey presented with a significantly higher prevalence of low weight for length than those who had been totally weaned; those receiving breast plus bottle feeding presented with intermediate levels. This association could not be explained by a number of possible confounding variables using a multiple logistic regression analysis. These variables are: 1) age of the child, divided into 8 3-month categories--associated both with prevalence of malnutrition and breastfeeding; 2) district of residence; 3) family income; 4) ethnic background (Portuguese, Italian, Black, or mixed); 5) type of family (nuclear or extended); 6) maternal education; 7) employment status of head of the family; 8) previous hospitalization due to infectious disease; 9) birth order; and 10) sex. Variables 3 to 7 were included to account for the social class differences in breastfeeding and nutrition. These results are also consistent with a controlled trial on supplementary feeding in the Sudan. This trial was carried out to assess the nutritional impact of a take home supplementary feeding program. The effect of dried skimmed milk was compared to that of local beans in children aged 6 to 26 months. The impact was measured by the average weight and height gain per month. The results suggest that children who were breastfed and received dried skim milk gained significantly more weight per month than those breastfed but given only beans.