[Aluminum content in individual components, used to prepare adult total parenteral nutrition mixtures in Argentine, and in comparison with international regulation]. / Contenido de aluminio en componentes individuales utilizados para preparar mezclas de nutrición parenteral en Argentina, y su comparación con la legislación internacional.

INTRODUCTION: Aluminum (Al) is a toxic element which may contaminate pharmaceutical products used as individual components to prepare total parenteral nutrition mixtures (TPN). OBJECTIVES: 1) to determine Al levels in the individual components used to prepare TPN mixtures; 2) to compare detected Al levels with those imposed by international regulations (FDA); 3) to calculate the total amount of Al administered to adult and children receiving those typical TPN mixtures. METHODS: Al was determined by Inductively Coupled Plasma- Atomic Emission Spectrometry (ICP-OES) (Perkin Elmer OPTIMA 5100 DV) in 44 individual products, from different labs and lots, belonging to 16 components available in Argentina: dextrose and amino acids for adult formulas and for pediatric formulas: lípids; potassium chloride; sodium chloride, magnesium sulfate; sodium phosphate; calcium gluconate; sodium glycerophosphate, zinc sulfate; multitrace elements; steril water (ampoules and great volume presentations). RESULTS: Al levels were detected in 43 of the 44 the studied components, except sterile water. The components of large volume presented between 249 y 1,580 µg Al/ L, between 4 and 180 times FDA established levels (25 µg Al/ L). Small volume components presented Al levels between 85 y 4,909 g/ L, not declared in labels. CONCLUSIONS: The highest amounts of Al were detected in calcium gluconate, sodium phosphate and multitrace elements. 2) Usually prescribed TPN mixtures would have higher Al levels than those accepted by FDA regulation; 3) The highest aluminum concentration was provided by dextrose, amino acids and lipids in adult TPN mixtures. In neonate TPN mixtures, Al highest amounts were provided by dextrose and calcium gluconate. The calculated concentration of Al in TPN mixtures was higher than those stipulated by international regulation (5 µg Al/kg (body weight)/ d). It would be advisable for manufacturers to declare the content of aluminum in the label, with the aim of avoiding toxicities which would compromise the critical patients' evolution.

Introducción: aluminio (Al) es un elemento tóxico que puede ser contaminante de productos farmacéuticos utilizados para preparar mezclas de nutrición parenteral (NP). Objetivos: 1) determinar la concentración de Al en componentes individuales utilizados para preparar mezclas de NP; 2) comparar las cantidades detectadas con los límites de la regulación internacional (FDA); 3) calcular la cantidad de Al administrada en fórmulas habituales de NP para neonatos, niños y adultos. Materiales y métodos: El Aluminio fue determinado por Espectroscopía de Emisión Atómica-Plasma-Inductivo de Argón (Perkin Elmer 5100 DV) en 44 productos comerciales, de diferentes laboratorios y lotes, correspondientes a 16 componentes individuales: dextrosa; aminoácidos para adultos y pediátricos; lípidos; cloruro de potasio; cloruro de sodio, sulfato de magnesio; fosfato de sodio; gluconato de calcio; glicerofosfato de sodio; sulfato de zinc; elementos multitraza; agua estéril en ampollas y de gran volumen. Resultados: Todos los componentes de gran volumen, excepto el agua, contenían entre 249 y 1.580 µg/L, superando entre 4 y 180 veces mas que los niveles establecidos por la FDA (25 µg/L). Los componentes de pequeño volumen contenían entre 85 y 4.909 µg/L, no declarados en los rótulos. Conclusiones: 1) La mayor cantidad de aluminio se encontró en el gluconato de calcio, fosfato de sodio y elementos multitraza. 2) Las mezclas de uso habitual para NP presentan niveles de Al mayores al límite de FDA. Los componentes que aportan mayor cantidad de aluminio en las mezclas de NP para adultos son: glucosa, aminoácidos y lípidos, pero en las de neonatos, el mayor aporte proviene de la dextrosa y gluconato de calcio. 3) En las mezclas de NP para neonatos, niños y adultos la cantidad de aluminio administrado por kg de peso supera la recomendación de FDA (5 µg/kg de peso /día). Los productos comerciales deberían declarar el contenido de Al para no comprometer la evolución de los pacientes graves.

Characteristics of pica practice during pregnancy in a sample of Argentine women.

The purpose of this study was to describe the practice of pica during pregnancy in Argentine women. Maternal and fetal characteristics as well as the practice of pica were evaluated during the puerperium in a sample of 1,014 women from five different geographical areas. Pica prevalence for the total sample was 23.2% (95% CI 20.6-25.8). Pagophagia (ice consumption) was the main type of pica practice, followed by geophagia (earth intake) and the ingestion of soap, toothpaste and chalk. The onset of the practice was mainly in the first months of pregnancy. A total of 49.8% of women revealed a family history of pica; 30.6% had pica in childhood and 13.2% suffered from polypica. Women with pica during pregnancy had similar age, pre-pregnancy body mass index (BMI), parity, neonatal birth weight and gestational age compared with non-pica mothers, although maternal haemoglobin concentration was lower in women with pica than in non-pica mothers (p = 0.0001).

Dietas desequilibradas en niños preescolares: estudio en un jardín integral de la provincia de Buenos Aires, Argentina / Imbalance diets in preschool children: study in a day-care center in the Province of Buenos Aires, Argentina

The purpose of this study was to investigate the impact of low fat diets in children aged 2 to 5. Eighty two children (40 females and 42 males) attending a school cafeteria (Province of Buenos Aires, Argentina), in a cross sectional study, were evaluated. Body weight (W), height (H) and body composition (BC) by bioimpedance were recorded. The anthropometric raw data were processed as Z-score of the weight-for-age (WEZ) and of the height-for-age (HAZ). Serum insulin-like growth factor 1 (IGF-1) and Zinc/haemoglobin ratio (Zn/Hb) were also measured. Results showed that 73.2 per cent of children were adequate (A) according WEZ, 13.4 per cent were lean (L) and 13.4 per cent overweight (O). 8.5 per cent presented simultaneously impairment in WEZ and HAZ. Body fat percentage and energy metabolism were higher in O than in L and A (p < 0.05). Serum IGF-1's children--aged 4 to 5 years--with HAZ deficit were low than adequate HAZ ones. No statistical differences in Zn/Hb ratio between A, L and O were found. This cross sectional study suggests metabolic disorders in young children attending school cafeterias. These conclusions will allow to design balanced diets in order to optimize the resources, promote optimal growth and development and prevent adult diseases through dietary practices in childhood.

[Food consumption and intake of several nutrients in a population of the University of Luján, Argentina]. / Consumo de alimentos e ingesta de algunos nutrientes en la población de la Universidad Nacional de Luján, Argentina.

A dietary survey was carried out at the National University of Luján (Argentina), with the objective of evaluating: a) food consumption and energy supply of cereals; b) the adequation of the intake of protein, calcium, iron, vitamins A, B1, B2, C and niacin, regarding the Recommended Dietary Allowances (RDA). A representative sample of 827 people (16% of the total population of 1991, equally distributed in the four seasons) was assessed with a 24 hour dietary recall. Sample was composed by: males: 189, aged 18-24 ys (GIM); 189, aged 25-50 ys (G2M); females: 209, aged 18-24 ys (GIF); 240, aged 25-50 ys (G2F). The results showed that cereals, 90% deriving from wheat products, supplied 32% of the total energy intake in G1F and between 40% and 48% in the other three groups. The mean daily intake of meat ranged between 90.5 g and 128.7 in females and over 140.0 g in males. Dairy products consumption was quite low, as well as fruits and vegetables in the whole of the population. Protein intake was over 1.25 g/d in 50% of the population. Calcium intake was below the RDA in a great percentage of the population, the mean percentage of adequation being: G1F, 71%; G2F, 62%; G1M, 64%; G2M, 65%. Iron mean daily intake was quite good, ranging between 16.4 and 20.8 mg in females and between 17.5 and 19.2 mg in males. The percentage of iron supplied by meat was: G1F, 16%; G2F, 21%; G1M, 34% and G2M, 26%; therefore iron bioavailability can be considered high. Besides, "mate", which is drunk between meals, supplied between 25% and 29% of the total iron intake in females and between 12% and 56% in males. Vitamin A intake was below the RDA in 74% to 58% of the population. The mean intake of vitamin B1 was 89% of the RDA in G1M and over RDA in the other three groups. Intake and percentage of adequation of vitamin B2, vitamin C and niacin presented a great range, but the mean values were over the RDA. The overall results showed: a) a high protein intake, providing red meat between 26% and 39%; b) low consumption of dairy products, with the consequence of a low calcium and vitamin A intake; c) low consumption of fruits and vegetables, being in relation to the low intake of fibre and carotenes; d) high consumption of cereals, mainly wheat products, that must be controlled from the toxicological point of view, due to the variable presence of mycotoxins. These results are in agreement with other dietary surveys carried out in previous years and are a consequence of some characteristic feeding habits of the Argentine population. They show that nutritional education is necessary for promoting changes in the latter, with the aim of reaching a better nutritional status.

[Erythrocyte protoporphyrin during recovery from malnutrition in rats]. / Protoporfirina eritrocitaria durante la recuperación nutricional en ratas.

Interrelationships between Erythrocyte Protoporphyrin (EP), dietary Iron/Protein ratio (Fe/Prot) and Fe liver content (Feh) were studied during nutritional recovery in an experimental model: weanling female Wistar rats (To) were depleted with a protein-free diet (LP), losing 20% of their initial body weight. Then they were recovered until 45 days of age (T45) with diets containing: casein: 20 g/100 g; Fe (ammonium Fe citrate) (ppm.): 0, 75 or 100 (groups A1, A2 and A3, respectively). Hematocrit, Hemoglobin (Hb) (g/dL). Erythrocyte Protoporphyrin (EP) (microgram/dL Red Blood Cells) and Feh (microgram) were determined at To, LP and T45. Results were compared with control rats (C) fed with 20% of casein and Fe, 50 ppm. EP: a) decreased in C from To to T45 (99 +/- 24; 36 +/- 9; p < 0.01); b) increased in A1 and A2 at T45 (123 +/- 21; 93 +/- 29, respectively, p < 0.01) while A3 did not show significant difference (45 +/- 7) regarding to C: c) correlated inversely with Feh. According to the inverse correlation between EP and Fe/Prot (r = -0.99), we found that 92 ppm was an adequate Fe amount to prevent EP increase. These results confirm that during recovery from undernutrition EP depends on iron liver content, being an adequate indicator of iron nutritional status; therefore, EP would be useful as a predictor of the optimum Fe/Prot ratio for nutritional recovery.

[Effect of iron supplementation and its frequency during pregnancy]. / Efecto de la suplementación con hierro y su frecuencia en gestantes.

The iron (Fe) nutritional status of 203 healthy pregnant women was assessed at the first prenatal visit (To) (gestational age: 16.9 weeks +/- 3.81. Women were randomly assigned to one of three groups: G1 and G2 were supplemented with ferrous fumarate (60 mg elemental Fe) daily or intermittently (three times a week), respectively; and GC was the control group, without supplementation. The follow up was carried out until 34-37 weeks of gestational age (Tf), but only 43% of pregnant women completed the trial. At To and Tf fasting blood samples were collected and Hematocrit (Hct), Hemoglobin (Hb), Erythrocyte Protoporphyrin (EP) and Serum Ferritin (FERR) were determined. The percentage of women with abnormal biochemical values at To (n = 203) was: Hb (g/dl) < 10.5: 2.6%; PE (microgram/dl of red blood cells) > 70: 4.8%; FERR (ng/ml) < 10: 4.4%. Results (X +/- DE) of women that completed the follow up were at To and Tf, respectively: Hct (%): GC: 37.7 +/- 3.4 and 36.0 +/- 3.2 (p < 0.05); G1: 38.8 +/- 2.2 and 38.0 +/- 2.6; G2: 39.0 +/- 2.7 and 37.7 +/- 3.7; Hb (g/dl): GC: 12.5 +/- 1.2 and 11.9 +/- 1.3 (p < 0.05); G1: 12.6 +/- 1.1 and 12.8 +/- 1.1; G2: 12.9 +/- 0.9 and 12.2 +/- 1.5; PE (microgram/dl red blood cells): GC: 30 +/- 17 and 43 +/- 22 (p < 0.01); G1: 26 +/- 13 and 38 +/- 21 (p < 0.01); G2: 26 +/- 16 and 31 +/- 26; FERR (ng/ml): GC: 75 +/- 67 and 31 +/- 49 (p < 0.01); G1: 46 +/- 34 and 19 +/- 10 (p < 0.01); G2: 43 +/- 11 and 11 +/- 7 (p < 0.01). These results show: a) Fe administration was efficient to mitigate Hb decrease; b) Fe stores decreased during pregnancy regardless of Fe supplementation and frequency; c) EP values indicate that intermittent Fe administration was more efficient to maintain normal erythropoiesis.

[Biochemical status and iron intake in a population of pregnant women of Buenos Aires, Argentina]. / Indicadores bioquimicos e ingesta de hierro en un grupo de gestantes del gran Buenos Aires.

The iron (Fe) nutritional status was studied in 113 healthy pregnant women, age: 24.8 +/- 6.1 Ys. During the second trimester (gestational age: 16.9 +/- 3.8 weeks), a 24 h dietary recall was carried out and daily Fe intake was calculated, according to Latinoamerican and German Food Composition Tables. On the same day, hematocrit (Hct), hemoglobin (Hb), erythrocyte protoporphyrin (EP) and serum ferritin (SF) were determined in fasting blood samples. Mean daily Fe intake was 10.8 +/- 4.6 mg. The percentage of population with abnormal biochemical values was: Hb (g/dL) < 10.5: 2%; PE > 70 microgram/dL of red blood cells: 6.5%; SF (ng/mL) < 12-20: 16%. According to the new recommendations of the American Institute of Medicine, Fe supplementation would be necessary in women with SF < 20 ng/ml (22%). Therefore, the follow-up of iron stores would be necessary in those with SF > 20 ng/mL before Fe administration.

[Contents of various nutrients, minerals and seasonal fluctuations in Porphyra columbina, an edible marine algae from the Argentine Patagonian++ coast]. / Contenido de algunos nutrientes, minerales y variaciones estacionales en Porphyra columbina, alga comestible de la Costa Patagónica argentina.

Porphyra columbina (Rodophyta Bangiales), one of the most important edible seaweeds, grows abundantly in the southern Argentine coast. Their mineral content and seasonal fluctuations were determined because there is no national data about their nutritional value. Samples were collected from April 1993 to February 1994 from Golfo San Jorge (30 Km South of Comodoro Rivadavia). Algae were washed with sea water and dried at room temperature (20-2 degrees C) for 24 hs, following the local processing procedure. Moisture and ashes were determined according to A.O.A.C. After mineralization with nitric acid sodium and potassium were determined by flame photometry; calcium, magnesium and iron by atomic absorption spectrophotometry (AAS); and phosphorus by Gomori's method. The results, expressed per 100 g dry algae showed the following values: moisture content: 7.03 to 11.00 g/100 g; ashes: 16.18 to 22.70 g/100 g; sodium: 3.18 to 6.41 g/100 g; potassium 1.24 to 1.96 g/100 g; magnesium: 600 to 836 mg/100 g; phosphorus: 78 to 276 mg/100 g; calcium: 63 to 108 mg/100 g and iron: 3.9 to 26.4 mg/100 g. The results of composition of algae as manufactured in the region showed important seasonal differences, with the highest values of ashes, sodium, potassium and magnesium in winter season (June and July).

[Review of present knowledge on the evaluation of the nutritional status of mineral elements. I. Major elements]. / Revisión de los conocimientos actuales acerca de la evaluación del estado nutricional de los elementos minerales. I. Elementos mayores.

For a long time, the human diet was supposed to provide mineral elements in adequate quantities. Nevertheless, in recent years knowledge of marginal or severe deficiencies has contributed to clarify the biological functions of some of them. For this reason, more and more attention is being given to the evaluation of mineral nutritional status, field which has progressed very rapidly. This summary, which covers the major elements, also applies to the following article, where trace elements are discussed. The purpose of both articles is to summarize actual knowledge on available biochemical methodology for a better understanding of mineral nutritional status.