Nutritional status and eating habits among public primary school children aged 9-13 years in education districts 2, 3, 4 in St. Lucia as well as food preferences of their parents/guardians

OBJECTIVE: To determine nutritional status and eating habits among public primary school children aged 9-13 years as well as food choices and preferences of their parents/guardians. DESIGN AND METHODS: A total of 555 participants (380 children, 175 parents) took part in the study. Participants, who returned written consent forms were allowed to complete a questionnaire consisting of 17 questions on eating habits; Questionnaires were structured to obtain food preferences and nutrition knowledge where photographs of foods were included. Participants were categorized into percentiles using WHO Body Mass Index (BMI) for age growth charts, where BMI for age was plotted and body fat was categorized with the use of body fat reference curves chart for children 7-18 years. Linear regression was used to analyze the relationship between age, gender, consumption patterns of the participants with BMI. RESULTS: Food consumption patterns and preferences of children were similar to those of their parents except for juice drinks, sugary foods, fatty foods, water, salty foods and whole wheat bread. High preference for energy dense foods both by children and their parents was found. 61.7% of overweight participants were female i.e.; their weight exceeded the WHO suggested ≥85th percentile overweight value. 60.4% of obese participants were female (≥95th percentile as per WHO age and gender specific reference). CONCLUSION: Participants with higher salty food consumption had a higher BMI as compared to those who abstained from the intakes of such foods.

Dietary patterns, nutritional status and activity levels of forth form secondary school children in Trinidad

Proper nutrition during adolescence in important for growth, long-term health promotion, and eating habits and physical inactivity are powerful determinants of some non-communicable chronic disease. The objective was to determine the dietary habits, nutritional status and physical activity patterns of adolescents in 4th form in Trinidad. A cross-sectional design study was used and a random sample of 1512 subjects identified. A qualitative food frequency questionnaire and a physical activity questionnaire were used to determine dietary and physical activity patterns. Weights, heights and triceps skin folds were measured. Adolescents were classified as being thin, normal overweight or obese. 619 girls and 601 boys, ages 14-17 participated. 34 percent was of East Indian descent, 32 percent African, 32 percent of mixed ethnicity and 2 percent other. The results indicated that 14 percent were thin, 74 percent had normal weight, 7 percent overweight and 5 percent obese. More adolescents of East Indian ethnicity were found to be thin. (p>0.001). Although fruits were consumed more regularly than vegetables, few adolescents consumed them daily. Rice and white bread/roti were the most commonly consumed staples. High fibre foods were not frequently eaten. Chicken was the most commonly consumed food from animals. 14 percent ate chicken daily. Fast foods were eaten on a weekly basis. The most important were chicken and chips, hotdogs, doubles, cakes and chocolates. 51 percent consumed alcoholic beverages; 1 percent drank them daily. 12 percent did not participate in any physical activity, while 32 percent exercised less than three hours per week. Walking, weight training, running/jogging and cricket were the most frequently reported activities. 78 percent did not participate in physical education at school. There was no association between body size and exercise, not were there any consistent associations between body size and diet. This study indicated a problem of both thinness and obesity in this population. Eating-related concerns are numerous, and must be addressed. Inclusion of regular physical activity as a tool for enhancing overall health and social values are of paramont importance (AU)

Nutritional status of children under 5 years of age in three hurricane-affected areas of Honduras

Hurricanes and other natural disasters can produce crop destruction, population displacement, infrastructure damage, and long-term public health consequences that include increased malnitrition among the affected populations. This paper presents the results of anthropometric measurements taken of 295 children under 5 years of age from three regions of Honduras that were affected by Hurricane Mitch, a major storm that struck Central America in the fall of 1998. The children in our study were sampled in three shelters in the capital city of Tegucigalpa; in the resettlement zone of Nueva Choluteca, Choluteca; and in the small urban area of Catacamas, Olancho. Our data indicated that, in comparison to the period before the hurricane, there was an elevated prevalence of wasting in all three of the study areas, and that there were also high levels of underweight in the Tegucigalpa and Nueva Choluteca study areas. There were statistically significant differences between the mean values of malnutrition indicators for Catacamas and those for the Tegucigalpa and Nueva Choluteca settlements. These differences suggest that resettled families were confronting a nutritional crisis in July and August of 1999, some 9 months after the hurricane struck (AU)

The nutritional status of the elderly residents at the Golden-Age Home, Kingston

The elderly group has been acclaimed as the fastest growing worldwide, with the most increase taking place in the developing countries. Due to this increase in the elderly population and importance of good nutrition which is the possibility of a more vigorous and abundant life, there is need for more research on this group of individuals especially as it relates to their nutrition. This study is aimed at assessing the nutritional status of the elderly residents at the Golden Age Home, Kingston, a government institution; and the relationship between nutritional status and state of health. This study involved 96 elderly resident at the institution aged 60 years and above. It was conducted in two phases; the first phase involved administration of a questionnaire to assess their demographic characteristics, dietary habits, functional status and state of health as reported by the individuals. The second phase involved taking anthropometric measurements and blood samples from each of the respondents to assess their nutritional status. Findings revealed that the majority (55.2 percent) of the respondents were males compared to 44.8 percent females, with mean age 77.2 ñ 8.9 years. The gender difference was statistically significant (t=3.19, p<0.01). Majority, (80.2 percent) was functionally independent and ambulant. Chronic illnesses prevalent among this group were hypertension, arthritis and diabetes. Nutritional status revealed malnutrition at different levels (36.5 percent) and high incidence of anaemia (52.1 percent), but this was higher in males than females (20 males compared to 15 females malnourished and 54.7 percent males compared with 48.8 percent females with anaemia). Overweight/obesity was more prevalent among the females (32.6 percent) compared to males (11.3 percent). Underweight/different levels of malnutrition were however more prevalent among males. Most of these elderly were involved in one form of physical activity or the other, with more males than females engaging in physical activities. Different sources of support were revealed but this needs to be improved. There was no significant relationship between nutritional status and state of health. Recommendations were made for improving the quality of the diets of the elderly residents at institutions to improve their nutritional status and addressing factors that affect nutrition ... (AU)

Determination of the nutritional status of high-risk antenatal women in St. Elizabeth, Jamaica

A cross-sectional study was done of forty-eight women attending the High Risk Antenatal Clinic at the Black River Hospital in the parish of St. Elizabeth during the three month period of September to November, 1999, to determine their nutritional status. The data collection instrument included a twenty-four diet recall as well as a food frequency questionnaire. The study group included teenagers (41.7 percent), women twenty years and older (20 percent) and women thirty to forty-four years old (38.3 percent). Twenty-seven women were pregnant for the first time while 18 women were multiparous and 3 women were grand multiparous. There was more than 50 percent unemployment and over 50 percent of the study group included students, housewives and unskilled women. Of note, there were no teritary graduates or any member of the Technical, Professional or Managerial occupational groups. All forty-eight women completed primary (56 percent) or secondary (44 percent) schooling. Fifteen women had confirmed medical conditions or diseases including anaemia, asthma, congenital heart disease, gout, hypertension, Rhesus negative blood group and sickle cell disease. Thirty-eight women experienced side effects of pregnancy, with high prevalences of heartburn and vomiting at 54 percent and 45.8 percent respectively. Thirty-eight women consumed pica agents such as dirt, cake soap and ashes, marl with ice showing the highest prevalence of 58.3 percent. For the first and second trimester periods of 0-28 weeks weight gain was in excess of the range while weight gain for the third trimester (29-40 weeks) was within the range for the period. The nutrient intakes used to determine nutritional status were the Recommended Daily Allowance for the group which included calories, protein and fat. Deficiencies expressed as a percentage of the RDA were vitamins C and D, calcium and iron. Adequate nutrient sources were demonstrated from the responses to the food frequency questionnaire. The prevalence of anaemia was 23.8 percent and close to one half of the group (47.9 percent) took iron supplements. The study group was already at risk due to their low socio-economic status and were deemed equally at a nutritional risk due to the notable excesses and deficiencies in their nutrient intake.(Au)

Undernutrition among Honduran children 12-71 months old

In 1996, the Ministry of Health of Honduras conducted a national micronutrient survey that included anthropometric measurements to determine the nutrition status of children 12-71 months old. Among the 1 744 children who participated, 38 percent of them were stunted, including 14 percent who were severely stunted; 24 percent were underweight, of which 4 percent were severely underweight; and 1 percent were wasted, of which 0.1 percent were severely wasted. The country can be divided into three groupings based on the level of stunting and underweight: 1) lowest prevalence: Tegucigalpa, San Pedro Sula, and medium cities; 2) medium prevalence: other urban areas, the rural north, and the rural south; and 3) highest prevalence: the rural west. Using logistic regression analysis, the important determinants of stunting were found to be: mother/caretaker's and father's schooling, source of water, the dominion (geographic location and strata) in which the child lived, and the "possession score" for ownership of such items as a radio, television, refrigerator, stereo system, and electric iron. The predictors for underweight were micronutrient status, diarrhea, maternal/caretaker's schooling, type of toilet, and possession score. Historical data include that the national prevalence of chronic undernutrition has changed little over the last 10 years despite the number of national food and nutrition plans implemented and the significant improvements in health services. It is possible that these positive interventions have been offset by the slow progress in economic development. Future nutrition interventions should take into account household-level perceived needs and priorities in order to set realistic nutrition targets (AU) (AU)

A comparative study of pregnancy outcome in teenage girls and mature women

The objective was to compare the pregnancy outcome of teenage girls and mature women. The design was a retrospective study of births from January to December 1990, based on the antenatal clinic and labour ward, University Hospital of the West Indies, Jamaica. Teenage mothers, 13 to 19 years old, and a control group of mothers, 22 to 23 years old, were selected from the records of 2,394 live, singleton births between 200 and 305 days' gestation. The main outcome measures were birth weight, crown heel length, head circumference: length ratio, ponderal index and placental weight. The results showed that in the teenage group, weight body mass index at booking, haemoglobin concentration in each trimester, and minimum haemoglobin level during pregnancy were lower than in the control group. Systolic blood pressure in the first and the second trimesters was lower than in controls, but there was no significant difference in the third trimester nor in the delivery systolic blood pressure. Babies of teenage mothers had lower birth weights and smaller head circumferences than the babies of the control group, but there was no significant difference between the groups in crown heel length, ponderal index, head circumference: length ratio, and placental weight. These data support the hypothesis that teenaged girls are not physically mature and, as a consequence, their offspring have lower birth weights and smaller head circumferences (AU)

Nutrition of Honduran mothers/caretakers

In 1966, the Honduran Ministry of Health conducted a national micronutrient survey of children 12-71 months old, which also included an assessment of the nutrition status of their mothers/caretakers. THe 1 126 mothers/caretakers who participated in the survey tended to be short and plump. About 15 percent of them were at obstetric risk by virtue of their short stature and/or low body weight. About 9 percent had chronic energy deficiency (CED), but 27 percent were at least 20 percent overweight. CED was associated with socioeconomic indicators of poverty. Risk factors for being at higher than grade 4, 5, or 6 of primary school, coming from a wealthier household, and living in San Pedro Sula or medium-sized cities. Among the women surveyed, 26 percent of nonpregnant and 32 percent of pregnant mothers/caretakers were anemic. The likely principal cause of anemia was the low intake of bioavailable iron from food and, in some cases, excessive iron loss associated with intestinal parasities, especially hookworm. Only 50 percent of the mothers/caretakers participating in this study had received iron during their last pregnancy, and just 13 percent had received postpartum vitamin A. The results highlighted the need to develop and implement an effective program to control iron deficiency anemia in women of reproductive age, including by fortifying such widely consumed foods as processed wheat and maize flour and by routinely administering iron supplements to high-risk groups. Postpartum vitamin A supplementation should be encouraged to protect both the mother and newborn infant against vitamin A deficiency (AU)

Nutrition and education: a randomized trial of the effects of breakfast in rural primary school children

Hunger during school may prevent children in developing countries from benefiting from education. Although many countries have implemented school feeding programmes, few of these have been rigorously evaluated. We conducted a randomized, controlled trial of giving breakfast to undernourished and adequately nourished children. The undernourished group comprised 407 children in grades 2-5 in 16 rural Jamaican schools (weights-for-age < - 1SD of the National Centre for Health Statistics references) and the adequately nourished group comprised of 407 children matched for school and class (weight-for-age > - 1SD). Both groups were stratified by class and school, than randomly assigned to breakfast or control groups. After the initial measurements, breakfast was provided every school day for one year. Children in control group were given one-quarter of an orange and the same amount of attention as children in breakfast group. All children had their heights and weights measured and were given the Wide Range Achievement Test before and after the intervention. School attendance was taken from the school's registers. Compared with the control group, height, weight, and attendance improved significantly in the breakfast groups. Both groups made poor progress in Wide Range Achievement Test scores. Younger children in the breakfast group improved in arithmetic. There was no effect of nutritional group on the response to breakfast. In conclusion, the provision of a school breakfast produced small benefits in children nutritional status, school attendance, and achievement. Greater improvements may occur in more undernourished populations; however, the massive problem of poor achievement levels requires integrated programmes including health and educational inputs as well as school meals.(AU)

The effect of maternal nutrition on foetal growth and blood pressure at age 2 years

This study was designed to examine the effects of maternal nutritional status on foetal growth and blood pressure at 2 years of age. It was a prospective study of women attending antenatal clinic at the University Hospital of the West Indies. 500 women attended the antenatal clinic and had six ultrasound measurements between 14 and 35 weeks gestation. The infants were followed at three-months intervals to 2 years. Main outcome measures were birth weight, head circumference, crown heel length, blood pressure. Measurements of the baby at birth were strongly related to maternal weight, BMI, weight gain in pregnancy (between 8 and 35 weeks), and triceps skinfold thickness. Relationships were strongest with booking weight and BMI. Women who weighed 55kg or less had the smallest, lightest babies and placentae. Placental volume was lower in the lighter women at both 17 and 20 weeks. Differences in abdominal circumference were not discernable until 35 weeks. The ratio of placental volume : abdominal circumference at 14 weeks as well as their relative rates of change between 14, 17 and 20 weeks gestation were different between the two groups of women. In the lighter women relative growth of placenta between 14 and 17 weeks was less than in the heavier women, suggesting poorer placental growth in underweight mothers. The data show that there is a relationship between maternal anthropometry, intrauterine growth, postnatal growth and blood pressure(AU)

Vitamin A, E and carotenoid status in Jamaica children with sickle cell disease

Nutritional deficiencies would appear to be an important determinant of morbidity in homozygous sickle cell (SS) disease. This is evidenced by the growth and development deficits which are observed in children with SS disease. In a study of the nutritional status of Jamaican children with SS disease aged 3 to 6 years, serum samples from blood taken after an overnight fast in the SS children and children of the same age with normal haemoglobin (AA) were collected. Micro-nutrient analyses of these serum samples for vitamin A (retinol) and vitamins E (alpha and gamma tocopherol) and the carotenoids, beta-carotene and lycopene were carried out using high performance liquid chromatography (HPLC). The results suggest that in children with SS disease several of the micro-nutrients which are essential for maintaining optimal antioxidant status are found in decreased amounts in serum. The confirmation of these micronutrients deficiencies in SS children provide the basis fo further exploration of their interrelationshipo with the growth and development deficits in this population. (AU)

Nutrition, anaemia, geohelminth infection and school achievement in rural Jamaican primary school children

OBJECTIVE: To determine whether nutritional status, anaemia and geohelminth infections were related to school achievement and attendance in Jamaican children. DESIGN: A cross-sectional study using a randomly selected sample. SUBJECTS: Eight hundred children aged 9-13 years randomly selected from those enrolled in grade 5 in 16 primary schools in rural Jamaica. RESULTS: The mean height for age of the children was -0.37 z-score +/-1.0 s.d. with 4.9 percent having the heights for age < -2 s.d. of the NCHS references. Anaemia (Hb < 11 g/dl) was present in 14.7 percent of the children, 38.3 percent were infected with Trichuris trichiura and 19.4 percent with Ascaris lumbricoides. Achievement levels on the Wide Range Achievement Test were low, with children performing at grade 3 level. In multilevel analyses, controlling for socioeconomic status, children with Trichuris infections had lower achievement levels than uninfected children in spelling, reading and arithmetic (P < 0.05). Children with Ascaris infections had lower scores in spelling and reading (P < 0.05) Height for age (P < 0.01) was positively associated with performance in arithmetic. Ascaris infection (P < 0.001) and anaemia (P < 0.01) predicted poorer school attendance. CONCLUSION: Despite mild levels, undernutrition and geohelminth infections were associated with achievement, suggesting that efforts to increase school achievement levels in developing countries should include strategies to improve the health and nutritional status of children(AU)

Weight and body composition changes during pregnancy in Barbadian women - abstract

Weight gains occur during normal pregnancy in women with free access to food. Maternal nutrition status prior to conception and during pregnancy is a critical determinant of foetal growth and pregnancy outcomes. These gains reflect changes in the composition of the maternal body as well as changes in the products of conception. There are limited data from the West Indies about maternal nutritional status during pregnancy as well as the factors determining changes in body composition and pregnancy weight gain. We report the results of a prospective study of 342 pregnant Barbadian women conducted between August 1994 and February 1996 which assessed nutritional changes during pregnancy and their impact on glucose metabolism. This report is, however, limited to the changes observed in nutritional indices. At registration, age and parity were strongly analysed demonstrated that change in weight between registration (at a median time of 15 weeks gestation) and 36 weeks gestation and postpartum, were independently and inversely associated with BMI and age. Parity was not found to be independently associated with weight change. Changes in body composition were examined by deriving estimates of fat and lean mass. Estimated fat mass gains were consistent with those reported from well-nourished Western societies, and were mainly determined by initial BMI. We also observed gains in lean mass as a consequence of pregnancy. (AU)

School breakfast benefits children's nutritional status

There are very few well-designed studies in developing countries to evaluate the benefits of school feeding programmes. The aim of this study was to determine the effects of giving breakfast on rural childrens' nutritional status, breakfast history and amount of money they brought to school. We conducted a randomized controlled trial of providing breakfast to rural primary school children in grade 2 to 5 in 16 schools in Jamaica. 407 undernourished children (weight for age,-ISD NCHS references and 407 adequtely nourished children (weight for age>-ISD) matched for age gender and class were randomly assigned to either breakfast or placebo groups for one school year. Breakfast consisted of bread or spiced bun with cheese and 250 ml flavoured milk which supplied 590-720 kcal and 22.5 g protein per day. The placebo was a small piece of orange. The children heights and weight were measured before and after the intervention. Differences between categorical variables were examined by Chi-squared tests and effects of giving breakfasts were tested by multiple regression analyses. The children receiving breakfast gained significantly more in weight and body mass index (p<.001) and height (p<0.05) than those in the placebo group. Participation in the programme did not reduce the amount of money brought to school, or change their home breakfasts, suggesting no significant income transfer to the families. We subsequently trained teaches to identify undernourished children who could benefit from a school meal using a calibrated measuring stick. (AU)

Relationship between maternal nutritional status and infant's weight and body proportions at birth

OBJECTIVE: To examine maternal nutritional status and its relationship to infant weight and body proportions. DESIGN: Retrospective study of births from January-December 1990. SETTING: University Hospital of the West Indies, Jamaica. SUBJECTS: Records for 2394 live, singleton births, between 200-305 d gestation. MAIN OUTCOME MEASURES: Birth weight, crown heel length, head circumference, ponderal index, head circumference: length ratio, placental weight, placental: birth weight ratio. RESULTS: Mothers who were lighter had babies who had lower birth weight, were shorter, had smaller heads and had a higher HC:L ratio. Shorter and thinner women had babies who had lower birth wieghts, were shorter, had smaller heads and lighter placentas. Thinner women also had babies with a lower placental: birth weight ratio, and their BMI's were not linearly related to ponderal index and HC:L ratio. Women whose first trimester Hb levels were < 9.5 g/d1 had babies with the lowest birth weight, crown heel length, placental weight and ponderal index. These measurements increased as the Hb levels rose to 12.5 g/dl but then fell at Hb levels > 12.5 g/dl. In the second and third trimester Hb levels were negatively associated with birth weight, crown heel length, head circumference, placenta weight and ponderal index. CONCLUSIONS: The data support the hypothesis that poor maternal nutrition is associated with foetal growth restraint. Poor maternal nutrition as indicated by low weight, height, and BMI are associated with smaller, shorter babies with smaller heads. Haemoglobin levels > 12.5 g/dl in pregnancy are associated with lighter, shorter, thinner babies, with smaller heads.(AU)

Dietary considerations when taking medication

Medicaments can affect and be affected by nutrition. Vitamins, minerals or other food components can alter the way a drug is used as well as some drugs cause nutritional deficiencies. Drugs can also affect appetite, taste and gut function, and in this way affect nutritional status.