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BACKGROUND AND AIMS: An increase in plasma branched-chain amino acids is associated with a higher risk of developing type 2 diabetes and cardiovascular diseases. However, little is known about the basal plasma amino acid concentrations in young adults. Our aim was to determine the plasma amino acid profiles of young adults and to evaluate how these profiles were modified by sex, body mass index (BMI) and insulin resistance (IR). METHODS AND RESULTS: We performed a transversal study with 608 Mexican young adults aged 19.9 ± 2.4 years who were applicants to the Universidad Autónoma de San Luis Potosí. The subjects underwent a physical examination and provided a clinical history and a blood sample for biochemical, hormonal and amino acid analyses. The women had higher levels of arginine, aspartate and serine and lower levels of α-aminoadipic acid, cysteine, isoleucine, leucine, methionine, proline, tryptophan, tyrosine, urea and valine than the men. The obese subjects had higher levels of alanine, aspartate, cysteine, ornithine, phenylalanine, proline and tyrosine and lower levels of glycine, ornithine and serine than the normal weight subjects. Subjects with IR (defined as HOMA > 2.5) had higher levels of arginine, alanine, aspartate, isoleucine, leucine, phenylalanine, proline, tyrosine, taurine and valine than the subjects without IR. Furthermore, we identified two main groups in the subjects with obesity and/or IR; one group was composed of amino acids that positively correlated with the clinical, biochemical and hormonal parameters, whereas the second group exhibited negative correlations. CONCLUSION: This study demonstrates that young adults with obesity or IR have altered amino acid profiles characterized by an increase in alanine, aspartate, proline and tyrosine and a decrease in glycine.
Assuntos
Aminoácidos/sangue , Índice de Massa Corporal , Resistência à Insulina , Obesidade Infantil/sangue , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Fatores Etários , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Masculino , México/epidemiologia , Estado Nutricional , Obesidade Infantil/diagnóstico , Obesidade Infantil/epidemiologia , Obesidade Infantil/fisiopatologia , Prevalência , Fatores de Risco , Fatores Sexuais , Adulto JovemRESUMO
The aim of the present study was to evaluate associations between intestinal parasitic infection with intestinal and systemic inflammatory markers in school-aged children with high rates of obesity. Plasma concentrations of C-Reactive Protein (CRP), leptin, TNF-α, IL-6 and IL-10 were measured as systemic inflammation markers and count of stool leukocytes as marker of intestinal inflammation in 291 children (6-10 years). Intestinal parasitic infection was measured by stool examination. Logistic regression analyses were performed to determine the odds of having high inflammatory markers for each parasite or group of parasites as compared to parasite-free children while adjusting for sex, age, mother's educational level and percentage of body fat. The prevalence of soil-transmitted helminths and intestinal protozoa infections was 12% and 36%, respectively. Parasitic infection was not associated with CRP, IL-6, IL-10 or TNF-α. Children infected with Ascaris lumbricoides (aOR: 5.91, 95% CI: 1.97-17.70) and Entamoeba coli (aOR: 8.46, 95% CI: 2.85-25.14) were more likely to have higher stool leucocytes than parasite-free children. Children with multiple infections (aOR: 10.60, 95% CI: 2.85-25.14) were more likely to have higher leptin concentrations than parasite-free children. Intestinal parasitic infection was not associated with systemic inflammation, but was associated with intestinal inflammation. Having multiple infections were associated with higher leptin concentrations.
Assuntos
Helmintíase/sangue , Helmintíase/imunologia , Enteropatias Parasitárias/sangue , Enteropatias Parasitárias/imunologia , Intestinos/parasitologia , Leptina/sangue , Animais , Ascaris lumbricoides/imunologia , Proteína C-Reativa/metabolismo , Criança , Estudos Transversais , Entamoeba histolytica/imunologia , Fezes/parasitologia , Feminino , Helmintíase/parasitologia , Humanos , Inflamação , Interleucina-10/sangue , Interleucina-6/sangue , Enteropatias Parasitárias/parasitologia , Masculino , Obesidade/complicações , Prevalência , Inquéritos e Questionários , Fator de Necrose Tumoral alfa/sangueRESUMO
BACKGROUND: Intestinal parasites, virus and bacterial infections are positively associated with obesity and adiposity in vitro and in animal models, but conclusive evidence of this relationship in humans is lacking. The aim of this cross-sectional study was to determine differences in adiposity between infected and non-infected children, with a high prevalence of intestinal parasitic infection and obesity. SUBJECTS: A total of 296 school-aged children (8.0 ± 1.5 years) from a rural area in Querétaro, Mexico, participated in this study. Anthropometry (weight, height and waist circumference) and body fat (DXA) were measured in all children. A fresh stool sample was collected from each child and analysed for parasites. Questionnaires related to socioeconomic status and clinical history were completed by caretakers. RESULTS: Approximately 11% of the children were obese, and 19% were overweight. The overall prevalence of infection was 61%. Ascaris lumbricoides was the most prevalent soil transmitted helminth (16%) followed by hookworm. Entamoeba coli was the predominant protozoa (20%) followed by Endolimax nana, Balantidium coli, Entamoeba histolytica/dispar, Iodamoeba bütschlii and Giardia lamblia. Children with moderate-heavy infection of E. coli had significantly higher waist circumference, waist-to-height ratio, body and abdominal fat than children not infected or with light-intensity infection (p < 0.05). CONCLUSION: These findings raise the possibility that a moderate or heavy infection with E. coli may contribute to fat deposition and thereby have long-term consequences on human health. Further studies are needed to better understand if E. coli contributes directly to fat deposition and possible mechanisms.
Assuntos
Adiposidade , Entamoeba/isolamento & purificação , Entamebíase/fisiopatologia , Enteropatias Parasitárias/fisiopatologia , Obesidade Infantil/fisiopatologia , Gordura Abdominal , Adiposidade/fisiologia , Antropometria , Criança , Estudos Transversais , Entamebíase/parasitologia , Fezes/parasitologia , Feminino , Humanos , Enteropatias Parasitárias/parasitologia , Masculino , México , Obesidade Infantil/parasitologia , Prevalência , Classe SocialRESUMO
BACKGROUND: The efficacy of micronutrient supplementation on growth may be modified by specific gastrointestinal parasite infections. METHODS: We carried out a double-blind placebo-controlled trial to evaluate the effect of vitamin A and zinc supplementation on gastro-intestinal pathogen infections and growth among 584 infants in Mexico City. Children aged 5-15 months were assigned to receive either a vitamin A supplement every 2 months (20,000 IU of retinol for infants < or =; 1 year or 45,000 IU for infants >1 year), a daily supplement of 20 mg of zinc, a combined vitamin A-zinc supplement or a placebo, and were followed up for 1 year. Weight and length were measured once a month and morbidity histories were recorded twice a week for 12 months. Monthly stool samples were screened for Giardia duodenalis, Ascaris lumbricoides and Entamoeba spp. Growth velocity slopes, generated from the linear regression of individual child length, and height-for-age z-scores on time were analyzed as end points in regression models, adjusting for the presence of parasite infections. RESULTS: The main effect of vitamin A supplementation was in height improvement (P<0.05), and was only found in the model evaluating infants with any parasite. There was an interaction effect of slower growth (P<0.05) found in infants infected with any parasite and supplemented with vitamin A in slower growth (P<0.05). In addition, the interaction of zinc supplementation and Giardia duodenalis or A. lumbricoides was associated with reduced growth (P<0.05). CONCLUSION: Gastro-intestinal parasite infections may modify the effect that zinc or vitamin A supplementation has on childhood growth.
Assuntos
Estatura/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Crescimento/efeitos dos fármacos , Enteropatias Parasitárias/complicações , Vitamina A/farmacologia , Zinco/farmacologia , Animais , Ascaríase/complicações , Ascaris lumbricoides , Estatura/fisiologia , Peso Corporal/fisiologia , Suplementos Nutricionais , Disenteria Amebiana/complicações , Fezes/parasitologia , Feminino , Giardíase/complicações , Crescimento/fisiologia , Transtornos do Crescimento/etiologia , Transtornos do Crescimento/prevenção & controle , Humanos , Lactente , Masculino , México , Oligoelementos/farmacologia , Vitaminas/farmacologiaRESUMO
OBJECTIVE: Protamine has been shown to have an inhibitory effect on protein lipase in vitro; the objective of this study was to evaluate the antiobesity activity effect of protamine in obese induced rats, and to evaluate the effect of protamine on postprandial hypertriacylglyceridemia in rats by intragastric administration of a lipid emulsion containing corn oil. DESIGN: Two experiments were carried out: (1) In a parallel study in rats, we administered a lipid emulsion containing corn oil plus 0, 200 or 500 mg kg(-1) of protamine intragastrically. (2) In a randomized parallel prospective rats experiment, rats were fed with a high-fat diet and 0, 200 or 500 mg of protamine per kg of animal weight during 5 weeks. SUBJECTS: Male Sprague-Dawley rats. MEASUREMENTS: In experiment 1, plasma triacylglycerol levels after oral administration of lipid emulsion were determined. In experiment 2, weight gain, concentrations of plasma triacylglycerol, plasma total cholesterol and albumin were determined, and the subcutaneous and visceral adipose tissues were weighed. RESULTS: Plasma triacylglycerol concentration in rats administered with 200 or 500 mg kg(-1) of protamine was significantly lower than that in rats in the control group (200 mg kg(-1) of protamine, P<0.05 at 1, 2, 3 and 4 h; 500 mg kg(-1) of protamine P<0.05 at 2, 3 and 4 h). In rats fed with a high-fat diet, and 200 and 500 mg kg(-1) of protamine, there was a decreased body weight gain by 52 and 66 g, respectively, reduced visceral fat by 5 and 8 g, respectively and subcutaneous tissue weights by 12 and 15 g, respectively. Plasma triacylglycerol was 17 and 45 mg per 100 ml lower in rats fed with high-fat diet plus 200 and 500 mg kg(-1) of protamine, respectively. And cholesterol concentrations were 18 and 22 mg per 100 ml lower in both protamine groups, respectively. CONCLUSION: Our study demonstrates that protamine reduce weight gain and body fat accumulation through the inhibition of dietary fat absorption.
Assuntos
Fármacos Antiobesidade/administração & dosagem , Gorduras na Dieta/administração & dosagem , Obesidade/tratamento farmacológico , Protaminas/administração & dosagem , Triglicerídeos/sangue , Tecido Adiposo/efeitos dos fármacos , Animais , Fármacos Antiobesidade/metabolismo , Gorduras na Dieta/metabolismo , Hipertrigliceridemia , Metabolismo dos Lipídeos , Masculino , Obesidade/metabolismo , Protaminas/metabolismo , Ratos , Ratos Sprague-Dawley , Aumento de Peso/efeitos dos fármacos , Aumento de Peso/fisiologiaRESUMO
The implications of delta-aminolevulinic acid dehydratase (ALAD) polymorphism for lead kinetics and toxicity have been mainly studied in occupationally exposed adults. Therefore, our purpose was to evaluate the distribution of ALAD genotype and its association with biomarkers of exposure (PbB levels) and effect (Blood ZPP) among children living in a smelter community in Mexico. We recruited 569 children from nine elementary schools close to a smelter site. PbB was determined by electrothermal atomic absorption spectrometry. A polymerase chain reaction (PCR)-based protocol was used for ALAD genotyping. Zinc protoporphyrin (ZPP) in blood was measured by direct fluorometry. Most children (93.15%) were homozygous for ALAD (1-1), 6.67% were heterozygous for ALAD for (1-2), and one child was homozygous for ALAD (2-2). There was an increased proportion of ALAD (1-2/2-2) genotype with respect to PbB levels. The ZPP geometric mean was slightly higher in ALAD (1-1) genotype children (63.48 mu mol ZPP/mol Hb) than in those having the ALAD-2 genotype (58.22 mu mol ZPP/mol Hb; p = 0.051). Linear and quadratic models showed significant relationships between ZPP and PbB. A significant increase in the odds ratio (OR) for the effect of lead exposure on ZPP levels was observed for ALAD (1-1) children having PbB values above 20 mu g/dL, as compared to those having PbB levels below 10 mu g/dL (OR = 2.95, 95% CI = 1.45-5.97; p = 0.003), whereas no significant increases were observed for the ALAD (1-2/2-2) children. In summary, our results suggest that heme biosynthesis was less affected in ALAD (1-2/2-2) lead-exposed children than in those carrying the ALAD (1-1) genotype.
RESUMO
BACKGROUND: The role of single micronutrient deficiencies in the etiology of growth retardation has recently gained attention. However, because multiple micronutrient deficiencies are common in children in developing countries, it is possible that more than one micronutrient may limit growth and, hence, the correction of a single deficiency may not be enough to improve growth substantially. OBJECTIVE: The objective was to evaluate the effect of multiple micronutrient supplementation on the growth of children aged 8-14 mo whose diets were poor in several micronutrients. DESIGN: Children were randomly assigned to 1 of 2 groups. One group received a multiple micronutrient supplement containing the recommended dietary allowance (RDA) or 1.5 times the RDA of vitamins A, D, E, K, C, B-1, B-6, B-12, riboflavin, niacin, biotin, folic acid, and pantothenic acid, and iron, zinc, iodine, copper, manganese, and selenium. The other group received a placebo. Supplements were administered 6 d/wk for an average of 12.2 mo. Body length was measured at baseline and monthly thereafter until the end of supplementation. RESULTS: Supplemented infants initially aged <12 mo had significantly greater length gains than did the placebo group, with a difference of 8.2 mm (length-for-age z score: 0.3) at the end of supplementation. In contrast, differences in length gains between the supplemented and placebo groups initially aged > or =12 mo were not significant. CONCLUSIONS: Micronutrient deficiencies limited the growth of the Mexican infants studied. Improving micronutrient intakes should be a component of interventions to promote growth in infants living in settings where micronutrient intakes are inadequate.
Assuntos
Estatura/efeitos dos fármacos , Suplementos Nutricionais , Transtornos do Crescimento/etiologia , Crescimento/efeitos dos fármacos , Micronutrientes/administração & dosagem , Fatores Etários , Estatura/fisiologia , Desenvolvimento Infantil , Método Duplo-Cego , Feminino , Crescimento/fisiologia , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/prevenção & controle , Humanos , Lactente , Masculino , México , Micronutrientes/farmacologiaRESUMO
AIM: To study the need for analgesia and sedation before colonoscopy. PATIENTS AND STUDY DESIGN: Fifty consecutive outpatients were randomly assigned to receive meperidine (0.7 mg/kg) or midazolam (0-035 mg/kg) intravenously (n = 25) or to receive no medication (n = 25) before colonoscopy. Oxygen saturation (SaO2) and heart rate were monitored. Mean blood pressure (MBP) was recorded before and after endoscopy. Patients in the group receiving no medication who experienced marked abdominal pain received sedation and analgesia similar to the premedicated group. Twenty-four hours after the procedure, the patients evaluated the degree of abdominal pain experienced during colonoscopy on a scale from 0 to 9. RESULTS: Complete colonoscopy was performed in 92% of the patients. No significant changes in heart rate were registered in either group. However, in the premedicated group mean blood pressure fell significantly (97.6 +/- 2.6 vs. 89.5 +/- 2.7 mmHg) before and after colonoscopy, respectively (p < 0.05). Nine patients experienced clinically relevant oxygen desaturation (SaO2 > 90%). Of these, five were from the premedicated group and four were from the group receiving no medication. In two patients, both from the premedicated group, the decrease in SaO2 was severe (SaO2 < 85%). The degree of abdominal pain was similar in both groups: 3.64_0.47 (premedicated) vs. 3.92 +/- 0.5 (non-medicated). In the non-medicated group, two patients required analgesia and sedation to complete the colonoscopy and 20 (80%) preferred not to receive sedation in future colonoscopies. CONCLUSIONS: Colonoscopy may be well tolerated without systematic administration of sedation and analgesia, which could be administered selectively.
Assuntos
Dor Abdominal/etiologia , Analgesia , Colonoscopia/métodos , Sedação Consciente , Dor Abdominal/prevenção & controle , Adjuvantes Anestésicos , Anestesia Intravenosa , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Meperidina , Midazolam , Pessoa de Meia-Idade , Oxigênio/sangueRESUMO
BACKGROUND: Zinc deficiency is prevalent in children in developing countries. Supplemental zinc provides therapeutic benefits in diarrhea. OBJECTIVE: We sought to measure the effect of supplemental zinc given with oral rehydration therapy during recovery from acute or persistent diarrhea. DESIGN: We conducted pooled analyses including all available published and unpublished randomized controlled trials of the effects of supplementary oral zinc in children aged <5 y with acute or persistent diarrhea. We used Cox survival regression analysis to evaluate the overall effect of zinc on continuation of diarrhea and possible differential effects in subgroups divided by sex, age, weight-for-height, and initial plasma zinc concentration. Dichotomous outcomes were analyzed by logistic regression. To assess the effects of excluding studies without original data from the pooled analyses, effect-size was estimated for all studies by using random-effects models. RESULTS: Zinc-supplemented children had a 15% lower probability of continuing diarrhea on a given day (95% CI: 5%, 24%) in the acute-diarrhea trials and a 24% lower probability of continuing diarrhea (95% CI: 9%, 37%) and a 42% lower rate of treatment failure or death (95% CI: 10%, 63%) in the persistent-diarrhea trials. In none of the subgroup analyses were the 2 subgroups of each pair significantly different from each other; however, in persistent diarrhea there tended to be a greater effect in subjects aged <12 mo, who were male, or who had wasting or lower baseline plasma zinc concentrations. CONCLUSION: Zinc supplementation reduces the duration and severity of acute and persistent diarrhea.
Assuntos
Países em Desenvolvimento , Diarreia/tratamento farmacológico , Zinco , Doença Aguda , Administração Oral , Pré-Escolar , Feminino , Hidratação , Humanos , Lactente , Modelos Logísticos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Zinco/administração & dosagem , Zinco/sangue , Zinco/deficiência , Zinco/uso terapêuticoRESUMO
BACKGROUND: In developing countries, incomplete resolution of anemia with iron supplementation is often attributed to poor compliance or inadequate duration of supplementation, but it could result from deficiencies of other micronutrients. OBJECTIVE: Our objective was to assess children's hematologic response to supervised, long-term iron supplementation and the relation of this response to other micronutrient deficiencies, anthropometry, morbidity, and usual dietary intake. DESIGN: Rural Mexican children aged 18-36 mo (n = 219) were supplemented for 12 mo with either 20 mg Fe, 20 mg Zn, both iron and zinc, or placebo. Children were categorized as iron-unsupplemented (IUS; n = 109) or iron supplemented (IS; n = 108). Hemoglobin, hematocrit, mean corpuscular volume, mean cell hemoglobin, plasma concentrations of micronutrients that can affect hematopoiesis, anthropometry, and diet were assessed at 0, 6, and 12 mo; morbidity was assessed biweekly. RESULTS: At baseline, 70% of children had low hemoglobin (=115 g/L), 60% had low hematocrit, 48% were ferritin deficient, 10% had deficient and 33% had low plasma vitamin B-12 concentrations, 29% had deficient vitamin A concentrations, and 70% had deficient vitamin E concentrations. Iron supplementation increased ferritin from 11 +/- 14 microg/L at baseline to 31 +/- 18 microg/L after 6 mo (P < 0.001) and 41 +/- 17 microg/L after 12 mo. However, anemia persisted in 30% and 31% of supplemented children at 6 and 12 mo, respectively, and was not significantly different between the IUS and IS groups at 12 mo. Initial plasma vitamin B-12, height-for-age, and dietary quality predicted the hematopoietic response to iron. CONCLUSION: Lack of hemoglobin response to iron was associated with indicators of chronic undernutrition and multiple micronutrient deficiencies.
Assuntos
Anemia/tratamento farmacológico , Suplementos Nutricionais , Hemoglobinas/metabolismo , Ferro/administração & dosagem , Pré-Escolar , Dieta , Índices de Eritrócitos , Ferritinas/sangue , Ferritinas/deficiência , Hematócrito , Hematopoese , Humanos , Lactente , México , Estado Nutricional , População Rural , Deficiência de Vitamina A/sangue , Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina E/sangueRESUMO
BACKGROUND: The coexistence of multiple micronutrient deficiencies is a widespread public health problem in many regions of the world. Interactions between zinc deficiency and vitamin A metabolism have been reported but no longitudinal studies have evaluated the effect of iron deficiency on vitamin A. OBJECTIVE: The objective of this study was to investigate the effect of supplementation with iron, zinc, or both on vitamin A and its metabolically related proteins retinol binding protein (RBP) and transthyretin. DESIGN: The study was a longitudinal, double-blind, placebo-controlled trial in which 219 rural Mexican children aged 18-36 mo were randomly assigned to receive 20 mg Zn/d, 20 mg Fe/d, 20 mg Zn/d plus 20 mg Fe/d, or placebo. RESULTS: Six months after supplementation, plasma retinol increased in all supplemented groups. Compared with placebo, zinc supplementation was associated with significantly higher plasma retinol and transthyretin but the increase in RBP was not significant. Iron supplementation significantly increased plasma retinol, RBP, and transthyretin. Supplementation with zinc plus iron significantly increased plasma retinol but not RBP or transthyretin. Children deficient in zinc, iron, or vitamin A (as indicated by nutrient plasma concentration) at the beginning of the study had a significantly greater increase in retinol than did children with adequate nutrient status. CONCLUSIONS: Supplementation with zinc, iron, or both improved indicators of vitamin A status. The results of this study agree with previous observations of a metabolic interaction between zinc and vitamin A and suggest an interaction between iron and vitamin A metabolism.
Assuntos
Suplementos Nutricionais , Ferro da Dieta/administração & dosagem , Estado Nutricional , Vitamina A/sangue , Zinco/administração & dosagem , Pré-Escolar , Método Duplo-Cego , Ferritinas/sangue , Hemoglobinas/análise , Humanos , Lactente , Ferro/sangue , Deficiências de Ferro , Estudos Longitudinais , México , Placebos , Pré-Albumina/análise , Zinco/sangue , Zinco/deficiênciaRESUMO
OBJECTIVES: This study assessed the effects of zinc supplementation in the prevention of diarrhea and pneumonia with the use of a pooled analysis of randomized controlled trials in children in developing countries. STUDY DESIGN: Trials included were those that provided oral supplements containing at least one half of the United States Recommended Daily Allowance (RDA) of zinc in children <5 years old and evaluated the prevention of serious infectious morbidity through household visits. Analysis included 7 "continuous" trials providing 1 to 2 RDA of elemental zinc 5 to 7 times per week throughout the period of morbidity surveillance and 3 "short-course" trials providing 2 to 4 RDA daily for 2 weeks followed by 2 to 3 months of morbidity surveillance. The effects on diarrhea and pneumonia were analyzed overall and in subgroups defined by age, baseline plasma zinc concentration, nutritional status, and sex. The analysis used random effects hierarchical models to calculate odds ratios (OR) and 95% CIs. RESULTS: For the zinc-supplemented children compared with the control group in the continuous trials, the pooled ORs for diarrheal incidence and prevalence were 0.82 (95% CI 0.72 to 0.93) and 0.75 (95% CI 0.63 to 0.88), respectively. Zinc-supplemented children had an OR of 0.59 (95% CI 0.41 to 0.83) for pneumonia. No significant differences were seen in the effects of the zinc supplement between the subgroups examined for either diarrhea or pneumonia. In the short-course trials the OR for the effects of zinc on diarrheal incidence (OR 0.89, 95% CI 0.62 to 1.28) and prevalence (OR 0.66, 95% CI 0.52 to 0.83) and pneumonia incidence (OR 0.74, 95% CI 0.40 to 1.37) were similar to those in the continuous trials. CONCLUSIONS: Zinc supplementation in children in developing countries is associated with substantial reductions in the rates of diarrhea and pneumonia, the 2 leading causes of death in these settings.
Assuntos
Diarreia/prevenção & controle , Suplementos Nutricionais , Pneumonia/prevenção & controle , Zinco/uso terapêutico , Criança , Países em Desenvolvimento , Humanos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
OBJECTIVE: To develop and evaluate nutritional supplements destined to a program of social assistance. MATERIAL AND METHODS: In the design of the nutritional supplements a series of criteria were considered including nutrient composition, physicochemical properties and feasibility of production and utilization. Final products were initially evaluated to determine the level of acceptance in 40 children, 52 pregnant women and 62 lactating women in Mexico City. A community trial was also carried out to determine acceptance and consumption in 108 children and 128 women from a rural community in the state of Morelos. RESULTS: The specific formulation and technical processes of production of the nutritional supplements are presented. Products proved to be widely accepted, with average scores of 4.11-4.29 for the children's beverage, and 3.98-4.15 for a more viscous pap (range of scores was 1 to 5). Products for women received average scores from 4.75 to 5.70 in pregnant and from 4.8 to 5.4 in lactating women (range of scores from 1 to 7). In the community trial, supplements were very well accepted. Average consumption was > 75% among children and > 98% among women. Mean energy intake from supplements was 244 Kcal/day for women, and for children, 168 Kcal/day with the pap and 147 Kcal/day with the beverage. Consumption was consistent in all cases along the study. CONCLUSIONS: Nine nutritional supplements were developed and evaluated which comply with the necessary nutritional, physicochemical and hygienic characteristics for the target population, besides being relatively simple to prepare, and widely well accepted and consumed.
Assuntos
Suplementos Nutricionais , Estado Nutricional , Desenvolvimento de Programas , Adulto , Pré-Escolar , Educação , Feminino , Promoção da Saúde , Humanos , Lactente , Lactação , Masculino , México , Gravidez , Avaliação de Programas e Projetos de SaúdeRESUMO
In Mexico, marginal micronutrient deficiency is widespread and affects the health status and function of many Mexicans. A program to add nutrients to corn and wheat flour has been promoted by the Ministry of Health. This document describes the scientific and technological bases of the program. The main objective is to restore the nutrients which are lost during cereal processing to obtain flour and food products. Also, certain nutrients which are known to be deficient in a high proportion of Mexicans, and which should be supplemented in the diet for the benefit of the population are also included. In the definition of the formula to be added to flours various other factors were considered such as the absorption levels of the nutrients, potential interactions among them and a wide range of security to eliminate the risk of an adverse effect on health even at the highest level of food intake. Finally, the most appropriate compounds to be added to flours are suggested considering their reactivity and their possible negative effects on the stability of flour, as well as the bioavailability, market availability and cost. The recommended compounds were 5 mg/kg of thiamine (thiamine mononitrate), 3 mg/kg of riboflavin (riboflavin hydrochlorhidrate), 35 mg/kg of niacine (nicotinamide), 30 mg/kg of iron (extrafine reduced iron) and 20 mg/kg of zinc (Zinc oxide) for both types of flour, as well as 2 mg/kg and 0.5 mg/kg of folic acid for wheat and corn flour, respectively.
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Farinha , Alimentos Fortificados , Minerais/administração & dosagem , Triticum , Vitaminas/administração & dosagem , Zea mays , Ferro/administração & dosagem , Magnésio/administração & dosagem , México , Micronutrientes , Niacina/administração & dosagem , Riboflavina/administração & dosagem , Tiamina/administração & dosagem , Óxido de Zinco/administração & dosagemRESUMO
Recent studies have investigated the effect of micronutrient deficiencies on growth stunting, with special attention toward the effect of zinc, iron, vitamin A and iodine deficiencies. In Mexico, the prevalence of growth stunting in children <5 y old is approximately 24%; it is higher in rural areas and lower in urban areas. In an initial study, the effect of zinc and/or iron supplementation on linear growth was investigated in a longitudinal, placebo-controlled design. After 12 mo of supplementation, there was no difference between the groups supplemented with zinc, iron or zinc plus iron and the placebo group. At baseline, 82% of the children in this study were deficient in at least two out of the five micronutrients that were determined, and 73% were anemic. In another study, a mixture of those micronutrients that were documented to be lacking in Mexican children was formulated in a supplement and given to Mexican children over a period of 12 mo in a longitudinal, placebo-controlled, supplementation design. Children in the low and medium socioeconomic status grew about 1 cm more than similar children in the placebo group. This difference was not found in children of high socioeconomic status. It is suggested that, in most cases, growth stunting is associated with marginal deficiencies of several micronutrients and that in populations with multiple micronutrient deficiencies, the effect on linear growth of supplementation with single nutrients will not be significant. Supplementation with multiple micronutrients is expected to be more effective, but even in that case the actual increment in height was less than the expected potential increment.
Assuntos
Transtornos do Crescimento/etiologia , Micronutrientes , Pré-Escolar , Suplementos Nutricionais , Transtornos do Crescimento/prevenção & controle , Humanos , Lactente , Ferro/administração & dosagem , México , Ensaios Clínicos Controlados Aleatórios como Assunto , Vitaminas/administração & dosagem , Zinco/administração & dosagemRESUMO
OBJECTIVE: To evaluate the nutritional impact of the ingestion of a fortified whole milk in children. MATERIAL AND METHODS: Prospective, longitudinal assay in 227 children aged 8-60 months. INTERVENTION: Daily consumption of 500 ml of fortified milk during 90 days. We registered milk acceptance and assessed weight, height; hemoglobin, serum iron, vitamin B12, and folic acid, at the beginning and the end of the study. Statistical evaluation were done with central and dispersion indices in the dimensional variables, using Student's t test and chi 2 test for compare nominal variables at initial and the end of the study. RESULTS: At admission, 45 children were malnourished and 36 were anemic. At the end of the supplementation period there was a reduction to 35 malnourished (p < 0.21) and 18 anemic (p < 0.01). Anthropometric weight/height score in Z at the beginning and end of the study (x +/- S.D) were -0.35 +/- 0.88 vs -0.14 +/- 9 (p < 0.01); Hb g/dl: 11 +/- 1.3 vs 11.9 +/- 1.9 (p < 0.001), Iron mg/dl: 108 +/- 44 vs 115 +/- 31 (p = 0.06) and vitamin B12 pg/ml: 649 +/- 494 to 1053 +/- 854 (p < 0.001). The milk was well tolerated and widely accepted. CONCLUSIONS: The consumption of a fortified whole milk during 90 days improved significantly the nutritional status of the children, the weight for height Z score, the plasma level of vitamin B12 and Hb, and decreased the number of anemic and malnourished children.
Assuntos
Anemia/dietoterapia , Alimentos Fortificados , Fenômenos Fisiológicos da Nutrição do Lactente , Leite , Distúrbios Nutricionais/dietoterapia , Animais , Pré-Escolar , Humanos , Lactente , Minerais/administração & dosagem , Estado Nutricional , Estudos Prospectivos , Vitaminas/administração & dosagemRESUMO
Nutrient composition in foods is necessary for the determination of nutrient intake. Food composition tables used for dietary studies in Mexico do not have information of zinc, iron and copper; when present the values have been extrapolated from laboratory analysis carried out with foods in other countries and regions of the world. In this study zinc, iron, and copper content of 104 plant foods and 32 animal foods was determined. The procedure used was atomic absorption spectrophotometry for the minerals. Foods were grouped into cereals, vegetables, fruits, legumes and animal foods. Zinc content ranged from 0.018 mg/100 g for strawberry to 9.193 mg/100 g for beef. Iron content ranged from 0.113 mg/100 g for yogurt to 19.82 mg/100 g for a commercial cereal which had minerals added during processing. In some foods copper was not found and the highest content was 3.371 mg/100 g in beef liver. This study has provided information on zinc, iron and copper content of the most commonly consumed foods in Mexico.
Assuntos
Cobre/análise , Ferro/análise , Zinco/análise , Animais , Grão Comestível/química , MéxicoRESUMO
The purpose of this article is to review theoretical aspects and research performed in Mexico suggesting the existence of marginal zinc deficiency in rural children and its consequences on health. Zinc is an indispensable nutrient for humans since it plays an important role in several metabolic pathways: it participates in the catalytic site of several enzymes, as a structural ion of biological membranes and is closely associated to protein synthesis, among other functions. It is therefore related to functional and health impairments, specially in children. A marginal deficiency of zinc in Mexican children is relevant because of its potential effects. Studies suggest that marginal zinc deficiency is associated to diets based on plant foods which are rich in zinc absorption inhibitors. Such diets are habitually consumed in rural areas and in poor areas of the cities. Marginal zinc deficiency was found to cause an increase in infectious diseases, specially diarrhea, and an impairment of the cognitive functions.
Assuntos
Zinco/deficiência , Cognição , Doenças Transmissíveis/etiologia , Deficiências Nutricionais/fisiopatologia , Dieta , Crescimento , Humanos , México , Zinco/metabolismoRESUMO
In rural Mexico and in many developing countries micronutrient deficiencies, growth stunting, and morbidity from infectious diseases are highly prevalent in young children. We assessed the extent to which growth stunting could be reversed and the number of infectious disease episodes reduced by zinc and/or iron supplementation. In a double-blind, randomized community trial 219 Mexican preschoolers were supplemented with either 20 mg Zn as zinc methionine, 20 mg Fe as ferrous sulfate, 20 mg Zn + 20 mg Fe, or a placebo. After 12 mo, plasma zinc increased significantly in the two zinc-treated groups, and plasma ferritin was significantly higher in the two iron-treated groups. There was no effect of treatments on growth velocity or body composition. Children in both zinc-supplemented groups had fewer episodes of disease (zinc alone, 3.9 +/- 0.3; zinc+iron, 3.7 +/- 0.4; placebo, 4.6 +/- 0.5; P < 0.03), including diarrhea (zinc alone, 0.7 +/- 0.1; zinc+iron, 0.8 +/- 0.1; placebo, 1.1 +/- 0.2; P < 0.01). Zinc and zinc+iron supplements reduced morbidity but had no effect on growth or body composition.
Assuntos
Composição Corporal/efeitos dos fármacos , Doenças Transmissíveis/epidemiologia , Crescimento/efeitos dos fármacos , Ferro/farmacologia , Zinco/farmacologia , Composição Corporal/fisiologia , Pré-Escolar , Doenças Transmissíveis/mortalidade , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Alimentos Fortificados , Crescimento/fisiologia , Humanos , Lactente , Masculino , México/epidemiologia , México/etnologia , Morbidade , Fatores de Tempo , Zinco/administração & dosagemRESUMO
Milk is an important source of high quality protein, energy, calcium, potassium, phosphorus and riboflavin. It also has good functional properties and a highly acceptable taste, making milk a good alternative for the nutrition of children and for food programmes in developing countries. However, in some instances it has been advocated that milk or milk based products might not be appropriate for nutritional support, given the high prevalence of lactose intolerance among populations in those countries. After reviewing studies in different regions of the world it is concluded that: 1. Prevalence of lactose maldigestion in children and adults is significantly reduced, to less than half in most studies, when assessed with a dose of milk similar to that normally taken in the diet, as distinct from a large dose of lactose used in the lactose tolerance test. 2. Lactose intolerance as a result of consuming a glass of milk occurs only in a small proportion (about 30% in most studies) of lactose maldigesters. Even this small group can ingest smaller amounts of milk without adverse symptoms and there is good evidence that colonic metabolism in these people adapts to the presence of lactose to reduce or eliminate adverse symptoms. 3. Lactose maldigestion and intolerance in children in developing countries is more likely to exist in association with gastrointestinal damage associated with diarrhoea, malnutrition and/or infection. 4. There is no evidence to support a reduction or elimination of milk intake for people in developing countries because of lactose maldigestion or intolerance.