Metabolic syndrome in rural Peruvian adults living at high altitudes using different cookstoves.

This study determined the prevalence of metabolic syndrome (MetS) in open fire stoves and improved cookstoves users (ICS) in the rural Peruvian Andes. Participants answered a socioeconomic questionnaire, one 24-hour food recall and underwent a physical examination. We analysed data from 385 participants, 190 (112 women and 78 men) were ICS users and 195 (123 women and 72 men) were open fire stove users. The prevalence of MetS was 21.3, 26.4% in women and 13.3% in men. We found no statistically significant association between the type of cookstove and MetS. Body mass index and altitude were important determinants of MetS. Research on cardiometabolic diseases and open fire stove use contributes to understanding the effect of household air pollution on health in high altitude populations.

Use of Salt-Restriction Spoons and Its Associations with Urinary Sodium and Potassium in the Zhejiang Province of China: Results of a Population-Based Survey.

In China, a major source of sodium is salt added during cooking. In this context, use of a salt-restriction spoon (SRS) has been promoted in public health campaigns and by health care providers. To describe use of and factors associated with SRS use, knowledge of correct use, and actual correct use. This study is a population-based, representative survey of 7512 residents, aged 18 to 69 years, of China's Zhejiang Province. The survey, which was conducted in 2017 using a multistage random sampling strategy, collected demographic information, SRS use, and physical measurements; a 24-h urine collection was obtained from 1,496 of the participants. The mean age of the participants was 44.8 years, 50.1% were females, and over 1/3 (35.3%) were classified as hypertensive. Mean 24-h urinary sodium and potassium excretions were 167.3(72.2) mmol/24 h and 38.2(18.2) mmol/24 h, respectively. Only 12.0% (899/7512) of participants once used or were currently using SRS; of the 899 users, 73.4% knew how to use the SRS correctly, and just 46.5% actually used it correctly. SRS use was more commonly associated with behavioral factors rather than socio-demographic factors. Initiation of SRS use by health care providers was associated with correct technical knowledge of SRS. Lower sodium-to-potassium ratio was associated with SRS use, while SRS use was not associated with urinary sodium and potassium excretion. Use of SRS was uncommon in Zhejiang Province of China. Given that a common source of sodium in China is salt added during cooking, use of SRS is an appealing strategy, ideally as part of a multi-component campaign.

Toxicity associated with long term use of aluminum cookware in mice: A systemic, genetic and reproductive perspective.

Studies on the toxic effects of cooking with aluminum pots are limited and none of them have explored its impact on the genetic material in germ and somatic cells. Therefore, this study investigated the cytogenotoxic effect of boiled water from new, 3- and 6-year old aluminum pots in germ and somatic cells viz-a-vis mouse sperm morphology test and sperm count; and the bone marrow micronucleus test. The mice were allowed to freely drink the boiled water from the different aluminum pots for 3, 4, and 5 weeks. The heavy metal analysis showed that As, Pb, Cd, and Al were present in the boiled water samples at different concentrations with the 6-year old pot having the highest concentrations of Pb, Cd, and Al. There were duration of exposure and age of pot-dependent significant increase in abnormal sperm cells and a significant decrease total mean sperm count of exposed mice. Similarly, there was a statistically significant increase in micronucleated polychromatic erythrocytes and nuclear abnormalities in the exposed mice that increased dependently upon the age of the cookware. Finally there were significantly increased activities of serum AST and ALT; and the liver concentrations of MDA, SOD and CAT in boiled water exposed mice. The findings of this study revealed that boiled water from aluminum pots is capable of inducing cytotoxic and genotoxic effects, especially as the pot ages.

Air pollution as a determinant of food delivery and related plastic waste.

Plastic waste is a growing environmental concern. The food delivery industry is criticized for its environmental impact, especially its current use of plastic packaging. At the same time, the environment impacts the industry. We show that air pollution is a behavioural driver of food delivery consumption in the urban developing world. Our hypothesis is that individuals are more likely to order delivery when their personal cost of exposure to the outdoor environment rises. We surveyed office workers in three Chinese cities and found that an increase of 100 µg m-3 in particulate matter pollution (PM2.5) raised the propensity to order food delivery by two-fifths of the sample mean. We used photographic evidence to quantify disposable plastic in meal delivery. Data from an online delivery platform with a broad customer base indicate a smaller, but still substantial, causal link between air quality and food delivery. Overall, air pollution control brings plastic waste co-benefits.

Effect of Holding Objects on the Occurrence of Head Impact in Falls by Older Adults: Evidence From Real-Life Falls in Long-Term Care.

BACKGROUND: Falls cause approximately 80% of traumatic brain injuries in older adults, and nearly one third of falls by residents in long-term care (LTC) result in head impact. Holding objects during falls, such as mobility aids, may affect the ability of LTC residents to avoid head impact by arresting the fall with their upper limbs. We examined the prevalence of holding objects and their effect on risk for head impact during real-life falls in older adults living in LTC. METHODS: We analyzed videos of 1105 real-life falls from standing height by 425 LTC residents, using a validated questionnaire to characterize the occurrence of head impact and whether the resident held objects during descent and impact. We classified objects as either "weight-bearing" (via contact to the fixed environment, eg, chairs and walkers) or "non-weight-bearing" (eg, cups) and tested their effect on odds for head impact with generalized estimating equations. RESULTS: Residents held objects in more than 60% of falls. The odds for head impact were reduced for falls where weight-bearing objects were held or grasped during descent (odds ratio = 0.52; 95% confidence interval = 0.39-0.70) or maintained throughout the fall (odds ratio = 0.34; 95% confidence interval = 0.23-0.49). The most commonly held objects were chairs/wheelchairs (23% of cases), tables/counters (10% of cases), and walkers/rollators (22% of cases); all reduced the odds of head impact when held during descent. Holding non-weight-bearing objects did not affect the odds of head impact (odds ratio = 1.00; 95% confidence interval = 0.64-1.55). CONCLUSION: Our results show that older adults in LTC use held, weight-bearing objects to reduce their risk for head impact during falls.

What the forks? A longitudinal quality improvement study tracking cutlery numbers in a public teaching and research hospital staff tearoom.

OBJECTIVES: To evaluate the circulation lifespan of forks and teaspoons in an institutional tearoom. DESIGN: Longitudinal quality improvement study, based on prospective tracking of marked teaspoons and forks. SETTING: Staff tearoom in a public teaching and research hospital, Brisbane. PARTICIPANTS: Tearoom patrons blinded to the purposes of the study. INTERVENTION: Stainless steel forks and teaspoons (18 each) were marked with red spots and introduced alongside existing cutlery (81 items) in the tearoom. MAIN OUTCOME MEASURES: Twice weekly count of marked forks and teaspoons for seven weeks; baseline and end of study count of all utensils on day 45. RESULTS: The loss of marked teaspoons (six of 18) was greater than that of forks (one of 18) by the conclusion of the study period (P = 0.038). The overall rate of utensil loss was 2.2 per 100 days for teaspoons and spoons, and -2.2 per 100 days for forks and knives. CONCLUSIONS: Teaspoon disappearance is a more substantial problem than fork migration in a multidisciplinary staff tearoom, and may reflect different kleptomaniacal or individual appropriation tendencies. If giving cutlery this Christmas, give teaspoons, not forks. The symbolism of fork rebirth or resurrection is appropriate for both Christmas and Easter, and forks are also mighty useful implements for eating cake!

Influence of food adhesivity and quantity in lip closing pressure.

Lip closing is an important motor act in food acquisition. Appropriate food capture in anticipatory and early oral stages of feeding is essential for mastication and swallowing. The aim of this study was to investigate the effect of food type and quantity on lip closing pressure during food capture with a spoon, and to identify normal lip function during food acquisition in healthy young adults. Twenty young healthy males (age range: 22-30 years) participated in this study. They were asked to eat the test food freely with a spoon. Test foods were yogurt and cream cheese, which were given in quantities of 3, 5 and 10 g in weight; 3 ml water was included as a reference. A strain gauge transducer was embedded in the spoon in advance, and lip closing pressures during food capture were measured and recorded. The Vicon motion analysis system was used to collect three-dimensional kinematic data of spoon operation. Positive pressure with lip closing during capture of adhesive food, such as cream cheese, significantly increased (P < 0.001). Moreover, positive pressure significantly decreased when food quantity increased (P < 0.01), irrespective of food type. Negative pressure that preceded positive pressure appeared more frequently during cream cheese intake and increased when food quantity on the spoon increased (P < 0.001). These findings indicated that participants sucked or squeezed the spoon further during capture of adhesive food. Maximum mouth opening occurred predominantly during the spoon insertion period, while mouth closing occurred predominantly during the spoon withdrawal period. After mouth closing, all subsequent lip pressure events appeared in the withdrawal period. Our results may be useful for comprehending normal lip function during food acquisition in healthy young adults. They may also aid in the diagnosis and management of abnormal lip function in oral hypofunction and dysfunction, which can be examined in future studies.

[National report of blood lead levels and lead-glazed ceramics use in vulnerable children.] / Reporte nacional de niveles de plomo en sangre y uso de barro vidriado en población infantil vulnerable.

OBJECTIVE: To estimate the prevalence of elevated (≥5.0µg /dL) blood lead levels (BLL) and its association with the use of lead glazed ceramics (LGC). MATERIALS AND METHODS: In 2018, we measured capillary BLL in a representative sample of children 1 to 4 years old residing in Mexican localities under 100 000 inhabitants (Ensanut 100k). We inquired about use of LGC for food preparation and consumption. To estimate its association with BLL, multinomial logit models stratified by region were generated. RESULTS: The prevalence of elevated BLL levels was 21.8%. For the North, Central and South regions, the prevalence were 9.8, 20.7 and 25.8%, respectively. The association with use and frequency of LGC was highly significant and differential by region. CONCLUSIONS: Lead exposure remains a public health problem in Mexico, particularly in the Central and South regions, and is strongly associated with the use of LGC.

OBJETIVO: Estimar la prevalencia de niveles elevados (≥5.0µg/dL) de plomo en sangre (PbS) y su asociación con el uso de loza de barro vidriado con plomo (LBVPb). MATERIAL Y MÉTODOS: En 2018 se midió PbS capilar en una muestra represen- tativa de niños de 1 a 4 años de edad residentes en localidades de México menores de 100 000 habitantes (Ensanut 100k). Se indagó sobre uso de LBVPb para consumo de alimentos. Para estimar su asociación con PbS, se generaron modelos logit multinomial estratificados por región. RESULTADOS: La prevalencia de niveles elevados de PbS fue de 21.8%. En las regiones Norte, Centro y Sur las prevalencias fueron 9.8, 20.7 y 25.8%, respectivamente. La asociación con uso y frecuencia de LBVPb fue altamente significativa y diferencial por región. CONCLUSIONES: La exposición a plomo permanece como un problema de salud pública en México, particularmente en el Centro y Sur, y está fuertemente asociada con el uso de LBVPb.

Reporte nacional de niveles de plomo en sangre y uso de barro vidriado en población infantil vulnerable / National report of blood lead levels and lead-glazed ceramics use in vulnerable children

Resumen: Objetivo: Estimar la prevalencia de niveles elevados (≥5.0μg/dL) de plomo en sangre (PbS) y su asociación con el uso de loza de barro vidriado con plomo (LBVPb). Material y métodos: En 2018 se midió PbS capilar en una muestra representativa de niños de 1 a 4 años de edad residentes en localidades de México menores de 100 000 habitantes (Ensanut 100k). Se indagó sobre uso de LBVPb para consumo de alimentos. Para estimar su asociación con PbS, se generaron modelos logit multinomial estratificados por región. Resultados: La prevalencia de niveles elevados de PbS fue de 21.8%. En las regiones Norte, Centro y Sur las prevalencias fueron 9.8, 20.7 y 25.8%, respectivamente. La asociación con uso y frecuencia de LBVPb fue altamente significativa y diferencial por región. Conclusiones: La exposición a plomo permanece como un problema de salud pública en México, particularmente en el Centro y Sur, y está fuertemente asociada con el uso de LBVPb.

Abstract: Objective: To estimate the prevalence of elevated (≥5.0μg / dL) blood lead levels (BLL) and its association with the use of lead glazed ceramics (LGC). Materials and methods: In 2018, we measured capillary BLL in a representative sample of children 1 to 4 years old residing in Mexican localities under 100 000 inhabitants (Ensanut 100k). We inquired about use of LGC for food preparation and consumption. To estimate its association with BLL, multinomial logit models stratified by region were generated. Results: The prevalence of elevated BLL levels was 21.8%. For the North, Central and South regions, the prevalence were 9.8, 20.7 and 25.8%, respectively. The association with use and frequency of LGC was highly significant and differential by region. Conclusions: Lead exposure remains a public health problem in Mexico, particularly in the Central and South regions, and is strongly associated with the use of LGC.

Food insecurity and food preparation equipment in US households: exploratory results from a cross-sectional questionnaire.

BACKGROUND: Food insecurity (FI) impacted 15.7% (5.9 million) of US households with children in 2017. These households often experience issues within one or more of the food security pillars: access, availability, utilisation or stability. An underexplored area within the pillar of utilisation that may impact FI risk is the availability of kitchen equipment in households. This exploratory project aimed to quantify household food preparation equipment ownership and use by household FI status. METHODS: An online platform (Qualtrics, Provo, UT, USA) was used to administer a questionnaire to a sample of 135 parents of children aged 11-14 years. The instrument queried sociodemographic characteristics, food preparation items owned and frequency of use of 44 items within a 6-month interval. Household FI was measured using the 18-item US Department of Agriculture, Household Food Security Survey Module with a 12-month reference period. RESULTS: Households experiencing FI (n = 39; 28.9%) owned an average of five fewer items than their food secure counterparts (n = 96, 71.1%, P < 0.001), reporting lower item ownership within each equipment category subgroup (i.e. large appliances, small appliances, food preparation utensils and cooking utensils; all P < 0.01). There were no differences between FI and food secure households in frequency of use (all P > 0.01). CONCLUSIONS: Compared to food secure households, the number of food preparation items owned was lower, although frequency of use was the same, in US households that were FI. Future projects should investigate how food equipment ownership impacts cooking behaviours, and whether households experiencing FI display behaviours to compensate for a differing set of equipment.

Brominated flame retardants in black plastic kitchen utensils: Concentrations and human exposure implications.

Concerns exist that restricted brominated flame retardants (BFRs) present in waste polymers may have, as a result of recycling, inadvertently contaminated items not required to meet flame retardancy regulations (e.g. plastic kitchen utensils). To investigate the extent to which kitchen utensils are contaminated with BFRs and the potential for resultant human exposure, we collected 96 plastic kitchen utensils and screened for Br content using a hand-held X-ray fluorescence (XRF) spectrometer. Only 3 out of 27 utensils purchased after 2011 contained detectable concentrations of Br (≥3µg/g). In contrast, Br was detected in 31 out of the 69 utensils purchased before 2011. Eighteen utensils with Br content higher than 100µg/g, and 12 new utensils were selected for GC-MS analysis of BFRs. BFRs targeted were polybrominated diphenyl ethers (PBDEs) BDE-28, 47, 99, 100, 153, 154, 183 and 209, and novel BFRs (NBFRs) pentabromoethylbenzene (PBEB), 2-ethylhexyl-2,3,4,5-tetrabromobenzoate (EH-TBB), 1,2-bis(2,4,6-tribromophenoxy)ethane (BTBPE), bis(2-ethylhexyl)-3,4,5,6-tetrabromo-phthalate (BEH-TEBP) and decabromodiphenyl ethane (DBDPE). The ability of XRF to act as a surrogate metric of BFR concentration was indicated by a significant (Spearman coefficient=0.493; p=0.006) positive relationship between Br and ΣBFR concentration. Measurements of ΣBFRs were always exceeded by those of Br. This may be due partly to the presence of BFRs not targeted in our study and also to reduced extraction efficiency of BFRs from utensils. Of our target BFRs, BDE-209 was the most abundant one in most samples, but an extremely high concentration (1000µg/g) of BTBPE was found in one utensil. Simulated cooking experiments were conducted to investigate BFR transfer from selected utensils (n=10) to hot cooking oil, with considerable transfer (20% on average) observed. Estimated median exposure via cooking with BFR contaminated utensils was 60ng/day for total BFRs. In contrast, estimated exposure via dermal contact with BFR-containing kitchen utensils was minimal.

Metal exposures from aluminum cookware: An unrecognized public health risk in developing countries.

Removing lead from gasoline has resulted in decreases in blood lead levels in most of the world, but blood lead levels remain elevated in low and middle-income countries compared to more developed countries. Several reasons for this difference have been investigated, but few studies have examined the potential contribution from locally-made aluminum cookware. In a previous study of cookware from a single African country, Cameroon, artisanal aluminum cookware that is made from scrap metal released significant quantities of lead. In this study, 42 intact aluminum cookware items from ten developing countries were tested for their potential to release lead and other metals during cooking. Fifteen items released ≥1 microgram of lead per serving (250mL) when tested by boiling with dilute acetic acid for 2h. One pot, from Viet Nam, released 33, 1126 and 1426 micrograms per serving in successive tests. Ten samples released >1 microgram of cadmium per serving, and fifteen items released >1 microgram of arsenic per serving. The mean exposure estimate for aluminum was 125mg per serving, more than six times the World Health Organization's Provisional Tolerable Weekly Intake of 20mg/day for a 70kg adult, and 40 of 42 items tested exceeded this level. We conducted preliminary assessments of three potential methods to reduce metal leaching from this cookware. Coating the cookware reduced aluminum exposure per serving by >98%, and similar reductions were seen for other metals as well. Potential exposure to metals by corrosion during cooking may pose a significant and largely unrecognized public health risk which deserves urgent attention.

Levels of perfluorinated compounds in human breast milk in Jordan: the impact of sociodemographic characteristics.

There is scarcity in literature in regards to the exact levels of such compounds in the Middle Eastern region including Jordan. This study was conducted to measure the presence and levels of perfluoroalkyl substances (PFASs) (perfluoroocane sulfonate (PFOS) and perfluorooctanoic acid (PFOA)) in human milk and local fresh cow milk in northern Jordan and also to investigate the relationship between levels of PFASs and some sociodemographic characteristics of breastfeeding mothers and their infants as well as usage of Teflon kitchenware products. Seventy-nine milk samples were collected from breastfeeding women and 25 samples from local fresh cow milk in northern Jordan. Levels of PFOS and PFOA were liquid/liquid extracted (LLE) by acetone followed by purification on an Oasis hydrophilic-lipophilic balance (HLB) solid-phase extraction (SPE). Separations and detections were performed by liquid chromatography-tandem mass spectrometry. Limits of quantitation (LOQs) were 10 ng/L for both PFOA and PFOS. The measured concentrations ranged between non-detectable (ND) and 178 ng/L for PFOS and between 24 and 1120 ng/L for PFOA in human milk and between ND-178 ng/L and LOQ-160 ng/L in fresh cow milk, respectively. Median concentrations of PFOS in human milk samples from Jordan in this study were lower than those found in a recent study from Italy. Moreover, mean concentrations of PFOA and PFOS were significantly higher in milk samples provided by older women. Also, mean concentrations of PFOA was much higher in multiparas and those who have younger infants. The mean rank of PFOA was twice as high in the milk of women who had older Teflon products in kitchen compared to those who had relatively new Teflon products.

Ultrafine particles from electric appliances and cooking pans: experiments suggesting desorption/nucleation of sorbed organics as the primary source.

Ultrafine particles are observed when metal surfaces, such as heating elements in electric appliances, or even empty cooking pans, are heated. The source of the particles has not been identified. We present evidence that particles >10 nm are not emitted directly from the heating elements or the metal surfaces. Using repeated heating of an electric burner, several types of cooking pans, and a steam iron, the increase in the number of particles (>10 nm) can be reduced to 0. After the devices are exposed to indoor air for several hours or days, subsequent heating results in renewed particle production, suggesting that organic matter has sorbed on their surfaces. Also, after a pan has been heated to the point that no increase in particles is observed, washing with detergent results in copious production of particles the next time the pan is heated. These observations suggest that detergent residue and organics sorbed from indoor air are the sources of the particles. We hypothesize that organic compounds are thermally desorbed from the hot surface as gaseous molecules; as they diffuse from the hot air near the pan into cooler air, selected compounds exceed their saturation concentration and nucleation occurs.

Can currently available advanced combustion biomass cook-stoves provide health relevant exposure reductions? Results from initial assessment of select commercial models in India.

Household air pollution from use of solid fuels is a major contributor to the national burden of disease in India. Currently available models of advanced combustion biomass cook-stoves (ACS) report significantly higher efficiencies and lower emissions in the laboratory when compared to traditional cook-stoves, but relatively little is known about household level exposure reductions, achieved under routine conditions of use. We report results from initial field assessments of six commercial ACS models from the states of Tamil Nadu and Uttar Pradesh in India. We monitored 72 households (divided into six arms to each receive an ACS model) for 24-h kitchen area concentrations of PM2.5 and CO before and (1-6 months) after installation of the new stove together with detailed information on fixed and time-varying household characteristics. Detailed surveys collected information on user perceptions regarding acceptability for routine use. While the median percent reductions in 24-h PM2.5 and CO concentrations ranged from 2 to 71% and 10-66%, respectively, concentrations consistently exceeded WHO air quality guideline values across all models raising questions regarding the health relevance of such reductions. Most models were perceived to be sub-optimally designed for routine use often resulting in inappropriate and inadequate levels of use. Household concentration reductions also run the risk of being compromised by high ambient backgrounds from community level solid-fuel use and contributions from surrounding fossil fuel sources. Results indicate that achieving health relevant exposure reductions in solid-fuel using households will require integration of emissions reductions with ease of use and adoption at community scale, in cook-stove technologies. Imminent efforts are also needed to accelerate the progress towards cleaner fuels.

Kitchen knives and homicide: a systematic study of people charged with murder in the Lothian and Borders region of Scotland.

A recent English study demonstrated high rates of kitchen knife use in homicides by mentally disordered offenders subject to independent inquiries. Everyone accused of homicide in Scotland undergoes psychiatric examination; all such evaluations in a Scottish region between 2006 and 2011 were systematically analysed to identify homicide characteristics. It was hypothesised that kitchen knives would be the commonest sharp instruments used, and would be associated with unplanned domestic homicide against known victims, with no independent association with mental disorder. Kitchen knives were used in 32 of 55 homicides: 94% of 34 sharp object homicides (p < 0.05). No independent association was found between kitchen knife use and planning, location, relationship, intoxication or mental disorder. Kitchen knife use in homicide appears to be a significant public health issue, and not only in the mentally disordered population. Research is recommended into kitchen knife use in non-fatal violence, and weapon control in populations at increased risk of knife violence.

Cup introduction, drink type and vitamin supplementation in preterm babies at 11-25 months.

BACKGROUND: To avoid adverse effects of prolonged bottle use, the recommendations are that full-term babies are introduced to cups from 6 months and discouraged bottles from 12 months old. There are no recommendations for preterm babies. In the UK, the Department of Heath recommends the introduction of vitamin supplements, alongside the transition from formula to cow's milk. The present study aimed to determine age of cup introduction in a group of preterm babies, identify drinks offered from bottles versus cups and the types of cups used, and establish the prevalence and appropriateness of vitamin supplementation. METHODS: A validated postal questionnaire was sent to the parents of 369 babies born <34 weeks of gestation at Queen Charlottes Neonatal Unit; 104 sent in 2003 and 265 sent in 2004-2005. The questionnaire was sent when the babies were calculated to be between 12 and 18 months (all ages stated are uncorrected). A separate questionnaire was sent for each baby from multiple pregnancies. RESULTS: The questionnaire return rate was 46% (n = 169). Length of gestation (P < 0.001), hospital stay (P = 0.009), birth weight (P = 0.002) and maternal age (P < 0.001) were significantly greater and more mothers were of European origin (P = 0.036) for those babies for whom questionnaires were returned compared to nonresponders. Infant gender did not differ. Fifty-seven percent had been introduced to a cup before 12 months, distribution was: 58% (n = 53) of singletons, 54% (n = 37) of twins and 67% (n = 6) of triplets. This rose to 80% before 13 months. Thirteen percent (n = 22) had not started drinking from a cup and 17% (n = 29) only used cups at the time of the questionnaire. Cow's milk had been introduced to 69% (n = 117) of all babies and 32% (n = 54) were still on formula (10 on both and eight were on neither; hence, the figures do not sum to 100%). Cow's milk was drunk from bottles by 56% (n = 95) and formula by 31% (n = 52). A significantly greater proportion of twins and triplets were drinking cow's milk compared to singletons [80% (n = 62) versus 60% (n = 55) P = 0.005] and significantly fewer were drinking formula [22% (n = 17) versus 40% (n = 37) P = 0.012]. Water was the drink most commonly given from a cup (80%) (n = 135) followed by juice, which was given to 64% (n = 108). Juice drinks were given by bottle in 16% (n = 27). Fifty-two percent (n = 88) used a 'spill-proof' cup some of the time. Vitamins were given as recommended in 18% (n = 31), given even though not recommended in 12% (n = 20), not given but recommended in 49% (n = 83) and appropriately not given in 21% (n = 35). A greater percentage of twins and triplets, compared to singletons, were not commenced on vitamins, even though they were no longer drinking formula. CONCLUSIONS: The present study reports baseline data on cup introduction in preterm babies both from singleton and multiple births. The data suggest that education about appropriate bottle drinks, timing of cup introduction, suitable cups and the correct use of vitamin drops is required. However, because the profile of responders differed from nonresponders, these results may not be applicable to all preterm babies.

Pressure cooker ownership and food security in Aurangabad, India.

OBJECTIVE: To explore associations between household food security and home gardening, use of soya and pressure cooker ownership in low-income households affected by HIV/AIDS in Aurangabad, India. DESIGN: Cross-sectional pilot study which assessed household food security using the validated US Department of Agriculture's food security core-module questionnaire. Questions were added to explore household environment, education, occupation, home gardening, use of soya and pressure cooker ownership. Households with very low v. low food security were compared using logistic regression analysis, controlling for confounding by socio-economic status. SETTING: Aurangabad is an urban setting situated in a primarily agricultural dependent area. The study was carried out in 2008, at the peak of the global food crisis. SUBJECTS: Adult caregivers of children affiliated with the Network of People Living with HIV/AIDS in Aurangabad. RESULTS: All except for one of 133 households were identified as food insecure (99.2 %). Of these households, 35.6 % had to cut size or skip a meal in the past 30 d. Households that cut meal size due to cooking fuel shortages were more likely to have very low food security (OR = 4.67; 95 % CI 1.62, 13.44) compared with households having no cooking fuel shortages. Owning a pressure cooker was shown to be protective against very low food security after controlling for confounding by socio-economic status (OR = 0.27; 95 % CI 0.11, 0.64). CONCLUSIONS: Only pressure cooker ownership showed a protective association with low household food security. Pressure cookers save household fuel costs. Therefore, future interventions should explore pressure cookers as a sustainable means of improving household food security.

Caregiver self-report of children's use of the sippy cup among children 1 to 4 years of age.

PURPOSE: This research examined the prevalence of the use of the sippy cup, as compared to the baby bottle, among children 1 to 4 years of age. METHOD: Using a population-based telephone surveillance survey in Ontario, caregivers of children 1 to 4 years of age were asked about their child's use of the sippy cup/baby bottle from the Rapid Risk Factor Surveillance System Module: Early Childhood Tooth Decay. RESULTS: Most caregivers reported that children 1 to 4 years of age were currently using the sippy cup (69.7%), with the proportion increasing to 94.4% when including children with past use of the sippy cup. Younger children were significantly more likely to use the sippy cup, and 10.8% of children 4 years of age continued to use the baby bottle. Diluted fruit juice was the most frequently used liquid in the sippy cup (58.2%). Most of the caregivers did not report the use of the sippy cup at night. CONCLUSION: Caregivers need education as to potential increases in exposure to sugared/acidic liquids through the use of the sippy cup. Future research is needed to understand the extensive and prolonged use of the sippy cup/baby bottle by young children.

Aluminio en pacientes con terapia de reemplazo renal crónico con hemodiálisis en dos unidades renales en Bogotá / Aluminium in chronic renal replacement therapy patients undergoing haemodialysis in two renal units in Bogotá

Objetivo Determinar las concentraciones de aluminio en suero de pacientes con terapia de reemplazo renal crónico con hemodiálisis y las concentraciones en agua de redes de distribución y diálisis en dos unidades renales en Bogotá. Material y Métodos Estudio descriptivo en 63 pacientes en hemodiálisis y 20 individuos sanos. Las concentraciones de aluminio se determinaron por espectrofotometría de absorción atómica horno de grafito con corrección de lámpara de deuterio. Resultados El promedio de las concentraciones de aluminio en suero de los pacientes fue de 26,5 µg/L (11,2 a 49,2 µg/L, DE=8,03), en individuos sanos de 8,05 µg/L (menor al Límite de Detección a 17,2 µg/L, DE=4,31), en agua de diálisis fue menor a 2 µg/L y en agua de las redes de distribución menor a 200 µg/L. Conclusiones Las concentraciones de aluminio en el agua de la red de distribución y diálisis estudiadas se encontraron por debajo de los valores establecidos internacionalmente indicando un adecuado tratamiento de las mismas. Igualmente las concentraciones de aluminio pre-HD y post-HD observadas en los pacientes se encontraron por debajo de las reportadas en la literatura. El consumo de hidróxido de aluminio aumenta significativamente la concentración de aluminio en suero. Variables como edad, género, estado civil y situación laboral no son factores de riesgo que alteren significativamente las concentraciones de aluminio en suero.

Objective Determining aluminium concentrations in the serum of patients undergoing chronic renal replacement therapy with haemodialysis and concentration in distribution network water and dialysis in two renal units in Bogotá. Material and Methods This was a descriptive study of 63 haemodialysed patients and 20 healthy subjects. Aluminium concentration was determined in water and serum using graphite furnace atomic absorption spectrometry with deuterium lamp background corrector. Results Average aluminium concentration was 26.5 µg/L in patients (ranging from 11.2 to 49.2 µg/L; 8.03 standard deviation) and 8.05 µg/L in healthy individuals (ranging from undetectable to 17.2 µg/L; 4.31 standard deviation). Aluminium concentration in dialysis water and distribution network water was below 2 µg/L and 200 µg/L, respectively. Conclusions Aluminium concentration in water and serum in this study was below international standard values, thereby indicating appropriate treatment. Additionally, aluminium concentration in pre-HD and post-HD sera was below that reported previously. Aluminium hydroxide uptake increases aluminium concentration in serum. Personal situation regarding age, gender, civil and work status were not risk factors determining aluminium concentrations in serum.