Effects of bovine serum concentrate, with or without supplemental micronutrients, on the growth, morbidity, and micronutrient status of young children in a low-income, peri-urban Guatemalan community.

OBJECTIVE: To determine the effects of dietary supplements containing bovine serum concentrate (BSC, a source of immunoglobulins) and/or multiple micronutrients (MMN) on children's growth velocity, rates of common infections, and MN status. DESIGN: Randomized, controlled, community-based intervention trial. SETTING: Low-income, peri-urban Guatemalan community. SUBJECTS: Children aged 6-7 months initially. INTERVENTIONS: Children received one of four maize-based dietary supplements daily for 8 months, containing: (1) BSC, (2) whey protein concentrate (WPC, control group), (3) WPC+MMN, or (4) BSC+MMN. RESULTS: There were no significant differences in growth or rates of morbidity by treatment group. Children who received MMN had lower rates of anemia and (in the group that received WPC+MMN) less of a decline in serum ferritin than those who did not, but there were no differences in other biochemical indicators of MN status by treatment group. CONCLUSIONS: MMN supplementation reduced anemia and iron deficiency in this population, but the MMN content and source of protein in the supplements did not affect other indicators of MN status, growth or morbidity.

Determinants of fasting glucose in young Guatemalan adults.

OBJECTIVE: To examine correlates of fasting glucose, a precursor for type 2 diabetes mellitus, in young adults in Guatemala, a country undergoing an epidemiologic transition. DESIGN: Cross-sectional. METHODS: Anthropometric, lifestyle, dietary, serum lipid, and socioeconomic characteristic data were collected on 189 men and 201 women (mean age 24.4 years) born in four villages in Eastern Guatemala. We used linear regression to identify parsimonious predictive models, including 2-way interactions. RESULTS: In men, mean fasting glucose was 87.3 mg/dL (SD 10.2); our model explained 30% of variance. Body mass index (BMI), abdomen-to-hip ratio (AHR), and total cholesterol showed graded positive effects. BMI and AHR interacted (P<.001); men with high BMI and high AHR had the highest fasting glucose levels. No dietary factors independently predicted fasting glucose. In women, mean fasting glucose was 83.9 mg/dL (SD 8.5); 22% of variance was explained by BMI, energy-adjusted fat intake, physical activity, birth village, and current residence (rural/urban). BMI and fasting glucose were positively related. Urban residence interacted with birth village (P=.06) and physical activity (P=.13). CONCLUSIONS: The major conclusion drawn from this study is that increased adiposity, even among lean individuals, is the largest environmental predictor of fasting glucose. Prevention and control of obesity in young adults in transitioning countries are key strategies for the prevention of diabetes.

[Fortification and enrichment of foods: considerations on their use for achieving nutritional goals]. / Fortificación y enriquecimiento de alimentos: consideraciones sobre su uso para alcanzar las metas nutricionales.

The diet should, ideally, provide adequate amounts of all nutrients. The traditional foods of many Latin American countries, however, must be fortified or enriched with certain nutrients to satisfy the needs of the whole population. These measures should be considered as temporary, until improvements are achieved in dietary diversification, economic conditions, nutrition education and food processing and storage. Restoration of nutrients lost during cooking or processing and equalization of new foods with the nutrients present in traditional foods, are also important. Conditions for a successful program of fortification or enrichment include a widespread and regular intake of the dietary vehicle, high bioavailability of the added nutrient, low costs of the nutrient and the fortified vehicle, central processing, organoleptic characteristics that ensure acceptability, stability of the product during storage and cooking, no risk of toxicity, and adequate control during the process, distribution, marketing and consumption of the fortified vehicle or food. Control measures must be supported by legal sanctions to those who do not comply with the norms for obligatory fortification or enrichment. Control measures must also identify the necessary modifications due to changes in dietary habits or public health interventions. In Latin America there are fortification and enrichment programs with various nutrients in which local diets are scarce. Many Latin American scientists have been pioneers in this field.