ABSTRACT
To assess the long-term impact of nutritional supplementation on bone mineralization during adolescence, we studied 356 Guatemalan adolescents who participated from birth to 7 y of age in a controlled supplementation trial. Bone mineralization of the distal radius was assessed using single photon absorptiometry. Children who consumed more cumulative energy from the supplement during childhood had greater bone mineral content, bone width and bone mineral density during adolescence than those who consumed less energy. The associations remained after controlling for each subject's age and gender, and for the type of supplement consumed, but became statistically nonsignificant after adjusting for weight and stature. Because intake of supplement also was associated positively with weight and stature during adolescence, it is concluded that supplementing malnourished children can have a demonstrable long-term impact on bone mineralization, but that the effects are probably not beyond those due to improvements in overall somatic growth associated with supplementation.
Subject(s)
Calcification, Physiologic , Child Nutrition Disorders/diet therapy , Food, Fortified , Growth Disorders/prevention & control , Adolescent , Adult , Age Factors , Body Weight , Bone Density , Child , Child Nutrition Disorders/complications , Child, Preschool , Female , Germany , Growth Disorders/diagnostic imaging , Growth Disorders/etiology , Guatemala , Humans , Infant , Infant, Newborn , Longitudinal Studies , Male , Radionuclide ImagingABSTRACT
The benefits of nutritional supplementation, with or without psychosocial stimulation, on the growth of stunted children were evaluated. Children aged 9-24 mo with lengths less than -2 SD of the National Center for Health Statistics references (n = 129) were randomly assigned to four groups: control, nutritional supplementation, stimulation, and both interventions. A fifth group with lengths greater than -1 SD was also enrolled. Length, weight, head and arm circumferences, and triceps and subscapular skinfold thicknesses were measured on enrollment and 6 and 12 mo later. Multiple-regression analysis was used to determine the effects of the interventions in which age, sex, initial status, initial dietary intake, and several socioeconomic variables were controlled for. Stimulation had no effect on growth and there was no interaction between the interventions. After 12 mo supplemented children had significantly increased length, weight, and head circumference (all P less than 0.01). The effects of supplementation were not cumulative but occurred in the first 6 mo.
Subject(s)
Food, Fortified , Growth Disorders/diet therapy , Occupational Therapy , Play Therapy , Female , Growth Disorders/rehabilitation , Humans , Infant , Jamaica , Male , Random Allocation , Regression AnalysisABSTRACT
The effects of maternal supplementation during pregnancy and lactation on bone growth of infants were investigated in 272 mother-infant pairs who participated in the Guatemalan Longitudinal Study of Nutritional Supplementation, Growth and Development. Mothers received one of two nutritional supplements according to village of residence, and bone growth was determined from dimensions of the second metacarpal measured directly from hand-wrist radiographs of 3-month-old infants. Multiple regression analyses indicated significant supplementation effects on cortical bone dimensions related to the volume of supplement intake. These findings were independent of maternal characteristics and attendance at the supplementation centres, and the infant's gender, size, gestational age and morbidity experience. The nutrient composition of the supplements and the patterns of the supplementation effects eliminate proteins, energy, calcium and phosphorus as the nutrients potentially responsible for the bone-specific response. Candidate nutrients for the observed effects are vitamin A, ascorbic acid, niacin, thiamin, iron or fluorine. Presumptive evidence suggests the effects may be due to vitamin A supplementation. These findings suggest opportunities for nutritional intervention in pregnancy and the early postpartum period to prevent osteopaenia in infancy.