Sex effect on growth faltering in an indigenous ethnic minority population of infants in Israel.

OBJECTIVE: We examined sex effects on growth faltering in an indigenous population of Bedouin Arab infants born in Israel, an economically developed country. DESIGN: Retrospective cohort study. Height-for-age Z-score (HAZ) at age 6, 12, 18 and 24 months was calculated for full-term, normal-birth-weight Bedouin infants born during years 2000-2009 and attending maternal and child health (MCH) clinics. Multivariate linear regression analysis (MLRA) was used to calculate the association between sex and HAZ, controlling for year of birth, birth weight (BW) and residence by type of settlement (established settlement (ES); non-established settlement (NES)). SETTING: Bedouin are an indigenous poor community of semi-nomadic Arabs, with the highest infant mortality rate in Israel. Fifty per cent of Bedouin infants live in NES with inadequate access to running water, electricity, and rubbish and sewage disposal. All Bedouin receive free well-baby care in community-based MCH clinics. PARTICIPANTS: Full-term, normal Bedouin infants (n 5426) born during 2000-2009 and attending computerized MCH clinics who had growth measurements at age 6, 12, 18 and 24 months. RESULTS: At all ages, girls had significantly higher mean HAZ than boys (P < 0·05). Increasing birth year, residence in ES and increasing BW were positively associated with HAZ (P < 0·05) at all ages. In MLRA controlling for birth year, BW and type of settlement, sex still had a significant effect, with lower HAZ among boys at 6, 12, 18 and 24 months of age (P < 0·001 at all ages). CONCLUSIONS: Our results indicated that sex effects on growth faltering can occur in an indigenous population with low socio-economic status within an economically developed country.

Adolescent inhalant abuse leads to other drug use and impaired growth; implications for diagnosis.

OBJECTIVE: Abuse of inhalants containing the volatile solvent toluene is a significant public health issue, especially for adolescent and Indigenous communities. Adolescent inhalant abuse can lead to chronic health issues and may initiate a trajectory towards further drug use. Identification of at-risk individuals is difficult and diagnostic tools are limited primarily to measurement of serum toluene. Our objective was to identify the effects of adolescent inhalant abuse on subsequent drug use and growth parameters, and to test the predictive power of growth parameters as a diagnostic measure for inhalant abuse. METHODS: We retrospectively analysed drug use and growth data from 118 Indigenous males; 86 chronically sniffed petrol as adolescents. RESULTS: Petrol sniffing was the earliest drug used (mean 13 years) and increased the likelihood and earlier use of other drugs. Petrol sniffing significantly impaired height and weight and was associated with meeting 'failure to thrive' criteria; growth diagnostically out-performed serum toluene. CONCLUSIONS: Adolescent inhalant abuse increases the risk for subsequent and earlier drug use. It also impairs growth such that individuals meet 'failure to thrive' criteria, representing an improved diagnostic model for inhalant abuse. Implications for Public Health: Improved diagnosis of adolescent inhalant abuse may lead to earlier detection and enhanced health outcomes.

Inflammatory bowel disease characteristics in Hispanic children in Texas.

BACKGROUND: Inflammatory bowel disease (IBD) has a wide spectrum and variability among different ethnic groups. We aimed to evaluate disease characteristics in the pediatric Hispanic population, which has not been well studied. METHODS: We identified patients <18 years old seen at Texas Children's Hospital (TCH) and diagnosed with IBD between 2004 and 2009. We compared them with their White, African American, and "other" counterparts with regard to their demographics, disease characteristics, and initial therapy. RESULTS: There were a total of 399 patients with IBD: 211 (52.9%) White, 67 (16.8%) African American, 53 (13.3%) Hispanic, and 68 (17%) "other." Crohn's disease (CD) was the most common IBD type among all groups; however, Hispanics had the highest proportion of patients with ulcerative colitis (UC) and IBD-unclassified (IBD-U). There was male predominance in all groups except African Americans. Hispanics had the highest percentage of Medicaid coverage (P < 0.01) and none of the Hispanics had a first-degree relative with IBD. They had a younger age at diagnosis but a similar duration of symptoms prior to diagnosis. Hispanics had less failure to thrive and a higher body mass index (BMI) Z-score. Hispanics with CD more often received systemic steroids while those with UC and IBD-U were more often treated with local steroids (P < 0.01), oral 5-aminosalicylate (P < 0.01), and less often received immunomodulators or biologics (P = 0.05). CONCLUSIONS: We demonstrate differences in disease characteristics between Hispanics and other ethnicities with IBD. Further epidemiologic studies are needed, including longer-term follow-up, to better define the burden of illness in Hispanics.

Postdischarge growth and development in a predominantly Hispanic, very low birth weight population.

OBJECTIVES: The goals were to assess postdischarge growth and developmental progress of very low birth weight (birth weight: <1500 g) premature infants in a predominantly Hispanic population and to identify predictors for neurodevelopmental impairment at 3 years of age. METHODS: A cohort of 135 very low birth weight infants (gestational age: 23 to 35 weeks) were monitored to 3 years of age. Maternal and neonatal characteristics, anthropometric z scores, and developmental performance (using corrected age until 24 months) were analyzed collectively and according to gestational age groups. Specific criteria for failure to thrive and microcephaly were used. RESULTS: A characteristic pattern of poor weight gain in the first 12 months was followed by accelerated weight gain starting at 18 months, whereas head growth decreased at 18 months, with recovery beginning at 30 months of age. Infants born at gestational age of or=27 weeks achieved catch-up growth by 30 months of age. Mean developmental scores also decreased in infancy, with improvements in motor development emerging at 18 months and cognitive skills at 30 months. Growth z scores, particularly for head growth, correlated with developmental scores. Infants born at gestational age of

Psychosocial predictors of being an underweight infant differ by racial group: a prospective study of Louisiana WIC program participants.

OBJECTIVES: In order to prospectively identify psychosocial predictors of infants being underweight, we followed 3,302 low-income infants. These infants received well-baby care in health departments and were enrolled in the Women, Infants, and Children (WIC) Supplemental Food Program from the newborn period to 12 months of age. METHODS: We linked risk factor data collected from newborn medical history records to anthropometric data from a WIC database. The unadjusted relative risk of being underweight at 12 months of age, defined as weight for recumbent length below the 5th percentile, according to current Centers for Disease Control and Prevention growth charts, for each group was calculated for the study population and for black and white racial groups. Using logistic regression, we calculated odds ratios measuring the effect of the newborn risk factors on underweight status at 12 months of age. RESULTS: There were no psychosocial risk factors that were significantly associated with being underweight simultaneously in both racial groups. Among black infants, those whose mothers had an eighth grade education or lower were at greater risk of being underweight at 12 months of age (OR=3.7, CI=1.5-4.8), as were those whose mothers were married (OR=2.7, CI=1.5-4.8). Among white infants, those whose mothers initiated prenatal care in the third trimester were significantly more likely to have underweight infants at 12 months of age (OR=4.5, CI=1.6-12.4). CONCLUSIONS: Predictors of being underweight at 12 months of age in a low-income population differ by racial group. Further research of public health interventions targeting families of infants with the significant psychosocial risk factors is needed.

Preliminary evaluation of the effects of a nutrition awareness project on the Ngaanyatjarra Pitjantjatjara Yankunytjatjara communities of central Australia.

Preliminary observations from one nutrition awareness project--Approaches to Failure to Thrive--in progress in the Ngaanyatjarra Pitjantjatjara Yankunytjatjara region of central Australia are discussed, current strategies are listed and the need for multi-faceted solutions emphasised. A more rigorous quantitative evaluation is recommended, within the constraints of funding and access to data.

Déficit de crecimiento en escolares de procedencia indígena / Growth retardation in schoolchildren of indigenous origin

Entre las causas del retardo de crecimiento observado en comunidades indígenas, se ha mencionado la influencia genética y la exposición a un medio ambiente desfavorable. El objetivo del estudio fue evaluar el estado nutricional de escolares con y sin procedencia indígena, de comunas de alta vulnerabilidad de Santiago. De un total de 5228 niños evaluados, se identificaron 154 escolares de 1§ y 2§ año básico cuyos padres tenían apellidos indígenas (AI). Aleatoriamente se identificó otro grupo, cuyos padres no tenían AI (pareados por sexo, edad y escuela). Con la información antropométrica recolectada se determinaron talla/edad y peso/talla (T/E y P/T) en puntajes z, tomando como referencia NCHS/OMS. En el análisis se dividió el grupo indígena en 2: con mayor y menor influencia, según el n§ de apellidos. El promedio de puntaje z de T/E fue inferior a la mediana en todos los grupos. Los con mayor influencia eran más altos aunque las diferencias no fueron significativas. La curva T/E, desviada hacia el déficit, tuvo una distribución similar. La prevalencia de talla baja fue inferior en niños con mayor carga indígena que los grupos con menor ascendencia y los no indígenas (17,2 vs, 23,6 y 22,6 por ciento, respectivamente) aunque sin significancia estadística. El sobrepeso y obesidad alcanzan a 39 por ciento, siendo superior en el grupo de mayor ascendencia, sin asociación entre los grupos. La ausencia de diferencias antropométricas entre grupos de diferente constitución genética, expuestos a similares condiciones socioeconómicas adversas, refuerza la importancia de factores ambientales en la determinación de estatura de los niños

Maternal insecurity and failure to thrive in Asian children.

Four Asian babies were investigated because they failed to thrive. In all four cases the failure to thrive was a result of the mother's social isolation and inability to communicate, and to the father's refusal to accept that there was a problem in the family.