A new doubly labelled water anthropometry-based equation for prediction of total daily energy expenditure in older people from low- and middle-income countries.

BACKGROUND: For community-living older people, the ability to estimate total daily energy expenditure (TDEE) with validated predictive equations based on anthropometry is limited. To our knowledge no studies exist for non-Caucasian populations OBJECTIVE: To design and validate an anthropometry-based equation to estimate TDEE using doubly-labelled water (DLW) as the criterion measure, and to assess the performance of three other published equations in community-living older people from rural and urban areas of Brazil, Chile, Guatemala, Senegal, Cuba, and Mexico METHODS: This cross-sectional study measured anthropometry and TDEE using DLW in 69 men and 43 women aged 60-89 years. TDEE was also estimated with an anthropometry-based equation derived from the sub-sample of Mexico (n = 38) and with three other published equations. Predictive accuracy of the equations was tested by an external validation procedure RESULTS: TDEE by DLW in the six country sample was 2411 ± 41 kcal/day (mean ± SE) in men and 1939 ± 51 kcal/day in women. The best new Mexican equation was TDEE, kcal/d = [223.4 + (27.9 × weight, kg) + (239.7 × sex)]; where sex: Man = 1 and Woman = 0; having high precision; R2 = 0.89, lowest RMSE = 149.2, and Cp value of 2.0. This new Mexican equation estimated TDEE accurately in the five country sample and at country level after correction for Guatemalan older men, while the published equations performed poorly CONCLUSIONS: The Mexican equation performed better that other published equations and is recommended to accurately estimate energy requirements for community-living older people in five Latin American and one African country.

Breast milk intake and mother to infant pesticide transfer measured by deuterium oxide dilution in agricultural and urban areas of Mexico.

Vector-borne diseases have increased pesticide use in urban areas (UA) and agricultural areas (AA) in Mexico. Breast milk can be contaminated by pesticide exposure. The objective of the study was to measure breast milk intake by deuterium oxide dilution as well as organochlorine and pyrethroid transfer from mother to infant in AA and UA of Sonora, Mexico. Human milk intake was determined by the 'dose-to-mother' technique using deuterium oxide (D2O) dilution. Mothers' body composition was also assessed by this technique and the intercept method. Pyrethroids (deltamethrin, cypermethrin and cyhalothrin) and organochlorine pesticide residues (p,p'- DDT, p,p'- DDE, p,p'- DDD) in breast milk samples were measured by gas chromatography. Sixty-two lactating women and their infants participated in the study, 32 lived in the UA and 30 lived in the AA. Breast milk intake was approximately 100 mL higher in the AA than in the UA 799 ± 193 and 707 ± 201 mL/day, respectively (p < 0.05). The concentrations of p,p'- DDT and cypermethrin levels in breast milk were higher in the UA than in the AA (p < 0.05 and p = 0.001, respectively). None of the pyrethroids and organochlorine pesticides studied surpassed the Acceptable Daily Intake (ADI) in milk for humans according to EPA and FAO/WHO. In conclusion, breast milk intake was higher in the AA compared to the UA. The p,p'- DDT and cypermethrin levels in breast milk were higher in the UA compared to the AA. Since pesticide levels in human milk did not exceed the ADI, breastfeeding is still a safe practice and should be encouraged.