Risk analysis of poor health and growth failure of children in the central highlands of Guatemala.

Child morbidity and growth failure are multidimensional phenomena. An assessment was undertaken of the food and nonfood risk factors of poor health and growth failure in children of different age groups in the central highlands of Guatemala. The aim was to identify high risk factors in under-five and school-age children. Under-five children at high risk of being ill tended to come from households with: high needs of child care, a lack of access to a private well or piped water, and no sewage connection. Women's illiteracy constituted an additional risk factor for diarrheal disease in under-five children. Growth failure in under-five children was mainly due to chronic factors: 74% were stunted, 6% were wasted and 44% were weight deficient. These prevalence rates were lower among school-age children. Low per capita food availability, and particularly the absence in the household of self-produced staple foods, was the most significant risk factor of growth failure in under-five children, followed by high risk of being ill, and participation by women in farm production. The latter was particularly a risk factor of wasting. Nonfood risk factors were most important for growth failure in school-age children. These factors included: sanitation, housing conditions, women's literacy status, and adult women's body mass index. Participation in farm production by school-age children was associated with a higher risk of growth failure in younger siblings. It is concluded that multisectoral programs need to reduce the impact of various risk factors of poor health and growth failure in children, and be careful not to introduce new risk factors. Depending on which age group is targeted, such programs should either prioritize improvements in household food availability, or nonfood interventions that reduce women's illiteracy and improve sanitary and housing conditions.

Body mass index, body composition and the chronic energy deficiency classification of rural adult populations in Guatemala.

The present study tested the hypotheses that: (a) individual body composition estimates obtained with the Durnin-Womersley (D-W) equations have low validity in certain populations in developing countries; (b) there exists a poor relationship between the body mass index (BMI) and body composition estimates (fat mass (BFM) and fat-free mass (FFM)), and (c) BMI cut-off estimates (fat mass (BFM) and fat-free mass (FFM)), and (c) BMI cut-off points provide an invalid classification of chronic energy deficiency (CED) in adults. The study involved four samples of rural men and women in Guatemala, who had mean BMI of approximately 21 kg/m2. Body composition estimates were obtained by densitometry in three of the samples. Mean body fat (%) and mean FFM (kg) were: men: 11.6 (+/- 4.7) and 47.7 (+/- 4.9); and women: 21.6 (+/- 5.3) and 35.8 (+/- 3.5), respectively. The D-W equations based on various combinations of skinfold measurements consistently overestimated body fat content with low precision and validity. The BMI was more related to BFM and FFM than to fat proportion, but explained little of the variation in both body components, particularly at low BMI levels. A small number of men and women had BMI values below 18.5 kg/m2, and only one woman fell below 16 kg/m2. The power coefficients of height in the weight/height ratio which provided the strongest correlations with BFM and FFM were: BFM: women: 1.0; men: 1.5; FFM: 0.5 for both women and men. We conclude that the Quetelet index should not be recommended as a universally valid indicator to classify CED in adult groups similar to the study population.

[Stretching the income in the demand for food and other goods in marginal urban populations in the city of Guatemala]. / Elasticidad ingreso de la demanda de alimentos y otros bienes en grupos de población marginal urbana de la ciudad de Guatemala.

The purpose of the present study was to evaluate the impact of changes in income and retail prices on the consumption of foods by low income groups living in Guatemala. A representative sample of 200 low-income families living in a marginal area of Guatemala City, known as "El Milagro", was studied. Of five surveys conducted, two concerned food demand exclusively. In the first one the food consumption survey used was the 24-hr recall method, and the second survey was related to income expenditures, obtaining weekly information on expenses on foods and in other items. The expenditures were utilized to estimate the elasticity of demand, including foods. Total family expenses were used as an estimation of total income. Analyses of the data were obtained by forming three income groups: families with per capita expenses below the per capita cost of the foods basket; families with per capita expenses within the cost of the food basket, and the cost of a modified food basket (all expenses); families with an income above the modified food basket. The analyzed data clearly confirmed that: a) food expenses increase less as a response to income increases than expenses for other family needs; the income elasticity for foods high in carbohydrates content is lower with respect to food of animal origin and the income elasticity of the demand for rice and wheat bread are higher in comparison to the more basic foods such as beans, maize and maize products, roots and tubers.

[Maximization of economic yield, minimum cost optimal diets and cultivation diversification for small scale farmers of the highland region of Guatemala]. / Maximización de rentabilid ad económica, diet as optimas de costo mínimo y diversificación de cultivos para los pequeños agricultores del altiplano de Guatemala.

The present study was conducted as part of an evaluation of the economic and nutritional effects of a crop diversification program for small-scale farmers in the Western highlands of Guatemala. Linear programming models are employed in order to obtain optimal combinations of traditional and non-traditional food crops under different ecological conditions that: a) provide minimum cost diets for auto-consumption, and b) maximize net income and market availability of dietary energy. Data used were generated by means of an agroeconomic survey conducted in 1983 among 726 farming households. Food prices were obtained from the Institute of Agrarian Marketing; data on production costs, from the National Bank of Agricultural Development in Guatemala. The gestation periods for each crop were obtained from three different sources, and then averaged. The results indicated that the optimal cropping pattern for the minimum-cost diets for auto consumption include traditional foods (corn, beans, broad bean, wheat, potato), non-traditional foods (carrots, broccoli, beets) and foods of animal origin (milk, eggs). A significant number of farmers included in the sample did not have sufficient land availability to produce all foods included in the minimum-cost diet. Cropping patterns which maximize net incomes include only non-traditional foods: onions, carrots, broccoli and beets for farmers in the low highland areas, and raddish, broccoli, cauliflower and carrots for farmers in the higher parts. Optimal cropping patterns which maximize market availability of dietary energy include traditional and non-traditional foods; for farmers in the lower areas: wheat, corn, beets, carrots and onions; for farmers in the higher areas: potato, wheat, raddish, carrots and cabbage.

Trends and differentials in dietary patterns and nutrient intake among migrant Puerto Rican families.

Preoccupation to define the nutritional status of Puerto Rican families migrating to the United States, motivated the present research. A total of 526 families residing in the South Bronx, New York, and four communities in Puerto Rico, were therefore studied. Results in regard to nutrient intake suggest that the mothers' diets appear to be adequate in the South Bronx as well as in Puerto Rico, except in iron consumption, in the latter. Furthermore, the data show an apparent tendency to overconsumption of certain foods in both the South Bronx and Puerto Rico, particularly of the protein group, as well as a high consumption of sugar and carbonated beverages in Puerto Rico. Dietary data were corroborated through nutritional anthropometry, conforming a tendency for overweight and obesity among the women studied. Detailed information on the dietary changes occurred during the last five years, is provided. Educational programs such as EFNEP, availability of new foods, and the food preferences of children in their homes, seem to be influencing factors in the dynamics of food modifications within societal groups in transition.

Trends and differentials in dietary patterns and nutrient intake among migrant Puerto Rican families

La presente investigación la motivó la preocupación por definir el estado nutricional de familias puertorriqueñas que migran los Estados Unidos de América. Con esta finalidad, se estudió un total de 526 familias residentes en el Sur del Bronx, Nueva York, y cuatro comunidades en Puerto Rico. Los resultados referentes a la ingesta de nutrientes sugieren que la dietas de las madres son bastante adecuadas, en el Sur del Bronx y en Puerto Rico, salvo en lo concerniente al consumo de hirro, en Puerto Rico. Más aún, los datos muestran una aparente tendencia al alto consumo de alimentos, particularmente de tipo proteínico en ambos lugares; revelan, asimismo, un alto consumo de azúcar y bebidas carvonatadas en Puero Rico. Estos datos dietarios fueron corroborados mediante antropometría nutricional, confirmando cierta tendencia al sobrepeso y obesidad en las madres estudiadas. Se informan en detalle cambios ocurridos en la dieta en el trasncurso de los últimos cinco años. Los programas educativos como el de EFNEP, la disponibilidad de nuevos alimentos y la influencia de los niños en el hogar a traves de sus propias preferencias, figuran como factores influyentes en a dinámica de cambios alimentarios de sociedades en transición

Energy supplementation and productivity of Guatemalan sugar-cane cutters: a longitudinal approach.

A long-term energy supplementation program was carried out to determine its effect on the productivity of agricultural workers in Guatemala. The program provided, free of charge, a low-energy (24 Kcal) and a high-energy (350 Kcal) bottled, orange-flavored soft drink to two groups of long-term resident sugar-cane cutters who worked on the same plantation, located in the Pacific Coast. Previous to, and periodically thereafter during implementation of the program, data relative to energy intake and anthropometry were collected. Through data obtained from payroll lists, a longitudinal series of average productivity (tons of sugar cane cut and loaded per day) covering 48 weeks of pre-supplementation, 90 weeks of supplementation and 21 weeks post-supplementation, was constructed. Control of the supplement consumption was daily observed. Random assignment of workers to the high-energy supplement (HES) and the low-energy (LES) groups, was not possible. Prior to supplementation both groups presented the same characteristics in terms of age, energy intake level, weight, height, tricipital adiposity and daily productivity. Little variation was found throughout the time the supplement was consumed by the HES Group. Energy intake of workers increased significantly in absolute terms in relation to the LES Group, except towards the end of the 28 months' supplementation period. Energy balance was maintained by workers throughout the study period. A time series of the difference in mean productivity of the two supplement groups (Yt) was modeled using the ARIMA techniques. No auto-regressive term was present in the Yt series. The ARIMA (0,0,1) model was fitted and expanded with different intervention components. None of the estimated parameters of the intervention components were statistically significant. It was therefore concluded that no abrupt, or gradual and sustained energy supplementation effect on productivity was present.

Food substitution with worker feeding programs: energy supplementation in guatemalan sugarcane workers.

An energy supplementation program provided free of charge a low energy (15 kcal) and a high energy (350 kcal) soft drink to two group of sugarcane workers in Guatemala. The high energy supplement supplied 550 kcal/day on a weekly basis. The workers tended to be moderately energy deficient before supplementation. Significant increases in total daily energy intake were obtained with the high energy supplement, but by less than the energy content of the supplement. Workers maintained energy balance with supplementation. The degree of substitution with energy supplementation was not related to the energy intake status of the workers' households. These households did generally not improve their energy intake status with worker supplementation.