Obesity and hunger among Mexican-Indian migrant children on the US-Mexico border.

BACKGROUND: Although Mexican-Indian migrant workers live under precarious conditions in both Mexico and the USA, they have more access to food than they did in their original communities. The nutritional status and food security among the children of these workers have not been reported. OBJECTIVE: The purpose of this study was to assess the prevalence of overweight, obesity, undernutrition and hunger among migrant children in a city on the US-Mexico border. DESIGN: During 2001-2002, a total of 1767 children from six schools from the Tijuana Indian school system was measured to assess anthropometric status. Third and fifth grade children were also interviewed for their perception of hunger experience and dietary intake by 24-h recall method. RESULTS: The overall prevalence of overweight and obesity was 38%. Abdominal obesity was found in 26% of subjects, while 43% had both obesity and abdominal obesity. The prevalence of undernutrition according to weight-for-age was 1.2%, and by height-for-age it was 4.8%. The prevalence of hunger was 2.5%, and at risk of hunger was 44%. Daily intake of food groups in servings was: 8.7 grains, 1.2 fruit, 1.0 vegetable, 2.1 milk and 2.6 meat. Only one child (0.07%) consumed The Apple of Health recommended portions. CONCLUSIONS: This study confirmed the coexistence of obesity, hunger, undernutrition and limited food group consumption among Indian children living in a prosperous and the largest US-Mexico border city.

Nutritional status of patients with Alzheimer's disease: a 1-year study.

OBJECTIVE: To describe the effects of activity level and energy intake over time on the body weight of patients with Alzheimer's disease compared with cognitively normal subjects. DESIGN: Repeated measures, case-control design with measurements taken at quarterly intervals for 12 months. Subjects were grouped by gender and activity level (sedentary or active) within cognitive status. SETTING: The Alzheimer's disease Special Care Unit, The Clinical Research Center at University of California, San Diego, and the Fred Kasch Exercise Physiology Laboratories at San Diego State University. PATIENTS: Seventeen institutionalized subjects with Alzheimer's disease and 23 community-dwelling control subjects successfully completed the 1-year study. MEASUREMENTS: Before admission to the nursing home, the patients with Alzheimer's disease had a formal assessment for dementia, which showed that they met the criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association work group for probable or possible Alzheimer's disease. Control subjects were screened using the Information-Memory-Concentration Mental Status Test and were found to have no cognitive disabilities. Baseline and quarterly measurements included height, weight, bioimpedance for body composition, and activity by accelerometer counts. Dietary intake of energy and protein was determined at baseline and at 6 and 12 months. RESULTS: Patients with Alzheimer's disease had a significantly higher energy intake than patients in the control group. Both women and men with Alzheimer's disease maintained their weight. Women with Alzheimer's disease had higher percentage of fat-free mass than the control group, but there were no differences in body composition between the groups of men. CONCLUSION: Subjects with Alzheimer's disease can maintain their weight if they are given a diet with adequate energy (35 kcal/kg of body weight).

The effects of theophylline on metabolic rate in chronic obstructive lung disease patients.

OBJECTIVE: To study the effect of theophylline and an alternative bronchodilator, ipratropium, on resting energy expenditure (REE) and thermic effect of food (TEF). DESIGN: 5-week randomized, repeated measures, double-blind, cross-over design, comparing the effects of theophylline and ipratropium drug treatments on metabolic measurements made during a baseline period. SETTING: Ambulatory Clinical Trials Center at University of California, San Diego. SUBJECTS: 14 patients at least 65 years old with a clinical diagnosis of chronic obstructive pulmonary disease. MEASUREMENTS: Resting energy expenditure and thermic effect of food were measured by indirect calorimetry. Body composition was determined using bioimpedance. RESULTS: Resting energy expenditure did not differ between baseline and either of the two drug treatments. In men, the thermic effect of food increased significantly during theophylline and ipratropium drug treatment periods (p < 0.03). CONCLUSIONS: Theophylline or ipratropium does not appear to increase resting energy expenditure in patients with chronic obstructive lung disease. The elevated values for thermic effect of food in men need further study.

Conditions altering plasma concentrations of urea cycle and other amino acids in elderly human subjects.

OBJECTIVE: Describe plasma amino acid concentrations and total urinary amino acid excretion in subjects from an elderly female population. SUBJECTS: Fasting plasma samples, complete 24-hour urine samples, and 3-day diet records were obtained from 96 healthy postmenopausal women in one study and fasting plasma samples were obtained from an additional 44 subjects in 3 separate studies. In one study, nonfasting plasma samples were also collected. The subjects ranged in age from 49 to 80 years of age. Samples were obtained to allow the evaluation of the effects of fasting vs. nonfasting, normal vs. Alzheimers subjects, and level of protein intake effects. MEASURES OF OUTCOME: Heparinized plasma samples were deproteinized with a 5-sulfosalicylic acid solution and centrifuged at 14,900 x g. Deproteinized plasma and urine samples were analyzed for free amino acids on a Beckman System 6300 analyzer using a postcolumn reaction with ninhydrin to quantitate the amino acids. RESULTS AND CONCLUSIONS: It is concluded that: 1) From fasting plasma samples, 1 or 2 sampling days are sufficient to establish a characteristic concentration for most plasma amino acids. 2) Fasting amino acid concentrations do not reflect levels of dietary protein intake when dietary amino acid composition is similar. Shifts in fasting amino acid concentrations would be more indicative of changes in relative amounts of amino acids absorbed rather than level of dietary protein per se. 3) Totals of fasting plasma concentrations of arginine, citrulline and ornithine were relatively constant, but fluctuations occurred in the ratio of ornithine to arginine in the different populations; and 4) Patients with Alzheimers disease exhibited altered plasma ornithine and arginine concentrations relative to active or sedentary controls.

Body composition of patients with Alzheimer's disease.

Low body weight is frequently reported in patients with Alzheimer's disease. We sought to discover why by comparing the body composition of 28 cognitively normal elders and 23 institutionalized individuals with Alzheimer's disease. Body mass index was calculated from standing height and weight. Percentages of lean body mass, body fat, and body water were derived from bioimpedance measurements of resistance and reactance. Skinfold thickness was measured at seven body sites to estimate regional fat distribution. Variables were analyzed by analysis of variance with subjects grouped by cognitive status within gender. Activity level and age were not significant covariates. Both women and men with Alzheimer's disease weighed less than control subjects. Differences in body composition were more pronounced in women with Alzheimer's disease, who had lower body mass index (22.0 +/- 3.0 vs 26.1 +/- 5.1), higher percentage of lean body mass (73.8 +/- 5.1 vs 66.9 +/- 6.5), lower percentage of body fat (26.1 +/- 5.1 vs 33.1 +/- 6.5), and higher percentage of body water (55.8 +/- 5.0 vs 49.3 +/- 6.5) compared with control women. Except for lower body weight, the body composition of men with Alzheimer's disease was not significantly different from that of control men. Patients of both sexes with Alzheimer's disease had less truncal body fat compared with controls, which gave them a youthful body habitus. These differences were not accounted for by age, diet, or activity. Our findings indicate that patients with Alzheimer's disease have lower body weight and may require higher energy intake than cognitively normal elders.

Nutritional status of free-living Alzheimer's patients.

Self-reported, dietary intake and biochemical estimates of thiamine, riboflavin, folate, vitamin B-12, protein, and iron were compared in 22, free-living elders by individuals who had senile dementia of the Alzheimer's type (SDAT) and in 41 who were cognitively normal (CN). The two groups did not differ significantly in their intake of these nutrients or the number of deficiency states for intake (less than 67% RDA). Low serum transketolase (thiamin; p less than 0.055), red blood cell (RBC) folate (p less than 0.06), and serum vitamin B-12 (p less than 0.05) levels occurred more often in SDAT patients than in CN subjects. Individuals in both groups who used multivitamin supplements had significantly higher biochemical values for thiamine (p less than 0.03), riboflavin (p less than 0.01), and vitamin B-12 (p less than 0.003) than nonsupplement users. Because of the differences in vitamin B-12 and RBC folate levels between groups, a retrospective analysis was performed on a larger group of subjects drawn from a geriatric assessment clinic. Patients with SDAT had significantly lower serum vitamin B-12 (p less than 0.01) and lower RBC folate (p less than 0.03) values than CN subjects. Which mean values for vitamin B-12 and RBC folate were grouped by degree of impairment in SDAT subjects, vitamin B-12 was significantly lower in mildly and moderately impaired subjects than in those with normal cognition. Mean values for both nutrients did not differ significantly between severely impaired and CN subjects. There was a significant quadratic relationship between cognitive impairment and biochemical values for vitamin B-12.(ABSTRACT TRUNCATED AT 250 WORDS)

Nutritional status and psychometric test scores in cognitively impaired elders.

In a pilot study, we compared dietary and biochemical status for vitamin B1, B2, B12, and C and folate, iron, and protein in CI and CN elders grouped by MMSE scores. Biochemical evaluation of folate and B12 status was continued beyond the preliminary study. Intakes of all nutrients except folate exceeded 66% of the RDA. There were no significant differences among MMSE groups for dietary intake or biochemical values. Transketolase activity increased with degree of impairment, whereas measures for the other vitamins declined. Low or deficient LAA levels were found in 33% of all elders. Folate and B12 deficiencies, respectively, were found in 11% (12/109) and 4% (10/254) of the population. Very low values for serum B12 (less than 250 pg/ml) existed in 15% (37/254) of the subjects (31 CI; 7 CN). Moderately impaired elders (MMSE = 15-20) who used multivitamin supplements had RBC folate (p less than .003) and serum B12 (p less than .02) levels higher than those of subjects who did not use supplements.