Risk factors for protein-energy malnutrition in pre-school shantytown children in São Paulo, Brazil.

OBJECTIVES: To investigate the health and nutritional conditions of people living in a shantytown in the city of São Paulo in order to identify risk factors for infant malnutrition. DESIGN: A retrospective cohort study. PARTICIPANTS: Children living in a shantytown was conducted among children less than 72 months of age. METHODS: Home visits were made and information was collected regarding the risk factors for malnutrition. RESULTS: The prevalence of chronic malnutrition was 41.6% according to Gomez, 36.6% according to Waterlow, and 17.6% according to WHO. Risk factors for malnutrition, according to the weight-for-age index, included birthweight, presence of upper respiratory tract infections, number of pregnancies, number of births, maternal body mass index, birthplace of father, and home building material; according to the weight-for-height index, they included birthweight and maternal age at the time of birth; and according to the height-for-age index, they included the number of prenatal medical visits, birthweight, maternal height, maternal body mass index, father's employment being unregistered, and maternal birthplace. An instrument for identifying children at risk of malnutrition was devised from these major risk factors for future malnutrition, which may then be applied to newly-born children.

[Evaluation of nutritional recovery pattern of malnourished children examined at the center of Recovery and Educational Nutrition, Brazil]. / Avaliação do padrão de recuperação nutricional de crianças desnutridas atendidas no centro de recuperação e educação nutricional.

PURPOSE: To assess the pattern of nutritional recovery in malnourished children. This prospective analysis was conducted between September 1995 and November 1996 at the Center for Recovery and Nutrition Education (CREN) in São Paulo, Brazil. Of the thirty-eight children studied, 47.4% were infants (nine girls and nine boys) and 52.6% preschool children (twelve boys and eight girls). METHOD: Thirty eight children were studied by velocity of W/A and H/A gain in standard deviation or Z score, according to weight and height median of NCHS. RESULTS: There was a statistically significant increase in the weight-for-age (W/A)(p = 0.012), height-for-age (H/A) (p = 0.001) from the time of admission. The difference in the velocity of W/A gain between infants (0.299-Z/year) and preschool children (0.684-Z/year) with more than six months of treatment, was found to be statistically significant (p = 0.038). The difference in the velocity of H/A gain for infants (0.794-Z/year) and for preschool children (0.506-Z/year), was not statistically significant (p = 0.166). In regards to gender, there was not a statistically significant difference between boys and girls in the velocity of W/A gain (0.540 and 0.524-Z/year, respectively). The difference in velocity of H/A gain was statistically significant, 0.485-Z/year for boys and 0.856-Z/year for girls (p = 0.043). CONCLUSION: These findings show that there are differences in the nutritional recovery patterns between gender and age groups.

Obesity and malnutrition in a Shantytown population in the city of São Paulo, Brazil.

To investigate the prevalence of obesity and malnutrition in the poor Brazilian population we conducted a survey on the socioeconomic and nutritional status of 535 families (comprising 2,411 individuals) living in shantytowns in the city of São Paulo. There was a 30% prevalence of malnutrition in the children, with chronic malnutrition as the most predominant problem. The prevalence of obesity was 6.4% in boys and 8.7% in girls. Overweight and obesity associated with stunting was found in 5.8% of boys and 6.8% girls. Adolescents showed a higher prevalence of malnutrition when weight-for-age distribution was used (boys 46.4%, girls 40.2%), but a right deviation in the distribution was observed with an increase in obesity and a decrease of malnutrition was observed (obesity was 21% in girls and 8.8% in boys; malnutrition was 15.5% in boys and 12.6% in girls) when the weight-for-height adjustment was made. Stunting was the most predominant type of malnutrition in both sexes. Obesity associated with stunting was more common than obesity without stunting, both in younger children and adolescents. Adults had a higher prevalence of obesity than malnutrition according to both the Metropolitan Life Insurance tables (1.7% of undernutrition, 16.7% of overweight, and 14.1% of obesity) and Body Mass Index (8.5% of undernutrition, 21.9% of overweight, and 14.6% of obesity). There was an increase in the percentage of obese children when at least one adult in the family was obese and an increased percentage of malnourished children when undernourished adults were present in the family. Obesity among the adults of the family decreased the occurrence of malnutrition among the children.(ABSTRACT TRUNCATED AT 250 WORDS)

Avaliaçäo do padräo de recuperaçäo nutricional de crianças desnutridas atendidas no centro de recuperaçäo e educaçäo nutricional / Pattern evaluation of nutritional recovery in malnourished children attended in center of nutritional educational and recuperation

Estudo de acompanhamento do padrao de recuperaçao nutricional de crianças desnutridas atendidas no Centro de Recuperaçao e Educaçao Nutricional (CREN), entre setembro de 1995 e novembro de 1996. Objetivo. Avaliar a recuperaçao nutricional das crianças em termos de velocidade de ganho anul de peso/idade e estatura/idade e identificar variaçoes do precesso de recuperaçao de acordo com o sexo e a idade. Métodos. Foram estudadas 38 crianças, utilizando-se os valores do incremento de peso/idade e estatura/idade em unidades de desvio padrao ou escore Z, em relaçao à mediana de peso e estatura do padrao NCHS, pelo método da velocidade de crescimento por incremento. Resultados. Houve uma relaçao significante entre ganhos de peso/idade (P=0,012) e estatura/idade (P=0,001) e tempo de internaçao. Os pré-escolares tiveram uma velocidade de ganho de peso-idade significantemente maior (0,684 escores Z/ano) que os lactentes (0,299 escores Z/ano), excluídas as crianças com menos de seis meses de internaçao. Em relaçao à velocidade de ganho de estatura-idade, os lactentes apresentaram um ganho maior (0,794 escores Z/ano) em relaçao aos pré-escolares (0,506 escores Z/ano), embora a diferença nao tenha sido estatisticamente significante. Entre os sexos, a velocidade de ganho de peso/idade foi 0,540 e 0,524 escores Z/ano para meninos e meninas, respectivamente. Quanto à velocidade de ganho de estatura/idade as meninas apresentaram um ganho significantemente maior (0,856 escores Z/ano) que os meninos (0,485 escores Z/ano). Conclusao; O presente trabalho evidenciou que existem diferenças no padrao de velocidade de recuperaçao nutricional de acordo com a idade e sexo.