Nutrition during pregnancy.

Nutritional concerns in pregnancy are gaining increasing importance as problems with obesity, poor nutrition, and improper weight gain during pregnancy have been shown to result in morbidity for mother and infant during the pregnancy. More recent studies show that the impact of poor nutrition in pregnancy extends for decades to follow for the mother and the offspring. Clearly, prevention of problems is the best approach. This article discusses aspects of, and controversies concerning, prenatal weight gain and specific nutrients, and special patient groups who may benefit from intervention by a registered dietitian.

Parenteral nutrition-associated cholestasis in neonates: multivariate analysis of the potential protective effect of taurine.

BACKGROUND: Neonates receiving parenteral nutrition (PN) are at risk for PN-associated cholestasis (PNAC); however, no preventive factors for PNAC have been clearly identified. Despite reports suggesting that taurine may prevent PNAC in neonates, such an effect of taurine has not yet been definitively demonstrated. We determined whether taurine supplementation reduces the incidence of PNAC in premature or critically ill neonates. METHODS: This study was part of a prospective, randomized, multi-institutional trial designed to assess cholecystokinin vs placebo as a potential preventive therapy of PNAC. Taurine supplementation of PN varied between institutions. The presence or absence of taurine in PN was analyzed by multivariate analysis, with a primary outcome measure of serum conjugated bilirubin (CB) as a measure of PNAC. RESULTS: Taurine reduced PNAC in premature infants (estimated maximum CB [95% confidence interval] 0.50 mg/dL [-0.17 to 1.18] for those receiving taurine, vs 3.45 mg/dL [1.79-5.11] for neonates not receiving taurine, approaching significance, p = .07). Taurine significantly reduced PNAC in infants with necrotizing enterocolitis (NEC; estimated maximum CB 4.04 mg/dL [2.85-5.23], NEC infants receiving taurine, vs 8.29 mg/dL [5.61-10.96], NEC infants not receiving taurine, p < .01). There were too few neonates with surgical anomalies to evaluate the effect of taurine in this group. CONCLUSIONS: Within specific subgroups of neonatal patients, taurine supplementation does offer a very significant degree of protection against PNAC. Patients with NEC or severe prematurity are most likely to benefit substantially from taurine supplementation.

The nutritional status of guaymi indians living in Chiriqui province, Republic of Panama / Estado nutricional de los indios Guaymi que viven en la Provincia de Chiriqui. República de Panamá

Guaymi Indian children have recenthy beem identified as a population group who are risk for vitamin A deficiency with numerous cases of xerophthalmia with ocular perforation being reported. A fourday parasitological and nutritional clinic based survey was conducted with 335 Guaymi women and children in the towns of San Félix and Alto Caballero to identify the prevalence of parasitic infections and factors associated with malnutrition. A subsample of 79 children, under 19 years of age, from independent families was constructed for the curret analysis. The results of the study indicated that 20% of the children had a plasma vitamin A concentration less than 20 *g/dl. Significant associations were identified between ascariasis, age, a food diversity score and vitamin A concentrations. Other indicators of nutritional status were also negatively associated with intestinal parasitic infections, and a modernization index, using multivariate regression analysis. In conclusion, this study identified several factors associated with poor nutritional status that can be used by health officers to identify Guaymi children at risk for malnutrition