Prevalence and associated impairments of mild mental retardation in six- to ten-year old children in Pakistan: a prospective study

The aim of this study was to find the prevalence of mild mental retardation (MMR) in 6-10-y-old children in a prospectively followed cohort in Pakistan from four areas with different socioeconomic conditions. Retarded children were identified by a two-step method, comprising a household screening with the Ten Questions Screening in 649 families followed by clinical investigation and psychometric testing (WISC-R and Griffiths) of the 132 children found by the screening. The overall prevalence of MMR among 6-10-y-old children was 6.2%. The distribution of MMR was uneven, with 1.2% among children from the upper-middle class, 4.8% in the village, 6.1% in the urban slum and 10.5% in the poor periurban slum area. Additional impairments were found in 75% of the children with MMR, of which speech impairment was the most common. CONCLUSION: The prevalence of MMR was found to be higher in a developing country than in developed countries. It also seemed to be related to poor socioeconomic conditions, as the prevalence in the upper-middle class was comparable to figures from developed countries, while the prevalence in children from poor population groups was much higher.     

Rate of trabecular bone area in 3–6‐year‐old children and relation to intrauterine growth

Background: The aim of the present study was to investigate bone mass using rate of trabecular bone area (RTBA) in Japanese children to determine its relationship with indices of growth such as height and weight from before birth through childhood. Methods: A cross‐sectional study was conducted. The sample consisted of Japanese boys (n= 716) and girls (n= 586) aged 3–6 years. RTBA was measured using quantitative ultrasound (ultrasonic bone densitometer, Benus III; Ishikawa Seisakusho, Kanazawa, Japan). The relation between RTBA and height and weight during childhood and also at birth was assessed. Results: The average RTBA in boys was 27.7 ± 1.59% (mean ± SD) and that in girls was 27.9 ± 1.59%. RTBA significantly correlated with weight both in boys (P= 0.013) and girls (P= 0.016). Significant correlation was demonstrated between RTBA and height, especially in girls (P= 0.045). Statistical significance was shown between RTBA and birth length in boys (P= 0.015) and girls (P= 0.007), and weight at birth in boys (P= 0.014). On multiple regression analysis RTBA correlated significantly with birthweight for boys (standardized coefficient β= 0.093, P= 0.028) and birth length for girls (β= 0.122, P= 0.007). Conclusion: Augmentation of bone mass is related not only to weight and height during childhood but also to prenatal factors such as growth, and possibly with nutrition in utero.     

PROP taster status,food preferences and consumption of high‐calorie snacks and sweet beverages among 6‐year‐old ethnically diverse children

A healthy diet is important for optimal growth and development in children. Food preferences are a main determinant of children's intake. The aim of this study was to examine the associations of 6‐n‐propylthiouracil (PROP) taster status (taste sensitivity to PROP) with children's food preferences and consumption of high‐calorie snacks and sweet beverages among ethnically diverse children. We analysed data from 5585 6‐year‐old children enrolled in the Generation R Study, a birth cohort study in Rotterdam, the Netherlands. PROP taster status was evaluated using a suprathreshold screening solution. Food preferences of the children were assessed by a two‐stage protocol using photographs of eight food items (candy, chocolate, mayonnaise, whipped cream, soup, potato chips, carrot and bread), yielding both hedonic ratings (1–3) and rank order scores (1–8). Univariate and multivariable linear and logistic regression analyses were performed, using tasters as the reference group. Non‐tasters had a slightly higher preference for carrots (β: ?0.07; 95% CI: ?0.13, ?0.02 and β: ?0.15; 95% CI: ?0.27, ?0.02 for hedonic ratings and rank order scores, respectively) and bread (hedonic ratings; β: ?0.06; 95% CI: ?0.11, ?0.01) compared with tasters. No differences were found in children's preference for sweet, fat or salty food items. Furthermore, there were no associations of PROP taster status with the consumption of high‐calorie snacks ≥ 2 times/day (aOR: 1.06; 95% CI: 0.91,1.24) or sweet beverages ≥ 3 glasses/day (aOR: 1.06; 95% CI: 0.92,1.23). Other factors relating to the family food environment may be more important for young children's food preferences and consumption of high‐calorie snacks and sweet beverages than their innate taste sensitivity.     

Combining food‐based dietary recommendations using Optifood with zinc‐fortified water potentially improves nutrient adequacy among 4‐ to 6‐year‐old children in Kisumu West district,Kenya

Children in developing countries often face multiple micronutrient deficiencies. Introduction of zinc‐fortified water can increase zinc intake, but additional recommendations are required to address overall diet nutrient adequacy. We developed and tested food‐based recommendations (FBRs) that included zinc‐fortified water for children aged between 4 and 6 years from rural Kenya to achieve the best possible nutrient adequacy. Dietary intakes of 60 children aged 4–6 years, from Kisumu West district, Kenya, were assessed using a quantitative multipass 24‐hr recall. Linear programming model parameters were derived, including a list of foods consumed, median serving sizes, and distribution of frequency of consumption. By using the Optifood linear programming tool, we developed FBRs for diets including zinc‐fortified water. FBRs with nutrient levels achieving ≥70% recommended nutrient intake (RNI) of the World Health Organization/Food and Agriculture Organization of the United Nations RNI for most of the 12 considered nutrients were selected as the final recommendations for the children. With no FBRs and no zinc‐fortified water, percent RNI coverage range was between 40% and 76% for zinc, improving to 66–101% after introduction of zinc‐fortified water. The final set of FBRs achieved nutrient adequacy for all nutrients except for vitamin A (25% RNI) and folate (68% RNI). Introduction of zinc‐fortified water combined with FBRs will likely improve the nutrient adequacy of diets consumed by children in Kenya but needs to be complemented with alternative interventions to ensure dietary adequacy.