Weaning Practices in the United Kingdom and Variations in Anthropometric Development

ABSTRACT. The influence of different weaning practices on the dietary energy intake and growth of Cambridge infants has been investigated. Bottle fed children were in general given solid foods sooner, 10.6 weeks for boys and 13.9 weeks with girls: among breast-fed babies the average age was 14.9 weeks in the case of boys and 17.4 weeks for girls. All four groups of children exhibited different growth patterns from those of the NCHS and Tanner reference curves. Over the first three months both boys and girls exhibited a faster velocity of growth in weight, length and weight-for-length. After this time, however, growth velocity was slower than that of the reference children particularly among breast-fed boys who were not given solids until after 16 weeks. For most of infancy triceps and subscapular skinfold thicknesses remained around the 10th centile of the corresponding Tanner reference children, although again the babies weaned later had the lower values. Bottle-fed infants had growth patterns similar to those of the earlier weaned breast-fed babies for all parameters. It is concluded that babies grow differently now that infant feeding patterns have changed.     

CASE STUDIES ON THE NUTRITIONAL STATUS OF SOCIALLY DEPRIVED CHILDREN IN SYDNEY

SYNOPSIS
The nutritional status of 35 socially deprived, apparently healthy children was investigated. The study included 6 preschool boys of widows or deserted wives, and 29 children from 3 orphanages, viz.: 8 school boys, 8 preschool girls (4 of whom were part-Aboriginal) and 13 school girls. Individual data on weighed and analysed dietary intakes from a 7-day survey, anthropometry, haematology, blood vitamin levels, clinical and social findings are presented and interrelationships are discussed.
No clinical evidence of overt deficiency diseases was found, but malnutrition was demonstrated in the groups studied. Only 2 children had satisfactory levels of all parameters measured.
These results cannot necessarily be extrapolated into conclusions as to the nutritional status of socially deprived Australian children as a group in the community because the sample was small. While the number of malnourished children to be found in the Australian population cannot be deduced from the data presented in this paper, it is hoped that it will stimulate interest in the investigation of nutrition in large numbers of Australian children.     

Growth and nutrition of Hong Kong children aged 0-7 years

OBJECTIVE: To study the early dietary practices in relation to growth of Hong Kong children from birth to 7 years. METHODOLOGY: One hundred and seventy-three full-term Hong Kong Chinese babies were recruited at birth and were followed up for anthropometric measurements using standardized methods and dietary assessment using a combination of dietary history, 24 h recall and food frequency. At 7 years, 125 children remained in the study. RESULTS: Mean (SD) birthweight was 3.3 (0.38) kg for boys and 3.1 (0.38) kg for girls. Mean (SD) weight at 7 years was 22.4 (4.2) kg for boys and 21.1 (3.7) kg for girls, and mean (SD) height was 120.3 (4.8) cm for boys and 119.8 (5.1) cm for girls. Hong Kong children were lighter and shorter than Australian children and the National Centre for Health Statistics (NCHS) references, but the magnitude is less than one standard deviation score. Mean weight and height of Hong Kong children were lower compared to Caucasian and Beijing children, with more obvious differences between 1 and 5 years. At 1 year, mean (SD) daily energy intake was 98 (24) kcal/kg/day for boys and 100 (26) kcal/kg/day for girls. By 7 years, it decreased to 82 (18) kcal/kg/day for boys and 73 (22) kcal/kg/day for girls. Between 2 to 4 years of age the energy intake of studied children were slightly lower than the Australian and Finnish children, but the protein intake was higher. Percentage of fat contributing to total daily energy intake was lower throughout at a level of 30%. Such differences in diet reflect a lower consumption of milk fat, higher consumption of meat and lower level of physical activity in Hong Kong children. Intakes of calcium, iron and vitamin C all reached 60% or above of US recommended daily allowance. CONCLUSIONS: The smaller body build of Chinese compared to Caucasians cannot be explained by dietary differences. The diet of Hong Kong children is changing to one which is more Westernized with a higher consumption of animal products.     

Nutritional status and dietary intake in tribal children of Bihar

OBJECTIVE: To assess the dietary intake and nutritional status in children of the tribal areas of Bihar. DESIGN: Cross sectional survey with two stage probability proportional to size sampling. SETTING: Study covered 396 villages from 17 tribal districts of Bihar. SUBJECTS: 1847 preschool children (0-6 Years) were studied. METHODS: 24 hours recall method was used to assess the nutrition intake and anthropometric measurements included height and weight. Nutritional intake was compared with Indian Council of Medical Research recommended dietary allowances (RDA) and nutritional status assessed by SD classification. RESULTS: The intake of protein was broadly in line with the recommended dietary allowances (RDA) in all age groups among children. However, the average intake of energy and other nutrients was lower in allage groups as compared to RDA. Calorie deficiency was 38% whereas protein deficiency was about 19%. More than half of the children were caloric deficient in Katihar, Bokaro, Godda and Singhbhum (east and west). The overall prevalence of stunting was about 60% and underweight about 55% and was comparable in boys and girls. However, wasting was more frequent in girls (urban - 34.5% vs. 16.3% and rural - 34.9% vs 18%). The level of malnutrition was not very different in rural and urban areas. CONCLUSION: The nutritional status and dietary intakes of tribal children in Bihar is very poor. Urgent remedial measures are required in this context, particularly on a war footing in especially vulnerable districts identified by this survey.     

Elevated serum selenium in diabetic children

Twenty-seven diabetic children, 16 girls and 11 boys, 5-18 years of age, with a duration of the disease ranging from 2-15 years, comprised the study group. Thirteen children with a similar age and sex distribution, living in the same area served as healthy controls. All 40 children had a normal growth pattern. The mean serum selenium concentration in the diabetic children, determined by neutron activation analysis, was 7.4 +/- 0.8 micrograms/100 ml (mean +/- SD) and in the healthy controls 6.5 +/- 0.8 micrograms/100 ml. The difference between the two groups was statistically highly significant (p less than 0.01). Boys and girls in both groups had nearly identical mean serum selenium levels and no correlation was observed between the selenium concentrations and either the age, weight or height of the children or the indicators of diabetic control. The selenium status in diabetic children has not been reported previously. The possibility of elevated serum selenium in diabetic children in response to altered lipid metabolism is discussed.     

Dietary Intake in Swedish Diabetic Children

ABSTRACT. The energy and nutrient intakes by 14 children with type I diabetes and 13 healthy peers were investigated by the 24–h recall method and the results were compared with current recommendations for the general population and with the guidelines for the dietary management of diabetes mellitus. The diabetic children showed not only good compliance with the recommendations but also a better intake in practically all respects than their healthy counterparts. The total energy intake by the diabetic children was in good agreement with the recommendations, while that of the controls was slightly lower. The protein energy per cent in the diet of the diabetic children was 18%, compared with 14% in the controls. Forty percent of the energy in the diet of the diabetic children was derived from fats, 36% in the controls. With the exception of carbohydrates, ascorbic acid and iron, the diet of the diabetic children had a higher nutrient density than that of the control children and the reverse was true for carbohydrates only. Howewr, because of the generally higher energy intake displayed by the diabetic children, even the intake of these nutrients was at least as good in the diabetic children as in the controls. Eighty-six percent of the diabetic children but only 46% of the control children stated that the day for which intake data were given was a representative day. Key words: Dietary intake, recall, diabetes mellitus, insulin dependent, Sweden .     

Gender differences in outcome after neonatal intensive care: speech and language skills are less influenced in boys than in girls at 6.5 years

AIM: To study language development at age 6.5 y in 230 children who had required neonatal intensive care (NIC) and 71 full-term neonatally healthy control children, all born in 1986-1989, with a focus on comparison between genders. METHODS: Eight aspects of spontaneous speech, 3 fine motor functions, 10 linguistic areas, Peabody Picture Vocabulary Test, and digit recall (ITPA) were assessed. RESULTS: Achievements for gender and gestational age groups were analysed (group I, 23-31 wk; subgroup IA, 23-27 wk; IB, 28-31 wk; group II, 32-36 wk; group III, >36 wk), with children with congenital malformations as a separate group. As a group, at 6.5 y NIC girls had more developed spontaneous speech than NIC boys, and performed better than NIC boys in some linguistic areas. NIC girls of group I had lower results than control girls in spontaneous speech aspects such as speech motor function, interaction and motivation, and in many areas of linguistic skills. In contrast, NIC boys of group I had higher results than control boys in auditory memory, and only regarding information and speech motor function in spontaneous speech were their results lower. Analysis of results of matched pairs of group I NIC girls versus control girls and group I NIC boys versus control boys revealed even more marked differences between NIC girls and their matched controls than between NIC boys and their matched controls. CONCLUSION: Language development in extremely or very preterm NIC boys seems to be less influenced than that in NIC girls by the need for and administration of NIC. The neonatal factors associated with low scores in girls are different from those in boys.     

Responses of non-obese white children to treadmill exercise

OBJECTIVE: To determine the response to maximal treadmill exercise with the Bruce protocol in a cohort of healthy non-obese American children and adolescents. STUDY DESIGN: A retrospective review of treadmill exercise studies on 347 white American children (188 boys, 159 girls) aged 5 to 18 years was performed with metabolic criteria to verify maximal exercise effort. Data on exercise endurance time, heart rate, blood pressure, and metabolic variables were assessed and compared between age groups and sexes by unpaired t testing and analysis of variance. RESULTS: Exercise endurance time was lower in all age groups when compared with earlier published data. Girls had a lower endurance time than boys at all ages. There was no significant difference in maximum heart rate with respect to age or sex. The maximum systolic blood pressure and diastolic blood pressure increased with increasing age in both boys and girls. Boys had significantly higher maximum systolic blood pressure and diastolic blood pressure after 13 years of age. The maximum absolute oxygen consumption and indexed oxygen consumption showed similar trends for both sexes. CONCLUSION: Lower exercise endurance times are seen despite physiologic evidence of maximal effort, raising the possibility that cardiovascular conditioning is reduced in contemporary American children.     

Elevated Serum Selenium in Diabetic Children

ABSTRACT. Twenty-seven diabetic children, 16 girls and 11 boys, 5–18 years of age, with a duration of the disease ranging from 2–15 years, comprised the study group. Thirteen children with a similar age and sex distribution, living in the same area served as healthy controls. All 40 children had a normal growth pattern. The mean serum selenium concentration in the diabetic children, determined by neutron activation analysis, was 7.4 ± 0.8 μg/100 ml (mean ± SD) and in the healthy controls 6.5 ± 0.8 μg/100 ml. The difference between the two groups was statistically highly significant ( p < 0.01). Boys and girls in both groups had nearly identical mean serum selenium levels and no correlation was observed between the selenium concentrations and either the age, weight or height of the children or the indicators of diabetic control. The selenium status in diabetic children has not been reported previously. The possibility of elevated serum selenium in diabetic children in response to altered lipid metabolism is discussed.     

Preschool weights and heights of Europeans and five subgroups of Asians in Britain

Heights and weights of five subgroups of Asian (545) and European children (685) were recorded after birth, at 1 year, 2 years, and at 5 years. Asian children were divided into Muslim Gujarati, Muslim Pakistani, Muslim Bangladeshi, Hindu, and Sikh. Although the Europeans were significantly the heaviest at birth (3.42 kg boys and 3.26 kg girls) when compared with any of the other groups, it was the Sikhs who had the best weight gain. They were also the heaviest at 5 years when compared with other groups, including the Europeans (20.13 kg and 19.22 kg for Sikh boys and girls respectively compared with 18.83 kg and 18.42 kg for European boys and girls respectively). Hindus had the lightest birth weight. Their weight at 5 years (17.41 kg boys and 16.93 kg girls) and that of the Muslim Gujaratis (17.27 kg boys and 17.20 kg girls) was comparable and was lowest, whereas that of the Bangladeshis at this age was the greatest among the Muslims (18.56 kg for boys and 17.87 kg for girls). Sikh boys and girls were found to be the tallest of all the groups, including the Europeans, at all periods of measurements--including at 5 years when the Sikh boys and girls were 3 cm and 1.5 cm taller than the European boys and girls. Hindus were the shortest of all the groups throughout the period of study.     

Preschool weights and heights of Europeans and five subgroups of Asians in Britain.

Heights and weights of five subgroups of Asian (545) and European children (685) were recorded after birth, at 1 year, 2 years, and at 5 years. Asian children were divided into Muslim Gujarati, Muslim Pakistani, Muslim Bangladeshi, Hindu, and Sikh. Although the Europeans were significantly the heaviest at birth (3.42 kg boys and 3.26 kg girls) when compared with any of the other groups, it was the Sikhs who had the best weight gain. They were also the heaviest at 5 years when compared with other groups, including the Europeans (20.13 kg and 19.22 kg for Sikh boys and girls respectively compared with 18.83 kg and 18.42 kg for European boys and girls respectively). Hindus had the lightest birth weight. Their weight at 5 years (17.41 kg boys and 16.93 kg girls) and that of the Muslim Gujaratis (17.27 kg boys and 17.20 kg girls) was comparable and was lowest, whereas that of the Bangladeshis at this age was the greatest among the Muslims (18.56 kg for boys and 17.87 kg for girls). Sikh boys and girls were found to be the tallest of all the groups, including the Europeans, at all periods of measurements--including at 5 years when the Sikh boys and girls were 3 cm and 1.5 cm taller than the European boys and girls. Hindus were the shortest of all the groups throughout the period of study.     

Apolipoproteins and Lipoproteins in Children with Type I Diabetes: Relation to Glycosylated Serum Protein and HbA1

ABSTRACT. Serum levels of cholesterol (C), triglycerides (TG), lipoprotein-C and apolipoproteins (apo) A-I, A-II and B were measured in 30 children with type I diabetes mellitus (16 boys, 14 girls, aged 11–14 years) and in 26 healthy controls (15 boys, 11 girls, aged 10–13 years). For 19 diabetics controls matched for age, sex and relative body weight were selected. The diabetic patients were considered to be in fair metabolic control according to HbA₁ levels and glycosylated serum protein concentrations. Mean serum apo A-I, A-II and B, C, TG, low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) did not differ significantly between diabetic and nondiabetic children. Very low density lipoprotein cholesterol (VLDL-C) was significantly higher in diabetic children than in controls. Serum C and LDL-C levels showed close univariate linear correlations with glycosylated serum protein (LDL-C: r =0.53, p <0.01, C: r =0.58, p <0.01) in diabetics. The ratio LDL/HDL-C was significantly correlated to HbA₁ levels ( r =0.47, p <0.01). By canonical and multiple linear correlation analysis significant relations of a selected set of variables concerning the control and therapy of diabetes (serum glucose, HbA₁, glycosylated serum protein, insulin dose) with a set of lipoprotein variables (C, TG, VLDL-C, HDL-C, LDL-C, apo A-I, A-II, B) could be demonstrated. From these data we conclude that significant relations between atherogenic serum lipids and lipoproteins (C, LDL-C) and the degree of metabolic control exist in diabetic children, even in the absence of marked dyslipoproteinemia. The close relation of LDL-C and total C with glycosylated serum protein in the diabetics might be due to glycosylation of LDL .     

Apolipoproteins and lipoproteins in children with type I diabetes: relation to glycosylated serum protein and HbA1

Serum levels of cholesterol (C), triglycerides (TG), lipoprotein-C and apolipoproteins (apo) A-I, A-II and B were measured in 30 children with type I diabetes mellitus (16 boys, 14 girls, aged 11-14 years) and in 26 healthy controls (15 boys, 11 girls, aged 10-13 years). For 19 diabetics controls matched for age, sex and relative body weight were selected. The diabetic patients were considered to be in fair metabolic control according to HbA1 levels and glycosylated serum protein concentrations. Mean serum apo A-I, A-II and B, C, TG, low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) did not differ significantly between diabetic nondiabetic children. Very low density lipoprotein cholesterol (VLDL-C) was significantly higher in diabetic children than in controls. Serum C and LDL-C levels showed close univariate linear correlations with glycosylated serum protein (LDL-C: r = 0.53, p less than 0.01, C: r = 0.58, p less than 0.01) in diabetics. The ratio LDL/HDL-C was significantly correlated to HbA1 levels (r = 0.47, p less than 0.01). By canonical and multiple linear correlation analysis significant relations of a selected set of variables concerning the control and therapy of diabetes (serum glucose, HbA1, glycosylated serum protein, insulin dose) with a set of lipoprotein variables (C, TG, VLDL-C, HDL-C, LDL-C, apo A-I, A-II, B) could be demonstrated. From these data we conclude that significant relations between atherogenic serum lipids and lipoproteins (C, LDL-C) and the degree of metabolic control exist in diabetic children, even in the absence of marked dyslipoproteinemia.(ABSTRACT TRUNCATED AT 250 WORDS)     

The Prevalence of Microalbuminuria in Diabetic Children and Adolescents and Its Relation to Puberty

The albumin excretion rate (AER) was studied in two groups of diabetic children and adolescents. Twenty-four-hour AER was studied in 75 children with diabetes for 5 years, in 49 children with diabetes for 10 years, in 55 children with diabetes for 10–20 years and in 21 age matched healthy controls. Overnight AER was studied in 129 diabetic children and adolescents with a duration of diabetes varying from 1–14 years. Diabetics exhibited a wide range of AER-values and when expressed per body surface area, diabetic children had significantly higher AER compared to controls. Log transformed AER-values were significantly correlated to age and body surface area in diabetics but not in controls. In the diabetics, log AER was also correlated to systolic and diastolic blood pressure but not to HbA_1c. 20% of the 0 diabetics had AER values exceeding the upper value for healthy controls which was 18.5 μg/min. 31/35 of them were older than 12 years. In both groups of diabetics, 5% had AER-values exceeding those reported to be predictive for later development of overt nephropathy, the youngest being 16 years old. When comparing diabetic children 0–12 years (i.e. before the maximal growth spurt of puberty) to those older than 12 years, at the same duration of diabetes, the latter group had significantly higher AER-values. No sex difference was found in either age group. It is concluded that after puberty diabetic patients also show evidence of incipient diabetic nephropathy. Thus, routine screening for microalbuminuria is recommended also in pediatric diabetes care after 12 years of age.     

Dietary Intake, Trace Elements and Serum Protein Status in Young Diabetics

ABSTRACT. Dietary intake of energy and nutrients and its relation to trace element and protein status, as observed in 27 diabetic children and 13 healthy controls are discussed. The diabetic children had consistently higher intakes than the healthy controls in nearly all respects, except for carbohydrate and ascorbic acid. In spite of this, the diabetic children had a significantly lower mean serum magnesium than the healthy controls. It is suggested that hypomagnesemia in diabetic children may be the result of increased urinary loss or diversion of magnesium from normal metabolic pathways in this disease. This review also revealed a significantly higher mean serum selenium level in the diabetic children than in the healthy controls. However, no significant correlation WBS observed between serum selenium concentrations and protein intake, suggesting that a factor other than protein intake underlay the elevated levels of serum selenium. The diabetic children as a group had significantly lower levels of selected serum proteins than the controls, in spite of a significantly higher intake of protein by the diabetic group. It is suggested that both reduced serum proteins and elevated levels of serum selenium in the diabetic children are an expression of altered metabolism in combination with the effects of current modes of insulin treatment in this disease.     

The prevalence of microalbuminuria in diabetic children and adolescents and its relation to puberty

The albumin excretion rate (AER) was studied in two groups of diabetic children and adolescents. Twenty-four-hour AER was studied in 75 children with diabetes for 5 years, in 49 children with diabetes for 10 years, in 55 children with diabetes for 10-20 years and in 21 age matched healthy controls. Overnight AER was studied in 129 diabetic children and adolescents with a duration of diabetes varying from 1-14 years. Diabetics exhibited a wide range of AER-values and when expressed per body surface area, diabetic children had significantly higher AER compared to controls. Log transformed AER-values were significantly correlated to age and body surface area in diabetics but not in controls. In the diabetics, log AER was also correlated to systolic and diastolic blood pressure but not to HbA1c. 20% of the diabetics had AER values exceeding the upper value for healthy controls which was 18.5 micrograms/min. 31/35 of them were older than 12 years. In both groups of diabetics, 5% had AER-values exceeding those reported to be predictive for later development of overt nephropathy, the youngest being 16 years old. When comparing diabetic children 0-12 years (i.e. before the maximal growth spurt of puberty) to those older than 12 years, at the same duration of diabetes, the latter group had significantly higher AER-values. No sex difference was found in either age group. It is concluded that after puberty diabetic patients also show evidence of incipient diabetic nephropathy. Thus, routine screening for microalbuminuria is recommended also in pediatric diabetes care after 12 years of age.     

Dietary changes in Swedish adolescents

A school-based dietary survey, using seven-day records, was performed in two cohorts of Swedish adolescents; 14– and 17-year-olds. The study comprised 366 boys and 365 girls. When compared to previous studies in Sweden, a striking finding was a decrease in dietary fat intake and an increase in carbohydrate intake. However, the relative intake of saturated fat had not changed (15% of total energy). The dietary change was mainly due to an increased consumption of cereal products. There were no major differences in dietary habits or nutrient density of the food between the two age groups, or between boys and girls. The mean intakes of protein, fat and carbohydrate, expressed as a percentage of the total energy intake, were 15, 33 and 52%, respectively. The mean intakes of vitamins and minerals were low only for selenium. The boys had a high iron intake (1.5 and 1.7 times the recommended intake for 14- and 17-year-olds, respectively) while the mean iron intake for girls was 0.9 times the recommended dietary allowances in both age groups. The intake of dietary salt was higher in boys than in girls (7.7 g and 9.0 g per day in 14- and 17-year-old boys, respectively, and 5.8 g per day in both 14- and 17-year-old girls). In a long-term health perspective, this positive change in nutrient intake in adolescents may contribute to a reduction in the incidence of diet-related diseases in Sweden. However, our results strongly suggest that if intakes are further reduced in the adolescent age groups, this may reduce the energy intake to a hazardously low level in a significant number of adolescents, particularly in girls.     

Motor performance in 5-year-old preschool children with developmental speech and language disorders

Aim:  The aim of the study was to evaluate motor performance in 5-year-old children with mild-to-moderate developmental speech and language disorders (DSLD) in comparison of age- and gender-matched healthy children.
Materials and methods:  A total of 32 DSLD children and 45 control group (CG) children participated in our study. The children were examined for dexterity skills and gross motor function through vertical jumping performance, maximal isometric strength of the leg extensors and isometric hand-grip strength.
Results:  Dexterity skills did not differ significantly in the measured groups, but DSLD children performed more poorly in gross motor tasks. DSLD children demonstrated significantly lower vertical jumping height compared to CG children. DSLD girls had lower isometric strength of the leg extensors compared to all other measured groups. The hand-grip strength was greater in CG boys compared to all other measured groups. No significant differences in this parameter were observed between CG girls and DSLD children, although DSLD girls' result was the lowest.
Conclusion: In children with mild-to-moderate DSLD, the lag of gross motor development is clearly evident; however, they do not differ from CG children in dexterity skills. DSLD girls had more affected gross motor function compared to DSLD boys.     

Sex influences on lung function and medication in childhood asthma

AIM: To evaluate possible sex differences in prevalence, diagnosis and treatment of asthma, and influence on lung function associated with asthma severity in a population-based birth cohort (BAMSE) of 4089 children. METHODS: At 4-y follow-up, 92% responded to a questionnaire on symptoms of asthma, current medication and doctor's diagnosis of asthma. A total of 2965 children participated in clinical testing, including measurements of peak expiratory flow (PEF), and were assigned to groups of asthma or no asthma by reported airway symptoms. RESULTS: Children in asthma groups had lower PEF readings compared to healthy children. This effect was most pronounced for both sexes in the persistent group (boys p<0.05, girls p<0.001) and for girls in the transient group (p<0.01). A doctor's diagnosis of asthma did not significantly differ between boys and girls, but significantly more boys than girls had inhaled corticosteroids, even when stratifying by frequency of symptoms. CONCLUSION: These results suggest that when 4-y-old children are stratified according to common diagnostic criteria, girls have a larger effect on PEF of asthma symptoms and are less frequently treated compared to boys.     

Red blood cell sorbitol in diabetic children

When red blood cells (RBC) were incubated with various concentrations of glucose, the RBC sorbitol level increased in a concentration-dependent manner. The elevated RBC sorbitol level was not reduced by further incubation in a glucose-free medium. In both diabetic and non-diabetic children, an increase of RBC sorbitol levels occurred in the oral glucose tolerance test and the return to baseline was delayed in diabetics compared with non-diabetics. In the majority of diabetics (87%), RBC sorbitol levels exceeded the upper limit of the normal range, which was arbitrarily determined as the mean + 2 s.d., in healthy non-diabetic children and adults. A good correlation was observed between RBC sorbitol levels and plasma glucose levels (r = 0.644). In both diabetics and non-diabetics, no correlation was observed between RBC sorbitol levels and age, and in diabetics the RBC sorbitol level was not related to the duration of disease. A good correlation was observed between RBC sorbitol levels, and hemoglobin Alc (HbAlc) or fructosamine levels in diabetic children.