IMPACT OF AGRO CLIMATIC AND SOCIO-ECONOMIC VARIABILITY ON THE NUTRITIONAL STATUS OF INHABITANTS In THE GARHWAL HIMALAYAS

The Garhwal Himalayas are a part of a unique ecosystem, with sharp agro-climatic variations within a very small geographical area (53,485 km²). The varied agro-climatic situations result in different cropping systems and socio-economic lifestyles that could likely affect the nutritional status of the people living in this region. This article will attempt to explore the impact of these variables (namely, age, family size, education, income, calorie and protein intake, land holding, number of animals, and wheat production) on the body mass index (BMI) of the population residing in the Garhwal Hills. A total of 1,030 subjects were studied from the three agro-climatic zones (406 from the high hills, 292 from the mid hills, and 332 from the low hills). It has been found that the people living in the high hills are the most undernourished, as the lowest percentage of people (52.6 per cent) with an acceptable BMI and the highest percentage of people in the severely malnourished category (11.1 per cent) are found here. People living in urban areas have a better nutritional status. Correlation studies show that the nutritional status of the population improves with age, literacy levels, and small family size. In some cases, calorie and protein intake have a positive impact on the health of the people, whereas size of land holding, number of animals, and income of the family do not have any significant influence on nutritional status.     

Wider income gaps,wider waistbands? An ecological study of obesity and income inequality

OBJECTIVES: To see if obesity, deaths from diabetes, and daily calorie intake are associated with income inequality among developed countries. DESIGN: Ecological study of 21 developed countries.Countries: Countries were eligible for inclusion if they were among the top 50 countries with the highest gross national income per capita by purchasing power parity in 2002, had a population over 3 million, and had available data on income inequality and outcome measures. MAIN OUTCOME MEASURES: Percentage of obese (body mass index >30) adult men and women, diabetes mortality rates, and calorie consumption per capita per day. RESULTS: Adjusting for gross national per capita income, income inequality was positively correlated with the percentage of obese men (r = 0.48, p = 0.03), the percentage of obese women (r = 0.62, p = 0.003), diabetes mortality rates per 1 million people (r = 0.46, p = 0.04), and average calories per capita per day (r = 0.50, p = 0.02). Correlations were stronger if analyses were weighted for population size. The effect of income inequality on female obesity was independent of average calorie intake. CONCLUSIONS: Obesity, diabetes mortality, and calorie consumption were associated with income inequality in developed countries. Increased nutritional problems may be a consequence of the psychosocial impact of living in a more hierarchical society.     

Relationship between socio-demographic and behaviour variables, and body mass index in a population with high-normal blood pressure: Hypertension Prevention Trial

The relationship between socio-demographic and behaviour variables and body mass index (BMI: weight/height2) adjusted for age were studied in a population with high-normal blood pressure who participated in the Hypertension Prevention Trial. The BMI of the participants ranged from 19.1 to 35.1 kg/m2 in men and from 16.0 to 35.1 kg/m2 in women. The prevalence of obesity (BMI greater than or equal to 25.0 kg/m2) was 77 per cent in men and 61 per cent in women, with prevalence of severe obesity (BMI greater than or equal to 30.0 kg/m2) being 23 per cent and 19 per cent respectively. Stepwise regression was carried out to identify the most important correlates of BMI. In men, they were family income (+), occupation (-), leisure time exercise frequency (-), number of meals eaten out (-), alcohol intake (-), smoking (-), caffeinated drink intake (+), and meal planner. Men who planned meals with their partners had a higher BMI than men who planned their own meals or had someone else plan their meals. Correlates of little importance were marital status, race, education, number of members in household, energy intake, percentage of total calories from fat, occupation activity level, and vitamin/mineral supplement intake. In women the most important correlates of BMI were alcohol intake (-), caffeinated drink intake (+), and race. Black women had a higher mean BMI than white women. The important socio-demographic and behaviour variables in both men and women accounted for about 20 per cent of the variance in BMI which leaves about 80 per cent of the variation unexplained. This indicates the presence of other factor(s) which may be determining body weight.     

Residental factors affecting nutrient intake and nutritional status of female pharmacy students in Bydgoszcz

The aim of present study was to estimate nutrient intake as well as nutritional status of female pharmacy students from Bydgoszcz, and to investigate relationship of these factors with type of usual residence place during academic year The 24-hour recall method was used to evaluate dietary intake of 47 subjects. Measured values of height, body mass and four skinfolds thickness were used for calculation of BM, FFM, %FM indices. An analysis of nutritional status of studied population showed lower body mass and BMI in the sub-group of female students residing outside of their family home. In comparison to the female students living without parents percentage of energy provided by total fat (29.9%) was significantly less and percentage of energy from carbohydrate was significantly higher (55.4%) than students who reside with their parents. Elevated intake of phosphorus and retinol accompanied by inadequate intake of riboflavin, calcium, iron and copper was exhibited in both residence-type related sub-groups of investigated female pharmacy students.     

Dietary Adequacy of Indian Children Residing in an Urban Slum – Analysis of Proximal and Distal Determinants

The influences of proximal and distal determinants of dietary adequacy of children from an urban slum in India were analyzed. Children numbering 271 (5–14 years) and their mothers were enrolled for the study. Intake of all nutrients except protein was inadequate in the dietaries of children. Among distal determinants, associations were found between (i) calorie intake and maternal nutritional status; (ii) protein, iron and B-complex intakes and economic status, and (iii) retinol, calcium and fat intakes and family size. Literacy status was not associated with dietary adequacy. Age of children and economic status of family were important determinants of dietary adequacy of children from slum area.     

Dietary adequacy of Indian children residing in an urban slum--analysis of proximal and distal determinants

The influences of proximal and distal determinants of dietary adequacy of children from an urban slum in India were analyzed. Children numbering 271 (5-14 years) and their mothers were enrolled for the study. Intake of all nutrients except protein was inadequate in the dietaries of children. Among distal determinants, associations were found between (i) calorie intake and maternal nutritional status; (ii) protein, iron and B-complex intakes and economic status, and (iii) retinol, calcium and fat intakes and family size. Literacy status was not associated with dietary adequacy. Age of children and economic status of family were important determinants of dietary adequacy of children from slum area.     

营养治疗慢性肾功能衰竭效果的初步观察

在非透析综合疗法中膳食治疗的原则,应是在限制低蛋白质摄入量的基础上设法提高必需氨基酸的摄入水平,以纠正体内氨基酸代谢紊乱。根据此原则我们为慢性肾功能衰竭患者制备了低蛋白麦淀粉膳食(蛋白质限制在20～40g/24hr,总热量2000～3000kcal/24hr),麦淀粉含蛋白质量甚低(0.4—0.6g％),故以其代替大米,面粉做为主食,既可减少植物蛋白质的进量,又可在低蛋白限量范围内适当增加含必需氨基酸丰富的食品,如蛋,奶、瘦肉等;并使优质蛋白质占膳食中总蛋白质量的50～70％。本组30例病人经治疗1—2个月后,除6例(2例无效,4例因故未坚持治疗)外,病人氮质血症均有减轻,临床症状得到改善,营养状况有所改进,延长了生命,根据6例氮平衡实验结果,提示慢性肾衰病人(Ccr5—10ml/min)的饮食在充足热量摄入的基础上,蛋白质摄入量至少0.5g/kg/24hr,(其中优质蛋白占50—70％),才可达到氮的平衡。     

Diet and nutritional status of adolescent tribal population in nine states of India

Tribal population constitutes about 8% of the total population in India. They are particularly vulnerable to undernutrition, because of their geographical isolation, socio-economic disadvantage and inadequate health facilities. Recognizing the problem, Government of India launched different programmes for their welfare. Adolescence is a significant period of growth and maturation. The nutritional status of adolescent girls, the future mothers, contributes significantly to the nutritional status of the community. Therefore an attempt was made to assess the diet and nutritional status of adolescent population from the different tribal areas of India. The available database collected by National Nutrition Monitoring Bureau (1998-99) was utilized for this purpose. Data on a total of 12,789 adolescents (10-17 yrs) was included for the analysis. Four percent of the adolescent girls were married and less than 1% were either pregnant (0.4%) or lactating (0.7%) at the time of the survey. The mean intake of all the foodstuffs, especially the income elastic foods such as Pulses, Milk & Milk products, Oils & fats and Sugar & Jaggery were lower than the recommended levels of ICMR. The intake of all the foodstuffs except green leafy vegetables was lower than that of their rural counterparts. The intake of all the nutrients were below the recommended level, while that of micronutrients such as iron, vitamin A and riboflavin were grossly inadequate in all the age and sex groups. About 63% of adolescent boys and 42% of girls were undernourished (< 5th BMI age percentiles of NHANES). A significant association between undernutrition and socio-economic parameters like type of family, size of land holding and occupation of head of household was observed. Therefore, there is a need to evolve comprehensive programmes for the overall development of tribal population with special focus on adolescents.     

中国人群膳食营养素及营养状况分析──1989年8省实例研究

为了解我国１０年经济体制改革后人群膳食结构的改变及身体的营养状况，于１９８９年对８省的１６市２４县居民的调查结果进行分析。结果表明，城市和县城居民热能摄入低于郊区和农村。来源于动物性食物的热能，城市和县城占１１％～１３％，郊区和农村只占５％～９％左右，各类地区来源于动物性食物的蛋白质和动物性脂肪随经济收入的上升而增加。调查人群成人（２０～４５岁）超重（ＢＭＩ≥２５．０）的检出率在７％～１２％之间，消瘦（ＢＭＩ＜１８．５）在７％～１０％之间。城市和县城居民超重检出率显著高于郊区和农村居民（Ｐ＜０．００１）。低收入组的超重检出率低于中高收入组（Ｐ＜０．００１）。体质指数（ＢＭＩ）随热能、蛋白质、脂肪等营养素摄入量的增加而升高。     

老年鼻饲患者营养状况的评价

目的评价老年鼻饲患者营养状况.方法采用膳食调查、人体测量、实验室检查方法,对31例78～99岁的老年鼻饲患者进行营养状况评价.结果调查的患者普遍存在营养不良.产生原因①热能摄入不足,平均每日1339±283kcal;②营养素摄入不均衡,蛋白质摄入基本符合要求,平均每日59.1±13.3g,碳水化物摄入偏低,占总热能的52.5%±8.90%,脂肪摄入偏高,占总热能的30.0%±8.96%;③老年人消化、吸收功能减退,自身合成代谢减少,分解代谢增加;④老年人往往同时患有多种慢性疾病,使鼻饲内容及用量受到限制.结论临床医生和营养人员应根据患者的具体情况进行科学计算,确定每日热能和营养素供给量以及各类食物的合理搭配,并在治疗过程中予以调整.     

Elderly men living alone: are they at high nutritional risk?

This review article investigates the influence of living arrangements on the dietary intake and nutritional status of elderly men. Elderly men living alone have been identified as a group particularly at risk of poor dietary habits, however available evidence is inconsistent. Data from the United States suggests that low income elderly men living alone are at high risk of an inadequate dietary intake, and that a low energy intake is the most important predictor of a poor quality diet in this group. In Australia, older men living with a spouse have a better quality diet (higher nutrient density) than those living alone or with a person or persons other than a spouse, particularly regarding fruit and vegetable intake; differences in nutrient intake are not explained by lower energy intakes. In contrast, older men in European countries who live alone appear to have a more favourable dietary intake as compared to their counterparts in other living arrangements. Information on the association between living arrangements and household food security in the elderly in developing countries is sparse, however single living among older men is rare and the ethos of the extended family appears to remain intact. The inconsistencies in the apparent level of nutritional risk associated with living alone in elderly men in different countries necessitates the development and validation of screening programmes and nutrition services which are country-specific.     

Nutritional status of institutionalized and free-living elderly in Alexandria

Because of an increase in the number of elderly and the problems of nutrition associated with them, it is of interest to study the nutritional status of elderly persons in Alexandria City. The purpose of this study was to assess the nutritional status of elderly population and to compare between the nutritional status of those institutionalized and those living free. The study was conducted on 240 elderly persons (120 institutionalized and 120 free living) selected randomly from institutions and from different sites. The basic data, weight, height, body mass index (BMI) of each were recorded. Dietary intake study was done by using 24 hours recall for 3 consecutive days and food frequency were used to obtain the best estimate of food intake. Energy and nutrient intakes were obtained and compared with the recommended dietary allowance (RDAs). The main findings of the study revealed that the mean age of the institutionalized elderly was greater than those living free. Percent of obesity among females was 71.7% among free living and 45% among institutionalized. Under-nutrition was present in 11.7% and 8.3% of institutionalized males and females respectively. Food habits showed that institutionalized subjects consume more amounts of many food items than free-living. Total daily energy intake was found to be below the recommendation for all subjects, with higher intake among institutionalized than free living. Nutrient intakes among institutionalized and free living elderly were inadequate except thiamin, riboflavin, vitamin C and iron. The nutrients least adequately supplied in the diets of elderly are vitamin A and calcium along with energy deficits. In conclusion both institutionalized and free living are at risk for developing nutrient deficiencies. Deficient energy, calcium and vitamin A are common problems among most subjects. The composition of the diet among free living subjects seem to be also poor in some micronutrients. We recommended a nutrition intervention program and nutrition education to improve nutritional status of elderly people.     

Assessment of nutritional status in adult patients with cystic fibrosis: whole-body bioimpedance vs body mass index, skinfolds, and leg-to-leg bioimpedance

OBJECTIVE: To investigate whether body mass index (BMI) or body fat percentage estimated from BMI, skinfolds, or leg-to-leg bioimpedance are good indicators of nutritional status in adult patients with cystic fibrosis. Body fat percentage measured by whole-body bioimpedance was used as the reference method. DESIGN: Cross-sectional study using four methods to estimate body fat percentage. All patients filled out a food frequency and a physical activity questionnaire for assessment of their habitual food intake and energy requirements, respectively. SUBJECTS/SETTING: Thirty-five adult patients (23 men/12 women) with cystic fibrosis, age range 18 to 46 years, were measured during their yearly visit at the outpatient clinic of the Cystic Fibrosis Center in Utrecht, the Netherlands. STATISTICAL ANALYSIS: Mean+/-standard deviation was calculated for all measurements and 95% confidence intervals for differences between methods. Bland-Altman plots were used to assess differences between the measures of body composition and Pearson correlation coefficients were calculated to determine the relationships between them, and between the energy requirements and the energy intakes. RESULTS: For men the whole-body body fat percentage reference was 14.1%+/-3.0, body fat percentage estimated from BMI was 15.8%+/-4.3, body fat percentage estimated from skinfolds was 8.6%+/-4.8, and body fat percentage estimated from leg-to-leg bioimpedance was 13.1%+/-4.9. For women the whole-body body fat percentage reference was 24.0%+/-5.9, body fat percentage estimated from BMI was 25.1%+/-4.0, body fat percentage estimated from skinfolds was 17.0%+/-4.8, and body fat percentage estimated from leg-to-leg bioimpedance was 25.0%+/-6.9. Body fat percentage estimated from BMI and body fat percentage estimated from skinfolds were significantly different from the reference value for body fat percentage (P <.05). The correlation coefficients between the reference body fat percentage and body fat percentage estimated from BMI, from skinfolds, and from leg-to-leg bioimpedance were all more than 0.72. In all but one patient, nutritional status was correctly assessed by BMI: those with a BMI less than 18.5 had body fat percentage less than 10% (men) or less than 20% (women). The mean energy intake of the men was 141% of the Recommended Dietary Allowance as proposed in European and Dutch guidelines. The mean energy intake of the women was 94% of the Recommended Dietary Allowance. CONCLUSIONS: A simple calculation of BMI is adequate to diagnose nutritional status in adult patients with cystic fibrosis. Bioimpedance measurements are only needed when nutritional therapy specifically focuses on lean body mass.     

深圳市南山区居民饮水习惯调查

目的了解深圳市居民饮水习惯。方法采用多阶段随机抽样的方法,由经过专业培训的调查者对调查对象进行一对一的问卷调查,问卷经核实后输入计算机。结果 401名入选居民,平均年龄为(39.6±10.8)岁,男女约各占一半,汉族为主,文化程度以大专为主,家庭收入在5 000~9 999元/月之间居多。调查结果表明,男性饮水摄入总量、饮茶量多于女性,豆浆及乳类摄入量少于女性,白开水、豆浆及乳类摄入人数少于女性;不同年龄段居民瓶装水、桶装水、饮料、饮茶、豆浆及乳类摄入量差异有统计学意义,瓶装水、桶装水、饮料、咖啡摄入人数差异有统计学意义;不同文化程度居民白开水、瓶装水、饮茶、豆浆及乳类、咖啡摄入量差异有统计学意义,饮茶、咖啡、豆浆及乳类摄入人数差异有统计学意义;不同家庭收入居民饮水摄入总量、饮茶、豆浆及乳类、咖啡摄入量差异有统计学意义,白开水、桶装水摄入人数差异有统计学意义;吸烟者饮水摄入总量,饮料摄入量多于非吸烟者,饮茶摄入量少于非吸烟者,吸烟者饮茶人数少于不吸烟者;饮酒者饮料摄入量多于不饮酒者,饮料、豆浆及乳类饮用人数多于不饮酒者;不同体质指数居民饮料、豆浆及乳类、咖啡摄入量差异有统计学意义,咖啡摄入人数差异有统计学意义...     

Nutrition in agricultural development: land settlement in Coast Province,Kenya

Coast Province is the third area of population concentration in Kenya with more than 1.8 million people at the time of the census in 1989. The region is economically underdeveloped relative to central and western Kenya. In response to a great demand for land, the government of Kenya has since 1963 parcelled out tracts of land in Coast Province among smallholder tenants. This paper reviews the settlement of land in the province during 1960-70 and the effects upon later household income, food production, and nutrition. Findings are based upon information gathered from 300 tenant households surveyed between August 1985 and September 1986 in the Ukunda, Mtwapa, and Roka-East schemes respectively established in 1962, 1968, and 1969, and 150 households in rural comparison locations visited during the same period. In all aspects studied, including living conditions, household resources and income, food self-sufficiency and consumption, and nutritional status of children, the settlement tenants were better off than the rural population. Further analysis determined that the relatively better nutritional status of tenant households is only partly due to increases in food production and agricultural income. Income from employment was also higher than that of the rural comparison population. Households with large farms generally realized larger incomes, but they also had much larger families and food consumption, and the nutritional status of young children was lower among those households.     

A nutritional status survey of older adults in long-term care in the Yazd province of Iran

It is important to assess the nutritional status of older adults because of its role in ensuring health and quality of life and its association with functional status. The purpose of this study was to evaluate the nutritional status of an older adult population living in long-term care institutions in the Yazd province of Iran. Fifty elderly subjects were randomly selected from each of two long-term care institutions in Yazd. A 3-day food intake survey was conducted using the direct weighing method and anthropometric measurements for calculating body mass index (BMI) were also collected. Of the participants, 54% of women and 41% of men had a BMI less than 19.9 kg/m(2). The mean intakes of energy, protein, vitamins A and C, riboflavin, and niacin as well as the minerals calcium, phosphorus, and iron, were significantly less than Dietary Reference Intakes (DRIs) for both genders. Thiamin intake was more than adequate in both women and men. In our study, the majority of elderly subjects displayed a poor reported nutritional intake according to the DRIs. Our findings support the development of national nutrition plans for older adults living in long-term care institutions as an important necessity.     

儿童重症结核影响因素病例对照研究

[目的]了解儿童重症结核致病的影响因素。[方法]采取以社区为基础的病例对照流行病学研究方法,筛选出儿童结脑等重症结核病例,根据病例的年龄、性别、来源地信息按1:3比例选取合适的对照,填写问卷调查表。采用Epi Info软件对资料进行卡方检验、单因素条件Logistic回归分析。[结果]纳入42例病例,126名对照。两组间家庭人口、家庭年总收入、家庭总居住面积、住宅状况、慢性疾病史,差异无统计学意义。肺结核病接触史和接触程度、与肺结核病人的关系、肺结核病史与儿童结脑等重症结核发病有统计学显著性关联。[结论家庭人口总数、家庭年总收入、家庭总居住面积、居住地状况、住宅状况、有无慢性病史等因素与儿童结脑等重症结核的发病无关。肺结核病人接触史、接触密切程度是儿童结脑等重症结核的影响因素。     

A Nutritional Status Survey of Older Adults in Long-Term Care in the Yazd Province of Iran

It is important to assess the nutritional status of older adults because of its role in ensuring health and quality of life and its association with functional status. The purpose of this study was to evaluate the nutritional status of an older adult population living in long-term care institutions in the Yazd province of Iran. Fifty elderly subjects were randomly selected from each of two long-term care institutions in Yazd. A 3-day food intake survey was conducted using the direct weighing method and anthropometric measurements for calculating body mass index (BMI) were also collected. Of the participants, 54% of women and 41% of men had a BMI less than 19.9 kg/m². The mean intakes of energy, protein, vitamins A and C, riboflavin, and niacin as well as the minerals calcium, phosphorus, and iron, were significantly less than Dietary Reference Intakes (DRIs) for both genders. Thiamin intake was more than adequate in both women and men. In our study, the majority of elderly subjects displayed a poor reported nutritional intake according to the DRIs. Our findings support the development of national nutrition plans for older adults living in long-term care institutions as an important necessity.     

AN ASSESSMENT OF DIETARY INTAKES OF THE WOMEN'S BASKETBALL, SWIMMING, AND VOLLEYBALL TEAMS AT HOWARD UNIVERSITY

African Americans have become dominant in sports teams. It was questioned in the Nutritional Sciences Department as to whether there were any outstanding dietary and nutritional characteristics of Howard University's women's basketball, swimming, and volleyball teams to explain this. The teams were 76 per cent Black. The mean body mass index (BMI) among all team members was 22.5. Dietary intakes were essentially unremarkable, but surprisingly, iron intakes were adequate. All teams, however, averaged only 50 per cent of the Dietary Reference Intakes (DRIs) for calcium. Efforts need to focus on coaches who may encourage a higher intake of dairy products and dark green, leafy vegetables to increase bone health and prevent osteoporosis later in life.