Ethnic Minorities, Migration and Risk of Undernutrition in Children

Well-controlled, comparative studies suggest that in "food rich" or "resource rich" environments, ethnic minority status is not an independent risk factor for malnutrition. In England, Australia, and the United States, nutrient intake, nutritional status measures and growth are comparable between children of ethnic minorities and non-minority children of similar economic status. Children of recent immigrants are an exception to this generalization, suggesting that recent arrival in a new environment is a risk factor for malnutrition. Family-level studies of intraethnic diversity are required to develop more sensitive and specific profiles of risk factors for malnutrition.     

Low levels of essential fatty acids are related to impaired delayed skin hypersensitivity in malnourished chronically ill elderly people

Abstract Essential fatty acid (FA) deficiency, which may accompany protein-energy malnutrition (PEM), has been associated with impaired inflammatory reactions. We evaluated this relationship by analysing FA profiles and delayed cutaneous hypersensitivity in 20 malnourished elderly non-cancer patients and in 20 age-matched control patients. As indicated by serum cholesterol and serum triglycerides, the lipid levels were decreased by about one-third in the subjects with PEM. In comparison with the controls, there was a reduction in the ω 3 FA (e.g. eicosapentanoate) in total serum lipids (mgl^-1) and serum phospholipids (%) of 40% and 47%, respectively. Reductions in serum ω 6 FA (e.g. linoleate and arachidonate) levels corresponded to the drop in total FA concentrations (30%). The cutaneous hypersensitivity was impaired in 14 of the malnourished patients. The magnitude of the skin reaction was positively correlated ( P < 0·05) to the concentrations of eicosapentanoate in serum lipids and serum phospholipids, as well as to the linoleate concentration in total serum lipids. Six of the malnourished patients took part in a nutritional intervention programme for 3 months. In parallel with an improvement in the nutritional status there was a 35% increase ( P < 0·05) in the total ω 3 FA serum concentration. Negative skin tests became positive and the median skin induration enlarged threefold ( P < 0·05). Thus, deficiency of ω 3 FA might be one factor contributing to cutaneous anergy in elderly malnourished patients.     

Chronic ethanol intake may delay the onset of gossypol-induced infertility in the male rat

Summary. Parameters were obtained from the reproductive organs of ethanol-fed, gossypol-treated Sprague Dawley rats. The experimental animals were fed either on a normal (15.17%) or low protein (8.00%) diet. Measurements included reproductive organ weights, seminal characteristics, serum concentration of testosterone and histological, stereological and histomorphometric evaluation of the testis. The testis size, length and diameter of the seminiferous tubule had the least values in the protein-malnourished, gossy-pol-treated rats (3.01±0.26 g, 0.56 ± 0.03 m, 281.34±11.30 μn), in comparison to corresponding animals which had received ethanol simultaneously with gossypol (3.40 ± 0.25, 0.71±0.06m, 314.42 ± 11.61 μn). As gossypol and ethanol are both associated with reduced reproductive capacity, this unexpected but interesting finding lends support to the hypothesis that either a normal dietary protein or ethanol consumption may modify the action of gossypol on body tissues, including the testis. This effect, presumably mediated through changes caused to the bioavailability of gossypol, modifies its antifertility activity. The present observation further highlights the need to consider the concurrent administration of other drugs, such as alcohol, and the nutritional status in the evaluation of gossypol for various potential uses.     

Determinants of dietary intake during childhood diarrhea and implications for appropriate nutritional therapy

Diarrheal diseases have a well recognized negative effect on children's growth, probably due in part to reduced dietary intake during illness. Previous studies have shown that the effects of diarrhea on dietary intake are greater among hospitalized children than among those observed in their homes. Breast milk intake does not change during diarrhea, however, so breast-fed children are less likely to reduce their total energy and nutrient intakes. Recent analyses of clinical studies found that acidosis and dehydration were most closely associated with reduced dietary intake of hospitalized patients. The implications of these and other studies for the dietary management of patients during and after diarrhea are discussed.     

Bone mineral density in malnourished children without rachitic manifestations

BACKGROUND: The purpose of this study was to determine bone mineral density (BMD) of lumbar spine in malnourished children without rachitic manifestations, before and after dietary treatment and vitamin D supplementation, and to compare with healthy children of the same community. METHODS: The subjects were 41 children with malnutrition and 21 healthy controls. None of the children had clinical, biochemical and/or radiological rickets features. The patients had moderate 15 and severe 26 malnutrition according to Gomez's criteria. Using the Wellcome Classification, marasmus was diagnosed in 16 children, kwashiorkor in 10 children. The children with malnutrition were given vitamin D supplementation. RESULTS: BMD was lower in children with malnutrition than in controls (P < 0.01). Mineralization significantly effected the severity of malnutrition (P < 0.01). BMD in kwashiorkor was similar to that of marasmus. The mean BMD level of infants receiving 400 IU of vitamin D daily was similar to that of infants receiving 800 IU of vitamin D daily at the beginning of treatment. In two supplementation groups, the BMD gradually increased during the first 3 months of treatment, but this increase in the infants receiving 800 IU of vitamin D daily was significantly higher than that in the infants receiving 400 IU of vitamin D daily. CONCLUSION: Measurements of BMD in children with malnutrition, especially severe malnutrition, are to be recommended in the initial assessment of the severity of osteopenia and in the follow up to monitor the response to therapy. Children with malnutrition should be given 800 IU of vitamin D daily. The loss of BMD must be accepted as a complication of malnutrition.     

Inadequate oral intake in surgical patients: a rational indication for nutritional support

Seven days or more of inadequate oral intake (IOI) inevitably results in a deterioration in nutritional status. Despite this well-known fact, little information is available as to the frequency with which such periods of IOI occur in clinical practice. This study results from an audit of IOI in a gastroenterological unit over a 6-month period. The results demonstrate that 17% of patients sustained significant periods of IOI of 7 days or longer. This has important implications with regard to the provision of adjuvant nutritional support.     

营养缺乏及补充维生素A对大鼠肺巨噬细胞功能的影响

采用Ｗｉｓｔａｒ大鼠，从怀孕１６天进行限食喂养直到生后４５天，干预组从生后第３６天及第４２天分别给予维生素Ａ灌胃，每次２０００ＩＵ。结果表明，补充维生素Ａ可明显增加大鼠的胸腺重量、肺巨噬细胞的数目、巨噬细胞的吞噬功能及ＮＯ－２的分泌。维生素Ａ可部分纠正营养缺乏导致的免疫缺陷、胸腺萎缩，活化肺巨噬细胞功能，其作用机制有待于进一步研究。     

营养不良的胃肠形态和功能

蛋白质－热能营养不良是儿科常见疾病之一，它与胃肠道形态和功能有密切联系。营养不良可引起胃肠形态异常和功能障碍，而胃肠道形态异常又可引起营养物质吸收障碍，从而进一步造成营养不良。我们认为了解营养不良的胃肠形态和功能有助于儿科医师对本病的治疗。     

Clinical assessment of pancreatic diabetes caused by chronic pancreatitis

Despite the high prevalence of diabetes mellitus in patients with chronic pancreatitis, few studies of pancreatic diabetes have been reported. We investigated 154 patients with chronic pancreatitis, of whom 50% were diabetics, with special reference to the features and clinical course of pancreatic diabetes. We arrived to clarify the features of pancreatic diabetes by comparing pancreatic exocrine function in 112 patients with primary diabetes with findings in a separate group of 80 patients with chronic pancreatitis. Pancreatic diabetes is proposed as a type of diabetes in which exocrine pancreatic function is markedly decreased. Progressive and fatal angiopathies were found in patients with pancreatic diabetes after a long duration of diabetes. The present investigation suggests that treatment of malnutrition is necessary in patients with pancreatic diabetes and that control of blood glucose is often difficult in these patients because of the high incidence of insulin-induced hypoglycemic episodes. (Received Feb. 6, 1997; accepted July 25, 1997)