Nutritional Status of Zinc in Children with Down Syndrome

Experimental and clinical studies have established that zinc metabolism is altered in individuals with Down syndrome (DS). The present study intends to evaluate the nutritional status of zinc in children with DS by determining their biochemical and dietary parameters. The investigation was carried out on a group of children with DS (n = 35) and compared with a control group (n = 33), both aging between 4 and 11 years. Weight-for-age, height-for-age, and weight-for-height indexes and diet were evaluated by using a 3-day dietary record. Zinc was evaluated in plasma, erythrocytes, and 24-h urine collection by using the method of atomic absorption spectroscopy. The frequency of short stature was higher in children with DS. Both groups presented high protein content, adequate concentrations of lipids and carbohydrates, and deficit in calories. Adequate zinc intake was observed in 40% of children with DS and in 67% of the control group. Zinc concentrations were significantly lower in plasma and urine and higher in erythrocytes of children with DS. The results allowed us to conclude that the altered zinc nutritional status of individuals with Down syndrome contributes to clinical disturbances that usually appear with aging in these patients.     

Nutritional Status of the Sekmai Children, Manipur

This paper reports on nutritional status of 4 to 10 year-old Sekmai children. The Sekmais belong to a section of the Meiteis of Manipur. They are included in the scheduled caste list of the state. The study is based on height and weight of 731 children, 360 boys 371 girls. It aims to throw light on different conventional methods of nutritional assessments based on height and weight and their varied results. The Sekmai children are shorter in height and lighter in body weight from the American (National Center for Health Statistics) and Indian children in all the age groups. According to Waterlow’s classification of height for age, 43.37% of the Sekmai children are malnourished, whereas Gomez’s classification of weight for age shows 68.67% as malnourished of different grades. But if we look at the classification of Vishveshwara Rao and the Indian Academy of Paediatrics classification (IAPC), the Sekmai children’s nutritional status is not disappointing. Rao’s classification of height for age reveals 88.37% as normal while that of IAPC shows 71.70% as normal. Waterlow’s classification of weight for height also depicts 89.74% of the children as normal. H. Jibonkumar is a lecturer at the Presidency College, Motbung, Manipur, India while T. Shyamacharan Singh is an associate professor of Department of Anthropology, Manipur University, Imphal, Canchipur, India.     

Nutritional Status of Children Hospitalized for Parapneumonic Effusion

Background & Aims

Among children hospitalized for pneumonia, those with parapneumonic effusion (PPE) are at particular risk for nutritional deterioration. This study aimed to 1) investigate the evolution of the nutritional status during hospitalization and at outpatient follow-up; 2) determine clinical risk factors for weight loss during hospitalization; 3) describe the nutritional interventions for these children.

Methods

Retrospective chart review (January ‘07 - September ‘12) of 56 children with pneumonia, complicated by PPE in two Belgian hospitals for data on body weight and height at admission (t₀) and discharge (t₁), and two weeks (t₂) and one month (t₃) after discharge. Length of hospitalization (LoS), length of stay in paediatric intensive care (LoS_PICU) and maximal in-hospital weight loss (t_max) were calculated and nutritional interventions were recorded.

Results

The median (range) age was 3.5 (1.0–14.8) years. Weight or height was lacking in five (8.9%) children at t₀ and in 28 (50%) at t₁; 21.4% was weighed only once during hospitalization. At t_max, respectively 17/44 and 5/44 children lost ≥5% and ≥10% of their weight. Median (range) LoS and LoS_PICU were 18.0 (10–41) and 4.0 (0–23) days. One-fourth received a nutritional intervention. Weight for height at admission (WFH(t₀)) significantly predicted maximal weight loss (β (95% CI) = −0.34 (−2.0–−0.1); p = 0.03). At t₂ and t₃, 13/32 and 5/22 of the children with available follow-up data did not reach WFH(t₀), whilst in 4/35 and 5/26 body weight remained ≥5% under the weight(t₀).

Conclusions

One-third of children with pneumonia complicated by PPE and monitored for weight and height, lost ≥5% of their body weight during hospitalization. One-fourth did not reach initial WFH one month after discharge. Those with a higher WFH at admission were at higher risk of weight loss. More attention for monitoring of weight loss and the nutritional policy during and after hospitalization is warranted.     

Secular Trends in Growth and Nutritional Status of Mozambican School-Aged Children and Adolescents

Objectives

The purpose of this study was to examine secular changes in growth and nutritional status of Mozambican children and adolescents between 1992, 1999 and 2012.

Methods

3374 subjects (1600 boys, 1774 girls), distributed across the three time points (523 subjects in 1992; 1565 in 1999; and 1286 in 2012), were studied. Height and weight were measured, BMI was computed, and WHO cut-points were used to define nutritional status. ANCOVA models were used to compare height, weight and BMI across study years; chi-square was used to determine differences in the nutritional status prevalence across the years.

Results

Significant differences for boys were found for height and weight (p<0.05) across the three time points, where those from 2012 were the heaviest, but those in 1999 were the tallest, and for BMI the highest value was observed in 2012 (1992<2012, 1999<2012). Among girls, those from 1999 were the tallest (1992<1999, 1999>2012), and those from 2012 had the highest BMI (1999<2012). In general, similar patterns were observed when mean values were analyzed by age. A positive trend was observed for overweight and obesity prevalences, whereas a negative trend emerged for wasting, stunting-wasting (in boys), and normal-weight (in girls); no clear trend was evident for stunting.

Conclusion

Significant positive changes in growth and nutritional status were observed among Mozambican youth from 1992 to 2012, which are associated with economic, social and cultural transitional processes, expressing a dual burden in this population, with reduction in malnourished youth in association with an increase in the prevalence of overweight and obesity.     

Status,trends, and equilibrium abundance estimates of the translocated sea otter population in Washington State

Sea otters (Enhydra lutris kenyoni) historically occurred in Washington State, USA, until their local extinction in the early 1900s as a result of the maritime fur trade. Following their extirpation, 59 sea otters were translocated from Amchitka Island, Alaska, USA, to the coast of Washington, with 29 released at Point Grenville in 1969 and 30 released at La Push in 1970. The Washington Department of Fish and Wildlife has outlined 2 main objectives for sea otter recovery: a target population level and a target geographic distribution. Recovery criteria are based on estimates of population abundance, equilibrium abundance (K), and geographic distribution; therefore, estimates of these parameters have important management implications. We compiled available survey data for sea otters in Washington State since their translocation (1977–2019) and fit a Bayesian state-space model to estimate past and current abundance, and equilibrium abundance at multiple spatial scales. We then used forward projections of population dynamics to explore potential scenarios of range recolonization and as the basis of a sensitivity analysis to evaluate the relative influence of movement behavior, frontal wave speed, intrinsic growth, and equilibrium density on future population recovery potential. Our model improves upon previous analyses of sea otter population dynamics in Washington by partitioning and quantifying sources of estimation error to estimate population dynamics, by providing robust estimates of K, and by simulating long-term population growth and range expansion under a range of realistic parameter values. Our model resulted in predictions of population abundance that closely matched observed counts. At the range-wide scale, the population size in our model increased from an average of 21 independent sea otters (95% CI = 13–29) in 1977 to 2,336 independent sea otters (95% CI = 1,467–3,359) in 2019. The average estimated annual growth rate was 12.42% and varied at a sub-regional scale from 6.42–14.92%. The overall estimated mean K density of sea otters in Washington was 1.71 ± 0.90 (SD) independent sea otters/km² of habitat (1.96 ± 1.04 sea otters/km², including pups), and estimated densities within the current range correspond on average to 87% of mean sub-regional equilibrium values (range = 66–111%). The projected value of K for all of Washington was 5,287 independent sea otters (95% CI = 2,488–8,086) and 6,080 sea otters including pups (95% CI = 2,861–9,300), assuming a similar range of equilibrium densities in currently un-occupied habitats. Sensitivity analysis of simulations of sea otter population growth and range expansion suggested that mean K density estimates in currently occupied sub-regions had the largest impact on predicted future population growth (r² = 0.52), followed by the rate of southward range expansion (r² = 0.26) and the mean K density estimate of currently unoccupied sub-regions to the south of the current range (r² = 0.04). Our estimates of abundance and sensitivity analysis of simulations of future population abundance and geographic range help determine population status in relation to population recovery targets and identify the most influential parameters affecting future population growth and range expansion for sea otters in Washington State.     

Soil-Transmitted Helminth Infections and Nutritional Status in School-age Children from Rural Communities in Honduras

Background

Soil-transmitted helminth (STH) infections are endemic in Honduras and efforts are underway to decrease their transmission. However, current evidence is lacking in regards to their prevalence, intensity and their impact on children''s health.

Objectives

To evaluate the prevalence and intensity of STH infections and their association with nutritional status in a sample of Honduran children.

Methodology

A cross-sectional study was done among school-age children residing in rural communities in Honduras, in 2011. Demographic data was obtained, hemoglobin and protein concentrations were determined in blood samples and STH infections investigated in single-stool samples by Kato-Katz. Anthropometric measurements were taken to calculate height-for-age (HAZ), BMI-for-age (BAZ) and weight-for-age (WAZ) to determine stunting, thinness and underweight, respectively.

Results

Among 320 children studied (48% girls, aged 7–14 years, mean 9.76±1.4) an overall STH prevalence of 72.5% was found. Children >10 years of age were generally more infected than 7–10 year-olds (p = 0.015). Prevalence was 30%, 67% and 16% for Ascaris, Trichuris and hookworms, respectively. Moderate-to-heavy infections as well as polyparasitism were common among the infected children (36% and 44%, respectively). Polyparasitism was four times more likely to occur in children attending schools with absent or annual deworming schedules than in pupils attending schools deworming twice a year (p<0.001). Stunting was observed in 5.6% of children and it was associated with increasing age. Also, 2.2% of studied children were thin, 1.3% underweight and 2.2% had anemia. Moderate-to-heavy infections and polyparasitism were significantly associated with decreased values in WAZ and marginally associated with decreased values in HAZ.

Conclusions

STH infections remain a public health concern in Honduras and despite current efforts were highly prevalent in the studied community. The role of multiparasite STH infections in undermining children''s nutritional status warrants more research.     

Impact of the Brain Death Ruling in Washington State

In a 1980 Washington State Supreme Court decision, brain death was recognized as a means of determining death, but the court declined to specify a procedural mechanism to be followed. According to a survey of hospitals in Washington, the decision has had little impact in the state, apparently due to the medical profession''s unfamiliarity with it. As a result of the survey, we have identified problems of procedure and interaction with the legal system. A consensus of those contacted was that no formal, hospital-mandated definition of brain death is needed.     

Zinc Nutritional Status in Adolescents with Down Syndrome

Studies have evidenced that zinc metabolism is altered in presence of Down syndrome, and zinc seems to have a relationship with the metabolic alterations usually present in this syndrome. In this work, the Zn-related nutritional status of adolescents with Down syndrome was evaluated by means of biochemical parameters and diet. A case–control study was performed in a group of adolescents with Down syndrome (n = 30) and a control group (n = 32), of both sexes, aged 10 to 19 years. Diet evaluation was accomplished by using a 3-day dietary record, and the analysis was performed by the NutWin program, version 1.5. Antropometric measurements were performed for evaluation of body composition. The Zn-related nutritional status of the groups was evaluated by means of zinc concentration determinations in plasma and erythrocytes, and 24-h urinary zinc excretion, by using the method of atomic absorption spectroscopy. The diet of both groups presented adequate concentrations of lipids, proteins, carbohydrates, and zinc. The mean values found for zinc concentration in erythrocytes were 49.2 ± 8.5 μg Zn/g Hb for the Down syndrome group and 35.9 ± 6.1 μg Zn/g Hb for the control group (p = 0.001). The average values found for zinc concentration in plasma were 67.6 ± 25.6 μg/dL for the Down syndrome group and 68.9 ± 22.3 μg/dL for the control group. The mean values found for zinc concentration in urine were 244.3 ± 194.9 μg Zn/24 h for the Down syndrome group and 200.3 ± 236.4 μg Zn/24 h for the control group. Assessment of body composition revealed overweight (26.7%) and obesity (6.6%) in the Down syndrome group. In this study, patients with Down syndrome presented altered zinc levels for some cellular compartments, and the average zinc concentrations were low in plasma and urine and elevated in erythrocytes.     

93例糖尿病住院患者的营养状况评价

对糖尿病住院患者入院时进行营养评价,分别对93例30～60岁糖尿病患者入院时做人体测量和生化检查,与正常人群作对照.结果显示,观察组患者的体质量、体质指数、总蛋白、白蛋白、低密度酯蛋白以及三酰甘油的平均值均高于正常组、而高密度脂蛋白低于正常组,差异有显著性意义(p＜0.05).结果表明,采用多项综合指标评价糖尿病患者的...     

Maternal Education and Micro-Geographic Disparities in Nutritional Status among School-Aged Children in Rural Northwestern China

Objectives

Prior evidence suggests geographic disparities in the effect of maternal education on child nutritional status between countries, between regions and between urban and rural areas. We postulated its effect would also vary by micro-geographic locations (indicated by mountain areas, plain areas and the edge areas) in a Chinese minority area.

Methods

A cross-sectional study was conducted with a multistage random sample of 1474 school children aged 5-12 years in Guyuan, China. Child nutritional status was measured by height-for-age z scores (HAZ). Linear mixed models were used to examine its association with place of residence and maternal education.

Results

Micro-geographic disparities in child nutritional status and the level of socioeconomic composition were found. Children living in mountain areas had poorer nutritional status, even after adjusting for demographic (plain versus mountain, β = 0.16, P = 0.033; edge versus mountain, β = 0.29, P = 0.002) and socioeconomic factors (plain versus mountain, β = 0.12, P = 0.137; edge versus mountain, β = 0.25, P = 0.009). The disparities significantly widened with increasing years of mothers’ schooling (maternal education*plain versus mountain: β = 0.06, P = 0.007; maternal education*edge versus mountain: β = 0.07, P = 0.005). Moreover, the association between maternal education and child nutrition was negative (β = -0.03, P = 0.056) in mountain areas but positive in plain areas (β = 0.02, P = 0.094) or in the edge areas (β = 0.04, P = 0.055).

Conclusions

Micro-geographic disparities in child nutritional status increase with increasing level of maternal education and the effect of maternal education varies by micro-geographic locations, which exacerbates child health inequity. Educating rural girls alone is not sufficient; improving unfavorable conditions in mountain areas might make such investments more effective in promoting child health. Nutrition programs targeting to the least educated groups in plain and in edge areas would be critical to their cost-effectiveness.     

Outcomes of Regionalized Perinatal Care in Washington State

We evaluated the extent to which the regionalization of perinatal care in Washington State has succeeded in concentrating high-risk pregnancies in technologically appropriate referral centers and in reducing differences in neonatal outcome among hospitals. Of all infants weighing less than 1,500 grams born between 1980 and 1983, nearly 68% were delivered in level III hospitals, although only 24% of all babies are born in these hospitals, indicating that the state is highly regionalized. Neonatal outcomes—as measured by standardized mortality ratios—are similar in level I, II and III hospitals and are not greatly influenced by the rural or urban location of the hospital. The most promising strategy for further reducing neonatal mortality is to decrease the number and proportion of very-low-birth-weight births.     

Age-related Patterns of Upper Arm Muscle and Fat Area in Turkish Children and Assessment of Nutritional Status

Anthropometric estimation of midarm muscularity and fatness was employed as a general index of nutritional status in developing countries. The present study attempts to evaluate the sex- and age-related pattern of regional muscle and fat area characteristics in Turkish children. A cross-sectional study was carried out on 1,068 10- to 14-year-old children (583 boys and 485 girls) from junior high schools in Ankara, the capital city of Turkey. According to general anthropometric protocols, weight, height, triceps skinfold thickness, and midarm circumference measurements were taken and socioeconomic data were collected. Arm muscle area (AMA) and arm fat area (AFA) were calculated and centile curves were evaluated using least median squares method. Results showed significant sexual dimorphism in muscle and fat patterning. AFA was found to be higher among girls and AMA among boys. The present findings suggest that the different levels of socioeconomic status (SES) appeared to be more prevalent on muscularity among boys (p < 0.05) and adiposity among girls (p < 0.001).     

Comparison of shiga-toxigenic Escherichia coli prevalences among dairy, feedlot, and cow-calf herds in Washington State

Shiga-toxigenic Escherichia coli (STEC) strains were isolated from 7.4% of 1,440 fecal and farm environmental samples. Shiga toxin gene and STEC prevalences were significantly associated with animal production type and season. A range of serogroups were identified. Nine percent of isolates possessed all three principal virulence markers: stx(2), eae, and ehx.     

Comparison of Shiga-Toxigenic Escherichia coli Prevalences among Dairy, Feedlot, and Cow-Calf Herds in Washington State

Shiga-toxigenic Escherichia coli (STEC) strains were isolated from 7.4% of 1,440 fecal and farm environmental samples. Shiga toxin gene and STEC prevalences were significantly associated with animal production type and season. A range of serogroups were identified. Nine percent of isolates possessed all three principal virulence markers: stx₂, eae, and ehx.