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      Nutrition of Honduran mothers/caretakers Translated title: La nutrición de madres y guardianas en Honduras

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          Abstract

          In 1996, the Honduran Ministry of Health conducted a national micronutrient survey of children 12-71 months old, which also included an assessment of the nutrition status of their mothers/caretakers. The 1 126 mothers/caretakers who participated in the survey tended to be short and plump. About 15% of them were at obstetric risk by virtue of their short stature and/or low body weight. About 9% had chronic energy deficiency (CED), but 27% were at least 20% overweight. CED was associated with socioeconomic indicators of poverty. Risk factors for being at least 20% overweight included being over 30 years old, not breast-feeding, having attended no higher than grade 4, 5, or 6 of primary school, coming from a wealthier household, and living in San Pedro Sula or medium-sized cities. Among the women surveyed, 26% of nonpregnant and 32% of pregnant mothers/caretakers were anemic. The likely principal cause of anemia was the low intake of bioavailable iron from food and, in some cases, exces sive iron loss associ ated with intestinal parasites, especially hookworm. Only 50% of the mothers/caretakers participating in this study had received iron during their last pregnancy, and just 13% had received postpartum vitamin A. The results highlight the need to develop and implement an effective program to control iron deficiency anemia in women of reproductive age, including by fortifying such widely consumed foods as processed wheat and maize flour and by routinely administering iron supplements to high-risk groups. Postpartum vitamin A supplementation should be encouraged to protect both the mother and newborn infant against vitamin A deficiency.

          Translated abstract

          En 1996, el Ministerio de Salud de Honduras realizó una encuesta nacional sobre los micronutrientes en niños de 12 a 71 meses de edad, en la cual también se evaluó el estado nutricional de las madres o guardianas. Las 1126 madres o guardianas que participaron en la encuesta mostraron la tendencia a ser de estatura baja y a tener un exceso de peso. Alrededor de 15% eran de riesgo obstétrico elevado debido a su baja estatura, su poco peso corporal, o ambas cosas. Cerca de 9% tenían deficiencia energética crónica (DEC), pero 27% tenían un sobrepeso mínimo de 20%. La DEC se asoció con indicadores socioeconómicos de pobreza. Entre los factores de riesgo de tener un sobrepeso mínimo de 20% figuraron tener más de 30 años de edad, no haber amamantado, no haber cursado más allá de cuarto, quinto o sexto año de primaria, venir de un hogar más próspero, y vivir en San Pedro Sula o en una ciudad de tamaño mediano. De las mujeres encuestadas, 26% de las madres y guardianas no embarazadas y 32% de las embarazadas tenían anemia. La causa más probable de la afección fue la poca ingestión de hierro biodisponible en los alimentos y, en algunos casos, la pérdida excesiva de hierro ocasionada por la parasitosis intestinal, especialmente la anquilistomiasis. Solamente 50% de las madres o guardianas que participaron en el estudio habían recibido hierro durante el embarazo previo, y apenas 13% habían recibido vitamina A después del parto. Los resultados subrayan la necesidad de crear y poner en marcha un programa eficaz para controlar la anemia por deficiencia de hierro en mujeres de edad reproductiva aplicando determinadas medidas, entre ellas la fortificación de alimentos de consumo general, como las harinas procesadas a base de trigo y maíz, y la administración periódica de suplementos de hierro a grupos de alto riesgo. La suplementación con vitamina A después del parto debe fomentarse con el fin de proteger a la madre y al recién nacido de la deficiencia de esta vitamina.

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          The 10-year incidence of overweight and major weight gain in US adults.

          We estimated the 10-year incidence of major weight gain (a gain in body mass index of greater than or equal to 5 kg/m2 and overweight (a body mass index of greater than or equal to 27.8 for men and greater than or equal to 27.3 for women) in US adults using data from the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Persons aged 25 to 74 years at baseline were reweighed a decade after their initial examination (men, 3727; women, 6135). The incidence of major weight gain was twice as high in women and was highest in persons aged 25 to 34 years (men, 3.9%; women, 8.4%). Initially overweight women aged 25 to 44 years had the highest incidence of major weight gain of any subgroup (14.2%). For person not overweight at baseline (men, 2760; women, 4295), the incidence of becoming overweight was similar in both sexes and was highest in those aged 35 to 44 years (men, 16.3%; women, 13.5%). We conclude that obesity prevention should begin among adults in their early 20s and that special emphasis is needed for young women who are already overweight.
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            Definition of chronic energy deficiency in adults. Report of a working party of the International Dietary Energy Consultative Group.

            New criteria are proposed for classifying chronic energy deficiency (CED) in adults. A progressively more precise approach to identifying affected individuals involves measuring body weight and height, then energy intake (or expenditure) and finally the basal metabolic rate (BMR). Three cut-off points for body mass index (BMI) were identified: 18.5, 17.0 and 16.0. A BMI above 18.5 is classified as normal and below 16.0 as grade III CED. A diagnosis of grades I and II CED depends on finding the combination of a BMI of 16.0-16.9 or 17.0-18.4 with a ratio of energy turnover to predicted BMR of less than 1.4. Measuring the individual BMR avoids misclassification and confirms the diagnosis. In groups of African adults 38-63 per cent of each group had a BMI below 18.5 and the majority require studies of their energy turnover before specifying their degree of CED; 3 per cent of Ethiopian women and 24 per cent of a selected male African group had grade III CED. These guidelines can be used when assessing the input of aid programmes and for clinical and other studies.
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              Evaluation of effectiveness of iron-folate supplementation and anthelminthic therapy against anemia in pregnancy--a study in the plantation sector of Sri Lanka.

              Intervention measures against anemia available to plantation workers during pregnancy include fortified food supplements (thriposha) and iron-folate supplements containing 60 mg elemental Fe. The effectiveness of these intervention measures was studied in 195 subjects whose iron and nutritional status were assessed at 32 wk of gestation. Taking thriposha conferred no significant benefit on maternal nutritional status, probably because sufficient amounts were not consumed. An increase in the duration of iron-folate supplementation to > 17 wk caused a significant positive change (P < 0.01) in hemoglobin, whereas an increase in the dose frequency had no significant benefit. Anthelminthic therapy in addition to iron-folate supplements caused a significant positive change in hemoglobin (P < 0.001) and serum ferritin (P < 0.005) compared with no supplementation. Thus, anthelminthic therapy significantly increased the beneficial effects of iron supplementation on hemoglobin concentration and iron status.
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                Author and article information

                Journal
                rpsp
                Revista Panamericana de Salud Pública
                Rev Panam Salud Publica
                Organización Panamericana de la Salud (Washington, Washington, United States )
                1020-4989
                1680-5348
                March 1999
                : 5
                : 3
                : 164-171
                Affiliations
                [04] Arlington Virginia orgnameInternational Science and Technology Institute jmora@ 123456istiinc.com
                [01] Washington D.C. orgnameInternational Life Sciences Institute
                [02] Tegucigalpa orgnameHonduras orgdiv1 Ministry of Health Honduras
                [03] Mexico D.F. orgnameMexico orgdiv1 National Institute of Nutrition Mexico
                Article
                S1020-49891999000300005 S1020-4989(99)00500300005
                10.1590/s1020-49891999000300005
                b7adf017-557d-4e48-9683-82ef6902e568

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 14 March 1998
                : 19 January 1999
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 14, Pages: 8
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                SciELO Public Health

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