ABSTRACT. This study was conducted in order to test the usefulness of measuring the concentration... more ABSTRACT. This study was conducted in order to test the usefulness of measuring the concentrations of selected serum proteins and acute phase reactants in assessing the nutritional status of children with undue susceptibility to acute infections. The concentrations of serum proteins were determined by an immunodiffusion technique in 28 children with undue susceptibility to infections and were compared with those in healthy children. The patients were grouped according to the clinical pattern, i.e. into children with mainly upper respiratory tract infections, with frequent middle ear infections and with lower respiratory tract infections. The total group and all three subgroups of patients had not only significantly lower (p < 0.001 or p < 0.01) mean serum levels of albumin and retinol-binding protein, but also of the acute phase reactants α2-macroglobulin and ceruloplasmin (p < 0.01) than the controls. No differences were observed between the patients and the controls in respect of the acute phase reactant orosomucoid. This study indicates that the concentrations of albumin and RBP along with selected acute phase reactants are rapidly influenced by altered nutritional status in children with undue susceptibility to acute infections.
ABSTRACT. Serum concentrations of iron, copper, zinc and magnesium and also serum transferrin and... more ABSTRACT. Serum concentrations of iron, copper, zinc and magnesium and also serum transferrin and ceruloplasmin were investigated in 28 children aged 10 months to 10 years with undue susceptibility to infections. None of the children had any classical immune defect. Seven of them had had frequent upper respiratory tract infections, 16 had suffered from frequent infections of the middle ear and five from mainly lower respiratory tract infections. Thirteen healthy children aged 9 to 18 years residing in the same area served as controls. The children with undue susceptibility to infections had significantly lower mean serum iron (p< 0.05) and zinc (p< 0.001) levels than the healthy controls. The mean serum concentrations of copper and magnesium and of transferrin and ceruloplasmin did not differ between the patients and controls. Children with frequent middle ear infections seemed to account for most of the differences in the serum levels of iron and zinc. An inverse correlation was observed between duration of breast feeding and serum concentration of zinc, and between weight as well as height and serum magnesium. The reasons for these changes and the possible role of trace element deficiency as a factor predisposing to or perpetuating undue susceptibility to infections in children are discussed.
The contents of iron, copper, zinc, calcium and magnesium were determined in human milk samples f... more The contents of iron, copper, zinc, calcium and magnesium were determined in human milk samples from 18 Ethiopian and 23 Swedish women. The Ethiopian women belonged to two groups with different socio-economic situations, a non-privileged and a privileged group. Both groups had an excessively high dietary iron intake–20 to 30 times that of the Swedish women–from the iron-rich traditional diet. In spite of this, the mean concentrations of iron in the milk, as well as of zinc and magnesium, were similar in all three groups. The mean copper concentration, however, was significantly lower in the Ethiopian than in the Swedish milk samples, the lowest mean value occurring in the privileged group. In contrast, a significantly higher mean calcium concentration was found in milk samples from the Ethiopian women than from the Swedish, the highest mean concentration being noted in the non-privileged group. The levels of minerals in breast milk showed no correlation to the birth weight of the infants or the length of gestation. Our data suggest that an excessively high dietary iron intake does not increase the breast milk content of iron in mothers with a good iron status. The reasons for the differences in the content of copper between the Ethiopian and Swedish milk samples are unclear. The higher calcium content in milk from the Ethiopian mothers, despite a low dietary calcium intake may be a result of an increased endogenous cholecalciferol synthesis due to greater exposure to sunshine.
Doubts have been raised about the effectiveness of carotene-containing foods in improving the vit... more Doubts have been raised about the effectiveness of carotene-containing foods in improving the vitamin A status of populations at risk. We investigated the effect of papaya and carrots on the vitamin A status of lactating women with 2-to 12-mo-old infants in Zimbabwe. The women were randomly assigned to three supplementation groups and a placebo group, and received 6 mg of -carotene capsules, 650 g puré ed papaya, 100 g grated carrots or a placebo, daily for 60 d. All groups were given a meal containing 10 g of vegetable oil daily. Serum retinol, relative dose response, serum ferritin, hemoglobin and C-reactive protein were measured before and after the supplementation period. Mean serum retinol increased significantly after supplementation in the -carotene group (P Ͻ 0.001), the papaya group (P Ͻ 0.001) and the carrot group (P Ͻ 0.001), but not in the placebo group (P Ͼ 0.05). The relative dose response decreased significantly (P Ͻ 0.05) in the -carotene and papaya groups, but not in the carrot or placebo groups (P Ͼ 0.05). There was an increase in mean serum ferritin in all groups but the increase did not differ among groups. The hemoglobin increases in the -carotene and papaya groups were greater than that in the placebo group. We conclude that puré ed papaya and grated carrots can improve the vitamin A and iron nutriture of lactating women. These findings reinforce the importance of plant food-based approaches in the control of vitamin A deficiency in low income countries.
Objective: To evaluate the long-term effects of a horticultural and nutrition education intervent... more Objective: To evaluate the long-term effects of a horticultural and nutrition education intervention in rural Tanzania. Design: A quasi-experimental post-test design was used. Setting: The research was carried out in 10 villages in Singida region, Tanzania. Subjects: Mothers and their children aged 6±71 months (n = 236) from an experimental (Ilongero) and control (Ihanja) area were interviewed regarding knowledge and practices related to vitamin A nutrition. Intake of vitamin A-rich foods by the children during the 7 days prior to the interview was recorded. Stools were examined for helminths and serum samples were analysed for retinol and C-reactive protein (CRP) (n = 146) for the children aged 12±71 months. Results: Knowledge and practices were more favourable to vitamin A intake in the experimental area than in the control area, and an increased frequency of intake of green leaves was associated with higher serum retinol values. The experimental area had lower mean serum retinol levels (13.7 mg dl -1 , n = 75) than the control area (19.3 mg dl -1 , n = 71). One likely confounder was the higher helminth infestation in the experimental area (n = 75, 79%) than in the control area (n = 71, 49%) (P , 0.001). Children with helminths (n = 94) had a lower mean serum retinol level than those without (n = 52) (12.3 6 5 vs. 24 6 10 mg dl -1 ; P = 0.001). Conclusions: Food-based vitamin A programmes can make sustainable improvements in knowledge and dietary practices but these may not necessarily be re¯ected in increases in serum retinol. Programme implementation and evaluation should take confounders into consideration as, in this case, helminth infestation.
Doubts have been raised about the effectiveness of carotene-containing foods in improving the vit... more Doubts have been raised about the effectiveness of carotene-containing foods in improving the vitamin A status of populations at risk. We investigated the effect of papaya and carrots on the vitamin A status of lactating women with 2-to 12-mo-old infants in Zimbabwe. The women were randomly assigned to three supplementation groups and a placebo group, and received 6 mg of -carotene capsules, 650 g puré ed papaya, 100 g grated carrots or a placebo, daily for 60 d. All groups were given a meal containing 10 g of vegetable oil daily. Serum retinol, relative dose response, serum ferritin, hemoglobin and C-reactive protein were measured before and after the supplementation period. Mean serum retinol increased significantly after supplementation in the -carotene group (P Ͻ 0.001), the papaya group (P Ͻ 0.001) and the carrot group (P Ͻ 0.001), but not in the placebo group (P Ͼ 0.05). The relative dose response decreased significantly (P Ͻ 0.05) in the -carotene and papaya groups, but not in the carrot or placebo groups (P Ͼ 0.05). There was an increase in mean serum ferritin in all groups but the increase did not differ among groups. The hemoglobin increases in the -carotene and papaya groups were greater than that in the placebo group. We conclude that puré ed papaya and grated carrots can improve the vitamin A and iron nutriture of lactating women. These findings reinforce the importance of plant food-based approaches in the control of vitamin A deficiency in low income countries.
Objective: To evaluate the long-term effects of a horticultural and nutrition education intervent... more Objective: To evaluate the long-term effects of a horticultural and nutrition education intervention in rural Tanzania. Design: A quasi-experimental post-test design was used. Setting: The research was carried out in 10 villages in Singida region, Tanzania. Subjects: Mothers and their children aged 6±71 months (n = 236) from an experimental (Ilongero) and control (Ihanja) area were interviewed regarding knowledge and practices related to vitamin A nutrition. Intake of vitamin A-rich foods by the children during the 7 days prior to the interview was recorded. Stools were examined for helminths and serum samples were analysed for retinol and C-reactive protein (CRP) (n = 146) for the children aged 12±71 months. Results: Knowledge and practices were more favourable to vitamin A intake in the experimental area than in the control area, and an increased frequency of intake of green leaves was associated with higher serum retinol values. The experimental area had lower mean serum retinol levels (13.7 mg dl -1 , n = 75) than the control area (19.3 mg dl -1 , n = 71). One likely confounder was the higher helminth infestation in the experimental area (n = 75, 79%) than in the control area (n = 71, 49%) (P , 0.001). Children with helminths (n = 94) had a lower mean serum retinol level than those without (n = 52) (12.3 6 5 vs. 24 6 10 mg dl -1 ; P = 0.001). Conclusions: Food-based vitamin A programmes can make sustainable improvements in knowledge and dietary practices but these may not necessarily be re¯ected in increases in serum retinol. Programme implementation and evaluation should take confounders into consideration as, in this case, helminth infestation.
Doubts have been raised about the effectiveness of carotene-containing foods in improving the vit... more Doubts have been raised about the effectiveness of carotene-containing foods in improving the vitamin A status of populations at risk. We investigated the effect of papaya and carrots on the vitamin A status of lactating women with 2-to 12-mo-old infants in Zimbabwe. The women were randomly assigned to three supplementation groups and a placebo group, and received 6 mg of -carotene capsules, 650 g puré ed papaya, 100 g grated carrots or a placebo, daily for 60 d. All groups were given a meal containing 10 g of vegetable oil daily. Serum retinol, relative dose response, serum ferritin, hemoglobin and C-reactive protein were measured before and after the supplementation period. Mean serum retinol increased significantly after supplementation in the -carotene group (P Ͻ 0.001), the papaya group (P Ͻ 0.001) and the carrot group (P Ͻ 0.001), but not in the placebo group (P Ͼ 0.05). The relative dose response decreased significantly (P Ͻ 0.05) in the -carotene and papaya groups, but not in the carrot or placebo groups (P Ͼ 0.05). There was an increase in mean serum ferritin in all groups but the increase did not differ among groups. The hemoglobin increases in the -carotene and papaya groups were greater than that in the placebo group. We conclude that puré ed papaya and grated carrots can improve the vitamin A and iron nutriture of lactating women. These findings reinforce the importance of plant food-based approaches in the control of vitamin A deficiency in low income countries.
Objective: To evaluate the long-term effects of a horticultural and nutrition education intervent... more Objective: To evaluate the long-term effects of a horticultural and nutrition education intervention in rural Tanzania. Design: A quasi-experimental post-test design was used. Setting: The research was carried out in 10 villages in Singida region, Tanzania. Subjects: Mothers and their children aged 6±71 months (n = 236) from an experimental (Ilongero) and control (Ihanja) area were interviewed regarding knowledge and practices related to vitamin A nutrition. Intake of vitamin A-rich foods by the children during the 7 days prior to the interview was recorded. Stools were examined for helminths and serum samples were analysed for retinol and C-reactive protein (CRP) (n = 146) for the children aged 12±71 months. Results: Knowledge and practices were more favourable to vitamin A intake in the experimental area than in the control area, and an increased frequency of intake of green leaves was associated with higher serum retinol values. The experimental area had lower mean serum retinol levels (13.7 mg dl -1 , n = 75) than the control area (19.3 mg dl -1 , n = 71). One likely confounder was the higher helminth infestation in the experimental area (n = 75, 79%) than in the control area (n = 71, 49%) (P , 0.001). Children with helminths (n = 94) had a lower mean serum retinol level than those without (n = 52) (12.3 6 5 vs. 24 6 10 mg dl -1 ; P = 0.001). Conclusions: Food-based vitamin A programmes can make sustainable improvements in knowledge and dietary practices but these may not necessarily be re¯ected in increases in serum retinol. Programme implementation and evaluation should take confounders into consideration as, in this case, helminth infestation.
Bjog-an International Journal of Obstetrics and Gynaecology, 1989
The interrelations between three placental hormones (oestradiol, progesterone and hPL), maternal ... more The interrelations between three placental hormones (oestradiol, progesterone and hPL), maternal glucose metabolism, maternal anthropometry and fetal growth were studied in a sample of 52 carefully selected pregnant women. A relation was found between infant birthweight and both fasting blood glucose and t½ of glucose of an intravenous glucose tolerance test at week 37 of pregnancy. The serum concentrations of the placental hormones were not significantly related to the glucose variables. The correlation between birthweight and the maternal levels of hPL in late pregnancy (r= 0·60) persisted when fasting blood glucose and tt½ of glucose were taken into account. Maternal fat mass was found to explain more of the Variation in basal insulin levels around week 37 than did the placental hormones.
Objectives. To analyze the influence of thumb sucking and pacifier use on breastfeeding patterns ... more Objectives. To analyze the influence of thumb sucking and pacifier use on breastfeeding patterns in exclusively breastfed infants, on the duration of exclusive breastfeeding, and on the total breastfeeding duration.
Objective: To investigate and compare feeding practices among infants of less than 7 months of ag... more Objective: To investigate and compare feeding practices among infants of less than 7 months of age in a rural and an urban area in Tanzania. Design: Cross-sectional, questionnaire-based interview of mothers and focus group discussions with extension workers and community leaders. Setting: Eleven villages in a rural district and 10 wards in an urban district in the Morogoro region, Tanzania, west of Dar es Salaam. Subjects: Probability samples of mothers with infants of less than 7 months of age n 320 from each area). Results: Exclusive breast-feeding was rarely practised in either the rural or urban areas investigated. However, the urban mothers initiated breast-feeding earlier, discarded colostrum less frequently, breast-fed exclusively for a longer period, gave breast milk as the first feed more often and delayed the introduction of solid foods for longer than their rural counterparts. The rural mothers, on the other hand, breastfed their previous infants slightly longer than the urban mothers. Conclusions: The better performance of urban mothers could be partly due to sustained breast-feeding support in hospital settings and other campaigns which may not have reached the rural areas. In both the rural and urban areas more efforts are needed to encourage exclusive breast-feeding, to avoid premature complementation and, in the case of the urban areas, to protect extended breast-feeding.
Hörnell A, Aarts C, Kylberg E, Hofvander Y, Gebre-Medhin M. Breastfeeding patterns in exclusively... more Hörnell A, Aarts C, Kylberg E, Hofvander Y, Gebre-Medhin M. Breastfeeding patterns in exclusively breastfed infants: a longitudinal prospective study in Uppsala, Sweden. Acta Paediatr 1999; 88: 203-11. Stockholm. ISSN 0803-5253 Exclusive breastfeeding was studied among 506 infants in Uppsala, Sweden, based on daily recordings during the first 6 mo. The mothers had previously breastfed at least one infant for at least 4 mo. Most of the mothers considered that they breastfed on demand. Wide variations in breastfeeding frequency and suckling duration were found both between different infants and in the individual infant over time. At 2 wk, the mean frequency of daytime feeds (based on one 13-d record) between different infants ranged from 2.9 to 10.8 and night-time feeds from 1.0 to 5.1. The daytime suckling duration (based on one 24-h record) ranged from 20 min to 4h 35 min and night-time duration from 0 to 2h 8 min. At any given age, a maximum of only 2% of the infants were not breastfed during the night. At 4 mo, 95% of the infants were breastfeeding and 40% were exclusively breastfed at this age. Longer breastfeeding duration and longer duration of exclusive breastfeeding were both associated with higher frequency of breastfeeds, longer breastfeeding of the previous child and higher education. No gender differences were found. Maternal smoking was associated with shorter duration of exclusive breastfeeding, and pacifier use was associated with shorter duration of both exclusive breastfeeding and total breastfeeding. This study confirms that every mother-infant pair needs to be understood as a unique dyad throughout lactation. These data demonstrate a wide range of patterns among women who are exclusively breastfeeding and indicate that it would be inappropriate to put pressure on individual families to adopt preconceived patterns of infant feeding.
Maternal smoking, studied in late pregnancy, was found to be associated with lower blood glucose ... more Maternal smoking, studied in late pregnancy, was found to be associated with lower blood glucose values, both during fasting and after an intravenous glucose load. As a correlation between blood glucose levels and infant birth weight has been reported, it is possible that smoking during pregnancy might reduce fetal growth through an effect on maternal glucose metabolism.
ABSTRACT. Twenty-seven diabetic children, 16 girls and 11 boys, 5–18 years of age, with a duratio... more 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.
The relations between some hereditary and environmental factors and the variation in infant birth... more The relations between some hereditary and environmental factors and the variation in infant birth weight were estimated by multiple linear regression analyses on a sample of 276 Scandinavian single term pregnancies.Gestational age explained 10.9%, fetal factors (maternal and paternal birth weights and fetal sex) 7.9%, maternal factors (parity, pre-pregnancy weight and height) 5.5% and external factors (adjusted weight gain and smoking) 5.8% of the variation in infant birth weight.It is concluded that maternal and paternal birth weights are rather poor predictors of infant birth weight. Together they explain only 5.6% of the variation in infant birth weight at term.
Bjog-an International Journal of Obstetrics and Gynaecology, 1987
Summary. During the second pregnancy of 56 Swedish women resulting in a term birth, energy intake... more Summary. During the second pregnancy of 56 Swedish women resulting in a term birth, energy intake and physical activity were measured for 3 days at weeks 17 and 33. The values were related to maternal lean body mass, pregnancy weight gain, maternal fat accretion and infant birth-weight by multiple linear regression analyses. A significant regression coefficient was found for energy intake at week 17 on maternal fat accretion. Energy intake was not significantly correlated with infant birthweight, not even when physical activity and maternal lean body mass were taken into account. Thus in a well-nourished Swedish population, energy intake is positively related to maternal fat accretion but not to the birthweight of term infants.
ABSTRACT. The concentrations of selected proteins of transport and nutrition were investigated in... more ABSTRACT. The concentrations of selected proteins of transport and nutrition were investigated in 27 diabetic children and 13 healthy controls by an immunodiffusion technique. The diabetic children had significantly lower mean pre-albumin (p<0.001), albumin (p<0.01) and orosomucoid levels (p<0.05) than the healthy controls. No correlation was observed between age or sex and the blood concentrations of the specific proteins analyzed in this series. Haptoglobin and hemopexin showed positive correlations with serum triglycerides (both p<0.01) and slight positive correlations with some of the variables of carbohydrate control. The reduced levels of prealbumin and albumin were not correlated to diabetic control as measured by HbA1, fasting plasma glucose or urinary glucose excretion. The non-physiological distribution site and the abnormal temporal pattern of insulin offered to diabetic children might be the reason for the protein abnormalities found in this study. This is seemingly the first time reduced serum levels of proteins have been reported in diabetic children.
ABSTRACT. The energy and nutrient intakes by 14 children with type I diabetes and 13 healthy peer... more 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.
Bjog-an International Journal of Obstetrics and Gynaecology, 1989
The interrelations between three placental hormones (oestradiol, progesterone and hPL), maternal ... more The interrelations between three placental hormones (oestradiol, progesterone and hPL), maternal glucose metabolism, maternal anthropometry and fetal growth were studied in a sample of 52 carefully selected pregnant women. A relation was found between infant birthweight and both fasting blood glucose and t½ of glucose of an intravenous glucose tolerance test at week 37 of pregnancy. The serum concentrations of the placental hormones were not significantly related to the glucose variables. The correlation between birthweight and the maternal levels of hPL in late pregnancy (r= 0·60) persisted when fasting blood glucose and tt½ of glucose were taken into account. Maternal fat mass was found to explain more of the Variation in basal insulin levels around week 37 than did the placental hormones.
ABSTRACT. This study was conducted in order to test the usefulness of measuring the concentration... more ABSTRACT. This study was conducted in order to test the usefulness of measuring the concentrations of selected serum proteins and acute phase reactants in assessing the nutritional status of children with undue susceptibility to acute infections. The concentrations of serum proteins were determined by an immunodiffusion technique in 28 children with undue susceptibility to infections and were compared with those in healthy children. The patients were grouped according to the clinical pattern, i.e. into children with mainly upper respiratory tract infections, with frequent middle ear infections and with lower respiratory tract infections. The total group and all three subgroups of patients had not only significantly lower (p < 0.001 or p < 0.01) mean serum levels of albumin and retinol-binding protein, but also of the acute phase reactants α2-macroglobulin and ceruloplasmin (p < 0.01) than the controls. No differences were observed between the patients and the controls in respect of the acute phase reactant orosomucoid. This study indicates that the concentrations of albumin and RBP along with selected acute phase reactants are rapidly influenced by altered nutritional status in children with undue susceptibility to acute infections.
ABSTRACT. Serum concentrations of iron, copper, zinc and magnesium and also serum transferrin and... more ABSTRACT. Serum concentrations of iron, copper, zinc and magnesium and also serum transferrin and ceruloplasmin were investigated in 28 children aged 10 months to 10 years with undue susceptibility to infections. None of the children had any classical immune defect. Seven of them had had frequent upper respiratory tract infections, 16 had suffered from frequent infections of the middle ear and five from mainly lower respiratory tract infections. Thirteen healthy children aged 9 to 18 years residing in the same area served as controls. The children with undue susceptibility to infections had significantly lower mean serum iron (p< 0.05) and zinc (p< 0.001) levels than the healthy controls. The mean serum concentrations of copper and magnesium and of transferrin and ceruloplasmin did not differ between the patients and controls. Children with frequent middle ear infections seemed to account for most of the differences in the serum levels of iron and zinc. An inverse correlation was observed between duration of breast feeding and serum concentration of zinc, and between weight as well as height and serum magnesium. The reasons for these changes and the possible role of trace element deficiency as a factor predisposing to or perpetuating undue susceptibility to infections in children are discussed.
The contents of iron, copper, zinc, calcium and magnesium were determined in human milk samples f... more The contents of iron, copper, zinc, calcium and magnesium were determined in human milk samples from 18 Ethiopian and 23 Swedish women. The Ethiopian women belonged to two groups with different socio-economic situations, a non-privileged and a privileged group. Both groups had an excessively high dietary iron intake–20 to 30 times that of the Swedish women–from the iron-rich traditional diet. In spite of this, the mean concentrations of iron in the milk, as well as of zinc and magnesium, were similar in all three groups. The mean copper concentration, however, was significantly lower in the Ethiopian than in the Swedish milk samples, the lowest mean value occurring in the privileged group. In contrast, a significantly higher mean calcium concentration was found in milk samples from the Ethiopian women than from the Swedish, the highest mean concentration being noted in the non-privileged group. The levels of minerals in breast milk showed no correlation to the birth weight of the infants or the length of gestation. Our data suggest that an excessively high dietary iron intake does not increase the breast milk content of iron in mothers with a good iron status. The reasons for the differences in the content of copper between the Ethiopian and Swedish milk samples are unclear. The higher calcium content in milk from the Ethiopian mothers, despite a low dietary calcium intake may be a result of an increased endogenous cholecalciferol synthesis due to greater exposure to sunshine.
Doubts have been raised about the effectiveness of carotene-containing foods in improving the vit... more Doubts have been raised about the effectiveness of carotene-containing foods in improving the vitamin A status of populations at risk. We investigated the effect of papaya and carrots on the vitamin A status of lactating women with 2-to 12-mo-old infants in Zimbabwe. The women were randomly assigned to three supplementation groups and a placebo group, and received 6 mg of -carotene capsules, 650 g puré ed papaya, 100 g grated carrots or a placebo, daily for 60 d. All groups were given a meal containing 10 g of vegetable oil daily. Serum retinol, relative dose response, serum ferritin, hemoglobin and C-reactive protein were measured before and after the supplementation period. Mean serum retinol increased significantly after supplementation in the -carotene group (P Ͻ 0.001), the papaya group (P Ͻ 0.001) and the carrot group (P Ͻ 0.001), but not in the placebo group (P Ͼ 0.05). The relative dose response decreased significantly (P Ͻ 0.05) in the -carotene and papaya groups, but not in the carrot or placebo groups (P Ͼ 0.05). There was an increase in mean serum ferritin in all groups but the increase did not differ among groups. The hemoglobin increases in the -carotene and papaya groups were greater than that in the placebo group. We conclude that puré ed papaya and grated carrots can improve the vitamin A and iron nutriture of lactating women. These findings reinforce the importance of plant food-based approaches in the control of vitamin A deficiency in low income countries.
Objective: To evaluate the long-term effects of a horticultural and nutrition education intervent... more Objective: To evaluate the long-term effects of a horticultural and nutrition education intervention in rural Tanzania. Design: A quasi-experimental post-test design was used. Setting: The research was carried out in 10 villages in Singida region, Tanzania. Subjects: Mothers and their children aged 6±71 months (n = 236) from an experimental (Ilongero) and control (Ihanja) area were interviewed regarding knowledge and practices related to vitamin A nutrition. Intake of vitamin A-rich foods by the children during the 7 days prior to the interview was recorded. Stools were examined for helminths and serum samples were analysed for retinol and C-reactive protein (CRP) (n = 146) for the children aged 12±71 months. Results: Knowledge and practices were more favourable to vitamin A intake in the experimental area than in the control area, and an increased frequency of intake of green leaves was associated with higher serum retinol values. The experimental area had lower mean serum retinol levels (13.7 mg dl -1 , n = 75) than the control area (19.3 mg dl -1 , n = 71). One likely confounder was the higher helminth infestation in the experimental area (n = 75, 79%) than in the control area (n = 71, 49%) (P , 0.001). Children with helminths (n = 94) had a lower mean serum retinol level than those without (n = 52) (12.3 6 5 vs. 24 6 10 mg dl -1 ; P = 0.001). Conclusions: Food-based vitamin A programmes can make sustainable improvements in knowledge and dietary practices but these may not necessarily be re¯ected in increases in serum retinol. Programme implementation and evaluation should take confounders into consideration as, in this case, helminth infestation.
Doubts have been raised about the effectiveness of carotene-containing foods in improving the vit... more Doubts have been raised about the effectiveness of carotene-containing foods in improving the vitamin A status of populations at risk. We investigated the effect of papaya and carrots on the vitamin A status of lactating women with 2-to 12-mo-old infants in Zimbabwe. The women were randomly assigned to three supplementation groups and a placebo group, and received 6 mg of -carotene capsules, 650 g puré ed papaya, 100 g grated carrots or a placebo, daily for 60 d. All groups were given a meal containing 10 g of vegetable oil daily. Serum retinol, relative dose response, serum ferritin, hemoglobin and C-reactive protein were measured before and after the supplementation period. Mean serum retinol increased significantly after supplementation in the -carotene group (P Ͻ 0.001), the papaya group (P Ͻ 0.001) and the carrot group (P Ͻ 0.001), but not in the placebo group (P Ͼ 0.05). The relative dose response decreased significantly (P Ͻ 0.05) in the -carotene and papaya groups, but not in the carrot or placebo groups (P Ͼ 0.05). There was an increase in mean serum ferritin in all groups but the increase did not differ among groups. The hemoglobin increases in the -carotene and papaya groups were greater than that in the placebo group. We conclude that puré ed papaya and grated carrots can improve the vitamin A and iron nutriture of lactating women. These findings reinforce the importance of plant food-based approaches in the control of vitamin A deficiency in low income countries.
Objective: To evaluate the long-term effects of a horticultural and nutrition education intervent... more Objective: To evaluate the long-term effects of a horticultural and nutrition education intervention in rural Tanzania. Design: A quasi-experimental post-test design was used. Setting: The research was carried out in 10 villages in Singida region, Tanzania. Subjects: Mothers and their children aged 6±71 months (n = 236) from an experimental (Ilongero) and control (Ihanja) area were interviewed regarding knowledge and practices related to vitamin A nutrition. Intake of vitamin A-rich foods by the children during the 7 days prior to the interview was recorded. Stools were examined for helminths and serum samples were analysed for retinol and C-reactive protein (CRP) (n = 146) for the children aged 12±71 months. Results: Knowledge and practices were more favourable to vitamin A intake in the experimental area than in the control area, and an increased frequency of intake of green leaves was associated with higher serum retinol values. The experimental area had lower mean serum retinol levels (13.7 mg dl -1 , n = 75) than the control area (19.3 mg dl -1 , n = 71). One likely confounder was the higher helminth infestation in the experimental area (n = 75, 79%) than in the control area (n = 71, 49%) (P , 0.001). Children with helminths (n = 94) had a lower mean serum retinol level than those without (n = 52) (12.3 6 5 vs. 24 6 10 mg dl -1 ; P = 0.001). Conclusions: Food-based vitamin A programmes can make sustainable improvements in knowledge and dietary practices but these may not necessarily be re¯ected in increases in serum retinol. Programme implementation and evaluation should take confounders into consideration as, in this case, helminth infestation.
Doubts have been raised about the effectiveness of carotene-containing foods in improving the vit... more Doubts have been raised about the effectiveness of carotene-containing foods in improving the vitamin A status of populations at risk. We investigated the effect of papaya and carrots on the vitamin A status of lactating women with 2-to 12-mo-old infants in Zimbabwe. The women were randomly assigned to three supplementation groups and a placebo group, and received 6 mg of -carotene capsules, 650 g puré ed papaya, 100 g grated carrots or a placebo, daily for 60 d. All groups were given a meal containing 10 g of vegetable oil daily. Serum retinol, relative dose response, serum ferritin, hemoglobin and C-reactive protein were measured before and after the supplementation period. Mean serum retinol increased significantly after supplementation in the -carotene group (P Ͻ 0.001), the papaya group (P Ͻ 0.001) and the carrot group (P Ͻ 0.001), but not in the placebo group (P Ͼ 0.05). The relative dose response decreased significantly (P Ͻ 0.05) in the -carotene and papaya groups, but not in the carrot or placebo groups (P Ͼ 0.05). There was an increase in mean serum ferritin in all groups but the increase did not differ among groups. The hemoglobin increases in the -carotene and papaya groups were greater than that in the placebo group. We conclude that puré ed papaya and grated carrots can improve the vitamin A and iron nutriture of lactating women. These findings reinforce the importance of plant food-based approaches in the control of vitamin A deficiency in low income countries.
Objective: To evaluate the long-term effects of a horticultural and nutrition education intervent... more Objective: To evaluate the long-term effects of a horticultural and nutrition education intervention in rural Tanzania. Design: A quasi-experimental post-test design was used. Setting: The research was carried out in 10 villages in Singida region, Tanzania. Subjects: Mothers and their children aged 6±71 months (n = 236) from an experimental (Ilongero) and control (Ihanja) area were interviewed regarding knowledge and practices related to vitamin A nutrition. Intake of vitamin A-rich foods by the children during the 7 days prior to the interview was recorded. Stools were examined for helminths and serum samples were analysed for retinol and C-reactive protein (CRP) (n = 146) for the children aged 12±71 months. Results: Knowledge and practices were more favourable to vitamin A intake in the experimental area than in the control area, and an increased frequency of intake of green leaves was associated with higher serum retinol values. The experimental area had lower mean serum retinol levels (13.7 mg dl -1 , n = 75) than the control area (19.3 mg dl -1 , n = 71). One likely confounder was the higher helminth infestation in the experimental area (n = 75, 79%) than in the control area (n = 71, 49%) (P , 0.001). Children with helminths (n = 94) had a lower mean serum retinol level than those without (n = 52) (12.3 6 5 vs. 24 6 10 mg dl -1 ; P = 0.001). Conclusions: Food-based vitamin A programmes can make sustainable improvements in knowledge and dietary practices but these may not necessarily be re¯ected in increases in serum retinol. Programme implementation and evaluation should take confounders into consideration as, in this case, helminth infestation.
Bjog-an International Journal of Obstetrics and Gynaecology, 1989
The interrelations between three placental hormones (oestradiol, progesterone and hPL), maternal ... more The interrelations between three placental hormones (oestradiol, progesterone and hPL), maternal glucose metabolism, maternal anthropometry and fetal growth were studied in a sample of 52 carefully selected pregnant women. A relation was found between infant birthweight and both fasting blood glucose and t½ of glucose of an intravenous glucose tolerance test at week 37 of pregnancy. The serum concentrations of the placental hormones were not significantly related to the glucose variables. The correlation between birthweight and the maternal levels of hPL in late pregnancy (r= 0·60) persisted when fasting blood glucose and tt½ of glucose were taken into account. Maternal fat mass was found to explain more of the Variation in basal insulin levels around week 37 than did the placental hormones.
Objectives. To analyze the influence of thumb sucking and pacifier use on breastfeeding patterns ... more Objectives. To analyze the influence of thumb sucking and pacifier use on breastfeeding patterns in exclusively breastfed infants, on the duration of exclusive breastfeeding, and on the total breastfeeding duration.
Objective: To investigate and compare feeding practices among infants of less than 7 months of ag... more Objective: To investigate and compare feeding practices among infants of less than 7 months of age in a rural and an urban area in Tanzania. Design: Cross-sectional, questionnaire-based interview of mothers and focus group discussions with extension workers and community leaders. Setting: Eleven villages in a rural district and 10 wards in an urban district in the Morogoro region, Tanzania, west of Dar es Salaam. Subjects: Probability samples of mothers with infants of less than 7 months of age n 320 from each area). Results: Exclusive breast-feeding was rarely practised in either the rural or urban areas investigated. However, the urban mothers initiated breast-feeding earlier, discarded colostrum less frequently, breast-fed exclusively for a longer period, gave breast milk as the first feed more often and delayed the introduction of solid foods for longer than their rural counterparts. The rural mothers, on the other hand, breastfed their previous infants slightly longer than the urban mothers. Conclusions: The better performance of urban mothers could be partly due to sustained breast-feeding support in hospital settings and other campaigns which may not have reached the rural areas. In both the rural and urban areas more efforts are needed to encourage exclusive breast-feeding, to avoid premature complementation and, in the case of the urban areas, to protect extended breast-feeding.
Hörnell A, Aarts C, Kylberg E, Hofvander Y, Gebre-Medhin M. Breastfeeding patterns in exclusively... more Hörnell A, Aarts C, Kylberg E, Hofvander Y, Gebre-Medhin M. Breastfeeding patterns in exclusively breastfed infants: a longitudinal prospective study in Uppsala, Sweden. Acta Paediatr 1999; 88: 203-11. Stockholm. ISSN 0803-5253 Exclusive breastfeeding was studied among 506 infants in Uppsala, Sweden, based on daily recordings during the first 6 mo. The mothers had previously breastfed at least one infant for at least 4 mo. Most of the mothers considered that they breastfed on demand. Wide variations in breastfeeding frequency and suckling duration were found both between different infants and in the individual infant over time. At 2 wk, the mean frequency of daytime feeds (based on one 13-d record) between different infants ranged from 2.9 to 10.8 and night-time feeds from 1.0 to 5.1. The daytime suckling duration (based on one 24-h record) ranged from 20 min to 4h 35 min and night-time duration from 0 to 2h 8 min. At any given age, a maximum of only 2% of the infants were not breastfed during the night. At 4 mo, 95% of the infants were breastfeeding and 40% were exclusively breastfed at this age. Longer breastfeeding duration and longer duration of exclusive breastfeeding were both associated with higher frequency of breastfeeds, longer breastfeeding of the previous child and higher education. No gender differences were found. Maternal smoking was associated with shorter duration of exclusive breastfeeding, and pacifier use was associated with shorter duration of both exclusive breastfeeding and total breastfeeding. This study confirms that every mother-infant pair needs to be understood as a unique dyad throughout lactation. These data demonstrate a wide range of patterns among women who are exclusively breastfeeding and indicate that it would be inappropriate to put pressure on individual families to adopt preconceived patterns of infant feeding.
Maternal smoking, studied in late pregnancy, was found to be associated with lower blood glucose ... more Maternal smoking, studied in late pregnancy, was found to be associated with lower blood glucose values, both during fasting and after an intravenous glucose load. As a correlation between blood glucose levels and infant birth weight has been reported, it is possible that smoking during pregnancy might reduce fetal growth through an effect on maternal glucose metabolism.
ABSTRACT. Twenty-seven diabetic children, 16 girls and 11 boys, 5–18 years of age, with a duratio... more 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.
The relations between some hereditary and environmental factors and the variation in infant birth... more The relations between some hereditary and environmental factors and the variation in infant birth weight were estimated by multiple linear regression analyses on a sample of 276 Scandinavian single term pregnancies.Gestational age explained 10.9%, fetal factors (maternal and paternal birth weights and fetal sex) 7.9%, maternal factors (parity, pre-pregnancy weight and height) 5.5% and external factors (adjusted weight gain and smoking) 5.8% of the variation in infant birth weight.It is concluded that maternal and paternal birth weights are rather poor predictors of infant birth weight. Together they explain only 5.6% of the variation in infant birth weight at term.
Bjog-an International Journal of Obstetrics and Gynaecology, 1987
Summary. During the second pregnancy of 56 Swedish women resulting in a term birth, energy intake... more Summary. During the second pregnancy of 56 Swedish women resulting in a term birth, energy intake and physical activity were measured for 3 days at weeks 17 and 33. The values were related to maternal lean body mass, pregnancy weight gain, maternal fat accretion and infant birth-weight by multiple linear regression analyses. A significant regression coefficient was found for energy intake at week 17 on maternal fat accretion. Energy intake was not significantly correlated with infant birthweight, not even when physical activity and maternal lean body mass were taken into account. Thus in a well-nourished Swedish population, energy intake is positively related to maternal fat accretion but not to the birthweight of term infants.
ABSTRACT. The concentrations of selected proteins of transport and nutrition were investigated in... more ABSTRACT. The concentrations of selected proteins of transport and nutrition were investigated in 27 diabetic children and 13 healthy controls by an immunodiffusion technique. The diabetic children had significantly lower mean pre-albumin (p<0.001), albumin (p<0.01) and orosomucoid levels (p<0.05) than the healthy controls. No correlation was observed between age or sex and the blood concentrations of the specific proteins analyzed in this series. Haptoglobin and hemopexin showed positive correlations with serum triglycerides (both p<0.01) and slight positive correlations with some of the variables of carbohydrate control. The reduced levels of prealbumin and albumin were not correlated to diabetic control as measured by HbA1, fasting plasma glucose or urinary glucose excretion. The non-physiological distribution site and the abnormal temporal pattern of insulin offered to diabetic children might be the reason for the protein abnormalities found in this study. This is seemingly the first time reduced serum levels of proteins have been reported in diabetic children.
ABSTRACT. The energy and nutrient intakes by 14 children with type I diabetes and 13 healthy peer... more 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.
Bjog-an International Journal of Obstetrics and Gynaecology, 1989
The interrelations between three placental hormones (oestradiol, progesterone and hPL), maternal ... more The interrelations between three placental hormones (oestradiol, progesterone and hPL), maternal glucose metabolism, maternal anthropometry and fetal growth were studied in a sample of 52 carefully selected pregnant women. A relation was found between infant birthweight and both fasting blood glucose and t½ of glucose of an intravenous glucose tolerance test at week 37 of pregnancy. The serum concentrations of the placental hormones were not significantly related to the glucose variables. The correlation between birthweight and the maternal levels of hPL in late pregnancy (r= 0·60) persisted when fasting blood glucose and tt½ of glucose were taken into account. Maternal fat mass was found to explain more of the Variation in basal insulin levels around week 37 than did the placental hormones.
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