Lechaim Naggan

Maternal recall of infant feeding events is accurate.

STUDY OBJECTIVE--Retrospective infant feeding data are important to the study of child and adult health patterns. The accuracy of maternal recall of past infant feeding events was examined and specifically the infants age when breast feeding was stopped and formula feeding and solid foods were introduced. DESIGN AND SETTING--The sample consisted of Bedouin Arab women (n = 318) living in the Negev in Israel who were a part of a larger cohort participating in a prospective study of infant health and who were delivered of their infants between July 1 and December 15, 1981. Data from interviews conducted 12 and 18 months postpartum were compared to the standard data collected six months postpartum. MAIN RESULTS--As length of recall increased there was a small increase in the mean difference, and its standard deviation, between the standard and recalled age when breast feeding was stopped and formula feeding and solid foods were started. Recall on formula feeding was less accurate than recall on solid foods and breast feeding. In particular, among those 61% reporting formula use at the six month interview, 51% did not recall introducing formula when interviewed at 18 months. The odds ratio (95% CI) of stunting versus normal length for age for formula fed versus breast fed infants based on recall data (OR = 2.07; 95% CI 0.82-5.22) differed only slightly from those based on the standard data (OR = 2.21; 95% CI 0.77-6.37). The accuracy of a mothers recall varied with her childs nutritional status at the time of the interview, but not with other sociodemographic, infant, or interviewer characteristics. CONCLUSIONS--Retrospective infant feeding data based on maternal recall of events up to 18 months in the past can be used with confidence in epidemiological studies. However, data on formula feeding may not be as accurate as data on breast feeding and solid food feeding, and accuracy may decrease as length of recall increases.

Giardia lamblia carriage in Israeli Bedouin infants: risk factors and consequences.

Giardiasis is a common protozoan infection, with varying clinical manifestations. We investigated the associations between Giardia lamblia carriage and environmental, family, illness, and growth characteristics. Bedouin infants (n=234) were followed from birth to age 18-23 months. At monthly home visits, stool samples were obtained, history of illness was determined, and an environmental assessment was done. The comparisons presented are between 4 groups defined by length of carriage of G. lamblia. Study children had a mean+/-SD of 4.1+/-2.9 diarrhea episodes. No illness, environmental, or family characteristics were associated with length of carriage. Significant differences were found in weight-for-age and weight-for-height z scores between the never-positive-for-G. lamblia group and all other carriage groups combined. Faltering growth was shown to be subsequent to G. lamblia infection rather than preceding it. Our findings confirm that G. lamblia carriage is not associated with diarrhea. However, the effect on growth deserves further investigation.

HCV antibodies in saliva and urine

Infection with hepatitis C virus (HCV) is usually established by detection of serum antibodies (anti‐HCV). This study was conducted in order to evaluate whether saliva and urine may substitute serum for anti‐HCV detection. Serum, saliva, and urine were obtained simultaneously from 141 patients with a variety of liver diseases and from 52 patients with autoimmune diseases (systemic lupus erythematosus n = 27 and rheumatoid arthritis n = 25). The cell free fraction of saliva and urine samples was tested for anti‐HCV using a modification of a serum anti‐HCV kit. Western blot analysis was used as a confirmation method. Of the patients with liver diseases, 73 were anti‐HCV‐seropositive. Salivary and urinary anti‐HCV could be detected in 66 (90%) and 36 (49%) of the anti‐HCV‐serpositive patients, respectively. The presence of anti‐HCV in saliva or urine was not related to the severity of liver disease. All the anti‐HCV‐seronegative liver patients were negative for salivary anti‐HCV and 22 (32%) had urinary anti‐HCV. The patients with autoimmune diseases were all anti‐HCV‐seronegative. None had detectable salivary anti‐HCV while 33 (63%) were positive for urinary anti‐HCV. Western Blot analysis confirmed the presence of anti‐HCV in all serum and saliva samples tested but only in 2/12 urine samples. The results suggest that saliva, but not urine, may serve as a substitute for serum for the determination of anti‐HCV positivity. J. Med. Virol. 55:24–27, 1998.

Mediterranean diet and functional indicators among older adults in non-Mediterranean and Mediterranean countries

Background/ObjectivesThe Mediterranean diet (MEDDIET) has been shown to be related to longevity. This study aimed to determine the association between adherence to MEDDIET and physical function of older adults in the United-States and Israel.MethodsData from the US National Health and Nutrition Survey (NHANES) 1999–2002 and from the Israeli National Health and Nutrition Survey (MABAT ZAHAV) 2005–2006 were used. Participants with nutritional and functional data were included. Adherence to the MEDDIET was assessed by a 9-unit score (MDS).ResultsAmong 2791 NHANES and 1786 MABAT ZAHAV participants, mean age=71.2y and 74.9y, 20% and 27% had low MDS (0–2), 66% and 62% had a medium score (3–5), and 14% and 11% had a high score (6–9), respectively. Higher MDS was associated with higher education and better lifestyle behaviors. Cognitive and physical functions were significantly better in NHANES and MABAT ZAHAV among the highest MDS. In NHANES, MDS (high vs. low) was associated with faster walking speed after adjusting for confounders in a logistic regression model [Odds Ratio (OR)=0.71, P=0.034, Cl 95% 0.511–0.974]. When cognitive function was added, the association was attenuated (OR=0.75, P=0.093, Cl 95% 0.540–1.049). In MABAT ZAHAV, in a logistic regression model adjusted among other to cognitive function, MDS (high vs. low) was associated with fewer disabilities (OR=0.51, P=0.029, Cl 95% 0.276–0.934).ConclusionsAdherence to the MEDDIET is associated with better health characteristics and better functioning. Further cohort and intervention studies may shed light on temporal and causal relationships between MEDDIET and these parameters.

Persistent Diarrhea in a Cohort of Israeli Bedouin Infants: Role of Enteric Pathogens and Family and Environmental Factors

This study examined the role of enteric pathogens and infant, family, and household characteristics in persistent diarrhea. Bedouin infants from southern Israel were followed from birth to age 18-23 months. During monthly home visits, stool samples were obtained, and feeding practices and history of diarrhea were determined, and at age 3 months, an environmental assessment was done. Diarrhea surveillance was either via a network covering all community health care facilities or via weekly interviews with the mother. None of the enteric pathogens examined, including Cryptosporidium parvum and enteroaggregative Escherichia coli, were associated with persistent diarrhea. In multivariate analyses, age at first diarrheal illness and maternal age and maternal education were independently and significantly associated with the risk of persistent diarrhea. These data suggest that persistent diarrhea is a clinical entity that may be related less to a specific enteric pathogen and more to the health experiences of children and their home environment.

Parental feeding practices in relation to low diet quality and obesity among LSES children.

Objective: To examine the relationships between parental feeding practices, diet quality, overweight, and obesity among low-socioeconomic status (LSES) preschoolers. Research Methods and Procedures: A cohort of preschool children (aged 5–6) and their mothers was recruited from November 2009 to December 2009. To overcome seasonal and personal variation in dietary intake, 3 replications of the Food Frequency Questionnaire (FFQ) and a parental Feeding Practices Questionnaire (CFPQ) were obtained in person at baseline, 3 months from baseline, and 6 months from baseline. Anthropometric measurements were attained at preschool class on the same dates. Scores of the 12 factors of the CFPQ were calculated and related to dietary intake. Correlation coefficients between the mean energy and fat intake and CFPQ factors’ scores were calculated. One-way analysis of variance with post hoc analyses was used to compare nutrient intake and anthropometric measures across CFPQ tertiles. Results: Preschoolers (n = 63), aged 64.4 ± 5.0 months (47% boys), were recruited. Unhealthy feeding practices including food as a reward for good behavior and food restriction for promoting health were associated with increased consumption of junk food, sweets, and snacks. Among healthy feeding practices, encouraging balance and food variety and healthy eating modeled by parents were associated with increased vegetable consumption and smaller waist circumference. Weight was negatively associated with factors that reflect parental pressure and food restriction for weight control. Conclusions: Our data showed that certain feeding practices relate to a higher diet quality and lower weight and waist circumference. These practices may be encouraged in order to improve diet quality and prevent overweight and obesity.

Antibody Pattern to Human Cytomegalovirus in Patients with Adenocarcinoma of the Colon

The role of human cytomegalovirus (CMV) was examined according to serological patterns in 37 patients with adenocarcinoma of the colon (ACC). The sera were examined for the presence of IgG antibodies by the immunoperoxidase antibody to membrane antigens (IPAMA) method and by the complement-fixation (CF) test. Antibody determinations were also performed by the IPAMA method for three other members of the herpesvirus group: Epstein-Barr virus (EBV), herpes simplex virus (HSV) and varicella-zoster virus (VZV). Comparison groups included normal subjects, ACC patients treated with chemotherapy, and patients operated on for benign diseases. No significant difference was found in the geometric mean titers (GMTs) for CMV and the other herpesviruses in the sera of nontreated ACC patients when compared with the control groups. However, a significantly elevated antibody titer to CMV was found in chemotherapy-treated ACC patients by both the IPAMA and CF methods. In this group, elevated titers were found by the IPAMA method for EBV and HSV, but not for VZV. The significance of serological studies in elucidating the role of CMV in ACC patients is discussed.

Maternal knowledge and environmental factors associated with risk of diarrhea in Israeli Bedouin children

Diarrhea is still a major cause of morbidity and mortality among children in developing countries. As it is due to multiple causative agents including viruses, bacteria and parasites, biological interventions are not currently available to markedly reduce incidence and severity. We examined maternal knowledge and reported behavior during diarrheal episodes, as well as environmental factors to determine their association with diarrhea. The children and mothers were from a Bedouin township in southern Israel, which has developed preventive and curative health care facilities. The Bedouin population in Israel is in transition from a nomadic to a settled life style. While almost all mothers exhibited good knowledge regarding food storage and prevention of diarrhea episodes in the children, the rate of illness in the children remained relatively high (two episodes per child year of observation). In a multivariate analysis, cessation of breastfeeding during diarrhea, child sleeping with siblings and lack knowledge about risk factors, were the major risk factors for illness with odds ratios (OR): 4.6, p = 0.02, 5.6, p = 0.03 and 1.7, p = 0.06, respectively. These data indicate that even in this population with free access to preventive medical care, greater efforts should be made to educate mothers regarding risk factor for diarrheal disease identification and the benefits of maintaining breastfeeding during diarrhea episodes.