Maria Amélia Amado Rivera

Magnitude, geographic distribution and trends of anemia in preschoolers, Brazil

OBJECTIVE To assess the magnitude, geographical distribution and trends of the prevalence of nutritional anemia among preschoolers and to identify risk groups in the state of Paraiba, Brazil. METHODS A cross-sectional survey with multistage random sampling procedure was conducted in 8 urban municipalities of three mid-regions (Zona da Mata, Agreste and Sertão) in the state of Paraíba in 1992. A total of 1,287 preschoolers of both sexes were selected. Hemoglobin was determined by the cyanometahemoglobin method in venous blood, employing <11 g/dl as the cut-off for anemia. Statistical analysis of proportions employed the chi Square test, whereas for means Mann-Whitney and Kruskal-Wallis were the choice, all with confidence interval of 95%. RESULTS The prevalence of anemia was 36.4% (CI 33.7 - 39.1) in the state of Paraiba, greater (p=0.00) than that observed (19.3%, CI 17.3 - 21.5) in 1982. Only 1.0% (CI 0.61 - 1.8) and 6.8% (CI 5.5 - 8.3) of anemia cases were classified as severe and moderate, respectively. Boys presented lower mean hemoglobin concentration (p=0.00), and children under age 3 comprised the biological group of highest susceptibility for deficiency status (p= 0.00). It was found that the second year of life is the most critical for developing nutritional deficiency (p= 0.00). The Agreste mid-region revealed to be the geographical area of highest risk (p= 0.00), outlining a new epidemiological dynamics when compared to the year 1982, when the drought-ridden Sertão region were the geographical area at greatest risk of deficiency. CONCLUSIONS According to international epidemiological criteria, anemia in the studied regions represents a public health problem of moderate degree Assuming the analytical comparability of the 1982 and 1992 cross-sectional surveys, it suggests an increasingly prevalence of nutritional anemia (+88.5%) in all 3 mid-regions in a 10-year-period (1982-92).

Relation between glucose levels, high-sensitivity C-reactive protein (hs-CRP), body mass index (BMI) and serum and dietary retinol in elderly in population-based study

The aim of this study was to evaluate the relationships between fasting glucose levels, hs-CRP, BMI and serum retinol and diet in elderly people. For this study, a cross-sectional, epidemiological, population-based format was adopted. One hundred and sixty-three individuals between 60 and 90 years of age participated; the participants were from different socioeconomic and health backgrounds, except for the individuals diagnosed with diabetes. Most subjects had serum concentrations in the reference ranges for all variables. There was not a significant relationship between fasting glucose and serum retinol or diet. There was a significant correlation between hs-CRP and BMI (r=0.22, p=0.0082) and hs-CRP and total calorie intake (p=0.0091), which reinforces the notion that an increased intake of calories results in being overweight and/or obese. Considering the importance of vitamin A in various physiological processes, more studies on these relationships are necessary to establish a recommendation of vitamin A for the treatment and prevention of changes in fasting glucose and obesity in the elderly population.

Impacto da multimistura no estado nutricional de pré-escolares matriculados em creches

OBJECTIVE: The objective of this study was to evaluate the impact of a diet supplemented with a bran-based cereal mixture on the nutritional status of preschool children presenting nutritional risk. METHODS: This was a two-month double-blinded study with a longitudinal follow up using 135 children with ages ranging from one to six years old and divided into three groups: intervention 1 (GI1=48), intervention 2 (GI2 n=45) and control (CG n=42), receiving 5g and 10g of the multi-mixture and placebo, respectively. The nutritional situation of the children in the study was evaluated before and after supplementation. RESULTS: No significant differences were observed in the weight/age, height/age and weight/height indicators at the base line (p=0.251 p=0.248 and p=0.399 respectively) between the groups studied. After intervention, the difference between the groups in the prevalence of anthropometrical deficit was also not significant (p=0.100 p=0.435 and p=0.210 respectively) and a comparison of the averages before and after intervention revealed no differences (p>0.05 using the Kruskall - Wallis and Analysis of Variance statistical methods). CONCLUSION: In the specific case of the bran-based mixture, the impact of the small amounts of supplement ingested did not warrant expecting alterations in the recovery of children presenting nutritional risk, since these supplements contain only small amounts of calories and macro and micronutrients.

Estudo caso-controle sobre exposição precoce ao leite de vaca e ocorrência de Diabetes Mellitus tipo 1 em Campina Grande, Paraíba

OBJECTIVES: to study the relationship between early exposure to cows milk and Diabetes Mellitus, type 1 among children under 18 years old seen at the Hospital Universitario Alcides Carneiro, in Campina Grande. METHODS: case-control study. Sample of 128 individuals of both sexes. Sixty-four mothers with Diabetes Mellitus type 1 and 64 mothers of a control group. Univariate and multivariate analysis was accomplished through logistic and conditional regression. RESULTS: 84,4% of diabetic individuals were exposed to cow mild before four months of age while in the control group this percentage was 64,1%. Univariate analysis determined a significant statistic association between early exposure to cows milk and Diabetes (p = 0,01). In multivariate analysis this association remained and estimated odds ratio was of 4,09 (95% CI: 14,04; p = 0,01). CONCLUSIONS: results indicate a strong association between children with early exposure to cows milk and Diabetes Mellitus type 1 events in the population studied. Therefore, children with early exposure to cows milk have a higher chance of acquiring the disease when compared with those who were exclusively breastfed until at least until four months old.