Sheila M. Maxwell

Ochratoxin A and aflatoxins in breast milk samples from Sierra Leone.

Breast milks from 113 mothers in two ‘Under-Five Clinics’ in the Southern Province of Sierra Leone, namely, Njala and Bo, were examined for their mycotoxin content. Only 10 were mycotoxin-free. Eighty-eight per cent of samples contained various aflatoxins and 35% contained ochratoxin A (OTA). Few samples (15%) had a single mycotoxin. Thirty-six (32%) had two mycotoxins and 50 (40%) had three or more. The occurrence of OTA in combination with various aflatoxins was recorded. It is concluded that infants in Sierra Leone are exposed to OTA and aflatoxins at levels which in some cases far exceed those permissible in animal feed in developed countries.

Human fetal exposure to ochratoxin A and aflatoxins

Analysis of 64 cord blood samples from pregnant women in Sierra Leone revealed the presence of ochratoxin A (OTA) and aflatoxins in 25% and 58% of samples, respectively. Of the eight maternal blood samples collected during delivery, one contained OTA and aflatoxins were detected in six. There was no relationship between mycotoxins in maternal and cord blood. The effect these toxins might have had on the birthweight of infants is discussed.

AFLATOXINS IN THE LUNGS OF CHILDREN WITH KWASHIORKOR AND CHILDREN WITH MISCELLANEOUS DISEASES IN NIGERIA

Autopsy lung specimens from 20 children with kwashiorkor and 20 with other miscellaneous diseases, at the Obafemi Awolowo Teaching Hospital complex, Ile-Ife, Nigeria, were analyzed for the presence of aflatoxin using high-performance liquid chromatography. Aflatoxins were detected in 18 children who died from kwashiorkor but only in 13 of those who died from miscellaneous diseases. Of the 10 children, 5 in each group, who died with pneumonia, all had detectable levels of aflatoxins in their lungs. The two children with congestive cardiac failure, one secondary to pneumonia and the other secondary to tuberculous pericarditis, had more than two detectable aflatoxins in their lungs. These findings demonstrate that Nigerian children are exposed to aflatoxins and that high levels can accumulate in lung tissue.

Aflatoxins in the autopsy brain tissue of children in Nigeria

Autopsy brain (cerebrum) specimens from 18 kwashiorkor children and 19 children who had died from a variety of other diseases, at the Obafemi Awolowo Teaching Hospital complex, Ile-Ife, Nigeria, were analysed for the presence of aflatoxins using high-performance liquid chromatography. Aflatoxins were detected in 81%, 15 specimens in each group. More than one type of aflatoxin was detected in 14 (37.8%) of all the specimens. Aflatoxin B1 and its reversible metabolite, aflatoxicol, were detected in 11 brain specimens of patients with kwashiorkor and 6 of those who died of other miscellaneous diseases; out of these 6, two died from measles and its complications. The frequent detection of aflatoxins in the brains of these children and sometimes in multiple forms may suggest that aflatoxins are stored in the brain tissue which could be related to the lipophilic nature of these compounds. These findings also suggest that although many children in the tropics are exposed to aflatoxins, the accumulation of aflatoxin B1 and aflatoxicol in the brains of kwashiorkor children may be a result of an impaired metabolism of these compounds by these children.

Dieting behavior among 11–15-year-old girls in Merseyside and the Northwest of England

PURPOSE To examine the general dieting behavior and characteristics of adolescent girls in the United Kingdom, and in particular, the Northwest of England. METHODS A total of 569 girls, ages 11-15 years, from six schools in the Merseyside and Lancashire area, representing a cross-section of social status, completed a nonstandardized questionnaire concerning general dieting behavior. Data were analyzed using SPSS (p < .05 was considered significant). RESULTS The incidence of dieting was 35.3%. The earliest reported age of starting to diet was 8 years. Significantly more girls from the independent schools (45.2%) had started to diet by the age of 10 years, compared to girls from the comprehensive schools (24%) (p = .03). Of those who had dieted, 30.3% had dieted up to two times during the previous 12 months, 17.4% had dieted up to four times, and 6% had dieted for most of the time. Most girls (33%) dieted for 2-4 weeks at a time, and 66% thought that dieting was good for their health. Only 52% said their parents did not approve of them dieting. Most girls (42.1%) dieted because they felt they were too fat. CONCLUSION This study has shown that many young girls are engaging in potentially harmful dieting practices from a very early age, and are of the opinion that dieting is a healthy activity. This would suggest that many misconceptions are held with regard to nutritional advice and education, and that such information should be reviewed and changed accordingly.

Food Coping Strategies: A Century on from Rowntree

The objectives of this study were to update Rowntrees food estimates to bring them into line with contemporary food habits and changing lifestyles; to determine whether food budgeting/coping strategies of low income households observed by Rowntree at the turn of the century were still prevalent in low income groups today: and to evaluate whether expenditure by low income households on food was sufficient to meet minimum dietary recommendations. Two hundred questionnaires were completed face to face with the interviewer within the Merseyside boundary and included only those households who were in the Post code area. Many low income households are unable to access a healthier diet due to income limitations. Many used a variety of coping strategies to stretch their incomes and were also found to rely on help from outside the immediate family such as extended family and friends and voluntary agencies. Households with children were found to be spending slightly more on food than the reconstructed Rowntree minimum dietary. There are thus two issues; firstly that there are households spending slightly more than the minimum yet that are unable to achieve a healthy diet. Secondly all the low income households are spending much less per person than the average person in the United Kingdom. It is concluded that whilst sterling work is being achieved within health promotion departments and within community health settings there is still a great deal to be undertaken. The value of Home Economics teaching in schools should be better recognised, and Home Economics should be reinstated in the National Curriculum. Secondly it is recommended that a standard approach be adopted to inform both welfare benefit payments and in-work top up payments, thus allowing households on low incomes to make informed choices within a budget that will accommodate healthier eating strategies.

The nutritional knowledge and attitudes of 11–12 year olds from four different European countries: A pilot project

Abstract Introduction The incidence of nutrition related diseases features to varying extents in different countries (WHO 1998). Individuals need to be provided with nutritional knowledge and skills to enable them to consume a healthy diet. Potentially, the main arena for providing children and adolescents with nutritional knowledge and skills is school. The aim of this study was to compare the knowledge and attitudes of adolescents in England [Merseyside] (E), Northern Ireland (NI), Sweden (S) and Lithuania (L). Methods A questionnaire was designed, which examined attitudes to aspects of healthy eating and tested the subjects knowledge, both practical and theoretical, of nutrition and healthy eating. Subjects aged 11–12 years were recruited (E 541, NI 128, S 87, L 50). Results Although significant differences were found between countries for nearly all attitude statements, the majority from all countries ‘liked the taste of healthy food’, ‘understood what to eat to have a healthy diet’, considered that ‘there were healthy foods at home’, that ‘healthy eating was important’ and that ‘their health in the future may be affected by what they eat today’. Poor knowledge concerning fat, carbohydrates and dietary fibre, and good knowledge of fruit and vegetables, breakfast cereals and salt were recorded. The mean percentage total and theoretical knowledge scores (correct answers) from England and the practical score from Lithuania were significantly higher than those from the other countries (p <0.05). Conclusions Adolescents from all countries have a positive attitude to healthy eating, however their knowledge appears not always to provide them with the means of making healthy eating choices.