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Few food tables exist for traditional Caribbean foods eaten by the British African-Caribbean (AFC) Community. This paper presents nutritional composition of dishes currently eaten by British AFCs (mainly from Jamaica) compared with the same dishes eaten in Jamaica 10 years previously. Nutritional analysis values for macronutrients were calculated by weighting raw ingredients at every stage of preparation in both sites. These weights were entered into a dietary analysis package "Microdiet". The macronutrient composition (only protein and energy available) was then compared to that obtained 10 years previously in Jamaica. Despite the small number of recipes per dish, between site composition is very similar for energy in both countries with some variation in protein. Fried food varied most probably because of oil dripping. Further work is needed but this small study has provided data for analysing dietary records on these populations (AU)

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In a prospective study, 163 moderately malnourished children, living in the slums of Kingston, were followed up for one year. The anthropometric measurements in weight and length in those children receiving a High Energy Supplement (HES), and in wasting in those receiving, additionally, a course of metronidazole (MET) have been previously reported. The point prevalence as assessed by positive stool tests for helminths and parasites of the children treated with metronidazole, and if deemed necessary with mebendazole, increased significantly over the period of one year concurrent with improvement of their nutritional status (chi-2 = 13.57; p < .001). A significant increase was observed in both the supplemented and unsupplemented group (chi-2 = 3.98; p < .05 and chi-2 = 5.31; p < .05 respectively). Children receiving health care (HC) only, or health care and a high energy supplement (HC/HES) failed more than twice (17 per cent) as often the community-based management as those receiving additional metronidazole (HC/MET and HC/HES/MET) (8 per cent). Admissions to hospital for full nutritional and clinical recovery in the HC/HES group were mostly for enteric infections and septicaemia, while children in the MET groups were admitted for respiratory tract infections leading to anorexia. Malnourished children, managed in the community, are less likely to be admitted for failure if a course of metronidazole and mebendazole is given combined with their rehabilitation, using HES. This treatment reduces social and nutritional costs to the child, as well as costs to the public health service (AU)

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During a study of nutrition in pregnancy, the diets of 108 Jamaican pregnant women were assessed by single 24-hour recalls. The women were 16-45 years old, of mixed parity (0-9), attended private (23 percent) and public (77 percent)antenatal clinics and differed in stage of pregnancy at interview. Mean energy intake (2110ñ739 kcal/d) was low, 83 per cent of the average Recommended Dietary Allowance for the Caribbean (CFNI 1976). Most (76 percent) women had low energy and dietary iron (75 percent) intakes. Fewer women had low riboflavin (42 percent) or protein intakes (29 percent). Maternal age, parity, obstetric performance, and unusual cravings influenced maternal nutrition to some extent. Dietary assessments overestimated the risk of maternal malnutrition. (AU)

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A survey was conducted on 145 toddlers, 6-36 months of age, in a suburb in Kingston, Jamaica. The aim of the study was to measure the prevalence of and association between parasitism and nutritional status. Forty-two per cent were malnourished (<80 percent of standard weight for age), most commonly (76 percent) in the 12-17 month age group. Thirty-four per cent had one or more parasites, particularly Trichuris trichuria (21 percent) or Ascaris lumbricoides (19 percent). The peak prevalence of parasitism was among the 30-36 month old children (63 percent). Nutritional status did not differ between children with and without parasites. Most of them had light intensities of infection. Therefore, in this sample, there was no association between parasitism and nutritional status (AU)

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The kinetics of urea metabolism were measured in four adults with homozyguous sickle cell disease (HbSS). On a dietary intake of 1.2 to 2.7g protein /kg/d. A relatively small proportion of the urea was excreted in the urine (40 per cent), with a high fixed rate of hydrolysis in the bowel, 145 mg nitrogen /kg/d. Although 50 per cent of the nitrogen from hydrolysed urea was resynthesized to urea, and a further 10 per cent may have been lost in the stool, it is estimated that 58 mg nitrogen /kg/d was available for synthetic metabolic activity. Urea kinetics in sickle cell disease subjects are markedly different from normals, and this may be a reflection of the metabolic demands for increased red cell synthesis. (AU)

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Malnutrition, ascariasis and trichuriasis are prevalent and co-exist among the poor. However, the nature of the relationship between nutritional status and helminthiasis remains unclear. We therefore compared the prevalence and intensity of infection with Trichuris trichuria and Ascaris lumbricoides in 11 to 25-month-old children in two groups from the same slum communities in Kingston, Jamaica. One group comprised 66 malnourished children (<90 percent weight-for-age) and the other 55 well-nourished children (<90 percent weight-for-age). Both groups of children had similar mean ages, comprised similar proportions of boys and girls and had similar socio-economic status. Duplicate faecal specimens were examined twice, using the Kato thick Smear technique. Infected children were treated with mebendazole (Janssen, Pharmaceuticals). Helminths occurred with similar prevalence among the well-nourished (38 percent) and the malnourished (44 percent) children. However, the prevalence was highest in the mildly wasted children (57 percent, n=30) and least in the moderately/severely wasted children (15 percent, p<0.05). Similar patterns were observed for both Ascaris and Trichuris. In both groups, the presence of helminths was positively associated with age (Xý = 10.7, p<0.05), acess to water (Xý = 9.1, p<0.05)and geophagia(Xý = 4.2, p<0.05). These results show that nutritional status alters the host-parasite relationship. Perhaps mild malnutrition increases whereas more severe malnutrition decreases susceptibility to helminths, as Bundy and Golden (Parasitolgy, 1987) have suggested (AU)

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The feasibility of rehabilitating malnourished children in the community, using the health service framework, was examined over a 6-month period. Eighty moderately and severely malnourished children, aged 3-36 months, were recruited from the Casualty Department, U.H.W.I., and Clinics in Kingston. The results of the first fifty to complete are reported. The children were randomly assigned to two treatment groups which provided medical care with and without a dietary supplement. The supplement, as prescribed, provided 750 Kcal/day for 3 months (55 percent of their energy requirements). At enrollment, both group had similar weight-for-age (WFA), height-for-age (HFA) and weight-for-height (WFH). At this point, mean WFA were 67 percent and 66 percent for supplemented and control groups respectively. By the end of the second month, the supplemented group was better nourished than their controls (p<0.05). The mean WFA were 73 percent and 69 percent respectively. By the end of the third month, the advantage of the supplemented group was more pronounced (p<0.01) with mean WFA of 74 percent and 69 percent respectively. This represented 8 percent WFA improvements in the supplemented as opposed to a 2 percent improvement in their controls. Mean weight gains of 1.22 and 0.84 Kg in supplemented and control groups were 2.0 and 1.3 times respectively, the normal rate for children of the same age. After three months, the supplemented group which had had three severely malnourished children at enrollment had none, while the control group which had had four still had two. Twice as many supplemented as opposed to control children had advanced to the mildly malnourished category. However, three months after the supplementation ceased (6 months), both groups were distributed similarly between the Gomez categories. Both interventions resulted in some catch-up growth. The regime of medical care plus supplementation proved more effective during the supplementation period. However, this advantage was not maintained when both groups received medical care only. Continous medical care and a onger supplementation period are needed for community rehabilitation of Jamaican malnourished children (AU)

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