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INTRODUCTION: Aluminum (Al) is a toxic element which may contaminate pharmaceutical products used as individual components to prepare total parenteral nutrition mixtures (TPN). OBJECTIVES: 1) to determine Al levels in the individual components used to prepare TPN mixtures; 2) to compare detected Al levels with those imposed by international regulations (FDA); 3) to calculate the total amount of Al administered to adult and children receiving those typical TPN mixtures. METHODS: Al was determined by Inductively Coupled Plasma- Atomic Emission Spectrometry (ICP-OES) (Perkin Elmer OPTIMA 5100 DV) in 44 individual products, from different labs and lots, belonging to 16 components available in Argentina: dextrose and amino acids for adult formulas and for pediatric formulas: lípids; potassium chloride; sodium chloride, magnesium sulfate; sodium phosphate; calcium gluconate; sodium glycerophosphate, zinc sulfate; multitrace elements; steril water (ampoules and great volume presentations). RESULTS: Al levels were detected in 43 of the 44 the studied components, except sterile water. The components of large volume presented between 249 y 1,580 µg Al/ L, between 4 and 180 times FDA established levels (25 µg Al/ L). Small volume components presented Al levels between 85 y 4,909 g/ L, not declared in labels. CONCLUSIONS: The highest amounts of Al were detected in calcium gluconate, sodium phosphate and multitrace elements. 2) Usually prescribed TPN mixtures would have higher Al levels than those accepted by FDA regulation; 3) The highest aluminum concentration was provided by dextrose, amino acids and lipids in adult TPN mixtures. In neonate TPN mixtures, Al highest amounts were provided by dextrose and calcium gluconate. The calculated concentration of Al in TPN mixtures was higher than those stipulated by international regulation (5 µg Al/kg (body weight)/ d). It would be advisable for manufacturers to declare the content of aluminum in the label, with the aim of avoiding toxicities which would compromise the critical patients' evolution.

Introducción: aluminio (Al) es un elemento tóxico que puede ser contaminante de productos farmacéuticos utilizados para preparar mezclas de nutrición parenteral (NP). Objetivos: 1) determinar la concentración de Al en componentes individuales utilizados para preparar mezclas de NP; 2) comparar las cantidades detectadas con los límites de la regulación internacional (FDA); 3) calcular la cantidad de Al administrada en fórmulas habituales de NP para neonatos, niños y adultos. Materiales y métodos: El Aluminio fue determinado por Espectroscopía de Emisión Atómica-Plasma-Inductivo de Argón (Perkin Elmer 5100 DV) en 44 productos comerciales, de diferentes laboratorios y lotes, correspondientes a 16 componentes individuales: dextrosa; aminoácidos para adultos y pediátricos; lípidos; cloruro de potasio; cloruro de sodio, sulfato de magnesio; fosfato de sodio; gluconato de calcio; glicerofosfato de sodio; sulfato de zinc; elementos multitraza; agua estéril en ampollas y de gran volumen. Resultados: Todos los componentes de gran volumen, excepto el agua, contenían entre 249 y 1.580 µg/L, superando entre 4 y 180 veces mas que los niveles establecidos por la FDA (25 µg/L). Los componentes de pequeño volumen contenían entre 85 y 4.909 µg/L, no declarados en los rótulos. Conclusiones: 1) La mayor cantidad de aluminio se encontró en el gluconato de calcio, fosfato de sodio y elementos multitraza. 2) Las mezclas de uso habitual para NP presentan niveles de Al mayores al límite de FDA. Los componentes que aportan mayor cantidad de aluminio en las mezclas de NP para adultos son: glucosa, aminoácidos y lípidos, pero en las de neonatos, el mayor aporte proviene de la dextrosa y gluconato de calcio. 3) En las mezclas de NP para neonatos, niños y adultos la cantidad de aluminio administrado por kg de peso supera la recomendación de FDA (5 µg/kg de peso /día). Los productos comerciales deberían declarar el contenido de Al para no comprometer la evolución de los pacientes graves.

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The purpose of this study was to describe the practice of pica during pregnancy in Argentine women. Maternal and fetal characteristics as well as the practice of pica were evaluated during the puerperium in a sample of 1,014 women from five different geographical areas. Pica prevalence for the total sample was 23.2% (95% CI 20.6-25.8). Pagophagia (ice consumption) was the main type of pica practice, followed by geophagia (earth intake) and the ingestion of soap, toothpaste and chalk. The onset of the practice was mainly in the first months of pregnancy. A total of 49.8% of women revealed a family history of pica; 30.6% had pica in childhood and 13.2% suffered from polypica. Women with pica during pregnancy had similar age, pre-pregnancy body mass index (BMI), parity, neonatal birth weight and gestational age compared with non-pica mothers, although maternal haemoglobin concentration was lower in women with pica than in non-pica mothers (p = 0.0001).

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OBJECTIVES: To study the interrelationship between serum Interleukin-6 (IL-6), serum Interleukin-6 soluble Receptor (IL-6 sR), C-Reactive Protein (C-RP), plasmatic Zinc levels (PlZn) and their response in relation to Zn administered by TPN, in critical patients. METHODS: 17 patients, receiving TPN as a consequence of acute pancreatitis (n = 4) or after a major abdominal surgery due to intestinal cancer (n = 7), intestinal fístula (n = 3), intestinal obstruction (n = 2) or intestinal íleus (n = 1) were studied. At the beginning (To) and at the end of the TPN administration (6-21 days) serum IL-6 and IL-6 sR were determined by ELISA; C-RP ultrasensitive (C-RP us) by inmunoturbidimetric method; Zn was determined in TPN and in plasma by Atomic Absorption Spectrometry. Characteristics of the patients were (mean +/- SD and ranges): age: 60.6 +/- 11.7 (37-77) years; BMI (kg/m(2)): 26.0 +/- 3.4 (19.9-34.0). RESULTS: The results (mean +/- standard deviation and ranges) were: Zn provided by TPN (mg/d): 6.1 +/- 2.0 (range 2.8 to 10.8). Biochemical levels were, at To and Tf, respectively: (mean+/-SD and ranges) were at To y Tf, respectively: Zn Pl (microg/dl): 104 +/- 46 (35-177); 120 +/- 55 (52-229); IL-6 (pg/mL) 93 +/- 74 (10-262); 117 +/- 180 (7-761); IL6sR (pg/mL): 1,012 +/- 322 (589-1855); 1,269 +/- 451 (631-2195); C-RP us (mg/L): 71 +/- 63 (2-196); 65 +/- 43 (0-137). There was no correlation between variations of IL6, IL6sR, C-RP, PlZn levels and the daily amount of Zn administered in the TPN mixtures. Two patients presented a bad evolution; they received 4.2 and 5.2 md/d of Zn and showed an increase of IL6 levels, maintained high levels of IL6sR but C-RP levels decreased. CONCLUSIONS: the range of 2.8 to 10.8 mg/d of Zn administered in TPN mixtures did not exacerbate the inflammatory response.

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OBJECTIVE: The aim of this investigation was to know and assess the characteristics of nutrient intake in pregnant women diagnosed with pica (consumption of non nutritive substances). MATERIALS AND METHODS: We studied a group of 71 women presenting pagophagia (compulsive consumption of ice) and other forms of pica, which was compared to a control group including the same number of women with similar socio-cultural and anthropometrical characteristics but without the eating disorder. Both groups were randomly selected among women assisted at the Hospital de la Matanza, province of Buenos Aires, Argentina. RESULTS: we did not observed statistically significant differences in energy, total proteins, iron, and calcium consumption. However, women with pica showed lower intakes (p < 0.03) of carbohydrates, animal proteins, hemic iron, and zinc. The median values for women with and without the disorder were, respectively: carbohydrates (g): 379/426; animal proteins (g): 35/39; hemic iron (mg): 1.5/1.9; zinc (mg): 7.1/8.1, calcium (mg): 625/612. In both groups, meat was the main source of iron and zinc, and its intake was lower in the group with pica. The daily average amounts consumed were 117 + 53 g for women with pica and 154 + 71 g (p < 0.03) for the control group. Only 22% of pregnant women with the disorder referred using iron supplements during their pregnancy. CONCLUSIONS: As compared with control women, pregnant women with pica disorder showed lower intake in traditionally marginal nutrients such as iron and zinc. These results show the need for early diagnosing this disorder during pregnancy in order to prevent or correct it and properly counseling pregnant women about food selection and supplementation regimens.

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The effect of dietary calcium (Ca) level on maternal zinc (Zn) nutritional status was studied. Female Wistar rats, weighing 250-350 g, were fed during pregnancy and lactation with an experimental diet containing/100 g different levels of calcium: 0.2 g (low calcium: LCa), 0.6 g (normal calcium: NCa) or 0.9 (high calcium: HCa). Maternal blood samples were drawn from the tail at delivery and at the end of lactation. Laboratory determinations were: Zn in whole blood (WB) at delivery and weaning; Zn (ZnF) and Ca (CaF) in the ashed femur at weaning. The results (mean +/- SEM) were: ZnWB (microgram/ml) at delivery and weaning: LCa: 8.73 +/- 1.05; 12.8 +/- 2.02; NCa: 3.49 +/- 0.19; 3.73 +/- 0.37; HCa: 3.21 +/- 0.19; 3.85 +/- 0.27. CaF (mg/100 mg): LCa: 19.2 +/- 0.8; NCa: 21.4 +/- 0.6; HCa: 20.4 +/- 1.1. ZnF (microgram/100 mg): LCa: 30.2 +/- 0.9; NCa: 24.1 +/- 0.3; HCa: 24.1 +/- 0.9. ZnWB was significantly higher in LCa (p < 0.0001) regarding NCa and Hca. ZnF showed an increase and CaF a decrease in LCa regarding NCa and HCa (p < 0.0001). There were no significant differences in ZnWB, ZnF and CaF between NCa and HCa These results show that: there was no detrimental effect when dietary Ca content was increased by 50 per cent above the normal requirements of the rat.; low dietary Ca during pregnancy and lactation produced an increase of Zn utilization, reflected in maternal blood Zn and in ZnF content.

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The purpose of this study was to investigate the impact of low fat diets in children aged 2 to 5. Eighty two children (40 females and 42 males) attending a school cafeteria (Province of Buenos Aires, Argentina), in a cross sectional study, were evaluated. Body weight (W), height (H) and body composition (BC) by bioimpedance were recorded. The anthropometric raw data were processed as Z-score of the weight-for-age (WEZ) and of the height-for-age (HAZ). Serum insulin-like growth factor 1 (IGF-1) and Zinc/haemoglobin ratio (Zn/Hb) were also measured. Results showed that 73.2 per cent of children were adequate (A) according WEZ, 13.4 per cent were lean (L) and 13.4 per cent overweight (O). 8.5 per cent presented simultaneously impairment in WEZ and HAZ. Body fat percentage and energy metabolism were higher in O than in L and A (p < 0.05). Serum IGF-1's children--aged 4 to 5 years--with HAZ deficit were low than adequate HAZ ones. No statistical differences in Zn/Hb ratio between A, L and O were found. This cross sectional study suggests metabolic disorders in young children attending school cafeterias. These conclusions will allow to design balanced diets in order to optimize the resources, promote optimal growth and development and prevent adult diseases through dietary practices in childhood.

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OBJECTIVE: To study, in healthy women, the correlation between the basal urinary zinc/creatinine ratio and dietary zinc intake. SUBJECTS: A group of 36 healthy female University students was evaluated. Mean age and body weight were, respectively, 25.6+/-3.3 years and 54.4+/-7.0 kg. METHODS: Basal urine was collected; Zn was determined by AAS and Creatinine (Creat) by the Jaffe method. A nutritional survey of seven days was recorded. Mean daily dietary intake of energy (DE) and zinc (DZn) were calculated according to the INCAP and English or German Food Composition Tables, respectively. RESULTS: Mean dietary daily intake were as follows (x +/- SD): Energy (kcal): 1606+/-570; zinc (mg): 9.1+/-3.8; basal urine Zn/Creat ratio: 0.41+/-0.24. Individual values of the Zn/Creat ratio correlated with dietary Zn (r=0.481, p=0.0339); data grouped according to ranges of dietary Zn fit the following equation: Zn/Creat=0.160+/-0.034 DZn (mg/day); (r=0.870, p=0.00497). CONCLUSIONS: These results showed that the basal urinary Zn/Creat ratio could be a useful indicator of dietary Zn intake in healthy adult women.

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Nutritional status of 80 preoperative patients from programmed surgeries of hernias and lithiasis was studied by anthropometric and biochemical parameters. Nutritional deficiencies related to pathology were not expected in these patients. Results were as follows: 77% of the population showed overweight, being 15% obese. Prevalent protein intake, evaluated by the urea nitrogen/creatinine ratio, was adequate in 87.5% of the patients; however, patients presented 72% of albumin, 52% of prealbumin and 50% of RBP below reference values. Transferrin, ceruloplasmin, alpha 2-macroglobulin and haptoglobin were not decreased. Assessment of vitamin A, carotenes and vitamin C showed plasmatic levels below reference values in 16% of the patients for vitamin A, 5% for carotenes and 27% for vitamin C. Respect to calcium status, data of calcium/creatinine ratio show deficiency in 45% of the population. Respect to iron, the nutritional status was in general adequate, patients at risk being 5% by Htc, 11% by Hb, 5% by TS% and 12.5% by FEP, women showed over twice abnormal values than men. Although some isolated relations were observed, in this population sex, age and pathology were variable that did not affect in a relevant way the nutritional status. In spite of the individual analysis of each nutrient did not show important deficiencies, the analysis by patient showed that only a few of them (7%) presented an optimal biochemical profile with all the studied parameters within the reference values.

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A dietary survey was carried out at the National University of Luján (Argentina), with the objective of evaluating: a) food consumption and energy supply of cereals; b) the adequation of the intake of protein, calcium, iron, vitamins A, B1, B2, C and niacin, regarding the Recommended Dietary Allowances (RDA). A representative sample of 827 people (16% of the total population of 1991, equally distributed in the four seasons) was assessed with a 24 hour dietary recall. Sample was composed by: males: 189, aged 18-24 ys (GIM); 189, aged 25-50 ys (G2M); females: 209, aged 18-24 ys (GIF); 240, aged 25-50 ys (G2F). The results showed that cereals, 90% deriving from wheat products, supplied 32% of the total energy intake in G1F and between 40% and 48% in the other three groups. The mean daily intake of meat ranged between 90.5 g and 128.7 in females and over 140.0 g in males. Dairy products consumption was quite low, as well as fruits and vegetables in the whole of the population. Protein intake was over 1.25 g/d in 50% of the population. Calcium intake was below the RDA in a great percentage of the population, the mean percentage of adequation being: G1F, 71%; G2F, 62%; G1M, 64%; G2M, 65%. Iron mean daily intake was quite good, ranging between 16.4 and 20.8 mg in females and between 17.5 and 19.2 mg in males. The percentage of iron supplied by meat was: G1F, 16%; G2F, 21%; G1M, 34% and G2M, 26%; therefore iron bioavailability can be considered high. Besides, "mate", which is drunk between meals, supplied between 25% and 29% of the total iron intake in females and between 12% and 56% in males. Vitamin A intake was below the RDA in 74% to 58% of the population. The mean intake of vitamin B1 was 89% of the RDA in G1M and over RDA in the other three groups. Intake and percentage of adequation of vitamin B2, vitamin C and niacin presented a great range, but the mean values were over the RDA. The overall results showed: a) a high protein intake, providing red meat between 26% and 39%; b) low consumption of dairy products, with the consequence of a low calcium and vitamin A intake; c) low consumption of fruits and vegetables, being in relation to the low intake of fibre and carotenes; d) high consumption of cereals, mainly wheat products, that must be controlled from the toxicological point of view, due to the variable presence of mycotoxins. These results are in agreement with other dietary surveys carried out in previous years and are a consequence of some characteristic feeding habits of the Argentine population. They show that nutritional education is necessary for promoting changes in the latter, with the aim of reaching a better nutritional status.

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