RESUMO
PIP: This document presents the results of the Bolivia Demographic and Health Survey (DHS), or Encuesta Nacional de Demografia y Salud 1998, conducted by the Instituto Nacional de Estadistica, La Paz, Bolivia, within the framework of the DHS Program of Macro International. Data were collected from 12,109 households and complete interviews were conducted with 11,187 women aged 15-49. A male survey was also conducted, which collected data from 3780 men aged 15-64. The information collected include the following: 1) general characteristics of the population, 2) fertility, 3) fertility preferences, 4) current contraceptive use, 5) contraception, 6) marital and contraceptive status, 7) postpartum variables, 8) infant mortality, 9) health: disease prevention and treatment, and 10) nutritional status: anthropometric measures.^ieng
Assuntos
Aleitamento Materno/estatística & dados numéricos , Transtornos da Nutrição Infantil/epidemiologia , Anticoncepção/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Diarreia Infantil/epidemiologia , Fertilidade , Mortalidade Infantil , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Intervalo entre Nascimentos , Bolívia/epidemiologia , Pré-Escolar , Anticoncepção/métodos , Demografia , Diarreia Infantil/terapia , Educação , Características da Família , Feminino , Hidratação , Inquéritos Epidemiológicos , Humanos , Lactente , Mortalidade Infantil/tendências , Transtornos da Nutrição do Lactente/epidemiologia , Recém-Nascido , Estado Civil , Pessoa de Meia-Idade , Mães , Estado Nutricional , População Rural , População UrbanaRESUMO
PIP: This article presents summary statistics gathered from the 1998 Nicaragua Demographic and Health Survey (Encuesta Nicaraguense de Demografia y Salud 1998, ENDESA-98). Data from the nationally representative ENDESA-98 were collected from 11,528 households. Interviews were conducted with 13,634 women aged 15-49 years and 2912 men aged 15-59 years between December 1, 1997, and May 31, 1998. The statistics presented were on fertility trends, fertility differentials, age-specific fertility, fertility preferences, current contraceptive use, contraception, marital and contraceptive status, differentials in median age at first birth, postpartum variables, and infant mortality. In addition, statistical data on the health and nutritional status of children were also presented.^ieng
Assuntos
Demografia , Inquéritos Epidemiológicos , Adolescente , Adulto , Coeficiente de Natalidade/tendências , Anticoncepção/estatística & dados numéricos , Escolaridade , Características da Família , Feminino , Fertilidade , Nível de Saúde , Humanos , Mortalidade Infantil/tendências , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Nicarágua/epidemiologia , Estado NutricionalRESUMO
OBJECTIVE: To develop an internationally acceptable definition of child overweight and obesity, specifying the measurement, the reference population, and the age and sex specific cut off points. DESIGN: International survey of six large nationally representative cross sectional growth studies. SETTING: Brazil, Great Britain, Hong Kong, the Netherlands, Singapore, and the United States. SUBJECTS: 97 876 males and 94 851 females from birth to 25 years of age. MAIN OUTCOME MEASURE: Body mass index (weight/height(2)). RESULTS: For each of the surveys, centile curves were drawn that at age 18 years passed through the widely used cut off points of 25 and 30 kg/m(2) for adult overweight and obesity. The resulting curves were averaged to provide age and sex specific cut off points from 2-18 years. CONCLUSIONS: The proposed cut off points, which are less arbitrary and more internationally based than current alternatives, should help to provide internationally comparable prevalence rates of overweight and obesity in children.
PIP: This study aimed to develop an internationally acceptable definition of child overweight and obesity, specifying the measurement, reference population, and age and sex specific cut off points. Data on body mass index (weight/height) were obtained from 6 large nationally representative cross sectional surveys on growth from Brazil, Great Britain, Hong Kong, the Netherlands, Singapore, and the US. The study included 97,876 males and 94,851 females from birth to 25 years of age. For each of the surveys, centile curves were drawn that at age 18 years passed through the widely used cut-off points of 25 and 30 kg/sq. m for adult weight and obesity. The resulting curves were averaged to provide age- and sex-specific cut-off points from 2 to 18 years. The proposed cut off points, which are less arbitrary and more internationally based than current alternatives, should help to provide internationally comparable prevalence rates of overweight and obesity in children.
Assuntos
Índice de Massa Corporal , Obesidade/diagnóstico , Adolescente , Adulto , Fatores Etários , Brasil , Criança , Feminino , Hong Kong , Humanos , Masculino , Países Baixos , Valores de Referência , Fatores Sexuais , Singapura , Reino Unido , Estados UnidosRESUMO
OBJECTIVE: To analyze the influence of parental stature and environmental factors on the stature of adolescents from a national survey sample. METHODS: A nationwide survey was carried out in 1989 among a stratified, two-stage, probability cluster sample of 14,455 Brazilian households to provide estimates of anthropometric deficits for urban and rural populations from the five regions of the country. Stature was measured for 5681 boys and girls age 14-18 years, 78.9% of their fathers, and 93.8% of their mothers. Associations between explanatory variables and adolescent height in centimeters were assessed by fitting multiple linear models to the data. RESULTS: The predicted effects of parental stature and environmental conditions together sum to a total of 17 cm when comparing a boy born to parents with stature below the median and living in the underdeveloped rural Northeast region (1.56 m) with one born to parents with stature above the median and living in the partially industrialized urban South region (1.73 m). For girls, this estimated difference was 12 cm. For boys, the overall influence of parents' stature was 10 cm (R(2)= 0.40) and the sociodemographic factors had an overall influence of 7 cm (R(2) = 0.29). For girls, these values were 7 cm (R(2)= 0.35) for the parental influence and 5 cm (R(2) = 0.11) for the sociodemographic factors. CONCLUSIONS: Mother's stature had the same influence on adolescent's stature as father's stature. Independent of parental stature, environmental factors have a strong influence on adolescent stature, particularly among boys.
Assuntos
Adolescente/fisiologia , Estatura/fisiologia , Pais , Fatores Socioeconômicos , Antropometria , Viés , Brasil , Análise por Conglomerados , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Lineares , Masculino , Valor Preditivo dos Testes , Características de Residência , Saúde da População Rural , Caracteres Sexuais , Distribuição por Sexo , Saúde da População UrbanaRESUMO
The aim of this study was to evaluate the growth of Chilean infants from medium-to-low socioeconomic status fed according to the current WHO guidelines. Growth pattern was compared to a recent reference chart published by WHO for infants, and the NCHS/WHO growth standards. The source of information was a nation-wide infant feeding survey conducted in 1993. From this database, infants aged 1-12 month +/- 5 days, with exclusive breast feeding until the fourth or sixth month were selected (939 males, 940 females). The weight-for-age z-score (WAZ), and the height-for-age z-score (HAZ) were calculated using both the NCHS/ WHO and the new WHO reference growth charts. At each month of age, WHZ and HAZ results were grouped in the following categories: < = -2.0; -1.9 to -1.0; 0 +/- 0.9; 1.0 to 1.9; and > = 2.0. Observed WAZ at the first month of age was below the new WHO reference chart (0.32 z-score), increasing up to 1.29 z-score at the tenth month. The HAZ results were lower the WHO reference chart throughout the period studied, although a trend to improved values was noted during the second semester (F = 6.01 p < 0.001). Growth pattern of the studied group was more similar to the NCHS/WHO chart than the new chart proposed by WHO. As a consequence, the new WHO reference chart identifies a higher proportion of the infants as having a subnormal nutritional status during the first semester of life, compared to those classified in this category by the NCHS/WHO standards (p < 0.001). This can be a factor for the introduction of complementary foods early in life. The relative homogeneity of the population used as source of the WHO reference chart may limit it use in developing countries.
PIP: Growth data from Chile's 1993 National Breast Feeding Survey of infants under 1 year old fed according the World Health Organization (WHO) recommendations were compared to recent reference standards for breast-fed infants published by WHO and to National Center for Health Statistics (NCHS)/WHO growth standards. WHO recommendations call for exclusive breast feeding for the first several months, with solid food introduced at 4-6 months. The Chilean sample included 939 boys and 940 girls. The z-scores for weight-for-age and height-for-age were calculated using both the NCHS/WHO and the new WHO growth charts. The weight-for-age z scores were below the new WHO norms by the 1st month of age, but later increased to 1.29 by the 10th month. Average height-for-age was below the new norm for the entire period studied, despite improved values noted in the second half of the 1st year of life. The observed pattern of growth was more similar to the old NCHS/WHO reference chart than to the proposed new WHO chart. The new WHO chart consequently identifies a higher proportion of breast-fed infants as showing nutritional deficits, which could contribute to premature introduction of supplemental feeding. The new WHO reference chart was based on observations of 226 infants in the US, Canada, Denmark, Sweden, Finland, and the UK who were exclusively breast fed for at least 4 months. The relative homogeneity of the population used as the source of the proposed WHO reference chart may make it inappropriate for use in developing countries.
Assuntos
Crescimento , Chile , Feminino , Humanos , Lactente , Recém-Nascido , Lactação/fisiologia , Masculino , Estudos RetrospectivosRESUMO
PIP: This study examines the impact of 4 health measures on wages of urban workers in Brazil. Data are obtained from the 1974-75 Estudo Nacional da Despesa Familiar among a sample population over 14 years old for wages earned by respondents 15-50 years old. The 4 health measures include height, body mass index (weight divided by height squared), per capita calorie intake, and per capita protein intake. Findings indicate that health measures significantly affected wages, even after accounting for endogeneity. Taller men and women earned more, even after controlling for education and other health measures. Body mass index affected only men's wages. The effect of height was larger for men. Body mass index had a larger impact on wages among persons with low levels of education. Nutrient intake affected wages of men and women in the market sector. More protein had the greatest return at high levels of intake, depending upon calorie intake, mass, and height. Height was a strong predictor of wages for self-employed men only. Body mass index affected the wages of only self-employed men with little or no education. Neither protein or caloric intake significantly affected wages of the self-employed. Models controlled for selection into the labor market and the choice between market and self-employment sectors in the estimated hazard rates based on multinomial logits, according to Heckman (1974) and Lee (1983). It is assumed that relative food prices and nonlabor income had no direct effect on wages. Findings suggest that health produces a substantial return in the formal sector of Brazilian labor markets.^ieng
Assuntos
Estatura , Peso Corporal , Dieta , Emprego , Ingestão de Energia , Renda , Fenômenos Fisiológicos da Nutrição , Salários e Benefícios , Fatores Sexuais , Estatística como Assunto , População Urbana , América , Biologia , Brasil , Demografia , Países em Desenvolvimento , Economia , Saúde , Mão de Obra em Saúde , América Latina , Fisiologia , População , Características da População , Pesquisa , Fatores Socioeconômicos , América do SulRESUMO
The effect of supplementation on growth was tested by means of four similar controlled randomized trials in the Congo (n = 120), Senegal (n = 110), Bolivia (n = 127), and New Caledonia (n = 90). Four-month-old infants were randomly allocated to supplement or control groups. A cereal-based precooked porridge was offered twice daily for 3 mo and consumption was monitored. Both groups were free to eat local food. At 7 mo of age, all infants were still breast-fed in the Congo, Senegal, and Bolivia compared with 47% in New Caledonia. Mean daily consumption of the supplement varied among countries (558-790 kJ/d). Mean length at 4 mo was lowest in Bolivia, higher in Senegal and the Congo, and near the National Center for Health Statistics reference in New Caledonia. The mean 4-7 mo length increment was 0.48 cm higher for supplemented than for control infants in Senegal (P < 0.05), whereas weight increments did not differ. No significant effect was found in the other countries.
PIP: Findings from this study of the link between nutritional supplementation during breast feeding and infant growth disagree with earlier studies. The effect of nutritional supplementation on growth in length was only modest, but significant only in Senegal and not significant in the Congo, Bolivia, and New Caledonia. It is hypothesized that food supplementation during the 4-7 month period would have a positive effect on linear growth. This study included four controlled randomized trials among 120 infants in the Congo, 110 infants in Senegal, 127 infants in Bolivia, and 90 infants in New Caledonia. The infants were 4 months old when placed in the supplement or control groups. Supplementation included the addition of a cereal-based precooked porridge twice daily for 3 months. Both groups continued to eat local foods. Breast feeding patterns were different in New Caledonia, where only 47% of infants were still breast fed at 7 months of age. Mean daily supplementation varied among countries, from 558 to 790 kJ/day. Mean length was lowest in Bolivia, higher in Senegal and the Congo, and close to the US National Center for Health Statistics reference measures in New Caledonia. The study was conducted in rural parts of Senegal and New Caledonia and periurban parts of Bolivia and the Congo. Supplementation was supervised by field workers. The samples included infants with a length-for-age score of -2.5 or higher and a weight-for-length Z score of -2 or higher at 4 months. Anthropometric measurements were taken at 4 months and 4, 8, and 13 weeks later (at 4.9, 5.8, and 7.0 months of age). 24-hour food recalls were collected monthly for consumption of breast milk, special local infant food, commercial "western" baby food, milk substitutes, family food, water, and other than milk liquids.
Assuntos
Países em Desenvolvimento , Grão Comestível , Crescimento , Alimentos Infantis , Fenômenos Fisiológicos da Nutrição do Lactente , Estatura/fisiologia , Bolívia , Aleitamento Materno , Congo , Feminino , Alimentos Fortificados , Humanos , Lactente , Masculino , Nova Caledônia , Senegal , Aumento de Peso/fisiologiaRESUMO
The prevalence of vitamin A deficiency in a nationally representative sample of children 12-59 months old in Panama was assessed using serum retinol levels and dietary indicators. The median serum retinol level found was 1.27 +/- 0.42 mumol/L (38 micrograms/dL); 6.0% of the study sample providing adequate blood specimens had levels below 0.7 mumol/L (20 micrograms/dL), indicating deficient vitamin A intake. The Panama City Metropolitan Area and the country's western region had the highest prevalences of low serum retinol levels (below 0.7 mumol/L in 9% and 6% of the study children, respectively), as compared to overall prevalences of 5% in the two other regions studied. Low serum retinol levels were significantly more prevalent among Indians in the study group (primarily Guaymí Indians) than among non-Indians (13% versus 5%). Dietary information provided by the study children's mothers showed that high risk of inadequate dietary vitamin A intake closely paralleled low serum retinol levels; specifically, the highest prevalence of dietary inadequacy was found in the western region, especially among the Indians. The Panamanian Government is currently increasing distribution of high-dose vitamin A capsules to Indian preschoolers in Chiriquí and Bocas del Toro Provinces.
Assuntos
Transtornos da Nutrição Infantil/epidemiologia , Deficiência de Vitamina A/epidemiologia , Transtornos da Nutrição Infantil/sangue , Transtornos da Nutrição Infantil/tratamento farmacológico , Pré-Escolar , Humanos , Lactente , Inquéritos Nutricionais , Panamá/epidemiologia , Prevalência , Vitamina A/sangue , Vitamina A/uso terapêutico , Deficiência de Vitamina A/sangue , Deficiência de Vitamina A/tratamento farmacológicoRESUMO
BACKGROUND: Data from a longitudinal study of 153 low-income Peruvian infants were used to assess the relationship between internationally-recommended definitions of feeding practices and infants' monthly weight gain and weight status at 12 months. METHODS: Infants were classified into feeding categories using monthly reported data. Analysis of variance was used to assess the relationship between reported usual feeding practices and growth. Reported breastfeeding practices were compared to observed breastfeeding practices and to weighted breast milk intakes to determine the validity of recommended breastfeeding definitions. RESULTS: Breastfed infants who consumed non-human milks during the first month of life gained less weight during that month (P < 0.002) than exclusively and predominantly breastfed infants. Reported daily nursing frequency was associated with observed nursing frequency and breast milk energy intake (P < 0.05) for infants < 9 months old. Patterns of growth varied according to early diets. Infants who consumed breast milk and non-human milks and those who were fully weaned by 4 months were more likely to be underweight at 12 months than other infants. Infants classified as token breastfeeders ( < or = 3 times/24 hours) from 0 to 120 days had monthly gains that were similar to those of fully weaned infants. CONCLUSIONS: Infants feeding definitions should 1) continue to differentiate exclusively breastfed infants from other infants who are almost exclusively or predominantly breastfed; 2) distinguish partially breastfed infants who consume only non-breastfeeding frequency or the % of their total daily energy that comes from breast milk.
Assuntos
Crescimento , Guias como Assunto , Fenômenos Fisiológicos da Nutrição do Lactente , Pobreza , Análise de Variância , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Peru , Reprodutibilidade dos TestesRESUMO
PIP: The body mass index (BMI) is currently the most accepted indicator of body fat for clinical purposes and is useful in definition of overweight or obesity. Most studies of BMI have been done in the United States, and very few anywhere have focused on evolving BMIs of children or adolescents. Data on weight and height of 2015 girls and 2053 boys 18 and younger in Santo Domingo gathered for a different study were used to calculate BMI. The sample children were evaluated in private clinics and health facilities in Santo Domingo and were all healthy and well nourished. Nearly all of the infants were bottle fed. A table presents the smoothed BMIs for the 3rd, 50th, and 97th percentiles separately for boys and girls at birth, 3, 6, 9, 12, 18, and 24 months, and each year through 18. The values corresponding to 120% and 80% of the median values are also shown. The values tended to rise in the first 9 months of life, especially in males. Values declined slowly between 9 months and 7 years and then progressively increased until 14 or 15 years, when the rate of increase slowed considerably. The pattern of slowing at 14 or 15 years resembles the corresponding pattern observed in skin folds.^ieng