Effect of folic acid supplement on birth weights of infants

Earlier observations from this Institute have indicated that the infants born to mothers receiving folic acid supplements in addition to iron during pregnancy were heavier than those born to mothers receiving iron alone. Since birth weights are influenced by maternal factors like height and parity, a trial was carried on in matched controls with iron and iron and folic acid during the last 12 to 16 weeks of pregnancy. Simultaneously, placental function was also assessed. The effect of the folic acid supplements was more marked on first born children. Incidence of small-for-dates births was half in the iron and folate-supplemented group as compared with the iron-supplemented group. The heights of mothers did not make any difference on the effect of folate supplement. The improvement in the birth weights seem to have been brought about by increase in placental size, cell number, and protein content in the folate supplement group. In view of multivariant deficiency and practical problems in implementing food supplement programs to expectant mothers, supplements of folate and iron to expectant mothers in large scale may bring about an improvement in the incidence of pregnancy anemia and also reduce the infant morbidity and mortality rate due to the high incidence of low-birth weight babies.

Nutrition and behavioral development

2 groups of 17 mother-child units each were studied longitudinally, 1 with the usual feeding habits which resulted in undernutrition of the child, and the other sufficient with food supplementation. From the 24th week on, the supplemented developed a different pattern of interaction with mother and environment; they slept less, barely used the cradle during the day, played more in the yard, and refused to be carried wrapped up. They moved about 6 times as much as the nonsupplemented and exhibited complex behavior. They were more restless, playful, demanding, and disobedient. It is concluded that better nutrition caused an increased level in the child, which made him more demanding, and in turn this increased interaction with his mother and established a feedback system, which in turn modified his behavior.

Oral contraceptives and ascorbic acid

Plasma, leukocyte, and platelet ascorbic acid levels are decreased in women ingesting oral contraceptive steroids. Studies have shown that it is the estrogenic component of the oral contraceptive agents that is associated with the decresased ascorbic acid concentrations. Urinary excretion of ascorbic acid does not appear to be increased by the steroids. Although serum levels of copper are increased by estrogens and oral contraceptives, ascorbic acid catabolism does not appear to be increased (unpublished). Our preliminary data on tissue uptake of ascorbic acid suggest that changes in tissue distribution are one possible answer for the observed effects of the steroids on blood levels of ascorbic acid.

Effect of oral contraceptive agents on nutrients: II. Vitamins

Clinical, biochemical and nutritional data were collected from a large population of women using oral contraceptive agents. Higher incidence of abnormal clinical signs related to malnutrition were observed in the lower (B) as compared to the higher (A) socioeconomic groups, and also in the nonsupplemented groups as compared to the supplemented groups in the B subjects. As a rule the intake of oral contraceptive agent subjects of vitamin A, C, B6 and folic acid did not differ from that of the controls As expected, subjects from the supplemented groups had higher intake of vitamin A, C, B6, thiamin, riboflavin and folic acid, and A groups had higher intake of vitamin C, B6, riboflavin and folic acid. Increased plasma vitamin A and decreased carotene levels were observed in oral contraceptive agent users. In general oral contraceptive agents had little or no effect on plasma ascorbic acid. Urinary excretion of both thiamin and riboflavin in subjects using oral contraceptive agents were lower in A groups. Erythrocyte folate and plasma pyridoxal phosphate was decreased in A groups due to oral contraceptive agents. Subjects who took supplements had higher levels of plasma vitamin A, ascorbic acid and folate. But urinary thiamin and riboflavin were higher only in group A subjects who took supplements.

Factors influencing breast feeding

A survey is reported of infant feeding practice at the time of discharge from a single maternity ward. It is shown that a change in the attitude of nursing staff increased the number of mothers breast feeding their infants and eliminated the practice of giving the infants formula feed complements. This change in attitude, however, did nothing to prevent the rapid decline in lactation after leaving hospital, such that 50% of mothers discharged breast feeding were no longer doing so by 2 months. The early introduction of solid feeds was common practice, 50% of mothers discharged breast feeding having introduced mixed feeds within 2 months. Successful lactation was found to be commoner in those mothers who had themselves been breast fed in infancy and in mothers from socioeconomic classes I and II. Successful lactation was not related to parity. The survey also shows the influential role of the health visitor, district nurse, and midwife upon mothers' decisions about infant feeding.

Health, nutrition, and the roots of world population growth

As concern over the expansion of world population has grown, much of this “population explosion” has been attributed to the introduction of modern medical and public health techniques in developing countries. There is little evidence, however, to support this belief. Malaria eradication, immunization programs, improved sanitation, and the use of antibiotics are cited as examples of the kind of medical intervention that has sent death rates into downward spirals on a global basis. Yet what is often ignored is the fact that, while each of these measures is medically effective, none is universally applied, a condition that must be achieved before the potential value of these measures can be realized. Sustained population growth has been found to precede the development of medicine and public health as effective weapons against mortality, both in the population expansion of Europe, which began in the 17th century, and in that of modern developing countries.

This article postulates that the roots of the present population crisis are to be found in a worldwide improvement in nutrition that is based less on the amount of food produced than on a greatly enhanced capacity to distribute it. Better food distribution in Europe followed in the wake of the Industrial Revolution and reached the developing countries late in the 19th century as the Third World came increasingly under the political domination of the West.