The composition of breast‐ and bottle‐milks fed to poor urban infants

Growth and Cognition in Brazilian Schoolchildren: A Spontaneously Occurring Intervention Study

This study examines the effects of dietary, cultural, and educational intervention on physical growth and cognition in Brazilian children aged from 7 to 10 years. A group of 38 domestic servants' children who had resided and studied for an average of three years in upper-middle class environments were compared with 88 upper-middle class children and 100 slum-dwelling (favela) children using the following measures: weight-for-height, height-for-age, Goodenough-Harris Drawing Test, the Brazilian Non-verbal Intelligence Test (INV), Raven Coloured Progressive Matrices (CPM), WISC-R Coding and Block Design subtest. Although domestic servants' children were significantly taller and heavier than their group of origin (slum-dwelling children) they continued to be significantly shorter than the middle class. Domestic servants' daughters scored significantly better than their slum-dwelling counterparts on cognitive tests measuring speed and accuracy (WISC-R Coding) and analogical reasoning (Raven Coloured Progressive Matrices), however, girls from both lower socioeconomic groups were similar in their performances on the Goodenough-Harris Drawing Test, Non-verbal Intelligence Test (INV), and WISC-R Block Design subtest. Domestic servants' sons were similar to slum-dwelling boys in performance on all cognitive measures. The length of time domestic servants' children had resided in middle class homes was positively and significantly correlated with their weight-for-height and two of the five cognitive tests. Among domestic servants, mothers' egalitarian sex role and less orthodox religious attitudes were positively correlated with children's cognitive performance. The experience of living and studying in a middle class environment resulted in greater gains in physical than in cognitive development.

Home-made feeding bottles have inadequacies in their nutritional composition regardless of socioeconomic class

Fifty-four and fifty samples of home-prepared feeding bottles for infants from a public health unit (low socioeconomic group, LSG) and from a private pediatric clinic (high socioeconomic group, HSG), respectively, were chemically analyzed, and their energy, macronutrient and iron contents were compared with the standard composition recommended for follow-up formulas. Cow's milk and sucrose and cereals added to the bottles were largely used in the study. Energy, protein and carbohydrate contents were higher than the recommended level in 75.9, 27.7 and 81.5% of LSG samples and 62.0, 48.0 and 34.0% of HSG samples, respectively. Fat content was lower than the recommended level in 83.3% of LSG and 58.0% of HSG samples. Excessive values of energy, carbohydrates and protein, low fat content and macronutrient imbalance were found regardless of the socioeconomic class, thus indicating the need to improve the domestic feeding bottles' preparation practices and discourage the use of cow's milk and the addition of other ingredients.

Persistent, bioaccumulative and toxic substances in fish: human health considerations

Fish are important dietary items that provide essential nutrients. Fish however, bioaccumulate monomethyl mercury (MMHg) and organo-halogenated pollutants (OHP) that are persistent bioaccumulative and toxic substances (PBTS). Unlike man-made OHP, MMHg is mainly of natural origin but background concentrations of aquatic systems are determined by the environmental Hg-methylating potential. Industrial activities can modulate environmental discharges and fish bioaccumulation of PBTS. Fish and seafood consumption are associated with human body load of PBTS, but farming practices that utilize fishmeal increase the terrestrial food chain resulting in farm-animal accumulation of PBTS. These substances are neurotoxic and endocrine active that can impact humans and wild life, but chemical characteristics of MMHg and OHP modulate interactions with animal tissues. MMHg is protein reactive with a faster metabolism (months) than OHP that are stored and slowly (years) metabolized in fat tissues. Except for brain-Hg, neither Hg nor OHP in tissues are markers of toxic effects; however, deficits in neurobehavioral test-scores of children have been shown in some fish-eating populations. These deficits are transient and within normal range, and are not prodromes of neurological diseases. Although population studies show that consumption of fish at current levels of contamination do not explain neurological disorders, endocrine activity remains controversial. Understanding risk of hazard caused by fish-PBTS consumption requires a wide range of expertise. We discuss chemical, toxic, metabolic, and ecological characteristics associated with PBTS in fish. There are proven health outcome derived from fish consumption, while risk of exposure to avoidable PBTS is a chance that can be minimized by societal actions.

Determination of macronutrients, by chemical analysis, of home-prepared milk feeding bottles and their contribution to the energy and protein requirements of infants from high and low socioeconomic classes

OBJECTIVES

To determine the macronutrients composition of home-prepared milk feeding bottles, by chemical analysis, and assess their contribution to the energy and protein requirements of children under two years of age from high (HSE) and low (LSE) socioeconomic classes.

METHODS

72 samples were analyzed for energy density and protein, fat and carbohydrate content: 41 from the LSE group and 31 from the HSE group. The assessment of the percentages of the energy and protein requirements met by the consumption of the milk bottles was calculated as follows: the energy and protein per 100 mL obtained through chemical analysis were multiplied by the volume consumed at each feeding, then by the number of feedings per day, the results divided by the energy and protein requirements and multiplied by 100. Energy and protein requirements were those recommended by the FAO/WHO/UNU Committee and the Food and Nutrition Board. The children's weight-for-age index was assessed.

RESULTS

Unmodified cow's milk was largely consumed by both groups. The addition of sugar and other ingredients to the milk was significantly higher in the LSE group. Moisture, protein and fat content were lower in the LSE group, whereas carbohydrate and energy content were higher. The percentages of energy and protein requirements provided by feeding bottles were higher in the LSE group. Children in the LSE group had lower z-scores for weight-for-age.

CONCLUSIONS

Differences in the preparation practices led to differences in the chemical results. The feeding bottles in the LSE group were high in energy, due to the addition of sugar and cereals to the milk in the bottle. The milk feeding bottles were an important weaning food providing more than 50% and 100% of the children's energy and protein requirements, respectively. The children's weight-for-age index was within the normal limits.

Concentration of zinc, copper and metallocalorie ratio in bottle-milks prepared by poor urban families

The concentration of zinc and copper and metallocalorie ratios were measured in samples of bottle-milks fed to infants from a poor urban settlement in Brasilia, Brazil. The bottle-milks fed to infants under 1 year of age from a sample of 40 families were analysed for zinc and copper. Zinc and copper concentrations ranged from 0.7 to 11.5 mg/l (mean 3.37) and from 0.09 to 1.47 mg/l (mean 0.43), respectively. The mean metallocalorie ratio was 1.26 mg/MJ (5.29 mg/1000 kcal) for zinc and 0.17 mg/MJ (0.73 mg/1000 kcal) for copper. Based on minimum recommendations for formulae, 55% of the bottle-milks had both zinc and copper concentrations below 3.2 and 0.4 mg/l, respectively. However, owing to added sugar and high caloric concentrations in the milk preparations, metal:calorie ratios were below the minimum recommendations in 72.5 and 62.5% of cases for zinc and copper, respectively. The variation in zinc and copper concentrations in the milks prepared by mothers/infant caretakers under unsupervized home conditions is wide. Owing to the low availability of zinc in cow's milk preparations, it is of concern that more than half the bottle preparations had zinc and copper concentrations/ratios below the minimum recommendations.