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Objective: To explore anthropometric indicators and mental development in very-low-income children in the second year of life. Design: Cross-sectional survey. Setting: Low-income areas (income < 20th percentile) in semi-urban Mexico (defined as towns or cities with 2500-50 000 inhabitants). Subjects: Eight hundred and ninety-six children aged 12.5-23.5 months surveyed from September to December 2001. Methods: Questionnaire survey and anthropometric survey of households. Multivariate regression models evaluated differences across age in anthropometry (height-for-age Z-score (HAZ) and weight-for-height Z-score) and cognitive function (Mental Development Index (MDI) of the Bayley Scales of Infant Development) while controlling for socio-economic and parental characteristics. Results: There was a significant decline in HAZ and in age-adjusted MDI score across the second year of life. Although the children showed MDI scores close to the mean, normed US values at 13-14 months, the scores were significantly lower than expected in older children (P < 0.0001), even after controlling for socio-economic status and parental characteristics. At 13-14 months, only 3% of children received scores below 70 (less than minus two standard deviations), whereas by 19-20 months, almost 17% of children were performing below this level. No socio-economic or parental characteristics were significant predictors of HAZ or MDI. Conclusions: Parallel deficits are evident in both height-for-age and cognitive functioning during the second year of life in low-income Mexican infants. The consistency of these growth and development findings further stresses the need for targeted interventions to reduce the vulnerability of low-income Mexican children very early in life.

Objective: Long-chain PUFA (LCPUFA) found in breast milk are derived from dietary sources and critical for optimal infant development. We examined associations between fish consumption and concentrations of LCPUFA and essential n-3 and n-6 fatty acids in breast milk among mothers living around Lake Victoria.Design: We used cross-sectional analyses of associations between recent fish consumption and breast-milk fatty acid concentrations.Setting: The study was conducted around Lake Victoria on Mfangano Island, Kenya, where multiple fish species are key dietary components and also are widely exported.Subjects: Breast-feeding mothers (n 60) provided breast-milk samples, anthropometric measurements and questionnaire responses.Results: In the previous 3 d, 97 % of women consumed a mean of 178 (sd 111) g fish (~2 servings/3 d). Mean breast-milk concentrations included DHA (0·75 % of total fatty acids), EPA (0·16 %), α-linolenic acid (ALA; 0·54 %), arachidonic acid (AA; 0·44 %) and linoleic acid (LA; 12·7 %). Breast-milk DHA concentrations exceeded the global average of 0·32 % in fifty-nine of sixty samples. We found native cichlids (Cichlidae) and dagaa (Rastrineobola argentea) contributed high levels of DHA, EPA and AA to local diets. We also found evidence for associations between fish species consumed and breast-milk LCPUFA concentrations when controlling for intake of other fish species, maternal body mass, maternal age, child age and exclusive breast-feeding.Conclusions: The fatty acid composition of breast milk was influenced by the fish species consumed. Ensuring access to diverse fish and particularly inexpensive, locally available species, may be important for diet quality as well as infant growth and development. [ABSTRACT FROM AUTHOR]

Objectives: To assess the ability of anthropometric measurements to identify young women at risk of developing diabetes, hypertension and heart disease in the future and to compare cut-off points for common anthropometric measures established with receiver-operating characteristic (ROC) curves with those reported in the literature.Design: Cross-sectional study.Subjects: Eight hundred and two young Mexican women living in semi-urban poverty. MEASUREMENTS/METHODS: The ability of anthropometric measures of fatness and fat distribution (body mass index (BMI), summed skinfold thickness (SST), waist circumference (WC), waist-to-hip ratio (WHR), conicity index (CI), abdominal volume index (AVI)) to predict risk of future disease (pre-diabetes: fasting blood glucose 100-126 mg dl-1; pre-hypertension: systolic blood pressure 120-139 mmHg and/or diastolic blood pressure 80-89 mmHg; hypertriglyceridaemia: triglycerides > or =150 mg dl-1; or a combination of risk factors) was assessed using ROC curve analysis.Results: Twenty-three of the 802 women who were interviewed had incomplete data and 50 (6.4%) were eliminated from the analysis due to hypertension and/or diabetes. Mean age of the remaining 729 women was 29.6 +/- 5.4 years and mean BMI was 27.7 +/- 4.5 kg m-2. There were no significant differences in the area under the ROC curve for BMI, WC, AVI or SST for any of the four outcomes. However, these indices performed significantly better than WHR and CI (P < 0.05). The BMI cut-off points that maximised sensitivity and specificity for the four outcomes were in the range of 27.7-28.4 kg m-2, and for WC were 89.3-91.2 cm. To detect 90% of the cases of any metabolic alteration, the necessary BMI cut-off was 26.1 kg m-2. Younger women (<25 years) were at greater risk than older women for a given BMI increment (P < 0.05).Conclusions: We found that BMI and WC cut-off points commonly used for the identification of risk of existing disease were also appropriate in this population for the identification of risk in the future among women without diabetes or hypertension. The early identification of at-risk individuals, prior to the onset of disease, is fundamental particularly in the context of a country with scarce resources that is rapidly undergoing nutrition transition. [ABSTRACT FROM AUTHOR]

Objective: To explore anthropometric indicators and mental development in very-low-income children in the second year of life.Design: Cross-sectional survey.Setting: Low-income areas (income <20th percentile) in semi-urban Mexico (defined as towns or cities with 2500–50 000 inhabitants).Subjects: Eight hundred and ninety-six children aged 12.5–23.5 months surveyed from September to December 2001.Methods: Questionnaire survey and anthropometric survey of households. Multivariate regression models evaluated differences across age in anthropometry (height-for-age Z-score (HAZ) and weight-for-height Z-score) and cognitive function (Mental Development Index (MDI) of the Bayley Scales of Infant Development) while controlling for socio-economic and parental characteristics.Results: There was a significant decline in HAZ and in age-adjusted MDI score across the second year of life. Although the children showed MDI scores close to the mean, normed US values at 13–14 months, the scores were significantly lower than expected in older children (P<0.0001), even after controlling for socio-economic status and parental characteristics. At 13–14 months, only 3% of children received scores below 70 (less than minus two standard deviations), whereas by 19–20 months, almost 17% of children were performing below this level. No socio-economic or parental characteristics were significant predictors of HAZ or MDI.Conclusions: Parallel deficits are evident in both height-for-age and cognitive functioning during the second year of life in low-income Mexican infants. The consistency of these growth and development findings further stresses the need for targeted interventions to reduce the vulnerability of low-income Mexican children very early in life. [ABSTRACT FROM AUTHOR]