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The anthropometry of children aged 0-12 years was studied during the multiple objectives survey conducted in the Middle Senegal River Valley (MISOES) in 1957-1958. This survey was based on two representative samples, in urban areas (769 children) and in rural areas (1240 children). Several measurements were taken: weight, height, arm circumference, triceps skinfold, subscapular skinfold, sub-iliac crest height, biacromial breadth, biiliac breadth. They were compared with American standards. Data show an overwhelming anthropometric deficit compared with standards, and complex interactions with age, gender, and place of residence. The average deficit, expressed as the percentage of reference values were: 80.6% for weight, 95.5% for height, 91.7% for body mass index (BMI), 78.6% for body surface area; it was more marked for triceps skinfold (67.6%) and for subscapular skinfold (66.3%), but less for arm circumference (84.9%) and for muscle circumference (87.7%); it was also marked for biacromial breadth (90.5%) and for biiliac breadth (91.9%), although keeping approximately constant the acromial-iliac ratio. Overall, deficits were more marked among children 1-2 years old, as well as among the 9-12 years old. Gender differences were not pronounced, but boys were some what disadvantaged before age 3 years, while girls were in greater deficit at age 9-12 years. Differences by place of residence were small and complex: deficits were higher in rural areas for skinfolds, but higher in urban areas for arm- and muscle- circumference. Results from the MISOES survey were put into perspective by comparing them with other studies also conducted in Senegal among under-five children: Niakhar (1983-1984) and DHS surveys (1993-2017). The relationships with economic development in the valley are discussed

International audience; Background. Reconstruction of radiation doses to the thyroid for a case-control study of thyroid cancer in French Polynesians exposed to radioactive fallout from atmospheric nuclear weapons tests during childhood and adolescence faced a major limitation on very little availability of information on lifestyle of French Polynesians in the 1960s–1970s.Method: We use the focus group discussion and key informant interview methodology to collect historical, for the 1960s–1970s, data on behavior and food consumption for French Polynesia population exposed to radioactive fallout from nuclear weapons tests conducted between 1966 and 1974.Results. We obtained archipelago-specific data on food consumptions by children of different ages and by pregnant and lactating women during pregnancy and breastfeeding and behaviour, including time spent outdoors and type and construction materials of residences.Conclusions. This article presents the first detailed information on several key aspects of daily life on French Polynesian archipelagoes during the 1960s–1970s impacting radiation exposure. Important behavior and food consumptions data obtained in this study are being used to improve the radiation dose estimates and to update the risk analysis reported earlier by correcting biases from previous assumptions and by providing better estimates of the parameter values important to radiation dose assessment.

International audience; Global and national food security policies require a good knowledge of trends in prevalence of undernourishment (PoU). Progress towards the Sustainable Development Goals might be difficult to assess if trends in undernourishment are not correctly estimated. However, methods of estimating PoU are still subject to debate. FAO Food Balance Sheets are used to measure food availability and undernourishment at country level. The aim of this paper is to compare trends in PoU using the FAO approach to that using Household Consumption and Expenditure Surveys (HCES).We used FAO Food Balance Sheets and parameters, and two nationwide representative Cameroonian Household Surveys (ECAM), conducted by the National Institute of Statistics (INS) in 2001 and 2007. Our findings, based on ECAM, show that 38% and 24% of the population were undernourished in 2001 and 2007, respectively. FAO estimates were 29% in 2001 and 17% in 2007. Both approaches showed a downward trend in PoU, but ECAMresults showed a greater decrease. Using ECAMenabled disaggregation of trends in PoU by area of residence and region. This, in turn, will enable better targeting of vulnerable areas and disadvantaged segments of the population. The North and Far-North regions of the country were facing major food insecurity problems at the time of the surveys.

Undernutrition causes long-term damages on the physical and cognitive development and half of deaths among children under 5 y. Most of the current interventions are concentrated on improving nutrition among young children and mothers. However, malnutrition is also prevalent among older children and adolescents, especially in Africa and in South-East Asia. It has adverse effects on their global development because of the high requirements in energy, protein and micronutrients resulting from growth and brain development spurts occurring these periods of life. Our research evaluated the prevalence of malnutrition and their determinants factors among school-aged children and adolescents in Senegal and Cambodia, as well as the effectiveness of micronutrient fortified food in schools in Cambodia. A cross-sectional study was conducted on a representative sample of ~ 600 children aged from 5 to 17 years from primary state schools of Dakar area, selected through a two-stage random cluster sample (30 schools × 20 children). Elevated rates of thinness (19%) and micronutrient deficiencies (iron 39%, iodine 33%, zinc 26%) were showed. The food consumption survey revealed insufficient micronutrients and energy intake, as well as contribution to total energy intake insufficient in proteins and excessive in lipids, which reveals poor conditions among school children in Senegal. In Cambodia, a cluster-randomized placebo-controlled double-blind trial was conducted among 2400 children aged 6-16 y to measure the impact of fortified rice consumed during 6 months within the school feeding program of WFP on their micronutrient status and cognitive performance. Before the intervention, poor cognitive performance was associated to stunting, iron deficiency and parasite infestation. The growth was positively associated to zinc status, which was negatively associated to parasite infestation. Rice fortified with vitamin A improved vitamin A status and rice with the highest iron concentration had a positive impact on cognitive performance. Data from Senegal and Cambodia were analyzed to study indicators of malnutrition among school-aged children and adolescents. According to the WHO recommendations, we suggested mid-upper-arm circumference (MUAC) cut-offs to screen for acute malnutrition among children above 5 years in Cambodia (15.5 cm, 16.4 cm and 18.2cm in boys and 15.4 cm, 16.6 cm and 17.9 cm in girls aged 5-7.9y, 8-11.9 y, and 11-13.9 y). We confirmed the need to correct plasma concentrations of retinol-binding-protein and ferritin according to inflammatory status, and showed the interest of a similar correction for transferrin receptor, these corrections improving the estimation of prevalence of vitamin A and iron deficiencies in populations where inflammation is endemic. Undernutrition remains a public health issue among school-aged children and adolescents in Senegal and Cambodia. Determination of malnutrition in this age range could be improved by research on indicators taking into account intra variability populations, environmental factors and specific needs of these populations. School-based interventions like the one in Cambodia have positive effects on nutrition and development of children, advocating for extension of school feeding, including in disadvantaged urban areas. Distribution fortified food in existing school canteens is a cost-effective strategy to improve nutrition and health. More research and efforts should be shifted to the nutritional status of adolescent girls because of the risk of early childbearing, still commonly practiced in developing countries, and the importance of adequate nutrition during pregnancy. Investing in nutrition in this age range is an opportunity to consolidate the progress achieved in pregnant women and young children through a life-cycle approach and to optimize the development of next generations in developing countries.; La dénutrition est responsable de dommages à long terme sur le développement physique et cognitif et de la moitié des décès chez les enfants de moins de 5 ans. La majorité des interventions est concentrée sur la nutrition des jeunes enfants et des mères. Cependant, la malnutrition, également prévalente chez les enfants plus âgés et les adolescents, notamment en Afrique et en Asie du Sud-Est, a des conséquences sur leur développement global, en raison des besoins élevés en énergie, protéines et micronutriments induits par les pics de croissance et de développement cérébral durant ces périodes de la vie. Nos travaux ont évalué la prévalence des malnutritions et leurs facteurs déterminants chez des enfants d’âge scolaire et des adolescents au Sénégal et au Cambodge, ainsi que l’efficacité d’une intervention avec une alimentation enrichie en micronutriments en milieu scolaire au Cambodge. Une étude transversale fut conduite sur un échantillon représentatif de 600 enfants des écoles primaires publiques de la région de Dakar sélectionnés par un échantillonnage aléatoire en grappes. Des taux élevés de maigreur (19%) et de carences en micronutriments (fer 39%, iode 33%, zinc 26%) ont été démontrés. L’enquête de consommation alimentaire a révélé des apports en micronutriments et en énergie insuffisants, ainsi qu’une contribution à l’apport énergétique déficitaire pour les protéines et en excédent pour les lipides, révélant des conditions précaires de ces scolaires en milieu urbain au Sénégal. Au Cambodge, un essai contrôlé randomisé en grappes en double aveugle conduit sur 2400 enfants a permis de mesurer l’impact de riz enrichis en micronutriments consommés pendant 6 mois, dans le cadre du programme d’alimentation scolaire du PAM, sur leurs statuts en micronutriments et leurs performances cognitives. Avant l’intervention, les faibles performances cognitives étaient associées au retard de croissance, à la carence en fer et aux infections parasitaires. La croissance était positivement associée au statut en zinc, lui-même négativement associé à l’infection parasitaire. Les riz enrichis en vitamine A ont amélioré le statut en vitamine A et le riz avec la concentration en fer la plus élevée a eu un impact positif sur les performances cognitives. Les données du Sénégal et du Cambodge ont été analysées pour étudier les indicateurs de malnutrition chez ces enfants d’âge scolaire et adolescents. Comme recommandé par l’OMS, nous avons déterminé les valeurs seuils du périmètre brachial pour détecter la malnutrition aigüe chez les enfants de plus de 5 ans au Cambodge. Nous avons confirmé la nécessité de corriger les concentrations plasmatiques de RBP et de ferritine en fonction du statut inflammatoire et démontré l’intérêt d’une telle correction pour les récepteurs de la transferrine pour améliorer l’estimation de la prévalence des carences en vitamine A et en fer dans ces populations ou l’inflammation est endémique. La dénutrition reste un problème de santé publique chez les enfants d’âge scolaire et les adolescents au Sénégal et Cambodge. La détermination des malnutritions dans cette tranche d’âge pourrait être améliorée par des recherches sur les indicateurs prenant en compte la variabilité intra populations, les facteurs environnementaux et les besoins spécifiques de ces populations. Des interventions scolaires comme au Cambodge ont des effets positifs sur la nutrition et le développement, plaidant en faveur d’une extension des programmes d’alimentation scolaire y compris dans les zones urbaines défavorisées. La distribution d’aliments fortifiés dans les cantines scolaires existantes est une stratégie peu couteuse d’amélioration de la nutrition et de la santé. La nutrition des adolescentes requiert une attention particulière en raison du risque de grossesse précoce élevé dans de nombreux pays du Sud.

The global food context is characterised by growing uncertainties and increasing constraints. The two sides of the global equation for food self-sufficiency are known: the planet will have to provide food for more than 9 billion people in 2050, while satisfying growing non-food demands because of the increasing rarity of fossil energy sources, all in the context of development that is respectful of both the environment and human beings. The joint INRA-CIRAD Agrimonde foresight study (Paillard et al., 2010) showed that achieving these ambitions is not impossible if certain conditions are met; in particular, a sustainable increase in yields on the supply side and an improvement in the use of agricultural products at different stages, including a reduction in los ses and wastage between the farm gate and the consumer's plate, and possible reductions in, or modifications to, the content of different diets on the demand side. Increased and more secure trade is also necessary, insofar as Afi-ica and Asia, where the greatest population rises are anticipated, will remain deficient in agricultural and food products. Finally, the food context of the future is characterised by increasing uncertainties and considerable constraints. These different elements provide a framework for the challenges that will have to be met by food sustainability.

To assess the traditional postpartum practices, mother and child nutritional status and associated factors.A cross-sectional study in 41 randomly selected villages on the outskirts of Vientiane capital city, Lao PDR (Laos). 300 pairs of infants (6 months of age) and their mothers were enrolled. Information was collected about pregnancy, delivery and traditional practices through a standardized questionnaire. Dietary intake and food frequency were estimated using the 24 h recall method, calibrated bowls and FAO food composition tables. Mothers' and infants' anthropometry was assessed and multivariate analysis performed.Contrasting with a high antenatal care attendance (91%) and delivery under health professional supervision (72%), a high prevalence of traditional practices was found, including exposure to hot beds of embers (97%), use of traditional herb tea as the only beverage (95%) and restricted diets (90%). Twenty-five mothers (8.3%) were underweight. Mothers had insufficient intake of calories (55.6%), lipids (67.4%), iron (92.0%), vitamins A (99.3%) and C (45%), thiamin (96.6%) and calcium (96.6%). Chewed glutinous rice was given to infants as an early (mean 34.6, 95% CI:29.3-39.8 days) complementary food by 53.7% of mothers, and was associated with stunting in 10% children (OR=1.35, 95% CI:1.04-1.75).The high prevalence of traditional postpartum restricted diets and practices, and inadequate maternal nutritional intake in urban Laos, suggest that antenatal care may be an important opportunity to improve postpartum diets.

In 1996, the Government of the Republic of Congo launched a pilot project to improve the child growth and development component of primary healthcare. The present study was carried out (i) to explore perceptions and practices of mothers and health workers regarding child growth, health, and development, and (ii) to design culturally-appropriate tools to enhance their monitoring and promotion. The study was carried out in two randomly-selected health centres in Brazzaville. Qualitative data collected included 16 focus-group discussions with 174 mothers, two focus-group discussions with 18 health workers, and 20 individual interviews with paediatricians or psychologists. The health workers reported that the main indicator of child growth was weight, while the mothers used broader concepts for evaluating growth and development of their toddlers. A strategy encompassing anthropometrics, developmental milestones, and acquisition of social skills was elaborated to enhance communication between health workers and mothers. A new growth chart was designed, and a new calendar of systematic visits, including key tasks and messages, was established. However, these new tools derived from the formative research still need to be carefully tested.

BACKGROUND In many developing countries, breastfed children have a lower nutritional status than those weaned from 12 months of age. Reverse causality, that is, earlier weaning of healthy and well-nourished children, is a possible explanation. METHODS Maternal reasons for early and late weaning were investigated in a cohort of 485 rural Senegalese children using structured interviews during two rounds at the ages of 18--28 and 23--33 months, respectively. Length, weight and height were assessed, and dates of weaning were monitored. RESULTS The mean duration of breastfeeding was 24.1 months (quartiles 21.9 and 26.3). Two-thirds of mothers of breastfed children under 2 stated that they would wean at the age of 2, while for breastfed children aged 2 years, a 'tall and strong' child was the most prevalent criterion. The main reasons for weaning prior to 2 years (N = 244) were that the child ate well from the family plate (60%), that the child was 'tall and strong' (46%) and maternal pregnancy (35%). The main reasons for weaning later than the age of 2 were: a 'little, weak' child (33%), food shortage (25%), illness of the child (24%) and refusal of family food (14%, N = 120). Children breastfed above the age of 2 because they were 'small and weak' had lower mean height-for-age and a greater prevalence of stunting than children breastfed late for other reasons (P < 0.0001). CONCLUSION The habit of postponing weaning of stunted children very likely explains why breastfed children have lower height-for-age than weaned children in this setting.

Nutritional status was monitored in a random sample of inhabitants of three villages in Northern Senegal where irrigated rice cultivation started in July 1989. In early 1990, weight and height were measured in children and adults. From 1990-1995, 290 preschool children, 175 mothers of the children and 99 men aged 20-60 years were followed longitudinally. The prevalence of wasting in children fell from 11.4% (95% confidence interval : 7.4-15.4%) in 1990 to 3.8% (1.6-6.0) in 1995, while the prevalence of stunting initially declined and then increased. Prevalence of chronic energy deficiency (BMI is less than 18.5 kg/m2) in men fell from 22.5% (14.6-30.4%) in 1990 to 6.6% (1.4-11.8%) in 1991 and thereafter increased to 13.0% in 1995, while no significant variations were found among women. The prevalence of overweight (BMI is greater than 25 kg/m2) increased significantly over time in both sexes. Individual annual weight gains of adults were significantly greater than zero from 1990 to 1991 (mean : 1.8 kg/yr) and from 1991 to 1992 (mean : 1.2 kg/yr), and close to zero thereafter. In conclusion, the onset of irrigated rice cultivation was followed by a decrease in the prevalences of wasting and chronic energy deficiency, but a causal relationship between the agricultural project and nutrition changes cannot be ascertained. (Résumé d'auteur)

Peu après la dévaluation du franc de la Communauté financière africaine (CFA) intervenue le 12 janvier 1994 dans 14 pays africains, des inquiétudes se sont exprimées quant aux conséquences qu'elle pourrait avoir, notamment en matière de santé, pour des populations déjà fragilisées par plusieurs années de crise économique d'ajustement. On prévoyait en particulier que les populations urbaines seraient très touchées. Jusqu'à présent, cette question n'a pas vraiment été analysée. Une étude préliminaire faite à Brazzaville (Congo) un an après la dévaluation a montré que la qualité des aliments de complément donnés aux nourrissons commençait à se dégrader. L'étude présentée ici visait à répondre à plusieurs questions : cette dégradation allait-elle s'inscrire dans la durée ? L'état nutritionnel des enfants allait-il lui aussi se détériorer ? La situation nutritionnelle des adultes était-elle menacée ? L'étude se fondait sur deux enquêtes nutritionnelles faites en 1993 et 1996 dans deux quartiers centraux de Brazzaville auprès d'un échantillon représentatif des ménages ayant un enfant âgé de 4 à 23 mois (n = 2623 et n = 1583, respectivement). Les deux enquêtes ont été réalisées par passage à domicile, avec la même méthodologie et le même questionnaire. On s'est servi de mesures anthropométriques normalisées pour calculer les indices de Quételet pour les mères. Pour tenir compte de certaines modifications de caractéristiques sociales des ménages en raison des troubles civils survenus à Brazzaville à la fin de 1993, nous avons ajusté les comparaisons entre les deux enquêtes pour les variables correspondantes. La dégradation de la qualité de l'alimentation de complément amorcée en 1994 s'est poursuivie en 1996 : 4 à 11 mois était moins souvent un aliment de transition spécial (48,1% en 1996 contre 58,9% en 1993, p = 0,0001)... (D'après résumé d'auteur)

The objective of this study was to evaluate the ability of the body mass index (BMI, kg/m2) to reflect low percent body fat (%BF) in a population with a rather mild but widespread prevalence of low BMI. A sample of 586 women was studied in the Plateau Koukouya, a rural area of the Republic of Congo, Central Africa. Percent BF was estimated from bio-electrical impedance (BIA). BIA parameters were assumed to reflect lean body mass. The correlation between %BF and BMI was high (r = 0.84; P is less than 0.001). Low %BF or low BIA parameters were defined as the first quartile of value of BMI is less than 18.5, an accepted international cutoff for thinness, in relation to %BF was 58.5%, 93.6%, 75.4%, and 87.1%, respectively. A continuous sensitivity/specificity analysis (receiver operator characteristic (ROC) curves) for characterizing low %BF or low BIA parameters was done for a large range of BMI values. ROC curve analysis for %BF suggested that an acceptable trade-off between sensitivity (89.8%) and specificity (77.9%) occurred at a BMI of 19.7 kg/m2. However, the positive predictive value was low (57.6%). For the prediction of low BIA parameters, results were similar, showing moderate sensitivity and high specificity for BMI is less than 18.5, a cutoff point of BMI = 19.6, and low positive predictive values (less than 48%). The data suggest that BMI was not a good predictor of low %BF. This is consistent with the assumption of a decrease in both fat and fat free body mass in cases of low BMI. (Résumé d'auteur)

ObjectiveTo assess the relative importance of socioeconomic and maternal/prenatal determinants of the nutritional situation of children < 6 years old in an urban African area after several years of economic crisis.DesignCross-sectional cluster sample survey.SettingBrazzaville, capital city of the Congo.SubjectsInformation on socioeconomic characteristics was gathered from a random sample of 1368 households by house visits and anthropometric measurements were performed using standardized procedures on preschool children (n=2373) and their mothers (n=1512).ResultsThe influence of socioeconomic factors on the nutritional status of children, taking into account adjustment variables such as mother's age and child's age and sex was assessed. For stunting, as well as for the mean height-for-age index among children, the main determinants were economic level of the household (P=0.048 and P=0.004, respectively), schooling of the mother (P=0.004 and P < 10−3) and living in the peripheral district (P=0.005 and P < 10−3). The influence of socioeconomic determinants on weight-for-age and wasting was less straightforward. When adjusting, in addition, for maternal and prenatal factors (mother's height and body mass index (BMI) and birth weight), most of the effects of the socioeconomic determinants on the nutritional status of children persisted somewhat, but the effect of the economic level on the stunting became not significant (P=0.11). The mean BMI of mothers appeared to be related to the economic level of the household (P < 10−4), to the marital status (P=0.01) and to the occupation of the mother (P < 10−4).ConclusionsAmong the socioeconomic determinants of malnutrition in children, some, such as economic level of the household or schooling of the mother, seem to act mainly through prenatal factors, whereas others, mainly dwelling district characteristics, seem to influence more directly the children's nutritional status.

Objective: To study the physical activity patterns and daily estimates of energy expenditure (EE) of rural adolescent Senegalese girls. Design: Physical activity was monitored using a portable accelerometer during four consecutive days and within the same time, by direct observation during two consecutive days. Adolescent girls were followed during the dry season (June, n=40) and again during the rainy season (September, n=30) Setting: The Niakhar district in the central part of Senegal. Subjects: Forty adolescents (13.3±0.5 y) drawn from a sample of 221 rural girls followed as part of a longitudinal study on growth and nutrition during puberty. Results: Reliability of movement counts was acceptable (intraclass correlation, R=0.71). There was a linear relationship between movement counts and observed scores. Predicted physical activity levels were high: 1.90±0.12 Mets (EE: 9.03±0.77 MJ). Physical activity levels derived from movement counts during the day are higher in the rainy season than during the dry season. This coincided with a depression in nutritional indicators during the rainy season apparent in the overall sample. Sleep duration appeared to be short in both seasons (6–6.5 h per night). Senegalese adolescents participated in daily household tasks but time spent in productive activities, agricultural or handicraft, was less than 1 h per day. Conclusions: Estimates of activity-related EE of Senegalese adolescents were greater than those of adolescents from developed countries but closed to recent estimates for rural areas in developing countries. Energy requirements drawn from developed countries do not necessarily apply to African adolescent girls. Sponsorship: The ‘Conditions d'Amelioration des Situations Nutritionnelles’ project of the IRD (anciennement ORSTOM) and the Nestle Foundation.

The objective of this study was to determine the zinc and copper status in hair of a group of Indonesian infants aged 0-5 months, a period when growth faltering in this population is known to occur, and to determine the daily znc and copper availability in the habitual diet. A mixed cross-sectional longitudinal design was used. Infants 0-3 months of age were recruited in two villages on the south coast of the island of Madura, Indonesia and follwed up to the age of 5 months. All newborns during the study period were included. Hair samples were collected between the ages of 0 and 5 months at monthly intervals. Zinc and copper concentrations were determined by flame atomic absorption spectrophotometry and compared with a sample of Belgian controls, recruited cross-sectionally. Zinc and copper content of the habitual diet was calculated on the results of a food intake study previously performed in the same community. For the 42 Madurese infants recruited, 107 hair zinc and 96 hair copper concentrations were determined. Belgian infants (15 boys, 15 girls) served as controls. One Madurese infant died during the study and six moved from the area. Hair zinc concentrations were found to decrease with age in both populations, while the zinc and copper values did not differ from the Belgian controls. Hair zinc values were not correlated with growth performance. The boys had lower hair zinc values than did the girls. Copper values among the Indonesian infants did not show a trend over time ; however, the Belgian children showed an increase towards the age of 12 months, although this was not significant. The mean daily zinc and copper availability in the habitual diet was less than half of the recommended daily allowance for adult women. The situation was much worse for lactating women given that the availability of these elements increased very little... (D'après le résumé d'auteur)

To measure the lipid content and the fatty acid (FA) composition of breast milk as part of a nutritional survey of the essential fatty acid (EFA) status of 5 months old Congolese infants.Cross sectional nutrition survey.A suburban district of Brazzaville (capital of the Congo).A random sample of nursing mothers and their 5 months old infants (n = 102). Data collection procedures: The mothers were questioned on their socio-economic status, dietary habits, and their body mass index (BMI) was measured. Breast milk samples were collected from each mother. Milk lipid content and fatty acid composition were determined.Compared with milk from various countries, Congolese women's mature breast milk was low in lipid (28.70+/-11.33 g/L) but rich in 8:0-14:0 FAs (25.97+/-8.17% of total FAs) and in polyunsaturated FAs (PUFAs), particularly n-3 PUFAs (2.39+/-0.68% of total FAs, mainly 18:3 and 22:6). This was associated with the frequent consumption of high-carbohydrate foods (processed cassava roots, wheat bread, doughnuts) known to enhance 8:0-14:0 FA biosynthesis, and with that of foods providing n-6 and n-3 EFAs such as freshwater and saltwater fish, vegetable oil, green leafy vegetables, and high-fat fruit (peanuts, avocado, bushbutter). These foods were traditionally and locally produced. Milk lipid content was negatively related with mothers' BMI (P0.01) and varied with the frequency of consumption of certain foods corresponding to distinct dietary patterns.Lipid content and FA composition of Congolese breast milk were dependent on mother's nutritional status. However, despite an adequate EFA composition of breast milk, partially breast-fed 5 months old Congolese infants probably did not get enough n-6 and n-3 EFAs from breast milk to meet their EFA requirements.Optimum infant growth and development, especially neurodevelopment and visual acuity, require sufficient n-6 and n-3 essential fatty acid supplies from the placenta or breast milk. The lipid content and fatty acid composition of mature breast milk were measured in samples from 102 randomly selected Congolese mothers of 5-month-old infants, residing in a suburban district of Brazzaville. Mean body mass index (BMI) was 22.3; 14% of mothers were energy-deficient and 22% were overweight. Breast milk samples from these mothers were low in lipids (mean, 28.70 g/l), and 75% had a lipid content below reference values. Adequate lipid content was associated with a maternal diet high in carbohydrates and low in fats. Breast milk was rich in 8:0-14:0 fatty acids (25.97% of total fatty acids) and in polyunsaturated fatty acids, especially n-3. These findings appear related to Congolese mothers' frequent consumption of high-carbohydrate foods such as processed cassava roots, wheat bread, and doughnuts known to enhance 8:0-14:0 fatty acid biosynthesis, as well as locally produced foods such as fish, vegetable oil, leafy green vegetables, and high-fat fruit that provide n-6 and n-3 essential fatty acids. Milk lipid content was inversely associated with the maternal BMI, but was unrelated to maternal age or socioeconomic status. Since the essential fatty acid content of traditional complementary foods is lower than that present in breast milk, Congolese mothers should be encouraged to postpone the introduction of such foods until their infant is 4-6 months old.

In 1986, 1991 and 1996, three anthropometric cross-sectional surveys were carried out in Brazzaville, the capital city of the Congo, on the representative samples of children less than 6 y. old (n = 2,265, 2,345 and 2,000, respectively) and their mothers. In addition all other members of the households were also investigated in 1991 and 1996. Comparisons between years were adjusted for age, district and, when necessary, sex. Prevalence of wasting (weight-for-height is less than -2 z-scores) among children showed a significant increase over the three surveys (2.9%, 3.9%, 4.6% - OR 96 vs 86 = 1.72, p = 0.001). The prevalence of low Body Mass Index (BMI is less than 18.5 Kg/m2) among mothers also significantly increased (8.4%, 10.5%, 14.2% - OR 96 vs 86 = 1.89, p is less than 0.001). Paradoxically the proportion of stunted children (height-for-age is less than -2 z-scores) first decreased from 1986 to 1991 (13.4% to 10.7% - OR 91 vs 86 = 0.73, p is less than 0.001). These results reflect a global deterioration of the nutritional situation. Moreover, similar trends among the other household members were observed from 1991 to 1996 ; increase of low BMI prevalence among adults (women, OR = 1.42, p is less than 0.001 ; men, OR = 1,49, p = 0.001) ; increase of low BMI for age among adolescents, especially males (OR = 1.75, p is less than 0.001), increase of stunting in school children (9.6% to 14.5% - OR = 1.54, p. is less than 0.01). (Résumé d'auteur)

Relationships between iron deficiency, cell-mediated immunity (CMI) and morbidity were studied in 220 children in rural south Togo. Iron deficiency was defined by abnormal values of at least two biochemical indicators of iron status viz. (i) plasmat ferritin, (ii) transferrin saturation, (iii) erythrocyte protophorphyrin. In children without any sign of inflammation, the percentage of B lymphocytes was higher in iron-deficient than in iron-sufficient children (26.7 +/- 2.9 vs 18 +/- 1.5). Mature T lymphocyte and helper-inducer T lymphocyte percentages were lower (51.6 +/- 3.7 vs 62.2 +/- 1.6 and 32.5 +/- 2.4 vs 38.7 +/- 1.4, p