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Observational studies of dietary patterns and growth and studies with milk supplementation have shown that children consuming diets containing animal source foods grow better. This study evaluates the growth of 544 Kenyan schoolchildren (median age 7.1 y) after 23 mo of food supplementation with a meat, milk or energy supplement (~1255 kJ) compared to a control group without a supplement. Multivariate analyses controlled for covariates compared gain in weight, height, weight-for-height Z-score (WHZ), height-for-age Z-score (HAZ), mid-upper-arm circumference, triceps and subscapular skinfolds, mid-upper-arm muscle and mid-upper-arm fat area. Children in each of the supplementation groups gained ~0.4 kg (10%) more weight than children in the Control group. Children in the Meat, Milk and Energy groups gained 0.33, 0.19 and 0.27 cm more, respectively, in mid-upper-arm circumference than children in the Control group. Children who received the Meat supplement gained 30-80% more mid-upper-arm muscle area than children in the other groups, and children who received the milk supplement gained 40% more mid-upper-arm muscle area than children who did not receive a supplement. No statistically significant overall effects of supplementation were found on height, HAZ, WHZ or measures of body fat. A positive effect of the milk supplement on height gain could be seen in the subgroup of children with a lower baseline HAZ ([is less than or equal to]-1.4). The results indicate that food supplements had a positive impact on weight gain in the study children and that the addition of meat increased their lean body mass. KEY WORDS: * animal source foods * growth * body composition * schoolchildren * Kenya

The contribution of various factors to malnutrition, particularly stunting, may differ among areas and communities. This cross-sectional study aimed to estimate the level of malnutrition and identify factors associated with the high level of stunting in breast-fed infants aged 5-11 mo living in Dodota-Sire District, Ethiopia. Infants (n = 305) and their mothers were examined physically, and anthropometric and demographic data were collected. The content of zinc, calcium and copper in breast milk was measured, and data collected on the type, frequency of consumption, and time of introduction of supplementary feeding. Overall, 36% were stunted, 41% underweight and 13% wasted. The highest prevalence of malnutrition was seen in infants aged 9-11 mo. Among mothers, 27% had chronic energy deficiency (body mass index, 3 times/d, consuming >600 mL/d or consuming cow's milk in addition to cereals and/or legumes had markedly higher length-for-age Z-scores than their peers fed less frequently, consuming less food or not consuming cow's milk [differences: 0.39, 95% confidence interval (CI): 0.04-0.74; 0.17, 95% CI: 0.02-0.32; 0.40, 95% Ch 0.07-0.72, respectively). Infants of mothers with low concentrations of zinc in their breast milk were more stunted. In conclusion, the quality and quantity of foods consumed by infants is insufficient to prevent stunting. Thus it is necessary to increase the nutrient supply to infants by increasing intake and nutrient concentration of breast milk and of supplementary foods they consume, and by providing supplements to infants where appropriate. J. Nutr. 133: 1064-1069, 2003. KEY WORDS: * anthropometry * breast-feeding * nutritional status * supplementary feeding * Ethiopia

Carotenoids are thought to contribute to the beneficial effects of increased vegetable consumption. Various dietary factors have an effect on the bioavailability of carotenoids. The type of food matrix in which carotenoids are located is a major factor. The bioavailability of [beta]-carotene from vegetables in particular has been shown to be low (14% from mixed vegetables) compared with that of purified [beta]-carotene added to a simple matrix (e.g., salad dressing), whereas for lutein, the difference is much smaller (relative bioavailability of 67% from mixed vegetables). Processing, such as mechanical homogenization or heat treatment, has potential to enhance the bioavailability of carotenoids from vegetables (from 18% to a sixfold increase). The amount of dietary fat required to ensure carotenoid absorption seems low (~3-5 g per meal), although it depends on the physicochemical characteristics of the carotenoids ingested. Unabsorbable, fat-soluble compounds reduce carotenoid absorption, and interaction among carotenoids may also result in a reduced carotenoid bioavailability. Research into the functional benefits of carotenoids should consider the fact that file bioavailability of [beta]-carotene in particular is one order of magnitude higher when provided as a pure compound added to foods than when it is present naturally in foods. J. Nutr. 130. 503-506, 2000. KEY WORDS: * carotenoids * bioavailability * vegetables * processing * fat * interaction

One of the health problems in Indonesia is the high prevalence of stunting in infants. Determinants and specifically the relative contribution of prenatal and postnatal factors to growth and nutritional status of Indonesian infants were investigated. Newborn infants, from women recruited at ~18 wk of pregnancy from 9 rural villages in West Java, Indonesia, were followed until 12-15 mo of age. Weight, length, morbidity, breast-feeding and food intake were assessed monthly. Determinants of length and weight increase and nutritional status reflected by Z-scores were evaluated using multiple linear regression. Neonatal weight (3.2 [+ or -] 0.5 kg) and length (49.7 [+ or -] 2.2 cm) were reasonable. However, growth started to falter at 6-7 mo of age, resulting in prevalences of 24% stunting and 32% underweight at 12 mo of age. The multiple regression models explained 19-41% of the variation in growth and nutritional status of infants. Neonatal weight ([beta] = 0.285) and length ([beta] = 0.492) were the strongest positive predictors of weight-for-age and height-for-age Z-scores, respectively. Fever was negatively associated with weight increase ([beta] = -0.144) and weight-for-age ([beta] = -0.142) and weight-for-height Z-scores ([beta] = - 0.255) but not with length increase or height-for-age Z-scores. Intake of complementary foods was positively associated with increases in weight ([beta] = 0.190) and length ([beta] = 0.179) and nutritional status of infants ([beta] = 0.136- 0.194). In conclusion, in this rural population in West Java, neonatal weight and especially length, reflecting the prenatal environment, are the most important predictors of infant nutritional status. KEY WORDS: * infants * growth * nutritional status * feeding * morbidity * determinants

In developing countries, low food intake is often reported in children < 5 y old. Reduced appetite may be a contributing factor. We investigated whether a combination of a multivitamin-multimineral supplement and additional iron treatment improved appetite and growth of 18- to 30-mo-old stunted and anemic Beninese children. The study was placebo-controlled using VITALIA tablets (11 vitamins and 10 minerals) and ferrous fumarate tablets (66 mg of iron). One hundred fifty stunted (height-for-age Z score < -2) and anemic children (hemoglobin < 110 g/L) were randomly assigned to one of four groups: group 1, multivitamin-multimineral plus iron; group 2, multivitamin-multimineral plus placebo; group 3, placebo plus placebo; and group 4, placebo plus iron. Supplementation was daily and supervised for 6 wk. Appetite, knee-heel length, dietary intakes and morbidity were assessed before and after supplementation. Length, weight, arm circumference and hemoglobin concentration were assessed before, just after supplementation and 4 mo after the intervention. Appetite was assessed by means of an appetite test using a test food, riz-au-gras, eaten ad libitum after an overnight fast. Dietary intakes were assessed during three consecutive days in a subsample by means of the observed weighed record method. Energy intake from the habitual breakfast was significantly correlated with that from the test food (r = 0.49, n = 38, P = 0.002). There were no differences among groups in changes in appetite and growth performance. The habitual diet of the children was monotonous and contained only small amounts of animal products. The morbidity status of the children was comparable in all study groups, before as well as after supplementation. We conclude that the 6-wk multivitamin-multimineral supplementation with additional iron treatment failed to improve the appetite and growth of the children. J. Nutr. 131:2874-2879, 2001. KEY WORDS: * appetite * growth * young children * micronutrient supplementation * deworming

Elevated total plasma homocysteine (tHcy) concentrations are considered a risk factor for neural tube defects (NTD) and cardiovascular disease. Supplementation with folic acid decreases the risk of women having children with NTD. In both sexes, it decreases tHcy levels. We investigated the efficacy of natural dietary folate in improving folate and homocysteine status. We performed a 4-wk dietary controlled, parallel design intervention trial with 66 healthy subjects (18-45 y) divided into 3 treatment groups: the dietary folate group, the folic acid group and the placebo group. Each day each group was fed a different diet. The dietary folate group received a diet high in vegetables and citrus fruit (total folate content [approximately]560 [[micro]gram]) plus a placebo tablet. The folic acid group received a diet naturally low in folate ([approximately]210 [[micro]gram]) plus 500 [[micro]gram] folic acid and placebo tablet on alternate days, i.e., 250 [[micro]gram] folic acid/d. And the placebo group received the same low-folate diet as the folic acid group plus a placebo tablet. After 4 wk of intervention, folate status improved, and tHcy concentrations decreased in both the dietary folate and the folic acid groups. From the amount of additional folate (350 [[micro]gram]/d) and folic acid (250 [[micro]gram]/d) consumed, the relative bioavailability of dietary folate compared to folic acid was calculated to be 60-98%, depending on the endpoint used. In conclusion, increasing the consumption of vegetables and citrus fruit, both good sources of folate, will improve folate status and decrease tHcy concentrations. This may contribute to the prevention of cardiovascular disease and NTD in the general population KEY WORDS: humans; folate; homocysteine; vegetables; fruit

Tomatoes are the main dietary source of lycopene, and the bioavailability of lycopene from tomato paste is higher than that from fresh tomatoes. We investigated systematically the effect of mechanical homogenization and heating on the bioavailability of carotenoids from canned tomatoes. Further, we compared the carotenoid response in triglyceride-rich lipoproteins (TRL) after single consumption with the change in fasting plasma carotenoid concentrations after 4 d of daily consumption. In a split plot design, 17 men and women consumed tomatoes which had received minimal additional heating and 16 others consumed extensively additionally heated tomatoes (1 h at 100 [degrees] C). These tomatoes were not, mildly or severely homogenized. The tomato products were consumed daily (ca. 22 mg/d lycopene) for 4 d. Eleven participants provided postprandial blood samples on the d 1 and all gave fasting blood samples on d 1 and 4. Homogenization enhanced the lycopene response significantly (P [is less than] 0.05) both in TRL [mean areas under the curves: 54.9, 72.0 and 88.7 nmol [multiplied by] h/L (SE 11.0) for not, mildly and severely homogenized tomatoes, respectively] and in plasma [mean changes: 0.19, 0.22 and 0.23 [micro]mol/L (SE 0.009), respectively]. Additional heating also tended to enhance the lycopene responses in TRL (P = 0.14) and plasma (P = 0.17). Similar effects to those for lycopene were found for [Beta]-carotene. We conclude that the intactness of the cellular matrix of tomatoes determines the bioavailability of carotenoids and that matrix disruption by mechanical homogenization and/or heat treatment enhances the bioavailability. The carotenoid response in plasma after 4 d intervention can be used to compare the bioavailability of carotenoids from different foods. J. Nutr. 130: 1189-1196, 2000. KEY WORDS: * carotenoids * lycopene * bioavailability * tomatoes * humans