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Background: Studies in several countries comparing the performance of WHO references and their own national growth standards reported differences that could affect screening and growth monitoring., Aim: To estimate weight and height centiles on a sample of Argentinian children and adolescents and compare selected centiles with WHO and national growth references., Subjects and Methods: A cross-sectional school survey was conducted on 6239 boys and girls aged 5-18. Data were collected between 2005-2009 in Santa Rosa, Argentina. Smoothed weight and height centiles were estimated by the LMS method and compared with WHO 2007 and Argentinian (ARG) growth references., Results: Weight centiles were higher than those of WHO and ARG. Height centiles were above the ARG and below the WHO ones. The greatest differences with ARG were seen before puberty and then declined up to age 18. In contrast, differences with WHO increased from puberty onwards., Conclusion: Compared with the ARG reference, linear growth of these schoolchildren shows a secular acceleration without substantial improvements in the adult height. In relation to WHO, the results suggest that around the adolescent growth spurt differences in linear growth between populations became larger, limiting the clinical usefulness of international growth references in adolescents.

Prenatal lead exposure is a health hazard that may cause cognitive development impairments and other adverse effects in children. We conducted a cross sectional study analyzing cord blood lead levels (CBLL) of newborns and their relationship with maternal determinants of lead exposure. Mothers answered a questionnaire about socio-demographic, lifestyle habits and environmental characteristics. We used Mann-Whitney's test to compare CBLL geometrical means (GM) corresponding to the presence or absence of each lead exposure determinant, and Chi square test to study the relationship between CBLL and maternal lead exposure determinants. A total of 159 newborns participated in the study. CBLL GM was 2.1 μg/dL; and 25% of the participants had a measurable CBLL (LOQ=3.3 μg/dl). Although the participants had several determinants of lead exposure, we only found a significant relationship with inside household determinants, such as presence of lead piping (p=0.026), unplastered walls (p=0.046) and peeling paint (p=0.048). Our results show that CBLL GM was similar to that reported in several studies conducted around the world. However, 25% of the participants might have some degree of risk for lead poisoning., (Copyright © 2013 Elsevier B.V. All rights reserved.)

We studied the impact of a food supplementation program (Plan Más Vida (PMV)) on the micronutrient nutritional condition of pregnant women from low-income families 1 year after its implementation. The food program provided supplementary diet (wheat and maize--fortified flour, rice or sugar, and fortified soup). We performed a prospective, nonexperimental, cross-sectional study in the province of Buenos Aires, Argentina, evaluating pregnant women at baseline (n = 164) and 1 year after PMV implementation (n = 108). Biochemical tests (hemogram, ferritin, vitamin A, zinc, and folic acid), anthropometric assessments (weight and height), and dietary surveys (24 h recall) were performed at the two study points. One year after PMV implementation, no significant changes in anthropometric values were observed. Folic acid deficiency and the risk of vitamin A deficiency (retinol, 20-30 μg/dl) decreased significantly (35.8 to 6.1 % and 64 to 41 %, respectively; p < 0.000). Anemia and prevalence of iron and zinc deficiency values did not change. Diet survey results showed that although nutrient intake increased significantly, it was still below recommendations. Implementation of the PMV and of the government nutritional strategies had a high impact on the prevalence of folic acid deficiency. We also observed a decrease in the risk of vitamin A deficiency, and no impact on iron and zinc nutritional status. Adherence to the specific fortified food (soup) was not good and intra-family dilution and distribution of food was high.

This study was conducted to evaluate the impact of a food aid program (Plan Más Vida, PMV) on the micronutrient nutritional condition of lactating mothers 1 year after its implementation. The food program provided supplementary diets (wheat- and maize-fortified flour, rice or sugar, and fortified soup) to low-income families from the province of Buenos Aires, Argentina. A prospective, non-experimental study was carried out to evaluate the micronutrient nutritional status of lactating mothers (n = 178 at baseline and n = 151 after 1 year). Biochemical tests (hemoglobin, ferritin, zinc, vitamin A, and folic acid), anthropometric assessments (weight and height) and dietary surveys (24-h recall) were performed. We found no significant changes in anthropometric values 1 year after the intervention. The risk for vitamin A (retinol 20-30 μg/dl) and folate deficiency significantly decreased 1 year after PMV implementation (56.3 vs. 29.9 and 50.3 vs. 3.4 %, respectively; p < 0.001). Anemia was seen in 25.8 % of lactating mothers at baseline, without statistically significant differences 1 year after (p = 0.439). The nutritional data obtained after assessing the early impact of PMV actions may be useful to provincial health authorities to perform periodic evaluations in the future.

Introduction. Anemia is a public healthcare problem that particularly affects children under the age of 2 years, with consequences that greatly affect psychomotor and intellectual growth during childhood and productive capacities in adulthood. Objective. To study the prevalence of anemia, its variations and possibly associated factors in children under 6 months of age. Material and methods. Cross-sectional descriptive study analyzing health records of 363 children aged 4-5 months assisted in the period 2007-2010. We determined the association of anemia (hemoglobin <10,3 g/dl) with feeding (exclusive breastfeeding and mixed feeding), type of birth and sex. Birth weight means and z-scores for weight-for-age, height-for-age, and weight-for-height were compared in anemic versus non-anemic children. Results. Anemia was present in 28.9% (105/363) of children, being its prevalence significantly higher in boys (38.3% versus 20.9%; p= 0.000). There were no significant differences in type of birth or feeding. Mean birth weight and mean z-score for weight-for-age, height-for-age and weight-for-height was significantly lower in anemic vs. non-anemic children. We found a significant reduction in anemia (37.8% in 2007 to 20.3% in 2010 during the study period, p= 0.012) Conclusion. The prevalence of anemia was 28.9%; decreased significantly between 2007 and 2010, and represents a serious public healthcare problem. The prevalence was higher in boys, in children with lower birth weight and in those with lower antropometric indices. Our results, even though local, reflect the high nutritional risk of the population under 6 months of age.

We determined the effect of calcium supplementation on bone mineral density (BMD) and bone mineral content (BMC) and identified predictors of bone mass changes in adolescent mothers 6 months postpartum. A prospective, analytical, clinical study was performed in adolescent mothers (< or = 19 years old; n = 37) from La Plata, Argentina. At 15 days postpartum, mothers were randomly assigned into one of two groups and started with calcium supplementation; one group received dairy products (932 mg Ca; n = 19) and the other calcium citrate tablets (1000 mg calcium/day; n = 18). Weight, height and dietary intake were measured and BMD was determined by DEXA at 15 days (baseline) and 6 months postpartum. BMC, total body BMD and BMD were assessed in lumbar spine, femoral neck, trochanter and total hip. Regression models were used to identify the relationship of total body BMD and BMC with independent variables (calcium supplementation, months of lactation, weight at 6 months, percent weight change, lean mass at 6 months, percent lean mass change, total calcium intake). Results showed that changes in BMD and BMC at the different sites were similar in both groups, and changes in percent body weight and total calcium intake were the main predictive factors. In conclusion, the effect of calcium was similar with either form of supplementation, i.e., dairy products or tablets, and changes in percent body weight and total calcium intake were predictors of total body BMD and BMC changes.

This study was undertaken to evaluate the impact of Plan Más Vida (PMV) on the micronutrient nutritional condition of children aged 1 to 6 years 1 year after PMV implementation. The food program was intended for low-income families from the province of Buenos Aires, Argentina and provided supplementary diets. A prospective, nonexperimental study was carried out. Children (472 at baseline and 474 after 1 year) were divided into two groups (1-2 and 2-6 years of age). Biochemical tests (hemogram, ferritin, zinc, vitamin A, and folic acid), anthropometric assessments (weight and height), and dietary surveys (24-h recall) were performed. Chronic growth retardation (-2 height/age Z-score) was present in 2.8% and 8.7% of 1-2- and 2-6-year-old children, respectively; 14.4% in the former and 8.8% in the latter group had overweight/obesity. No significant changes were recorded 1 year after PMV implementation. Whereas anemia values decreased (55.3% to 39.1%, p = 0.003) and serum zinc values increased in 1-2-year-old children, the risk for vitamin A deficiency decreased significantly in both age groups. The evaluation of the early impact of PMV actions provided important nutritional data that should be used by provincial health authorities to conduct future evaluations.

Objective: Bone mineral density (BMD) loss has been described in adult women in the 12-month postpartum period. However, little is known about the precise BMD pattern in adolescent mothers. The present study aimed to evaluate BMD in Argentinean adolescent mothers followed up during the 12-month postpartum period., Design: Analytical, prospective clinical trial. BMD and body composition were determined by dual-energy X-ray absorptiometry; bone mineral content (BMC) and BMD were measured in the lumbar spine (L2-L4), femoral neck (FN), femur trochanter (TR), total hip (TH) and total body. Changes in BMD and BMC were analysed using ANOVA for pairwise comparisons. Other comparisons were performed with the paired-sample t test and Wilcoxon test; Pearson's correlation coefficient was used to analyse the relationship among continuous variables., Setting: La Plata, Argentina., Subjects: Adolescent mothers (n 35; 17 years old or less) were recruited within 15 d after delivery. Studies and follow-up were performed at 15 d and 3, 6 and 12 months postpartum., Results: BMD and BMC losses at 3 and 6 months and recovery at 12 months fitted a quadratic curve (ANOVA) at the three sites studied (FN, TH, TR), in total-body BMD (P = 0.000) and BMC (P = 0.038). At hip sites, BMD loss occurred at 3 months (FN, P = 0.000; TR, P = 0.000; TH, P = 0.000) and 6 months (FN, P = 0.000; TR, P = 0.000; TH, P = 0.000) compared with basal values. Percentage BMD loss immediately after delivery up to 6 months was about 5 %., Conclusions: Adolescents showed significant BMD and BMC losses at 6 months postpartum, with an almost total recovery at 12 months in all sites studied.

Introduction: Environmental exposure to lead and the subsequent poisoning are a main public health concern worldwide. Children have a higher vulnerability to lead toxic effects, and many reports have shown the association between iron deficiency and lead poisoning. In Argentina, reports about lead levels in children are scarce. Our aims were to assess blood lead levels in children and determining their relationship with iron deficiency and known lead exposure risk factors., Material and Methods: We performed a cross-sectional study in a sample of 93 children (age range, 6 months to 5 years) receiving care at La Plata Children s Hospital. A social and environmental survey was done, and blood lead, hemoglobin and ferritin levels were assessed., Results: Geometric mean blood lead level was 4.26 microg/dl (95% CI, 3.60-5.03); prevalence of blood lead levels >or=10 microg/dl was 10.8%. Higher blood lead levels were found in children living in households with lead-handling contaminating activities (6.74 vs. 3.78 microg/dl; p= 0.005) and in very low-income households (5.68 vs. 3.71 microg/ dl; p= 0.020). The presence of blood lead levels >or=10 microg/dl was strongly associated with iron deficiency (OR 5.7; 95% CI: 1.34-23.41) and with lead-handling activities at home (OR 4.8; 95% CI: 1.12-20.16)., Conclusion: The prevalence of blood lead levels >or=10 microg/dl is a matter of concern in the population studied. Iron deficiency and development of lead-handling activities at home were the risk factors associated with high blood lead levels.