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Biomedical subjects

B Torún

Publications and source records attributed to B Torún.

At least 19 recordsLinked to original sources
PubMed1999

Epidemiology of altered intestinal permeability to lactulose and mannitol in Guatemalan infants.

BACKGROUND: Subclinical alterations of small intestinal function have been reported frequently in tropical countries. Studies of small intestinal permeability to lactulose and mannitol were therefore completed in Guatemalan infants from a low-income, periurban community to assess the prevalence of altered intestinal function and the factors associated with this condition. METHODS: Two hundred studies were successfully completed in 158 infants who had been free of diarrhea for at least 1 week before the day of study. Urinary concentrations of lactulose and mannitol during the 5-hour period after ingestion of 400 mg/kg body weight of lactulose and 100 mg/kg body weight of mannitol were measured by gas-liquid chromatography and compared by age group, feeding practices, anthropometric indexes, and serum iron and zinc concentrations. RESULTS: The overall prevalence of altered intestinal permeability (defined as a ratio of urinary recovery of lactulose to mannitol [L/M] > or =0.07) was 30%. The urinary L/M recovery ratio was positively associated with age; low weight for age; and, in infants less than 6 months of age, non-breast-feeding. Children with serum iron concentrations less than 7.16 microM/l (40 [microg/dl) had higher median L/M ratios (L/M = 0.068; 95% confidence interval [CI], 0.054, 0.085) than those with iron levels higher than this cutoff (L/M = 0.052; CI = 0.046, 0.058; p = 0.038). The median urinary L/M recovery ratio in 10 currently asymptomatic infants who had diarrhea during the week before testing (0.087; CI = 0.49, 0.154) was higher than that in children who had been free from diarrhea for at least 1 week (0.052; CI = 0.048, 0.056; p = 0.01). CONCLUSION: Age, feeding practices, low weight-for-age, low serum iron concentration, and recent diarrhea were all associated with altered intestinal function in this group of Guatemalan infants.

Aging↗
PubMed1999

[Eating behavior from birth to 5 years].

Dietary and nutritional recommendations made in 1993 by a group of Latin American specialists are still valid. They were based on physiological maturation, nutritional requirements, desirable eating habits, and cultural and economic patterns. Exclusive breast-feeding for 4-6 months is ideal for every child. It should continue as part of a mixed diet that is culturally acceptable. Other foods must be added to satisfy nutritional needs and expose the child to different textures and flavors. When breast-feeding is not possible, the following options should be used, in order of preference: 1) Milk from a wet nurse; 2) Milk formulas designed in accordance to gastrointestinal and renal maturation; 3) Cow's mil properly diluted, reconstituted and boiled, o; 4) Vegetable base formulas. These foods must be fortified or supplemented with certain vitamins, minerals and essential fatty acids. The first semi-solid foods should be cereals without gluten, tubers and fruits with low allergenic potential. Additional animal and vegetable foods should be added after six months, withholding those associated with a higher allergenic risk until after 8 or 12 months. All foods accustomed in the household must be introduced gradually in the second year, making sure to provide adequate intakes of energy and nutrients. Other important aspects are hygienic handling of foods, frequency of feeding, and a positive attitude of parents and child-carers during meals to avoid rejection of certain foods or stimulation of over-eating.

Breast Feeding↗
PubMed1997

Dietary management of acute diarrhea with local foods in a Guatemalan rural community.

A community-based, randomized trial was conducted to evaluate a locally available diet for the management of acute diarrhea (n = 99 episodes) in 90 Guatemalan children, 4-42 months of age. The Test Diet (TD), a combination of a semi-solid pap (maize flour, black beans, oil) and a liquid gruel, Incaparina (maize flour, cotton seed flour, sugar), in addition to breast-milk and other home foods (group TD, n = 45 episodes) was offered for 14 d and compared to usual home feeding (group HF, n = 54 episodes). Diarrhea episodes after admission were significantly shorter for group TD (median 2.0 d) than group HF (median 4.4 d, p = 0.003) after adjusting for potential confounders. Weight gains did not differ significantly between groups. We conclude that community-based dietary management of acute childhood diarrhea using energy-dense, locally available foods is feasible and may shorten diarrhea duration. This may encourage mothers to follow recommendations for continued feeding during diarrhea in developing country environments.

Acute Disease↗
PubMed1995

Fortification of sugar with iron sodium ethylenediaminotetraacetate (FeNaEDTA) improves iron status in semirural Guatemalan populations.

A 32-mo-long, double-blind field study involving one highland control community receiving only vitamin A-fortified sugar and three vitamin A- and FeNaEDTA-sugar-fortified communities, two in the lowlands and one in the highlands of Guatemala, was undertaken to test the effectiveness of this approach in controlling iron deficiency. The communities' population ranged between 1200 and 17000. Sugar fortified with 1 g FeNaEDTA and 15 mg retinol as retinyl palmitate/kg was stable, did not segregate, and was well accepted by the communities. The impact of fortification on iron nutrition was estimated at 8, 20, and 32 mo of intervention. All pregnant women and subjects with severe anemia received supplements or treatment and were excluded from the analysis. Iron stores in the fortified communities increased significantly except for women 18-48 y of age in one lowland community and > 49 y in the highland community. Iron stores in the control community remained unchanged except for a rise among adult males.

Adolescent↗
PubMed1990

Adenovirus types 40 and 41 and rotaviruses associated with diarrhea in children from Guatemala.

From March 1987 to February 1988, fecal excretion of adenovirus types 40 and 41 and rotavirus serotypes in 194 children (age, 0 to 3 years) from a rural community of Guatemala was monitored. In total, 458 samples taken during 385 episodes of diarrhea and 191 specimens obtained during symptom-free periods were examined by enzyme-linked immunosorbent assay. Fifty-seven children hospitalized because of diarrhea were also studied. Among the rural children, 43 (22.2%) excreted adenovirus types 40 and 41 and 20 (10.3%) shed rotaviruses. Adenovirus types 40 and 41 were associated with 54 (14.0%) illnesses, and rotaviruses were associated with 18 (4.7%) illnesses. Asymptomatic infections with adenovirus types 40 and 41 were documented in nine children and with rotaviruses in two children. Fifteen typeable rotaviruses were identified as serotype 2. In the hospital population, 36 (63.2%) children had viral infections. Rotaviruses were identified in 29 (50.9%) and adenovirus types 40 and 41 were identified in 15 (31.2%) of 48 subjects tested. Dual infections by these viruses were found in eight children. Of 22 typeable strains of rotaviruses, 9 (34.6%) were serotype 1, 12 (46.1%) were serotype 2, and 1 (3.8%) was serotype 3. All the children infected with serotype 2 rotavirus were coinfected with other enteric pathogens, while only three (37.5%) of those infected with rotavirus serotype 1 excreted another pathogen. Adenovirus types 40 and 41 are an important cause of gastroenteritis in both ambulatory and hospitalized Guatemalan children. There seems to be a difference in the pathogenicity among rotavirus serotypes.

Adenoviridae Infections↗
PubMed1989

[Increase of physical activity by improvement of the nutritional status].

Physical activity is affected by nutritional modifications and, in turn, influences growth, cognition, social behavior, work performance and other functions. Studies in preschool children showed that: 1. A decrease in energy intake during four to seven days reduced the time allocated to energy-demanding activities and increased sedentary activities. 2. Children with mild weight deficit were more sedentary than well-nourished counterparts. 3. Children became more active when nutritional status improved. 4. A 10% reduction in energy intake reduced total energy expenditure by 15% without affecting weight gain nor basal metabolism. Studies of men working in non-mechanized agriculture showed that: 1. Dietary improvements led to faster salaried work, reduction of napping time and greater physical activity after work. 2. An increase in energy intake increased total daily energy expenditure, tending to maintain energy balance and relatively stable body weight within the cyclic variations of the agricultural year. 3. Food supplementation did not necessarily improve productivity. Other labor incentives without dietary improvements increased energy expenditure during working hours, which resulted in weight loss. In conclusion, good health and nutrition provide the biological basis for adequate physical activity that may improve cognitive development, social interactions, economic productivity and the quality of life of an individual or a population, but other incentives are required for the optimal expression of that biologic potential.

Adult↗
PubMed1988

[Fortification and enrichment of foods: considerations on their use for achieving nutritional goals].

The diet should, ideally, provide adequate amounts of all nutrients. The traditional foods of many Latin American countries, however, must be fortified or enriched with certain nutrients to satisfy the needs of the whole population. These measures should be considered as temporary, until improvements are achieved in dietary diversification, economic conditions, nutrition education and food processing and storage. Restoration of nutrients lost during cooking or processing and equalization of new foods with the nutrients present in traditional foods, are also important. Conditions for a successful program of fortification or enrichment include a widespread and regular intake of the dietary vehicle, high bioavailability of the added nutrient, low costs of the nutrient and the fortified vehicle, central processing, organoleptic characteristics that ensure acceptability, stability of the product during storage and cooking, no risk of toxicity, and adequate control during the process, distribution, marketing and consumption of the fortified vehicle or food. Control measures must be supported by legal sanctions to those who do not comply with the norms for obligatory fortification or enrichment. Control measures must also identify the necessary modifications due to changes in dietary habits or public health interventions. In Latin America there are fortification and enrichment programs with various nutrients in which local diets are scarce. Many Latin American scientists have been pioneers in this field.

Diet↗
PubMed1988

[Proteins and amino acids: features and fulfillment of requirements with Latin American diets].

Diets must supply enough nitrogen and essential amino acids to satisfy human needs. A diet's protein quality is associated to its digestibility, amino acid composition, protein concentration and dietary and preparation factors that enhance or reduce essential amino acid and protein bioavailability. Dietary energy intake also affects the utilization efficiency of dietary proteins. Protein quality of Latin American diets varies between countries and between socioeconomic groups in a given country. Most poor and lower-middle income persons consume diets with strong predominance of vegetable proteins. These diets are usually bulky, with relatively low protein concentration and energy density, and sometimes do not provide enough of one or more essential amino acids. In some countries and in some population groups, over 50% of the dietary proteins are of animal origin. This may be a risk factor of cardiovascular disease. Protein quality of Latin American diets, however, can be improved by modifying the proportions of some foods in order to achieve amino acid complementation, increase protein concentration and, in some instances, increase digestibility. Examples of diets that are satisfactory for preschool children and adults are given. Nevertheless, improvement of the overall nutritional quality of the diets is of foremost importance, so that they may provide the energy and all essential nutrients required for humans.

Adolescent↗
PubMed1986

Energy supplementation and productivity of Guatemalan sugar-cane cutters: a longitudinal approach.

A long-term energy supplementation program was carried out to determine its effect on the productivity of agricultural workers in Guatemala. The program provided, free of charge, a low-energy (24 Kcal) and a high-energy (350 Kcal) bottled, orange-flavored soft drink to two groups of long-term resident sugar-cane cutters who worked on the same plantation, located in the Pacific Coast. Previous to, and periodically thereafter during implementation of the program, data relative to energy intake and anthropometry were collected. Through data obtained from payroll lists, a longitudinal series of average productivity (tons of sugar cane cut and loaded per day) covering 48 weeks of pre-supplementation, 90 weeks of supplementation and 21 weeks post-supplementation, was constructed. Control of the supplement consumption was daily observed. Random assignment of workers to the high-energy supplement (HES) and the low-energy (LES) groups, was not possible. Prior to supplementation both groups presented the same characteristics in terms of age, energy intake level, weight, height, tricipital adiposity and daily productivity. Little variation was found throughout the time the supplement was consumed by the HES Group. Energy intake of workers increased significantly in absolute terms in relation to the LES Group, except towards the end of the 28 months' supplementation period. Energy balance was maintained by workers throughout the study period. A time series of the difference in mean productivity of the two supplement groups (Yt) was modeled using the ARIMA techniques. No auto-regressive term was present in the Yt series. The ARIMA (0,0,1) model was fitted and expanded with different intervention components. None of the estimated parameters of the intervention components were statistically significant. It was therefore concluded that no abrupt, or gradual and sustained energy supplementation effect on productivity was present.

Adolescent↗
PubMed1985

Homeostatic mechanisms in the utilization of exogenous iron in children recovering from severe malnutrition.

We evaluated the role of initial iron stores on iron accumulation during recovery from severe edematous protein-energy malnutrition in children. Twenty-six preschool children were divided in two groups according to their initial iron reserves, as estimated from serum ferritin concentration, using a cutoff criterion of 30 ng/ml. The low ferritin (LF) group had a mean serum ferritin level of 12 +/- 8 ng/dl, and the high ferritin (HF) group, 86 +/- 32 ng/dl. Both groups had similar degrees of malnutrition and of anemia, as defined by hemoglobin concentration. All children received an adequate therapeutic diet and 60 mg iron daily as ferrous sulfate. The recovery of biochemical and anthropometric indicators of nutritional status, as well as of hemoglobin concentration, was similar in both groups. On the contrary, the LF group showed a marked increase in serum ferritin concentration from the onset of treatment, whereas the HF group had a net decline in this parameter by 30 days, and a stable level thereafter. The difference in serum ferritin concentration between groups was maintained until day 60, and both groups ended the study (90 days) with similar levels. Estimation of the utilization of exogenous iron from changes in total-body iron during the first 60 days of recovery showed the LF group to retain an average of 9.3% of iron intake, whereas the HF group retained only 1.4%.(ABSTRACT TRUNCATED AT 250 WORDS)

Anemia, Hypochromic↗
PubMed1983

Fecal reducing substances and breath hydrogen excretion as indicators of carbohydrate malabsorption.

Data from serial determinations of fecal volume, characteristics, pH, and reducing substances, and postprandial breath hydrogen (H2) concentrations in severely malnourished children receiving milk-based recovery diets were used to evaluate the quality of the correspondence among diagnostic indices for carbohydrate malabsorption, with specific emphasis on the comparison of breath H2 excretion and fecal reducing substances. Only postprandial breath H2 results for subjects with a proven capacity to mount an H2 response to the nonabsorbable disaccharide, lactulose, were included. There was a poor correlation between the diagnostic indication provided by the breath test and fecal reducing sugars. Biological considerations about the metabolism of unabsorbed carbohydrates in relation to colonic transit time and fecal flora may explain the poor degree of correlation. The two indices should not be considered interchangeable, but should be used selectively in accordance with the clinical situation.

Breath Tests↗