Water requirements: physiology and pathology.
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Biology↗
Biomedical subjects
M Chauliac
Publications and source records attributed to M Chauliac.
Women's lives, mothers' health.
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Abortion, Induced↗
[Vitamin A deficiency and food consumption of children aged 6 to 84 months in a Mali rural area].
A cross-sectional study was carried out during the dry season, within the framework of an extension of an existing sanitary program. In December 1991, a cluster sample of 2,631 children was selected in a rural district of Mali, in the district of Koutiala, with good agricultural conditions. A sub-sample of 262 mothers was selected for interviews concerning their knowledge and attitudes about vitamin A deficiency symptoms. Prevalence of clinical symptoms was 2% for night blindness, 0.3% for Bitot's spots and 0.2% for corneal scars. Night blindness was more common after 3 years. The study of weekly consumption of vitamin A rich foods, made on a sample of 519 children, revealed that only 3.3% ate vitamin A rich foods less than seven times a week and 2.7% never ate any. According to the recommended dietary allowances, vitamin A deficiency was not a public health problem in this region. However, these results do not agree with those of the clinical study. It should be noted also that protein energy malnutrition is scarce among the children. These results allowed an estimate of the prevalence of vitamin A deficiency, but were insufficient for the design of strategies to reduce this prevalence. Simple and relatively cheap epidemiological methods like case-control studies are not commonly used in developing countries. These methods could be used to obtain a better estimate of social, cultural and biological risk factors, and therefore, better targeting interventions.
Child↗
[Bamako school age children and their diet from street vendors].
Eating outside the home is very common in African cities. Food is bought from street vendors and eaten on the street. A large proportion of these consumers are school children, but little is known about what they buy, and the reasons why they make the choices they do. We therefore surveyed 494 second and sixth year primary school children in 1993. They were all enrolled at schools or Muslim colleges in both affluent and underprivileged areas of Bamako (Mali). The language used for the survey was Bambara. Almost all the children had money, mostly given by either or both of their parents and in most cases supplemented by odd jobs. The richest group of children were those in the sixth year in the more privileged areas. However, within a district or a (school) class, there was no correlation between the family's socio-economic group (SEG) and money available to the child. The proportions of children in each area, SEG and class buying the following classes of food were nearly identical; drinks, ice cream, groundnuts, fruit, cooked meals, uncooked meals, and sweets. The amount of money available correlated with the purchase of cooked or uncooked meals and drinks. The amount spent on food correlated with the money available, and the relationship is particularly clear for cooked and uncooked meals. The independence of the children in buying food represents a large part of the total daily food budget of the family. Their true diet and its nutritional value should therefore be quantified. Strategies targeting these children to help improve their diet would have a favorable effect on nutrition, because of their autonomy. Any such strategy should involve the street vendors so as to improve the quality of their products.
Adolescent↗
[High altitude anemia: validity of definition criteria].
The effect of iron and folate supplementation on the hemoglobin response and iron status was studied in male and female equatorian medical students: 66 in Quito (2,800 m altitude) and 40 in Guayaquil (sea level). At the end of the supplementation, there was a nearly complete disappearance of biochemical evidence of iron deficiency in the two groups of students. In Quito, 30% of the men and 26% of the women increased their hemoglobin concentration by more than 1 g/dl after one month of supplementation and could be considered as true anemics, compared to 31% of the men and 29% of the women in Guayaquil. This study shows that at sea level, cut-off points defined by WHO for hemoglobin, taking as reference the impact of a supplementation trial, have a specificity of 100% but poor sensitivity (58%). For people living at high altitudes, cut-off limits adjusted for altitude seem unsuitable: the specificity is 98% but the sensitivity is 0%. Studies taking into account all the factors impacting on the hemoglobin level could be useful for defining cut-off points for high-altitude anemia better than those currently recommended.
Adult↗
[An approach to food consumption in an urban environment. The case of west Africa].
West Africa has undergone rapid economic and political changes during the last 20 years. After the failure of economic policies implemented since independence, programs for structural adjustment have strongly influenced the economy. Food problems affect each country differently. The Sahel has experienced food shortages and starvation whereas in forested countries the food supply has remained stable. Nevertheless, food policies have not succeeded in contributing to urban and rural development. The rate of urbanization in west Africa is generally low but the rate of urban population growth is particularly high, much more than the growth rates of industry and infrastructure. Although metropolitan areas are affected by poverty, they offer more hope and opportunities than rural areas. Urban markets have expanded and diversified as social differences have also increased and contributed to changes in consumption structure. Urban growth has contributed to the increase of imported food: this is indicated by both the strong dependency and the change of food habits towards western food patterns. Recently however, west African urban dwellers are still preferring local items if they are affordable. When imported products are used, they are integrated within a stable meal plan consisting of a single dish with a base and a sauce, which is typical of African food preparation. Surveys of consumption-budgets are still only available on a national scale. These can provide accurate information about food consumption patterns of families, particularly for significant trends. However, they do not provide information about the dynamics of food consumption, neither for urban areas or the individual. Now a significant proportion of individual food consumption occurs outside of the home, mainly with food provided by street vendors. This new consumption habit is a response to the urban food crisis. Consumption of street-vendor-food comprises one component but this cannot be dissociated from in-home food consumption. Despite the growing importance of street-vendor food consumption, it has still not been adequately documented. Theoretically, food consumption is an evolving concept. Single disciplines, such as economics or nutrition, first studied food consumption. More recently, social sciences developed new approaches with various interpretations, which were sometimes contradictory. The evolution of urban food consumption and the numerous related problems support the approach proposed by some authors suggesting a mixed analysis integrating both economics and cultural factors. Operationally, a global and dynamic approach to food styles must consider urban heterogeneity and diversity of situations. For example, food consumption by people maintaining their in-home food habits shows the pertinence of studies focusing on individuals. Therefore, the food course concept may be a useful method for the study of food consumption.
Africa, Western↗
[Variability of home dietary habits of families living in Bamako (Mali) according to their socioeconomic status].
We investigated the influence of standard of living on the dietary and eating habits of families in Bamako (Mali). Family meals eaten at home at any time of day were studied. Families were selected for the study according to two criteria: the place of residence and the domestic commodities and urban investments. Thus, 24 families were included from affluent and 24 from moderately affluent neighborhoods, and 26 families from poor neighborhoods. All families ate three meals a day, each including staples and sauce. However, the dishes selected for the different meals and their ingredients varied considerably with the family's status. Cereals were the main component of breakfast, but the type varied from one category of family to another. All poor families and 79% of the intermediate group and only 54% of the affluent group ate millet/sorghum. Seventy-five % of the affluent, 13% of the intermediate and none of the poor families drank coffee at breakfast. Fifty % of the affluent, 29% of the intermediate and 19% of the poor families ate rice with nadji sauce at lunch. The quality of the nadji sauce varied with economic status. Tigadeguena sauce was eaten with rice in 17% of the affluent families, 50% of the intermediate group and 12% of the poor families. Very little millet/sorghum was eaten by the affluent at lunch, whereas it was included in lunch by over half the poor and one fifth of the intermediate families. The diversity of dishes was larger at supper, but only in the affluent families which had 2 to 4 different dishes or produce. They included garden vegetable salads and stews, with or without bread. Dinner for the intermediate and poor families was similar to lunch, that is a cereal base and a sauce. Home eating habits also differed according to status. In the affluent families breakfast was eaten alone, whereas in the poor families it was a communal meal. The intermediate group displayed both patterns. Affluent families tried to alternate and diversify their food intake from one meal to another, whereas the diet of the poor was monotonous. Most intermediate families tried to alternate a small range of staples (rice and traditional cereals) although this necessitated reducing the quality of the sauce. Our study shows that eating habits are affected by both cultural factors and standard of living.
Adolescent↗
[Vitamin A deficiency: epidemiological aspects and control methods].
Vitamin A deficiency is one of the most common nutrient deficiency syndromes in children from developing countries. It is also correlated with the increased severity and incidence of certain infections. Until recently, vitamin A research was focused on preventing xerophthalmia and blindness in Third World Countries and on the development of synthetic retinoid molecules, with lower toxicity than vitamin A, for the treatment of skin diseases. However, there has been a major shift of emphasis in the last five to ten years. There is a risk of death from xerophthalmia, primarily from complications with infectious diseases. Intermittent treatment with the very large doses of vitamin A prescribed to combat blindness was shown to be effective. This suggests that vitamin A may affect specific elements of the immune system. High-dose vitamin A supplements have been given, at widely-spaced time intervals, to preschool children in communities where vitamin A deficiency causes xerophthalmia and blindness, over the last 20 to 30 years. A strong correlation between mortality and xerophthalmia was identified. Death then became the principal outcome measured because it was easier to detect than xerophthalmia, particularly in large clinical trials in high risk regions where clinical expertise was minimal and vitamin A deficiency was a commoner cause of death than blindness. Other, food-based approaches to the treatment and prevention of vitamin A deficiency, involving foods naturally rich in retinol or carotenoid, or foods artificially fortified with these nutrients, should be developed.
Adult↗
[Devaluation of the African Financial Community franc and the dietary strategies of families in Bamako (Mali)].
This survey, conducted in 1996, evaluated changes in the way families feed themselves caused by the effects of devaluation of the CFA franc. It involved semi-directed interviews with 64 subjects from various socio-economic backgrounds (affluent, middle-class, poor). The subjects spoke of the difficulties of daily life, lack of money and rapid, unpredictable rises in the prices of essential goods caused by the devaluation. They did not understand the reasons for the devaluation, which has caused rapid changes in the social conditions and nutrition of urban families and has exacerbated the inequality of access to foodstuffs. Affluent families have adopted strategies that increase the family food budget, compensating for price increases. The meals of poor and middle-class families have been directly affected in both structure and content. Poor families have been particularly badly affected. All the changes in strategy, and substitutions of one product for another described by middle-class families were already being used by the poor families before devaluation.
Attitude↗
[Food habits outside the home by school children in Cotonou (Benin)].
Urban growth leads to the consumption of food outside the home, with the demand for street food coming particularly from school children. A survey of 240 primary school children aged 8 to 13 was carried out, by means of personal interviews. More than 90% were regularly given pocket money by their parents, and this money was used mainly for buying food from vendors inside or near their schools. Less than 20% of children ate breakfast at home before going to school. Food purchases occurred mostly before the end of school morning break and an average of 38 CFA Francs were spent on each purchase (7.6 US cents). A wide variety of foods were bought, mostly including cereals. This buying of food seems to be part of a family food strategy to reduce the preparation of breakfast at home. The combination of this demand, and the supply of food in schools provides a useful means for campaigns aimed at improving the quality of children's diets in the short and long term.
Adolescent↗