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M Irigoyen

Publications and source records attributed to M Irigoyen.

33 records · Page 2Linked to original sources

Is there a relationship between dietary fat and stature or growth in children three to five years of age?

STUDY OBJECTIVE: To determine whether a moderately reduced fat diet affects the stature or growth of healthy preschool children. DESIGN: Cohort study with mean of 25 months of follow-up. SETTING: Primary care pediatrics practice at a large urban medical center. SUBJECTS: A predominantly Hispanic group of 215 children aged 3 to 4 years at baseline. MEASUREMENTS AND MAIN RESULTS: The children's diet was assessed using four 24-hour recalls and three Willett semiquantitative food-frequency questionnaires administered to the children's mothers over a 1-year baseline period. Stature was defined in terms of height, weight, and body mass index at baseline. Growth was defined in terms of change during follow-up in height, weight, and body mass index. Total fat provided a mean of 27.1% of caloric intake in the lowest quintile of intake compared with 38.4% in the highest quintile. There were no differences in stature or growth across quintiles of children defined by consumption of total fat, saturated fat, or cholesterol. These findings were consistent across the two methods of diet assessment. Children who consumed a smaller percentage of total calories from fat consumed significantly less total calories, saturated fat, cholesterol, calcium, and phosphorus, as well as more carbohydrates, iron, thiamine, niacin, vitamin A, and vitamin C. CONCLUSIONS: These data support the safety of a moderately reduced fat diet in healthy preschool children. Maintenance of calcium and phosphorus intake should be part of any program of dietary fat reduction. Substitution of low-fat milk for whole milk, rather than elimination of whole milk, is one such strategy.

Body Height↗

Relationships of dietary fat consumption to serum total and low-density lipoprotein cholesterol in hispanic preschool children.

BACKGROUND: Studies of the relationship between dietary fat intake and serum lipids in young children have yielded inconclusive results. We studied this relationship in 108 Hispanic children ages 4-5 years. METHODS: Four 24-hr recalls approximately 3 months apart and two Willett semiquantitative food frequency questionnaires approximately 6 months apart were obtained by interviewing the children's mothers. Diet measures were averaged for the multiple administrations of each of these instruments. RESULTS: Based on the 24-hr recalls, children in the highest tertile of total fat consumption (36.2% of total calories) compared with the lowest tertile (30.2% of total calories) had mean total serum cholesterol of 4.32 mmol/liter (167 mg/dl) vs 3.91 mmol/liter (151 mg/d) (test for linear trend across tertiles, P less than 0.05) and mean low-density lipoprotein cholesterol of 2.74 mmol/liter (106 mg/dl) vs 2.29 mmol/liter (89 mg/dl) (test for linear trend, P less than 0.01). Children in the highest tertile of saturated fat consumption (14.6% of total calories) compared with the lowest tertile (11.2% of total calories) had mean total serum cholesterol of 4.39 mmol/liter (170 mg/dl) vs 3.97 mmol/liter (154 mg/dl) (test for linear trend, P less than 0.05) and mean low-density lipoprotein cholesterol of 2.80 mmol/liter (108 mg/dl) vs 2.35 mmol/liter (91 mg/dl) (test for linear trend, P less than 0.01). These relationships remained significant when calorie-adjusted nutrient intakes were examined and after adjustment in multiple linear regression models for age, sex, and body mass index, with the exception of the association of calorie-adjusted total fat with total serum cholesterol level (P = 0.07). Similar results were obtained using the Willett questionnaires. CONCLUSIONS: These findings indicate that dietary fat, particularly saturated fat consumption, is an important correlate of blood lipid levels in preschool children. These are also the first reported data indicating that the Willett questionnaire, as a method for measuring the atherogenic components of diet, has criterion-related validity in young children.

Child, Preschool↗

Randomized, placebo-controlled trial of iron supplementation in infants with low hemoglobin levels fed iron-fortified formula.

In spite of the declining prevalence of iron-deficiency anemia, a large proportion of low-income infants have "low-normal" (11-11.5 g/dL) and "low" (less than 11 g/dL) hemoglobin (Hgb) values. Because most of these infants are fed iron-fortified formulas, it was of interest whether additional iron supplementation would enhance Hgb values. A cohort of 334 healthy, inner-city, minority, 6-month-old infants, fed iron-fortified formulas, with Hgb values ranging from 9 to 11.5 g/dL, participated in a double-blind, randomized, placebo-controlled trial of supplemental iron at 0, 3, and 6 mg/kg per day for 3 months. Hemoglobin values increased significantly with age, regardless of assignment to placebo or supplemental iron (means for the entire cohort: 6 months 10.9 g/dL, 8 months 11.2, 10 months 11.3, and 12 months 11.4). The proportion of "responders" (Hgb level increased greater than or equal to 1 g/dL) was 34% and did not differ significantly by placebo or iron dose. There were no significant differences in mean corpuscular volume or levels of erythrocyte porphyrins or serum ferritin between treatment groups. The implications of this clinical trial are twofold: (1) screening healthy infants fed iron-fortified formula at the age of 6 months is not justified, regardless of socioeconomic status; (2) the clinical practice of routinely treating low-income, "low-Hgb" infants with iron supplementation, without regard to dietary considerations, is unwarranted.

Anemia, Hypochromic↗

Blood pressure, fitness, and fatness in 5- and 6-year-old children.

Cross-sectional relations among blood pressure (BP), aerobic fitness, body fatness, and fat patterning were studied in 216 primarily Hispanic inner-city 5- and 6-year-olds. Fitness was measured with a submaximal treadmill test, and fatness was measured with five skin folds. Diastolic BP was inversely related to fitness in the boys and girls, and positively related to fatness for the boys. Systolic BP was positively related to fatness for the boys and girls. Using multiple regression and including parental BPs, fatness explained significant proportions of the variance in systolic BP for both the boys and girls and in diastolic BP for the boys. There were tendencies for central skin folds to explain more of the variation in BP than peripheral skin folds only for the boys. Fitness and fatness were inversely related for the boys and girls. Thus, at 5 and 6 years of age children exhibit some of the same risk factors for cardiovascular disease seen in adults.

Blood Pressure↗

Failure of family history to predict high blood cholesterol among hispanic preschool children.

Recommendations for screening children for high blood cholesterol remain controversial. The American Academy of Pediatrics, the American Heart Association, and the National Institutes of Health (NIH) Consensus Conference have recommended targeted screening of children with positive family history. We examined data from a sample of 108 Hispanic preschool children and their families to test targeted screening strategies. Thirty-seven children (34.3%) had total cholesterol levels of greater than or equal to 4.40 mmole/liter (170 mg/dl). Using the American Academy of Pediatrics definition of family history, sensitivity (proportion of those with high blood cholesterol with positive family history) was 0.57 (95% confidence interval, 0.40 to 0.73) and accuracy (overall proportion correctly classified) was 0.58 (0.48 to 0.68). Using the American Heart Association and NIH Consensus Conference definition of family history, sensitivity was 0.46 (0.30 to 0.63) and accuracy was 0.62 (0.52 to 0.71). Classification of children based on the mother's total cholesterol level of greater than or equal to 5.17 mmole/liter (200 mg/dl), the mother's low-density lipoprotein cholesterol level of greater than or equal to 4.14 mmole/liter (160 mg/dl), the mother's low-density lipoprotein cholesterol level of greater than or equal to 3.36 mmole/liter (130 mg/dl), or the child's own body mass index greater than or equal to 75th percentile was less sensitive and no more accurate. These findings indicate that current recommendations as well as other potential strategies for targeted cholesterol screening in young children have serious shortcomings and lend support to universal cholesterol screening in childhood.

Body Mass Index↗

Validation of mothers' reports of dietary intake by four to seven year-old children.

The validity of mothers' recall of four to seven year-old children's diet was assessed among 46 first generation Latino immigrant families from the Dominican Republic by comparing intake recalled by the mother to unobtrusive home observations of children. Correlations were moderate to high for calories and for most nutrients. There were no differences in mean intake of total calories or in intake of most macronutrients and micronutrients assessed. At least two-thirds of the children in the lowest (or highest) quintile based on home observations were correctly classified into the lowest or second lowest (or highest) quintiles based on mother's reports for calories and most nutrients. For all food items that were both observed and reported, 51 percent of reported portion sizes were equivalent to observed portion sizes, 15.5 percent were smaller, and 33.5 percent were larger. There was fair to good agreement on the number of food items eaten, with the exception of vegetables. Mothers' recall appears to be useful for classifying children by intake of calories, macronutrients and micronutrients, but provides a somewhat less accurate measure of actual foods eaten, portion sizes, and nutrient levels consumed.

Child↗

Screening using National Cholesterol Education Program guidelines in a population of urban Hispanic mothers.

We measured serum total cholesterol, high-density lipoprotein cholesterol, and triglycerides and calculated low-density lipoprotein cholesterol in 217 urban Hispanic mothers. On the basis of total cholesterol values, as recommended by the Expert Panel of the National Cholesterol Education Program, 6 subjects (2.8%) had high blood cholesterol (greater than or equal to 240 mg/dl), 27 (12.4%) had borderline-high blood cholesterol (200-239 mg/dl), and 184 (84.8%) had desirable blood cholesterol (less than 200 mg/dl). One of the 27 with borderline-high total cholesterol had two other coronary risk factors. Thus 7 of the 217 (3.2%, 95% confidence interval 1.4 to 6.8%) met Expert Panel criteria for lipoprotein measurement. Six of the seven had high-risk low-density lipoprotein cholesterol (greater than or equal to 160 mg/dl). Four additional subjects with borderline-high total cholesterol, not identified by this sequential screening strategy, also had high-risk low-density lipoprotein cholesterol. Thus a total of 10 of 217 (4.6%, 95% confidence interval 2.4 to 8.6%) met Expert Panel criteria for high-risk low-density lipoprotein cholesterol and initiation of cholesterol-lowering treatment. None of these 10 had been previously identified as having high-risk low-density lipoprotein cholesterol. Two years later subjects with high or borderline-high total cholesterol were rescreened. Seven of 22 subjects completing the second screening were classified differently with regard to having high-risk low-density lipoprotein cholesterol, illustrating the potential for misclassification of individuals on the basis of a single measurement. The prevalence of women with high-risk low-density lipoprotein cholesterol was not significantly different at the two screenings.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Dental caries status of young children in a suburban community of Mexico City.

One hundred and thirty-four children, 6 to 7 yr of age from a public school in Tepepan, Mexico were examined for the prevalence and severity of dental caries. Average deft score was 6.08 and defs was 12.15. Average DMFT and DMFS scores were .57 and .99 respectively. It was observed that 66% of primary teeth with carious lesions required one surface restoration and 11% three or more surface restorations. In the permanent dentition 99% of the affected teeth required one surface restoration. A comparison of the results with those of the Mexico City public school children survey (1980) showed that the Tepepan children had a similar caries level in primary teeth and a lower caries level in permanent teeth. Although the Tepepan group showed fewer carious lesions, their caries index and unmet restorative index are still high, especially for primary dentition, so an intensive educational, preventive and restorative program is required.

Child↗