Objectives. To identify maternal characteristics associated with the risk of pregnancy weight gain below the range recommended by the Institute of Medicine (IOM), particularly focusing upon whether risk factors differ by race. To identify the maternal factors associated with excessive maternal weight gain. And, to identify maternal characteristics associated with recurrent adverse birth weight outcomes in a representative sample of Louisiana multiparous women, 1997--1999 Methods. For each of these three studies I analyzed deterministically-linked birth certificates and PRAMS questionnaires for 4,078 live births, delivered in 1997--1999. Nineteen variables reflecting socioeconomic, demographic, substance exposure, pregnancy history, psychosocial, and anthropometric indicators were included in multiple logistic regression models Results. Maternal race was not statistically associated with the risk of gaining below the IOM guidelines after adjusting for other covariates, despite a higher frequency of Black women being classified within this low weight gain group. Instead, risk was significantly associated with low pregravid BMI, maternal youth, gestational duration, and smoking cessation Women who gained more weight than recommended were more likely to have high pregravid BMI, longer gestations, quit smoking, smoking cessation counseling, household incomes >$40,000, and reported stress from moving residences. Multiparity and low pregravid BMI were related to a lower risk of excessive pregnancy gain. White mothers over-gained more frequently, but again, race was not associated with HiMWG risk after controlling for other factors The last of the three studies found that consecutive negative birth weight outcomes were not associated with inappropriate maternal weight gain. Instead these adverse outcomes were positively related to drinking alcohol late in pregnancy, shortened gestation, maternal youth, and Black race. Traditional risk factors, such as smoking and prenatal care, were not associated with repeated negative birth outcomes in this representative sample Conclusion. Race alone was not significantly related to the risk of gaining outside the recommended levels for pregnant mothers in this sample. Instead, these results suggest that underlying risk factors (many being pre-conceptional) could provide more accurate targeting information when designing pregnancy weight gain compliance efforts / acase@tulane.edu

acase@tulane.edu

In developing countries households have traditionally been considered to be homogeneous with respect to members' health. Household members share socioeconomic, environmental and genetic factors, among others, which influence a family member's health status. However, recent research has reported evidence that maternal malnutrition and child malnutrition do not necessarily exist in the same household. In other words, households exist where the mother is malnourished and the child is not and vice versa. The present study uses national survey data from eight Sub-Saharan African countries to determine predictors of undernutrition among mother/child intrahousehold discordant contrasts Child's weight-for-height and height-for-age and mother's body mass index (weight/height$\sp2$) are dichotomized to reflect undernourished and non-undernourished groups. Logistic regression techniques are used to develop models to examine differences between mother-child pairs where the mother is undernourished and the child is not and vice versa. Findings reveal that socioeconomic and demographic variables may be sufficient to describe malnutrition in comparisons where both the mother and child are undernourished and the mother only is undernourished. Comparisons involving child only undernourished pairs are more difficult to describe. Variables consistent with age specific feeding recommendations were important in some, but not all, of their respective age disaggregated models. Often the direction of association was not as expected. When gender differences occurred, female children tended to be less likely than males to be in undernourished pairs. As has been demonstrated here, intrahousehold discordance is a useful analytical technique to study household nutritional status / acase@tulane.edu

The development in the last decade of methodology for measuring and scaling household food insecurity and hunger in U.S. populations makes systematic examination of the ways in which hunger and food insecurity affect individuals and families possible. The impact of food insecurity on children has always been of primary concern for policy, advocacy, and science because of the vulnerability of children to long-term developmental sequelae. There is an emerging and rapidly growing literature demonstrating deleterious links between inadequate food and a variety of developmental outcomes for children, including poorer health status, school absenteeism, and emotional and behavioral dysfunction. The research presented here explores the relationship of household food insecurity to children's well-being in terms of cognitive and social development at kindergarten entry, utilizing a large and representative sample children in the United States. The timing of this evaluation, in the fall and spring of the child's first school experience, allows not only a snapshot of a child's development throughout his/her preschool years but also the effect of the first year of schooling in relation to these outcomes The data are from the Early Childhood Longitudinal Study of Kindergartners (ECLS-K), collected in 1998--99 by the National Center for Education Statistics, and comprise 20,929 children attending 1,000 private and public schools. Results indicate that measures of reading, math, and general knowledge competence were not impacted by household food insecurity independent of other influences, but child emotional and functioning were negatively associated with household food insecurity even when controlling for many other relevant variables. The relationship of household food insecurity to children's attained growth was also examined and no independent relationship of household food insecurity to height for age or weight for height was found in either the fall or the spring of kindergarten / acase@tulane.edu

The impact of S. haematobium infection on nutritional and health status with regards to hemoglobin levels, anthropometric measures, hepatomegaly and splenomegaly, and the effect of praziquantel treatment on these parameters six months after intervention were studied in primary school children in Bertoua, Cameroon. The prevalence of schistosomiasis in the study sample was 23.9%, 10% of whom had heavy infection (egg count $>$ 499 per 10 ml of urine). Malaria and hookworm infection affected 42.6% and 23.2% respectively. The mean hemoglobin level of the study population with and without S. haematobium infection was 12.1 g/dl. There was no difference in mean hemoglobin levels per intensity of infection. Mean hemoglobin levels were significantly lower in children with malaria, splenomegaly or hepatomegaly. The percent median weight for age, height for age and weight for height of the study sample were 83.7%, 94.3% and 97.5% respectively. Mean height for age and weight for age indices were significantly greater in the uninfected than the infected (p $<$ 0.001). Subjects with light-moderate S. haematobium infection (1-499 eggs/10 ml urine) were randomly allocated to either praziquantel treatment (PZQ, n = 238) or placebo (PLB, n = 198) groups. The uninfected controls (NON, n = 174) were randomly selected from the study population. Children were examined before and six months after praziquantel treatment. Hemoglobin levels and height for age indices decreased significantly (p $<$ 0.05) in all three groups but anthropometric measures increased significantly between the two exams. Increase in mid arm circumference was significantly different between the PZQ and NON (p = 0.036) and marginally significant between the PZQ and PLB (p = 0.056). Praziquantel had no significant effect on hepatomegaly or splenomegaly. There was an interaction between changes in hemoglobin levels and malaria (p = 0.0015). Neither iron nor folic acid was responsible for the increase in hemoglobin levels observed one month after deworming and iron/folic acid intervention. Praziquantel treatment did not have a significant effect on the nutritional status of these children after six months despite the impact of S. haematobium infection on growth / acase@tulane.edu

acase@tulane.edu

acase@tulane.edu

In developing countries, several poor infant feeding practices are common, resulting in physical and intellectual developmental impairments. Good feeding practices are crucial, especially in the first year of life. In addition to the malnutrition currently suffered in developing countries, HIV/AIDS has worsened the clinical and nutritional status of both mothers and their children. HIV-infected women face difficulties in choosing among infant feeding options because they must balance the risks of postnatal HIV transmission and infant morbidity and mortality. Many mothers in low-income settings like Rwanda do choose to breast feed but this simply shifts the difficult decision to when to stop. However, few studies have explored feeding practices among HIV-exposed infants during the transition period when breastfeeding is stopped An Infant and Child Feeding Index (ICFI) was created in this study to (1) explore infant feeding practices, (2) assess their association with nutritional status among HIV-exposed infants, and (3) evaluate the magnitude of the association over time in Rwanda. Data analysis, using a cross-sectional time series model, suggests that ICFI is positively associated with Weight for Length Z-score (WLZ) and Weight for Age Z-score (WAZ). However, neither the ICFI nor any of its components were associated with the Length for Age Z-score. Other feeding variables related to behaviors, including initiation of breastfeeding within one hour after birth and ever breastfeeding, were not associated with the anthropometric indices, but these take place much earlier. There was no correlation between changes in the index over time and anthropometric indices. Mean LAZ, WLZ, and WAZ were all lower in male infants. In Rwanda, reorganizing nutritional units at the central level and integrating nutritional services at district and health facility levels are critical to delivering simple and concise nutritional messages that involve all types of orphans and vulnerable children / acase@tulane.edu

acase@tulane.edu

Statement of the Problem. The purpose of the research was to describe the present dietary habits of Vietnamese, Black and Caucasian Elementary Public School students in two schools of Orleans Parish. The objectives of the study were to determine: (1) similarities and differences in the dietary habits and socio-demographic characteristics of the three ethnic groups; (2) average consumption of each of nineteen nutrients in the three ethnic groups; and (3) average consumption of nineteen nutrients compared to one-third of the Recommended Dietary Allowances (RDA) for the seven to ten year old students of each ethnic group Method and Material. To achieve the objective of this study a dietary questionnaire was sent home to the parents. The dietary questionnaire was used to obtain data on the dietary habits and socio-demographic characteristics of the three groups of students. Data from 126 questionnaires were tabulated and analyzed. A plate waste study of school lunch for 150 students from each of the three ethnic groups in the two schools was conducted and nineteen nutrients were analyzed, and were compared to one-third of the RDA Findings and Conclusions. Caucasians had the highest yearly incomes, smallest households and spent more money on weekly food purchases. Vietnamese students consumed less milk and consumed breakfast and dinner less frequently than the other two groups. Foods most commonly disliked by all three ethnic groups were vegetables The mean nutrient levels meeting one-third RDA for all three ethnic groups were for: protein, riboflavin, niacin, vitamin B(,12) and phosphorus. School lunch trays of food served to the students did not meet one-third RDA for the following nutrients: calories, iodine, magnesium folacin and vitamin E. There were no significant differences for the mean levels of all nineteen nutrients for the three ethnic groups / acase@tulane.edu