Thesis (M.S.)--University of Michigan, 1986.

Thesis (PhD.--Faculty of Health Sciences)-University of Pretoria, 2004. / Summary in English and Afrikaans. Includes bibliographical references.

INTRODUÇÃO: As prevalências de desnutrição infantil ainda são altas nos países da África Subsaariana; porém, há indícios de que a obesidade em adultos esteja aumentando. Neste cenário, se, por um lado, é importante combater a desnutrição, por outro, é fundamental identificar as tendências do excesso de peso ao longo do tempo, a fim de prevenir grandes elevações de obesidade e doenças crônicas. Com isso, os objetivos desta pesquisa foram: descrever as tendências de obesidade ao longo das últimas décadas em mulheres em idade fértil e em crianças menores de 5 anos, paralelamente àquelas de desnutrição nesse mesmo grupo de crianças em países da África Subsaariana; e identificar os fatores associados à desnutrição em crianças menores de 2 anos em um município de Luanda, Angola. MÉTODOS: Para descrever as tendências da situação nutricional, foram utilizados dados de inquéritos nacionais (Demographic and Health Surveys e Multiple Indicator Cluster Samples) de 13 países do continente africano, que tinham pelo menos quatro inquéritos disponíveis. Foram traçadas tendências para os desfechos: obesidade em mulheres com idade entre 15 e 49 anos, e sobrepeso, baixa estatura (stunting), baixo peso para altura (wasting), baixo peso para idade (underweight) e baixo peso ao nascer em crianças com menos de 5 anos. Para as tendências individuais de cada país, foi realizada regressão linear, enquanto para as tendências considerando o conjunto dos 13 países, empregou-se modelo de regressão multinível. Quanto à identificação dos fatores associados com a desnutrição, foram utilizados dados de um estudo transversal de base populacional realizado em Cacuaco, município da província de Luanda, em 2010. Os desfechos estudados foram baixa estatura (stunting) e baixo peso para idade (underweight). Foram estimadas razões de prevalência (RP) por regressão de Poisson com variância robusta utilizando modelo hierarquizado. RESULTADOS: A prevalência de obesidade cresceu entre mulheres em idade fértil na maior parte dos países estudados, em média 2,8 pontos percentuais por década (P<0,001), acompanhada por importante diminuição de stunting, em média de 5,6 pontos percentuais por década (P<0,001) e diminuição bem menor de wasting, em média de 1,1 ponto percentual por década (P=0,09), sem evidência, até o momento, de aumento de sobrepeso em crianças abaixo de 5 anos (aumento de 1,0 ponto percentual por década, P=0,14). Em Angola, das 749 crianças incluídas no estudo, 232 [32,0% (IC 95%: 28,7-35,5%)] tinham baixa estatura e 109 [15,1% (IC 95%: 12,6-17,9%)] estavam com peso baixo para idade. Na análise multivariável final, foram identificados os seguintes fatores associados com os desfechos pesquisados: ocorrência de diarreia nos últimos 15 dias (RP 1,39 [IC95% 1,06-1,84]) para baixa estatura; e presença de óbito de outros filhos (RP 1,52 [IC95% 1,01-2,28]) para baixo peso para idade. Em modelo composto apenas de fatores distais e intermediários, a presença de cuidador principal (outro que não a mãe) aumentou a prevalência de baixa estatura em 42% (RP 1,42; IC95% 1,10-1,84) e para cada mês mais tarde que a mãe o iniciou pré-natal, a prevalência de baixo peso para idade aumentou em 20% (RP 1,20; IC95% 1,03-1,40). CONCLUSÃO: Foi possível descrever a tendência preocupante de aumento de obesidade em mulheres em idade fértil nos países estudados. Em Angola, poucos fatores individuais foram descritos, sugerindo que a influência de fatores coletivos é importante. Esses dados devem ser úteis para o planejamento de ações visando, por um lado, à prevenção de uma epidemia de obesidade em crianças na África Subsaariana e, por outro, ao enfrentamento atual das altas taxas de desnutrição em crianças em Angola e outros países. / INTRODUCTION: The prevalence of child malnutrition is still high in sub-Saharan Africa; however, there is evidence that obesity in adults is increasing. In this scenario, on the one hand, it is important to tackle malnutrition, while on the other, it is essential to identify trends in excess weight over time, so as to focus attention on the prevention of large increases in obesity and the chronic diseases it causes. Thus, the objectives of this study were to describe trends in sub-Saharan Africa in obesity over the past decades in women of childbearing age and in children under 5 years of age, in parallel with those of malnutrition in the same group of children; as well as to identify factors associated with malnutrition in children under 2 years living in the suburban area of Luanda, Angola. METHODS: To describe the trends in nutritional status, secondary data from national surveys (Demographic and Health Surveys and Multiple Indicator Cluster Samples) of 13 African countries having at least four available surveys, were used. Trends were described for the outcomes obesity in women aged 15 to 49, and overweight, stunting, wasting, underweight and low birthweight in children under 5 years. For individual trends in each country, linear regression was performed. For trends considering the group of 13 countries, we used a multilevel regression model. To identify the factors associated with malnutrition, data from a cross-sectional population-based study held in Cacuaco, a municipality of Luanda, in 2010 were used. The outcomes studied were stunting and underweight. Prevalence ratios (PR) were estimated by Poisson regression with robust variance using a hierarchical model. RESULTS: The prevalence of obesity increased among women of reproductive age in most of the countries studied, on average 2.8 percentage points per decade (P<0.001), accompanied by significant reduction of stunting, on average 5.6 percentage points per decade (P<0.001) and a decrease, though much smaller, of wasting, on average 1.1 percentage points per decade (P=0.09), with no evidence, to date, of an increase in overweight in children under 5 years (increase of 1.0 percentage points per decade, P = 0.14).In Angola, among the 749 children included in the study, 232 [32.0% (95% CI: 28.7 to 35.5%)] were stunted and 109 [15.1% (95% CI: 12.6- 17.9)] were underweight. In the final multivariate analysis model, the following factors have been identified as associated with the studied outcomes: occurrence of diarrhea in the last 15 days (PR 1.39 [95% CI 1.06 to 1.84]) for stunting; and death of other children from the same mother (PR 1.52 [95% CI 1.01-2.28]) for underweight. In a model composed only of distal and intermediate factors, the primary caregiver not being the mother increased the prevalence of stunting by 42% (PR 1.42, 95%CI 1.10- 1.84) and each month that prenatal care was delayed increased the prevalence of underweight by 20% (PR 1.20, 95% CI 1.03-1.40). CONCLUSION: These results enabled the identification of a worrying increasing trend of obesity in women of childbearing age in the studied countries, in a context in which child malnutrition still prevails, especially stunting. In Angola, although it was possible to identify factors associated with malnutrition never before studied in Luanda, few individual factors were identified that increased the prevalence of malnutrition, suggesting that the problem results primarily from factors affecting society as a whole. These data should be useful for planning aimed, on the one hand, to prevent an epidemic of obesity in children in sub-Saharan Africa, and on the other, meeting the challenge of current widespread childhood malnutrition in Angola and other countries.

INTRODUÇÃO: As prevalências de desnutrição infantil ainda são altas nos países da África Subsaariana; porém, há indícios de que a obesidade em adultos esteja aumentando. Neste cenário, se, por um lado, é importante combater a desnutrição, por outro, é fundamental identificar as tendências do excesso de peso ao longo do tempo, a fim de prevenir grandes elevações de obesidade e doenças crônicas. Com isso, os objetivos desta pesquisa foram: descrever as tendências de obesidade ao longo das últimas décadas em mulheres em idade fértil e em crianças menores de 5 anos, paralelamente àquelas de desnutrição nesse mesmo grupo de crianças em países da África Subsaariana; e identificar os fatores associados à desnutrição em crianças menores de 2 anos em um município de Luanda, Angola. MÉTODOS: Para descrever as tendências da situação nutricional, foram utilizados dados de inquéritos nacionais (Demographic and Health Surveys e Multiple Indicator Cluster Samples) de 13 países do continente africano, que tinham pelo menos quatro inquéritos disponíveis. Foram traçadas tendências para os desfechos: obesidade em mulheres com idade entre 15 e 49 anos, e sobrepeso, baixa estatura (stunting), baixo peso para altura (wasting), baixo peso para idade (underweight) e baixo peso ao nascer em crianças com menos de 5 anos. Para as tendências individuais de cada país, foi realizada regressão linear, enquanto para as tendências considerando o conjunto dos 13 países, empregou-se modelo de regressão multinível. Quanto à identificação dos fatores associados com a desnutrição, foram utilizados dados de um estudo transversal de base populacional realizado em Cacuaco, município da província de Luanda, em 2010. Os desfechos estudados foram baixa estatura (stunting) e baixo peso para idade (underweight). Foram estimadas razões de prevalência (RP) por regressão de Poisson com variância robusta utilizando modelo hierarquizado. RESULTADOS: A prevalência de obesidade cresceu entre mulheres em idade fértil na maior parte dos países estudados, em média 2,8 pontos percentuais por década (P<0,001), acompanhada por importante diminuição de stunting, em média de 5,6 pontos percentuais por década (P<0,001) e diminuição bem menor de wasting, em média de 1,1 ponto percentual por década (P=0,09), sem evidência, até o momento, de aumento de sobrepeso em crianças abaixo de 5 anos (aumento de 1,0 ponto percentual por década, P=0,14). Em Angola, das 749 crianças incluídas no estudo, 232 [32,0% (IC 95%: 28,7-35,5%)] tinham baixa estatura e 109 [15,1% (IC 95%: 12,6-17,9%)] estavam com peso baixo para idade. Na análise multivariável final, foram identificados os seguintes fatores associados com os desfechos pesquisados: ocorrência de diarreia nos últimos 15 dias (RP 1,39 [IC95% 1,06-1,84]) para baixa estatura; e presença de óbito de outros filhos (RP 1,52 [IC95% 1,01-2,28]) para baixo peso para idade. Em modelo composto apenas de fatores distais e intermediários, a presença de cuidador principal (outro que não a mãe) aumentou a prevalência de baixa estatura em 42% (RP 1,42; IC95% 1,10-1,84) e para cada mês mais tarde que a mãe o iniciou pré-natal, a prevalência de baixo peso para idade aumentou em 20% (RP 1,20; IC95% 1,03-1,40). CONCLUSÃO: Foi possível descrever a tendência preocupante de aumento de obesidade em mulheres em idade fértil nos países estudados. Em Angola, poucos fatores individuais foram descritos, sugerindo que a influência de fatores coletivos é importante. Esses dados devem ser úteis para o planejamento de ações visando, por um lado, à prevenção de uma epidemia de obesidade em crianças na África Subsaariana e, por outro, ao enfrentamento atual das altas taxas de desnutrição em crianças em Angola e outros países. / INTRODUCTION: The prevalence of child malnutrition is still high in sub-Saharan Africa; however, there is evidence that obesity in adults is increasing. In this scenario, on the one hand, it is important to tackle malnutrition, while on the other, it is essential to identify trends in excess weight over time, so as to focus attention on the prevention of large increases in obesity and the chronic diseases it causes. Thus, the objectives of this study were to describe trends in sub-Saharan Africa in obesity over the past decades in women of childbearing age and in children under 5 years of age, in parallel with those of malnutrition in the same group of children; as well as to identify factors associated with malnutrition in children under 2 years living in the suburban area of Luanda, Angola. METHODS: To describe the trends in nutritional status, secondary data from national surveys (Demographic and Health Surveys and Multiple Indicator Cluster Samples) of 13 African countries having at least four available surveys, were used. Trends were described for the outcomes obesity in women aged 15 to 49, and overweight, stunting, wasting, underweight and low birthweight in children under 5 years. For individual trends in each country, linear regression was performed. For trends considering the group of 13 countries, we used a multilevel regression model. To identify the factors associated with malnutrition, data from a cross-sectional population-based study held in Cacuaco, a municipality of Luanda, in 2010 were used. The outcomes studied were stunting and underweight. Prevalence ratios (PR) were estimated by Poisson regression with robust variance using a hierarchical model. RESULTS: The prevalence of obesity increased among women of reproductive age in most of the countries studied, on average 2.8 percentage points per decade (P<0.001), accompanied by significant reduction of stunting, on average 5.6 percentage points per decade (P<0.001) and a decrease, though much smaller, of wasting, on average 1.1 percentage points per decade (P=0.09), with no evidence, to date, of an increase in overweight in children under 5 years (increase of 1.0 percentage points per decade, P = 0.14).In Angola, among the 749 children included in the study, 232 [32.0% (95% CI: 28.7 to 35.5%)] were stunted and 109 [15.1% (95% CI: 12.6- 17.9)] were underweight. In the final multivariate analysis model, the following factors have been identified as associated with the studied outcomes: occurrence of diarrhea in the last 15 days (PR 1.39 [95% CI 1.06 to 1.84]) for stunting; and death of other children from the same mother (PR 1.52 [95% CI 1.01-2.28]) for underweight. In a model composed only of distal and intermediate factors, the primary caregiver not being the mother increased the prevalence of stunting by 42% (PR 1.42, 95%CI 1.10- 1.84) and each month that prenatal care was delayed increased the prevalence of underweight by 20% (PR 1.20, 95% CI 1.03-1.40). CONCLUSION: These results enabled the identification of a worrying increasing trend of obesity in women of childbearing age in the studied countries, in a context in which child malnutrition still prevails, especially stunting. In Angola, although it was possible to identify factors associated with malnutrition never before studied in Luanda, few individual factors were identified that increased the prevalence of malnutrition, suggesting that the problem results primarily from factors affecting society as a whole. These data should be useful for planning aimed, on the one hand, to prevent an epidemic of obesity in children in sub-Saharan Africa, and on the other, meeting the challenge of current widespread childhood malnutrition in Angola and other countries.

The purpose of this study was to investigate parental influence on treatment progression in children with feeding disorders. Children diagnosed with a feeding disorder were recruited with their parents at the Children's House at Baylor (N=22; 11 boys, 11 girls). Caloric intake was recorded daily as outcome measures of treatment progression. It was hypothesized that the initial parental participation would delay the child's progress as measured by caloric intake. Patient's average caloric intake (measured in grams) for 3 days prior to parents entering the room was compared to the average caloric intake measured for 3 days after the parents entered the room. A paired t-test was performed on the averaged caloric intake three days pre and post-parental presence, yielding significant results: t(21) = 3.17, p = .005. Caloric intake was greater prior to parent involvement (M = 811.17) as compared to after the parent entered the room (M = 704.88).

Please read the abstract in the section 00front of this document / Dissertation (M Dietetics)--University of Pretoria, 1999. / Human Nutrition / unrestricted

The parasitosis in the tropical countries like Ecuador, are found in the different population groups of all ages, sexes, social conditions, ethnic groups, especially in those without hygienic conditions, pertaining to different geographic zones and the prevalence varies in agreement with the ecology, the human factors and the social economic characteristics. The fecal contamination on land and water where an adequate disposition of excretes, the surrounding conditions, the deficient living conditions, the rural life, the absence of bathrooms, the custom to not use shoes and to have contact with the water. The deficiency of hygienic education, contamination of foods and human migration all favor intestinal parasites. The parasitic plague in Ecuador and especially in the province of Imbabura is not very well known, this is because of the little attention and economical means that are given to an investigation. This investigation clearly points out the different concepts, definitions, consequences, treatments and prophylaxis that the community should take into account. This investigative work was done in the rural area of the Imbabura province for the following ethnic groups: Indigenous, Black, and Mestizo, with children younger than five years old and it is directed to the health personnel, and students It is estimated that in the whole world more than 20 million people are infected by the "himenolepsis" parasite. The Intestinal parasite has a direct relation with the Nutritional state of any given country, as well as the basic services, like water, collection of trash, elimination of excretes, illiteracy, bad family hygiene habits, and a healthy environment. This is how 40 thousand children die of hunger in the world daily, the difference here is an American child eats 500 times more than third world child. The lack of interest by the governments both international and national in health Programs in rural zones, impedes a solution being found. 50% of investigations are dedicated to the advancements in military, which also influences the lack of water, 3 billion people in the world lack drinkable water. There are many forms of exposure to the parasite, including, ground (garbage or trash left on floor) or contaminated water, contaminated food, biting insects, domestic or wild animals which have the parasite, another person, and their clothes or bed sheets. The most common of these being contaminated water. There are many reasons these parasites are found in higher numbers in third world countries. The lack of healthiness in the rural population increases the intestinal parasite in children under five years old, the lack of knowledge by part of the mothers on the consequences of the intestinal parasites. Bad hygiene habits that the mothers have as well as the children under five years old in not washing their hands before eating and after using the restroom add to the rapid spread of the parasite. The nutritional state of the children greatly increases exposure, mostly concerning food preparation. The presence of intestinal parasites in the children under five years old does the same damage with no importance to age, race, or sex. The bad form in which excretes are eliminated in the town also contributes to parasite spreading. To fight against further parasite spreading it is advised that a program of investigation is applied with many disciplinary teams including: Doctors, Epidemists, Microbiologists, Anthropologist, Nutritionists, and nurses to study and help find solution for the well-being of the areas that most need it. To also help, it is advised that Nutritionists, Nurses, Doctors, and people who have direct knowledge of what is health, capacitate the leaders of the community and citizens on the basic hygiene norms, including preparation and manipulation of foods, consequences and ways to prevent parasites. This would help slow the rapid spread of parasites among youth as well as adults. Have meetings teaching proper use of bathrooms both private and public in rural areas, to avoid massive parasite contamination. It is important to teach families that they should treat the water before drinking it because water has a direct link with parasite spreading. Demand that government pay more attention to health issues in rural communities.

Objectives: This study aimed to evaluate physiological and microbiome differences in a murine model consuming a Mediterranean (M) v. Western (W) diet. Methods Study design: To investigate the potential of diets in modifying the fecal microbiota, we used 16 ICR mice per diet split evenly between males and females. Mice were acclimated for 5 weeks, consuming regular chow, before switching to M or W diets. Four same sex mice were housed per cage and randomly assigned M or W diets with 2 cages of male and female mice/diet. All animals were weighed weekly, and stool samples were collected, freeze-dried, and ground. An aliquot was analyzed for short-chain fatty acid (SCFA) to determine the fecal fermentation profile (FFP). Diets: All animals were acclimated to their surroundings while consuming the standard mouse chow diet for 5 wks. Experimental diets were from Envigo for 10 wks. M v.. W diets were 24.2v. 17.3% protein, 42.3 v. 48.5% carbohydrate, 13 v. 21.2 % fat, 9 v. 5% fiber, and energy density of 3.6 v. 4.5 kcal/g, and were offered ad libitum. Fecal Fermentation Profile: Fecal samples had SCFA extracted and analyzed using a modified Schwiertz et al. method via gas chromatography. The resulting SCFA profiles were used to determine differences between diets. Statistical Model: General linear models examined main effects of diet, sex, and week while accounting for baseline value and a random effect for cage (SCFA) or mouse (weight). Results: Diet effects for M v. W diets for SCFA were Acetate 50.12 v. 38.45% (p< 0.01), Propionate 14.19 v. 7.98% (p< 0.01), Butyrate 8.37 v. 17.27% (p< 0.01), Caproate 16.19 v. 23.68% (p< 0.01), and Caprillic 0.44 v. 0.68% (p< 0.01). Sex comparisons showed higher percentages of Butyrate (p< 0.05) for males and higher percentages of Isobutyrate (p< 0.01), Isovalerate (p< 0.01), and Propionate (p=0.02) for female mice. On the Mediterranean diet, male mice gained more weight than female mice, 4.96g v. 2.86g compared to baseline (p<0.01). Animals on a Western diet approached significance by gaining more weight (p<0.0871).

Alzheimer's disease (AD) kills about 120,000 adults each year (1), perhaps ranking as the fourth or fifth leading cause of death in the United States (2). Progressively through its three stages, AD patients demonstrate an inability to identify familiar smells, lose weight, and develop malnutrition. This study was undertaken to compare the ability of AD patients verses non-AD patients concerning food identification and its potential influence on food intake. Another objective of the study was to assess whether an improved AD patient/caregiver relationship could improve the probability that the AD patient will accept more food items as a result of an enhanced relationship with the caregiver. Ten food items were used in each testing. Each patient was given a list of four food items to pick from when smelling and/or tasting each test sample. A response was required, regardless of whether or not the food item was correctly identified. Three separate tests were conducted for each patient, each a week apart, by three different administrators with a different third of the control and experin1ental patients until each had tested all of them. The data showed that AD patients have lessened food identification skills when compared to non-AD patients. Patient caregivers were able to attain the best results in toto (70.8%); almost double the results from the nurse coordinator (33.3%) and the researcher (33.4%), thus supporting the theory that the closer the patient/caregiver relationship, the greater the probability that the patient will accept more food items. / Master of Science

Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 5 uppsatser.