T Walter’s research while affiliated with University of Chile and other places

In Chile infant malnutrition is better reflected by the length/age indicator than by weight/length. In this study we will present the progression of length during the first year of life from the year 1978 through 1992 of infants of low socioeconomic status. We selected healthy infants with > 3000 g birth weight and birth length > 0.5 z. According to type of milk feedings they were defined as CM (cow milk) those who were weaned before 4 months of life and EM (exclusive breast milk) those who continued exclusive breast milk (as only source of milk solids permitted) past 6 months. Infants CM of the 1978-80 cohort had a length at birth z +0.21 reaching 1 year with z -0.65, a loss of 0.86 z. Infants from the cohorts of 1982-86 and 1988-92 fell from z +0.15 to z -0.37 (a loss of -0.52 z) and +0.16 to -0.19 (a loss of -0.45 z) between birth and 12 months respectively. EBM infants length also fell significantly (delta z: -1.12, -0.69 and 0.59 respectively). Proteincalorie nutrition was adequate confirmed with weight/age or length/weight curves with means of +0.52 throughout the first year. Analysis of the length curves by regression shows that the slopes of the 3 cohorts are significantly different (< 0.01) for CM and EBM favoring the most recent cohorts. Multiple regression analysis identified association of length at 1 year with birth weight (p < 0.05), birth length (p < 0.01) and socioeconomic index (p < 0.01). We suggest that there is an improvement in the trend of Chilean infants growth in length for the past 20 years, likely due to improvement in socioeconomic level.

Growth in terms of length of Chilean infants of low socioeconomic stratum: 1978-1992. In Chile infant malnutrition is better reflected by the length/age indicator than by weight/length. In this study we will present the progression of length during the first year of life from the year 1978 through 1992 of infants of low socioeconomic status. We selected healthy infants with >3000 g birth weight and birth length >0,5z. According to type of milk feedings they were defined as CM (cow milk) those who were weaned before 4 months of life and EM (exclusive breast milk) those who continued exclusive breast milk (as only source of milk solids permitted) past 6 months. Infants CM of the 1978-80 cohort had a length at birth z+0.21 reaching 1 year with z-0,65, a loss of 0,86z. Infants from the cohorts of 1982-86 and 1988-92 fell from z+0.15 to z-0,37 (a loss of-0,52 z) and+0,16to-0,19 (a loss of -0,45 z) between birth and 12 months respectively. EBM infants length also fell significantly (Az: -1.12, -0.69 and 0.59 respectively). Protein-calorie nutrition was adequate confirmed with weight/age or lenght/weight curves with means of+0,52 throughout the first year. Analysis of the length curves by regression shows that the slopes of the 3 cohorts are significantly different (<0,01) for CM and EBM favoring the most recent cohorts. Multiple regression analysis identified associations of length all year with birth weight (p<0,05), birth length (p<0,01) and socioeconomic index (p<0.01). We suggest that there is an improvement in the trend of Chilean infants growth in length for the past 20 years, likely due to improvement in socioeconomic level.

To address the hypothesis that increased infectious morbidity is associated with iron supplementation, 783 randomly selected infants were provided with a powdered full fat cow's milk (non-fortified group) and 872 with a powdered acidified full fat cow's milk fortified with 15 mg of iron as ferrous sulfate (fortified group). All infants were followed from birth to 15 months of age with a monthly home visit by a nurse who recorded morbidity occurring during the previous 30 days. At 9 months of age, 15% of infants in each cohort were receiving breast milk only; data for these infants were segregated to make the third group. Episodes (mean +/- SD) of diarrhea/infant/year were 1.06 +/- 1.29, 1.14 +/- 1.37, and 0.82 +/- 1.04 for the fortified, non-fortified and breast-fed groups, respectively; the fortified and non-fortified bottle-fed groups had a very similar incidence of respiratory illness; 2.66 +/- 2.07 and 2.74 +/- 2.24 episodes/infant/year, respectively. The incidence of respiratory illness for both bottle-fed groups was significantly higher than that for the breast-fed group (2.22 +/- 1.84 respiratory episodes/infant/year). We conclude that for the infants the tested form of iron fortified milk, which is sufficient to lower iron deficiency anemia, does not result in an increased incidence of diarrhea or respiratory illness.

Tannins are natural compounds that abound in herbs, wood and fruits. Their numerous hydroxyl radicals confer them a strong avidity for metals such as Fe, Zn and Cu. This property makes them strong inhibitors for the gastrointestinal absorption of these metals. Our purpose was to determine the tannin content of herbal infusions commonly consumed in Chile and other Latino American countries. The determination was performed from dessicated herbs with the Folin-Denis technique. Yerba mate, tea and oregano had the highest tannin content (117, 100 and 84 mg of tannic acid/g dry herb respectively). An intermediate level (between 20 and 40 of tannic acid/g) was for coca, matico, boldo, palto, laurel, orange and binojo. The lowest level of tannin for paico, cedrón, apio and manzanilla (< 10 mg/g). We conclude that the consumption of herbal teas at or around meals may inhibit the absorption of metals such as Fe, Zn, or Cu by decreasing their bioavailability.

To assess the duration and intensity of the changes appearing in laboratory values related to iron utilisation during viral infection. With previous parental consent, 120 eutrophic infants received vaccination with attenuated measles virus or a combination of measles, mumps and rubella viruses as a model of mild viral infection. A number of laboratory tests were performed on day 0 and in two later occasions (4-21, 9-14 or 9-30); these included blood cell counts, ESR, serum iron, total iron binding capacity, transferrin saturation index, free erythrocytic protoporphyrin, serum ferritin, intra-erythrocytic ferritin, direct anti-human globulin test and C-reactive protein. The statistical analyses were done in accordance with ANOVA, Student's t test, Wilcoxon, Kruskall - Wallis, Mann-Whitney and Fisher methods. A significant haemoglobin drop was seen on days 9 and 14 post-vaccination. This descent was > 10 g/L in 8.2% of the cases, and > or = 6 g/L in 19.6%. Serum iron and transferrin saturation decreased significantly, whereas mean corpuscular volume, free erythrocyte protoporphyrin and serum ferritin were significantly increased. All these but protoporphyrin recovered by day 30. Subjects with normal iron metabolism figures on day 0 and those whose thermal variations were above 38 degrees C had greater changes in the figures related to iron metabolism. The evaluation of iron metabolism is not reliable if the patient has suffered from infection, although a mild viral one, in the three weeks prior to the study.

The Chilean School Lunch program, which serves one million children nationwide, was supplied with three 10-g cookies fortified with 6% bovine hemoglobin concentrate, designed to provide 1 mg bioavailable iron per day. A survey of 1000 children was performed after 3 y. Significant differences in hemoglobin concentrations were found in the children from the fortified vs the nonfortified province (P < 0.01). Low serum ferritin values were also significantly more prevalent in the nonfortified group. The effect was evident despite the very low prevalence of anemia in both the fortified and the unfortified school groups. Heme-iron-fortified cookies are a feasible and effective way to improve the iron status of school-age children. In regions of high prevalence of iron-deficiency anemia, the effect of a heme-fortified cookie program should be even more important.

We evaluated the effect of iron-supplemented milk on 86 healthy infants who were followed from 3 to 12 months of age. Whole milk was supplemented with 15 mg elementary iron as ferrous sulphate and 100 mg ascorbic acid per 100 g powder. 104 infants received the same milk with no supplement and served as control. All iron nutritional parameters were higher in the supplemented group at 9 and 12 months of treatment (p < 0.01). Iron-deficiency anemia was shown in 34% of the control as compared to 0% of the treatment group. The product exhibited excellent tolerance and could therefore be used to eradicate iron-deficiency anemia of the infant.

We tested in the field an extruded rice flour, fortified with a bovine haemoglobin concentrate (Fe:14 mg/100 g of powder). This cereal has a high iron bioavailability, good protein quality and amino acid score. Healthy, term breast-fed infants were prospectively studied. One group (n = 92) received the fortified cereal (from 4 to 12 months of age). As control, 96 infants received regular solid foods (cooked vegetables and meat) from age 4 months. At the end of the field trial, a subsample of infants in both groups was supplemented with 45 mg Fe during 90 d. Iron nutrition status was determined at 9, 12 and 15 months. At 12 months, iron deficiency anaemia was present in 17 per cent of controls, in 10 per cent of fortified infants as a whole, but only in 6 per cent of the babies who consumed over 30 g of cereal/d. In addition, this latter group did not show any significant changes in iron nutrition status after the supplementation trial. Results demonstrate that the consumption of a haemoglobin fortified cereal is effective in markedly reducing the incidence of iron deficiency in breast-fed infants.