Five plant-based weaning foods (WF) (Dietrend, Jot-M, Soy, Ang, and Vic-T) locally prepared in Jos, Nigeria were analyzed by gas-liquid chromatography, reverse-phase high performance liquid chromatography, and atomic emission spectrometry with inductively coupled plasma to determine their fatty acid (FA), amino acid, and trace mineral contents, respectively. Results of these direct analyses were compared to expected values derived from food composition tables prepared by the United States Department of Agriculture (USDA). Additionally, results were compared against recommended nutrient values, using breast milk as the standard for FA content and recommended dietary allowances (RDA) for amino acid and mineral contents. The overall nutritional value of the five WF varied considerably and the quantities of particular nutrients determined by direct analysis differed markedly from those estimated using USDA food tables. Comparison of WF fatty acid composition relative to the RDA recommendations and a human milk standard revealed a much higher proportion of both linoleic (35-55 wt%) and alpha-linolenic acids (1%-7 wt%) relative to human milk lipids (11%-12% and 0.8%-0.9% wt, respectively); however, the WF were devoid of arachidonic acid and docosahexaenoic acid. Soy contained the highest amounts of linoleic acid (59.7 mg/g) and alpha-linolenic acid (7.46 mg/g) compared to the other four WF (10.2-41.0 and 0.35-3.18 mg/g, respectively). The linoleic acid/alpha-linolenic acid ratio was within the recommended range (5:1 to 10:1) in only Jot-M (10:1) and Soy (8:1). Dietrend, Vic-T and Ang, contained linoleic/alpha-linolenic ratios of 12:1, 29:1, and 82:1, respectively. The Soy weaning food would provide the most protein (24.3 g/day), based on an estimated daily intake of 65 g of weaning food by a normal six-month-old infant, compared to Jot-M (11.9 g/day), Dietrend (11.7 g/day), Ang (8.07 g/day), and Vic-T (7.26 g/day). The protein RDA for children up to 1 year of age is 13-14 g/day. Comparison of the mineral contents of the WF to the RDAs for various minerals indicated that all five would provide suboptimal amounts of calcium (16 to 250 mg/day) and zinc (1.42 to 3.56 mg/day) compared to respective RDAs of 400 mg/day and 5 mg/day. These data show that the Soy weaning food is an excellent source of linoleic acid and alpha-linolenic acid, as well as being a good source of high quality protein. Jot-M and Dietrend provide useful amounts of the essential FA; however, it is advisable to reevaluate the composition of Ang and Vic-T to find ways to improve the linoleic/alpha-linolenic ratio of each and increase their total protein content. These results document the shortcomings of using published food composition tables based on foods in America when devising weaning foods based on ingredients in another part of the world.
SUMMARY We report four patients with hypertrichosis cubiti who were referred for investigation of short stature. Two males, whose height was on and just below the 3rd centile respectively, were sporadic cases and two females with disproportionate short stature were mother and daughter. Radiological changes present in the familial cases were non-specific and biochemical investigations were normal. Of the four other published cases, two were sporadic and of normal height. The other two were sibs with short stature and their parents were heterozygous for the Weill-Marchesani syndrome. We were unable to ascertain whether hypertrichosis cubiti cosegregates with the same type of skeletal dysplasia or elucidate the type of genetic transmissior of hypertrichosis cubiti alone.Hypertrichosis cubiti was first reported by Beighton,l who described a localised hypertrichosis confined to the extensor surface of the elbow regions in two sibs from an inbred Amish family. They had normal development and clinical abnormalities were confined to short stature and foreshortened, but not dysplastic, nails. Their parents were short and both were heterozygous for the Weill-Marchesani syndrome. The short stature of the affected sibs was not investigated. Subsequently, Rudolph2 and Andrev and Stansky3 each reported a sporadic case of hypertrichosis cubiti without other clinical abnormalities. Sighting of a case in the local parish A church congregation was reported by Warner4 and a few cases were apparently observed, but not published.3We have had the opportunity to examine four previously unreported patients with hypertrichosis cubiti, all of whom were referred for investigation of short stature. Case reportsTwo males and two females presented with a history of excessive hair growth over the lateral aspects of the lower third of the upper arm and upper third of the forearm observed soon after birth. In early childhood the hair became coarser, sometimes
Case reports Many features of this syndrome could be explained by an underlying myopathy. In congenital fibre type disproportion, short stature, contractures, scoliosis, and high arched palate were reported in a review by Cavanagh et al.6 In nemaline myopathy skeletal abnormalities and reduced muscle bulk are well recognised.7 Further investigation of muscle function in other patients with this syndrome is likely to be rewarding. We would like to thank Drs J Wilson and J Payan for their help in investigating this patient, and Dr S Ware for referring the patient to our clinic. Dr M A Patton is supported by a Child Health Research Fund Fellowship. References Goodman RM, Katznclson MB, Manor E. Camptodactyly: occurrence in two genetic syndromcs and its relationship to other syndromes.
SUMMARY Most infants in the UK are bottle fed with cows' milk formulae that are alleged to provide less than the minimum requirement for linoleic acid, i.e. 1 % of the total dietary energy. 20 term infants fed solely on a modified cows' milk formula that provided 0 * 55 % of the energy from linoleic acid were therefore examined for evidence of deficiency. Rates of growth in length and weight, measured during the first 3 months of life, were identical with those of 20 wholly breast-fed infants. Voluntary food intakes (kcal/kg per day) followed the normal pattern. The fatty acid composition of the plasma lipids showed changes characteristic of a low intake of linoleic acid, but triene:tetraene ratios did not indicate a deficiency state, and clinical signs of deficiency were not observed. These findings suggest that the requirement for linoleic acid is substantially less than was formerly believed. The small amount of a-linolenic acid present in cows' milk may however exert a sparing effect on linoleic acid.The experiments of Hansen and his colleagues Hansen et al., 1958;Wiese et al., 1958) clearly demonstrated that the human infant has a specific requirement for linoleic acid (18:2, n-6). Infants who were fed a skim-milk formula in which linoleic acid provided <0-1 % of the total energy developed a deficiency syndrome, the main features of which were (a) a reduction in the plasma concentration of linoleic acid and arachidonic acid (20:4, n-6) associated with an increase in the concentration of a triene; (b) impairment of energy use, shown by a pronounced rise in voluntary food consumption which was detected within 1-2 weeks; and (c) a characteristic dermatosis, a dry scaly thickened skin, which was apparent after 1-3 months of feeding. All symptoms disappeared promptly on treatment with the ethyl ester of linoleic acid, the so-called 'essential fatty acid'.In the body, linoleic acid undergoes alternating desaturation and chain elongation to produce its metabolically active derivative arachidonic acid. This process is not, however, confined to linoleic acid, but high concentrations of linoleic acid in the tissues appear to suppress the desaturation and chain elongation of other fatty acids. When the concen-
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