The iron bioavailability from three typical diets consumed by socioeconomic stratum IV (SES IV--working class) of the Venezuelan population was determined by the extrinsic label method. Although the iron content of the SES IV diets was about the same (250 mumol/d) as that of upper (SES I-III) and lower (SES V) socioeconomic strata diets, iron-replete subjects absorbed 43 and 61% more iron from the SES I-III diets than from the SES IV and V diets, respectively, and absorption from the main meal of the SES I-III diets was 100% greater. However, iron deficient subjects absorbed about the same amount of iron (45 mumol/d) from the SES IV diets as from the SES I-III diets. The SES I-III diets contained more iron absorption enhancers (ascorbic acid and meat protein) and less of the inhibitor phytate, than the SES IV and V diets. Iron absorption from the meals of four diets consumed at different times during the day was also measured. There was no significant difference in the percentage iron absorption from the same meals eaten in the morning after an overnight fast, and when eaten at the customary time of day.
Iron bioavailability was determined by the extrinsic label method in seven diets consumed by low, middle, and high socio-economic strata of the Venezuelan population. The results were compared with physiologic iron requirements and the prevalence of iron deficiency according to age and sex of others in the same strata. The iron metabolic balance obtained by comparing the iron absorption from diets with the physiologic iron requirement was negative in subjects consuming the low-bioavailability diets, being more marked in children below four years of age, and in adolescents and adult females. These groups also showed the highest prevalence of iron deficiency with and without anaemia. The metabolic iron balance in subjects consuming high iron-bioavailability diets was less negative among vulnerable groups consuming low-bioavailability diets and positive in the age and sex groups less vulnerable to iron deficiency. This information was used to identify the principal categories of dietary iron bioavailability in various regions of the world and their effect on the prevalence of iron deficiency.
Background/objectivesTo elicit and compare preferences in terms of the attributes of home enteral nutrition (HEN) among patients and physicians, using a discrete choice experiment (DCE).Subjects/methodsA DCE comprising eight choice scenarios, with six HEN attributes (tolerability, adaptation to comorbidities, nutrition and calories, handling, connections and information; two levels each) was designed. The Relative Importance (RI) for patients and physicians of each attribute was estimated. Sociodemographic and clinical variables, as well as additional questions (n = 8) were compiled to analyze possible explanatory variables and other preferences.ResultsA total of 148 HEN patients (71 needing caregivers to answer on their behalf) and 114 physicians completed the DCE. The most important attributes for patients were adaptation to comorbidities (33% RI), tolerability (33% RI), and nutrition and calories (26% RI). Significantly, younger patients had stronger preferences for tolerability whereas elderly ones (≥75 years) were more concerned about handling. In comparison, physicians gave a higher RI to tolerability, and nutrition and calories compared to patients (p = 0.002). Overall, a higher percentage of physicians answered that HEN characteristics such as easy-handling bags (85.1 vs. 64.9%; p = 0.001), container material (69.3 vs. 57.1%; p = 0.003) or reusable containers (79.8 vs. 70.3%; p = 0.01) were “important” or “very important” compared to patients.ConclusionsOur findings showed that although patients and physicians have a similar perception about the relevance of different HEN attributes, the relative weight given to each one varies between them. Therefore, both points of view should be considered when choosing a HEN product in order to improve patients’ satisfaction and clinical outcomes.
The height and weight of 28,752 urban and 10,557 rural individuals aged birth to 18 years were measured as part of a cross-sectional national survey (Project Venezuela) between 1981 and 1986. The Preece-Baines model 1 was fitted to the means; pooled residual mean squares of 0.21 and 0.13 in height and 0.44 and 0.13 in weight, for boys and girls respectively, indicated a good fit. Derived means and biological parameters were compared. The nutritional status of 18,849 children aged birth to 8 years was assessed using the WHO-recommended NCHS/CDC 3rd or 10th and 90th centiles as cut-off points for weight for height, weight for age, and height for age. A t test for proportions was used to test significance. Urban children were taller and heavier than their rural counterparts; differences were evident after age 2 and maximal at 14 years in boys and 12 years in girls, due to differences in tempo, although part of the differences persist into adulthood. Prevalences of wasting and stunting were 3.5% and 10.5% higher in rural children and overweight was 3.6% higher in urban children, significantly so in height for age. A mixed nutritional problem is present in Venezuelans, with a prevalence of stunting greater than that of wasting and a prevalence of overweight greater in urban children. Urban-rural differences in growth persisted into adulthood in boys, while rural girls were similar to urban girls at the end of growth.
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