At Sorrento Maternity Hospital Asian mothers whose babies had grown poorly in utero had anthropometric and biochemical evidence suggesting an inadequate nutritional state. To test this hypothesis further the effect of unselective dietary protein energy supplementation was studied. A total of 153 Asian mothers received one of three supplements from the 18th to 38th weeks of pregnancy: (a) vitamins only-vitamin C 30 mg daily, iron 3 mg daily; (b) energy-42-80 MJ; (10 000-19 000 kcal)/ trimester, all from carbohydrate, plus vitamins; (c) protein energy-energy and vitamins as before, but with 5-11% of energy from milk protein. By the 28th week mothers receiving the protein energy supplement had put on more-weight and more fat than the vitamin-only group. Neither protein energy nor energy supplementation alone enhanced intrauterine growth.It is concluded that dietary supplementation of all pregnant mothers does not enhance intrauterine growth.

1. The previous paper (Eaton et al. 1984) described the nutrient intake of pregnant Asian women attending Sorrento Maternity Hospital, Birmingham using the weighed and recall methods. The present paper describes the subethnic variation in nutrient intake by comparing the results from Pakistanis, Sikhs, Hindus and Bangladeshis and also describes food eaten by the pregnant women.2. Generally. Sikhs had the highest intake of most nutrients (mean energy 7.5 MJ (1800 kcal)/d) and the greatest variety of foods; they ate chapatti and paratha but few ate meat. Hindus had a very similar diet but more ate meat, chicken and rice. Pakistanis had an energy intake about 10% below that of the Sikhs and Hindus; meat was eaten, and intake of fruit, and therefore vitamin C, was quite large. Bangladeshis were the smallest women; they had the lowest intake of energy (mean energy 6.5 MJ (1555 kcal)/d) and most nutrients, except for protein, so that 15% of energy was provided by protein. Fish, rice and a low-fat intake were other features of their diet.3. From a nutritional standpoint, peoples coming from the Asian subcontinent should be divided into subethnic groups; the collective term 'Asian' is insufficient.4. It is not clear whether these differences have any effect on the life and health of the individuals. Comparison of groups does not suggest an obvious relationship between dietary intake and fetal growth; however, there is other evidence to implicate the possible role of deficiencies of protein, energy, zinc and pyridoxine.5. The results provide some support for the community nutritional policies of (a) offering vitamin D supplements to all pregnant Asian women and (b) fortifying bread with calcium, thiamin and nicotinic acid. There is probably no need to offer vitamin A and C supplements but they are harmless. Indications for iron supplementation are no different from those for white English women.The nutrient intake of Asian women during the second and third trimesters of pregnancy has been described in the previous paper (Eaton et al. 1984). The present paper describes the subethnic differences in the nutrient intake, and the different kinds of food eaten by the expectant Sikh and Hindu mothers originating from India (although some came to Britain via East Africa) and the expectant Moslem mothers from Pakistan and Bangladesh. METHODSDeterminations of the dietary intakes using the weighed and recall methods were made exactly as described in the previous paper, that is at five-weekly intervals from 18 weeks of pregnancy.The number of women in each subethnic group at each 5-week interval was sometimes small, however. Therefore, for each subethnic group, the results for 18,23,28 and 33 weeks have been combined and presented together. This seemed valid since the total energy intake showed little change between 18 and 33 weeks (Durnin et al. 1983;Eaton et al. 1984). Values at 38 weeks of pregnancy have not been included in the combined presentation; some women had delivered before 38 weeks and in others who had not delivered t...

1. The dietary intake of pregnant Asian women (that is originating from the Indian subcontinent) attending Sorrento Maternity Hospital in Birmingham was determined, using the weighed and recall techniques, at five-weekly intervals from 18 to 38 weeks of pregnancy.2. Mean energy intake of the group was 7.1 MJ (1700 kcal)/d. The intakes of most nutrients were substantially below those consumed by pregnant European women in Britain, a little below those of expectant Pakistani mothers in Islamabad, and about the same as those of expectant East London mothers. Intakes of vitamin D, total folate, vitamin B,, zinc and magnesium were particularly low.3. These observations suggest that a number of Asian women in Birmingham are likely to experience nutritional stress in pregnancy, and there is some anthropometric and biochemical evidence from Sorrento, published elsewhere (Bissenden ef al. 1981), to support this. . 1982a, b). The present paper describes the nutrient intake, determined by weighed and recall methods, of Asian women during the second and third trimesters of pregnancy. The observed nutrient intake is compared with the recommendations made by various bodies and with other studies in pregnant European women and pregnant Asian women in Asia. A later paper describes the nutrient intake and the variety of foods eaten by the individual groups within this Asian community, Pakistani, Bangladeshi, Hindu and Sikh expectant mothers, in more detail (Wharton et al. 1984). METHODS Women studiedThe women studied were taking part in a trial of selective dietary protein-energy supplementation (Viegas et al. 1982~). In the trial, women received a vitamin and iron supplement from 18 to 28 weeks of pregnancy and then at 28 weeks they were randomly allocated to one of three regimens to continue until 38 weeks: (a) vitamins supplement only, (b) vitamins plus an energy supplement, (c) vitamins plus a protein-energy supplement. Although dietary intakes of women on all three regimens were measured, results in the present paper are presented from women when they were receiving the vitamins supplement only. There are, therefore, more values for the second trimester (1 8-28 weeks) than for the * Present address: Dudley Road Hospital, Birmingham. t For reprints.

This review discusses five questions concerning nutrition in adolescence. Do adolescents have special nutritional needs? What are the recommended dietary intakes? What do adolescent schoolchildren eat? What nutritional disorders occur at this age? The prevalence of iron deficiency anaemia, rickets, coeliac disease, iodine deficiency, dental caries, weight disorders, zinc deficiency and pellagra are discussed. What is the role of school meals or other food supplementation programmes?

The zinc concentration of placental tissue and cord blood in sixteen mothers who gave birth to normal babies was measured. The blood volume of each placenta was estimated from measurements of haemoglobin concentration of placental homogenate and cord blood, and, by deduction, the Zn content of blood-free placental tissue was calculated. Results were compared with eleven mothers whose fetuses showed a low biparietal diameter velocity between 17 and 28 weeks gestation and with ten mothers who gave birth to intra-uterine growth-retarded (IUGR) babies. As expected, placental weight was significantly correlated with infant birth weight. Blood-free placental tissue contained about four times xmore Zn (approximately 10 µg Zn/g) than cord blood (approximately 2.5 µg Zn/ml). Concentrations of Zn in blood-free placental tissue were similar in all three groups, but the cord blood Zn of mothers producing IUGR babies was significantly lower than that of the other two groups. Results of the present study suggested that fetal growth retardation in the mothers studied could not be explained by differences in blood-free placental Zn concentration, but that there may be some association between lower cord blood Zn levels and intra-uterine growth retardation.