The transient depression in plasma retinol produced by subclinical infection increased the number of at-risk children by 10% (76 of 797) and 56% (49 of 87) for plasma retinol concentrations <0.7 and <0.35 micromol/L, respectively. In addition, dietary inadequacy may be responsible for retinol concentrations being approximately 16% lower in Pakistani children than in children in the United Kingdom, where dietary vitamin A is adequate.

BackgroundThe elderly population is increasing worldwide, which warrants their nutritional status assessment more important. The present study was undertaken to establish the nutritional status of the least-studied elderly population in Pakistan.MethodsThis was a cross-sectional study with a sample of 526 generally healthy free-living elderly men (mean age: 68.9 yr; range: 50-98 yr) from Peshawar, Pakistan. Anthropometric measurements (weight, height, WC) were measured and BMI and WHR were calculated from these measurements following WHO standard procedures. Dietary intake was assessed by 24-hr dietary recall. Nutrients were calculated from the information on food intake. Nutrients in terms of % of RNI were calculated using WHO data on recommended intakes.ResultsBased on BMI, the numbers of obese, overweight and underweight elderly were 13.1, 3.1 and 10.8%, respectively. Age was negatively and significantly correlated with BMI (p = 0.0028). Energy (p = 0.0564) and protein intake (p = 0.0776) tended to decrease with age. There was a significant increase in % BF with age (p = <0.0001). The normal weight elderly had significantly (p < 0.05) higher intake of all nutrients studied, except energy which was significantly (p < 0.05) higher in obese and overweight elderly. Overall, however, the majority of subjects had lower than adequate nutrient intake (67.3 - 100% of recommendation).ConclusionsMalnutrition is common in apparently healthy elderly Pakistani men. Very few elderly have adequate nutrient intake. Obese and overweight had higher % BF as compared to normal weight elderly. Older age is associated with changes not only in anthropometrics and body composition but also in intake of key nutrients like energy and protein.

A comparative study was undertaken to assess the nutritional status, dietary practices and physical activities of school going adolescents in public and private schools (PPSs) of Karachi, Pakistan. A sample of 101 boys and 100 girls from PPSs was randomly selected for their weight, height, waist and hip circumferences, percent body fat and lean body mass measurements. Adolescent boys and girls were interviewed for their dietary practices, socio-economic status, frequency and type of physical activities and their responses were recorded. Results by gender and school type revealed that both the boys and girls of private schools had a significantly lower mean age but significantly higher mean height-for-age Z-score, waist and hip circumferences than the public school adolescents. Food frequency results revealed that the frequency and patterns of breakfast, break-time snack, lunch and dinner of private school going adolescents were more diverse and nutritiously rich. Skipping breakfast was more common among adolescents being higher in girls than boys. Parents of adolescents belonging to private schools had a higher education and socio-economic status. Private school adolescents were physically more active (p<0.05) in terms of frequency and type of physical activities. The study concludes that the adolescents of private schools had a better nutritional status, consumed food and beverages of better quality and were physically more active. However, boys and girls of both the public and private schools failed to meet the national and international dietary guidelines of recommended food servings.

We report an apparently protective effect of vitamin A in infants who received iron supplements (15 mg/d) for 3 mo. Those receiving iron showed increases in hemoglobin (8 g/L), ferritin (3.7 micrograms/L), and the acute-phase protein alpha 1-antichymotrypsin (ACT; 0.06 g/L). In both the placebo and iron-supplemented groups there were increases in plasma retinol, lutein, alpha-tocopherol, immunoglobulin A, and immunoglobulin G. The improvement in vitamin A status could only have been from a seasonal increase in dietary sources of vitamin A, eg, breast milk and early weaning foods, and there were no obvious effects on iron utilization (hemoglobin concentrations). However, in the infants receiving iron, those whose retinol concentrations increased also showed reductions in ACT, ferritin, immunoglobulin A, and immunoglobulin M. Vitamin A is well known for its antiinfective properties and we suggest that these observations illustrate the importance of even small increases in dietary vitamin A or differences in vitamin A status in reducing the potentially toxic effects of iron supplements in persons in developing countries. These conclusions should now be confirmed with an intervention study to show that the benefits of vitamin A on iron status are due to reduced levels of infection.

Nutrition influences immunity in multiple ways, with different nutrients affecting many immune parameters. Aging also affects immunity, making the outcome of the interplay between nutrition, age and immunity complex. Moreover, a particular nutrient may alter the whole immune constellation as deficiency of one nutrient may affect the proper metabolism of another nutrient and elicit a chain reaction of secondary malnutrition. In this article, we review these interactions and the possible mechanisms mediating such relationships.

Recent evidence suggests that plasma lutein is better correlated than either p-carotene or lycopene with its respective carotenoid intake and therefore may be a better marker of vegetable intake than either p-carotene or lycopene. In the study reported in this paper, measurements of plasma carotenes and retinol were made in infants from two villages near Peshawar in the North West Frontier Province, Pakistan, in July and November 1993. The approximate age at the start was 14 months, and 101 boys and ninety girls completed the study. Of the usual plasma carotenes, only lutein was measurable in all samples and was correlated with retinol in both boys (r 0.38, P < 0.0001; r 0.35, P < 0.001) and girls (r 0.21, P = 0-038; r 0.307, P = 0.003) at the two time points respectively. In addition, the change in lutein was even more strongly correlated with the change in retinol in both boys (r 0.453, P

Dietary intake has been shown to influence the acid–base balance in human subjects; however, this phenomenon is poorly understood and rarely reported for the least well-studied segment of older people in a developing country. The aims of the present study were to: (1) quantify estimates of daily net endogenous acid production (NEAP) (mEq/d) in a sample of otherwise healthy elderly aged 50 years and above; and (2) compare NEAP between the elderly and young to determine the effects of aging, which could contribute to changes in the acid–base balance. Analyses were carried out among 526 elderly and 131 young participants (aged 50–80 and 23–28 years, respectively), all of whom were free of discernible disease, nonsmokers, and not on any chronic medication. Selected anthropometric factors were measured and 24-hour dietary recall was recorded. We used two measures to characterize dietary acid load: (1) NEAP estimated as the dietary potential renal acid load plus organic acid excretion, the latter as a multiple of estimated body surface area; and (2) estimated NEAP based on protein and K. For the young and elderly, the ranges of NEAP were 12.1–67.8 mEq/d and 2.0–78.3 mEq/d, respectively. Regardless of the method used, the mean dietary acid–base balance (NEAP) was significantly higher for the elderly than the young (P = 0.0035 for NEAP [elderly, 44.1 mEq/d versus young 40.1 mEq/d]; and P = 0.0035 for the protein:potassium ratio [elderly, 1.4 mEq/d versus young 1.1 mEq/d]). A positive and significant correlation was found between NEAP and energy, protein, and phosphorus (P < 0.05 for all trends). The findings from this study provide evidence of the relatively higher production of NEAP in older people, possibly as an effect of higher consumption of certain acid-producing foods by the elderly.

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