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Undernutrition – protein energy malnutrition or specific nutrient deficiencies – has been an inherent characteristic of impoverished populations throughout the world. Over-nutrition, obesity and nutrition imbalance is a current concern among those with rising though still insufficient incomes. We review data to suggest that the prevalence of these forms of malnutrition in populations is highly influenced by the rate of appearance of discretionary income.In developed countries, discretionary (alternatively "disposable") income refers to funds available after obligate payments (rent, heat, and the cost of getting to work) and payment for necessities (food and clothing). For families living at or below poverty, the last dollar earned is spent on these obligations. Undernutrition is common. By contrast, likelihood for obesity or imbalance increases with rising income when that last dollar is earned without certainty that it is available for discretionary spending. In the United States, neither under- nor over-nutrition is likely when new income is free and clear of debt or obligation. This occurs at approximately three times the poverty level.While income poverty and food insecurity affect risk for malnutrition rather than outcome, nutrition education programs that address issues of income and food support increase likelihood for adherence to recommendations.

Twenty-seven pediatric residents were assessed for knowledge, attitudes, and behaviors regarding rights of immigrant families. A program documenting immigrant rights was reinforced in the clinic with posters and individual consultations on immigrant children's needs. This brief program was effective in instructing residents on health and nutritional services for immigrant patients.

Background. While rapid early weight gain are common in children who become obese later in life, so is growth faltering in the first 3 months of life. Objective. We seek to determine what relationship weight gain in the first six months of age, separated into two 3-month periods, have with the BMI of children ages 4 to 6 years in an inner-city community. Subjects. A convenience sample cohort of 154 children attending an inner-city clinic. Methods. Consecutive charts were reviewed retrospectively. Age, gender, birth weight and weight change in the first and second 3 months of life were introduced as fixed factors using mixed linear models with BMI in years 4 to 6 as the dependent variable. Results. Weight change quartile in the first 3 months of life did not predict of BMI in years 4 to 6; however, weight changes quartiles during months 4 to 6 were significant predictors for subsequent overweight. Conclusion. The data presented herein suggest that, for this specific population, weight gain can be promoted when it is most essential. It is necessary, however, to identify intermediary variables that could affect outcomes in this and other communities.

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. M i r t e s V. Beirao. Univ. o f Pa. Sch. o f Med., Pa. Hosp, Dept. Pediat. P h i l a . No evidence o f phototherapy r e l a t e d deficiency has y e t been found i n these 5 years. S i m i l a r l y there has been no evidence o f t r e a tment r e l a t e d decrease i n G6PD a c t i v i t y o r GSH blood content. H wever low GSH l e v e l s a r e not infrequently found i n small sick babies regardless o f Rx. Beginning studies o f a second FAD dependendent enzyme, methemoglobin reductase(MR) a r e showing s i m i l a r r es u l t s , except t h a t MR a c t i v i t y i n contrast t o t h a t o f GR i s lower i n newborn RBC than i n adult. Occasional instances o f s l i g h t l y l ower a c t i v i t y following onset o f Rx have a l l reversed themselves before cessation of Rx. These data differ from those of Gromiscl~ e t . a l . perhaps because o f differences i n maternal n u t r i t i o n . --*APA-um p-nitrophenol phosphatelgm proteinlmin +P<0.005. Conclusion: 80% of pta with GSE exhibited in vitro gluten sensitivity while gluten had no effect on non-GSE flat jejunal mucosa. In vitro gluten sensitivity appears to be specific for the diagnosis of GSE, thus perhaps obviating repeat biopsies and challenge to confirm the diagnosis in these pts. Ulceration recurred within 10 daya after drug discontinuation necessitating its resumption and ongoing use. m j o r hemorrhage from atrusa ulcers (a teroid-induced, bilisry atrerialport-Usei operation) in the other two children ceaeed within 24 hour* aftinstitution of cirtidine. Serial gastric acid etudias in the a u l l e r children s h a n d inconatant control of gastric secretion probably d w to lack of exprience with dosaga. Naverthelesa. there was prompt radiographic healing of duodenal ulcara tion in both patients. Drug toxicity waa monitorad by mequential heutologic, renal, hepatic and neurologic mtudias. Although most likely not drug-related. a tranaimnt decreaae in bile output in one patient and lethargy in another repranentad the only poerible toxic ride effects obaervad thue far. For the past 5 years we have been doing s e r i a l deterininations o f the a c t i v i t y o f the f l avin adenine dinucleotide(FA0) dependent enzyme, glutathione reductase (GR) i n RBC's of babies undergoing phototherapy. A c t i v i t y . f o l l o w i n q i n v i t r o exposure totFAD,is a l s o measured(method o f Glatzle RELATION OF SPECIFIC DYNAMIC ACTION (SDA) TO