Abstract

Chronic undernutrition causes reduced growth and endocrine adaptations in order to maintain basic life processes. In the present study, the biochemical profiles of chronically undernourished children were determined in order to test the hypothesis that chronic undernutrition also causes changes in lipid profile in pre-school children. The study population comprised 80 children aged between 12 and 71 months, including 60 with moderate undernutrition [height-for-age Z (HAZ) scores ≤ −2 and > −3] and 20 with severe undernutrition (HAZ scores ≤ −3). Socioeconomic, demographic and environmental data were obtained by application of a questionnaire, and anthropometric measurements and information relating to sex, age and feeding habits were collected by a trained nutritionist. Blood samples were analysed for haemoglobin, vitamin A, insulin-like growth factor 1 (IGF-1) and serum lipids, while cortisol was assayed in the saliva. Faecal samples were submitted to parasitological investigation. Analysis of variance and χ2 methods were employed in order to select the variables that participated in the multivariate logistic regression analysis. The study population was socioeconomically homogeneous, while the lack of a treated water supply was clearly associated with the degree of malnutrition. Most children were parasitised and anaemia was significantly more prevalent among the severely undernourished. Levels of IGF-1 decreased significantly with increasing severity of undernutrition. Lipid analysis revealed that almost all of the children had dyslipidemia, while low levels of high-density lipoprotein were associated with the degree of undernutrition. It is concluded that chronic malnutrition causes endocrine changes that give rise to alterations in the metabolic profile of pre-school children.

Highlights

  • The World Health Organization defines undernutrition as the outcome of a variety of pathological conditions that result from deficiencies in absorption, transportation or utilization of nutrients by cells of the body

  • It is estimated that more than one quarter of the global population of children are currently affected by protein-energy undernutrition (PEU), and that 148 million (26.7%) of the 555 million pre-school children living in developing countries are underweight for their age, while 180 million (32.5%)

  • Similar to previous reports [12,36], the present study demonstrated that poor socioeconomic conditions, but most especially reliance on an untreated water supply, strongly influence the development of PEU

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Summary

Introduction

The World Health Organization defines undernutrition as the outcome of a variety of pathological conditions that result from deficiencies in absorption, transportation or utilization of nutrients by cells of the body. This type of nutritional disorder mainly affects infants and children of pre-school age [1]. But, owing to social inequality, the condition remains a public health problem, especially in the northern and north-eastern regions of the country [5,6]. According to a nutritional survey conducted in 2005 in the semiarid region of Brazil, the prevalence of undernutrition (stunting) among children living in the State of Alagoas was greater than in other north-eastern states. High amongst the factors influencing this situation was the level of absolute poverty in Alagoas, which remains the highest of any state in the country [7,8]

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