Nutritional status of a population sample in Macon County, Alabama 2

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1 nutrition survey Nutritionl sttus of popultion smple in Mcon ounty, Albm Johnnie j Ph.D., Mry Mickles, nd Berndine To/bert, Ph.D. ABSTRAT A nutrition survey ws conducted in Mcon ounty, Albm, with popultion smple of 1 individuls, 6% of whom were blck. Three hr dietry reclls were obtined for ech prticipnt nd nutrients nd energy were clculted for ech combined dy intke. Serologicl nd hemtologicl nlyses ofblood were performed. Dietry clcultions indicted tht intkes of clcium, vitmin B1 clories, nd iron were lowest within the popultion smple. Blood nlyses did not confirm the clculted indequcies ofdietry clcium, vitmin B, or iron. Body weight dt did not support the clculted indequte energy intkes. Serum nlysis indicted folic cid deficiency. Men intkes of energy nd mcronutrients were higher in nonblcks thn in blcks: for most vitmins nd minerls, the sme ws true. The lower clcium intkes mong blcks thn mong nonblcks in the growing yers exceeded the differentil in energy intkes. Higher serum vitmin B, levels in blcks thn in nonblcks were observed but not explined. Am.J. /in. Nuir. 9: 91, 196. The present study ws undertken to ssess the nutritionl sttus of representtive smple of the popultion in the county in which Tuskegee Institute is locted. While mny generliztions hve been mde bout hunger nd mlnutrition in the Southern nited Sttes, dt inclusive of dietry intkes, biochemicl vlues, nd clinicl prmeters for popultion smple re not usully offered to substntite such sttements. Methods Dt collection In the summer of 191, four questionnires were developed for recording informtion pertining to residents of Mcon ounty. These were concerned with: 1) helth screeninghistoricl dt; ) demogrphic informtion; ) physicl exmintion; nd ) dietry informtion. xcept for the physicl exmintion, informtion for the completion of questionnires ws obtined by nutritionist who interviewed prticipnts in their homes. Three hr reclls of food intke were obtined from ech prticipnt. The mother, or nother dult, provided informtion for preschoolers. In no instnces were these obtined on consecutive dys. All interviews were compieted between September 191 nd Jnury 19. In December 191, ech prticipnt in the popultion smple cme to John A. Andrew Memoril Hospitl, Tuskegee Institute, for physicl exmintion, t which time urine nd blood smples were donted. A home visit to obtin fecl specimen ws mde to ech prticipnt during the week period fter physicl exmintion. Description of smple The popultion smple consisted ofi fmilies, or 1 individuls preschool children, dolescents, nd dults. Six of the dults were over 6 yers of ge (Tble I). Rcil constituency of the popultion smple ws 6% blck nd % nonblck; 9% ws mle nd 61% femle. According to the 19 ensus (1), 1% of the Mcon ounty popultion ws below 6 yers of ge, 1% ws in the dolescent ge rnge, nd 61% ws dult; 8% ws blck nd 19% ws nonblck; 8% ws mle nd % ws femle. Hence, the Mcon ounty popultion smple consisted of lrger percentge of preschooli From the Deprtment of Home conomics, School of Applied Sciences, Tuskegee Institute, Tuskegee, Albm 688. Supported by grnt from Regionl Medicl Progrm Service, Deprtment of Helth, duction, nd Welfre. Present ddress: Division of Allied Helth Professions, School of Medicine, mory niversity, Atlnt, Georgi. Present ddress: North Jersey ommunity nion, Newrk, New Jersey 1. Present ddress: ollege of Medicine, Howrd niversity, Wshington, D.. Downloded from by on September 8, 9 9 The Americn Journl oflinicl Nutrition 9: JANARY 196, pp. 91. Printed in.s.a.

2 NTRITIONAL STATS OF AN ALABAMA POPLATION 9 ers nd dolescents nd smller proportion of dults thn ws chrcteristic of the totl county popultion. thnic constituency ws similr, but the experimentl popultion hd fewer mles nd more femles thn ws recorded in the ensus. TABL I Age nd sex distribution in popultion smple Sex Age(yers) Mle Femle Totl Selection of smple Prticipnts were selected through use of twostge re smple of Mcon ounty citizens. In collbortion with the Socil Science Deprtment of Tuskegee Institute, the county ws subclssified in terms of I) probbility selection of re segments, nd ) probbility selection of people within the re segment covering ll ge rnges. Are segment mps hd been prepred yers previously by personnel in the Socil Science Deprtment. Initilly, informtion ws gthered reltive to household constituency nd willingness to prticipte. All persons who were willing nd either to yers of ge, 1 to 18 yers, or 19 yers nd overconstituted three pools from which rndom smples were chosen. The enlistment of white rurl prticipnts ws difficult nd rndomness ws not mintined in this segment of the smple. The re segment mps showed ll houses in Mcon ounty nd rcil composition therein. There were encountered instnces in which houses hd been vcted since the mps were constructed nd in which rcil composition hd chnged; nevertheless, this ws useful model. Prticipnts were informed directly, or indirectly vi the physicin uthorized by the prticipnt, of ny bnorml test results. In ddition, letter ws sent to ech prticipnt s home ddress, informing him of his blood type. linicl nd biochemicl ssessments Mcon ounty is predominntly rurl, nd in order to gurntee resonbly good prticiption rte, round trip trnsporttion ws provided between the prticipnt s home nd the site of the physicl exmintion. The exmintions were conducted over dy period by physicins with the ssistnce of nurses, student nurses, nd lbortory technicins. In ddition, representtive from onsolidted Biomedicl Lbortories, Inc., olumbus, Ohio, supervised the collecting, lbeling, nd pckging of smples for the mjor bttery of serologicl nd hemtologicl nlyses, nd member of the Nutrition Deprtment Fculty of the niversity of Albm Medicl enter supervised the hndling of smples to be tken to Birminghm for vitmin nlyses. Tests performed on blood specimens by onsolidted Biomedicl Lbortories included: I) executive profile consisting of glucose, ure nitrogen, totl protein, lbumin, lkline phosphtse, serum glutmic oxlocetic trnsminse, lctic dehydrogense, clcium, phosphorus, uric cid, totl bilirubin, totl cholesterol, T MurphyPttee, triglycerides, white blood cell count, red blood cell count, hemoglobin, hemtocrit, men corpusculr hemoglobin, men corpusculr hemoglobin concentrtion, bnd neutrophils, segmented neutrophils, totl neutrophils, lymphocytes, eosinophils, bsophils, pltelets; ) ABO blood grouping; ) sickle cell preprtion; nd ) serum iron nd iron binding cpcity. The Nutrition Lbortory of the niversity of Albm Medicl enter nlyzed serum for scorbic cid, folic cid, vitmin B,, retinol, nd crotenes. The Hem Subtotl Subtotl Subtotl I IS 8 6 Totl tology Lbortory of the Veterns Administrtion Hospitl, Birminghm, Albm, performed hemoglobin electrophoresis on blood specimens. onsolidted Biomedicl Lbortories did routine urinlysis of urine specimens nd exmined feces for ov nd prsites. The mount of blood obtined from dolescents nd dults ws ml nd from preschoolers 1 ml. The lesser volume tken from preschoolers precluded the determintion of certin items in the executive profile series, vitmin B, serum iron, nd iron binding cpcity. Dt nlysis The energy nd nutrient content of the diets ws clculted by specil computer progrm written by one of the uthors (B. T.), using food vlues compiled by Bowes nd hurch (). Food vlues for folic cid nd vitmin B1, were obtined from SDA Hndbook 9 nd Home conomics Reserch Report 1 (, ), respectively. The computer ws HewlettPckrd model G. Qulity of the dietry intkes ws evluted using the 1968 Ntionl Reserch ouncil (NR) Recommended Dietry Allownces (RDA) (). Results Demogrphic nd socioeconomic chrcteristics The size nd distribution of fmilies in the popultion smple re shown in Tble. Among the 1 fmilies, five were welfre recipients nd seven were Socil Security recipients. ighteen fmilies received commodity foods. There were rurl nd 18 urbn fmilies. Twentythree fmilies owned Downloded from by on September 8, 9

3 96 PROTHRO T AL. TABL Size of fmilies in popultion smple Si ze of fmily No. of fmilies % of fmilies I 1 II ormore 8 19 their homes nd 18 were renting. Fiftytwo percent of rurl fmilies nd 61% of urbn fmilies were home owners. Lnge fmilies hd smller income per cpit thn smll fmilies, nd rurl fmilies hd less income thn urbn ones. Fortynine percent of the fmilies spent less thn $ per week pen cpit for food, % spent $ to 1, nd % spent $1 to 1. Among the 18 fmilies who received commodity foods, 1 utilized them dily wheres others did so pproximtely twice weekly. Twentysix fmilies hd grdens nd 1 owned livestock. The food group purchsed most frequently ws met by both grden owners (%) nd livestock owners (8%). Hving grden ws not relted to owning/ renting but ws rebted to rurl/urbn sites; 8% of rurl fmilies hd grdens in contrst to % of urbn fmilies. Fmilies with both grdens nd livestock tended to spend more per cpit for food thn those with neither. Vitmin supplements were used by pproximtely % of the fmilies. There ws positive correltion between the use of vitmm supplements nd the eductionl level of the mother. Seventyfive percent of ll fmilies used iodized slt. Three fmilies prcticed pictwo te dint nd one te rw stnch. The frequency of eting mels t school vried inversely with food expenditure per cpit. Among the 8 fmilies with both mother nd fther, 1 fthers nd 18 mothers hd completed high school eduction. The men weekly fmily income for the totl smple ws $1. Nutrient intkes Although vitmin supplements were used by 18 of the 1 fmilies, the pttern of use ws irregulr nd no ttempt ws mde to include vitmin supplements in the clcultion of nutrient intkes. Mens nd stndrd devitions for energy nd nutrient intkes of the vrious ge groups re shown in Tble. Mles between 1 nd 8 yers of ge consumed more clories nd mcronutnients thn did femles. The nutnients of gretest vribility in dily intke were vitmins A nd B1 nd folcin; in most instnces, stnd rd devit ions exceeded mens. Vlues for vitmin D, folcin, nd mgnesium were omitted from Tble becuse of incomplete nutrient dt for mny foods in the food composition tbles. In Tble is shown comprison of men intkes with 1968 NR RDA s stndrds for the severl ge groups. When the totl popultion smple ws considered, the nutrient intke which most closely met the RDA ws protein, followed by vitmins nd A. Men intkes of essentil mino cids (Tble ) were in excess of sfe llownces for the ge groups nd sexes, with only three minor exceptions: men intkes of phenyllnine were to 1% of sfe llownces, of methionine 8 to 1%, nd of tryptophn 9 to 1%. Nicin dt in Tbles nd include biosynthetic nicin derived from tryptophn. Among the B vitmins, the poorest intkes were of vitmin B1, nd the deficiency ws most severe in lte yers of life. The dietry B1 indequcy is more drmticlly shown when individul intkes re exmined (Tble ) thn when group mens re the criteri (Tble ). In the totl popultion smple, clcium ws the dietry nutrient the intke of which ws most indequte, followed by clories, then iron. The bck ofclonies mde questionbbe the fvorble protein intke. Phosphorus intkes were higher thn those for clcium; in mny instnces dietry phosphorus ws lmost twice the level ofcbcium (Tble ). This is relted to the fct tht most of the phosphorus ws provided by nondiry, plnt sources. The unvilbility of dequte mgnesium dt for foods is prticulrly unfortunte in this study becuse of the bow dietry clcium vlues nd the physiologicl intenneltionships of clcium nd mgnesium in the humn body. Dietry sodium nd potssium were ptesent in bundnce for ll ge groups. Downloded from by on September 8, 9

4 NTRITIONAL STATS OF AN ALABAMA POPLATION 9 ooo. #{19} _ #{19} rooo _ #{19} #{19}, ri. e 1 l#{19} r r I HH1 HH11H I I u ri ri r1 O ri r i ri e e e O r ooco Qoors I L #{19}r,,, r O ri I.:.:_: d. r.h;r. Qol. O O I,QOco o,. H1 O t O i oo_.., I r%$ f O O #{19}t ( O :: vi _g I. r1 I c I_ H1HHH I I o r ri fi r O lu I Li., r : %Q r r.: #{19}F r r.r.1r1 ul > I Iv i 11H1H1?roor. r o, o O ri #{19},r. O u r 1 o 11HHH r.s O? ri..o ri r r;. #{19}. ( ri r ri O ri O e ei ri #{19}, ri 1 r r r O I #{19} H11 1HHH I I u fi F O (1 I O ir r (1 fi i l ri.ooo fori OO. n. l >J \d I! I r i r Q ri 1 _. #{19}q. I #{19}. I 11lH1 HH11HH1.... r#{19}i.. Z o < z... :... l tunizt&o z>>>u.> Z Downloded from by on September 8, 9.! r ri trio f O or$r.1 r O r r f f fb r r v ; I _, %rrir I...! #{19}rlr.lr.lOr.1....r e.o.roe r. i _. r (J HH11HH1 1H{H >. I.. ri O O e Q f #{19}1 ri O O J#{19} / O f N O,,. i f r. %O O e f ;.: :: rrri :..... :... _,. DO

5 98 PROTHRO T AL. If exmined by ge groups, the best nutnient intkes occurred in the to yer ge group, lthough clcium nd iron were low. In dolescents, clcium, iron, nd clories were low; in dults, clcium nd clorie intkes were lowest. Biochemicl vlues The stndrds selected to ssess dequcy of biochem icb nd hemtobogicl prmeters (68) re shown in Tble. In instnces in which stndrds specific for preschoolers nd dolescents were not vilble, those for dults were used. Results for the executive profile nd vitmin nlyses re shown in Tble 6. xecutive profile. Serum totl protein nd serum lbumin were bove the norml rnge, confirming dequcy of protein intkes clculted from dietry reclls despite the mdequcy of clculted energy intkes. Men serum clcium levels pproched the upper limit of the norml rnge, lthough dietry clcium ws limiting nutrient ccording to dietry reclls. Totl cholesterol ws elevted in 19 to yerold mles nd in both sexes of the 6 to 8yer ge group. Men uric cid ws elevted in both sexes over the ge rnge 19 to 8 yers. Mens for ll other mesurements included in the executive profile, s shown in Tble 6, were within the norml rnge. Vitmin nlyses. onsistent with dietry dt, serum scorbic cid mens were bove verge, lthough two dolescents nd five dults hd serum vlues below. mg/mb. The most extensive nutrient deficiency, bsed on serum bevels, ws of fobic cid. Men serum fobte for ll ge groups ws bow, considering 6 ng/mb s cceptble. If one considers the deficiency stte to be below ng/ml, ll group mens were bove the deficiency level, but three preschoolers, four dolescents, nd 1 dults hd folte bevels below ng. One dult hd level of ng folte/mi serum. In contrst to expecttion bsed on dietry dt, there were no individubs with vitmin B1 bevel below pg/mb, lthough there were seven dolescents nd 16 dults who hd bevels bove the upper limit of norml, three in excess of pg/mb. The significnce of extremely high levels of vitmm B1 nd fobte is uncler. xcept for the to yer ge group, men netinol levels in serum were in the norml rnge, lthough eight dolescents nd four dults hd levels below zg/db; 1 of the preschoolers hd less thn zg netinol/di. Only one ofthe 1 prticipnts hd crotene level below zg/db. Hemtology. Hemtobogicl dt re presented in Tble. xcept for white blood cell count, mens for the vrious blood cells nd erythrocyte indices were within the norml rnge. The men white blood cell count in the preschoolers ws higher thn in other ge groups, s expected; nevertheless, it ws below the norml rnge for preschoolers. The men white cell count for 6 to 8yerold prticipnts lso ws below the norml rnge. Totl iron, iron binding cpcity, nd trnsfenrin sturtion were not determined in the Downloded from by on September 8, 9 TABL Percentge of individuls whose intkes were 1% nd 6% of NR RDA nergynd nutrients Syers 118 yers 19 Syers 1% 6% 1% 6% 1% 6% 6 8 yers I#{16} 6% nergy Protein VitminA Vitmin Nicin Riboflvin Thimin Vitmin B1 1 8 lcium Phosphorus Iron 9 1 8

6 TABL NTRITIONAL STATS OF AN ALABAMA POPLATION 99 Stndrds for serum biochemicl nd hemotologicl vlues Serum constituent Preschooler Adolescent Adult Glucose (mg/dl) re N (mg/dl) Totl protein (g/dl) Albumin (g/dl) Alkline phosphtse (ng/ml) Serum glutmic oxlocette trnsminse (ng/ml) Lctic dehydrogense (ng/ml) Serum (mg/dl) Serum P (mg/dl) ric cid (mg/dl) Totl bilirubin (mg/di) Totl cholesterol (mg/dl) T (MurphyPttee (tg/dl) Triglycerides (mg/dl) Totl Fe (g/dl) Fe binding cpcity (zg/dl) Trnsferrin sturtion (%) Retinol (pg/dl) flcrotenes (jzg/di) Ascorbte (mg/dl) Serum folte (ng/ml) Vitmin B1(pg/ml) WB (no/mm) RB Hb (g/dl) Hct (%) (no/mm) MV (p) MH (pg) MH (%) Bnd neutrophils (no/mm ) Segmented neutrophils (no/mm) Lymphocytes (no/mm) Monocytes (no/mm) osinophils (no/mm) Bsophils (no/mm) > >. 8 1 x l x >1 8 8 >. x l. x l. x l. x I. x l. x l mle femle mle femle 1 mle femle mle femle > > > >1 8l 8.6 x l.8 x l.8 x l. x l. x l. x l mle 6..1 femle > mle.16. femle.1. < 1. mle femle mle femle 1 16 II > > >. > x l mle.6.x 16 femle.. x 1 mle 1. femle 1. mle femle l x l.8 x 1. x l. x 1. x l. x l Downloded from by on September 8, 9 preschooler, but mens for other ge groups were within the norml rnge. Hemoglobin electrophonesis determintions indicted one AS type in the to yer ge group, three AS nd two A in the 19 to yer ge group, nd one AS in the 6 to 8yer ge group. onsidering the fct tht 6% of the prticipnts were blck, the observed mcidence of sickling trit, 9%, ws less thn expected.

7 1 PROTHRO T AL. o..ro I ri #{19}r HH1H so so / l I... r so l r o so I I 1 so r r. _rsr. so.so.g r. ri Os , Q O O,e I. el r O O riooeot e m N r s r t, #{19}. esi O ri so so so, oo r.i rirsi m ri s r. ri #{19} v_v #{19} I r so Downloded from by on September 8, 9 r ri ). I).. _;. :L.,.i!.HiIHh::! D#{19} >.. 1 I Q:if<#{1}<<( <>Q >

8 NTRITIONAL STATS OF AN ALABAMA POPLATION 11 Prsites.,r o r o c. ri I. r (1 r r. r v 11..,c r : ri I H.. i. t r. : o:.... L) 1. ri r 9 r.i, Or <. r. Fecl specimens were obtined from 91 of the 1 prticipnts. These were exmined for six types of prsites nd ov. Results re shown in Tble 8. The prsitic infections were observed in individuls, four of whom hd two types of prsites, nd two of whom hd three types. The individuls with positive fecl specimens represented 16 fmilies. Without regrd to nture of prsitic gent, the nte of infection ws one pen.6 fmilies, or one per.6 individuls. These results indicte the need for improvement in snitry conditions of the home nd its environs.. <. r. i. ri #{19}1. f O.1.I..c r. r... ri c r,.. N.. 1. r.c. I r ri o.. r.i l F. (,. r r ri. r i.. ri. ri <... r, r.1,.i. r r I. r,. l.... N f1,. N..,,, Discussion Dietry intkes: ntionl trends versus Mcon ounty smple According to recent nlysis of trends in food consumption (9), there hs been dcwnwnd trend in consumption of diry products since 19 to 199. During the pst yers the per cpit consumption of met, poultry, nd sugr nd other sweeteners hs incresed. Most intkes of prticipnts in this study re consistent with ntionl trends. The 196 survey by the SDA of fmily food consumption in the.s.a. (1) mdicted tht the three nutrients most frequently below the RDA were clcium, vitmin A, nd vitmin. The nutrient the intke of which ws lowest in the Mcon ounty popultion ws clcium. Wkefield nd Menrow (1 1) observed indequte intkes of clcium in 6 to I yerold children nd Hmpton et b. (1) reported tht clcium intke ws indequte in diets of high school students. Jerome nd Pningle (1) found clcium indequte in intkes of southern fmilies who hd migrted to Wisconsin. The low clcium intkes in the Mcon ounty popultion, ccompnied by serum clcium levels which pproched the upper limit of the norml rnge, confirm the previously reported observtion tht serum clcium level s the sole clinicl index of mlnutrition is unrelible until fter body stones re exhusted nd nutritionl deficiency is dvnced. Mesurements of bone density long with norml serum cl Downloded from by on September 8, 9

9 1 PROTHRO T AL. TABL 8 Prevlence of prsitic infections in popultion smple. Prsites No.of positive cses ntmoeb co/i 1 Nector mericnus ndolimx nn 8 ntmoeb histolytic Girdi lmbli I Jodmoeb b#{}ischlii cium vlues re necessry to ssess the true clcium sttus in the body. Although clcium intkes of the Mcon ounty popultion prlleled those of the 196 SDA survey, intkes of vitmins A nd were second only to protein in stisfying the respective RDA s. The second nd third limiting dietry fctors in the Mcon ounty group were clories nd iron, in this order. Since the RDA for iron in the femle ws incresed in 1968, this my explin the ppernce of iron mong the three most limited nutrients in the present study. Over the 1yer period between 19 nd 196, the SDA survey reported tht the consumption of clories nd clcium decresed while protein nd iron incresed (1). Becuse folte vlues for severl food items were unvilble, dietry fobte dt in the present study were not regrded s ccurte reflections of the mounts eten. However, blood folte levels substntite tht intkes were indequte. Although fobte is widely distributed in food, the fct tht it is prtilly destroyed by cooking processeswhich re lengthy in the hnds of Southernerscontnibutes to decresed vilbility of the vitmin. Leevy et l. ( 1) reported tht low serum folte level ws the most common vitmin deficiency in bowincome hospitl popubtion. nergy intkes nd height/weight observtions Obesity hs been observed in lrge segment of the Americn popultion (6). The observtion tht % of the Mcon ounty smple popultion hd less thn the recommended energy intke nd 1 % hd less thn twothirds of the recommended intke is perplexing in view of body weight dt for this group. sing the NR body weights s stndrds (), the men body weights for the femles nd 19 mles in this study were 6 nd 19 pounds oven the NR vlues. In the 1 to 1yer dolescent group men body weights exceeded the NR vlues by pounds in mles nd pounds in femles: in the 1 to 18yer dolescent group, mles hd men body weight similr to the NR vlue nd femles were 1 pounds over. sing heights published by NR s stndrds, 1 to 1 yerold mles were inches tller nd femles in this ge rnge were inches tller thn NR vlues; bove 1 yers of ge, observed heights in both sexes were similr to NR vlues. When body weight nd height dt were nlyzed for differences between ethnic groups, using NR vlues for dolescent nd dult groups () nd those of Grn et l. for preschool children (1), the differences were not significnt. Blck dolescent mles, 1 to 19 yers of ge, were tller thn nonblck mles, nonbbck femles, or blck femles (P <.). In the 19 to yer ge group only, mles in ech ethnic ctegory were tller thn femles (P <.1). Distribution ofdieirt nutrients by ethnic nd ge groups Among the preschoolers, 1 were blck nd eight were nonblck, nd mong the dolescents, 19 were blck nd eight were nonbbck. In other ge groups, the number of blcks constituted threefourths of the totl smple. This inequity in numbers of blcks nd nonbbcks in the severl ge groups ws intentionl in order to simulte ethnic constituency of Mcon ounty, but the vlue of sttistics in comprisons which follow is lessened by this inequity. In the to yer ge group, nonblcks consumed % more clories, 6% more protein, 1% more crbohydrte, 1% more fiber, 16% more ft, % more sodium, nd % more clcium thn blcks. Only the differences in fiber (P <.1) nd sodium (P <.) consumption were significnt. Although.nonblck preschoolers consumed % more clories thn blcks, the percentge of Downloded from by on September 8, 9

10 NTRITIONAL STATS OF AN ALABAMA POPLATION 1 protein clories in diets ws similnl8% for both blck nd nonblck children; the percentge of clories contributed by crbohydrte ws higher in diets of nonbbck children while the percentge of clories from ft ws higher in diets ofblck children. Intkes of ll vitmins nd minerls were higher in diets of nonblcks thn in those of blck children; the differences were not significnt. In the I to 19yer ge group, clories for nonblck mles nd femles combined were % higher, protein 6%, crbohydrte 8%, fiber 1%, ft %, sodium 18%, nd clcium 11% higher thn for blcks. In this ge group, vitmin A nd folic cid intkes were higher (9 nd 1%, respectively) in diets of blcks, while ll other vitmins nd minerls were higher in diets of nonbbcks. Becuse ofdisproportionte smple sizes nd degree of vribility within subgroups, none of these differences were significnt. While dolescent nonblck children consumed % more clories thn blcks, ech ethnic group consumed 18% protein clories; blcks consumed smller percentge of crbohydrte clories nd lrger percentge of ft clories thn nonblcks. Anlysis of dt by sex for the dolescent ge group showed no ethnic differences mong femles, but mong the mles nonblcks hd lrger intkes of protein (P <.), crbohydrte (P <.), sodium (P <.), clcium (P <.), phosphorus (P <.), nd vitmin D (P <.1). For ll subgroups in the popultion bove 18 yers of ge, the only significnt differences in nutrient intkes occurred in the 19 to yer old femle subgroup; nonblcks hd lrger men nicin intke thn blcks (P <.). In the totl popultion smple, clcium intkes were % higher for nonblck femles thn for blck femles nd % higher for nonblck thn for blck mles. The lrgest ethnic differences in clcium intke, to over 1%, occurred in preschool nd dolescent ge groups. The smllest ethnic differences, % nd less, occurred in prticipnts oven yers of ge. In ech ethnic group, femles consumed % less clcium thn mles. As result of both ethnic nd sex fctors, blck mles nd nonblck femles hd equivlent clcium intkes. The dietry questionnire did not contin items tht would provide the specific explntion for the brge ethnic differences observed in clcium intkes during the growing yers of life. One is tempted to speculte tht economic level of the fmily is not the overriding determinnt, s ethnic differences prcticlly disppered fter ge. In the totl popultion smple, iron consumption ws % higher in nonblck mles nd % higher in nonbick femles thn in blck mle nd femle groups, respectively. Iron intkes were % higher in nonblck mles nd % higher in blck mles thn in the corresponding femle ethnic groups. Although trend is estblished by clcium nd iron intke dt, reflecting higher nutrient intkes for nonblcks thn for blcks, the smll smple sizes nd inherent vrition my hve cused these differences not to be sign ificnt. Serum hemoglobin nd vitmin levels by ethnic nd ge groups Hemoglobin. There were no differences in hemoglobin by either ethnic or sex groupings. However, in the dolescent group, blck femles hd lower vlues thn blck mles, nonblck mles, or nonblck femles (P <.). In the 19 to yer nd over ge groups, within ech ethnic group mles hd higher men hemoglobin level thn femles (P <.1). Vitmins. In preschoolers, there were no ethnic differences in serum scorbte levels, but the levels were higher in femles thn in mles (P <.). In the dolescent group, serum flcrotene bevels were higher in blcks thn in nonblcks (P <.), nd higher in the blck mle thn in the blck femle (P <.). Anlysis of folte dt for this ge group by sex nd ethnic groups indicted only one significnt difference: nonblck mles hd higher TABL 9 Serum vitmin B1 levels (pg/mi) Age (yers) Blck Nonblck ± 8 ± ± 6 6 ± ± 9 69 ± Downloded from by on September 8, 9

11 1 PROTHRO l AL. serum folte level thn nonblck femles (P <.). The 19 to yer ge group showed no difference in serum retinol levels by ethnic bckground, but the nonblck femle hd lower serum netinol level thn either the nonblck mle or the blck femle (P <.). Most enigmtic mong the dt were those for vitmin B1. This vitmin ws 6 times higher in diets for nonblck preschoolers nd times higher for nonblck 1 to 8yerold prticipnts thn for blcks in the respective ge groups. Serum vitmin B1 vlues were not obtined for the preschoolers, but for the remining 8 subjects, serum vitmin B1 ws % higher for the blck mle thn for the nonbick mle nd % higher for the blck femle thn for the nonblck femle. A higher serum vitmin B1 for blcks ws observed for ech ge group (Tble 9), lthough the only significnt diffference rebted to ethnic origin ws for mles 1 nd 1 yers of ge (P <.)the men vlues were 6 ± 11 pg/mi for blcks nd 6 ± 1 for nonblcks. When serum vitmin B1 dt were pooled nd exmined by sex, 1 to 18yerold femles hd significntly higher levels of vitmin B1 (1, ± pg/mi) thn mles (81 ± 1; P <.1); bove 19 yers of ge, there were no differences relted to sex. We do not hve n explntion for the observtion tht dietry vitmin B1 intkes were lower nd serum vitmin B levels were higher in blcks thn in nonbicks. Among the prticipnts previously mentioned who hd serum vitmin B1 bevels bove 9 pg/mi, were blck. It should be noted tht while ucsins were the predominnt nonblck group, lso included were Middle stennens, Fr sterners, nd Orientl Jm cns. The uthors cknowledge: Dr. Phillip. ornwell, Ph.Ij.. Assistnt Professor, Nutrition Deprtment, niverslty of Albm Medicl enter, who performed ll vitmin nlyses in this investigtion; Dr. ornelius L. Hopper, M.D., Vice President of Helth Affirs, Tuskegee Institute, nd Dr. Nthniel. llowy, M.D., I 1 Regent Street, Mdison, Wisconsin 1, who performed ll physicl exmintions of subjects; nd Dr. Murice A. Mloney, Professor, Deprtment of Agriculturl Sciences, Tuskegee Institute, who provided sttisticl services. References ensus of Popultion P(Si)..S. Deprtment of ommerce. Socil nd conomic Sttistics Administrtion, Bureu ofensus, June, 19.. BOWS, A., AND. F. HRH. Food Vlues of Portions ommonly sed (1 Ith ed), edited by. F. hurch nd H. N. hurch. Phildelphi: Lippincott, TOPFR,. W.,. G. ZooK, M. L. ORR AND L. R. RIHARDSON. Folic cid content offoods. Microbiologicl ssy by stndrdized methods nd compiltion of dt from the literture. Agr. Hndbook 9: 116, LIHTNSTIN, H., A. BLOIAN AND. W. MRPH\. Vitmin B1microbiologicl ssy methods nd distribution in selected foods. Home conomics Reserch Report 1: 1, June Recommended Dietry Allownces (th ed). Ntionl Acdemy of SciencesNtionl Reserch ouncil Publiction No. 169, Wshington, D..: NtI. Acd. Sci.Ntl. Res. ouncil, TenStte Nutrition Survey DHW Publiction No. (HSM) 81. Atlnt, Georgi:.S. Deprtment of Helth, duction, nd Welfre, Helth Services nd Mentl Helth Administrtion, enter for Disese ontrol, 19.. Screening hildren for Nutritionl Sttus: Suggestions for hild Helth Progrms. Rockville, Mrylnd:.S. Deprtment of Helth, duction, nd Welfre, Public Helth Service, Helth Services nd Mentl Helth Administrtion, Mternl nd hild Helth Service, MIAL, J. B. Lbortory Medicine: Hemtology (th ed). St. Louis:. V. Mosby o., FRIND, B. Trends in food consumption. Am. J. lin. Nutr. : 9, Food onsumption of Households in the nited Sttes, Spring 196, ARS 616. onsumer nd Food conomics Reserch Division. Argiculturl Reserch Service, SDA, 196. II. WAKFILD, L. M., AND S. B. MRROW. Interreltionships between selected nutritionl, clinicl, nd sociologicl mesurements of predolescent children from independent lowincome fmilies. Am. J. lin. Nutr. : 91, HAMPTON, M.., R. L. HNSIANN, L. R. SHAPIRO AND B. W. MITHLL. loric nd nutrient intkes of teengers. J. Am. Dietet. Assoc. : 8, JROM, N. W., AND D. J. PRINGL. Socioculturl fctors nd food hbits of inmigrnt fmilies. Presented t the meeting of the Americn Dietetic Assocition, August 18, LVY,. M., L. ARDI,. FRANK, R. GLLN AND H. BAKR. Incidence nd significnce of hypovitminemi in rndomly selected municipl hospitl popultion. Am. J. lin. Nutr. 1: 9, GARN, S. M., D.. LARK AND F. L. TROWRRIDG. Tendency towrd greter stture in Americn blck children. Am. J. Disese hildhood 16: 16, 19. Downloded from by on September 8, 9