Summaryinfants developed transient late metabolic acidosis (14) during the course of the studies. This interfered with energy retention and studies were during On l5 weight gain (4), but since the infants remained active and apparimmature infants of mean birth weight 1581 g. Mean gross energy ently well, these results have been included, inasmuch as they intake was 757 kJ/kg (181 kcal) and 79 % of this was retained, so enabled us to examine energy balance during periods of poor that metabolizable energy was 602 kJ/kg (143 kcal). Mean resting weight gain. metabolic rate was 244 kJ/kg (58.1 kcal), and it increased with advancing maturity. Minimum resting metabolism averaged 199 FEEDING kJ/kg (47.5 kcal). Energy expended in activity increased with maturity, but amounted to less than 17 % of the total energy All the infants were fed on V Formula (Cow and Gate Baby turnover. Postprandial metabolism caused the mean VOz to rise Foods Ltd., Trowbridge, England). No studies were undertaken by 17 % in the hour after a feed, and during 24 hr resulted in until a daily feed intake of 180 ml/kg or more had been achieved, consumption of energy equivalent to about 10 % of the resting which was usually by the middle of the second week of life. Mean metabolism. Stored energy amounted to 230 kJ/kg (55 kcal) and feed intake during study periods was 227 ml/kg (range 198-262).was linearly related to weight gain (r = 0.92). Energy cost of The feeds were given 2-3 hourly depending on the size of the weight gain was 24 kJ/g (5.7 kcal) and energy stored in new tissue infants. was 16.8 kJ/g (4.0 kcal). Maintenance energy requirement at zero growth rate was about 270 kJ/kg (64 kcal). FEED COMPOSlTIONV Formula is a filled milk prepared from skimmed milk, lactose Speculation and vegetable oils, with the following composition (per 100 ml Data on energy balance in immature infants are scanty. There prepared feed): fat, 3.1 g; protein, 1.8 g; CHO (lactose), 7.0 g; is need for information on energy retention, maintenance energy mineral salts 0.4 g (Nay 26 mg; K 9 61 mg; Ca, 62 mg; PO43 50 mg) requirements, postprandial energy expenditure, and energy cost of energy 260 kJ (62 kcal). The gross energy, determined us growth. We have attempted to provide such information, but our bomb calorimetry (20) on 23 separate occasions was 344 kJ/100 data show wide variation between infants. However, in spite of this ml (SD 1% 32 more than the specified energy, the for variation, a relationship is present between energy retention which is derived from theoretical considerations as "metabolizable and weight gain, the main limiting factor in weight gain probably (32). being energy absorption from the gut. We need more data to show whether efticiency of energy utilization alters with different levels

Objective: To determine the impact of nutritional status in a multicausal approach of socio-economic, socio-cultural, family, intellectual, educational and demographic variables at the onset of elementary school in 1987 on the educational situation of these children in 1998, when they should have graduated from high school. Setting: Chile's Metropolitan Region. Design: Prospective, observational and 12-year follow-up study. Methods: A representative sample of 813 elementary first grade school-age children was randomly chosen in 1987. The sample was assessed in two cross-sectional studies. The first cross-sectional study was carried out in at the onset of elementary school in 1987 and the second was carried out in 1998, 12-years later, when they should be graduating from high school. In 1998, 632 adolescent students were located and their educational situation was registered (dropout, delayed, graduated and not located). At the onset of elementary school were determined the nutritional status, socio-economic status (SES), family characteristics, intellectual ability (IA), scholastic achievement (SA) and demographic variables. Statistical analysis included variance tests and Scheffe's test was used for comparison of means. Pearson correlation coefficients and logistic regression were used to establish the most important independent variables at the onset of elementary school in 1987 that affect the educational situation 1998. Data were analysed using the statistical analysis system (SAS). Results: Logistic regression revealed that SES, IA, SA and head circumference-for-age Z score at the onset of elementary school in 1987 were the independent variables with the greatest explanatory power in the educational situation of school-age children in 1998. Conclusions: These parameters at an early school age are good predictors of the educational situation later and these results can be useful for nutrition and educational planning in early childhood.

Like in many other countries, few investigations have been carried out in Chile to measure the long-term effects of nutritional status at an early age on scholastic achievement in a multicausal approach. The objectives of the present study were to describe the impact of nutritional, intellectual, family, educational and socio-economic variables at the onset of elementary school in 1987 that may affect achievement on the academic aptitude test (AAT) taken in 1998 at the end of high school, and to quantify the impact of these independent variables on the AAT. The present study comprises two cross-sectional stages: in 1987, a representative sample of 813 elementary school first-grader Chilean children from the Metropolitan Region was randomly chosen; in 1998, 12 years later, 632 school-age children were located and only 351 of them graduated from high school and, from these, 260 students took the AAT. In 1987 nutritional status was assessed through anthropometric parameters, intellectual ability by the Raven's Progressive Matrices Test, scholastic achievement through Spanish language and mathematics tests, and socio-economic status using Graffar's modified scale; family variables were also recorded. Maternal schooling, scholastic achievement, intellectual ability and head circumference-for-age z-score (anthropometric indicator of both nutritional background and brain development) all in 1987 were the independent variables with the greatest explanatory power for AAT variance in 1998 (r 2 0·402). These results provide a foundation to identify the risk factors at an early age that affect AAT scores and should be useful to improve nutritional and educational policies. Child nutrition: Intelligence: EducationAmong the main national priorities in Chile are the decrease of extreme poverty and improvement in the quality of education. However, this depends on the child, his family and factors related to the educational system that affect scholastic achievement and desertion (1 -7) . Like in many other countries, few investigations have been carried out in Chile to measure the long-term effects of nutritional status at an early age on scholastic achievement because most of the research has been focused on the socio-economic determinants of the learning process. In addition, research related with a global approach of this in follow-up studies is scant (5,8 -12) . Schoolage children of the poor strata attend mainly public (state) schools and achieve significantly lower results than their peers from the medium or high socio-economic strata both in scholastic achievement and intelligence tests. The unsatisfactory results can be explained by deficient environmental conditions such as low parental income and schooling and precarious quality of housing with inadequate sewerage and water supply systems, situations that do not encourage learning and intellectual development (5,11 -17) . In Chilean school-age children, nutritional status has been positively and significantly correlated with socio-economic conditions, scholastic a...

SUMMARY Early postnatal malnutrition produces delay in growth and developmental processes, and children from a low socioeconomical level where undernutrition is prevalent are shorter than those from higher socioeconomic levels. We examined the effects of severe and early protein energy malnutrition on growth and bone maturation. We studied 40 preschool children who had been admitted to hospital in infancy with protein energy malnutrition and 38 children from the same socioeconomic level, paired for age and sex, who had never been malnourished. Growth measurements were made over a period of 4-6 years, and bone age was determined in a subgroup through wrist roentgenograms. Results showed a correlation between protein energy malnutrition, birth weight of infants, and mother's height and head circumference. The group with protein energy malnutrition showed a significant delay in stature after four years, especially the girls (p

SUMMARY Three racial groups of mothers and their newborn babies-North European 75, Negro 75, and 'Indian' Asian 37--were matched for parity, gestational age, sex, maternal age, maternal smoking habits, and social class. Multiple anthropometric measurements, including skinfold thickness, limb circumferences, and various linear measurements were made on the mothers and their infants to determine the effects of race and smoking on fetal size. Indian-Asian mothers, though shorter and lighter than Europeans and Negroes, had similar skinfold thickness and weight: height2 ratios and gained as much weight during pregnancy. Their infants, however, were lighter than the others, and had smaller head and limb circumferences, although their linear measurements were the same. Negro and European infants were almost identical in size. We found no effect on any of the fetal measurements which could be attributed to smoking.