Nutritional Status of People in Isolated Areas of Puerto Rico

Abstract

A nutrition survey was carried out in the rural area of Mavilla, Vega Alta, Puerto Rico, during the period February 8 to February 15, 1963. The survey included the collection of clinical, biochemical and dietary data. A total of 306 subjects were examined clinically. Biochemical studies were also carried out in 97 per cent of the subjects. The dietary survey included selected families representing 27 per cent of the total population and was carried out using the 24-hour individual weighed intake method. Feces were examined for ova and parasites. The diet was basically deficient in calories, vitamin A and calcium. Protein, iron, ascorbic acid and thiamine intakes were adequate. In general, riboflavin and niacin intakes were borderline. The amount of fat in the diet was low and mostly saturated. The main clinical findings were skin xerosis and hyperkeratosis grossly associated with vitamin A deficiency, and retardation of growth as expressed in terms of height and weight for age. These data suggest that there exists, in general, a problem of under nutrition in the realm of borderline cases manifested by unspecific signs and symptoms. Biochemically a considerable number of subjects showed low serum vitamin A and carotene levels. Serum proteins and ascorbic acid values were satisfactory. In the group as a whole the hemoglobin levels were higher than expected, except for a few low values in the range of 3 to 8 gm. Hypochromia was observed, usually in members of particular family groups. Urinary excretion rates of thiamine per gram of creatinine were adequate. N-methylnicotinamide was low in 15 per cent of the subjects studied. Twenty-eight per cent had deficient excretion rates of riboflavin. Intestinal infestation with helminth parasites was highly prevalent and severe cases were the exception rather than the rule.