American Journal of Clinical Nutrition, Vol 26, 87-94, Copyright © 1973 by The American Society for Clinical Nutrition, Inc.

Nutritional status and intestinal function among rural populations of the West Indies. III. Barrio Cabreto, Dominican Republic

¹ From the Tropical Malabsorption Unit of the Universities of Rochester and Puerto Rico, University (District) Hospital, San Juan, Puerto Rico 00935, and the Hospital Militar "Dr. Ramón de Lara," San Isidro, Dominican Republic

Dietary intake, nutritional status, and intestinal structure and function were evaluated in 42 subjects selected as representative on the basis of age and sex of a rural barrio in the Dominican Republic. Mean dietary intake among the group studied was 35 g protein and 54 g fat per day. Twenty (47%) subjects had a deficiency of one or more nutrients. These included anemia in 11 (26%), iron in 13 (31%), folate in 6 (14%), vitamin B₁₂ in 4 (9%), albumin in 1 (3%), carotene in 3 (7%), and cholesterol in 9 (21%). Twenty-three subjects (55%) had either one (41%) or multiple (14%) abnormalities of intestinal function. These included xylose absorption in 19 (44%), fecal fat excretion in 1 (2%), nitrogen excretion in 1 (2%), and vitamin B₁₂ absorption in 11 (26%). Intestinal morphology was examined in 32 cases. In 2, the structure was normal; in 8, mild 1⁺ changes were present; in 20, moderate 2⁺ abnormalities were present; and in 2, severe 3⁺ abnormalities were present.

The presence of iron deficiency did not appear to be related to impaired intestinal function but, rather, could be attributed to the excessive demands of previous multiple pregnancies in most instances. On the other hand, malabsorption did appear to be a factor in the pathogenesis of deficiency of other nutrients found present in 13 subjects. All 4 persons deficient in vitamin B₁₂ had impaired absorption of this vitamin, and 9 (75%) of the 12 persons who had a deficiency of either folate, albumin, carotene, or cholesterol had subnormal absorption of xylose. Among the 36 subjects who had normal absorption of xylose, only 3 (8%) had a deficiency of one or more of these nutrients, whereas 7 (88%) of the 8 persons who had xylose absorption of less than 4 g/5 hr had a deficiency.

These observations indicate that the marginal dietary intake consumed by the subjects under study only rarely results in deficiency states other than that of iron. However, when the supplemental factor of impaired intestinal absorption is added, deficiencies develop in a large proportion of such individuals.