American Journal of Clinical Nutrition, Vol 22, 1639-1651, Copyright © 1969 by The American Society for Clinical Nutrition, Inc.

Nutrition Survey of Two Rural Puerto Rican Areas before and after a Community Improvement Program

¹ From the Department of Biochemistry and Nutrition, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico

Two rural Puerto Rican communities were surveyed in 1963 and 1967 in order to evaluate the nutritional changes occurring in their population after the administration of a government community improvement program. The survey included tile collection of dietary, clinical, and biochemical data. Stools were examined for ova and parasites.

Surveys carried out in 1963 had shown that the diet was basically deficient in calories, vitamin A, riboflavin, and calcium. The ingestion of iron, protein, niacin, and vitamin C varied from fair to adequate. Thiamine intake was satisfactory. Fat consumption was low, but mainly saturated.

There were few clinical signs associated with deficiency diseases. The most revealing clinical finding was retardation of growth as expressed in terms of height and weight for age. The main biochemical deficiencies were vitamin A, riboflavin, and niacin. Stool examinations showed a considerable prevalence of intestinal helminthiasis.

Between 1963 and 1967 the government Commission for the Improvement of Isolated Communities carried out an improvement program in these areas that included permanent works such as paved roads and electrification and general orientation regarding the betterment of agriculture, health, diet, and other living conditions.

In 1967 one of the areas showed improvement of the diet except in animal protein, calcium, and vitamin C. The other community showed a general deterioration of the diet.

Clinically, an increase in the skin-fold thicknesses was observed in all age groups and in the weight of adults. No significant changes in height and weight were found in children and adolescents. Adult prevalence of arterial hypertension also increased.

The hematologic studies and the plasma levels of ascorbic acid showed improvement. However, a higher prevalence of low-deficient plasma protein values was observed.

The urinary excretion rates of B vitamins showed slight improvement in the case of thiamine and very little change for riboflavin. N-Methylnicotinamide excretions showed improvement in one area while in the other a larger number of low values were found.

In view of the data obtained in these surveys it is concluded that better coordination and more intensive nutrition education based on the true needs of the people are necessary in order to correct the existing nutrition problems and to avoid further deterioration of the nutritional status.