An Evaluation of the Nutritional Status of a Population Group in Madrid, Spain, During the Summer of 1941

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Abstract
A study of the nutritional status of 561 persons of a low economic level was carried out in an industrial suburb of Madrid during the summer of 1941 by the combined methods of family food consumption records, individual clinical examination, and laboratory determinations. The dietary records indicated an average intake of calories and calcium far below maintenance levels, and a protein intake of questionable adequacy. The levels of iron, phosphorus, thiamine, and ascorbic acid appeared generally adequate for maintenance; those for vitamin A and riboflavin at, or below, the border line. Clinical examination revealed almost universal evidence of quantitative (caloric) underfeeding. Classical qualitative deficiency disease was rare: two cases of nutritional edema, one of pellagra (chronic), three of rickets. Search for early manifestations of such qualitative deficiencies disclosed a significant number of persons with skin lesions attributable to vitamin A deficiency, and a fairly high incidence, especially among the females, of capillary invasion of the cornea which is probably due to ariboflavinosis. In addition, many subjects had signs and symptoms of a mild neural or neuromuscular disturbance of undetermined origin. Laboratory studies showed that about one-third of the subjects had a mild macrocytic hyperchromic anemia. The incidence of hypoproteinemia was 11% among males and 5% among females. Serum vitamin A levels suggest that at least one-third of the subjects may have been inadequately fed in this respect at the time of the survey. Serum ascorbic acid values indicate that nearly all had adequate body stores of this vitamin.