Problems in the nutritional assessment of black individuals.

Nutritional assessment of American Negro (Black) individuals of largely-African ancestry is complicated by differences that transcend socioeconomic status (SES). These include smaller size at birth but greater size from 2 to 14 years, advanced skeletal development ("bone age"), advanced dental development, a larger skeletal mass and bone "density" and a lesser rate of adult bone loss in the Black female from age 40 on as shown in a variety of bone-losing situtations, including renal osteodystrophies. Thus, appropriate dimensional and radiographic and radiogrammetric measures must be employed. Differences in hemoglobin concentration approximating 1.0g/100ml and in hematocrit levels also indicate the need for population-specific standards, otherwise gross errors will be made in calculating the per cent "deficient" and "low". Since self-assignments to racial categories are commonly used, the problem of racial identification is minimal. Failure to employ appropriate standards will result in underestimating the dimensional, radiographic and radiogrammetric effects of undernutrition in Blacks after the 2nd year, underestimating adult bone loss to a large degree, but overestimating the severity of hematologic responses from the 1st year through the 9th decade.