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Sample records for antenatal micronutrient supplementation

  1. Pilot Study: Mother's Attitude and Practices toward Antenatal Care, Micronutrient Supplementation and Breastfeeding in Salmaniya Medical Complex

    International Nuclear Information System (INIS)

    Husain, Dana

    2014-01-01

    Full text: Good nutrition in the first 1000 days provides a stable long term foundation for society, as it ensures a child's growth to his/her potential (1). Pregnant women who suffer from multiple micronutrient deficiencies have been associated with poor pregnancy outcomes including Low Birth weight-LBW (4). Iron deficiency anemia is linked to an increased risk of infections (4), and is still a health problem in the kingdom of Bahrain with the prevalence of 22.7% to 54% (5). The World Health Organization (WHO), United Nation Children's fund (UNICEF) and American Academy of Pediatrics recommendations are to initiate breastfeeding within the first hour of life and to and sustain exclusive breastfeeding for 6 months (6). Several studies have shown a downward trend of breastfeeding in developing countries such as Kingdom of Saudi Arabia (7,8). Studies in Kingdom of Saudi Arabia and Kingdom of Bahrain have shown partial breastfeeding at early months<6month age (8,9) Aim: To provide a preliminary evaluation of the mother's attitude/practices toward antenatal care, micronutrient supplementation and breastfeeding in Salmaniya Medical Complex (SMC), Kingdom of Bahrain. Methods: A sample of 62 Bahraini mothers - inpatients and outpatients- within the age group of 20 years to 35 years old at SMC were asked by dietitians and diet technicians to answer 7 closed ended questions about importance of antenatal care, compliance to nutritional recommendations during pregnancy and breastfeeding practices. Statistical Package for Social Science (SPSS) was used in analyzing data collected. Fisher Exact test and Chi-Square test were used to correlate the determinants (age and education level) with mother's attitude/practices. Statistical significance was assumed at p<0.05 Results: Scores showed no significant correlation between education level mother's attitude/practices toward antenatal care, micronutrient supplementation and breastfeeding. As for age, we found more mothers above 25

  2. Monitoring and surveillance for multiple micronutrient supplements in pregnancy.

    Science.gov (United States)

    Mei, Zuguo; Jefferds, Maria Elena; Namaste, Sorrel; Suchdev, Parminder S; Flores-Ayala, Rafael C

    2017-12-22

    The World Health Organization (WHO) recommends iron-folic acid (IFA) supplementation during pregnancy to improve maternal and infant health outcomes. Multiple micronutrient (MMN) supplementation in pregnancy has been implemented in select countries and emerging evidence suggests that MMN supplementation in pregnancy may provide additional benefits compared to IFA alone. In 2015, WHO, the United Nations Children's Fund (UNICEF), and the Micronutrient Initiative held a "Technical Consultation on MMN supplements in pregnancy: implementation considerations for successful incorporation into existing programmemes," which included a call for indicators needed for monitoring, evaluation, and surveillance of MMN supplementation programmes. Currently, global surveillance and monitoring data show that overall IFA supplementation programmes suffer from low coverage and intake adherence, despite inclusion in national policies. Common barriers that limit the effectiveness of IFA-which also apply to MMN programmes-include weak supply chains, low access to antenatal care services, low-quality behaviour change interventions to support and motivate women, and weak or non-existent monitoring systems used for programme improvement. The causes of these barriers in a given country need careful review to resolve them. As countries heighten their focus on supplementation during pregnancy, or if they decide to initiate or transition into MMN supplementation, a priority is to identify key monitoring indicators to address these issues and support effective programmes. National and global monitoring and surveillance data on IFA supplementation during pregnancy are primarily derived from cross-sectional surveys and, on a more routine basis, through health and logistics management information systems. Indicators for IFA supplementation exist; however, the new indicators for MMN supplementation need to be incorporated. We reviewed practice-based evidence, guided by the WHO/Centers for Disease

  3. Effect of maternal multiple micronutrient vs iron-folic acid supplementation on infant mortality and adverse birth outcomes in rural Bangladesh: the JiVitA-3 randomized trial.

    Science.gov (United States)

    West, Keith P; Shamim, Abu Ahmed; Mehra, Sucheta; Labrique, Alain B; Ali, Hasmot; Shaikh, Saijuddin; Klemm, Rolf D W; Wu, Lee S-F; Mitra, Maithilee; Haque, Rezwanul; Hanif, Abu A M; Massie, Allan B; Merrill, Rebecca Day; Schulze, Kerry J; Christian, Parul

    Maternal micronutrient deficiencies may adversely affect fetal and infant health, yet there is insufficient evidence of effects on these outcomes to guide antenatal micronutrient supplementation in South Asia. To assess effects of antenatal multiple micronutrient vs iron-folic acid supplementation on 6-month infant mortality and adverse birth outcomes. Cluster randomized, double-masked trial in Bangladesh, with pregnancy surveillance starting December 4, 2007, and recruitment on January 11, 2008. Six-month infant follow-up ended August 30, 2012. Surveillance included 127,282 women; 44,567 became pregnant and were included in the analysis and delivered 28,516 live-born infants. Median gestation at enrollment was 9 weeks (interquartile range, 7-12). Women were provided supplements containing 15 micronutrients or iron-folic acid alone, taken daily from early pregnancy to 12 weeks postpartum. The primary outcome was all-cause infant mortality through 6 months (180 days). Prespecified secondary outcomes in this analysis included stillbirth, preterm birth (<37 weeks), and low birth weight (<2500 g). To maintain overall significance of α = .05, a Bonferroni-corrected α = .01 was calculated to evaluate statistical significance of primary and 4 secondary risk outcomes (.05/5). Among the 22,405 pregnancies in the multiple micronutrient group and the 22,162 pregnancies in the iron-folic acid group, there were 14,374 and 14,142 live-born infants, respectively, included in the analysis. At 6 months, multiple micronutrients did not significantly reduce infant mortality; there were 764 deaths (54.0 per 1000 live births) in the iron-folic acid group and 741 deaths (51.6 per 1000 live births) in the multiple micronutrient group (relative risk [RR], 0.95; 95% CI, 0.86-1.06). Multiple micronutrient supplementation resulted in a non-statistically significant reduction in stillbirths (43.1 vs 48.2 per 1000 births; RR, 0.89; 95% CI, 0.81-0.99; P = .02) and significant

  4. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention

    Science.gov (United States)

    Gernand, Alison D.; Schulze, Kerry J.; Stewart, Christine P.; West, Keith P.; Christian, Parul

    2016-01-01

    Micronutrients, vitamins and minerals accessible from the diet, are essential for biologic activity. Micronutrient status varies widely throughout pregnancy and across populations. Women in low-income countries often enter pregnancy malnourished, and the demands of gestation can exacerbate micronutrient deficiencies with health consequences to the fetus. Examples of efficacious single micronutrient interventions include folic acid to prevent neural tube defects, iodine to prevent cretinism, zinc to reduce of preterm birth, and iron to reduce the risk of low birth weight. Folic acid and vitamin D might also increase birth weight. While extensive mechanism and association research links antenatal multiple micronutrients to plausible materno-fetal health advantages, hypothesized benefits have often been absent, minimal or unexpected in trials. These findings suggest a role for population context in determining health responses and extensive gaps in knowledge. Multiple micronutrient supplements reduce risks of being born low birth weight, small for gestational age or stillborn in undernourished settings, and justify micronutrient interventions with antenatal care. Measurable health effects of gestational micronutrient exposure may persist into childhood but few data exists on potential long-term benefits. In this Review, we discuss micronutrient intake recommendations, risks and consequences of deficiencies, and the effects of interventions with a particular emphasis on offspring. PMID:27032981

  5. Efficacy of multiple micronutrient supplementation for improving anemia, micronutrient status, growth, and morbidity of Peruvian infants.

    Science.gov (United States)

    López de Romaña, Guillermo; Cusirramos, Sandra; López de Romaña, Daniel; Gross, Rainer

    2005-03-01

    Anemia, micronutrient deficiencies, and growth faltering are still common in Peru. The study objective was to determine the efficacy of different micronutrient supplements in preventing growth failure, anemia, and micronutrient deficiencies in Peruvian infants. Three hundred and thirteen infants aged 6 to 12 mo participated in a double-blind, masked, controlled trial in which they were randomly assigned to receive either a daily dose of iron (DI), a daily dose of multiple micronutrients (DMM), a weekly dose of multiple micronutrients, or a placebo (P) for 6 mo. None of the supplements tested prevented growth faltering or the morbidities common during infancy. Anemia and plasma homocysteine concentrations fell significantly in all groups during the study, but the mean change of plasma homocysteine during the trial period was significantly smaller in the DI group than in other groups, and the increase in hemoglobin concentrations was smaller in the P group than the micronutrient treatment groups. Plasma ferritin concentrations decreased least in the groups taking daily micronutrient supplements containing iron (DI and DMM). There were no significant differences among groups in mean final values or changes in plasma zinc, retinol, tocopherol, or riboflavin. Although the DMM intervention was the most efficacious for preventing anemia, iron, and zinc deficiencies, 15%, 20%, and 50% of this group still remained anemic, zinc deficient, and iron deficient, respectively, at the end of the study. Further research thus should investigate whether higher doses of iron and zinc, together with infection control measures, are more efficacious.

  6. Micronutrient Intake and the Contribution of Dietary Supplements in Hispanic Infants.

    Science.gov (United States)

    Amaro-Rivera, Kiara; López-Cepero, Andrea; Diaz, Beatriz; Lee, Jae Eun; Palacios, Cristina

    2018-03-04

    To calculate micronutrient adequacy among infants and toddlers and to determine the contribution of dietary supplements to this adequacy, micronutrient intake was assessed using two nonconsecutive 24-hour recalls in a sample of 296 infants aged 0-24 months. Micronutrient intake was calculated from foods and beverages and from supplements and compared between nonusers and users of supplements. Percentages of children below the Dietary Reference Intake (DRI) and above the tolerable upper limit intake (UL) were also compared between groups. A total of 241 participants had complete data. The prevalence of dietary supplement use among the sample was 15%. Mean intake of all micronutrients from foods and beverages was similar between nonusers and users of supplements (p > .05) but significantly higher for the following vitamins when supplements were included: D, E, B1, B2, B3, and B6 (p supplements were included, this percentage significantly decreased among users compared to nonusers (p supplements were added. Supplements significantly increased the intake of some vitamins. Vitamins D and E had the highest percentage of children below the DRI, which was partly corrected with the use of supplements. The UL was exceeded for magnesium, zinc, and vitamin B3 in many children. It is important to understand these patterns as they may be indicative of future nutritional deficiencies and excesses.

  7. Effect of micronutrient supplementation on treatment outcomes in children with intrathoracic tuberculosis

    DEFF Research Database (Denmark)

    Lodha, Rakesh; Mukherjee, Aparna; Singh, Varinder

    2014-01-01

    BACKGROUND: Micronutrients play an important role in immune function. To our knowledge, there have been no comprehensive studies on the role of micronutrient supplementation in children with tuberculosis. OBJECTIVE: We assessed the effect of micronutrient supplementation in children treated...... with antituberculosis therapy (ATT). DESIGN: A randomized, double-blind, placebo-controlled trial that used a 2 × 2 factorial design was undertaken at 2 teaching hospitals in Delhi. Children with newly diagnosed intrathoracic tuberculosis were enrolled, and they received ATT together with daily supplementation for 6 mo...

  8. Effect of low-dose versus higher-dose antenatal iron supplementation on child health outcomes at 36 months of age in Viet Nam: longitudinal follow-up of a cluster randomised controlled trial.

    Science.gov (United States)

    Hanieh, Sarah; Ha, Tran T; Simpson, Julie A; Braat, Sabine; Thuy, Tran T; Tran, Thach D; King, Janet; Tuan, Tran; Fisher, Jane; Biggs, Beverley-Ann

    2017-01-01

    Intermittent iron-folic acid supplementation (IFA) is currently recommended for pregnant women in populations where anaemia prevalence among pregnant women is Viet Nam among children of 36 months of age, born to women previously enrolled in a cluster randomised controlled trial of antenatal micronutrient supplementation (daily IFA (60 mg elemental iron) vs twice-weekly IFA (60 mg elemental iron) vs twice-weekly multiple micronutrient (MMN) supplementation (60 mg elemental iron)). Primary outcomes were height-for-age z-scores (HAZ), according to WHO growth standards and cognitive composite scores (Bayley Scales of Infant and Toddler Development, third edition) at 36 months of age. A total of 1017 children born to mothers enrolled in the cluster randomised trial were assessed at 36 months of age. Adjusted mean differences (MDs) in HAZ were -0.14 (95% CI -0.28 to -0.01) and -0.15 (95% CI -0.29 to -0.01) in children born to mothers who received twice-weekly IFA or MMN compared with those who received daily IFA. Children born to mothers who received twice-weekly MMN had lower composite motor scores compared with those who received daily IFA (MD -2.07, 95% CI -4.11 to -0.03). There were no differences in composite cognitive scores in the twice-weekly compared with daily regimens. Low-dose antenatal IFA supplementation (120 mg elemental iron per week) resulted in lower HAZ and motor composite scores in children compared with higher-dose antenatal IFA supplementation (420 mg elemental iron per week). This highlights the importance of adequate iron stores during pregnancy and the need for careful monitoring when lower-dose antenatal iron regimens are used. Australia New Zealand Clinical Trials Registry: 12610000944033.

  9. Laparoscopic Gastric Sleeve and Micronutrients Supplementation: Our Experience

    Directory of Open Access Journals (Sweden)

    D. Capoccia

    2012-01-01

    Full Text Available Background. Laparoscopic gastric sleeve (LGS has been recently introduced as a stand-alone, restrictive bariatric surgery. Theoretically, LGS attenuates micronutrients deficiencies and associated complications that were typically observed following malabsorptive procedures. The aim of this study was to assess some micronutrients and mineral deficiencies in patients undergoing LGS. Methods. In the period between July 2008 and April 2010, 138 obese patients (110 females and 28 males with mean BMI 44.4 kg/m2 ± 6.5, mean age 43.9±10.9 years were enrolled and underwent LGS. Patients were followed up with routine laboratory tests and anthropometric measurements and assessed for nutritional status, as regards vitamin B12, folic acid, iron, hemoglobin, calcium, and vitamin D, every three months throughout 12 months. Results. 12 months after sleeve, patients did not show iron deficiency and/or anemia; plasma calcium levels were in the normal range without supplementation from the sixth month after the operation. Vitamin B12 and folic acid were adequately supplemented for all the follow-up period. Vitamin D was in suboptimal levels, despite daily multivitamin supplementation. Conclusion. In this study, we showed that LGS is an effective surgery for the management of morbid obesity. An adequate supplementation is important to avoid micronutrients deficiencies and greater weight loss does not require higher dosage of multivitamins.

  10. Do dietary supplements improve micronutrient sufficiency in children and adolescents?

    Science.gov (United States)

    Bailey, Regan L.; Fulgoni, Victor L.; Keast, Debra R.; Lentino, Cindy V.; Dwyer, Johanna T.

    2012-01-01

    Objective To examine if children use supplements to fill gaps in nutritionally inadequate diets or whether supplements contribute to already adequate or excessive micronutrient intakes from foods. Study design Data were analyzed for children (2–18 y) from the NHANES 2003–2006, a nationally representative, cross-sectional survey (n=7,250). Diet was assessed using two 24-hour recalls, and dietary supplement use was assessed with a 30-day questionnaire. Results Prevalence of supplements use was 21% (Supplement users had higher micronutrient intakes than nonusers. Calcium and vitamin D intakes were low for all children. Inadequate intakes of phosphorus, copper, selenium, folate, and vitamins B-6 and B-12 were minimal from foods alone among 2–8 y olds. However, among 9–18 y olds, a higher prevalence of inadequate intakes of magnesium, phosphorus, and vitamins A, C, and E were observed. Supplement use increased the likelihood of intakes above the Upper Tolerable Intake Level for iron, zinc, copper, selenium, folic acid, and vitamins A and C. Conclusions Even with the use of supplements, more than a one-third of children failed to meet calcium and vitamin D recommendations. Children 2–8 y had nutritionally adequate diets regardless of supplement use. However, in children older than 8 y dietary supplements added micronutrients to diets that would have otherwise been inadequate for magnesium, phosphorus, vitamins A,C, and E. Supplement use contributed to the potential for excess intakes of some nutrients. These findings may have implications for reformulating dietary supplements for children. PMID:22717218

  11. Effect of micronutrient supplement on health and nutritional status of schoolchildren: mental function.

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    Vazir, Shahnaz; Nagalla, Balakrishna; Thangiah, Vijayapushpam; Kamasamudram, Vijayaraghavan; Bhattiprolu, Sivakumar

    2006-01-01

    We evaluated the effect of a micronutrient-fortified beverage on mental function in schoolchildren. This double-blind, placebo-controlled, matched-pair, cluster, randomized feeding trial assessed baseline before supplementation and after 14 mo in a cohort of 608 children aged 6 to 15 y who received a micronutrient-fortified beverage or placebo. Children in two classes (clusters) in each of nine grades were assessed for intelligence, attention and concentration, memory, and school achievement. Mean intelligence quotient scores of the micronutrient-fortified beverage group and the placebo group at baseline and final follow-up were not significantly different. Mean verbal and performance scores and increments were also not different. After supplementation, attention-concentration increment scores of the micronutrient group were significantly higher (P < 0.05) than those of the placebo group. Mean and incremental scores of the supplemented group on the memory scale were not significantly different from those of the placebo group. Supplementation with a beverage fortified with a range of micronutrients significantly improved attention-concentration over 14 mo, but not intelligence quotient, memory, or school achievement among middle-income schoolchildren.

  12. Micronutrient Supplement Use and Diet Quality in University Students

    Directory of Open Access Journals (Sweden)

    Adam R. Wiltgren

    2015-02-01

    Full Text Available Many national and international public health organisations recommend achieving nutrient adequacy through consumption of a wide variety of nutritious foods. Despite this, dietary supplement sales continue to increase. Understanding the characteristics of micronutrient supplement users and the relationship with diet quality can help develop effective public health interventions to reduce unnecessary consumption of vitamin and mineral supplements. Participants (n = 1306 were a convenience sample of students studying first year food and nutrition. Data was collected via a Food and Diet Questionnaire (FDQ and a Food Frequency Questionnaire (FFQ. Supplement users were defined as participants who indicated consuming any listed supplement as frequently as once a month or more. Diet quality was assessed using a Dietary Guideline Index (DGI score. Prevalence of supplement use was high in this study population with 56% of participants reporting supplement use; the most popular supplements consumed were multivitamins (28% and vitamin C (28%. A higher DGI score was significantly associated with an increased likelihood of supplement use (mean: 105 ± 18 vs. 109 ± 17, p = 0.001. Micronutrient supplement use was associated with a higher DGI score, suggesting that supplements are more likely to be used by those who are less likely to require them.

  13. Multivitamin/mineral supplement contribution to micronutrient intakes in the United States, 2007-2010.

    Science.gov (United States)

    Wallace, Taylor C; McBurney, Michael; Fulgoni, Victor L

    2014-01-01

    Multivitamin/mineral (MVMM) supplements are the most common dietary supplements consumed in the United States; however, intake data specific to how MVMM use contributes to micronutrient intakes among Americans are absent from the current scientific literature. This analysis aimed to assess contributions of micronutrients to usual intakes derived from MVMM supplements and to compare those intakes to the dietary reference intakes for US residents aged ≥ 4 years according to the National Health and Nutrition Examination Survey (NHANES) 2007-2010 (n = 16,444). We used the National Cancer Institute method to assess usual intakes of 21 micronutrients. Our results showed that 51% of Americans consumed MVMM supplements containing ≥ 9 micronutrients. Large portions of the population had total usual intakes (food and MVMM supplement use) below the estimated average requirement for vitamins A (35%), C (31%), D (74%), and E (67%) as well as calcium (39%) and magnesium (46%). Only 0%, 8%, and 33% of the population had total usual intakes of potassium, choline, and vitamin K above the adequate intake when food and MVMM use was considered. The percentage of the population with total intakes greater than the tolerable upper intake level (UL) was very low for all nutrients; excess intakes of zinc were the highest (3.5%) across the population of all of the nutrients assessed in NHANES. In large proportions of the population, micronutrient sufficiency is currently not being achieved through food solutions for several essential vitamins and minerals. Use of age- and gender-specific MVMM supplements may serve as a practical means to increase the micronutrient status in subpopulations of Americans while not increasing intakes above the UL.

  14. Influence of mango mesocarp flour supplement to micronutrient ...

    African Journals Online (AJOL)

    Influence of mango mesocarp flour supplement to micronutrient, physical and organoleptic qualities of wheat-based bread. ... Mango mesocarp flour was incorporated into wheat flour at 15, 20 and 30% levels to ... HOW TO USE AJOL.

  15. The Effect of Intermittent Antenatal Iron Supplementation on Maternal and Infant Outcomes in Rural Viet Nam: A Cluster Randomised Trial

    Science.gov (United States)

    Hanieh, Sarah; Ha, Tran T.; Simpson, Julie A.; Casey, Gerard J.; Khuong, Nguyen C.; Thoang, Dang D.; Thuy, Tran T.; Pasricha, Sant-Rayn; Tran, Thach D.; Tuan, Tran; Dwyer, Terence; Fisher, Jane; Biggs, Beverley-Ann

    2013-01-01

    Background Anemia affects over 500 million women, and in pregnancy is associated with impaired maternal and infant outcomes. Intermittent antenatal iron supplementation is an attractive alternative to daily dosing; however, the impact of this strategy on infant outcomes remains unclear. We compared the effect of intermittent antenatal iron supplementation with daily iron supplementation on maternal and infant outcomes in rural Viet Nam. Methods and Findings This cluster randomised trial was conducted in Ha Nam province, Viet Nam. 1,258 pregnant women (<16 wk gestation) in 104 communes were assigned to daily iron–folic acid (IFA), twice weekly IFA, or twice weekly multiple micronutrient (MMN) supplementation. Primary outcome was birth weight. Mean birth weight was 3,148 g (standard deviation 416). There was no difference in the birth weights of infants of women receiving twice weekly IFA compared to daily IFA (mean difference [MD] 28 g; 95% CI −22 to 78), or twice weekly MMN compared to daily IFA (MD −36.8 g; 95% CI −82 to 8.2). At 32 wk gestation, maternal ferritin was lower in women receiving twice weekly IFA compared to daily IFA (geometric mean ratio 0.73; 95% CI 0.67 to 0.80), and in women receiving twice weekly MMN compared to daily IFA (geometric mean ratio 0.62; 95% CI 0.57 to 0.68), but there was no difference in hemoglobin levels. Infants of mothers who received twice weekly IFA had higher cognitive scores at 6 mo of age compared to those who received daily IFA (MD 1.89; 95% CI 0.23 to 3.56). Conclusions Twice weekly antenatal IFA or MMN did not produce a clinically important difference in birth weight, when compared to daily IFA supplementation. The significant improvement in infant cognitive outcomes at 6 mo of age following twice weekly antenatal IFA requires further exploration, and provides additional support for the use of intermittent, rather than daily, antenatal IFA in populations with low rates of iron deficiency. Trial registration

  16. Efficacy of a foodlet-based multiple micronutrient supplement for preventing growth faltering, anemia, and micronutrient deficiency of infants: the four country IRIS trial pooled data analysis.

    Science.gov (United States)

    Smuts, Cornelius M; Lombard, Carl J; Benadé, A J Spinnler; Dhansay, Muhammad A; Berger, Jacques; Hop, Le Thi; López de Romaña, Guillermo; Untoro, Juliawati; Karyadi, Elvina; Erhardt, Jürgen; Gross, Rainer

    2005-03-01

    Diets of infants across the world are commonly deficient in multiple micronutrients during the period of growth faltering and dietary transition from milk to solid foods. A randomized placebo controlled trial was carried out in Indonesia, Peru, South Africa, and Vietnam, using a common protocol to investigate whether improving status for multiple micronutrients prevented growth faltering and anemia during infancy. The results of the pooled data analysis of the 4 countries for growth, anemia, and micronutrient status are reported. A total of 1134 infants were randomized to 4 treatment groups, with 283 receiving a daily placebo (P), 283 receiving a weekly multiple micronutrient supplement (WMM), 280 received a daily multiple micronutrient (DMM) supplement, and 288 received daily iron (DI) supplements. The DMM group had a significantly greater weight gain, growing at an average rate of 207 g/mo compared with 192 g/mo for the WMM group, and 186 g/mo for the DI and P groups. There were no differences in height gain. DMM was also the most effective treatment for controlling anemia and iron deficiency, besides improving zinc, retinol, tocopherol, and riboflavin status. DI supplementation alone increased zinc deficiency. The prevalence of multiple micronutrient deficiencies at baseline was high, with anemia affecting the majority, and was not fully controlled even after 6 mo of supplementation. These positive results indicate the need for larger effectiveness trials to examine how to deliver supplements at the program scale and to estimate cost benefits. Consideration should also be given to increasing the dosages of micronutrients being delivered in the foodlets.

  17. Individual and structural environmental influences on utilization of iron and folic acid supplementation among pregnant women in Harare, Zimbabwe.

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    Tinago, Chiwoneso B; Annang Ingram, Lucy; Blake, Christine E; Frongillo, Edward A

    2017-07-01

    Micronutrient deficiencies are prevalent among Zimbabweans with serious health and social implications. Due to a lack of a national micronutrient food fortification policy, the Zimbabwe Ministry of Health and Child Care established a policy for the prevention of maternal micronutrient deficiencies, which centres on pregnant women receiving daily iron and folic acid (IFA) at their first antenatal care visit and throughout pregnancy. Despite these efforts, utilization of IFA supplementation in pregnancy in Zimbabwe is low. This study aimed to understand the experiences and knowledge of IFA supplementation among pregnant women and healthcare workers in Harare, Zimbabwe, and the influence of health-service and social environments on utilization. Semi-structured in-depth interviews were conducted in Shona and English, with pregnant women (n = 24) and healthcare workers (n = 14) providing direct antenatal care services to pregnant women in two high-density community clinics. Data were analysed thematically using NVivo 10. Influences on utilization were at the individual and structural environmental levels. Reasons for low utilization of IFA supplementation included forgetting to take IFA, side effects, misconceptions about IFA, limited access to nutrition information, delayed entry or non-uptake of antenatal care and social norms of pregnant women for IFA supplementation. Utilization was enhanced by knowledge of risks and benefits of supplementation, fear of negative health complications with non-utilization, family support and healthcare worker recommendation for supplementation. Study findings can inform approaches to strengthen micronutrient supplementation utilization to improve the micronutrient status of pregnant women to decrease maternal mortality and improve overall maternal and child health in Zimbabwe. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

  18. Micronutrients in Pregnancy in Low- and Middle-Income Countries

    Directory of Open Access Journals (Sweden)

    Ian Darnton-Hill

    2015-03-01

    Full Text Available Pregnancy is one of the more important periods in life when increased micronutrients, and macronutrients are most needed by the body; both for the health and well-being of the mother and for the growing foetus and newborn child. This brief review aims to identify the micronutrients (vitamins and minerals likely to be deficient in women of reproductive age in Low- and Middle-Income Countries (LMIC, especially during pregnancy, and the impact of such deficiencies. A global prevalence of some two billion people at risk of micronutrient deficiencies, and multiple micronutrient deficiencies of many pregnant women in LMIC underline the urgency to establishing the optimal recommendations, including for delivery. It has long been recognized that adequate iron is important for best reproductive outcomes, including gestational cognitive development. Similarly, iodine and calcium have been recognized for their roles in development of the foetus/neonate. Less clear effects of deficiencies of zinc, copper, magnesium and selenium have been reported. Folate sufficiency periconceptionally is recognized both by the practice of providing folic acid in antenatal iron/folic acid supplementation and by increasing numbers of countries fortifying flours with folic acid. Other vitamins likely to be important include vitamins B12, D and A with the water-soluble vitamins generally less likely to be a problem. Epigenetic influences and the likely influence of micronutrient deficiencies on foetal origins of adult chronic diseases are currently being clarified. Micronutrients may have other more subtle, unrecognized effects. The necessity for improved diets and health and sanitation are consistently recommended, although these are not always available to many of the world’s pregnant women. Consequently, supplementation programmes, fortification of staples and condiments, and nutrition and health support need to be scaled-up, supported by social and cultural measures

  19. Do dietary supplements improve micronutrient sufficiency in children and adolescents?

    Science.gov (United States)

    Bailey, Regan L; Fulgoni, Victor L; Keast, Debra R; Lentino, Cindy V; Dwyer, Johanna T

    2012-11-01

    To examine if children use supplements to fill gaps in nutritionally inadequate diets or whether supplements contribute to already adequate or excessive micronutrient intakes from foods. Data were analyzed for children (2-18 years) from the National Health and Nutrition Examination Survey 2003-2006, a nationally representative, cross-sectional survey (n = 7250). Diet was assessed using two 24-hour recalls, and dietary supplement use was assessed with a 30-day questionnaire. Prevalence of supplements use was 21% (vitamin D intakes were low for all children. Inadequate intakes of phosphorus, copper, selenium, folate, and vitamins B-6 and B-12 were minimal from foods alone among 2-8 year olds. However, among 9-18 year olds, a higher prevalence of inadequate intakes of magnesium, phosphorus, and vitamins A, C, and E were observed. Supplement use increased the likelihood of intakes above the upper tolerable intake level for iron, zinc, copper, selenium, folic acid, and vitamins A and C. Even with the use of supplements, more than a one-third of children failed to meet calcium and vitamin D recommendations. Children 2-8 years old had nutritionally adequate diets regardless of supplement use. However, in children older than 8 years, dietary supplements added micronutrients to diets that would have otherwise been inadequate for magnesium, phosphorus, vitamins A, C, and E. Supplement use contributed to the potential for excess intakes of some nutrients. These findings may have implications for reformulating dietary supplements for children. Published by Mosby, Inc.

  20. Prenatal Micronutrient Supplementation Is Not Associated with Intellectual Development of Young School-Aged Children.

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    Li, Chao; Zeng, Lingxia; Wang, Duolao; Yang, Wenfang; Dang, Shaonong; Zhou, Jing; Yan, Hong

    2015-08-01

    Micronutrient supplementation is often prescribed during pregnancy. The effects of prenatal iron and multimicronutrient supplementation on intellectual development in young school-aged children are less than clear. The aim of this study was to examine the long-term effects of prenatal iron plus folic acid or multiple micronutrient (including iron and folic acid) supplementation vs. folic acid supplementation on the intellectual development of young school-aged children in rural China. Young school-aged children (aged 7-10 y, n = 1744) of women who had participated in a trial of prenatal supplementation with various combinations of micronutrients and remained residents in 2 rural counties in China were followed. We measured their intellectual development by Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV). The WISC-IV generated the Full-Scale Intelligence Quotient (FSIQ), Verbal Comprehension Index (VCI), Working Memory Index (WMI), Perceptual Reasoning Index (PRI), and Processing Speed Index (PSI). Multilevel analyses were used to assess the effect of prenatal micronutrient supplementation on the intellectual development of children. The mean differences in FSIQ, VCI, WMI, PRI, and PSI, respectively, were not significant between prenatal folic acid supplementation and either iron plus folic acid [-0.34 (P = 0.65), -0.06 (P = 0.95), -0.22 (P = 0.76), -0.01 (P = 0.99), and -1.26 (P = 0.11)] or multimicronutrient [-0.39 (P = 0.60), -0.64 (P = 0.48), 0.11 (P = 0.87), -0.43 (P = 0.59), and -0.34; (P = 0.65)] supplementation after adjusting for confounders. There is no evidence to suggest a different effect on intellectual development between prenatal iron plus folic acid, multimicronutrient supplementation, and prenatal folic acid supplementation in children aged 7-10 y. This trial was registered at www.isrctn.com as ISRCTN08850194. © 2015 American Society for Nutrition.

  1. Intake of micronutrients among Danish adult users and non-users of dietary supplements

    DEFF Research Database (Denmark)

    Tetens, Inge; Biltoft-Jensen, Anja Pia; Spagner, Camilla

    2011-01-01

    Objectives: To evaluate the intake of micronutrients from the diet and from supplements in users and non-users of dietary supplements, respectively, in a representative sample of the Danish adult population. A specific objective was to identify the determinants of supplement use. Design: A cross-...

  2. Decreased serum homocysteine levels after micronutrient supplementation in older people

    Directory of Open Access Journals (Sweden)

    Pusparini Pusparini

    2016-02-01

    Full Text Available Aging is associated with a gradual impairment in cognitive function. The elderly also show a high prevalence of undernutrition, whereas nutrition plays an important role in the metabolism of neuronal cells and enzymes. Homocysteine is an amino acid resulting from methionine metabolism and is dependent on intake of vitamin B12, vitamin B6 and folic acid. Homocysteine is said to play a role in cognitive function. The objective of this study was to evaluate the effect of micronutrient supplementation for 6 months on serum homocysteine levels and cognitive function in older people. This study was an experimental study of pre-post test design, carried out in Mampang subdistrict, South Jakarta. A total of 94 elderly people was recruited for this study, consisting of 44 females and 50 males. Serum homocysteine level was assessed by fluorescent polarization immunoassay and cognitive function by means of the mini mental state examination (MMSE before and after micronutrient supplementation. Mean serum homocysteine concentration after supplementation decreased significantly to 14.8 ± 5.8 mmol/L, compared with mean serum homocysteine level of 15.9 ± 5.9 mmol/L before supplementation (p=0.000. Multiple regression analysis indicated that the factors influencing post-supplementation MMSE scores were gender (â=-0.350; p=0.000, education (â=0.510; p=0.000 and post-supplementation homocysteine levels (â=-0.201; p=0.000, while age, pre-supplementation homocysteine levels and BMI did not affect MMSE scores. Homocysteine concentration decreased significantly after 6 months of supplementation. The factors affecting post-supplementation MMSE scores were gender, level of education, and post-supplementation homocysteine level.

  3. Decreased serum homocysteine levels after micronutrient supplementation in older people

    Directory of Open Access Journals (Sweden)

    Pusparini

    2010-12-01

    Full Text Available Aging is associated with a gradual impairment in cognitive function. The elderly also show a high prevalence of undernutrition, whereas nutrition plays an important role in the metabolism of neuronal cells and enzymes. Homocysteine is an amino acid resulting from methionine metabolism and is dependent on intake of vitamin B12, vitamin B6 and folic acid. Homocysteine is said to play a role in cognitive function. The objective of this study was to evaluate the effect of micronutrient supplementation for 6 months on serum homocysteine levels and cognitive function in older people. This study was an experimental study of pre-post test design, carried out in Mampang subdistrict, South Jakarta. A total of 94 elderly people was recruited for this study, consisting of 44 females and 50 males. Serum homocysteine level was assessed by fluorescent polarization immunoassay and cognitive function by means of the mini mental state examination (MMSE before and after micronutrient supplementation. Mean serum homocysteine concentration after supplementation decreased significantly to 14.8 ± 5.8 mmol/L, compared with mean serum homocysteine level of 15.9 ± 5.9 mmol/L before supplementation (p=0.000. Multiple regression analysis indicated that the factors influencing post-supplementation MMSE scores were gender (â=-0.350; p=0.000, education (â=0.510; p=0.000 and post-supplementation homocysteine levels (â=-0.201; p=0.000, while age, pre-supplementation homocysteine levels and BMI did not affect MMSE scores. Homocysteine concentration decreased significantly after 6 months of supplementation. The factors affecting post-supplementation MMSE scores were gender, level of education, and post-supplementation homocysteine level.

  4. Spontaneous neural tube defects in splotch mice supplemented with selected micronutrients

    International Nuclear Information System (INIS)

    Wlodarczyk, Bogdan J.; Tang, Louisa S.; Triplett, Aleata; Aleman, Frank; Finnell, Richard H.

    2006-01-01

    Splotch (Sp/Sp) mice homozygous for a mutation in the Pax3 gene inevitably present with neural tube defects (NTDs), along with other associated congenital anomalies. The affected mutant embryos usually die by gestation days (E) 12-13. In the present study, the effect of modifier genes from a new genetic background (CXL-Sp) and periconceptional supplementation with selected micronutrients (folic acid, 5-formyltetrahydrofolate, 5-methyltetrahydrofolate, methionine, myoinositol, thiamine, thymidine, and α-tocopherol) was determined with respect to the incidence of NTDs. In order to explore how different exposure parameters (time, dose, and route of compound administration) modulate the beneficial effects of micronutrient supplementation, female mice received either short- or long-term nutrient supplements via enteral or parenteral routes. Embryos were collected on E12.5 and examined for the presence of anterior or posterior NTDs. Additionally, whole mount in situ hybridization studies were conducted in order to reveal/confirm normal expression patterns of the Pax3 gene during neurulation in the wild-type and Sp/Sp homozygous mutant mouse embryos utilized in this study. A strong Pax3 signal was demonstrated in CXL-Sp embryos during neural tube closure (E9.5 to E10.5). The intensity and spatial pattern of expression were similar to other Splotch mutant mice. Of all the micronutrients tested, only supplementation with folic acid or 5-methyltetrahydrofolate rescued the normal phenotype in Sp/Sp embryos. When the folate supplementation dose was increased to 200 mg/kg in the diet, the incidence of rescued splotch homozygotes reached 30%; however, this was accompanied by six-fold increased resorption rate

  5. Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality

    DEFF Research Database (Denmark)

    Smith, Emily R; Shankar, Anuraj H; Wu, Lee S-F

    2017-01-01

    -analysis of individual patient included data from 17 randomised controlled trials done in 14 low-income and middle-income countries, which compared multiple micronutrient supplements containing iron-folic acid versus iron-folic acid alone in 112 953 pregnant women. We generated study-specific estimates and pooled...... subgroup estimates using fixed-effects models and assessed heterogeneity between subgroups with the χ(2) test for heterogeneity. We did sensitivity analyses using random-effects models, stratifying by iron-folic acid dose, and exploring individual study effect. FINDINGS: Multiple micronutrient supplements...... containing iron-folic acid provided significantly greater reductions in neonatal mortality for female neonates compared with male neonates than did iron-folic acid supplementation alone (RR 0·85, 95% CI 0·75-0·96 vs 1·06, 0·95-1·17; p value for interaction 0·007). Multiple micronutrient supplements resulted...

  6. Impact of multi-micronutrient supplementation on growth and morbidity of HIV-infected South African children

    NARCIS (Netherlands)

    Raaij, van J.M.A.; Villiers, de F.P.R.; Kok, F.J.

    2013-01-01

    Poor growth, micronutrient deficiencies and episodes of diarrhea and respiratory infections occur frequently in HIV-infected children. We investigated whether multi-micronutrient supplementation would improve the growth performance and reduce the number of episodes of diarrhea and/or of respiratory

  7. Adherence to iron supplements among women receiving antenatal care at Mulago National Referral Hospital, Uganda-cross-sectional study.

    Science.gov (United States)

    Kiwanuka, Tusuubira S; Ononge, Sam; Kiondo, Paul; Namusoke, Fatuma

    2017-10-25

    Antenatal iron supplementation is a cost effective way of reducing iron deficiency anaemia among pregnant women in resource limited countries like Uganda. Poor adherence to iron supplements has limited its effectiveness in reducing maternal anaemia as evidenced by the high burden of iron deficiency anemia in Sub-saharan Africa. The aim of this study was to determine the level of and factors associated with adherence to iron supplementation among women attending antenatal clinic at Mulago National Referral Hospital, Kampala, Uganda. Three hundred and seventy pregnant women were recruited in a cross sectional survey in Mulago National Referral Hospital antenatal clinic after informed consent between February and April 2014. Levels of adherence to iron supplements were assessed using visual analogue scale and factors associated collected using an interviewer administered questionnaire. About 12% (11.6%) of the mothers attending the antenatal clinic adhered to iron supplements over 30 day period. Mothers who had had four or more antenatal visits prior to the survey [odds ratio (OR) = 1.49, 95% confidence interval (CI) 1.12-1.97], had more than 2 week supply of iron supplements in the previous visit (OR 2.81, 95% CI 1.02-1.09), prior health education (OR 1.56, 95% CI 1.07-2.29) were more likely to adhere to iron supplements. Inadequate drug supplies and fear for side effects were the main reasons why participants missed the iron supplements. There was low adherence to iron supplements among mothers attending antenatal clinic at Mulago National Referral  Hospital. We recommend a national evaluation of adherence to iron supplements and look at ways of increasing adherence.

  8. Prenatal micronutrient supplementation and postpartum depressive symptoms in a pregnancy cohort

    NARCIS (Netherlands)

    Leung, B.M.; Kaplan, B.J.; Field, C.J.; Tough, S.; Eliasziw, M.; Gomez, M.F.; McCargar, L.J.; Gagnon, L.; APrON Study Team, the; Pop, V.J.M.

    2013-01-01

    Background Postpartum depression is a serious problem for women and their offspring. Micronutrient supplements are recommended for pregnant women because of their documented protective effects for the offspring, but their potential beneficial effects on maternal mental health are unknown. This study

  9. Optimization of micronutrient supplement for enhancing biogas production from food waste in two-phase thermophilic anaerobic digestion.

    Science.gov (United States)

    Menon, Ajay; Wang, Jing-Yuan; Giannis, Apostolos

    2017-01-01

    The aim of this study was to enhance the biogas productivity of two-phase thermophilic anaerobic digestion (AD) using food waste (FW) as the primary substrate. The influence of adding four trace metals (Ca, Mg, Co, and Ni) as micronutrient supplement in the methanogenic phase of the thermophilic system was investigated. Initially, Response Surface Methodology (RSM) was applied to determine the optimal concentration of micronutrients in batch experiments. The results showed that optimal concentrations of 303, 777, 7 and 3mg/L of Ca, Mg, Co and Ni, respectively, increased the biogas productivity as much as 50% and significantly reduced the processing time. The formulated supplement was tested in continuous two-phase thermophilic AD system with regard to process stability and productivity. It was found that a destabilized thermophilic AD process encountering high VFA accumulation recovered in less than two weeks, while the biogas production was improved by 40% yielding 0.46L CH 4 /gVS added /day. There was also a major increase in soluble COD utilization upon the addition of micronutrient supplement. The results of this study indicate that a micronutrient supplement containing Ca, Mg, Co and Ni could probably remedy any type of thermophilic AD process. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Effect of multiple micronutrient supplementation during pregnancy on maternal and birth outcomes

    Directory of Open Access Journals (Sweden)

    Yakoob Mohammad

    2011-04-01

    Full Text Available Abstract Objectives/background Given the widespread prevalence of micronutrient deficiencies in developing countries, supplementation with multiple micronutrients rather than iron-folate alone, could be of potential benefit to the mother and the fetus. These benefits could relate to prevention of maternal complications and reduction in other adverse pregnancy outcomes such as small-for-gestational age (SGA births, low birth weight, stillbirths, perinatal and neonatal mortality. This review evaluates the evidence of the impact of multiple micronutrient supplements during pregnancy, in comparison with standard iron-folate supplements, on specific maternal and pregnancy outcomes of relevance to the Lives Saved Tool (LiST. Data sources/review methods A systematic review of randomized controlled trials was conducted. Search engines used were PubMed, the Cochrane Library, the WHO regional databases and hand search of bibliographies. A standardized data abstraction and Child Health Epidemiology Reference (CHERG adaptation of the Grading of Recommendations Assessment, Development and Evaluation (GRADE technique were used for data abstraction and overall quality of evidence. Meta-analyses were performed to calculate summary estimates of utility to the LiST model for the specified outcome of incidence of SGA births. We also evaluated the potential impact of multiple micronutrients on neonatal mortality according to the proportion of deliveries occurring in facilities (using a threshold of 60% to indicate functionality of health systems for skilled births. Results We included 17 studies for detailed data abstraction. There was no significant benefit of multiple micronutrients as compared to iron folate on maternal anemia in third trimester [Relative risk (RR = 1.03; 95% confidence interval (CI: 0.87 – 1.22 (random model]. Our analysis, however, showed a significant reduction in SGA by 9% [RR = 0.91; 95% CI: 0.86 – 0.96 (fixed model]. In the fixed model

  11. The effect of folic acid, protein energy and multiple micronutrient supplements in pregnancy on stillbirths

    Directory of Open Access Journals (Sweden)

    Bhutta Zulfiqar A

    2011-04-01

    Full Text Available Abstract Background Pregnancy is a state of increased requirement of macro- and micronutrients, and malnourishment or inadequate dietary intake before and during pregnancy, can lead to adverse perinatal outcomes including stillbirths. Many nutritional interventions have been proposed during pregnancy according to the nutritional status of the mother and baseline risk factors for different gestational disorders. In this paper, we have reviewed three nutritional interventions including peri-conceptional folic acid supplementation, balanced protein energy supplementation and multiple micronutrients supplementation during pregnancy. This paper is a part of a series to estimate the effect of interventions on stillbirths for input to Live Saved Tool (LiST model. Methods We systematically reviewed all published literature to identify studies evaluating effectiveness of peri-conceptional folic acid supplementation in reducing neural tube defects (NTD, related stillbirths and balanced protein energy and multiple micronutrients supplementation during pregnancy in reducing all-cause stillbirths. The primary outcome was stillbirths. Meta-analyses were generated where data were available from more than one study. Recommendations were made for the Lives Saved Tool (LiST model based on rules developed by the Child Health Epidemiology Reference Group (CHERG. Results There were 18 studies that addressed peri-conceptional folic acid supplementation for prevention of neural tube defects (NTDs. Out of these, 7 studies addressed folic acid supplementation while 11 studies evaluated effect of folic acid fortification. Pooled results from 11 fortification studies showed that it reduces primary incidence of NTDs by 41 % [Relative risk (RR 0.59; 95 % confidence interval (CI 0.52-0.68]. This estimate has been recommended for inclusion in the LiST as proxy for reduction in stillbirths. Pooled results from three studies considered to be of low quality and suggest that

  12. New criteria for supplementation of selected micronutrients in the era of nutrigenetics and nutrigenomics.

    Science.gov (United States)

    Schwartz, Betty

    2014-08-01

    Advances in molecular biology, emergence of novel techniques and huge amount of information generated in the post-Human Genome Project era have fostered the emergence of new disciplines in the field of nutritional research: Nutrigenomics deals with the effect of diet on gene expression whereas nutrigenetics refers to the impact of inherited traits on the response to a specific dietary pattern, functional food or supplement. Understanding the role of micronutrient supplementation with specific genetic backgrounds may provide an important contribution to a new optimum health strategy based on individualized nutritional treatment and may provide the strategies for the development of safer and more effective dietary interventions. This overview of the various aspects of supplementation of micronutrients in the era of nutrigenetics and nutrigenomics may provide a better understanding of novel nutritional research approach and provide an additional insight that can be applied to the daily dietary practice.

  13. The Long Term Impact of Micronutrient Supplementation during Infancy on Cognition and Executive Function Performance in Pre-School Children

    Directory of Open Access Journals (Sweden)

    Marisol Warthon-Medina

    2015-08-01

    Full Text Available Brain growth and development are critically dependent on several micronutrients. During early development cellular activity may be sensitive to micronutrient deficiencies, however the evidence from human studies is equivocal. The objective of this study was to examine the long-term cognitive and social-emotional effects of multiple micronutrient supplementation compared with iron supplementation alone, administered during infancy. This study was a follow-up to an initial randomized, double-blind controlled trial (RCT in 2010 in which 902 infants, aged 6–17 months, from Lima, Peru, were given daily supplements of either iron (Fe or multiple micronutrients (MMN including zinc (451 in each group. The supplementation period for both groups was six months. In 2012, a subsample of 184 children from the original cohort (now aged 36–48 months was randomly selected to participate in a follow-up trial and was assessed for intelligence, working memory, inhibition, and executive function. The tests showed no significant differences between the supplementation groups though there were some gender differences, with girls displaying higher scores than boys across both groups on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI Verbal IQ sentences subtest, the Day-Night cognitive test and on the Brief Infant-Toddler Social Emotional Assessment (BITSEA social competency, and boys scoring higher than girls in problem behaviour. The results indicate that MMN supplementation had no long term additional effects on cognitive function compared with iron supplementation alone. The timing of supplement administration for maximum impact on a child’s cognitive development requires further investigation.

  14. The Long Term Impact of Micronutrient Supplementation during Infancy on Cognition and Executive Function Performance in Pre-School Children

    Science.gov (United States)

    Warthon-Medina, Marisol; Qualter, Pamela; Zavaleta, Nelly; Dillon, Stephanie; Lazarte, Fabiola; Lowe, Nicola M.

    2015-01-01

    Brain growth and development are critically dependent on several micronutrients. During early development cellular activity may be sensitive to micronutrient deficiencies, however the evidence from human studies is equivocal. The objective of this study was to examine the long-term cognitive and social-emotional effects of multiple micronutrient supplementation compared with iron supplementation alone, administered during infancy. This study was a follow-up to an initial randomized, double-blind controlled trial (RCT) in 2010 in which 902 infants, aged 6–17 months, from Lima, Peru, were given daily supplements of either iron (Fe) or multiple micronutrients (MMN) including zinc (451 in each group). The supplementation period for both groups was six months. In 2012, a subsample of 184 children from the original cohort (now aged 36–48 months) was randomly selected to participate in a follow-up trial and was assessed for intelligence, working memory, inhibition, and executive function. The tests showed no significant differences between the supplementation groups though there were some gender differences, with girls displaying higher scores than boys across both groups on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) Verbal IQ sentences subtest, the Day-Night cognitive test and on the Brief Infant-Toddler Social Emotional Assessment (BITSEA) social competency, and boys scoring higher than girls in problem behaviour. The results indicate that MMN supplementation had no long term additional effects on cognitive function compared with iron supplementation alone. The timing of supplement administration for maximum impact on a child’s cognitive development requires further investigation. PMID:26262642

  15. Response to Antenatal Cholecalciferol Supplementation Is Associated With Common Vitamin D-Related Genetic Variants.

    Science.gov (United States)

    Moon, Rebecca J; Harvey, Nicholas C; Cooper, Cyrus; D'Angelo, Stefania; Curtis, Elizabeth M; Crozier, Sarah R; Barton, Sheila J; Robinson, Sian M; Godfrey, Keith M; Graham, Nikki J; Holloway, John W; Bishop, Nicholas J; Kennedy, Stephen; Papageorghiou, Aris T; Schoenmakers, Inez; Fraser, Robert; Gandhi, Saurabh V; Prentice, Ann; Inskip, Hazel M; Javaid, M Kassim

    2017-08-01

    Single-nucleotide polymorphisms (SNPs) in genes related to vitamin D metabolism have been associated with serum 25-hydroxyvitamin D [25(OH)D] concentration, but these relationships have not been examined following antenatal cholecalciferol supplementation. To determine whether SNPs in DHCR7, CYP2R1, CYP24A1, and GC are associated with the response to gestational cholecalciferol supplementation. Within-randomization group analysis of the Maternal Vitamin D Osteoporosis Study trial of antenatal cholecalciferol supplementation. Hospital antenatal clinics. In total, 682 women of white ethnicity (351 placebo, 331 cholecalciferol) were included. SNPs at rs12785878 (DHCR7), rs10741657 (CYP2R1), rs6013897 (CYP24A1), and rs2282679 (GC) were genotyped. 1000 IU/d cholecalciferol from 14 weeks of gestation until delivery. 25(OH)D at randomization and 34 weeks of gestation were measured in a single batch (Liaison; Diasorin, Dartford, UK). Associations between 25(OH)D and the SNPs were assessed by linear regression using an additive model [β represents the change in 25(OH)D per additional common allele]. Only rs12785878 (DHCR7) was associated with baseline 25(OH)D [β = 3.1 nmol/L; 95% confidence interval (CI), 1.0 to 5.2 nmol/L; P D status following supplementation, whereas rs12785878 and rs6013897 (CYP24A1) were not. Genetic variation in DHCR7, which encodes 7-dehyrocholesterol reductase in the epidermal vitamin D biosynthesis pathway, appears to modify baseline 25(OH)D. In contrast, the response to antenatal cholecalciferol supplementation was associated with SNPs in CYP2R1, which may alter 25-hydroxylase activity, and GC, which may affect vitamin D binding protein synthesis or metabolite affinity. Copyright © 2017 Endocrine Society

  16. Vitamin A, iron and zinc deficiency in Indonesia : micronutrient interactions and effects of supplementation

    NARCIS (Netherlands)

    Dijkhuizen, M.A.; Wieringa, F.T.

    2001-01-01

    The research described in this thesis was concerned with vitamin A, iron and zinc deficiency in pregnant and lactating women and in infants. The effects of supplementation withβ-carotene, iron and zinc on micronutrient status, growth, pregnancy outcome and immune function, and interactions

  17. Prevalence of antenatal care, use of food supplements during pregnancy and lactation and factors responsible for not taking them in tarlai, urban slum of islamabad

    International Nuclear Information System (INIS)

    Zubair, M.; Adil, M.M.; Alam, A.Y.; Qureshi, A.A.

    2006-01-01

    The objective of this study was to ascertain the prevalence of antenatal care, use of food supplements during pregnancy and lactation and factors responsible for not taking them in Tarlai, an urban slum of Islamabad. A Cross-sectional survey of 100 married women in the age range 15-45 years women utilizing and not utilizing antenatal care facilities during their previous pregnancy was carried out in April 2004. Data was collected through a structured questionnaire and processed and analyzed by using SPPS 10.0. Use of supplements was found high in women attending antenatal care. Realization of the importance of taking a healthy diet during pregnancy was significantly higher among women utilizing antenatal care. In most of the women's the diet remain unchanged. 56% women attended the antenatal care clinics. Those not taking food supplements, 39% were non affording, 21% had no concept of their benefits, 36% did not like to take and 4% felt nausea and vomiting. Just over 50% women received antenatal care. Utilization of antenatal care showed a positive impact on awareness of taking food supplements during pregnancy and lactation. (author)

  18. Prevalence of antenatal care, use of food supplements during pregnancy and lactation and factors responsible for not taking them in tarlai, urban slum of islamabad

    Energy Technology Data Exchange (ETDEWEB)

    Zubair, M; Adil, M M; Alam, A Y; Qureshi, A A [Shifa College of Medicine, Islamabad (Pakistan)

    2006-07-15

    The objective of this study was to ascertain the prevalence of antenatal care, use of food supplements during pregnancy and lactation and factors responsible for not taking them in Tarlai, an urban slum of Islamabad. A Cross-sectional survey of 100 married women in the age range 15-45 years women utilizing and not utilizing antenatal care facilities during their previous pregnancy was carried out in April 2004. Data was collected through a structured questionnaire and processed and analyzed by using SPPS 10.0. Use of supplements was found high in women attending antenatal care. Realization of the importance of taking a healthy diet during pregnancy was significantly higher among women utilizing antenatal care. In most of the women's the diet remain unchanged. 56% women attended the antenatal care clinics. Those not taking food supplements, 39% were non affording, 21% had no concept of their benefits, 36% did not like to take and 4% felt nausea and vomiting. Just over 50% women received antenatal care. Utilization of antenatal care showed a positive impact on awareness of taking food supplements during pregnancy and lactation. (author)

  19. Cluster-randomized non-inferiority trial to compare supplement consumption and adherence to different dosing regimens for antenatal calcium and iron-folic acid supplementation to prevent preeclampsia and anaemia: rationale and design of the Micronutrient Initiative study

    Directory of Open Access Journals (Sweden)

    Moshood O. Omotayo

    2015-11-01

    Full Text Available Background: To prevent pre-eclampsia in populations with insufficient dietary calcium (Ca intake, the World Health Organisation (WHO recommends routine Ca supplementation during antenatal care (ANC. WHO guidelines suggest a complex dosing regimen, requiring as many as 5 pill-taking events per day when combined with iron and folic acid (IFA supplements. Poor adherence may undermine public health effectiveness, so simpler regimens may be preferable. This trial will compare the effect of the WHO-recommended (higher-dose regimen vs. a simpler, lower-dose regimen on supplement consumption and pill-taking behaviours in Kenyan ANC clients. Design and methods: This is a parallel, non-inferiority, cluster-randomized trial; we examined 16 primary care health facilities in Kenya, 1047 pregnant women between 16-30 weeks gestational age. Higher-dose regimen: 1.5 g elemental calcium in 3 separate doses (500 mg Ca/pill and IFA (60 mg Fe + 400 μg folic acid taken with evening dose. Lower-dose regimen: 1.0 g calcium in 2 separate doses (500 mg Ca/pill with IFA taken as above. Measurements: Primary outcome is Ca pills consumed per day, measured by pill counts. Secondary outcomes include IFA pills consumed per day, client knowledge, motivation, social support, and satisfaction, measured at 4 to 10 weeks post-enrolment. Statistical analyses: Unit of randomization is the health-care facility; unit of analysis is individual client. Intent-to-treat analysis will be implemented with multi-level models to account for clustering. Expected public health impact: If pregnant women prescribed lower doses of Ca ingest as many pills as women prescribed the WHO-recommended regimen, developing a lower-dose recommendation for antenatal Ca and IFA supplementation programs could save resources.

  20. The effect of universal maternal antenatal iron supplementation on neurodevelopment in offspring: a systematic review and meta-analysis.

    Science.gov (United States)

    Jayasinghe, C; Polson, R; van Woerden, H C; Wilson, P

    2018-05-04

    Although antenatal iron supplementation is beneficial to mothers, its impact on the neurodevelopment of offspring is controversial. A systematic review and meta-analysis was undertaken to assess whether routine maternal antenatal iron supplementation confers later neurodevelopmental benefit to offspring. Electronic databases were searched using MESH terms or key words and identified papers were reviewed by two independent reviewers. The study quality was assessed using the Cochrane risk of bias assessment tool. The review was registered in the PROSPERO CRD data base. Seven publications were identified, based on four randomised trials published between 2006 and 2016. Three of the trials were in the Asian sub-continent. A range of tools were used to evaluate neurodevelopment. Meta-analysis of outcomes from the three RCTs meeting our inclusion criteria showed minimal effect of antenatal iron supplementation on the neurodevelopment of offspring, which was not statistically significant: weighted mean difference of 0.54 (95% CI: -0.67 to 1.75); test for overall effect Z = 0.87; p = 0.38; and heterogeneity 48%. Meta-analysis of outcomes of these RCTs at later stages of development produced similar results. The benefit of routine antenatal iron supplementation on neurodevelopment in offspring was not statistically significant in this relatively limited set of trials, and some benefit cannot be excluded in areas with a high prevalence of maternal anaemia. A large randomized controlled trial showing significant benefit would be required to modify our conclusions.

  1. Utilization of folic acid and iron supplementation services by pregnant women attending an antenatal clinic at a regional referral hospital in Kenya.

    Science.gov (United States)

    Maina-Gathigi, L; Omolo, J; Wanzala, P; Lindan, C; Makokha, A

    2013-09-01

    To determine utilization of iron and folic acid supplementation services among pregnant women in Kenya. A cross sectional study was conducted at Nyeri Hospital, a regional referral hospital in central Kenya. Women attending the antenatal clinic were selected through systematic sampling. A semi-structured questionnaire was administered to collect information on utilization of folic acid and iron supplementation services. Women who ingested folic acid or iron supplements for >4 days in a week were considered "highly compliant". The health worker in-charge of the antenatal clinic was interviewed about the frequency of supplement stock-outs during the past year. Haemoglobin concentration was measured directly from one drop of capillary blood and measured using portable HEMOCUE B-Hb photometer. Of the 381 women interviewed, only 23.6 % obtained antenatal care in the first trimester; 69.3 and 51.2 % received folic acid and iron supplements, respectively. However, only half (45-58 %) received any information about supplementation. Most women were initiated on folic acid (80.7 %) or iron (67.7 %) after 12 and 16 weeks of gestation, respectively, well after the recommended time period. However, more than 80 % of those who received folic acid and iron were highly compliant. Stock-outs were common at the facility. Of 361 women tested for Hb level, the prevalence of anaemia (Hb levels importance of supplements to pregnant women. Women who come late to antenatal clinic miss opportunities to start supplementation early in pregnancy. Problems with supply chain management exacerbate the problem.

  2. Effect of supplementation with a lipid-based nutrient supplement on the micronutrient status of children aged 6–18 months living in the rural region of Intibucá, Honduras

    Science.gov (United States)

    Background: Lipid-based nutrient supplements (LNS) have been effective in the treatment of acute malnutrition among children. We evaluated the use of LNS supplementation for improving the micronutrient status of young children. Methods: A 12-month randomised controlled trial was conducted among chil...

  3. Drug-micronutrient interactions: food for thought and thought for action.

    Science.gov (United States)

    Karadima, Vasiliki; Kraniotou, Christina; Bellos, George; Tsangaris, George Th

    2016-01-01

    Micronutrients are indispensable for a variety of vital functions. Micronutrient deficiencies are a global problem concerning two billion people. In most cases, deficiencies are treatable with supplementation of the elements in lack. Drug-nutrient interactions can also lead to micronutrient reduce or depletion by various pathways. Supplementation of the elements and long-term fortification programs for populations at risk can prevent and restore the related deficiencies. Within the context of Predictive, Preventive, and Personalized Medicine, a multi-professional network should be developed in order to identify, manage, and prevent drug-micronutrient interactions that can potentially result to micronutrient deficiencies.

  4. Micronutrient intake in relation to all-cause mortality in a prospective Danish cohort

    DEFF Research Database (Denmark)

    Roswall, Nina; Olsen, Anja; Christensen, Jane

    2012-01-01

    and supplements, and overall mortality. Furthermore, to examine effect modification by smoking, alcohol intake, and BMI and to investigate if the effect of supplement use differs with dietary micronutrient intake. Methods and Material: In a prospective cohort study of 55,453 middle-aged Danes, information...... regarding diet, supplement use, and lifestyle was collected through questionnaires. During follow-up, 6,767 deaths were identified and incidence rate ratios (IRRs) of mortality related to micronutrient intake were calculated using Cox proportional hazards models. Results: The present study found no effect......, was suggested in relation to some dietary micronutrients. The effect of supplements did not differ in groups defined by dietary micronutrient intake. Conclusion: This study suggests no effect of dietary micronutrients in relation to overall mortality. Supplemental folic acid was found to be associated...

  5. Combined food and micronutrient supplements during pregnancy have limited impact on child blood pressure and kidney function in rural Bangladesh.

    Science.gov (United States)

    Hawkesworth, Sophie; Wagatsuma, Yukiko; Kahn, Ashraf I; Hawlader, Mohammad D H; Fulford, Anthony J C; Arifeen, Shams-El; Persson, Lars-Åke; Moore, Sophie E

    2013-05-01

    Observational evidence suggests nutritional exposures during in utero development may have long-lasting consequences for health; data from interventions are scarce. Here, we present a trial follow-up study to assess the association between prenatal food and micronutrient supplementation and childhood blood pressure and kidney function. During the MINIMat Trial in rural Bangladesh, women were randomly assigned early in pregnancy to receive an early or later invitation to attend a food supplementation program and additionally to receive either iron and folate or multiple micronutrient tablets daily. The 3267 singleton birth individuals with measured anthropometry born during the trial were eligible for a follow-up study at 4.5 y old. A total of 77% of eligible individuals were recruited and blood pressure, kidney size by ultrasound, and glomerular filtration rate (GFR; calculated from plasma cystatin c) were assessed. In adjusted analysis, early invitation to food supplementation was associated with a 0.72-mm Hg [(95% CI: 0.16, 1.28); P = 0.01] lower childhood diastolic blood pressure and maternal MMS supplementation was associated with a marginally higher [0.87 mm Hg (95% CI: 0.18, 1.56); P = 0.01] childhood diastolic blood pressure. There was also some evidence that a supplement higher in iron was associated with a higher offspring GFR. No other effects of the food or micronutrient interventions were observed and there was no interaction between the interventions on the outcomes studied. These marginal associations and small effect sizes suggest limited public health importance in early childhood.

  6. The historical evolution of thought regarding multiple micronutrient nutrition.

    Science.gov (United States)

    Semba, Richard D

    2012-01-01

    Multiple micronutrient nutrition is an idea that originated in the 1940s and exemplifies the iterative nutritional paradigm. In the first four decades of the 20th century, scientists sought to separate and characterize the vitamins that were responsible for xerophthalmia, rickets, pellagra, scurvy, and beriberi. The dietary requirements of the different micronutrients began to be established in the early 1940s. Surveys showed that multiple micronutrient deficiencies were widespread in industrialized countries, and the problem was addressed by use of cod-liver oil, iodized salt, fortified margarine, and flour fortification with multiple micronutrients, and, with rising living standards, the increased availability and consumption of animal source foods. After World War II, surveys showed that multiple micronutrient deficiencies were widespread in developing countries. Approaches to the elimination of multiple micronutrient deficiencies include periodic vitamin A supplementation, iodized salt, targeted iron/folate supplementation, fortified flour, other fortified foods, home fortification with micronutrient powders, and homestead food production. The prevention of multiple micronutrient malnutrition is a key factor in achieving the Millennium Development Goals, given the important effects of micronutrients on health and survival.

  7. Effect of antenatal zinc supplementation on impetigo in infants in Bangladesh.

    Science.gov (United States)

    Darmstadt, Gary L; Osendarp, Saskia J M; Ahmed, Saifuddin; Feldman, Candace; Van Raaij, Joop M A; Baqui, Abdullah H; Hautvast, J G A J; Fuchs, George J

    2012-04-01

    We sought to determine the effects of maternal zinc supplementation on skin infections among infants in poor urban areas of Dhaka, Bangladesh. A double-blind, placebo-controlled, randomized trial was conducted among 199 and 221 Bangladeshi infants whose mothers were administered 30 mg daily of zinc or placebo, respectively. The mothers received zinc supplementation from 12-16 weeks' gestation until delivery, and the infants were followed up until 6 months of age. Among the infants of mothers who received zinc supplementation during the antenatal period, 10.6% had at least 1 episode of impetigo compared with 19.6% of the infants of mothers in the placebo group (P = 0.01). Infants in the treatment group had a 54% reduction in incidence rate of episodes of impetigo when compared with infants in the placebo group (P = 0.01). The effect of zinc supplementation was more pronounced among male infants (64% reduction) and intrauterine growth restricted and low birth weight infants (73% reduction) and among infants of mothers with increased parity (60% reduction) or decreased socioeconomic status (71% reduction).

  8. Micronutrient supplements during pregnancy and/or lactation in Malawi and Ghana increase breast milk B-vitamins [abstract

    Science.gov (United States)

    There are few data available on the effect of micronutrient (MN) supplementation interventions during pregnancy/lactation on breast milk (BM) MN concentrations. Exclusive breast feeding is recommended fort 6mo and BM-MN concentrations are important determinants of infant MN status, growth and devel...

  9. Micronutrient Intakes in 553 Dutch Elite and Sub-Elite Athletes: Prevalence of Low and High Intakes in Users and Non-Users of Nutritional Supplements

    NARCIS (Netherlands)

    Wardenaar, Floris; Brinkmans, Naomi; Ceelen, Ingrid; Rooij, Van Bo; Mensink, Marco; Witkamp, Renger; Vries, De Jeanne

    2017-01-01

    This study investigated whether athletes meet micronutrient recommendations and whether the adequacy of their intake is related to the use of dietary supplements, sport nutrition products or a combination. Micronutrient intakes of 553 Dutch (sub-) elite athletes were assessed using web-based 24-h

  10. Drug-micronutrient interactions: food for thought and thought for action

    OpenAIRE

    Karadima, Vasiliki; Kraniotou, Christina; Bellos, George; Tsangaris, George Th.

    2016-01-01

    Micronutrients are indispensable for a variety of vital functions. Micronutrient deficiencies are a global problem concerning two billion people. In most cases, deficiencies are treatable with supplementation of the elements in lack. Drug-nutrient interactions can also lead to micronutrient reduce or depletion by various pathways. Supplementation of the elements and long-term fortification programs for populations at risk can prevent and restore the related deficiencies. Within the context of...

  11. Effects of micronutrients on oxidative stress in HIV positive patients ...

    African Journals Online (AJOL)

    Micronutrient supplementation was therefore shown to reduce oxidative stress in HIV positive patients on HAART and could possibly be very helpful as an adjunct in the treatment of this disease. Key Words: Antiretroviral, micronutrients, malondialdehyde, ART naïve, reactive oxygen species, supplementation.

  12. Maternal cortisol and stress are associated with birth outcomes, but are not affected by lipid-based micronutrient supplements during pregnancy: an analysis of data from a randomized controlled trial in rural Malawi

    Science.gov (United States)

    Background: Prenatal micronutrient supplements have been found to increase birth weight, but mechanisms for increased growth are poorly understood. Our hypotheses were that 1) women who receive lipid-based micronutrient supplements (LNS) during pregnancy would have lower salivary cortisol concentrat...

  13. MICRONUTRIENT THERAPY FOR SEPSIS

    Directory of Open Access Journals (Sweden)

    Agung Prasetiyo

    2015-05-01

    Full Text Available Micronutrients are nutrients which are needed by the body to perform the function of body. The amounts is less than 100% μg per day and consist of vitamins and minerals. It cannot be synthesized in the body. Research in the US mentioned that the rate prevalence of sepsis is tended to be increased 8.7 % annually. In sepsis, nutrition is one of the important component which could drive the success treatment. Micronutrient, especially a vitamin which is soluble in fats, it would be toxic if the number exceed the capability of body to receive it. Although there are guidance and mutual agreement about sepsis using, it still need to concern on micronutrient which potentially giving bad effect. In sepsis case, micronutrients also determine the success of treatment due to redistribution of vitamin and trace element from circulation to the tissue which involved in the proteins formation and immune system. The conclusions of the latest 7 experiments and 4 random controlled studies of multi-centre support the micronutrients supplementation because it can decrease mortality rate. However, it still need to be aware to the toxicity of fat soluble micronutrient if the doses are excessive.

  14. Simple educational intervention will improve the efficacy of routine antenatal iron supplementation.

    Science.gov (United States)

    Senanayake, Hemantha M; Premaratne, Samanthi P; Palihawadana, Thilina; Wijeratne, Sumeda

    2010-06-01

    Sri Lanka has a policy of free provision of iron supplements to pregnant women. However, iron deficiency anemia remains common in pregnancy. We tested the hypothesis that educating women regarding improving bioavailability could improve the efficacy of iron supplementation. The education focused on how best supplements could be taken and on how they should be stored. We carried out a study using a quasi-experimental design on a group of women attending for antenatal care at a suburban University Obstetric Unit in Sri Lanka. The control group had care free of charge including iron supplementation and antihelminthic therapy. In addition, the study group received an education in small groups regarding maximizing bioavailability of iron. Hemoglobin and iron status of the women were compared between the groups at recruitment and at 34 weeks of gestation. The two groups were equally matched in demographic data, and hemoglobin and iron status. There were significant differences between the two groups at 34 weeks in the hemoglobin levels, serum ferritin levels, anemia rates and the number with low ferritin (P tablets in ways that improved their bioavailability. A simple health education improved the efficacy of iron supplementation in this population. Such interventions should be an integral part of iron supplementation programs, especially in populations whose habits tend to reduce the bioavailability of iron.

  15. The effect of maternal multiple micronutrient supplementation on cognition and mood during pregnancy and postpartum in Indonesia: a randomized trial.

    Directory of Open Access Journals (Sweden)

    Elizabeth L Prado

    Full Text Available Maternal caregiving capacity, which is affected in part by cognition and mood, is crucial for the health of mothers and infants. Few interventions aim to improve maternal and infant health through improving such capacity. Multiple micronutrient (MMN supplementation may improve maternal cognition and mood, since micronutrients are essential for brain function. We assessed mothers who participated in the Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT, a double-blind cluster-randomized trial in Indonesia comparing MMN supplementation to iron and folic acid (IFA during pregnancy and until three months postpartum. We adapted a set of well-studied tests of cognition, motor dexterity, and mood to the local context and administered them to a random sample of 640 SUMMIT participants after an average of 25 weeks (SD = 9 of supplementation. Analysis was by intention to treat. Controlling for maternal age, education, and socio-economic status, MMN resulted in a benefit of 0.12 SD on overall cognition, compared to IFA (95%CI 0.03-0.22, p = .010, and a benefit of 0.18 SD on reading efficiency (95%CI 0.02-0.35, p = .031. Both effects were found particularly in anemic (hemoglobin<110 g/L; overall cognition: B = 0.20, 0.00-0.41, p = .055; reading: B = 0.40, 0.02-0.77, p = .039 and undernourished (mid-upper arm circumference<23.5 cm; overall cognition: B = 0.33, 0.07-0.59, p = .020; reading: B = 0.65, 0.19-1.12, p = .007 mothers. The benefit of MMN on overall cognition was equivalent to the benefit of one year of education for all mothers, to two years of education for anemic mothers, and to three years of education for undernourished mothers. No effects were found on maternal motor dexterity or mood. This is the first study demonstrating an improvement in maternal cognition with MMN supplementation. This improvement may increase the quality of care mothers provide for their infants, potentially partly mediating effects of maternal MMN

  16. The association of maternal social factors and antenatal care with ...

    African Journals Online (AJOL)

    Zinc is a crucial micronutrient in early childhood survival and the development of innate and acquired immunity. The objective is to determine the relationship between of maternal social class and antenatal care to serum zinc level in newborns in a tertiary and a rural hospital. It is prospective study using questionnaires on ...

  17. Impact of Food Rations and Supplements on Micronutrient Status by Trimester of Pregnancy: Cross-Sectional Studies in the Maela Refugee Camp in Thailand

    Directory of Open Access Journals (Sweden)

    Wolfgang Stuetz

    2016-01-01

    Full Text Available Micronutrient fortified flour (MFF, supplementary food rations and micronutrient (MN supplements may prevent deficiencies among pregnant women. Objectives of cross-sectional surveys in 2004 (n = 533 and 2006 (n = 515 were to assess the impact of new food rations (flour, oil and supplements on MN status by trimester of pregnancy in the Maela refugee camp. Hemoglobin, iron status, zinc, retinol, β-carotene and tryptophan decreased, while α-/γ-tocopherol and 5-methyltetrahydrofolate (5-MTHF increased from first to third trimester. In 2006, mean zinc and α-tocopherol for each trimester was significantly higher than in 2004. The weeks of supplemented thiamine and folic acid were positively correlated with thiamine diphosphate (TDP and 5-MTHF, but not for ferrous sulfate as iron deficiency was observed in 38.5% of third-trimester women. Frequent consumption of fish paste and owning a garden or animal were associated with significantly higher iron status, retinol, β-carotene, and 5-MTHF. In conclusion, MFF and supplementary oil were most likely to explain improved zinc and α-tocopherol status, while thiamine and folate supplements ensured high TDP and 5-MTHF in late pregnancy. MN supplements, MN-rich staple food, small gardens, and programs to improve iron compliance are promising strategies to prevent MN deficiencies during pregnancy in vulnerable populations.

  18. Effects of prenatal food and micronutrient supplementation on child growth from birth to 54 months of age: a randomized trial in Bangladesh

    Directory of Open Access Journals (Sweden)

    Khan Ashraful

    2011-12-01

    Full Text Available Abstract Background There is a lack of information on the optimal timing of food supplementation to malnourished pregnant women and possible combined effects of food and multiple micronutrient supplementations (MMS on their offspring's growth. We evaluated the effects of prenatal food and micronutrient interventions on postnatal child growth. The hypothesis was that prenatal MMS and early invitation to food supplementation would increase physical growth in the offspring during 0-54 months and a combination of these interventions would further improve these outcomes. Methods In the large, randomized MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab, Bangladesh, 4436 pregnant women were enrolled between November 2001 and October 2003 and their children were followed until March 2009. Participants were randomized into six groups comprising 30 mg Fe and 400 μg folic acid (Fe30F, 60 mg Fe and 400 μg folic acid (Fe60F or MMS combined with either an early (immediately after identification of pregnancy or a later usual (at the time of their choosing, i.e., usual care in this community program invitation to food supplementation. The anthropometry of 3267 children was followed from birth to 54 months, and 2735 children were available for analysis at 54 months. Results There were no differences in characteristics of mothers and households among the different intervention groups. The average birth weight was 2694 g and birth length was 47.7 cm, with no difference among intervention groups. Early invitation to food supplementation (in comparison with usual invitation reduced the proportion of stunting from early infancy up to 54 months for boys (p = 0.01, but not for girls (p = 0.31. MMS resulted in more stunting than standard Fe60F (p = 0.02. There was no interaction between the food and micronutrient supplementation on the growth outcome. Conclusions Early food supplementation in pregnancy reduced the occurrence of stunting during 0

  19. Micronutrients in HIV: a Bayesian meta-analysis.

    Directory of Open Access Journals (Sweden)

    George M Carter

    Full Text Available Approximately 28.5 million people living with HIV are eligible for treatment (CD4<500, but currently have no access to antiretroviral therapy. Reduced serum level of micronutrients is common in HIV disease. Micronutrient supplementation (MNS may mitigate disease progression and mortality.We synthesized evidence on the effect of micronutrient supplementation on mortality and rate of disease progression in HIV disease.We searched MEDLINE, EMBASE, the Cochrane Central, AMED and CINAHL databases through December 2014, without language restriction, for studies of greater than 3 micronutrients versus any or no comparator. We built a hierarchical Bayesian random effects model to synthesize results. Inferences are based on the posterior distribution of the population effects; posterior distributions were approximated by Markov chain Monte Carlo in OpenBugs.From 2166 initial references, we selected 49 studies for full review and identified eight reporting on disease progression and/or mortality. Bayesian synthesis of data from 2,249 adults in three studies estimated the relative risk of disease progression in subjects on MNS vs. control as 0.62 (95% credible interval, 0.37, 0.96. Median number needed to treat is 8.4 (4.8, 29.9 and the Bayes Factor 53.4. Based on data reporting on 4,095 adults reporting mortality in 7 randomized controlled studies, the RR was 0.84 (0.38, 1.85, NNT is 25 (4.3, ∞.MNS significantly and substantially slows disease progression in HIV+ adults not on ARV, and possibly reduces mortality. Micronutrient supplements are effective in reducing progression with a posterior probability of 97.9%. Considering MNS low cost and lack of adverse effects, MNS should be standard of care for HIV+ adults not yet on ARV.

  20. Early invitation to food and/or multiple micronutrient supplementation in pregnancy does not affect body composition in offspring at 54 months: follow-up of the MINIMat randomised trial, Bangladesh.

    Science.gov (United States)

    Khan, Ashraful Islam; Kabir, Iqbal; Hawkesworth, Sophie; Ekström, Eva-Charlotte; Arifeen, Shams; Frongillo, Edward A; Persson, Lars Åke

    2015-07-01

    Growth patterns in early life are associated with later health. The effect of nutrition during in utero development on later body composition is unclear. We evaluated whether prenatal early invitation to food and/or multiple micronutrient supplementation (MMS) in pregnancy has an effect on offspring body composition at 54 months of age. In Maternal and Infant Nutrition Interventions in Matlab trial (ISRCTN16581394) in Bangladesh, 4436 pregnant women were randomised into six equally sized groups: double-masked supplementation with capsules of either 30 mg Fe and 400 μg folic acid, or 60 mg Fe and 400 μg folic acid, or MMS (15 micronutrients), was combined with a randomised early invitation (around 9 weeks) or a usual invitation (around 20 weeks) to start food supplementation (608 kcal 6 days per week). At 54 months, the body composition of the offspring was assessed by leg-to-leg bioelectrical impedance analysis. Of the 3267 live singletons with birth anthropometry, 2290 children were measured at 54 months, representing 70% of the live births. There was no interaction between the food and micronutrient supplementation on body composition outcomes. There were no significant differences in a range of anthropometric and body composition measurements, including weight, height, mid-upper arm circumference, head circumference, skinfold thickness, and fat mass and fat-free mass between the different prenatal food and micronutrient groups using an intention-to-treat analysis. This analysis shows that early invitation to food supplementation and MMS provided to rural Bangladeshi women during pregnancy did not affect offspring body composition at 54 months of age. © 2012 Blackwell Publishing Ltd.

  1. Daily multi-micronutrient supplementation during tuberculosis treatment increases weight and grip strength among HIV-uninfected but not HIV-infected patients in Mwanza, Tanzania

    DEFF Research Database (Denmark)

    PrayGod, George; Range, Nyagosya; Faurholt-Jepsen, Daniel

    2011-01-01

    Undernutrition is common among tuberculosis (TB) patients. The objective of this study was to assess the effect of multi-micronutrient supplementation during TB treatment on weight, body composition, and handgrip strength. A total of 865 patients with smear-positive (PTB+) or -negative (PTB......-) pulmonary TB were randomly allocated to receive a daily biscuit with or without multi-micronutrients for 60 d during the intensive phase of TB treatment. Weight, arm fat area, arm muscle area, and handgrip strength were assessed at baseline and after 2 and 5 mo. At 2 mo, the multi...

  2. Micronutrient intake of HIV-infected women in Mangaung, Free State ...

    African Journals Online (AJOL)

    Conclusions. Insufficient micronutrient intakes are common in both HIV-infected and uninfected women. A well-balanced diet and micronutrient supplementation seem warranted to ensure optimal health and survival, particularly in HIV-infected women. South African Journal of Clinical Nutrition Vol. 20 (1) 2007: pp. 28-36 ...

  3. Intake of macro- and micronutrients in Danish vegans.

    Science.gov (United States)

    Kristensen, Nadja B; Madsen, Mia L; Hansen, Tue H; Allin, Kristine H; Hoppe, Camilla; Fagt, Sisse; Lausten, Mia S; Gøbel, Rikke J; Vestergaard, Henrik; Hansen, Torben; Pedersen, Oluf

    2015-10-30

    Since information about macro- and micronutrient intake among vegans is limited we aimed to determine and evaluate their dietary and supplementary intake. Seventy 18-61 years old Danish vegans completed a four-day weighed food record from which their daily intake of macro- and micronutrients was assessed and subsequently compared to an age-range-matched group of 1,257 omnivorous individuals from the general Danish population. Moreover, the vegan dietary and supplementary intake was compared to the 2012 Nordic Nutrition Recommendations (NNR). Dietary intake differed significantly between vegans and the general Danish population in all measured macro- and micronutrients (p vegans the intake of macro- and micronutrients (including supplements) did not reach the NNR for protein, vitamin D, iodine and selenium. Among vegan women vitamin A intake also failed to reach the recommendations. With reference to the NNR, the dietary content of added sugar, sodium and fatty acids, including the ratio of PUFA to SFA, was more favorable among vegans. At the macronutrient level, the diet of Danish vegans is in better accordance with the NNR than the diet of the general Danish population. At the micronutrient level, considering both diet and supplements, the vegan diet falls short in certain nutrients, suggesting a need for greater attention toward ensuring recommended daily intake of specific vitamins and minerals.

  4. Effect of supplementation with a lipid-based nutrient supplement on the micronutrient status of children aged 6-18 months living in the rural region of Intibucá, Honduras.

    Science.gov (United States)

    Siega-Riz, Anna M; Estrada Del Campo, Yaniré; Kinlaw, Alan; Reinhart, Gregory A; Allen, Lindsay H; Shahab-Ferdows, Setareh; Heck, Jeff; Suchindran, Chirayath M; Bentley, Margaret E

    2014-05-01

    Lipid-based nutrient supplements (LNS) have been effective in the treatment of acute malnutrition among children. We evaluated the use of LNS supplementation for improving the micronutrient status of young children. A 12-month randomised controlled trial was conducted among children aged 6-18 months living in Intibucá, Honduras. Communities (n = 18) were randomised into clusters matched by poverty indicators (9 intervention, n = 160 and 9 controls, n = 140). Intervention participants received LNS. All children received food vouchers and nutrition education. Primary outcomes included measures of micronutrient status: at baseline, 6 and 12 months' blood were collected for assessment of folate, iron, zinc, riboflavin, and vitamin B12 status; haemoglobin was measured every 3 months; and dietary and anthropometry collected monthly. Longitudinal analyses were based on intent to treat and LNS adherence. Generalised estimating equations were used in the estimation of generalised linear regression models specified for the data. At 6-month follow-up, children in the intervention group had a lower proportion classified as deficient for B12 (43.6%) compared with the control (67.7%; P = 0.03). The intervention group had a higher mean concentration for folate at 6 months (P = 0.06), and improvements continued through 12 months for folate (P = 0.002) and vitamin A deficiency (P = 0.03). This pattern of results, with improved significance, remained in subanalysis based on LNS adherence. These data demonstrate that LNS improved select micronutrient status in young non-malnourished Honduran children. © 2014 John Wiley & Sons Ltd.

  5. Rationale, design, methodology and sample characteristics for the Vietnam pre-conceptual micronutrient supplementation trial (PRECONCEPT: a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Nguyen Phuong H

    2012-10-01

    Full Text Available Abstract Background Low birth weight and maternal anemia remain intractable problems in many developing countries. The adequacy of the current strategy of providing iron-folic acid (IFA supplements only during pregnancy has been questioned given many women enter pregnancy with poor iron stores, the substantial micronutrient demand by maternal and fetal tissues, and programmatic issues related to timing and coverage of prenatal care. Weekly IFA supplementation for women of reproductive age (WRA improves iron status and reduces the burden of anemia in the short term, but few studies have evaluated subsequent pregnancy and birth outcomes. The Preconcept trial aims to determine whether pre-pregnancy weekly IFA or multiple micronutrient (MM supplementation will improve birth outcomes and maternal and infant iron status compared to the current practice of prenatal IFA supplementation only. This paper provides an overview of study design, methodology and sample characteristics from baseline survey data and key lessons learned. Methods/design We have recruited 5011 WRA in a double-blind stratified randomized controlled trial in rural Vietnam and randomly assigned them to receive weekly supplements containing either: 1 2800 μg folic acid 2 60 mg iron and 2800 μg folic acid or 3 MM. Women who become pregnant receive daily IFA, and are being followed through pregnancy, delivery, and up to three months post-partum. Study outcomes include birth outcomes and maternal and infant iron status. Data are being collected on household characteristics, maternal diet and mental health, anthropometry, infant feeding practices, morbidity and compliance. Discussion The study is timely and responds to the WHO Global Expert Consultation which identified the need to evaluate the long term benefits of weekly IFA and MM supplementation in WRA. Findings will generate new information to help guide policy and programs designed to reduce the burden of anemia in women and

  6. A factorial randomized controlled trial to evaluate the effect of micronutrients supplementation and regular aerobic exercise on maternal endothelium-dependent vasodilatation and oxidative stress of the newborn.

    Science.gov (United States)

    Ramírez-Vélez, Robinson; Romero, Miryam; Echeverri, Isabella; Ortega, José Guillermo; Mosquera, Mildrey; Salazar, Blanca; Girón, Sandra Lorena; Saldarriaga, Wilmar; Aguilar de Plata, Ana Cecilia; Mateus, Julio Cesar

    2011-02-28

    Many studies have suggested a relationship between metabolic abnormalities and impaired fetal growth with the development of non-transmissible chronic diseases in the adulthood. Moreover, it has been proposed that maternal factors such as endothelial function and oxidative stress are key mechanisms of both fetal metabolic alterations and subsequent development of non-transmissible chronic diseases. The objective of this project is to evaluate the effect of micronutrient supplementation and regular aerobic exercise on endothelium-dependent vasodilation maternal and stress oxidative of the newborn. 320 pregnant women attending to usual prenatal care in Cali, Colombia will be included in a factorial randomized controlled trial. Women will be assigned to the following intervention groups: 1. usual prenatal care (PC) and placebo (maltodextrine). 2. Exercise group: PC, placebo and aerobic physical exercise. 3. Micronutrients group: PC and a micronutrients capsule consisting of zinc (30 mg), selenium (70 μg), vitamin A (400 μg), alphatocopherol (30 mg), vitamin C (200 mg), and niacin (100 mg). 4. Combined interventions Group: PC, supplementation of micronutrients, and aerobic physical exercise. Anthropometric measures will be taken at the start and at the end of the interventions. Since in previous studies has been showed that the maternal endothelial function and oxidative stress are related to oxidative stress of the newborn, this study proposes that complementation with micronutrients during pregnancy and/or regular physical exercise can be an early and innovative alternative to strengthen the prevention of chronic diseases in the population. NCT00872365.

  7. Antenatal calcium intake in Malaysia.

    Science.gov (United States)

    Mahdy, Zaleha Abdullah; Basri, Hashimah; Md Isa, Zaleha; Ahmad, Shuhaila; Shamsuddin, Khadijah; Mohd Amin, Rahmah

    2014-04-01

    To determine the adequacy of antenatal calcium intake in Malaysia, and the influencing factors. A cross-sectional study was conducted among postnatal women who delivered in two tertiary hospitals. Data were collected from antenatal cards, hospital documents and diet recall on daily milk and calcium intake during pregnancy. SPSS version 19.0 was used for statistical analyses. A total of 150 women were studied. The total daily calcium intake was 834 ± 43 mg (mean ± standard error of the mean), but the calcium intake distribution curve was skewed to the right with a median intake of 725 mg daily. When calcium intake from milk and calcium supplements was excluded, the daily dietary calcium intake was only 478 ± 25 mg. Even with inclusion of milk and calcium supplements, more than a third (n=55 or 36.7%) of the women consumed less than 600 mg calcium in their daily diet. The adequacy of daily calcium intake was not influenced by maternal age, ethnicity, income or maternal job or educational status as well as parity. The daily dietary calcium intake of the Malaysian antenatal population is far from adequate without the addition of calcium supplements and milk. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

  8. Local foods can meet micronutrient needs for women in urban Burkina Faso, but only if rarely consumed micronutrient-dense foods are included in daily diets: A linear programming exercise.

    Science.gov (United States)

    Arimond, Mary; Vitta, Bineti S; Martin-Prével, Yves; Moursi, Mourad; Dewey, Kathryn G

    2018-01-01

    Women of reproductive age are at nutritional risk due to their need for nutrient-dense diets. Risk is further elevated in resource-poor environments. In one such environment, we evaluated feasibility of meeting micronutrient needs of women of reproductive age using local foods alone or using local foods and supplements, while minimizing cost. Based on dietary recall data from Ouagadougou, we used linear programming to identify the lowest cost options for meeting 10 micronutrient intake recommendations, while also meeting energy needs and following an acceptable macronutrient intake pattern. We modeled scenarios with maximum intake per food item constrained at the 75th percentile of reported intake and also with more liberal maxima based on recommended portions per day, with and without the addition of supplements. Some scenarios allowed only commonly consumed foods (reported on at least 10% of recall days). We modeled separately for pregnant, lactating, and nonpregnant, nonlactating women. With maxima constrained to the 75th percentile, all micronutrient needs could be met with local foods but only when several nutrient-dense but rarely consumed items were included in daily diets. When only commonly consumed foods were allowed, micronutrient needs could not be met without supplements. When larger amounts of common animal-source foods were allowed, all needs could be met for nonpregnant, nonlactating women but not for pregnant or lactating women, without supplements. We conclude that locally available foods could meet micronutrient needs but that to achieve this, strategies would be needed to increase consistent availability in markets, consistent economic access, and demand. © 2017 John Wiley & Sons Ltd.

  9. The Importance of Antioxidant Micronutrients in Pregnancy

    Directory of Open Access Journals (Sweden)

    Hiten D. Mistry

    2011-01-01

    Full Text Available Pregnancy places increased demands on the mother to provide adequate nutrition to the growing conceptus. A number of micronutrients function as essential cofactors for or themselves acting as antioxidants. Oxidative stress is generated during normal placental development; however, when supply of antioxidant micronutrients is limited, exaggerated oxidative stress within both the placenta and maternal circulation occurs, resulting in adverse pregnancy outcomes. The present paper summarises the current understanding of selected micronutrient antioxidants selenium, copper, zinc, manganese, and vitamins C and E in pregnancy. To summarise antioxidant activity of selenium is via its incorporation into the glutathione peroxidase enzymes, levels of which have been shown to be reduced in miscarriage and preeclampsia. Copper, zinc, and manganese are all essential cofactors for superoxide dismutases, which has reduced activity in pathological pregnancy. Larger intervention trials are required to reinforce or refute a beneficial role of micronutrient supplementation in disorders of pregnancies.

  10. A factorial randomized controlled trial to evaluate the effect of micronutrients supplementation and regular aerobic exercise on maternal endothelium-dependent vasodilatation and oxidative stress of the newborn

    Directory of Open Access Journals (Sweden)

    Girón Sandra

    2011-02-01

    Full Text Available Abstract Background Many studies have suggested a relationship between metabolic abnormalities and impaired fetal growth with the development of non-transmissible chronic diseases in the adulthood. Moreover, it has been proposed that maternal factors such as endothelial function and oxidative stress are key mechanisms of both fetal metabolic alterations and subsequent development of non-transmissible chronic diseases. The objective of this project is to evaluate the effect of micronutrient supplementation and regular aerobic exercise on endothelium-dependent vasodilation maternal and stress oxidative of the newborn. Methods and design 320 pregnant women attending to usual prenatal care in Cali, Colombia will be included in a factorial randomized controlled trial. Women will be assigned to the following intervention groups: 1. Control group: usual prenatal care (PC and placebo (maltodextrine. 2. Exercise group: PC, placebo and aerobic physical exercise. 3. Micronutrients group: PC and a micronutrients capsule consisting of zinc (30 mg, selenium (70 μg, vitamin A (400 μg, alphatocopherol (30 mg, vitamin C (200 mg, and niacin (100 mg. 4. Combined interventions Group: PC, supplementation of micronutrients, and aerobic physical exercise. Anthropometric measures will be taken at the start and at the end of the interventions. Discussion Since in previous studies has been showed that the maternal endothelial function and oxidative stress are related to oxidative stress of the newborn, this study proposes that complementation with micronutrients during pregnancy and/or regular physical exercise can be an early and innovative alternative to strengthen the prevention of chronic diseases in the population. Trial registration NCT00872365.

  11. Impact of Preconception Micronutrient Supplementation on Anemia and Iron Status during Pregnancy and Postpartum: A Randomized Controlled Trial in Rural Vietnam.

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    Phuong H Nguyen

    Full Text Available Preconception micronutrient interventions may be a promising approach to reduce anemia and iron deficiency during pregnancy, but currently we have limited data to inform policies. We evaluated whether providing additional pre-pregnancy weekly iron-folic acid (IFA or multiple micronutrient (MM supplements compared to only folic acid (FA improves iron status and anemia during pregnancy and early postpartum.We conducted a double blind randomized controlled trial in which 5011 Vietnamese women were provided with weekly supplements containing either only 2800 μg FA (control group, IFA (60 mg Fe and 2800 μg FA or MM (15 micronutrients with similar amounts of IFA. All women who became pregnant (n = 1813 in each of the 3 groups received daily IFA (60 mg Fe and 400 μg FA through delivery. Hematological indicators were assessed at baseline (pre-pregnancy, during pregnancy, 3 months post-partum, and in cord blood. Adjusted generalized linear models were applied to examine the impact of preconception supplementation on anemia and iron stores, using both intention to treat and per protocol analyses (women consumed supplements ≥ 26 weeks before conception.At baseline, 20% of women were anemic, but only 14% had low iron stores (ferritin <30 μg/L and 3% had iron deficiency (ferritin <12 μg/L. The groups were balanced for baseline characteristics. Anemia prevalence increased during pregnancy and post-partum but was similar among intervention groups. In intention to treat analyses, prenatal ferritin was significantly higher among women receiving MM (geometric mean (μg/L [95% CI]: 93.6 [89.3-98.2] and IFA (91.9 [87.6-96.3] compared to control (85.3 [81.5-89.2]. In per protocol analyses, women receiving MM or IFA had higher ferritin 3 months postpartum (MM 118.2 [109.3-127.8], IFA 117.8 [108.7-127.7] vs control 101.5 [94.0-109.7] and gave birth to infants with greater iron stores (MM 184.3 [176.1-192.9], IFA 189.9 [181.6-198.3] vs control 175.1 [167

  12. Zinc or multiple micronutrient supplementation to reduce diarrhea and respiratory disease in South African children: a randomized controlled trial.

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    Kany-Kany Angelique Luabeya

    2007-06-01

    Full Text Available Prophylactic zinc supplementation has been shown to reduce diarrhea and respiratory illness in children in many developing countries, but its efficacy in children in Africa is uncertain.To determine if zinc, or zinc plus multiple micronutrients, reduces diarrhea and respiratory disease prevalence.Randomized, double-blind, controlled trial.Rural community in South Africa.THREE COHORTS: 32 HIV-infected children; 154 HIV-uninfected children born to HIV-infected mothers; and 187 HIV-uninfected children born to HIV-uninfected mothers.Children received either 1250 IU of vitamin A; vitamin A and 10 mg of zinc; or vitamin A, zinc, vitamins B1, B2, B6, B12, C, D, E, and K and copper, iodine, iron, and niacin starting at 6 months and continuing to 24 months of age. Homes were visited weekly.Primary outcome was percentage of days of diarrhea per child by study arm within each of the three cohorts. Secondary outcomes were prevalence of upper respiratory symptoms and percentage of children who ever had pneumonia by maternal report, or confirmed by the field worker.Among HIV-uninfected children born to HIV-infected mothers, median percentage of days with diarrhea was 2.3% for 49 children allocated to vitamin A; 2.5% in 47 children allocated to receive vitamin A and zinc; and 2.2% for 46 children allocated to multiple micronutrients (P = 0.852. Among HIV-uninfected children born to HIV-uninfected mothers, median percentage of days of diarrhea was 2.4% in 56 children in the vitamin A group; 1.8% in 57 children in the vitamin A and zinc group; and 2.7% in 52 children in the multiple micronutrient group (P = 0.857. Only 32 HIV-infected children were enrolled, and there were no differences between treatment arms in the prevalence of diarrhea. The prevalence of upper respiratory symptoms or incidence of pneumonia did not differ by treatment arms in any of the cohorts.When compared with vitamin A alone, supplementation with zinc, or with zinc and multiple

  13. Micronutrient intake and risk of colon and rectal cancer in a Danish cohort.

    Science.gov (United States)

    Roswall, Nina; Olsen, Anja; Christensen, Jane; Dragsted, Lars O; Overvad, Kim; Tjønneland, Anne

    2010-02-01

    Micronutrients may protect against colorectal cancer. Especially folate has been considered potentially preventive. However, studies on folate and colorectal cancer have found contradicting results; dietary folate seems preventive, whereas folic acid in supplements and fortification may increase the risk. To evaluate the association between intake of vitamins C, E, folate and beta-carotene and colorectal cancer risk, focusing on possibly different effects of dietary, supplemental and total intake, and on potential effect modification by lifestyle factors. In a prospective cohort study of 56,332 participants aged 50-64 years, information on diet, supplements and lifestyle was collected through questionnaires. 465 Colon and 283 rectal cancer cases were identified during follow-up. Incidence rate ratios of colon and rectal cancers related to micronutrient intake were calculated using Cox proportional hazard analyses. The present study found a protective effect of dietary but not supplemental folate on colon cancer. No association with any other micronutrient was found. Rectal cancer did not seem associated with any micronutrient. For both colon and rectal cancer, we found an interaction between dietary folate and alcohol intake, with a significant, preventive effect among those consuming above 10g alcohol/day only. This study adds further weight to the evidence that dietary folate protects against colon cancer, and specifies that there is a source-specific effect, with no preventive effect of supplemental folic acid. Further studies should thus take source into account. Vitamins C, E and beta-carotene showed no relation with colorectal cancer.

  14. [Micronutrients in oncology. Current data about vitamin D, selenium, L-carnitine and vitamin C].

    Science.gov (United States)

    Gröber, Uwe; Mücke, Ralph; Holzhauer, Peter; Kisters, Klaus

    2013-04-01

    Many patients receiving cancer treatment use micronutrient supplements, with the intention to complement their cancer treatment, or help them cope with the therapy- and disease-associated side-effects. Up to 90% of the cancer patients are adding antioxidants without the knowledge of the treating physician. There are many concerns that antioxidants might decrease the effectiveness of chemotherapy, but increasing evidence suggests a benefit when antioxidants and other micronutrients, such as selenium, L-carnitine and vitamin D are added to conventional cytotoxic therapies. It is imperative that physicians discuss the use ofantioxidant and other micronutrient supplements with their cancer patients and educate them about potentially negative, but also potentially beneficial effects.

  15. Micronutrient supplementation adherence and influence on the prevalences of anemia and iron, zinc and vitamin A deficiencies in preemies with a corrected age of six months

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    Brunnella Alcantara Chagas de Freitas

    Full Text Available OBJECTIVE: To analyze adherence to the recommended iron, zinc and multivitamin supplementation guidelines for preemies, the factors associated with this adherence, and the influence of adherence on the occurrence of anemia and iron, zinc and vitamin A deficiencies. METHODS: This prospective cohort study followed 58 preemies born in 2014 until they reached six months corrected age. The preemies were followed at a referral secondary health service and represented 63.7% of the preterm infants born that year. Outcomes of interest included high or low adherence to iron, zinc and multivitamin supplementation guidelines; prevalence of anemia; and prevalences of iron, zinc, and vitamin A deficiencies. The prevalence ratios were calculated by Poisson regression. RESULTS: Thirty-eight (65.5% preemies presented high adherence to micronutrient supplementation guidelines. At six months of corrected age, no preemie had vitamin A deficiency. The prevalences of anemia, iron deficiency and zinc deficiency were higher in the low-adherence group but also concerning in the high-adherence group. Preemies with low adherence to micronutrient supplementation guidelines were 2.5 times more likely to develop anemia and 3.1 times more likely to develop zinc deficiency. Low maternal education level increased the likelihood of nonadherence to all three supplements by 2.2 times. CONCLUSIONS: Low maternal education level was independently associated with low adherence to iron, zinc and vitamin A supplementation guidelines in preemies, which impacted the prevalences of anemia and iron and zinc deficiencies at six months of corrected age.

  16. Adjunctive micronutrient supplementation for pulmonary tuberculosis Suplementación con micronutrientes como tratamiento adjunto para tuberculosis pulmonar

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    Rodrigo X Armijos

    2010-06-01

    Full Text Available OBJECTIVE: To assess the effect of micronutrient supplementation on tuberculosis (TB patient outcomes. MATERIAL AND METHODS: The randomized, double-blinded, placebo-controlled study was conducted in pulmonary TB patients undergoing directly observed treatment short course/ tratamiento acortado estrictamente supervisado (TAES/ DOTS at IMSS in Ciudad Juarez, Chihuahua, Mexico, who were recruited during August 2005-July 2006. Consecutive patients received zinc and vitamin A supplements or matched placebo for four months. Dietary intake, blood zinc and vitamin A, immune response (IFN-γ,TNF-α, and IL-10 mRNA, and sputum smear conversion were measured. RESULTS: The proportion of micronutrient compared to placebo group subjects with a negative sputum smear by month 3 was significantly increased (p= 0.03. This occurred subsequent to increased TNF-α and IFN-γ and decreased IL-'0 observed at month 2. Micronutrient supplementation appeared to accelerate the beneficial therapeutic effect of chemotherapy. CONCLUSIONS: The earlier elimination of bacilli from sputum was associated with improved zinc status and Th' immune response. The therapeutic effect of vitamin A was less evident.OBJETIVO: Determinar el efecto de la suplementación con zinc y vitamina A o placebo en pacientes tratados por tuberculosis (TB. MATERIAL Y MÉTODOS: Se realizó un ensayo aleatorizado en pacientes tuberculosos que iniciaron el tratamiento acortado estrictamente supervisado/ directly observed treatment short course (TAES/DOTS en las clínicas del IMSS, Ciudad Juárez, Chihuahua, México, reclutados durante agosto 2005-julio 2006. A cada paciente en forma aleatoria se le designó un código para recibir ya sea micronutrientes o placebo por cuatro meses, bajo el diseño doble ciego. Se evaluó la ingesta dietética, niveles de zinc y vitamina A en sangre, respuesta inmune (IFN-γ,TNF-α, IL-l0 mRNA en sangre y bacilo ácido alcohol resistente (BAAR en esputo. RESULTADOS: Al

  17. Effect of vitamin D, calcium and multiple micronutrients supplementation on lipid profile in pre-menopausal Bangladeshi garment factory workers with hypovitaminosis D.

    Science.gov (United States)

    Islam, Md Zahirul; Shamim, Abu Ahmed; Akhtaruzzaman, Mohammad; Kärkkäinen, Merja; Lamberg-Allardt, Christel

    2014-12-01

    Elevated total cholesterol and low-density lipoprotein cholesterol in sera are both well-known risk factors of coronary heart disease. Adequate vitamin D status is important for optimal function of many organs and tissues of our body. There is continuing controversy about the effect of adequate vitamin D consumption on serum lipids and lipoproteins. The present study assessed the effect of vitamin D, calcium and multiple micronutrients supplementation on the lipid profile in Bangladeshi young female garment factory workers who have hypovitaminosis D. This placebo-controlled intervention trial conducted over a period of one year randomly assigned a total of 200 apparently healthy subjects aged 16-36 years to 4 groups. The subjects received daily supplements of 400 IU of vitamin D (VD group) or 400 IU of vitamin D+600 mg of calcium lactate (VD-Ca group), or multiple micronutrients with 400 IU of vitamin-D+600 mg of calcium lactate (MMN-VD-Ca group), or the group consuming placebo (PL group). Serum concentrations of lipid and lipoprotein, 25-hydroxyvitamin D (25OHD) and intact parathyroid hormone (iPTH) were measured at baseline and after one year of follow-up. No significant changes in the serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), LDL-C/HDL-C ratio were observed in the supplemented groups compared to the placebo group. Supplementation had a positive effect (pS-iPTH had the greatest increase in HDL-C. The results suggest that consumption of adequate vitamin D with calcium or MMN for one-year may have no impact on serum lipid profile in the subjects studied. Longer-term clinical trials with different doses of supplemental vitamin D are warranted in evaluating the effect of intervention.

  18. The impact of micronutrient supplementation in alcohol-exposed pregnancies on information processing skills in Ukrainian infants.

    Science.gov (United States)

    Kable, J A; Coles, C D; Keen, C L; Uriu-Adams, J Y; Jones, K L; Yevtushok, L; Kulikovsky, Y; Wertelecki, W; Pedersen, T L; Chambers, C D

    2015-11-01

    The potential of micronutrients to ameliorate the impact of prenatal alcohol exposure (PAE) was explored in a clinical trial conducted in Ukraine. Cardiac orienting responses (ORs) during a habituation/dishabituation learning paradigm were obtained from 6 to 12 month-olds to assess neurophysiological encoding and memory. Women who differed in prenatal alcohol use were recruited during pregnancy and assigned to a group (No study-provided supplements, multivitamin/mineral supplement, or multivitamin/mineral supplement plus choline supplement). Heart rate was collected for 30 s prior to stimulus onset and 12 s post-stimulus onset. Difference values (∆HR) for the first 3 trials of each condition were aggregated for analysis. Gestational blood samples were collected to assess maternal nutritional status and changes as a function of the intervention. Choline supplementation resulted in a greater ∆HR on the visual habituation trials for all infants and for the infants with no PAE on the dishabituation trials. The latency of the response was reduced in both conditions for all infants whose mothers received choline supplementation. Change in gestational choline level was positively related to ∆HR during habituation trials and levels of one choline metabolite, dimethylglycine (DMG), predicted ∆HR during habituation trials and latency of responses. A trend was found between DMG and ∆HR on the dishabituation trials and latency of the response. Supplementation did not affect ORs to auditory stimuli. Choline supplementation when administered together with routinely recommended multivitamin/mineral prenatal supplements during pregnancy may provide a beneficial impact to basic learning mechanisms involved in encoding and memory of environmental events in alcohol-exposed pregnancies as well as non- or low alcohol-exposed pregnancies. Changes in maternal nutrient status suggested that one mechanism by which choline supplementation may positively impact brain development is

  19. Nutrition (Micronutrients) in Child Growth and Development: A Systematic Review on Current Evidence, Recommendations and Opportunities for Further Research.

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    Yakoob, Mohammad Yawar; Lo, Clifford W

    2017-10-01

    An important aspect of malnutrition is deficiency of different micronutrients during pregnancy or early childhood. We systematically reviewed the role of nutrition in child growth (weight or height gain) and development. A comprehensive literature search was done on PubMed/Cochrane Library browsing through 38,795 abstracts until December 31, 2016 to select systematic reviews/meta-analyses and individual randomized controlled trials (RCTs) of micronutrient supplementation. Micronutrients studied included iron, iodine, folate, zinc, calcium, magnesium, selenium, vitamin D, vitamin A, vitamin B complex, and multiple micronutrients. We summarize evidence with details and results of RCTs, highlight strengths/weaknesses, and critically interpret findings. Effects of breastfeeding-promotion, food-supplementation (complementary and school feeding), conditional-cash-transfers, and integrated nutrition/psychosocial interventions are discussed. Based on this evidence we make policy and programmatic recommendations for supplementation to mothers and children at high-risk of deficiency.

  20. Effect of vitamin D, calcium and multiple micronutrient supplementation on vitamin D and bone status in Bangladeshi premenopausal garment factory workers with hypovitaminosis D: a double-blinded, randomised, placebo-controlled 1-year intervention.

    Science.gov (United States)

    Islam, Md Zahirul; Shamim, Abu Ahmed; Viljakainen, Heli T; Akhtaruzzaman, Mohammad; Jehan, Atia H; Khan, Habib Ullah; Al-Arif, Ferdaus Ahmad; Lamberg-Allardt, Christel

    2010-07-01

    Due to little outdoor activity and low dietary intake of vitamin D (VD), Bangladeshi low-income women are at risk for osteoporosis at an early age. The present study assessed the effect of VD, Ca and multiple micronutrient supplementation on VD and bone status in Bangladeshi young female garment factory workers. This placebo-controlled 1-year intervention randomly assigned 200 apparently healthy subjects (aged 16-36 years) to four groups: VD group, daily 10 microg VD; VD and Ca (VD-Ca) group, daily 10 microg VD+600 mg Ca; multiple micronutrient and Ca (MMN-Ca) group, 10 microg VD and other micronutrients+600 mg Ca; a placebo group. Serum 25-hydroxyvitamin D (S-25OHD), intact parathyroid hormone (S-iPTH), Ca, phosphate and alkaline phosphatase were measured. Bone mineral density and bone mineral content were measured by dual-energy X-ray absorptiometry. All measurements were made at baseline and at 12 months. Significantly (P S-25OHD concentrations were observed in the supplemented groups than in the placebo group after the intervention. Supplementation had an effect (P S-iPTH in the VD-Ca and MMN-Ca groups compared with the placebo group. Bone mineral augmentation increased at the femur in the supplemented groups. Supplementation with VD-Ca should be recommended as a strategic option to reduce the risk of osteomalacia and osteoporosis in these subjects. MMN-Ca may have analogous positive health implications with additional non-skeletal benefits.

  1. Micronutrient deficiencies and gender: social and economic costs.

    Science.gov (United States)

    Darnton-Hill, Ian; Webb, Patrick; Harvey, Philip W J; Hunt, Joseph M; Dalmiya, Nita; Chopra, Mickey; Ball, Madeleine J; Bloem, Martin W; de Benoist, Bruno

    2005-05-01

    Vitamin and mineral deficiencies adversely affect a third of the world's people. Consequently, a series of global goals and a serious amount of donor and national resources have been directed at such micronutrient deficiencies. Drawing on the extensive experience of the authors in a variety of institutional settings, the article used a computer search of the published scientific literature of the topic, supplemented by reports and published and unpublished work from the various agencies. In examining the effect of sex on the economic and social costs of micronutrient deficiencies, the paper found that: (1) micronutrient deficiencies affect global health outcomes; (2) micronutrient deficiencies incur substantial economic costs; (3) health and nutrition outcomes are affected by sex; (4) micronutrient deficiencies are affected by sex, but this is often culturally specific; and finally, (5) the social and economic costs of micronutrient deficiencies, with particular reference to women and female adolescents and children, are likely to be considerable but are not well quantified. Given the potential impact on reducing infant and child mortality, reducing maternal mortality, and enhancing neuro-intellectual development and growth, the right of women and children to adequate food and nutrition should more explicitly reflect their special requirements in terms of micronutrients. The positive impact of alleviating micronutrient malnutrition on physical activity, education and productivity, and hence on national economies suggests that there is also an urgent need for increased effort to demonstrate the cost of these deficiencies, as well as the benefits of addressing them, especially compared with other health and nutrition interventions.

  2. Helminth infections and micronutrients in school-age children: a systematic review and meta-analysis.

    Science.gov (United States)

    de Gier, Brechje; Campos Ponce, Maiza; van de Bor, Margot; Doak, Colleen M; Polman, Katja

    2014-06-01

    Helminth infections and micronutrient deficiencies are highly prevalent in developing countries. Neither condition typically causes overt disease, but they do lead to indirect morbidity such as impaired physical and cognitive development. We aimed to systematically review current evidence on the relation of helminth infections with micronutrient status in school-age children worldwide. We included both observational studies and randomized controlled trials (RCTs). We applied a random-effects meta-analysis to estimate 1) cross-sectional associations between helminths and micronutrient status, 2) effects of anthelminthic treatment on micronutrient status, and 3) effects of micronutrient supplementation on helminth infection and reinfection. Meta-analyses of observational studies showed an association between helminth infections and serum retinol [standardized mean difference (SMD): -0.30; 95% CI: -0.48, -0.13] but not serum ferritin (SMD: 0.00; 95% CI: -0.7, 0.7). Conversely, meta-analyses of anthelminthic treatment RCTs showed a positive effect on ferritin (SMD: 0.16; 95% CI: 0.09, 0.22) but not retinol (SMD: 0.04; 95% CI: -0.06, 0.14). The number of studies on micronutrients other than ferritin and retinol was not sufficient for pooling. Meta-analyses of micronutrient-supplementation RCTs showed only a modest protective effect for multimicronutrient interventions on helminth infection and reinfection rates (OR: 0.77; 95% CI: 0.61, 0.97). In this review, we show evidence of distinct associations between helminth infections and micronutrients in school-age children. More studies are needed on micronutrients other than iron and vitamin A and on possible helminth species-specific effects. A thorough comprehension of the interplay between helminth infections and micronutrients will help guide integrated and sustainable intervention strategies in affected children worldwide. © 2014 American Society for Nutrition.

  3. Phytotoxicity of carbon nanotubes in soybean as determined by interactions with micronutrients

    Energy Technology Data Exchange (ETDEWEB)

    Zaytseva, Olga, E-mail: olga.zaytseva@uni-hohenheim.de [University of Hohenheim, Institute of Crop Science (340h), Faculty of Agriculture (Germany); Wang, Zhengrui [Academia Sinica, Agricultural Biotechnology Research Center (China); Neumann, Günter [University of Hohenheim, Institute of Crop Science (340h), Faculty of Agriculture (Germany)

    2017-02-15

    Carbon nanomaterials released into the environment exert extremely variable effects on living organisms. In this study, we used soybean (Glycine max) to investigate early responses to seed exposure to multi-walled carbon nanotubes (MWCNTs, outer diameter 20–70 nm, inner diameter 5–10 nm, length of >2 μm). Soybean seeds were imbibed with deionised water (control) or MWCNT suspension (1000 mg L{sup −1}) and were analysed for MWCNT contamination using light microscopy. The seedlings vitality status was evaluated by staining with triphenyltetrazolium chloride and measurement of oxidative stress indicators in the root tissue. Micronutrient (Zn, Mn, Cu) availability in different seedling organs was assessed and the effects of antioxidants, and micronutrient supplementation was investigated. Oxidative stress induction by MWCNTs was detectable in radicle tips, coincided with MWCNTs accumulation and was reverted by external application of proline as antioxidant and micronutrients (Zn, Cu, Mn) as cofactors for various enzymes involved in oxidative stress defence. Accordingly, SOD activity increased after Zn supplementation. During germination, the MWCNT treatments reduced Zn translocation from the cotyledons to the seedling and MWCNTs exhibited adsorption potential for Zn and Cu, which may be involved in internal micronutrients immobilisation. This study demonstrates for the first time that MWCNT phytotoxicity is linked with oxidative stress-related disturbances of micronutrient homeostasis.

  4. Phytotoxicity of carbon nanotubes in soybean as determined by interactions with micronutrients

    International Nuclear Information System (INIS)

    Zaytseva, Olga; Wang, Zhengrui; Neumann, Günter

    2017-01-01

    Carbon nanomaterials released into the environment exert extremely variable effects on living organisms. In this study, we used soybean (Glycine max) to investigate early responses to seed exposure to multi-walled carbon nanotubes (MWCNTs, outer diameter 20–70 nm, inner diameter 5–10 nm, length of >2 μm). Soybean seeds were imbibed with deionised water (control) or MWCNT suspension (1000 mg L"−"1) and were analysed for MWCNT contamination using light microscopy. The seedlings vitality status was evaluated by staining with triphenyltetrazolium chloride and measurement of oxidative stress indicators in the root tissue. Micronutrient (Zn, Mn, Cu) availability in different seedling organs was assessed and the effects of antioxidants, and micronutrient supplementation was investigated. Oxidative stress induction by MWCNTs was detectable in radicle tips, coincided with MWCNTs accumulation and was reverted by external application of proline as antioxidant and micronutrients (Zn, Cu, Mn) as cofactors for various enzymes involved in oxidative stress defence. Accordingly, SOD activity increased after Zn supplementation. During germination, the MWCNT treatments reduced Zn translocation from the cotyledons to the seedling and MWCNTs exhibited adsorption potential for Zn and Cu, which may be involved in internal micronutrients immobilisation. This study demonstrates for the first time that MWCNT phytotoxicity is linked with oxidative stress-related disturbances of micronutrient homeostasis.

  5. Micronutrient-fortified rice can increase hookworm infection risk

    DEFF Research Database (Denmark)

    de Gier, Brechje; Campos Ponce, Maiza; Perignon, Marlene

    2016-01-01

    or inflammation after iron supplementation. OBJECTIVE: To study effects of micronutrient-fortified rice on hookworm infection in Cambodian schoolchildren. METHODS: A double-blinded, cluster-randomized trial was conducted in 16 Cambodian primary schools partaking in the World Food Program school meal program....... Three types of multi-micronutrient fortified rice were tested against placebo rice within the school meal program: UltraRice_original, UltraRice_improved and NutriRice. Four schools were randomly assigned to each study group (placebo n = 492, UltraRice_original n = 479, UltraRice_improved n = 500, NutriRice.......6%, but differed considerably among schools (range 0%- 48.1%).Micronutrient-fortified rice significantly increased risk of new hookworm infection. This effect was modified by baseline hookworm prevalence at the school; hookworm infection risk was increased by all three types of fortified rice in schools where...

  6. The influence of micronutrients on oral and general health

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    Willershausen B

    2011-11-01

    Full Text Available Abstract Objective The aim of the present clinical pilot study was to examine the influence of a combination of micronutrients on individuals with high stress experience. Methods 40 healthy students (28 female, 12 male with a mean age of 27.1 ± 3.0 years, experiencing high examination stress, were chosen. After approval of the ethics commission, one group of students (n = 19 took a combination of micronutrients (Orthomol vital m/f for three months, whereas other students (n = 21 served as control group. All participants underwent at the beginning and at the end of the trial a dental examination, a determination of 10 periodontal pathogens, a salivary and a blood analysis. In addition, the participants filled in a questionnaire on nutrition, quality of life and degree of stress experienced during their final examinations. Results The evaluation of the results, obtained at the end of the trial period, showed that for all students a slight worsening of oral hygiene and an increased consumption of unhealthy food could be observed. The intake of the micronutrients led to a slight improvement of the degree of gingival inflammation in comparison to the control group. The blood analysis showed an increase in vitamin (vitamin C, vitamin E and zinc concentrations, and a lower increase in CRP. In the male subjects, a decrease in the serum concentrations of triglycerides (p = 0.073 and LDL (p = 0.048 was observed. Conclusions This pilot study shows that micronutrients, taken during periods of high stress experience, had a beneficial effect on inflammatory processes and helped reduce the level of some of the plasma lipids in males, and thus can be recommended for supplementing the diet. However, additional studies with a higher number of subjects, also suffering from periodontal disease, are necessary to show the effect of a micronutrient supplementation more clearly.

  7. Should infant girls receive micronutrient supplements?

    DEFF Research Database (Denmark)

    Benn, Christine Stabell; Lund, Sofia; Fisker, Ane

    2009-01-01

    BACKGROUND: We have proposed the hypothesis that the combination of vitamin A supplementation and diphtheria-tetanus-pertussis (DTP) vaccination may be associated with increased mortality in girls. Recent zinc/folic acid (FA) and iron supplementation trials did not find any beneficial effects...

  8. Micronutrients attenuate progression of prostate cancer by elevating the endogenous inhibitor of angiogenesis, Platelet Factor-4

    International Nuclear Information System (INIS)

    Cervi, David; Pak, Brian; Venier, Natalie A; Sugar, Linda M; Nam, Robert K; Fleshner, Neil E; Klotz, Laurence H; Venkateswaran, Vasundara

    2010-01-01

    Longstanding evidence implicates an inadequate diet as a key factor in the onset and progression of prostate cancer. The purpose herein was to discover, validate and characterize functional biomarkers of dietary supplementation capable of suppressing the course of prostate cancer in vivo. The Lady transgenic mouse model that spontaneously develops prostate cancer received a diet supplemented with a micronutrient cocktail of vitamin E, selenium and lycopene ad libitum. A proteomic analysis was conducted to screen for serum biomarkers of this dietary supplementation. Candidate peptides were validated and identified by sequencing and analyzed for their presence within the prostates of all mice by immunohistochemistry. Dietary supplementation with the combined micronutrients significantly induced the expression of the megakaryocyte-specific inhibitor of angiogenesis, platelet factor-4 (P = 0.0025). This observation was made predominantly in mice lacking tumors and any manifestations associated with progressive disease beyond 37 weeks of life, at which time no survivors remained in the control group (P < 0.0001). While prostates of mice receiving standard chow were enlarged and burdened with poorly differentiated carcinoma, those of mice on the supplemented diet appeared normal. Immunohistochemical analysis revealed marked amplifications of both platelet binding and platelet factor-4 within the blood vessels of prostates from mice receiving micronutrients only. We present unprecedented data whereby these combined micronutrients effectively promotes tumor dormancy in early prostate cancer, following initiation mutations that may drive the angiogenesis-dependent response of the tumor, by inducing platelet factor-4 expression and concentrating it at the tumor endothelium through enhanced platelet binding

  9. Role of micronutrients for physical growth and mental development.

    Science.gov (United States)

    Singh, Meharban

    2004-01-01

    Due to control of florid and severe cases of protein-energy malnutrition, deficiencies of micronutrients in children have assumed public health importance. According to National Nutrition Monitoring Bureau of India, over 50% of apparently healthy looking children have subclinical or biochemical deficiencies of vitamin A, vitamins B2, B6, folate and vitamin C. Over two-third of children have clinical evidences of iron deficiency while deficiency of trace minerals like iodine and zinc is quite common in certain populations. Children have food preferences and they are quite fussy to take green leafy vegetables and fruits thus compromising their intake of micronutrients from dietary sources. The full genetic potential of the child for physical growth and mental development may be compromised due to subclinical deficiencies of micronutrients which are commonly referred to as "hidden hunger". Micronutrients are required for the integrity and optimal functioning of immune system. Children with subclinical deficiency of micronutrients are more vulnerable to develop frequent and more severe common day-to-day infections thus triggering a vicious cycle of undernutrition and recurrent infections. A number of micronutrients are required for optimal physical growth and neuromotor development. Isolated deficiencies of micronutrients are rare in clinical practice and usually deficiencies of multiple micronutrients co-exist. The first 3 years of life are most crucial and vulnerable to the hazards of undernutrition. All efforts should be made so that preschool children are given a balanced and nutritious home-based diet. However, it has been shown that it is not possible to meet 100% requirements of recommended dietary allowances (RDA's) of micronutrients from dietary sources alone and most preschool children need administration of nutritional supplements to optimize their genetic potential for physical growth and mental development.

  10. Assessment of Micronutrient Status in Critically Ill Children: Challenges and Opportunities

    Directory of Open Access Journals (Sweden)

    Duy T. Dao

    2017-10-01

    Full Text Available Micronutrients refer to a group of organic vitamins and inorganic trace elements that serve many functions in metabolism. Assessment of micronutrient status in critically ill children is challenging due to many complicating factors, such as evolving metabolic demands, immature organ function, and varying methods of feeding that affect nutritional dietary intake. Determination of micronutrient status, especially in children, usually relies on a combination of biomarkers, with only a few having been established as a gold standard. Almost all micronutrients display a decrease in their serum levels in critically ill children, resulting in an increased risk of deficiency in this setting. While vitamin D deficiency is a well-known phenomenon in critical illness and can predict a higher need for intensive care, serum concentrations of many trace elements such as iron, zinc, and selenium decrease as a result of tissue redistribution in response to systemic inflammation. Despite a decrease in their levels, supplementation of micronutrients during times of severe illness has not demonstrated clear benefits in either survival advantage or reduction of adverse outcomes. For many micronutrients, the lack of large and randomized studies remains a major hindrance to critically evaluating their status and clinical significance.

  11. Effect of Micronutrient and Probiotic Fortified Yogurt on Immune-Function of Anti-Retroviral Therapy Naive HIV Patients  

    Directory of Open Access Journals (Sweden)

    J. Dik F. Habbema

    2011-10-01

    Full Text Available Background: Micronutrient supplementation has been shown to reduce the progression of HIV but does not have an effect on the intestinal barrier or the intestinal microbiota of HIV patients. Studies have suggested that probiotics could potentially complement micronutrients in preserving the immune-function of HIV patients. Objective: Assess the impact of micronutrient supplemented probiotic yogurt on the immune function of HIV patients. Design: We performed a randomized, double blind, controlled trial with CD4 count as primary outcome among HIV patients naïve to anti-retroviral treatment. Secondary outcomes included hematological parameters, incidence of diarrhea and clinical symptoms. A total of 112 HIV patients were randomized to receive a micronutrient fortified yogurt with (n = 55 or without additional probiotic Lactobacillus rhamnosus GR-1 (n = 57 for four weeks. Results: An average decline in CD4 count of −70 cells/μL (95% CI: −154 to −15 was observed in the micronutrient, probiotic group versus a decrease of −63 cells/μL (95% CI: −157 to −30 in the micronutrient control group (p = 0.9. Additional probiotic supplementation was well tolerated and not associated with adverse events. No difference between groups was detected in incidence of diarrhea or clinical symptoms. An improvement of hemoglobin levels was observed for all subjects, based upon a mean difference from baseline of 1.4 g/L (SD = 6 (p = 0.02. Conclusion: The addition of probiotics to a micronutrient fortified yogurt was well tolerated by HIV patients but was not associated with a further increase in CD4 count after one month.

  12. Supplements in pregnancy: the latest recommendations

    Science.gov (United States)

    Martínez García, Rosa María

    2016-07-12

    Pregnancy is a challenge from the nutritional point of view, because nutrient requirements are increased and alter its intake can affect maternal and fetal health. Micronutrient defi ciency states are related to preeclampsia, intrauterine growth restriction, abortion and congenital anomalies. Currently, the diet of many expectant mothers is insufficient in micronutrients, in this cases supplementation is necessary. It is recommended supplementation with folic acid in doses of 400 mcg / day and 5 mg/day in risk pregnant, and should begin at least one month before conception and during the first 12 weeks gestation, and extend it throughout pregnancy in mothers with nutritional risk. It is important to keep watch the proper dose of folic acid to prevent possible adverse effects of unmetabolized accumulation in plasma. A high percentage of pregnant women presented iron deficiency anemia, being recommended intermittent use of iron supplements (with lower gastrointestinal alteration and oxidative stress); not recommended for mothers without anemia (hemoglobin> 13.5 g / L). Since calcium absorption is increased up to 40% in gestation, its supplementation is not recommended for mothers with adequate intakes (3 dairy / day), and its use must be reserved to women with inadequate intakes and / or high risk of preeclampsia. Regarding the iodine, there are confl icting positions by different working groups established potassium iodide supplementation in women who do not reach their recommended intake (3 servings of milk and dairy products + 2 g of iodized salt), with their diets. Given that vitamin A and D can be toxic to mother and fetus, it is not recommended its supplementation except in cases of deficiency. Although the use of multiple micronutrients supplements may favorably impact the outcome of pregnancy, more scientific evidence is needed to establish the replacement of iron and folic acid with a multiple micronutrient supplement.

  13. The science and practice of micronutrient supplementations in nutritional anemia: an evidence-based review.

    Science.gov (United States)

    Chan, Lingtak-Neander; Mike, Leigh Ann

    2014-08-01

    Nutritional anemia is the most common type of anemia, affecting millions of people in all age groups worldwide. While inadequate access to food and nutrients can lead to anemia, patients with certain health status or medical conditions are also at increased risk of developing nutritional anemia. Iron, cobalamin, and folate are the most recognized micronutrients that are vital for the generation of erythrocytes. Iron deficiency is associated with insufficient production of hemoglobin. Deficiency of cobalamin or folate leads to impaired synthesis of deoxyribonucleic acid, proteins, and cell division. Recent research has demonstrated that the status of copper and zinc in the body can significantly affect iron absorption and utilization. With an increasing number of patients undergoing bariatric surgical procedures, more cases of anemia associated with copper and zinc deficiencies have also emerged. The intestinal absorption of these 5 critical micronutrients are highly regulated and mediated by specific apical transport mechanisms in the enterocytes. Health conditions that persistently alter the histology of the upper intestinal architecture, expression, or function of these substrate-specific transporters, or the normal digestion and flow of these key micronutrients, can lead to nutritional anemia. The focus of this article is to review the science of intestinal micronutrient absorption, discuss the clinical assessment of micronutrient deficiencies in relation to anemia, and suggest an effective treatment plan and monitoring strategies using an evidence-based approach. © 2014 American Society for Parenteral and Enteral Nutrition.

  14. Cost-effectiveness of invitation to food supplementation early in pregnancy combined with multiple micronutrients on infant survival: analysis of data from MINIMat randomized trial, Bangladesh.

    Science.gov (United States)

    Shaheen, Rubina; Persson, Lars Åke; Ahmed, Shakil; Streatfield, Peter Kim; Lindholm, Lars

    2015-05-28

    Absence of cost-effectiveness (CE) analyses limits the relevance of large-scale nutrition interventions in low-income countries. We analyzed if the effect of invitation to food supplementation early in pregnancy combined with multiple micronutrient supplements (MMS) on infant survival represented value for money compared to invitation to food supplementation at usual time in pregnancy combined with iron-folic acid. Outcome data, infant mortality (IM) rates, came from MINIMat trial (Maternal and Infant Nutrition Interventions, Matlab, ISRCTN16581394). In MINIMat, women were randomized to early (E around 9 weeks of pregnancy) or usual invitation (U around 20 weeks) to food supplementation and daily doses of 30 mg, or 60 mg iron with 400 μgm of folic acid, or MMS with 15 micronutrients including 30 mg iron and 400 μgm of folic acid. In MINIMat, EMMS significantly reduced IM compared to UFe60F (U plus 60 mg iron 400 μgm Folic acid). We present incremental CE ratios for incrementing UFe60F to EMMS. Costing data came mainly from a published study. By incrementing UFe60F to EMMS, one extra IM could be averted at a cost of US$907 and US$797 for NGO run and government run CNCs, respectively, and at US$1024 for a hypothetical scenario of highest cost. These comparisons generated one extra life year (LY) saved at US$30, US$27, and US$34, respectively. Incrementing UFe60F to EMMS in pregnancy seems worthwhile from health economic and public health standpoints. Maternal and Infant Nutrition Interventions, Matlab; ISRCTN16581394 ; Date of registration: Feb 16, 2009.

  15. Antioxidant Micronutrients and Cardiovascular Risk in Patients with Diabetes: A Systematic Review

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    Sarmento, Roberta Aguiar [Instituto de Cardiologia do Rio Grande do Sul - Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil); Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Silva, Flávia Moraes [Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Sbruzzi, Graciele [Instituto de Cardiologia do Rio Grande do Sul - Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil); Schaan, Beatriz D' Agord [Instituto de Cardiologia do Rio Grande do Sul - Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil); Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Departamento de Medicina Interna - Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Almeida, Jussara Carnevale de, E-mail: jussara.carnevale@gmail.com [Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Departamento de Medicina Interna - Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil)

    2013-09-15

    Inverse associations between micronutrient intake and cardiovascular outcomes have been previously shown, but did not focus on diabetic patients. To systematically review the role of micronutrients in the development/presence of cardiovascular outcomes in patients with diabetes. We searched Medline, Embase, and Scopus (January/1949-March/2012) for observational studies that evaluated micronutrients and cardiovascular outcomes in patients with diabetes, and then selected and extracted the data (two independent reviewers). From the 15 658 studies identified, five were included, comprising three case-control and two cohorts, with a follow-up of 7-15 years. A meta-analysis was not performed due to the different antioxidant micronutrients (types and measurement methods) and outcomes evaluated. The micronutrients assessed were vitamin C intake in diet and/ or supplementation, chromium and selenium in toenail samples, and α-tocopherol and zinc in serum levels. Intake of > 300 mg of vitamin C through supplementation was associated with increased risk of cardiovascular disease, coronary artery disease (CAD), and stroke (RR 1.69-2.37). High levels of α-tocopherol in serum were associated with 30% lower CAD risk in another study (HR 0.71; 95%CI 0.53-0.94). Among minerals (zinc, selenium, and chromium), an inverse association between zinc and CAD was observed; levels lower than 14.1 μmol/L were associated with an increased risk for CAD (RR 1.70; 95%CI 1.21-2.38). The information available on this issue is scarce. Further prospective studies are needed to elucidate the role of these nutrients in the cardiovascular risk of patients with diabetes.

  16. Antioxidant Micronutrients and Cardiovascular Risk in Patients with Diabetes: A Systematic Review

    International Nuclear Information System (INIS)

    Sarmento, Roberta Aguiar; Silva, Flávia Moraes; Sbruzzi, Graciele; Schaan, Beatriz D'Agord; Almeida, Jussara Carnevale de

    2013-01-01

    Inverse associations between micronutrient intake and cardiovascular outcomes have been previously shown, but did not focus on diabetic patients. To systematically review the role of micronutrients in the development/presence of cardiovascular outcomes in patients with diabetes. We searched Medline, Embase, and Scopus (January/1949-March/2012) for observational studies that evaluated micronutrients and cardiovascular outcomes in patients with diabetes, and then selected and extracted the data (two independent reviewers). From the 15 658 studies identified, five were included, comprising three case-control and two cohorts, with a follow-up of 7-15 years. A meta-analysis was not performed due to the different antioxidant micronutrients (types and measurement methods) and outcomes evaluated. The micronutrients assessed were vitamin C intake in diet and/ or supplementation, chromium and selenium in toenail samples, and α-tocopherol and zinc in serum levels. Intake of > 300 mg of vitamin C through supplementation was associated with increased risk of cardiovascular disease, coronary artery disease (CAD), and stroke (RR 1.69-2.37). High levels of α-tocopherol in serum were associated with 30% lower CAD risk in another study (HR 0.71; 95%CI 0.53-0.94). Among minerals (zinc, selenium, and chromium), an inverse association between zinc and CAD was observed; levels lower than 14.1 μmol/L were associated with an increased risk for CAD (RR 1.70; 95%CI 1.21-2.38). The information available on this issue is scarce. Further prospective studies are needed to elucidate the role of these nutrients in the cardiovascular risk of patients with diabetes

  17. Using formative research to promote antenatal care attendance and iron folic acid supplementation in Zinder, Niger.

    Science.gov (United States)

    Hess, Sonja Y; Ouédraogo, Césaire T; Bamba, Ibrahim F; Wessells, K Ryan; Keith, Nancy; Faye, Thierno; Ndiaye, Banda; Doudou, Maimouna; Nielsen, Jennifer

    2018-04-01

    In Niger, use of antenatal care (ANC) and iron folic acid (IFA) supplements is suboptimal. The objectives of this paper are as follows: (a) to conduct formative research to understand barriers and beliefs among pregnant women related to ANC, IFA supplementation, and pregnancy outcomes; (b) assess the quality of currently provided ANC services; (c) use the findings to guide the development of programmatic interventions to improve coverage of ANC services and IFA supplementation of pregnant women. Structured in-home interviews (n = 72) and focus groups (n = 4) were conducted with pregnant women in 4 randomly selected villages in rural Zinder. ANC consultations (n = 33) were observed in 5 randomly selected health centres, and exit interviews were conducted with all pregnant women and seven health agents following these observations. During workshops with stakeholders, results of the formative research were interpreted, and programmatic interventions were developed. In home interviews, 72% of women reported having attended at least one ANC visit. They also reported husbands (71%), mothers (40%), and friends (33%) supporting ANC attendance. Among those having attended ANC, only 65% reported taking IFA the day prior to the interview. Three of five health centres visited had IFA in stock. Health staff did not provide IFA supplements during 18 of 33 observed ANC consultations of which only 7 cases could be explained by the lack of IFA supplements in stock. Findings were used to design a 3-pronged intervention: (a) behaviour change communication activities in communities; (b) quality improvement activities in health centres to strengthen ANC; and (c) provision of key supplies required for ANC. © 2017 John Wiley & Sons Ltd.

  18. Vitamin K and other markers of micronutrient status in morbidly obese patients before bariatric surgery.

    Science.gov (United States)

    Ewang-Emukowhate, M; Harrington, D J; Botha, A; McGowan, B; Wierzbicki, A S

    2015-06-01

    Micronutrient deficiencies occur in morbidly obese patients. The aim of this study was to assess vitamin deficiencies prior to bariatric surgery including vitamin K about which there is little data in this population. A prospective assessment of 118 consecutive patients was performed. Clinical allied with haematological and biochemical variables were measured. Micronutrients measured included vitamins K1 , PIVKA-II (protein-induced in vitamin K absence factor II), vitamin D, vitamin B12 (holotranscobalamin), iron, transferrin and folate. Patients were aged 49 ± 11 [mean (SD, standard deviation)] years, body mass index (BMI) 50 ± 8 kg/m(2), 66% female and 78% Caucasian. Hypertension was present in 47% and type 2 diabetes in 32%. Vitamin D supplements had been prescribed in 8%. Micronutrient insufficiencies were found for vitamin K (40%), vitamin D (92%) and vitamin B12 (25%), and also iron (44%) and folate (18%). Normocalcaemic vitamin D insufficiency with secondary hyperparathyroidism was present in 18%. Iron and transferrin levels were associated with age, sex and estimated glomerular filtration rate. Vitamin K levels were associated with age, and inversely with BMI and diabetes mellitus; and PIVKA-II with smoking, triglycerides and liver function markers. Vitamin D levels were associated with statin use and prescription of supplements and inversely with BMI. Vitamin B12 levels were associated with ethnicity and HbA1c. Micronutrient status shows differing relationships with age, gender and BMI. Vitamin K insufficiency was present in 40% and not related to deficiencies in other vitamins or micronutrients. Vitamin D and vitamin K supplementation should be considered prebariatric surgery in patients with diabetes or severe insulin resistance. © 2014 John Wiley & Sons Ltd.

  19. Micronutrients attenuate progression of prostate cancer by elevating the endogenous inhibitor of angiogenesis, Platelet Factor-4

    Directory of Open Access Journals (Sweden)

    Fleshner Neil E

    2010-06-01

    Full Text Available Abstract Background Longstanding evidence implicates an inadequate diet as a key factor in the onset and progression of prostate cancer. The purpose herein was to discover, validate and characterize functional biomarkers of dietary supplementation capable of suppressing the course of prostate cancer in vivo. Methods The Lady transgenic mouse model that spontaneously develops prostate cancer received a diet supplemented with a micronutrient cocktail of vitamin E, selenium and lycopene ad libitum. A proteomic analysis was conducted to screen for serum biomarkers of this dietary supplementation. Candidate peptides were validated and identified by sequencing and analyzed for their presence within the prostates of all mice by immunohistochemistry. Results Dietary supplementation with the combined micronutrients significantly induced the expression of the megakaryocyte-specific inhibitor of angiogenesis, platelet factor-4 (P = 0.0025. This observation was made predominantly in mice lacking tumors and any manifestations associated with progressive disease beyond 37 weeks of life, at which time no survivors remained in the control group (P Conclusion We present unprecedented data whereby these combined micronutrients effectively promotes tumor dormancy in early prostate cancer, following initiation mutations that may drive the angiogenesis-dependent response of the tumor, by inducing platelet factor-4 expression and concentrating it at the tumor endothelium through enhanced platelet binding.

  20. Consumer preferences for micronutrient strategies in China. A comparison between folic acid supplementation and folate biofortification.

    Science.gov (United States)

    De Steur, Hans; Feng, Shuyi; Xiaoping, Shi; Gellynck, Xavier

    2014-06-01

    Despite public health efforts, folate deficiency is still largely prevalent in poor, rural populations and continues to cause a large burden of disease. The present paper determines and compares consumer preferences for two folate strategies: folic acid supplementation v. folate biofortification, i.e. the enhancement of the folate content in staple crops. Experimental auctions with non-repeated information rounds are applied to rice in order to obtain willingness-to-pay for folate products. Thereby, GM or non-GM folate-biofortified rice (FBR) is auctioned together with rice that is supplemented with free folic acid pills (FAR). Shanxi Province (China) as a high-risk region of folate deficiency. One hundred and twenty-six women of childbearing age, divided into a school (n 60) and market sample (n 66). Despite differences according to the targeted sample, a general preference for folate biofortification is observed, regardless of the applied breeding technology. Premiums vary between 33·9 % (GM FBR), 36·5 % (non-GM FBR) and 19·0 % (FAR). Zero bidding behaviour as well as the product choice question, respectively, support and validate these findings. The targeted sample, the timing of the auction, the intention to consume GM food and the responsibility for rice purchases are considered key determinants of product choice. A novel ex-post negative valuation procedure shows low consistency in zero bidding. While the low attractiveness of FAR provides an additional argument for the limited effectiveness of past folic acid supplementation programmes, the positive reactions towards GM FBR further support its potential as a possible complementary micronutrient intervention.

  1. Use of micronutrient supplements among pregnant women in Alberta: results from the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort.

    Science.gov (United States)

    Gómez, Mariel Fajer; Field, Catherine J; Olstad, Dana Lee; Loehr, Sarah; Ramage, Stephanie; McCargar, Linda J

    2015-10-01

    Maternal nutrient intake in the prenatal period is an important determinant of fetal growth and development and supports maternal health. Many women, however, fail to meet their prenatal nutrient requirements through diet alone and are therefore advised to consume nutrient supplements. The purpose of this study was to describe the use of natural health products (NHP) by pregnant women in each trimester of pregnancy. Women (n = 599) participating in the first cohort of the Alberta Pregnancy Outcomes and Nutrition (APrON) study completed an interviewer-administered supplement intake questionnaire during each trimester of pregnancy. NHP use was high, with >90% taking multivitamin/mineral supplements, and nearly half taking at least one additional single-nutrient supplement. Compliance with supplementation guidelines was high for folic acid (>90%), vitamin D (∼70%) and calcium (∼80%), but low for iron (<30%) and for all four nutrients together (≤11%). On average, women met or exceeded the recommended dietary allowance for folic acid, vitamin D and iron from NHPs alone, with median daily intakes of 1000 μg, 400 IU and 27 mg, respectively. The median calcium intake was 250 mg d(-1) . Up to 26% of women exceeded the tolerable upper intake level for folic acid and up to 19% did so for iron at some point of their pregnancy. Findings highlight the need to consider both dietary and supplemental sources of micronutrients when assessing the nutrient intakes of pregnant women. © 2013 John Wiley & Sons Ltd.

  2. The influence of micronutrients in cell culture: a reflection on viability and genomic stability.

    Science.gov (United States)

    Arigony, Ana Lúcia Vargas; de Oliveira, Iuri Marques; Machado, Miriana; Bordin, Diana Lilian; Bergter, Lothar; Prá, Daniel; Henriques, João Antonio Pêgas

    2013-01-01

    Micronutrients, including minerals and vitamins, are indispensable to DNA metabolic pathways and thus are as important for life as macronutrients. Without the proper nutrients, genomic instability compromises homeostasis, leading to chronic diseases and certain types of cancer. Cell-culture media try to mimic the in vivo environment, providing in vitro models used to infer cells' responses to different stimuli. This review summarizes and discusses studies of cell-culture supplementation with micronutrients that can increase cell viability and genomic stability, with a particular focus on previous in vitro experiments. In these studies, the cell-culture media include certain vitamins and minerals at concentrations not equal to the physiological levels. In many common culture media, the sole source of micronutrients is fetal bovine serum (FBS), which contributes to only 5-10% of the media composition. Minimal attention has been dedicated to FBS composition, micronutrients in cell cultures as a whole, or the influence of micronutrients on the viability and genetics of cultured cells. Further studies better evaluating micronutrients' roles at a molecular level and influence on the genomic stability of cells are still needed.

  3. Meeting the challenges of micronutrient malnutrition in the developing world.

    Science.gov (United States)

    Bhutta, Zulfiqar A; Salam, Rehana A; Das, Jai K

    2013-01-01

    Malnutrition still remains one of the major public health challenges, particularly in developing countries. Major risk factors for undernutrition such as suboptimal breastfeeding and micronutrient deficiencies (vitamin A and zinc) are responsible for more than one-third of all under five child deaths and 11% of the global total disease burden. Several strategies have been employed to supplement micronutrients. These include education, dietary modification, food provision, supplementation and fortification either alone or in combination. Supplementation is the most widely practiced intervention while fortification can also be a potentially cost-effective public health intervention and target a larger population through a single strategy. Universal coverage with the full bundle of interventions including micronutrient provision, complementary foods, treatments for worms and diarrheal diseases and behavior change programs package could be the way forward in achieving the Millennium Development Goals (MDGs). Bio-fortification and agricultural interventions including home and school gardening are relatively newer strategies and require further research as they have the potential to impact nutritional status of populations at large. Effectiveness of the various interventions is well recognized; however, consensus needs to be built around approaches to scale up coverage and delivery strategies to reduce disparities and provide equitable access. Future studies should focus on evaluating various approaches to address malnutrition with a standard methodology and defined outcomes. This will help gauge the actual morbidity and mortality impacts of these specific interventions and the long-term viability of these programs. On a broader scale, strategies to address food insecurity and poverty alleviation are the key as these are complex sustainable development issues, linked to health through malnutrition, but also to sustainable economic development, environment and trade.

  4. Micronutrient deficiency in urban Indonesia.

    Science.gov (United States)

    Gross, R; Schultink, W

    1997-06-01

    The economic situation of Indonesia is characterized by a large increase in the gross national product which has been on average 7% annually during the last ten years. This was accompanied by rapid urbanization. With the economic improvement, "First World" and "Third World" health and nutrition problems are coexisting in Indonesia. In 1992, the most common of death cause was cardiovascular disease whereas tuberculosis was the second ranking. About 40% of the preschool children are stunted. The main stable food and energy source is rice, although the urban population has a more diverse food pattern than the rural population. In Jakarta, many children receive too late colostrum feeding and mothers are not aware about the importance of correct breastfeeding practices after delivery. Three studies had shown that about one fifth of preschool children and one fourth of elderly take micronutrient supplements. Nevertheless, micronutrient deficiencies are prevalent in Jakarta. About one third of women suffer from moderate vitamin A deficiency (plasma retinol middle class to spend more time and money to solve their own problems.

  5. Effect of Short-Term Supplementation with Ready-to-Use Therapeutic Food or Micronutrients for Children after Illness for Prevention of Malnutrition: A Randomised Controlled Trial in Nigeria

    Science.gov (United States)

    van der Kam, Saskia; Salse-Ubach, Nuria; Roll, Stephanie; Swarthout, Todd; Gayton-Toyoshima, Sayaka; Jiya, Nma Mohammed; Matsumoto, Akiko; Shanks, Leslie

    2016-01-01

    Background Globally, Médecins Sans Frontières (MSF) treats more than 300,000 severely malnourished children annually. Malnutrition is not only caused by lack of food and poor infant and child feeding practices but also by illnesses. Breaking the vicious cycle of illness and malnutrition by providing ill children with nutritional supplementation is a potentially powerful strategy for preventing malnutrition that has not been adequately investigated. Therefore, MSF investigated whether incidence of malnutrition among ill children malnutrition rates. Methods and Findings We investigated the effect of supplementation with ready-to-use therapeutic food (RUTF) and a micronutrient powder (MNP) on the incidence of malnutrition in ill children presenting at an outpatient clinic in Goronyo during February to September 2012. A three-armed, partially-blinded, randomised controlled trial was conducted in children diagnosed as having malaria, diarrhoea, or lower respiratory tract infection. Children aged 6 to 59 mo were randomised to one of three arms: one sachet/d of RUTF; two sachets/d of micronutrients or no supplement (control) for 14 d for each illness over 6 mo. The primary outcome was the incidence of first negative nutritional outcome (NNO) during the 6 mo follow-up. NNO was a study-specific measure used to indicate occurrence of malnutrition; it was defined as low weight-for-height z-score (malnutrition. The lack of effect in Goronyo may be due to a high frequency of morbidity, which probably further affects a child’s nutritional status and children’s ability to escape from the illness–malnutrition cycle. The duration of the supplementation may have been too short or the doses of the supplements may have been too low to mitigate the effects of high morbidity and pre-existing malnutrition. An integrated approach combining prevention and treatment of diseases and treatment of moderate malnutrition, rather than prevention of malnutrition by nutritional

  6. Maternal Prenatal Nutrition and Birth Outcomes on Malnutrition among 7- to 10-Year-Old Children: A 10-Year Follow-Up.

    Science.gov (United States)

    Zhou, Jing; Zeng, Lingxia; Dang, Shaonong; Pei, Leilei; Gao, Wenlong; Li, Chao; Yan, Hong

    2016-11-01

    To identify postnatal predictors of malnutrition among 7- to 10-year-old children and to assess the long-term effects of antenatal micronutrient supplementation on malnutrition. A follow-up study was conducted to assess the nutritional status of 7- to 10-year-olds (1747 children) whose mothers participated in a cluster-randomized double-blind controlled trial from 2002 to 2006. The rate of malnourished 7- to 10-year-olds was 11.1%. A mixed-effects logistic regression model adjusted for the cluster-sampling design indicated that mothers with low prepregnant midupper arm circumference had boys with an increased risk of thinness (aOR  2.05, 95% CI  1.11, 3.79) and girls who were more likely to be underweight (aOR 2.01, 95% CI 1.05, 3.85). Antenatal micronutrient supplementation was not significantly associated with malnutrition. Low birth weight was significantly associated with increased odds of malnutrition among boys (aOR 4.34, 95% CI 1.82, 10.39) and girls (aOR  7.50, 95% CI 3.48, 16.13). Being small for gestational age significantly increased the odds of malnutrition among boys (aOR 1.75, 95% CI 1.01, 3.04) and girls (aOR 4.20, 95% CI  2.39, 7.39). In addition, household wealth, parental height, being picky eater, and illness frequency also predicted malnutrition. Both maternal prenatal nutrition and adverse birth outcomes are strong predictors of malnutrition among early school-aged children. Currently, available evidence is insufficient to support long-term effects of antenatal micronutrient supplementation on children's nutrition. www.isrctn.com: ISRCTN08850194. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Micronutrient Supplementation, Dietary Intervention and Resulting Body Weight Gain of Severe Acute Malnourished Children – A Pilot Project Study of OJUS Medical Institute with Existing ICDS Project in Nasik District, Maharashtra

    Directory of Open Access Journals (Sweden)

    Subhasree Ray

    2014-12-01

    Full Text Available Introduction: OJUS Medical Institute in collaboration with Women & Child development department of Nashik District, Maharashtra conducted a target oriented pilot project study to see the improvement in body weight gain of SAM children, supplemented with nutritionally enriched diet and micronutrients. The Egg-DOT project is a target vertical intervention study that involved both Anganwadi workers and Community health workers to bring a fruitful result by working hand-in-hand. Rationale: ICDS is one of the best supplementary nutrition programs to address and eliminate malnutrition from the country. To make it more comprehensive and result oriented the pilot project study is formulated and executed to see if the addition in existing system could eradicate malnutrition in an effective manner and strengthen the Govt. health machinery. Objective: The study aimed at working along with the Govt. to reduce severity of malnutrition. It shouted for a healthy public-private relationship to bring optimum result from the existing Govt. project in reducing burden of malnutrition, spreading health education and behavioural modification in the community members by adopting a systematic micronutrient-diet-health education  intervention strategy. Materials & methods: Along with existing nutritional intervention, a small modification in diet is introduced to fulfill the deficit of 300 Kcal approximately. Good quality fat and protein are added to the Anganwadi meal with daily micronutrient supplementation. The supplementation is continued for 30 days in 25 SAM children of 3 to 5 years. The baseline and end line body weight measurements are taken and compared to see the improvement. Result: After 30 days of intervention the supplemented SAM children showed statistically significant increased body weight (P<0.01 with an overall healthy nutritional status. Conclusion: The study showed that public-private collaborative systematic strategy with proper

  8. Addressing the risk of inadequate and excessive micronutrient intakes: traditional versus new approaches to setting adequate and safe micronutrient levels in foods

    Directory of Open Access Journals (Sweden)

    Maaike J. Bruins

    2015-01-01

    Full Text Available Fortification of foods consumed by the general population or specific food products or supplements designed to be consumed by vulnerable target groups is amongst the strategies in developing countries to address micronutrient deficiencies. Any strategy aimed at dietary change needs careful consideration, ensuring the needs of at-risk subgroups are met whilst ensuring safety within the general population. This paper reviews the key principles of two main assessment approaches that may assist developing countries in deciding on effective and safe micronutrient levels in foods or special products designed to address micronutrient deficiencies, that is, the cut-point method and the stepwise approach to risk–benefit assessment. In the first approach, the goal is to shift population intake distributions such that intake prevalences below the Estimated Average Requirement (EAR and above the Tolerable Upper Intake Level (UL are both minimized. However, for some micronutrients like vitamin A and zinc, a narrow margin between the EAR and UL exists. Increasing their intakes through mass fortification may pose a dilemma; not permitting the UL to be exceeded provides assurance about the safety within the population but can potentially leave a proportion of the target population with unmet needs, or vice versa. Risk–benefit approaches assist in decision making at different micronutrient intake scenarios by balancing the magnitude of potential health benefits of reducing inadequate intakes against health risks of excessive intakes. Risk–benefit approaches consider different aspects of health risk including severity and number of people affected. This approach reduces the uncertainty for policy makers as compared to classic cut-point methods.

  9. The effect of macro- and micro-nutrient fortification of biscuits on their sensory properties and on hedonic liking of older people.

    Science.gov (United States)

    Tsikritzi, Roussa; Moynihan, Paula J; Gosney, Margot A; Allen, Victoria J; Methven, Lisa

    2014-08-01

    Under-nutrition in older adults is widespread. Oral nutritional supplement beverages (ONS) are prescribed, yet consumption by older people is often insufficient. A variety of supplement formats may improve nutrient intake. This study developed protein and micro-nutrient fortified biscuits and evaluated their sensory attributes and liking by older people. Two micro-nutrient strategies were taken, to match typical ONS and to customise to the needs of older people. Oat biscuits and gluten-free biscuits developed contained over 12% protein and over 460 kcal 100 g(-1). Two small (40 g) biscuits developed to match ONS provided approximately 40% of an ONS portion of micro-nutrients and 60% of macro-nutrients; however, the portion size was considered realistic whereas the average ONS portion (200 mL) is excessive. Biscuits developed to the needs of older adults provided, on average, 18% of the reference nutrient intake of targeted micro-nutrients. Sensory characteristics were similar between biscuits with and without micro-nutrient fortification, leading to no differences in liking. Fortified oat biscuits were less liked than commercial oat biscuits, partly attributed to flavour imparted by whey protein fortification. Macro- and micro-nutrient fortification of biscuits could provide an alternative fortified snack to help alleviate malnutrition in older adults. © 2013 Society of Chemical Industry.

  10. Prevention and control of micronutrient deficiencies in developing countries: current perspectives

    Directory of Open Access Journals (Sweden)

    Berti C

    2014-05-01

    Full Text Available Cristiana Berti,1 Mieke Faber,2 Cornelius M Smuts11Centre for Excellence in Nutrition, North-West University, Potchefstroom, South Africa; 2Non-communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South AfricaAbstract: Despite strategies employed to tackle micronutrient malnutrition, limited progress has been achieved in the developing countries. Of global concern are deficiencies in iron, vitamin A, zinc, folate, and iodine. This review aims to explore up-to-date scientific evidence on the effect of different micronutrient strategies on biomarkers and health outcomes, and for each strategy, to highlight strengths, limitations, and factors contributing to success or failure. PubMed/MEDLINE and EBSCO databases and Google-indexed scientific literature were searched for relevant articles and documents, limited to human studies reported since 2003. Evidence shows that the most cost-effective approaches to address symptoms of micronutrient malnutrition are targeted supplementation and/or fortification with iron, iodine, zinc, folic acid, vitamin A, and multimicronutrients, provided that households have access to primary health care and that there is consistent long-term coverage, monitoring, adequate marketing, and commercial commitment. Dietary diversification/modification interventions are probably the most sustainable strategies to address causes of deficiency, but permanent solutions are still required in controlling micronutrient malnutrition at both research and public health levels. Furthermore, many scientific gaps remain, hindering the development of robust public health guidance. These gaps are due to the paucity of well-designed community-based studies, lack of information on biological mechanisms behind relationships between micronutrients and outcomes, and inconsistent results. Further adequately powered long-term trials are needed to fill these gaps. Lessons learned from large-scale nutritional

  11. Sex-Specific Muscular Maturation Responses Following Prenatal Exposure to Methylation-Related Micronutrients in Pigs

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    Michael Oster

    2017-01-01

    Full Text Available Supplementation of micronutrients involved in DNA methylation, particularly during pregnancy, is recommended because of its impacts on human health, but further evidence is needed regarding the effects of over-supplementation and differences between sexes. Here, a porcine model was used to assess effects of maternal supplementation with one-carbon-cycle compounds during prenatal and postnatal stages on offspring muscle development. Sows received either a standard diet (CON or a standard diet supplemented with folate, B6, B12, methionine, choline, and zinc (MET throughout gestation. Myogenesis-, growth-, and nutrient utilization-related transcript expression was assessed using quantitative PCR. Organismal phenotype and gene expression effects differed significantly between males and females. Male MET-offspring showed increased fetal weight during late pregnancy but decreased live weight postnatally, with compensatory transcriptional responses comprising myogenic key drivers (Pax7, MyoD1, myogenin. In contrast, female weights were unaffected by diet, and mRNA abundances corresponded to a phenotype of cellular reorganization via FABP3, FABP4, SPP1 and Insulin-like Growth Factor-signaling. These findings in an animal model suggest that supplementation during pregnancy with methylation-related micronutrients can promote sex-specific myogenic maturation processes related to organismal growth and muscle metabolism. The usage of maternal dietary supplements should be more carefully considered regarding its ability to promote fetal and postnatal health.

  12. Situation analysis of procurement and production of multiple micronutrient supplements in 12 lower and upper middle-income countries.

    Science.gov (United States)

    Monterrosa, Eva C; Beesabathuni, Kalpana; van Zutphen, Kesso G; Steiger, Georg; Kupka, Roland; Fleet, Alison; Kraemer, Klaus

    2017-12-26

    Globally, there are few vitamin and mineral ingredient manufacturers. To support local, in-country or regional procurement and production of multiple micronutrient supplements (MMS), the following production scenarios are possible: (a) straight ingredients of vitamins and minerals forms imported or locally produced that are mixed, tableted, or encapsulated and packaged by a local manufacturer; (b) import or local production of a vitamin and minerals premix that is tableted or encapsulated and packaged locally; (c) import of a bulk, finished product (tablets or capsules) that is packaged and branded; and (d) or import of a branded packaged product. This paper is a situation analysis of the market, manufacturing, and policy factors that are driving the production of MMS in 12 lower and upper middle-income countries. Key informants completed a self-administered structured questionnaire, which examined the local context of products available in the market and their cost, regulations and policies, in Brazil, Colombia, Guatemala, Mexico, Peru, Bangladesh, India, Vietnam, Ghana, Kenya, Nigeria, and South Africa. Our study found that although most countries have the capacity to produce locally MMS, the major barriers observed for sustainable and affordable production include (a) poor technical capacity and policies for ensuring quality along the value chain and (b) lack of policy coherence to incentivize local production and lower the manufacture and retail price of MMS. Also, better guidelines and government oversight will be required because not one country had an MMS formulation that matched the globally recommended formulation of the United Nations Multiple Micronutrient Preparation (UNIMMAP). © 2018 John Wiley & Sons Ltd.

  13. Effects of Prenatal Multiple Micronutrient Supplementation on Fetal Growth Factors: A Cluster-Randomized, Controlled Trial in Rural Bangladesh.

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    Alison D Gernand

    Full Text Available Prenatal multiple micronutrient (MM supplementation improves birth weight through increased fetal growth and gestational age, but whether maternal or fetal growth factors are involved is unclear. Our objective was to examine the effect of prenatal MM supplementation on intrauterine growth factors and the associations between growth factors and birth outcomes in a rural setting in Bangladesh. In a double-blind, cluster-randomized, controlled trial of MM vs. iron and folic acid (IFA supplementation, we measured placental growth hormone (PGH at 10 weeks and PGH and human placental lactogen (hPL at 32 weeks gestation in maternal plasma (n = 396 and insulin, insulin-like growth factor-1 (IGF-1, and IGF binding protein-1 (IGFBP-1 in cord plasma (n = 325. Birth size and gestational age were also assessed. Early pregnancy mean (SD BMI was 19.5 (2.4 kg/m2 and birth weight was 2.68 (0.41 kg. There was no effect of MM on concentrations of maternal hPL or PGH, or cord insulin, IGF-1, or IGFBP-1. However, among pregnancies of female offspring, hPL concentration was higher by 1.1 mg/L in the third trimester (95% CI: 0.2, 2.0 mg/L; p = 0.09 for interaction; and among women with height <145 cm, insulin was higher by 59% (95% CI: 3, 115%; p = 0.05 for interaction in the MM vs. IFA group. Maternal hPL and cord blood insulin and IGF-1 were positively, and IGFBP-1 was negatively, associated with birth weight z score and other measures of birth size (all p<0.05. IGF-1 was inversely associated with gestational age (p<0.05, but other growth factors were not associated with gestational age or preterm birth. Prenatal MM supplementation had no overall impact on intrauterine growth factors. MM supplementation altered some growth factors differentially by maternal early pregnancy nutritional status and sex of the offspring, but this should be examined in other studies.ClinicalTrials.gov NCT00860470.

  14. Development of protein, dietary fiber, and micronutrient enriched extruded corn snacks.

    Science.gov (United States)

    Shah, Faiz-Ul-Hassan; Sharif, Mian Kamran; Butt, Masood Sadiq; Shahid, Muhammad

    2017-06-01

    The study was aimed to develop protein, dietary fiber, and micronutrient enriched corn snacks through extrusion processing. Corn snacks supplemented with chickpea, defatted soy flour (20-40/100 g) and guar gum (7/100 g) were prepared through extrusion processing. Micronutrients (iron, zinc, iodine, and vitamins A, C, and folic acid) at recommended daily values were added in all formulations. Extruded corn snacks were analyzed for physical, textural, and sensory attributes. Results showed that piece density (0.34-0.44 g/cm 3 ), moisture (3.40-5.25%), water activity (0.203-0.361), hardness (64.4-133.2 N), and cohesiveness (0.25-0.44) was increased Whereas, expansion ratio (3.72-2.64), springiness (0.82-0.69), chewiness (1.63-0.42), and resilience (1.37-0.14) was decreased as supplementation with soy and chickpea flour increased from 20 to 40/100 g. Overall corn snack supplemented with 15/100 g of soy and 15/100 g of chickpea flour got the highest acceptance from the sensory panelists. The article focuses on physical, textural, and sensory attributes of extruded corn snacks enriched with protein, dietary fiber, and micronutrients Awareness about the importance of healthy snacks has grown among the consumers during the last decade. Extruded snacks developed using nutrient rich ingredients with good textural and sensory properties has always remained a challenge for the snack industry. Texture of the extruded snacks varies a lot with high levels of protein and dietary fiber. This study is helpful for the development of healthy snacks especially in developing countries lacking storage infrastructure or tropical environment. Nutrient rich extruded snacks can also be used to alleviate malnutrition by incorporating in school lunch programs. © 2016 Wiley Periodicals, Inc.

  15. Combating micronutrient deficiency disorders amongst children

    Directory of Open Access Journals (Sweden)

    Umesh Kapil

    2014-11-01

    further deteriorates their micronutrients nutritional status. The direct supplementation of Micronutrients like Vitamin A, Iron   are beneficial in short term but they are not sustainable. We do not know for how many years or generations we need to continue with direct supplementation. The families also develop a culture of dependence on the “state” for nutrition support. We need to look in to the long term but sustainable strategies. There is a need to strengthen the family resources so that family may able to look after the diet of children and prevent micronutrient deficiencies.The Food Fortification is an important intervention. It is sustainable as the cost of fortification is borne by the beneficiaries who consume the fortified foods like the case of Iodized salt. However, an important consideration for the food fortification strategy is that it increases the cost of foods as compared to non-fortified foods. The poor families who do not have resources to buy raw food, they are more constraint for   availability of foods. There is a need of developing Food Fortification strategies which are scientifically sound, operationally feasible and with proven effectiveness before they are implemented in developing countries. We need to assess this food fortification interventions carefully before we launch them.  We also need   to ensure that the poorest to the poor, including families which are below the poverty line   are covered on priority basis.  The issue of implementation of targeted versus universal fortification of foods needs to be considered based on the epidemiological evidence of prevalence of micronutrient deficiencies in the region for   judicious utilization of resources. To achieve this, there is a need of joining hands amongst the nutrition scientists, public health specialists and food fortification technologists to shoulder responsibility towards devising effective and practical strategies to overcome the emergent challenges of

  16. Combating micronutrient deficiency disorders amongst children

    Directory of Open Access Journals (Sweden)

    Umesh Kapil

    2014-12-01

    which further deteriorates their micronutrients nutritional status. The direct supplementation of Micronutrients like Vitamin A, Iron   are beneficial in short term but they are not sustainable. We do not know for how many years or generations we need to continue with direct supplementation. The families also develop a culture of dependence on the “state” for nutrition support. We need to look in to the long term but sustainable strategies. There is a need to strengthen the family resources so that family may able to look after the diet of children and prevent micronutrient deficiencies. The Food Fortification is an important intervention. It is sustainable as the cost of fortification is borne by the beneficiaries who consume the fortified foods like the case of Iodized salt. However, an important consideration for the food fortification strategy is that it increases the cost of foods as compared to non-fortified foods. The poor families who do not have resources to buy raw food, they are more constraint for   availability of foods. There is a need of developing Food Fortification strategies which are scientifically sound, operationally feasible and with proven effectiveness before they are implemented in developing countries. We need to assess this food fortification interventions carefully before we launch them.  We also need   to ensure that the poorest to the poor, including families which are below the poverty line   are covered on priority basis.  The issue of implementation of targeted versus universal fortification of foods needs to be considered based on the epidemiological evidence of prevalence of micronutrient deficiencies in the region for   judicious utilization of resources. To achieve this, there is a need of joining hands amongst the nutrition scientists, public health specialists and food fortification technologists to shoulder responsibility towards devising effective and practical strategies to overcome the emergent challenges of

  17. Dietary supplements and disease prevention: a global overview

    Science.gov (United States)

    Undernutrition and micronutrient malnutrition are prevalent conditions that affect global public health. Dietary supplements are widely used in many developed countries. However, it remains unclear whether supplementation with individual or combined vitamins, minerals, and other nutrients are effe...

  18. Feasibility and effect of life skills building education and multiple micronutrient supplements versus the standard of care on anemia among non-pregnant adolescent and young Pakistani women (15-24 years): a prospective, population-based cluster-randomized trial.

    Science.gov (United States)

    Baxter, Jo-Anna B; Wasan, Yaqub; Soofi, Sajid B; Suhag, Zamir; Bhutta, Zulfiqar A

    2018-05-30

    Adolescence is a critical period for physical and psychological growth and development, and vitamin and mineral requirements are correspondingly increased. Health and health behaviours correspond strongly from adolescence to adulthood. Developing a preconception care package for adolescent and young women in resource-limited settings could serve to empower them to make informed decisions about their nutrition, health, and well-being, as well as function as a platform for the delivery of basic nutrition-related interventions to address undernutrition. In this population-based two-arm, cluster-randomized, controlled trial of life skills building education (provided bi-monthly) and multiple micronutrient supplementation (provided twice-weekly; UNIMMAP composition), we aim to evaluate the effectiveness of the intervention on the prevention of anemia (hemoglobin concentration nutrition (anthropometry [height, weight, middle upper arm circumference (MUAC)], nutritional status [iron, vitamin A, vitamin D]); general health (morbidity, mortality); and empowerment (age at marriage, completion of the 10th grade, use of personal hygienic materials during menstruation) will also be assessed. Participants will be enrolled in the study for a maximum of 2 years. Empowering adolescent and young women with the appropriate knowledge to make informed and healthy decisions will be key to sustained behavioural change throughout the life-course. Although multiple micronutrient deficiencies are known to exist among adolescent and young women in low-resource settings, recommendations on preconception multiple micronutrient supplementation do not exist at this time. This study is expected to offer insight into providing an intervention that includes both education and supplements to non-pregnant adolescent and young women for a prolonged duration of time within the existing public health programmatic context. This study is part of the Matiari emPowerment and Preconception Supplementation

  19. Contribution made by biomarkers of status to an FP6 Network of Excellence, EURopean micronutrient RECommendations Aligned (EURRECA).

    Science.gov (United States)

    Fairweather-Tait, Susan J

    2011-08-01

    Dietary reference values for micronutrients vary considerably among countries, and harmonization is needed to facilitate nutrition policy and public health strategies at the European and global levels. The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence is developing generic instruments for systematically deriving and updating micronutrient reference values and dietary recommendations. These include best practice guidelines, interlinked web pages, online databases, and decision trees. Journal supplements have been published on micronutrient intakes and status, and an ongoing activity of EURRECA is the completion of systematic reviews on associations between intakes, status, and various health outcomes for priority micronutrients (ie, iron, zinc, folate, vitamin B-12, and iodine), which were selected by using a triage technique. Future activities include meta-analyses to identify dose-response relations and the variability, factorial estimates of requirements, bioavailability from whole diets, effects of genotype, and modeling techniques for addressing dietary recommendations for combinations of nutrients with common health endpoints.

  20. Mapping low intake of micronutrients across Europe.

    Science.gov (United States)

    Mensink, G B M; Fletcher, R; Gurinovic, M; Huybrechts, I; Lafay, L; Serra-Majem, L; Szponar, L; Tetens, I; Verkaik-Kloosterman, J; Baka, A; Stephen, A M

    2013-08-01

    Achieving an understanding of the extent of micronutrient adequacy across Europe is a major challenge. The main objective of the present study was to collect and evaluate the prevalence of low micronutrient intakes of different European countries by comparing recent nationally representative dietary survey data from Belgium, Denmark, France, Germany, The Netherlands, Poland, Spain and the United Kingdom. Dietary intake information was evaluated for intakes of Ca, Cu, I, Fe, Mg, K, Se, Zn and the vitamins A, B₁, B₂, B₆, B₁₂, C, D, E and folate. The mean and 5th percentile of the intake distributions were estimated for these countries, for a number of defined sex and age groups. The percentages of those with intakes below the lower reference nutrient intake and the estimated average requirement were calculated. Reference intakes were derived from the UK and Nordic Nutrition Recommendations. The impact of dietary supplement intake as well as inclusion of apparently low energy reporters on the estimates was evaluated. Except for vitamin D, the present study suggests that the current intakes of vitamins from foods lead to low risk of low intakes in all age and sex groups. For current minerals, the study suggests that the risk of low intakes is likely to appear more often in specific age groups. In spite of the limitations of the data, the present study provides valuable new information about micronutrient intakes across Europe and the likelihood of inadequacy country by country.

  1. The impact of antenatal care, iron-folic acid supplementation and tetanus toxoid vaccination during pregnancy on child mortality in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Tanvir Abir

    Full Text Available Appropriate antenatal care (ANC is an important preventive public health intervention to ensure women's and newborn health outcomes. The study aimed to investigate the impact of ANC, iron-folic acid (IFA supplementation and tetanus toxoid (TT vaccination during pregnancy on child mortality in Bangladesh.A cross-sectional study of three datasets from the Bangladesh Demographic and Health Surveys for the years 2004, 2007 and 2011 were pooled and used for the analyses. A total weighted sample of 16,721 maternal responses (5,364 for 2004; 4,872 for 2007 and 6,485 for 2011 was used. Multivariate logistic models that adjusted for cluster and sampling weights were used to examine the impact of ANC, IFA supplementation and TT vaccination during pregnancy on the death of a child aged 0-28 days (neonatal, 1-11 months (post-neonatal and 12-59 months (child.Multivariable analyses revealed that the odds of postnatal and under-5 mortality was lower in mothers who had ANC [Odds Ratio (OR = 0.60, 95% confidence interval (95% CI: 0.43-0.85], IFA supplementation [OR = 0.66, 95% CI: (0.45-0.98] and ≥2 TT vaccinations (OR = 0.43, 95% CI: 0.49-0.78 for post-natal mortality; and for under-5 mortality, any form of ANC (OR = 0.69, 95% CI: 0.51-0.93, IFA supplementation (OR = 0.67, 95% CI: 0.48-0.94 and ≥2 TT vaccinations (OR = 0.50, 95% CI: 0.36-0.69. When combined, TT vaccination with IFA supplementation, and TT vaccination without IFA supplementation were protective across all groups.The study found that ANC, IFA supplementation, and TT vaccination during pregnancy reduced the likelihood of child mortality in Bangladesh. The findings suggest that considerable gains in improving child survival could be achieved through ensuring universal coverage of ANC, promoting TT vaccination during pregnancy and IFA supplementation among pregnant women in Bangladesh.

  2. Micronutrient supplementation of young stunted Beninese children: effects on appetite and growth performance

    NARCIS (Netherlands)

    Dossa, R.A.M.

    2001-01-01

    Linear growth retardation (stunting) still has a high prevalence rate in developing countries (ACC/SCN, 2000). In the republic of Benin reported prevalence rates range from 25% to 40%. In malnourished children it is quite common to observe a combination of multiple micronutrient deficiency,

  3. Nutritional supplements in age-related macular degeneration.

    Science.gov (United States)

    Schmidl, Doreen; Garhöfer, Gerhard; Schmetterer, Leopold

    2015-03-01

    Age-related macular degeneration (AMD) is the most frequent cause of blindness in the Western World. While with new therapies that are directed towards vascular endothelial growth factor (VEGF), a potentially efficient treatment option for the wet form of the disease has been introduced, a therapeutic regimen for dry AMD is still lacking. There is evidence from several studies that oral intake of supplements is beneficial in preventing progression of the disease. Several formulations of micronutrients are currently available. The present review focuses on the role of supplements in the treatment and prevention of AMD and sums up the current knowledge about the most frequently used micronutrients. In addition, regulatory issues are discussed, and future directions for the role of supplementation in AMD are highlighted. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  4. Selection of micronutrients used along with DMSA in the treatment of moderately lead intoxicated mice

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Yingjun [China Medical University, Department of Physiology, School of Basic Medicine, Shenyang, Liaoning (China); Yu, Fei; Zhi, Xuping; An, Li; Yang, Jun [China Medical University, Department of Nutrition and Food Hygiene, School of Public Health, Shenyang, Liaoning (China); Jin, Yaping; Lu, Chunwei; Li, Gexin [China Medical University, Department of Environmental and Occupational Health, School of Public Health, Shenyang, Liaoning (China)

    2008-01-15

    The objective of this study was to explore the optimum combination of micronutrients used with 2,3-dimercaptosuccinic acid (DMSA) in the treatment of moderately lead-intoxicated mice. Experiment was carried out based on the orthogonal design L{sub 8}(2{sup 7}) setting six factors with two different levels of each, and eight groups of mice were needed. Mice were exposed to lead by drinking water contaminated with 0.1% lead acetate for four consecutive weeks, and then supplemented by gavage with different combinations of micronutrients with and without DMSA as designed in the orthogonal table. Lead levels in blood, liver, kidney, brain and bone and activities of blood {delta}-aminolevulinic acid dehydratase (ALAD) were analyzed after cessation of supplementation. The results suggested that DMSA was the only factor which could decrease significantly lead levels in blood, liver, kidney and bone; calcium and ascorbic acid were the notable factors decreasing lead levels in blood, liver, kidney, bone and brain; zinc and calcium were the notable factors reversing the lead-inhibited activities of blood ALAD; taurine was the notable factor decreasing lead levels in kidney and brain; and thiamine was the notable factor decreasing lead levels in brain. The lowest lead level in blood, liver, kidney and bone was shown in the mice supplemented with combination of calcium and ascorbic acid along with DMSA. In conclusion, the optimum combination of micronutrients used with DMSA suggested in present study was calcium and ascorbic acid, which seemed to potentiate the chelating efficacy of DMSA in the treatment of moderately lead intoxicated mice. (orig.)

  5. Effect and mechanism of micronutrient compound on swimming endurance in mice with nutritional deficiency

    Directory of Open Access Journals (Sweden)

    Jian-quan WU

    2012-07-01

    Full Text Available Objective To investigate the anti-fatigue effect and possible mechanisms of micronutrient compound. Methods One hundred and twenty-five male Kunming mice (SPF were fed following different feeding stuffs: sufficient feed, i.e. AIN-93M feed (corn starch 46.6%, casein 14%, dextrinized corn starch 15.5%, sucrose 10%, soybean oil 4%, fiber 5%, mineral mix 3.5%, vitamin mix 1%, L-cystine 0.18%, choline chloride 0.138% and tert-butylhydroquinone 8 ppm; insufficient feed (composed the same ingredients as the AIN-93M diet, replacing 30%, 50% or 70% of the content of mineral and vitamin mix with corn starch; compound micronutrient-added feed (CMAF, replacing 30% of the content of mineral and vitamin mix of AIN-93M diet with micronutrient compound composed of (g/kg Vit A 0.25, Vit B1 0.3, Vit B2 0.3, Vit B6 0.35, nicotinic acid 1.5, Vit D 0.05, Vit C 50, Vit E 10, calcium carbonate 180, ferrous glycine 1, zinc lactate 1 and corn starch 755.25. The mice were fed for 14 or 28 d, and then subjected to forced swim test with a load on their tails to exhaustion. The maximal swimming time was recorded. In another experiment, the Kunming mice were fed with corresponding feed for 28 d, and then subjected to forced swim test for 60 min, thereafter the samples of blood and liver were collected immediately. The serum contents of glucose, lactate, nonprotein nitrogen, nonesterified fatty acids and hepatic glycogen were measured. Results The dietary intake of 30% nutritional insufficient group (30% group was significantly decreased compared with normal control group (fed with AIN-93M diet, (P 0.05. The serum glucose and hepatic glycogen decreased and serum lactate, nonprotein nitrogen and nonesterified fatty acids increased in the control group, which were aggravated in nutrient insufficient group and reversed in micronutrient supplementation group. Conclusions Insufficient intake of micronutrients has significant influence on swimming endurance in mice and compound

  6. Effects of prenatal multiple micronutrient supplementation on growth and cognition through 2 y of age in rural Bangladesh: the JiVitA-3 Trial.

    Science.gov (United States)

    Christian, Parul; Kim, Jeongyong; Mehra, Sucheta; Shaikh, Saijuddin; Ali, Hasmot; Shamim, Abu Ahmed; Wu, Lee; Klemm, Rolf; Labrique, Alain B; West, Keith P

    2016-10-01

    Childhood undernutrition may have prenatal origins, and the impact of prenatal interventions on postnatal growth is not well known. We assessed the effects of prenatal multiple micronutrient (MM) supplementation on child growth and cognitive development. In a cluster-randomized controlled trial in rural Bangladesh, prenatal MM supplementation compared with iron-folic acid (IFA) supplementation was examined for its impact on growth assessed longitudinally from birth up to 24 mo of age (n = 8529) and, in a subsample (n = 734), on cognitive function at 24 mo of age by use of the Bayley scales of infant and toddler development-third edition test. Prevalence of stunting at birth [length for age z score (LAZ): growth. Ponderal and linear growth velocities were somewhat slower from 3 to 12 mo of age in the MM group than in the IFA group, but not from 12 to 24 mo of age. There was no difference between groups on composite scores of cognition, language, and motor performance at 24 mo of age. In this Bangladeshi trial, maternal pre- and postnatal MM supplementation resulted in improvements in LAZ and reduction in stunting through 3 mo of age, but not thereafter and had no impact on cognitive and motor function at 2 y. This trial was registered at clinicaltrials.gov as NCT000860470. © 2016 American Society for Nutrition.

  7. Micronutrients, N-Acetyl Cysteine, Probiotics and Prebiotics, a Review of Effectiveness in Reducing HIV Progression

    Science.gov (United States)

    Hummelen, Ruben; Hemsworth, Jaimie; Reid, Gregor

    2010-01-01

    Low serum concentrations of micronutrients, intestinal abnormalities, and an inflammatory state have been associated with HIV progression. These may be ameliorated by micronutrients, N-acetyl cysteine, probiotics, and prebiotics. This review aims to integrate the evidence from clinical trials of these interventions on the progression of HIV. Vitamin B, C, E, and folic acid have been shown to delay the progression of HIV. Supplementation with selenium, N-acetyl cysteine, probiotics, and prebiotics has considerable potential, but the evidence needs to be further substantiated. Vitamin A, iron, and zinc have been associated with adverse effects and caution is warranted for their use. PMID:22254046

  8. Effect of Short-Term Supplementation with Ready-to-Use Therapeutic Food or Micronutrients for Children after Illness for Prevention of Malnutrition: A Randomised Controlled Trial in Nigeria.

    Science.gov (United States)

    van der Kam, Saskia; Salse-Ubach, Nuria; Roll, Stephanie; Swarthout, Todd; Gayton-Toyoshima, Sayaka; Jiya, Nma Mohammed; Matsumoto, Akiko; Shanks, Leslie

    2016-02-01

    Globally, Médecins Sans Frontières (MSF) treats more than 300,000 severely malnourished children annually. Malnutrition is not only caused by lack of food and poor infant and child feeding practices but also by illnesses. Breaking the vicious cycle of illness and malnutrition by providing ill children with nutritional supplementation is a potentially powerful strategy for preventing malnutrition that has not been adequately investigated. Therefore, MSF investigated whether incidence of malnutrition among ill children malnutrition rates. We investigated the effect of supplementation with ready-to-use therapeutic food (RUTF) and a micronutrient powder (MNP) on the incidence of malnutrition in ill children presenting at an outpatient clinic in Goronyo during February to September 2012. A three-armed, partially-blinded, randomised controlled trial was conducted in children diagnosed as having malaria, diarrhoea, or lower respiratory tract infection. Children aged 6 to 59 mo were randomised to one of three arms: one sachet/d of RUTF; two sachets/d of micronutrients or no supplement (control) for 14 d for each illness over 6 mo. The primary outcome was the incidence of first negative nutritional outcome (NNO) during the 6 mo follow-up. NNO was a study-specific measure used to indicate occurrence of malnutrition; it was defined as low weight-for-height z-score (children), mid-upper arm circumference children who were moderately malnourished compared with non-malnourished at enrollment. The average number of study illnesses for the RUTF, MNP, and control groups were 4.2 (95% CI, 4.0-4.3), 3.4 (3.2-3.6), and 3.6 (3.4-3.7). The proportion of children who died in the RUTF, MNP, and control groups were 0.8% (95% CI, 0.3-1.8), 1.8% (1.0-3.3), and 1.4% (0.7-2.8). A 2-wk supplementation with RUTF or MNP to ill children as part of routine primary medical care did not reduce the incidence of malnutrition. The lack of effect in Goronyo may be due to a high frequency of morbidity

  9. Food Components and Supplements

    DEFF Research Database (Denmark)

    Parlesak, Alexandr

    2012-01-01

    The major part of food consists of chemical compounds that can be used for energy production, biological synthesis, or maintenance of metabolic processes by the host. These components are defined as nutrients, and can be categorized into macronutrients (proteins, carbohydrates, triglycerides......, and alcohol), minerals, and micronutrients. The latter category comprises 13 vitamins and a hand full of trace elements. Many micronutrients are used as food supplements and are ingested at doses exceeding the amounts that can be consumed along with food by a factor of 10–100. Both macro- and micronutrients...... can interact with enzyme systems related to xenobiotic metabolism either by regulation of their expression or direct interference with their enzymatic activity. During food consumption, we consume a wide range of xenobiotics along with the consumable food, either as an original part of the food (e...

  10. The Micronutrient Genomics Project: A community-driven knowledge base for micronutrient research

    NARCIS (Netherlands)

    Ommen, B. van; El-Sohemy, A.; Hesketh, J.; Kaput, J.; Fenech, M.; Evelo, C.T.; McArdle, H.J.; Bouwman, J.; Lietz, G.; Mathers, J.C.; Fairweather-Tait, S.; Kranen, H. van; Elliott, R.; Wopereis, S.; Ferguson, L.R.; Méplan, C.; Perozzi, G.; Allen, L.; Rivero, D.

    2010-01-01

    Micronutrients influence multiple metabolic pathways including oxidative and inflammatory processes. Optimum micronutrient supply is important for the maintenance of homeostasis in metabolism and, ultimately, for maintaining good health. With advances in systems biology and genomics technologies, it

  11. Nutritional supplements for people being treated for active tuberculosis: A technical summary.

    Science.gov (United States)

    Grobler, L; Durao, S; Van der Merwe, S M; Wessels, J; Naude, C E

    2017-12-13

    Tuberculosis and nutrition are intrinsically linked in a complex relationship. Altered metabolism and loss of appetite associated with tuberculosis may result in undernutrition, which in turn may worsen the disease or delay recovery. We highlight an updated Cochrane review assessing the effects of oral nutritional supplements in people with active tuberculosis who are receiving antituberculosis drug therapy. The review authors conducted a comprehensive search (February 2016) for all randomised controlled trials comparing any oral nutritional supplement, given for at least 4 weeks, with no nutritional intervention, placebo or dietary advice only in people receiving antituberculosis treatment. Of the 35 trials (N=8 283 participants) included, seven assessed the provision of free food or high-energy supplements, six assessed multi-micronutrient supplementation, and 21 assessed single- or dual-micronutrient supplementation. There is currently insufficient evidence to indicate whether routinely providing free food or high-energy supplements improves antituberculosis treatment outcomes (i.e. reduced death and increased cure rates at 6 and 12 months), but it probably improves weight gain in some settings. Plasma levels of zinc, vitamin D, vitamin E and selenium probably improve with supplementation, but currently no reliable evidence demonstrates that routine supplementation with multi-, single or dual micronutrients above the recommended daily intake has clinical benefits (i.e. reduced death, increased cure rate at 6 and 12 months, improved nutritional status) in patients receiving antituberculosis treatment. In South Africa, most provinces implement a supplementation protocol based on nutritional assessment and classification of individuals rather than on disease diagnosis or treatment status.

  12. Antenatal dietary supplementation with myo-inositol in women during pregnancy for preventing gestational diabetes.

    Science.gov (United States)

    Crawford, Tineke J; Crowther, Caroline A; Alsweiler, Jane; Brown, Julie

    2015-12-17

    Gestational diabetes, glucose intolerance with onset or first recognition during pregnancy, is a rising problem worldwide. Both non-pharmacological and pharmacological approaches to the prevention of gestational diabetes have been, and continue to be explored. Myo-inositol, an isomer of inositol, is a naturally occurring sugar commonly found in cereals, corn, legumes and meat. It is one of the intracellular mediators of the insulin signal and correlated with insulin sensitivity in type 2 diabetes. The potential beneficial effect on improving insulin sensitivity suggests that myo-inositol may be useful for women in preventing gestational diabetes. To assess if antenatal dietary supplementation with myo-inositol is safe and effective, for the mother and fetus, in preventing gestational diabetes. We searched the Pregnancy and Childbirth Group's Trials Register, ClinicalTrials.gov, WHO ICTRP (2 November 2015) and reference lists of retrieved studies. We sought published and unpublished randomised controlled trials, including conference abstracts, assessing the effects of myo-inositol for the prevention of gestational diabetes mellitus (GDM). Quasi-randomised and cross-over trials were not eligible for inclusion, but cluster designs were eligible. Participants in the trials were pregnant women. Women with pre-existing type 1 or type 2 diabetes were excluded. Trials that compared the administration of any dose of myo-inositol, alone or in a combination preparation were eligible for inclusion. Trials that used no treatment, placebo or another intervention as the comparator were eligible for inclusion. Two review authors independently assessed trials for inclusion, risk of bias and extracted the data. Data were checked for accuracy. We included four randomised controlled trials (all conducted in Italy) reporting on 567 women who were less than 11 weeks' to 24 weeks' pregnant at the start of the trials. The trials had small sample sizes and one trial only reported an

  13. The role of micronutrients in crop production and human health

    International Nuclear Information System (INIS)

    Imtiaz, M.; Rashid, A.

    2010-01-01

    The soils in Pakistan across 22 Mha cultivated area are predominantly alluvial and loessal, alkaline in pH, calcareous and low in organic matter. These factors are mainly responsible for nutrient fixation in soil and low availability to plants. Zinc (Zn) deficiency in Pakistan was the first micro nutrient disorder recognised in early 1970s as a cause of hadda disease in rice. After identification of Zn deficiency, extensive research has been carried out during last four decades on micro nutrient deficiencies in soils and their drastic effects on crops. Subsequently, field-scale deficiencies of zinc (Zn) boron (B) and iron (Fe) have been established in many field and horticultural crops. The most widespread deficiency is of Zn as 70 % of the soils of Pakistan are Zn deficient and observed in rice, wheat, cotton, maize, sunflower, sugarcane, brassica, potato and in many other crops along with citrus and deciduous fruits. Boron deficiency is another major nutritional disorder which severely affects rice, cotton, wheat, sugarbeet, peanut, citrus and deciduous fruits. The third field-scale disorder is Fe chlorosis which has been exhibited in peanut, chickpea, cotton, citrus, ornamentals and many tree species. Copper (Cu) and manganese (Mn) deficiencies are of localized occurrence. The mineral elements like Zn, Fe and Cu are as crucial for human health as organic compounds such as carbohydrates, fats, protein and vitamins. The daily dietary intake of young adult ranges from 10-60 mg for Fe, 2-3 mg for Cu and 15 mg for Zn. Intake less than these values can cause slow physiological processes. These micronutrients deficiencies in soil are not only hampering the crop productivity but also are deteriorating produce quality. High consumption of cereal based foods with low contents of micronutrients is causing health hazards in humans. The contents of micronutrients in food can be elevated either by supplementation, fortification or by agricultural strategies i.e., bio

  14. Compliance to micronutrient supplementation in children 3 to 24 months of age from a semi-rural community in Mexico

    Directory of Open Access Journals (Sweden)

    Fernando López-Flores

    2012-10-01

    Full Text Available OBJECTIVE: To identify associated factors to compliance for multiple micronutrient (MM or iron and vitamin A (IVITA supplementation, in children (3 to 24 months old. MATERIALS AND METHODS: A database (n=465 children from a randomized, controlled, clinical trial, carried out in a semi-rural setting in Mexico, was analyzed. The compliance rate of MM and IVITA supplements was calculated. Adequate compliance rate (AC>80%, and its association with children and households characteristics, was determined. RESULTS: The compliance mean was high (MM:78.2%, IVITA:80.1%; pOBJETIVO: Identificar factores asociados con el cumplimiento del consumo de suplementos con micronutrimentos múltiples (MM o con hierro y vitamina A (FEVITA en niños (80% y su asociación con varias características. RESULTADOS: El cumplimiento fue alto (MM: 78.2%, FEVITA: 80.1%; p<0.05. Los momios de CA fueron 59% mayores en niños del grupo FEVITA que en MM (p=0.052. Escolaridad materna (p<0.001, peso al nacer del niño (p=0.003, porcentaje de tiempo con tos (p<0.001 y con fiebre (p=0.024 y marginalmente, la condición indígena materna (p=0.071 se asociaron con el CA. CONCLUSIONES: La alta tasa de cumplimiento fue consistente con otros estudios. Es necesaria mayor investigación sobre factores fisiológicos, culturales, sociales y operativos relacionados con el cumplimiento del consumo de suplementos.

  15. Combined intensive nutrition education and micronutrient powder supplementation improved nutritional status of mildly wasted children on Nias Island, Indonesia.

    Science.gov (United States)

    Inayati, Dyah A; Scherbaum, Veronika; Purwestri, Ratna C; Wirawan, Nia N; Suryantan, Julia; Hartono, Susan; Bloem, Maurice A; Pangaribuan, Rosnani V; Biesalski, Hans K; Hoffmann, Volker; Bellows, Anne C

    2012-01-01

    To assess the impact of intensive nutrition education (INE) with or without the provision of micronutrient powder (MNP) on the nutritional status of mildly wasted children in Nias, Indonesia, two groups of mildly wasted (>=-1.5 to children aged >=6 to children who were living at a clear distance from INE and INE+MNP villages were selected to receive a monthly non-intensive nutrition education program (NNE) with or without MNP (n=50 both respectively). WHZ, weight, height, haemoglobin (Hb) level, and morbidity data were assessed at admission, during the study, and at individual discharge. Children's weight gain (g/kg body weight/day) was highest in INE+MNP group (2.2±2.1), followed by INE (1.1±0.9), NNE+MNP (0.3±0.5) and NNE (0.3±0.4) group. In both MNP intervention groups (INE+MNP, NNE+MNP), supplements significantly increased Hb value (g/L) of respective children (10.0±10.0; pchildren who reached discharge criterion was highest among the INE+MNP (70.6%; n=36), followed by INE (64.1%; n=41), NNE+MNP (26.0%; n=13), and NNE (20.0%; n=10) groups (pchildren in the INE+MNP group (29.9 days), followed by INE (40.0 days), NNE+MNP (80.6 days), and NNE (86.2 days) respectively (pnutrition education supported by MNP supplementation produced the best results regarding weight gain and haemoglobin status of mildly wasted children.

  16. Main issues in micronutrient supplementation in phenylketonuria

    NARCIS (Netherlands)

    Lammardo, A. M.; Robert, M.; Rocha, J. C.; van Rijn, M.; Ahring, K.; Belanger-Quintana, A.; MacDonald, A.; Dokoupil, K.; Ozel, H. Gokmen; Goyens, P.; Feillet, F.

    2013-01-01

    For almost all patients with PKU, a low phenylalanine diet is the basis of the treatment despite a widely varying natural protein tolerance. A vitamin and mineral supplement is essential and it is commonly added to a phenylalanine-free (phe-free) source of L-amino acids. In PKU, many phe-free

  17. Maternal Supplementation with Small-Quantity Lipid-Based Nutrient Supplements Compared with Multiple Micronutrients, but Not with Iron and Folic Acid, Reduces the Prevalence of Low Gestational Weight Gain in Semi-Urban Ghana: A Randomized Controlled Trial.

    Science.gov (United States)

    Adu-Afarwuah, Seth; Lartey, Anna; Okronipa, Harriet; Ashorn, Per; Ashorn, Ulla; Zeilani, Mamane; Arimond, Mary; Vosti, Stephen A; Dewey, Kathryn G

    2017-04-01

    Background: It is unclear whether maternal supplementation with small-quantity lipid-based nutrient supplements (SQ-LNSs; 118 kcal/d) affects maternal weight. Objective: We compared several secondary anthropometric measures between 3 groups of women in the iLiNS (International Lipid-based Nutrient Supplements)-DYAD trial in Ghana. Methods: Women ( n = 1320; gestation) were randomly assigned to receive 60 mg Fe + 400 μg folic acid/d (IFA), 18 vitamins and minerals/d [multiple micronutrients (MMNs)], or 20 g SQ-LNSs with 22 micronutrients/d (LNS) during pregnancy and a placebo (200 mg Ca/d), MMNs, or SQ-LNSs, respectively, for 6 mo postpartum. Weight, midupper arm circumference (MUAC), and triceps skinfold (TSF) thickness at 36 wk of gestation and 6 mo postpartum were analyzed, as were changes from estimated prepregnancy values. We assessed the adequacy of estimated gestational weight gain (GWG) by using Institute of Medicine (IOM) and International Fetal and Newborn Growth Standards for the 21st Century (INTERGROWTH-21st) guidelines. Results: The estimated prepregnancy prevalence of overweight or obesity was 38.5%. By 36 wk of gestation, women ( n = 1015) had a mean ± SD weight gain of 7.4 ± 3.7 kg and changes of -1.0 ± 1.7 cm in MUAC and -2.8 ± 4.1 mm in TSF thickness. The LNS group had a lower prevalence of inadequate GWG on the basis of IOM guidelines (57.4%) than the MMN (67.2%) but not the IFA (63.1%) groups ( P = 0.030), whereas the prevalence of adequate (26.9% overall) and excessive (10.4% overall) GWG did not differ by group. The percentages of normal-weight women (in kg/m 2 : 18.5 < body mass index < 25.0; n = 754) whose GWG was less than the third centile of the INTERGROWTH-21st standards were 23.0%, 28.7%, and 28.5% for the LNS, MMN, and IFA groups, respectively ( P = 0.36). At 6 mo postpartum, the prevalence of overweight or obesity was 45.3%, and the risk of becoming overweight or obese did not differ by group. Conclusion: SQ-LNS supplementation

  18. The role of micronutrients and macronutrients in patients hospitalized for heart failure.

    Science.gov (United States)

    Trippel, Tobias D; Anker, Stefan D; von Haehling, Stephan

    2013-07-01

    The detrimental pathophysiology of heart failure (HF) leaves room for physiologic and metabolomic concepts that include supplementation of micronutrients and macronutrients in these patients. Hence myocardial energetics and nutrient metabolism may represent relevant treatment targets in HF. This review focuses on the role of nutritive compounds such as lipids, amino acids, antioxidants, and other trace elements in the setting of HF. Supplementation of ferric carboxymaltose improves iron status, functional capacity, and quality of life in HF patients. To close the current gap in evidence further interventional studies investigating the role of micro- and macronutrients are needed in this setting. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Foods, Fortificants, and Supplements: Where Do Americans Get Their Nutrients?123

    Science.gov (United States)

    Fulgoni, Victor L.; Keast, Debra R.; Bailey, Regan L.; Dwyer, Johanna

    2011-01-01

    Limited data are available on the source of usual nutrient intakes in the United States. This analysis aimed to assess contributions of micronutrients to usual intakes derived from all sources (naturally occurring, fortified and enriched, and dietary supplements) and to compare usual intakes to the Dietary Reference Intake for U.S. residents aged ≥2 y according to NHANES 2003–2006 (n = 16,110). We used the National Cancer Institute method to assess usual intakes of 19 micronutrients by source. Only a small percentage of the population had total usual intakes (from dietary intakes and supplements) below the estimated average requirement (EAR) for the following: vitamin B-6 (8%), folate (8%), zinc (8%), thiamin, riboflavin, niacin, vitamin B-12, phosphorus, iron, copper, and selenium (supplements further reduced the percentage of the population consuming less than the EAR for all nutrients. The percentage of the population with total intakes greater than the tolerable upper intake level (UL) was very low for most nutrients, whereas 10.3 and 8.4% of the population had intakes greater than the UL for niacin and zinc, respectively. Without enrichment and/or fortification and supplementation, many Americans did not achieve the recommended micronutrient intake levels set forth in the Dietary Reference Intake. PMID:21865568

  20. Micronutrients Deficiency, a Hidden Hunger in Nepal: Prevalence, Causes, Consequences, and Solutions.

    Science.gov (United States)

    Bhandari, Shiva; Banjara, Megha Raj

    2015-01-01

    Micronutrient deficiency is a global challenge to health as in Nepal. In Nepal, the targeted beneficiaries are less aware about importance of micronutrients (MNs), which has resulted in low intake of foods rich in MNs. Micronutrient deficiencies (MNDs) have huge impact on health of vulnerable population like women and children and have jeopardized the national economy and prosperity of developing countries including Nepal. However, less attention has been paid towards MNDs, which can be prevented. Therefore, this study aims to draw attention of the concerned authorities and researchers to combat against MNDs in Nepal. This study showed that different types of MNDs with higher prevalence exist in Nepal. The major causes of MNDs were poor diet, diseases and infestations, and poor health caring practices. The results of MNDs were unwanted child and maternal mortality, impairments of lives, and reduction in productivity and intellectual capacity. School health and nutrition education and supplementation and fortification of essential MNs proved to be effective while dietary diversification and economic growth and poverty eradication seemed promising. Control and prevention of MNDs can help to achieve Millennium Development Goals as well, so studies in this sector should be emphasized.

  1. Essential and Nonessential Micronutrients and Sport

    Science.gov (United States)

    Beavers, Kristen M.; Serra, Monica C.

    The purpose of this chapter is to review the role of micronutrients in sport. Attention is given to the function of micronutrients in the body, examples of quality dietary sources of each micronutrient, and an assessment of the literature examining how the recommended daily intake of a micronutrient may or may not change with exercise. The discussion includes plausible biological mechanisms of proposed performance enhancement and current research to support or negate these claims. Water-soluble vitamins, fat-soluble vitamins, macrominerals, and select microminerals are discussed in detail, and a comprehensive table reviewing all micronutrients recommendations for the athlete is provided. Practical applications for professionals working with athletes conclude the chapter.

  2. Zinc and other micronutrients supplementation through the use of sprinkles: impact on the occurrence of diarrhea and respiratory infections in institutionalized children

    Directory of Open Access Journals (Sweden)

    Danile L.B. Sampaio

    2013-05-01

    Full Text Available Objective: To evaluate the incidence of diarrheal disease (DD and acute respiratory infection (ARI in children undergoing supplementation of zinc and other micronutrients through the use of sprinkles, as well as their acceptance by these patients. Method: This was a randomized double-blinded clinical trial of 143 healthy institutionalized children, aged 6 to 48 months. They were randomized into two groups and received daily zinc and micronutrients – test group (sprinkles, or micronutrients without zinc - control group. Children were supplemented for 90 days and followed regarding the outcomes of DD and ARI. Results: Of the randomized children, 52.45% belonged to the test and 47.55% to the control group. The incidence of DD in the test group was 14.7% and was 19.1% in the control group. The test group showed a lower risk of developing DD when compared to controls, but this finding was not statistically significant (RR = 0.77 [0.37 to 1.6], p = 0.5088. ARI had high incidence in both groups, 60% in the test group and 48.5% in the control group, with an increased risk of developing the disease in the test group, but with no statistical significance (RR = 1.24 [0.91 to 1.68], p = 0.1825. Regarding acceptance, the mean percentage of consumption, in days, of the entire content of the sachets containing sprinkles was 95.72% (SD = 4.9 and 96.4% (SD = 6.2 for the test and control groups, respectively. Conclusions: Zinc supplementation through the use of sprinkles did not reduce the incidence of DD or ARI among the evaluated children. The sprinkles were well accepted by all study participants. Resumo: Objetivo: Avaliar a incidência de doenças diarreicas (DA e infecção respiratória aguda (IRA em crianças submetidas à suplementação de zinco e outros micronutrientes através dos sprinkles, bem como a aceitação destes pelos pacientes. Método: Ensaio clínico, duplo cego, randomizado, realizado com 143 crianças institucionalizadas

  3. Expression of Genes Encoding Enzymes Involved in the One Carbon Cycle in Rat Placenta is Determined by Maternal Micronutrients (Folic Acid, Vitamin B12 and Omega-3 Fatty Acids

    Directory of Open Access Journals (Sweden)

    Vinita Khot

    2014-01-01

    Full Text Available We have reported that folic acid, vitamin B12, and omega-3 fatty acids are interlinked in the one carbon cycle and have implications for fetal programming. Our earlier studies demonstrate that an imbalance in maternal micronutrients influence long chain polyunsaturated fatty acid metabolism and global methylation in rat placenta. We hypothesize that these changes are mediated through micronutrient dependent regulation of enzymes in one carbon cycle. Pregnant dams were assigned to six dietary groups with varying folic acid and vitamin B12 levels. Vitamin B12 deficient groups were supplemented with omega-3 fatty acid. Placental mRNA levels of enzymes, levels of phospholipids, and glutathione were determined. Results suggest that maternal micronutrient imbalance (excess folic acid with vitamin B12 deficiency leads to lower mRNA levels of methylene tetrahydrofolate reductase (MTHFR and methionine synthase , but higher cystathionine b-synthase (CBS and Phosphatidylethanolamine-N-methyltransferase (PEMT as compared to control. Omega-3 supplementation normalized CBS and MTHFR mRNA levels. Increased placental phosphatidylethanolamine (PE, phosphatidylcholine (PC, in the same group was also observed. Our data suggests that adverse effects of a maternal micronutrient imbalanced diet may be due to differential regulation of key genes encoding enzymes in one carbon cycle and omega-3 supplementation may ameliorate most of these changes.

  4. Micronutrients, Essential Fatty Acids and Bone Health in Phenylketonuria.

    Science.gov (United States)

    Demirdas, Serwet; van Spronsen, Francjan J; Hollak, Carla E M; van der Lee, J Hanneke; Bisschop, Peter H; Vaz, Fred M; Ter Horst, Nienke M; Rubio-Gozalbo, M Estela; Bosch, Annet M

    2017-01-01

    In phenylketonuria (PKU), a natural protein-restricted dietary treatment prevents severe cognitive impairment. Nutrient deficiencies may occur due to strict diet. This study is aimed at evaluating the dietary intake and blood concentrations of micronutrients and essential fatty acids (FA), bone mineral density (BMD) and fracture history in patients on long-term dietary treatment. Sixty early diagnosed Dutch patients (aged 1-39 years) were included in a multi-center cross-sectional study. Their dietary intake, blood concentrations of micronutrients, FA, fracture history and BMD were assessed. Selenium dietary intake and serum concentrations were low in 14 and 46% of patients, respectively. The serum 25-OH vitamin D2 + D3 concentration was low in 14% of patients while 20% of patients had a low vitamin D intake. Zinc serum concentrations were below normal in 14% of patients, despite adequate intake. Folic acid serum concentrations and intake were elevated. Despite safe total protein and fat intake, arginine plasma concentrations and erythrocyte eicosapentaenoic acid were below reference values in 19 and 6% of patients, respectively. Low BMD (Z-score <-2) was slightly more prevalent in patients, but the lifetime fracture prevalence was comparable to the general population. Dutch patients with PKU on long-term dietary treatment have a near normal nutrient status. Supplementation of micronutrients of which deficiency may be deleterious (e.g., vitamin D and selenium) should be considered. BMD warrants further investigation. © 2017 S. Karger AG, Basel.

  5. Feeding the brain - The effects of micronutrient interventions on cognitive performance among school-aged children: A systematic review of randomized controlled trials.

    Science.gov (United States)

    Lam, Long Fung; Lawlis, Tanya R

    2017-08-01

    Micronutrients are essential for brain development with deficiencies in specific nutrients linked to impaired cognitive function. Interventions are shown to be beneficial to children's mental development, particularly in subjects who were micronutrient-deficient at baseline but results on healthy subjects remain inconsistent. This systematic review evaluated the effect of micronutrient inventions on different cognitive domains. Studies conducted in both developing and developed countries, and trials that investigate the effect of both single and multiple micronutrient intervention were reviewed. Systematic searches of Medline, CINAHL Plus and Academic Search database were undertaken to identify trials published after year 2000. Randomized controlled trials (RCTs) that evaluate the effect of micronutrients on cognitive performance or academic performance among children aged 4-18 years were included. 19 trials were identified from 18 articles. The major cognitive outcomes assessed included fluid intelligence, crystallized intelligence, short-term memory, long-term memory, cognitive processing speed, attention and concentration, and school performance. Eight of ten trials assessing fluid intelligence reported significant positive effects of micronutrient supplementation among micronutrient-deficient children, especially those who were iron-deficient or iodine-deficient at baseline. The effects of micronutrient interventions on other domains were inconsistent. Improvement in fluid intelligence among micronutrient-deficient children was consistently reported. Further research is needed to provide more definite evidence on the beneficial effects of micronutrient inventions on other cognitive domains and the effects in healthy subjects. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  6. Maternal Supplementation with Small-Quantity Lipid-Based Nutrient Supplements Compared with Multiple Micronutrients, but Not with Iron and Folic Acid, Reduces the Prevalence of Low Gestational Weight Gain in Semi-Urban Ghana: A Randomized Controlled Trial123

    Science.gov (United States)

    Vosti, Stephen A; Dewey, Kathryn G

    2017-01-01

    Background: It is unclear whether maternal supplementation with small-quantity lipid-based nutrient supplements (SQ-LNSs; 118 kcal/d) affects maternal weight. Objective: We compared several secondary anthropometric measures between 3 groups of women in the iLiNS (International Lipid-based Nutrient Supplements)-DYAD trial in Ghana. Methods: Women (n = 1320; gestation) were randomly assigned to receive 60 mg Fe + 400 μg folic acid/d (IFA), 18 vitamins and minerals/d [multiple micronutrients (MMNs)], or 20 g SQ-LNSs with 22 micronutrients/d (LNS) during pregnancy and a placebo (200 mg Ca/d), MMNs, or SQ-LNSs, respectively, for 6 mo postpartum. Weight, midupper arm circumference (MUAC), and triceps skinfold (TSF) thickness at 36 wk of gestation and 6 mo postpartum were analyzed, as were changes from estimated prepregnancy values. We assessed the adequacy of estimated gestational weight gain (GWG) by using Institute of Medicine (IOM) and International Fetal and Newborn Growth Standards for the 21st Century (INTERGROWTH-21st) guidelines. Results: The estimated prepregnancy prevalence of overweight or obesity was 38.5%. By 36 wk of gestation, women (n = 1015) had a mean ± SD weight gain of 7.4 ± 3.7 kg and changes of −1.0 ± 1.7 cm in MUAC and −2.8 ± 4.1 mm in TSF thickness. The LNS group had a lower prevalence of inadequate GWG on the basis of IOM guidelines (57.4%) than the MMN (67.2%) but not the IFA (63.1%) groups (P = 0.030), whereas the prevalence of adequate (26.9% overall) and excessive (10.4% overall) GWG did not differ by group. The percentages of normal-weight women (in kg/m2: 18.5 < body mass index < 25.0; n = 754) whose GWG was less than the third centile of the INTERGROWTH-21st standards were 23.0%, 28.7%, and 28.5% for the LNS, MMN, and IFA groups, respectively (P = 0.36). At 6 mo postpartum, the prevalence of overweight or obesity was 45.3%, and the risk of becoming overweight or obese did not differ by group. Conclusion: SQ-LNS supplementation is

  7. Impact of Multi-Micronutrient-Fortified Rice on Micronutrient Status, Health, and Cognitive Performance in Schoolchildren in Cambodia

    DEFF Research Database (Denmark)

    Khov, Kuong

    ferritin concentrations nutritional status of school-age children as well as the reasons of iron deficiency. Food fortification...... with multiple micronutrients has the potential to improve micronutrient status, growth and cognitive performance, and reduce morbidity incidence in developing countries. In Cambodia, rice is a staple food, and therefore fortified rice with multiple micronutrients could be a promising strategy to reduce...... the prevalence of micronutrient deficiencies. However, few studies have investigated the impact of fortified rice on micronutrient status, health and cognitive development in school-age children. Therefore, the aim of this PhD study is to evaluate the impact of fortified rice on nutritional status, health...

  8. Preconception Micronutrient Supplementation with Iron and Folic Acid Compared with Folic Acid Alone Affects Linear Growth and Fine Motor Development at 2 Years of Age: A Randomized Controlled Trial in Vietnam.

    Science.gov (United States)

    Nguyen, Phuong H; Gonzalez-Casanova, Ines; Young, Melissa F; Truong, Truong Viet; Hoang, Hue; Nguyen, Huong; Nguyen, Son; DiGirolamo, Ann M; Martorell, Reynaldo; Ramakrishnan, Usha

    2017-08-01

    Background: Maternal health and nutrition play a crucial role in early child growth and development. However, little is known about the benefits of preconception micronutrient interventions beyond the role of folic acid (FA) and neural tube defects. Objective: We evaluated the impact of weekly preconception multiple micronutrient (MM) or iron and folic acid (IFA) supplementation on child growth and development through the age of 2 y compared with FA alone. Methods: We followed 1599 offspring born to women who participated in a randomized controlled trial of preconception supplementation in Vietnam. Women received weekly supplements that contained either 2800 μg FA, 60 mg Fe and 2800 μg FA, or 15 MMs including IFA, from baseline until conception followed by daily prenatal IFA supplements until delivery. Child anthropometry was measured at birth and at 3, 6, 12, 18, and 24 mo. Child development was measured with the use of the Bayley Scales for Infant Development III at 24 mo. Results: The groups were similar for baseline maternal and offspring birth characteristics. At 24 mo of age, the offspring in the IFA group had significantly higher length-for-age z scores (LAZs) (0.14; 95% CI: 0.03, 0.26), reduced risk of being stunted (0.87; 95% CI: 0.76, 0.99), and smaller yearly decline in LAZs (0.10; 95% CI: 0.04, 0.15) than the offspring in the FA group. Similar trends were found for the offspring in the MM group compared with the FA group for LAZs (0.10; 95% CI: -0.02, 0.22) and the risk of being stunted (0.88; 95% CI: 0.77, 1.01). Offspring in the IFA group had improved motor development ( P = 0.03), especially fine motor development (0.41; 95% CI: 0.05, 0.77), at the age of 24 mo, but there were no differences for measures of cognition or language. Conclusions: Preconception supplementation with IFA improved linear growth and fine motor development at 2 y of age compared with FA. Future studies should examine whether these effects persist and improve child health and

  9. From micronutrient recommendations to policy

    DEFF Research Database (Denmark)

    Timotijevic, Lada; Raats, Monique M.; Barnett, Julie

    2010-01-01

    towards achieving a greater link between micronutrient recommendations and behaviour. This study aims to examine the rationale and processes associated with consumer and stakeholder involvement in setting micronutrient recommendations across Europe. Subjects/Methods: Using the contacts established through......Background/Objectives: To achieve the nutritional goals stipulated by micronutrient recommendations, greater attention must be paid to the behavioural routes to such nutritional outcomes. Coopting stakeholders and consumers into decisions regarding micronutrient recommendations is an important step...... countries and its effect on final decisions. Stakeholders were not involved at the outset of the process ('framing' of the problem) in any of the countries, and there was no evidence of consumer involvement and open public fora. Conclusions: Some of the key explanatory factors for diversity in the degree...

  10. Role of micronutrients and natural antioxidants in fighting against HIV; a quick mini-review

    Directory of Open Access Journals (Sweden)

    S. Saeidnia

    2014-10-01

    Full Text Available Oxidative stress has been implicated in the progression of HIV to AIDS, since HIV usually replicates in a highly oxidized condition and CD4+ T lymphocytes can be activated via a cascade of internal oxidative pathways, which enhances the formation of proteins and enzymes. Thus, antioxidants should potentially be useful for the treatment and prevention of HIV infection as a new alternative strategy. Regarding the point that there are various approaches for treating the HIV-positive patients, antioxidant supplementation therapy alongside with other medications possesses many benefits. In fact, antioxidants and micronutrient supplements have been considered as a costly and short-term strategy to improve antioxidant deficiency. If diets come with sufficient education and scientific recommendations, they can provide a low-cost and long-term strategy to reduce oxidative stress, prevent micronutrient deficiency, and slow down HIV progression. This strategy may be applicable and beneficial particularly in countries around coast of Africa, where HIV is most common. Meantime these countries are rich of natural food resources. It seems that a healthy diet is the best way to insure proper nutrient intake, since it contains many nutrients not available in pills.

  11. Maternal supplementation with small-quantity lipid-based nutrient supplements during pregnancy and lactation does not reduce depressive symptoms at 6 months postpartum in Ghanaian women: a randomized controlled trial.

    Science.gov (United States)

    Okronipa, Harriet; Adu-Afarwuah, Seth; Lartey, Anna; Ashorn, Per; Vosti, Stephen A; Young, Rebecca R; Dewey, Kathryn G

    2018-02-01

    We examined the impact on depression at 6 months postpartum of maternal supplementation with small-quantity lipid-based nutrient supplement (SQ-LNS) compared to supplementation with iron and folic acid (IFA) or multiple micronutrients (MMN). In this partially double-blinded randomized controlled trial, pregnant women ≤20 weeks gestation (n = 1320) were recruited from antenatal clinics and randomly assigned to receive either (1) SQ-LNS during pregnancy and for 6 months postpartum, or (2) IFA during pregnancy only, or (3) MMN during pregnancy and for 6 months postpartum. Maternal depressive symptoms were measured at 6 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Women who scored 12 or more on the EPDS were considered to show symptoms of depression. One thousand one hundred fifty-one women were included in this analysis (LNS = 382, IFA = 387 and MMN = 382). Characteristics of the three groups were similar at baseline, and there were no significant differences between women who were included in the analysis (n = 1151) and those who were not (n = 169). At 6 months postpartum, 13% of the women overall showed symptoms of depression, and this did not differ by group (LNS = 13.1%, IFA = 11.2% and MMN = 14.7%. P = 0.36). The median (25, 75 percentile) EPDS score did not differ by group (LNS 4.0 (1.0, 8.0), IFA 4.0 (1.0, 8.0), MMN 5.0 (2.0, 9.0), P transformed  = 0.13). Adjustment for covariates did not alter these findings. Maternal supplementation with SQ-LNS compared to MMN or IFA did not affect postnatal depressive symptoms in this sample of Ghanaian women.

  12. Prevalence of and factors associated with antenatal care seeking and adherence to recommended iron-folic acid supplementation among pregnant women in Zinder, Niger.

    Science.gov (United States)

    Begum, Khadija; Ouédraogo, Césaire T; Wessells, K Ryan; Young, Rebecca R; Faye, M Thierno; Wuehler, Sara E; Hess, Sonja Y

    2018-02-01

    The World Health Organization recommends iron and folic acid (IFA) supplementation for pregnant women. The high prevalence of anaemia among pregnant women in Niger warrants better understanding of the utilization of antenatal care (ANC) and IFA. We aimed to assess the prevalence of and factors associated with ANC coverage and adherence to IFA recommendation among pregnant women. Pregnant women (n = 923) from 64 randomly selected villages within the catchment area of 12 health centres were interviewed during a baseline household survey in Zinder, Niger. ANC and IFA coverage were 60.1% and 43.6%, respectively. Only 71.7% of women who attended ANC received IFA. Of the 401 women who reportedly received any IFA supplements, 99.3% had attended any ANC during their current pregnancy and 68.6% reported adherence to recommended IFA supplementation (i.e., consumed IFA every day in the previous week). Women with gestational age ≥27 weeks were more likely to have attended ANC than women with gestational age ANC were more likely to attend ANC (OR: 1.48, 95% CI [1.03, 2.11]) and adhere to IFA recommendations (OR: 1.80, 95% CI [1.04, 3.13]) compared to those who did not receive any advice. ANC attendance is crucial to ensure distribution of IFA supplementation among pregnant women in Zinder. Interventions to improve ANC and IFA adherence will require promotion of early ANC, ensure availability of IFA at ANC, and involve husbands in ANC. © 2018 John Wiley & Sons Ltd.

  13. Antenatal Bartter syndrome.

    Science.gov (United States)

    Afzal, Muhammad; Khan, Ejaz A; Khan, Wisal A; Anwar, Viqas; Yaqoob, Asma; Rafiq, Shahid; Azam, Shaheena

    2014-05-01

    Antenatal Bartter syndrome is characterized by severe polyhydramnios in mother leading to premature delivery. Antenatal treatment has proven effective to prevent these problems. Postnatally newborns suffer from recurrent episodes of severe dehydration and electrolyte imbalance which can lead to fatal outcome. These manifestations are likely to be overlooked and missed under the umbrella of diagnosis of prematurity. This premature newborn with antenatal polyhydramnios had severe manifestations of polyuria, recurrent dehydration, electrolyte derangements and metabolic alkalosis. She was managed accordingly but unfortunately could not survive beyond 4 weeks.

  14. Antenatal and postnatal radiologic diagnosis of holocarboxylase synthetase deficiency: a systematic review

    International Nuclear Information System (INIS)

    Bandaralage, Sahan P.S.; Farnaghi, Soheil; Dulhunty, Joel M.; Kothari, Alka

    2016-01-01

    Holocarboxylase synthetase deficiency results in impaired activation of enzymes implicated in glucose, fatty acid and amino acid metabolism. Antenatal imaging and postnatal imaging are useful in making the diagnosis. Untreated holocarboxylase synthetase deficiency is fatal, while antenatal and postnatal biotin supplementation is associated with good clinical outcomes. Although biochemical assays are required for definitive diagnosis, certain radiologic features assist in the diagnosis of holocarboxylase synthetase deficiency. To review evidence regarding radiologic diagnostic features of holocarboxylase synthetase deficiency in the antenatal and postnatal period. A systematic review of all published cases of holocarboxylase synthetase deficiency identified by a search of Pubmed, Scopus and Web of Science. A total of 75 patients with holocarboxylase synthetase deficiency were identified from the systematic review, which screened 687 manuscripts. Most patients with imaging (19/22, 86%) had abnormal findings, the most common being subependymal cysts, ventriculomegaly and intraventricular hemorrhage. Although the radiologic features of subependymal cysts, ventriculomegaly, intraventricular hemorrhage and intrauterine growth restriction may be found in the setting of other pathologies, these findings should prompt consideration of holocarboxylase synthetase deficiency in at-risk children. (orig.)

  15. Antenatal and postnatal radiologic diagnosis of holocarboxylase synthetase deficiency: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Bandaralage, Sahan P.S. [Gold Coast Hospital and Health Service, Southport, Queensland (Australia); Griffith University, School of Medicine, Southport, Queensland (Australia); Farnaghi, Soheil [Caboolture Hospital, Caboolture, Queensland (Australia); Dulhunty, Joel M.; Kothari, Alka [Redcliffe Hospital, Redcliffe, Queensland (Australia); The University of Queensland, School of Medicine, Herston, Queensland (Australia)

    2016-03-15

    Holocarboxylase synthetase deficiency results in impaired activation of enzymes implicated in glucose, fatty acid and amino acid metabolism. Antenatal imaging and postnatal imaging are useful in making the diagnosis. Untreated holocarboxylase synthetase deficiency is fatal, while antenatal and postnatal biotin supplementation is associated with good clinical outcomes. Although biochemical assays are required for definitive diagnosis, certain radiologic features assist in the diagnosis of holocarboxylase synthetase deficiency. To review evidence regarding radiologic diagnostic features of holocarboxylase synthetase deficiency in the antenatal and postnatal period. A systematic review of all published cases of holocarboxylase synthetase deficiency identified by a search of Pubmed, Scopus and Web of Science. A total of 75 patients with holocarboxylase synthetase deficiency were identified from the systematic review, which screened 687 manuscripts. Most patients with imaging (19/22, 86%) had abnormal findings, the most common being subependymal cysts, ventriculomegaly and intraventricular hemorrhage. Although the radiologic features of subependymal cysts, ventriculomegaly, intraventricular hemorrhage and intrauterine growth restriction may be found in the setting of other pathologies, these findings should prompt consideration of holocarboxylase synthetase deficiency in at-risk children. (orig.)

  16. Periodontal disease severity is associated with micronutrient intake.

    Science.gov (United States)

    Luo, P-P; Xu, H-S; Chen, Y-W; Wu, S-P

    2018-03-06

    This study aimed to examine if specific micronutrients were associated with periodontal disease using data from the US National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. Participants who were aged 30 years or more and received complete periodontal examinations were included. Regression analyses were performed to determine associations of variables of interest with periodontal disease. Data of 6415 NHANES participants were included in the analysis. Multivariable analysis revealed that less intake of vitamin A (adjusted odds ratio (aOR) = 1.784), vitamin B1 (aOR = 1.334), vitamin C (aOR = 1.401), vitamin E (aOR = 1.576), iron (aOR = 1.234), folate (aOR = 1.254) and phosphorus (aOR = 1.280) was associated with increased severity of periodontal disease. Compared with the highest level of vitamin D intake, the second highest level of vitamin D intake was associated with lower severity of periodontal disease (aOR = 0.727). Insufficient intake of vitamin A, B1, C and E, iron, folate and phosphorus was significantly associated with severity of periodontal disease. Results of the present study suggest that the above micronutrients may be increased in the diet or taken as dietary supplements in order to reduce severity of periodontal disease. © 2018 Australian Dental Association.

  17. Prevalence of micronutrient deficiency in popular diet plans

    Directory of Open Access Journals (Sweden)

    Calton Jayson B

    2010-06-01

    Full Text Available Abstract Background Research has shown micronutrient deficiency to be scientifically linked to a higher risk of overweight/obesity and other dangerous and debilitating diseases. With more than two-thirds of the U.S. population overweight or obese, and research showing that one-third are on a diet at any given time, a need existed to determine whether current popular diet plans could protect followers from micronutrient deficiency by providing the minimum levels of 27 micronutrients, as determined by the U.S. Food and Drug Administrations (FDA Reference Daily Intake (RDI guidelines. Methods Suggested daily menus from four popular diet plans (Atkins for Life diet, The South Beach Diet, the DASH diet, the DASH diet were evaluated. Calorie and micronutrient content of each ingredient, in each meal, were determined by using food composition data from the U.S. Department of Agriculture Nutrient Database for Standard Reference. The results were evaluated for sufficiency and total calories and deficient micronutrients were identified. The diet plans that did not meet 100% sufficiency by RDI guidelines for each of the 27 micronutrients were re-analyzed; (1 to identify a micronutrient sufficient calorie intake for all 27 micronutrients, and (2 to identify a second micronutrient sufficient calorie intake when consistently low or nonexistent micronutrients were removed from the sufficiency requirement. Results Analysis determined that each of the four popular diet plans failed to provide minimum RDI sufficiency for all 27 micronutrients analyzed. The four diet plans, on average, were found to be RDI sufficient in (11.75 ± 2.02; mean ± SEM of the analyzed 27 micronutrients and contain (1748.25 ± 209.57 kcal. Further analysis of the four diets found that an average calorie intake of (27,575 ± 4660.72 would be required to achieve sufficiency in all 27 micronutrients. Six micronutrients (vitamin B7, vitamin D, vitamin E, chromium, iodine and molybdenum were

  18. Enhancing micronutrient content of beverage powder by incorporating malted finger millet

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    Jaya Tripathi

    2014-12-01

    Full Text Available Introduction: There is growing interest in the role of the micronutrients in optimizing health, and in prevention or treatment of disease. Micronutrients play a central part in metabolism and in the maintenance of tissue function, an adequate intake therefore is necessary. Rationale: This research work was concerned with the development of micronutrient especially calcium rich instant health beverage powder from malted finger millet (Eleusine coracana and gurhal powder (Hibiscus rosa- sinensis. Aims & Objectives: In this study attempts have been made to investigate that whether the extruded malted finger millet flour and hibiscus flower powder has improved the nutritional and phytochemical quality of instant health beverage powder without deteriorating their sensory properties and whether it can be a supplement for calcium deficit sedentary women. Materials and methods: Instant health beverage powder was prepared by adding malted and extruded finger millet with glucose, hibiscus flower powder, citric acid and vanilla essence. All the ingredients were mixed well. Prior to consumption this powder was dissolved in water and stirred well manually. Further Instant health beverage powder was assessed for nutritional composition. Results: Results shows that beverage powder has very high content of protein (12.25 % and calcium (96.5 % along with highly beneficial neutraceutical properties as compared with the health drinks available in market, it is because of enhanced antioxidant activity resulted due to the incorporation of gurhal leaf powder and malting of the finger millet. Conclusion: This study may prove as a potential step to utilise malted finger millet as a supplement for calcium deficit women. The nutritional composition was found sufficient enough to meet approximately one fourth of RDA of Protein and Calcium as prescribed by NIN, India for sedentary women who are the main sufferers of calcium deficiencies in various life stages

  19. A preliminary micronutrient investigation in maize

    International Nuclear Information System (INIS)

    Rosales, C.M.; Cabildo, M.S.

    1986-01-01

    This paper is a result of the greenhouse experiments conducted on micronutrient studies in corn. Low yields of corn in some localities despite the application of major elements points out the need for examining the micro-nutrient requirements of corn. Hence, this study aims to determine the fate of added micronutrients on major soil groups with the application of varying levels of nitrogen, phosphorus, and potassium to provide the better understanding of soil micronutrients especially in problem soil. Three soil types, four N-P-K treatments and two micronutrients (Zn and Fe) were used. The test crop was a Tinigib corn variety and sampled at tasseling and silking stages. It was found that NPK combinations of 120-60-30 kg/ha and 60-30-30 kg/ha gave better Fe and Zn fertilizer use efficiency, respectively for a given soil type. Further investigation in major soil types is recommended. (Auth.) 12 refs.; 9 tabs

  20. The impact of micronutrient supplementation in alcohol-exposed pregnancies on information processing skills in Ukrainian infants

    Science.gov (United States)

    Objectives: The role that micronutrients play in ameliorating the impact of prenatal alcohol exposure was explored in a clinical trial conducted in the Ukraine. Cardiac orienting responses during a habituation/dishabituation learning paradigm were obtained from 6-12 month-olds to assess neurodevelop...

  1. Effect of provision of daily zinc and iron with several micronutrients on growth and morbidity among young children in Pakistan: A cluster-randomised trial

    International Nuclear Information System (INIS)

    Soofi, Sajid

    2014-01-01

    Full text: Background: Powders containing iron and other micronutrients are recommended as a strategy to prevent nutritional anaemia and other micronutrient deficiencies in children. We assessed the effects of provision of two micronutrient powder formulations, with or without zinc, to children in Pakistan. Methods: We did a cluster randomised trial in urban and rural sites in Sindh, Pakistan. A baseline survey identified 256 clusters, which were randomly assigned (within urban and rural strata, by computer-generated random numbers) to one of three groups: non-supplemented control (group A), micronutrient powder without zinc (group B), or micronutrient powder with 10 mg zinc (group C). Children in the clusters aged 6 months were eligible for inclusion in the study. Powders were to be given daily between 6 and 18 months of age; follow-up was to age 2 years. Micronutrient powder sachets for groups B and C were identical except for colour; investigators and field and supervisory staff were masked to composition of the micronutrient powders until trial completion. Parents knew whether their child was receiving supplementation, but did not know whether the powder contained zinc. Primary outcomes were growth, episodes of diarrhoea, acute lower respiratory tract infection, fever, and incidence of admission to hospital. This trial is registered with ClinicalTrials.gov, number NCT00705445. Results: The trial was done between Nov 1, 2008, and Dec 31, 2011. 947 children were enrolled in group A clusters, 910 in group B clusters, and 889 in group C clusters. Micronutrient powder administration was associated with lower risk of iron-deficiency anaemia at 18 months compared with the control group (odds ratio [OR] for micronutrient powder without zinc = 0•20, 95% CI 0•11–0•36; OR for micronutrient powder with zinc = 0•25, 95% CI 0•14–0•44). Compared with the control group, children in the group receiving micronutrient powder without zinc gained an extra 0•31 cm

  2. Micronutrients: do small things matter?

    African Journals Online (AJOL)

    prevention of clinical deficiency syndromes, the fast developing field of immunonutrition has added yet another dimension to the importance of foods, nutrition and micronutrients in disease ... micronutrient requirements in the critically ill, a growing body of .... effects thereof.2 Intracellular glutathione and nonenzymatic ROS.

  3. Micronutrient Deficiency Control in Vietnam from Policy and Research to Implementation: Keys for Success, Challenges and Lessons Learned.

    Science.gov (United States)

    Tran, Van Khanh; Spohrer, Rebecca; LE, Tuyen Danh; Poonawala, Alia; Monech-Pfanner, Regina

    2015-01-01

    Micronutrient deficiencies are still a public health problem in Vietnam. The Government of Vietnam has taken several steps to improve the situation through issuing supportive policy documents over the last several decades. Food fortification is an important complementary strategy to help bridge the nutrient gap in the population. Currently technical regulations are in place and food fortification is taking place on a voluntary basis, along with other complementary targeted programs including home fortification of complementary foods with micronutrient powders and a communications campaign to reach adolescent girls. These have been built on innotative partnerships with industries on a voluntary, market basis. Other innovative targeted nutrition programs are also being piloted, including a micronutrient supplement project in four provinces and a campain to reach adolescent girls through sports. High level political commitment and resources is a crucial element to scale up in Vietnam. A micronutrient survey planned in 2015 will help provide the evidence to support a possible mandatory decree on food fortification. Vietnam has built a solid foundation in order to scale up its national food fortification program in the future to reach the majority of the population with improved intakes of iron, vitamin A, zinc, and iodine.

  4. The Prevalence of Micronutrient Deficiencies and  Inadequacies in the Middle East and Approaches to  Interventions

    Directory of Open Access Journals (Sweden)

    Nahla Hwalla

    2017-03-01

    Full Text Available Micronutrient deficiencies and inadequacies constitute a global health issue, particularly among countries in the Middle East. The objective of this review is to identify micronutrient deficits in the Middle East and to consider current and new approaches to address this problem. Based on the availability of more recent data, this review is primarily focused on countries that are in advanced nutrition transition. Prominent deficits in folate, iron, and vitamin D are noted among children/adolescents, women of childbearing age, pregnant women, and the elderly. Reports indicate that food fortification in the region is sporadic and ineffective, and the use of dietary supplements is low. Nutrition monitoring in the region is limited, and gaps in relevant information present challenges for implementing new policies and approaches to address the problem. Government‐sponsored initiatives are necessary to assess current dietary intakes/patterns, support nutrition education, and to reduce food insecurity, especially among vulnerable population groups. Public–private partnerships should be considered in targeting micronutrient fortification programs and supplementation recommendations as approaches to help alleviate the burden of micronutrient deficiencies and inadequacies in the Middle East.

  5. Effect of a micronutrient-rich snack taken preconceptionally and throughout pregnancy on ultrasound measures of fetal growth: The Mumbai Maternal Nutrition Project (MMNP).

    Science.gov (United States)

    Lawande, Ashwin; Di Gravio, Chiara; Potdar, Ramesh D; Sahariah, Sirazul A; Gandhi, Meera; Chopra, Harsha; Sane, Harshad; Kehoe, Sarah H; Marley-Zagar, Ella; Margetts, Barrie M; Jackson, Alan A; Fall, Caroline H D

    2018-01-01

    Improving micronutrient intakes of under-nourished mothers in low- and middle-income countries increases birth weight, but there is little data on the nature and timing during gestation of any effects on fetal growth. Ultrasound measures of fetal size were used to determine whether and when a food-based supplement affected fetal growth. Non-pregnant women living in Mumbai slums, India (N = 6,513), were randomly assigned to receive either a daily micronutrient-rich snack containing green leafy vegetables, fruit, and milk (treatment) or a snack made from lower-micronutrient vegetables (control) in addition to their usual diet from before pregnancy until delivery. From 2,291 pregnancies, the analysis sample comprised 1,677 fetuses (1,335 fetuses of women supplemented for ≥3 months before conception). First-trimester (median: 10 weeks, interquartile range: 9-12 weeks) fetal crown-rump length was measured. Fetal head circumference, biparietal diameter, femur length, and abdominal circumference were measured during the second (19, 19-20 weeks) and third trimesters (29, 28-30 weeks). The intervention had no effect on fetal size or growth at any stage of pregnancy. In the second trimester, there were interactions between parity and allocation group for biparietal diameter (p = .02) and femur length (p = .04) with both being smaller among fetuses of primiparous women and larger among those of multiparous women, in the treatment group compared with the controls. Overall, a micronutrient-rich supplement did not increase standard ultrasound measures of fetal size and growth at any stage of pregnancy. Additional ultrasound measures of fetal soft tissues (fat and muscle) may be informative. © 2017 The Authors. Maternal & Child Nutrition Published by John Wiley & Sons Ltd.

  6. Cost-effectiveness of prenatal food and micronutrient interventions on under-five mortality and stunting: Analysis of data from the MINIMat randomized trial, Bangladesh.

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    Pernilla Svefors

    Full Text Available Nutrition interventions may have favourable as well as unfavourable effects. The Maternal and Infant Nutrition Interventions in Matlab (MINIMat, with early prenatal food and micronutrient supplementation, reduced infant mortality and were reported to be very cost-effective. However, the multiple micronutrients (MMS supplement was associated with an increased risk of stunted growth in infancy and early childhood. This unfavourable outcome was not included in the previous cost-effectiveness analysis. The aim of this study is to evaluate whether the MINIMat interventions remain cost-effective in view of both favourable (decreased under-five-years mortality and unfavourable (increased stunting outcomes.Pregnant women in rural Bangladesh, where food insecurity still is prevalent, were randomized to early (E or usual (U invitation to be given food supplementation and daily doses of 30 mg, or 60 mg iron with 400 μg of folic acid, or MMS with 15 micronutrients including 30 mg iron and 400 μg of folic acid. E reduced stunting at 4.5 years compared with U, MMS increased stunting at 4.5 years compared with Fe60, while the combination EMMS reduced infant mortality compared with UFe60. The outcome measure used was disability adjusted life years (DALYs, a measure of overall disease burden that combines years of life lost due to premature mortality (under five-year mortality and years lived with disability (stunting. Incremental cost effectiveness ratios were calculated using cost data from already published studies.By incrementing UFe60 (standard practice to EMMS, one DALY could be averted at a cost of US$24.When both favourable and unfavourable outcomes were included in the analysis, early prenatal food and multiple micronutrient interventions remained highly cost effective and seem to be meaningful from a public health perspective.

  7. A Randomized, Double-Blind Study Assessing Changes in Cognitive Function in Indian School Children Receiving a Combination of Bacopa monnieri and Micronutrient Supplementation vs. Placebo

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    Tora Mitra-Ganguli

    2017-11-01

    Full Text Available Several studies have indicated a chronic cognitive enhancing effect of Bacopa monnieri across different ages and cognitive impairment associated with vitamin and mineral deficiencies in children. Therefore, we investigated the effects of 4-month supplementation with a combination of B. monnieri extract and multiple micronutrients on cognitive functions in Indian school children aged 7–12 years. This was a randomized, double-blind, parallel design, single-center study in which 300 children were randomized to receive a beverage either fortified with B. monnieri and multiple micronutrients (“fortified” or a non-fortified isocaloric equivalent (“control” twice-daily for 4 months. Cognitive function was assessed by the Cambridge Neuropsychological Automated Test Battery (CANTAB administered at baseline, Day 60 and Day 121. The primary endpoint was change in short-term memory (working memory from baseline in subjects receiving “fortified” vs. “control” beverages after 4 months. Secondary endpoints included sustained attention, episodic memory, and executive function. The “fortified” beverage did not significantly improve short-term memory or any of the secondary outcomes tested relative to the “control” beverage. However, the spatial working memory “strategy” score showed significant improvement on Day 60 (difference between groups in change from baseline: −0.55; p < 0.05, but not on Day 121 due to the active intervention. Study products were well-tolerated. Reasons for these unexpected findings are discussed.

  8. Suboptimal Micronutrient Intake among Children in Europe

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    Boris Kaganov

    2015-05-01

    Full Text Available Adequate dietary intake of micronutrients is not necessarily achieved even in resource-rich areas of the world wherein overeating is a public health concern. In Europe, population-based data suggests substantial variability in micronutrient intake among children. Two independent surveys of micronutrient consumption among European children were evaluated. Stratified by age, the data regarding micronutrient intake were evaluated in the context of daily requirements, which are typically estimated in the absence of reliable absolute values derived from prospective studies. The proportion of children living in Europe whose intake of at least some vitamins and trace elements are at or below the estimated average requirements is substantial. The most common deficiencies across age groups included vitamin D, vitamin E, and iodine. Specific deficiencies were not uniform across countries or by age or gender.  Micronutrient intake appears to be more strongly influenced by factors other than access to food. Substantial portions of European children may be at risk of reversible health risks from inadequate intake of micronutrients. Despite the growing health threat posed by excess intake of calories, adequate exposure to vitamins, trace elements, and other micronutrients may deserve attention in public health initiatives to optimize growth and development in the European pediatric population.

  9. Iron-Folic Acid Supplementation During Pregnancy Reduces the Risk of Stunting in Children Less Than 2 Years of Age: A Retrospective Cohort Study from Nepal

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    Yasir Bin Nisar

    2016-01-01

    Full Text Available The aim of the study was to investigate the effect of antenatal iron-folic acid (IFA supplementation on child stunting in Nepalese children age <2 years. A retrospective cohort study design was used, in which a pooled cohort of 5235 most recent live births 2 years prior to interview from three Nepal Demographic and Health Surveys (2001, 2006 and 2011 was analysed. The primary outcome was stunting in children age <2 years. The main exposure variable was antenatal IFA supplementation. Multivariate Poisson regression analysis was performed. In our sample, 31% and 10% of Nepalese children age <2 years were stunted and severely stunted, respectively. The adjusted relative risk of being stunted was 14% lower in children whose mothers used IFA supplements compared to those whose mothers did not use (aRR = 0.86, 95% CI = 0.77–0.97. Additionally, the adjusted relative risk of being stunted was significantly reduced by 23% when antenatal IFA supplementation was started ≤6 months with ≥90 IFA supplements used during pregnancy (aRR = 0.77, 95% CI = 0.64–0.92. Antenatal IFA supplementation significantly reduced the risk of stunting in Nepalese children age <2 years. The greatest impact on the risk reduction of child stunting was when IFA supplements were started ≤6 months with ≥90 supplements were used.

  10. Antenatal care in practice: an exploratory study in antenatal care clinics in the Kilombero Valley, south-eastern Tanzania

    Directory of Open Access Journals (Sweden)

    Kessy Flora

    2011-05-01

    Full Text Available Abstract Background The potential of antenatal care for reducing maternal morbidity and improving newborn survival and health is widely acknowledged. Yet there are worrying gaps in knowledge of the quality of antenatal care provided in Tanzania. In particular, determinants of health workers' performance have not yet been fully understood. This paper uses ethnographic methods to document health workers' antenatal care practices with reference to the national Focused Antenatal Care guidelines and identifies factors influencing health workers' performance. Potential implications for improving antenatal care provision in Tanzania are discussed. Methods Combining different qualitative techniques, we studied health workers' antenatal care practices in four public antenatal care clinics in the Kilombero Valley, south-eastern Tanzania. A total of 36 antenatal care consultations were observed and compared with the Focused Antenatal Care guidelines. Participant observation, informal discussions and in-depth interviews with the staff helped to identify and explain health workers' practices and contextual factors influencing antenatal care provision. Results The delivery of antenatal care services to pregnant women at the selected antenatal care clinics varied widely. Some services that are recommended by the Focused Antenatal Care guidelines were given to all women while other services were not delivered at all. Factors influencing health workers' practices were poor implementation of the Focused Antenatal Care guidelines, lack of trained staff and absenteeism, supply shortages and use of working tools that are not consistent with the Focused Antenatal Care guidelines. Health workers react to difficult working conditions by developing informal practices as coping strategies or "street-level bureaucracy". Conclusions Efforts to improve antenatal care should address shortages of trained staff through expanding training opportunities, including health worker

  11. Evidence Synthesis and Translation for Nutrition Interventions to Combat Micronutrient Deficiencies with Particular Focus on Food Fortification

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    Mark Lawrence

    2016-09-01

    Full Text Available Over two billion people suffer from micronutrient deficiencies. Food fortification is a prominent nutrition intervention to combat such deficiencies; however, its effectiveness, risks, and ethical implications vary depending on the contexts associated with the deficiency it is addressing and the circumstances with its implementation. The aim of this research was to analyse the profile of nutrition interventions for combating micronutrient deficiency with particular focus on food fortification reported in existing systematic reviews (SRs, guidelines and policy statements, and implementation actions for nutrition. A review of secondary data available from online databases of SRs, guidelines and policy statements, and implementation actions, categorised as either “nutrition-specific interventions” (NSpI or “nutrition-sensitive interventions” (NSeI, was conducted. Currently, there is evidence available for a diversity of food fortification topics, and there has been much translation into action. Indeed, food fortification and micronutrient supplementation interventions and NSpI more broadly dominate the profile of interventions for which there were SRs, guidelines, and policy statements available. The findings demonstrate that, although there is a rational linear relationship between evidence synthesis and translation in formulating policy and actions to combat micronutrient deficiencies, the various nutrition interventions available to help combat micronutrient deficiencies are not equally represented in the evidence synthesis and translation processes. Effective and safe policies and actions to combat micronutrient deficiencies require decisions to be informed from a body of evidence that consists of evidence from a variety of interventions. Into the future, investment in making available a higher number of SRs, guidelines and policy statements, and actions of NSeI is indicated.

  12. The Key Role of Government in Addressing the Pandemic of Micronutrient Deficiency Conditions in Southeast Asia

    Directory of Open Access Journals (Sweden)

    Theodore H. Tulchinsky

    2015-04-01

    Full Text Available Micronutrient deficiency conditions are a major global public health problem. While the private sector has an important role in addressing this problem, the main responsibility lies with national governments, in cooperation with international agencies and donors. Mandatory fortification of basic foods provides a basic necessary intake for the majority and needs to be supported by provision of essential vitamin and mineral supplements for mothers and children and other high risk groups. Fortification by government mandate and regulation is essential with cooperation by private sector food manufacturers, and in the context of broader policies for poverty reduction, education and agricultural reform. Iron, iodine, vitamin A, vitamin B complex, folic acid, zinc, vitamin D and vitamin B12 are prime examples of international fortification experience achieved by proactive governmental nutrition policies. These are essential to achieve the Millennium Development Goals and their follow-up sustainable global health targets. National governmental policies for nutritional security and initiatives are essential to implement both food fortification and targeted supplementation policies to reduce the huge burden of micronutrient deficiency conditions in Southeast Asia and other parts of the world.

  13. Chlorella vulgaris: A Multifunctional Dietary Supplement with Diverse Medicinal Properties.

    Science.gov (United States)

    Panahi, Yunes; Darvishi, Behrad; Jowzi, Narges; Beiraghdar, Fatemeh; Sahebkar, Amirhossein

    2016-01-01

    Chlorella vulgaris is a green unicellular microalgae with biological and pharmacological properties important for human health. C. vulgaris has a long history of use as a food source and contains a unique and diverse composition of functional macro- and micro-nutrients including proteinsChlorella vulgaris is a green unicellular microalgae with biological and pharmacological properties important for human health. C. vulgaris has a long history of use as a food source and contains a unique and diverse composition of functional macro- and micro-nutrients including proteins, omega-3 polyunsaturated fatty acids, polysaccharides, vitamins and minerals. Clinical trials have suggested that supplementation with C. vulgaris can ameliorate amelioration hyperlipidemia and hyperglycemia, and protect against oxidative stress, cancer and chronic obstructive pulmonary disease. In this review, we summarize the findings on the health benefits of Chlorella supplementation and the molecular mechanisms underlying these effects., omega-3 polyunsaturated fatty acids, polysaccharides, vitamins and minerals. Clinical trials have suggested that supplementation with C. vulgaris can ameliorate amelioration hyperlipidemia and hyperglycemia, and protect against oxidative stress, cancer and chronic obstructive pulmonary disease. In this review, we summarize the findings on the health benefits of Chlorella supplementation and the molecular mechanisms underlying these effects.

  14. Vitamin D nutritional status and antenatal depressive symptoms in African American women.

    Science.gov (United States)

    Cassidy-Bushrow, Andrea E; Peters, Rosalind M; Johnson, Dayna A; Li, Jia; Rao, D Sudhaker

    2012-11-01

    Vitamin D deficiency is associated with depression; however, no studies have examined the relationship of vitamin D and antenatal depression. Antenatal depression increases the risk of adverse birth outcomes and poorer postpartum maternal and infant health. African American women are at increased risk for vitamin D deficiency and antenatal depression. Thus, we examined if early pregnancy vitamin D nutrition (VDN) was associated with antenatal depressive symptoms among African American women in the second trimester of pregnancy. Women (n=178) were recruited from obstetrics clinics of a large health system. VDN was assessed by serum 25-hydroxyvitamin D (25-OHD). Depression symptoms were measured with the Center for Epidemiological Studies Depression (CES-D) scale; CES-D≥16 equates with criteria for clinical depression. Logistic regression was used to examine the association of log-transformed 25-OHD and elevated depression symptoms (CES-D≥16). Mean 25-OHD was 13.4±8.4 ng/mL; most women (82.6%, n=147) were vitamin D inadequate or deficient (25-OHD<20 ng/mL). Mean CES-D was 15.2±10.7, and 74 (41.6%) women had a CES-D≥16, suggestive of clinical depression. A significant inverse relationship was found between log (25-OHD) and CES-D≥16 (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.29-0.99, p=0.046). For every 1-unit increase in log (25-OHD) (corresponding to ~2.72 ng/mL increase in 25-OHD), the odds of CES-D≥16 decreased by 46%. African American women with lower VDN exhibit increased depressive symptoms. Research on vitamin D supplementation for reducing antenatal depressive symptoms is needed.

  15. Nutrition and Supplementation in Soccer

    Science.gov (United States)

    Oliveira, César Chaves; Ferreira, Diogo; Caetano, Carlos; Granja, Diana; Pinto, Ricardo; Mendes, Bruno; Sousa, Mónica

    2017-01-01

    Contemporary elite soccer features increased physical demands during match-play, as well as a larger number of matches per season. Now more than ever, aspects related to performance optimization are highly regarded by both players and soccer coaches. Here, nutrition takes a special role as most elite teams try to provide an adequate diet to guarantee maximum performance while ensuring a faster recovery from matches and training exertions. It is currently known that manipulation and periodization of macronutrients, as well as sound hydration practices, have the potential to interfere with training adaptation and recovery. A careful monitoring of micronutrient status is also relevant to prevent undue fatigue and immune impairment secondary to a deficiency status. Furthermore, the sensible use of evidence-based dietary supplements may also play a role in soccer performance optimization. In this sense, several nutritional recommendations have been issued. This detailed and comprehensive review addresses the most relevant and up-to-date nutritional recommendations for elite soccer players, covering from macro and micronutrients to hydration and selected supplements in different contexts (daily requirements, pre, peri and post training/match and competition). PMID:29910389

  16. Nutrition and Supplementation in Soccer.

    Science.gov (United States)

    Oliveira, César Chaves; Ferreira, Diogo; Caetano, Carlos; Granja, Diana; Pinto, Ricardo; Mendes, Bruno; Sousa, Mónica

    2017-05-12

    Contemporary elite soccer features increased physical demands during match-play, as well as a larger number of matches per season. Now more than ever, aspects related to performance optimization are highly regarded by both players and soccer coaches. Here, nutrition takes a special role as most elite teams try to provide an adequate diet to guarantee maximum performance while ensuring a faster recovery from matches and training exertions. It is currently known that manipulation and periodization of macronutrients, as well as sound hydration practices, have the potential to interfere with training adaptation and recovery. A careful monitoring of micronutrient status is also relevant to prevent undue fatigue and immune impairment secondary to a deficiency status. Furthermore, the sensible use of evidence-based dietary supplements may also play a role in soccer performance optimization. In this sense, several nutritional recommendations have been issued. This detailed and comprehensive review addresses the most relevant and up-to-date nutritional recommendations for elite soccer players, covering from macro and micronutrients to hydration and selected supplements in different contexts (daily requirements, pre, peri and post training/match and competition).

  17. Folic acid supplementation during pregnancy for maternal health and pregnancy outcomes.

    Science.gov (United States)

    Lassi, Zohra S; Salam, Rehana A; Haider, Batool A; Bhutta, Zulfiqar A

    2013-03-28

    During pregnancy, fetal growth causes an increase in the total number of rapidly dividing cells, which leads to increased requirements for folate. Inadequate folate intake leads to a decrease in serum folate concentration, resulting in a decrease in erythrocyte folate concentration, a rise in homocysteine concentration, and megaloblastic changes in the bone marrow and other tissues with rapidly dividing cells To assess the effectiveness of oral folic acid supplementation alone or with other micronutrients versus no folic acid (placebo or same micronutrients but no folic acid) during pregnancy on haematological and biochemical parameters during pregnancy and on pregnancy outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2012) and we contacted major organisations working in micronutrient supplementation, including UNICEF Nutrition Section, World Health Organization (WHO) Maternal and Reproductive Health, WHO Nutrition Division, and National Center on Birth defects and Developmnetal Disabilities, US Centers for Disease Control and Prevention (CDC). All randomised, cluster-randomised and cross-over controlled trials evaluating supplementation of folic acid alone or with other micronutrients versus no folic acid (placebo or same micronutrients but no folic acid) in pregnancy. Two review authors independently assessed trials for inclusion, assessed risk of bias and extracted data. Data were checked for accuracy. Thirty-one trials involving 17,771 women are included in this review. This review found that folic acid supplementation has no impact on pregnancy outcomes such as preterm birth (risk ratio (RR) 1.01, 95% confidence interval (CI) 0.73 to 1.38; three studies, 2959 participants), and stillbirths/neonatal deaths (RR 1.33, 95% CI 0.96 to 1.85; three studies, 3110 participants). However, improvements were seen in the mean birthweight (mean difference (MD) 135.75, 95% CI 47.85 to 223.68). On the other hand, the review

  18. The impact of antioxidant supplementation on clinical outcomes in ...

    African Journals Online (AJOL)

    Methodology: A systematic review and meta-analysis of the English literature was performed to determine the effect of antioxidant micronutrient supplementation on clinically important outcomes in the critically ill. Pubmed, Google Scholar and Science Direct electronic databases were searched for papers published ...

  19. Dietary supplements and disease prevention — a global overview

    Science.gov (United States)

    Dietary supplements are widely used and offer the potential to improve health if appropriately targeted to those in need. Inadequate nutrition and micronutrient deficiencies are prevalent conditions that adversely affect global health. Although improvements in diet quality are essential to address t...

  20. Multi-micronutrient supplementation during pregnancy for prevention of maternal anaemia and adverse birth outcomes in a high-altitude area: a prospective cohort study in rural Tibet of China.

    Science.gov (United States)

    Kang, Yijun; Dang, Shaonong; Zeng, Lingxia; Wang, Duolao; Li, Qiang; Wang, Jianpeng; Ouzhu, Luobu; Yan, Hong

    2017-09-01

    Anaemia during pregnancy, characterised by Hb anaemia among pregnant women and their infants' health in a high-altitude area. A prospective cohort study was carried out in two rural counties in Tibet from 2007 to 2012. A total of 1149 eligible pregnant women were allocated daily supplementation with FA in one county and MMN containing a recommended allowance of twenty-three vitamins and minerals in another county starting ≤24 weeks of gestation and continuing until delivery. Compared with the FA group, prenatal supplementation with MMN was significantly associated with reduced odds of anaemia in the third trimester. This was demonstrated in the primary outcome, with an adjusted OR (AOR) of 0·63; 95 % CI 0·45, 0·88 and P=0·007 and also reduced odds of preterm delivery (AOR: 0·31; 95 % CI 0·15, 0·61; P=0·001). There was no difference between MMN and FA groups in mean birth weight (adjusted mean difference: 36·78; 95 % CI -19·42, 92·98 g; P=0·200), whereas MMN supplementation significantly reduced the odds of low-birth weight (LBW) babies (AOR: 0·58; 95 % CI 0·36, 0·91; P=0·019). In conclusion, the antenatal MMN supplementation in rural Tibet is associated with a reduction of maternal anaemia in the third trimester, and may potentially decrease the risk of preterm delivery and LBW babies.

  1. Microfinance Institutions' Successful Delivery Of Micronutrient Powders: A Randomized Trial In Rural Haiti.

    Science.gov (United States)

    Baum, Aaron; Elize, Wesly; Jean-Louis, Florence

    2017-11-01

    Globally, two-thirds of child deaths could be prevented by increased provision of health interventions such as vaccines, micronutrient supplements, and water purification tablets. We report the results from a randomized controlled trial in Haiti during 2012 that tested whether microfinance institutions-which reach 200 million households worldwide-can effectively deliver health products. These institutions provide loans to underserved entrepreneurs, primarily poor women in rural areas. In the intervention group, micronutrient powders to improve the nutrition of young children were distributed at regularly occurring microfinance meetings by a trained borrower. In both the control and the intervention groups, nurses led seminars on nutrition and extended breastfeeding during microfinance meetings. At three-month follow-up, the mean difference in hemoglobin concentration between children in the intervention group and those in the control group was 0.28 grams per deciliter (g/dL)-with a subsample of younger children (under two years of age) showing greater relative improvement (0.46 g/dL)-and the odds ratio for children in the intervention group meeting the diagnostic criteria for anemia was 0.64. The results are similar to those of previous studies that evaluated micronutrient powder distribution through dedicated health institutions. Our findings suggest that microfinance institutions are a promising platform for the large-scale delivery of health products in low-income countries.

  2. Co-ordinated research project on isotopic and complementary tools for the study of micronutrient status and interactions in developing country populations exposed to multiple nutritional deficiencies. Report on the first research co-ordination meeting

    International Nuclear Information System (INIS)

    2002-01-01

    From a global perspective and in spite of decades of nutrition programmes, micronutrients deficiency is at alarming proportions in many developing societies today. It affects millions of people worldwide, and includes consequences that potentially compromise morbidity, mortality, cognitive development, and growth, reproductive and work capacity. Recent estimates by the WHO are that deficiencies of iron (Fe), iodine (I), and vitamin A continue to influence the health of 2000 million, 740 million, and 250 million persons respectively. In addition to these three micronutrients, the possible negative consequences of deficiencies of zinc (Zn), copper (Cu) and selenium (Se) are now also being increasingly recognized as important health concerns. As a result of the increasing recognition of the co-existence of multiple micronutrient deficiencies in developing countries, United Nations Agencies have urged that supplementation, fortification and dietary modification/diversification programmes are designed to combat multiple micronutrient deficiencies simultaneously. Fortificant levels for fortification, like supplementation, must be carefully selected to minimize risk of antagonistic nutrient interactions and to take into account the toxic threshold level for normal individuals. Possible antagonistic interactions that may interfere with the utilisation of trace elements in the supplements or fortificants per se, and/or with the utilization of elements intrinsic to the food or the meal include those between Cu-Zn, Cu-Fe, Fe-Zn, Mn-Fe, Ca-Zn. Stable isotope techniques play an important role in quantifying the optimal levels and the bioavailability of micronutrient supplements and fortificants for a range of indigenous meals consumed in developing countries, especially those containing potent absorption inhibitors. This Capacity building CRP or Thermatic CRP (T-CRP) addresses the need to develop effective strategies to combat micro-nutrient malnutrition in developing countries

  3. Co-ordinated research project on isotopic and complementary tools for the study of micronutrient status and interactions in developing country populations exposed to multiple nutritional deficiencies. Report on the first research co-ordination meeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    From a global perspective and in spite of decades of nutrition programmes, micronutrients deficiency is at alarming proportions in many developing societies today. It affects millions of people worldwide, and includes consequences that potentially compromise morbidity, mortality, cognitive development, and growth, reproductive and work capacity. Recent estimates by the WHO are that deficiencies of iron (Fe), iodine (I), and vitamin A continue to influence the health of 2000 million, 740 million, and 250 million persons respectively. In addition to these three micronutrients, the possible negative consequences of deficiencies of zinc (Zn), copper (Cu) and selenium (Se) are now also being increasingly recognized as important health concerns. As a result of the increasing recognition of the co-existence of multiple micronutrient deficiencies in developing countries, United Nations Agencies have urged that supplementation, fortification and dietary modification/diversification programmes are designed to combat multiple micronutrient deficiencies simultaneously. Fortificant levels for fortification, like supplementation, must be carefully selected to minimize risk of antagonistic nutrient interactions and to take into account the toxic threshold level for normal individuals. Possible antagonistic interactions that may interfere with the utilisation of trace elements in the supplements or fortificants per se, and/or with the utilization of elements intrinsic to the food or the meal include those between Cu-Zn, Cu-Fe, Fe-Zn, Mn-Fe, Ca-Zn. Stable isotope techniques play an important role in quantifying the optimal levels and the bioavailability of micronutrient supplements and fortificants for a range of indigenous meals consumed in developing countries, especially those containing potent absorption inhibitors. This Capacity building CRP or Thermatic CRP (T-CRP) addresses the need to develop effective strategies to combat micro-nutrient malnutrition in developing countries

  4. Optimizing nitrification in biological rapid sand filters: Diagnosing and supplementing micronutrients needed for proper filter performance

    DEFF Research Database (Denmark)

    Lee, Carson Odell; Wagner, Florian Benedikt; Boe-Hansen, Rasmus

    Nitrification is an important biological process commonly used in biological drinking water filters to remove ammonium from drinking water. Recent research has shown that a lack of micronutrients could be limiting the performance of these filters. Because nitrification is a biological process, ca...... to be an important diagnostic tool that could decrease regulatory hurdles, and save time and money....

  5. REVIEW OF FOCUSSED ANTENATAL CARE

    Directory of Open Access Journals (Sweden)

    Sreelatha

    2015-09-01

    Full Text Available INTRODUCTION: Antenatal care is a comprehensive antepartum programme which involves a coordinated approach to medical care , continuous risk assessment , and psychological support that optimally begins before conception and extends throughout the postpartum period and int erconceptional period . [1] One of major responsibility of obstetrician providing antenatal care is to identify high risk factors based on past history, examination and investigation results. The objective of antenatal care therefore is to assure that every wanted pregnancy results in the delivery of a healthy baby without impairing the mothers health . [2] In a 1914 study by Williams antenatal care reduced fetal mortality by 40%

  6. Are Dietary Supplements and Nutraceuticals Effective for Musculoskeletal Health and Cognitive Function? A Scoping Review.

    Science.gov (United States)

    Iolascon, G; Gimigliano, R; Bianco, M; De Sire, A; Moretti, A; Giusti, A; Malavolta, N; Migliaccio, S; Migliore, A; Napoli, N; Piscitelli, P; Resmini, G; Tarantino, U; Gimigliano, F

    2017-01-01

    The aim of our scoping review was to summarize the state of the art regarding micronutrients in order to identify which of them might effectively improve health status in the areas typically impaired in older people: bone, skeletal muscle, and cognitive function. Scoping review. The Italian Study Group on Healthy Aging by Nutraceuticals and Dietary Supplements (HANDS) performed this scoping review, based on the following steps: doing a list of micronutrients related with musculoskeletal or cognitive functions, included in dietary supplements and nutraceuticals commercialized in Italy; planning a research on PubMed, according to an evidence-based approach, in order to the most relevant positive study for each micronutrient into each of the three areas involved (bone, skeletal muscle and cognitive function); identifying the micronutrients effective in maintaining or achieving an adequate health status in older people, specifying the effective and safe daily doses, according to the selected studies. In literature we found 12 relevant positive studies (1 international society guidelines/recommendations, 1 systematic review, 7 randomized controlled trials, and 3 prospective cohort studies). We showed that only 16 micronutrients resulted to have appropriate scientific evidences in terms of improving musculoskeletal health and/or cognitive function in older people: beta-alanine, calcium, creatine, fluorides, leucine, magnesium, omega-3 fatty acids, potassium, vitamin B6, vitamin B9, vitamin B12, vitamin C, vitamin D, vitamin E, vitamin K2, and zinc. This scoping review showed that selected micronutrients in adequate doses might have an ancillary role in musculoskeletal health and cognitive functions in older people.

  7. Vitamin A supplementation awareness among mothers of children ...

    African Journals Online (AJOL)

    Background: Vitamin A deficiency is one of the leading micro-nutrient deficiencies of public health importance in Kenya. Provision of vitamin A supplements every six months is an inexpensive, safe, quick and effective way to improve vitamin A status and save children's lives. Objectives: To determine vitamin A ...

  8. Micronutrient Gaps in Three Commercial Weight-Loss Diet Plans.

    Science.gov (United States)

    G Engel, Matthew; J Kern, Hua; Brenna, J Thomas; H Mitmesser, Susan

    2018-01-20

    Weight-loss diets restrict intakes of energy and macronutrients but overlook micronutrient profiles. Commercial diet plans may provide insufficient micronutrients. We analyzed nutrient profiles of three plans and compared their micronutrient sufficiency to Dietary Reference Intakes (DRIs) for male U.S. adults. Hypocaloric vegan (Eat to Live-Vegan, Aggressive Weight Loss; ETL-VAWL), high-animal-protein low-carbohydrate (Fast Metabolism Diet; FMD) and weight maintenance (Eat, Drink and Be Healthy; EDH) diets were evaluated. Seven single-day menus were sampled per diet ( n = 21 menus, 7 menus/diet) and analyzed for 20 micronutrients with the online nutrient tracker CRON-O-Meter. Without adjustment for energy intake, the ETL-VAWL diet failed to provide 90% of recommended amounts for B 12 , B₃, D, E, calcium, selenium and zinc. The FMD diet was low (90% DRIs for all but vitamin D, calcium and potassium. Several micronutrients remained inadequate after adjustment to 2000 kcal/day: vitamin B 12 in ETL-VAWL, calcium in FMD and EDH and vitamin D in all diets. Consistent with previous work, micronutrient deficits are prevalent in weight-loss diet plans. Special attention to micronutrient rich foods is required to reduce risk of micronutrient deficiency in design of commercial diets.

  9. Micronutrient Gaps in Three Commercial Weight-Loss Diet Plans

    Science.gov (United States)

    J. Kern, Hua; Brenna, J. Thomas; H. Mitmesser, Susan

    2018-01-01

    Weight-loss diets restrict intakes of energy and macronutrients but overlook micronutrient profiles. Commercial diet plans may provide insufficient micronutrients. We analyzed nutrient profiles of three plans and compared their micronutrient sufficiency to Dietary Reference Intakes (DRIs) for male U.S. adults. Hypocaloric vegan (Eat to Live-Vegan, Aggressive Weight Loss; ETL-VAWL), high-animal-protein low-carbohydrate (Fast Metabolism Diet; FMD) and weight maintenance (Eat, Drink and Be Healthy; EDH) diets were evaluated. Seven single-day menus were sampled per diet (n = 21 menus, 7 menus/diet) and analyzed for 20 micronutrients with the online nutrient tracker CRON-O-Meter. Without adjustment for energy intake, the ETL-VAWL diet failed to provide 90% of recommended amounts for B12, B3, D, E, calcium, selenium and zinc. The FMD diet was low (diet met >90% DRIs for all but vitamin D, calcium and potassium. Several micronutrients remained inadequate after adjustment to 2000 kcal/day: vitamin B12 in ETL-VAWL, calcium in FMD and EDH and vitamin D in all diets. Consistent with previous work, micronutrient deficits are prevalent in weight-loss diet plans. Special attention to micronutrient rich foods is required to reduce risk of micronutrient deficiency in design of commercial diets. PMID:29361684

  10. The effect of energy-protein supplementation on weight, body composition and handgrip strength among pulmonary tuberculosis HIV-co-infected patients

    DEFF Research Database (Denmark)

    PrayGod, George; Range, Nyagosya; Faurholt-Jepsen, Daniel

    2012-01-01

    Undernutrition is common among smear-positive pulmonary tuberculosis (PTB+) patients. Micronutrient supplementation may improve treatment outcomes, but it is unclear whether additional energy-protein would be beneficial. The present study aimed to assess the effect of energy-protein supplementation...... on weight, body composition and handgrip strength against a background of high micronutrient intake during tuberculosis (TB) treatment. A total of 377 PTB+ patients co-infected with HIV were randomly allocated one or six biscuits daily for 60 d during TB treatment. Weight, arm fat area, arm muscle area...

  11. [Evaluation of the impact of multiple micronutrient powders on children anemia in three Andean regiones in Peru].

    Science.gov (United States)

    Munayco, César V; Ulloa-Rea, María E; Medina-Osis, José; Lozano-Revollar, Carmen R; Tejada, Violeta; Castro-Salazar, Consuelo; Munarriz-Villafuerte, José; de Bustos, Cecilia; Arias, Lena

    2013-04-01

    The aim of this research was to determine the impact of the strategy of multi-micronutrient supplementation (MMN) on the childhood anemia in three Andean regions of Peru. A sentinel surveillance system was established in 29 health centers of Andahuaylas, Ayacucho and Huancavelica (Peru) to monitor a cohort of children of 6 to 35 months of age whom been received MMM for a period of 12 months. Data regarding hemoglobin levels were gathered at the beginning and at the end of the research; they included consumption of MMN, and other data from clinical records and from growth and development charts. Between the child who completed the supplementation, the prevalence of anemia decreased from 70.2% to 36.6% (p value anemia at the beginning of the supplementation got cured. This research shows that supplementation with MMN could be a valuable strategy to fight anemia.

  12. Factors associated with socio-demographic characteristics and antenatal care and iron supplement use in Ethiopia, Kenya, and Senegal.

    Science.gov (United States)

    Verney, Allison; Reed, Barbara A; Lumumba, Jude B; Kung'u, Jacqueline K

    2018-02-01

    Antenatal care (ANC) offers remarkable opportunities to reach a large number of women with effective nutrition and health interventions, including iron (Fe) supplementation. However, all women do not equally seek nor benefit from ANC. We aimed to identify characteristics associated with ANC and Fe use among women in hard-to-reach areas in Afar, Ethiopia; Sedhiou and Kolda, Senegal; and Kakamega, Kenya. Women who gave birth within 1 year preceding the survey (n = 4,575) from 15 different sub-regions were randomly selected and surveyed. Multivariable logistic regression was used to identify associations of socio-demographic characteristics with ANC and Fe use. Factors that showed positive associations with ANC uptake included education, income, possession of a mobile phone, and the occupation of the mother or another household member. Beginning ANC in the first trimester associated positively with achievement of 4 or more ANC visits, and having any ANC visits related positively with Fe intake. Distance to the nearest health facility was negatively associated, and type of nearest facility and counselling and health education were positively associated with some outcomes. The results from these surveys demonstrate the need to ensure access of services across all population groups and can help identify ANC programming needs. © 2018 John Wiley & Sons Ltd.

  13. Food-Based Interventions to Modify Diet Quality and Diversity to Address Multiple Micronutrient Deficiency.

    Science.gov (United States)

    Nair, Madhavan K; Augustine, Little Flower; Konapur, Archana

    2015-01-01

    Global data indicate a high prevalence of hidden hunger among population. Deficiencies of certain micronutrients such as folic acid, iodine, iron, and vitamin A have long lasting effects on growth and development and therefore have been a National priority from many decades. The strategy implemented so far limits to the use of supplemental sources or fortified foods in alleviating the burden of deficiencies. These approaches however undermine the food-based strategies involving dietary diversification as the long-term sustainable strategy. There is lack of understanding on the level of evidence needed to implement such strategies and the level of monitoring required for impact evaluation. Dietary diversity concerns how to ensure access for each individual to a quality and safe diet with adequate macro- and micronutrients. The key to success in using dietary diversity as a strategy to tackle hidden hunger is in integrating it with the principles of bioavailability, translated to efficient food synergies with due emphasis on food accessibility, affordability, and outdoor physical activity/life style modifications. Promoting enabling environment and sustainable agriculture is crucial for practicing dietary diversification with behavior change communication as an integral segment. It can be concluded that food-based strategies require careful understanding of the factors associated with it and moderate it to form an effective strategy for controlling multiple micronutrient deficiencies.

  14. Food-based interventions to modify diet quality and diversity to address multiple micronutrient deficiency

    Directory of Open Access Journals (Sweden)

    Madhavan K Nair

    2016-01-01

    Full Text Available Global data indicates a high prevalence of hidden hunger among population. Deficiencies of certain micronutrients such as folic acid, iodine, iron and vitamin A have long lasting effects on growth and development and therefore have been a National priority from many decades. The strategy implemented so far limits to the use of supplemental sources or fortified foods in alleviating the burden of deficiencies. These approaches however undermine the food based strategies involving dietary diversification as the long term sustainable strategy. There is lack of understanding on the level of evidence needed to implement such strategies and the level of monitoring required for impact evaluation. Dietary diversity concerns how to ensure access for each individual to a quality and safe diet with adequate macro and micronutrients. The key to success in using dietary diversity as a strategy to tackle hidden hunger is in integrating it with the principles of bioavailability, translated to efficient food synergies with due emphasis on food accessibility, affordability and outdoor physical activity/ life style modifications. Promoting enabling environment and sustainable agriculture is crucial for practicing dietary diversification with behaviour change communication as an integral segment. It can be concluded that food based strategies require careful understanding of the factors associated with it and moderate it to form an effective strategy for controlling multiple micronutrient deficiencies.

  15. Micronutrient Gaps in Three Commercial Weight-Loss Diet Plans

    Directory of Open Access Journals (Sweden)

    Matthew G. Engel

    2018-01-01

    Full Text Available Weight-loss diets restrict intakes of energy and macronutrients but overlook micronutrient profiles. Commercial diet plans may provide insufficient micronutrients. We analyzed nutrient profiles of three plans and compared their micronutrient sufficiency to Dietary Reference Intakes (DRIs for male U.S. adults. Hypocaloric vegan (Eat to Live-Vegan, Aggressive Weight Loss; ETL-VAWL, high-animal-protein low-carbohydrate (Fast Metabolism Diet; FMD and weight maintenance (Eat, Drink and Be Healthy; EDH diets were evaluated. Seven single-day menus were sampled per diet (n = 21 menus, 7 menus/diet and analyzed for 20 micronutrients with the online nutrient tracker CRON-O-Meter. Without adjustment for energy intake, the ETL-VAWL diet failed to provide 90% of recommended amounts for B12, B3, D, E, calcium, selenium and zinc. The FMD diet was low (<90% DRI in B1, D, E, calcium, magnesium and potassium. The EDH diet met >90% DRIs for all but vitamin D, calcium and potassium. Several micronutrients remained inadequate after adjustment to 2000 kcal/day: vitamin B12 in ETL-VAWL, calcium in FMD and EDH and vitamin D in all diets. Consistent with previous work, micronutrient deficits are prevalent in weight-loss diet plans. Special attention to micronutrient rich foods is required to reduce risk of micronutrient deficiency in design of commercial diets.

  16. Orange juice, a marker of diet quality, contributes to essential micronutrient and antioxidant intakes in the United States population.

    Science.gov (United States)

    Yang, Meng; Lee, Sang-Gil; Wang, Ying; Lloyd, Beate; Chung, Sang-Jin; Song, Won O; Chun, Ock K

    2013-01-01

    To evaluate the impact of 100% orange juice (OJ) on the healthy diet and micronutrient intakes of the United States population. Cross-sectional study of 13,971 people in the United States aged ≥ 4 years using 2 24-hour diet recalls from the National Health and Nutrition Examination Survey, 2003-2006. Consumption of OJ was higher among 4- to 8-year-old children, older adults (> 50 y old), non-Hispanic blacks, those with lower body mass index, those of lower income level, nonsmokers, dietary supplement users, and those participating in regular exercise (P < .05). Consumption of OJ was positively associated with the percentage of participants meeting MyPyramid recommendations for fruit consumption. Increased OJ consumption was correlated with increased daily intakes of certain micronutrients and antioxidants (P < .05). Percentages of participants with intakes below Estimated Average Requirements for these micronutrients decreased with increased OJ consumption (P < .001). The implicated nutritional and potential health benefits of OJ warrant further investigation in clinical research studies. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  17. Micronutrients and Diabetic Retinopathy A Systematic Review

    NARCIS (Netherlands)

    Lee, Chee-Tin Christine; Gayton, Emma L.; Beulens, Joline W. J.; Flanagan, Declan W.; Adler, Amanda I.

    Background: We have evaluated the evidence for the association between intake and blood levels of micronutrients and diabetic retinopathy. Treatment for diabetic retinopathy requires significant clinical input and specialist ophthalmologic care. Micronutrients, including vitamin C, vitamin E, and

  18. Multiple micronutrient supplementation and dietary energy intake in pregnant women Suplementación con micronutrimentos múltiples y consumo de eneregía en mujeres embarazadas

    Directory of Open Access Journals (Sweden)

    María de Lourdes Flores

    2007-06-01

    Full Text Available OBJECTIVE: To compare dietary intake of women supplemented with multiple micronutrients (MM or iron only during pregnancy. MATERIALS AND METHODS: Design: Randomized, double-blind, controlled community-based trial. Setting: One semi-urban community in Central Mexico. Subjects: Pregnant women identified before week 13 of pregnancy, willing to provide informed consent. Interventions: Women were randomly assigned to receive daily supplementation with MM or iron only from recruitment until delivery. Supplements were delivered to the participants' home and compliance observed daily. Dietary intake was assessed by repeat 24-hr recall. Data were analyzed using non-parametric tests and multiple regression analysis to determine the impact of MM supplementation on dietary intake of energy and select micronutrients. RESULTS: During the third trimester, women in the MM group consumed more energy and iron from dietary sources than women in the iron only group. After adjustment for differences between the groups at baseline, women in the MM group consumed 111.3 kcal/day more (pOBJETIVO: Comparar la dieta de mujeres suplementada con múltiples micronutrimentos (MM o sólo con hierro durante el embarazo. MATERIAL Y MÉTODOS: Diseño: ensayo comunitario, aleatorizado, controlado, doble ciego. Lugar: una comunidad semiurbana en el México central. Participantes: mujeres embarazadas identificadas antes de la semana 13 de embarazo, dispuestas a entregar el consentimiento informado. Actividades: las mujeres fueron asignadas en forma aleatoria a recibir suplementación diaria con MM o exclusivamente hierro desde el reclutamiento hasta el parto. Los suplementos se entregaron en la casa de las participantes y se observó su cumplimiento con frecuencia diaria. El consumo dietético fue valorado por mediciones repetidas de recordatorio de alimentos de 24 h. Los datos se analizaron mediante pruebas no paramétricas y análisis de regresión múltiple, para determinar el

  19. Hydrothermally treated chitosan hydrogel loaded with copper and zinc particles as a potential micro-nutrient based antimicrobial feed additive

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    Parthiban eRajasekaran

    2015-11-01

    Full Text Available Large-scale use of antibiotics in food animal farms as growth promoters is considered as one of the driving factors behind increasing incidence of microbial resistance. Several alternatives are under investigation to reduce the amount of total antibiotics used in order to avoid any potential transmission of drug resistant microbes to humans through food chain. Copper sulfate and zinc oxide salts are used as feed supplement as they exhibit antimicrobial properties in addition to being micronutrients. However, higher dosage of copper and zinc (often needed for growth promoting effect to animals is not advisable because of potential environmental toxicity arising from excreta. Innovative strategies are needed to utilize the complete potential of trace minerals as growth promoting feed supplements. To this end, we describe here the development and preliminary characterization of hydrothermally treated chitosan as a delivery vehicle for copper and zinc nanoparticles that could act as a micronutrient based antimicrobial feed supplement. Material characterization studies showed that hydrothermal treatment makes a chitosan hydrogel that re-arranged to capture the copper and zinc metal particles. Systemic antimicrobial assays showed that this chitosan biopolymer matrix embedded with copper (57.6 μg/ml and zinc (800 μg/ml reduced the load of model gut-bacteria (target organisms of growth promoting antibiotics such as Escherichia coli, Enterococcus faecalis, Staphylococcus aureus and Lactobacillus fermentum under in vitro conditions. Particularly, the chitosan/copper/zinc hydrogel exhibited significantly higher antimicrobial effect against L. fermentum, one of the primary targets of antibiotic growth promoters. Additionally, the chitosan matrix ameliorated the cytotoxicity levels of metal supplements when screened against a murine macrophage cell line RAW 264.7 and in TE-71, a murine thymic epithelial cell line. In this proof of concept study, we show

  20. Women's education level, antenatal visits and the quality of skilled antenatal care: a study of three African countries.

    Science.gov (United States)

    Babalola, Stella

    2014-02-01

    Many pregnant women in Africa who access professional antenatal care do not receive all the WHO-recommended components of care. Using Demographic and Health Survey (DHS) data from Kenya, Malawi and Nigeria, this study assesses the relationship of education level with the quality of antenatal care received and highlights how the number of antenatal visits mediates this relationship. The results show that a large proportion of the effect of education level on quality of care is direct, while only a small portion is mediated through the number of antenatal visits. Efforts to improve pregnancy outcomes for under-privileged women should focus on removing structural barriers to access, strengthening the technical and interpersonal skills of providers, and addressing providers' biases and discriminatory practices towards these women. Such efforts should also seek to empower underprivileged women to insist on quality antenatal care by explaining what to expect during an antenatal visit.

  1. The road to micronutrient biofortification of rice:Progress and prospects

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    Khurram eBashir

    2013-02-01

    Full Text Available Biofortification (Increasing the contents of vitamins and minerals through plant breeding or biotechnology of food crops with micronutrient elements has the potential to combat widespread micronutrient deficiencies in humans. Rice (Oryza sativa L. feeds more than half of the world’s population and is used as a staple food in many parts of Asia. As in other plants, micronutrient transport in rice is controlled at several stages, including uptake from soil, transport from root to shoot, careful control of subcellular micronutrient transport, and finally, and most importantly, transport to seeds. To enhance micronutrient accumulation in rice seeds, we need to understand and carefully regulate all of these processes. During the last decade, numerous attempts such as increasing the contents/expression of genes encoding metal chelators (mostly phytosiderophores and metal transporters; overexpressing Fe storage protein ferritin and phytase were successfully undertaken to significantly increase the micronutrient content of rice. However, despite the rapid progress in biofortification of rice, the commercialization of biofortified crops has not yet been achieved. Here, we briefly review the progress in biofortification of rice with micronutrient elements (Fe, Zn and Mn and discuss future prospects to mitigate widespread micronutrient deficiencies in humans.

  2. Mapping low intake of micronutrients across Europe

    DEFF Research Database (Denmark)

    Mensink, G. B. M.; Fletcher, R.; Gurinovic, M.

    2013-01-01

    Achieving an understanding of the extent of micronutrient adequacy across Europe is a major challenge. The main objective of the present study was to collect and evaluate the prevalence of low micronutrient intakes of different European countries by comparing recent nationally representative diet...

  3. Multi-micronutrient supplementation in HIV-infected South African children : effect on nutritional s tatus, diarrhoea and respiratory infections

    NARCIS (Netherlands)

    Mda, S.

    2011-01-01

    Background: The nutritional status of HIV-infected children is reported to be poor. Diarrhoea and acute respiratory infections tend to be more common and severe in HIV-infected children than in uninfected ones. Deficiencies of micronutrients may result in poor

  4. Common micronutrient deficiencies among food aid beneficiaries ...

    African Journals Online (AJOL)

    admin

    Abstract. Background: Ethiopia is amongst the African countries that have received significant food aid. Nonetheless, the common micronutrient deficiencies among food aid beneficiaries are not well documented. Objective: To find out the common micronutrient deficiencies among food aid beneficiaries in the country based ...

  5. Micronutrient levels and nutritional status of school children living in Northwest Ethiopia.

    Science.gov (United States)

    Amare, Bemnet; Moges, Beyene; Fantahun, Bereket; Tafess, Ketema; Woldeyohannes, Desalegn; Yismaw, Gizachew; Ayane, Tilahun; Yabutani, Tomoki; Mulu, Andargachew; Ota, Fusao; Kassu, Afework

    2012-12-13

    Several micronutrients are essential for adequate growth of children. However, little information is available on multiple micronutrient status of school children in Ethiopia. The present study was designed to evaluate the relationship between multiple micronutrient levels and nutritional status among school children. In this cross-sectional study, anthropometric data, blood and stool samples were collected from 100 children at Meseret Elementary School in Gondar town, Northwest Ethiopia. Serum concentration of magnesium, calcium, iron, copper, zinc, selenium and molybdenum were measured by inductively coupled plasma mass spectrometer. Anthropometric indices of weight-for-age, height-for-age and BMI-for-age were used to estimate the children's nutritional status. Stool samples were examined by standard microscopic methods for intestinal parasites. The prevalence of stunting, underweight, wasting and intestinal parasitoses among school children was 23%, 21%, 11% and 18%, respectively. The mean serum levels of magnesium, calcium, iron, copper, zinc, selenium and molybdenum were 2.42±0.32 (mg/dl), 15.31±2.14 (mg/dl), 328.19±148.91 (μg/dl), 191.30±50.17 (μg/dl), 86.40±42.40 (μg/dl), 6.32±2.59 (μg/dl), and 0.23±0.15 (μg/dl), respectively. Selenium deficiency, zinc deficiency and magnesium deficiency occurred in 62%, 47%, and 2% of the school children, respectively. Height-for-age showed significant positive correlation with the levels of copper and molybdenum (p = 0.01) and with the levels of magnesium (p = 0.05). Deficiencies of selenium and zinc were high among the school children although the deficiencies were not significantly related with their nutritional status. The prevalence of both malnutrition and intestinal parasitism was not negligible. These calls for the need to undertake multicentre studies in various parts of the country to substantiate the data obtained in the present study so that appropriate and beneficial strategies for micronutrient

  6. Micronutrient levels and nutritional status of school children living in Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Amare Bemnet

    2012-12-01

    appropriate and beneficial strategies for micronutrient supplementation and interventions on nutritional deficiencies can be planned.

  7. Effect of life skills building education and micronutrient supplements provided from preconception versus the standard of care on low birth weight births among adolescent and young Pakistani women (15-24 years): a prospective, population-based cluster-randomized trial.

    Science.gov (United States)

    Baxter, Jo-Anna B; Wasan, Yaqub; Soofi, Sajid B; Suhag, Zamir; Bhutta, Zulfiqar A

    2018-05-31

    Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one's own well-being, as well as future pregnancy outcomes and the health of the next generation. The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate the impact on pre-identified nutrition and health outcomes among adolescent and young women (15-24 years) in Matiari district Pakistan, and the infants born to them within the context of the trial. The primary aim is to assess the effect of the intervention on the prevalence of low birth weight births (< 2500 g). The intervention includes bi-monthly life skills building education provided from preconception, and supplementation with multiple micronutrients during preconception (twice-weekly), pregnancy (daily), and post-partum (daily to 6 months). The standard of care includes non-regulated community-based health sessions and daily iron and folic acid supplementation during pregnancy. Additional outcome information will also be collected at set time periods. Among participants, these relate to nutrition (anthropometry, nutritional status), morbidity, and mortality. Among infants, these include birth outcomes (stillbirth, preterm birth, length of gestation, small for gestational age, birth defects), anthropometry, morbidity, and mortality. Preconception care from adolescence that includes interventions targeting life skills development and nutrition is suggested to be important to improving the health and nutrition of adolescent and young women and their future

  8. Nutritional supplements for people being treated for active tuberculosis

    Science.gov (United States)

    Grobler, Liesl; Nagpal, Sukrti; Sudarsanam, Thambu D; Sinclair, David

    2016-01-01

    , including 8283 participants, met the inclusion criteria of this review. Macronutrient supplementation Six trials assessed the provision of free food, or high-energy supplements. Only two trials measured total dietary intake, and in both trials the intervention increased calorie consumption compared to controls. The available trials were too small to reliably prove or exclude clinically important benefits on mortality (RR 0.34, 95% CI 0.10 to 1.20; four trials, 567 participants, very low quality evidence), cure (RR 0.91, 95% CI 0.59 to 1.41; one trial, 102 participants, very low quality evidence), or treatment completion (data not pooled; two trials, 365 participants, very low quality evidence). Supplementation probably produces a modest increase in weight gain during treatment for active tuberculosis, although this was not seen consistently across all trials (data not pooled; five trials, 883 participants, moderate quality evidence). Two small studies provide some evidence that quality of life may also be improved but the trials were too small to have much confidence in the result (data not pooled; two trials, 134 participants, low quality evidence). Micronutrient supplementation Six trials assessed multi-micronutrient supplementation in doses up to 10 times the dietary reference intake, and 18 trials assessed single or dual micronutrient supplementation. Routine multi-micronutrient supplementation may have little or no effect on mortality in HIV-negative people with tuberculosis (RR 0.86, 95% CI 0.46 to 1.6; four trials, 1219 participants, low quality evidence), or HIV-positive people who are not taking antiretroviral therapy (RR 0.92, 95% CI 0.69 to 1.23; three trials, 1429 participants, moderate quality evidence). There is insufficient evidence to know if supplementation improves cure (no trials), treatment completion (RR 0.99, 95% CI 0.95 to 1.04; one trial, 302 participants, very low quality evidence), or the proportion of people who remain sputum positive during the

  9. Effects of multivitamin-multimineral supplementation on appetite of stunted young Beninese children

    NARCIS (Netherlands)

    Dossa, R.A.M.; Ategbo, E.A.D.; Raaij, van J.M.A.; Graaf, de C.; Hautvast, J.G.A.J.

    2002-01-01

    In the developing world, food intake of young children is often insufficient for growth. Reduced appetite due to several factors including micronutrient deficiencies might be an explanation. We hypothesized that a multivitamin-multimineral supplementation will improve appetite of stunted children in

  10. The process of setting micronutrient recommendations

    DEFF Research Database (Denmark)

    Timotijevic, Lada; Barnett, Julie; Brown, Kerry

    2011-01-01

    in the field of micronutrient recommendations and a case study that focused on mandatory folic acid (FA) fortification. Setting: Questionnaire-based data were collected across thirty-five European countries. The FA fortification case study was conducted in the UK, Norway, Denmark, Germany, Spain, Czech...... Republic and Hungary. Results: Varied bodies are responsible for setting micronutrient recommendations, each with different statutory and legal models of operation. Transparency is highest where there are standing scientific advisory committees (SAC). Where the standing SAC is created, the range...... of expertise and the terms of reference for the SAC are determined by the government. Where there is no dedicated SAC, the impetus for the development of micronutrient recommendations and the associated policies comes from interested specialists in the area. This is typically linked with an ad hoc selection...

  11. Effect Of Supplementation On Haematological And Biochemical Parameters During Pregnancy

    Directory of Open Access Journals (Sweden)

    Mohapatra P

    1988-01-01

    Full Text Available One hundred forty eight antenatal women were studied as supplemented (70 and non-supplemented (78 groups. The former group received nutritional supplementation in addition, to Iron, Folic acid and calcium tablets, which were given to both the groups. There was significant increase in the serum protein (p<0.001 and albumin (p<0.001 levels of the supplemented women. Haemoglobin was found to be increased in both the groups because of Iron therapy. But the increment was significantly higher (p<0.001 in supplemented group. Thus apart from Iron and Folic Acid, a diet rich in proteins (11 gm with calories (330 kcal is essential during pregnancy, at least for a period of 100 days.

  12. Impact of micronutrients sprinkle on weight and height of children aged 6-36 months in Tonk district of Rajasthan state

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    Vijay Jyoti

    2014-12-01

    Full Text Available Introduction: In India, multiple micronutrient deficiencies continue to be a major public health problem, especially for children below three years of age. It is a crucial period for the growth and development of children. There is lack of data from Rajasthan state on the effect of micronutrients supplementation on growth of children below three years of age. Aims & Objectives: To assess the impact of ICDS supplementary food with or without micronutrients sprinkles on weight and height of children aged 6-36 months in the Tonk district, Rajasthan state. Materials & Methods: The trial was conducted in the 15 Angan wadi centers, each from Tonk (rural and Malpura blocks of Tonk District in Rajasthan state. Children from both blocks were considered as experimental and control groups. Experimental (N=790 and Control groups (N=540 received ICDS supplementary food for six months with or without micronutrients sprinkles. Anthropometric measurements were taken using standard techniques. Results: At baseline, children with severe underweight, severe stunting and severe wasting in experimental group stood at 19.2%, 19.3%, 7.3%, respectively, which declined to 14.9%, 15.3% and 6.3%, after intervention. Significant difference was observed in the mean weights of post intervention children between experimental and control groups, whereas, there was no significant difference in mean heights. In experimental group, statistical significant difference was also noted in the mean weights and heights of children between pre and post intervention periods. Conclusion: Micronutrients sprinkles can be effective in reducing malnutrition amongst vulnerable population.

  13. Placental adaptations to micronutrient dysregulation in the programming of chronic disease.

    Science.gov (United States)

    Hofstee, Pierre; McKeating, Daniel; Perkins, Anthony V; Cuffe, James S M

    2018-04-21

    Poor nutrition during pregnancy is known to impair foetal development and increase the risk of chronic disease in offspring. Both macronutrients and micronutrients are required for a healthy pregnancy although significantly less is understood about the role of micronutrients in the programming of chronic disease. This is despite the fact that modern calorie rich diets are often also deficient in key micronutrients. The importance of micronutrients in gestational disorders is clearly understood but how they impact long term disease in humans requires further investigation. In contrast, animal studies have demonstrated how diets high or low in specific micronutrients influence offspring physiology. Many of these studies highlight the importance of the placenta in determining disease risk. This review will explore the effects of individual vitamins, minerals and trace elements on offspring disease outcomes and discuss several key placental adaptations that are affected by multiple micronutrients. These placental adaptations include micronutrient induced dysregulation of oxidative stress, altered methyl donor availability and its impact on epigenetic mechanisms as well as endocrine dysfunction. Critical gaps in our current knowledge and the relative importance of different micronutrients at different gestational ages will also be highlighted. Finally, this review will discuss the need for further studies to characterise the micronutrient status of Australian women of reproductive age and correlate micronutrient status to placental adaptations, pregnancy complications and offspring disease. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. EURRECA—Principles and Future for Deriving Micronutrient Recommendations

    NARCIS (Netherlands)

    Claessens, M.; Contor, L.; Dhonukshe-Rutten, R.; Groot, L.C.P.Q.M. de; Fairweather-Tait, S.J.; Gurinovic, M.; Koletzko, B.; Ommen, B. van; Raats, M.M.; Veer, P. van 't

    2013-01-01

    The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence (NoE) explored an approach for settingmicronutrient recommendations, which would address the variation in recommendations across Europe. Therefore, a framework for deriving and using micronutrient Dietary Reference

  15. Why is multiple micronutrient powder ineffective at reducing anaemia among 12–24 month olds in Colombia? Evidence from a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Alison Andrew

    2016-12-01

    Full Text Available In Colombia’s bottom socio-economic strata, 46.6% of children under two are anaemic. A prevalence of above 20% falls within the WHO guidelines for daily supplementation with multiple micronutrient powder (MNP. To evaluate the effect of daily MNP supplementation on anaemia amongst Colombian children aged 12–24 months we ran a cluster RCT (n=1440. In previous work, we found the intervention had no impact on haemoglobin or anaemia in this population. In this current paper, we investigate this null result and find it cannot be explained by an underpowered study design, inaccurate measurements, low adoption of and compliance with the intervention, or crowding out through dietary substitution. We conclude that our intervention was ineffective at reducing rates of childhood anaemia because MNP itself was inefficacious in our population, rather than poor implementation of or adherence to the planned intervention. Further analysis of our data and secondary data suggests that the evolution with age of childhood anaemia in Colombia, and its causes, appear different from those in settings where MNP has been effective. Firstly, rates of anaemia peak at much earlier ages and then fall rapidly. Secondly, anaemia that remains after the first year of life is relatively, and increasingly as children get older, unrelated to iron deficiency. We suggest that factors during gestation, birth, breastfeeding and early weaning may be important in explaining very high rates of anaemia in early infancy. However, the adverse effects of these factors appear to be largely mitigated by the introduction of solid foods that often include meat. This renders population wide MNP supplementation, provided after a diet of solid foods has become established, an ineffective instrument with which to target Colombia’s childhood anaemia problem. Keywords: Anaemia, Iron-deficiency, Haemoglobin, Colombia, Micronutrients, Multiple micronutrient powder, Child, Nutrition

  16. Micronutrients in the life cycle: Requirements and sufficient supply

    Directory of Open Access Journals (Sweden)

    K. Biesalski Hans

    2018-06-01

    Full Text Available Macronutrients (fat, protein, carbohydrates deliver energy and important material to ensure the entire body composition. Micronutrients are needed to keep this process of continuous construction and re-construction running. Consequently, the requirement for micronutrients will differ depending on the individual need which is related to the different metabolic conditions within the life cycle. Within the first 1000 days of life, from conception to the end of the second year of life the requirement for micronutrients is high and if the supply is inadequate that might have consequences for physical and at least cognitive development. In particular, iron, iodine, vitamin D and folate are micronutrients which might become critical during that period. Due to the fact that clinical symptoms of deficiencies develop late, but inadequate supply of one or more micronutrients may have consequences for health the term hidden hunger has been introduced to describe that situation. In particular the time period of pregnancy and early childhood is critical and hidden hunger is a worldwide problem, affecting >2 billion people, primarily females and children. The importance of different requirements during the life cycle is usually not considered. In addition, we do not really know what the individual requirement is. The estimation of the requirement is based on studies calculating the supply of a micronutrient to avoid a deficiency disease within a healthy population and is not based on sound scientific methodology or data. We need to consider that at different moments in the life cycle the supply might become critical in particular in case of a disease or sudden increase of metabolic turnover. In this narrative review we summarize data from studies dealing with different micronutrient requirements in pregnancy, exercise, vegan diet, adolescents and elderly. Knowledge of critical periods and related critical micronutrients might help to avoid hidden hunger and

  17. EURRECA—Evidence-Based Methodology for Deriving Micronutrient Recommendations

    NARCIS (Netherlands)

    Dhonukshe-Rutten, R.A.M.; Bouwman, J.; Brown, K.A.; Cavelaars, A.E.J.M.; Collings, R.; Grammatikaki, E.; Groot, L.C.P.G.M. de; Gurinovic, M.; Harvey, L.J.; Hermoso, M.; Hurst, R.; Kremer, S.H.A.; Ngo, J.; Novakovic, R.; Raats, M.M.; Rollin, F.; Serra-Majem, L.; Souverein, O.W.; Timotijevic, L.; Veer, P. van 't

    2013-01-01

    The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence explored the process of setting micronutrient recommendations to address the variance in recommendations across Europe. Work centered upon the transparent assessment of nutritional requirements via a series of

  18. Lessons learned from the scaling-up of a weekly multimicronutrient supplementation program in the integrated food security program (PISA).

    Science.gov (United States)

    Lechtig, Aarón; Gross, Rainer; Vivanco, Oscar Aquino; Gross, Ursula; López de Romaña, Daniel

    2006-01-01

    Weekly multimicronutrient supplementation was initiated as an appropriate intervention to protect poor urban populations from anemia. To identify the lessons learned from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]) weekly multimicronutrient supplementation program implemented in poor urban populations of Chiclayo, Peru. Data were collected from a 12-week program in which multimicronutrient supplements were provided weekly to women and adolescent girls 12 through 44 years of age and children under 5 years of age. A baseline survey was first conducted. Within the weekly multimicronutrient supplementation program, information was collected on supplement distribution, compliance, biological effectiveness, and cost. Supplementation, fortification, and dietary strategies can be integrated synergistically within a micronutrient intervention program. To ensure high cost-effectiveness of a weekly multimicronutrient supplementation program, the following conditions need to be met: the program should be implemented twice a year for 4 months; the program should be simultaneously implemented at the household (micro), community (meso), and national (macro) levels; there should be governmental participation from health and other sectors; and there should be community and private sector participation. Weekly multimicronutrient supplementation programs are cost effective options in urban areas with populations at low risk of energy deficiency and high risk of micronutrient deficiencies.

  19. Nutrient supplementation may adversely affect maternal oral health--a randomised controlled trial in rural Malawi.

    Science.gov (United States)

    Harjunmaa, Ulla; Järnstedt, Jorma; Dewey, Kathryn G; Ashorn, Ulla; Maleta, Kenneth; Vosti, Stephen A; Ashorn, Per

    2016-01-01

    Nutritional supplementation during pregnancy is increasingly recommended especially in low-resource settings, but its oral health impacts have not been studied. Our aim was to examine whether supplementation with multiple micronutrients (MMN) or small-quantity lipid-based nutrient supplements affects dental caries development or periodontal health in a rural Malawian population. The study was embedded in a controlled iLiNS-DYAD trial that enrolled 1391 pregnant women Women were provided with one daily iron-folic acid capsule (IFA), one capsule with 18 micronutrients (MMN) or one sachet of lipid-based nutrient supplements (LNS) containing protein, carbohydrates, essential fatty acids and 21 micronutrients. Oral examination of 1024 participants was conducted and panoramic X-ray taken within 6 weeks after delivery. The supplement groups were similar at baseline in average socio-economic, nutritional and health status. At the end of the intervention, the prevalence of caries was 56.7%, 69.1% and 63.3% (P = 0.004), and periodontitis 34.9%, 29.8% and 31.2% (P = 0.338) in the IFA, MMN and LNS groups, respectively. Compared with the IFA group, women in the MMN group had 0.60 (0.18-1.02) and in the LNS group 0.59 (0.17-1.01) higher mean number of caries lesions. In the absence of baseline oral health data, firm conclusions on causality cannot be drawn. However, although not confirmatory, the findings are consistent with a possibility that provision of MMN or LNS may have increased the caries incidence in this target population. Because of the potential public health impacts, further research on the association between gestational nutrient interventions and oral health in low-income settings is needed. © 2015 John Wiley & Sons Ltd.

  20. Maternal Micronutrient Deficiency during the First Trimester among Indonesian Pregnant Women Living in Jakarta

    Directory of Open Access Journals (Sweden)

    Saptawati Bardosono

    2016-09-01

    Full Text Available Restricted fetal growth and development is supported by the adequacy of several micronutrients, andmostly by iron, zinc, calcium, folate and B12 vitamin. This study aims to evaluate the maternal micronutrientstatus from dietary intake and blood sample. A cross-sectional study as part of the micronutrient interventionstudy was carried out in 143 healthy pregnant women during their first visit to the two maternity clinics inJakarta Indonesia (August 2013 – July 2014. Twenty-four hour dietary recall and semi-quantitative foodfrequency questionnaire were used to collect micronutrient intake data, while standard laboratory procedureswere applied to analyze micronutrient status from the blood sample. The dietary assessment data showedinsufficiency of iron, zinc, calcium, vitamin D, folate and vitamin B12 intake (less than its RDA among 88.8%,95.1%, 97.9%, 100%, 90% and 78.3%, respectively. In relation iron status, 11.2% of the subjects were anemicand 20.3% had low ferritin level. Zinc deficient was found among 35% of the subjects. Deficiency of calciumand vitamin D were found among 25.2% and 90.2% of the subjects, respectively. Furthermore, deficiency ofboth folate and vitamin B12 were found to be 2.8%. Nutrition counseling and education, and the provision ofmulti-micronutrient fortified food as well as multi-micronutrient supplement specifically designed for mothersshould be started in the earliest time, i.e. starting from the peri-conception period. Keywords: Indonesia, micronutrient, pregnancy     Defisiensi Mikronutrien Maternal Selama Trimester Pertamapada Ibu Hamil di Jakarta Abstrak Pertumbuhan dan perkembangan janin didukung oleh kecukupan beberapa mikronutrien, terutama olehzat besi, seng, kalsium, folat dan vitamin B12. Tujuan penelitian untuk mengevaluasi status mikronutrienibu dari asupan makanan dan sampel darah. Penelitian cross-sectional ini bagian dari penelitian intervensimikronutrien dan melibatkan 143 wanita hamil sehat yang

  1. Antenatal corticosteroids: an assessment of anticipated benefits and potential risks.

    Science.gov (United States)

    Jobe, Alan H; Goldenberg, Robert L

    2018-04-07

    Antenatal corticosteroids are standard of care for pregnancies at risk of preterm delivery between 24-34 weeks' gestational age. Recent trials demonstrate modest benefits from antenatal corticosteroids for late preterm and elective cesarean deliveries, and antenatal corticosteroids for periviable deliveries should be considered with family discussion. However, many women with threatened preterm deliveries receive antenatal corticosteroids but do not deliver until >34 weeks or at term. The net effect is that a substantial fraction of the delivery population will be exposed to antenatal corticosteroids. There are gaps in accurate assessments of benefits of antenatal corticosteroids because the randomized controlled trials were performed prior to about 1990 in pregnancies generally >28 weeks. The care practices for the mother and infant survival were different than today. The randomized controlled trial data also do not strongly support the optimal interval from antenatal corticosteroid treatment to delivery of 1-7 days. Epidemiology-based studies using large cohorts with >85% of at-risk pregnancies treated with antenatal corticosteroids probably overestimate the benefits of antenatal corticosteroids. Although most of the prematurity-associated mortality is in low-resource environments, the efficacy and safety of antenatal corticosteroids in those environments remain to be evaluated. The short-term benefits of antenatal corticosteroids for high-risk pregnancies in high-resource environments certainly justify antenatal corticosteroids as few risks have been identified over many years. However, cardiovascular and metabolic abnormalities have been identified in large animal models and cohorts of children exposed to antenatal corticosteroids that are consistent with fetal programming for adult diseases. These late effects of antenatal corticosteroids suggest caution for the expanded use of antenatal corticosteroids beyond at-risk pregnancies at 24-34 weeks. A way forward

  2. Influence of preoperative peripheral parenteral nutrition with micronutrients after colorectal cancer patients.

    Science.gov (United States)

    Liu, Ming-Yi; Tang, Hsiu-Chih; Hu, Shu-Hui; Yang, Hui-Lan; Chang, Sue-Joan

    2015-01-01

    The inflammatory reactions are stronger after surgery of malnourished preoperative patients. Many studies have shown vitamin and trace element deficiencies appear to affect the functioning of immune cells. Enteral nutrition is often inadequate for malnourished patients. Therefore, total parenteral nutrition (TPN) is considered an effective method for providing preoperative nutritional support. TPN needs a central vein catheter, and there are more risks associated with TPN. However, peripheral parenteral nutrition (PPN) often does not provide enough energy or nutrients. This study investigated the inflammatory response and prognosis for patients receiving a modified form of PPN with added fat emulsion infusion, multiple vitamins (MTV), and trace elements (TE) to assess the feasibility of preoperative nutritional support. Methods. A cross-sectional design was used to compare the influence of PPN with or without adding MTV and TE on malnourished abdominal surgery patients. Both preoperative groups received equal calories and protein, but due to the lack of micronutrients, patients in preoperative Group B exhibited higher inflammation, lower serum albumin levels, and higher anastomotic leak rates and also required prolonged hospital stays. Malnourished patients who receive micronutrient supplementation preoperatively have lower postoperative inflammatory responses and better prognoses. PPN with added fat emulsion, MTV, and TE provides valid and effective preoperative nutritional support.

  3. Effects of Two Micronutrient-Fortified Food Aid Products Containing Different Levels of Dairy Protein on Nutrition Status in Rural Infants and Young Children in Guinea-Bissau

    International Nuclear Information System (INIS)

    Batra, Payal; Roberts, Susan; Saltzman, Edward; Balan, Ela; Pruzensky, William; Schlossman, Nina

    2014-01-01

    Full text: Food insecurity in Guinea-Bissau is widespread and micronutrient deficiencies are anticipated among vulnerable groups. The objective: to test the efficacy of two Micronutrient-Rich Ready to Use Supplementary Foods (MNR-RUSF) in rural village children aged 6 to 24 months. This study was funded by the United States Department of Agriculture as part of a larger pilot project testing different supplements in pregnant and lactating women and infants and children aged 6-59 months. 411 children were randomly assigned to one of two intervention arms (46 g MNR-RUSF sachets containing 250 kcal/sachet and either 15% or 33% of dairy protein, collected 5 days per week from a supplement distribution center in the village) or to a control (C) group that received no MNR-RUSF. Weight, height and mid upper arm circumference (MUAC), hemoglobin, and retinol-binding protein were measured at baseline and end-line. Randomization to the 33% supplement group was associated with significantly increased visits to the distribution center to collect supplement, as well as higher ratings for product taste and overall acceptability. The 15% supplement improved hemoglobin levels relative to controls (+0.81±1.43 vs. 0.07±1.47, P -2.0 at baseline. This study is the first to examine the effects of supplements containing different amounts of dairy protein in infants and young children in Guinea-Bissau and indicates that, while substitution of provided supplement for home food may have reduced the potential impact of the supplements on weight and height, the nutritional quality of the supplements was high relative to traditional food sources, with the result that both standard and high-dairy containing MNR-RUSF products improved hemoglobin and rates of reported diseases. Furthermore, the supplements containing a higher level of dairy protein had a very high rate of acceptability, leading to increased supplement usage, which, over time, may translate to additional health and cognitive

  4. results of an interview with pregnant women in Berlin concerning supplements

    OpenAIRE

    Alex, Stefania

    2010-01-01

    The maternal nutritional status before and during pregnancy is a determinant for the health of the mother and her child. Besides the higher need of macronutrients to get enough energy, the supply with micronutrients plays an important role. Especially a sufficient intake of iodine, folate and iron is essential for the health of the mother and the development of the child. This is difficult to reach without supplementation. Therefore a supplementation with 100-200 μg iodine and 400 μg folate s...

  5. [Micronutrient consumption and overweight: is there a relationship?].

    Science.gov (United States)

    Leão, Ana Luisa Marcucci; dos Santos, Luana Caroline

    2012-03-01

    In past decades, the growth in obesity has been associated with changes in the lifestyle of the population, including comprehensive dietary changes, especially in the intake of micronutrients. To describe micronutrient intake and review its consequences on nutritional status. A literature review was performed covering domestic and international articles published over the past 11 years, on the SciELO, LILACS, MEDLINE and governmental databases, using descriptors such as "micronutrients", "food consumption", "excess weight", "health", "nutritional status" in Portuguese and in English. Micronutrient intake deficiency is a global health problem, affecting about 2 billion people and seems to be associated with an increased risk for non-communicable diseases and disorders, including obesity. Insufficient intake of vitamin A favors overweight by altering thyroid metabolism, while vitamin C is related to the synthesis of carnitine and fat oxidation; vitamin D favors the control of satiety and energy expenditure. As for minerals, calcium helps the regulation of thermogenesis and lipogenesis / lipolysis, and zinc is involved in regulating insulin and leptin. The promotion of healthy eating habits through educational practices is necessary for greater public awareness of the implications of micronutrient intake on nutritional status, and should be included in Public Health strategies in order to control obesity and its complications.

  6. Trends in pregnancy outcomes in Malawian adolescents receiving antimalarial and hematinic supplements

    NARCIS (Netherlands)

    Msyamboza, Kelias; Savage, Emma; Kalanda, Gertrude; Kazembe, Peter; Gies, Sabine; d'Alessandro, Umberto; Brabin, Bernard J.

    2010-01-01

    Objective. To describe pregnancy outcomes of adolescent and adult primigravidae receiving antimalarials and hematinic supplementation and compare findings with a survey in this area a decade earlier. Design. Cross-sectional surveys in intervention and control sites. Setting. Community, antenatal and

  7. Antenatal education for childbirth-epidural analgesia.

    Science.gov (United States)

    Cutajar, Lisa; Cyna, Allan M

    2018-05-07

    The language structures used by antenatal educators have not been previously researched in the context of antenatal childbirth classes. Epidural analgesia for labour is a common, and a frequently asked about, component of antenatal education for parents in hospitals providing maternity care. We aimed to identify the way information is described and presented by childbirth educators to assess content and determine which language structures such as metaphor, suggestion, information and storytelling are utilized. This observational study of antenatal education was conducted at a single tertiary referral center for maternity care in Western Sydney, Australia. All three childbirth educators agreed to be video recorded whilst providing information to parents during antenatal classes. Audio data was subsequently transcribed and then analysed by two researchers, independently categorising the various language structures and types of information provided. For the purposes of the current study, data concerning a single topic was used for the analysis-'epidural analgesia for labour'. Language structures used were highly variable between educators, as was the content and time taken for the information being provided. Our findings represent a first attempt to identify baseline information used in the clinical setting of antenatal education in order to categories communication structures used. This study has identified areas for further improvements and consistency in the way educators provide information to parents and has important implications for future midwifery practice, education and research. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. Intake of macro- and micronutrients in Danish vegans

    DEFF Research Database (Denmark)

    Kristensen, Nadja B; Madsen, Mia L; H Hansen, Tue

    2015-01-01

    Since information about macro- and micronutrient intake among vegans is limited we aimed to determine and evaluate their dietary and supplementary intake. Seventy 18-61 years old Danish vegans completed a four-day weighed food record from which their daily intake of macro- and micronutrients was ...

  9. Quality of antenatal care provided by nurse midwives in an Urban health centre with regard to low-risk antenatal mothers

    Directory of Open Access Journals (Sweden)

    Ruby Angeline Pricilla

    2017-01-01

    Full Text Available Background:India contributes to 19% of the global maternal deaths. Good quality antenatal care can prevent maternal deaths by early detection of complications and maintaining maternal health. There are few studies documenting quality of antenatal care in India. This study aimed to document the antenatal services provided by nurse midwives to low-risk pregnant mothers from an urban population. Aims: The primary objective was to describe the quality of the antenatal care provided by nurse midwives of an urban health centre with regard to low-risk mothers. The secondary objective was to document the maternal and early neonatal outcomes of the enrolled mothers during the period of study. Methods: This prospective cohort study was done on 200 pregnant women who had antenatal care by nurse midwives between April 2014 and November 2014. The quality of care was assessed by a checklist adapted from World Health Organization (WHO. Results: We report that the quality of antenatal care for all domains was above 90% except for the health education domain, which was poor with regard to breastfeeding and family planning in the enrolled 200 pregnant women. Conclusion: Our study concluded that trained nurse midwives when regularly monitored, audited and linked with reliable referral facilities can deliver good quality antenatal care.

  10. Vitamin D supplementation for women during pregnancy

    Science.gov (United States)

    De-Regil, Luz Maria; Palacios, Cristina; Ansary, Ali; Kulier, Regina; Peña-Rosas, Juan Pablo

    2013-01-01

    Background Vitamin D deficiency or insufficiency is thought to be common among pregnant women. Vitamin D supplementation during pregnancy has been suggested as an intervention to protect against adverse gestational outcomes. Objectives To examine whether supplements with vitamin D alone or in combination with calcium or other vitamins and minerals given to women during pregnancy can safely improve maternal and neonatal outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2011), the International Clinical Trials Registry Platform (ICTRP) (31 October 2011), the Networked Digital Library of Theses and Dissertations (28 October 2011) and also contacted relevant organisations (8 April 2011). Selection criteria Randomised and quasi-randomised trials with randomisation at either individual or cluster level, evaluating the effect of supplementation with vitamin D alone or in combination with other micronutrients for women during pregnancy. Data collection and analysis Two review authors independently i) assessed the eligibility of studies against the inclusion criteria ii) extracted data from included studies, and iii) assessed the risk of bias of the included studies. Data were checked for accuracy. Main results The search strategy identified 34 potentially eligible references. We included six trials assessing a total of 1023 women, excluded eight studies, and 10 studies are still ongoing. Five trials involving 623 women compared the effects of vitamin D alone versus no supplementation/placebo and one trial with 400 women compared the effects of vitamin D and calcium versus no supplementation. Only one trial with 400 women reported on pre-eclampsia: women who received 1200 IU vitamin D along with 375 mg of elemental calcium per day were as likely to develop pre-eclampsia as women who received no supplementation (average risk ratio (RR) 0.67; 95% confidence interval (CI) 0.33 to 1.35). Data from four trials

  11. Micronutrients: do small things matter? | Visser | South African ...

    African Journals Online (AJOL)

    Despite the major developments on the importance of micronutrient status in health and disease, understanding of the exact role of the latter in critical illness remains elusive and ill defined, complicating decision-making on the part of the nutrition support practitioner. Micronutrient deficiencies in critically ill patients may ...

  12. Evaluation of the impact of multiple micronutrient powders on children anemia in three andean regiones in Peru

    OpenAIRE

    Munayco, César V.; Dirección General de Epidemiología, Ministerio de Salud. Lima, Perú. Médico, magister en Epidemiologia y Salud Pública.; Ulloa-Rea, María E.; Dirección General de Epidemiología, Ministerio de Salud. Lima, Perú. técnico en informática.; Medina-Osis, José; Dirección General de Epidemiología, Ministerio de Salud. Lima, Perú. médico.; Lozano-Revollar, Carmen R.; Oficina de Epidemiología, Dirección Regional de Ayacucho. Ayacucho, Perú. licenciada en enfermería.; Tejada, Violeta; Oficina de Epidemiología, Dirección Regional de Andahuaylas. Andahuaylas, Perú. licenciada en enfermería.; Castro-Salazar, Consuelo; Oficina de Epidemiología, Dirección Regional de Huancavelica. Huancavelica, Perú. licenciada en enfermería.; Munarriz-Villafuerte, José; Oficina de Epidemiología, Dirección Regional de Huancavelica. Huancavelica, Perú. bachiller en Ingeniería de Sistemas y Computación.; de Bustos, Cecilia; Programa Mundial de Alimentos de las Naciones Unidas, Sede Perú. Lima, Perú. PhD en Patología experimental.; Arias, Lena; Fondo de Naciones Unidas para la Infancia (UNICEF), Sede Perú. Lima, Perú. licenciada en Nutrición.

    2014-01-01

    The aim of this research was to determine the impact of the strategy of multi-micronutrient supplementation (MMN) on the childhood anemia in three Andean regions of Peru. A sentinel surveillance system was established in 29 health centers of Andahuaylas, Ayacucho and Huancavelica (Peru) to monitor a cohort of children of 6 to 35 months of age whom been received MMM for a period of 12 months. Data regarding hemoglobin levels were gathered at the beginning and at the end of the research; th...

  13. Micronutrient Profile Of Children And Women In Rural Bangladesh ...

    African Journals Online (AJOL)

    Background: Micronutrient deficiencies are so important to public health ... and significant amounts of donor and national funds have been directed at them. Objectives: This paper makes an attempt to compile the micronutrient profile of ...

  14. Prevalence and factors associated with late antenatal care visit ...

    African Journals Online (AJOL)

    Flora

    Background: Adequate utilization of antenatal health care services is associated ... access to antenatal care services including provision of ANC services that are free of charge (Gross ... Information about demographic characteristics, antenatal.

  15. An assessment of antenatal care among Syrian refugees in Lebanon.

    Science.gov (United States)

    Benage, Matthew; Greenough, P Gregg; Vinck, Patrick; Omeira, Nada; Pham, Phuong

    2015-01-01

    After more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian refugee women is critical to preventing maternal and fetal mortality but is not well characterized given the multiple factors obtaining health data in a displaced population. This study describes antenatal care access, the scope of existing antenatal care, and antenatal and family planning behaviors and practice among pregnant Syrian refugees in various living conditions and multiple geographic areas of Lebanon. A field-based survey was conducted between July and October 2013 in 14 main geographic sites of refugee concentration. The assessment evaluated antenatal services among a non-randomized sample of 420 self-identified pregnant Syrian refugee women that included demographics, gestational age, living accommodation, antenatal care coverage, antenatal care content, antenatal health behaviors, antenatal health literacy, and family planning perception and practices. In total, 420 pregnant Syrian refugees living in Lebanon completed the survey. Of these, 82.9% (348) received some antenatal care. Of those with at least one antenatal visit, 222 (63.8%) received care attended by a skilled professional three or more times, 111 (31.9%) 1-2 times, and 15 (4.3%) had never received skilled antenatal care. We assessed antenatal care content defined by blood pressure measurement, and urine and blood sample analyses. Of those who had received any antenatal care, only 31.2% received all three interventions, 18.2% received two out of three, 32.1% received one out of three, and 18.5% received no interventions. Only (41.2%) had an adequate diet of vitamins, minerals, and folic acid. Access, content and health behaviors varied by gestational age, type of accommodation and location in Lebanon. Standards of antenatal care are not being met for pregnant Syrian refugee women in

  16. From micronutrient recommendations to policy: consumer and stakeholder involvement.

    Science.gov (United States)

    Timotijevic, L; Raats, M M; Barnett, J; Brown, K; Shepherd, R; Fernandez, L; Dömölki, L; Ruprich, J; Sonne, A-M; Hermoso, M; Koletzko, B; Frost-Andersen, L; Timmer, A

    2010-06-01

    To achieve the nutritional goals stipulated by micronutrient recommendations, greater attention must be paid to the behavioural routes to such nutritional outcomes. Coopting stakeholders and consumers into decisions regarding micronutrient recommendations is an important step towards achieving a greater link between micronutrient recommendations and behaviour. This study aims to examine the rationale and processes associated with consumer and stakeholder involvement in setting micronutrient recommendations across Europe. Using the contacts established through the Eurreca network of excellence (commissioned by the European Commission), the research involved in-depth desk research of key documents and communication channels linked to the process of setting micronutrient recommendations across seven countries: the United Kingdom, Norway, Denmark, Germany, Spain, the Czech Republic and Hungary. Stakeholder engagement is recognized by most countries as an important aspect of the process of setting micronutrient recommendations and their translation into policy, although there is notable variation in the extent to which this has been achieved across the seven countries and its effect on final decisions. Stakeholders were not involved at the outset of the process ('framing' of the problem) in any of the countries, and there was no evidence of consumer involvement and open public fora. Some of the key explanatory factors for diversity in the degree of involvement include historical sociopolitical context; the extent to which food and nutrition are key policy agenda; and the relative power of stakeholders in influencing food and nutrition policy.

  17. Multimicronutrient supplementation in older persons decreased zinc deficiency but not serum TNF-á

    Directory of Open Access Journals (Sweden)

    Elly Herwana

    2011-08-01

    Full Text Available The increase in the population of older persons needs to be accompanied by increased quality of healthcare in older persons, particularly a decrease in the incidence of infections. Impaired immune responses are common in older adults, and immune senescence likely contributes to the increased incidence of infectious diseases in the older persons. The aging process decreases the immune response and many studies have been conducted to explain the role of supplementation with various micronutrients, such as vitamin C, vitamin E, â-carotene and zinc, on the immune response. The aim of the present study was to assess the influence of 6 months of multi-micronutrient (MMN supplementation on zinc and tumor necrosis factor (TNF-á levels in older persons. A randomized controlled trial was conducted on 78 older persons, who were divided into two groups. The treatment group received MMN supplementation containing 40 mg elemental zinc, 120 mg ascorbic acid, 6 mg â-carotene, 15 mg á-tocopherol and 400 ìg folic acid and the control group 400 mg calcium carbonate. The study did not demonstrate that 6 months of MMN supplementation resulted in significant differences between both groups, with respect to total protein, albumin, globulin, and TNF-á levels. In contrast, MMN supplementation significantly decreased the proportion of older persons with zinc deficiency in the treatment group, in comparison with the control group. The present data suggest that in older persons with relatively good immune and protein status, improvement of the immune status by MMN supplementation may be difficult and at best limited.

  18. Do Chinese Children Get Enough Micronutrients?

    Directory of Open Access Journals (Sweden)

    Huijun Wang

    2017-04-01

    Full Text Available The aim of this study was to examine usual daily micronutrient intake of Chinese children based on data from the 2011 China Health and Nutrition Survey. We analyzed data from 4 to 17-year-old participants, who provided dietary data on three consecutive days combined with the household weighing method in 2011. Usual daily intake of each nutrient was estimated using a mixed effects model based on the China Food Composition published in 2009. The means, medians and percentages below Estimated Average Requirements (EAR were reported for selected micronutrients, including calcium, sodium, potassium, iron, zinc, selenium, vitamin A, thiamine, riboflavin and vitamin C. For sodium and potassium, the means and the distribution of intakes were compared to the Adequate Intake (AI level. The average usual daily intakes of all micronutrients increase with age, and the intakes of boys were found to be higher than girls in the same age group. The average calcium intake increased from 272 mg/day in 4–6 years to 391 mg/day in 14–17 years, but the percentage of inadequate calcium intake remained very high (>96%. The prevalence of inadequacy of calcium was the highest among the mineral nutrients reported in this study. As the requirements of micronutrients increased with age, the percentage of subjects with inadequate intake increased in the 11–17 years age groups. Among 14–17 years group, the percentages of study participants with dietary intakes of calcium, iron, zinc, selenium, vitamin A, thiamine, riboflavin and vitamin C below the EAR were 96.8%, 18.8%, 37.6%, 72.8%, 36.8%, 91.8%. 85.9% and 75.5%, respectively. Among 11–13 years group, the percentages of study participants with dietary intakes of iron, zinc and vitamin A below the EAR were 23.5%, 41.5%, and 41.6%, respectively. Thus, micronutrient deficiency is a problem in Chinese children. Nutrition education and intervention programs are needed to address these nutritional gaps.

  19. Mobile phones improve antenatal care attendance in Zanzibar

    DEFF Research Database (Denmark)

    Lund, Stine; Nielsen, Birgitte B; Hemed, Maryam

    2014-01-01

    BACKGROUND: Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems. Antenatal care has the potential to reduce maternal morbidity and improve newborns' survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality...... of care is declining. We evaluated the association between a mobile phone intervention and antenatal care in a resource-limited setting. We aimed to assess antenatal care in a comprehensive way taking into consideration utilisation of antenatal care as well as content and timing of interventions during...... included at their first antenatal care visit and followed until 42 days after delivery. 24 primary health care facilities in six districts were randomized to either mobile phone intervention or standard care. The intervention consisted of a mobile phone text-message and voucher component. Primary outcome...

  20. The Influence of Vitamin A Supplementation on Iron Status

    Directory of Open Access Journals (Sweden)

    Patricia H. C. Rondó

    2013-11-01

    Full Text Available Vitamin A (VA and iron deficiencies are important nutritional problems, affecting particularly preschool children, as well as pregnant and lactating women. A PubMed (National Library of Medicine, National Institutes of Health, Bethesda, MD, USA literature review was carried out to search for clinical trials published from 1992 to 2013 that assessed the influence of vitamin A supplementation on iron status. Simultaneous use of iron and vitamin A supplements seemed to be more effective to prevent iron deficiency anemia than the use of these micronutrients alone. Some studies did not include a placebo group and only a few of them assessed vitamin A status of the individuals at baseline. Moreover, the studies did not consider any inflammatory marker and a reasonable number of iron parameters. Another important limitation was the lack of assessment of hemoglobin variants, especially in regions with a high prevalence of anemia. Assessment of hemoglobin variants, inflammatory markers and anemia of chronic inflammation would be important to the studies investigated. Studies involving different populations are necessary to elucidate the interaction between the two micronutrients, especially regarding iron absorption and modulation of erythropoiesis.

  1. The influence of vitamin A supplementation on iron status.

    Science.gov (United States)

    Michelazzo, Fernanda B; Oliveira, Julicristie M; Stefanello, Juliana; Luzia, Liania A; Rondó, Patricia H C

    2013-11-07

    Vitamin A (VA) and iron deficiencies are important nutritional problems, affecting particularly preschool children, as well as pregnant and lactating women. A PubMed (National Library of Medicine, National Institutes of Health, Bethesda, MD, USA) literature review was carried out to search for clinical trials published from 1992 to 2013 that assessed the influence of vitamin A supplementation on iron status. Simultaneous use of iron and vitamin A supplements seemed to be more effective to prevent iron deficiency anemia than the use of these micronutrients alone. Some studies did not include a placebo group and only a few of them assessed vitamin A status of the individuals at baseline. Moreover, the studies did not consider any inflammatory marker and a reasonable number of iron parameters. Another important limitation was the lack of assessment of hemoglobin variants, especially in regions with a high prevalence of anemia. Assessment of hemoglobin variants, inflammatory markers and anemia of chronic inflammation would be important to the studies investigated. Studies involving different populations are necessary to elucidate the interaction between the two micronutrients, especially regarding iron absorption and modulation of erythropoiesis.

  2. Effect of Short-Term Supplementation with Ready-to-Use Therapeutic Food or Micronutrients for Children after Illness for Prevention of Malnutrition: A Randomised Controlled Trial in Uganda

    Science.gov (United States)

    van der Kam, Saskia; Roll, Stephanie; Swarthout, Todd; Edyegu-Otelu, Grace; Matsumoto, Akiko; Kasujja, Francis Xavier; Casademont, Cristian; Shanks, Leslie; Salse-Ubach, Nuria

    2016-01-01

    Background Globally, Médecins Sans Frontières (MSF) treats more than 300,000 severely malnourished children annually. Malnutrition is not only caused by lack of food but also by illnesses and by poor infant and child feeding practices. Breaking the vicious cycle of illness and malnutrition by providing ill children with nutritional supplementation is a potentially powerful strategy for preventing malnutrition that has not been adequately investigated. Therefore, MSF investigated whether incidence of malnutrition among ill children malnutrition rate between 8.4% and 11.5% of which 2% to 3% severe malnutrition, more than half (58%) of the population in the district of Kaabong is considered food insecure. Methods and Findings We investigated the effect of two types of nutritional supplementation on the incidence of malnutrition in ill children presenting at outpatient clinics during March 2011 to April 2012 in Kaabong, Karamoja region, Uganda, a resource-poor region where malnutrition is a chronic problem for its seminomadic population. A three-armed, partially-blinded, randomised controlled trial was conducted in children diagnosed with malaria, diarrhoea, or lower respiratory tract infection. Non-malnourished children aged 6 to 59 mo were randomised to one of three arms: one sachet/d of ready-to-use therapeutic food (RUTF), two sachets/d of micronutrient powder (MNP), or no supplement (control) for 14 d for each illness over 6 mo. The primary outcome was the incidence of first negative nutritional outcome (NNO) during the 6 mo follow-up. NNO was a study-specific measure used to indicate progression to moderate or severe acute malnutrition; it was defined as weight-for-height z-score malnutrition in eastern Uganda. The low incidence of malnutrition in this population may warrant a more targeted intervention to improve cost effectiveness. Trial Registration clinicaltrials.gov NCT01497236 PMID:26859481

  3. Determination of Micronutrient Accumulation in Greenhouse Cucumber Crop Using a Modeling Approach

    Directory of Open Access Journals (Sweden)

    Lino J. Ramírez-Pérez

    2017-11-01

    Full Text Available The control of micronutrient application in cucumber cultivation has great importance as they participate in many functions of metabolism. In addition, micronutrient application efficiency is fundamental to avoid periods of overconsumption or deficits in the crop. To determine micronutrient accumulation using a dynamic model, two cycles of Vitaly and Luxell cucumber crops were grown. During the development of the crop, micronutrient content (Fe, B, Mn, Cu, and Zn in the different organs of the cucumber plant was quantified. The model dynamically simulated the accumulation of biomass and micronutrients using climatic variables recorded inside the greenhouse as inputs. It was found that a decrease in photosynthetically active radiation and temperature significantly diminished the accumulation of biomass by the cucumber plants. On the other hand, the results demonstrated that the model efficiently simulated both the accumulation of biomass and micronutrients in a cucumber crop. The efficiency evaluation showed values higher than R2 > 0.95. This dynamic model can be useful to define adequate strategies for the management of cucumber cultivation in greenhouses as well as the application of micronutrients.

  4. Antenatal imaging of cutis verticis gyrata

    International Nuclear Information System (INIS)

    Kennedy, Ana; Perry, David; Battin, Malcolm

    2008-01-01

    Cutis verticis gyrata (CVG) is a skin condition characterized by thick folds and deep furrows, resembling a cortical gyral pattern. There is a recognized but rare association with Noonan syndrome. We report the antenatal imaging, including three-dimensional surface-rendered sonography and MRI, of a fetus with CVG who was subsequently diagnosed with Noonan syndrome. The case illustrates the antenatal appearances of congenital CVG and the potential yield of antenatal imaging in excluding a major central nervous system anomaly. This is important because without prior knowledge of this condition and its imaging characteristics, it is possible to get a false impression of an underlying skull defect on mid-trimester imaging. (orig.)

  5. Antenatal imaging of cutis verticis gyrata

    Energy Technology Data Exchange (ETDEWEB)

    Kennedy, Ana [Starship Hospital, Department of Paediatric Cardiology, Auckland (New Zealand); Perry, David [Starship Children' s Hospital, Radiology Department, Auckland (New Zealand); Battin, Malcolm [Auckland City Hospital, Newborn Services, National Women' s Health, Auckland (New Zealand); University of Auckland, Department of Paediatrics, Auckland (New Zealand)

    2008-05-15

    Cutis verticis gyrata (CVG) is a skin condition characterized by thick folds and deep furrows, resembling a cortical gyral pattern. There is a recognized but rare association with Noonan syndrome. We report the antenatal imaging, including three-dimensional surface-rendered sonography and MRI, of a fetus with CVG who was subsequently diagnosed with Noonan syndrome. The case illustrates the antenatal appearances of congenital CVG and the potential yield of antenatal imaging in excluding a major central nervous system anomaly. This is important because without prior knowledge of this condition and its imaging characteristics, it is possible to get a false impression of an underlying skull defect on mid-trimester imaging. (orig.)

  6. Antenatal services for Aboriginal women: the relevance of cultural competence.

    Science.gov (United States)

    Reibel, Tracy; Walker, Roz

    2010-01-01

    Due to persistent significantly poorer Aboriginal perinatal outcomes, the Women's and Newborns' Health Network, Western Australian Department of Health, required a comprehensive appraisal of antenatal services available to Aboriginal women as a starting point for future service delivery modelling. A services audit was conducted to ascertain the usage frequency and characteristics of antenatal services used by Aboriginal women in Western Australia (WA). Telephone interviews were undertaken with eligible antenatal services utilising a purpose specific service audit tool comprising questions in five categories: 1) general characteristics; 2) risk assessment; 3) treatment, risk reduction and education; 4) access; and 5) quality of care. Data were analysed according to routine antenatal care (e.g. risk assessment, treatment and risk reduction), service status (Aboriginal specific or non-specific) and application of cultural responsiveness. Significant gaps in appropriate antenatal services for Aboriginal women in metropolitan, rural and remote regions in WA were evident. Approximately 75% of antenatal services used by Aboriginal women have not achieved a model of service delivery consistent with the principles of culturally responsive care, with few services incorporating Aboriginal specific antenatal protocols/programme, maintaining access or employing Aboriginal Health Workers (AHWs). Of 42 audited services, 18 Aboriginal specific and 24 general antenatal services reported utilisation by Aboriginal women. Of these, nine were identified as providing culturally responsive service delivery, incorporating key indicators of cultural security combined with highly consistent delivery of routine antenatal care. One service was located in the metropolitan area and eight in rural or remote locations. The audit of antenatal services in WA represents a significant step towards a detailed understanding of which services are most highly utilised and their defining characteristics

  7. Diagnosis of antenatal Bartter syndrome.

    Science.gov (United States)

    Narayan, R; Peres, M; Kesby, G

    2016-01-01

    Bartter syndrome is a rare heterogeneous group of autosomal-recessive salt-losing renal tubular disorders that can present in fetal life (antenatal Bartter syndrome; ABS) as "unexplained" early-onset polyhydramnios, often associated with growth restriction. Prenatal diagnosis of the condition involves assessment of amniotic fluid biochemistry in a setting of polyuric polyhydramnios; with elevated chloride levels considered a consistent and diagnostic finding. Other amniotic fluid biochemical markers have been described, notably increased aldosterone levels, and low total protein levels. NOVEL INSIGHT: Antenatal Bartter syndrome is a heterogeneous group of renal disorders. While certain biochemical features in amniotic fluid might heighten suspicion, final diagnosis can only be made in the postnatal setting. In the setting of unexplained severe polyhydramnios, clinicians should continue to entertain the diagnosis of antenatal Bartter Syndrome and maintain neonatal surveillance, even if amniotic fluid markers do not support the diagnosis.

  8. Control of micronutrient deficiencies in India: obstacles and strategies.

    Science.gov (United States)

    Vijayaraghavan, K

    2002-05-01

    Micronutrient deficiencies of vitamin A, iron, and iodine continue to be of public health significance in India. The government of India initiated national programs to prevent, control and combat these deficiencies and their serious consequences. The interventions involved (1) distribution of iodized salt in the endemic areas, (2) administration of semiannual massive dose of vitamin A to young children, and (3) distribution of iron-folic acid tablets to the vulnerable groups. Evaluations revealed that the biologic impact of these interventions was unsatisfactory. Inadequate allocation of funds (10% of the actual needs) necessary to cover the enormous number of beneficiaries was one of the important obstacles. Consequently, the allocation of supplies to different provinces was far short of the requirements (10-30%). As a result of poor orientation, the functionaries were not adhering to the guidelines, leading to woefully inadequate (1-20%) and irregular coverage. There was no proper monitoring or supervision to make midcourse corrections to improve the functioning. The community was not informed of the purpose and details of each intervention. Hence, it did not utilize the resources completely and remained passive recipients. The community was not aware of the dietary approaches to prevent micronutrient disorders owing to absence of nutrition education. With the adoption of National Nutrition Policy by the government of India, a concerted and focused approach should be adopted. The future strategies should include a mix of short-term supplementation and food-based strategy encompassing food fortification and home gardening. Innovative approaches in information, education, and communication (such as social marketing strategy) for making the interventions sustainable should be adopted.

  9. Health care providers' knowledge and practice of focused antenatal ...

    African Journals Online (AJOL)

    ... observational checklist were the instruments for data collection. Findings revealed poor knowledge of concept, components, timing of visits on focused antenatal care and non compliance with the guidelines for the practice of focused antenatal care, because of health workers lack of knowledge on focused antenatal care.

  10. [Prenatal supplementations of iron, iron-containing multimicronutrients and antianemic Chinese patent medicines in women in Shaanxi province, 2010-2013].

    Science.gov (United States)

    Liu, D M; Li, J M; Qu, P F; Dang, S N; Wu, X Y; Zhang, R; Yan, H; Yan, H

    2017-11-10

    Objective: To understand the prevalence of prenatal supplementations of iron, iron-containing multi-micronutrients (IMMN) and antianemic Chinese patent medicines (ACPM) and associated factors in women in Shaanxi province. Methods: A sample of 28 367 childbearing-age women who gave birth during 2010-2013 and had specific information of the prenatal nutrients supplementation were recruited using stratified multistage cluster random sampling in Shaanxi province. The information about their basic characteristics and prenatal supplementation of nutrients were collected by a questionnaire survey. Descriptive analysis method was used to analyze the intake rate of iron, IMMN and ACPM during each period of pregnancy, and logistic regression model was used to identify associated factors. Results: The overall prevalence of prenatal iron, IMMN and ACPM supplementation was low (28.99%), and the intake rate of iron was the lowest (5.33%). The prevalence of prenatal supplementation of iron, IMMN and ACPM were lower before pregnancy and in the first trimester than in the second and third trimester. The intake rates for consecutive 2 periods were very low (all were lower than 2.00%). The intake rates of iron, IMMN and ACPM significantly increased year by year. Women living in central Shaanxi had relatively high intake rates of iron (7.22%) and IMMN (16.55%), and women in southern Shaanxi had relatively high intake rate of ACPM (18.50%). The results of logistic regression analysis showed that higher educational level ( OR =1.920, 95 %CI : 1.617-2.279), antenatal care times≥6 ( OR =1.832, 95 %CI : 1.604-2.091), etc . were the positive factors for iron intake, and these positive factors were similar to those for IMMN intake. Additionally, rural residence was the negative factor for IMMN intake (compared with urban residence, OR =0.872, 95 %CI : 0.788-0.966). Conversely, higher educational level ( OR =0.855, 95 %CI : 0.746-0.979), higher household income ( OR =0.864, 95 %CI : 0

  11. Costs of the multimicronutrient supplementation program in Chiclayo, Peru.

    Science.gov (United States)

    Lechtig, Aarón; Gross, Rainer; Paulini, Javier; de Romaã, Daniel López

    2006-01-01

    There is little information on the cost parameters of weekly multimicronutrient supplementation programs. To assess the cost parameters and cost-effectiveness of a weekly multimicronutrient supplementation program in an urban population of Peru. Data from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]), which distributed capsules and foodlets to women and adolescent girls and to children under five, were extrapolated to a population of 100,000 inhabitants. The annual cost per community member was US$1.51. The cost-effectiveness ratio was US$0.12 per 1% of prevented anemia per community member. These costs are in the upper margin of iron supplementation alone. They will decrease notably when weekly multimicronutrient supplementation programs are integrated into health packages and participation by women increases. Focusing on micronutrient deficiencies would prevent these problems, and food-distribution programs would be effectively targeted to food-deficient populations.

  12. Internet: a new concept of antenatal education.

    Science.gov (United States)

    Nikolova, Gergana

    2015-02-01

    Historically antenatal education has been seen as an important part of antenatal care and a mechanism to provide women with close to realistic interpretations of childbirth and motherhood. Through the years, the main themes and emphases of parenting education have changed, sometimes to reflect the new socio-economic structure and sometimes forced by the women themselves seeking specific information and knowledge. Yet again, this time the invasion of online information and social media is about to change the perception and the philosophy of antenatal education from an informative opportunity to a powerful and effective intervention.

  13. A Micronutrient Fortified Beverage Given at Different Dosing Frequencies Had Limited Impact on Anemia and Micronutrient Status in Filipino Schoolchildren

    Science.gov (United States)

    Angeles-Agdeppa, Imelda; Magsadia, Clarita R.; Aaron, Grant J.; Lloyd, Beate B.; Hilmers, David C.; Bhutta, Zulfiqar A.

    2017-01-01

    This study evaluated the effects of a multi-micronutrient fortified juice drink given in different frequencies of consumption on hemoglobin (Hb) concentration of schoolchildren. Hb was measured in 2423 schoolchildren aged 6- to 9-years-old at baseline. All anemic children (n = 246) were randomly allocated into groups: Daily dose (HD: high dose), 5X/week (MD: Moderate Dose), 3X/week (LD: Low Dose) and unfortified (Control). Pre- and post-study measurements of micronutrients were collected from 228 children. At the endpoint, significant Hb increases were observed in all groups, but there was no significant difference between groups. There was a significant reduction in anemia prevalence in all groups from 100% to 36% (Control), 30% (LD), 23% (MD) and 26% (HD). No dose-response effect was observed in Hb in this population. Most likely, this resulted from better than expected micronutrient status and lower than expected severity of anemia and micronutrient deficiencies in this cohort. It is unlikely that the addition of a fortified beverage to school feeding programs in this population would have a positive impact. Whether such an intervention would be cost-effective as a preventative approach needs to be assessed. This study demonstrates the importance of targeting such interventions to appropriate populations. PMID:28895887

  14. Contraceptive‑seeking Behavior of Women Attending Antenatal ...

    African Journals Online (AJOL)

    Department of Community Medicine, Abia State University Teaching Hospital, Aba, 1Department of Public ... cross‑sectional study of 430 antenatal women using structured self‑administered ... KEY WORDS: Antenatal, contraception, population control Nigeria ... hence, the need to study the contraceptive-seeking behavior.

  15. Antenatal care and pregnancy outcome in Ghana, the importance of ...

    African Journals Online (AJOL)

    Antenatal care and pregnancy outcome in Ghana, the importance of women\\'s ... The antenatal characteristics of 503 pregnant women attending maternal and child ... Higher educational level associated with early antenatal care attendance.

  16. Psychoprophylaxis - Antenatal preparation and actual use during labour

    OpenAIRE

    Bergström, Malin

    2010-01-01

    The aim of this thesis was to study the effects of a model of antenatal education, focusing on natural childbirth preparation by including psychoprophylaxis, breathing and relaxation techniques to cope with labour pain, and the actual use of psychoprophylaxis during labour. Satisfaction with antenatal education and experiences of a subgroup of men with antenatal fear of childbirth were also explored. The principal design was a randomised controlled trial where the new mo...

  17. Effect of Short-Term Supplementation with Ready-to-Use Therapeutic Food or Micronutrients for Children after Illness for Prevention of Malnutrition: A Randomised Controlled Trial in Uganda.

    Science.gov (United States)

    van der Kam, Saskia; Roll, Stephanie; Swarthout, Todd; Edyegu-Otelu, Grace; Matsumoto, Akiko; Kasujja, Francis Xavier; Casademont, Cristian; Shanks, Leslie; Salse-Ubach, Nuria

    2016-02-01

    Globally, Médecins Sans Frontières (MSF) treats more than 300,000 severely malnourished children annually. Malnutrition is not only caused by lack of food but also by illnesses and by poor infant and child feeding practices. Breaking the vicious cycle of illness and malnutrition by providing ill children with nutritional supplementation is a potentially powerful strategy for preventing malnutrition that has not been adequately investigated. Therefore, MSF investigated whether incidence of malnutrition among ill children malnutrition rate between 8.4% and 11.5% of which 2% to 3% severe malnutrition, more than half (58%) of the population in the district of Kaabong is considered food insecure. We investigated the effect of two types of nutritional supplementation on the incidence of malnutrition in ill children presenting at outpatient clinics during March 2011 to April 2012 in Kaabong, Karamoja region, Uganda, a resource-poor region where malnutrition is a chronic problem for its seminomadic population. A three-armed, partially-blinded, randomised controlled trial was conducted in children diagnosed with malaria, diarrhoea, or lower respiratory tract infection. Non-malnourished children aged 6 to 59 mo were randomised to one of three arms: one sachet/d of ready-to-use therapeutic food (RUTF), two sachets/d of micronutrient powder (MNP), or no supplement (control) for 14 d for each illness over 6 mo. The primary outcome was the incidence of first negative nutritional outcome (NNO) during the 6 mo follow-up. NNO was a study-specific measure used to indicate progression to moderate or severe acute malnutrition; it was defined as weight-for-height z-score children who died in the RUTF, MNP, and control groups were 0%, 0.8%, and 0.4%. The findings apply to ill but not malnourished children and cannot be generalised to a general population including children who are not necessarily ill or who are already malnourished. A 2-wk nutrition supplementation programme with RUTF

  18. The phenomenon of micronutrient deficiency among children in China: a systematic review of the literature.

    Science.gov (United States)

    Wong, Angel Y S; Chan, Esther W; Chui, Celine S L; Sutcliffe, Alastair G; Wong, Ian C K

    2014-11-01

    The present study aimed to review the literature on micronutrient deficiency and other factors influencing a deficiency status among children living in China. A systematic review was performed to analyse the literature. Studies were identified through a search of PubMed and secondary references. Children living in China aged less than 18 years. Sixty-one articles were included. The prevalence of vitamin A deficiency decreased to approximately 10 % in 1995-2009. It increased with age but no significant difference was found between genders. The prevalence of thiamin and vitamin B12 deficiency was 10·5 % in Yunnan and 4·5 % in Chongqing provinces, respectively. Higher vitamin D deficiency rates were seen in spring and winter. The incidence of bleeding due to vitamin K deficiency was 3·3 % in 1998-2001 and more prevalent in rural areas. Both iodine deficiency and excess iodine intake were observed. Goitre rates were reported in Tibet, Jiangxi, Gansu and Hong Kong (3·5-46 %). Anaemia rates ranged from 20 % to 40 % in 2007-2011. High Se deficiency rates were found in Tibet, Shaanxi and Jiangsu. High Zn deficiency rates were also found (50-70 %) in 1995-2006. Few studies reported Ca deficiency rates (19·6-34·3 %). The degrees of deficiency for vitamin A, vitamin B12, Fe and Zn were more substantial in rural areas compared with urban areas. The prevalence of micronutrient deficiency rates varied. Socio-economic status, environmental factors and the Chinese diet may influence micronutrient deficiency. Public health policies should consider implementing programmes of supplementation, food fortification and nutrition education to address these deficiencies among Chinese children.

  19. Adherence to multiple micronutrient powders and associated factors in children aged 6 to 35 months treated in sentinel health facilities, Ministry of Health of Peru.

    Science.gov (United States)

    Munares-García, Oscar; Gómez-Guizado, Guillermo

    2016-01-01

    Anemia in children is a public health issue, and the current strategies include treatment and iron supplementation, but their level of adherence or compliance is unknown. To consider the adherence to multiple micronutrient powders and the associated factors. Epidemiological study of active surveillance through sentinel facilities in 2,024 children aged 6 to 35 months treated in health facilities of the Ministry of Health of Peru, from October to December 2014. Household visits were conducted in which counting of multiple micronutrient powders was applied and determined an adherence of consumption ≥ 90% envelopes, besides a form on the associated factors (anemia knowledge, iron-rich food, side effects, dosage regimen, drugs used, and motivation) was applied. Descriptive statistics, χ² test, Odds Ratio with a 95% confidence interval (CI), and binary logistic regression or adjusted Odds Ratio (aOR) were used. Of all, 79.1% participants were aged 6 to 23 months; 75.9% received multiple micronutrient powders; and the adherence was equivalent to 24.4% (95%CI 22.3 - 26.6). The factors: continue supplementation (OR = 3.5; 95%CI 1.7 - 7.5); no nausea (OR = 3.0; 95%CI 2.0 - 4.3); no use of antibiotics (OR = 2.5; 95%CI 1.7 - 3.6); and intention to continue treatment (OR = 2.3; 95%CI 1.3 - 4.1) were associated with adherence. The variables: thought of continuing treatment (aOR = 2.6; 95%CI 1.1 - 6.1); presence of side effects, but no discontinuation of the treatment (aOR = 2.5; 95%CI 1.4 - 4.3); no use of antibiotics (aOR = 2.0; 95%CI 1.1 - 3.4); and belief that not only drugs cure anemia (aOR = 1.6; 95%CI 1.0 - 2.6) were associated in the multivariate analysis. There was a low prevalence of adherence to a demanding cut-off point (≥ 90% of envelopes of multiple micronutrient powders), and the associated factors are associated with absence of infections, side effects, and mother's beliefs.

  20. Ghanaian parents' perceptions of pre and postnatal nutrient supplements and their effects.

    Science.gov (United States)

    Adams, Katherine P; Okronipa, Harriet; Adu-Afarwuah, Seth; Arimond, Mary; Kumordzie, Sika; Oaks, Brietta M; Ocansey, Maku E; Young, Rebecca R; Vosti, Stephen A; Dewey, Kathryn G

    2018-04-15

    Small-quantity lipid-based nutrient supplements (SQ-LNS) have been studied in efficacy and effectiveness trials, but little is known about how parents perceive the products and their effects. In a randomised trial in Ghana, efficacy of SQ-LNS provided to women during pregnancy and the first 6 months postpartum and to their children from 6 to 18 months of age was assessed by comparison with iron-folic acid (IFA) capsules and multiple micronutrient (MMN) capsules provided to women. In a follow-up study conducted when the index children from the original trial were between 4 and 6 years of age, we used survey-based methods to assess retrospective and current parental perceptions of nutrient supplements generally and of SQ-LNS and their effects compared with perceptions IFA and MMN capsules. Most parents perceived that the assigned supplements (SQ-LNS, IFA, or MMN) positively impacted the mother during pregnancy (approximately 89% of both mothers and fathers) and during lactation (84% of mothers and 86% of fathers). Almost all (≥90%) of mothers and fathers perceived that the assigned supplement positively impacted the index child and expected continued positive impacts on the child's health and human capital into the future. A smaller percentage of parents perceived negative impacts of the supplements (7%-17% of mothers and 4%-12% of fathers). Perceptions of positive impacts and of negative impacts did not differ by intervention group. The results suggest that similar populations would likely be receptive to programs to deliver SQ-LNS or micronutrient capsules. © 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

  1. Determinants of Antenatal Care Use in Ghana

    NARCIS (Netherlands)

    Overbosch, G.B.; Nsowah-Nuamah, N.N.N.; van den Boom, G.J.M.; Damnyag, L.

    2004-01-01

    The paper investigates the determinants of antenatal care use in Ghana. In particular, we study how economic factors affect the demand for antenatal care and the probability that the number of visits falls below the recommended number of four. Estimation results from a nested three-level multinomial

  2. Micronutrient studies in soil-plant system using nuclear techniques

    International Nuclear Information System (INIS)

    Deb, D.L.; Sachdev, P.; Rattan, R.K.

    1996-01-01

    The ranges between the critical levels of deficiency and toxicity of the micronutrients are relatively narrow and the utilisation of these nutrients by the crops from the fertilizer source seldom exceeds two per cent. An attempt is made to review the information generated on various aspects of the radioisotope aided micronutrient studies in soil-plant system. 184 refs

  3. Micronutrient status (calcium, zinc, vitamins D and E) in patients with medullary thyroid carcinoma: A cross-sectional study.

    Science.gov (United States)

    Emami, Ali; Nazem, Mohammad Reza; Shekarriz, Reza; Hedayati, Mehdi

    2017-09-01

    The aim of this study was to evaluate the micronutrient status of Iranian patients with medullary thyroid carcinoma (MTC) and to analyze potential relationships with respect to MTC risk. This was a cross-sectional study (Tehran Thyroid Cancer Survey 2015-2016). We measured and compared preoperative serum calcium, zinc, and vitamins D and E in patients with MTC and healthy controls. Forty cases with MTC and 40 (age-, sex-, and body mass index-matched) healthy controls voluntarily participated in the project. Serum calcium, zinc, and vitamin D and E concentrations were lower in the patients with cancer (P Ca calcium remarkably associated with enhanced risk for thyroid cancer (odds ratio [OR], 6.5; P = 0.001). Likewise, serum vitamin E was linked to the risk for cancer (OR, 1.31; P = 0.056). Moreover, serum zinc was correlated with vitamin E and calcium (r = +0.23; P = 0.04 and r = +0.25, P = 0.03; respectively). We also observed a correlation between calcium and vitamin E (r = +0.27; P = 0.02). A multiple-micronutrient decrease was confirmed in patients with MTC. A low serum calcium level was a potent risk factor for MTC. Findings from the present study suggest that dietary intake and/or supplementation of micronutrients, especially calcium and vitamin E, may be beneficial in reducing the risk for thyroid cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Role of public-private partnership in micronutrient food fortification.

    Science.gov (United States)

    Mannar, M G Venkatesh; van Ameringen, Marc

    2003-12-01

    Iron, iodine, and vitamin A deficiencies prevent 30% of the world's population from reaching full physical and mental potential. Fortification of commonly eaten foods with micronutrients offers a cost-effective solution that can reach large populations. Effective and sustainable fortification will be possible only if the public sector (which has the mandate and responsibility to improve the health of the population), the private sector (which has experience and expertise in food production and marketing), and the social sector (which has grass-roots contact with the consumer) collaborate to develop, produce, and promote micronutrient-fortified foods. Food fortification efforts must be integrated within the context of a country's public health and nutrition situation as part of an overall micronutrient strategy that utilizes other interventions as well. Identifying a set of priority actions and initiating a continuous dialogue between the various sectors to catalyze the implementation of schemes that will permanently eliminate micronutrient malnutrition are urgently needed. The partners of such a national alliance must collaborate closely on specific issues relating to the production, promotion, distribution, and consumption of fortified foods. Such collaboration could benefit all sectors: National governments could reap national health, economic, and political benefits; food companies could gain a competitive advantage in an expanding consumer marketplace; the scientific, development, and donor communities could make an impact by achieving global goals for eliminating micronutrient malnutrition; and by demanding fortified foods, consumers empower themselves to achieve their full social and economic potential.

  5. The persistence of maternal vitamin D deficiency and insufficiency during pregnancy and lactation irrespective of season and supplementation.

    Science.gov (United States)

    Kramer, Caroline K; Ye, Chang; Swaminathan, Balakumar; Hanley, Anthony J; Connelly, Philip W; Sermer, Mathew; Zinman, Bernard; Retnakaran, Ravi

    2016-05-01

    Pregnancy and lactation comprise a critical window spanning all seasons during which maternal vitamin D status potentially may influence the long-term health of the newborn. Women typically receive calcium/vitamin D supplementation through antenatal vitamins, but there has been limited serial evaluation of maternal vitamin D status across this critical window. In this prospective observational cohort study, 467 women in Toronto, Canada, underwent measurement of serum 25-hydroxy vitamin D (25-OH-D) at mean 29·7 ± 2·9 weeks' gestation, 3 months postpartum and 12 months postpartum, enabling serial assessment across 3 seasons. At each assessment, vitamin D status was classified as deficiency (25-OH-Dl), insufficiency (25-OH-D≥50 nmol/l and l) or sufficiency (25-OH-D≥75 nmol/l). The prevalence rates of vitamin D deficiency and insufficiency were 31·5% and 35·1% in pregnancy, 33·4% and 35·3% at 3 months, and 35·6% and 33·8% at 12 months postpartum, respectively. These high rates remained stable over time (P = 0·49) despite declining usage of antenatal calcium/vitamin D supplementation from pregnancy to 3 months to 12 months postpartum (P vitamin D deficiency and insufficiency in pregnancy were independently associated with decrements in average 25-OH-D over time of 49·6 nmol/l and 26·4 nmol/l, respectively (both P vitamin D supplements were independently associated with changes in 25-OH-D in the range of 3-5 nmol/l (both P vitamin D deficiency/insufficiency during pregnancy and lactation, irrespective of season and supplementation, supports the emerging concept that current vitamin D supplementation in antenatal care is likely inadequate. © 2015 John Wiley & Sons Ltd.

  6. Risk factors for antenatal depression, postnatal depression and parenting stress

    Directory of Open Access Journals (Sweden)

    Milgrom Jeannette

    2008-04-01

    Full Text Available Abstract Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Methods Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26–32 weeks gestation. A subsample of these women (N = 161 also completed questionnaires at 10–12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI. Results Regression analyses identified significant risk factors for the three outcome measures. (1. Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2. Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3. Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator

  7. Risk factors for antenatal depression, postnatal depression and parenting stress.

    Science.gov (United States)

    Leigh, Bronwyn; Milgrom, Jeannette

    2008-04-16

    Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26-32 weeks gestation. A subsample of these women (N = 161) also completed questionnaires at 10-12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI). Regression analyses identified significant risk factors for the three outcome measures. (1). Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2). Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3). Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator for other risk factors. Risk factor profiles for

  8. Efficacy and safety of twice-weekly administration of three RDAs of iron and folic acid with and without complement of 14 essential micronutrients at one or two RDAs: a placebo-controlled intervention trial in anemic Cambodian infants 6 to 24 months of age.

    Science.gov (United States)

    Schümann, K; Longfils, P; Monchy, D; von Xylander, S; Weinheimer, H; Solomons, N W

    2009-03-01

    To determine the differential efficacy and safety of twice-weekly administration of 3 RDAs of iron and folic acid, with and without a complement of 2 RDAs of 11, and 1 RDA of 3 additional essential micronutrients as compared to a placebo control (PlbCON) given as foodLETs. A total of 250 children aged 6-24 months were enrolled after recruitment by village health workers; 19 of them dropped out during the trial. Children were assigned to one of three treatment arms and followed for 20.5 weeks; 41 supervised twice-weekly dosings of 30 mg of iron plus folic acid, either with or without accompanying micronutrients or placebo were given as foodLETs, a tool for ready-to-eat fortification in infant food. Initial and final measurements of anthropometry and blood biomarkers for hematological, iron stores and inflammatory status, as well as for abnormal hemoglobin (Hb), were obtained. Symptoms of listlessness, vomiting, watery stools and acute respiratory infections were monitored weekly. Iron-containing supplements increased Hb concentrations significantly (P<0.0001) and virtually eradicated any IDA, as compared to no change in hematological status in the PlbCON group (P=0.011). Iron stores, as reflected by ferritin, increased significantly with iron-containing treatments (P<0.0001). Responses were as effective in individuals with HbE as in those with exclusively HbA phenotypes. Watery stools (P=0.002) and listlessness (P=0.001) were significantly more frequent in those receiving iron and folic acid alone than in the PlbCON group. In contrast, acute respiratory infections (P=0.014) and listlessness (P=0.001) were significantly less frequent in those receiving the multiple micronutrient formulation than in the PlbCON group. Supplementation of micronutrients along with iron and folic acid mitigates the excess morbidity of iron-folate alone, without reducing its efficacy in correcting anemia and building iron stores. FoodLETs are a suitable vehicle to provide micronutrient

  9. Antenatal physical activity: a qualitative study exploring women's experiences and the acceptability of antenatal walking groups.

    Science.gov (United States)

    Currie, Sinéad; Gray, Cindy; Shepherd, Ashley; McInnes, Rhona J

    2016-07-22

    Regular physical activity (PA) can be beneficial to pregnant women, however, many women do not adhere to current PA guidelines during the antenatal period. Patient and public involvement is essential when designing antenatal PA interventions in order to uncover the reasons for non-adherence and non-engagement with the behaviour, as well as determining what type of intervention would be acceptable. The aim of this research was to explore women's experiences of PA during a recent pregnancy, understand the barriers and determinants of antenatal PA and explore the acceptability of antenatal walking groups for further development. Seven focus groups were undertaken with women who had given birth within the past five years. Focus groups were transcribed and analysed using a grounded theory approach. Relevant and related behaviour change techniques (BCTs), which could be applied to future interventions, were identified using the BCT taxonomy. Women's opinions and experiences of PA during pregnancy were categorised into biological/physical (including tiredness and morning sickness), psychological (fear of harm to baby and self-confidence) and social/environmental issues (including access to facilities). Although antenatal walking groups did not appear popular, women identified some factors which could encourage attendance (e.g. childcare provision) and some which could discourage attendance (e.g. walking being boring). It was clear that the personality of the walk leader would be extremely important in encouraging women to join a walking group and keep attending. Behaviour change technique categories identified as potential intervention components included social support and comparison of outcomes (e.g. considering pros and cons of behaviour). Women's experiences and views provided a range of considerations for future intervention development, including provision of childcare, involvement of a fun and engaging leader and a range of activities rather than just walking

  10. The role of biofortification in the reduction of micronutrient food ...

    African Journals Online (AJOL)

    Micronutrient malnutrition is a global public health problem, especially in developing countries. Hunger and starvation which are causative agents of malnutrition are occasioned by poor food supply and low income purchasing power for the expensive animal sources of micronutrients. Access to adequate, safe and nutritious ...

  11. A meta-analysis of pica and micronutrient status.

    Science.gov (United States)

    Miao, Diana; Young, Sera L; Golden, Christopher D

    2015-01-01

    Pica is the craving for and consumption of nonfood items, including the ingestion of earth (geophagy), raw starch (amylophagy), and ice (pagophagy). Pica has long been associated with micronutrient deficiencies, but the strength of this relationship is unclear. We aimed to evaluate the association between pica behavior and the risk of being anemic or having low hemoglobin (Hb), hematocrit (Hct), or plasma zinc (Zn) concentrations. We systematically reviewed studies in which micronutrient levels were reported by pica status. We calculated the pooled odds ratio for anemia or weighted mean difference in Hb, Hct, or Zn concentrations between groups practicing or not practicing pica behaviors. Forty-three studies including 6,407 individuals with pica behaviors and 10,277 controls were identified. Pica was associated with 2.35 times greater odds of anemia (95% CI: 1.94-2.85, P < 0.001), lower Hb concentration (-0.65 g/dl, 95% CI: -0.83 to -0.48 g/dl, P < 0.001), lower Hct concentration (-1.15%, 95% CI: -1.61 to -0.70%, P < 0.001), and lower Zn concentration (-34.3 μg/dl, 95% CI: -59.58 to -9.02 μg/dl, P = 0.008). Statistical significance persisted after excluding outliers and in subgroup analyses by pica type and life stage. Pica is significantly associated with increased risk for anemia and low Hb, Hct, and plasma Zn. Although the direction of the causal relationship between pica and micronutrient deficiency is unknown, the magnitude of these relationships is comparable to other well-recognized causes of micronutrient deficiencies. Pica warrants greater public health attention; specifically the potential physiological mechanisms underpinning the relationship between pica and micronutrient deficiencies merit further study. © 2014 Wiley Periodicals, Inc.

  12. Micronutrient Dietary Intake in Latina Pregnant Adolescents and Its Association with Level of Depression, Stress, and Social Support

    Directory of Open Access Journals (Sweden)

    Angelie Singh

    2017-11-01

    Full Text Available Adolescent pregnant women are at greater risk for nutritional deficits, stress, and depression than their adult counterparts, and these risk factors for adverse pregnancy outcomes are likely interrelated. This study evaluated the prevalence of nutritional deficits in pregnant teenagers and assessed the associations among micronutrient dietary intake, stress, and depression. One hundred and eight pregnant Latina adolescents completed an Automated Self-Administered 24-hour dietary recall (ASA24 in the 2nd trimester. Stress was measured using the Perceived Stress Scale and the Prenatal Distress Questionnaire. Depressive symptoms were evaluated with the Reynolds Adolescent Depression Scale. Social support satisfaction was measured using the Social Support Questionnaire. More than 50% of pregnant teenagers had an inadequate intake (excluding dietary supplement of folate, vitamin A, vitamin E, iron, zinc, calcium, magnesium, and phosphorous. Additionally, >20% of participants had an inadequate intake of thiamin, riboflavin, niacin, vitamin B6, vitamin B12, vitamin C, copper, and selenium. Prenatal supplement inclusion improved dietary intake for most micronutrients except for calcium, magnesium, and phosphorous, (>50% below the Estimated Average Requirement (EAR and for copper and selenium (>20% below the EAR. Higher depressive symptoms were associated with higher energy, carbohydrates, and fats, and lower magnesium intake. Higher social support satisfaction was positively associated with dietary intake of thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, vitamin C, vitamin E, iron, and zinc. The findings suggest that mood and dietary factors are associated and should be considered together for health interventions during adolescent pregnancy for the young woman and her future child.

  13. Aibika (Abelmoschus manihot L.): Genetic variation, morphology and relationships to micronutrient composition.

    Science.gov (United States)

    Rubiang-Yalambing, Lydia; Arcot, Jayashree; Greenfield, Heather; Holford, Paul

    2016-02-15

    Aibika (Abelmoschus manihot L.) is believed to be a good source of micronutrients. However, although many varieties of aibika are commonly consumed in Papua New Guinea, their micronutrient content is unknown. Therefore, the mineral (Ca, Fe, K, Mg, Mn, Na, Zn & Cu), folate composition and the genetic variation of 23 aibika accessions from the collection at the National Agricultural Research Institute were studied over a 3year period to provide data for nutritional studies and to inform breeding programs. The data showed that aibika is, potentially, a crop of high nutritional value with the potential to boost the micronutrient status of local PNG communities. However, there were substantial differences in the micronutrient concentrations of the accessions from year to year and accessions that had the highest concentration of a particular mineral in 1year did not have the high concentrations in other years. Clusters determined using unweighted pair group method with arithmetic mean analysis (UPGMA) of the micronutrient contents differed in each of the 3years. Genetic analysis made using random amplification of polymorphic DNA and directed amplification of mini satellite region DNA placed the accessions into five groups. There was no correlation between these groups and leaf morphology, nor were there correlations with the clusters determined from the UPGMA analyses. There appears to be considerable interaction between genotype and environmental factors determining micronutrient composition and environmental factors may play a greater role than genotype in influencing micronutrient composition. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. A tale of two pregnancies: A Critical Interpretive Synthesis of women's perceptions about delayed initiation of antenatal care.

    Science.gov (United States)

    Haddrill, Rosalind; Jones, Georgina L; Anumba, Dilly; Mitchell, Caroline

    2017-10-14

    Delayed access to antenatal care in high income countries is associated with poor maternal, fetal and neonatal outcomes. The aim was to synthesise the diverse body of evidence around women's views of early antenatal care and barriers to attendance in such countries. Critical Interpretive Synthesis integrates the process of systematic review with the qualitative methods of meta-ethnography and grounded theory, with a focus on theory generation to inform policy, practice and future research. Database searches were conducted, supplemented with reference and citation tracking and website searching between February 2014 and April 2016. Qualitative data analysis methods were used to extract and summarise the key themes from each study. A taxonomy of constructs was created, with the synthesis developed to thread these together. Fifty-four papers were synthesised, including qualitative, quantitative, mixed method and systematic review, published between 1987 and 2016. Seventeen constructs around the core concept of 'acceptance of personal and public pregnancies' were produced. Acceptance of the 'personal' pregnancy considers the contribution of mindset in the recognition and acceptance of pregnancy, influenced by knowledge of pregnancy symptoms, pregnancy planning and desire. Acceptance of the 'public' pregnancy considers women's assessment of the social consequences of pregnancy, and the relevance and priority of antenatal care. Critical Interpretive Synthesis offers a systematic yet creative approach to the synthesis of diverse evidence. The findings offer new perspectives on women's perceptions of early pregnancy and attendance for care, which may be used to facilitate timely antenatal provision for all pregnant women. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  15. Contribution of fish to intakes of micronutrients important for fetal development: a dietary survey of pregnant women in the Republic of Seychelles.

    Science.gov (United States)

    Bonham, Maxine P; Duffy, Emeir M; Robson, Paula J; Wallace, Julie M; Myers, Gary J; Davidson, Philip W; Clarkson, Tom W; Shamlaye, Conrad F; Strain, J J; Livingstone, M Barbara E

    2009-09-01

    To characterise the diets of pregnant women in the Republic of Seychelles and to determine the contribution of fish to intakes of nutrients important for fetal and neonatal development. Observational, prospective study. Seychelles Child Development Centre, Mahé, Republic of Seychelles. Pregnant women (n 300) were recruited at their first visit to an antenatal clinic. At 28 weeks' gestation subjects completed a 4 d diet diary (n 273) and intakes were analysed using dietary analysis software. Mean (sd) energy intake was 9.0 (2.5) MJ/d and fat intakes were higher than UK recommendations for almost two-thirds of the cohort. Fish consumption was lower than in previous surveys, suggesting a move towards a more Westernised diet. Low intakes of a number of nutrients important during pregnancy for fetal development (Fe, Zn, Se and iodine) were observed. However, women who met the current recommendations for these nutrients consumed significantly more fish than those who did not (97 v. 73 g/d). The present study highlights the importance of fish in the diet of pregnant Seychellois women for ensuring adequate intakes of micronutrients important in fetal development. Dietary patterns in Seychelles, however, are in a state of transition, with a move towards a Western-style diet as evidenced by higher fat and lower fish intakes. If these dietary trends continue and fish consumption declines further, micronutrient status may be compromised. These findings suggest caution in establishing public health policies that promote limitation of fish intake during pregnancy.

  16. Evaluation of Dietary Intakes and Supplement Use in Paralympic Athletes

    Directory of Open Access Journals (Sweden)

    Robyn F. Madden

    2017-11-01

    Full Text Available Dietary intakes and supplement use in Paralympic athletes remains largely unexplored, and specialized recommendations are lacking. The aim of this study was to evaluate nutrient intakes and supplement use in high-performance athletes with physical disabilities using three-day food records and a validated dietary supplement use questionnaire. A secondary aim examined gender differences in nutrient and supplement intakes. Male (n = 18 and female (n = 22 athletes were recruited from nine Paralympic sports through sporting organizations, coaches, and social media. Athletes generally met able-bodied recommendations for macronutrients. Male and female athletes often failed to meet the Recommended Dietary Allowance (RDA or Adequate Intake (AI for vitamin D, vitamin E, pantothenic acid, magnesium, and potassium. On average, females did not meet the RDA for iron and calcium, whereas males did not meet the RDA for vitamin A and folate. Commonly consumed supplements were vitamin D, protein powder, sport bars, and sport drinks. Analysis of diet and supplement use within this population shows several micronutrient deficiencies and irregular use of specific supplements. Athlete support and education is required to optimize nutrition in Paralympic athletes.

  17. Consumer attitudes about the role of multivitamins and other dietary supplements: report of a survey.

    Science.gov (United States)

    Dickinson, Annette; MacKay, Douglas; Wong, Andrea

    2015-07-02

    U.S. nutrition surveys find that intakes of many nutrients fall short of recommendations. The majority of U.S. adults use multivitamins and other dietary supplements as one means of improving nutrient intakes. Some policy makers and health professionals appear reluctant to recommend routine use of dietary supplements to fill nutrient gaps in the diet, in part because they are concerned that people will view the supplements as a substitute for dietary improvement and that the use of supplements may lead to overconsumption of micronutrients. Surveys find that in fact users of dietary supplements tend to have better diets and adopt other healthy habits, suggesting that the supplements are viewed as one aspect of an overall effort to improve wellness. Furthermore, evidence demonstrates that the incidence of excess micronutrient intake is low. We report the results of a survey probing consumer attitudes about the role of dietary supplements. The Council for Responsible Nutrition funded a survey to measure consumer attitudes about the role of multivitamins, calcium and/or vitamin D supplements, and other supplements in improving dietary intakes. The research was designed and analyzed by FoodMinds and was fielded using Toluna's On-line Omnibus. The weighted sample of 2159 respondents is representative of U.S. adults. Nearly 90% of the survey respondents agreed that multivitamins and supplements of calcium and/or vitamin D can help meet nutrient needs when desirable intakes are not achieved through food alone. At the same time, 80% agreed that dietary supplements should not be used to replace healthy dietary or lifestyle habits, and 82% agreed that people considering taking a high dose, single nutrient supplement should talk with their physician. These results provide additional support for the conclusion that the vast majority of consumers recognize that multivitamins and other supplements can help fill nutrient gaps but should not be viewed as replacements for a healthy

  18. EURRECA: development of tools to improve the alignment of micronutrient recommendations

    NARCIS (Netherlands)

    Matthys, C.; Bucchini, L.; Busstra, M.C.; Cavelaars, A.J.E.M.; Eleftheriou, P.; Garcia-Alvarez, A.; Fairweather-Tait, S.; Gurinovic, M.; Ommen, van B.; Contor, L.

    2010-01-01

    Approaches through which reference values for micronutrients are derived, as well as the reference values themselves, vary considerably across countries. Harmonisation is needed to improve nutrition policy and public health strategies. The EURRECA (EURopean micronutrient RECommendations Aligned,

  19. Effect of antenatal zinc supplementation on impetigo in infants in Bangladesh

    NARCIS (Netherlands)

    Darmstadt, G.L.; Osendarp, S.J.M.; Ahmed, S.; Feldman, C.; Raaij, van J.M.A.; Baqui, A.H.; Hautvast, J.G.A.J.; Fuchs, G.J.

    2012-01-01

    We sought to determine the effects of maternal zinc supplementation on skin infections among infants in poor urban areas of Dhaka, Bangladesh. A double-blind, placebo-controlled, randomized trial was conducted among 199 and 221 Bangladeshi infants whose mothers were administered 30 mg daily of zinc

  20. Antenatal hypnosis training and childbirth experience

    DEFF Research Database (Denmark)

    Werner, Anette; Uldbjerg, Niels; Zachariae, Robert

    2013-01-01

    Childbirth is a demanding event in a woman's life. The aim of this study was to explore whether a brief intervention in the form of an antenatal course in self-hypnosis to ease childbirth could improve the childbirth experience.......Childbirth is a demanding event in a woman's life. The aim of this study was to explore whether a brief intervention in the form of an antenatal course in self-hypnosis to ease childbirth could improve the childbirth experience....

  1. ABOVE GROUND BIOMASS MICRONUTRIENTS IN A SEASONAL SUBTROPICAL FOREST

    Directory of Open Access Journals (Sweden)

    Hamilton Luiz Munari Vogel

    2015-06-01

    Full Text Available In the above ground biomass of a native forest or plantation are stored large quantities of nutrients, with few studies in the literature, especially concerning micronutrients. The present work aimed to quantify the micronutrients in above ground biomass in a Seasonal Subtropical forest in Itaara-RS, Brazil. For the above ground biomass evaluation, 20 trees of five different diameter classes were felled. The above ground biomass was separated in the following compartments: stem wood, stem bark, branches and leaves. The contents of B, Cu, Fe, Mn and Zn in the biomass samples were determined. The stock of micronutrients in the biomass for each component was obtained based on the estimated dry biomass, multiplied by the nutrient content. The total production of above ground biomass was estimated at 210.0 Mg.ha-1. The branches, stem wood, stem bark and leaves corresponded to 48.8, 43.3, 5.4 and 2.4% of the above ground biomass. The lower levels of B, Cu, Fe and Mn are in stem wood, except for Zn; in the branches and trunk wood are the largest stocks of B, Cu, Fe and Mn. In the branches, leaves and trunk bark are stored most micronutrients, pointing to the importance of these to remain on the soil.

  2. Dietary supplements for football.

    Science.gov (United States)

    Hespel, P; Maughan, R J; Greenhaff, P L

    2006-07-01

    Physical training and competition in football markedly increase the need for macro- and micronutrient intake. This requirement can generally be met by dietary management without the need for dietary supplements. In fact, the efficacy of most supplements available on the market is unproven. In addition, players must be cautious of inadequate product labelling and supplement impurities that may cause a positive drug test. Nonetheless, a number of dietary supplements may beneficially affect football performance. A high endurance capacity is a prerequisite for optimal match performance, particularly if extra time is played. In this context, the potential of low-dose caffeine ingestion (2 - 5 mg . kg body mass(-1)) to enhance endurance performance is well established. However, in the case of football, care must be taken not to overdose because visual information processing might be impaired. Scoring and preventing goals as a rule requires production of high power output. Dietary creatine supplementation (loading dose: 15 - 20 g . day(-1), 4 - 5 days; maintenance dose: 2 - 5 g g . day(-1)) has been found to increase muscle power output, especially during intermittent sprint exercises. Furthermore, creatine intake can augment muscle adaptations to resistance training. Team success and performance also depend on player availability, and thus injury prevention and health maintenance. Glucosamine or chondroitin may be useful in the treatment of joint pain and osteoarthritis, but there is no evidence to support the view that the administration of these supplements will be preventative. Ephedra-containing weight-loss cocktails should certainly be avoided due to reported adverse health effects and positive doping outcomes. Finally, the efficacy of antioxidant or vitamin C intake in excess of the normal recommended dietary dose is equivocal. Responses to dietary supplements can vary substantially between individuals, and therefore the ingestion of any supplement must be assessed

  3. The Prevalence of Osteoporosis among Antenatal Clinic Attendees ...

    African Journals Online (AJOL)

    Introduction: Osteoporosis is a global public health problem characterized by reduction of bone mineral density (BMD). This study aimed to assess the prevalence of osteoporosis among antenatal clinic attendees in a rural Southeastern hospital. Material and Methods: This was a cross‑sectional study of booking. Antenatal ...

  4. Influence of multiple antenatal counselling sessions on modern contraceptive uptake in Nigeria.

    Science.gov (United States)

    Adanikin, Abiodun I; Onwudiegwu, Uche; Loto, Olabisi M

    2013-10-01

    To determine the influence of multiple contraceptive counselling sessions during antenatal care on use of modern postpartum contraception. A total of 216 eligible pregnant women were randomised into antenatal and postnatal counselling groups. The 'Antenatal group' received one-to-one antenatal contraceptive counselling on several occasions while the 'Postnatal group' received a single one-to-one contraceptive counselling session at the sixth week postnatal check, as is routinely practised. All participants were contacted six months postpartum by telephone or personal visit, and questioned about their contraceptive use, if any. More women who had multiple antenatal contraceptive counselling sessions used modern contraceptive methods than those who had a single postnatal counselling session (57% vs. 35%; p = 0.002). There was also a significantly more frequent use of contraception among previously undecided patients in the Antenatal group (p = 0.014). Multiple antenatal contraceptive counselling sessions improve the use of modern postpartum contraception.

  5. Game-based online antenatal breastfeeding education: A pilot.

    Science.gov (United States)

    Grassley, Jane S; Connor, Kelley C; Bond, Laura

    2017-02-01

    The aim of this study was to evaluate the effect of the Healthy Moms intervention on antenatal breastfeeding self-efficacy and intention and to determine the feasibility of using an online game-based learning platform to deliver antenatal breastfeeding education. The Internet has potential for improving breastfeeding rates through improving women's access to antenatal breastfeeding education. Twelve computer-based breastfeeding education modules were developed using an online learning platform. Changes in participants' breastfeeding self-efficacy and intention pre- and post-intervention were measured using descriptive statistics and a one-way ANOVA. Of the 25 women submitting the pretest, four completed zero quests; seven, orientation only; eight, one to six breastfeeding quests; and six, 10 to 12 breastfeeding quests. No significant differences in breastfeeding self-efficacy and intention were found among the groups. Online antenatal breastfeeding education is feasible; however, further research is warranted to determine if it can affect breastfeeding outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Global burden of maternal and child undernutrition and micronutrient deficiencies.

    Science.gov (United States)

    Ahmed, Tahmeed; Hossain, Muttaquina; Sanin, Kazi Istiaque

    2012-01-01

    Maternal and child undernutrition and micronutrient deficiencies affect approximately half of the world's population. These conditions include intrauterine growth restriction (IUGR), low birth weight, protein-energy malnutrition, chronic energy deficit of women, and micronutrient deficiencies. Although the rates of stunting or chronic protein-energy malnutrition are increasing in Africa, the absolute numbers of stunted children are much higher in Asia. The four common micronutrient deficiencies include those of iron, iodine, vitamin A, and zinc. All these conditions are responsible directly or indirectly for more than 50% of all under-5 deaths globally. According to more recent estimates, IUGR, stunting and severe wasting are responsible for one third of under-5 mortality. About 12% of deaths among under-5 children are attributed to the deficiency of the four common micronutrients. Despite tremendous progress in different disciplines and unprecedented improvement with many health indicators, persistently high undernutrition rates are a shame to the society. Human development is not possible without taking care to control undernutrition and micronutrient deficiencies. Poverty, food insecurity, ignorance, lack of appropriate infant and young child feeding practices, heavy burden of infectious illnesses, and poor hygiene and sanitation are factors responsible for the high levels of maternal and child undernutrition in developing countries. These factors can be controlled or removed by scaling up direct nutrition interventions and eliminating the root conditions including female illiteracy, lack of livelihoods, lack of women's empowerment, and poor hygiene and sanitation. Copyright © 2013 S. Karger AG, Basel.

  7. Effect of Short-Term Supplementation with Ready-to-Use Therapeutic Food or Micronutrients for Children after Illness for Prevention of Malnutrition: A Randomised Controlled Trial in Uganda.

    Directory of Open Access Journals (Sweden)

    Saskia van der Kam

    2016-02-01

    Full Text Available Globally, Médecins Sans Frontières (MSF treats more than 300,000 severely malnourished children annually. Malnutrition is not only caused by lack of food but also by illnesses and by poor infant and child feeding practices. Breaking the vicious cycle of illness and malnutrition by providing ill children with nutritional supplementation is a potentially powerful strategy for preventing malnutrition that has not been adequately investigated. Therefore, MSF investigated whether incidence of malnutrition among ill children <5 y old could be reduced by providing a fortified food product or micronutrients during their 2-wk convalescence period. Two trials, one in Nigeria and one in Uganda, were conducted; here, we report on the trial that took place in Kaabong, a poor agropastoral region of Karamoja, in east Uganda. While the region of Karamoja shows an acute malnutrition rate between 8.4% and 11.5% of which 2% to 3% severe malnutrition, more than half (58% of the population in the district of Kaabong is considered food insecure.We investigated the effect of two types of nutritional supplementation on the incidence of malnutrition in ill children presenting at outpatient clinics during March 2011 to April 2012 in Kaabong, Karamoja region, Uganda, a resource-poor region where malnutrition is a chronic problem for its seminomadic population. A three-armed, partially-blinded, randomised controlled trial was conducted in children diagnosed with malaria, diarrhoea, or lower respiratory tract infection. Non-malnourished children aged 6 to 59 mo were randomised to one of three arms: one sachet/d of ready-to-use therapeutic food (RUTF, two sachets/d of micronutrient powder (MNP, or no supplement (control for 14 d for each illness over 6 mo. The primary outcome was the incidence of first negative nutritional outcome (NNO during the 6 mo follow-up. NNO was a study-specific measure used to indicate progression to moderate or severe acute malnutrition; it was

  8. The effect of oral iron with or without multiple micronutrients on hemoglobin concentration and hemoglobin response among nonpregnant Cambodian women of reproductive age: a 2 x 2 factorial, double-blind, randomized controlled supplementation trial.

    Science.gov (United States)

    Karakochuk, Crystal D; Barker, Mikaela K; Whitfield, Kyly C; Barr, Susan I; Vercauteren, Suzanne M; Devlin, Angela M; Hutcheon, Jennifer A; Houghton, Lisa A; Prak, Sophonneary; Hou, Kroeun; Chai, Tze Lin; Stormer, Ame; Ly, Sokhoing; Devenish, Robyn; Oberkanins, Christian; Pühringer, Helene; Harding, Kimberly B; De-Regil, Luz M; Kraemer, Klaus; Green, Tim J

    2017-07-01

    Background: Despite a high prevalence of anemia among nonpregnant Cambodian women, current reports suggest that iron deficiency (ID) prevalence is low. If true, iron supplementation will not be an effective anemia reduction strategy. Objective: We measured the effect of daily oral iron with or without multiple micronutrients (MMNs) on hemoglobin concentration in nonpregnant Cambodian women screened as anemic. Design: In this 2 × 2 factorial, double-blind, randomized trial, nonpregnant women (aged 18-45 y) with hemoglobin concentrations ≤117 g/L (capillary blood) were recruited from 26 villages in Kampong Chhnang province and randomly assigned to receive 12 wk of iron (60 mg; Fe group), MMNs (14 other micronutrients; MMN group), iron plus MMNs (Fe+MMN group), or placebo capsules. A 2 × 2 factorial intention-to-treat analysis with the use of a generalized mixed-effects model was used to assess the effects of iron and MMNs and the interaction between these factors. Results: In July 2015, 809 women were recruited and 760 (94%) completed the trial. Baseline anemia prevalence was 58% (venous blood). Mean (95% CI) hemoglobin concentrations at 12 wk in the Fe, MMN, Fe+MMN, and placebo groups were 121 (120, 121), 116 (116, 117), 123 (122, 123), and 116 (116, 117) g/L, with no iron × MMN interaction ( P = 0.66). Mean (95% CI) increases in hemoglobin were 5.6 g/L (3.8, 7.4 g/L) ( P < 0.001) among women who received iron ( n = 407) and 1.2 g/L (-0.6, 3.0 g/L) ( P = 0.18) among women who received MMNs ( n = 407). The predicted proportions (95% CIs) of women with a hemoglobin response (≥10 g/L at 12 wk) were 19% (14%, 24%), 9% (5%, 12%), 30% (24%, 35%), and 5% (2%, 9%) in the Fe, MMN, Fe+MMN, and placebo groups, respectively. Conclusions: Daily iron supplementation for 12 wk increased hemoglobin in nonpregnant Cambodian women; however, MMNs did not confer additional significant benefit. Overall, ∼24% of women who received iron responded after 12 wk; even fewer would be

  9. Effect of Micronutrient Powder Addition on Sensory Properties of Foods for Older Adults.

    Science.gov (United States)

    Field, Katherine M; Duncan, Alison M; Keller, Heather H; Stark, Ken D; Duizer, Lisa M

    2017-10-01

    Micronutrient fortification can improve nutrient intake of older adults in long-term care. However, previous studies indicate that micronutrient fortification can alter food sensory attributes and, potentially, consumer liking. Others have found no effect of fortification on liking. This research investigates the effect of micronutrient powder addition on the sensory properties of selected foods commonly served in long-term care. A micronutrient powder containing 9 vitamins and 3 minerals was added to tomato soup and oatmeal at different levels. Using projective mapping, changes in sensory properties were observed with powder addition. Descriptive analysis, used to quantify these changes, showed that both the tomato soup and oatmeal had reduced flavor as the amount of added micronutrient powder increased. Oatmeal also showed changes in texture with fortification. Consumer liking scores for tomato soup showed that micronutrient addition affected liking when 100% of a daily dose was added into the soup. Addition of 50% of the daily dose did not affect liking. Oatmeal liking did not differ between fortified and unfortified samples. Results from this research can be used to decide whether a micronutrient powder of selected vitamins and minerals can be added to foods served to older adults in long-term care. Although sensory properties of the foods will be altered, fortification of both tomato soup and oatmeal with the developed powder is possible without reducing consumer liking to the point where it is disliked. © 2017 Institute of Food Technologists®.

  10. Micronutrient bioavailability: Dietary Reference Intakes and a future perspective1234

    Science.gov (United States)

    2010-01-01

    This article provides a review of how the challenge of bioavailability was approached in establishing the Dietary Reference Intakes, with a special focus on folic acid, vitamin B-12, β-carotene, iron, selenium, and zinc, the targeted micronutrients for this workshop. In a future perspective, the necessity of having a clear working definition of bioavailability is emphasized. The bioavailability of micronutrients should be considered, with advantage, under subheadings determined by the broad factors that affect bioavailability. Special emphasis is given to giving greater and specific attention to factors involved in the maintenance of homeostasis. These factors, it is argued, are best considered separately from even a broad definition of bioavailability and have the potential to provide new insights into some micronutrient requirements. PMID:20200261

  11. Antenatal care services utilization among women of reproductive ...

    African Journals Online (AJOL)

    Methods: A cross-sectional study was carried out between September and October 2013 among 425 women of reproductive age using a multi-stage sampling technique. Results: Almost all the respondents (93.9%) were aware of antenatal care services. A good proportion of the mothers (90.1%) used antenatal services, ...

  12. Variables influencing delay in antenatal clinic attendance among ...

    African Journals Online (AJOL)

    A delay in deciding to seek antenatal care is predominant among pregnant teenagers in Lesotho. This subsequently leads to delay in reaching treatment and in receiving adequate treatment. Early antenatal care attendance plays a major role in detecting and treating complications of pregnancy and forms a good basis for ...

  13. Pattern and Determinants of Antenatal Booking at Abakaliki ...

    African Journals Online (AJOL)

    for pregnant women to enable them attain and maintain a state of good health throughout pregnancy and to improve ... subsidization of cost of medical services will help in reversing the trend of late antenatal booking. Keywords: Abakaliki, Antenatal booking, .... Artisan/fashion/ design. 10 (2.9). 3 (30). 7 (70). Civil servant.

  14. Risk factors for major antenatal depression among low-income African American women.

    Science.gov (United States)

    Luke, Sabrina; Salihu, Hamisu M; Alio, Amina P; Mbah, Alfred K; Jeffers, Dee; Berry, Estrellita Lo; Mishkit, Vanessa R

    2009-11-01

    Data on risk factors for major antenatal depression among African American women are scant. In this study, we seek to determine the prevalence and risk factors for major antenatal depression among low-income African American women receiving prenatal services through the Central Hillsborough Healthy Start (CHHS). Women were screened using the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff of > or =13 as positive for risk of major antenatal depression. In total, 546 African American women were included in the analysis. We used logistic regression to identify risk factors for major antenatal depression. The prevalence of depressive symptomatology consistent with major antenatal depression was 25%. Maternal age was identified as the main risk factor for major antenatal depression. The association between maternal age and risk for major antenatal depression was biphasic, with a linear trend component lasting until age 30, at which point the slope changed markedly tracing a more pronounced likelihood for major depression with advancing age. Women aged > or =30 were about 5 times as likely to suffer from symptoms of major antenatal depression as teen mothers (OR = 4.62, 95% CI 2.23-9.95). The risk for major antenatal depression increases about 5-fold among low-income African American women from age 30 as compared to teen mothers. The results are consistent with the weathering effect resulting from years of cumulative stress burden due to socioeconomic marginalization and discrimination. Older African American mothers may benefit from routine antenatal depression screening for early diagnosis and intervention.

  15. Effects of Antenatal Betamethasone and Dexamethasone in Preterm Neonates

    Directory of Open Access Journals (Sweden)

    Chen-Yu Chen

    2005-09-01

    Conclusion: In our study, no significant differences between antenatal betamethasone and dexamethasone were found in complications of preterm neonates. Incomplete courses of antenatal corticosteroids were associated with an increased incidence of RDS compared with complete courses.

  16. EURRECA—Framework for Aligning Micronutrient Recommendations

    NARCIS (Netherlands)

    Veer, van 't P.; Grammatikaki, E.; Matthys, C.; Raats, M.M.; Contor, L.

    2013-01-01

    There is currently no standard approach for deriving micronutrient recommendations, and large variations exist across Europe, causing confusion among consumers, food producers, and policy makers. More aligned information could influence dietary behaviors and potentially lead to a healthier

  17. Forests, Trees, and Micronutrient-Rich Food Consumption in Indonesia.

    Science.gov (United States)

    Ickowitz, Amy; Rowland, Dominic; Powell, Bronwen; Salim, Mohammad Agus; Sunderland, Terry

    2016-01-01

    Micronutrient deficiency remains a serious problem in Indonesia with approximately 100 million people, or 40% of the population, suffering from one or more micronutrient deficiencies. In rural areas with poor market access, forests and trees may provide an essential source of nutritious food. This is especially important to understand at a time when forests and other tree-based systems in Indonesia are being lost at unprecedented rates. We use food consumption data from the 2003 Indonesia Demographic Health Survey for children between the ages of one and five years and data on vegetation cover from the Indonesian Ministry of Forestry to examine whether there is a relationship between different tree-dominated land classes and consumption of micronutrient-rich foods across the archipelago. We run our models on the aggregate sample which includes over 3000 observations from 25 provinces across Indonesia as well as on sub-samples from different provinces chosen to represent the different land classes. The results show that different tree-dominated land classes were associated with the dietary quality of people living within them in the provinces where they were dominant. Areas of swidden/agroforestry, natural forest, timber and agricultural tree crop plantations were all associated with more frequent consumption of food groups rich in micronutrients in the areas where these were important land classes. The swidden/agroforestry land class was the landscape associated with more frequent consumption of the largest number of micronutrient rich food groups. Further research needs to be done to establish what the mechanisms are that underlie these associations. Swidden cultivation in is often viewed as a backward practice that is an impediment to food security in Indonesia and destructive of the environment. If further research corroborates that swidden farming actually results in better nutrition than the practices that replace it, Indonesian policy makers may need to

  18. Medicinal Plants used during Antenatal Care by Pregnant Women in Eastern Uganda.

    Science.gov (United States)

    Nalumansi, Patricia A; Kamatenesi-Mugisha, Maud; Anywar, Godwin

    2017-12-01

    Plants are commonly used during the antenatal stage in pregnancy to manage different ailments in Africa. In Uganda, both medicinal and food plants are used to handle common pregnancy related conditions. An ethnobotanical survey was conducted in Iganga district, eastern Uganda. Seven traditional birth attendants (TBA) and 46 mothers were interviewed. Data was collected using structured questionnaires and household interviews. The TBAs were identified using snowball sampling. A total of 33 plant species, belonging to 23 families were documented. Out of these, the pregnant mothers used 45.5 % as both food and medicine. The most frequently used plant life form was herbs (58.8%). The leaves are the most commonly used plant parts (59%). Most of the plants (58.8%) were semi cultivated and were being domesticated in crop fields and home gardens. Most of the plants were used to manage anaemia and for child development and good health among the pregnant women. The pregnant women and TBAs in Namungalwe sub County have diverse knowledge on medicinal and nutri-medicinal plants in the management of common pregnancy related diseases, which can be used to supplement modern antenatal services, inspite of the ban of the activities of TBA. Further research on the bioavailability of nutrients, efficacy and safety of the medicinal plants used by pregnant women should be done.

  19. Dietary assessment methods for micronutrient intake in elderly people: a systematic review

    NARCIS (Netherlands)

    Ortiz-Andrellucchi, A.; Sanzech-Villegas, A.; Doreste-Alonso, J.; Vries, de J.H.M.; Groot, de C.P.G.M.; Serra-Majem, L.

    2009-01-01

    The European micronutrient recommendations aligned (EURRECA) Network of Excellence seeks to establish clear guidelines for assessing the validity of reported micronutrient intakes among vulnerable population groups. A systematic literature review identified studies validating the methodology used in

  20. Enrichment of tropical peat with micronutrients for agricultural applications: evaluation of adsorption and desorption processes

    Energy Technology Data Exchange (ETDEWEB)

    Melo, Camila de A.; Oliveira, Lilian K. de; Fraceto, Leonardo F.; Rosa, Andre H., E-mail: ahrosa@sorocaba.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Sorocaba, SP (Brazil). Dept. de Engenharia Ambiental; Goveia, Danielle [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Araraquara, SP (Brazil). Inst. de Quimica

    2014-01-15

    The objective of this work was to evaluate the adsorption and desorption of micronutrients in tropical peats, from the perspective of potential agricultural applications. Adsorption experiments were performed at different pH values, using solutions containing individual and multiple metal ions. Maximum adsorption capacity occurred at pH 6.0, and the order of affinity was Cu > Fe > Co > Ni > Zn = Mn. Release of the micronutrients was evaluated at different pH values, using an aqueous medium as well as soil and plants. Release of the micronutrients was most efficient at pH 6.0, and followed the order: Fe > Zn > Mn > Co = Ni > Cu. Micronutrient release to the soil was accompanied by uptake by the plant. The use of tropical peat enriched with micronutrients could contribute to improved agricultural productivity, since the release profile of the micronutrients can effectively stimulate plant growth. (author)

  1. Expert meeting on Child Growth and Micronutrient Deficiencies--New Initiatives for Developing Countries to Achieve Millennium Development Goals: executive summary report.

    Science.gov (United States)

    Usfar, Avita A; Achadi, Endang L; Martorell, Reynaldo; Hadi, Hamam; Thaha, Razak; Jus'at, Idrus; Atmarita; Martianto, Drajat; Ridwan, Hardinsyah; Soekirman

    2009-01-01

    Undernutrition in early childhood has long-term physical and intellectual consequences. Improving child growth should start before the age of two years and be an integrated effort between all sectors, covering all aspects such as diet and nutrient intake, disease reduction, optimum child care, and improved environmental sanitation. To discuss these issues, the Indonesian Danone Institute Foundation organized an expert meeting on Child Growth and Micronutrient Deficiencies: New Initiatives for Developing Countries to Achieve Millennium Development Goals. The objective of the meeting was to have a retrospective view on child growth: lessons learned from programs to overcome under-nutrition in the developed countries and to relate the situation to the Indonesian context, as well as to discuss implications for future programs. Recommendations derived from the meeting include focus intervention on the window of opportunity group, re-activation of the Integrated Health Post at the village level, improvement of infant and young child feeding, expand food fortification intervention programs, strengthen supplementation programs with multi-micronutrient, and strengthening public and private partnership on food related programs.

  2. Prevalence of antenatal depressive symptoms among women in Sabah, Malaysia.

    Science.gov (United States)

    Mohamad Yusuff, Aza Sherin; Tang, Li; Binns, Colin W; Lee, Andy H

    2016-01-01

    To investigate the prevalence of antenatal depression and to assess whether the common risk factors identified in previous studies were applicable to women in Sabah, Malaysia. A prospective cohort study of 2072 women was conducted in Sabah during 2009-2010. Participants were recruited at 36-38 weeks of gestation to complete a self-administered questionnaire regarding their demographic, socioeconomic and health characteristics. The presence of depression was assessed using the validated Malay version of the Edinburgh Postnatal Depression Scale. The prevalence of antenatal depression was 13.8% [95% confidence interval (CI) 12.3%, 15.3%]. Women who were happy with the pregnancy [odds ratio (OR) 0.43, 95% CI 0.21, 0.89] and those with a planned pregnancy (OR 0.45, 95% CI 0.33, 0.60) were less likely to suffer from antenatal depression. Pregnant mothers who were taking oral contraceptives before pregnancy (OR 1.63, 95% CI 1.20, 2.22) and women who experienced antenatal anxiety (OR 3.17, 95% CI 2.35, 4.26) appeared to have an increased risk of antenatal depression. A substantial proportion of women suffered from antenatal depression in Sabah, Malaysia. Screening and culturally tailored intervention programs targeting vulnerable subgroups of women in the early stage of pregnancy are recommended to deal with the problem.

  3. Nutri-RecQuest: a web-based search engine on current micronutrient recommendations

    NARCIS (Netherlands)

    Cavelaars, A.J.E.M.; Kadvan, A.; Doets, E.L.; Tepsic, J.; Novakovic, R.N.; Dhonukshe-Rutten, R.A.M.; Renkema, M.; Glibetic, M.; Bucchini, L.; Matthys, C.; Smith, R.; Veer, van 't P.; Groot, de C.P.G.M.; Gurinovic, M.

    2010-01-01

    Background: The EURRECA (EURopean micronutrient RECommendations Aligned) Network of Excellence collated current micronutrient recommendations. A user-friendly tool, Nutri-RecQuest, was developed to allow access to the collated data and to create a database source for use in other nutritional

  4. Audit of antenatal care at a community health centre in Tshwane ...

    African Journals Online (AJOL)

    Objective: Few studies document the level of compliance with antenatal care protocols in primary health care in South Africa. The aim of this study was to conduct an audit of antenatal care at a community health centre in Tshwane North subdistrict in order to measure the level of compliance of maternity staff with antenatal ...

  5. Antenatal education in the transition to motherhood

    OpenAIRE

    Burley, Suzanne Elizabeth

    2003-01-01

    This thesis explores the relationship between antenatal education and the transition to motherhood, focusing on the pre-natal expectations and postnatal experiences of a small sample of first-time mothers in Plymouth. The aims of the study were 1) to investigate the style and content of statutory and voluntary sector antenatal classes in the Plymouth area. 2) To investigate factors affecting non-attendance, including non-attenders' perceptions of them. 3) To examine the role of...

  6. Micronutrient problems in Brazilian soils with special emphasis on zinc

    International Nuclear Information System (INIS)

    Stewart, J.W.B.; Neptune, A.M.L.; Sao Paulo Univ., Piracicaba

    1975-01-01

    Brazil, with approximately 50% of the total land area in South America, has areas in which different micronutrient deficiencies (zinc, boron, copper, iron, manganese and molybdenum) have been noted in specific crops. This paper reviews the published research on such deficiencies and puts special emphasis on zinc which appears to be the most widespread deficiency. The need for an integrated approach to determining the extent of micronutrient deficiencies is discussed. (author)

  7. Utilisation of Antenatal Services at the Provincial Hospital, Mongomo ...

    African Journals Online (AJOL)

    Utilisation of Antenatal Services at the Provincial Hospital, Mongomo, Guinea Equatoria. AAG Jimoh. Abstract. This prospective study was carried out to evaluate the utilisation of antenatal care at the Provincial Specialist Hospital, Mongomo, Guinea Equatoria, paying close attention to the confounding factors affecting ...

  8. Enhancing biohydrogen production through sewage supplementation of composite vegetable based market waste

    International Nuclear Information System (INIS)

    Mohanakrishna, G.; Kannaiah Goud, R.; Venkata Mohan, S.; Sarma, P.N.

    2010-01-01

    The function of domestic sewage supplementation as co-substrate with composite vegetable based market waste was studied during the process of fermentative hydrogen (H 2 ) production. Significant improvement in H 2 production and substrate degradation were noticed upon supplementing the waste with domestic sewage. Maximum H 2 production (cummulative) was observed at 5.2 kg COD/m 3 with pulp operation and 4.8 kg COD/m 3 with non-pulp operation accounting for improvement of 51 and 55% respectively after sewage upplementation. Substrate degradation was also found to improve with respect to both carbohydrates [8% (with pulp); 5% (non-pulp)] and chemical oxygen demand [COD, 12% (with pulp); 13% (non-pulp)] after adding domestic sewage. Specific H 2 yield improved especially at lower concentrations. Supplementation of waste with co-substrate helps to maintain good buffering microenvironment supports fermentation process and in addition provides micro-nutrients, organic matter and microbial biomass. Variation in the outlet pH was less in supplementation experiments compared to normal operation. (author)

  9. Anaemia Prevention In Pregnancy Among Antenatal Clinic Attendees In A General Hospital In Lagos.

    Science.gov (United States)

    Yesufu, B M; Olatona, F A; Abiola, A O; Ibrahim, M T O

    2013-01-01

    Anemia is the world's second leading cause of disability and thus one of the most serious global public health problems. The World Health Organization (WHO) estimates that an average of 56% of pregnant women in developing countries, are anaemic. This study was conducted to. determine the knowledge, attitude and practices of prevention of anaemia in pregnancy amongst pregnant women attending the Antenatal Clinic at Ifako-Ijaiye General Hospital. The design was cross-sectional descriptive study. Simple random sampling method was used to select two hundred and twenty respondents (220). A pretested, structured, interviewer administered questionnaires were used for data collection. Majority (95%) of the respondents was aware of anemia in pregnancy but the mean knowledge score was 56.5%. Less than half (46.3%) of the respondents thought that contraceptives could help prevent anemia in pregnancy by reducing closely spaced pregnancies. Only 31.8% were compliant with the use of iron supplements. About one third (33.2%) didn't combine drinking tea with meals while 47.3% of the respondents didn't use iron supplements with milk products. The study showed that most of the respondents had a moderate level of knowledge, and positive attitude towards contraceptive use but a high proportion were not compliant with the daily use of iron supplements. It is recommended that health education of women as well as close family members should be reinforced to improve the compliance with supplements.

  10. Adverse outcomes of poor micronutrient status in childhood and adolescence.

    Science.gov (United States)

    Viteri, Fernando E; Gonzalez, Horacio

    2002-05-01

    The adverse effects of micronutrient deficiencies and excesses in children up to reproductive age are presented. A summary of risks and adverse functional and health outcomes associated with deficient and excessive intakes and nutrition status of iron, iodine, zinc, vitamins A and D, folate, vitamin B12, and riboflavin is presented. Nutrient-nutrient interactions of micronutrients, age, gender, and other host and environmental conditions, such as pregnancy, genetic conditions, overall nutrition, force of infection, and social conditions are considered as covariates in trying to define causation and outcomes due to specific micronutrients. The outcomes analyzed focus on growth and development, mental and neuromotor performance, immunocompetence, physical working capacity, morbidity, and in the case of pregnancy, overall reproductive performance. The results presented include responses to specific and multiple "experimental" interventions. A brief analysis of possible public health programs is presented, with emphasis on prevention.

  11. Awareness of family planning amongst antenatal patients in a ...

    African Journals Online (AJOL)

    Aim: This study aimed at determining the awareness about family planning amongst pregnant women presenting to the antenatal clinic of Federal Medical Centre, Owo, Ondo State, Nigeria. Methodology: The study was conducted between December, 2007 and February, 2008 at the antenatal clinic of the hospital. Ethical ...

  12. Mobile phones improve antenatal care attendance in Zanzibar: a cluster randomized controlled trial

    Science.gov (United States)

    2014-01-01

    Background Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems. Antenatal care has the potential to reduce maternal morbidity and improve newborns’ survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality of care is declining. We evaluated the association between a mobile phone intervention and antenatal care in a resource-limited setting. We aimed to assess antenatal care in a comprehensive way taking into consideration utilisation of antenatal care as well as content and timing of interventions during pregnancy. Methods This study was an open label pragmatic cluster-randomised controlled trial with primary healthcare facilities in Zanzibar as the unit of randomisation. 2550 pregnant women (1311 interventions and 1239 controls) who attended antenatal care at selected primary healthcare facilities were included at their first antenatal care visit and followed until 42 days after delivery. 24 primary health care facilities in six districts were randomized to either mobile phone intervention or standard care. The intervention consisted of a mobile phone text-message and voucher component. Primary outcome measure was four or more antenatal care visits during pregnancy. Secondary outcome measures were tetanus vaccination, preventive treatment for malaria, gestational age at last antenatal care visit, and antepartum referral. Results The mobile phone intervention was associated with an increase in antenatal care attendance. In the intervention group 44% of the women received four or more antenatal care visits versus 31% in the control group (OR, 2.39; 95% CI, 1.03-5.55). There was a trend towards improved timing and quality of antenatal care services across all secondary outcome measures although not statistically significant. Conclusions The wired mothers’ mobile phone intervention significantly increased the proportion of women receiving the recommended four antenatal care

  13. Safety and benefits of antenatal oral iron supplementation in low-income countries

    NARCIS (Netherlands)

    Mwangi, Martin N.; Prentice, Andrew M.; Verhoef, Hans

    2017-01-01

    The World Health Organization recommends universal iron supplementation of 30-60 mg/day in pregnancy but coverage is low in most countries. Its efficacy is uncertain, however, and there has been a vigorous debate in the last decade about its safety, particularly in areas with a high burden of

  14. The effects of regular consumption of a multiple micronutrient fortified milk beverage on the micronutrient status of school children and on their mental and physical performance.

    Science.gov (United States)

    Kuriyan, Rebecca; Thankachan, Prashanth; Selvam, Sumithra; Pauline, Maria; Srinivasan, K; Kamath-Jha, Shilpa; Vinoy, Sophie; Misra, Situn; Finnegan, Yvonne; Kurpad, Anura V

    2016-02-01

    Multiple micronutrient deficiencies exist in school going children in India and bridging the gap between nutrient intake and requirements is an effective way to combat the deficiencies. This study aimed to test the effect of a multi-micronutrient fortified malt and cocoa based milk beverage on the micronutrient status, cognition, physical performance and nutritional deficiencies of 7-10 years old south Indian children. A randomized, double blind placebo controlled study design was used with normal healthy children from low to middle income families, aged 7-10 years randomly assigned to receive either a multi-micronutrient fortified or an unfortified milk based control drink. The drinks were provided 6 days/week for 5 months. Assessments included anthropometry, blood biochemistry, physical performance and cognition at baseline and endline. The baseline characteristics of the study groups were similar. The changes in body weight and height were similar between the groups at the end of the study. Levels of vitamin B12, red cell folate and vitamin B2 significantly improved in the intervention group, while vitamin D, selenium and body iron showed no difference. The Hemoglobin (Hb) and serum ferritin levels of the control group decreased at endline, while those in the intervention group maintained their levels. The serum transferrin receptor levels increased in both the groups. The prevalence of iron deficiency and Vitamin B2 deficiency were significantly lower in the intervention group at endline. Overall improvement in cognitive and physical performance was seen in both the groups at endline, with no significant differences between the groups. The micronutrient fortified milk based drink was efficacious in improving the micronutrient status of Vitamin B2, Vitamin B12 and red cell folate and in preventing a decline in Hb level compared to an unfortified milk based drink. It also reduced anemia and the risk of deficiencies of iron, and B12, in apparently healthy children

  15. The Impact of Antenatal Depression on Perinatal Outcomes in Australian Women.

    Directory of Open Access Journals (Sweden)

    John Eastwood

    Full Text Available In Australia, there is limited evidence on the impact of antenatal depression on perinatal outcomes. This study investigates the association between maternal depressive symptoms during pregnancy and key perinatal outcomes, including birth weight, gestational age at birth, breastfeeding indicators and postnatal depressive symptoms.A retrospective cohort of mothers (N = 17,564 of all infants born in public health facilities within South Western Sydney Local Health District and Sydney Local Health District in 2014, in the state of New South Wales (NSW, Australia, was enumerated from routinely collected antenatal data to investigate the risk of adverse perinatal outcomes associated with maternal depressive symptoms during pregnancy. Antenatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS. Logistic regression models that adjusted for confounders were conducted to determine associations between antenatal depressive symptoms and low birth weight, early gestational age at birth (<37 weeks, breast feeding indicators and postnatal depressive symptoms.The prevalence of maternal depressive symptoms during pregnancy was 7.0% in the cohort, and was significantly associated with postnatal depressive symptoms [Adjusted Odd Ratios (AOR = 6.4, 95% CI: 4.8-8.7, P<0.001]. Antenatal depressive symptoms was associated with a higher odds of low birth weight [AOR = 1.7, 95% CI: 1.2-2.3, P = 0.003] and a gestational age at birth of <37 weeks [AOR = 1.3, 95% CI: 1.1-1.7, P = 0.018] compared to women who reported lower EPDS scores in antenatal period. Antenatal depressive symptoms were not strongly associated with non-exclusive breast feeding in the early postnatal period.Maternal depressive symptoms in the antenatal period are strongly associated with postnatal depressive symptoms and adverse perinatal outcomes in Australian infants. Early identification of antenatal and postnatal depressive symptoms, and referral for appropriate

  16. Maternal multiple micronutrient supplementation and other biomedical and socioenvironmental influences on children's cognition at age 9-12 years in Indonesia: follow-up of the SUMMIT randomised trial.

    Science.gov (United States)

    Prado, Elizabeth L; Sebayang, Susy K; Apriatni, Mandri; Adawiyah, Siti R; Hidayati, Nina; Islamiyah, Ayuniarti; Siddiq, Sudirman; Harefa, Benyamin; Lum, Jarrad; Alcock, Katherine J; Ullman, Michael T; Muadz, Husni; Shankar, Anuraj H

    2017-02-01

    Brain and cognitive development during the first 1000 days from conception are affected by multiple biomedical and socioenvironmental determinants including nutrition, health, nurturing, and stimulation. An improved understanding of the long-term influence of these factors is needed to prioritise public health investments to optimise human development. We did a follow-up study of the Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT), a double-blind, cluster-randomised trial of maternal supplementation with multiple micronutrients (MMN) or iron and folic acid (IFA) in Indonesia. Of 27 356 live infants from birth to 3 months of age in 2001-04, we re-enrolled 19 274 (70%) children at age 9-12 years, and randomly selected 2879 from the 18 230 who were attending school at a known location. Of these, 574 children were oversampled from mothers who were anaemic or malnourished at SUMMIT enrolment. We assessed the effects of MMN and associations of biomedical (ie, maternal and child anthropometry and haemoglobin and preterm birth) and socioenvironmental determinants (ie, parental education, socioeconomic status, home environment, and maternal depression) on general intellectual ability, declarative memory, procedural memory, executive function, academic achievement, fine motor dexterity, and socioemotional health. The SUMMIT trial was registered, number ISRCTN34151616. Children of mothers given MMN had a mean score of 0·11 SD (95% CI 0·01-0·20, p=0·0319) higher in procedural memory than those given IFA, equivalent to the increase in scores with half a year of schooling. Children of anaemic mothers in the MMN group scored 0·18 SD (0·06-0·31, p=0·0047) higher in general intellectual ability, similar to the increase with 1 year of schooling. Overall, 18 of 21 tests showed a positive coefficient of MMN versus IFA (p=0·0431) with effect sizes from 0·00-0·18 SD. In multiple regression models, socioenvironmental determinants had coefficients

  17. Do Nutritional Supplements Have a Role in Age Macular Degeneration Prevention?

    Directory of Open Access Journals (Sweden)

    Maria D. Pinazo-Durán

    2014-01-01

    Full Text Available Purpose. To review the proposed pathogenic mechanisms of age macular degeneration (AMD, as well as the role of antioxidants (AOX and omega-3 fatty acids (ω-3 supplements in AMD prevention. Materials and Methods. Current knowledge on the cellular/molecular mechanisms of AMD and the epidemiologic/experimental studies on the effects of AOX and ω-3 were addressed all together with the scientific evidence and the personal opinion of professionals involved in the Retina Group of the OFTARED (Spain. Results. High dietary intakes of ω-3 and macular pigments lutein/zeaxanthin are associated with lower risk of prevalence and incidence in AMD. The Age-Related Eye Disease study (AREDS showed a beneficial effect of high doses of vitamins C, E, beta-carotene, and zinc/copper in reducing the rate of progression to advanced AMD in patients with intermediate AMD or with one-sided late AMD. The AREDS-2 study has shown that lutein and zeaxanthin may substitute beta-carotene because of its potential relationship with increased lung cancer incidence. Conclusion. Research has proved that elder people with poor diets, especially with low AOX and ω-3 micronutrients intake and subsequently having low plasmatic levels, are more prone to developing AMD. Micronutrient supplementation enhances antioxidant defense and healthy eyes and might prevent/retard/modify AMD.

  18. Influence of pregnancy perceptions on patterns of seeking antenatal ...

    African Journals Online (AJOL)

    To the women with a positive orientation towards antenatal care, pregnancy provides joy, happiness, pride, promotes their social status and safe-guards their marriage. Pregnancy is rewarding with care, love, support and gifts. Women who shun antenatal care perceive pregnancy to be a source of misery, sadness, pain and ...

  19. Factors associated with late antenatal care attendance in selected ...

    African Journals Online (AJOL)

    Background: Despite antenatal care services being provided free of charge or sometimes at a minimal cost in Zambia, only 19% of women attend antenatal care by their fourth month of pregnancy, as recommended by World Health Organization (WHO). An estimated 21% of pregnant women in urban and 18% in rural ...

  20. Antenatal Care and Skilled Birth Attendance in Three Communities ...

    African Journals Online (AJOL)

    Antenatal Care and Skilled Birth Attendance in Three Communities in Kaduna State, Nigeria. ... Most importantly, safer delivery options that would be acceptable in communities where women traditionally birth at home need to be explored (Afr. J. Reprod. Health 2010; 14[3]: 89-96). Key words: Antenatal care, skilled birth ...

  1. Interactions between leaf macro, micronutrients and soil properties in pistachio (Pistacia vera L.) orchards

    OpenAIRE

    Koukoulakis, Prodromos; Chatzissavvidis, Christos; Papadopoulos, Aristotelis; Pontikis, Dimitrios

    2013-01-01

    The interactions between: (i) leaf dry matter macronutrients, micronutrients and soil chemical properties, (ii) leaf macro- and micronutrients, (iii) soil macro- and micronutrients and (iv) soil chemical properties, and soil micro- and macronutrients in 50 pistachio orchards were investigated in leaves and soils by means of regression analysis. Most of the soils were deficient in plant-available P, Zn, Mn, Fe, and B, while they were excessively supplied with Cu. Leaf analysis showed that most...

  2. Habitual micronutrient intake during and after pregnancy in Caucasian Londoners.

    Science.gov (United States)

    Derbyshire, E; Davies, G J; Costarelli, V; Dettmar, P W

    2009-01-01

    Micronutrient status is of fundamental importance both upon conception and throughout pregnancy. There is an abundance of literature investigating nutrient intakes during individual trimesters of pregnancy but few studies have investigated baseline intakes of nutrients throughout gestation as a continuum. The current investigation set out to measure habitual micronutrient intakes at weeks 13, 25, 35 of pregnancy and 6 weeks postpartum using a prospective background information questionnaire, 4-7-day weighed food diary and postnatal questionnaire. Seventy-two primiparous, Caucasian Londoners were recruited at the study start with 42 completing the first, second, third trimester and postpartum study stages respectively. Study findings indicated that sodium intakes were significantly higher than UK guidelines throughout and after pregnancy (P pregnancy, but to varying levels of statistical significance (P health interventions may be required to help expectant mothers achieve an optimal diet, particularly after birth when dietary recommendations increase for some micronutrients.

  3. Measuring the adequacy of antenatal health care: a national cross-sectional study in Mexico.

    Science.gov (United States)

    Heredia-Pi, Ileana; Servan-Mori, Edson; Darney, Blair G; Reyes-Morales, Hortensia; Lozano, Rafael

    2016-06-01

    To propose an antenatal care classification for measuring the continuum of health care based on the concept of adequacy: timeliness of entry into antenatal care, number of antenatal care visits and key processes of care. In a cross-sectional, retrospective study we used data from the Mexican National Health and Nutrition Survey (ENSANUT) in 2012. This contained self-reported information about antenatal care use by 6494 women during their last pregnancy ending in live birth. Antenatal care was considered to be adequate if a woman attended her first visit during the first trimester of pregnancy, made a minimum of four antenatal care visits and underwent at least seven of the eight recommended procedures during visits. We used multivariate ordinal logistic regression to identify correlates of adequate antenatal care and predicted coverage. Based on a population-weighted sample of 9 052 044, 98.4% of women received antenatal care during their last pregnancy, but only 71.5% (95% confidence interval, CI: 69.7 to 73.2) received maternal health care classified as adequate. Significant geographic differences in coverage of care were identified among states. The probability of receiving adequate antenatal care was higher among women of higher socioeconomic status, with more years of schooling and with health insurance. While basic antenatal care coverage is high in Mexico, adequate care remains low. Efforts by health systems, governments and researchers to measure and improve antenatal care should adopt a more rigorous definition of care to include important elements of quality such as continuity and processes of care.

  4. Micronutrient Intake in the Etiology, Prevention and Treatment of Osteosarcopenic Obesity.

    Science.gov (United States)

    Kelly, Owen J; Gilman, Jennifer C; Kim, Youjin; Ilich, Jasminka Z

    2016-01-01

    Aging, chronic inflammation and/or many chronic conditions may result in loss of bone, loss of muscle and increased adiposity, manifested either overtly (overweight) or furtively as fat infiltration into bone and muscle. This combined condition has been identified as osteosarcopenic obesity. Micronutrients are required, not just to prevent deficiency diseases, but for optimal health and metabolic homeostasis. Further, micronutrients have multifunctional roles in the body. However, it is unknown if the micronutrient intake of the Western diet contributes to bone and muscle loss, increased adiposity, and ultimately osteosarcopenic obesity. The aim of this review is to examine the micronutrient intake using US National Health and Nutrition Examination Survey (NHANES) data, and explore if the insufficiencies, or excesses present contribute to the development of osteosarcopenic obesity in aging. First NHANES food intake data from 2002-2012 were obtained and transposed to Microsoft Excel for analysis. A literature search of PubMed and Medline for human data using combinations and synonyms of osteoporosis, sarcopenia and obesity, and each mineral and vitamin indicated as insufficient by NHANES. NHANES data suggested phosphorus, calcium, magnesium, potassium, iron, and vitamins B6/B12/C/A/D/E and K were candidates for further evaluation. 170 articles were included. While chronic single/multiple micronutrient insufficiency/excess is not studied in clinical trials, NHANES data suggest that they have existed for at least a decade. Examining the status and roles of those nutrients may be important to understanding the health issues associated with Western-type diets, including development of osteosarcopenic obesity.

  5. Antenatal care service utilization and associated factors in Metekel ...

    African Journals Online (AJOL)

    socioeconomic and some obstetric factors have been stated by few studies in other areas, the factors associated with low utilization of Antenatal care in Metekel Zone are not well assed before. Therefore, the objective of this study was to assess the status of Antenatal care service utilization and associated factors among ...

  6. A Risk Assessment Model for Bacterial Leaf Spot of Pepper (Capsicum annuum), Caused by Xanthomonas euvesicatoria, Based on Concentrations of Macronutrients, Micronutrients, and Micronutrient Ratios.

    Science.gov (United States)

    Dutta, B; Langston, D B; Luo, X; Carlson, S; Kichler, J; Gitaitis, R

    2017-11-01

    The phytopathogenic bacterium Xanthomonas euvesicatoria causes bacterial leaf spot (BLS) of pepper and has a worldwide distribution. BLS is difficult to control and an integrated management strategy that incorporates crop rotation, use of clean seed and clean plants, weed control, resistant varieties, applications of bactericides, biocontrol agents, and systemic acquired resistance (SAR) inducers is generally recommended. However, even with that arsenal of weapons, BLS can still be responsible for severe losses under favorable environmental conditions. Thus, additional tools need to be added to an overall integrated management strategy to combat BLS. In this article, we developed several models from 2012 to 2014 that were based on how macronutrients, micronutrients, and micronutrient ratios affect BLS severity. Factors used to select a model for validation included highly significant P values, high adjusted R 2 values, low variance inflation factor values (macronutrient and micronutrient concentrations affect plant disease resistance genes in the SAR pathway.

  7. Perception of prenatal services by antenatal clinic attendees in a ...

    African Journals Online (AJOL)

    DR ADDAH A.O

    2015-09-30

    Sep 30, 2015 ... also been recognised that most women who registered for antenatal care in a particular health ..... is not yet appropriate to embrace focused antenatal care.9 There are still gaps in the continued use of ... higher wages.

  8. Do multiple micronutrient interventions improve child health, growth, and development?

    Science.gov (United States)

    Ramakrishnan, Usha; Goldenberg, Tamar; Allen, Lindsay H

    2011-11-01

    Micronutrient deficiencies are common and often co-occur in many developing countries. Several studies have examined the benefits of providing multiple micronutrient (MMN) interventions during pregnancy and childhood, but the implications for programs remain unclear. The key objective of this review is to summarize what is known about the efficacy of MMN interventions during early childhood on functional outcomes, namely, child health, survival, growth, and development, to guide policy and identify gaps for future research. We identified review articles including meta-analyses and intervention studies that evaluated the benefits of MMN interventions (3 or more micronutrients) in children (growth. Two studies found no effects on child mortality. The findings for respiratory illness and diarrhea are mixed, although suggestive of benefit when provided as fortified foods. There is evidence from several controlled trials (>25) and 2 meta-analyses that MMN interventions improve hemoglobin concentrations and reduce anemia, but the effects were small compared to providing only iron or iron with folic acid. Two recent meta-analyses and several intervention trials also indicated that MMN interventions improve linear growth compared to providing a placebo or single nutrients. Much less is known about the effects on MMN interventions during early childhood on motor and mental development. In summary, MMN interventions may result in improved outcomes for children in settings where micronutrient deficiencies are widespread.

  9. Fertilization with filter cake and micronutrients in plant cane

    Directory of Open Access Journals (Sweden)

    Jaqueline Cristiane Adorna

    2013-06-01

    Full Text Available The response of sugarcane to application of micronutrients is still not very well known. In view of the need for this information, the aim of this study was to evaluate the application of the micronutrients Zn, Cu, Mn, Fe, B, and Mo to plant cane in three soils, with and without application of filter cake. This study consisted of three experiments performed in the State of São Paulo, Brazil, (in Igaraçu do Tiete, on an Oxisol; in Santa Maria da Serra, on an Entisol, both in the 2008/2009 growing season; and in Mirassol, on an Ultisol, in the 2009/2010 growing season in a randomized block design with four replications with a 8 x 2 factorial combination of micronutrients (1 - no application/control, 2 - addition of Zn, 3 - addition of Cu, 4 - addition of Mn 5 - addition of Fe, 6 - addition of B, 7 - addition of Mo, 8 - Addition of Zn, Cu, Mn, Fe, B, and Mo and filter cake (0 and 30 t ha-1 of filter cake in the furrow at planting. The application of filter cake was more efficient than of Borax in raising leaf B concentration to sufficiency levels for sugarcane in the Entisol, and it increased mean stalk yield in the Oxisol. In areas without filter cake application, leaf concentrations were not affected by the application of Zn, Cu, Mn, Fe, B, and Mo in the furrow at planting; however, Zn and B induced an increase in stalk and sugar yield in micronutrient-poor sandy soil.

  10. Current micronutrient recommendations in Europe: towards understanding their differences and similarities.

    Science.gov (United States)

    Doets, Esmée L; de Wit, Liesbeth S; Dhonukshe-Rutten, Rosalie A M; Cavelaars, Adriënne E J M; Raats, Monique M; Timotijevic, Lada; Brzozowska, Anna; Wijnhoven, Trudy M A; Pavlovic, Mirjana; Totland, Torunn Holm; Andersen, Lene F; Ruprich, Jiri; Pijls, Loek T J; Ashwell, Margaret; Lambert, Janet P; van 't Veer, Pieter; de Groot, Lisette C P G M

    2008-04-01

    Nowadays most countries in Europe have established their own nutrient recommendations to assess the adequacy of dietary intakes and to plan desirable dietary intakes. As yet there is no standard approach for deriving nutrient recommendations, they may vary from country to country. This results in different national recommendations causing confusion for policy-makers, health professionals, industry, and consumers within Europe. EURRECA (EURopean micronutrient RECommendations Aligned) is a network of excellence funded by the European Commission (EC), and established to identify and address the problem of differences between countries in micronutrient recommendations. The objective of this paper is to give an overview of the available micronutrient recommendations in Europe, and to provide information on their origin, concepts and definitions. Furthermore this paper aims to illustrate the diversity in European recommendations on vitamin A and vitamin D, and to explore differences and commonalities in approaches that could possibly explain variations observed. A questionnaire was developed to get information on the process of establishing micronutrient recommendations. These questionnaires were sent to key informants in the field of micronutrient recommendations to cover all European countries/regions. Also the latest reports on nutrient recommendations in Europe were collected. Standardisation procedures were defined to enable comparison of the recommendations. Recommendations for vitamin A and vitamin D were compared per sex at the ages 3, 9 months and 5, 10, 15, 25, 50 and 70 years. Information extracted from the questionnaires and reports was compared focusing on: (1) The concept of recommendation (recommended daily allowance (RDA), adequate intake (AI) or acceptable range), (2) The year of publication of the report (proxy for available evidence), (3) Population groups defined, (4) Other methodological issues such as selected criteria of adequacy, the type of

  11. Dietary diversity scores: an indicator of micronutrient inadequacy instead of obesity for Chinese children.

    Science.gov (United States)

    Zhao, Wenzhi; Yu, Kai; Tan, Shengjie; Zheng, Yingdong; Zhao, Ai; Wang, Peiyu; Zhang, Yumei

    2017-05-12

    Micronutrient malnutrition affects the well-being of both adults and children. Dietary diversity score (DDS) is a useful evaluation index with a relatively well-developed guideline by FAO. It's meaningful to assess and predict inadequate micronutrient intakes using DDS in Chinese children, after ruling out the risk of obesity coming with more dietary diversity. Data for evaluation were extracted from the Nutrition Study of Preschool Children and School Children, which is a cross-sectional study covering 8 cities of China, including 1694 children in kindergartens and primary schools. This study applied DDS to Chinese children to test the validity for micronutrient inadequacy, and then explored the relationship between dietary diversity and obesity. It reveals that dietary diversity varied with age and place of residence; the older ones and the ones living in rural areas tend to have poorer dietary diversity. Another discovery is that DDS is positively correlated with indicators of micronutrient adequacy, with a score of 6-8 indicating the lowest risk of micronutrient inadequacy in different groups of children. In our study population, dietary diversity is not related with obesity. Dietary diversity score is a valid indicator to evaluate micronutrient inadequacy in Chinese children, though there is still room for improvement of the method. Besides, the relationship between increase of dietary diversity and risk of obesity should be treated circumspectly.

  12. The effect of antenatal education in small classes on obstetric and psycho-social outcomes

    DEFF Research Database (Denmark)

    Brixval, Carina Sjöberg; Axelsen, Solveig Forberg; Andersen, Stig Krøger

    2014-01-01

    The aims of antenatal education contain both outcomes related to pregnancy, birth and parenthood. Both content and methods of antenatal education have changed over time without evidence of effects on relevant outcomes. The effect of antenatal education in groups, with participation of a small num......-analysis aims to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes....

  13. The association between maternal dietary micronutrient intake and neonatal anthropometry - secondary analysis from the ROLO study.

    LENUS (Irish Health Repository)

    Horan, Mary K

    2015-01-01

    Micronutrients are necessary for fetal growth. However increasingly pregnant women are nutritionally replete and little is known about the effect of maternal micronutrient intakes on fetal adiposity in mothers with increased BMI. The aim of this study was to examine the association of maternal dietary micronutrient intake with neonatal size and adiposity in a cohort at risk of macrosomia.

  14. Social capital and antenatal depression among Chinese primiparas: A cross-sectional survey.

    Science.gov (United States)

    Zhou, Chi; Ogihara, Atsushi; Chen, Hao; Wang, Weijue; Huang, Liu; Zhang, Baodan; Zhang, Xueni; Xu, Liangwen; Yang, Lei

    2017-11-01

    The aim of this study is to investigate the associations between social capital and antenatal depression among Chinese primiparas. A cross-sectional design was used and a questionnaire survey was conducted with 1471 participants using the intercept method at the provincial hospital in Zhejiang in 2016. Antenatal depression was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) and social capital was assessed by the Chinese version of Social Capital Assessment Questionnaire (C-SCAQ). The prevalence of antenatal depression was assessed among Chinese primiparas in their third trimesters. The antenatal depression prevalence among sub-groups with lower social trust (ST), social reciprocity (SR), social network (SN), and social participation (SP) were significantly higher than those among higher score sub-groups. In the fully adjusted model, primiparas' antenatal depression was significantly associated with ST, SR, SN, and SP. Compared to the structural social capital, the cognitive social capital was a more crucial dimension to the prevalence of antenatal depression. For future community pregnancy health care management programs in China, it might be beneficial to add more social capital related intervention. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. On-site screening for maternal syphilis in an antenatal clinic

    African Journals Online (AJOL)

    Abstract Study objective. To determine the sensitivity, specificity, negative predictive value and positive predictive value of the rapid plasma reagin (RPR) test as performed on site in an antenatal clinic to facilitate immediate diagnosis and treatment of maternal syphilis. Design. Open, descriptive study. Setting. Antenatal ...

  16. On-site screening for maternal syphilis in an antenatal clinic ...

    African Journals Online (AJOL)

    Study objective. To determine the sensitivity, specificity, negative predictive value and positive predictive value of the rapid plasma reagin (RPR) test as performed on site in an antenatal clinic to facilitate immediate diagnosis and treatment of maternal syphilis. Design. Open, descriptive study. Setting. Antenatal clinic ...

  17. Micronutrient malnutrition and wasting in adults with pulmonary tuberculosis with and without HIV co-infection in Malawi

    Directory of Open Access Journals (Sweden)

    Clark Tamara D

    2004-12-01

    Full Text Available Abstract Background Wasting and micronutrient malnutrition have not been well characterized in adults with pulmonary tuberculosis. We hypothesized that micronutrient malnutrition is associated with wasting and higher plasma human immunodeficiency virus (HIV load in adults with pulmonary tuberculosis. Methods In a cross-sectional study involving 579 HIV-positive and 222 HIV-negative adults with pulmonary tuberculosis in Zomba, Malawi, anthropometry, plasma HIV load and plasma micronutrient concentrations (retinol, α-tocopherol, carotenoids, zinc, and selenium were measured. The risk of micronutrient deficiencies was examined at different severity levels of wasting. Results Body mass index (BMI, plasma retinol, carotenoid and selenium concentrations significantly decreased by increasing tertile of plasma HIV load. There were no significant differences in plasma micronutrient concentrations between HIV-negative individuals and HIV-positive individuals who were in the lowest tertile of plasma HIV load. Plasma vitamin A concentrations Conclusions These data demonstrate that wasting and higher HIV load in pulmonary tuberculosis are associated with micronutrient malnutrition.

  18. Prognostic accuracy of antenatal neonatology consultation.

    Science.gov (United States)

    Kukora, S; Gollehon, N; Weiner, G; Laventhal, N

    2017-01-01

    Neonatologists provide antenatal counseling to support shared decision-making for complicated pregnancies. Poor or ambiguous prognostication can lead to inappropriate treatment and parental distress. We sought to evaluate the accuracy of antenatal prognosticaltion. A retrospective cohort was assembled from a prospectively populated database of all outpatient neonatology consultations. On the basis of the written consultation, fetuses were characterized by diagnosis groups (multiple anomalies or genetic disorders, single major anomaly and obstetric complications), assigned to five prognostic categories (I=survivable, IIA=uncertain but likely survivable, II=uncertain, IIB=uncertain but likely non-survivable, III non-survivable) and two final outcome categories (fetal demise/in-hospital neonatal death or survival to hospital discharge). When possible, status at last follow-up was recorded for those discharged from the hospital. Prognostic accuracy was assessed using unweighted, multi-level likelihood ratios (LRs). The final cohort included 143 fetuses/infants distributed nearly evenly among the three diagnosis groups. Over half (64%) were assigned an uncertain prognosis, but most of these could be divided into 'likely survivable' or 'likely non-survivable' subgroups. Overall survival for the entire cohort was 62% (89/143). All but one of the fetuses assigned a non-survivable prognosis suffered fetal demise or died before hospital discharge. The neonatologist's antenatal prognosis accurately predicted the probability of survival by prognosis group (LR I=4.56, LR IIA=10.53, LR II=4.71, LR IIB=0.099, LR III=0.040). The LRs clearly differentiated between fetuses with high and low probability of survival. Eleven fetuses (7.7%) had misalignment between the predicted prognosis and outcome. Five died before discharge despite being given category I or IIA prognoses, whereas six infants with category IIB or III prognoses survived to discharge, though some of these were

  19. Poor micronutrient intake and status is a public health problem among adolescent Mozambican girls.

    Science.gov (United States)

    Korkalo, Liisa; Freese, Riitta; Alfthan, Georg; Fidalgo, Lourdes; Mutanen, Marja

    2015-08-01

    Micronutrient deficiencies can damage the health of adolescent girls and their offspring. There is a lack of population-based data on the micronutrient status of adolescents in Sub-Saharan Africa. We conducted a cross-sectional, population-based study to examine the biochemical status, prevalence of deficiency, dietary intake, and food sources of selected micronutrients among adolescent girls in Central Mozambique. Separate groups of study participants were recruited in 2 seasons in 2010. The participants were girls between 14 and 19 years of age (n = 551) from 1 urban area and 2 rural districts. Micronutrient status indicators were analyzed from blood and urine samples. Twenty-four-hour dietary recalls were also carried out. The overall prevalence with 95% confidence interval (calculated using sampling weights) among nonpregnant girls was 42.4% (37.2%-47.8%; n = 466) for anemia, 27.4% (23.1%-32.2%; n = 427) for low serum ferritin, 32.7% (27.7%-38.1%; n = 423) for low serum zinc, 14.7% (11.2%-19.0%; n = 426) for low plasma retinol, and 4.1% (2.9%-5.8%; n = 448) for low serum folate. The selenium status was considered sufficient. Mild to moderate iodine deficiency was found in the rural districts, whereas the iodine status of urban girls was adequate. Significantly lower serum folate concentrations were found in the urban area compared to the rural districts. The seasonal differences in vitamin A intake were significant. The intakes of micronutrients from animal source foods were small. In summary, adolescent Mozambican girls are at risk of several micronutrient deficiencies. This raises concern especially because adolescent motherhood is common in the region. Actions need to be taken to prevent and control micronutrient deficiencies. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. IOC consensus statement: dietary supplements and the high-performance athlete

    Science.gov (United States)

    Maughan, Ronald J; Burke, Louise M; Dvorak, Jiri; Larson-Meyer, D Enette; Peeling, Peter; Rawson, Eric S; Walsh, Neil P; Garthe, Ina; Geyer, Hans; Meeusen, Romain; van Loon, Lucas J C; Shirreffs, Susan M; Spriet, Lawrence L; Stuart, Mark; Vernec, Alan; Currell, Kevin; Ali, Vidya M; Budgett, Richard GM; Ljungqvist, Arne; Mountjoy, Margo; Pitsiladis, Yannis P; Erdener, Uğur; Engebretsen, Lars

    2018-01-01

    Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition programme. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including (1) the management of micronutrient deficiencies, (2) supply of convenient forms of energy and macronutrients, and (3) provision of direct benefits to performance or (4) indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can benefit the athlete, but others may harm the athlete’s health, performance, and/or livelihood and reputation (if an antidoping rule violation results). A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome and habitual diet. Supplements intended to enhance performance should be thoroughly trialled in training or simulated competition before being used in competition. Inadvertent ingestion of substances prohibited under the antidoping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete’s health and awareness of the potential for harm must be paramount; expert professional opinion and assistance is strongly advised before an athlete embarks on supplement use. PMID:29540367

  1. IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete.

    Science.gov (United States)

    Maughan, Ronald J; Burke, Louise M; Dvorak, Jiri; Larson-Meyer, D Enette; Peeling, Peter; Phillips, Stuart M; Rawson, Eric S; Walsh, Neil P; Garthe, Ina; Geyer, Hans; Meeusen, Romain; van Loon, Luc; Shirreffs, Susan M; Spriet, Lawrence L; Stuart, Mark; Vernec, Alan; Currell, Kevin; Ali, Vidya M; Budgett, Richard G M; Ljungqvist, Arne; Mountjoy, Margo; Pitsiladis, Yannis; Soligard, Torbjørn; Erdener, Uğur; Engebretsen, Lars

    2018-03-01

    Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition program. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including the management of micronutrient deficiencies, supply of convenient forms of energy and macronutrients, and provision of direct benefits to performance or indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can offer benefits to the athlete, but others may be harmful to the athlete's health, performance, and/or livelihood and reputation if an anti-doping rule violation results. A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome, and habitual diet. Supplements intended to enhance performance should be thoroughly trialed in training or simulated competition before implementation in competition. Inadvertent ingestion of substances prohibited under the anti-doping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete's health and awareness of the potential for harm must be paramount, and expert professional opinion and assistance is strongly advised before embarking on supplement use.

  2. Influence of Antenatal Care on the Haematocrit Value of Pregnant ...

    African Journals Online (AJOL)

    Context: Antenatal care is generally believed to influence the outcome of any pregnancy. Haematocrit values are important in the assessment of anaemia in pregnancy. A good antenatal care is expected to be associated with good haematocrit values, prevent anaemia in pregnancy, and result in an overall good pregnancy ...

  3. Importance of vitamin and mineral supplementation in HIV/AIDS patients to improve their nutritional and immunological status

    International Nuclear Information System (INIS)

    Oguntibeju, O.O.; Schalkwyk, F.V; Heever, WMJ. V.den.; Veldman, F.J.

    2003-01-01

    Nutrition intervention aimed at preventing or reversing weight loss and wasting in HIV infection may help to improve quality of life and prolong survival. Micronutrient supplementation may help to strengthen the immune system and reduce the severity and impact of opportunistic infections in people living with HIV / AIDS. HIV contributes to malnutrition for physiological reasons related to the infection itself. HIV /AIDS, being a disease of the immune system, new strategies, including specific dietary nutrients (nutrient supplementation) to improve immune functions, quality of life and prolong survival in infected individuals, could provide additional/alternative approaches for therapeutic treatment in HIV infected subjects. Several vitamins and minerals are important in fighting HIV infection and its resultant effects, hence nutritional supplementation has been advocated. This review focuses on the importance of vitamin/mineral supplementation in HIV / AIDS subjects. (author)

  4. Antioxidant micronutrients as intersectoral link between health and ...

    African Journals Online (AJOL)

    Antioxidant micronutrients as intersectoral link between health and agriculture. ... desirable by helping to prevent disease, promoting health and improving the ... for sustainable development of which health should be a goal (Afr. J. Biomed.

  5. Common micronutrient deficiencies among food aid beneficiaries ...

    African Journals Online (AJOL)

    Results: Vitamin A and iron deficiencies were the most prevalent micronutrient deficiencies among food aid beneficiaries. Other probable deficiencies prevailing were zinc, vitamins thiamine, riboflavin, niacin folate, cyano-cobalamine, ascorbic acid vitamin D and calcium because of the low intake of dairy products and meat.

  6. Antenatal mother–infant bonding scores are related to maternal reports of infant crying behaviour

    NARCIS (Netherlands)

    Kommers, D.R.; Truijens, S.E.M.; Oei, S.G.; Bambang Oetomo, S.; Pop, V.J.M.

    2017-01-01

    Objective: To assess the relation between antenatal mother–infant bonding scores and maternal reports of infant crying behaviour. Background: Crying is normal behaviour and it is important for parent–infant bonding. Even though bonding starts antenatally, the relation between antenatal bonding

  7. Pattern of Family Planning Methods used by Antenatal Patients in ...

    African Journals Online (AJOL)

    This study aimed at assessing the pattern of family planning methods used by antenatal patients at Federal Medical Centre, Owo, Ondo State, Nigeria. The study was conducted between December,2007 and February,2008 at the antenatal clinic of the hospital. Ethical clearance was obtained from the Ethical committee of ...

  8. Adsorption and release of micronutrients by humin extracted from peat samples

    Energy Technology Data Exchange (ETDEWEB)

    Goveia, Danielle; Melo, Camila de A.; Oliveira, Lilian K. de; Rocha, Julio Cesar [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Araraquara, SP (Brazil). Instituto de Quimica; Fraceto, Leonardo F.; Rosa, Andre Henrique, E-mail: ahrosa@sorocaba.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Sorocaba, SP (Brazil). Departamento de Engenharia Ambiental; Dias Filho, Newton Luiz [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Ilha Solteira, SP (Brazil). Departamento de Fisica e Quimica

    2013-05-15

    The objective of this work was to investigate the adsorption of micronutrients in humin and to verify the ability to release these elements in water. The first step was to determine the adsorption capacity of humin for several essential plant micronutrients and check the kinetic parameters. The order of adsorption was Zn < Ni < Co < Mn < Mo < Cu < Fe, whereas Zn showed maximum values of ca. 2.5 mg g-1 and Fe values of ca. 0.5 mg g-1 for systems containing 1 g of humin. Iron presented higher percentages of release (ca. 100%) and Co the lowest percentages (0.14%). The findings suggested that the use of humin enriched with micronutrients can be a promising alternative for the fertilization of agricultural soils, with the additional benefit of incorporating organic matter present in the form of humic substances into the soil and improving the agricultural productivity. (author)

  9. Using Spent Mushroom Substrate as the Base for Organic-Mineral Micronutrient Fertilizer – Field Tests on Maize

    Directory of Open Access Journals (Sweden)

    Łukasz Tuhy

    2015-07-01

    Full Text Available Spent mushroom substrate (SMS is a noxious byproduct of the mushroom industry. The aim of this work was to convert SMS into organic-mineral micronutrient (Zn(II, Mn(II, and Cu(II fertilizer via biosorption and examine the effect of its application in field tests on maize compared to commercial reference micronutrient fertilizer. Crop yield and crop quality were assessed, and multielemental analysis of grains was conducted for the evaluation of the fertilization effect on maize grains and to assess bioavailability of nutrients from fertilizers. Grain yield for maize treated with micronutrients delivered with SMS was noticeably higher (11.5% than the untreated group and the NPK (nitrogen, phosphorus, potassium fertilizer treated only group (2.8%. Bioavailability (TF of micronutrients from SMS were comparable with reference micronutrient fertilizer (7% Zn, 4% Mn, and 2.3% Cu. The new product has the potential to be used as a micronutrient fertilizer. Satisfactory results of grain yield (6.4 Mg ha-1, high content of micronutrients (Zn 1.6%, Mn 1.2%, and Cu 1.8%, and macronutrients (P 1.0%, S 3.1%, Ca 8.2%, and K 0.2% were observed. The bioavailability suggests that enriched SMS could be a good alternative to fertilizers in the present market.

  10. Siderophore production by mycorrhizal sorghum roots under micronutrient deficient condition

    Directory of Open Access Journals (Sweden)

    N. Aliasgharzad

    2009-05-01

    Full Text Available It has widely been accepted that mycorrhizal symbiosis improves micronutrients uptake by most of the plants. In this study, sorghum (Sorghum bicolor L. plants were grown in sterile perlite and were inoculated with either Glomus etunicatum (GE or G.intraradices (GI, while the control set was left un-inoculated. Rorison's nutrient solution with three levels of 0, half and full strength (C0, C0.5 and C1, respectively of Fe, Cu, Zn and Mn was applied to the pots during 85 days of growth period. Chrome azurol-S assay was used for determination of siderophores in root leachates on 45, 65 and 85 days after sowing (DAS. Siderophore production per unit volume of root was higher in mycorrhizal than non-mycorrhizal plants. Both GE and GI were efficient fungi in this respect. Siderophore production was significantly induced at C0 level of the micronutrients. Amount of siderophores produced on 45 and 85 DAS was more than 65 DAS. Mycorrhizal root colonization by GE or GI was not significantly affected by micronutrient levels.

  11. HIV testing and treatment in the antenatal care setting.

    LENUS (Irish Health Repository)

    Coulter-Smith, S

    2010-01-01

    Routine linked HIV antenatal screening, with "opt-out", was introduced at the Rotunda in January 1998. This paper reviews the screening and subsequent pregnancy management and outcome in HIV positive women from 1998 to 2006. During this time 225 women (280 pregnancies) were HIV positive and 194 women subsequently delivered at the Rotunda, representing 233 liveborn infants. Overall anti-HIV prevalence was 0.42%, increasing from 0.06% in 1998 to 0.57% in 2006. Of 233 livebirths, 111 (48%) were delivered by spontaneous vaginal delivery (SVD). HIV treatment was started pre-pregnancy in 14 (6%) pregnancies and antenatally in 208 (90%). The vertical transmission rate in mothers receiving >4 weeks of treatment was 0%. We conclude that routine antenatal HIV screening is effective and significantly benefits the health of mother and child.

  12. HIV testing and treatment in the antenatal care setting.

    LENUS (Irish Health Repository)

    Coulter-Smith, S

    2012-02-01

    Routine linked HIV antenatal screening, with "opt-out", was introduced at the Rotunda in January 1998. This paper reviews the screening and subsequent pregnancy management and outcome in HIV positive women from 1998 to 2006. During this time 225 women (280 pregnancies) were HIV positive and 194 women subsequently delivered at the Rotunda, representing 233 liveborn infants. Overall anti-HIV prevalence was 0.42%, increasing from 0.06% in 1998 to 0.57% in 2006. Of 233 livebirths, 111 (48%) were delivered by spontaneous vaginal delivery (SVD). HIV treatment was started pre-pregnancy in 14 (6%) pregnancies and antenatally in 208 (90%). The vertical transmission rate in mothers receiving >4 weeks of treatment was 0%. We conclude that routine antenatal HIV screening is effective and significantly benefits the health of mother and child.

  13. Antenatal care visits and pregnancy outcomes at a Kenyan rural ...

    African Journals Online (AJOL)

    Background: The goal of antenatal care (ANC) is to improve maternal and neonatal outcomes. Fewer ANC visits in focused antenatal care (FANC) model can affect maternal and perinatal outcomes in low income settings where the number ANC visits are often low. Objective: To determine the number of ANC visits and their ...

  14. Optimizing micronutrient intake of lactating women through ...

    African Journals Online (AJOL)

    Increasing consumption of wild edible plants, which are micronutrient rich, easy to grow, and culturally familiar, has been recommended to combat these deficiencies, but there is a gap in knowledge on which ... This data can provide policy makers with the information necessary to formulate effective nutritional interventions.

  15. Randomised controlled trial to test the effectiveness of a locally-produced ready-to-use supplementary food (RUSF) in preventing growth faltering and improving micronutrient status for children under two years in Cambodia

    DEFF Research Database (Denmark)

    Borg, Bindi; Mihrshahi, Seema; Griffin, Mark

    2018-01-01

    -based nutrient supplement (LNS) has been developed for use as an RUSF. Unlike most RUSFs, which contain milk, this product contains fish as the animal protein. Few RUSFs have been formulated using non-milk animal-source foods and they have not been widely tested. An acceptability trial that was conducted......-needed data on the effectiveness of supplementary foods with an animal-source food other than milk, by comparing a novel RUSF based on fish to one that uses milk (CSB++). Moreover, it will deepen the understanding of the impact of multiple micronutrients provided with or without macronutrients, by comparing......Background: Existing ready-to-use supplementary and therapeutic foods (RUSFs and RUTFs) have had limited acceptance and effectiveness in Cambodia. This has hampered the treatment and prevention of child malnutrition. An innovative, locally produced, multiple micronutrient fortified lipid...

  16. Education and micronutrient deficiencies: an ecological study exploring interactions between women's schooling and children's micronutrient status.

    Science.gov (United States)

    Harding, Kassandra L; Aguayo, Victor M; Masters, William A; Webb, Patrick

    2018-04-10

    Formal education can be a nutrition-sensitive intervention that supports the scale-up and impact of nutrition-specific actions. Maternal education has long been linked to child survival, growth, and development while adult earnings and nutrition are tied to years in school as a child. However, less is known about the relationship between maternal education and the micronutrient status of children, women and the general population. Using country-level data and an ecological study design, we explored the global associations between women's educational attainment and: a) anemia and vitamin A deficiency (VAD) in children aged 6-59 months; b) anemia in non-pregnant women; and c) zinc deficiency, urinary iodine excretion (UIE), and the proportion of infants protected against iodine deficiency in the general population Cross-sectional relationships (2005-2013) were assessed using linear regression models. Percentage of women without schooling was negatively associated with all outcomes. Number of years of schooling among women was positively associated with all outcomes except for UIE and the proportion of infants protected against iodine deficiency. Income level was a significant effect modifier of the effect of years of women's schooling on child anemia as well as of the proportion of women without formal education on zinc deficiency in the population. The relationship was strongest in low-income countries for child anemia, and was not significant in upper middle-income countries. For zinc deficiency, the relationship was not significant in low or lower middle income countries, which may suggest that a minimum threshold of resources needs to be reached before education can influence zinc status. While relationships between maternal schooling and micronutrient outcomes vary around the globe, more schooling is generally linked to lower rates of deficiency. These findings draw policy-relevant connections between formal education and anemia and micronutrient status

  17. Analysis of socioeconomic differences in the quality of antenatal services in low and middle-income countries (LMICs.

    Directory of Open Access Journals (Sweden)

    Joshua Amo-Adjei

    Full Text Available The desired results of increasing access and availability of antenatal care (ANC services may not be realized if the quality of care offered is not adequate. We analyzed the content/quality of antenatal care to determine whether there are socioeconomic (education and wealth inequalities in the services provided in 59 low and middle income countries in six WHO regions-Africa, East Asia and Pacific, Europe and Central Asia, Latin America and Caribbean, Middle East and South Asia. We aggregated the most recent (2005-2015 Demographic and Health Survey for each country. The quality of content was measured on eight recommended ANC services-(1 monitoring of blood pressure; (2 tetanus injection; (3 urine analysis for protein; (4 blood test; (5 information about danger signs (6; weight (7; height measurements and (8 provision of iron-folate supplement. Descriptive and Poisson regression techniques were applied to analyse the data. We found considerable wealth and educational differences prior to controlling for known covariates. Between wealth and education, however, the disparities in the latter are larger than the former. Whereas the socioeconomic differences remained at post adjusting for residence, place and number of antenatal care, parity and region, the magnitude of change was minimal. Higher number of ANC content was provided in "other" forms of private facilities; the Latin America and Caribbean region recorded the highest number of content compared to the other regions. The hypothesized socioeconomic status on content/number of ANC services was generally supported, although the associations are substantially constrained to other variables. Efforts are made to increase the number and timing of ANC services; due recognition is needed for the content offered.

  18. Micronutrient recommendations and policies in Spain: the cases of iodine, folic acid and vitamin D.

    Science.gov (United States)

    Brito Garcia, N; Serra Majem, L

    2012-01-01

    INTRODUCCIÓN: As part of the work carried out within the EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence in Spain, we conducted a series of semi-structured interviews with decision makers and relevant scientific institutions in the field of nutrition and public health. The information gathered was collated with national relevant official and unofficial documents and subsequently analysed. To describe the current situation about nutrition policy in Spain, with special focus on the process of setting micronutrient recommendations and the development of subsequent policies. 3 cases will be detailed: iodine, folic acid and vitamin D. Information from 9 interviews was contrasted with the available official and unofficial documents on micronutrients recommendations setting and subsequent policy applications to help the population to achieve their requirements. Common topics and themes were identified in the interviews and desk research. They describe a heterogenic picture of isolated initiatives and timid measures regarding micronutrients recommendations and subsequent policy instruments. Several recommendations coexist but none of them is the result of an official request by the government or competent authority. Iodine, folic acid and vitamin D represent the past, the present and the future of public health policy measures on micronutrients in Spain. Despite of some examples, there exist a need for action. Current nutrition strategies are focused on obesity, with little room for micronutrients national measures despite of the opinion of many experts. Regardless of the several nutrients recommendations coexisting nowadays in Spain, there exist the need for a coordinated action in the field of micronutrients recommendations, fostered by the health and nutrition official authorities with financial support and clear terms of reference.

  19. the role of industry in micronutrient intervention programmes

    African Journals Online (AJOL)

    food industry, the media, consumer groups, and donor c· agencies, all of which must ... programmes and make them self-supporting and sustainable. The following ... Development of micronutrient product forms which are suitable for food ...

  20. Prevalence of Novel MAGED2 Mutations in Antenatal Bartter Syndrome.

    Science.gov (United States)

    Legrand, Anne; Treard, Cyrielle; Roncelin, Isabelle; Dreux, Sophie; Bertholet-Thomas, Aurélia; Broux, Françoise; Bruno, Daniele; Decramer, Stéphane; Deschenes, Georges; Djeddi, Djamal; Guigonis, Vincent; Jay, Nadine; Khalifeh, Tackwa; Llanas, Brigitte; Morin, Denis; Morin, Gilles; Nobili, François; Pietrement, Christine; Ryckewaert, Amélie; Salomon, Rémi; Vrillon, Isabelle; Blanchard, Anne; Vargas-Poussou, Rosa

    2018-02-07

    Mutations in the MAGED2 gene, located on the X chromosome, have been recently detected in males with a transient form of antenatal Bartter syndrome or with idiopathic polyhydramnios. The aim of this study is to analyze the proportion of the population with mutations in this gene in a French cohort of patients with antenatal Bartter syndrome. The French cohort of patients with antenatal Bartter syndrome encompasses 171 families. Mutations in genes responsible for types 1-4 have been detected in 75% of cases. In patients without identified genetic cause ( n =42), transient antenatal Bartter syndrome was reported in 12 cases. We analyzed the MAGED2 gene in the entire cohort of negative cases by Sanger sequencing and retrospectively collected clinical data regarding pregnancy as well as the postnatal outcome for positive cases. We detected mutations in MAGED2 in 17 patients, including the 12 with transient antenatal Bartter syndrome, from 16 families. Fifteen different mutations were detected (one whole deletion, three frameshift, three splicing, three nonsense, two inframe deletions, and three missense); 13 of these mutations had not been previously described. Interestingly, two patients are females; in one of these patients our data are consistent with selective inactivation of chromosome X explaining the severity. The phenotypic presentation in our patients was variable and less severe than that of the originally described cases. MAGED2 mutations explained 9% of cases of antenatal Bartter syndrome in a French cohort, and accounted for 38% of patients without other characterized mutations and for 44% of male probands of negative cases. Our study confirmed previously published data and showed that females can be affected. As a result, this gene must be included in the screening of the most severe clinical form of Bartter syndrome. Copyright © 2018 by the American Society of Nephrology.

  1. Micronutrient deficiencies in early childhood can lower a country's GDP: The Myanmar example.

    Science.gov (United States)

    Win, Aung Zaw

    2016-01-01

    Myanmar (Burma) is a developing country in South East Asia. While Myanmar is among the 20 countries where 80% of the world's malnourished children live, its military consumes the majority of the national budget. Children who are malnourished between conception and age two are at high risk for impaired physical and mental development, which adversely affects the country's productivity and growth. Myanmar is facing three major micronutrient deficiencies which are iodine, iron and vitamin A deficiencies. The three micronutrient deficiencies can cost about 2.4% of the country's GDP. Children are the future of Myanmar and persistent micronutrient deficiencies will hamper its economic growth and lower its GDP. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Micronutrient quality of weight-loss diets that focus on macronutrients: results from the A TO Z study123

    Science.gov (United States)

    Gardner, Christopher D; Kim, Soowon; Bersamin, Andrea; Dopler-Nelson, Mindy; Otten, Jennifer; Oelrich, Beibei; Cherin, Rise

    2010-01-01

    Background: Information on the micronutrient quality of alternative weight-loss diets is limited, despite the significant public health relevance. Objective: Micronutrient intake was compared between overweight or obese women randomly assigned to 4 popular diets that varied primarily in macronutrient distribution. Design: Dietary data were collected from women in the Atkins (n = 73), Zone (n = 73), LEARN (Lifestyle, Exercise, Attitudes, Relationships, Nutrition) (n = 73), and Ornish (n = 72) diet groups by using 3-d, unannounced 24-h recalls at baseline and after 8 wk of instruction. Nutrient intakes were compared between groups at 8 wk and within groups for 8-wk changes in risk of micronutrient inadequacy. Results: At 8 wk, significant differences were observed between groups for all macronutrients and for many micronutrients (P macronutrient composition should attend to the overall quality of the diet, including the adequacy of micronutrient intakes. Concerning calorie-restricted diets, there may be a micronutrient advantage to diets providing moderately low carbohydrate amounts and that contain nutrient-dense foods. PMID:20573800

  3. Antenatal breastfeeding education for increasing breastfeeding duration

    Science.gov (United States)

    Lumbiganon, Pisake; Martis, Ruth; Laopaiboon, Malinee; Festin, Mario R; Ho, Jacqueline J; Hakimi, Mohammad

    2014-01-01

    Background Breastfeeding (BF) is well recognised as the best food for infants. The impact of antenatal BF education on the duration of BF has not been evaluated. Objectives To evaluate the effectiveness of antenatal BF education for increasing BF initiation and duration. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (21 April 2010), CENTRAL (The Cochrane Library 2010, Issue 2), MEDLINE (1966 to April 2010) and SCOPUS (January 1985 to April 2010). We contacted experts and searched reference lists of retrieved articles. We updated the search of the Pregnancy and Childbirth Group’s Trials Register on 28 September 2011 and added the results to the awaiting classification section of the review. Selection criteria All identified published, unpublished and ongoing randomised controlled trials (RCTs) assessing the effect of formal antenatal BF education or comparing two different methods of formal antenatal BF education, on duration of BF. We excluded RCTs that also included intrapartum or postpartum BF education. Data collection and analysis We assessed all potential studies identified as a result of the search strategy. Two review authors extracted data from each included study using the agreed form and assessed risk of bias. We resolved discrepancies through discussion. Main results We included 17 studies with 7131 women in the review and 14 studies involving 6932 women contributed data to the analyses. We did not do any meta-analysis because there was only one study for each comparison. Five studies compared a single method of BF education with routine care. Peer counselling significantly increased BF initiation. Three studies compared one form of BF education versus another. No intervention was significantly more effective than another intervention in increasing initiation or duration of BF. Seven studies compared multiple methods versus a single method of BF education. Combined BF educational interventions were not

  4. The effect of antenatal education in small classes on obstetric and psycho-social outcomes

    DEFF Research Database (Denmark)

    Brixval, Carina Sjöberg; Axelsen, Solveig Forberg; Lauemøller, Stine Glenstrup

    2015-01-01

    of small group antenatal education on obstetric and psycho-social outcomes. CONCLUSIONS: Insufficient evidence exists as to whether antenatal education in small classes is effective in regard to obstetric and psycho-social outcomes. We recommend updating this review following the emergence of well......, with participation of a small number of participants, may differ from the effect of other forms of antenatal education due to, for example, group dynamic. The objective of this systematic review is to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes. METHODS...

  5. The Evolving Role of Multivitamin/Multimineral Supplement Use among Adults in the Age of Personalized Nutrition

    Directory of Open Access Journals (Sweden)

    Jeffrey B. Blumberg

    2018-02-01

    Full Text Available Micronutrient deficiencies occur in segments of the adult population in the United States. Multivitamin/multimineral supplements (MVMS are widely used by this population, which reduces inadequacies in micronutrient intake, but the potential for exceeding tolerable upper intake levels in others should be considered. There are concerns associated with the excessive intake of certain nutrients, particularly folic acid, and potential untoward consequences. The advent of nutrigenomics and the enhanced ability to directly study the interactions between nutrition and genetic variants and expression will allow for the conduct of more targeted studies with specific endpoints and may ultimately lead to progress in the field of personalized nutrition. The role of MVMS in health maintenance and chronic disease prevention remains controversial. Conducting studies in this area has been hampered by, among other factors, inconsistent definitions of MVMS, ranging from as few as three vitamins to broad-spectrum products containing more than two dozen vitamins and minerals. Results from some observational studies and large-scale, randomized, controlled trials suggest that MVMS may reduce the risk of some forms of cancer and, potentially, cardiovascular disease. The ongoing COcoa Supplement and Multivitamin Outcomes Study (COSMOS is expected to build on this research and provide additional insights into these areas.

  6. (HIV) infection among pregnant women in an antenatal clinic in Port

    African Journals Online (AJOL)

    Women attending ante-natal clinic in Nigeria are routinely screened for HIV/AIDS. A retrospective study was conducted between 2000 and 2004 to investigate the prevalence of the human immunodeficiency virus (HIV) infection among pregnant women attending ante-natal clinic in Braithwalte Memorial Hospital (BMH), Port ...

  7. Micronutrients, N-Acetyl Cysteine, Probiotics and Prebiotics, A Review of Effectiveness in Reducing HIV Progression

    NARCIS (Netherlands)

    R.B.S. Hummelen (Ruben); J. Hemsworth (Jaimie); G.K. Reid (Gregor)

    2010-01-01

    textabstractLow serum concentrations of micronutrients, intestinal abnormalities, and an inflammatory state have been associated with HIV progression. These may be ameliorated by micronutrients, N-acetyl cysteine, probiotics, and prebiotics. This review aims to integrate the evidence from clinical

  8. Micronutrients, N-acetyl cysteine, probiotics and prebiotics, a review of effectiveness in reducing HIV progression

    NARCIS (Netherlands)

    R.B.S. Hummelen (Ruben); J. Hemsworth (Jaimie); G. Reid (Gregor)

    2010-01-01

    textabstractLow serum concentrations of micronutrients, intestinal abnormalities, and an inflammatory state have been associated with HIV progression. These may be ameliorated by micronutrients, N-acetyl cysteine, probiotics, and prebiotics. This review aims to integrate the evidence from clinical

  9. Effects of maternal micronutrient supplementation on fetal loss and under-2-years child mortality

    DEFF Research Database (Denmark)

    Andersen, Gregers Stig; Friis, Henrik; Michaelsen, Kim F.

    2010-01-01

    mortality, as compared with iron-folic acid supplementation among 2,100 pregnant women in Guinea-Bissau. Women receiving a 1xRDA MMS preparation (consisting of 14 vitamins and minerals) had a marginally reduced risk of fetal loss (Relative risk (RR) 0.65, 95% CI 0.40; 1.05), and women receiving a 2xRDA MMS...

  10. The Queuine Micronutrient: Charting a Course from Microbe to Man

    Directory of Open Access Journals (Sweden)

    Claire Fergus

    2015-04-01

    Full Text Available Micronutrients from the diet and gut microbiota are essential to human health and wellbeing. Arguably, among the most intriguing and enigmatic of these micronutrients is queuine, an elaborate 7-deazaguanine derivative made exclusively by eubacteria and salvaged by animal, plant and fungal species. In eubacteria and eukaryotes, queuine is found as the sugar nucleotide queuosine within the anticodon loop of transfer RNA isoacceptors for the amino acids tyrosine, asparagine, aspartic acid and histidine. The physiological requirement for the ancient queuine molecule and queuosine modified transfer RNA has been the subject of varied scientific interrogations for over four decades, establishing relationships to development, proliferation, metabolism, cancer, and tyrosine biosynthesis in eukaryotes and to invasion and proliferation in pathogenic bacteria, in addition to ribosomal frameshifting in viruses. These varied effects may be rationalized by an important, if ill-defined, contribution to protein translation or may manifest from other presently unidentified mechanisms. This article will examine the current understanding of queuine uptake, tRNA incorporation and salvage by eukaryotic organisms and consider some of the physiological consequence arising from deficiency in this elusive and lesser-recognized micronutrient.

  11. Micronutrient Composition of 35 Food Fishes from India and Their Significance in Human Nutrition.

    Science.gov (United States)

    Mohanty, Bimal P; Sankar, T V; Ganguly, Satabdi; Mahanty, Arabinda; Anandan, R; Chakraborty, Kajal; Paul, B N; Sarma, Debajit; Dayal, J Syama; Mathew, Suseela; Asha, K K; Mitra, Tandrima; Karunakaran, D; Chanda, Soumen; Shahi, Neetu; Das, Puspita; Das, Partha; Akhtar, Md Shahbaz; Vijayagopal, P; Sridhar, N

    2016-12-01

    The micronutrients (vitamins and minerals) are required in small amounts but are essential for health, development, and growth. Micronutrient deficiencies, which affect over two billion people around the globe, are the leading cause of many ailments including mental retardation, preventable blindness, and death during childbirth. Fish is an important dietary source of micronutrients and plays important role in human nutrition. In the present investigation, micronutrient composition of 35 food fishes (includes both finfishes and shellfishes) was investigated from varying aquatic habitats. Macrominerals (Na, K, Ca, Mg) and trace elements (Fe, Cu, Zn, Mn, Se) were determined by either atomic absorption spectroscopy (AAS) or inductively coupled plasma mass spectrometry (ICP-MS)/atomic emission spectrometry (ICP-AES). Phosphorus content was determined either spectrophotometrically or by ICP-AES. Fat-soluble vitamins (A, D, E, K) were analyzed by high-performance liquid chromatography (HPLC). The analysis showed that, in general, the marine fishes were rich in sodium and potassium; small indigenous fishes (SIFs) in calcium, iron, and manganese; coldwater fishes in selenium; and the brackishwater fishes in phosphorous. The marine fishes Sardinella longiceps and Epinephelus spp. and the SIFs were rich in all fat-soluble vitamins. All these recommendations were made according to the potential contribution (daily value %) of the species to the recommended daily allowance (RDA). Information on the micronutrients generated would enhance the utility of fish in both community and clinical nutrition.

  12. Micronutrient Daily Intake of Elementary School Children in Bandung as Determined by Using NAA and AAS Methods

    Directory of Open Access Journals (Sweden)

    E. Damastuti

    2011-08-01

    Full Text Available Micronutrients in human diet are known to be among the most essential sources of nutrition, that required by the human body in small amount to maintain normal physiological function. Micronutrient malnutrition (MNM is widespread all over the world, mostly in the developing country, where young children tend to be the most at risk of developing micronutrient deficiencies. In Indonesia, data of micronutrient status of children is limited. Therefore, the assessment of micronutrient intake of young children is needed to carry out. Food samples were taken by duplicate diet method of 19 elementary school children in Bandung and were analyzed using neutron activation analysis and atomic absorption spectrophotometry. Quality control of data analysis was assessed using SRM NIST 1548a Typical Diet. The result was giving the average daily intake of Ca, Cr, Cu, Fe, K, Mg, Mn, Na, Se and Zn were 228, 0.15, 0.57, 9.3, 929, 106, 2,1, 2314, 0.022 and 4.6 mg/day respectively and gives 22, 527, 86, 111, 17, 54, 116, 49 and 63% of Recommended Dietary Allowance (RDA values. Its generally concluded that these children are still lack of micronutrient intake, and many of them were below their recommended dietary allowances. These result were expected could be used as baseline data and reference to encourage government and related institution in making policies for public health improvement and micronutrient malnutrition solution as well.

  13. Differential regulation of hepatic transcription factors in the Wistar rat offspring born to dams fed folic acid, vitamin B12 deficient diets and supplemented with omega-3 fatty acids.

    Directory of Open Access Journals (Sweden)

    Akshaya Meher

    Full Text Available Nutritional status of the mother is known to influence various metabolic adaptations required for optimal fetal development. These may be mediated by transcription factors like peroxisome proliferator activated receptors (PPARs, which are activated by long chain polyunsaturated fatty acids. The objective of the current study was to examine the expression of different hepatic transcription factors and the levels of global methylation in the liver of the offspring born to dams fed micronutrient deficient (folic acid and vitamin B12 diets and supplemented with omega-3 fatty acids. Female rats were divided into five groups (n = 8/group as follows; control, folic acid deficient (FD, vitamin B12 deficient (BD and omega-3 fatty acid supplemented groups (FDO and BDO. Diets were given starting from pre-conception and continued throughout pregnancy and lactation. Pups were dissected at the end of lactation. Liver tissues were removed; snap frozen and stored at -80°C. Maternal micronutrients deficiency resulted in lower (p<0.05 levels of pup liver docosahexaenoic acid (DHA and arachidonic acid (ARA as compared to the control group. Pup liver PPARα and PPARγ expression was lower (p<0.05 in the BD group although there were no differences in the expression of SREBP-1c, LXRα and RXRα expression. Omega-3 fatty acids supplementation to this group normalized (p<0.05 levels of both PPARα and PPARγ but reduced (p<0.05 SREBP-1c, LXRα and RXRα expression. There was no change in any of the transcription factors in the pup liver in the FD group. Omega-3 fatty acids supplementation to this group reduced (p<0.05 PPARα, SREBP-1c and RXRα expression. Pup liver global methylation levels were higher (p<0.01 in both the micronutrients deficient groups and could be normalized (p<0.05 by omega-3 fatty acid supplementation. Our novel findings suggest a role for omega-3 fatty acids in the one carbon cycle in influencing the hepatic expression of transcription factors

  14. Radioisotope aided micronutrient research for increasing fertiliser use efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Deb, D L; Gupta, G N; Meisheri, M B; Rattan, R K; Sarkar, A K

    1986-02-01

    Results of fundamental studies involving the use of radioisotopes of micronutrients especially of Zn, Fe, Mn, Cu and Cl to find out the effect of soi l characteristics on the diffusion coefficient of these ions and the availability of micronutrient fertilisers to the crops have been reported for a large number of soils. The usefulness of mathematical models for evolving rational basis of micronutrient fertiliser recommendation for crops from soil factors such as intensity, capacity and rate factors of a nutrient in a given soil and plant characteristics such as root morphology and nutrient demand of a crop have been studied. Results showed good agreement between observed and predicted uptake of fertiliser Zn by wheat roots. Results of fundamental studies on severa l soils strongly suggest that the diffusion coefficient to Zn to plant root in a soil can be increased by appropriate manipulation of soil characters even without the application of fertiliser Zn. The effects of various sources, methods and rate of application of fertilizer Zn on the grain yield and fertiliz er Zn use efficiency in rice under water-logged conditions have been studied in alluvial and black soils of Delhi and Hyderabad, respectively. The fate of fe rtilizer Zn in these soils has been studied and the results are reported. (author). 5 figs., 9 tabs., 25 refs.

  15. Radioisotope aided micronutrient research for increasing fertiliser use efficiency

    International Nuclear Information System (INIS)

    Deb, D.L.; Gupta, G.N.; Meisheri, M.B.; Rattan, R.K.; Sarkar, A.K.

    1986-01-01

    Results of fundamental studies involving the use of radioisotopes of micronutrients especially of Zn, Fe, Mn, Cu and Cl to find out the effect of soi l characteristics on the diffusion coefficient of these ions and the availability of micronutrient fertilisers to the crops have been reported for a large number of soils. The usefulness of mathematical models for evolving rational basis of micronutrient fertiliser recommendation for crops from soil factors such as intensity, capacity and rate factors of a nutrient in a given soil and plant characteristics such as root morphology and nutrient demand of a crop have been studied. Results showed good agreement between observed and predicted uptake of fertiliser Zn by wheat roots. Results of fundamental studies on severa l soils strongly suggest that the diffusion coefficient to Zn to plant root in a soil can be increased by appropriate manipulation of soil characters even without the application of fertiliser Zn. The effects of various sources, methods and rate of application of fertilizer Zn on the grain yield and fertiliz er Zn use efficiency in rice under water-logged conditions have been studied in alluvial and black soils of Delhi and Hyderabad, respectively. The fate of fe rtilizer Zn in these soils has been studied and the results are reported. (author). 5 figs., 9 tabs., 25 refs

  16. Providers of antenatal care services in Ghana: evidence from Ghana demographic and health surveys 1988-2014.

    Science.gov (United States)

    Dickson, Kwamena Sekyi; Darteh, Eugene Kofuor Maafo; Kumi-Kyereme, Akwasi

    2017-03-14

    Antenatal care is one of the three most essential care - antenatal, delivery and post-natal, given to women during pregnancy and has the potential to contribute towards the achievement of the Sustainable Development Goal (SDG) target 3.1- reducing the global maternal mortality ratio to less than 70 per 100,000 and target 3.8 - achieve universal health coverage. The main objective is to examine the contribution of the various providers of antenatal care services in Ghana from 1988 to 2014. The study uses data from all the six rounds of the Ghana Demographic and Health Survey (GDHS). Binary logistic regression models were applied to examine the association between background characteristics of respondents and providers of antenatal care services. The results show that majority of antenatal care services were provided by nurses over the period under review. The proportion of women who received antenatal care services from nurses improved over the period from 55% in 1988 to 89.5% in 2014. Moreover, there was a decline in antenatal care services provided by traditional birth attendants and women who did not receive antenatal care services from any service provider over the years under review. It was observed that women from rural areas were more likely to utilise antenatal care services provided by traditional birth attendants, whilst those from urban areas were more likely to utilise antenatal care from doctors and nurses. To further improve access to and utilisation of antenatal care services provided by nurses and doctors it is recommended that the Ghana Health Service and the Ministry of Health should put in place systems aimed at improving on the quality of care given such as regular training workshops for health personnel and assessment of patient's satisfaction with services provided. Also, they should encourage women in rural areas especially those from the savannah zone to utilise antenatal care services from skilled providers through social and behaviour

  17. Food Group and Micronutrient Intake Adequacy among Children, Adults and Elderly Women in Greece

    Directory of Open Access Journals (Sweden)

    Yannis Manios

    2015-03-01

    Full Text Available The aim of the present study was to record the percentage of children, adults and elderly women in Greece meeting food and micronutrient intake recommendations. Additionally, the present study was aiming to identify the main food contributors of micronutrient intakes and assess the degree up to which meeting food intake recommendations also ensures micronutrient intake adequacy. Dietary intake data from three studies conducted in Greece (on 9–13-year-old children; 40–60-year-old adults; and 50–75-year-old women were used to estimate mean intakes, the percentages of subjects meeting food and nutrient intake recommendations and the contribution of six core food groups to nutrient intake adequacy. The present study showed that more than 50% of children, adults and elderly women were failing to consume the recommended portions of vegetables, dairy and grains. Furthermore, children and adults consuming the recommended portions of individual core food groups had significantly lower percentages of inadequate micronutrient intakes compared to their counterparts not meeting food intake recommendations (p < 0.05. Nevertheless, even among those consuming the recommended portions from a specific core food group, the recommended intake of the corresponding micronutrient (for which this food group is the main contributor was not always met. Indicatively, 18.2%–44.1% and 4.2%–7.0% of the populations under study were not meeting calcium and vitamin C intake recommendations, although they were consuming the recommended portions of dairy and fruits, respectively. In conclusion, these findings highlight the importance for public health policy makers to take all necessary initiatives to support the population in achieving the recommended intakes from all core food groups, but also emphasize on food variety to ensure adequate intake for all micronutrients.

  18. Micronutrient status in anemic and non-anemic Chinese women in the third trimester of pregnancy

    NARCIS (Netherlands)

    Ma, A.G.; Schouten, E.G.; Wang, Y.; Xu, R.X.; Zheng, M.C.; Li, Y.; Wang, Q.Z.; Sun, Y.Y.

    2009-01-01

    Background: Anemia is a major nutrition related problem in China. In addition to iron deficiency this may be due to deficiencies of other micronutrients. Objective: To describe the micronutrient status of anemic and non-anemic pregnant women in China. Subjects and Methods: 734 clinically normal

  19. Quality and uptake of antenatal and postnatal care in Haiti.

    Science.gov (United States)

    Mirkovic, Kelsey R; Lathrop, Eva; Hulland, Erin N; Jean-Louis, Reginald; Lauture, Daniel; D'Alexis, Ghislaine Desinor; Handzel, Endang; Grand-Pierre, Reynold

    2017-02-02

    Despite improvement, maternal mortality in Haiti remains high at 359/100,000 live births. Improving access to high quality antenatal and postnatal care has been shown to reduce maternal mortality and improve newborn outcomes. Little is known regarding the quality and uptake of antenatal and postnatal care among Haitian women. Exit interviews were conducted with all pregnant and postpartum women seeking care from large health facilities (n = 10) in the Nord and Nord-Est department and communes of St. Marc, Verrettes, and Petite Rivière in Haiti over the study period (March-April 2015; 3-4 days/facility). Standard questions related to demographics, previous pregnancies, current pregnancy, and services/satisfaction during the visit were asked. Total number of antenatal visits were abstracted from charts of recently delivered women (n = 1141). Provider knowledge assessments were completed by antenatal and postnatal care providers (n = 39). Frequencies were calculated for descriptive variables and multivariable logistic regression was used to explore predictors of receiving 5 out of 10 counseling messages among pregnant women. Among 894 pregnant women seeking antenatal care, most reported receiving standard clinical service components during their visit (97% were weighed, 80% had fetal heart tones checked), however fewer reported receiving recommended counseling messages (44% counselled on danger signs, 33% on postpartum family planning). Far fewer women were seeking postnatal care (n = 63) and similar service patterns were reported. Forty-three percent of pregnant women report receiving at least 5 out of 10 counseling messages. Pregnant women on a repeat visit and women with greater educational attainment had greater odds of reporting having received 5 out of 10 counseling messages (2 nd visit: adjusted odds ratio [aOR] =1.70, 95% confidence interval [CI]: 1.09-2.66; 5+ visit: aOR = 5.44, 95% CI: 2.91-10.16; elementary school certificate: a

  20. Improving Tolerance of Faba Bean during Early Growth Stages to Salinity through Micronutrients Foliar Spray

    Directory of Open Access Journals (Sweden)

    Mohamed M. EL FOULY

    2010-06-01

    Full Text Available Salinity, either of soil or of irrigation water, causes disturbances in plant growth and nutrient balance. Previous work indicates that applying nutrients by foliar application increases tolerance to salinity. A pot experiment with three replicates was carried out in the green house of NRC, Cairo, Egypt, to study the effect of micronutrients foliar application on salt tolerance of faba bean. Two concentrations of a micronutrient compound (0.1% and 0.15% were sprayed in two different treatments prior to or after the salinity treatments. Levels of NaCl (0.00-1000-2000-5000 ppm were supplied to irrigation water. Results indicated that 2000 and 5000 ppm NaCl inhibited growth and nutrient uptake. Spraying micronutrients could restore the negative effect of salinity on dry weight and nutrients uptake, when sprayed either before or after the salinity treatments. It is suggested that micronutrient foliar sprays could be used to improve plant tolerance to salinity.

  1. Maternal vitamin D supplementation during pregnancy prevents vitamin D deficiency in the newborn: an open-label randomized controlled trial.

    Science.gov (United States)

    Rodda, C P; Benson, J E; Vincent, A J; Whitehead, C L; Polykov, A; Vollenhoven, B

    2015-09-01

    To determine whether maternal vitamin D supplementation, in the vitamin D deficient mother, prevents neonatal vitamin D deficiency. Open-label randomized controlled trial. Metropolitan Melbourne, Australia, tertiary hospital routine antenatal outpatient clinic. Seventy-eight women with singleton pregnancies with vitamin D deficiency/insufficiency (serum 25-OH Vit D l) at their first antenatal appointment at 12-16-week gestation were recruited. Participants were randomized to vitamin D supplementation (2000-4000 IU cholecalciferol) orally daily until delivery or no supplementation. The primary outcome was neonatal serum 25-OH vit D concentration at delivery. The secondary outcome was maternal serum 25-OH vit D concentration at delivery. Baseline mean maternal serum 25-OH vit D concentrations were similar (P = 0·9) between treatment (32 nmol/l, 95% confidence interval 26-39 nmol/l) and control groups (33 nmol/l, 95% CI 26-39 nmol/l). Umbilical cord serum 25-OH vit D concentrations at delivery were higher (P l, 95% CI; 70-91 nmol/l) compared with neonates of control group mothers (42 nmol/l, 95% CI; 34-50 nmol/l) with a strongly positive correlation between maternal serum 25-OH Vit D and umbilical cord serum 25-OH vit D concentrations at delivery (Spearman rank correlation coefficient 0·88; P l, 95% CI; 62-81 nmol/l) compared with the control group (36 nmol/l, 95% CI; 29-42 nmol/l). Vitamin D supplementation of vitamin D deficient pregnant women prevents neonatal vitamin D deficiency. © 2015 John Wiley & Sons Ltd.

  2. Conventional foods, followed by dietary supplements and fortified foods, are the key sources of vitamin D, vitamin B6, and selenium intake in Dutch participants of the NU-AGE study

    NARCIS (Netherlands)

    Berendsen, Agnes A.M.; Lieshout, van Lilou E.L.M.; Heuvel, van den Ellen G.H.M.; Matthys, Christophe; Péter, Szabolcs; Groot, de Lisette C.P.G.M.

    2016-01-01

    With aging, energy needs decrease, necessitating a more nutrient-dense diet to meet nutritional needs. To bridge this gap, the use of nutrient-dense foods, fortified foods, and dietary supplements can be important. This observational study aims to describe current micronutrient intakes of Dutch

  3. Increased lipid peroxidation in pregnant women after iron and vitamin C supplementation.

    Science.gov (United States)

    Lachili, B; Hininger, I; Faure, H; Arnaud, J; Richard, M J; Favier, A; Roussel, A M

    2001-11-01

    Iron overload could promote the generation of free radicals and result in deleterious cellular damages. A physiological increase of oxidative stress has been observed in pregnancy. A routine iron supplement, especially a combined iron and vitamin C supplementation, without biological justifications (low hemoglobin [Hb] and iron stores) could therefore aggravate this oxidative risk. We investigated the effect of a daily combined iron supplementation (100 mg/d as fumarate) and vitamin C (500 mg/d as ascorbate) for the third trimester of pregnancy on lipid peroxidation (plasma TBARS), antioxidant micronutriments (Zn, Se, retinol, vitamin E, (beta-carotene) and antioxidant metalloenzymes (RBC Cu-Zn SOD and Se-GPX). The iron-supplemented group (n = 27) was compared to a control group (n = 27), age and number of pregnancies matched. At delivery, all the women exhibited normal Hb and ferritin values. In the supplemented group, plasma iron level was higher than in the control group (26.90 +/- 5.52 mmol/L) and TBARs plasma levels were significantly enhanced (p cell antioxidant metalloenzymes. Furthermore, the alpha-tocopherol plasma level was lowered in the iron-supplemented groups, suggesting an increased utilization of vitamin E. These data show that pharmalogical doses of iron, associated with high vitamin C intakes, can result in uncontrolled lipid peroxidation. This is predictive of adverse effects for the mother and the fetus. This study illustrates the potential harmful effects of iron supplementation when prescribed only on the assumption of anemia and not on the bases of biological criteria.

  4. Antenatal Bartter's syndrome with sensorineural deafness

    OpenAIRE

    Bhamkar, R. P.; Gajendragadkar, A.

    2009-01-01

    Bartter's syndrome is a group of inherited, salt-losing tubulopathies presenting as metabolic alkalosis with normotensive hyperreninemia and hyperaldosteronism. We report here the first case of a neonate with bilateral, sensorineural deafness, a variant of antenatal Bartter's syndrome from an Indian community.

  5. The adequacy of antenatal care services among slum residents in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Bayou, Yibeltal T; Mashalla, Yohana S; Thupayagale-Tshweneagae, Gloria

    2016-06-15

    There are recent efforts made to eliminate inequalities in the utilisation of basic health care services. More emphasis is given for improvement of health in developing countries including maternal and child health. However, disparities for the fast-growing population of urban poor are masked by the urban averages. The aim of this paper is to report on the findings of antenatal care adequacy among slum residents in Addis Ababa, Ethiopia. This was a quantitative and cross-sectional community based study design which employed a stratified two-stage cluster sampling technique to determine the sample. Data was collected using structured questionnaire administered to 870 women aged 15-49 years. Weighted 'backward selection' logistic regression models were employed to identify predictors of adequacy of antenatal care. Majority of slum residents did not have adequate antenatal care services with only 50.3, 20.2 and 11.0 % of the slum resident women initiated antenatal care early, received adequate antenatal care service contents and had overall adequate antenatal care services respectively. Educational status and place of ANC visits were important determinant factors for adequacy of ANC in the study area. Women with secondary and above educational status were 2.7 times more likely to receive overall adequate care compared to those with no formal education. Similarly, clients of private healthcare facilities were 2.2 times respectively more likely to receive overall adequate antenatal care compared to those clients of public healthcare facilities. In order to improve ANC adequacy in the study area, the policy-making, planning, and implementation processes should address the poor adequacy of ANC among the disadvantaged groups in particular and the slum residents in general.

  6. Effect of a micronutrient-fortified beverage on cognition and nutritional status of primary school children / C. Taljaard.

    OpenAIRE

    Taljaard, Christine

    2012-01-01

    Childhood micronutrient deficiencies have negative effects on cognition. Little is known about the effects of combined consumption of micronutrients and sugar on growth and cognitive function. The aim of this thesis was to 1) investigate the effects of micronutrients and sugar, alone and in combination, in a beverage, on growth and cognition in South African children and 2) review recent evidence on iron status and anaemia prevalence in South African children since the National Food Consu...

  7. Impact of antenatal glucocorticosteroids on whole-genome expression in preterm babies.

    Science.gov (United States)

    Saugstad, Ola Didrik; Kwinta, Przemko; Wollen, Embjørg Julianne; Bik-Multanowski, Mirosław; Madetko-Talowska, Anna; Jagła, Mateusz; Tomasik, Tomasz; Pietrzyk, Jacek Józef

    2013-04-01

    To study the impact that using antenatal steroid to treat threatened preterm delivery has on whole-genome expression. A prospective whole-genome expression study was carried out on 50 newborn infants, delivered before 32 weeks gestation, who had been exposed to antenatal steroids, including 40 who had received a full antenatal steroid course. Seventy infants not exposed to antenatal steroids formed the control group. Microarray analyses were performed five and 28 days after delivery, and the results were validated by real-time PCR. The study was conducted between September 2008 and November 2010. Twenty thousand six hundred and ninety-three genes were studied in the infants' leucocytes. Thirteen were differentially expressed 5 days after delivery, but there were no differences at day 28. Four genes related to cancer or inflammation were up-regulated. Nine genes were down-regulated: six were Y-linked and associated with malignancies, graft-versus-host disease, male infertility and cell differentiation and three were associated with pre-eclampsia, oxidative stress and chloride/bicarbonate exchange. Seven gene pathways were up-regulated at day five and only one at day 28. These were associated with cell growth, cell cycle regulation, metabolism and apoptosis. Antenatal steroid therapy affects a limited number of genes and gene pathways in leucocytes in preterm babies at day five of life. The effect is short-lived, but long-term effects cannot be ruled out. ©2013 The Author(s)/Acta Paediatrica ©2013 Foundation Acta Paediatrica.

  8. Marginal Micronutrient Intake in High-Performance Male Wheelchair Basketball Players: A Dietary Evaluation and the Effects of Nutritional Advice.

    Science.gov (United States)

    Grams, Lena; Garrido, Guadalupe; Villacieros, Jorge; Ferro, Amelia

    2016-01-01

    Wheelchair basketball has evolved into a high-performance sport over several years, and small variations in player performance can determine the difference between winning and losing. Therefore, adequate micronutrient intake may influence this difference if performance-promoting macronutrient intake and physical fitness are equal between teams. Seventeen elite male wheelchair basketball players belonging to the Spanish National Team participated in this study. Macro- and micronutrient intake were determined using a food-weighing diary over three consecutive days during three training camps in two consecutive years. Current Dietary Reference Intake levels were used to determine the adequacy of intake of seventeen micronutrients of particular interest for athletes. After categorizing the consumed foods into fourteen food groups according to the National Nutrient Database for Standard References (USDA) these groups were used to identify the best predictors of the adequacy of intake for each micronutrient. Total energy intake correlated positively with the adequacy of all micronutrient intake levels, except for vitamins A and E. Five B vitamins and phosphorus, selenium, and iron showed 100% adequacy. All other micronutrient intake levels were found to be inadequate, e.g., vitamin E (51% adequacy) and calcium (73%). The fruit, fish and cereal food groups were found to be predictors of adequate intake of most micronutrients. Together with energy intake (p = .009, η2 = 0.49), the intake of the fruit (p = .032, η2 = 0.39) and egg (p = .036, Kendall's W = 0.42) food groups increased significantly over time, along with improved iodine (p = .008, W = 0.61) and magnesium (p = .030, W = 0.44) adequacy levels. Because the adequacy of micronutrient intake correlates positively with energy intake (R = 0.64, p nutritional knowledge of the athletes and assure adequate micronutrient intake.

  9. Effect of cooking methods on the micronutrient profile of selected ...

    African Journals Online (AJOL)

    Effect of cooking methods on the micronutrient profile of selected vegetables: okra fruit ( Abelmoshcus esculentus ), fluted pumpkin ( Telfairia occidentalis ), African spinach ( Amarantus viridis ), and scent leaf ( Ocumum gratissimum.

  10. Sociodemographic factors associated with anaemia in pregnancy at booking for antenatal care.

    Science.gov (United States)

    Adanikin, A I; Awoleke, J O

    2016-01-01

    Late patronage of antenatal care by women in low-resource areas makes timely intervention at correcting anaemia difficult. This study aimed to identify modifiable sociodemographic factors that predict anaemia before commencing antenatal care and make appropriate recommendation. A survey of sociodemographic features and haemoglobin concentrations of 232 women booking for antenatal care was conducted. Anaemia was diagnosed in 119 (51.3%), of which 87 (37.5%) had mild anaemia and 32 (13.8%) were moderately anaemic. There was no severe anaemia. Anaemia was highest among respondents who were 35 years of age, Muslims, of Igbo ethnicity (64.3%), single (55.0%), student/unemployed (58.8%), nulliparous (57.3%) and those who registered at 21 weeks' gestation (54.2%). Only occupation of the woman showed association with anaemia before antenatal care (p 0.007). A personal source of income may reduce anaemia in pregnancy; and it is advisable to have a social welfare package for unemployed pregnant women.

  11. A Review on the Role of Chromium Supplementation in Ruminant Nutrition-Effects on Productive Performance, Blood Metabolites, Antioxidant Status, and Immunocompetence

    DEFF Research Database (Denmark)

    Lashkari, Saman; Habibian, Mahmood; Jensen, Søren Krogh

    2018-01-01

    , Cr supplementation improved dry matter intake, milk production, and milk composition of dairy cows in the early, mid, or late stage of lactation. Also, in some studies, performance of growing animal, immune response, and some blood parameters responded positively to Cr supplementation. In conclusion...... microminerals is important. Chromium (Cr) is one of the important micronutrients which plays an important role in metabolism of ruminants. Experimental studies have found that Cr could change performance, immune responses, glucose and fatty acid metabolism, and antioxidant status in dairy cows. In some studies......, the effects of Cr supplementation on performance of ruminants are inconsistent; however, its long-term effects on health, productivity, immune system, and antioxidant activity of ruminants still need to be investigated....

  12. Micronutrient malnutrition, obesity, and chronic disease in countries undergoing the nutrition transition: potential links and program/policy implications

    OpenAIRE

    Eckhardt, Cara L.

    2006-01-01

    This paper discusses the potential long-term effects of micronutrient malnutrition in early childhood on obesity and related disease outcomes. The links between early micronutrient malnutrition, stunting, and subsequent short adult stature — emerging risk factors for obesity and associated chronic diseases—are reviewed. This paper also explores recent literature linking micronutrient malnutrition in adults to increased risk and severity of chronic disease. Finally, this paper discusses the pr...

  13. Nutritional factors associated with antenatal depressive symptoms in the early stage of pregnancy among urban South Indian women.

    Science.gov (United States)

    Lukose, Ammu; Ramthal, Asha; Thomas, Tinku; Bosch, Ronald; Kurpad, Anura V; Duggan, Christopher; Srinivasan, Krishnamachari

    2014-01-01

    Many women of reproductive age from developing countries have poor nutritional status, and the prevalence of depression during pregnancy is high. The objective of the present study was to assess the prevalence of antenatal depressive symptoms in early pregnancy, and to identify the demographic and nutritional factors associated with these symptoms in a sample of urban South Indian pregnant women. This cross-sectional study was the baseline assessment of a prospective randomized controlled trial of vitamin B12 supplementation in urban pregnant south Indian women between the ages of 18 and 40 years ( www.clinicaltrials.gov : NCT00641862). 365 women in their first trimester of pregnancy were screened for depressive symptoms at an urban clinic in Karnataka, South India, using the Kessler Psychological Distress Scale (K-10). Nutritional, clinical and biochemical factors were also assessed. Mean (SD) age of the cohort was 22.6 (3.7) years and mean (SD) BMI was 20.4 (3.3) kg/m(2). 121 (33 %) of the women in the 1st trimester had symptoms consistent with depression (K-10 score >6). In multivariate log binomial regression analysis, presence of antenatal depressive symptoms in the first trimester were positively associated with vomiting, prevalence ratio (PR) = 1.54 (95 % CI 1.10, 2.16) and negatively with anemia, PR = 0.67 (95 % CI 0.47, 0.96). Nutrient intakes, serum vitamin B12, methylmalonic acid, homocysteine and red cell folate levels were not associated with measures of depression. Antenatal depressive symptoms in early pregnancy are highly prevalent in urban Indian women and are more common in women with vomiting and without anemia. In this cross-sectional data, blood concentrations of vitamin B12 and folate were not associated with depressive symptoms. The relationship between nutritional status and depressive symptoms may require larger and longitudinal studies.

  14. Wealth and antenatal care use: implications for maternal health care utilisation in Ghana.

    Science.gov (United States)

    Arthur, Eric

    2012-08-06

    The study investigates the effect of wealth on maternal health care utilization in Ghana via its effect on Antenatal care use. Antenatal care serves as the initial point of contact of expectant mothers to maternal health care providers before delivery. The study is pivoted on the introduction of the free maternal health care policy in April 2005 in Ghana with the aim of reducing the financial barrier to the use of maternal health care services, to help reduce the high rate of maternal deaths. Prior to the introduction of the policy, studies found wealth to have a positive and significant influence on the use of Antenatal care. It is thus expected that with the policy, wealth should not influence the use of maternal health care significantly. Using secondary data from the 2008 Ghana Demographic and Health survey, the results have revealed that wealth still has a significant influence on adequate use of Antenatal care. Education, age, number of living children, transportation and health insurance are other factors that were found to influence the use of Antenatal care in Ghana. There also exist considerable variations in the use of Antenatal care in the geographical regions and between the rural and urban dwellers. It is recommended that to improve the use of Antenatal care and hence maternal health care utilization, some means of support is provided especially to women within the lowest wealth quintiles, like the provision and availability of recommended medication at the health center; secondly, women should be encouraged to pursue education to at least the secondary level since this improves their use of maternal health services. Policy should also target mothers who have had the experience of child birth on the need to use adequate Antenatal care for each pregnancy, since these mothers tend to use less antenatal care for subsequent pregnancies. The regional disparities found may be due to inaccessibility and unavailability of health facilities and services in the

  15. Postnatal Imaging of Antenatal Hydronephrosis

    Science.gov (United States)

    Kitchens, David M.; Herndon, C. D. Anthony

    2009-01-01

    Radiologic imaging of the newborn detected prenatally with hydronephrosis should follow a systematic approach. Upper and lower urinary tract imaging should be performed in most cases in order to determine the etiology and gauge the use of future imaging. An overview of renal ultrasound, voiding cystourethrography, renal scintigraphy, and magnetic resonance urography in the setting of antenatal hydronephrosis are discussed. PMID:19484160

  16. Postnatal Imaging of Antenatal Hydronephrosis

    Directory of Open Access Journals (Sweden)

    David M. Kitchens

    2009-01-01

    Full Text Available Radiologic imaging of the newborn detected prenatally with hydronephrosis should follow a systematic approach. Upper and lower urinary tract imaging should be performed in most cases in order to determine the etiology and gauge the use of future imaging. An overview of renal ultrasound, voiding cystourethrography, renal scintigraphy, and magnetic resonance urography in the setting of antenatal hydronephrosis are discussed.

  17. Socioeconomic Determinants of the Utilization of Antenatal Care and Child Vaccination in India.

    Science.gov (United States)

    Zuhair, Mohd; Roy, Ram Babu

    2017-11-01

    Antenatal care and child vaccination services are adopted worldwide to reduce the risk of child mortality, maternal mortality, and burden of infectious diseases. This article examines the effect of socioeconomic factors on the utilization of antenatal care and child vaccination services in India. The generalized linear model has been used along with the Indian National Family Health Survey data for the period 2005-2006. The analysis shows that the health insurance plan has a significant effect on the use of antenatal care but not in the child vaccination. Furthermore, there is inequality in the utilization of antenatal care as well as child vaccination services and it is positively related to the wealth. The study suggests that there is a need to improve the socioeconomic status of the financially weaker section of the society for improving the use of child and maternal care services.

  18. Impact of zinc supplementation on the improved fructose/xylose utilization and butanol production during acetone-butanol-ethanol fermentation.

    Science.gov (United States)

    Wu, You-Duo; Xue, Chuang; Chen, Li-Jie; Bai, Feng-Wu

    2016-01-01

    Lignocellulosic biomass and dedicated energy crops such as Jerusalem artichoke are promising alternatives for biobutanol production by solventogenic clostridia. However, fermentable sugars such as fructose or xylose released from the hydrolysis of these feedstocks were subjected to the incomplete utilization by the strains, leading to relatively low butanol production and productivity. When 0.001 g/L ZnSO4·7H2O was supplemented into the medium containing fructose as sole carbon source, 12.8 g/L of butanol was achieved with butanol productivity of 0.089 g/L/h compared to only 4.5 g/L of butanol produced with butanol productivity of 0.028 g/L/h in the control without zinc supplementation. Micronutrient zinc also led to the improved butanol production up to 8.3 g/L derived from 45.2 g/L xylose as sole carbon source with increasing butanol productivity by 31.7%. Moreover, the decreased acids production was observed under the zinc supplementation condition, resulting in the increased butanol yields of 0.202 g/g-fructose and 0.184 g/g-xylose, respectively. Similar improvements were also observed with increasing butanol production by 130.2 % and 8.5 %, butanol productivity by 203.4% and 18.4%, respectively, in acetone-butanol-ethanol fermentations from sugar mixtures of fructose/glucose (4:1) and xylose/glucose (1:2) simulating the hydrolysates of Jerusalem artichoke tubers and corn stover. The results obtained from transcriptional analysis revealed that zinc may have regulatory mechanisms for the sugar transport and metabolism of Clostridium acetobutylicum L7. Therefore, micronutrient zinc supplementation could be an effective way for economic development of butanol production derived from these low-cost agricultural feedstocks. Copyright © 2015 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

  19. Maternal Antenatal Depression and Infant Disorganized Attachment at 12 months

    OpenAIRE

    Hayes, Lisa J.; Goodman, Sherryl H.; Carlson, Elizabeth

    2012-01-01

    Although high rates of attachment disorganization have been observed in infants of depressed mothers, little is known about the role of antenatal depression as a precursor to infant attachment disorganization. The primary aim of this study was to examine associations between maternal antenatal depression and infant disorganization at 12 months in a sample of women (N = 79) at risk for perinatal depression. A secondary aim was to test the roles of maternal postpartum depression and maternal pa...

  20. Utilizing Dietary Micronutrient Ratios in Nutritional Research May be More Informative than Focusing on Single Nutrients

    Directory of Open Access Journals (Sweden)

    Owen J. Kelly

    2018-01-01

    Full Text Available The 2015 US dietary guidelines advise the importance of good dietary patterns for health, which includes all nutrients. Micronutrients are rarely, if ever, consumed separately, they are not tissue specific in their actions and at the molecular level they are multitaskers. Metabolism functions within a seemingly random cellular milieu however ratios are important, for example, the ratio of adenosine triphosphate to adenosine monophosphate, or oxidized to reduced glutathione. Health status is determined by simple ratios, such as the waist hip ratio, or ratio of fat mass to lean mass. Some nutrient ratios exist and remain controversial such as the omega-6/omega-3 fatty acid ratio and the sodium/potassium ratio. Therefore, examining ratios of micronutrients may convey more information about how diet and health outcomes are related. Summarized micronutrient intake data, from food only, from the National Health and Nutrition Examination Survey, were used to generate initial ratios. Overall, in this preliminary analysis dietary ratios of micronutrients showed some differences between intakes and recommendations. Principles outlined here could be used in nutritional epidemiology and in basic nutritional research, rather than focusing on individual nutrient intakes. This paper presents the concept of micronutrient ratios to encourage change in the way nutrients are regarded.

  1. Understanding delayed access to antenatal care: a qualitative interview study

    Science.gov (United States)

    2014-01-01

    Background Delayed access to antenatal care ('late booking’) has been linked to increased maternal and fetal mortality and morbidity. The aim of this qualitative study was to understand why some women are late to access antenatal care. Methods 27 women presenting after 19 completed weeks gestation for their first hospital booking appointment were interviewed, using a semi-structured format, in community and maternity hospital settings in South Yorkshire, United Kingdom. Interviews were transcribed verbatim and entered onto NVivo 8 software. An interdisciplinary, iterative, thematic analysis was undertaken. Results The late booking women were diverse in terms of: age (15–37 years); parity (0–4); socioeconomic status; educational attainment and ethnicity. Three key themes relating to late booking were identified from our data: 1) 'not knowing’: realisation (absence of classic symptoms, misinterpretation); belief (age, subfertility, using contraception, lay hindrance); 2) 'knowing’: avoidance (ambivalence, fear, self-care); postponement (fear, location, not valuing care, self-care); and 3) 'delayed’ (professional and system failures, knowledge/empowerment issues). Conclusions Whilst vulnerable groups are strongly represented in this study, women do not always fit a socio-cultural stereotype of a 'late booker’. We report a new taxonomy of more complex reasons for late antenatal booking than the prevalent concepts of denial, concealment and disadvantage. Explanatory sub-themes are also discussed, which relate to psychological, empowerment and socio-cultural factors. These include poor reproductive health knowledge and delayed recognition of pregnancy, the influence of a pregnancy 'mindset’ and previous pregnancy experience, and the perceived value of antenatal care. The study also highlights deficiencies in early pregnancy diagnosis and service organisation. These issues should be considered by practitioners and service commissioners in order to promote

  2. SAFETY OF MICRONUTRIENTS

    African Journals Online (AJOL)

    ingestion of vitamins A, D and B6-' most of the side-effects that occur with vitamin supplements are rapidly reversible on withdrawal of the supplementation and leave minimal or no ... Children> 12 months of age .... safety (since the infant receives relatively low doses of ... metabolism of protein, fat and carbohydrate. Because ...

  3. Parents' experiences and perceptions of group-based antenatal care in four clinics in Sweden.

    Science.gov (United States)

    Andersson, Ewa; Christensson, Kyllike; Hildingsson, Ingegerd

    2012-08-01

    group-based antenatal care consists of six to nine two-hour sessions in which information is shared and discussed during the first hour and individual examinations are conducted during the second hour. Groups generally consist of six to eight pregnant women. Parent education is built into the programme, which originated in the United States and was introduced in Sweden at the beginning of the year of 2000. to investigate parents' experiences of group antenatal care in four different clinics in Sweden. a qualitative study was conducted using content analysis five group interviews and eleven individual interviews with parents who experienced group-based antenatal care. An interview guide was used. the study was set in four antenatal clinics that had offered group-based antenatal care for at least one year. The clinics were located in three different areas of Sweden. the participants were women and their partners who had experienced group-based antenatal care during pregnancy. Other criteria for participation were mastery of the Swedish language and having followed the care programme. three themes emerged, 'The care-combining individual physical needs with preparation for parenthood, refers to the context, organisation, and content of care'. Group antenatal care with inbuilt parent education was appreciated, but respondents reported that they felt unprepared for the first few weeks after birth. Their medical needs (for physical assessment and screening) were, however, fulfilled. The theme, 'The group-a composed recipient of care', showed the participants role and experience. The role could be passive or active in groups or described as sharers. Groups helped parents normalise their symptoms. The theme, 'The midwife-a controlling professional', showed midwives are ignorant of gender issues but, for their medical knowledge, viewed as respectable professionals. in the four clinics studied, group-based antenatal care appeared to meet parents' needs for physical assessment

  4. Macro- and micronutrient disposition in an ex vivo model of extracorporeal membrane oxygenation.

    Science.gov (United States)

    Estensen, Kristine; Shekar, Kiran; Robins, Elissa; McDonald, Charles; Barnett, Adrian G; Fraser, John F

    2014-12-01

    Extracorporeal membrane oxygenation (ECMO) circuits have been shown to sequester circulating blood compounds such as drugs based on their physicochemical properties. This study aimed to describe the disposition of macro- and micronutrients in simulated ECMO circuits. Following baseline sampling, known quantities of macro- and micronutrients were injected post oxygenator into ex vivo ECMO circuits primed with the fresh human whole blood and maintained under standard physiologic conditions. Serial blood samples were then obtained at 1, 30 and 60 min and at 6, 12 and 24 h after the addition of nutrients, to measure the concentrations of study compounds using validated assays. Twenty-one samples were tested for thirty-one nutrient compounds. There were significant reductions (p single-dose ex vivo circuit study. Most significantly, there is potential for circuit loss of essential amino acid isoleucine and lipid soluble vitamins (A and E) in the ECMO circuit, and the mechanisms for this need further exploration. While the reductions in glucose concentrations and an increase in other macro- and micronutrient concentrations probably reflect cellular metabolism and breakdown, the decrement in arginine and glutamine concentrations may be attributed to their enzymatic conversion to ornithine and glutamate, respectively. While the results are generally reassuring from a macronutrient perspective, prospective studies in clinical subjects are indicated to further evaluate the influence of ECMO circuit on micronutrient concentrations and clinical outcomes.

  5. Socio Demographic Factors Determining the Adequacy of Antenatal Care among Pregnant Women Visiting Ekiti State Primary Health Centers

    Directory of Open Access Journals (Sweden)

    Ikeoluwapo O. Ajayi

    2013-08-01

    Full Text Available A cross sectional study was conducted in Primary Health Centers among pregnant women to elucidate adequacy of antenatal care across different socio demographic variables. Four hundred respondents were proportionately selected from 18 primary health centers using simple random sampling. Exit interviews were conducted using the adapted antenatal care exit interview form of the Safe Motherhood Needs Assessment package. Data was analyzed using descriptive statistics and Chi square test. Adequacy of antenatal care in this study was measured by the single adequacy indicators which are duration of pregnancy at entry into antenatal care and number of antenatal visits; which are particularly suitable for developing countries. Age of respondents, means of transportation to the PHCs, occupation, location and level of education of the respondents were found to be determinants of whether the pregnant women attended their first antenatal visit in the first trimester, similarly, age of the respondents was a predictor of whether the women made up to four antenatal visits by their third trimester. Occupation and level of education were determinants of whether or not the pregnant women made their first antenatal visits at the first trimester. More respondents who were not working and those who were unskilled workers made their first antenatal visit at the first trimester compared to those who were skilled workers; work place policies and the fact that antenatal booking are made on weekdays and at work hours may hinder or be discouraging to the working class mothers.

  6. Antenatal exposure following the Chernobyl accident: neuropsychiatric aspects

    International Nuclear Information System (INIS)

    Igumnov, S.A.; Drozdovitch, V.V.

    2004-01-01

    Ten years follow-up investigation of intellectual development of 250 persons from Belarus exposed in utero following the Chernobyl accident and a control group of 250 persons from non- and slightly contaminated regions has been conducted. Neuropsychiatry and psychological examinations were performed among persons of both groups at the age of 6-7, 0-12, and 15-16 years. Mean antenatal external dose among persons of exposed group is 10 ± 13 mGy, maximal dose - 91 mGy. No statistically significant correlation was found in exposed group between individual thyroid dose as well as individual antenatal external dose and IQ at the age of 6-7 years, 10-12 years, and 15-16 years

  7. Minimal impact by antenatal subpatent P. falciparum infections on delivery outcomes in Malawian women: a cohort study.

    OpenAIRE

    Taylor, Steve M; Madanitsa, Mwayiwawo; Thwai, Kyaw-Lay; Khairallah, Carole; Kalilani-Phiri, Linda; vanEijk, Anna; Mwapasa, Victor; terKuile, Feiko; Meshnick, Steven R

    2017-01-01

    Antenatal malaria screening with a rapid diagnostic test (RDT) and treatment only of RDT-positive women may potentially prevent low birthweight resulting from malaria. The consequences of subpatent antenatal infections below the detection limit of RDTs are incompletely understood. In Malawi, pregnant women of any gravidity were tested at each antenatal visit for P. falciparum using RDT and PCR and followed until delivery. Associations between antenatal infections and delivery outcomes were as...

  8. ECONOMICAL BASIS TO ADDRESS MICRONUTRIENT DEFICIENCIES IN DEVELOPING WORLD

    Directory of Open Access Journals (Sweden)

    Amirul Hassan

    2015-01-01

    Full Text Available Malnutrition has been called by economists at the World Bank as the “non-human face” of poverty,1 Adults who were malnourished as children earn at least 20% less on average than those who weren’t , 2.Malnutrition is often caused by underlying economics, i.e. the lack of money. Economics is very important in regards to malnutrition; it allows an individual to purchase nutrients. In many places around the world, a lack of money prevents the purchase of a variety of foods. The lack in variety usually leads to micronutrient malnutrition. Economics also decides the production of food in all countries around the world and the ability of a country to overcome difficult times. Thus economics affects ALL people at ALL levels of society, 3.Micronutrient deficiencies also known as ‘hidden hunger’ are determining and aggravating factors for health status and quality of life. It is estimated half of anaemia cases are due to iron deficiency , 4.  Almost half of children in low- and middle-income countries – 47% of under-fives are affected by anaemia, impairing cognitive and physical development,5. Iodine deficiency is the greatest single cause of mental retardation and brain damage. Coincidently,  the number of countries in which iodine-deficiency disorders were considered a public health concern reduced by 43% between 1993 and 2007,6.  Zinc deficiency affects children’s health and physical growth; it is also essential for mothers during pregnancy. It is estimated to cause 4% of deaths in pre-school aged children in lower-income countries. 7 . The Global Burden of Disease estimates showed that among the 26 major risk factors of the global burden of disease,8 iron deficiency ranks ninth overall, zinc deficiency is eleventh, and vitamin A deficiency, is thirteenth. Annually each developing country of the world are losing over millions or billions US $ in Gross Domestic Product (GDP to vitamins and minerals deficiencies. But scaling up core

  9. Creatinine, diet, micronutrients, and arsenic methylation in West Bengal, India.

    Science.gov (United States)

    Basu, Arin; Mitra, Soma; Chung, Joyce; Guha Mazumder, D N; Ghosh, Nilima; Kalman, David; von Ehrenstein, Ondine S; Steinmaus, Craig; Liaw, Jane; Smith, Allan H

    2011-09-01

    Ingested inorganic arsenic (InAs) is methylated to monomethylated (MMA) and dimethylated metabolites (DMA). Methylation may have an important role in arsenic toxicity, because the monomethylated trivalent metabolite [MMA(III)] is highly toxic. We assessed the relationship of creatinine and nutrition--using dietary intake and blood concentrations of micronutrients--with arsenic metabolism, as reflected in the proportions of InAS, MMA, and DMA in urine, in the first study that incorporated both dietary and micronutrient data. We studied methylation patterns and nutritional factors in 405 persons who were selected from a cross-sectional survey of 7,638 people in an arsenic-exposed population in West Bengal, India. We assessed associations of urine creatinine and nutritional factors (19 dietary intake variables and 16 blood micronutrients) with arsenic metabolites in urine. Urinary creatinine had the strongest relationship with overall arsenic methylation to DMA. Those with the highest urinary creatinine concentrations had 7.2% more arsenic as DMA compared with those with low creatinine (p creatinine concentration was the strongest biological marker of arsenic methylation efficiency, and therefore should not be used to adjust for urine concentration in arsenic studies. The new finding that animal fat intake has a positive relationship with MMA% warrants further assessment in other studies. Increased MMA% was also associated, to a lesser extent, with low serum selenium and folate.

  10. Status of micronutrient nutrition in Zimbabwe: A review | Gadaga ...

    African Journals Online (AJOL)

    malnutrition including vitamin and mineral malnutrition. This paper constitutes a review of the micronutrient malnutrition status of the Zimbabwean population, focusing on the period from 1980 to 2006, using data from nutrition surveys, the demographic health surveys, sentinel surveillance and monitoring programmes. Data

  11. Effect of multi-micronutrient-fortified rice on cognitive performance depends on premix composition and cognitive function tested

    DEFF Research Database (Denmark)

    Fiorentino, Marion; Perignon, Marlène; Khov, Kuong

    2018-01-01

    OBJECTIVE: Even though current policy is strongly focused on the crucial first '1000 days', it might be still possible to enhance cognitive function during the pre-adolescent and adolescent years by improving micronutrient status. In Cambodia, nutritional status is poor. Provision of rice fortified...... with micronutrients through a school meal programme (SMP) could be a cost-effective strategy to help improve health and school performance. The present study aimed to evaluate the effect of three different micronutrient-fortified rice formulations on cognitive function in Cambodian children. SETTING: Sixteen...

  12. Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs.

    Science.gov (United States)

    Zulu, Rodah M; Byrne, Nuala M; Munthali, Grace K; Chipeta, James; Handema, Ray; Musonda, Mofu; Hills, Andrew P

    2011-09-21

    Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV) treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS) is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA) beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW) and derive fat-free mass (FFM) and fat mass (FM). This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI), body composition, CD4, viral load and micronutrient status. This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques. Pan African Clinical Trial Registry PACTR201108000303396.

  13. Effects of a multi-micronutrient-fortified beverage, with and without sugar, on growth and cognition in South African schoolchildren: a randomised, double-blind, controlled intervention.

    Science.gov (United States)

    Taljaard, Christine; Covic, Namukolo M; van Graan, Averalda E; Kruger, Herculina S; Smuts, Cornelius M; Baumgartner, Jeannine; Kvalsvig, Jane D; Wright, Hattie H; van Stuijvenberg, Martha E; Jerling, Johann C

    2013-12-01

    Little is known about the effects of combined micronutrient and sugar consumption on growth and cognition. In the present study, we investigated the effects of micronutrients and sugar, alone and in combination, in a beverage on growth and cognition in schoolchildren. In a 2 × 2 factorial design, children (n 414, 6-11 years) were randomly allocated to consume beverages containing (1) micronutrients with sugar, (2) micronutrients with a non-nutritive sweetener, (3) no micronutrients with sugar or (4) no micronutrients with a non-nutritive sweetener for 8.5 months. Growth was assessed and cognition was tested using the Kaufman Assessment Battery for Children version II (KABC-II) subtests and the Hopkins Verbal Learning Test (HVLT). Micronutrients decreased the OR for Fe deficiency at the endpoint (OR 0.19; 95% CI 0.07, 0.53). Micronutrients increased KABC Atlantis (intervention effect: 0.76; 95% CI 0.10, 1.42) and HVLT Discrimination Index (1.00; 95% CI 0.01, 2.00) scores. Sugar increased KABC Atlantis (0.71; 95% CI 0.05, 1.37) and Rover (0.72; 95% CI 0.08, 1.35) scores and HVLT Recall 3 (0.94; 95% CI 0.15, 1.72). Significant micronutrient × sugar interaction effects on the Atlantis, Number recall, Rover and Discrimination Index scores indicated that micronutrients and sugar in combination attenuated the beneficial effects of micronutrients or sugar alone. Micronutrients or sugar alone had a lowering effect on weight-for-age z-scores relative to controls (micronutrients - 0.08; 95% CI - 0.15, - 0.01; sugar - 0.07; 95% CI - 0.14, - 0.002), but in combination, this effect was attenuated. The beverages with micronutrients or added sugar alone had a beneficial effect on cognition, which was attenuated when provided in combination.

  14. Micronutrient Synergy in the Fight against Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Roomi, M. Waheed; Roomi, Nusrath W.; Kalinovsky, Tatiana; Niedzwiecki, Aleksandra, E-mail: a.niedz@drrath.com; Rath, Matthias [Dr. Rath Research Institute, 1260 Memorex Drive, Santa Clara, CA 95050 (United States)

    2012-03-23

    The incidence of hepatocellular carcinoma (HCC), once thought to be a rare tumor in North America, has rapidly increased in recent years in the United States. Current treatment modalities to halt the progression of this disease are only marginally effective. The mainstay treatment is liver transplantation, which is often confronted with donor shortage. Invasion, metastasis and recurrence contribute to the high mortality rate of this disease. Matrix metalloproteinases (MMPs) that degrade the extracellular matrix (ECM) have been associated with the progression, invasion and metastasis of the disease. We have developed strategies to strengthen the ECM collagen and inhibit MMPs through micronutrients such as lysine, proline and ascorbic acid. Addition of epigallocatechin gallate or green tea extract to these micronutrients synergistically enhanced anti-carcinogenic activity in HepG2 cells. Addition of certain other micronutrients, such as N-acetylcysteine, selenium, copper and zinc (NM) synergistically enhanced the anticancer activity of the mixture in a model of hepatocellular carcinoma using HepG2 cells. In vitro studies using HepG2 demonstrated that NM was very effective in inhibiting cell proliferation (by MTT assay), MMPs secretion (by gelatinase zymography), cell invasion (through Matrigel) and induction of apoptosis (by live green caspase). In addition, NM was shown to down-regulate urokinase plasminogen activator (by fibrin zymography) and up-regulate tissue inhibitors of metalloproteinases (by reverse zymography) in another HCC cell line, SK-Hep-1. MMP-2 and MMP-9 activities were further modulated by phorbol 12-myristate 13-acetate (PMA) induction and inhibited by NM. In previous studies, NM inhibited Sk-Hep-1 xenografts in nude mice and also inhibited hepatic metastasis of B16FO melanoma cells. Our results suggest that NM is an excellent candidate for therapeutic use in the treatment HCC by inhibiting critical parameters in cancer development and progression

  15. Micronutrient Synergy in the Fight against Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    Roomi, M. Waheed; Roomi, Nusrath W.; Kalinovsky, Tatiana; Niedzwiecki, Aleksandra; Rath, Matthias

    2012-01-01

    The incidence of hepatocellular carcinoma (HCC), once thought to be a rare tumor in North America, has rapidly increased in recent years in the United States. Current treatment modalities to halt the progression of this disease are only marginally effective. The mainstay treatment is liver transplantation, which is often confronted with donor shortage. Invasion, metastasis and recurrence contribute to the high mortality rate of this disease. Matrix metalloproteinases (MMPs) that degrade the extracellular matrix (ECM) have been associated with the progression, invasion and metastasis of the disease. We have developed strategies to strengthen the ECM collagen and inhibit MMPs through micronutrients such as lysine, proline and ascorbic acid. Addition of epigallocatechin gallate or green tea extract to these micronutrients synergistically enhanced anti-carcinogenic activity in HepG2 cells. Addition of certain other micronutrients, such as N-acetylcysteine, selenium, copper and zinc (NM) synergistically enhanced the anticancer activity of the mixture in a model of hepatocellular carcinoma using HepG2 cells. In vitro studies using HepG2 demonstrated that NM was very effective in inhibiting cell proliferation (by MTT assay), MMPs secretion (by gelatinase zymography), cell invasion (through Matrigel) and induction of apoptosis (by live green caspase). In addition, NM was shown to down-regulate urokinase plasminogen activator (by fibrin zymography) and up-regulate tissue inhibitors of metalloproteinases (by reverse zymography) in another HCC cell line, SK-Hep-1. MMP-2 and MMP-9 activities were further modulated by phorbol 12-myristate 13-acetate (PMA) induction and inhibited by NM. In previous studies, NM inhibited Sk-Hep-1 xenografts in nude mice and also inhibited hepatic metastasis of B16FO melanoma cells. Our results suggest that NM is an excellent candidate for therapeutic use in the treatment HCC by inhibiting critical parameters in cancer development and progression

  16. Focusing on relationships, not information, respects autonomy during antenatal consultations.

    Science.gov (United States)

    Gaucher, Nathalie; Payot, Antoine

    2017-01-01

    Policy statements regarding antenatal consultations for preterm labour are guided by physicians' concerns for upholding the legal doctrine of informed consent, through the provision of standardised homogeneous medical information. This approach, led by classical in-control conceptions of patient autonomy, conceives moral agents as rational, independent, self-sufficient decision-makers. Recent studies on these antenatal consultations have explored patients' perspectives, and these differ from guidelines' suggestions. Relational autonomy - which understands moral agents as rational, emotional, creative and interdependent - resonates impressively with these new data. A model for antenatal consultations is proposed. This approach encourages clinicians to explore individual patients' lived experiences and engage in trusting empowering relationships. Moreover, it calls on physicians to enhance patients' relational autonomy by becoming advocates for their patients within healthcare institutions and professional organisations, while calling for broadscale policy changes to encourage further funding and support in investigations of the patient's voice. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  17. Medical improvisation training to enhance the antenatal counseling skills of neonatologists and neonatal fellows: a pilot study.

    Science.gov (United States)

    Sawyer, Taylor; Fu, Belinda; Gray, Megan; Umoren, Rachel

    2017-08-01

    Neonatologists must be skilled at providing antenatal counseling to expectant parents of premature infants at the limits of viability. We conducted a medical improvisation workshop with the objective of enhancing antenatal counseling skills. Pre- and postworkshop questionnaires were collected to examine the impact of the training. A follow-up survey was distributed 3 months after the workshop to examine the impact of the training on antenatal counseling skills. Nine neonatologists and three neonatal fellows participated in the workshop. Participants reported the skills learned in the workshop could enhance the quality of antenatal counseling. On follow-up survey, 90% of subjects reported improvements in the quality of their antenatal counseling. Participation in a medical improvisation workshop resulted in enhancements of self-perceived antenatal counseling skills. Medical improvisation training may provide a feasible and effective method of communication training for neonatologists. Further research into this innovative method are needed.

  18. Nutrition meets the microbiome: micronutrients and the microbiota.

    Science.gov (United States)

    Biesalski, Hans K

    2016-05-01

    There is increasing evidence that food is an important factor that influences and shapes the composition and configuration of the gut microbiota. Most studies have focused on macronutrients (fat, carbohydrate, protein) in particular and their effects on the gut microbiota. Although the microbiota can synthesize different water-soluble vitamins, the effects of vitamins synthesized within the microbiota on systemic vitamin status are unclear. Few studies exist on the shuttling of vitamins between the microbiota and intestine and the impact of luminal vitamins on the microbiota. Studying the interactions between vitamins and the microbiota may help to understand the effects of vitamins on the barrier function and immune system of the intestinal tract. Furthermore, understanding the impact of malnutrition, particularly low micronutrient supply, on microbiota development, composition, and metabolism may help in implementing new strategies to overcome the deleterious effects of malnutrition on child development. This article reviews data on the synthesis of different micronutrients and their effects on the human microbiota, and further discusses the consequences of malnutrition on microbiota composition. © 2016 New York Academy of Sciences.

  19. Modifying effects of maternal Hb concentration on infant birth weight in women receiving prenatal iron-containing supplements: a randomised controlled trial.

    Science.gov (United States)

    Wang, Linlin; Mei, Zuguo; Li, Hongtian; Zhang, Yali; Liu, Jianmeng; Serdula, Mary K

    2016-02-28

    Concerns have been raised about the benefits of Fe-containing supplements on infant birth weight among women with normal/high Hb levels at baseline. Thus far, no clinical trials have examined whether the effects of prenatal Fe-containing supplements on birth weight vary by maternal Hb levels. We compared the effects of Fe-folic acid (IFA) or multiple micronutrients (MMN) with folic acid (FA) supplements on birth weight among pregnant women with mild/no anaemia or high Hb levels. A double-blind randomised controlled trial was conducted in 2006-2009. In total, 18 775 pregnant women with mild/no anaemia (145 g/l) baseline Hb levels, IFA and MMN supplements increased birth weight by 91·44 (95% CI 3·37, 179·51) g and 107·63 (95% CI 21·98, 193·28) g (PHb concentration. In conclusion, the effects of Fe-containing supplements on birth weight depended on baseline Hb concentrations. The Fe-containing supplements improved birth weight in women with very high Hb levels before 20 weeks of gestation.

  20. Compliance to iron and folic acid supplementation in pregnancy, Northwest Ethiopia.

    Science.gov (United States)

    Birhanu, Tesfaye Molla; Birarra, Mequanent Kassa; Mekonnen, Fantahun Ayenew

    2018-05-30

    Strict compliance to iron and folic acid supplementation is vital for prevention of anemia in pregnancy. However, data are scarce in Ethiopia. So, we conducted this study to assess the level of compliance to iron and folic acid supplementation during pregnancy and its associated factors. Of 418 women, over half, 231 (55.3%), adhered to the recommended iron and folic acid supplementation. Women who started antenatal care (ANC) follow up early [AOR; 95% CI 2.43 (1.12-5.26)], had more frequent number of ANC visit [AOR; 95% CI 2.73 (1.32-5.61)], took small number of tablets per visit [AOR; 95% CI 3.0 (1.21-7.43)], had history of anemia [AOR; 95% CI 1.9 (1.17-3.12)], and were from urban areas [AOR; 95% CI 2.2 (1.29-3.77)], were more likely to conform to recommended iron and folic acid supplementation. Therefore, there need to be prescription of the lowest possible number of tablets per visit. Furthermore, education targeting on increasing maternal health service utilization need to be in place. There need to also be further research aimed at determining the number of tablets to be prescribed per visit specific to individuals' background characteristics.

  1. Socioeconomic differences in micronutrient intake and status in Europe

    NARCIS (Netherlands)

    Novakovic, R.N.

    2013-01-01

    The aim of this thesis was to evaluate micronutrient intake and status of socioeconomic disadvantaged populations, such as from Central and Eastern European (CEE) as compared to other European populations, and low socioeconomic status (SES) groups as compared to high SES groups within European

  2. Anaemia in pregnancy and associated factors: a cross sectional study of antenatal attendants at the Sunyani Municipal Hospital, Ghana.

    Science.gov (United States)

    Anlaakuu, Peter; Anto, Francis

    2017-08-11

    Anaemia in pregnancy is an important health issue resulting in high maternal morbidity and mortality. The purpose of the current study was to identify factors associated with anaemia among pregnant women receiving antenatal care at the Sunyani Municipal Hospital in Ghana. A cross-sectional study involving pregnant women seeking antenatal care at the Sunyani Municipal Hospital was conducted between May and June, 2015. It involved the collection of data on socio demographic and obstetric variables, medical interventions and malaria infection, consumption of iron containing foods and supplements using a case record form and a structured questionnaire. Also, data on haemoglobin concentrations at first and current antenatal visit were collected. Bivariate and multivariate statistical analysis were done to determine factors associated with anaemia. Out of the 316 participants, 129 (40.8%) were found to be anaemic (Hb prevalence of anaemia was found to be similar to that of the first visit with 131 (41.5%) of them being anaemic [mean Hb: 11.24 g/dl, range 8.10-14.5 g/dl]. The haemoglobin levels however improved significantly during the most recent visit compared to the first with none of the women being severely anaemic (Hb prevalence of moderate anaemia reduced from 37.2% (CI 28.9-46.2) during the first visit to 19.1% (12.7-26.9) during the most recent visit, a reduction of 48.7%. Malaria infection, frequency at which one consumed fish/snails and gestational age at first ANC visit were the main factors found to be associated with anaemia among the pregnant women. Malaria infection, fish/snails intake and gestational age at first ANC visit were significantly associated with anaemia. Addressing these factors can reduce the incidence of anaemia in pregnancy.

  3. Quadruple burden of HIV/AIDS, tuberculosis, chronic intestinal parasitoses, and multiple micronutrient deficiency in ethiopia: a summary of available findings.

    Science.gov (United States)

    Amare, Bemnet; Moges, Beyene; Mulu, Andargachew; Yifru, Sisay; Kassu, Afework

    2015-01-01

    Human immunodeficiency virus (HIV), tuberculosis (TB), and helminthic infections are among the commonest public health problems in the sub-Saharan African countries like Ethiopia. Multiple micronutrient deficiencies also known as the "hidden hunger" are common in people living in these countries either playing a role in their pathogenesis or as consequences. This results in a vicious cycle of multiple micronutrient deficiencies and infection/disease progression. As infection is profoundly associated with nutritional status resulting from decreased nutrient intake, decreased nutrient absorption, and nutrient losses, micronutrient deficiencies affect immune system and impact infection and diseases progression. As a result, micronutrients, immunity, and infection are interrelated. The goal of this review is therefore to provide a summary of available findings regarding the "quadruple burden trouble" of HIV, TB, intestinal parasitic infections, and multiple micronutrient deficiencies to describe immune-modulating effects related to disorders.

  4. Antenatal care and morbidity profile of pregnant women in an urban resettlement colony of Delhi, India.

    Science.gov (United States)

    Rustagi, N; Prasuna, J G; Vibha, M D

    2011-06-01

    The burden of antenatal morbidities and health care services utilization during antenatal period serve an important role in defining service needs and to assess reproductive health status of women. To evaluate the burden of antenatal morbidities in women and to assess the health care utilization by study subjects during antenatal period. A community based follow up study was carried out in an urban resettlement colony of Delhi. All pregnant women in the study area were enrolled and followed for two more visits to collect information about morbidities suffered and health care services utilized during pregnancy. Appropriate tests of significance were applied. Of 358 women enrolled, three hundred could be followed for two more visits. Majority of women (80.3%) suffered one or more morbidities during their current pregnancy but overall care sought for illness during pregnancy was poor. Visits for routine preventive check up was made by most of women (95% and above) but recommended three antenatal visits was significantly low among women of age more than thirty (OR=16.6; 2.2-125.9), of lower middle socio economic status (OR=2.84; 1.16-6.93) and parity three or more (OR=4.37; 1.07-17.83). Women with education status of high school and above had significantly lower odd ratio (OR=0.33; 0.11-0.99) for having less than three antenatal visits. Care sought for antenatal morbidities is still poor among women of urban resettlement colonies and age, parity and education of women has a significant bearing on antenatal visits.

  5. Factors affecting satisfaction on antenatal care services in Sarawak, Malaysia: evidence from a cross sectional study.

    Science.gov (United States)

    Rahman, Md Mizanur; Ngadan, Deburra Peak; Arif, Mohammad Taha

    2016-01-01

    High levels of satisfaction among women with the antenatal care services will increase the compliance of antenatal visits during pregnancy. Thus, this study was done to assess the level of satisfaction among women on the quality of antenatal care received and the factors influencing thereof. This was a cross-sectional study conducted in the three zones of Sarawak. Women aged 18 years and above, irrespective of ethnic groups, having children aged 3 years and below were included in the study. Data was collected by face-to-face interview using interview schedule. A validated Patient Satisfaction Questionnaire (PSQ-18) was used to assess the satisfaction with antenatal care. A total of 1236 data was analysed using IBM SPSS version 22.0. A p value <0.05 was considered as statistically significant. A multinomial logistic regression analysis revealed that Bidayuh 17.4 % was less likely to be highly satisfied with antenatal care. Similarly, respondents with secondary level of education 29.9 % were less likely to be highly satisfied, whereas, respondents having primary level of education, 1.6 % were less likely to be highly satisfied. However, those who did not spend any money as out of pocket expenses were 1.935 times more likely to be highly satisfied with antenatal care. Overall the studied women were satisfied with the antenatal care services. Ethnicity, level of education and out of pocket expenses appeared to be important predictors of satisfaction with antenatal care. The finding recommends the community-based and language-specific interventions should be implemented to sustain the satisfaction of maternal care.

  6. Characterization of nutrient deficiency in Hancornia speciosa Gomes seedlings by omitting micronutrients from the nutrient solution

    Directory of Open Access Journals (Sweden)

    Layara Alexandre Bessa

    2013-06-01

    Full Text Available Hancornia speciosa Gomes (Mangaba tree is a fruit tree belonging to the Apocynaceae family and is native to Brazil. The production of seedlings of this species is limited by a lack of technical and nutritional expertise. To address this deficiency, this study aimed to characterize the visual symptoms of micronutrient deficiency and to assess growth and leaf nutrient accumulation in H. speciosa seedlings supplied with nutrient solutions that lack individual micronutrients. H. speciosa plants were grown in nutrient solution in a greenhouse according to a randomized block design, with four replicates. The treatments consisted of a group receiving complete nutrient solution and groups treated with a nutrient solution lacking one of the following micronutrients: boron (B, copper (Cu, iron (Fe, manganese (Mn, zinc (Zn, and molybdenum (Mo. The visual symptoms of nutrient deficiency were generally easy to characterize. Dry matter production was affected by the omission of micronutrients, and the treatment lacking Fe most limited the stem length, stem diameter, root length, and number of leaves in H. speciosa seedlings as well as the dry weight of leaves, the total dry weight, and the relative growth in H. speciosa plants. The micronutrient contents of H. speciosa leaves from plants receiving the complete nutrient solution treatment were, in decreasing order, Fe>Mn>Cu>Zn>B.

  7. Antenatal education in small classes may increase childbirth self-efficacy

    DEFF Research Database (Denmark)

    Brixval, Carina S; Axelsen, Solveig F; Thygesen, Lau C

    2016-01-01

    Antenatal education in small classes may increase childbirth self-efficacy. In this randomised trial we assessed the effect of a structured antenatal programme versus auditorium-based lectures on childbirth self-efficacy measured by three single items. We found that women in the intervention group...... reported statistically significant higher levels of confidence in their ability to cope at home during labour compared to the control group. Likewise, the intervention had a positive effect on the women's confidence in own ability to handle the birth process....

  8. Impact of antenatal steroids on intraventricular hemorrhage in very-low-birth weight infants.

    Science.gov (United States)

    Wei, J C; Catalano, R; Profit, J; Gould, J B; Lee, H C

    2016-05-01

    To determine the association between antenatal steroids administration and intraventricular hemorrhage rates. We used cross-sectional data from the California Perinatal Quality Care Collaborative during 2007 to 2013 for infants ⩽32 weeks gestational age. Using multivariable logistic regression, we evaluated the effect of antenatal steroids on intraventricular hemorrhage, stratified by gestational age. In 25 979 very-low-birth weight infants, antenatal steroid use was associated with a reduction in incidence of any grade of intraventricular hemorrhage (odds ratio=0.68, 95% confidence interval: 0.62, 0.75) and a reduction in incidence of severe intraventricular hemorrhage (odds ratio=0.51, 95% confidence interval: 0.45, 0.58). This association was seen across gestational ages ranging from 22 to 29 weeks. Although current guidelines recommend coverage for preterm birth at 24 to 34 weeks gestation, our results suggest that treatment with antenatal steroids may be beneficial even before 24 weeks of gestational age.

  9. Impact of Antenatal Steroids on Intraventricular Hemorrhage in Very Low Birth Weight Infants

    Science.gov (United States)

    Wei, Julia C.; Catalano, Ralph; Profit, Jochen; Gould, Jeffrey B.; Lee, Henry C.

    2016-01-01

    Objective To determine the association between antenatal steroids administration and intraventricular hemorrhage rates. Methods We used cross-sectional data from the California Perinatal Quality Care Collaborative during 2007-2013 for infants ≤ 32 weeks gestational age. Using multivariable logistic regression, we evaluated the effect of antenatal steroids on intraventricular hemorrhage, stratified by gestational age. Results In 25,979 very low birth weight infants, antenatal steroid use was associated with a reduction in incidence of any grade of intraventricular hemorrhage (odds ratio = 0.51, 95% confidence interval: 0.45, 0.58) and a reduction in incidence of severe intraventricular hemorrhage (odds ratio = 0.62, 95% confidence interval: 0.57, 0.67). This association was seen across gestational ages ranging from 22 to 29 weeks. Conclusions While current guidelines recommend coverage for preterm birth at 24 to 34 weeks gestation, our results suggest that treatment with antenatal steroids may be beneficial even before 24 weeks of gestational age. PMID:27010109

  10. Antenatal hydronephrosis: Negative predictive value of normal postnatal ultrasound - a 5-year study

    Energy Technology Data Exchange (ETDEWEB)

    Moorthy, I.; Joshi, N.; Cook, J.V. E-mail: jcook@epsom-sthelier.nhs.uk; Warren, M

    2003-12-01

    AIM: To determine whether normal postnatal ultrasound, as part of a strict screening protocol for the detection and follow-up of antenatal hydronephrosis, effectively excludes the majority of babies with congenital urinary tract abnormalities that would otherwise present with a urinary tract infection. MATERIALS AND METHODS: We retrospectively reviewed all babies who had postnatal follow-up of antenatally detected hydronephrosis over a 5-year period at our institution, a district general Trust with a specialist paediatric unit. We then studied all babies presenting with urinary tract infection before their first birthday to our institution over the same period. By cross-referencing these two study groups we were able to determine which babies developed a urinary tract infection having been previously discharged after normal postnatal ultrasound. RESULTS: Four hundred and twenty-five babies had postnatal follow-up of antenatal hydronephrosis. Of these, 284 were investigated with ultrasound alone. In the same 5-year period, 230 babies presented with urinary tract infection before their first birthday. Only three of these babies had been previously discharged after normal postnatal ultrasound. The negative predictive value of a normal postnatal ultrasound was therefore 98.9% (281/284) for babies who subsequently presented with a urinary tract infection before their first birthday. CONCLUSION: Careful antenatal and postnatal ultrasound with strict protocols is effective in detecting congenital renal tract abnormalities. Infants discharged after normal postnatal ultrasound are highly unlikely to still have an undetected urinary tract abnormality. We suggest that all babies with antenatal hydronephrosis are started on prophylactic antibiotics at birth, pending further investigation. All babies without features of severe obstruction antenatally should have their postnatal ultrasound delayed for a month. We recommend selective use of micturating cystourethrogram (MCUG

  11. Antenatal hydronephrosis: Negative predictive value of normal postnatal ultrasound - a 5-year study

    International Nuclear Information System (INIS)

    Moorthy, I.; Joshi, N.; Cook, J.V.; Warren, M.

    2003-01-01

    AIM: To determine whether normal postnatal ultrasound, as part of a strict screening protocol for the detection and follow-up of antenatal hydronephrosis, effectively excludes the majority of babies with congenital urinary tract abnormalities that would otherwise present with a urinary tract infection. MATERIALS AND METHODS: We retrospectively reviewed all babies who had postnatal follow-up of antenatally detected hydronephrosis over a 5-year period at our institution, a district general Trust with a specialist paediatric unit. We then studied all babies presenting with urinary tract infection before their first birthday to our institution over the same period. By cross-referencing these two study groups we were able to determine which babies developed a urinary tract infection having been previously discharged after normal postnatal ultrasound. RESULTS: Four hundred and twenty-five babies had postnatal follow-up of antenatal hydronephrosis. Of these, 284 were investigated with ultrasound alone. In the same 5-year period, 230 babies presented with urinary tract infection before their first birthday. Only three of these babies had been previously discharged after normal postnatal ultrasound. The negative predictive value of a normal postnatal ultrasound was therefore 98.9% (281/284) for babies who subsequently presented with a urinary tract infection before their first birthday. CONCLUSION: Careful antenatal and postnatal ultrasound with strict protocols is effective in detecting congenital renal tract abnormalities. Infants discharged after normal postnatal ultrasound are highly unlikely to still have an undetected urinary tract abnormality. We suggest that all babies with antenatal hydronephrosis are started on prophylactic antibiotics at birth, pending further investigation. All babies without features of severe obstruction antenatally should have their postnatal ultrasound delayed for a month. We recommend selective use of micturating cystourethrogram (MCUG

  12. Sero-epidemiology of toxoplasmosis and associated risk factors among antenatal women in Ranchi, Jharkhand, India

    OpenAIRE

    Rana Pratap; Ahmad Nadeem Aslami; Manjushri; Narayan Prasad Sahu

    2016-01-01

    Background: Toxoplasmosis seroprevalence in antenatal women has remained a contentious issue in Indian subcontinent. Bad obstetric history (BOH) is specific to women of childbearing age and can be caused by infection with Toxoplama gondii. In Jharkhand, scarce data exist for the roles of toxoplasmosis in the aetiology of adverse pregnancy outcome. Aim: To study the sero-epidemiology of Toxoplasmosis and associated risk factors among antenatal women attending antenatal clinic of a tertiary car...

  13. Seroprevalence of toxoplasmosis in antenatal women with bad obstetric history.

    Science.gov (United States)

    Chintapalli, Suryamani; Padmaja, I Jyothi

    2013-01-01

    The occurrence of fetal death is one of the tragedies that confront the physician providing obstetric care. Among the various agents associated with infections of pregnancy, viruses are the most important followed by bacteria and protozoa. Among protozoal infections in pregnancy, toxoplasmosis is reported to have a high incidence, sometimes causing fetal death. The study was intended to observe the seroprevalence of Toxoplasmosis in pregnant women presenting with bad obstetric history (BOH). A total of 92 antenatal women were included in the study (80 in the study group and 12 in control group). The study group comprised of antenatal women with BOH in the age group of 20-35 years. Antenatal women with Rh incompatibility, pregnancy induced hypertension, diabetes mellitus, renal disorders and syphilis were not included in the study. The control group included women in reproductive age group without BOH. All the samples were screened by enzyme linked immuno sorbent assay (ELISA) for Toxoplasma specific Immunoglobulin M (IgM) and Immunoglobulin G (IgG) antibodies. Of the 80 antenatal women in the study group, 36 (45%) were seropositive for Toxoplasma specific IgG antibodies (P habits, illiteracy, socio-economic status and residential status were also studied. We conclude that toxoplasmosis during pregnancy causes congenital fetal infection with possible fetal loss. ELISA was found to be a sensitive serological test for diagnosis of Toxoplasmosis in pregnant women with BOH. Major cause of fetal loss in BOH cases in the study group was abortion.

  14. Risk factors for incident HIV infection among antenatal mothers in rural Eastern Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Charles Bitamazire Businge

    2016-01-01

    Full Text Available Background: The prevalence of HIV among antenatal clients in South Africa has remained at a very high rate of about 29% despite substantial decline in several sub-Saharan countries. There is a paucity of data on risk factors for incident HIV infection among antenatal mothers and women within the reproductive age bracket in local settings in the Eastern Cape, South Africa. Objective: To establish the risk factors for incident HIV infection among antenatal clients aged 18–49 years attending public antenatal clinics in rural Eastern Cape, South Africa. Design: This was an unmatched case–control study carried out in public health antenatal clinics of King Sabata District Municipality between January and March 2014. The cases comprised 100 clients with recent HIV infection; the controls were 200 HIV-negative antenatal clients. Socio-demographic, sexual, and behavioral data were collected using interviewer-administered questionnaires adapted from the standard DHS5 women's questionnaire. Multivariate logistic regression models were used to identify the independent risk factors for HIV infection. A p<0.05 was considered statistically significant. Results: The independent risk factors for incident HIV infection were economic dependence on the partner, having older male partners especially among women aged ≤20 years, and sex under the influence of alcohol. Conclusions: Therefore, effective prevention of HIV among antenatal mothers in KSDM must target the improvement of the economic status of women, thereby reducing economic dependence on their sexual partners; address the prevalent phenomenon of cross-generation sex among women aged <20 years; and regulate the brewing, marketing, and consumption of alcohol.

  15. Conventional foods, followed by dietary supplements and fortified foods, are the key sources of vitamin D, vitamin B6, and selenium intake in Dutch participants of the NU-AGE study.

    Science.gov (United States)

    Berendsen, Agnes A M; van Lieshout, Lilou E L M; van den Heuvel, Ellen G H M; Matthys, Christophe; Péter, Szabolcs; de Groot, Lisette C P G M

    2016-10-01

    With aging, energy needs decrease, necessitating a more nutrient-dense diet to meet nutritional needs. To bridge this gap, the use of nutrient-dense foods, fortified foods, and dietary supplements can be important. This observational study aims to describe current micronutrient intakes of Dutch elderly and to identify the contribution of nutrient-dense foods, fortified foods, and dietary supplements to the intake of micronutrients that are often inadequately consumed in Dutch elderly. Data of 245 Dutch volunteers from the NU-AGE study aged 65 to 80 years were used. Dietary intake was assessed by means of 7-day food records, and dietary supplement use was recorded with an additional questionnaire. Information on fortified foods was obtained from the Dutch Food Composition Table 2011. Nutrient density of foods was evaluated using the Nutrient Rich Food 9.3 score. The percentages of participants not meeting their average requirement were high for vitamin D (99%), selenium (41%), and vitamin B6 (54%) based on conventional foods and also when taking into account fortified foods (98%, 41%, and 27%, respectively) and vitamin and mineral supplements (87%, 36%, and 20%, respectively). Conventional foods were the main source of vitamin D, vitamin B6, and selenium intake (42%, 45%, and 82%, respectively), followed by vitamin and mineral supplements (41%, 44%, and 18%) and fortified foods (17%, 11%, and 1%). Foods with the highest nutrient density contributed most to total vitamin B6 intake only. To optimize nutrient intakes of elderly, combinations of natural food sources, fortified foods, and dietary supplements should be considered. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Natural genetic variation of seed micronutrients of Arabidopsis thaliana grown in zinc-deficient and zinc-amended soil

    Directory of Open Access Journals (Sweden)

    Xiaochao Chen

    2016-07-01

    Full Text Available The quality of edible seeds for human and animal nutrition is crucially dependent on high zinc (Zn and iron (Fe seed concentrations. The micronutrient bioavailability is strongly reduced by seed phytate that forms complexes with seed cations. Superior genotypes with increased seed Zn concentrations had been identified, but low micronutrient seed levels often prevail when the plants are grown in Zn-deficient soils, which are globally widespread and correlate with human Zn-deficiency. Here, seed Zn concentrations of Arabidopsis accessions grown in Zn-deficient and Zn-amended conditions were measured together with seed Fe and manganese (Mn, in a panel of 108 accessions. By applying genome-wide association, de novo candidate genes potentially involved in the seed micronutrient accumulation were identified. However, a candidate inositol 1,3,4-trisphosphate 5/6-kinase 3 gene (ITPK3, located close to a significant nucleotide polymorphism associated with relative Zn seed concentrations, was dispensable for seed micronutrients accumulation in Col-0. Loss of this gene in itpk3-1 did neither affect phytate seed levels, nor seed Zn, Fe and Mn. It is concluded that large natural variance of micronutrient seed levels is identified in the population and several accessions maintain high seed Zn despite growth in Zn-deficient conditions.

  17. Dietary modifications to improve micronutrient status of Indian children and adolescents with type 1 diabetes.

    Science.gov (United States)

    Parthasarathy, Lavanya S; Chiplonkar, Shashi A; Khadilkar, Anuradha V; Khadilkar, Vaman V

    2015-01-01

    Diet plays a crucial role for maintaining normal growth and development while optimizing glycemic control in children with diabetes. Dietary restrictions, in a diabetic child's diet may lead to micronutrient deficiencies. To examine dietary nutritional deficiencies of Asian Indian children with Type 1 diabetes mellitus and develop micronutrient-rich recipes suitable for them. Anthropometry, diet (3-day recall) of 70 children with diabetes (24 boys) was recorded. Daily nutrient intakes and nutrient content of recipes were estimated using CDIET version 2.0. Mean intake amongst children for energy was 79% of Indian Recommended Dietary Allowance (RDA), protein was 105% RDA, but fat intakes were high (143% RDA). Mean intakes of riboflavin, β carotene, zinc, iron were less than 50%, and thiamin and calcium were around 60% RDA suggesting a possible multiple micronutrient deficiency. Based on popularly consumed snacks, 20 healthy recipes were devised that can be incorporated in children's diet. Mean energy content of new recipes was similar to routine snacks (281±28 kcal/100 g vs 306±27 kcal/100 g cooked weight). However, the mean vitamin and mineral content of new recipes was significantly higher (pcontent (zinc, calcium and iron) and twofold increase in total vitamin content (β carotene, vitamin C, vitamin B-1, B-2, and B-3) in new recipes compared with the routine snacks. Multiple dietary micronutrient deficiencies are observed in diabetic children. Addition of newly developed recipes in their everyday diet may help to enhance micronutrient intakes without increasing their energy load.

  18. Added Sugar, Macro- and Micronutrient Intakes and Anthropometry of Children in a Developing World Context.

    Directory of Open Access Journals (Sweden)

    Eleni M W Maunder

    Full Text Available The objective of this study was to determine the relationship between added sugar and dietary diversity, micronutrient intakes and anthropometric status in a nationally representative study of children, 1-8.9 years of age in South Africa.Secondary analysis of a national survey of children (weighted n = 2,200; non weighted n = 2818 was undertaken. Validated 24-hour recalls of children were collected from mothers/caregivers and stratified into quartiles of percentage energy from added sugar (% EAS. A dietary diversity score (DDS using 9 food groups, a food variety score (FVS of individual food items, and a mean adequacy ratio (MAR based on 11 micronutrients were calculated. The prevalence of stunting and overweight/obesity was also determined.Added sugar intake varied from 7.5-10.3% of energy intake for rural and urban areas, respectively. Mean added sugar intake ranged from 1.0% of energy intake in Quartile 1 (1-3 years (Q1 to 19.3% in Q4 (4-8 years. Main sources of added sugar were white sugar (60.1%, cool drinks (squash type (10.4% and carbonated cool drinks (6.0%. Added sugar intake, correlated positively with most micronutrient intakes, DDS, FVS, and MAR. Significant negative partial correlations, adjusted for energy intake, were found between added sugar intake and intakes of protein, fibre, thiamin, pantothenic acid, biotin, vitamin E, calcium (1-3 years, phosphorus, iron (4-8 years, magnesium and zinc. The prevalence of overweight/obesity was higher in children aged 4-8 years in Q4 of %EAS than in other quartiles [mean (95%CI % prevalence overweight 23.0 (16.2-29.8% in Q4 compared to 13.0 (8.7-17.3% in Q1, p = 0.0063].Although DDS, FVS, MAR and micronutrient intakes were positively correlated with added sugar intakes, overall negative associations between micronutrients and added sugar intakes, adjusted for dietary energy, indicate micronutrient dilution. Overweight/obesity was increased with higher added sugar intakes in the 4-8 year old

  19. Micronutrient Deficiencies and Related Factors in School-Aged Children in Ethiopia: A Cross-Sectional Study in Libo Kemkem and Fogera Districts, Amhara Regional State

    Science.gov (United States)

    Herrador, Zaida; Sordo, Luis; Gadisa, Endalamaw; Buño, Antonio; Gómez-Rioja, Rubén; Iturzaeta, Jose Manuel; de Armas, Lisset Fernandez; Benito, Agustín; Aseffa, Abraham; Moreno, Javier; Cañavate, Carmen; Custodio, Estefania

    2014-01-01

    , strategies should target not only isolated micronutrient supplementation but also diet diversification. PMID:25546056

  20. Micronutrient mineral and folate content of Australian and imported dried fruit products.

    Science.gov (United States)

    Bennett, Louise E; Singh, Davinder P; Clingeleffer, Peter R

    2011-01-01

    A selection of Australian and imported fresh and dried fruit products, including sultanas, Sunmuscats, Carina currants, Zante currants, apricots, and prunes, were analyzed for selected minerals (Ca, Mg, Na, S, B, Al, Fe, Mn, Cu, Zn, Mo, and Se), folate and vitamin C, and the capacity of dried fruits for dietary provision of these micronutrients evaluated. Micro-nutrients were concentrated by a factor of 3-5 in dried fruits compared with their fresh fruit counterparts and were consequently present in nutritionally significant levels, in contrast to fresh fruit. Australian dried sultanas, Carina currant, Zante currant, apricots, and prunes contained Cu, Fe, K, and Mn at levels of >20% of daily Required Dietary Intake (RDI, taken as the average for adult men and women as nominated by the Australian National Health and Medical Research Council) and Sunmuscats contained Cu, Fe, and K at >20% of RDI. All dried fruits studied contained boron in the range of 1.5 to 5.4 mg per 100 g; however, the RDI for boron has not been defined by the NHMRC at the present time. All sultanas and currants studied contained folate at levels of 10-20% of RDI per 100 g. Experimental drying methods significantly affected folate levels with higher folate content in non-ground versus ground-based drying methods. Of the micro-nutrients supplying >20% of RDI, folate represents a particular nutrient for which the mean daily intake of adult Australians is typically inadequate. This study shows that dried fruit consumption, in contrast with fresh fruit, can provide significant proportions of daily requirements of several micronutrients, particularly folate.

  1. The Importance of Antioxidant Micronutrients in Pregnancy

    OpenAIRE

    Mistry, Hiten D.; Williams, Paula J.

    2011-01-01

    Pregnancy places increased demands on the mother to provide not only adequate nutrition to support her own health but also to enable the growth and development of the conceptus. A key role of a number of micronutrients and vitamins is their function as essential cofactors for or themselves acting as antioxidants. Oxidative stress is generated during normal placental development however expression of antioxidant enzymes within the placenta provides protection from undue damage. However, when s...

  2. Micronutrients evaluation in Bidens pilosa L., a plant applied in diabetes treatments

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, Rodolfo D.M.R.; Silva, Paulo S.C. da, E-mail: rdmrg89@usp.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    Diabetes mellitus is a disease that has increasingly affected individuals over the last years. World Health Organization estimates that the worldwide number of diabetes cases will rise from 171 million in 2000 to 366 million in 2030. Besides the therapy with pharmaceutical drugs, many diabetic patients use medicinal plants to control the glycemic levels. This herb has anti-diabetic action due to the presence of organic compounds and micronutrients. Among the plants applied in diabetes treatment, Bidens pilosa L., popularly known in Brazil as picao preto, belongs to the family of Asteraceaes, grows fast and is globally distributed. The aim of this study was evaluate the concentration of Cr, Fe, Mg, Mn, V and Zn in aerial parts of Bidens pilosa samples, as well as its growth substrate by means of instrumental neutron activation analysis (INAA). The samples were separated into two groups named control and treatment. During the plant development, micronutrient solution, containing Cr, Fe, Mg, Mn, V and Zn, was added to the treatment group. It was observed that micronutrient solution added to the Biden pilosa samples may had contributed to the preferentially absorption of Fe, Mg and V, as well as to decrease Zn absorption. (author)

  3. Micronutrients evaluation in Bidens pilosa L., a plant applied in diabetes treatments

    International Nuclear Information System (INIS)

    Goncalves, Rodolfo D.M.R.; Silva, Paulo S.C. da

    2015-01-01

    Diabetes mellitus is a disease that has increasingly affected individuals over the last years. World Health Organization estimates that the worldwide number of diabetes cases will rise from 171 million in 2000 to 366 million in 2030. Besides the therapy with pharmaceutical drugs, many diabetic patients use medicinal plants to control the glycemic levels. This herb has anti-diabetic action due to the presence of organic compounds and micronutrients. Among the plants applied in diabetes treatment, Bidens pilosa L., popularly known in Brazil as picao preto, belongs to the family of Asteraceaes, grows fast and is globally distributed. The aim of this study was evaluate the concentration of Cr, Fe, Mg, Mn, V and Zn in aerial parts of Bidens pilosa samples, as well as its growth substrate by means of instrumental neutron activation analysis (INAA). The samples were separated into two groups named control and treatment. During the plant development, micronutrient solution, containing Cr, Fe, Mg, Mn, V and Zn, was added to the treatment group. It was observed that micronutrient solution added to the Biden pilosa samples may had contributed to the preferentially absorption of Fe, Mg and V, as well as to decrease Zn absorption. (author)

  4. Volume 9 No. 4 2009 June 2009 992 MICRONUTRIENT ...

    African Journals Online (AJOL)

    Deficiencies in zinc, folate (particularly in pregnancy), vitamins B-12, C, and D, thiamine .... for zinc deficiency is likely high in pregnant women in developing countries, as ..... Vitamin C (ascorbic acid) – Clinical vitamin C deficiency (scurvy) has been .... micronutrient delivery to beneficiaries of U.S. food aid commodities.

  5. Effects of a multi-micronutrient-fortified beverage, with and without sugar, on growth and cognition in South African schoolchildren: a randomised, double-blind, controlled intervention

    OpenAIRE

    Taljaard, Christine; Covic, Namukolo M.; Van Graan, Averalda E.; Kruger, Herculina S.; Smuts, Cornelius M.; Baumgartner, Jeannine; Wright, Hattie H.; Jerling, Johann C.

    2013-01-01

    Little is known about the effects of combined micronutrient and sugar consumption on growth and cognition. In the present study, we investigated the effects of micronutrients and sugar, alone and in combination, in a beverage on growth and cognition in schoolchildren. In a 2 £ 2 factorial design, children (n 414, 6–11 years) were randomly allocated to consume beverages containing (1) micronutrients with sugar, (2) micronutrients with a non-nutritive sweetener, (3) no micronutrients w...

  6. Antenatal corticosteroids beyond 34 weeks gestation: What do we do now?

    Science.gov (United States)

    Kamath-Rayne, Beena D; Rozance, Paul J; Goldenberg, Robert L; Jobe, Alan H

    2016-10-01

    The practice of antenatal corticosteroid administration in pregnancies of 24-34 weeks of gestation that are at risk of preterm delivery was adopted over 20 years after the first randomized clinical trial in humans. It is biologically plausible that antenatal corticosteroid in pregnancies beyond 34 weeks of gestation would reduce rates of respiratory morbidity and neonatal intensive care admission. Mostly guided by the results of a large multicenter randomized trial of antenatal corticosteroid in late preterm infants, the Antenatal Late Preterm Steroids Trial, the American Congress of Obstetricians and Gynecologists has released a practice advisory that the "administration of betamethasone may be considered in women with a singleton pregnancy between 34 0/7 and 36 6/7 weeks of gestation at imminent risk of preterm birth within 7 days." However, many unanswered questions about the risks and benefits of antenatal corticosteroids in this population remain and should be considered with the adoption of this treatment recommendation. This review of the literature indicates that the greatest effect is in the reduction of transient tachypnea of the newborn infant, which is a mostly self-limited condition. This benefit must be weighed against unanticipated outcomes, such as neonatal hypoglycemia, and unknowns about long-term neurodevelopmental follow up and metabolic risks. Amelioration of respiratory morbidity in late preterm infants does not preclude these infants from having other complications that are related to prematurity that require intensive care. Other possible morbidities of prematurity may be magnified if these babies no longer have respiratory symptoms. Conversely, if these late preterm babies no longer exhibit respiratory symptoms and "look good," they may be discharged before other morbidities of prematurity have resolved and be at risk for readmission. Furthermore, it is also important to ensure that unintended consequences are avoided to achieve a minor

  7. Pelaksanaan Antenatal Care Berhubungan dengan Anemia pada Kehamilan Trimester III di Puskesmas Sedayu I Yogyakarta

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    Fatimah Fatimah

    2015-11-01

    Full Text Available Anemia is one of the problems in Indonesia that important to examine, especially for pregnant women. This research used quantitative with explanatory design. Population were 44 pregnant women in 3 trimester selected by the total sampling technique. The independent variable were implementation of the antenatal care by midwives and dependent variable is anemia in 3 trimester of pregnancy at Puskesmas Sedayu I Yogyakarta. Data was collected using questionnaire. The analysis used was chi-square. The results of study showed that there was 33 (75% of antenatal care in good category, with no anemia were 32 (72.7% respondents, and there was a significant relationship between antenatal care and anemia in the third trimester of pregnancy with p-value=0.004. In conclusion, there was a significant relationship between antenatal care and anemia in the third trimester of pregnancy. Suggestions were needed to maintain and improve the care of midwives in antenatal care to improve the health of pregnant women, especially anemia in pregnancy.

  8. Contraceptive‑seeking Behavior of Women Attending Antenatal ...

    African Journals Online (AJOL)

    Contraceptive‑seeking Behavior of Women Attending Antenatal Care in a Developing Country: A Veritable Tool for Slowing Population Growth. ... Background: The use of modern contraceptives has been embraced by developed nations as a means of achieving controlled growth rate. Nigeria, Africa's most populous nation ...

  9. Chemical Properties And Toxicity of Chromium(III) Nutritional Supplements

    Energy Technology Data Exchange (ETDEWEB)

    Levina, A.; Lay, P.A.

    2009-05-19

    The status of Cr(III) as an essential micronutrient for humans is currently under question. No functional Cr(III)-containing biomolecules have been definitively described as yet, and accumulated experience in the use of Cr(III) nutritional supplements (such as [Cr(pic){sub 3}], where pic = 2-pyridinecarboxylato) has shown no measurable benefits for nondiabetic people. Although the use of large doses of Cr(III) supplements may lead to improvements in glucose metabolism for type 2 diabetics, there is a growing concern over the possible genotoxicity of these compounds, particularly of [Cr(pic){sub 3}]. The current perspective discusses chemical transformations of Cr(III) nutritional supplements in biological media, with implications for both beneficial and toxic actions of Cr(III) complexes, which are likely to arise from the same biochemical mechanisms, dependent on concentrations of the reactive species. These species include: (1) partial hydrolysis products of Cr(III) nutritional supplements, which are capable of binding to biological macromolecules and altering their functions; and (2) highly reactive Cr(VI/V/IV) species and organic radicals, formed in reactions of Cr(III) with biological oxidants. Low concentrations of these species are likely to cause alterations in cell signaling (including enhancement of insulin signaling) through interactions with the active centers of regulatory enzymes in the cell membrane or in the cytoplasm, while higher concentrations are likely to produce genotoxic DNA lesions in the cell nucleus. These data suggest that the potential for genotoxic side-effects of Cr(III) complexes may outweigh their possible benefits as insulin enhancers, and that recommendations for their use as either nutritional supplements or antidiabetic drugs need to be reconsidered in light of these recent findings.

  10. Timing and factors associated with first antenatal care booking among pregnant mothers in Gondar Town; North West Ethiopia.

    Science.gov (United States)

    Gudayu, Temesgen Worku; Woldeyohannes, Solomon Meseret; Abdo, Abdella Amano

    2014-08-25

    Antenatal care service which is among strategies to maintain maternal and fetal wellbeing is strongly recommended to be initiated early during pregnancy. To developing world where there is uncommon practice of pre-pregnancy care and support, timely commencement is crucial in getting potential benefits from some of the elements of the care. Therefore, we sought to assess timing and factors associated with the first antenatal care booking among pregnant mothers attending antenatal care clinics in Gondar town health facilities; North West Ethiopia. Health institution based cross-sectional study was conducted among pregnant mothers from April to June 2012 in Gondar town. A total of 407 pregnant mothers were interviewed at exit from antenatal clinic by using structured and pre-tested questionnaire. Bivariate and multivariate data analysis was performed using SPSS for Windows version 16.0. The study indicated that 35.4% of mothers started antenatal care timely (in the first trimester of pregnancy). The mean time was 4.5 months (17.7 weeks) of pregnancy. Multivariate logistic regression analysis showed that: [(AOR (95% CI)) maternal age ≤ 25 (1.85 (1.10, 3.09)), age at marriage ≥20 years (2.21 (1.33, 3.68)), pregnancy recognition by urine test (2.29 (1.42, 3.71)), mothers who perceived the right time to start antenatal care within first trimester (3.93 (2.29, 6.75)) and having decision power to use antenatal care (2.43 (1.18, 4.99))] were significantly associated with timely commencement to antenatal care. Timely entry to antenatal care was low in the study area. In order to improve the situation, it is important to provide community based information, education and communication on antenatal care and its right time of commencement. In addition, empowering women and implementing the proclamation designed for the age at marriage is mandatory up to the local level.

  11. Relative influence of soil chemistry and topography on soil available micronutrients by structural equation modeling

    OpenAIRE

    Zhu, Hongfen; Zhao, Ying; Nan, Feng; Duan, Yonghong; Bi, Rutian

    2016-01-01

    Soil chemical and topographic properties are two important factors influencing available micronutrient distribution of soil in the horizontal dimension. The objective of this study was to explore the relative influence of soil chemistry (including soil pH, soil organic matter, total nitrogen, available phosphorus, and available potassium) and topography (including elevation, slope, aspect, and wetness index) on the availability of micronutrients (Fe, Mn, Cu, Zn, and B) using structural equati...

  12. ECONOMICAL BASIS TO ADDRESS MICRONUTRIENT DEFICIENCIES IN DEVELOPING WORLD

    Directory of Open Access Journals (Sweden)

    Amirul Hassan

    2015-12-01

    Full Text Available Malnutrition has been called by economists at the World Bank as the “non-human face” of poverty,1 Adults who were malnourished as children earn at least 20% less on average than those who weren’t , 2.Malnutrition is often caused by underlying economics, i.e. the lack of money. Economics is very important in regards to malnutrition; it allows an individual to purchase nutrients. In many places around the world, a lack of money prevents the purchase of a variety of foods. The lack in variety usually leads to micronutrient malnutrition. Economics also decides the production of food in all countries around the world and the ability of a country to overcome difficult times. Thus economics affects ALL people at ALL levels of society, 3.Micronutrient deficiencies also known as ‘hidden hunger’ are determining and aggravating factors for health status and quality of life. It is estimated half of anaemia cases are due to iron deficiency , 4.  Almost half of children in low- and middle-income countries – 47% of under-fives are affected by anaemia, impairing cognitive and physical development,5. Iodine deficiency is the greatest single cause of mental retardation and brain damage. Coincidently,  the number of countries in which iodine-deficiency disorders were considered a public health concern reduced by 43% between 1993 and 2007,6.  Zinc deficiency affects children’s health and physical growth; it is also essential for mothers during pregnancy. It is estimated to cause 4% of deaths in pre-school aged children in lower-income countries. 7 . The Global Burden of Disease estimates showed that among the 26 major risk factors of the global burden of disease,8 iron deficiency ranks ninth overall, zinc deficiency is eleventh, and vitamin A deficiency, is thirteenth. Annually each developing country of the world are losing over millions or billions US $ in Gross Domestic Product (GDP to vitamins and minerals deficiencies. But scaling up

  13. Effectiveness of advertising availability of prenatal ultrasound on uptake of antenatal care in rural Uganda: A cluster randomized trial.

    Science.gov (United States)

    Cherniak, William; Anguyo, Geoffrey; Meaney, Christopher; Yuan Kong, Ling; Malhame, Isabelle; Pace, Romina; Sodhi, Sumeet; Silverman, Michael

    2017-01-01

    In rural Uganda pregnant women often lack access to health services, do not attend antenatal care, and tend to utilize traditional healers/birth attendants. We hypothesized that receiving a message advertising that "you will be able to see your baby by ultrasound" would motivate rural Ugandan women who otherwise might use a traditional birth attendant to attend antenatal care, and that those women would subsequently be more satisfied with care. A cluster randomized trial was conducted across eight rural sub-counties in southwestern Uganda. Sub-counties were randomized to a control arm, with advertisement of antenatal care with no mention of portable obstetric ultrasound (four communities, n = 59), or an intervention arm, with advertisement of portable obstetric ultrasound. Advertisement of portable obstetric ultrasound was further divided into intervention A) word of mouth advertisement of portable obstetric ultrasound and antenatal care (one communitity, n = 16), B) radio advertisement of only antenatal care and word of mouth advertisement of antenatal care and portable obstetric ultrasound (one community, n = 7), or C) word of mouth + radio advertisement of both antenatal care and portable obstetric ultrasound (two communities, n = 75). The primary outcome was attendance to antenatal care. 159 women presented to antenatal care across eight sub-counties. The rate of attendance was 65.1 (per 1000 pregnant women, 95% CI 38.3-110.4) where portable obstetric ultrasound was advertised by radio and word of mouth, as compared to a rate of 11.1 (95% CI 6.1-20.1) in control communities (rate ratio 5.9, 95% CI 2.6-13.0, padvertising antenatal care and portable obstetric ultrasound by radio attendance was significantly improved. This study suggests that women can be motivated to attend antenatal care when offered the concrete incentive of seeing their baby.

  14. Antenatal breastfeeding education for increasing breastfeeding duration.

    Science.gov (United States)

    Lumbiganon, Pisake; Martis, Ruth; Laopaiboon, Malinee; Festin, Mario R; Ho, Jacqueline J; Hakimi, Mohammad

    2016-12-06

    Breast milk is well recognised as the best food source for infants. The impact of antenatal breastfeeding (BF) education on the duration of BF has not been evaluated. To assess the effectiveness of antenatal breastfeeding (BF) education for increasing BF initiation and duration. We searched Cochrane Pregnancy and Childbirth's Trials Register on 1 March 2016, CENTRAL (The Cochrane Library, 2016, Issue 3), MEDLINE (1966 to 1 March 2016) and Scopus (January 1985 to 1 March 2016). We contacted experts and searched reference lists of retrieved articles. All identified published, unpublished and ongoing randomised controlled trials (RCTs) assessing the effect of formal antenatal BF education or comparing two different methods of formal antenatal BF education, on the duration of BF. We included RCTs that only included antenatal interventions and excluded those that combined antenatal and intrapartum or postpartum BF education components. Cluster-randomised trials were included in this review. Quasi-randomised trials were not eligible for inclusion. We assessed all potential studies identified as a result of the search strategy. Two review authors extracted data from each included study using the agreed form and assessed risk of bias. We resolved discrepancies through discussion. We assessed the quality of the evidence using the GRADE approach. This review update includes 24 studies (10,056 women). Twenty studies (9789 women) contribute data to analyses. Most studies took place in high-income countries such as the USA, UK, Canada and Australia. In the first five comparisons, we display the included trials according to type of intervention without pooling data. For the 'Summary of findings' we pooled data for a summary effect.Five included studies were cluster-randomised trials: all of these adjusted data and reported adjustments as odds ratios (OR). We have analysed the data using the generic inverse variance method and presented results as odds ratios, because we were

  15. Vitamin D supplementation in pregnancy, prenatal 25(OH)D levels, race, and subsequent asthma or recurrent wheeze in offspring: Secondary analyses from the Vitamin D Antenatal Asthma Reduction Trial.

    Science.gov (United States)

    Wolsk, Helene M; Harshfield, Benjamin J; Laranjo, Nancy; Carey, Vincent J; O'Connor, George; Sandel, Megan; Strunk, Robert C; Bacharier, Leonard B; Zeiger, Robert S; Schatz, Michael; Hollis, Bruce W; Weiss, Scott T; Litonjua, Augusto A

    2017-11-01

    Nutrient trials differ from drug trials because participants have varying circulating levels at entry into the trial. We sought to study the effect of a vitamin D intervention in pregnancy between subjects of different races and the association between 25-hydroxyvitamin D 3 (25[OH]D) levels in pregnancy and the risk of asthma/recurrent wheeze in offspring. The Vitamin D Antenatal Asthma Reduction Trial is a randomized trial of pregnant women at risk of having children with asthma randomized to 4400 international units/d vitamin D or placebo plus 400 international units/d vitamin D. Asthma and recurrent wheezing until age 3 years were recorded. African American (AA) women (n = 312) had lower initial levels of 25(OH)D (mean [SD], 17.6 ng/mL [8.3 ng/mL]) compared with non-AA women (n = 400; 27.1 ng/mL [9.7 ng/mL], P asthma/recurrent wheezing in offspring (P for interaction = .77). Having an initial level of greater than 30 ng/mL and being randomized to the intervention group was associated with the lowest risk for asthma/recurrent wheeze by age 3 years compared with having an initial level of less than 20 ng/mL and receiving placebo (adjusted odds ratio, 0.42; 95% CI, 0.19-0.91). We did not find differences between AA and non-AA mothers in the effect of maternal vitamin D supplementation and asthma/recurrent wheeze in offspring at 3 years. Maternal supplementation of vitamin D, particularly in mothers with initial 25(OH)D levels of greater than 30 ng/mL, reduced asthma/recurrent wheeze in the offspring through age 3 years, suggesting that higher vitamin D status beginning in early pregnancy is necessary for asthma/recurrent wheeze prevention in early life. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  16. Antioxidant supplementation for lung disease in cystic fibrosis

    DEFF Research Database (Denmark)

    Ciofu, Oana; Lykkesfeldt, Jens

    2014-01-01

    BACKGROUND: Airway infection leads to progressive damage of the lungs in cystic fibrosis and oxidative stress has been implicated in the etiology. Supplementation of antioxidant micronutrients (vitamin E, vitamin C, ß-carotene and selenium) or glutathione may therefore potentially help maintain...... COLLECTION AND ANALYSIS: Two authors independently selected studies, extracted data and assessed the risk of bias in the included studies. We contacted trial investigators to obtain missing information. Primary outcomes are lung function and quality of life; secondary outcomes are oxidative stress...... or by inhalation) appears to improve lung function in some cases and decrease oxidative stress; however, due to the very intensive antibiotic treatment and other treatments that cystic fibrosis patients receive, the beneficial effect of antioxidants is very difficult to assess in patients with chronic infection...

  17. The effects of selenium, zinc and vitamin E supplementation on performance of Broiler Breeder Males

    Directory of Open Access Journals (Sweden)

    L. Zezza

    2011-03-01

    Full Text Available Evidence from the literature and practical experiences suggests that nutritional factors are perhaps the most crucial for their direct effects on the reproductive phenomenon. Several studies and reviews (Barnes et al., 1996; Brake and Garlich, 1989; Chen et al., 1994; Donoghue et al., 1995; Donoghue et al., 1997; Froman et al., 1997; Hocking and Bernard, 1997; Holm, 1998 describe the effects of quantitative feed and energy on reproductive performance of farm animals but only recently there was an increasing attention for the effects of micronutrients intake. The aim of the present work was to verify and compare the effects of a supplementation of selenium, zinc and vitamin E on quality of poultry semen, with a particular attention to the selenium, because its beneficial effects on reproduction (Surai, 2002 needs further elucidation. These micronutrients were chosen because play a fundamental role in semen quality, in fact it was known that chicken semen contains the natural antioxidant vitamin E (Surai, 1997; Surai, 2000 together with antioxidant enzymes glutathione peroxidase (GSH-Px and superoxide dismutase (SOD...

  18. Quality of antenatal care in Zambia: a national assessment

    Science.gov (United States)

    2012-01-01

    Background Antenatal care (ANC) is one of the recommended interventions to reduce maternal and neonatal mortality. Yet in most Sub-Saharan African countries, high rates of ANC coverage coexist with high maternal and neonatal mortality. This disconnect has fueled calls to focus on the quality of ANC services. However, little conceptual or empirical work exists on the measurement of ANC quality at health facilities in low-income countries. We developed a classification tool and assessed the level of ANC service provision at health facilities in Zambia on a national scale and compared this to the quality of ANC received by expectant mothers. Methods We analysed two national datasets with detailed antenatal provider and user information, the 2005 Zambia Health Facility Census and the 2007 Zambia Demographic and Health Survey (DHS), to describe the level of ANC service provision at 1,299 antenatal facilities in 2005 and the quality of ANC received by 4,148 mothers between 2002 and 2007. Results We found that only 45 antenatal facilities (3%) fulfilled our developed criteria for optimum ANC service, while 47% of facilities provided adequate service, and the remaining 50% offered inadequate service. Although 94% of mothers reported at least one ANC visit with a skilled health worker and 60% attended at least four visits, only 29% of mothers received good quality ANC, and only 8% of mothers received good quality ANC and attended in the first trimester. Conclusions DHS data can be used to monitor “effective ANC coverage” which can be far below ANC coverage as estimated by current indicators. This “quality gap” indicates missed opportunities at ANC for delivering effective interventions. Evaluating the level of ANC provision at health facilities is an efficient way to detect where deficiencies are located in the system and could serve as a monitoring tool to evaluate country progress. PMID:23237601

  19. Antenatal small-class education versus auditorium-based lectures to promote positive transitioning to parenthood

    DEFF Research Database (Denmark)

    Koushede, Vibeke; Brixval, Carina Sjöberg; Thygesen, Lau Caspar

    2017-01-01

    Prospective parents widely use education to gain information about, e.g., labour and parenting skills. It is unknown if antenatal education in small classes is more beneficial for parenting stress and parenting alliance compared with other types of antenatal education. In the present randomised t...

  20. Study of compliance with a new, targeted antenatal D immunization prevention programme in Denmark

    DEFF Research Database (Denmark)

    Damkjaer, M B; Perslev, A; Clausen, F B

    2012-01-01

    A targeted routine antenatal anti-D prophylaxis programme was implemented in Denmark where anti-D immunoglobulin is given based on the result from noninvasive antenatal screening for fetal RHD. Our objective was to evaluate compliance with this new programme right after its initiation. Materials and...

  1. Outcomes of Isolated Antenatal Hydronephrosis at First Year of Life

    Science.gov (United States)

    Orabi, Mutaz; Abozaid, Sameh; Sallout, Bahauddin; Abu Shaheen, Amani; Heena, Humariya; Al Matary, Abdulrahman

    2018-01-01

    Objectives To compare the grade of hydronephrosis between the antenatal and first postnatal ultrasound (US) and their clinical outcomes. Methods This retrospective study included all cases of isolated hydronephrosis detected by antenatal US from August 2005 to February 2011. Hydronephrosis was classified based on the standard criteria into mild, moderate, or severe. Cases associated with other major congenital anomalies were excluded. All patients were followed-up postnatally and outcomes available were analyzed at one year of age. Results A total of 105 cases were included out of which 83 (79.0%) were males and 22 (20.9%) were females with a median gestational age of 38 weeks. First postnatal US of 105 cases showed that 20 (19.0%) were free of hydronephrosis, 39 (37.1%) had mild, 29 (27.6%) moderate, and 17 (16.1%) had severe hydronephrosis. Half (50.4%) of hydronephrosis cases improved in their clinical presentation while 13.3% showed deterioration and 36.3% remained the same. Almost half of all cases (52 cases) were diagnosed by US at the end of first year without any effect on renal function. Conclusions Antenatal and postnatal US are sensitive tools for detecting hydronephrosis as well as for postnatal counseling. Fetal anatomy US is usually done at 18 weeks gestation and if this reveals any evidence of hydronephrosis, the patient is followed according to the severity. Postnatal US is not done routinely for cases where hydronephrosis resolves completely during pregnancy. Although newborns with antenatal hydronephrosis due to secondary causes are at greater risk for renal impairment, surgical intervention reserves renal function. PMID:29657681

  2. Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs

    Directory of Open Access Journals (Sweden)

    Musonda Mofu

    2011-09-01

    Full Text Available Abstract Background Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW and derive fat-free mass (FFM and fat mass (FM. Methods/Design This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI, body composition, CD4, viral load and micronutrient status. Discussion This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques. Trial Registration Pan African Clinical Trial Registry PACTR201108000303396.

  3. Use of micronutrients attenuates cannabis and nicotine abuse as evidenced from a reversal design: a case study.

    Science.gov (United States)

    Harrison, Rachel; Rucklidge, Julia J; Blampied, Neville

    2013-01-01

    Prior research shows that micronutrients, particularly amino acids, can assist individuals with substance dependence to quit various drugs of abuse, including cannabis, alcohol, and cocaine. As part of a wider investigation of the impact of micronutrients (mostly vitamins and minerals) on psychiatric symptoms, such as Attention-Deficit/Hyperactivity Disorder (ADHD), depression, and anxiety, we observed that many participants reduced or eliminated use of alcohol, cigarettes, and cannabis. One case using a single-case reversal (off-on-off-on-off) design is presented and shows not only on-off control of psychiatric symptoms as micronutrients are consumed or withdrawn, but also simultaneous on-off use of cannabis and cigarettes, despite not directly targeting this substance use as part of the treatment protocol. This case adds to a growing body of research supporting the use of micronutrients in the treatment of psychiatric symptoms and suggests it may extend to substance dependence. Micronutrients, by assisting with mood regulation and reductions in anxiety, may assist with successful cessation of drug use. Alternatively, they may directly impact on the brain reward circuitry believed to be involved in the expression of addictions, thereby providing the appropriate precursors and cofactors necessary for adequate neurotransmitter synthesis. This case should continue to stimulate researchers to consider the role of nutrients, in particular vitamins and minerals, in drug treatment programs and encourage more rigorous trials.

  4. Long-term outcome of patients with chronic pancreatitis treated with micronutrient antioxidant therapy.

    Science.gov (United States)

    Rupasinghe, Sukitha Namal; Siriwardena, Ajith K

    2017-04-01

    Micronutrient antioxidant therapy did not relieve pain in a European randomized trial of patients with chronic pancreatitis without malnutrition. However, intervention was undertaken only for 6 months leaving unanswered the question of whether long-term antioxidant therapy may modulate chronic pancreatitis. The aim of this study is to assess the outcome of long-term use of micronutrient antioxidant therapy in patients with chronic pancreatitis. This is a single center clinical cohort report of patients with chronic pancreatitis prescribed micronutrient antioxidant therapy and followed for up to 10 years. Data were collected on demographic detail, clinic pain assessment, insulin requirements, interventions and outcome. A group of 30 patients with a diagnosis of chronic pancreatitis constitute the study population. Median age at time of diagnosis was 40 years (range 14-66); 19 (63%) were male and the median duration of symptoms was 2 years (range 0-18). Alcohol was the dominant cause in 22 (73%) patients and 16 (53%) patients were Cambridge stage 1. Twenty-four (80%) patients had pain at presentation. During antioxidant treatment of 4 years (range 1-10), pain decreased but the proportion with abdominal pain compared to those who were pain-free remained constant (P=0.16; two-way ANOVA with Bonferroni correction). There was a significant increase in requirement for insulin (P=0.028) with time together with use of both endoscopic and surgical interventions. This is the first study to report long-term disease-specific outcome in patients with chronic pancreatitis prescribed micronutrient antioxidant therapy. There appears to be no effect of intervention on outcome.

  5. Determinants of Home Delivery among Women attending Antenatal ...

    African Journals Online (AJOL)

    USER

    Abstract. Unskilled home delivery is a threat to maternal and child health. ... home delivery after attending antenatal services, this study employed a cross-sectional design and a non-probability purposive ... deaths occur in sub-Saharan Africa.

  6. Metabolomic Insights into the Nutritional Status of Adults and Adolescents with Phenylketonuria Consuming a Low-Phenylalanine Diet in Combination with Amino Acid and Glycomacropeptide Medical Foods.

    Science.gov (United States)

    Stroup, Bridget M; Ney, Denise M; Murali, Sangita G; Rohr, Frances; Gleason, Sally T; van Calcar, Sandra C; Levy, Harvey L

    2017-01-01

    Nutrient status in phenylketonuria (PKU) requires surveillance due to the restrictive low-Phe diet in combination with amino acid medical foods (AA-MF) or glycomacropeptide medical foods (GMP-MF). Micronutrient profiles of medical foods are diverse, and optimal micronutrient supplementation in PKU has not been established. In a crossover design, 30 participants with PKU were randomized to consume AA-MF and Glytactin™ GMP-MF in combination with a low-Phe diet for 3 weeks each. Fasting venipunctures, medical food logs, and 3-day food records were obtained. Metabolomic analyses were completed in plasma and urine by Metabolon, Inc. The low-Phe diets in combination with AA-MF and GMP-MF were generally adequate based on Dietary Reference Intakes, clinical measures, and metabolomics. Without micronutrient supplementation of medical foods, >70% of participants would have inadequate intakes for 11 micronutrients. Despite micronutrient supplementation of medical foods, inadequate intakes of potassium in 93% of participants and choline in >40% and excessive intakes of sodium in >63% of participants and folic acid in >27% were observed. Sugar intake was excessive and provided 27% of energy. Nutrient status was similar with AA-MF and Glytactin GMP-MF. More research related to micronutrient supplementation of medical foods for the management of PKU is needed.

  7. Variability of micronutrient content in enriched dairy and fruit products

    NARCIS (Netherlands)

    Jong, de N.; Adam, S.G.N.; Groot, de C.P.G.M.; Graaf, de C.

    2000-01-01

    Accurate measures of micronutrient levels in newly developed enriched foods are indispensable for valid labelling, for determination of ultimate levels for possible claimed health effects and for safety. To date, only a limited amount of public literature is available on the reproducibility of

  8. Hair Zinc Level Analysis and Correlative Micronutrients in Children Presenting with Malnutrition and Poor Growth

    OpenAIRE

    Han, Tae Hwan; Lee, Jin; Kim, Yong Joo

    2016-01-01

    Purpose Zinc deficiency can induce serious clinical problems in the gastrointestinal (GI) system and immune system and can affect growth and development. It is more severe in younger patients. Chronic zinc deficiency is reflected more precisely in hair than in serum. We studied hair zinc levels and other hair and serum micronutrients in chronic malnourished children to identify which micronutrients are affected or correlated with the other ones. Methods Hair mineral analyses were performed in...

  9. Antenatal Deworming and Materno-Perinatal Outcomes in Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Ubong Bassey Akpan

    2018-05-01

    CONCLUSION: Presumptive deworming during the antenatal period can significantly reduce the incidence of peripartum anaemia. However, more studies may be needed to prove any positive perinatal outcome.

  10. Food synergies for improving bioavailability of micronutrients from plant foods.

    Science.gov (United States)

    Nair, K Madhavan; Augustine, Little Flower

    2018-01-01

    Plant foods are endowed with micronutrients but an understanding of bioavailability is essential in countries primarily dependent on plant based foods. Bioavailability depends majorly on food synergies. This review examines the nature of certain food synergies and methods to screen and establish it as a strategy to control micronutrient deficiency in the populations. Strong evidence on the synergistic effect of inclusion of vitamin C rich fruits and non-vegetarian foods in enhancing the bioavailability of iron has been demonstrated. Fat is found to be synergistic for vitamin A absorption. Red wine and protein have been explored for zinc absorption and effect of fat has been studied for vitamin D. Methods for screening of bioavailability, and biomarkers to demonstrate the synergistic effects of foods are required. Translation of food synergy as a strategy requires adaptation to the context and popularization of intelligent food synergies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Micronutrient Synergy in the Fight against Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    Aleksandra Niedzwiecki

    2012-03-01

    Full Text Available The incidence of hepatocellular carcinoma (HCC, once thought to be a rare tumor in North America, has rapidly increased in recent years in the United States. Current treatment modalities to halt the progression of this disease are only marginally effective. The mainstay treatment is liver transplantation, which is often confronted with donor shortage. Invasion, metastasis and recurrence contribute to the high mortality rate of this disease. Matrix metalloproteinases (MMPs that degrade the extracellular matrix (ECM have been associated with the progression, invasion and metastasis of the disease. We have developed strategies to strengthen the ECM collagen and inhibit MMPs through micronutrients such as lysine, proline and ascorbic acid. Addition of epigallocatechin gallate or green tea extract to these micronutrients synergistically enhanced anti-carcinogenic activity in HepG2 cells. Addition of certain other micronutrients, such as N-acetylcysteine, selenium, copper and zinc (NM synergistically enhanced the anticancer activity of the mixture in a model of hepatocellular carcinoma using HepG2 cells. In vitro studies using HepG2 demonstrated that NM was very effective in inhibiting cell proliferation (by MTT assay, MMPs secretion (by gelatinase zymography, cell invasion (through Matrigel and induction of apoptosis (by live green caspase. In addition, NM was shown to down-regulate urokinase plasminogen activator (by fibrin zymography and up-regulate tissue inhibitors of metalloproteinases (by reverse zymography in another HCC cell line, SK-Hep-1. MMP-2 and MMP-9 activities were further modulated by phorbol 12-myristate 13-acetate (PMA induction and inhibited by NM. In previous studies, NM inhibited Sk-Hep-1 xenografts in nude mice and also inhibited hepatic metastasis of B16FO melanoma cells. Our results suggest that NM is an excellent candidate for therapeutic use in the treatment HCC by inhibiting critical parameters in cancer development and

  12. Antenatal and postnatal corticosteroid and resuscitation induced lung injury in preterm sheep

    Directory of Open Access Journals (Sweden)

    Kallapur Suhas G

    2009-12-01

    Full Text Available Abstract Background Initiation of ventilation using high tidal volumes in preterm lambs causes lung injury and inflammation. Antenatal corticosteroids mature the lungs of preterm infants and postnatal corticosteroids are used to treat bronchopulmonary dysplasia. Objective To test if antenatal or postnatal corticosteroids would decrease resuscitation induced lung injury. Methods 129 d gestational age lambs (n = 5-8/gp; term = 150 d were operatively delivered and ventilated after exposure to either 1 no medication, 2 antenatal maternal IM Betamethasone 0.5 mg/kg 24 h prior to delivery, 3 0.5 mg/kg Dexamethasone IV at delivery or 4 Cortisol 2 mg/kg IV at delivery. Lambs then were ventilated with no PEEP and escalating tidal volumes (VT to 15 mL/kg for 15 min and then given surfactant. The lambs were ventilated with VT 8 mL/kg and PEEP 5 cmH20 for 2 h 45 min. Results High VT ventilation caused a deterioration of lung physiology, lung inflammation and injury. Antenatal betamethasone improved ventilation, decreased inflammatory cytokine mRNA expression and alveolar protein leak, but did not prevent neutrophil influx. Postnatal dexamethasone decreased pro-inflammatory cytokine expression, but had no beneficial effect on ventilation, and postnatal cortisol had no effect. Ventilation increased liver serum amyloid mRNA expression, which was unaffected by corticosteroids. Conclusions Antenatal betamethasone decreased lung injury without decreasing lung inflammatory cells or systemic acute phase responses. Postnatal dexamethasone or cortisol, at the doses tested, did not have important effects on lung function or injury, suggesting that corticosteroids given at birth will not decrease resuscitation mediated injury.

  13. Very low adequacy of micronutrient intakes by young children and women in rural Bangladesh is primarily explained by low food intake and limited diversity.

    Science.gov (United States)

    Arsenault, Joanne E; Yakes, Elizabeth A; Islam, M Munirul; Hossain, Mohammad B; Ahmed, Tahmeed; Hotz, Christine; Lewis, Bess; Rahman, Ahmed Shafiqur; Jamil, Kazi M; Brown, Kenneth H

    2013-02-01

    Documentation of micronutrient intake inadequacies among developing country populations is important for planning interventions to control micronutrient deficiencies. The objective of this study was to quantify micronutrient intakes by young children and their primary female caregivers in rural Bangladesh. We measured 24-h dietary intakes on 2 nonconsecutive days in a representative sample of 480 children (ages 24-48 mo) and women in 2 subdistricts of northern Bangladesh by using 12-h weighed food records and subsequent 12-h recall in homes. We calculated the probability of adequacy (PA) of usual intakes of 11 micronutrients and an overall mean PA, and evaluated dietary diversity by counting the total number of 9 food groups consumed. The overall adequacy of micronutrient intakes was compared to dietary diversity scores using correlation and multivariate regression analyses. The overall mean prevalence of adequacy of micronutrient intakes for children was 43% and for women was 26%. For children, the prevalence of adequate intakes for each of the 11 micronutrients ranged from a mean of 0 for calcium to 95% for vitamin B-6 and was foods.

  14. Hypnosis Antenatal Training for Childbirth (HATCh: a randomised controlled trial [NCT00282204

    Directory of Open Access Journals (Sweden)

    Baghurst Peter

    2006-03-01

    Full Text Available Abstract Background Although medical interventions play an important role in preserving lives and maternal comfort they have become increasingly routine in normal childbirth. This may increase the risk of associated complications and a less satisfactory birth experience. Antenatal hypnosis is associated with a reduced need for pharmacological interventions during childbirth. This trial seeks to determine the efficacy or otherwise of antenatal group hypnosis preparation for childbirth in late pregnancy. Methods/design A single centre, randomised controlled trial using a 3 arm parallel group design in the largest tertiary maternity unit in South Australia. Group 1 participants receive antenatal hypnosis training in preparation for childbirth administered by a qualified hypnotherapist with the use of an audio compact disc on hypnosis for re-enforcement; Group 2 consists of antenatal hypnosis training in preparation for childbirth using an audio compact disc on hypnosis administered by a nurse with no training in hypnotherapy; Group 3 participants continue with their usual preparation for childbirth with no additional intervention. Women > 34 and Discussion If effective, hypnosis would be a simple, inexpensive way to improve the childbirth experience, reduce complications associated with pharmacological interventions, yield cost savings in maternity care, and this trial will provide evidence to guide clinical practice.

  15. Micronutrient intake and status in Central and Eastern Europe compared with other European countries, results from the EURRECA network

    NARCIS (Netherlands)

    Novakovic, R.N.; Cavelaars, A.J.E.M.; Bekkering, G.E.; Roman-Vinas, B.; Ngo, J.; Gurinovic, M.; Glibetic, M.; Golesorkhi, M.; Warthon-Medina, M.; Satalic, Z.; Geelen, A.; Serra Majem, L.; Veer, van 't P.; Groot, de C.P.G.M.

    2013-01-01

    Objective: To compare micronutrient intakes and status in Central and Eastern Europe (CEE) with those in other European countries and with reference values. Design: Review of the micronutrient intake/status data from open access and grey literature source

  16. Changes of micronutrients, dry weight and plant development in ...

    African Journals Online (AJOL)

    User

    2011-05-09

    May 9, 2011 ... This study was carried out to determine the effects of salt stress on the growth, dry weights and micronutrient contents of canola (Brassica napus L.) cultivars grown in greenhouse ... crop productivity in the arid and semiarid regions of the ... fertilizer equivalent to 150 kg ha-1 and triple-superphosphate (80 kg.

  17. Antenatal Hydronephrosis: Differential Diagnosis, Evaluation, and Treatment Options

    Science.gov (United States)

    Herndon, C.D. Anthony

    2006-01-01

    The diagnosis, evaluation and management of antenatal hydronephrosis has undergone a two stage paradigm shift since the advent of prenatal ultrasonography in the early 1980s. Initially the identification of a large number of asymptomatic infants appeared to afford the surgeon the opportunity for preemptive intervention. However, it has now become apparent that antenatal hydronephrosis (AH) is far more difficult to interpret thanoriginally perceived. The initial enthusiasm for surgery has now been replaced by a much more conservative approach to ureteropelvic junction(UPJ) obstruction, multi-cystic dysplastic kidney(MCDK), vesicoureteral reflux and the non-refluxing megaureter. This review will highlight the postnatal evaluation of AH and include an overview of the Society for Fetal Urology grading system for hydronephrosis. The differential diagnosis and treatment options for UPJ obstruction, vesicoureteral reflux, MCDK, duplication anomalies, megaureter, and posterior urethral valves will be discussed. PMID:17619702

  18. MICRONUTRIENTS USE EFFICIENCY IN TROPICAL COVER CROPS AS INFLUENCED BY PHOSPHORUS FERTILIZATION

    Directory of Open Access Journals (Sweden)

    NAND KUMAR FAGERIA

    2015-01-01

    Full Text Available Deficiency of micronutrients is increasing in the recent years in cropping systems in many parts of the world and cover crops are important components of cropping systems. A greenhouse experiment was conducted to evaluate copper (Cu, iron (Fe, manganese (Mn and zinc (Zn use efficiency in 14 tropical leg-ume cover crops grown on an Oxisol. The P levels used were low (0 mg kg-1, medium (100 mg kg-1 and high (200 mg kg-1. The P X cover crops interactions were significant for Cu, Fe, Mn, and Zn use efficiency (tops dry weight/unit nutrient uptake. Hence, cover crop species varied in nutrient use efficiency with change in P levels. The micronutrient use efficiency was in the order of Cu > Zn > Mn > Fe. Higher Cu use efficiency was associated with lower uptake of this element, in the cover crop tops compared to other micronutrients. Similar-ly, lower efficiency of Fe and Mn was associated with their higher uptake in the tops of cover crops. Overall, Cu and Mn use efficiency was decreased when P level was raised from low to medium level and then it was constant. Iron use efficiency was increased with increasing P level but Zn use efficiency was constant with the addition of P fertilizer

  19. Effects of micronutrient fortified milk and cereal food for infants and children: a systematic review

    Directory of Open Access Journals (Sweden)

    Eichler Klaus

    2012-07-01

    Full Text Available Abstract Background Micronutrient deficiency is a common public health problem in developing countries, especially for infants and children in the first two years of life. As this is an important time window for child development, micronutrient fortified complementary feeding after 6 months of age, for example with milk or cereals products, in combination with continued breastfeeding, is recommended. The overall effect of this approach is unclear. Methods We performed a Systematic Review and Meta-analysis to assess the impact of micronutrient fortified milk and cereal food on the health of infants and little children (aged 6 months to 5 years compared to non-fortified food. We reviewed randomized controlled trials using electronic databases (MEDLINE and Cochrane library searches through FEB 2011, reference list screening and hand searches. Three reviewers assessed 1153 studies for eligibility and extracted data. One reviewer assessed risk of bias using predefined forms. Results We included 18 trials in our analysis (n = 5’468 children; range of mean hemoglobin values: 9.0 to 12.6 g/dl. Iron plus multi micronutrient fortification is more effective than single iron fortification for hematologic outcomes. Compared to non-fortified food, iron multi micronutrient fortification increases hemoglobin levels by 0.87 g/dl (95%-CI: 0.57 to 1.16; 8 studies and reduces risk of anemia by 57% (relative risk 0.43; 95%-CI 0.26 to 0.71; absolute risk reduction 22%; number needed to treat 5 [95%-CI: 4 to 6]; 6 Studies. Compared to non-fortified food, fortification increases serum levels of vitamin A but not of zinc. Information about functional health outcomes (e.g. weight gain and morbidity was scarce and evidence is inconclusive. Risk of bias is unclear due to underreporting, but high quality studies lead to similar results in a sensitivity analysis. Conclusions Multi micronutrient fortified milk and cereal products can be an effective option to

  20. Teenage pregnancy antenatal and perinatal morbidity: results from a tertiary centre in Greece.

    Science.gov (United States)

    Pergialiotis, V; Vlachos, D-E G; Gkioka, E; Tsotra, K; Papantoniou, N; Vlachos, G D

    2015-01-01

    We present the experience of a tertiary referral hospital in Greece, evaluating obstetric and perinatal outcomes among teenage and average maternal age (AMA) women. We retrospectively assessed all singleton pregnancies during a twelve-month period (January-December 2012). A total of 1,704 cases were reviewed and divided into two groups: one of AMA mothers (20-34 years old) (1,460 women) and the other of teenage mothers (12-19 years old) (244 women). We observed significantly higher incidence rates of preterm births (p teenage mothers. Antenatal surveillance was decreased among teenage mothers (p Teenage pregnancy is accompanied by significant antenatal and perinatal complications that need specific obstetrical attention. Obstetricians should be aware of these complications in order to ameliorate the antenatal outcome of childbearing teenagers.

  1. A framework to explore micronutrient deficiency in maternal and child health in Malawi, Southern Africa

    OpenAIRE

    Nisbet Zoe; Cummings Maria; Rankin Jean; Atkinson John; MacPherson Gordon; Gulliver John; Dickinson Natalie; Hursthouse Andrew; Taylor Avril; Robertson Chris; Burghardt Wolfgang

    2009-01-01

    Abstract Background Global food insecurity is associated with micronutrient deficiencies and it has been suggested that 4.5 billion people world-wide are affected by deficiencies in iron, vitamin A and iodine. Zinc has also been identified to be of increasing concern. The most vulnerable are young children and women of childbearing age. A pilot study has been carried out in Southern Malawi, to attempt to link the geochemical and agricultural basis of micronutrient supply through spatial varia...

  2. Maternal vitamin D status and infant outcomes in rural Vietnam: a prospective cohort study.

    Science.gov (United States)

    Hanieh, Sarah; Ha, Tran T; Simpson, Julie A; Thuy, Tran T; Khuong, Nguyen C; Thoang, Dang D; Tran, Thach D; Tuan, Tran; Fisher, Jane; Biggs, Beverley-Ann

    2014-01-01

    Vitamin D deficiency affects 1 billion people globally. It has an important role in bone homeostasis, brain development and modulation of the immune system and yet the impact of antenatal vitamin D deficiency on infant outcomes is poorly understood. We assessed the association of 25- hydroxyvitamin D levels (25-OHD) in late pregnancy and early infant growth and developmental outcomes in rural Vietnam. A prospective cohort study of 960 women who had previously participated in a double-blind cluster randomized controlled trial of antenatal micronutrient supplementation in rural Vietnam was undertaken. Maternal 25-OHD concentration was measured at 32 weeks gestation, and infants were followed until 6 months of age. Main outcome measures were cognitive, motor, socio-emotional and language scores using the Bayley Scales of Infant Development, 3rd edition, and infant length-for-age z scores at 6 months of age. 60% (582/960) of women had 25-OHD levels language scores compared to those born to women who were vitamin D replete (≥75 nmol/L) (Mean Difference (MD) -3.48, 95% Confidence Interval (CI) -5.67 to -1.28). For every 25 nmol increase in 25-OHD concentration in late pregnancy, infant length-for-age z scores at 6 months of age decreased by 0.08 (95% CI -0.15 to -0.02). Low maternal 25- hydroxyvitamin D levels during late pregnancy are of concern in rural Vietnam, and are associated with reduced language developmental outcomes at 6 months of age. Our findings strengthen the evidence for giving vitamin D supplementation during pregnancy.

  3. The Readiness of Students to Learn Interprofessional Teamwork in Antenatal Care

    Directory of Open Access Journals (Sweden)

    Dina Zakiyyatul Fuadah

    2016-09-01

    Full Text Available Introduction: Indonesia as a developing country have a higher Maternal Mortality Rate (MMR. The prevention efforts is developing interprofessional collaborative practice (IPCP in the level of health care. Collaboration attitudes should start from education level through interprofessional education training and simulation for student. The objective of this study was to analyze the effect of interprofessional education training toward the readiness of students to learn interprofessional teamwork in antenatal care. Methods: Quasi-experimental design (pre test and post test without control with Time-Series Design. Participants used in this study were students of five semester in STIKes Karya Husada Kediri year of 2011/2012 and the number of samples are 60 students. Technique sampling using simple random. The data collected by used questionnaires Readiness Interprofessional Learning Scale (RIPLS and checklist observations using Teamwork Score (TWS. Anova, Friedman test, and Kruskal Wallis was used to statistically analyzed the data. Results: Readiness to learn interprofessional teamwork indicates the value of p = 0.001 thats means there are significant differences between the readiness before and after training IPE. Delta test showed that p value > 0.05 so there is no difference between the three programs study on readiness to learn interprofessional teamwork in antenatal care. Discussion: Interprofessional education training using simulation methods can affect the readiness of nursing, midwifery and nutritionist students for learning interprofessional teamwork in antenatal care. Keywords: interprofessional education, readiness, training and simulations, pre clinics students, antenatal care.

  4. Role of Macronutrients and Micronutrients in DNA Damage: Results From a Food Frequency Questionnaire.

    Science.gov (United States)

    Ladeira, Carina; Carolino, Elisabete; Gomes, Manuel C; Brito, Miguel

    2017-01-01

    The links between diet and genomic instability have been under investigation for several decades, and evidence suggests a significant causal or preventive role for various dietary factors. This study investigates the influence of macronutrients (calories, protein, and glucides) and micronutrients, such as vitamins and minerals, as assessed by a food frequency questionnaire, on genotoxicity biomarkers measured by cytokinesis-blocked micronucleus assay and comet assay. The results found significant positive and negative correlations. Micronucleus frequency tends to increase with higher intake of caffeine, calcium, magnesium, zinc, and protein ( P macronutrients and micronutrients.

  5. Public health facility resource availability and provider adherence to first antenatal guidelines in a low resource setting in Accra, Ghana.

    Science.gov (United States)

    Amoakoh-Coleman, Mary; Agyepong, Irene Akua; Kayode, Gbenga A; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin; Ansah, Evelyn K

    2016-09-21

    Lack of resources has been identified as a reason for non-adherence to clinical guidelines. Our aim was to describe public health facility resource availability in relation to provider adherence to first antenatal visit guidelines. A cross-sectional analysis of the baseline data of a prospective cohort study on adherence to first antenatal care visit guidelines was carried out in 11 facilities in the Greater Accra Region of Ghana. Provider adherence was studied in relation to health facility resource availability such as antenatal workload for clinical staffs, routine antenatal drugs, laboratory testing, protocols, ambulance and equipment. Eleven facilities comprising 6 hospitals (54.5 %), 4 polyclinics (36.4 %) and 1 health center were randomly sampled. Complete provider adherence to first antenatal guidelines for all the 946 participants was 48.1 % (95 % CI: 41.8-54.2 %), varying significantly amongst the types of facilities, with highest rate in the polyclinics. Average antenatal workload per month per clinical staff member was higher in polyclinics compared to the hospitals. All facility laboratories were able to conduct routine antenatal tests. Most routine antenatal drugs were available in all facilities except magnesium sulphate and sulphadoxine-pyrimethamine which were lacking in some. Antenatal service protocols and equipment were also available in all facilities. Although antenatal workload varies across different facility types in the Greater Accra region, other health facility resources that support implementation of first antenatal care guidelines are equally available in all the facilities. These factors therefore do not adequately account for the low and varying proportions of complete adherence to guidelines across facility types. Providers should be continually engaged for a better understanding of the barriers to their adherence to these guidelines.

  6. Association of gender disadvantage factors and gender preference with antenatal depression in women: a cross-sectional study from rural Maharashtra.

    Science.gov (United States)

    Shidhaye, Pallavi; Shidhaye, Rahul; Phalke, Vaishali

    2017-06-01

    Maternal depression is a major public health problem in low- and middle-income countries including India. Very few studies have assessed association of various risk factors with antenatal depression in rural Indian women, especially the effect of marital conflict, gender disadvantage and gender preference on antenatal depression. This paper describes the prevalence of probable antenatal depression in rural Maharashtra, a state in the western part of India and specifically assesses the association of marital and gender disadvantage factors and gender preference for a male child with antenatal depression. Primary Health Centre-based cross-sectional survey of antenatal women in rural Maharashtra was carried out. The outcome of interest was a probable diagnosis of depression in antenatal women which was measured using the Edinburgh postnatal depression scale (EPDS). Data were analyzed using simple and multiple logistic regression. 302 women in their antenatal period were included in this study. The outcome of antenatal depression (EPDS > 12) was found in 51 women (16.9%, 95% CI 12.6-21.1%). Feeling pressurized to deliver a male child was strongly associated with the outcome of antenatal depression (adjusted odds ratio (OR): 3.0; 95% CI 1.4-6.5). Unsatisfactory reaction of in-laws to dowry (adjusted OR 11.2; 95% CI 2.4-52.9) and difficult relationship with in-laws (adjusted OR 5.3; 95% CI 2.4-11.6) were also significantly associated with antenatal depression. Our findings demonstrate that antenatal depression in rural women of Western Maharashtra is associated with gender disadvantage factors, especially related to preference for a male child. The agenda to improve maternal mental health should be ultimately linked to address the broader social development goals and gender empowerment.

  7. Outcomes of Isolated Antenatal Hydronephrosis at First Year of Life

    Directory of Open Access Journals (Sweden)

    Mutaz Orabi

    2018-03-01

    Full Text Available Objectives: To compare the grade of hydronephrosis between the antenatal and first postnatal ultrasound (US and their clinical outcomes. Methods: This retrospective study included all cases of isolated hydronephrosis detected by antenatal US from August 2005 to February 2011. Hydronephrosis was classified based on the standard criteria into mild, moderate, or severe. Cases associated with other major congenital anomalies were excluded. All patients were followed-up postnatally and outcomes available were analyzed at one year of age. Results: A total of 105 cases were included out of which 83 (79.0% were males and 22 (20.9% were females with a median gestational age of 38 weeks. First postnatal US of 105 cases showed that 20 (19.0% were free of hydronephrosis, 39 (37.1% had mild, 29 (27.6% moderate, and 17 (16.1% had severe hydronephrosis. Half (50.4% of hydronephrosis cases improved in their clinical presentation while 13.3% showed deterioration and 36.3% remained the same. Almost half of all cases (52 cases were diagnosed by US at the end of first year without any effect on renal function. Conclusions: Antenatal and postnatal US are sensitive tools for detecting hydronephrosis as well as for postnatal counseling. Fetal anatomy US is usually done at 18 weeks gestation and if this reveals any evidence of hydronephrosis, the patient is followed according to the severity. Postnatal US is not done routinely for cases where hydronephrosis resolves completely during pregnancy. Although newborns with antenatal hydronephrosis due to secondary causes are at greater risk for renal impairment, surgical intervention reserves renal function.

  8. Database analysis of children and adolescents with Bipolar Disorder consuming a micronutrient formula

    Directory of Open Access Journals (Sweden)

    Gately Dermot

    2010-09-01

    Full Text Available Abstract Background Eleven previous reports have shown potential benefit of a 36-ingredient micronutrient formula (known as EMPowerplus for the treatment of psychiatric symptoms. The current study asked whether children (7-18 years with pediatric bipolar disorder (PBD benefited from this same micronutrient formula; the impact of Attention-Deficit/Hyperactivity Disorder (ADHD on their response was also evaluated. Methods Data were available from an existing database for 120 children whose parents reported a diagnosis of PBD; 79% were taking psychiatric medications that are used to treat mood disorders; 24% were also reported as ADHD. Using Last Observation Carried Forward (LOCF, data were analyzed from 3 to 6 months of micronutrient use. Results At LOCF, mean symptom severity of bipolar symptoms was 46% lower than baseline (effect size (ES = 0.78 (p 50% improvement at LOCF, with 38% still taking psychiatric medication (52% drop from baseline but at much lower levels (74% reduction in number of medications being used from baseline. The results were similar for those with both ADHD and PBD: a 43% decline in PBD symptoms (ES = 0.72 and 40% in ADHD symptoms (ES = 0.62. An alternative sample of children with just ADHD symptoms (n = 41 showed a 47% reduction in symptoms from baseline to LOCF (ES = 1.04. The duration of reductions in symptom severity suggests that benefits were not attributable to placebo/expectancy effects. Similar findings were found for younger and older children and for both sexes. Conclusions The data are limited by the open label nature of the study, the lack of a control group, and the inherent self-selection bias. While these data cannot establish efficacy, the results are consistent with a growing body of research suggesting that micronutrients appear to have therapeutic benefit for children with PBD with or without ADHD in the absence of significant side effects and may allow for a reduction in psychiatric medications while

  9. HEAVY METALS AND MICRONUTRIENTS IN THE SOIL AND GRAPEVINE UNDER DIFFERENT IRRIGATION STRATEGIES

    Directory of Open Access Journals (Sweden)

    Vanessa de Souza Oliveira

    2015-02-01

    Full Text Available Soils under natural conditions have heavy metals in variable concentrations and there may be an increase in these elements as a result of the agricultural practices adopted. Transport of heavy metals in soil mainly occurs in forms dissolved in the soil solution or associated with solid particles, water being their main means of transport. In this context, the aim of this study was to evaluate the heavy metal and micronutrient content in the soil and in the grapevine plant and fruit under different irrigation strategies. The experiment was carried out in Petrolina, PE, Brazil. The treatments consisted of three irrigation strategies: full irrigation (FI, regulated deficit irrigation (RDI, and deficit irrigation (DI. During the period of grape maturation, soil samples were collected at the depths of 0-10, 10-20, 20-40, 40-60, and 60-80 cm. In addition, leaves were collected at the time of ripening of the bunches, and berries were collected at harvest. Thus, the heavy metal and micronutrient contents were determined in the soil, leaves, and berries. The heavy metal and micronutrient contents in the soil showed a stochastic pattern in relation to the different irrigation strategies. The different irrigation strategies did not affect the heavy metal and micronutrient contents in the vine leaves, and they were below the contents considered toxic to the plant. In contrast, the greater availability of water in the FI treatment favored a greater Cu content in the grape, which may be a risk to vines, causing instability and turbidity. Thus, adoption of deficit irrigation is recommended so as to avoid compromising the stability of tropical wines of the Brazilian Northeast.

  10. Concurrent medical conditions among pregnant women - ignore at their peril: report from an antenatal anesthesia clinic.

    Science.gov (United States)

    Weiniger, Carolyn F; Einav, Sharon; Elchalal, Uriel; Ozerski, Vladislav; Shatalin, Daniel; Ioscovich, Alexander; Ginosar, Yehuda

    2018-03-19

    Care of pregnant women with concurrent medical conditions can be optimized by multidisciplinary antenatal management. In the current study we describe women with concurrent medical conditions who attended our antenatal anesthesia clinic over a 14-year period, 2002-2015 and, based on the findings, we suggest new policies, strategies and practices to improve antenatal care. In 2002, an antenatal anesthesia clinic was established in Hadassah Medical Center. Each consultation focused on the concurrent medical condition. A written anesthesia strategy according to the medical condition and its anesthesia considerations was discussed and given to the patient. Data regarding clinic visits were recorded. A total of 451 clinic women attended the antenatal anesthesia clinic. Maternal age was 31.7 ± 6.0 years (mean ± SD), with gestational age of pregnancy 33.0 ± 5.4 weeks at the clinic visit. Musculoskeletal conditions (23% of all the women seen) were the most frequent concurrent conditions, followed by anesthesia related concerns 20%, neurologic conditions 19%, and cardiac conditions 15%. Women were provided plans that were deliberated carefully rather than being concocted during labor. A wide range of concurrent medical conditions was seen in the antenatal anesthesia clinic, however fewer women attended the clinic than expected according to known population frequencies of concurrent medical conditions. Women with concurrent medical conditions should have labor and anesthesia plans considered during the nine months of pregnancy, prior to delivery, and hospitals should have a means of obtaining this information in a timely manner. Finally, there is a need to develop additional antenatal anesthesia clinics.

  11. The quality of free antenatal and delivery services in Northern Sierra Leone.

    Science.gov (United States)

    Koroma, Manso M; Kamara, Samuel S; Bangura, Evelyn A; Kamara, Mohamed A; Lokossou, Virgil; Keita, Namoudou

    2017-07-12

    The number of maternal deaths in sub-Saharan Africa continues to be overwhelmingly high. In West Africa, Sierra Leone leads the list, with the highest maternal mortality ratio. In 2010, financial barriers were removed as an incentive for more women to use available antenatal, delivery and postnatal services. Few published studies have examined the quality of free antenatal services and access to emergency obstetric care in Sierra Leone. A cross-sectional survey was conducted in 2014 in all 97 peripheral health facilities and three hospitals in Bombali District, Northern Region. One hundred antenatal care providers were interviewed, 276 observations were made and 486 pregnant women were interviewed. We assessed the adequacy of antenatal and delivery services provided using national standards. The distance was calculated between each facility providing delivery services and the nearest comprehensive emergency obstetric care (CEOC) facility, and the proportion of facilities in a chiefdom within 15 km of each CEOC facility was also calculated. A thematic map was developed to show inequities. The quality of services was poor. Based on national standards, only 27% of women were examined, 2% were screened on their first antenatal visit and 47% received interventions as recommended. Although 94% of facilities provided delivery services, a minority had delivery rooms (40%), delivery kits (42%) or portable water (46%). Skilled attendants supervised 35% of deliveries, and in only 35% of these were processes adequately documented. None of the five basic emergency obstetric care facilities were fully compliant with national standards, and the central and northernmost parts of the district had the least access to comprehensive emergency obstetric care. The health sector needs to monitor the quality of antenatal interventions in addition to measuring coverage. The quality of delivery services is compromised by poor infrastructure, inadequate skilled staff, stock-outs of

  12. determinants of first antenatal care visit by pregnant women

    African Journals Online (AJOL)

    2014-09-01

    Sep 1, 2014 ... Subjects: Four hundred and seventeen (417) pregnant women attending antenatal care ... convenience of opening hours at ANC facility, commuting distance from home to ... identifying maternal education, employment, age,.

  13. Do antenatal education classes decrease use of epidural analgesia during labour? – a Danish RCT

    DEFF Research Database (Denmark)

    Brixval, Carina Sjöberg; Thygesen, Lau Caspar; Axelsen, Solveig Forberg

    Background: Epidural analgesia is widely used as pain relief during labour but has negative side effects, such as prolonged labour and increased risk of obstetric interventions. Antenatal education in small groups may increase trust in own ability to cope at home in the early stages of labour...... of an antenatal education program in small classes on use of epidural analgesia. Methods: Data from the NEWBORN trial were used. A total of 1766 women from the Copenhagen area, Denmark were randomized to participate in either antenatal education in small groups or standard care. Data were analysed according...... on whether to implement the NEWBORN program in a clinical setting also depend upon the trial effect on psycho-social outcomes which will be analysed in near future. Main messages (max 200 anslag): 1. No effect of antenatal education in small groups on use of epidural analgesia as pain relief during labour...

  14. Effects of soil applications of micro-nutrients and chelating agent citric acid on mineral nutrients in soybean seeds

    Science.gov (United States)

    Micro-nutrients deficiency in soil result in crop yield loss and poor seed quality. Correcting this deficiency is normally conducted by foliar or soil application. The objective of this research was to determine the effects of soil applications of five micro-nutrients (Mn, Cu, Zn, Mo, and B) with a ...

  15. Effect of preventive supplementation with zinc and other micronutrients on malaria and diarrhoeal morbidity in African children

    NARCIS (Netherlands)

    Veenemans, J.

    2011-01-01

    Background: Zinc is important for innate and adaptive immune responses
    to infection. Preventive zinc supplementation has been shown to reduce
    the incidence of acute diarrhoea by 20%. Few trials have evaluated its effect
    against malaria. Because trial results for both outcomes are

  16. The effects of antenatal depression and antidepressant treatment on placental gene expression

    Directory of Open Access Journals (Sweden)

    Jocelien DA Olivier

    2015-01-01

    Full Text Available The effects of antenatal depression and antidepressant treatment during pregnancy on both mother and child are vigorously studied, but the underlying biology for these effects is largely unknown. The placenta plays a crucial role in the growth and development of the fetus. We performed a gene expression study on the fetal side of the placenta to investigate gene expression patterns in mothers with antenatal depression and in mothers using antidepressant treatment during pregnancy.Placental samples from mothers with normal pregnancies, from mothers with antenatal depression, and from mothers using antidepressants were collected. We performed a pilot microarray study to investigate alterations in the gene expression and selected several genes from the microarray for biological validation with qPCR in a larger sample.In mothers with antenatal depression 108 genes were differentially expressed, whereas 109 genes were differentially expressed in those using antidepressants. Validation of the microarray revealed more robust gene expression differences in the seven genes picked for confirmation in antidepressant-treated women than in depressed women. Among the genes that were validated ROCK2 and C12orf39 were differentially expressed in both depressed and antidepressant-treated women, whereas ROCK1, GCC2, KTN1, and DNM1L were only differentially expressed in the antidepressant-treated women. In conclusion, antenatal depression and antidepressant exposure during pregnancy are associated with altered gene expression in the placenta. Findings on those genes picked for validation were more robust among antidepressant-treated women than in depressed women, possibly due to the fact that depression is a multifactorial condition with varying degrees of endocrine disruption. It remains to be established whether the alterations found in the gene expression of the placenta are found in the fetus as well.

  17. The effect of a micronutrient-fortified complementary food on micronutrient status, growth and development of 6- to 12-month-old disadvantaged urban South-African infants

    NARCIS (Netherlands)

    Oelofse, A.; Raaij, van J.M.A.; Benade, A.J.S.; Dhansay, M.A.; Tolboom, J.J.M.; Hautvast, J.G.A.J.

    2003-01-01

    The study was conducted to look at the effectiveness of a multimicronutrient-fortified complementary food on the micronutrient status, linear growth and psychomotor development of 6- to 12-month-old infants from a black urban disadvantaged community in the Western Cape, South Africa. The study was

  18. Micronutrient Status and Dietary Intake of Iron, Vitamin A, Iodine, Folate and Zinc in Women of Reproductive Age and Pregnant Women in Ethiopia, Kenya, Nigeria and South Africa: A Systematic Review of Data from 2005 to 2015

    Directory of Open Access Journals (Sweden)

    Rajwinder Harika

    2017-10-01

    Full Text Available A systematic review was conducted to evaluate the status and intake of iron, vitamin A, iodine, folate and zinc in women of reproductive age (WRA (≥15–49 years and pregnant women (PW in Ethiopia, Kenya, Nigeria and South Africa. National and subnational data published between 2005 and 2015 were searched via Medline, Scopus and national public health websites. Per micronutrient, relevant data were pooled into an average prevalence of deficiency, weighted by sample size (WAVG. Inadequate intakes were estimated from mean (SD intakes. This review included 65 surveys and studies from Ethiopia (21, Kenya (11, Nigeria (21 and South Africa (12. In WRA, WAVG prevalence of anaemia ranged from 18–51%, iron deficiency 9–18%, and iron deficiency anaemia at 10%. In PW, the prevalence was higher, and ranged from 32–62%, 19–61%, and 9–47%, respectively. In WRA, prevalence of vitamin A, iodine, zinc and folate deficiencies ranged from 4–22%, 22–55%, 34% and 46%, while in PW these ranged from 21–48%, 87%, 46–76% and 3–12% respectively. Inadequate intakes of these micronutrients are high and corresponded with the prevalence figures. Our findings indicate that nationally representative data are needed to guide the development of nutrition interventions and public health programs, such as dietary diversification, micronutrient fortification and supplementation.

  19. Reparative Osteogenesis in Normal Conditions and in Micronutrient Iodine and Selenium Deficiency

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    P.Ye. Kovalchuk

    2015-04-01

    Full Text Available Today, a number of unresolved issues remains without researchers’ attention and should be explored, among them: the impact of selenium and iodine deficiencies on bone tissue, healing of bone defects and morphological peculiarities of the process under micronutrient iodine and selenium deficiency. This paper presents the results of experimental study of physiological features and reparative osteogenesis in posttraumatic defects of femoral metadiaphysis under selenium and iodine deficiency. The data that we have shown testify the negative impact of micronutrient deficiency on reparative osteogenesis that is manifested by inhibition of this process and is accompanied by the formation of bone regenerate, deterioration of structural and functional state of bone tissue, development of degenerative and necrotic changes in bone tissue and epiphyseal cartilage.

  20. Lentil and Kale: Complementary Nutrient-Rich Whole Food Sources to Combat Micronutrient and Calorie Malnutrition

    Directory of Open Access Journals (Sweden)

    Megan Migliozzi

    2015-11-01

    Full Text Available Lentil (Lens culinaris Medik. is a nutritious food and a staple for millions of people. Not only are lentils a good source of energy, they also contain a range of micronutrients and prebiotic carbohydrates. Kale (Brassica oleracea v. acephala has been considered as a health food, but its full range of benefits and composition has not been extensively studied. Recent studies suggest that foods are enrich in prebiotic carbohydrates and dietary fiber that can potentially reduce risks of non-communicable diseases, including obesity, cancer, heart disease, and diabetes. Lentil and kale added to a cereal-based diet would enhance intakes of essential minerals and vitamins to combat micronutrient malnutrition. This review provides an overview of lentil and kale as a complementary nutrient-rich whole food source to combat global malnutrition and calorie issues. In addition, prebiotic carbohydrate profiles and the genetic potential of these crops for further micronutrient enrichment are briefly discussed with respect to developing sustainable and nutritious food systems.