Calton Jayson B
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
Objective. To assess whether the high prevalence of stunting and overweight accompanied by serum deficiencies of iron, folate and vitamin B12 in children at ages 1 and 3 years, can be explained by their diet. Design. A prospective cohort study. Setting. Villages in the central region of Limpopo province, which are serviced ...
Krzizek, Eva-Christina; Brix, Johanna Maria; Herz, Carsten Thilo; Kopp, Hans Peter; Schernthaner, Gerit-Holger; Schernthaner, Guntram; Ludvik, Bernhard
Postoperative micronutrient deficiency is a known side effect of bariatric surgery. In this study, we examined the prevalence of micronutrient deficiency in patients with morbid obesity (MO) preoperatively. A total of 1732 patients with MO wishing to undergo bariatric surgery (age: 40 ± 12 years, mean BMI: 44 ± 9 kg/m 2 , means ± SD, 77.3% female) were analyzed in this cross-sectional examination. Iron state, vitamin B12, folic acid, 25hydroxy(OH)-vitamin D, PTH, vitamin A, and vitamin E levels were determined. Subsequently, patients underwent nutritional counseling and were substituted accordingly. A total of 63.2% (n = 1094) of the patients had a deficit in folic acid ( 56.9 pg/ml). A total of 5.1% (n = 88) of the patients presented with a deficit in vitamin B12 (deficiency (ferritin deficiency (women 11.8% vs. men 1.5%, p prevalence of micronutrient deficiency in patients with morbid obesity preoperatively and emphasize the importance of exact preoperative evaluation and adequate substitution as well as postoperative surveillance.
Bhandari, Shiva; Banjara, Megha Raj
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.
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.
Moizé Arcone, Violeta
[eng] BACKGROUND: Bariatric surgery (BS) is the most effective long-term therapy for the treatment of severe obesity. Benefits of BS include a reduction of overall and cardiovascular mortality, incidence of first occurrence of fatal- or nonfatal-cardiovascular events, prevention and remission of type 2 diabetes mellitus, and improved quality of life. Nonetheless, BS is associated with potential complications amongst which micronutrient deficiencies are relevant. AIM: Against this background,...
Shivakoti, Rupak; Christian, Parul; Yang, Wei-Teng; Gupte, Nikhil; Mwelase, Noluthando; Kanyama, Cecilia; Pillay, Sandy; Samaneka, Wadzanai; Santos, Breno; Poongulali, Selvamuthu; Tripathy, Srikanth; Riviere, Cynthia; Berendes, Sima; Lama, Javier R; Cardoso, Sandra W; Sugandhavesa, Patcharaphan; Tang, Alice M; Semba, Richard D; Campbell, Thomas B; Gupta, Amita
HIV-infected adults have increased risk of several individual micronutrient deficiencies. However, the prevalence and risk factors of concurrent and multiple micronutrient deficiencies and whether micronutrient concentrations change after antiretroviral therapy (ART) initiation have not been well described. The objective of this study was to determine the prevalence and risk factors of individual, concurrent and multiple micronutrient deficiencies among ART-naïve HIV-infected adults from nine countries and assess change in micronutrient status 48 weeks post-ART initiation. A random sub-cohort (n = 270) stratified by country was selected from the multinational PEARLS clinical trial (n = 1571 ART-naïve, HIV-infected adults). We measured serum concentrations of vitamins A, D (25-hydroxyvitamin), E, carotenoids and selenium pre-ART and 48 weeks post-ART initiation, and measured vitamins B6, B12, ferritin and soluble transferrin receptor at baseline only. Prevalence of single micronutrient deficiencies, concurrent (2 coexisting) or conditional (a deficiency in one micronutrient given a deficiency in another) and multiple (≥3) were determined using defined serum concentration cutoffs. We assessed mean changes in micronutrient concentrations from pre-ART to week 48 post-ART initiation using multivariable random effects models. Of 270 participants, 13.9%, 29.2%, 24.5% and 32.4% had 0, 1, 2 and multiple deficiencies, respectively. Pre-ART prevalence was the highest for single deficiencies of selenium (53.2%), vitamin D (42.4%), and B6 (37.3%) with 12.1% having concurrent deficiencies of all three micronutrients. Deficiency prevalence varied widely by country. 48 weeks post-ART initiation, mean vitamin A concentration increased (p ART (p ART initiation but vary between countries. Importantly, despite increases in micronutrient concentrations, prevalence of individual deficiencies remains largely unchanged after 48 weeks on ART. Our results suggest that ART alone is
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.
Sanati Pour, Mehdi; Kumble, Surabhi; Hanieh, Sarah; Biggs, Beverley-Ann
Afghanistan is the 15th least developed country in the world, with poor sanitation and high rates of infectious diseases and malnutrition. However, little is known about the health of young Afghan refugees resettling in Western countries. We used a cross-sectional study design to examine the health profile of newly arrived Afghan refugees presenting to a General Practice between 20th April 2010 and 22nd March 2013 in rural Australia. Data collected included information on nutritional status and prevalence of infectious diseases. Challenges associated with health screening in a General Practice setting in this population were also documented. Data were available on 92 patients. Mean age of presentation was 22.6 years [SD 11.9], and the majority of patients were male (88%). Mean total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride concentrations were 4.4 mmol/L (95% CI, 2.9-7.3), 2.6 mmol/L (95% CI, 1.3-4.4), 1.24 mmol/L (95% CI, 0.7-2.0) and 1.19 mmol/L (95% CI, 0.4-4.7) respectively, and dyslipidaemia (defined as elevated total or low-density lipoprotein (LDL) cholesterol levels, or low levels of high-density lipoprotein (HDL) cholesterol) was seen in 27.5% of patients. There was also a high prevalence of vitamin D and B12 deficiency (50% and 18%, respectively) in this cohort. Issues that impacted on provision and access to health care for refugees included cost, language barriers, patient mobility and mental health issues. Dyslipidaemia and micronutrient deficiencies are significant health issues in young recently settled Afghan refugees, and routine screening should be considered for this population.
Alexandra L. Bellows
Full Text Available Infant mortality accounts for the majority of child deaths in Tanzania, and malnutrition is an important underlying cause. The objectives of this cross-sectional study were to describe the micronutrient status of infants in Tanzania and assess predictors of infant micronutrient deficiency. We analyzed serum vitamin D, vitamin B12, folate, and ferritin levels from 446 infants at two weeks of age, 408 infants at three months of age, and 427 mothers three months post-partum. We used log-Poisson regression to estimate relative risk of being deficient in vitamin D and vitamin B12 for infants in each age group. The prevalence of vitamin D and vitamin B12 deficiency decreased from 60% and 30% at two weeks to 9% and 13% at three months respectively. Yet, the prevalence of insufficiency at three months was 49% for vitamin D and 17% for vitamin B12. Predictors of infant vitamin D deficiency were low birthweight, urban residence, maternal education, and maternal vitamin D status. Maternal vitamin B12 status was the main predictor for infant vitamin B12 deficiency. The majority of infants had sufficient levels of folate or ferritin. Further research is necessary to examine the potential benefits of improving infants’ nutritional status through vitamin D and B12 supplements.
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 ...
the recommended strategy for the prevention of micronutrient deficiency, literature provides the basis for the adoption of supplementation programmes in certain circumstances, such as in cases of severe deficiencies. Evidence has shown that the rate of conversion of â-carotene in fruits and vegetables to retinol is less than ...
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
Sánchez, Andrés; Rojas, Pamela; Basfi-Fer, Karen; Carrasco, Fernando; Inostroza, Jorge; Codoceo, Juana; Valencia, Alejandra; Papapietro, Karin; Csendes, Attila; Ruz, Manuel
Although morbid obesity is related to excess of energy and macronutrient intake, it does not rule out the presence of micronutrient deficiencies. The aim of this study was to evaluate food intake and the prevalence of micronutrient deficiencies in a group of morbidly obese women seeking bariatric surgery. A total of 103 morbidly obese women were studied prior to bariatric surgery. Anthropometry and body composition (dual-energy X-ray absorptiometry, DEXA) were performed on all subjects. Energy and nutrient intake was determined by food frequency questionnaire. Blood tests to assess micronutrients status, including plasma iron, ferritin, transferrin, zinc, copper, calcium, phosphorus, hemoglobin, hematocrit, mean corpuscular volume (MCV), and hair zinc, were performed. Folic acid, vitamin B12, vitamin D, and parathyroid hormone (PTH) were also assessed in 66 subjects. Mean energy intake was 2801 ± 970 kcal/day. Carbohydrate, protein, and lipid intake represented 55 ± 9.1, 13.9 ± 3.3, and 32.5 ± 8.2% of total energy intake, respectively. Iron, calcium, and vitamin D intake was below the recommended dietary allowance. The prevalence of nutritional deficiencies were as follows: plasma iron 12.6%, ferritin 8.7%, transferrin 14.6%, plasma zinc 2.9%, calcium 3.3%, phosphorus 2.3%, hemoglobin 7.7%, hematocrit 13.6%, MCV 6.8%, and hair zinc 15.7%. In the subsample, 10.6% had a vitamin B12 deficiency, 71.7% showed low concentrations of vitamin D, and 66% had high PTH levels. No folic acid or copper deficiencies were detected. Despite high daily energy intake and adequate macronutrient distribution, morbidly obese Chilean women seeking bariatric surgery present with deficient intake of some micronutrients and a high prevalence of micronutrient deficiencies.
Tulchinsky Theodore H
Full Text Available Micronutrient deficiency conditions are widespread among 2 billion people in developing and in developed countries. These are silent epidemics of vitamin and mineral deficiencies affecting people of all genders and ages, as well as certain risk groups. They not only cause specific diseases, but they act as exacerbating factors in infectious and chronic diseases, greatly impacting morbidity, mortality, and quality of life. Deficiencies in some groups of people at special risk require supplementation, but the most effective way to meet community health needs safely is by population based approaches involving food fortification. These complementary methods, along with food security, education, and monitoring, are challenges for public health and for clinical medicine. Micronutrient deficiency conditions relate to many chronic diseases, such as osteoporosis osteomalacia, thyroid deficiency colorectal cancer and cardiovascular diseases. Fortification has a nearly century long record of success and safety, proven effective for prevention of specific diseases, including birth defects. They increase the severity of infectious diseases, such as measles, HIV/AIDS and tuberculosis. Understanding the pathophysiology and epidemiology of micronutrient deficiencies, and implementing successful methods of prevention, both play a key part in the New Public Health as discussed in this section, citing the examples of folic acid, vitamin B12, and vitamin D.
Full Text Available Abstract Background The prevalence of micronutrient deficiencies is higher in obese individuals compared to normal-weight people, probably because of inadequate eating habits but also due to increased demands among overweight persons, which are underestimated by dietary reference intakes (DRI intended for the general population. We therefore evaluated the dietary micronutrient intake in obese individuals compared to a reference population and DRI recommendations. Furthermore, we determined the micronutrient status in obese subjects undergoing a standardized DRI-covering low-calorie formula diet to analyze if the DRI meet the micronutrient requirements of obese individuals. Methods In 104 subjects baseline micronutrient intake was determined by dietary record collection. A randomly assigned subgroup of subjects (n = 32 underwent a standardized DRI-covering low-calorie formula diet over a period of three months. Pre- and post-interventional intracellular micronutrient status in buccal mucosa cells (BMC was analyzed, as well as additional micronutrient serum concentrations in 14 of the subjects. Results Prior to dietetic intervention, nutrition was calorie-rich and micronutrient-poor. Baseline deficiencies in serum concentrations were observed for 25-hydroxyvitamin-D, vitamin C, selenium, iron, as well as ß-carotene, vitamin C, and lycopene in BMC. After a three-month period of formula diet even more subjects had reduced micronutrient levels of vitamin C (serum, BMC, zinc, and lycopene. There was a significant negative correlation between lipophilic serum vitamin concentrations and body fat, as well as between iron and C-reactive protein. Conclusions The present pilot study shows that micronutrient deficiency occurring in obese individuals is not corrected by protein-rich formula diet containing vitamins and minerals according to DRI. In contrast, micronutrient levels remain low or become even lower, which might be explained by insufficient
de Lima, Karla Vanessa Gomes; Costa, Maria José de Carvalho; Gonçalves, Maria da Conceição Rodrigues; Sousa, Bruno Soares
Data already demonstrated the increased prevalence of obesity in various segments of the population. In this context, bariatric surgery is accepted nowadays as the most effective tool in the treatment and control of morbid obesity. Several studies have evaluated the nutritional status after bariatric surgery, especially mixed by detecting a reduction in food intake of protein, vitamins and minerals. However, other studies have investigated the presence of nutritional deficiencies prior to surgery, which may be aggravated by the surgical procedure, resulting in serious postoperative complications. To analyze the literature in relationship to micronutrient deficiencies in obese patients before bariatric surgery. Was carried out a systematic review in several electronic databases, such as PubMed/ Medline, Scielo, Lilacs and Bireme. The following keywords were used alone or in combination: bariatric surgery, obesity, preoperative, gastric bypass, vitamin deficiencies, deficiencies and mineral nutrient absorption. Were included 40 review and original articles published between 2005 to 2012. There were consensus on the combination of preoperative nutritional deficiencies, restrictions and malabsorption, possibly induced by bariatric surgery that can lead patients to experience significant nutritional deficits during the late postoperative period, especially of micronutrients, resulting in serious complications. The high occurrence of micronutrient deficiencies preoperatively detected in morbidly obese candidates for bariatric surgery, plus a malabsorptive procedure, may involve worse prognosis during the late postoperative period. Preoperative evaluation of nutritional parameters and food intake is recommended in conjunction with surgical interventions.
In order to identify micronutrients likely to be deficient in food aid beneficiary populations and to guide the formulation of food aid products, this review was undertaken to summarize published data about micronutrient deficiencies in food aid beneficiaries as compared to the general population in seven African countries ...
Solutions to control and prevent micronutrient deficiencies are available and ... Des solutions pour la prévention et le traitement des carences en micronutriments sont disponibles à coût accessible. Les questions de ... opérateurs des secteurs privés pour qu\\'ils puissent élargir leurs marchés aux zones rurales. Keywords: ...
Wong, Angel Y S; Chan, Esther W; Chui, Celine S L; Sutcliffe, Alastair G; Wong, Ian C K
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.
Thirty-four HIV/AIDS patients at various stages of disease progression volunteered to manage their health using a nutritional supplement that contained several micronutrients that included a 15 mg daily dose of elemental zinc. This initial publication only focuses on trends in the serum zinc levels and the observed ...
Full Text Available The MAINTAIN study is an on-going RCT comparing high-dose micronutrient and anti-oxidant supplementation versus recommended daily allowance (RDA vitamins in slowing HIV immune deficiency progression in ART-naïve people with HIV infection.We planned analysis of the first 127 participants to determine the baseline prevalence of serum micronutrient deficiencies and correlates, as well as tolerance and adherence to study interventions.Participants receive eight capsules twice daily of 1 high-dose or 2 RDA supplements for two years and are followed-up quarterly for measures of immune deficiency progression, safety and tolerability. Regression analysis was used to identify correlates of micronutrient levels at baseline. Adherence was measured by residual pill count, self-report using the General Treatment Scale (GTS and short-term recall HIV Adherence Treatment Scale (HATS.Prior micronutrient supplementation (within 30 days was 27% at screening and 10% of study population, and was not correlated with baseline micronutrient levels. Low levels were frequent for carotene (24%80% in 75% of participants.Micronutrient levels in asymptomatic HIV+ persons are in keeping with population norms, but micronutrient deficiencies are frequent. Adherence levels are high, and will permit a valid evaluation of treatment effects.ClinicalTrials.gov NCT00798772.
Full Text Available Understanding dietary patterns is vital to reducing the number of people experiencing hunger (about 795 million, micronutrient deficiencies (2 billion, and overweight or obesity (2.1 billion. We characterize global trends in dietary quality by estimating micronutrient density of the food supply, prevalence of inadequate intake of 14 micronutrients, and average prevalence of inadequate intake of these micronutrients for all countries between 1961 and 2011. Over this 50-year period, the estimated prevalence of inadequate intakes of micronutrients has declined in all regions due to increased total production of food and/or micronutrient density. This decline has been particularly strong in East and Southeast Asia and weaker in South Asia and sub-Saharan Africa. Sub-Saharan Africa is the only region where dietary micronutrient density has declined over this 50-year period. At the global level, micronutrients with the lowest levels of adequate estimated intake are calcium, iron, vitamin A, and zinc, but there are strong differences between countries and regions. Fortification has reduced the estimated prevalence of inadequate micronutrient intakes in all low-income regions, except South Asia. The food supply in many countries is still far below energy requirements, which suggests a need to increase the availability and accessibility of nutritious foods. Countries where the food energy supply is adequate show a very large variation in dietary quality, and in many of these countries people would benefit from more diverse diets with a greater proportion of micronutrient-dense foods. Dietary quality can be improved through fortification, biofortification, and agricultural diversification, as well as efforts to improve access to and use of micronutrient-dense foods and nutritional knowledge. Reducing poverty and increasing education, especially of women, are integral to sustainably addressing malnutrition.
Beal, Ty; Massiot, Eric; Arsenault, Joanne E; Smith, Matthew R; Hijmans, Robert J
Understanding dietary patterns is vital to reducing the number of people experiencing hunger (about 795 million), micronutrient deficiencies (2 billion), and overweight or obesity (2.1 billion). We characterize global trends in dietary quality by estimating micronutrient density of the food supply, prevalence of inadequate intake of 14 micronutrients, and average prevalence of inadequate intake of these micronutrients for all countries between 1961 and 2011. Over this 50-year period, the estimated prevalence of inadequate intakes of micronutrients has declined in all regions due to increased total production of food and/or micronutrient density. This decline has been particularly strong in East and Southeast Asia and weaker in South Asia and sub-Saharan Africa. Sub-Saharan Africa is the only region where dietary micronutrient density has declined over this 50-year period. At the global level, micronutrients with the lowest levels of adequate estimated intake are calcium, iron, vitamin A, and zinc, but there are strong differences between countries and regions. Fortification has reduced the estimated prevalence of inadequate micronutrient intakes in all low-income regions, except South Asia. The food supply in many countries is still far below energy requirements, which suggests a need to increase the availability and accessibility of nutritious foods. Countries where the food energy supply is adequate show a very large variation in dietary quality, and in many of these countries people would benefit from more diverse diets with a greater proportion of micronutrient-dense foods. Dietary quality can be improved through fortification, biofortification, and agricultural diversification, as well as efforts to improve access to and use of micronutrient-dense foods and nutritional knowledge. Reducing poverty and increasing education, especially of women, are integral to sustainably addressing malnutrition.
Laillou, Arnaud; Yakes, Elizabeth; Le, Thi Hop; Wieringa, Frank Tammo; Le, Bach Mai; Moench-Pfanner, Regina; Berger, Jacques
Vietnamese Living Standard Surveys showed that the rate of overweight and obese in Vietnamese adults doubled between 1992 and 2002, from 2% to 5.5%, respectively with no significant difference in the proportions of overweight/obesity between men and women. Considering the increasing public health concern over the double burden of malnutrition in Vietnam, we investigated micronutrient deficiencies among women of reproductive age according to their Body Mass Index. A transversal study was conducted in 2010 among 1530 women of reproductive age from 19 provinces. Participating women were asked to give a non-fasting blood sample for plasma iron, vitamin A, folate, vitamin B12 and zinc assessment. Although % body fat was associated with haemoglobin, ferritin, retinol and zinc concentrations, BMI category was only associated with marginal vitamin A status (19% among underweight vs 7% among overweight/obese; poverweight/obese women; prevalence of zinc deficiency and marginal/deficient folate status was much higher, affecting respectively 61.1% and 25.8%. Intra-individual double burden of malnutrition (overweight/obesity (OW) and micronutrient deficiency) was observed among 2.0% for OW-anemia, 2.3% OW-iron deficient, 3.0% for OW-Vitamin B12 deficiency, 12.2% for OW-Zinc deficiency and 5.2% for OW-marginal/deficient folate status. This large, cross-sectional survey demonstrated that micronutrient deficiencies are an issue across the weight spectrum among women in Vietnam, with only vitamin A status being better among overweight than underweight women. It is therefore essential for Vietnam to actively prevent women of reproductive age from overweight/obesity and at same time to control micronutrient deficiencies in this population to limit their economic and health consequences.
Harding, Kassandra L; Aguayo, Victor M; Masters, William A; Webb, Patrick
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
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
Prevalence of iron deficiency and its associated risk factors among primary school children in Kelantan. H Halib, W.M.W. Muda, P.C. Dam, H.J.J. Mohamed. Abstract. Iron deficiency anemia (IDA) is the most common micronutrient deficiency that may leads to serious health problems such as poor behavior, cognitive and ...
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.
Micronutrient malnutrition affects the health and well being of 3 billion people globally. Identifying means to improve the micronutrient density in the edible portions of crops is an important way to combat nutrient deficiencies. By studying how plants obtain micronutrients from the soil, we can develop methods to enhance uptake. Although more…
Oliveira, Cristieli Sérgio de Menezes; Augusto, Rosângela Aparecida; Muniz, Pascoal Torres; da Silva, Sara Araújo; Cardoso, Marly Augusto
The present study investigated the factors associated with anemia and micronutrient deficiencies in a cross-sectional analysis conducted with 150 children aged 11 to 14 months attending at basic health centers in Rio Branco, Acre. Venous blood samples were obtained to assess the occurrence of anemia and deficiencies of iron (ID), vitamin A (VAD), and B12 (VB12D). Multiple Poisson regression models were used to identify factors associated with anemia. Anemia, ID, VAD and B12D were observed in 23%, 76%, 18% and 20% of children, respectively. The factors associated with anemia were: do not be only child, living in households without access to cable TV or internet, stunting, late introduction of the complementary feeding (more than 240 days), VAD, VB12D, and current evidence of infection (plasma CRP > 5 mg/L). There was a lower prevalence of anemia among children with birth weight > 3,500 g. Overall, 82% of the study children had at least one of the micronutrient deficiencies (ID, VAD and VB12D). Actions with emphasis on timely and healthy feeding practices, better management of morbidities and supplementation with other micronutrients should be focused on the improvement of child care services at primary health care in this county.
Madhavan K Nair
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.
Silicon protects plants against various biotic and abiotic stresses, including metal toxicity. Under a high metal concentration, Si can externally decrease metal availability to the plant by its precipitation in the growth media, and Si also affects the metal distribution inside the plant, diminishing the damage. Could Si also protect plants against metal deficiency stress? Recently, the physiological role of Si in relation to micronutrients deficiency symptoms has been assessed in several plant species in hydroponics. In cucumber, Si supply mitigated the symptoms of Fe deficiency, but this effect was not clear under Zn- or Mn-deficiency conditions. The main factor controlling this beneficial effect seems to be the Si contribution to the formation of metal deposits in the root and/or leaves apoplast and its role in their following remobilization when required. The enhancement of the content of long-distance transport molecules (such as citrate) due to Si addition should also contribute to the metal transport from root to shoot, which will diminish deficiency symptoms.
Patel, Jayshil J; Mundi, Manpreet S; Hurt, Ryan T; Wolfe, Bruce; Martindale, Robert G
Obesity has become a worldwide epidemic with a disproportionate increase in grade III obesity. Bariatric surgery offers an attractive option for sustained weight loss compared with traditional methods such as exercise and diet. Micronutrient deficiencies are common and clinically significant after bariatric surgery. These deficiencies are related to a combination of patient and surgical variables. A thorough understanding of specific micronutrient deficiencies is necessary for early recognition and optimal management. The purpose of this review is to describe indications, outcomes, and types of bariatric procedures, risk factors, and mechanisms for micronutrient deficiencies, as well as outline specific vitamin and trace element deficiencies after bariatric surgery.
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.
Toh, Seok Yee; Zarshenas, Nazy; Jorgensen, John
The aims of this study were to determine the prevalence of nutrient deficiencies in patients who present for bariatric surgery, assess nutritional status after surgery, and compare these with preoperative levels. A retrospective study was conducted to identify preoperative and 1-year postoperative nutrition deficiencies in patients undergoing bariatric surgery. The screening included serum ferritin, vitamin D, vitamin B(12), homocysteine, folate, red blood cell folate, and hemoglobin. Results were available for 232 patients preoperatively and 149 patients postoperatively. Two-tailed chi(2) tests and paired-sample t tests were used. Preoperatively, vitamin D deficiency was noted at 57%. The prevalence of abnormalities 1 year after roux-en-Y gastric bypass was higher compared with preoperative levels (P surgery, anemia was detected in 17%, elevated homocysteine levels (women only) in 29%, low ferritin in 15%, low vitamin B(12) in 11%, and low RBC folate in 12%. Mean hemoglobin, ferritin, and RBC folate levels deteriorated significantly but remained well within normal ranges. The prevalence of vitamin D deficiencies decreased, but not significantly. In sleeve gastrectomy patients, mean ferritin levels decreased (P deficiency. Vitamin D deficiency is common among morbidly obese patients seeking bariatric surgery. Because the prevalence of micronutrient deficiencies persists or worsens postoperatively, routine nutrition screening, recommendation of appropriate supplements, and monitoring adherence are imperative in this population.
Wessells, K Ryan; Ouédraogo, Césaire T; Young, Rebecca R; Faye, M Thierno; Brito, Alex; Hess, Sonja Y
Anemia and micronutrient (MN) deficiencies in pregnant women are associated with adverse pregnancy outcomes. In Niger, 58.6% of pregnant women are anemic; however, MN statuses are unknown. The study objectives were to estimate the prevalence of MN deficiencies among pregnant women in Zinder, Niger and explore associated risk factors. Pregnant women living in randomly selected rural villages ( n = 88) were included. Capillary and venous blood samples ( n = 770) were analyzed for hemoglobin (Hb) and plasma ferritin, soluble transferrin receptor (sTfR), zinc (pZn), retinol binding protein (RBP), folate and vitamin B 12 . C-reactive protein and alpha-1-acid glycoprotein were measured to adjust for inflammation. The prevalence of MN deficiencies in pregnant woman was high, indicative of a severe public health problem. Prevalence of iron deficiency was 20.7% and 35.7%, by ferritin (8.3 mg/L), respectively. In total, 40.7% of women had low pZn (women had low folate (pregnant women in this population.
Bruno da Silva Moretti
Full Text Available The Australian Red Cedar presents a great exploitation potential in Brazil, but works about the nutrient requirements and deficiency characterization in that species are still scarce. The objectives of this work were evaluating the effects of the omission of micronutrients and characterizing the nutrient deficiency symptoms in Australian Red Cedar saplings. The experiment was conducted in a greenhouse for a 90-day period. Australian Red Cedar cuttings were cultivated in pots with a nutrient solution under the missing element technique. The omission of the micronutrients B, Cu, Fe, Mn, and Zn affect negatively the height, diameter, and dry matter yield of the Australian Red Cedar plants. The micronutrient which affected the relative growth of the plants the most was B. Australian Red Cedar plants deficient in micronutrients present several visual symptoms characteristic of the metabolism disorders. The perception of the deficiencies through the visual diagnosis can be useful in the nutrient management of the culture of the Australian Red Cedar.
Jans, Goele; Matthys, Christophe; Bogaerts, Annick; Lannoo, Matthias; Verhaeghe, Johan; Van der Schueren, Bart; Devlieger, Roland
Pregnant and postpartum women with a history of bariatric surgery are at risk of micronutrient deficiencies as a result of the combination of physiologic changes related to pregnancy and iatrogenic postoperative alterations in the absorption and metabolism of crucial nutrients. This systematic review investigates micronutrient deficiencies and related adverse clinical outcomes in pregnant and postpartum women after bariatric surgery. A systematic approach involving critical appraisal was cond...
Portillo-Castillo, Zulay Coromoto; Solano, Liseti; Fajardo, Zuleida
The dietary pattern and energy and nutrient intake as basic indicators of nutritional deficiencies were assessed in 408 preschoolers by three 24-hour recalls and food frequency questionnaire. Socioeconomic status (Graffar/Méndez-Castellano) and nutritional status by corporal dimensions were assessed. Student t test, ANOVA and Chi2 were applied. 95% of the children were living in poverty (62% relative and 32% critical). Nutritional deficit was present in 14% of children, being more prevalent in the group from 4 to 6.99 years of age (p children aged 1 to 3.99 years (p children aged 4 to 6.99 consumed a larger variety of foods, including corn flour fortified with iron and Vit. A. There was a deficient intake of energy and iron in 52.5%, of Vit. A in 31% and zinc in 88.6% of the children. 90% of the studied population consumed an excessive amount of proteins. The risk of deficiency was low for protein intake in all social classes and high for Vit. A, iron and zinc intake, with a higher risk for children of low socioeconomic level. The food pattern intake was based on 10 food items, suggesting a monotonous alimentation. Cereals and legumes were the main source of proteins, vit A, iron and zinc. Due to a deficient intake of calories and micronutrients, a situation of "hidden hunger" must be considered.
Bilenko, Natalya; Fraser, Drora; Vardy, Hillel; Belmaker, Ilana
A high prevalence of iron deficiency anemia persists in Bedouin Arab and Jewish pediatric populations in southern Israel. To compare the effect of daily use of the micronutrient supplementation (MMS), "Sprinkles," a powdered formulation of iron, vitamins A and C, folic acid and zinc, with liquid iron and vitamins A and D on iron deficiency at 12 months of age. The 621 eligible Bedouin and Jewish infants in the study were assigned to the MMS and control arms and received supplementations from age 6 to 12 months. We examined the change in hemoglobin, hematocrit, mean cell volume, red blood cell distribution, serum ferritin and transferrin saturation. In addition, we used the high Iron Deficiency Index (IDI) if two or more of the above six parameters showed abnormal levels. Rates of anemia decreased significantly over the 6 month period, from 58.8% to 40.6% among Bedouin infants (P = 0.037) and from 40.6 to 15.8% among Jewish infants (P = 0.017). In Bedouin infants the prevalence of high IDI decreased significantly from 79.2% to 67.4% (P = 0.010) in the MMS group, but there was no change in the controls. Among Jewish infants, the high IDI prevalence decreased from 67% to 55.6% with no statistically significant difference in the two study arms. In the multivariate analysis in Bedouin infants MMS use was associated with a reduced risk of 67% in high IDI at age 12 months as compared to controls (P = 0.001). Fewer side effects in the intervention groups in both ethnic populations were reported. MMS fortification of home food can be recommended as an effective and safe method for preventing iron deficiency anemia at 12 months of age.
K. Ryan Wessells
Full Text Available Anemia and micronutrient (MN deficiencies in pregnant women are associated with adverse pregnancy outcomes. In Niger, 58.6% of pregnant women are anemic; however, MN statuses are unknown. The study objectives were to estimate the prevalence of MN deficiencies among pregnant women in Zinder, Niger and explore associated risk factors. Pregnant women living in randomly selected rural villages (n = 88 were included. Capillary and venous blood samples (n = 770 were analyzed for hemoglobin (Hb and plasma ferritin, soluble transferrin receptor (sTfR, zinc (pZn, retinol binding protein (RBP, folate and vitamin B12. C-reactive protein and alpha-1-acid glycoprotein were measured to adjust for inflammation. The prevalence of MN deficiencies in pregnant woman was high, indicative of a severe public health problem. Prevalence of iron deficiency was 20.7% and 35.7%, by ferritin (<15 µg/L and sTfR (>8.3 mg/L, respectively. In total, 40.7% of women had low pZn (<50 µg/dL, 79.7% had marginal RBP (<1.32 µmol/L, 44.3% of women had low folate (<10 nmol/L and 34.8% had low B12 concentrations (<148 pmol/L. Common risk factors associated with MN status included gravidity, mid-upper-arm circumference, geophagy, malaria, and result of the woman’s last pregnancy. Interventions to promote the strengthening of antenatal care, and access and adherence to nutrition and health interventions are critical among pregnant women in this population.
Schiavo, Luigi; Scalera, Giuseppe; Pilone, Vincenzo; De Sena, Gabriele; Capuozzo, Vincenza; Barbarisi, Alfonso
Bariatric surgery candidates often show preoperative micronutrient deficiency. Although it is documented that a comprehensive micronutrient assessment should be conducted preoperatively to correct the deficiencies before surgery, no previous studies have been effective in correcting deficiencies in sufficient time prior to surgery. Our aim was to identify micronutrient deficiencies preoperatively and correct them before surgery. 50 patients (18 female, 32 male) scheduled for bariatric surgery were assessed for micronutrient status 20 weeks prior to surgery. Baseline levels of vitamin B12, folic acid, 25-vitamin D, vitamin C, vitamin A, vitamin E, iron, zinc, magnesium, and selenium were measured. Data were compared with accepted clinical cutoff values. Patients found to have one or more micronutrient deficiencies were instructed to take daily micronutrient supplements specially formulated for obese patients and were evaluated every 5 weeks over a 20-week period. Nutrient intake was also evaluated before and after supplementation. Micronutrient deficiencies were observed in 40 patients (80 %, 13 female, 27 male). All 40 patients started prescribed supplementation immediately. 20 patients (10 female, 10 male) completed a follow-up at 20 weeks. Herein we found that 10 weeks of preoperative micronutrient supplementation is capable of effectively treating micronutrient deficiencies in our candidates for bariatric surgery. Considering that: 1) no new medication was allowed during the study; 2) patients already under pharmacological treatment did not change their therapy; 3) no statistically differences in nutrient intake were observed before and after the supplementation, we are confident to attribute the improvements in patients' micronutrient status directly to the supplement.
Rohde, C; von Teeffelen-Heithoff, A; Thiele, A G; Arelin, M; Mütze, U; Kiener, C; Gerloff, J; Baerwald, C; Schultz, S; Heller, C; Müller, A S; Kiess, W; Beblo, S
To investigate micronutrient supply in phenylketonuria (PKU) patients on a relaxed diet. Sixty-seven patients (6-45 years) with a phenylalanine tolerance ≥ 600 mg/day were included in the study. From a 3-day diet record, protein supply as well as consumption of essential amino acids and several micronutrients were assessed and compared with the current recommendations and data for the healthy population. Protein supply and consumption of all essential amino acids were sufficient in all patients. Supply of micronutrients depended on dietary regime. Patients with a total protein supply of 120% or more of the recommended amount and at least 0.5 g protein per kg body weight from amino-acid mixture (AAM) were sufficiently supplied with all investigated micronutrients. All patients without AAM supplement showed severe micronutrient deficiencies in their diet records. PKU patients under a relaxed diet are at risk of an insufficient nutrient supply, if they have first no substitution with AAM, second a protein supply less than 0.5 g per kg body weight from AAM or third a total protein supply less than 120% of the recommendations. Therefore, close monitoring, specific dietary counseling and potential supplementation is mandatory to prevent micronutrient deficiencies in PKU patients.
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.
Jans, Goele; Matthys, Christophe; Bogaerts, Annick; Lannoo, Matthias; Verhaeghe, Johan; Van der Schueren, Bart; Devlieger, Roland
Pregnant and postpartum women with a history of bariatric surgery are at risk of micronutrient deficiencies as a result of the combination of physiologic changes related to pregnancy and iatrogenic postoperative alterations in the absorption and metabolism of crucial nutrients. This systematic review investigates micronutrient deficiencies and related adverse clinical outcomes in pregnant and postpartum women after bariatric surgery. A systematic approach involving critical appraisal was conducted independently by 2 researchers to examine deficiencies of phylloquinone, folate, iron, calcium, zinc, magnesium, iodide, copper, and vitamins A, D, and B-12 in pregnant and postpartum women after bariatric surgery, together with subsequent outcomes in the neonates. The search identified 29 relevant cases and 8 cohort studies. The quality of reporting among the case reports was weak according to the criteria based on the CARE (CAse REporting) guidelines as was that for the cohort studies based on the criteria from the Cohort Study Quality Assessment list of the Dutch Cochrane Center. The most common adverse neonatal outcomes related to maternal micronutrient deficiencies include visual complications (vitamin A), intracranial hemorrhage (phylloquinone), neurological and developmental impairment (vitamin B-12), and neural tube defects (folate). On the basis of the systematically collected information, we conclude that the evidence on micronutrient deficiencies in pregnant and postpartum women after bariatric surgery and subsequent adverse neonatal outcomes remains weak and inconclusive. © 2015 American Society for Nutrition.
Jans, Goele; Matthys, Christophe; Bogaerts, Annick; Lannoo, Matthias; Verhaeghe, Johan; Van der Schueren, Bart; Devlieger, Roland
Pregnant and postpartum women with a history of bariatric surgery are at risk of micronutrient deficiencies as a result of the combination of physiologic changes related to pregnancy and iatrogenic postoperative alterations in the absorption and metabolism of crucial nutrients. This systematic review investigates micronutrient deficiencies and related adverse clinical outcomes in pregnant and postpartum women after bariatric surgery. A systematic approach involving critical appraisal was conducted independently by 2 researchers to examine deficiencies of phylloquinone, folate, iron, calcium, zinc, magnesium, iodide, copper, and vitamins A, D, and B-12 in pregnant and postpartum women after bariatric surgery, together with subsequent outcomes in the neonates. The search identified 29 relevant cases and 8 cohort studies. The quality of reporting among the case reports was weak according to the criteria based on the CARE (CAse REporting) guidelines as was that for the cohort studies based on the criteria from the Cohort Study Quality Assessment list of the Dutch Cochrane Center. The most common adverse neonatal outcomes related to maternal micronutrient deficiencies include visual complications (vitamin A), intracranial hemorrhage (phylloquinone), neurological and developmental impairment (vitamin B-12), and neural tube defects (folate). On the basis of the systematically collected information, we conclude that the evidence on micronutrient deficiencies in pregnant and postpartum women after bariatric surgery and subsequent adverse neonatal outcomes remains weak and inconclusive. PMID:26178026
Layara Alexandre Bessa
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.
Alayne M Adams
Full Text Available Micronutrient deficiencies can compromise the development potential of school-aged children, and their later health and productivity as adults. School feeding and school-based fortification approaches have been utilized globally to redress nutritional deficiencies in this age group.We explored the acceptability and micronutrient impact of a Bangladesh Government supported school-based micronutrient fortification program for children attending rural primary schools in 10 disadvantaged sub-districts.We applied a mixed methods approach. The quantitative component assessed the impact of micronutrient fortification on 351 children aged 6-11 years using a cohort pre-post research design with a control group. The qualitative component explored the acceptability of the intervention using focus group discussions, body mapping and semi-structured interviews with teachers, school-going children and school authorities.Daily consumption of fortified biscuits by primary school children had a significant positive impact on mean levels of iron, folic acid, vitamin B12, retinol and vitamin D controlling for sex, baseline deficiency status, CRP, and H. pylori. Levels of anemia and vitamin D deficiency were also significantly reduced. Qualitative findings indicated the widespread acceptability of the daily biscuit. Teachers perceived students to be more attentive in class, less tired, and some attributed better school performance to biscuit consumption. Children reported similar improvements in concentration and energy levels.This study is among the first in Bangladesh to comprehensively assess a school-based fortification program in terms of its acceptability and impact on micronutrient status of children aged 6-11 years of age. While results strongly support this modality of school feeding, research on the cognitive impacts of micronutrient fortified biscuits will help clarify the case for scaled-up investments in school- based feeding program in Bangladesh and
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.
Dijkhuizen, M.A.; Wieringa, F.T.
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
Bruno da Silva Moretti; Antonio Eduardo Furtini Neto; Bruno Peres Benatti; Eduane José de Pádua; Lauana Lopes Santos; Julian Junio de Jesus Lacerda; Soami Fernanda Caio Deccetti
The Australian Red Cedar presents a great exploitation potential in Brazil, but works about the nutrient requirements and deficiency characterization in that species are still scarce. The objectives of this work were evaluating the effects of the omission of micronutrients and characterizing the nutrient deficiency symptoms in Australian Red Cedar saplings. The experiment was conducted in a greenhouse for a 90-day period. Australian Red Cedar cuttings were cultivated in pots with a nutrient s...
Wieser, Simon; Brunner, Beatrice; Tzogiou, Christina; Plessow, Rafael; Zimmermann, Michael B; Farebrother, Jessica; Soofi, Sajid; Bhatti, Zaid; Ahmed, Imran; Bhutta, Zulfiqar A
In Pakistan, nearly half of children younger than 5 years are stunted, and 1 in 3 is underweight. Micronutrient deficiencies, a less visible form of undernutrition, are also endemic. They may lead to increased morbidity and mortality as well as to impaired cognitive and physical development. To estimate the lifetime costs of micronutrient deficiencies in Pakistani children aged between 6 and 59 months. We develop a health economic model of the lifetime health and cost consequences of iodine, iron, vitamin A, and zinc deficiencies. We assess medical costs, production losses in terms of future incomes lost, and disability-adjusted life-years (DALYs). The estimation is based on large population surveys, information on the health consequences of micronutrient deficiencies extracted from randomized trials, and a variety of other sources. Total societal costs amount to US$46 million in medical costs, US$3,222 million in production losses, and 3.4 million DALYs. Costs are dominated by the impaired cognitive development induced by iron-deficiency anemia in 6- to 23-month-old children and the mortality caused by vitamin A deficiency. Costs are substantially higher in poorer households. Societal costs amounted to 1.44% of gross domestic product and 4.45% of DALYs in Pakistan in 2013. These costs hinder the country's development. They could be eliminated by improved nutrition of 6- to 59-month-old children and public health measures. Our results may contribute to the design of cost-effective interventions aiming to reduce micronutrient deficiencies in early childhood and their lifetime consequences.
Verger, Eric O; Aron-Wisnewsky, Judith; Dao, Maria Carlota; Kayser, Brandon D; Oppert, Jean-Michel; Bouillot, Jean-Luc; Torcivia, Adriana; Clément, Karine
Roux-en-Y gastric bypass (GBP) and sleeve gastrectomy (SG) have increased dramatically, potentially increasing the prevalence of nutritional deficiencies. The aim of this study was to analyze the effects of food restriction during the first year after bariatric surgery (BS) on nutritional parameters. Twenty-two and 30 obese patients undergoing GBP and SG were prospectively followed at baseline and 3, 6, and 12 months after BS (N = 14 and N = 19 at T12). We evaluated food intake and nutrient adequacy (T0, T3, T12), as well as serum vitamin and mineral concentration (T0, T3, T6, T12). At baseline, GBP and SG patients had similar clinical characteristics, food intake, nutrient adequacy, and serum concentration. The drastic energy and food reduction led to very low probabilities of adequacy for nutrients similar in both models (T3, T12). Serum analysis demonstrated a continuous decrease in prealbumin during the follow-up, indicating mild protein depletion in 37 and 38% of GBP patients and 57 and 52% of SG patients, respectively, at T3 and T12. Conversely, despite the low probabilities of adequacy observed at T3 and T12, systematic multivitamin and mineral supplementation after GBP and SG prevented most nutritional deficiencies. GBP and SG have comparable effects in terms of energy and food restriction and subsequent risk of micronutrient and protein deficiencies in the first year post BS. Such results advocate for a cautious monitoring of protein intake after GPB and SG and a systematic multivitamin and mineral supplementation in the first year after SG.
Wolde - Gebriel, Z.
A nationwide study on the prevalence of xerophthalmia was carried out in 6,636 children aged 6 months to 6 years in all the Regions of Ethiopia except Eritrea and Tigrai which were excluded for security reasons. Bitot's spots were observed in 1.0% of all children with higher prevalence in
Bal, Bikram S; Finelli, Frederick C; Koch, Timothy R
Roux-en-Y gastric bypass surgery remains the major surgical option for individuals with medically complicated obesity. The importance of preoperative evaluation to permit identification of micronutrient deficiencies is being re-evaluated. The risk of complications related to pregnancy after gastric bypass supports careful follow-up. Micronutrient deficiencies are common in postoperative gastric bypass patients, despite the suggested use of routine vitamin and mineral supplements after surgery. Copper deficiency must be considered as an origin for visual disorders after gastric bypass. Vitamin D deficiency with metabolic bone disease remains common after gastric bypass and the results suggest that the present postoperative supplements of calcium and vitamin D are inadequate. Major nutritional complications of bariatric surgery are occurring more than 20 years after surgery. There is no evidence for intestinal adaptation as there remains decreased intestinal absorption of iron up to 18 months after gastric bypass surgery. This article supports ongoing examination of nutritional complications after gastric bypass surgery and supports the notion that the daily doses of micronutrient supplements, such as vitamin D, may need to be revised.
Alexandrou, Andreas; Armeni, Eleni; Kouskouni, Evangelia; Tsoka, Evangelia; Diamantis, Theodoros; Lambrinoudaki, Irene
Nutritional deficiencies are highly prevalent in obese patients. Bariatric surgery has been associated with adverse effects on homeostasis of significant vitamins and micronutrients, mainly after gastric bypass. The aim of the present study was to compare the extent of long-term postsurgical nutritional deficiencies between Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). This cross-sectional, pilot study included 95 patients who underwent RYGB or SG surgery with a mean follow-up of 4 years. Demographic, anthropometric, and biochemical parameters were compared according to the type of surgery. Both types of surgery were associated with significant nutritional deficiencies. Vitamin B12 deficiency was significantly higher in patients with RYGB compared with SG (42.1% versus 5%, P = .003). The type of surgery was associated neither with anemia nor with iron or folate deficiency (SG versus RYGB: anemia, 54.2% versus 64.3%, P = .418; folate deficiency, 20% versus 18.4%, P = .884; iron deficiency, 30% versus 36.4%, P = .635). During a mean follow up period of 4 years postRYGB or SG, patients were identified with several micronutrient deficiencies, including vitamin D, folate, and vitamin B12. SG may have a more favorable effect on the metabolism of vitamin B12 compared with RYGB, being associated with less malabsorption. Adherence to supplemental iron and vitamin intake is of primary significance in all cases of bariatric surgery. Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Hibberd, Matthew C. [Washington Univ. School of Medicine, St. Louis, MO (United States). Center for Genome Sciences and Systems Biology, Center for Gut Microbiome and Nutrition Research; Wu, Meng [Washington Univ. School of Medicine, St. Louis, MO (United States). Center for Genome Sciences and Systems Biology; Rodionov, Dmitry A. [Russian Academy of Sciences (RAS), Moscow (Russian Federation). A.A. Kharkevich Inst. for Information Transmission Problems; Sanford Burnham Prebys Medical Discovery Inst., La Jolla, CA (United States); Li, Xiaoqing [Sanford Burnham Prebys Medical Discovery Inst., La Jolla, CA (United States); Cheng, Jiye [Washington Univ. School of Medicine, St. Louis, MO (United States). Center for Genome Sciences and Systems Biology, Center for Gut Microbiome and Nutrition Researc; Griffin, Nicholas W. [Washington Univ. School of Medicine, St. Louis, MO (United States). Center for Genome Sciences and Systems Biology, Center for Gut Microbiome and Nutrition Researc; Barratt, Michael J. [Washington Univ. School of Medicine, St. Louis, MO (United States). Center for Genome Sciences and Systems Biology, Center for Gut Microbiome and Nutrition Researc; Giannone, Richard J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Chemical Sciences Division; Hettich, Robert L. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Chemical Sciences Division; Osterman, Andrei L. [Sanford Burnham Prebys Medical Discovery Inst., La Jolla, CA (United States); Gordon, Jeffrey I. [Washington Univ. School of Medicine, St. Louis, MO (United States). Center for Genome Sciences and Systems Biology, Center for Gut Microbiome and Nutrition Researc
Micronutrient deficiencies afflict two billion people. And while the impact of these imbalances on host biology has been studied extensively, much less is known about their effects on the developing or adult gut microbiota. Thus, we established a community of 44 cultured, sequenced human gut-derived bacterial species in gnotobiotic mice and fed the animals a defined, micronutrient-sufficient diet, followed by a derivative diet devoid of vitamin A, folate, iron or zinc, followed by return to the sufficient diet. Acute vitamin A deficiency had the largest effect on community structure and meta-transcriptome, with Bacteroides vulgatus, a prominent responder, increasing its abundance in the absence of vitamin A, and manifesting transcriptional changes involving various metabolic pathways. Applying retinol selection to a library of 30,300 B. vulgatus transposon mutants revealed that disruption of acrR abrogated retinol sensitivity. Genetic complementation studies, microbial RNA-Seq, and transcription factor binding assays disclosed that AcrR functions as a repressor of an adjacent AcrAB-TolC efflux system plus other members of its regulon. Retinol efflux measurements in wild-type, acrR-mutant, and complemented acrR mutant strains, plus treatment with a pharmacologic inhibitor of the efflux system, revealed that AcrAB-TolC is a determinant of retinol and bile acid sensitivity. We associated acute vitamin A deficiency with altered bile acid metabolism in vivo, raising the possibility that retinol, bile acid metabolites, and AcrAB-TolC interact to influence the fitness of B. vulgatus and perhaps other microbiota members. This type of preclinical model can help develop mechanistic insights about and more effective treatment strategies for micronutrient deficiencies.
Dijkhuizen, M.A.; Wierenga, F.T.; West, C.E.; Muherdiyantiningsih,; Muhilal,
Deficiencies of vitamin A, iron, and zinc are prevalent worldwide, affecting vulnerable groups such as lactating women and infants. However, the existence of concurrent deficiencies has received little attention. Objective: The aim was to investigate the extent to which deficiencies of vitamin A,
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
Introduction The present study describes the distribution of selected micronutrients and anaemia among school-aged children living in Libo Kemkem and Fogera (Amhara State, Ethiopia), assessing differences by socio-demographic characteristics, health status and dietary habits. Methods A cross-sectional survey was carried out during May–December 2009. Socio-demographic characteristics, health status and dietary habits were collected. Biomarkers were determined for 764 children. Bivariate and multivariable statistical methods were employed to assess micronutrient deficiencies (MD), anaemia, and their association with different factors. Results More than two thirds of the school-aged children (79.5%) had at least one MD and 40.5% had two or more coexisting micronutrient deficiencies. The most prevalent deficiencies were of zinc (12.5%), folate (13.9%), vit A (29.3%) and vit D (49%). Anaemia occurred in 30.9% of the children. Children living in rural areas were more likely to have vit D insufficiency [OR: 5.9 (3.7–9.5)] but less likely to have folate deficiency [OR: 0.2 (0.1–0.4)] and anaemia [OR: 0.58 (0.35–0.97)]. Splenomegaly was positively associated with folate deficiency and anaemia [OR: 2.77 (1.19–6.48) and 4.91 (2.47–9.75)]. Meat and fish consumption were inversely correlated with zinc and ferritin deficiencies [OR: 0.2 (0.1–0.8) and 0.2 (0.1–0.9)], while oil consumption showed a negative association with anaemia and deficiencies of folate and vitamin A [0.58 (0.3–0.9), OR: 0.5 (0.3–0.9) and 0.6 (0.4–0.9)]. Serum ferritin levels were inversely correlated to the presence of anaemia (p<0.005). Conclusion There is a high prevalence of vitamin A deficiency and vitamin D insufficiency and a moderate prevalence of zinc and folate deficiencies in school-aged children in this area. The inverse association of anaemia and serum ferritin levels may be due to the presence of infectious diseases in the area. To effectively tackle malnutrition
Full Text Available INTRODUCTION: The present study describes the distribution of selected micronutrients and anaemia among school-aged children living in Libo Kemkem and Fogera (Amhara State, Ethiopia, assessing differences by socio-demographic characteristics, health status and dietary habits. METHODS: A cross-sectional survey was carried out during May-December 2009. Socio-demographic characteristics, health status and dietary habits were collected. Biomarkers were determined for 764 children. Bivariate and multivariable statistical methods were employed to assess micronutrient deficiencies (MD, anaemia, and their association with different factors. RESULTS: More than two thirds of the school-aged children (79.5% had at least one MD and 40.5% had two or more coexisting micronutrient deficiencies. The most prevalent deficiencies were of zinc (12.5%, folate (13.9%, vit A (29.3% and vit D (49%. Anaemia occurred in 30.9% of the children. Children living in rural areas were more likely to have vit D insufficiency [OR: 5.9 (3.7-9.5] but less likely to have folate deficiency [OR: 0.2 (0.1-0.4] and anaemia [OR: 0.58 (0.35-0.97]. Splenomegaly was positively associated with folate deficiency and anaemia [OR: 2.77 (1.19-6.48 and 4.91 (2.47-9.75]. Meat and fish consumption were inversely correlated with zinc and ferritin deficiencies [OR: 0.2 (0.1-0.8 and 0.2 (0.1-0.9], while oil consumption showed a negative association with anaemia and deficiencies of folate and vitamin A [0.58 (0.3-0.9, OR: 0.5 (0.3-0.9 and 0.6 (0.4-0.9]. Serum ferritin levels were inversely correlated to the presence of anaemia (p<0.005. CONCLUSION: There is a high prevalence of vitamin A deficiency and vitamin D insufficiency and a moderate prevalence of zinc and folate deficiencies in school-aged children in this area. The inverse association of anaemia and serum ferritin levels may be due to the presence of infectious diseases in the area. To effectively tackle malnutrition, strategies should target
Teenagers are frequently at very high risk of developing nutrient deficiencies, including iron deficiency and folate deficiency anaemia.1. A survey in the Western Cape among nonpregnant teenagers has also shown some serious dietary inadequacies with regard to a number of nutrients, including iron.2 This was partly ...
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
Ortega, Pablo; Leal, Jorymar; Amaya, Daysi; Chávez, Carlos
Female adolescents in reproductive age are a susceptible group to anemia and micronutrient deficiencies. The objective of this study was to know the nutritional, anthropometric and dietetic status, the prevalence of anemia, depletion of iron deposits (FeD) and Vitamin A deficiency (VAD) in female adolescents. Seventy-eight not pregnant female adolescents (15.9 +/- 1.1 years old), from an urban and a periurban zone of Maracaibo, and a rural zone near this city, without infectious and inflammatory processes, were analyzed. Anemia in adolescents was considered when Hb zone showed significant lower values of weight (p = 0.0024), height (p = 0.0027), body mass index BMI (p = 0.0487), fatty area (p = 0.0183), MCV (p = 0.0241), MCH (p = 0.0488), MHCC (p = 0.0228), and the highest prevalence of anemia (66.67%), anemia+FeD (33.33%), and anemia+FeD+RVAD (5.56%), with respect to adolescents from the urban zone. Although, anemic adolescents from the rural zone showed a non significant decrease of the iron percentage adjustment. Iron requirements are increased during adolescence, reaching a maximum at the peak of growth and remaining almost as high in girls after menarche, to replace menstrual losses. The low iron status among adolescents from the rural zone determine that this is a high risk group to anemia and FeD and they require prevention, control and suplementation strategies.
Theodore H. Tulchinsky
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.
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.
Peterson, Leigh A; Cheskin, Lawrence J; Furtado, Margaret; Papas, Konstantinos; Schweitzer, Michael A; Magnuson, Thomas H; Steele, Kimberley E
Over 78 million American adults have obesity. Bariatric surgery is the leading means of durable weight loss. Nutritional deficiencies are commonly treated post-operatively but are often undiagnosed pre-operatively. Malnutrition is correlated with adverse surgical outcomes. The aim of this study is to assess pre-operative nutritional status in our bariatric surgery candidates in a cross-sectional study. We recruited 58 bariatric candidates approved to undergo the Roux-en Y gastric bypass. Nutritional status was determined for vitamins A, B12, D, E-α, and E-β/γ as well as thiamine, folate, and iron. We used clinical as well as frank deficiency cut-offs based on the Institute of Medicine and the World Health Organization guidelines. This cohort was largely female (77.6%) and white (63.8%). Median age was 42.2 years. Median body mass index (BMI) was 46.3 kg/m(2). Multiple comorbidities (MCM) were present in 41.4%, 54.0% hypertension, 42.0% diabetic, 34.0% sleep apnea. Men had more comorbidities, 69.2 % with MCM. Folate and iron saturation varied significantly by sex. Vitamins A, D, E-α, and thiamine significantly varied by race. Vitamin D negatively correlated with BMI (p = 0.003) and age (p = 0.030). Vitamin A negatively correlated with age (p = 0.001) and number of comorbidities (p = 0.003). These pre-operative bariatric candidates had significant malnutrition, particularly in vitamin D (92.9%) and iron (36.2 to 56.9 %). Multiple micronutrient deficiency (MMND) was more common in blacks (50.0 versus 39.7% overall). Number of comorbidities did not correlate with MMND. Malnutrition in one or multiple micronutrients is pervasive in this pre-operative bariatric cohort. The effect of pre-operative supplementation, especially vitamin D and iron, should be explored.
Maria Claudia Mendes Sorreano
Full Text Available This study had the following objectives: to induce and describe symptoms of deficiency of boron (B, copper (Cu, iron(Fe, manganese (Mn, molybdenum (Mo and zinc (Zn, determining the effect on the mineral composition of leaves. The experimentwas developed in a green house and used diagnosis technique by subtraction. The experimental design usedn was a randomizedblocks, with seven treatments and three replicates. It was verified that micronutrient omission led to morphological alterations which,in turn, caused visual symptoms. The symptoms caused by the omission of Cu, Mn and Zn were the first to appear, and were followedby those of B, Fe and Mo. The omission of B, Mn and Zn was responsible for the more pronounced reduction in height and stemdiameter.
Full Text Available Bárbara Rita Cardoso,1 Cristiane Cominetti,2 Silvia Maria Franciscato Cozzolino11Faculty of Pharmaceutical Sciences, University of São Paulo (USP, São Paulo, Brazil; 2Faculty of Nutrition, Federal University of Goiás, Goiás, BrazilAbstract: Alzheimer’s disease (AD is the most common form of dementia, and it generally affects the elderly. It has been suggested that diet is an intensively modifiable lifestyle factor that might reduce the risk of AD. Because epidemiological studies generally report the potential neuronal protective effects of various micronutrients, the aim of this study was to perform a literature review on the major nutrients that are related to AD, including selenium, vitamins C and E, transition metals, vitamin D, B-complex vitamins, and omega-3 fatty acids.Keywords: Alzheimer’s disease, nutritional deficiencies, diet, oxidative stress, lipid, vitamins
Wirth, James P; Rohner, Fabian; Woodruff, Bradley A; Chiwile, Faraja; Yankson, Hannah; Koroma, Aminata S; Russel, Feimata; Sesay, Fatmata; Dominguez, Elisa; Petry, Nicolai; Shahab-Ferdows, Setareh; de Onis, Mercedes; Hodges, Mary H
To identify the factors associated with anemia and to document the severity of micronutrient deficiencies, malaria and inflammation, a nationally representative cross-sectional survey was conducted. A three-stage sampling procedure was used to randomly select children anemia (76.3%; 95% CI: 71.8, 80.4), malaria (52.6%; 95% CI: 46.0, 59.0), and acute and chronic inflammation (72.6%; 95% CI: 67.5, 77.1) were high. However, the prevalence of vitamin A deficiency (17.4%; 95% CI: 13.9, 21.6) was moderate, and the prevalence of iron deficiency (5.2%; 95% CI: 3.3, 8.1) and iron-deficiency anemia (3.8%; 95% CI: 2.5, 5.8) were low. Malaria and inflammation were associated with anemia, yet they explained only 25% of the population-attributable risk. In women, 44.8% (95% CI: 40.1, 49.5), 35.1% (95% CI: 30.1, 40.4), and 23.6% (95% CI: 20.4, 27.3) were affected by anemia, malaria, or inflammation, respectively. The prevalence rates of iron deficiency (8.3%; 95% CI: 6.2, 11.1), iron-deficiency anemia (6.1%; 95% CI: 4.4, 8.6), vitamin A deficiency (2.1%; 95% CI: 1.1, 3.1) and vitamin B12 deficiency (0.5%; 95% CI: 0.2, 1.4) were low, while folate deficiency was high (79.2%; 95% CI: 74.1, 83.5). Iron deficiency, malaria, and inflammation were significantly associated with anemia, but explained only 25% of cases of anemia. Anemia in children and women is a severe public health problem in Sierra Leone. Since malaria and inflammation only contributed to 25% of anemia, other causes of anemia, such as hemoglobinopathies, should also be explored. PMID:27163254
To identify the factors associated with anemia and to document the severity of micronutrient deficiencies, malaria and inflammation, a nationally representative cross-sectional survey was conducted. A three-stage sampling procedure was used to randomly select children <5 years of age and adult women...
Pedraza, Dixis Figueroa; Rocha, Ana Carolina Dantas
The scope of the study was to review the scientific publications on the nutritional status of iron, vitamin A and zinc among Brazilian children attending daycare centers, focusing on diagnostic methods, the prevalence of respective deficiencies and associated factors. A review of the literature was conducted in the PubMed, LILACS and SciELO databases. Observational studies with random representative samples using biochemical indicators to evaluate the nutritional status of iron, vitamin A and zinc of children attending public daycare centers were included. The average weighted prevalence for anemia and vitamin A deficiency was estimated. The variables associated with anemia were computed. Twenty-one observational studies were included, in which the nutritional status of iron, vitamin A and zinc were analyzed in 17, 4 and 3, respectively. The average weighted prevalence of anemia and vitamin A deficiency were 42.7% and 12.5%, respectively. Young children and children living in less favorable socioeconomic situations represented the main explanatory conditions predominantly associated with the occurrence of anemia. The results suggest a high prevalence of anemia, as well as vitamin A deficiency in Brazilian children attending daycare centers, with etiological prospects focused on infectious diseases.
Full Text Available Recent studies have shown that in spite of being generally close to the equator; vitamin D deficiency is common in South East Asian countries. In order to quantify micronutrient status for women and children in Cambodia; a nationally-representative survey was conducted in 2014 linked to the Cambodian Demographic Health Survey. The countrywide median of 25(OHD was, respectively, 64.9 and 91.1 nmol/L for mothers and children. Based on The Endocrine Society cutoffs (>50<75 nmol/L = insufficiency; ≤50 nmol/L = deficiency; 64.6% of mothers and 34.8% of their children had plasma vitamin D concentrations indicating insufficiency or deficiency. For deficiency alone, 29% of the mothers were found to be vitamin D deficient, but only 13.4% of children. Children who live in urban areas had a 43% higher rate of vitamin D insufficiency versus those who live in rural areas (OR; 1.434; 95% CI: 1.007; 2.041. However, such differences were not observed in their mothers. The high prevalence of vitamin D deficiency is likely in part due to lifestyle choices, including sun avoidance, increasingly predominant indoor work, and covered transport. These survey findings support the need for a broader national Cambodian study incorporating testing of adult men, adolescents and the elderly, and encompassing other parameters such as skeletal health. However, the data presented in this study already show significant deficiencies which need to be addressed and we discuss the benefit of establishing nationally-mandated food fortification programs to enhance the intake of vitamin D.
ferritin concentrations 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...
Berger, J.; Blanchard, G.; Doets, E.L.; Fahmida, U.; Hulshof, P.J.M.
BACKGROUND: The "Sustainable Micronutrient Interventions to Control Deficiencies and Improve Nutritional Status and General Health in Asia" project (SMILING), funded by the European Commission, is a transnational collaboration of research institutions and implementation agencies in five Southeast
Throughout the developing world, the long-term consequences of insufficient amounts of essential micronutrients in the human diet can be more devastating than low energy intake. Micronutrients are involved in all aspects of development, growth, and physiology of the human body (including from early ...
Full Text Available The aetiology of Africa's easterly-lying corridor of squamous cell oesophageal cancer is poorly understood. Micronutrient deficiencies have been implicated in this cancer in other areas of the world, but their role in Africa is unclear. Without prospective cohorts, timely insights can instead be gained through ecological studies.Across Africa we assessed associations between a country's oesophageal cancer incidence rate and food balance sheet-derived estimates of mean national dietary supplies of 7 nutrients: calcium (Ca, copper (Cu, iron (Fe, iodine (I, magnesium (Mg, selenium (Se and zinc (Zn. We included 32 countries which had estimates of dietary nutrient supplies and of better-quality GLOBCAN 2012 cancer incidence rates. Bayesian hierarchical Poisson lognormal models were used to estimate incidence rate ratios for oesophageal cancer associated with each nutrient, adjusted for age, gender, energy intake, phytate, smoking and alcohol consumption, as well as their 95% posterior credible intervals (CI. Adult dietary deficiencies were quantified using an estimated average requirements (EAR cut-point approach.Adjusted incidence rate ratios for oesophageal cancer associated with a doubling of mean nutrient supply were: for Fe 0.49 (95% CI: 0.29-0.82; Mg 0.58 (0.31-1.08; Se 0.40 (0.18-0.90; and Zn 0.29 (0.11-0.74. There were no associations with Ca, Cu and I. Mean national nutrient supplies exceeded adult EARs for Mg and Fe in most countries. For Se, mean supplies were less than EARs (both sexes in 7 of the 10 highest oesophageal cancer ranking countries, compared to 23% of remaining countries. For Zn, mean supplies were less than the male EARs in 8 of these 10 highest ranking countries compared to in 36% of other countries.Ecological associations are consistent with the potential role of Se and/or Zn deficiencies in squamous cell oesophageal cancer in Africa. Individual-level analytical studies are needed to elucidate their causal role in this
Wieringa, Frank Tammo; Dahl, Miriam; Chamnan, Chhoun
BACKGROUND: Anemia is highly prevalent in Cambodian women and children, but data on causes of anemia are scarce. We performed a national micronutrient survey in children and women that was linked to the Cambodian Demographic Health Survey 2014 (CDHS-2014) to assess the prevalence of micronutrient...... for 1512 subjects (792 children and 720 women). RESULTS: Anemia was found in 43% of the women and 53% of the children. Hemoglobin disorders affected >50% of the population, with Hemoglobin-E the most prevalent disorder. Deficiencies of iron (ferritin ... and hemoglobinopathy were significantly associated with anemia in children, whereas in the women none of the factors was significantly associated with anemia. Iron deficiency anemia (IDA) was more prevalent in children
Smith, Geoffry; Wimalawansa, Sunil J; Laillou, Arnaud
Recent studies have shown that in spite of being generally close to the equator; vitamin D deficiency is common in South East Asian countries. In order to quantify micronutrient status for women and children in Cambodia; a nationally-representative survey was conducted in 2014 linked to the Cambo...
Rozowski Narkunska, Jaime; Castillo Valenzuela, Oscar; Figari Jullian, Nicole; García-Díaz, Diego F; Cruchet Muñoz, Sylvia; Weisstaub Nuta, Gerardo; Pérez-Bravo, Francisco; Gotteland Russel, Martín
The prevalence of obesity in Chilean children has been increasing steadily for the last two decades. The first study to determine nutritional status and food intake in a representative sample of this population was carried out in 1960. Recently the National Food Consumption Survey (ENCA) carried out in 2012 was released by the Ministry of Health. However, this study did not include biochemical determinations of micronutrients which would allow a better diagnosis of nutritional status in children. to review the literature available from 2004 to 2014 in food intake and nutritional status in Chilean children aged 4 to 14 years. a total of 362 references published between 2004 and 2014 were obtained through searches in the databases PubMed, Lilacs, Embase and Scielo. From these, 40 articles were selected for a thorough review. food intake by children is characterized by a high-energy intake, a low consumption of fruits and vegetables and a high consumption of bread. The ENCA showed that 95% of the Chilean population has a deficient diet. A high prevalence of obesity is observed from very early in life. There is a dearth of data available on plasma indicators of vitamin and mineral status since 1960, which would provide more reliable information on nutritional assessment. It is imperative to implement a representative nutrition survey of children in Chile that includes biochemical indicators to get reliable information in order to develop strategies aimed to correct micronutrient malnutrition from excess or deficiency. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
First research co-ordination meeting of the thematic co-ordinated research project on 'Isotopic and complementary tools for the study of micronutrient status and interactions in developing country populations exposed to multiple micronutrient deficiencies'. Summary report
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
Tayupova, I M
In the article the features of healthy nutrition in pregnant women suffering from iron deficiency has been discussed. The criteria for diagnosis of anemia during pregnancy, the stage of the disease development, the specifics of iron deficiency during gestation, the need in this trace element in pregnant women have been defined. The necessity of an adequate selection of a balanced diet during pregnancy complicated with anemia has been based. Iron content in food products along with the extent of absorption depending upon the origin of the product have been considered. The compounds that contribute to a better absorption of iron, as well as medicinal substances that prevent its absorption have been presented. Special attention is paid to the questions of preventative measures in preventing anemia in pregnant women. In addition to a balanced diet and iron preparations for treatment and prevention of anemia, the appointment of vitamin-mineral supplements and specialized foods for pregnant enriched with micronutrients has been substantiated.
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
Moizé, Violeta; Deulofeu, Ramon; Torres, Ferran; de Osaba, Jesus Martinez; Vidal, Josep
The prevalence of obesity in Spain is on the rise with the consequent increase in bariatric surgery. Studies in non-Mediterranean populations have shown that micronutrient deficits are present before surgery. However, there is no data on this topic in a Spanish population. We evaluated food intake and the prevalence of nutritional deficiencies in 231 obese patient (72.3% women, 45.6 ± 9.9 years, BMI 48.2 ± 7.8 kg/m(2)) candidates for bariatric surgery. Forty-six normal weight individuals with similar demographic variables except BMI were included for comparison of deficiencies. In obese subjects, the mean estimated energy intake was 2,584 ± 987 kcal/day in males and 2,094 ± 669 kcal/day in females (p deficiency was vitamin D25(OH): obese 94%, control 24%; (p deficiencies in obese patients included magnesium, vitamin B6 and anaemia (p deficiencies were observed although did not reach statistical significance. Nutritional deficiencies are commonly found in the Spanish obese population undergoing bariatric surgery and are significantly more prevalent than in normal weight individuals.
Results: The prevalence of iron deficiency was found to be 16.9% (95% CI 9.8- 24.1%). Conclusion: There is a high prevalence of iron deficiency among patients with congenital heart disease with cyanosis in the two institutions. Routine screening for iron deficiency is recommended for these children and those found to be ...
de Gier, B.; Campos Ponce, M.; van de Bor, M.; Doak, C.M.; Polman, K.
Background: 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. Objective: We aimed to systematically review
Poli, Vanessa Fadanelli Schoenardie; Sanches, Ricardo Badan; Moraes, Amanda Dos Santos; Fidalgo, João Pedro Novo; Nascimento, Maythe Amaral; Bresciani, Paula; Andrade-Silva, Stephan Garcia; Cipullo, Marcos Alberto Taddeo; Clemente, José Carlos; Caranti, Danielle Arisa
The aim of this study was to assess the effectiveness of a long-term interdisciplinary lifestyle modification therapy on food intake, body composition, and anthropometric measurements of obese women. Seventy obese women (age 41 ± 5.9 y) attended the interdisciplinary therapy, with nutrition, physical exercise, physiotherapy, and psychological support during the course of 1 y. Usual food intake was estimated by 3-d dietary record. Dual-energy x-ray absorptiometry was performed to determine body fat and fat-free mass. Waist and hip circumferences also were measured. Student's t test and Wilcoxon test were used for comparisons among categories; P obesity; however, the present study reinforced the need to address the micronutrient deficiency in the target population. Copyright © 2017 Elsevier Inc. All rights reserved.
Karim, Rezaul; Desplats, Gwénola; Schaetzel, Thomas; Herforth, Anna; Ahmed, Faruk; Salamatullah, Quazi; Shahjahan, Mohammad; Akhtaruzzaman, Mohammed; Levinson, James
In seeking to improve the micronutrient contents of a food supplement used in a major community-based nutrition project in Bangladesh, operations research was conducted to compare the provision of needed micronutrients through additional food sources (fresh or dried fruits or vegetables), a micronutrient multi-mix, and a combination of the two. Micronutrient gaps (the difference between micronutrient requirements and actual micronutrient intake) were estimated for four groups of project beneficiaries, with target intakes defined as requirements for iron, calcium, zinc, vitamin A, vitamin C, riboflavin, niacin, and vitamin B12 recommended by the Food and Agriculture Organization/World Health Organization. Primary focus was placed on iron and vitamin A. Cost and bulk constraint analyses, based on cost of supplement, feasibility of delivery, and serving volume needed to achieve micronutrient targets, were used for comparing the supplement options. In terms of these analyses, the micronutrient multimix proved, by far, to be the most advantageous. Food options, however, are arguably desirable in that they provide dietary benefits additional to that of known micronutrients and may increase demand to boost production of domestic fruits and vegetables for the population as a whole. The study concludes that it is cost-effective to use powdered micronutrient mixes for such specific purposes as enrichment of supplementary food and food fortification, but encourages production and consumption of micronutrient-rich foods through programme messages and activities.
folate deficiency (≤ 2 - 3 ng/mL). Correlation analysis showed that serum cobalamin and homocysteine in the study samples were not significant (p > 0.05). Conclusion: The prevalence of severe cobalamin deficiency with clinical significance is high in the elderly population of Shiraz, Iran. Keywords: Vitamin B12 deficiency, ...
Full Text Available African mahogany (Khaya ivorensis is a high value forest species and of great potential to replace the brazilian mahogany (Swietenia macrophylla. Currently, little is known about the nutritional requirements of African mahogany. In this sense, the present study aimed to evaluate the growth and mineral composition K. ivorensis plants submitted to the omission of macro and micronutrients. For this, we carried out a experiment with nutrient solution with the following treatments: T1-Complete Solution; T2-omission of nitrogen; T3-omission of phosphorus; T4-omission of potassium; T5-omission of calcium; T6-omission of magnesium; T7-omission of sulfur; T8-omission of iron; T9-omission of boron; T10-omission of copper; T11-omission of manganese; T12-omission of zinc; T13-omission of molybdenum; and T14-deionized water. The evaluations were carried out based on commercial seedlings ready for planting, which remained in a greenhouse, irrigated only with deionized water. After fifteen days, the plants started to receive 200 ml of nutrient solution daily. The experimental design used was completely randomized with fourteen treatments and ten replications. The dendrological data were collected every fifteen days until they became well defined. The plants had their growth affected only by the omission of N, showing smaller contents of the element in the leaves. The omissions of the other nutrients only slightly affected the growth of plants.
Full Text Available Os objetivos deste trabalho foram caracterizar os sintomas visuais de deficiência de micronutrientes e avaliar efeitos desses micronutrientes no estado nutricional da mamoeira. O experimento foi realizado em casa de vegetação utilizando-se solução nutritiva, de fevereiro a junho de 2003. Foram utilizadas plantas de mamoneira (Ricinus communis L. do híbrido comercial Íris. Os tratamentos foram: completo, omissão de B, omissão de Cu, omissão de Fe, omissão de Mn, omissão de Mo e omissão de Zn. A omissão de B, Fe e Mn resultou em sintomas característicos de deficiência. Os sintomas se desenvolveram primeiramente em plantas deficientes em Fe ou Mn, seguidas das deficientes em boro. A produção de matéria seca foi afetada na seguinte ordem: Fe>Mn>B. Tanto as folhas superiores como as inferiores refletem o estado nutricional da mamoneira em relação a B, Cu, Fe, Mn, Mo e Zn. O teor de clorofila nas folhas, medido em unidades SPAD, foi influenciado pela omissão dos micronutrientes.The objectives of this work were to characterize the visual symptoms of micronutrient deficiencies, and their effects on nutricional status of castor beans. A greenhouse experiment with nutrient solutions was carried out from February to June, 2003. The commercial hybrid "Iris" was used. Treatments were as follows: complete, minus B, minus Cu, minus Fe, minus Mn, minus Mo, and minus Zn. Symptoms of deficiency were observed in the treatments with omission of B, Fe, and Mn. The symptoms firstly developed when either Fe or Mn was deficient, and they were followed by those deficient in boron. Dry matter yield was affected in the decreasing order: Fe>Mn>B. Both upper and lower leaves reflect the nutritional status of the castor bean with respect to B, Cu, Fe, Mn, Mo and Zn. Leaf chlorophyll, as measured in units SPAD, was influenced by the treatments.
Chaudhry, F.M.; Sharif, M.
Studies on the mechanisms of zinc-65 adsorption by various types of soil are being conducted. The soils of the Hyderabad region of the Sind province appear to de deficient in Zn for maize and in B for cotton, sweet clover, wheat and millets. Zinc, Cu and B deficiency seems to be widespread for wheat on many non-rice growing soils of the Punjab. In the North Frontier Province, sugarbeet and citrus orchards respond markedly to the application of Zn, Cu and Fe. Lowland rice responds to the addition of Zn in all the provinces of Pakistan. In rice tracts of the Punjab, Zn and Cu deficiency is quite prevalent for rice. The scope of necessary future research is discussed
Full Text Available Background Inflammatory Bowel Disease (IBD patients often present with nutritional disorders that affect both macronutrient and micronutrient levels. Vitamin and mineral deficiencies are typically more frequent in Crohn's disease (CD patients than other IBD patients. However, some studies have shown that these deficiencies can also be present in ulcerative colitis (UC patients, even in those in remission. Aims To describe the prevalence of micronutrient deficiencies in patients diagnosed with IBD and to correlate these micronutrient deficiencies with demographic, clinical and disease characteristics. Methods A cross-sectional study of patients in the IBD program who were 18 years and older was completed. Clinical characteristics and disease activity indexes were assessed. Body Mass Index (BMI, haematocrit, serum albumin, serum iron profile, serum 25(OH D, vitamin B12, folate, zinc and copper were measured. Results Ninety-one patients with IBD were included: 46 patients (50.5 per cent with UC and 45 patients (49.5 per cent with CD. At least one micronutrient deficiency was found in 39.5 per cent of patients, 35.1 per cent had two deficiencies, and 12 per cent had three or more deficiencies. Iron, zinc, copper, and vitamin B12 deficiencies were found in 33 per cent, 22 per cent, 11 per cent and 10 per cent of patients, respectively. No folate deficiencies were found. Low levels of serum 25(OH D were detected in 76 per cent of patients. The mean BMI was 24.3 (SD 3.4, and the mean serum albumin level was 4.0g/l (SD 0.4. Conclusion Micronutrient deficiencies were frequent in our study cohort and did not correlate with macronutrient status. Measurement of macronutrients and micronutrients should become a routine assessment in IBD patients to improve patient care and to avoid negative repercussions on disease activity
Roust, Lori R; DiBaise, John K
The purpose of this review is to provide an update of recent additions to our understanding of the prevalence of nutrient deficiencies and the potential role of preoperative weight loss in contributing to these deficiencies in obese individuals planning to undergo bariatric surgery. Recent reports that have included bariatric surgery candidates from sites around the world have shown consistent deficiencies in a variety of nutrients. Although protein-energy malnutrition is uncommon preoperatively, micronutrient deficiencies occur commonly with multiple deficiencies often present in the same individual. No difference in the prevalence of deficiency between men and women is apparent, and a standard profile of susceptibility to deficiency has not been identified. In the only studies that have evaluated dietary intake of total energy, macronutrients and micronutrients preoperatively, despite an excess of calories ingested, micronutrient intake tends to be lower than recommended. A high prevalence of micronutrient deficiencies, especially vitamin D, folate, B12 and iron, is present in obese individuals being considered for bariatric surgery. Despite high-caloric intake, the deficiencies present appear to be related to the poor quality of the diet and low micronutrient intake. These findings strengthen prior recommendations of routine preoperative nutritional screening. Because a standard profile of susceptibility to deficiency has not been identified, extensive nutritional screening, including micronutrient testing, should be considered in all patients in the preoperative setting. Finally, we recommend early supplementation of vitamins and minerals based on laboratory assessment and incorporation of a program to optimize eating behaviors prior to surgery.
The increased prevalence of iron deficiency among infants can be attributed to the consumption of an iron deficient diet or a diet that interferes with iron absorption at the critical time of infancy, among other factors. The gradual shift from breast milk to other foods and liquids is a transition period which greatly contributes to ...
Micronutrients and their role in the prevention and treatment of disease are ... These levels are by definition safe, but are designed to ... VITAMIN A. Clinical vitamin A deficiency (VAD) is one of the leading causes of childhood blindness.) It is, however, not only clinical vitamin. A deficiency that is considerd of importance.
Matthew G. Engel
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.
J. Kern, Hua; Brenna, J. Thomas; H. Mitmesser, Susan
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 (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. PMID:29361684
de Gier, Brechje; Campos Ponce, Maiza; Perignon, Marlene
in environments with high infection pressure. When considering fortification of staple foods, a careful risk-benefit analysis is warranted, taking into account severity of micronutrient deficiencies and local prevalence of parasitic infections. TRIAL REGISTRATION: ClinicalTrials.gov NCT01706419....
Nov 3, 2012 ... Iodine deficiency causes reduced production of thyroid hormones (T3/T4). A decrease in the serum level of T3/T4 triggers the secretion of high amount of pituitary thyroid stimulating hormone, which stimulates thyroid glandular activities that results in enlargement of the gland (9). Thyroid hormones play an ...
May 11, 2010 ... Zinc deficiency in primary school children in a South African peri-urban settlement. (page number ... of 149 respondents was evaluated by 24-hour recall and quantitative food frequency questionnaires. ... Antropometriese data is geanaliseer deur die statistiese program, Anthro plus, uitgawe 1.0.2, van die.
Full Text Available 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 dietary recalls with accompanying nutritional supplement questionnaires. In the majority of both users and non-users of dietary supplements, vitamin D intake was below the estimated average requirement (AR if supplements were not included in the analysis. Including dietary supplements improved vitamin D intake, but still a part of the athletes, both men and women, reported an intake below the AR. Non-users of dietary supplements were particularly at risk for low intakes of vitamins B1, B2, B3 and vitamins A, C and selenium. Mean iron intake was reported below the AR in a substantial group of women, both users and non-users. The use of sport nutrition products contributed only slightly to micronutrient intake. A small prevalence of athletes using dietary supplements showed intakes of some micronutrients above the Upper Level. In conclusion, both users and non-users of nutritional supplements reported inadequate intake of micronutrients. For most micronutrients, use of nutritional supplements does not completely compensate for intakes below AR. Athletes should consider making better food choices and the daily use of a low-dosed multivitamin supplement.
M Noori Shadkam
Full Text Available Introduction: It is generally assumed that 50% of the cases of anemia are due to iron deficiency. The most severe consequence of iron depletion is iron deficiency anemia (IDA, and it is still considered the most common nutrition deficiency worldwide. The main risk factors for IDA include: inadequate iron intake, impaired absorption or transport, physiologic losses associated with chronological or reproductive age, or acute or chronic blood loss, parasite infections such as hookworms, acute and chronic infections, including malaria, cancer, tuberculosis, HIV and other micronutrient deficiencies, including vitamins A and B12, folate, riboflavin, and copper deficiency. Methods: This work as a cross-sectional study was done in 2007-2008 in Yazd. Two hundred girls who participated in the study were selected randomly from eight girl high schools. Five ml venous blood was collected for determination of serum ferritin and cell blood count (CBC. Serum ferritin was determined by using ECLIA method and CBC by cell counter SYSMEX KX21N. Iron deficiency was defined as having serum ferritin values below 12 μ/l. Anemia was defined as having Hemoglobin levels below12 g/dl. Iron-deficiency anemia was considered to be the combination of both. Results: The3 mean ageyears and body mass index (kg/m2 were 15.19±0.7years and 21.5±4.2, respectively. Distribution in the 14, 15 and 16 years and more age groups were 13, 58.5 and 28.5 percent, respectively. Mean of Hemoglobin(g/dl, Hematocrit(%, MCV (fl, MCH (pg, MCHC (g/dl and ferritin(μ/l were 12.8±0.9, 38.9±3.0, 80.7±4.3, 26.6±1.8, 33.2±3.6 and 23±18.2, respectively. Of the total, 13.5% were anemic, 68% of which had Iron Deficiency Anemia (9.3% of the total. Iron deficiency was present in 34.7% of the population under study. Conclusion: According to world health organization criteria, anemia is a mild public health problem in this region, but iron deficiency is a significant problem and suitable measures for
A series of field and greenhouse experiments with flooded rice was carried out on contrasting soil types of Korea to study the zinc status of soils, evaluate the chemical methods for extracting zinc from soils in terms of ability to identify zinc deficiency, perform 65 Zn-aided experiments including the residual effects of zinc fertilizers to evaluate the efficiency of zinc sources and methods of zinc application to rice, and associated studies on factors affecting zinc nutrition in rice such as effect of organic matter and chelates. The results show that i) 0.05 N HCl solution for extracting available zinc in soil was effective to separating the soils which require zinc fertilizer application. The proposed zinc value to identify is 2.4 ppm. Among rice soils surveyed, the red-yellow podsolic soil derived from basalt, the reddish-brown lateritic soil of calcareous material and newly reclaimed saline soils were shown to be below this limit; ii) 5 kg Zn/ha as zinc sulphate introduced the highest response in terms of % Zndff, total zinc yield in rice plant, and the fertilizer zinc use efficiency. Applying higher zinc amounts, in case of 20 kg Zn/ha, retarded nitrogen uptake by the plant and as a result the rice grain yield was decreased; iii) Significant yields increases due to the residual effects of zinc fertilizers were obtained on the second and third crops; iv) On the zinc-deficient calcareous soil the use of chelated zinc sources is recommended
Kennedy, G.L.; Fanou-Fogny, N.M.L.; Seghieri, C.; Arimond, M.; Koreissi, Y.; Dossa, R.A.M.; Kok, F.J.; Brouwer, I.D.
The prevalence of micronutrient deficiency is high among women of reproductive age living in urban Mali. Despite this, there are little data on the dietary intake of micronutrients among women of reproductive age in Mali. This research tested the relationship between the quantity of intake of 21
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
Darnton-Hill, Ian; Mkparu, Uzonna C
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. Because of the life
Purpose: To investigate the prevalence of cobalamin and folate deficiencies among the elderly in the general population of Shiraz in southern Iran. Methods: This is a descriptive cross-sectional study including 340 individuals who are over 50 years old and were selected randomly from all the regions of Shiraz. Results: The ...
Dec 1, 2009 ... East African Medical Journal Vol. 86 (Supplement) December 2009. PREVALENCE OF IRON DEFICIENCY IN CHILDREN WITH CYANOTIC HEART DISEASE SEEN AT KENYATTA. NATIONAL HOSPITAL AND MATER HOSPITAL NAIROBI. M. O. Lang'o, MBChB, MMed (Paed), Paediatrician, Gertrude's ...
Feb 6, 2016 ... Meta-analysis;. Prevalence. Abstract Background: Glucose-6-phosphate dehydrogenase (G6PD) is a house keeping enzyme which catalyzes the first step in the hexose monophosphate pathway of glucose metabolism. G6PD deficiency is the commonest hemolytic X-linked genetic disease, which affects ...
Prevalence of iron deficiency and megaloblastic Anaemia at booking in a secondary health facility in north eastern Nigeria. ... Nigerian Medical Journal ... This further supports the continued use of iron supplements for all pregnant women preferably at no cost in the short run and economic empowerment of the women folk in ...
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,
Full Text Available Vitamin D deficiency prevails in epidemic proportions all over the Indian subcontinent, with a prevalence of 70%–100% in the general population. In India, widely consumed food items such as dairy products are rarely fortified with vitamin D. Indian socioreligious and cultural practices do not facilitate adequate sun exposure, thereby negating potential benefits of plentiful sunshine. Consequently, subclinical vitamin D deficiency is highly prevalent in both urban and rural settings, and across all socioeconomic and geographic strata. Vitamin D deficiency is likely to play an important role in the very high prevalence of rickets, osteoporosis, cardiovascular diseases, diabetes, cancer and infections such as tuberculosis in India. Fortification of staple foods with vitamin D is the most viable population based strategy to achieve vitamin D sufficiency. Unfortunately, even in advanced countries like USA and Canada, food fortification strategies with vitamin D have been only partially effective and have largely failed to attain vitamin D sufficiency. This article reviews the status of vitamin D nutrition in the Indian subcontinent and also the underlying causes for this epidemic. Implementation of population based educational and interventional strategies to combat this scourge require recognition of vitamin D deficiency as a public health problem by the governing bodies so that healthcare funds can be allocated appropriately.
Bityutskii, Nikolai; Pavlovic, Jelena; Yakkonen, Kirill; Maksimović, Vuk; Nikolic, Miroslav
Although the beneficial role of silicon (Si) in alleviation of abiotic stress is well established, little is known of the relevance of Si nutrition under microelement deficiency. The aim of our work was to investigate the physiological role of Si in relation to micronutrient (Fe, Zn and Mn) deficiencies in cucumber (Cucumis sativus L.). Cucumber (cv. Semkross) plants were grown hydroponically in a complete nutrient solution (control) and in nutrient solutions free from Fe, Zn or Mn, with or without Si supply. Plant tissue concentrations of microelements, organic acids and phenolics were measured. Si supply effectively mitigated the symptoms of Fe deficiency, but only in part, the symptoms of Zn- or Mn deficiency. Leaf Fe concentration significantly increased in plants deprived of Fe but treated with Si, whereas the concentrations of other microelements were not affected by Si supply. The effects of Si supply in increasing accumulation of both organic acids and phenolic compounds in cucumber tissues were exclusively related to Fe nutrition. Enhancement of Fe distribution towards apical shoot parts, along with the tissue accumulation of Fe-mobilizing compounds such as citrate (in leaves and roots) or cathechin (in roots) appears to be the major alleviating effect of Si. Si nutrition, however, was without effect on the mobility and tissue distribution of either Zn or Mn. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Nett, Philipp; Borbély, Yves; Kröll, Dino
Malabsorptive bariatric surgery requires life-long micronutrient supplementation. Based on the recommendations, we assessed the number of adjustments of micronutrient supplementation and the prevalence of vitamin and mineral deficiencies at a minimum follow-up of 5 years after biliopancreatic diversion with duodenal switch (BPD-DS). Between October 2010 and December 2013, a total of 51 patients at a minimum follow-up of 5 years after BPD-DS were invited for a clinical check-up with a nutritional blood screening test for vitamins and minerals. Forty-three of fifty-one patients (84.3 %) completed the blood sampling with a median follow-up of 71.2 (range 60-102) months after BPD-DS. At that time, all patients were supplemented with at least one multivitamin. However, 35 patients (81.4 %) showed either a vitamin or a mineral deficiency or a combination of it. Nineteen patients (44.1 %) were anemic, and 17 patients (39.5 %) had an iron deficiency. High deficiency rates for fat-soluble vitamins were also present in 23.2 % for vitamin A, in 76.7 % for vitamin D, in 7.0 % for vitamin E, and in 11.6 % for vitamin K. The results of our study show that the prevalence of vitamin and mineral deficiencies after BPD-DS is 81.4 % at a minimum follow-up of 5 years. The initial prescription of micronutrient supplementation and further adjustments during the first follow-up were insufficient to avoid long-term micronutrient deficiencies. Life-long monitoring of micronutrients at a specialized bariatric center and possibly a better micronutrient supplementation, is crucial to avoid a deficient micronutrient status at every stage after malabsorptive bariatric surgery.
Macharia-Mutie, Catherine W; Moretti, Diego; Van den Briel, Natalie; Omusundi, Agnes M; Mwangi, Alice M; Kok, Frans J; Zimmermann, Michael B; Brouwer, Inge D
Few studies have evaluated the impact of fortification with iron-rich foods such as amaranth grain and multi-micronutrient powder (MNP) containing low doses of highly bioavailable iron to control iron deficiency anemia (IDA) in children. We assessed the efficacy of maize porridge enriched with amaranth grain or MNP to reduce IDA in Kenyan preschool children. In a 16-wk intervention trial, children (n = 279; 12-59 mo) were randomly assigned to: unrefined maize porridge (control; 4.1 mg of iron/meal; phytate:iron molar ratio 5:1); unrefined maize (30%) and amaranth grain (70%) porridge (amaranth group; 23 mg of iron/meal; phytate:iron molar ratio 3:1); or unrefined maize porridge with MNP (MNP group; 6.6 mg iron/meal; phytate:iron molar ratio 2.6:1; 2.5 mg iron as NaFeEDTA). Primary outcomes were anemia and iron status with treatment effects estimated relative to control. At baseline, 38% were anemic and 30% iron deficient. Consumption of MNP reduced the prevalence of anemia [-46% (95% CI: -67, -12)], iron deficiency [-70% (95% CI: -89, -16)], and IDA [-75% (95% CI: -92, -20)]. The soluble transferrin receptor [-10% (95% CI: -16, -4)] concentration was lower, whereas the hemoglobin (Hb) [2.7 g/L (95% CI: 0.4, 5.1)] and plasma ferritin [40% (95% CI: 10, 95)] concentrations increased in the MNP group. There was no significant change in Hb or iron status in the amaranth group. Consumption of maize porridge fortified with low-dose, highly bioavailable iron MNP can reduce the prevalence of IDA in preschool children. In contrast, fortification with amaranth grain did not improve iron status despite a large increase in iron intake, likely due to high ratio of phytic acid:iron in the meal.
Macharia-Mutie, C.W.; Moretti, D.; Briel, van den N.; Omusundi, A.M.; Mwangi, A.M.; Kok, F.J.; Zimmerman, J.B.; Brouwer, I.D.
Few studies have evaluated the impact of fortification with iron-rich foods such as amaranth grain and multi-micronutrient powder (MNP) containing low doses of highly bioavailable iron to control iron deficiency anemia (IDA) in children. We assessed the efficacy of maize porridge enriched with
Bernadette N. Ng’eno
Full Text Available Many children in low- and middle-income countries may have inadequate intake of vitamin B12 and folate; data confirming these inadequacies are limited. We used biochemical, demographic, behavioral and anthropometric data to describe the folate and vitamin B12 concentrations among six- to 23-month-old Nepalese children. Vitamin B12 (serum B12 < 150 pmol/L and folate deficiencies (red blood cell (RBC folate < 226.5 nmol/L were assessed. We used logistic regression to identify predictors of vitamin B12 deficiency. The vitamin B12 geometric mean was 186 pmol/L; 30.2% of children were deficient. The mean RBC folate concentration was 13,612 nmol/L; there was no deficiency. Factors associated with vitamin B12 deficiency included: (a age six to 11 months (adjusted odds ratio (aOR 1.51; 95% confidence interval (CI: 1.18, 1.92 or 12–17 months (aOR 1.38; 95% CI: 1.10, 1.72 compared to 18–23 months; (b being stunted (aOR 1.24; 95% CI: 1.03, 1.50 compared to not being stunted; (c and not eating animal-source foods (aOR 1.85; 95% CI: 1.42, 2.41 compared to eating animal-source foods the previous day. There was a high prevalence of vitamin B12 deficiency, but no folate deficiency. Improving early feeding practices, including the consumption of rich sources of vitamin B12, such as animal-source foods and fortified foods, may help decrease deficiency.
Valentino, Daniel; Sriram, Krishnan; Shankar, Padmini
Obesity is a growing worldwide epidemic. Obese patients are often deficient in micronutrients despite macronutrient excess. Bariatric surgery is an increasingly utilized modality in the treatment of obesity and obesity-related conditions. Bariatric surgery itself may cause or exacerbate micronutrient deficiencies with serious sequelae. This review will focus on perioperative strategies to detect, prevent and treat micronutrient deficiencies in patients undergoing bariatric surgery, and will highlight practical and clinical aspects of these nutritional problems. Micronutrient deficiency is common in obese patients undergoing bariatric surgery both preoperatively and postoperatively. Bariatric procedures with a malabsorptive component are more likely to result in postoperative micronutrient deficiency. A system-based approach will facilitate clinical suspicion of specific or combined micronutrient deficiencies, leading to appropriate laboratory tests for confirmation. Supplementation by the oral route is always tried first, reserving parenteral administration for specific situations. Clinicians should be aware that micronutrient deficiencies are common in obese patients who may have macronutrient excess. Micronutrient deficiency may exist preoperatively or be caused by bariatric procedures themselves. A systematic and team-based approach will decrease morbidity associated with delays in diagnosis and treatment.
Silvana Gomes Nunes Piva
Full Text Available OBJECTIVE: To determine the prevalence of nutritional deficiency among patients with pulmonary tuberculosis. METHODS: This was a cross-sectional study using data obtained from the Brazilian Case Registry Database and from the medical records of patients diagnosed with pulmonary tuberculosis (15-59 years of age residing in one of the municipalities that make up the 16th Regional Health District of the state of Bahia. We calculated the incidence, lethality, and mortality rates, as well as the prevalence of nutritional deficiency, as evaluated by body mass index. Demographic, social, clinical, and epidemiological data were collected. RESULTS: Of the 72 confirmed cases of tuberculosis, 59 (81.9% were in males, and 21 (29.2% of the patients were in the 40-49 year age bracket. The majority (85.3% described themselves as Mulatto or Black; 55.2% reported using alcohol; and approximately 90% were treated as outpatients. In the district and age bracket studied, the incidence of pulmonary tuberculosis was 30.6/100,000 population. Among the 72 patients, data regarding nutritional status was available for 34. Of those, 50% and 25%, respectively, presented nutritional deficiency at the beginning and at the end of treatment. No statistically significant differences were found between normal-weight and malnourished patients regarding the characteristics studied. CONCLUSIONS: The prevalence of nutritional deficiency was high among our sample of patients with pulmonary tuberculosis. This underscores the importance of nutritional follow-up for the assessment of tuberculosis treatment in the decision-making process regarding therapeutic interventions.
Effect of some vitamins and micronutrient deficiencies on the production of higher alcohols by Saccharomyces cerevisiae Efeito da deficiência de vitaminas e micronutrientes sobre a produção de álcoois superiores por Sacharomyces cerevisiae
Full Text Available A study was carried out in order to determine the effect of vitamins (biotin, thiamine, pantotheniic acid and pyridoxal and micronutrient (zinc, boron, manganese and iron deficiencies on higher alcohol production during alcoholic fermentation with the industrially used yeast Saccharomyces cerevisiae M-300-A. Zinc deficiency induced a reduction on the levels of isobutyl and isoamyl alcohols. An increase on isobutyl alcohol (fivefold and a reduction of isoamyl alcohol (two fold and n-propyl alcohol (three fold contents resulted from pantotheiiic acid deficiency, whereas pyridoxal deficiency caused an increase on the levels of isobutyl and isoamyl alcohols. Biotin was not essential for the growth of this strain.Foi estudado o efeito da deficiência das vitaminas (biotina, ti amina, ácido pantotênico e piridoxal e de micronutrientes (boro, zinco, manganês e ferro sobre a produção de álcoois superiores durante a fermentação alcoólica com a levedura industrial Saccharomyces cerevisiae M-300-A. Com a deficiência de zinco ocorreu redução na formação dos álcoois isobutílico e isoamílico enquanto que a deficiência de pantotenato provocou aumento no nível de álcool isobutflico (cerca de cinco vezes e redução dos álcoois isoamílico (duas vezes e n-propílico (três vezes. Na deficiência de piridoxina ocorreu aumento nos teores de isobutílico e de isoamflico. A biotina não foi essencial para o crescimento dessa linhagem de levedura.
Al-Faris, Nora A.
Vitamin D deficiency has emerged as a public health problem worldwide due to its important role in health and disease. The present work is intended to examine prevalence of vitamin D deficiency among pregnant Saudi women and related risk factors. A cross-sectional study was carried out at King Fahad Medical City in Riyadh, Saudi Arabia. Serum 25-hydroxy vitamin D (25(OH)D) was measured by enzyme-linked immunosorbent assay in 160 pregnant women during the first trimester of pregnancy. Socio-demographic, lifestyle and maternal characteristics were collected and vitamin D intake was assessed using a 24-h dietary recall. Weight and height were measured using standardized methods. Vitamin D deficiency (25(OH)D women. Age group, educational level, sun exposure frequency and daytime and daily practice of exercise were significantly associated with vitamin D status. Overall, vitamin D deficiency was common among pregnant Saudi women in Riyadh. Steps should be taken to address the current situation, including increased sunlight exposure, consumption of fatty fish, and vitamin D supplements. PMID:26861386
Cláudio Azevedo Nolasco
Full Text Available The aim of this research work was to characterize the visual symptoms of micronutrient deficiencies of tomato plants. A greenhouse experiment with nutrient solutions was used with “Salada” group tomato hybrid plants. Treatments were as follows: complete, minus B, minus Zn, minus Mn, minus Mo, minus Fe, and minus Cu. Except the omission of Cu, the other omissions resulted in morphological alteration with peculiar symptoms. The symptoms firstly and had when either Fe or Zn was deficient. Fe, Zn, Cu, Mn, Mo and B. The Zn deficiency caused fruit cracking and the B omition caused blossom-end rotEste experimento foi conduzido em casa-de-vegetação da Universidade Estadual do Sudoeste da Bahia – Vitória da Conquista com o objetivo de caracterizar os sintomas visuais de deficiência de micronutrientes em um híbrido de tomateiro do grupo salada, cultivado em solução nutritiva. Os tratamentos foram: completo, omissão de B, omissão de Zn, omissão de Mn, omissão de Mo, omissão de Fe e omissão de Cu. Com exceção da omissão de Cu, as demais omissões resultaram em alterações morfológicas com sintomas característicos. Os sintomas ocorreram primeiramente, e com maior intensidade nas deficiências de Fe e Zn. A seqüência de surgimento de sintomas foi a seguinte: Fe, Zn, Cu, Mn, Mo, B. A deficiência de Zn promoveu a rachadura no fruto e de B promoveu a podridão apical do fruto de tomate.
An extensive survey identified 500,000 ha of soil in the Philippines as being potentially Zn-deficient for rice production. Isotope-aided laboratory, greenhouse, and field experiments were conducted to identify the most efficient methods of supplying fertilizer Zn to flooded rice. The application of 5 kg Zn/ha as ZnSO 4 effectively corrected a Zn deficiency and increased rice yield and Zn uptake for three successive growing seasons. No further increases were noted with higher rates of Zn application. Fertilizer ZnSO 4 was equally effective when mixed with the soil, combined with urea fertilizers, or surface-applied at or two weeks after transplanting the rice. Mine tailings were also shown to be an effective source of Zn. Mixing organic compost with the ZnSO 4 decreased the percent Zn derived from the fertilizer and the rice yield. 65 Zn-labelled ZnSO 4 was used
Full Text Available Abstract Background In Mexico, as in other developing countries, micronutrient deficiencies are common in infants between 6 and 24 months of age and are an important public health problem. The objective of this study was to determine the prevalence of anemia and of iron, folic acid, and zinc deficiencies in Mexican children under 2 years of age who use the health care services provided by the Mexican Institute for Social Security (IMSS. Methods A nationwide survey was conducted with a representative sample of children younger than 2 years of age, beneficiaries, and users of health care services provided by IMSS through its regular regimen (located in urban populations and its Oportunidades program (services offered in rural areas. A subsample of 4,955 clinically healthy children was studied to determine their micronutrient status. A venous blood sample was drawn to determine hemoglobin, serum ferritin, percent of transferrin saturation, zinc, and folic acid. Descriptive statistics include point estimates and 95% confidence intervals for the sample and projections for the larger population from which the sample was drawn. Results Twenty percent of children younger than 2 years of age had anemia, and 27.8% (rural to 32.6% (urban had iron deficiency; more than 50% of anemia was not associated with low ferritin concentrations. Iron stores were more depleted as age increased. Low serum zinc and folic acid deficiencies were 28% and 10%, respectively, in the urban areas, and 13% and 8%, respectively, in rural areas. The prevalence of simultaneous iron and zinc deficiencies was 9.2% and 2.7% in urban and rural areas. Children with anemia have higher percentages of folic acid deficiency than children with normal iron status. Conclusion Iron and zinc deficiencies constitute the principal micronutrient deficiencies in Mexican children younger than 2 years old who use the health care services provided by IMSS. Anemia not associated with low ferritin values
A series of pot and field experiments with flooded rice were carried out on contrasting soil types of Bangladesh to study the zinc status of soils, evaluate chemical methods for extracting zinc from soils in terms of ability to identify zinc deficiency, 65 Zn-aided experiments including the residual effect of zinc fertilizers to evaluate the efficiency of zinc sources and methods of zinc application to rice. The results show that (1) the available zinc extracted successively with 0.1 N HCl showed a significant, positive correlation between available soil zinc and plant zinc content; (2) among rice soils of Bangladesh the zinc content from critical limits to adequate levels in the south and south-eastern part of the country was determined. In the northern part of the country, deficiency problems were clearly seen; (3) the rates and methods of zinc application under experimental conditions influences the yield parameters differently and may show an apparent or significant change; (4) 5-7 kg Zn/ha as zinc sulfate were introduced as optimal rates for the soils under experiments; (5) significant yield increases due to the residual effect of zinc fertilizer were obtained on the experiments under dry season conditions but not under wet conditions
Mogendi, Joseph Birundu; De Steur, Hans; Gellynck, Xavier; Makokha, Anselimo
Despite successes recorded in combating iodine deficiency, more than 2 billion people are still at risk of iodine deficiency disorders. Rural landlocked and mountainous areas of developing countries are the hardest hit, hence the need to explore and advance novel strategies such as biofortification. We evaluated adoption, purchase, and consumption of iodine biofortified vegetable legumes (IBVL) using the theory of protection motivations (PMT) integrated with an economic valuation technique. A total of 1,200 participants from three land-locked locations in East Africa were recruited via multi-stage cluster sampling, and data were collected using two, slightly distinct, questionnaires incorporating PMT constructs. The survey also elicited preferences for iodine biofortified foods when offered at a premium or discount. Determinants of protection motivations and preferences for iodine biofortified foods were assessed using path analysis modelling and two-limit Tobit regression, respectively. Knowledge of iodine, iodine-health link, salt iodization, and biofortification was very low, albeit lower at the household level. Iodine and biofortification were not recognized as nutrient and novel approaches, respectively. On the other hand, severity, fear, occupation, knowledge, iodine status, household composition, and self-efficacy predicted the intention to consume biofortified foods at the household level; only vulnerability, self-efficacy, and location were the most crucial elements at the school level. In addition, results demonstrated a positive willingness-to-pay a premium or acceptance of a lesser discount for biofortification. Furthermore, preference towards iodine biofortified foods was a function of protection motivations, severity, vulnerability, fear, response efficacy, response cost, knowledge, iodine status, gender, age. and household head. Results lend support for prevention of iodine deficiency in unprotected populations through biofortification; however
, Ethiopia. Brief Communication. Prevalence of Iodine deficiency disorder in a highland district in Tigray. Teklay Kidane1, Aregai Woldegebriel2. Abstract. A cross-sectional community based goiter prevalence survey was conducted in February ...
Deficiências de micronutrientes em crianças e adolescentes com anemia falciforme: uma revisão sistemática Micronutrient deficiency in children and adolescents with sickle cell anemia: a systematic review
Pilar S. R. Mataratzis
Full Text Available A anemia falciforme é a doença hemolítica crônica, de caráter hereditário mais comum no Brasil, sendo escassas as informações sobre o estado nutricional de micronutrientes em portadores dessa enfermidade no Brasil. Estudos internacionais vêm demonstrando correlação positiva entre deficiência de micronutrientes e evolução desfavorável da doença.O objetivo deste estudo foi realizar revisão sistemática sobre deficiência de micronutrientes em crianças e adolescentes com anemia falciforme.Foram selecionadas publicações nas bases científicas de dados Medline e Lilacs através do Pubmed e Scielo, disponíveis entre os anos de 1998 e 2008. Foram incluídas na análise as publicações realizadas com crianças e adolescentes portadores da forma homozigótica da doença (SS. A qualidade metodológica dos artigos foi avaliada segundo as recomendações de Strobe, sendo selecionados 11 estudos, sendo 2 transversais, 4 caso-controle e 5 de coorte, todos realizados nos Estados Unidos. A avaliação da concordância entre os avaliadores na classificação da qualidade dos artigos demonstrou ótima concordância (k = 1,00, com um total de 90,9% de trabalhos com classificação B. Para a maioria dos nutrientes estudados (vit. A, D, B6, folato, cálcio e zinco, observou-se estado nutricional desfavorável entre os portadores de anemia falciforme, à exceção do ferro e vitamina B12, cujos resultados revelaram baixo ou nenhum nível de inadequação, seja bioquímica ou dietética. Tal constatação reforça a necessidade do cuidado nutricional no manejo desses pacientes, garantindo qualidade de vida para os portadores da doença.Sickle cell anemia is a chronic hemolitic disease and very common in Brazil and there are few information about nutritional status of micronutrients in people with sickle cell anemia in this country. International studies have shown positive correlation between deficiency of micronutrients and worst evolution of
de Gier, Brechje; Campos Ponce, Maiza; van de Bor, Margot; Doak, Colleen M; Polman, Katja
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.
Rafael de Souza Miranda
transferred for a complete nutrient solution for the period of acclimatization. After three days, the seedlings were submitted to the different treatments. The experiment had the following treatments: complete nutrient solution (N; P; K; Ca; Mg; S and micronutrients and individual omission of each element -N; -P; -K; -Ca; -Mg; -S; -B, -Fe and -aeration. The symptoms of the deficiencies were observed, characterized and registered by pictures. In the end of the experiment, the length measures and the fresh and dry matters of the root and shoot of the seedlings were analyzed. All macro and micronutrients caused deficiency symptoms and they affected the development of the seedlings. The symptoms were developed firstly in seedlings with failure in Fe, Ca and N. The total dry matter was reduced in all the treatments with absence of nutrients, but the absence of Ca, N and Fe were responsible for the larger reduction of biomass. The decreasing order of reduction was: Ca > N > Fe > P > K > Mg > S > Aeration > B > Complete.
Carroll, Tomas P
BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) results from mutations in the SERPINA1 gene and classically presents with early-onset emphysema and liver disease. The most common mutation presenting with clinical evidence is the Z mutation, while the S mutation is associated with a milder plasma deficiency. AATD is an under-diagnosed condition and the World Health Organisation recommends targeted detection programmes for AATD in patients with chronic obstructive pulmonary disease (COPD), non-responsive asthma, cryptogenic liver disease and first degree relatives of known AATD patients. METHODS: We present data from the first 3,000 individuals screened following ATS\\/ERS guidelines as part of the Irish National Targeted Detection Programme (INTDP). We also investigated a DNA collection of 1,100 individuals randomly sampled from the general population. Serum and DNA was collected from both groups and mutations in the SERPINA1 gene detected by phenotyping or genotyping. RESULTS: The Irish National Targeted Detection Programme identified 42 ZZ, 44 SZ, 14 SS, 430 MZ, 263 MS, 20 IX and 2 rare mutations. Analysis of 1,100 randomly selected individuals identified 113 MS, 46 MZ, 2 SS and 2 SZ genotypes. CONCLUSION: Our findings demonstrate that AATD in Ireland is more prevalent than previously estimated with Z and S allele frequencies among the highest in the world. Furthermore, our targeted detection programme enriched the population of those carrying the Z but not the S allele, suggesting the Z allele is more important in the pathogenesis of those conditions targeted by the detection programme.
Carroll, Tomas P
Abstract Background Alpha-1 antitrypsin deficiency (AATD) results from mutations in the SERPINA1 gene and classically presents with early-onset emphysema and liver disease. The most common mutation presenting with clinical evidence is the Z mutation, while the S mutation is associated with a milder plasma deficiency. AATD is an under-diagnosed condition and the World Health Organisation recommends targeted detection programmes for AATD in patients with chronic obstructive pulmonary disease (COPD), non-responsive asthma, cryptogenic liver disease and first degree relatives of known AATD patients. Methods We present data from the first 3,000 individuals screened following ATS\\/ERS guidelines as part of the Irish National Targeted Detection Programme (INTDP). We also investigated a DNA collection of 1,100 individuals randomly sampled from the general population. Serum and DNA was collected from both groups and mutations in the SERPINA1 gene detected by phenotyping or genotyping. Results The Irish National Targeted Detection Programme identified 42 ZZ, 44 SZ, 14 SS, 430 MZ, 263 MS, 20 IX and 2 rare mutations. Analysis of 1,100 randomly selected individuals identified 113 MS, 46 MZ, 2 SS and 2 SZ genotypes. Conclusion Our findings demonstrate that AATD in Ireland is more prevalent than previously estimated with Z and S allele frequencies among the highest in the world. Furthermore, our targeted detection programme enriched the population of those carrying the Z but not the S allele, suggesting the Z allele is more important in the pathogenesis of those conditions targeted by the detection programme.
Zinc (Zn) deficiency is a prevalent micronutrient insufficiency. Although the gut is a vital organ for Zn utilization, and Zn deficiency is associated with impaired intestinal permeability and a global decrease in gastrointestinal health, alterations in the gut microbial ecology of the host under co...
Watson, Sinead; Chen, Gaoyun; Sylla, Abdoulaye; Routledge, Michael N; Gong, Yun Yun
Aflatoxin exposure coincides with micronutrient deficiencies in developing countries. Animal feeding studies have postulated that aflatoxin exposure may be exacerbating micronutrient deficiencies. Evidence available in human subjects is limited and inconsistent. The aim of the study was to investigate the relationship between aflatoxin exposure and micronutrient status among young Guinean children. A total of 305 children (28.8 ± 8.4 months) were recruited at groundnut harvest (rainy season), of which 288 were followed up 6 months later postharvest (dry season). Blood samples were collected at each visit. Aflatoxin-albumin adduct levels were measured by ELISA. Vitamin A, vitamin E and β-carotene concentrations were measured using HPLC methods. Zinc was measured by atomic absorption spectroscopy. Aflatoxin exposure and micronutrient deficiencies were prevalent in this population and were influenced by season, with levels increasing between harvest and postharvest. At harvest, children in the highest aflatoxin exposure group, compared to the lowest, were 1.98 (95%CI: 1.00, 3.92) and 3.56 (95%CI: 1.13, 11.15) times more likely to be zinc and vitamin A deficient. Although children with high aflatoxin exposure levels were more likely to be zinc and vitamin A deficient, further research is necessary to determine a cause and effect relationship. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Annals of Medical and Health Sciences Research | Sep-Oct 2014 | Vol 4 | Special Issue 3 |. 291. Address ... to determine the association between iron deficiency and ADHD and the impact and role of iron deficiency ... Keywords: Attention deficit hyperactivity disorder, Case‑control, Epidemiology, Iron deficiency,. Risk factors ...
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
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.
Merlo, C; Ross, C; Trummler, M; Zeller, A
In 776 primary care patients serum vitamin D level was measured in month of september showing deficiency (fatigue, muscle weakness, and muscle and joint pain. A significant correlation between muscle weakness and degree of vitamin D deficiency was shown (p=0,04), whereas there was no correlation in the two other symptoms. However, patients with vitamin D deficiency more frequently reported fatigue (p=0,02) and muscle weakness (p=0,009) than patients without deficiency did, and no difference was seen concerning muscle and joint pain.
Iron deficiency anaemia, one of the most prevalent problems of micronutrient malnutrition, occurs in many developing countries. Causes of the problem are many, but one of the major causes is low bioavailability of food iron. An increase in the supply of absorbable iron-rich food in the diet should decrease the prevalence of ...
Angeles-Agdeppa, Imelda; Magsadia, Clarita R.; Aaron, Grant J.; Lloyd, Beate B.; Hilmers, David C.; Bhutta, Zulfiqar A.
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
Gustafson, Kimara L; Eckerle, Judith K; Howard, Cynthia R; Andrews, Beth; Polgreen, Lynda E
Vitamin D deficiency impairs bone health and development. To determine the prevalence of and risk factors for vitamin D deficiency in pediatric international adoptees. A prospective cohort (N = 189) study from a single international adoption clinic was conducted. Total 25-hydroxy vitamin D [25(OH)D] level was measured at the initial clinical assessment (within 6 months of adoption). Vitamin D deficiency was defined as a 25(OH)D adoption needs to be determined.
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.
Background: iron deficiency is the commonest cause of nutritional anaemia in children worldwide particularly in developing countries. Infants and toddlers are prone to developing iron deficiency anaemia (IDA). This study was carried out to determine the prevalence of IDA and some factors associated with it in this group of ...
Prevalence of vitamin A deficiency among pre-school and school aged children in Arssi zone, Ethiopia. ... Based on the WHO recommended cut-off level, serum retinol levels were in the “low” range (<20µ1/d1) in 51% of the children. Conclusion: The results indicate that vitamin A deficiency (VAD) is a public health problem ...
Suibhne, Treasa Nic
Vitamin D deficiency impacts on bone health and has potential new roles in inflammation. We aimed to determine the prevalence of and risk factors for vitamin D deficiency and to explore vitamin D supplement usage in patients with Crohn\\'s disease (CD) in an outpatient setting, compared with controls.
Morris Valerie B; Dimitrov Borislav D; O'Brien Geraldine; Kelleher Dermot P; McPartlin Joseph; Floyd Olwen; O'Connor Catherine A; Carroll Tomás P; Taggart Clifford C; McElvaney Noel G
PUBLISHED Background: Alpha-1 antitrypsin deficiency (AATD) results from mutations in the SERPINA1 gene and classically presents with early-onset emphysema and liver disease. The most common mutation presenting with clinical evidence is the Z mutation, while the S mutation is associated with a milder plasma deficiency. AATD is an under-diagnosed condition and the World Health Organisation recommends targeted detection programmes for AATD in patients with chronic obstructive pulmonary disea...
Devlieger, Roland; Guelinckx, Isabelle; Jans, Goele; Voets, Willy; Vanholsbeke, Caroline; Vansant, Greet
Background Studies report frequent micronutrient deficiencies after bariatric surgery, but less is known about micronutrient levels of pregnant women after bariatric surgery. Objective To prospectively evaluate micronutrient levels and supplement intake in pregnancy following bariatric surgery. Design A multicenter prospective cohort study including women with restrictive or malabsorptive types of bariatric surgery. Nutritional deficiencies, together with supplement intake, were screened duri...
Stuetz, Wolfgang; Carrara, Verena Ilona; McGready, Rose; Lee, Sue Jean; Erhardt, Juergen Georg; Breuer, Joern; Biesalski, Hans Konrad; Nosten, François Henry
Deficiency of micronutrients is common in refugee populations. Identify deficiencies and whether provided supplements and wheat flour fortified with 10 micronutrients impacts upon status among breast-feeding women from Maela refugee camp. Two sequential cross-sectional studies were conducted in different groups of lactating mothers at 12 weeks postpartum. The first survey was before and the second 4-5 months after micronutrient fortified flour (MFF) had been provided to the camp (in addition to the regular food basket). Iron status and micronutrients were measured in serum, whole blood, and in breast milk samples. Iron and zinc deficiency and anemia were highly prevalent while low serum retinol and thiamine deficiency were rarely detected. Iron and zinc deficiency were associated with anemia, and their proportions were significantly lower after the introduction of MFF (21 vs. 35% with soluble transferrin receptor (sTfR) >8.5 mg/L, P = 0.042, and 50 vs. 73% with serum zinc <0.66 mg/L, P = 0.001). Serum sTfR, whole-blood thiamine diphosphate (TDP) and serum β-carotene were significant predictors (P < 0.001) of milk iron, thiamine and β-carotene, respectively. Lower prevalence of iron deficiency in the MFF group was associated with significantly higher iron and thiamine in breast milk. High whole-blood TDP and breast milk thiamine reflected good compliance to provided thiamine; high prevalence of iron deficiency suggested insufficient dietary iron and low acceptance to ferrous sulfate supplements. MFF as an additional food ration in Maela refugee camp seemed to have an effect in reducing both iron and zinc deficiency postpartum.
Schultink, W; Gross, R; Sastroamidjojo, S; Karyadi, D
Urbanisation runs in parallel with economic growth. Urban areas are characterised by income inequality between population groups. Because of inequality in socioeconomic situation, Indonesian urban areas are confronted with problems of undernutrition and overnutrition. Selected studies conducted by the SEAMEO-TROPMED Regional Centre for Community Nutrition have demonstrated that food intake of the lower socioeconomic class households is deficient. Furthermore, intrahousehold food distribution among the lower economic class households is contributory to the determination of food intake. The prevalence of anaemia in urban Jakarta ranges from as low as 4.5% in female school children to as high as 63.2% in pregnant women. Zinc deficiency might also be prevalent among lactating mothers. Strategies for improvement of urban micronutrient status are required and may include food-based, nutrient supplementation of fortification methods.
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.
A potential risk of interactions between micronutrients affecting absorption and bioavailability has to be considered in any supplementation or fortification strategy. At levels of essential micronutrients present in foods, most micronutrients appear to utilise specific absorptive mechanisms and not be vulnerable to interactions. In aqueous solutions and at higher intake levels competition between elements with similar chemical characteristics and uptake by non-regulated processes can take place. These interactions have clearly been demonstrated in experimental absorption studies and to some extent have been confirmed in supplementation studies. Negative effects of iron supplementation on indices of zinc and copper status and of zinc supplementation on iron and copper status have been reported. In contrast, the negative effect of calcium on iron absorption has not been confirmed in long-term supplementation studies. Ascorbic acid has a strong iron absorption promoting potential and in iron deficient populations ascorbic acid supplementation improves iron status. Thus, ascorbic acid supplements or an increased intake of ascorbic acid rich foods could have important public health implications, especially in populations subsisting on a mainly plant food based diet. The effect of poor status of a given micronutrient on absorption and utilisation of other micronutrients should also be considered while developing strategies to improve micronutrient status in a population. Awareness of these interactions, combined with a balanced evaluation of the dietary intake of the population with regard to absorption promoting and inhibiting substances and the risk for multiple deficiencies, could lead to more effective strategies to improve micronutrient status.
Wardenaar, Floris; Brinkmans, Naomi; Ceelen, Ingrid; Rooij, Van Bo; Mensink, Marco; Witkamp, Renger; Vries, De Jeanne
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
Micronutrient deficiencies affect the health and development of the population of China as well as its socia] and economic development. Iron and zinc deficiencies are quite prevalent, while insufficient intake and poor bioavailability are the major causes. Phytate is be!ieved to bc a potent
Pee, de S.
Micronutrient deficiencies seriously hinder mental and physical development and are still an important cause of death in developing countries. Therefore, goals have been set worldwide for the year 2000: to eliminate deficiencies of vitamin A and iodine and to reduce prevalence of iron
A total of 630 children with ADHD aged 5-18 and 630 controls aged 5-18 years old. Sociodemographic and clinical data were collected, including physician diagnosis. The health status of the subjects was assessed by ascertaining clinical presentations and symptoms, family history, body mass index (BMI), iron deficiency, ...
Background: Iron deficiency anaemia has been described as the commonest type of nutritional anaemia in infancy and childhood. The associated adverse health sequelae include permanent behavioural and cognitive impairments. Early detection and prompt treatment are necessary to prevent these complications. Aim: To ...
The median urinary iodine level was 56 4g/L that indicates iodine deficiency. Out of 389 households in the study area, 277 (71.2%) were using non-iodinated salt, 102 (26.2%) of the households were using iodinated salt. Cabbage usage was significantly associated with goiter. CONCLUSION: Endemic goiter is quite ...
Children are the most nutritionally vulnerable group of society as children are dependants and they are also at a critical stage of the growing process. They need adequate vitamin A, zinc, iron and iodine for their development and school performance. Most often iron deficiency causes anaemia with resultant fatigue and low ...
Vitamin A (VA) deficiency (VAD) is a major nutritional public health problem among children under-5-years-old in the developing world including Kenya. A community-based cross-sectional survey among 1,630 children (aged 6-23 mos) was undertaken in Western Kenya. A questionnaire was administered to collect ...
Background: Glucose-6-phosphate dehydrogenase (G6PD) is a house keeping enzyme which catalyzes the first step in the hexose monophosphate pathway of glucose metabolism. G6PD deficiency is the commonest hemolytic X-linked genetic disease, which affects approximately 400 million people worldwide.
The median urinary iodine concentration (MUIC) was 248.5μg/l and the Interquartile Range (IQR) was 145 – 380 μg/L. These results indicated that Iodine Deficiency was not of public health concern among children in Zambia at the time of this study. However, the proportion of households with access to adequately iodised ...
Micronutrient malnutrition and food insecurity are widespread global public health problems. Micronutrient deficiencies affect one-third of the global population. Household food insecurity, often results in monotonous diets, a contributing factor to malnutrition. Consuming a varied diet comprised of
van der Hoeven, Marinka; Faber, Mieke; Osei, Jennifer; Kruger, Annamarie; Smuts, Cornelius M
A randomized controlled trial was conducted to assess the effect of African leafy vegetable (ALV) consumption on Fe, Zn and vitamin A status in children. Children were randomly allocated to receive either a 300 g cooked ALV dish and school meal starch (n 86) or the normal school meal (n 81) five times per week for three months. ALV in the dish consisted mainly of Amaranthus cruentus (at least 80 %) and the remainder of Cleome gynandra, Cucurbita maxima or Vigna unguiculata. Nutrient content and consumer acceptance of the ALV dish were also determined. North West Province, South Africa. Grade R to grade 4 children (6-12 years old) of two farm schools. The ALV dish contributed 11·6-15·8 mg Fe and 1·4-3·7 mg Zn. At baseline, prevalence of deficiencies in the intervention group was 16·0 %, 16·3 %, 7·0 % and 75·6 %, respectively, for anaemia (Hb<11·5 g/dl), Fe (serum ferritin<15 µg/l), vitamin A (serum retinol<20 μg/dl) and Zn (serum Zn<65 μg/dl); and in the control group 10·5 %, 18·5 %, 2·5 % and 75·3 %, respectively. No significant estimated intervention effect was found. This randomized controlled trial showed that ALV were unable to improve serum retinol, serum ferritin or Hb if there are only mild deficiencies present. Furthermore, despite the low Zn status in the study population, ALV consumption did not improve serum Zn concentrations either.
Gletsu-Miller, N; Broderius, M; Frediani, J K; Zhao, V M; Griffith, D P; Davis, S S; Sweeney, J F; Lin, E; Prohaska, J R; Ziegler, T R
The frequency of copper deficiency and clinical manifestations following roux-en-y gastric bypass (RYGB) surgery is not yet clear. Objectives were to determine the prevalence and incidence of copper deficiency in patients who have undergone RYGB. We sought to determine the number of RYGB patients undergoing medical and nutritional follow-up visits at the Emory Bariatric Center who experienced copper deficiency and associated hematological and neurological complaints (n=136). Separately, in patients followed longitudinally before and during 6 and 24 months following RYGB surgery, we obtained measures of copper status (n=16). Systemic blood cell counts and measures of copper, zinc and ceruloplasmin were determined using standardized assays in reference laboratories including atomic absorption spectrometry and immunoassays. Thirteen patients were identified to have copper deficiency suggesting a prevalence of copper deficiency of 9.6%, and the majority of these had concomitant complications including anemia, leukopenia and various neuro-muscular abnormalities. In the longitudinal study, plasma copper concentrations and ceruloplasmin activity decreased over 6 and 24 months following surgery, respectively (Pdeficiency in these subjects was determined to be 18.8%. The prevalence and incidence of copper deficiency following RYGB surgery was determined to be 9.6% and 18.8%, respectively, with many patients experiencing mild-to-moderate symptoms. Given that copper deficiency can lead to serious and irreversible complications if untreated, frequent monitoring of the copper status of RYGB patients is warranted.
Few zinc-rich sources appeared in the diet that was predominantly plant-based. Mean dietary zinc intake was 4.6±2.2 mg/day. The mean value of serum zinc was 66.4±21.5 μg/dL, with 46% of the children having values less than the 70 μg/dL cutoff. The findings indicate a high risk of zinc deficiency and suboptimal zinc ...
Moosazadeh, Mahmood; Amiresmaili, Mohammadreza; Aliramezany, Maryam
Search results show that numerous primary studies have been carried out in different parts of Iran regarding prevalence of G6PD deficiency; if results of these studies are combined, a reliable estimation of prevalence of this factor will be achieved in Iran. Thus, present study, aimed to determine the prevalence of G6PD deficiency by combining findings of qualified primary studies using meta-analysis and taking into account heterogeneity considerations. Searching the relevant keywords in Iranian and International databases, primary studies were selected. After quality appraisal and applying inclusion and exclusion criteria, relevant primary studies were selected. In each study, standard error of prevalence of G6PD was calculated according to binominal distribution formula. Finally, heterogeneity index was determined among studies using Cochran's test. Prevalence of G6PD in Iran was estimated by STATA software ver 11 using fixed or random effect model based on heterogeneity results. 148916 subjects in 36 primary studies which entered this meta-analysis were examined. G6PD deficiency prevalence was 6.7% in Iran (men: 8.8% and women: 2.2%). Also, this deficiency in the present study was four times higher in men than in women. Its prevalence was adjusted in different parts of Iran and it was shown that it was between 0.8 and 15.2 using Bayesian analysis. This meta-analysis showed that Iran is among countries with high frequency of G6PD deficiency and there is a significant difference in prevalence of G6PD in different parts of Iran. According to these results, screening newborn children seems very vital. Carrying out other primary studies regarding prevalence of G6PD seems unnecessary.
Full Text Available Search results show that numerous primary studies have been carried out in different parts of Iran regarding prevalence of G6PD deficiency; if results of these studies are combined, a reliable estimation of prevalence of this factor will be achieved in Iran. Thus, present study, aimed to determine the prevalence of G6PD deficiency by combining findings of qualified primary studies using meta-analysis and taking into account heterogeneity considerations. Searching the relevant keywords in Iranian and International databases, primary studies were selected. After quality appraisal and applying inclusion and exclusion criteria, relevant primary studies were selected. In each study, standard error of prevalence of G6PD was calculated according to binominal distribution formula. Finally, heterogeneity index was determined among studies using Cochran's test. Prevalence of G6PD in Iran was estimated by STATA software ver 11 using fixed or random effect model based on heterogeneity results. 148916 subjects in 36 primary studies which entered this meta-analysis were examined. G6PD deficiency prevalence was 6.7% in Iran (men: 8.8% and women: 2.2%. Also, this deficiency in the present study was four times higher in men than in women. Its prevalence was adjusted in different parts of Iran and it was shown that it was between 0.8 and 15.2 using Bayesian analysis. This meta-analysis showed that Iran is among countries with high frequency of G6PD deficiency and there is a significant difference in prevalence of G6PD in different parts of Iran. According to these results, screening newborn children seems very vital. Carrying out other primary studies regarding prevalence of G6PD seems unnecessary.
Kuriyan, Rebecca; Thankachan, Prashanth; Selvam, Sumithra; Pauline, Maria; Srinivasan, K; Kamath-Jha, Shilpa; Vinoy, Sophie; Misra, Situn; Finnegan, Yvonne; Kurpad, Anura V
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
Full Text Available Objective. To determine the prevalence of anemia and iron status among Chilean women of childbearing age between 1981 and 2010. Materials and methods. Calculation of the prevalence of anemia and iron status was based on multiple cross-sectional iron absorption studies performed in 888 women during this period of time. All studies included measurements of hemoglobin, mean corpuscular volume, zinc protoporphyrin, percentage of transferrin saturation and serum ferritin. Data were grouped by decade (1981-1990,1991-2000, and 2001-2010. Results. Prevalence of anemia for these decades was 9, 6 and 10%, respectively (p=NS. Iron deficiency anemia was the main cause of anemia in all periods (55, 85 and 75%, respectively; p=NS. A high prevalence of women with normal iron status was observed for all periods (64, 69, and 67, respectively; p=NS. Prevalence of iron deficiency without anemia in 1981-1990, 1991-2000 and 2001-2010 was 7, 20 and 12%, respectively (p menor que 0.05. Finally, prevalence of iron depleted stores was 20, 6 and 10%, respectively (p menor que 0.05. Conclusions. Prevalence of iron deficiency anemia in Chilean women of childbearing age was mild between 1981 and 2010. More than 60% of childbearing age women presented normal iron status in all periods. However, prevalence of iron depleted stores was moderate during 1981-1990, and was mild during 1991-2000 and 2001-2010.
Makurat, Jan; Friedrich, Hanna; Kuong, Khov; Wieringa, Frank T; Chamnan, Chhoun; Krawinkel, Michael B
Concerns about the nutritional status of Cambodian garment workers were raised years ago but data are still scarce. The objectives of this study are to examine the nutritional, hemoglobin and micronutrient status of female workers in a garment factory in Phnom Penh, Cambodia, and to assess if body mass index is associated with hemoglobin and/or micronutrient status. A cross-sectional survey was conducted among 223 female workers (nulliparous, non-pregnant) at a garment factory in Phnom Penh. Anthropometric measurements were performed and blood samples were taken to obtain results on hemoglobin, iron, vitamin A, vitamin B12 and inflammation status (hemoglobinopathies not determined). Bivariate correlations were used to assess associations. Overall, 31.4% of workers were underweight, 26.9% showed anemia, 22.1% showed iron deficiency, while 46.5% had marginal iron stores. No evidence of vitamin A or vitamin B12 deficiency was found. Body mass index was associated with serum ferritin (negative) and serum retinol-binding protein (positive) concentrations, but not strongly. A comparison between underweight and not underweight workers resulted in distinctions for iron deficiency and iron deficiency anemia, with a higher prevalence among not underweight. The prevalence of underweight, anemia and poor iron status was high. Young and nulliparous female garment workers in Cambodia might constitute a group with elevated risk for nutritional deficiencies. Strategies need to be developed for improving their nutritional, micronutrient and health status. The poor iron status seems to contribute to the overall prevalence of anemia. Low hemoglobin and iron deficiency affected both underweight and those not underweight. Despite the fact that body mass index was negatively associated with iron stores, true differences in iron status between underweight and not underweight participants cannot be confirmed.
Full Text Available Background: Concerns about the nutritional status of Cambodian garment workers were raised years ago but data are still scarce. The objectives of this study are to examine the nutritional, hemoglobin and micronutrient status of female workers in a garment factory in Phnom Penh, Cambodia, and to assess if body mass index is associated with hemoglobin and/or micronutrient status. Methods: A cross-sectional survey was conducted among 223 female workers (nulliparous, non-pregnant at a garment factory in Phnom Penh. Anthropometric measurements were performed and blood samples were taken to obtain results on hemoglobin, iron, vitamin A, vitamin B12 and inflammation status (hemoglobinopathies not determined. Bivariate correlations were used to assess associations. Results: Overall, 31.4% of workers were underweight, 26.9% showed anemia, 22.1% showed iron deficiency, while 46.5% had marginal iron stores. No evidence of vitamin A or vitamin B12 deficiency was found. Body mass index was associated with serum ferritin (negative and serum retinol-binding protein (positive concentrations, but not strongly. A comparison between underweight and not underweight workers resulted in distinctions for iron deficiency and iron deficiency anemia, with a higher prevalence among not underweight. Conclusions: The prevalence of underweight, anemia and poor iron status was high. Young and nulliparous female garment workers in Cambodia might constitute a group with elevated risk for nutritional deficiencies. Strategies need to be developed for improving their nutritional, micronutrient and health status. The poor iron status seems to contribute to the overall prevalence of anemia. Low hemoglobin and iron deficiency affected both underweight and those not underweight. Despite the fact that body mass index was negatively associated with iron stores, true differences in iron status between underweight and not underweight participants cannot be confirmed.
Komatsu, Fumio; Kagawa, Yasuo; Kawabata, Terue; Kaneko, Yoshinori; Kudoh, Hideki; Purvee, Baatar; Otgon, Jugder; Chimedregzen, Ulziiburen
Parkinson's disease and other neurological disorders are prevalent in Mongolia. Our previous studies revealed a significant correlation of these diseases with high oxidative stress due to a high body burden of harmful metals, such as manganese, iron, lead, cadmium, and aluminum. This report describes a 37-year-old male Mongolian patient with multiple sclerosis and essential micronutrient deficiency. This patient demonstrated high oxidative stress, as shown by high urinary 8-hydroxy-2'-deoxyguanosine levels of 14.7 and 14.3 ng/mg creatinine (crea), although his hair levels of these toxic metals were markedly lower than other Mongolians. In addition, this patient was deficient not only in various essential minerals, including selenium, magnesium, copper, cobalt, vanadium, and nickel, but also in micronutrients such as vitamin B6, C, E, folic acid, niacin, and β-carotene. Furthermore, after taking 2,3-dimercaptosuccinic acid, a chelating agent, urinary excretion of lead, cadmium, manganese, aluminum, iron, copper, and lithium were increased 156-, 8.4-, 7.6-, 4.3-, 3.3-, 2.1-, and 2.1-fold, respectively. These results suggest that this patient suffered from a deficiency in micronutrients such as essential minerals and vitamins, which resulted in a disturbance in the ability to excrete harmful metals into the urine and hair. It is possible that a deficiency of micronutrients and a high burden of heavy metals play a role in the pathogenesis of multiple sclerosis. Nutritional treatment may be an effective approach to this disease.
Background: Anaemia is a public health problem affecting children with potential consequences on physical and mental development. Children living in resource poor countries where micro-nutrient deficiency and infections are prevalent are mostly affected. Objective: To determine the prevalence of anaemia in a rural ...
Robalo Nunes, António; Fonseca, Cândida; Marques, Filipa; Belo, Aurora; Brilhante, Dialina; Cortez, José
The present study aimed to characterize the prevalence of anemia and iron deficiency in older Portuguese adults, and to compare it with the prevalence in younger individuals. A population-based, cross-sectional study (EMPIRE study) enrolling a representative sample of 6267 adults aged Portuguese adults, particularly among those aged ≥80 years. Better diagnosis, prevention and treatment strategies should be implemented taking into account the outstanding role of iron deficiency in older Portuguese adults, the differences between regions and the intrinsic characteristics of this population. Geriatr Gerontol Int 2017; 17: 1814-1822. © 2017 Japan Geriatrics Society.
Kotepui, Manas; Uthaisar, Kwuntida; PhunPhuech, Bhukdee; Phiwklam, Nuoil
This study aimed to evaluate the prevalence and alteration of hematological parameters in malaria patients with a glucose-6-phosphate dehydrogenase (G6PD) deficiency, in the western region of Thailand, an endemic region for malaria. Data about patients with malaria hospitalized between 2013 and 2015 were collected. Clinical and sociodemographic characteristics such as age and gender, diagnosis on admission, and parasitological results were mined from medical records of the laboratory unit of the Phop Phra Hospital in Tak Province, Thailand. Venous blood samples were collected at the time of admission to hospital to determine G6PD deficiency by fluorescence spot test and detect malaria parasites by thick and thin film examination. Other data such as complete blood count and parasite density were also collected and analyzed. Among the 245 malaria cases, 28 (11.4 %) were diagnosed as Plasmodium falciparum infections and 217 cases (88.6 %) were diagnosed as P. vivax infections. Seventeen (6.9 %) patients had a G6PD deficiency and 228 (93.1 %) patients did not have a G6PD deficiency. Prevalence of male patients with G6PD deficiency was higher than that of female patients (P G6PD deficiency, two (11.8 %) were infected with P. falciparum, while the remaining were infected with P. vivax. Malaria patients with a G6PD deficiency have higher monocyte counts (0.6 × 10(3)/μL) than those without a G6PD deficiency (0.33 × 10(3)/μL) (P G6PD deficiency have high monocyte counts. The association between G6PD status and monocyte counts was independent of age, gender, nationality, Plasmodium species, and parasite density (P G6PD deficiency in a malaria-endemic area. This study also supported the assertion that patients with G6PD-deficient red blood cells had no protection against the P. falciparum infection. In addition, malaria patients with a G6PD deficiency had higher monocyte counts than those without a G6PD deficiency. These findings will help to recognize and
Pål A Olsvik
Full Text Available This work studies final nutritional status and transcriptional responses of rainbow trout (Oncorhynchus mykiss Walbaum 1792 (28 g after a 10 week feeding experiment designed to elucidate the effect of adding a vitamin and mineral premix on growth, health, and nutritional endpoints. Juvenile fish were fed a either a diet supplemented with a vitamin and mineral premix (Diet S or the same diet without premix supplementation (Diet U. The analyzed micronutrient composition of diets differed accordingly. Pooled livers from 15 fish from each dietary group were used to create suppression subtractive hybridization (SSH cDNA libraries that were sequenced with 454 FLX GS Titanium Technology. In total 552 812 reads were sequenced from the two cDNA libraries. Ingenuity pathway analysis (IPA was then used to characterize the hepatic transcriptome of the two dietary groups of rainbow trout. In the present communication we discuss how selected micronutrients may affect the transcriptome at suboptimal status by directly impacting the cellular metabolism, functions, and structures, and by introducing respective compensatory mechanisms. Processes related to lipid metabolism, peptide hydrolysis, oxygen transportation, and growth development were mostly affected. Considering the transcriptomics data relative to changes in nutritional status from the feeding study and the background phenotypic outcome of growth performance and gill histopathology, the outcome of the transcriptional profiling are suggested to be mainly related to suboptimal pantothenic acid and vitamin C nutrition.
Mearin, Fermín; Barreiro-de Acosta, Manuel; González-Galilea, Ángel; Gisbert, Javier P; Cucala, Mercedes; Ponce, Julio
To determine the prevalence and characteristics of anemia and iron deficiency in patients hospitalized for gastrointestinal diseases. An epidemiological, multicenter, mixed design study (retrospective review of randomized clinical records and prospective visits) conducted between February 2010 and March 2011 in 22 Spanish gastroenterology departments. Severe anemia was defined as Hb < 10g/dL, mild/moderate as Hb ≥ 10g/dL, and iron deficiency as ferritin < 30ng/ml or transferrin saturation < 16%. We included 379 patients. The mean±SD age was 57±19 years and 47% were men. The prevalence of anemia at admission was 60% (95% CI 55 to 65), and anemia was severe (Hb <10g/dl) in half the patients. The prevalence of iron deficiency was 54% of evaluable patients (95% CI 47 to 61). Gastrointestinal bleeding at admission was found in 39% of the patients, of whom 83% (121/146) were anemic. At discharge, the proportion of anemic patients was unchanged (from 60% at admission to 58% at discharge) (95% CI 53 to 63) and iron deficiency was found in 41% (95% CI 32 to 50): anemia was severe in 17% and mild/moderate in 41%. During follow-up, at 3-6 months after admission, 44% (95% CI 39 to 50) of evaluable patients continued to have iron deficiency and 28% (95% CI 23 to 32) were still anemic: 5% severe and 23% mild/moderate. The prevalence of iron deficiency was 44% (95% CI: 39-50). During admission, 50% of patients with anemia did not receive treatment. At discharge, 55% were untreated. The prevalence of anemia in patients hospitalized for gastroenterological diseases was very high. Anemia persisted in over a quarter of patients at the follow-up visit. Only half of hospitalized patients received treatment for anemia, even when the anemia was severe. Copyright © 2013 Elsevier España, S.L. y AEEH y AEG. All rights reserved.
Ana Rita Gomes
Full Text Available Abstract Background The prevalence of hypogonadism in HIV-infected patients is still a matter of debate as there is no standardized consensual diagnostic method. In addition, the etiology and endocrine/metabolic implications of hypogonadism in this population remain controversial. This study aims to determine the prevalence of testosterone deficiency in a single-site hospital and to evaluate its association with potential risk factors, lipodystrophy, metabolic syndrome, and cardiovascular risk. Methods This study analyzed 245 HIV-infected men on combined antiretroviral therapy. Patients with low total testosterone (TT levels (<2.8 ng/mL and/or low calculated free testosterone (FT levels (<6.5 ng/dL were considered testosterone deficient. According to their LH and FSH levels, patients were classified as having hypogonadotropic or hypergonadotropic dysfunction. Other clinical, anthropometric, and analytic parameters were also collected and analyzed. Results The prevalence of testosterone deficiency in our population was 29.4 %. Among them, 56.9 % had hypogonadotropic dysfunction and 43.1 % presented with hypergonadotropic dysfunction. Patients with testosterone deficiency were older (p < 0.001, had higher HbA1c levels (p = 0.016 and higher systolic blood pressure (p = 0.007. Patients with lower testosterone levels had higher prevalence of isolated central fat accumulation (p = 0.015 and had higher median cardiovascular risk at 10 years as measured by the Framingham Risk Score (p = 0.004 and 10-Year ASCVD risk (p = 0.002. Conclusions The prevalence of testosterone deficiency in this HIV population is high, with hypogonadotropic dysfunction being responsible for the majority of cases. Testosterone deficiency might predispose to, or be involved, in the pathogenesis of HIV-associated lipodystrophy. Patients with low testosterone levels have higher cardiovascular risk, highlighting the importance of early diagnosis of this
Full Text Available Introduction: Zinc deficiency is a health problem in many communities, especially among children because of growth spurt. Zinc deficiency can cause;growth limitation, delay in sexuel maturity, behavior disorders and abnormalities of immune system,susceptibility to respiratory and gasterointestinal infections and impairment of taste and smell perception. Material and Method: One of the methods of assessment the zinc defeciency is “ Zinc taste test” using zinc sulfate solution 0.1% , this test performed used to assess the zinc deficiency among preshool childeren in Yazd. The results were evaluated with measurments of weight,height and demographic data. 400 preschool children were selected by multi stage random sampling.Having good taste perception of zinc sulfate 0.1% was used as impaired taste test ( zinc deficiency and having bad taste perception as normal zinc level. Results: Regarding to zinc taste test 73.9% of study group had zinc deficiency (77.6%femal, 69.7% male There were no significant relation between zinc deficiency and measurment of weight and height,but there was higher prevalence of zinc deficiency in children who were below the 5th percentile in height and weight by age. Conclusion: 70% of preschool children in yazd had zinc deficiency assessed by “ zinc taste test”,31% of adolecents in Tehran have had zinc deficiency based on plasma , erythrocyte and hairindex. There is no significant relation between zinc deficiency and antropometric and demographic data, in this study and the study that had been done on adolescents in Tehran.Considering the prevalnce of zinc deficiency with “ Zinc taste test” ;it seems more accurate studies need to be done like zinc measurment in WBC,RBC and Platelets and zinc taste test at the same time,if correlation coefficients between zinc taste test and other tests were very strong , we can used zinc tase test in the different age for assessment of zinc body.
Feeding micro-nutrient mixture B improved energy efficiency. It was concluded that the poor performance and the poor energy efficiency of C-fed broilers was as a result of the micronutrient imbalance of the mixture since the mixture is deficient in Zinc and four B-vitamins that affect energy utilization. It also contains ...
The global control of micronutrient deficiencies is a realistic goal, notwithstanding the magnitude of the task and the many challenges and constraints that remain to be resolved. The - '. development of successful programmes for micronutrient fortification of foods calls for active collaboration between several sectors: the ...
The role of some micronutrients (eldervit) in the management of anaemic pregnant Nigerian women: A preliminary report. ... Although, the commonest cause of anaemia in pregnancy is iron deficiency, the enormous contributions of other micronutrients have been underestimated. As a result, the need to identify relevant ...
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 ...
Deb, D.L.; Sachdev, P.; Rattan, R.K.
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
Full Text Available Primary empty sella (PES is a particular anatomical condition characterized by the herniation of liquor within the sella turcica. The pathogenesis of this alteration, frequently observed in general population, is not yet completely understood. Recently reports demonstrated, in these patients, that hormonal pituitary dysfunctions, specially growth hormone (GH/insulin-like growth factor (IGF-I axis ones, could be relevant. The aim of this paper is to evaluate GH/IGF-I axis in a group of adult patients affected by PES and to verify its clinical relevance. We studied a population of 28 patients with a diagnosis of PES. In each patient we performed a basal study of thyroid, adrenal and gonadal - pituitary axis and a dynamic evaluation of GH/IGF-I after GH-releasing hormone (GHRH plus arginine stimulation test. To evaluate the clinical significance of GH/IGF-I axis dysfunction we performed a metabolic and bone status evaluation in every patients. We found the presence of GH deficit in 11 patients (39.2 %. The group that displayed a GH/IGF-I axis dysfunction showed an impairment in metabolic profile and bone densitometry. This study confirms the necessity to screen the pituitary function in patients affected by PES and above all GH/IGF-I axis. Moreover the presence of GH deficiency could be clinically significant.
Spínola, Carla; Bruges-Armas, Jácome; Pereira, Conceição; Brehm, António; Spínola, Hélder
Alpha-1-antitrypsin (AAT) deficiency is a common genetic disease which affects both lung and liver. Early diagnosis can help asymptomatic patients to adjust their lifestyle choices in order to reduce the risk of Chronic Obstructive Pulmonary Disease (COPD). The determination of this genetic deficiency prevalence in Madeira Island (Portugal) population is important to clarify susceptibility and define the relevance of performing genetic tests for AAT on individuals at risk for COPD. Two hundred samples of unrelated individuals from Madeira Island were genotyped for the two most common AAT deficiency alleles, PI*S and PI*Z, using Polymerase Chain Reaction-Mediated Site-Directed Mutagenesis. Our results show one of the highest frequencies for both mutations when compared to any already studied population in the world. In fact, PI*S mutation has the highest prevalence (18%), and PI*Z mutation (2.5%) was the third highest worldwide. The frequency of AAT deficiency genotypes in Madeira (PI*ZZ, PI*SS, and PI*SZ) is estimated to be the highest in the world: 41 per 1000. This high prevalence of AAT deficiency on Madeira Island reveals an increased genetic susceptibility to COPD and suggests a routine genetic testing for individuals at risk.
A multiple micronutrient-fortified drink could be an effective strategy to combating micronutrient deficiencies in school-going children. Our objective was to assess the efficacy of a multiple micronutrient-fortified drink in reducing iron deficiency (ID), ID anemia (IDA), anemia and improving micro...
Rosenberg, EH; Almeida, LS; Kleefstra, T; deGrauw, RS; Yntema, HG; Bahi, N; Moraine, C; Ropers, HH; Fryns, JP; deGrauw, TJ; Jakobs, C; Salomons, GS
A novel X-linked mental retardation (XLMR) syndrome was recently identified, resulting from creatine deficiency in the brain caused by mutations in the creatine transporter gene, SLC6A8. We have studied the prevalence of SLC6A8 mutations in a panel of 290 patients with nonsyndromic XLMR archived by
Halbmayer, W M; Haushofer, A; Schön, R; Mannhalter, C; Strohmer, E; Baumgarten, K; Fischer, M
Factor XII (FXII) deficiency has been reported to be a risk factor for the development of arterial and venous thromboembolism. However, no data are available on the prevalence of FXII deficiency within the normal population. Measuring APTT and FXII activity, seven FXII deficiencies could be detected among 300 healthy blood donors. This corresponds to an incidence of FXII deficiency of 2.3%. On the basis of these data the prevalence of severe and mild FXII deficiency in the normal population can be estimated to be 1.5-3.0%. Assessment of FXII antigen levels revealed, that all seven FXII deficient individuals had FXII antigen levels matching the activity. One presented a severe FXII deficiency (1/300, 0.3%) without detectable FXII activity and an APTT prolongation of more than 120 s. The remaining six FXII deficiencies (6/300, 2.0%) were moderate variations with FXII activities ranging from 20-45% and less prolonged APTTs. Among the 300 healthy donors 16 (5.3%) subjects with prolonged APTTs were identified. Causes for APTT-prolongation were FXII deficiency (7/16), lupus anticoagulant (6/16), mild FVIII deficiency (1/16) and hepatic disorder (1/16). In the remaining sample (1/16) the cause for the prolongation of the APTT remained unexplained. Although 8.7% (26/300) of the donors had a positive family-history of thromboembolism (TE-FHx), none of the FXII deficient subjects were among those with positive TE-FHx.
Imane El Menchawy
Full Text Available Iron deficiency constitutes a major public health problem in Morocco, mainly among women and children. The aim of our paper is to assess the efficacy of consumption of multiple micronutrients (MMN fortified milk on iron status of Moroccan schoolchildren living in rural region. Children (N=195, aged 7 to 9 y, were recruited from schools and divided into two groups: the nonfortified group (NFG received daily a nonfortified Ultra-High-Temperature (UHT milk and the fortified group received (FG daily UHT milk fortified with multiple micronutrients including iron sulfate. Blood samples were collected at baseline (T0 and after 9 months (T9. Hemoglobin (Hb was measured in situ by Hemocue device; ferritin and C Reactive Protein were assessed in serum using ELISA and nephelometry techniques, respectively. Results were considered significant when the p value was <0.05. At T9 FG showed a reduction of iron deficiency from 50.9% to 37.2% (p=0.037. Despite the low prevalence of iron deficiency anemia (1.9%; more than 50% of children in our sample suffered from iron deficiency at baseline. The consumption of fortified milk reduced the prevalence of iron deficiency by 27% in schoolchildren living in high altitude rural region of Morocco. Clinical Trial Registration. Our study is registered in the Pan African Clinical Trial Registry with the identification number PACTR201410000896410.
Maaike J. Bruins
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.
Amini, F; Ismail, E; Zilfalil, B-A
This study aims to define the prevalence and the molecular basis of G6PD deficiency in the Negrito tribe of the Malaysian Orang Asli. Four hundred and eighty seven consenting Negrito volunteers were screened for G6PD deficiency through the use of a fluorescent spot test. DNA from deficient individuals underwent PCR-RFLP analysis using thirteen recognized G6PD mutations. In the instances when the mutation could not be identified by PCR-RFLP, the entire coding region of the G6PD gene was subjected to DNA sequencing. In total, 9% (44/486) of the sample were found to be G6PD-deficient. However, only 25 samples were subjected to PCR-RFLP and DNA sequencing. Of these, three were found to carry Viangchan, one Coimbra and 16, a combination of C1311T in exon 11 and IVS11 T93C. Mutation(s) for the five remaining samples are unknown. The mean G6PD enzyme activity ranged 5.7 IU/gHb in deficient individuals. Our results demonstrate that the frequency of G6PD deficiency is higher among the Negrito Orang Asli than other Malaysian races. The dual presence of C1311T and IVS11 T93C in 64% of the deficient individuals (16/44) could well be a result of genetic drift within this isolated group. © 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.
Yun, Chunfeng; Chen, Jing; He, Yuna; Mao, Deqian; Wang, Rui; Zhang, Yu; Yang, Chun; Piao, Jianhua; Yang, Xiaoguang
To evaluate vitamin D deficiency prevalence and risk factors among pregnant Chinese women. A descriptive cross-sectional analysis. China National Nutrition and Health Survey (CNNHS) 2010-2013. A total of 1985 healthy pregnant women participated. Possible predictors of vitamin D deficiency were evaluated via multiple logistic regression analyses. The median serum 25-hydroxyvitamin D level was 15·5 (interquartile range 11·9-20·0, range 3·0-51·5) ng/ml, with 74·9 (95 % CI 73·0, 76·7) % of participants being vitamin D deficient (25-hydroxyvitamin D D deficiency was positively correlated with Hui ethnicity (P=0·016), lack of vitamin D supplement use (P=0·021) and low ambient UVB level (PD deficiency was related to Hui ethnicity (P=0·012) and low ambient UVB level (PD deficiency was correlated with younger age (P=0·050), later gestational age (P=0·035), higher pre-pregnancy BMI (P=0·019), low ambient UVB level (PD supplement use (P=0·007). Vitamin D deficiency is prevalent among pregnant Chinese women. Residing in areas with low ambient UVB levels increases the risk of vitamin D deficiency, especially for women experiencing advanced stages of gestation, for younger pregnant women and for women of Hui ethnicity; therefore, vitamin D supplementation and sensible sun exposure should be encouraged, especially in the winter months. Further studies must determine optimal vitamin D intake and sun exposure levels for maintaining sufficient vitamin D levels in pregnant Chinese women.
Warny, Marie; Klausen, Tobias Wirenfeldt; Petersen, Jesper
Similar to the thalassaemia syndromes, glucose-6-phosphate dehydrogenase (G6PD) deficiency is highly prevalent in areas historically exposed to malaria. In the present study, we used quantitative and molecular methods to determine the prevalence of G6PD deficiency in a population of 1508 immigran...
Liu, Rong; Luo, Lan; Yang, Yuling; Zhang, Lu; Liu, Huaie; Zhang, Wen; Fan, Zhixiang; Yang, Zhaoqing; Cui, Liwang; He, Yongshu
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked hereditary disease that predisposes red blood cells to oxidative damage. G6PD deficiency is particularly prevalent in historically malaria-endemic areas. Use of primaquine for malaria treatment may result in severe hemolysis in G6PD deficient patients. In this study, we systematically evaluated the prevalence of G6PD deficiency in the Kachin (Jingpo) ethnic group along the China-Myanmar border and determined the underlying G6PD genotypes. We surveyed G6PD deficiency in 1770 adult individuals (671 males and 1099 females) of the Kachin ethnicity using a G6PD fluorescent spot test. The overall prevalence of G6PD deficiency in the study population was 29.6% (523/1770), among which 27.9% and 30.6% were males and females, respectively. From these G6PD deficient samples, 198 unrelated individuals (147 females and 51 males) were selected for genotyping at 11 known G6PD single nucleotide polymorphisms (SNPs) in Southeast Asia (ten in exons and one in intron 11) using a multiplex SNaPshot assay. Mutations with known association to a deficient phenotype were detected in 43.9% (87/198) of cases, intronic and synonymous mutations were detected alone in 34.8% (69/198) cases and no mutation were found in 21.2% (42/198) cases. Five non-synonymous mutations, Mahidol 487G>A, Kaiping 1388G>A, Canton 1376G>T, Chinese 4 392G>T, and Viangchan 871G>A were detected. Of the 87 cases with known deficient mutations, the Mahidol variant was the most common (89.7%; 78/87), followed by the Kaiping (8.0%; 7/87) and the Viangchan (2.2%; 2/87) variants. The Canton and Chinese 4 variants were found in 1.1% of these 87 cases. Among them, two females carried the Mahidol/Viangchan and Mahidol/Kaiping double mutations, respectively. Interestingly, the silent SNPs 1311C>T and IVS11nt93T>C both occurred in the same 95 subjects with frequencies at 56.4% and 23.5% in tested females and males, respectively (PT/IVS11nt93T>C SNPs. Further
Full Text Available Ignacio Jáuregui-Lobera Department of Nutrition and Bromatology, Pablo de Olavide University, Seville, Spain Abstract: Micronutrient deficiencies, especially those related to iodine and iron, are linked to different cognitive impairments, as well as to potential long-term behavioral changes. Among the cognitive impairments caused by iron deficiency, those referring to attention span, intelligence, and sensory perception functions are mainly cited, as well as those associated with emotions and behavior, often directly related to the presence of iron deficiency anemia. In addition, iron deficiency without anemia may cause cognitive disturbances. At present, the prevalence of iron deficiency and iron deficiency anemia is 2%–6% among European children. Given the importance of iron deficiency relative to proper cognitive development and the alterations that can persist through adulthood as a result of this deficiency, the objective of this study was to review the current state of knowledge about this health problem. The relevance of iron deficiency and iron deficiency anemia, the distinction between the cognitive consequences of iron deficiency and those affecting specifically cognitive development, and the debate about the utility of iron supplements are the most relevant and controversial topics. Despite there being methodological differences among studies, there is some evidence that iron supplementation improves cognitive functions. Nevertheless, this must be confirmed by means of adequate follow-up studies among different groups. Keywords: iron deficiency, anemia, cognitive functions, supplementation
Xanthakos, Stavra A.
The presence of nutritional deficiencies in overweight and obesity may seem paradoxical in light of excess caloric intake, but several micronutrient deficiencies appear to higher in prevalence in overweight and obese adults and children. Causes are multi-factorial and include decreased consumption of fruits and vegetables, increased intake of high calorie, but nutritionally poor quality foods, as well as increased adiposity which may influence the storage and availability of some nutrients. A...
Kim, Ki-Tack; Kang, Kyung-Chung; Shin, Dong-Eun; Lee, Sang-Hoon; Lee, Jung-Hee; Kwon, Tae-Yoon
Vitamin D is considered essential for bone and muscle health, and some studies have demonstrated the positive effects of vitamin D on metabolic diseases and cancer. Nevertheless, a high prevalence of vitamin D deficiency has been reported in various populations, regardless of country or race. However, no studies regarding the prevalence of vitamin D deficiency in Korean orthopedic patients currently exist. This cross-sectional study included 272 male and 937 female patients aged 50 years and older who were consecutively admitted to the authors' orthopedic department. Vitamin D (25-hydroxy vitamin D), bone turnover markers (osteocalcin, c-telopeptide), and bone mineral density were measured. The prevalence of vitamin D deficiency and its association with other factors were evaluated. Mean patient age was 67.2 ± 8.9 years, and mean level of vitamin D was 16.1 ± 9.1 ng/mL. Overall, 91.2% of patients had deficient (orthopedic patients of this region was extremely low, regardless of sex and age. Although vitamin D was not directly associated with bone mineral density, there were significant associations between vitamin D and other factors related to bone health and metabolic diseases. Copyright 2015, SLACK Incorporated.
Ebru Yilmaz Keskin
Results: Thirty-six (58.1% women had a low serum vitamin B12 level (9.99 and micro;mol/L. All of the 20 infants examined had normal neurodevelopmental findings. Vitamin B12 supplementation resulted in normalization of vitamin B12 and homocysteine levels in all the cases. Conclusion: The frequency of neonatal vitamin B12 deficiency secondary to maternal deficiency may be higher than thought in Samsun province of Turkey. Large-scale screening studies may reveal its prevalence more accurately, and may help in taking preventive measurements. [Cukurova Med J 2014; 39(4.000: 840-847
Laillou, Arnaud; Pham, Thuy Van; Tran, Nga Thuy; Le, Hop Thi; Wieringa, Frank; Rohner, Fabian; Fortin, Sonia; Le, Mai Bach; Tran, Do Thanh; Moench-Pfanner, Regina; Berger, Jacques
Background The 2000 Vietnamese National Nutrition Survey showed that the population's dietary intake had improved since 1987. However, inequalities were found in food consumption between socioeconomic groups. As no national data exist on the prevalence of micronutrient deficiencies, a survey was conducted in 2010 to assess the micronutrient status of randomly selected 1526 women of reproductive age and 586 children aged 6–75 mo. Principal Findings In women, according to international thresholds, prevalence of zinc deficiency (ZnD, 67.2±2.6%) and vitamin B12 deficiency (11.7±1.7%) represented public health problems, whereas prevalence of anemia (11.6±1.0%) and iron deficiency (ID, 13.7±1.1%) were considered low, and folate (population) or underweight occurred in 20% of women respectively highlighting the double burden of malnutrition. In children, a similar pattern was observed for ZnD (51.9±3.5%), anemia (9.1±1.4%) and ID (12.9±1.5%) whereas prevalence of marginal vitamin A status was also high (47.3±2.2%). There was a significant effect of age on anemia and ID prevalence, with the youngest age group (6–17 mo) having the highest risk for anemia, ID, ZnD and marginal vitamin A status as compared to other groups. Moreover, the poorest groups of population had a higher risk for zinc, anemia and ID. Conclusion The prevalence of anemia and ID in Vietnam has been markedly reduced over the last decade, but a large part of the population is still at risk for other deficiencies such as zinc, vitamin A, folate and vitamin B12 especially the youngest children aged 6–17 mo. Consequently specific interventions to improve food diversity and quality should be implemented, among them food fortification of staple foods and condiments and improvement of complementary feeding. PMID:22529954
Full Text Available Background: In India, 60-90% of adolescent suffer from anemia. Studies have documented folate, ferritin, and cobalamin deficiencies to be the major causes of nutritional anemia. However, limited data is available on the prevalence of folate, ferritin, and cobalamin deficiencies amongst adolescent from India. Objectives: The present study was carried out to find out the magnitude of folate, ferritin, and cobalamin deficiencies amongst adolescent of 11-18 years of age in National Capital Territory (NCT of Delhi, India. Materials and Methods: A cross-sectional, school-based study was conducted in NCT of Delhi, India in the year 2010-2011. About 347 adolescent belonging to low- (LIG, middle- (MIG, and high-income groups (HIG were selected using the probability proportionate to size (PPS sampling methodology. Serum ferritin, serum folate, and serum cobalamin levels were determined by the enzyme-linked immunosorbent assay (ELISA method, radioimmunoassay (RIA method, and radioisotopic method, respectively. Hemoglobin (Hb estimation was done by cyanmethemoglobin method in all the blood samples collected. Results: The prevalence of deficiency of ferritin in HIG, MIG, and LIG categories of adolescent was found to be 52.9, 67, and 58.8%, respectively. In the HIG, MIG, and LIG categories of adolescent, the prevalence of folate deficiency was 22.5, 40.4, and 52.2%, respectively. The prevalence of deficiency of cobalamin in HIG, MIG, and LIG categories of adolescent was 47.1, 80.7 and 87.5%, respectively. About 48, 66.1, and 68.4% of adolescent in the HIG, MIG, and LIG categories, respectively had Hb levels less than 12 g/dL and were found to be suffering from anemia. Conclusions: A high prevalence of anemia existed along with deficiency of ferritin, cobalamin, and folate amongst adolescent. The strategies for prevention of anemia amongst adolescent in India should also include cobalamin along with iron and folate supplementation for prevention and control of
Miri-Aliabad, Ghasem; Khajeh, Ali; Shahraki, Tooran
Introduction : Hepatitis A virus is the most prevalent viral hepatitis. It is globally a major public health problem with different clinical symptoms. This study aimed at investigating the clinical findings and prevalence of glucose 6-phosphate dehydrogenase (G6PD) deficiency in children with hepatitis A. Materials and Methods : In this prospective study, demographical information, clinical findings, and G6PD level of hepatitis A patients, who were visited at Pediatric Hematology clinic, were entered into the database. The diagnosis of hepatitis A infection was based on the presence of anti-HAV IgM antibody. The activity of G6PD enzyme was measured with florescent spot test. Results : Of the 117 children with hepatitis A, 52 (44.4%) were male and 65 (55.6%) were female. The mean age of these patients was 2.79±5.39 years. The most prevalent clinical manifestations were dark yellow urine and anorexia. G6PD deficiency was observed in 26 (26.3%) out of 99 patients whose G6PD levels were measured. Conclusion : Given the high prevalence of G6PD deficiency in this study, the measurement of G6PD level along with other liver and biochemical markers in areas with endemic hepatitis A is recommended. In addition, it is recommended that patients undertake precise monitoring for hemolysis and renal function.
Saghafi, Shiva; Pourpak, Zahra; Aghamohammadi, Asghar; Pourfathollah, Ali Akbar; Samadian, Azam; Farghadan, Maryam; Attarchi, Zohreh; Zeidi, Majid; Asgaripour, Fariba; Rajabi, Tajbakhsh; Kardar, Gholam Ali; Moin, Mostafa
Selective deficiency of immunoglobulin A (IgA) is the most frequent primary hypogammaglobulinemia. As some IgA-deficient patients have IgA antibodies in their plasma which may cause anaphylactic reactions, blood centers usually maintain a list of IgA-deficient blood donors to prepare compatible blood components. In this study we determined the incidence of selective IgA deficiency (SIgAD) in normal adult Iranian population. 13022 normal Iranian blood donors were included in this study. The assay which we used was adapted to the manual pipetting system and ELISA reader was used for screening. Other classes of immunoglobulins (G, M), as well as secretory IgA and IgG subclasses were tested in IgA deficient cases by ELISA. SPSS was used for statistical analysis.Among 13022 studied cases, 11608 blood donors were males (89.14%) and 1414 were females (10.86%). Their mean (+/-SD) age and weight were 38.5+/-11 years and 82+/-12 Kg respectively. Twenty of the screened samples were found by means of ELISA to be IgA-deficient (less than 5mg/dl), (frequency; 1:651). The data could indicate a compensation for IgA deficiency by serum IgM in one of our IgA deficient cases (Patient 5). We observed a correlation between IgG3 and serum IgA in deficient cases (r=0.498, P=0.025). Our results indicate that in present study the prevalence of S IgA D is in agreement with data from other Caucasians populations (from 1:300 to 1:700). In conclusion, Selective IgA Deficiency could be almost asymptomatic in most cases in general population. Our study suggests that; due to high frequency of IgA deficiency in Iran, it seems necessary to measure IgA levels for every blood donor and blood recipient to find IgA deficient cases.
Heine, G; Lahl, A; Müller, C; Worm, M
Vitamin D mediates immunomodulatory functions and its deficiency has been associated with an increased prevalence of immunological diseases including systemic lupus erythematosus (SLE). Chronic discoid or subacute cutaneous lupus erythematosus (CLE) are ultraviolet (UV)-triggered skin diseases. As vitamin D is mostly UV-derived and not from nutrition, its deficiency is frequent especially during the UV-deprived winter months. To compare the vitamin D status of patients with CLE with patients with type I allergy and healthy individuals during the summer or winter months. The vitamin D status of patients with CLE (n = 41) was compared with patients with type I allergy (n = 24), healthy individuals (n = 25) and a reference pool (n = 1951) by means of concentrations of circulating storage metabolite 25-hydroxyvitamin D in the summer and winter. Serum 25-hydroxyvitamin D concentrations were lower during the winter in the reference population, and type I allergic and healthy individuals (29.2–35.5 nmol L)1) compared with the summer months (56.3–89.8 nmol L)1) and paralleled by the prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D< 50 nmol L)1; winter: 70.8–73.4%, summer: 34.9–39.4%). In contrast, vitamin D deficiency in patients with CLE was prevalent throughout the year (summer: 85.7%,winter: 97.1%). In patients with CLE with concomitant prednisolone treatment, the 25-hydroxyvitamin D serum levels were comparable with (mean daily intake 877 IU) or without vitamin D supplementation during summer or winter (P = 0.75 and P = 0.14, respectively). Our data identify vitamin D deficiency in patients with CLE throughout the year and indicate that monitoring and correcting the vitamin D status should be considered to prevent bone demineralization and fractures and to modulate beneficially immunological dysfunction.
Full Text Available Background and Aims: Blood donation from glucose-6-phosphate dehydrogenase (G6PD-deficient and sickle cell trait (SCT donors might alter the quality of the donated blood during processing, storage or in the recipient′s circulatory system. The aim of this study was to determine the prevalence of G6PD deficiency and SCT among blood donors coming to King Khalid University Hospital (KKUH in Riyadh. It was also reviewed the benefits and risks of transfusing blood from these blood donors. Materials and Methods: This cross-sectional study was conducted on 1150 blood samples obtained from blood donors that presented to KKUH blood bank during the period April 2006 to May 2006. All samples were tested for Hb-S by solubility test, alkaline gel electrophoresis; and for G6PD deficiency, by fluorescent spot test. Results: Out of the 1150 donors, 23 (2% were diagnosed for SCT, 9 (0.78% for G6PD deficiency and 4 (0.35% for both conditions. Our prevalence of SCT and G6PD deficiency is higher than that of the general population of Riyadh. Conclusion: We recommend to screen all units for G6PD deficiency and sickle cell trait and to defer donations from donors with either of these conditions, unless if needed for special blood group compatibility, platelet apheresis or if these are likely to affect the blood bank inventory. If such blood is to be used, special precautions need to be undertaken to avoid complications in high-risk recipients.
Full Text Available Background . Vitamin D is considered to be an important co-factor of metabolic processes. However, the available data is ambiguous. Some data indicates an important role of vitamin D in adipocyte metabolism, and hence also in obesity – a well-known risk factor of diabetes mellitus and cardiovascular diseases (CVD. Objectives . To assess the prevalence of vitamin D deficiency and to evaluate the relationship between serum 25(OHD concentration and metabolic disorders in elderly patients attending primary care. Material and methods . This observational study was performed on 110 elderly patients: 88 females, 22 males, Caucasian, > 60 years. A questionnaire was completed concerning lifestyle and chronic diseases. Clinical examination, anthropometric measurements and laboratory tests (25(OHD, lipids, glycemia, blood morphology, serum creatinine, PT H were performed. BMI and WHR were calculated. Patients reporting physical activity (walking, Nordic walking, swimming, cycling, other ≥ 150 minutes per week were classified as “physically active”. Results . Vitamin D deficiency (25(OHD < 30 ng/ml; < 75 nmol/l was found in 84.5%, extreme deficiency (< 10 ng/ml; < 25 nmol/l in 6.3%. A significant correlation between serum vitamin D deficiency and visceral obesity was found (p = 0.02. No correlation was found with BMI, physical activity, lipids, diabetes or CVD. Conclusions . Vitamin D deficiency was found to be highly prevalent in the examined group of elderly people. Visceral obesity in the elderly is associated with vitamin D deficiency. Vitamin D supplementation may supposedly contribute to prevention of obesity and its treatment.
Gibson, Rosalind S; Kafwembe, Emmanuel; Mwanza, Sydney; Gosset, Laura; Bailey, Karl B; Mullen, Anne; Baisley, Kathy; Filteau, Suzanne
Micronutrient-fortified, cereal-based infant foods are recommended for reducing multiple micronutrient deficiencies in low-income countries, but their nutritional quality is not always optimal. In a double-blind randomized trial, we compared the efficacy of a locally produced porridge based on maize, beans, bambaranuts, and groundnuts fortified with 19 (rich) or 9 (basal) micronutrients. Infants aged 6 mo from Lusaka, Zambia were randomized to receive the richly fortified (n = 373) or basal (n = 370) porridge daily for 12 mo along with routine vitamin A supplements. Baseline and final micronutrient status and inflammation (based on α-1-glycoprotein) were assessed using nonfasting blood samples. Baseline prevalence of anemia (39%) and zinc deficiency (51%) were a public health concern. There were overall treatment effects on hemoglobin (Hb) (P = 0.001), serum transferrin receptor (P selenium (P = 0.009); biomarker responses for iron and zinc were modified by baseline concentrations, and for Hb and iron by socioeconomic status. At 18 mo, the adjusted odds of anemia, iron deficiency anemia (Hb 11.0 mg/L), and iron deficiency were 0.37 (95% CI = 0.25, 0.55), 0.18 (0.09, 0.35), and 0.30 (0.18, 0.50) times those in the basal group, respectively. The rich level of fortification had no overall treatment effect on serum zinc (1.09; 0.66, 1.80) but improved serum zinc in children with lower Hb concentrations at baseline (P = 0.024). A locally produced cereal- and legume-based infant food richly fortified with micronutrients reduced anemia and improved iron and selenium status but may require reformulation to improve the biochemical zinc status of urban Zambian infants.
Pajuelo, Jaime; Miranda, Marianella; Zamora, Rosa
To determine the prevalence of vitamin A deficiency (VAD) and nutritional anemia (NA) in children under five in Peru. Cross-sectional study with a stratified and multi-staged probabilistic sample conducted between November 2007 and April 2010.2,736 children were included for NA and 1,465 children for VAD. NA was defined as Hbjungle. The prevalence of NA shows a slight improvement. It is necessary to improve the efficiency and impact of programs that include supplementation of vitamin A and iron.
Ramírez-Vélez, Robinson; Facultad de Cultura Física, Deporte y Recreación. Universidad Santo Tomás, Bogotá, Colombia. Fisioterapeuta, PhD en Ciencias Biomédicas; Matínez-Torres, Javier; Programa de Enfermería, Universidad de Pamplona, Norte de Santander, Colombia. Fisioterapeuta especialista en Epidemiologia.; Meneses-Echavez, José Francisco; Facultad de Cultura Física, Deporte y Recreación. Universidad Santo Tomás, Bogotá, Colombia. Fisioterapeuta máster en Salud Pública.
Objectives. To determine prevalence and socio-demographic factors associated with ferritin deficiency in a representative sample of children in Colombia. Materials and methods. Cross sectional secondary data analysis of the National Survey on the Nutritional Situation (ENSIN) conducted in 2010 in Colombia in 3542 children between 12 and 59 months. Plasma ferritin levels were determined by chemiluminescence and values <12 ug/L were considered as deficit ferritin. Sociodemographic factors (s...
Małgorzata Koziarska-Rościszewska; Jacek Rysz; Mariusz Stępień
Background . Vitamin D is considered to be an important co-factor of metabolic processes. However, the available data is ambiguous. Some data indicates an important role of vitamin D in adipocyte metabolism, and hence also in obesity – a well-known risk factor of diabetes mellitus and cardiovascular diseases (CVD). Objectives . To assess the prevalence of vitamin D deficiency and to evaluate the relationship between serum 25(OH)D concentration and metabolic disorders in elderly patients ...
Loraine Farias Landgraf; Nelson Augusto Rosário; Juliana Ferreira de Moura; Katherine Andrew Wells; Bonald Cavalcanti Figueiredo
Objective: To measure serum levels of immunoglobulin A byimmunoenzymatic assay (ELISA) in type 1 diabetes mellitus (DM-1)patients and to verify the prevalence of immunoglobulin A deficiency(IgAD) in diabetic patients. Methods: The serum immunoglobulin Alevel was determined in 149 DM-1 patients by three methods. IgADwas defined as serum immunoglobulin A level lower than 5 mg/dl.If serum immunoglobulin A level was undetectable by turbidimetry,radial immunodiffusion was performed in low plate co...
Rossini, Maurizio; Maddali Bongi, Susanna; La Montagna, Giovanni; Minisola, Giovanni; Malavolta, Nazzarena; Bernini, Luigi; Cacace, Enrico; Sinigaglia, Luigi; Di Munno, Ombretta; Adami, Silvano
Introduction The aim of this study was to estimate the prevalence and determinants of vitamin D deficiency in patients with rheumatoid arthritis (RA) as compared to healthy controls and to analyze the association between 25-hydroxyvitamin D (25(OH)D) with disease activity and disability. Methods The study includes 1,191 consecutive RA patients (85% women) and 1,019 controls, not on vitamin D supplements, from 22 Italian rheumatology centres. Together with parameters of disease activity, funct...
Russo, Rodrigo; Zillmer, Laura Russo; Nascimento, Oliver Augusto; Manzano, Beatriz; Ivanaga, Ivan Teruaki; Fritscher, Leandro; Lundgren, Fernando; Miravitlles, Marc; Gondim, Heicilainy Del Carlos; Santos, Gildo; Alves, Marcela Amorim; Oliveira, Maria Vera; Souza, Altay Alves Lino de; Sales, Maria Penha Uchoa; Jardim, José Roberto
To determine the prevalence of alpha 1-antitrypsin (AAT) deficiency (AATD), as well as allele frequency, in COPD patients in Brazil. This was a cross-sectional study involving 926 COPD patients 40 years of age or older, from five Brazilian states. All patients underwent determination of AAT levels in dried blood spot (DBS) samples by nephelometry. Those with DBS AAT levels ≤ 2.64 mg/dL underwent determination of serum AAT levels. Those with serum AAT levels of sangue seco por meio de nefelometria. Aqueles em que a concentração de AAT no sangue seco foi ≤ 2,64 mg/dl foram submetidos a dosagem sérica de AAT. Aqueles em que a concentração sérica de AAT foi sangue seco ≤ 2,64 mg/dl, e 24 (2,6% da amostra) apresentaram concentração sérica de AAT < 113 mg/dl. A distribuição genotípica nesse subgrupo de 24 pacientes foi a seguinte: PI*MS, em 3 (12,5%); PI*MZ, em 13 (54,2%); PI*SZ, em 1 (4,2%); PI*SS, em 1 (4,2%); e PI*ZZ, em 6 (25,0%). Na amostra estudada, a prevalência global da deficiência de AAT foi de 2,8% e a prevalência do genótipo PI*ZZ (deficiência grave de AAT) foi de 0,8%. A prevalência da deficiência de AAT em pacientes com DPOC no Brasil é semelhante àquela encontrada na maioria dos países e reforça a recomendação de que se deve medir a concentração de AAT em todos pacientes com DPOC.
Baştürk, Bilkay; Sari, Sinan; Aral, Arzu; Dalgiç, Buket
Immunoglobulin A (IgA) deficiency is the most common primary deficiency. We aimed to define the prevalence of IgA deficiency among healthy school children in Turkey and the differences between geographical regions. Blood samples were collected from 20,331 healthy school children from all regions across Turkey. The serum IgA levels were tested through nephelometric method, and all 108 samples with IgA levels lower than 5 g/L were tested through ELISA for IgG and IgM levels. All IgG and IgM values were within the normal range in all cases, and no concomitant deficiency was observed. Our study results showed that the selective IgA deficiency incidence was 0.52% (1:188). The highest incidence, of 1:128.7, was observed in children from the Marmara region; the Black Sea Region levels (1:132.7) were lower, and the Mediterranean levels (1:365.7) were the lowest.
Serpa, Jose A; Villarreal-Williams, Erick; Giordano, Thomas P
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzyme defect. Screening for this condition in HIV-infected patients from susceptible ethnic groups is recommended based on expert opinion. Here we determined the prevalence of G6PD deficiency and the occurrence of G6PD-related hemolytic events in a large cohort of patients. We identified all HIV-infected adults who presented as new patients at a single urban HIV clinic between 02/01/2007 and 01/31/2009. Demographic and laboratory data including G6PD results were collected. In addition, outpatient and inpatient medical records of G6PD deficient patients were reviewed for episodes of hemolytic anemia. A total of 1172 patients were identified and G6PD testing was performed in 1110 (94.7%). Overall, 75 (6.8%) subjects had G6PD deficiency. Rates were higher among African Americans (68/699; 9.7%) and Hispanics (5/253; 2.0%). Only one non-Hispanic White subject had G6PD deficiency (1/153; 0.7%). At baseline, hemoglobin concentrations were similar among subjects with or without G6PD deficiency. Among patients with G6PD deficiency, 40 (53.3%) were prescribed trimethoprim-sulfamethoxazole or dapsone. During follow-up, five (6.7%) of these patients developed acute hemolytic anemia. These results provide strong clinical evidence for recommending G6PD testing in HIV-infected subjects from susceptible ethnic backgrounds. Copyright © 2010 The British Infection Society. Published by Elsevier Ltd. All rights reserved.
Amaro-Rivera, Kiara; López-Cepero, Andrea; Diaz, Beatriz; Lee, Jae Eun; Palacios, Cristina
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.
Ma, A.G.; Schouten, E.G.; Wang, Y.; Xu, R.X.; Zheng, M.C.; Li, Y.; Wang, Q.Z.; Sun, Y.Y.
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
A series of pot and field experiments with flooded rice were carried out on contrasting soil types of the Punjab, Pakistan to study the zinc status of soils, evaluate chemical methods for extracting available zinc and copper in flooded rice soils, study the residual effects of zinc fertilizer, evaluate the efficiency of zinc application to rice. The results show a wide-spread deficiency of Zn and, to some extent, of Cu in rice plants; (2) the correlation coefficient values between soil-available Zn and Cu and that extracted by rice plants were very small; (3) the various sources of Zn applied to rice by different ways proved quite effective in alleviating Zn deficiency under pot and field experiments; (4) uptake of N, P, Cu in rice plants was variably affected with Zn applied; (5) the addition of P in any form alone and with Zn or Cu invariably depressed Zn uptake by rice plants; (6) both Zn and Cu concentrations in plants were depressed with manure applications alone, as well as when Zn or Cu was respectively applied with it; (7) Zn reduced Cu while Cu induced Zn concentration in plants
Han, Yoo Min; Yoon, Hyuk; Lim, Soo; Sung, Mi-Kyung; Shin, Cheol Min; Park, Young Soo; Kim, Nayoung; Lee, Dong Ho; Kim, Joo Sung
Studies on the micronutrient status of Asian patients with inflammatory bowel disease (IBD) are scarce. We evaluated the prevalence of micronutrient deficiency and verified the risk factors for micronutrient deficiency in Korean patients with IBD. We measured the serum levels of 25-hydroxyvitamin D3 [25-(OH)D], zinc, and selenium to analyze the clinical risk factors for micronutrient levels below the reference values. In addition, we compared the 25-(OH)D levels of patients with IBD to those of age- and sex-matched healthy controls. Among the 83 patients, 74 (89.2%) had suboptimal serum 25-(OH)D levels. The mean plasma 25-(OH)D level in patients with IBD was significantly reduced compared to that of the healthy controls (12.3±6.2 ng/mL vs 20.0±6.7 ng/mL; pzinc and selenium levels were 39.0% and 30.9%, respectively. Female sex (p=0.012) and Crohn's disease (p=0.012) were associated with vitamin D deficiency. Patients younger than 40 years were at increased risk for zinc deficiency (p=0.045). Female sex (p=0.015) and low serum albumin level (zinc, and selenium deficiencies, suggesting the necessity for monitoring levels of these micronutrients.
Ad A. van Bodegraven
Full Text Available Malabsorption, weight loss and vitamin/mineral-deficiencies characterize classical celiac disease (CD. This study aimed to assess the nutritional and vitamin/mineral status of current “early diagnosed” untreated adult CD-patients in the Netherlands. Newly diagnosed adult CD-patients were included (n = 80, 42.8 ± 15.1 years and a comparable sample of 24 healthy Dutch subjects was added to compare vitamin concentrations. Nutritional status and serum concentrations of folic acid, vitamin A, B6, B12, and (25-hydroxy D, zinc, haemoglobin (Hb and ferritin were determined (before prescribing gluten free diet. Almost all CD-patients (87% had at least one value below the lower limit of reference. Specifically, for vitamin A, 7.5% of patients showed deficient levels, for vitamin B6 14.5%, folic acid 20%, and vitamin B12 19%. Likewise, zinc deficiency was observed in 67% of the CD-patients, 46% had decreased iron storage, and 32% had anaemia. Overall, 17% were malnourished (>10% undesired weight loss, 22% of the women were underweight (Body Mass Index (BMI 25. Vitamin deficiencies were barely seen in healthy controls, with the exception of vitamin B12. Vitamin/mineral deficiencies were counter-intuitively not associated with a (higher grade of histological intestinal damage or (impaired nutritional status. In conclusion, vitamin/mineral deficiencies are still common in newly “early diagnosed” CD-patients, even though the prevalence of obesity at initial diagnosis is rising. Extensive nutritional assessments seem warranted to guide nutritional advices and follow-up in CD treatment.
Derks, Terry G. J.; Duran, Marinus; Waterham, Hans R.; Reijngoud, Dirk-Jan; ten Kate, Leo P.; Smit, G. Peter A.
Medium chain acyl coenzyme A dehydrogenase ( MCAD) deficiency is assumed to be the most common inherited disorder of mitochondrial fatty acid oxidation. Few reports mention the difference between the expected and observed prevalence of MCAD deficiency on the basis of the carrier frequency in the
Derks, Terry G J; Duran, Marinus; Waterham, Hans R; Reijngoud, Dirk-Jan; Ten Kate, Leo P; Smit, G Peter A
Medium chain acyl coenzyme A dehydrogenase ( MCAD) deficiency is assumed to be the most common inherited disorder of mitochondrial fatty acid oxidation. Few reports mention the difference between the expected and observed prevalence of MCAD deficiency on the basis of the carrier frequency in the
Halbmayer, W M; Haushofer, A; Radek, J; Schön, R; Deutsch, M; Fischer, M
Several case reports of myocardial infarction in patients with factor XII deficiency have been published. In the present study we investigated the prevalence of this condition. Factor XII activity (one-stage clotting assay), fibrinogen (derived method), and lipoprotein (a) (enzyme-linked immunosorbent assay) were measured in the plasma of 426 consecutive patients with coronary heart disease awaiting cardiac surgery. Among the 426 patients, 44 (10.3%) were found to be moderately deficient in factor XII (factor XII activity 17-50%, antigen 15-57%). The prevalence of factor XII deficiency was significantly higher (P < 0.0001) among patients with coronary heart disease than among 300 healthy blood donors (2.3%). Among coronary heart disease patients with this deficiency, elevated levels of fibrinogen, lipoprotein (a), and blood pressure were no more prevalent than in those without the deficiency; nor were cigarette smoking or a positive family history of thromboembolism more prevalent. Coronary heart disease patients showed a 10% prevalence of factor XII deficiency. However, the pattern of atherosclerotic risk factors did not differ between patients with or without the deficiency.
Robert, M.; Rocha, J. C.; van Rijn, M.; Ahring, K.; Belanger-Quintana, A.; MacDonald, A.; Dokoupil, K.; Ozel, H. Gokmen; Lammardo, A. M.; Goyens, P.; Feillet, F.
Patients with phenylketonuria (PKU) encompass an 'at risk' group for micronutrient imbalances. Optimal nutrient status is challenging particularly when a substantial proportion of nutrient intake is from non-natural sources. In PKU patients following dietary treatment supplementation with
Rodrigues, Dalva N; Siqueira, Lucia H; Galizoni, Andréa M; Arruda, Valder R; Annichino-Bizzacchi, Joyce M
The prevalence of factor VII (FVII) deficiency in 267 Brazilian patients was estimated to be 4.1%, including one patient with significant bleeding, five with minor bleeding and five patients asymptomatic. Only one novel mutation 8926G F7 polymorphisms and FVII activity were found in these patients, as those with higher levels of FVII activity presented the genotype described in the literature as related to reduced FVII activity. As the R304Q mutation was the most frequent in these patients, and may be associated with an asymptomatic form of the disease, particularly in Blacks, we examined this mutation and FVII activity in 49 Blacks and 49 Caucasian blood donors with no clinical bleeding. None of the individuals showed the R304Q mutation, and FVII activity was normal in all of them, thus indicating that FVII deficiency is not common in normal individuals of these two ethnic groups in Brazil. This is the first study in South America to examine the prevalence and molecular basis of FVII deficiency, including the description of a novel mutation.
Giza, Styliani; Kotanidou, Eleni; Papadopoulou-Alataki, Efimia; Antoniou, Maria Christina; Maggana, Ioanna; Kyrgios, Ioannis; Galli-Tsinopoulou, Assimina
The association of selective immunoglobulin A (IgA) deficiency with type 1 diabetes (T1D) remains unclear. This study was to evaluate serum IgA concentrations in Greek children and adolescents with T1D. In two hundred individuals with T1D, serum IgA concentrations were quantitatively determined using nephelometry. Immunoglobulin A deficiency was detected in 6 (3.0%) of 200 patients who were subjected to immunological evaluation. Recurrent infections were not recorded, but human papilloma virus infection was clinically suspected and confirmed by laboratory examination in a 5-year-old girl. In regard to coincidence of selective IgA deficiency with autoimmune diseases, celiac disease was detected in a girl and juvenile idiopathic arthritis in a boy. Serum IgA concentrations differed significantly when patients were grouped according to age at the beginning of the study (PIgA concentrations was not statistically significant despite CD was present or not. Moreover, serum IgA concentrations were positively correlated with serum IgG (PIgA concentrations with glycemic control. The prevalence of selective IgA deficiency in Greek children and adolescents with T1D is high (3.0%). The correlation of serum IgA concentrations with serum IgG, IgE and anti-gliadin antibody IgG concentrations needs further investigation.
Amare, Bemnet; Moges, Beyene; Fantahun, Bereket; Tafess, Ketema; Woldeyohannes, Desalegn; Yismaw, Gizachew; Ayane, Tilahun; Yabutani, Tomoki; Mulu, Andargachew; Ota, Fusao; Kassu, Afework
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
Full Text Available Targeted fortification programs for infants and young children are an effective strategy to prevent micronutrient deficiencies in developing countries, but the role of large-scale fortification of staple foods and condiments is less clear. Dietary modeling in children aged 6–60 months was undertaken, based on food consumption patterns described in the 2009 national food consumption survey, using a 24-h recall method. Consumption data showed that the median intake of a child for iron, vitamin A and zinc, as a proportion of the Vietnamese Recommended Dietary Allowance (VRDA, is respectively 16%–48%, 14%–49% and 36%–46%, (depending on the age group. Potential fortification vehicles, such as rice, fish/soy sauces and vegetable oil are consumed daily in significant amounts (median: 170 g/capita/day, 4 g/capita/day and 6 g/capita/day, respectively by over 40% of the children. Vegetable oil fortification could contribute to an additional vitamin A intake of 21%–24% of VRDA recommended nutrient intake, while fortified rice could support the intakes of all the other micronutrients (14%–61% for iron, 4%–11% for zinc and 33%–49% of folate requirements. Other food vehicles, such as wheat flour, which is consumed by 16% of children, could also contribute to efforts to increase micronutrient intakes, although little impact on the prevalence of micronutrient deficiencies can be expected if used alone. The modeling suggests that fortification of vegetable oil, rice and sauces would be an effective strategy to address micronutrient gaps and deficiencies in young children.
Arias, Angela; Corbella, Marc; Fons, Carmen; Sempere, Angela; García-Villoria, Judit; Ormazabal, Aida; Poo, Pilar; Pineda, Mercé; Vilaseca, María Antonia; Campistol, Jaume; Briones, Paz; Pàmpols, Teresa; Salomons, Gajja S; Ribes, Antonia; Artuch, Rafael
To report the prevalence of creatine transporter deficiency in males with mental retardation and to study whether a protein-rich food intake might be a potential diagnostic pitfall. We determined creatine/creatinine ratio in urine samples from 1600 unrelated male patients with mental retardation and/or autism. Urine creatine was analyzed by HPLC-MS/MS. Thirty-three of 1600 cases showed increased urine creatine/creatinine ratio. Four out of these thirty-three cases were definitively diagnosed with creatine transporter deficiency, while the other 29 were false positive results. Significantly higher values were observed for urine Cr/Crn ratio in healthy volunteers after a meal based on beef or oily fish as compared to eggs, pasta or salad (Wilcoxon test: pdeficiency, and they may be due to intake of meals rich in creatine prior to urine samples analysis.
Monteiro, Wuelton M; Val, Fernando FA; Siqueira, André M; Franca, Gabriel P; Sampaio, Vanderson S; Melo, Gisely C; Almeida, Anne CG; Brito, Marcelo AM; Peixoto, Henry M; Fuller, Douglas; Bassat, Quique; Romero, Gustavo AS; Maria Regina F, Oliveira; Marcus Vinícius G, Lacerda
Plasmodium vivax radical cure requires the use of primaquine (PQ), a drug that induces haemolysis in glucose-6-phosphate dehydrogenase deficient (G6PDd) individuals, which further hampers malaria control efforts. The aim of this work was to study the G6PDd prevalence and variants in Latin America (LA) and the Caribbean region. A systematic search of the published literature was undertaken in August 2013. Bibliographies of manuscripts were also searched and additional references were identified. Low prevalence rates of G6PDd were documented in Argentina, Bolivia, Mexico, Peru and Uruguay, but studies from Curaçao, Ecuador, Jamaica, Saint Lucia, Suriname and Trinidad, as well as some surveys carried out in areas of Brazil, Colombia and Cuba, have shown a high prevalence (> 10%) of G6PDd. The G6PD A-202A mutation was the variant most broadly distributed across LA and was identified in 81.1% of the deficient individuals surveyed. G6PDd is a frequent phenomenon in LA, although certain Amerindian populations may not be affected, suggesting that PQ could be safely used in these specific populations. Population-wide use of PQ as part of malaria elimination strategies in LA cannot be supported unless a rapid, accurate and field-deployable G6PDd diagnostic test is made available. PMID:25141282
Wuelton M Monteiro
Full Text Available Plasmodium vivax radical cure requires the use of primaquine (PQ, a drug that induces haemolysis in glucose-6-phosphate dehydrogenase deficient (G6PDd individuals, which further hampers malaria control efforts. The aim of this work was to study the G6PDd prevalence and variants in Latin America (LA and the Caribbean region. A systematic search of the published literature was undertaken in August 2013. Bibliographies of manuscripts were also searched and additional references were identified. Low prevalence rates of G6PDd were documented in Argentina, Bolivia, Mexico, Peru and Uruguay, but studies from Curaçao, Ecuador, Jamaica, Saint Lucia, Suriname and Trinidad, as well as some surveys carried out in areas of Brazil, Colombia and Cuba, have shown a high prevalence (> 10% of G6PDd. The G6PD A-202A mutation was the variant most broadly distributed across LA and was identified in 81.1% of the deficient individuals surveyed. G6PDd is a frequent phenomenon in LA, although certain Amerindian populations may not be affected, suggesting that PQ could be safely used in these specific populations. Population-wide use of PQ as part of malaria elimination strategies in LA cannot be supported unless a rapid, accurate and field-deployable G6PDd diagnostic test is made available.
Samba, Claude; Tchibindat, Félicité; Gourmel, Bernard; Houzé, Patrick; Malvy, Denis
Vitamin A status in a sample of pregnant and lactating women living in several representative regions of Congo was assessed and compared between August and September 2004. This survey was conducted using a randomized two-stage cluster-sampling method with stratification on 90 clusters, each consisting of at least 15 women. Vitamin A status was determined in a total of 1,054 individuals, using the impression cytology with transfer (ICT) test, the modified relative dose response test (MRDR test) on dried blood spots (DBS), and clinical examination to detect signs of xerophthalmia. The clinical criterion defining vitamin A deficiency was the presence of active xerophthalmia (Bitot's spots [X1B]), active corneal disease), and/or night blindness (XN stage). The prevalence of clinical signs of stage XN and X1B xerophthalmia in the Republic of Congo was found to be 16% and 19% respectively. The prevalence of clinical signs (X1B) was greater in the rural north than in urban areas, with a gradient running from urban (5%) to rural area (33%); 27% of all the ICT tests showed that the subjects were suffering from vitamin A deficiency. The deficiency rates were significantly higher (p or = 0.06) in 26% of the mothers in Brazzaville compared to 6% in the town of Kouilou; 44% of the women had retinol levels of or = 0.06) compared to no malaria. The results of the present study confirm that vitamin A deficiency is a serious public-health issue in pregnant and lactating mothers in the Republic of Congo.
Buhari Hauwa Ali
Full Text Available Objective: To investigate the prevalence and socio-demographic factors associated with iron deficiency anaemia among blood donors in Sokoto, North Western, Nigeria using a combination of haemoglobin haematocrit and serum ferritin measurements. Methods: One hundred and fifty consecutively recruited whole blood donors, comprising of 148 (98.7% family replacement donors and 2 (1.3% voluntary non-remunerated donors aged 18-60 years and mean age 39±21 years constituted the subjects for this study. The full blood count was carried out using Mythic 22 CT fully automated haematology analyser (Orphee SA, Switzerland. Serum was tested for ferritin using a human ferritin enzyme immunoassay kitACCU Diag™ ELISA Ferritin kit (Diagnostic Automation/Cortez Diagnostic Inc. California, USA. Results: The prevalence of anaemia (haemoglobin<11.0 g/dL was evident in 24 (16% and iron deficiency anaemia (serum ferritin<12 ng/mL+haemoglobin<11 g/dL in 5 (10% of donors. The haemoglobin and ferritin levels was significantly lower among regular voluntary remunerated blood donors (13.50±0.00 and 34.88±0.00 compared to family replacement donors (14.10±2.40 and 74.12±45.20 respectively (P=0.01 and 0.05 respectively. The mean haemoglobin and ferritin level was compared among donors based on gender. The haemoglobin and ferritin was significantly higher among male donors (14.20±2.00, 78.02±49.10 compared to female donors (12.35±2.5 and 42.20±32.13 (P=0.01. The mean haemoglobin and ferritin level was compared among donors based on occupational groups. The haemoglobin and ferritin was significantly higher among civil servants compared to farmers and students (P=0.01. Conclusions: Iron deficiency anaemia is prevalent among blood donors in Sokoto, North Western, Nigeria. There is need to include routine ferritin in the blood donor testing protocol in the area to enable the diagnosis of donors with latent iron deficiency anaemia to facilitate iron supplementation for
Wang, Cunchuan; Guan, Bingsheng; Yang, Wah; Yang, Jingge; Cao, Guo; Lee, Shing
Electrolyte and nutritional deficiencies have been reported in Western populations seeking bariatric surgery. However, data are scarce for Chinese patients. To investigate the prevalence of electrolyte and nutritional deficiencies in Chinese bariatric surgery candidates and to explore their associations with patients' demographic data. University hospital, China. Demographical data of 211 patients presenting for bariatric surgery were collected on gender, age, body mass index (BMI) and waist circumference (WC). Blood biochemical data were collected on some nutrients (hemoglobin, albumin, globulin, folate, vitamin B12, calcium, phosphorus, iron, ferritin, magnesium, parathyroid hormone [PTH], and vitamin D) and some electrolytes (potassium, sodium, and chloride). Deficiencies were found for hemoglobin (2.8%), albumin (11.8%), globulin (1.4%), folate (32.2%), vitamin B12 (4.7%), corrected calcium (13.7%), phosphorus (10.4%), iron (9.0%), ferritin (1.9%), vitamin D (80.0%), potassium (5.7%), sodium (7.6%), and chloride (15.6%). Secondary hyperparathyroidism was found in 17.3%; no hypomagnesemia was encountered. A significant correlation was observed between age and folate, corrected calcium and PTH levels (r = .257, -.206, and .273, respectively; Pdeficiency was more common in the 18- to 30-year-old age group (P = .042) and the patients with BMI>45 kg/m(2) (P = .001). WC had an association with rates of albumin, folate, and corrected calcium deficiencies, as well as hemoglobin, albumin, and globulin, folate, phosphorus, and ferritin levels. Electrolyte and nutritional deficiencies are common in Chinese bariatric surgery candidates. Routine evaluation of electrolyte and nutritional levels should be carried out in this population. Copyright © 2016 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Russo, Rodrigo; Zillmer, Laura Russo; Nascimento, Oliver Augusto; Manzano, Beatriz; Ivanaga, Ivan Teruaki; Fritscher, Leandro; Lundgren, Fernando; Miravitlles, Marc; Gondim, Heicilainy Del Carlos; Santos Junior, Gildo; Alves, Marcela Amorim; Oliveira, Maria Vera; Souza, Altay Alves Lino de; Sales, Maria Penha Uchoa; Jardim, José Roberto
ABSTRACT Objective: To determine the prevalence of alpha 1-antitrypsin (AAT) deficiency (AATD), as well as allele frequency, in COPD patients in Brazil. Methods: This was a cross-sectional study involving 926 COPD patients 40 years of age or older, from five Brazilian states. All patients underwent determination of AAT levels in dried blood spot (DBS) samples by nephelometry. Those with DBS AAT levels ≤ 2.64 mg/dL underwent determination of serum AAT levels. Those with serum AAT levels of <...
Khanbhai, M; Dubb, S; Patel, K; Ahmed, A; Richards, T
As bariatric surgery rates continue to climb, anaemia will become an increasing concern. We assessed the prevalence of anaemia and length of hospital stay in patients undergoing bariatric surgery. Prospective data (anaemia [haemoglobin bariatric surgery. Results from a prospective database of 1530 patients undergoing elective general surgery were used as a baseline. Fifty-seven patients (14%) were anaemic pre-operatively, of which 98% were females. Median MCV (fL) and overall median ferritin (μg/L) was lower in anaemic patients (83 vs. 86, p=0.001) and (28 vs. 61, psurgery patients, prevalence of anaemia was similar (14% vs. 16%) but absolute iron deficiency was more common in those undergoing bariatric surgery; microcytosis pbariatric surgery. In bariatric patients with anaemia there was an overall increased length of hospital stay. Copyright © 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
Parrott, Julie; Frank, Laura; Rabena, Rebecca; Craggs-Dino, Lillian; Isom, Kellene A; Greiman, Laura
Optimizing postoperative patient outcomes and nutritional status begins preoperatively. Patients should be educated before and after weight loss surgery (WLS) on the expected nutrient deficiencies associated with alterations in physiology. Although surgery can exacerbate preexisting nutrient deficiencies, preoperative screening for vitamin deficiencies has not been the norm in the majority of WLS practices. Screening is important because it is common for patients who present for WLS to have at least 1 vitamin or mineral deficiency preoperatively. The focus of this paper is to update the 2008 American Society for Metabolic and Bariatric Surgery Nutrition in Bariatric Surgery Guidelines with key micronutrient research in laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, biliopancreatic diversion, and biliopancreatic diversion/duodenal switch. Four questions regarding recommendations for preoperative and postoperative screening of nutrient deficiencies, preventative supplementation, and repletion of nutrient deficiencies in pre-WLS patients have been applied to specific micronutrients (vitamins B1 and B12; folate; iron; vitamins A, E, and K; calcium; vitamin D; copper; and zinc). Out of the 554 articles identified as meeting preliminary search criteria, 402 were reviewed in detail. There are 92 recommendations in this update, 79 new recommendations and an additional 13 that have not changed since 2008. Each recommendation has a corresponding graded level of evidence, from grade A through D. Data continue to suggest that the prevalence of micronutrient deficiencies is increasing, while monitoring of patients at follow-up is decreasing. This document should be viewed as a guideline for a reasonable approach to patient nutritional care based on the most recent research, scientific evidence, resources, and information available. It is the responsibility of the registered dietitian nutritionist and WLS program to determine
Full Text Available BackgroundThe association between type 1 diabetes and immunoglobulin A deficiency (IgA-D has long been recognized in many populations. The aim of this study was to assess the prevalence of IgA-D in patients with type 1 diabetes mellitus all coming from a defined geographical area and to investigate the clinical features of these subjects.MethodsThe records of 150 consecutive patients with type 1 diabetes mellitus referred in a period of one year were analyzed. A detailed history was obtained for each patient. Information was collected concerning age, gender, time of onset of diabetes, and presence of other autoimmune diseases.ResultsOut of 150 patients with type 1 diabetes, eight (5.3% had a diagnosis of IgA-D. There were one female and seven male; all these patients were diagnosed by screening: none of them had history of recurrent infections. Autoimmune thyroiditis was coexisting in five patients (62%. Although other associated autoimmune disorders were found in a number of patients, there was no different prevalence rate in IgA deficient patients.ConclusionThis study shows the prevalence of IgA-D in Sicilian patients with type 1 diabetes as 5.3% which is much higher than reported in other Italian studies. Moreover, our data show a high prevalence of IgA-D in male gender and describe thyroiditis as the most frequent autoimmune disease present in these patients. Finally, in our case report, IgA-D diagnosis always followed routine IgA measurement when case finding for celiac disease with no history of recurrent infections in each patient.
Greco, Domenico; Maggio, Filippo
The association between type 1 diabetes and immunoglobulin A deficiency (IgA-D) has long been recognized in many populations. The aim of this study was to assess the prevalence of IgA-D in patients with type 1 diabetes mellitus all coming from a defined geographical area and to investigate the clinical features of these subjects. The records of 150 consecutive patients with type 1 diabetes mellitus referred in a period of one year were analyzed. A detailed history was obtained for each patient. Information was collected concerning age, gender, time of onset of diabetes, and presence of other autoimmune diseases. Out of 150 patients with type 1 diabetes, eight (5.3%) had a diagnosis of IgA-D. There were one female and seven male; all these patients were diagnosed by screening: none of them had history of recurrent infections. Autoimmune thyroiditis was coexisting in five patients (62%). Although other associated autoimmune disorders were found in a number of patients, there was no different prevalence rate in IgA deficient patients. This study shows the prevalence of IgA-D in Sicilian patients with type 1 diabetes as 5.3% which is much higher than reported in other Italian studies. Moreover, our data show a high prevalence of IgA-D in male gender and describe thyroiditis as the most frequent autoimmune disease present in these patients. Finally, in our case report, IgA-D diagnosis always followed routine IgA measurement when case finding for celiac disease with no history of recurrent infections in each patient.
Mohammad Eshagh Roze
Full Text Available This study was aimed to determine prevalence of Vitamin D deficiency and rickets in children with cholestatic liver diseases. Forty eight children with established cholestatic liver disease who referred to gastrointestinal clinic of Children Medical Center (Tehran, Iran between April 2010 and March 2011 were enrolled in a cross-sectional study. Laboratory analysis including calcium, phosphate, albumin, total and direct bilirubin, aminotransferases, alkalinephosphatase (ALP, prothrombin time (PT, parathyroid hormone (PTH, total protein determined by routine laboratory techniques. Mean age of participants was 299.1 ± 676.8 days (range 2-3600 days whereas twenty one were female (43.8% and 27 (56.3% were male. Twenty two (45.8% had evidences of rickets in X-ray evaluation. Three children with rickets and two with normal X-ray had Vitamin D deficiency while ten in rickets group and 16 in normal group had Vitamin D insufficiency. The main underlying diseases were anatomical biliary atresia in cases with rickets and idiopathic in other group. Rickets and Vitamin D deficiency should be considered in chronic cholestatic children.
Mohammadi, Bahram; Najafi, Mehri; Farahmand, Fateme; Motamed, Farzaneh; Ghajarzadeh, Mahsa; Mohammadi, Jamshid; Eshagh Roze, Mohammad
This study was aimed to determine prevalence of vitamin D deficiency and rickets in children with cholestatic liver diseases. Forty eight children with established cholestatic liver disease who referred to gastrointestinal clinic of Children Medical Center (Tehran, Iran) between April 2010 and March 2011 were enrolled in a cross-sectional study. Laboratory analysis including calcium, phosphate, albumin, total and direct bilirubin, aminotransferases, alkalinephosphatase (ALP), prothrombin time (PT), parathyroid hormone (PTH), total protein determined by routine laboratory techniques. Mean age of participants was 299.1 ± 676.8 days (range 2-3600 days) whereas twenty one were female (43.8%) and 27 (56.3%) were male. Twenty two (45.8%) had evidences of rickets in X-ray evaluation. Three children with rickets and two with normal X-ray had vitamin D deficiency while ten in rickets group and 16 in normal group had vitamin D insufficiency. The main underlying diseases were anatomical biliary atresia in cases with rickets and idiopathic in other group. Rickets and vitamin D deficiency should be considered in chronic cholestatic children.
Rossini, Maurizio; Maddali Bongi, Susanna; La Montagna, Giovanni; Minisola, Giovanni; Malavolta, Nazzarena; Bernini, Luigi; Cacace, Enrico; Sinigaglia, Luigi; Di Munno, Ombretta; Adami, Silvano
The aim of this study was to estimate the prevalence and determinants of vitamin D deficiency in patients with rheumatoid arthritis (RA) as compared to healthy controls and to analyze the association between 25-hydroxyvitamin D (25(OH)D) with disease activity and disability. The study includes 1,191 consecutive RA patients (85% women) and 1,019 controls, not on vitamin D supplements, from 22 Italian rheumatology centres. Together with parameters of disease activity, functional impairment, and mean sun exposure time, all patients had serum 25(OH)D measured in a centralized laboratory. A total of 55% of RA patients were not taking vitamin D supplements; the proportion of these with vitamin D deficiency (25(OH)D level Body mass index (BMI) and sun exposure time were good predictors of 25(OH)D values (P < 0.001). The association between disease activity or functional scores and 25(OH)D levels remained statistically significant even after adjusting 25(OH)D levels for both BMI and sun exposure time. In RA patients vitamin D deficiency is quite common, but similar to that found in control subjects; disease activity and disability scores are inversely related to 25(OH)D levels.
Rani, Ningappa Asha; Arasegowda, Rajeshwari; Mukherjee, Pramit; Dhananjay, Shilpashree Yeliyur
Nutritional deficiency anaemia can lead to development of headache, fatigue, lethargy, apathy, exertional dyspnoea, palpitations and tinnitus and thereby decrease the quality of everyday life to a great extent. Such symptoms may pose a hindrance for students in their academic life and have a negative impact on their career. To determine prevalence of nutritional deficiency anaemia and its correlation with academic performance among medical students. A cross-sectional study was conducted at Adichunchanagiri Institute of Medical Sciences. Two hundred eighty nine healthy undergraduate medical students of both genders were included in this study. A predesigned and pre-structured questionnaire was used as a tool to obtain information regarding demographic profile, dietary habits and academic performance. Haemoglobin level was estimated. Student's t-test and Chi-square test were employed. Majority of the participants were within the age group of 17-20 years (84.4%). The overall prevalence of anaemia was 15.6% with high rates among female students (93.3%), this gender difference was statistically significant (pperformers. There was no association between the anaemic status and students scholastic performance (χ 2 =3.1533, p=0.368). The mean haemoglobin level was higher among low performer, indicating that nutritional anaemia may not \\play a major role in educational performance and intelligence in higher education.
Grant, Cameron C; Wall, Clare R; Brunt, Deborah; Crengle, Sue; Scragg, Robert
Previous prevalence estimates of iron deficiency (ID) in young New Zealand children are inaccurate because of sampling bias and imprecise definition of ID. The aim of this study was to estimate the prevalence of ID in children aged 6-23 months and the factors associated with ID. An ethnically stratified sample identified from random residential address start points. Children resident in Auckland, New Zealand were enrolled from 1999 to 2002. Children with elevated C-reactive protein (>4 mg/L) were excluded. Iron status was determined in 324 (78%) of 416 enrolled children. Analyses adjusted for clustering and weighted for ethnic stratification. ID defined as abnormal values for two or more of serum ferritin (or= 18.5 kg/m(2) (RR = 4.34, 95% CI 1.08-10.67), and with receiving no infant or follow on formula (RR = 3.60, 95% CI 1.56-6.49). ID is prevalent in young New Zealand children. Variance in ID prevalence with ethnicity but not social deprivation implies that cultural practices influence iron status. Young children with more rapid growth are at increased risk of ID as are those receiving milk other than that specifically modified for them.
Azam, N.; Awan, A.J.
Objective: To study the prevalence of vit D deficiency in Karachi by evaluating the levels of vit D in patients reporting to an orthopaedic out patients department (OPD) with complaints of persistent 'r backache or generalized aches and pains. Study Design: Cross sectional descriptive study. Place and duration of study: From Aug 2008 to May 2009 in orthopaedic OPD of Pakistan Steel Mills Hospital Karachi. Patients and Methods: A non probability convenience sample was taken from 334 patients referred to orthopaedic specialist by primary care physicians for persistent backache and or generalized aches and pains, minimum for the last 6 months. A total 89 patients were included keeping in view the exclusion criteria. X-ray lumbosacral spine, and serum Vitamin D levels were advised in all cases. The normal range is 40-100 ng/ml. Value of 20-39 ng/ml was taken as mild deficiency, 5-19 ng/ml was considered as moderate and < 5 ng/ml was noted as severe deficiency. Results: There were 73 (82%) females and 16(18%) males. Mean Vitamin D3 level estimated in the study population was 7.76 ng/ml (SD= 3.50). Mean age was 40.2 years +- 10.75. Serum Vitamin D3 levels were checked and found to be moderately low in 75% of cases checked. Conclusion: Vitamin D deficiency constitutes a common reason of morbidity in Pakistan and deserves to be considered in the common differential diagnosis of backache and unexplained aches and pains. (author)
Full Text Available Objective. To describe the prevalence of iron, folate, and B12 deficiencies in Mexican women of reproductive age from the National Health and Nutrition Survey (Ensanut 2012.Materials and methods. Data came from a ationalprobabilistic survey, representative from rural and urban areas,and different age groups. Blood samples were obtained from 4 263, 20 to 49 years old women for serum ferritin, vitamin B12 and serum folate oncentrations. The prevalence of deficiencies, was assessed using adjusted logistic regression models. Results. The deficiency of folate was 1.9% (95%CI1.3-2.8, B12 deficiency was 8.5% (95%CI 6.7-10.1 and iron deficiency was 29.4% (95%CI 26.5-32.2. No differences were found when compared with 2006, 24.8% (95%CI 22.3-27.2.Conclusions. The vitamin B12 deficiency is still a problem for women of reproductive age and their offspring in Mexico,while folate deficiency disappeared as a problem. Iron deficiency needs prevention and fortification strategies.
Shamah-Levy, Teresa; Villalpando, Salvador; Mejía-Rodríguez, Fabiola; Cuevas-Nasu, Lucía; Gaona-Pineda, Elsa Berenice; Rangel-Baltazar, Eduardo; Zambrano-Mujica, Norma
To describe the prevalence of iron, folate, and B12 deficiencies in Mexican women of reproductive age from the National Health and Nutrition Survey (Ensanut) 2012. Data came from a national probabilistic survey, representative from rural and urban areas, and different age groups. Blood samples were obtained from 4 263, 20 to 49 years old women for serum ferritin, vitamin B12 and serum folate concentrations. The prevalence of deficiencies, was assessed using adjusted logistic regression models. The deficiency of folate was 1.9% (95%CI 1.3-2.8), B12 deficiency was 8.5% (95%CI 6.7-10.1) and iron deficiency was 29.4% (95%CI 26.5-32.2). No differences were found when compared with 2006, 24.8% (95%CI 22.3-27.2). The vitamin B12 deficiency is still a problem for women of reproductive age and their offspring in Mexico, while folate deficiency disappeared as a problem. Iron deficiency needs prevention and fortification strategies.
Muhammad Atif Habib
Full Text Available Iron deficiency Anemia (IDA in children is a recognized public health problem that impacts adversely on child morbidity, mortality and impairs cognitive development. In Pakistan information on the true prevalence and predictors of IDA is limited. This study sought to investigate IDA in children under five years of age using data from a nationally representative stratified cross-sectional survey.Secondary analysis was performed on the National Nutrition Survey in Pakistan 2011-2012. We used a pre-structured instrument to collect socio demographic and nutritional data on mothers and children. We also collected Anthropometric measurements and blood samples for micronutrient deficiencies. IDA was defined as having both haemoglobin levels of <110 g/L and ferritin levels of < 12 μg/L. Data analysis was performed by applying univariate and multivariate techniques using logistic regression through SPSS.A total of 7138 children aged between 6-59 months were included in the analysis. The prevalence of IDA was 33.2%. In multivariate regression analysis adjusted odds ratios (AOR were calculated. Age < 24 months (AOR 1.40, 95% CI 1.18-1.55 p <0.05, stunting (AOR 1.42 CI 1.23-1.63 p<0.05, presence of clinical anemia (AOR 5.69 CI 4.93-6.56 p<0.05, having a mother with IDA (AOR 1.72 CI 1.47-2.01 p<0.05 and household food insecurity (AOR 1.20 CI 1.10-1.40 P<0.05 were associated with IDA. Living in a rural area (AOR 0.77 CI 0.65-0.90 p<0.05 and being a female child (AOR 0.87 CI 0.76-0.98 p<0.05 were associated with reduced odds of IDA.The prevalence of IDA amongst Pakistani children represents a moderate burden that disproportionately affects the youngest, growth retarded children, affected children are more likely to have mothers with IDA and live in areas where food security is lacking. National efforts to alleviate the burden of IDA should involve both short term vertical programs such as iron supplementation and long term horizontal programs including wheat
Full Text Available BACKGROUND: A micronutrient survey carried out in 2010 among randomly selected Vietnamese women in reproductive age indicated that anemia and micronutrient deficiencies are still prevalent. The objective of this study was thus to analyze the dietary micronutrient intakes of these women, to select the food vehicles to be fortified and to calculate their contributions to meet the recommended nutrient intake (RNI for iron, zinc, vitamin A and folic acid. MAIN FINDINGS: Consumption data showed that the median intake was 38.4% of the RNI for iron, 61.1% for vitamin A and 91.8% for zinc. However, more than 50% of the women had daily zinc consumption below the RNI. Rice and vegetable oil were consumed daily in significant amounts (median: 320.4 g/capita/day and 8.6 g/capita/day respectively by over 90% of the women, making them suitable vehicles for fortification. Based on consumption data, fortified vegetable oil could contribute to an additional vitamin A intake of 27.1% of the RNI and fortified rice could increase the intake of iron by 41.4% of the RNI, zinc by 15.5% and folate by 34.1%. Other food vehicles, such as fish and soy sauces and flavoring powders, consumed respectively by 63% and 90% of the population could contribute to increase micronutrient intakes if they are properly fortified and promoted. Wheat flower was consumed by 39% of the women and by less than 20% women from the lowest socioeconomic strata. CONCLUSION: The fortification of edible vegetable oils with vitamin A and of rice with iron, zinc and folic acid are the most promising fortification strategies to increase micronutrient intakes of women in reproductive age in Vietnam. While rice fortification will be implemented, fortification of fish and soy sauces with iron, that has been proven to be effective, has to be supported and fortification of flavouring powders with micronutrients investigated.
Laillou, Arnaud; Berger, Jacques; Le, Bach Mai; Pham, Van Thuy; Le, Thi Hop; Nguyen, Cong Khan; Panagides, Dora; Rohner, Fabian; Wieringa, Frank; Moench-Pfanner, Regina
A micronutrient survey carried out in 2010 among randomly selected Vietnamese women in reproductive age indicated that anemia and micronutrient deficiencies are still prevalent. The objective of this study was thus to analyze the dietary micronutrient intakes of these women, to select the food vehicles to be fortified and to calculate their contributions to meet the recommended nutrient intake (RNI) for iron, zinc, vitamin A and folic acid. Consumption data showed that the median intake was 38.4% of the RNI for iron, 61.1% for vitamin A and 91.8% for zinc. However, more than 50% of the women had daily zinc consumption below the RNI. Rice and vegetable oil were consumed daily in significant amounts (median: 320.4 g/capita/day and 8.6 g/capita/day respectively) by over 90% of the women, making them suitable vehicles for fortification. Based on consumption data, fortified vegetable oil could contribute to an additional vitamin A intake of 27.1% of the RNI and fortified rice could increase the intake of iron by 41.4% of the RNI, zinc by 15.5% and folate by 34.1%. Other food vehicles, such as fish and soy sauces and flavoring powders, consumed respectively by 63% and 90% of the population could contribute to increase micronutrient intakes if they are properly fortified and promoted. Wheat flower was consumed by 39% of the women and by less than 20% women from the lowest socioeconomic strata. The fortification of edible vegetable oils with vitamin A and of rice with iron, zinc and folic acid are the most promising fortification strategies to increase micronutrient intakes of women in reproductive age in Vietnam. While rice fortification will be implemented, fortification of fish and soy sauces with iron, that has been proven to be effective, has to be supported and fortification of flavouring powders with micronutrients investigated.
Full Text Available Background. In spite of the works performed against iodine deficiency disorders (IDD, they still remain severe in Uzbekistan. The purpose of the study was to investigate the dynamics of the prevalence of IDD among the population in the Republic of Uzbekistan. Materials and methods. Epidemiological study of IDD in the Republic of Uzbekistan has been performed according to the World Health Organization (WHO recommendations. Degree of thyroid enlargement was determined according to the WHO classification. Such indexes, as assessment of urinary iodine concentration and evaluation of salt iodine concentration, have been analyzed. The data were compared with the results of previous years’ studies. Results. Estimation of the severity of IDD by the level of ioduria showed that the proportion of severe iodine deficiency (less than 20 μg/l decreased from 94.4 % in 1998 to 21.4 % in 2004, to 1.9 % in 2010 and to 1.9 % in 2016. The optimal level of iodine intake (more than 100 μg/l increased from 0 % in 1998 to 46.3 % in 2004, to 63.7 % in 2010 and 76.3 % in 2016. Comparative analysis of the prevalence of degree I and II diffuse goiter showed that in total the proportion of this disease was 72.8 % in 1998, 58.8 % in 2004, 40.2 % in 2010 and 28.3 % in 2016. Conclusions. The acceptance of law of Uzbekistan “On prevention of iodine deficiency diseases” in 2007 has substantially decreased the prevalence of IDD in Uzbekistan. Nevertheless, despite of large scale actions, our study of ioduria and salt iodine content in 2016 indicated that about 25 % of people in the country still prone to IDD.
Fares, Samira; Sethom, Mohamed Marouane; Khouaja-Mokrani, Chahnez; Jabnoun, Sami; Feki, Moncef; Kaabachi, Naziha
Preterm neonates are at high risk of vitamin deficiencies, which may expose them to increased morbidity and mortality. This study aimed to determine the prevalence and risk factors for vitamin A, E, and D deficiencies in Tunisian very low birth weight (VLBW) neonates. A total of 607 VLBW and 300 term neonates were included in the study. Plasma vitamins A and E were assessed by high performance liquid chromatography and vitamin D was assessed by radioimmunoassay. Prevalence of vitamin A, E, and D deficiencies were dramatically elevated in VLBW neonates and were significantly higher than term neonates (75.9% vs. 63.3%; 71.3% vs. 55.5%; and 65.2% vs. 40.4%, respectively). In VLBW neonates, the prevalence of vitamin deficiencies was significantly higher in lower classes of gestational age and birth weight. Vitamin E deficiency was associated with pre-eclampsia [odds ratio (OR) (95% confidence interval, 95% CI), 1.56 (1.01-2.44); p E, and D deficiencies are very common in Tunisian VLBW neonates and are associated with pre-eclampsia. Improved nutritional and health support for pregnant women and high dose vitamins A, E, and D supplementation in VLBW neonates are strongly required in Tunisia. Copyright © 2013. Published by Elsevier B.V.
The micronutrient intake of the average South African is not optimal. National fortification of staple foods does not solve all micronutrient deficiencies. Furthermore, urbanisation causes a shift in food intake, increasing the availability of cheaper and more energy dense food and drinks that are often lacking in micronutrients. It is unclear whether the current literature provides sufficient evidence of nutrient dilution by the moderate consumption of alcohol and/or added sugar. The aim of ...
The objectives of this study are to assess: (a) the prevalence of vitamin D deficiency among new patients attending rheumatology outpatient departments, (b) the age profile of these low vitamin D patients and (c) whether any diagnostic category had a particularly high number of vitamin D-deficient patients. All new patients seen consecutively in general rheumatology clinics between January to June 2007 inclusive were eligible to partake in this study, and 231 out of 264 consented to do so. Parathyroid hormone, 25-hydroxyvitamin D, creatinine, calcium, phosphate, albumin and alkaline phosphatase levels were measured. We defined vitamin D deficiency as <\\/=53 nmol\\/l and severe deficiency as <\\/=25 nmol\\/l. Overall, 70% of 231 patients had vitamin D deficiency, and 26% had severe deficiency. Sixty-five percent of patients aged >\\/=65 and 78% of patients aged <\\/=30 years had low vitamin D levels. Vitamin D deficiency in each diagnostic category was as follows: (a) inflammatory joint diseases\\/connective tissue diseases (IJD\\/CTD), 69%; (b) soft tissue rheumatism, 77%; (c) osteoarthritis, 62%; (d) non-specific musculoskeletal back pain, 75% and (e) osteoporosis, 71%. Seasonal variation of vitamin D levels was noted in all diagnostic groups apart from IJD\\/CTD group, where the degree of vitamin D deficiency persisted from late winter to peak summer. Very high prevalence of vitamin D deficiency was noted in all diagnostic categories (p = 0.006), and it was independent of age (p = 0.297). The results suggest vitamin D deficiency as a possible modifiable risk factor in different rheumatologic conditions, and its role in IJD\\/CTD warrants further attention.
Moradinejad, Mohammad Hasan; Rafati, Ali Hoseinpoor; Ardalan, Maryam; Rabiei, Mahnaz; Farghadan, Maryam; Ashtiani, Mohammad Taghi Haghi; Pourpak, Zahra; Moin, Mostafa
The purpose of this study was to investigate any association between IgA deficiency (IgAD) and juvenile rheumatoid arthritis (JRA) among Iranian children.This case-control study was carried out on 83 children who were diagnosed as JRA according to American College of Rheumatology (ACR) criteria; Patients were admitted at the rheumatology clinic of Children's Medical Center, (Tehran). Serum immunoglobulins concentrations were determined by nephelometry method. Control group was 112 healthy children who were matched for age and gender. Informed consent obtained from all parents.Selective IgA deficiency (sIgAD) was found only in a boy (1.2%) among JRA children; however, partial IgA deficiency was found in 6(7.1%) of patients with JRA and in 12(10.7%) of control subjects, this difference was not statistically significant (p=0.46). Immunoglobulins levels in patients with JRA (IgM: 126.7±57.2, IgG: 1182.3±351 and IgA:169.3±98) were significantly higher than their controls (IgM: 104±52, IgG:802±220 and IgA: 94.6±47) (pIgA levels in comparison with patients without growth failure; however, this difference was significant about IgM and IgG levels (p<0.05).In contrast to other similar studies, the number of IgAD did not differ significantly between JRA patients and their control counterpart; this might be partly due to the high rate of consanguineous marriages in Iran that resulted in increased prevalence of clinically undiagnosed partial IgAD in general population. Hence, future epidemiological studies are warranted to make it clear.
Achouri, I; Aboussaleh, Y; Sbaibi, R; Ahami, A; El Hioui, M
Iron deficiency anaemia is an important health problem in Morocco. This study was conducted to estimate the prevalence of anaemia among school children in Kenitra. The sample represents school children of all educational levels and age ranged between 6-15 years. The level of hemoglobin, haematocrit, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration was measured in a group of 271 school children. The seric iron was assessed and anaemia was defined when hemoglobin education of the mother and anaemia in children (p = 0.004) but not with the family income. It is concluded that improving the economic status of the family, women education and health education about balanced animal and plant food consumption are recommended strategies to reduce the burden of anaemia.
Anemia e deficiência de ferro em pré-escolares da Amazônia Ocidental brasileira: prevalência e fatores associados Anemia and iron deficiency among schoolchildren in the Western Brazilian Amazon: prevalence and associated factors
Teresa Gontijo de Castro
Full Text Available Estudo transversal de base populacional que investigou prevalênciasde anemia e fatores associados à anemia, anemia ferropriva e deficiência de ferro entre crianças de 6 a 60 meses da área urbana de dois municípios do Acre, Brasil (N = 624. Dosagens de hemoglobina sanguínea, ferritina e receptor solúvel de transferrina plasmáticas foram realizadas mediante sangue venoso. Condições sócio-econômicas, demográficas e de morbidade foram obtidas por questionário. Razões de prevalências foram calculadas por regressão de Poisson em modelo hierárquico. As prevalências de anemia, anemia ferropriva e deficiência de ferro foram de 30,6%, 20,9% e 43,5%, respectivamente. Menores de 24 meses apresentaram maior risco para anemia, anemia ferropriva e deficiência de ferro. Pertencer ao maior tercil do índice de riqueza conferiu proteção contra anemia ferropriva (RP = 0,62; IC95%: 0,40-0,98. Pertencer ao maior quartil do índice estatura/idade foi protetor contra anemia (0,62; 0,44-0,86 e anemia ferropriva (0,51; 0,33-0,79, e ocorrência recente de diarréia representou risco (anemia: 1,47; 1,12-1,92 e anemia ferropriva: 1,44; 1,03-2,01. A infestação por geohelmintos conferiu risco para anemia, anemia ferropriva e deficiência de ferro.This cross-sectional population-based study investigated prevalence rates and associated factors for anemia, iron deficiency anemia, and iron deficiency among children 6 to 60 months of age in two towns in Acre State, Brazil (N = 624. Hemoglobin, plasma ferritin, and soluble transferrin receptor were measured in venous blood samples. Socioeconomic, demographic, and disease data were obtained using a questionnaire. Prevalence ratios were calculated by Poisson regression in a hierarchical model. Prevalence rates for anemia, iron deficiency anemia, and iron deficiency were 30.6%, 20.9%, and 43.5%, respectively. Children younger than 24 months showed higher risk of anemia, iron deficiency anemia, and iron
Full Text Available BACKGROUND Diabetes mellitus is common endocrine disorder which involves multiple organs and leads to significant morbidity and mortality due to accompanying complications. Erectile dysfunction, reduced libido, orgasmic dysfunction, and retrograde ejaculation are established complications found with variable prevalence in men with diabetes. METHODOLOGY In the present study, total 90 male patients of diabetes mellitus of age below 40 years were taken from medical outpatient department and indoor patients of medical wards of a tertiary care teaching hospital of South Delhi. They were evaluated for complains regarding sexual dysfunction. Hormonal assays of serum free testosterone, LH, FSH, C-peptide, HbA1c and lipid profile were carried out in all patients. RESULT Present study shows that testosterone deficiency is quite common in young diabetic patients. Low serum free testosterone was more common in type 2 diabetes as compared to type 1 diabetes (38.46% Vs 29.41%. BMI has significant effect on serum free testosterone levels. Patients with higher BMI had negative correlation to free testosterone although testosterone deficiency was also seen in few lean patients. High serum triglyceride and low serum HDL were seen more frequently in patients with low free testosterone. CONCLUSION This study reveals that hypogonadism is not a rarity even at initial stages of diabetes. This study, although small, highlights importance of assessment of young diabetic patients for sexual dysfunction and hypogonadism.
Moon, Du Geon; Kim, Jin Wook; Kim, Je Jong; Park, Kwang Sung; Park, Jong Kwan; Park, Nam Cheol; Kim, Sae Woong; Lee, Sung Won
Testosterone deficiency syndrome (TDS) is a prevalent disease of the aging male with much confusion to its associated presentation, diagnosis, and comorbidities. We investigated the overall prevalence of TDS and its putative symptoms and associated diseases in a nationwide study on participants recruited from routine checkup. One thousand eight hundred seventy-five participants seeking biennial health checkup were enrolled from a nationwide distribution of randomly selected registry of primary clinics. Putative symptoms and comorbidities were assessed for serum testosterone-dependent prevalence change, independent of age. The identified symptoms were then assessed by multivariate backward stepwise binominal regression to determine the optimal reference level of testosterone and the strength of the associated comorbidities. TDS was assessed by serum testosterone, the Aging Males' Symptom scale, and the Androgen Deficiency in Aging Male questionnaire. Patient body habitus measurements and history of associated comorbidities were also described. The dependent variables included the age-specific prevalence of decreased testosterone and the probability of TDS-specific symptoms. Grossly 10.2% of the participants fell into the criteria for TDS. Testosterone was highly age dependent, and most putative symptoms of TDS showed significant age dependence but was not affected by serum testosterone levels. However, the symptoms of decreased libido and erectile dysfunction, and comorbidities such as hypertension, type 2 diabetes, and obesity showed relevant dependence on serum testosterone levels as well as age above 50 years of age. Furthermore, these symptoms were also affected at different serum testosterone thresholds. Decreased libido increased significantly at serum testosterone levels of 550 ng/dL (odds ratio [OR] = 1.295, 95% confidence interval [CI] = 1.047-1.601), and erectile dysfunction was affected by serum testosterone levels at 250 ng/dL (OR = 1.369, 95% CI = 1
Russo, Rodrigo; Zillmer, Laura Russo; Nascimento, Oliver Augusto; Manzano, Beatriz; Ivanaga, Ivan Teruaki; Fritscher, Leandro; Lundgren, Fernando; Miravitlles, Marc; Gondim, Heicilainy Del Carlos; Santos, Gildo; Alves, Marcela Amorim; Oliveira, Maria Vera; de Souza, Altay Alves Lino; Sales, Maria Penha Uchoa; Jardim, José Roberto
ABSTRACT Objective: To determine the prevalence of alpha 1-antitrypsin (AAT) deficiency (AATD), as well as allele frequency, in COPD patients in Brazil. Methods: This was a cross-sectional study involving 926 COPD patients 40 years of age or older, from five Brazilian states. All patients underwent determination of AAT levels in dried blood spot (DBS) samples by nephelometry. Those with DBS AAT levels ≤ 2.64 mg/dL underwent determination of serum AAT levels. Those with serum AAT levels of < 113 mg/dL underwent genotyping. In case of conflicting results, SERPINA1 gene sequencing was performed. Results: Of the 926 COPD patients studied, 85 had DBS AAT levels ≤ 2.64 mg/dL, and 24 (2.6% of the study sample) had serum AAT levels of < 113 mg/dL. Genotype distribution in this subset of 24 patients was as follows: PI*MS, in 3 (12.5%); PI*MZ, in 13 (54.2%); PI*SZ, in 1 (4.2%); PI*SS, in 1 (4.2%); and PI*ZZ, in 6 (25.0%). In the sample as a whole, the overall prevalence of AATD was 2.8% and the prevalence of the PI*ZZ genotype (severe AATD) was 0.8% Conclusions: The prevalence of AATD in COPD patients in Brazil is similar to that found in most countries and reinforces the recommendation that AAT levels be measured in all COPD patients. PMID:27812629
Cláudio Azevedo Nolasco; Bruno Vinícius Castro Guimarães; Otoniel Magalhães Morais; Tiyoko Nair Hojo Rebouças; Hercílio de Assis Pereira-Júnior; Myrne Jamilly Souza Lima; Rosa Honorato de Oliveira
Este experimento foi conduzido em casa-de-vegetação da Universidade Estadual do Sudoeste da Bahia – Vitória da Conquista com o objetivo de caracterizar os sintomas visuais de deficiência de micronutrientes em um híbrido de tomateiro do grupo salada, cultivado em solução nutritiva. Os tratamentos foram: completo, omissão de B, omissão de Zn, omissão de Mn, omissão de Mo, omissão de Fe e omissão de Cu. Com exceção da omissão de Cu, as demais omissões resultaram em alterações morfológicas com si...
Ongoing complementary public health measures include breastfeeding, immunization, control of infectious diseases and poverty alleviation policies. Many existing challenges devalue the potential impact of nutrition programs on development and national progress. There exists however, a wealth of innovative promising ...
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 ...
Sriwichai, Wichien; Berger, Jacques; Picq, Christian; Avallone, Sylvie
Micronutrient deficiencies are still a public health issue in least developed countries. Promoting diet diversification is a promising strategy. Numerous fruits and vegetables are rich in micronutrients, but some of these compounds are poorly bioaccessible. The objective of this study was to identify the biochemical determinants of the micronutrient bioaccessibility in leaves. The contents in cell walls, pectins, tannins, and proteins of the leafy vegetables were assessed, and correlations with the micronutrient bioaccessibitity were explored. The leafy vegetables have interesting nutritional profiles with noticeable amounts in protein, provitamin A (β-carotene), and α-tocopherol for some species. Their cell wall contents greatly varied from 3.4 to 8.7 g/100 g as well as their pectin percentages. Only the perilla and drumstick leaves contained condensed tannins. In fresh leaves, the contents in bioaccessible carotenoids were low. The correlation study highlighted that the carotenoid bioaccessibility was negatively correlated to the pectin contents of the leaves.
Full Text Available Nutrient deficiency in children’s food leads to delay in physical and neuropsychic development, increase risk of various diseases. Longstanding deficit of several nutrients in a diet can lead to permanent changes in child’s body. This is vitally important especially in childhood and adolescence — time of most extensive growth and development. The review covers physiological role of vitamins and minerals, especially vitamin-mineral metabolism in children and main reasons of possible deficit of these micronutrients in their diet. Recommendations upon prevention and correction of vitamin-mineral deficit with the use of individually prescribed vitamin-mineral complexes are given in the article.Key words: children, health, micronutrients, vitamin & mineral complexes. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (6: 179–185
Full Text Available BACKGROUND With improvement in serum vitamin D testing, there emerged an understanding that Vitamin D Deficiency (VDD exists in sunny regions of the world where it was once thought to be a rare occurrence. In addition, new understanding on the deleterious effects of VDD on health has also grown over the last several years to include not only skeletal disorders, but cardiovascular disease, diabetes, cancer, infectious and autoimmune diseases. The aim of the study was to examine the prevalence of Vitamin D Deficiency (VDD among pregnant and non-pregnant women at a Multispecialty Hospital in Bengaluru, India. MATERIALS AND METHODS This is a retrospective chart review study. Charts belonging to all women who presented to Divakars Speciality Hospital from October 1, 2015, to November 1, 2016, were selected for initial review. Charts for all non-pregnant women who presented for a routine annual checkup and pregnant women in their 12th week of pregnancy were reviewed. All charts selected included serum 25 (OH D levels that were obtained as part of routine care services. Charts of 213 pregnant women and 370 nonpregnant were reviewed. Serum 25 (OH D levels for each patient were collected and entered into a Microsoft® Excel spreadsheet for analysis by physician researchers along with information regarding patient’s age, employment status and education level. Serum 25 (OH D level of 20.0 to <30.0 ng/mL was classified as vitamin D insufficiency and levels <20 ng/mL were classified as being vitamin D deficient. Data were compiled as percentages and means across population characteristics. Pearson’s correlations were calculated to assess the correlation between 25 (OH D levels and population parameters. A P value of <0.05 was considered statistically significant. RESULTS The mean age of the pregnant women and non-pregnant women was 29 and 43, respectively. Mean serum vitamin D level of pregnant women and non-pregnant women was 15.1 and 19.4, respectively
Tabatabaei, Seyed Mehdi; Salimi Khorashad, Alireza; Sakeni, Mohammad; Raeisi, Ahmad; Metanat, Zahra
Glucose-6-phosphate dehydrogenase deficiency (G6PD) is an X-linked genetic disorder with a relatively high frequency in malaria-endemic regions. It is an obstacle to malaria elimination, as primaquine administered in the treatment of malaria can cause hemolysis in G6PD-deficient individuals. This study presents information on the prevalence of G6PD deficiency in Sistan and Balouchetsan province, which hosts more than 90% of Plasmodium vivax malaria cases in Iran. This type of information is needed for a successful malaria elimination program. A total of 526 students were randomly recruited through schools located in southeast Iran. Information was collected by interviewing the students using a structured questionnaire. Blood samples taken on filter papers were examined for G6PD deficiency using the fluorescent spot test. Overall, 72.8% (383/526) of the subjects showed normal G6PD enzyme function. Mild and severe G6PD deficiency was observed in 14.8% (78) and 12.2% (64) of subjects, respectively. A total 193/261 males (73.9%) and 190/265 (72%) females had normal enzyme activity. Mild G6PD deficiency was observed in 10.8% (28) and 18.9% (50) of male and female subjects, respectively. However, in comparison with females, a greater proportion of males showed severe enzyme deficiency (15.3% versus 9.1%). All these differences were statistically significant (p G6PD deficiency is highly prevalent in southeast Iran. G6PD-deficient individuals are susceptible to potentially severe and life-threatening hemolytic reactions after primaquine treatment. In order to achieve malaria elimination goals in the province, G6PD testing needs to be made routinely available within the health system.
von Fricken, Michael E; Weppelmann, Thomas A; Eaton, Will T; Alam, Meer T; Carter, Tamar E; Schick, Laura; Masse, Roseline; Romain, Jean R; Okech, Bernard A
Malaria remains a significant public health issue in Haiti, with chloroquine (CQ) used almost exclusively for the treatment of uncomplicated infections. Recently, single dose primaquine (PQ) was added to the Haitian national malaria treatment policy, despite a lack of information on the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency within the population. G6PD deficient individuals who take PQ are at risk of developing drug induced hemolysis (DIH). In this first study to examine G6PD deficiency rates in Haiti, 22.8% (range 14.9%-24.7%) of participants were found to be G6PD deficient (class I, II, or III) with 2.0% (16/800) of participants having severe deficiency (class I and II). Differences in deficiency were observed by gender, with males having a much higher prevalence of severe deficiency (4.3% vs. 0.4%) compared to females. Male participants were 1.6 times more likely to be classified as deficient and 10.6 times more likely to be classified as severely deficient compared to females, as expected. Finally, 10.6% (85/800) of the participants were considered to be at risk for DIH. Males also had much higher rates than females (19.3% vs. 4.6%) with 4.9 times greater likelihood (p value 0.000) of having an activity level that could lead to DIH. These findings provide useful information to policymakers and clinicians who are responsible for the implementation of PQ to control and manage malaria in Haiti. Copyright © 2014 Elsevier B.V. All rights reserved.
Marasinghe, Eshani; Chackrewarthy, Sureka; Abeysena, Chrishantha; Rajindrajith, Shaman
To assess the micronutrient status and its relationship with nutritional status in preschool children. In a cross sectional study, anthropometric data and fasting blood samples were obtained from 340 children attending preschool in urban Sri Lanka. Serum concentrations of vitamin D, parathyroid hormone, vitamin A, zinc and haemoglobin were measured. Z-scores of anthropometric indices of height-for-age, weight-for-age and weight-for-height were computed to evaluate the nutritional status. Prevalence of stunting, underweight, wasting and anaemia among children were 7.1%, 16.9%, 21.2% and 7.4%, respectively. Deficiencies of zinc and vitamin A occurred among 67% and 38% of children, respectively. Vitamin D deficiency (Nutritional status was significantly correlated (pnutritional status of the children was related to vitamin D status and with haemoglobin status. Zinc and vitamin A levels were low in children with severe stunting. Vitamins A, D and zinc levels were associated with haemoglobin status.
De Gier, Brechje; Nga, Tran Thuy; Winichagoon, Pattanee; Dijkhuizen, Marjoleine A.; Khan, Nguyen Cong; Van De Bor, Margot; Ponce, Maiza Campos; Polman, Katja; Wieringa, Frank T.
Soil-transmitted helminth (STH) infections and micronutrient deficiencies are closely related and often coexist among low-income populations. We studied the association between infections with specific STH species and micronutrient status in rural Vietnamese schoolchildren. Children (N = 510) aged
Smith, Emily R; Shankar, Anuraj H; Wu, Lee S-F
BACKGROUND: Micronutrient deficiencies are common among women in low-income and middle-income countries. Data from randomised trials suggest that maternal multiple micronutrient supplementation decreases the risk of low birthweight and potentially improves other infant health outcomes. However, h...
Micronutrients which are nutrients that are only needed by the body in minute amounts play leading roles in the production of enzymes, hormones and other substances and also help to regulate growth activity, development and functioning of the immune and reproductive systems. Micronutrient deficiency, which has been ...
Full Text Available Purpose: To evaluate refractive errors in school age children with color vision deficiency (CVD and those with normal color vision (NCV in order to make a better understanding of the emmetropization process. Methods: A total of 4,400 primary school students aged 7-12 years were screened for color vision using Ishihara pseudoisochromatic color vision plate sets. Of these, 160 (3.6% students had CVD. A total of 400 age- and sex-matched students with NCV were selected as controls. Refractive status was evaluated using objective cyclorefraction. Results: The CVD group included 136 male (85% and 24 female (15% subjects with mean age of 10.1 ± 1.8 years. The NCV group comprised of 336 male (84% and 64 female (16% subjects with mean age of 10.5 ± 1.2 years. The prevalence of myopia (7.7% vs. 13.9%, P < 0.001 and hyperopia (41% vs. 57.4%, P = 0.03 was significantly lower in the CVD group. Furthermore, subjects with CVD subjects demonstrated a lower magnitude of refractive errors as compared to the CVD group (mean refractive error: +0.54 ± 0.19 D versus + 0.74 ± 1.12 D, P < 0.001. Conclusion: Although the lower prevalence of myopia in subjects with CVD group supports the role of longitudinal chromatic aberration in the development of refractive errors; the lower prevalence of hyperopia in this group is an opposing finding. Myopia is a multifactorial disorder and longitudinal chromatic aberration is not the only factor influencing the emmetropization process.
Magen, Eli; Masalha, Atheer; Waitman, Dan Andrei; Kahan, Natan; Viner, Igor; Klassov, Leonora; Vardy, Daniel
There are no published large-scale epidemiologic studies regarding the prevalence of skin diseases in patients with selective immunoglobulin A (IgA) deficiency (sIgAD). The purpose of this study was to investigate the prevalence of dermatological diseases in patients with sIgAD. This retrospective matched case-control study was based on data from the Leumit Healthcare Services data base (approximately 725,000 residents of Israel), which was searched for all subjects aged ≥12 years who had undergone serum total IgA measurements during 2004-14 for any reason. The case group included subjects with sIgAD. The control A group was randomly sampled from those subjects in whom an IgA was drawn (n ≈ 725,000), with a ratio of 10 controls for every case (1:10). The control A group was randomly sampled from those subjects in whom an IgA was drawn (n = 104,729) and the control B group was randomly sampled from the full study population (n ≈ 725,000), with a ratio of 10 controls for every case (1:10). Comorbidity was compared between the study groups. The sIgAD group was characterized: 1) By a higher prevalence of atopic dermatitis (AD) (16 [4.6 %]) than the control A group (76 [2.1 %]; p = 0.004 and the control B group (64 [1.9 %]; p = 0.002). 2) By higher prevalence of acne (69 [19.9 %]) than the control A group (516 [13.8 %]; p = 0.013) and control B group (494 [14.2 %]; p < 0.001). 3) By higher rate of chronic spontaneous urticaria (CSU) (17 [4.9 %)] than in the control A group (31 [0.9 %], with odds ratio 5.54 [3.04-10.13]; p < 0.001) and the control B group (28 [0.8 %]; p < 0.001). sIgAD is characterized by a higher prevalence of AD, CSU and acne.
Full Text Available Vitamin D deficiency has become prevalent worldwide in recent years. However, less evidence was available for lactating women.The purpose of the study was to understand vitamin D status and prevalence of deficiency in lactating women and associated risk factors for vitamin D deficiency from eight provinces and municipalities in China.Lactating women within 1-10 months postpartum were recruited in 2011-2013 from eight provinces and municipalities in China. Radioimmunoassay was used to measure serum 25-hydroxyvitamin D [25(OHD] concentration. Standardized questionnaire was used to collect information on season, living site, ethnicity and socio-demographic characteristics.Totally 2004 lactating women were recruited. The median (p25, p75 of 25(OHD was 15.8 (10.5, 24.0 nmol/L. The prevalence of vitamin D deficiency was 85.3% as 25(OHD <30nmol/L. Serum 25(OHD levels of lactating women were significantly lower during October-January (14.0nmol/L than during February-May (18.0nmol/L (P<0.001, and were significantly higher in Dai ethnicity (22.5nmol/L than in Hui ethnicity (Chinese Muslims (9.0nmol/L (P<0.001. For every 10,000 CNY annual income per capita increasing, serum 25(OHD levels significantly increased 1.04 times (P<0.001. The odds of vitamin D deficiency in winter were 2.56 times higher than that in spring (OR 2.56, 95%CI: 1.91-3.43.Vitamin D deficiency of lactating women was highly prevalent in the eight provinces and municipalities in China. It is urgent to study the strategy and intervention ways for improving vitamin D status of lactating women, especially for certain population groups during low sunlight exposure season.
Gunawardena, Sharmini; Kapilananda, G M G; Samarakoon, Dilhani; Maddevithana, Sashika; Wijesundera, Sulochana; Goonaratne, Lallindra V; Karunaweera, Nadira D
Glucose-6-Phosphate Dehydrogenase (G6PD) enzyme deficiency is known to offer protection against malaria and an increased selection of mutant genes in malaria endemic regions is expected. However, anti-malarial drugs such as primaquine can cause haemolytic anaemia in persons with G6PD deficiency. We studied the extent of G6PD deficiency in selected persons attending Teaching Hospitals of Anuradhapura and Kurunegala, two previously high malaria endemic districts in Sri Lanka. A total of 2059 filter-paper blood spots collected between November 2013 and June 2014 were analysed for phenotypic G6PD deficiency using the modified WST-8/1-methoxy PMS method. Each assay was conducted with a set of controls and the colour development assessed visually as well as with a microplate reader at OD450-630nm. Overall, 142/1018 (13.95%) and 83/1041 (7.97%) were G6PD deficient in Anuradhapura and Kurunegala districts respectively. The G6PD prevalence was significantly greater in Anuradhapura when compared to Kurunegala (P0.05). Severe deficiency (G6PD deficiency are warranted in these high risk areas irrespective of gender for the prevention of disease states related to this condition.
It is estimated that the prevalence of anaemia in patients scheduled for bariatric surgery is higher than in the general population and the prevalence of iron deficiencies (with or without anaemia) may be higher as well. After surgery, iron deficiencies and anaemia may occur in a higher percentage of patients, mainly as a consequence of nutrient deficiencies. In addition, perioperative anaemia has been related with increased postoperative morbidity and mortality and poorer quality of life after bariatric surgery. The treatment of perioperative anaemia and nutrient deficiencies has been shown to improve patients' outcomes and quality of life. All patients should undergo an appropriate nutritional evaluation, including selective micronutrient measurements (e.g., iron), before any bariatric surgical procedure. In comparison with purely restrictive procedures, more extensive perioperative nutritional evaluations are required for malabsorptive procedures due to their nutritional consequences. The aim of this study was to review the current knowledge of nutritional deficits in obese patients and those that commonly appear after bariatric surgery, specifically iron deficiencies and their consequences. As a result, some recommendations for screening and supplementation are presented.
Full Text Available It is estimated that the prevalence of anaemia in patients scheduled for bariatric surgery is higher than in the general population and the prevalence of iron deficiencies (with or without anaemia may be higher as well. After surgery, iron deficiencies and anaemia may occur in a higher percentage of patients, mainly as a consequence of nutrient deficiencies. In addition, perioperative anaemia has been related with increased postoperative morbidity and mortality and poorer quality of life after bariatric surgery. The treatment of perioperative anaemia and nutrient deficiencies has been shown to improve patients’ outcomes and quality of life. All patients should undergo an appropriate nutritional evaluation, including selective micronutrient measurements (e.g., iron, before any bariatric surgical procedure. In comparison with purely restrictive procedures, more extensive perioperative nutritional evaluations are required for malabsorptive procedures due to their nutritional consequences. The aim of this study was to review the current knowledge of nutritional deficits in obese patients and those that commonly appear after bariatric surgery, specifically iron deficiencies and their consequences. As a result, some recommendations for screening and supplementation are presented.
Rohner, F.; Zimmermann, M.B.; Wegmueller, R.; Tschannen, A.B.; Hurrell, R.F.
There are few data on the prevalence of riboflavin deficiency in sub-Saharan Africa, and it remains unclear whether riboflavin status influences the risk for anaemia. The aims of this study were to: (1) measure the prevalence of riboflavin deficiency in children in south-central Côte d'Ivoire; (2)
Bistra T. Galunska
Full Text Available Purpose: To determine and compare the vitamin D status of different groups CKD patients on hemodialysis, peritoneal dialysis, or no renal replacement therapy and to evaluate the effect of vitamin D therapy. Patients and Methods: This pilot study enrolled 40 consecutive CKD patients (21 men, 19 women divided into three groups: 15 CKD patients in 1,2,3,4 stage of the disease without renal replacement therapy (RRT; 10CKD patients on hemodialysis (HD and 15 CKD patients on peritoneal dialysis (PD, ten of which were on vitamin D therapy. Vitamin D status was determined by serum 25-xydroxyvitamin D (25OHD. Results: Ninety percent of patients were in vitamin D deficiency/insufficiency; and only 4 patients (10.0% reached 25OHD levels above 75nmol/L. The median 25OHD level was 31.15nmol/L (interquartile range: 16.67-48.33nmol/L.Tendency of worse vitamin D status in women than in men was observed. Higher 25OHD levels were found in pre-dialysis patients (median 44.81nmol/L, 25%-75% percentile 16.24-52.21nmol/L and lower in HD (median 31.15nmol/L, 25%-75% percentile 13.04-64.45nmol/L and PD patients (median 33.38nmol/L, 25%-75% percentile 23.15-48.49nmol/L, but the difference did not reach statistical significance. Better vitamin D status was found in the PD group of patients receiving vitamin D preparations (p<0.05. Conclusions: 25OHD deficiency/insufficiency is prevalent in renal failure patients with or without renal replacement therapy. It seems that vitamin D therapy improves the vitamin D status of PD patients. Further larger studies are needed to clarify the effect of specific type vitamin D therapy on serum 25OHD levels and clinical outcome in different groups of CKD patients.
Modan-Moses, Dalit; Levy-Shraga, Yael; Pinhas-Hamiel, Orit; Kochavi, Brigitte; Enoch-Levy, Adi; Vered, Iris; Stein, Daniel
Previous studies assessing vitamin D status in adolescents with eating disorders showed inconsistent results. The aim of the current study was to assess vitamin D status in a large cohort of adolescent inpatients with eating disorders and its relation to bone mineral density (BMD) and depression. 25-Hydroxyvitamin D (25OHD), calcium, phosphorus, and alkaline phosphatase levels as well as BMD and depression were assessed on admission in 87 inpatients (aged 16 ± 2 years, females = 81) with eating disorders [anorexia nervosa (AN) = 64; bulimia nervosa (BN) = 5; eating disorders not otherwise specified-binge/purge type (EDNOS-B/P) = 18]. Mean 25OHD levels were 24.1 ± 7.5 ng/ml (25.0 ± 7.6, 25.4 ± 9.9, and 22.0 ± 9.9 ng/ml in patients with AB, BN, and EDNOS-B/P, respectively). Vitamin D deficiency (32 ng/ml, considered optimal by some experts. No associations were found between 25OHD levels and BMD or comorbid depression. 25OHD levels during winter were significantly lower than summer levels (p EDNOS-B/P type was low (-1.5 ± 1.1) and correlated with body mass index standard deviation score (p = .03). Adolescents with eating disorders show a high prevalence of vitamin D deficiency and insufficiency. Given the risk of osteoporosis in this population, 25OHD levels found in this group may not offer optimal bone protection. Vitamin D levels should be routinely checked and supplementation should be administered as required. © 2014 Wiley Periodicals, Inc.
Loraine Farias Landgraf
Full Text Available Objective: To measure serum levels of immunoglobulin A byimmunoenzymatic assay (ELISA in type 1 diabetes mellitus (DM-1patients and to verify the prevalence of immunoglobulin A deficiency(IgAD in diabetic patients. Methods: The serum immunoglobulin Alevel was determined in 149 DM-1 patients by three methods. IgADwas defined as serum immunoglobulin A level lower than 5 mg/dl.If serum immunoglobulin A level was undetectable by turbidimetry,radial immunodiffusion was performed in low plate concentration.For patients with undetectable serum immunoglobulin A levelby the two previous methods, quantification was performed byELISA. In patients with IgAD, the levels of immunoglobulins Gand M were measured by turbidimetry to exclude other humoralimmunodeficiencies. Results: Out of 149 DM-1 patients evaluated,141 (94.6% had normal serum immunoglobulin A levels byturbidimetry. Eight patients (5.3% had undetectable serumimmunoglobulin A levels by turbidimetry and radial immunodiffusion.In these eight patients, the determination of serum immunoglobulinA was performed by ELISA, a more sensitive method. Very lowlevels of serum immunoglobulin A were detected in these diabeticpatients. In all diabetic patients, immunoglobulins G and M werenormal for age by turbidimetry. All 150 patients of the Control Grouphad normal serum immunoglobulin A levels by ELISA. Conclusions:There was a significantly higher prevalence of immunoglobulindeficiency among DM-1 patients (5.3%. Measurement of serumimmunoglobulin A is necessary in all DM-1 particularly before someimmunoglobulin A antibody screening. Patients with IgAD may havefalse-negative results for celiac disease screening tests involvingimmunoglobulin A antiendomysium and antigliadin antibodies.
In Hyuk Chung
Full Text Available PurposeThis study was performed to investigate the relationship between serum vitamin D and parathyroid hormone (PTH levels as well as to describe the prevalence and the risk factors of vitamin D deficiency (VDD in Korean children.MethodsParticipants were 1,212 children aged 4 to 15 years, who visited Bundang CHA Medical Center (located at 37°N between March 2012 and February 2013. Overweight was defined as body mass index≥85th percentile. Participants were divided into 4 age groups and 2 seasonal groups. VDD was defined by serum 25-hydroxyvitamin D (25OHD <20 ng/mL.ResultsThe level of 25OHD was significantly lower in overweight group than in normal weight group (17.1±5.1 ng/mL vs. 19.1±6.1 ng/mL, P<0.001. Winter-spring season (odds ratio [OR], 4.46; 95% confidence interval [CI], 3.45-5.77, older age group (OR, 1.60; 95% CI, 1.36-1.88, and overweight (OR, 2.21; 95% CI, 1.62-3.01 were independently related with VDD. The PTH levels were significantly higher in VDD group compared to vitamin D insufficiency and sufficiency group (P<0.001. In normal weight children, 25OHD (β=-0.007, P<0.001 and ionized calcium (β=-0.594, P=0.007 were independently related with PTH, however, these associations were not significant in overweight children.ConclusionVDD is very common in Korean children and its prevalence increases in winter-spring season, in overweight children and in older age groups. Further investigation on the vitamin D and PTH metabolism according to adiposity is required.
Akhtar, Saeed; Ahmed, Anwaar; Randhawa, Muhammad Atif; Atukorala, Sunethra; Arlappa, Nimmathota; Ismail, Tariq; Ali, Zulfiqar
Vitamin A deficiency (VAD) has been recognized as a public-health issue in developing countries. Economic constraints, sociocultural limitations, insufficient dietary intake, and poor absorption leading to depleted vitamin A stores in the body have been regarded as potential determinants of the prevalence of VAD in South Asian developing countries. VAD is exacerbated by lack of education, poor sanitation, absence of new legislation and enforcement of existing food laws, and week monitoring and surveillance system. Several recent estimates confirmed higher morbidly and mortality rate among children and pregnant and non-pregnant women of childbearing age. Xerophthalmia is the leading cause of preventable childhood blindness with its earliest manifestations as night blindness and Bitot's spots, followed by blinding keratomalacia, all of which are the ocular manifestations of VAD. Children need additional vitamin A because they do not consume enough in their normal diet. There are three general ways for improving vitamin A status: supplementation, fortification, and dietary diversification. These approaches have not solved the problem in South Asian countries to the desired extent because of poor governmental support and supervision of vitamin A supplementation twice a year. An extensive review of the extant literature was carried out, and the data under various sections were identified by using a computerized bibliographic search via PubMed, Web of Science, and Google Scholar. All abstracts and full-text articles were examined, and the most relevant articles were selected for screening and inclusion in this review. Conclusively, high prevalence of VAD in South Asian developing countries leads to increased morbidity and mortality among infants, children, and pregnant women. Therefore, stem efforts are needed to address this issue of public-health significance at local and international level in lower- and middle-income countries of South Asia.
Ibrahim M. Kaddam
Full Text Available Objectives: To measure prevalence of vitamin D deficiency in Saudi Arabia, unveil the life style, nutritional habits and status, as well as identify the potential risk factors. Method: A school-based survey targeting Saudi school students and employees was conducted during the period from 2013 to 2014 using multistage cluster random sample in Central, Western and Eastern regions. The prevalence of vitamin D deficiency and difference between various population subgroups were calculated. Logistic regression analysis was used to determine the predictors of potential risk factors. Results: Prevalence of vitamin D deficiency was 49.5% in students and 44% in employees. Life style was not adequate to protect against vitamin D depletion. Unhealthy nutritional habits were widespread, some manifested in childhood while others manifested later in life. Living in the Eastern region, females, 16-19 years of age, low economic class, obese and lack of omega 3 supplements were risk factors in students. Employees living in the Eastern region, females, middle-income class, carbonated soft drink consumers, and lack of multivitamin supplements were at higher risk. Conclusion: There is a need for a health awareness program using evidence-based recommendations. Screening for early detection and correction of the condition should be proposed to be part of the national health strategy. There is need for identifying the burden of vitamin D deficiency on other diseases to control and improve the prognosis of these conditions.
Gupta, Raj Kishor; Gangoliya, Shivraj Singh; Singh, Nand Kumar
More than half of the world populations are affected by micronutrient malnutrition and one third of world’s population suffers from anemia and zinc deficiency, particularly in developing countries. Iron and zinc deficiencies are the major health problems worldwide. Phytic acid is the major storage form of phosphorous in cereals, legumes, oil seeds and nuts. Phytic acid is known as a food inhibitor which chelates micronutrient and prevents it to be bioavailabe for monogastric animals, includin...
Müller, Sophie A; Amoah, Stephen K B; Meese, Stefanie; Spranger, Joachim; Mockenhaupt, Frank P
Haematological parameters differ between individuals of African and European ancestry. However, respective data of first-generation African migrants are virtually absent. We assessed these in Ghanaian migrants living in Berlin, compared them with reference data from Germany and Ghana, and estimated the role of iron deficiency (ID) and erythrocyte polymorphisms in anaemia. A total of 576 Ghanaians (median age, 45 years) were analysed. Blood counts were performed, haemoglobinopathies and glucose-6-phosphate dehydrogenase (G6PD) deficiency were genotyped, and concentrations of ferritin and C-reactive protein were measured to define ID. Most individuals had resided in Germany for more than a decade (median, 18 years). By WHO definition, anaemia was present in 30.9% of females and 9.4% of males. Median haemoglobin (Hb) levels were lower than among Germans (women, -0.8 g/dl, men, -0.7 g/dl). However, applying reference values from Ghana, only 1.9% of the migrants were considered anaemic. Alpha-thalassaemia, Hb variants and G6PD deficiency were observed in 33.9%, 28.3% and 23.6%, respectively. ID was highly prevalent in women (32.0%; men, 3.9%). The population fraction of anaemia cases attributable to ID was 29.0% (alpha-thalassaemia, 13.6%; G6PD deficiency, 13.5%). Nevertheless, excluding ID, alpha-thalassaemia, G6PD deficiency and sickle cell disease, anaemia prevalence remained high (women, 18.4%; men, 6.5%), and was also high when applying uncensored thresholds proposed for African Americans (females, 19.3%; males, 7.8%). Iron deficiency and erythrocyte polymorphisms are common among first-generation Ghanaian migrants but explain only part of the increased prevalence of anaemia. Common Hb thresholds for the definition of anaemia may not be appropriate for this group. © 2015 John Wiley & Sons Ltd.
Ivan S. Ferraz
Full Text Available OBJETIVO: Estimar a carência de ferro na população estudada e verificar se isso se associa à falta de vitamina A. MÉTODOS: Foram estudadas 179 crianças com idade > 24 meses e OBJECTIVES: To identify the prevalence of iron deficiency in the population studied, as well as verifying if such deprivation is associated with vitamin A deficiency. METHODS: One hundred seventy-nine children, > 24 months and < 72 months of age, with no diarrhea and/or fever at collection were studied. Vitamin A deficiency identification was carried out through serum 30-day dose-response test. Samples of peripheral blood from fasting children was obtained for hemoglobin counts, serum iron, and unsaturated iron binding capacity assays. Information about the presence of diarrhea and/or fever during the 15 days preceding the study was also obtained. RESULTS: 35.8% (64/179 of the children presented iron deficiency and 75.4% (135/179, vitamin A deficiency. 29.1% (52/179 of the children presented both iron and vitamin A deficiencies. Iron deficiency was not associated with vitamin A deficiency. A separate analysis for each hematimetric index also demonstrated no significant difference between children with or without vitamin A deficiency. Children aged 24 to 36 months presented significantly higher prevalence rates of iron deficiency (p = 0.0005 as did children with diarrhea and/or fever during the 15 days preceding the study (p = 0.003. CONCLUSIONS: Although iron deficiency was not associated with vitamin A deficiency, high rates of both deficiencies were exhibited in a "healthy" population with low malnutrition indices. Such situations are known as "hidden hunger". Younger children presented a higher risk of iron deficiency as did children with diarrhea and/or fever during the 15 days preceding the study.
Lachili, B; Faure, H; Arnaud, J; Richard, M J; Benlatreche, C; Favier, A; Roussel, A M
Despite trace elements and vitamins are major public health problems in some African countries, there are few studies reporting micronutrient status in North Africa. Therefore, it could be interesting to evaluate plasma concentrations of vitamin A, E and beta-cartene, along with zinc, copper, selenium erythrocyte glutathione peroxidase and superoxide dismutase in Algeria. Volunteers were randomly recruited in Constantine, Batna and Mila. Vitamins, trace elements and enzymes were measured in the University Hospital of Grenoble. 455 persons were included in the study. Subjects were divided in 3 groups: group I: 15 girls and 12 boys who were 6 to 12.9 years old, group II: 190 women and 192 men 13 to 49.9 years old, group III: 24 women and 24 men 50 to 65 years old. Plasma concentrations of micronutrients and enzymes are close to those commonly observed in Europe, except for vitamin A concentrations. Indeed, retinol levels are 30-35% lower than those reported in European countries, moreover almost 8% of the population showed retinol concentrations less than 1.05 mumol/l. beta-Carotene levels were also lower than in the French average population. Ten per cent of the population had plasma zinc levels lower than 10.6 mumol/l. Vitamin E, copper and selenium status seems satisfactory in Algeria. Vitamin A is not a public health problem, however a significant percentage of residents exhibits impaired vitamin A levels and may benefit from retinol supplementation. Larger studies are needed, and particularly in children, to detect possible higher prevalence of vitamin A deficiency in poor socio-economical classes and in inner geographic areas.
Rita de Cássia Ribeiro-Silva
Full Text Available Objective: To identify the prevalence and factors associated with vitamin A deficiency (VAD in children and adolescents. Methods: This was a cross-sectional study involving 546 schoolchildren, aged between 7 and 14 years, of both genders, enrolled in public elementary schools. Blood was collected for measurement of serum retinol. The retinol concentration in the samples was determined by high performance liquid chromatography (HPLC. Data were collected on anthropometrics, dietary, demographic, and socioeconomic factors. Polytomous logistic regression was used to evaluate the associations of interest. Results: Approximately 27.5% of the students had retinol values < 30 μg/dL. The multivariate analysis showed, after the appropriate adjustments, a positive and statistically significant association of moderate/severe VAD (OR = 2.19; 95% CI 1.17 to 4.10 and marginal VAD (OR = 2.34; 95% CI 1.47 to 3.73 with age < 10 years. There was also association of VAD moderate/severe (OR = 2.01; 95% CI 1.01 to 5.05 and borderline VAD (OR = 2.14; 95% CI: 1.08 to 4.21 with the anthropometric status of underweight. Lower intake of retinol was detected among those with severe VAD. Conclusion: VAD is a health concern among children and adolescents. Lower weight and younger schoolchildren had greater vulnerability to VAD.
Full Text Available Vitamin D is an important nutrient involved in bone mineral metabolism, and vitamin D status is reflected by serum total 25-hydroxyvitamin D (25[OH]D concentrations. Vitamin D deficiency is highly prevalent in patients with chronic kidney disease (CKD, and nutritional vitamin D supplementation decreases elevated parathyroid hormone concentrations in subgroups of these patients. Furthermore, vitamin D is supposed to have pleiotropic effects on various diseases such as cardiovascular diseases, malignancies, infectious diseases, diabetes, and autoimmune diseases. Indeed, there is cumulative evidence showing the associations of low vitamin D with the development and progression of CKD, cardiovascular complication, and high mortality. Recently, genetic polymorphisms in vitamin D-binding protein have received great attention because they largely affect bioavailable 25(OHD concentrations. This finding suggests that the serum total 25(OHD concentrations would not be comparable among different gene polymorphisms and thus may be inappropriate as an index of vitamin D status. This finding may refute the conventional definition of vitamin D status based solely on serum total 25(OHD concentrations.
Full Text Available Background: Loop diuretics are an integral part of heart failure management. It has been shown that loop diuretics cause thiamine deficiency (TD by increasing its urinary loss. The aim of this study was to determine the prevalence of TD in heart failure patients on long-term oral loop diuretics. Methods: Heart failure patients (cases on oral loop diuretics (furosemide ≥40 mg/day or torsemide ≥20 mg/day, irrespective of the cause of heart failure, were compared to non-heart failure patients (controls not on loop diuretics in a 1:1 ratio. Whole blood free thiamine level was determined by liquid chromatography-tandem mass spectrometry method. Results: A total of 100 subjects were enrolled in a 1:1 ratio (50 cases and 50 controls. 67% of the total study population had TD, (defined as whole blood free thiamine level <0.7 ng/ml. There was no difference in mean thiamine level between cases and controls. On comparing patients with TD in both groups, patients on diuretics had significantly lower thiamine level compared to the patients, not on diuretics (P < 0.0001. Conclusions: There was no difference in the thiamine level when patients on loop diuretics were compared to controls. However, very low thiamine levels (<0.1 ng/ml was significantly more common in patients on loop diuretics.
Obi, Yoshitsugu; Hamano, Takayuki; Isaka, Yoshitaka
Vitamin D is an important nutrient involved in bone mineral metabolism, and vitamin D status is reflected by serum total 25-hydroxyvitamin D (25[OH]D) concentrations. Vitamin D deficiency is highly prevalent in patients with chronic kidney disease (CKD), and nutritional vitamin D supplementation decreases elevated parathyroid hormone concentrations in subgroups of these patients. Furthermore, vitamin D is supposed to have pleiotropic effects on various diseases such as cardiovascular diseases, malignancies, infectious diseases, diabetes, and autoimmune diseases. Indeed, there is cumulative evidence showing the associations of low vitamin D with the development and progression of CKD, cardiovascular complication, and high mortality. Recently, genetic polymorphisms in vitamin D-binding protein have received great attention because they largely affect bioavailable 25(OH)D concentrations. This finding suggests that the serum total 25(OH)D concentrations would not be comparable among different gene polymorphisms and thus may be inappropriate as an index of vitamin D status. This finding may refute the conventional definition of vitamin D status based solely on serum total 25(OH)D concentrations.
do Prado, Mara Rúbia Maciel Cardoso; Oliveira, Fabiana de Cássia Carvalho; Assis, Karine Franklin; Ribeiro, Sarah Aparecida Vieira; do Prado Junior, Pedro Paulo; Sant'Ana, Luciana Ferreira da Rocha; Priore, Silvia Eloiza; Franceschini, Sylvia do Carmo Castro
To assess the prevalence of vitamin D deficiency and its associated factors in women and their newborns in the postpartum period. This cross-sectional study evaluated vitamin D deficiency/insufficiency in 226 women and their newborns in Viçosa (Minas Gerais, BR) between December 2011 and November 2012. Cord blood and venous maternal blood were collected to evaluate the following biochemical parameters: vitamin D, alkaline phosphatase, calcium, phosphorus and parathyroid hormone. Poisson regression analysis, with a confidence interval of 95% was applied to assess vitamin D deficiency and its associated factors. Multiple linear regression analysis was performed to identify factors associated with 25(OH)D deficiency in the newborns and women from the study. The criteria for variable inclusion in the multiple linear regression model was the association with the dependent variable in the simple linear regression analysis, considering p<0.20. Significance level was α<5%. From 226 women included, 200 (88.5%) were 20 to 44 years old; the median age was 28 years. Deficient/insufficient levels of vitamin D were found in 192 (85%) women and in 182 (80.5%) neonates. The maternal 25(OH)D and alkaline phosphatase levels were independently associated with vitamin D deficiency in infants. This study identified a high prevalence of vitamin D deficiency and insufficiency in women and newborns and the association between maternal nutritional status of vitamin D and their infants' vitamin D status. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.
Iron deficiency (ID) is the most common micronutrient deficiency in the world. Iron is involved in oxygen transport, energy metabolism, immune response, and plays an important role in brain development. In infancy, ID is associated with adverse effects on cognitive, motor, and behavioral development
Penny, Mary Edith
Linear growth retardation or stunting may occur with or without low weight-for-age, but in both cases stunted or moderately malnourished children are deficient in micronutrients. Pregnancy and the first 2 years are critical periods. Dietary deficiency of zinc, iron, calcium, and vitamin A are especially common and often occur together. Zinc is essential for adequate growth, and supplements have been shown to increase intrauterine femur length and to prevent stunting. However, in general, supplements which provide a mixture of micronutrients have been more successful in preventing stunting and are simpler to take and distribute. Multiple micronutrients together with energy and macronutrients are also needed for the management of moderate malnutrition. Multiple micronutrients may be delivered as medicinal-like supplements, but may also be combined with food, for instance in milk drinks, in fortified dried cereal mixes used to supplement complementary foods or in lipid nutrition supplements. The latter also provide essential fats necessary for growth. Micronutrient powders for home fortification are effective in preventing anemia, but present combinations do not prevent stunting. Improving the diets of infant and young children is also possible, and increased intake of animal source foods can improve growth. Copyright © 2012 S. Karger AG, Basel.
Anna L. R. Pinto
Full Text Available INTRODUÇÃO: A deficiência de biotinidase é um erro inato do metabolismo caracterizado principalmente por ataxia, crise convulsiva retardo mental, dermatites, alopécia e susceptibilidade a infecções. É atribuída a esta deficiência enzimática a forma tardia de deficiência múltipla das carboxilases. Com o objetivo de verificar a prevalência da deficiência de biotinidase e validar o teste de triagem neonatal considerando a relação custo/benefício, elaborou-se estudo prospectivo na população de recém-nascidos no Estado do Paraná. MATERIAL E MÉTODO: Em um período de 8 meses foram triados 125.000 recém-nascidos. A amostra sangüínea foi a mesma obtida para os testes de triagem para fenilcetonúria e hipotireoidismo congênito, submetida ao teste semiquantitativo colorimétrico para atividade de biotinidase. As amostras consideradas suspeitas foram repetidas em duplicatas do mesmo cartão de papel de filtro, e as que permaneceram alteradas solicitou-se novo cartão. O teste quantitativo colorimétrico da doença foi realizado nos casos em que a segunda amostra testada em duplicata sugeriu deficiência de biotinidase. RESULTADOS: A taxa de repetição em duplicata variou de 0,9% a 0,5% do total de exames realizados por mês. A taxa de reconvocação do segundo cartão foi de 0,17%, sendo que destes 212 casos, 30% não retornaram o segundo cartão solicitado. Foram identificados 2 casos, um de deficiência total de biotinidase e outro de deficiência parcial. A prevalência da doença na população de estudo foi de 1:62.500 nascidos-vivos. A sensibilidade do teste semiquantativo colorimétrico foi calculada em 100% e a especificidade 99,88%. CONCLUSÃO: A prevalência da doença no Estado do Paraná foi de 1:125.000 nascidos-vivos para deficiência total da enzima, levando-se em consideração que 30% de casos suspeitos que repetiram novo teste. O teste semiquantitativo colorimétrico foi considerado efetivo em identificar os
Chandyo, R K; Henjum, S; Ulak, M; Thorne-Lyman, A L; Ulvik, R J; Shrestha, P S; Locks, L; Fawzi, W; Strand, T A
Iron deficiency anemia is a widespread public health problem, particularly in low- and middle-income countries. Maternal iron status around and during pregnancy may influence infant iron status. We examined multiple biomarkers to determine the prevalence of iron deficiency and anemia among breastfed infants and explored its relationship with maternal and infant characteristics in Bhaktapur, Nepal. In a cross-sectional survey, we randomly selected 500 mother-infant pairs from Bhaktapur municipality. Blood was analyzed for hemoglobin, ferritin, total iron-binding capacity, transferrin receptors and C-reactive protein. The altitude-adjusted prevalence of anemia was 49% among infants 2-6-month-old (hemaglobin (Hb) infants 7-12-month-old (Hb anemia, defined as anemia and serum ferritin infants of these same age groups. Twenty percent of mothers had anemia (Hb infant iron status and anemia were infant age, sex and duration of exclusive breastfeeding and maternal ferritin concentrations. Our findings suggest that iron supplementation in pregnancy is likely to have resulted in a low prevalence of postpartum anemia. The higher prevalence of anemia and iron deficiency among breastfed infants compared with their mothers suggests calls for intervention targeting newborns and infants.
Suryanarayana, Palla; Arlappa, Nimmathota; Sai Santhosh, Vadakattu; Balakrishna, Nagalla; Lakshmi Rajkumar, Pondey; Prasad, Undrajavarapu; Raju, Banavath Bhoja; Shivakeseva, Kommula; Divya Shoshanni, Kondru; Seshacharyulu, Madabushi; Geddam, Jagjeevan Babu; Prasanthi, Prabhakaran Sobhana; Ananthan, Rajendran
Deficiency of vitamin D has been associated with various health conditions. However, vitamin D deficiency (VDD) and factors associated with VDD are not well studied, especially among the urban elderly population of India. To assess the prevalence of VDD and its associated factors among the urban free-living elderly population in Hyderabad. A community-based cross-sectional study was conducted among 298 urban elderly (≥60 years) by adapting a random sampling procedure. Demographic particulars were collected. Blood pressure and anthropometric measurements were recorded using standard equipment. Fasting glucose, lipid profile and 25-hydroxy vitamin D [25(OH) D] were estimated in plasma samples. The mean ± SE plasma vitamin D and the prevalence of VDD among the urban elderly population were 19.3 ± 0.54 (ng/ml) and 56.3%, respectively. The prevalence of VDD was significantly associated with education, high body mass index (BMI), hypertension (HT) and metabolic syndrome (MS). Multiple logistic regression analysis revealed HT as a significant predictor of vitamin D deficiency and the risk of VDD was double among the elderly with hypertension. The prevalence of VDD was high among the urban elderly population in the south Indian city of Hyderabad. High BMI, MS, HT and education are significant associated factors of VDD.
Jennifer Hadary Cohen
Full Text Available This study had two primary objectives: 1 to derive a method to determine hemoglobin cutoffs that could be used to better estimate the prevalence of iron deficiency anemia in pregnancy at high altitudes and 2 to estimate the prevalence of anemia in a sample of pregnant women residing in two cities in Bolivia, La Paz (3 600 meters and El Alto (4 000 meters. We derived a hemoglobin-altitude curve from previously published data on the mean hemoglobin concentrations of nonanemic women of childbearing age at various altitudes. In addition, we abstracted data on hemoglobin concentration during pregnancy from medical records of women from La Paz and El Alto who had given birth at a maternity hospital in La Paz between January and June of 1996. Using our approach and two other previously published, currently used methods, we calculated and compared prevalences of iron deficiency anemia in this population using hemoglobin cutoffs determined from a hemoglobin-altitude curve corrected for pregnancy. The hemoglobin-altitude curve derived in this study provided a better fit to data for women of childbearing age than the two other models. Those models used cutoffs based on non-iron-replete populations of children or men, both of which were residing below 4 000 m, and then extrapolated to women and higher altitudes. The estimated prevalences of iron deficiency anemia in pregnancy using the hemoglobin cutoffs determined in this study were higher than those estimated by the two other approaches.
Jamal Shakir AR
Full Text Available Abstract Background Glucose-6-Phosphate dehydrogenase (G6PD is a key enzyme of the pentose monophosphate pathway, and its deficiency is the most common inherited enzymopathy worldwide. G6PD deficiency is common among Iraqis, including those of the Kurdish ethnic group, however no study of significance has ever addressed the molecular basis of this disorder in this population. The aim of this study is to determine the prevalence of this enzymopathy and its molecular basis among Iraqi Kurds. Methods A total of 580 healthy male Kurdish Iraqis randomly selected from a main regional premarital screening center in Northern Iraq were screened for G6PD deficiency using methemoglobin reduction test. The results were confirmed by quantitative enzyme assay for the cases that showed G6PD deficiency. DNA analysis was performed on 115 G6PD deficient subjects, 50 from the premarital screening group and 65 unrelated Kurdish male patients with documented acute hemolytic episodes due to G6PD deficiency. Analysis was performed using polymerase chain reaction/restriction fragment length polymorphism for five deficient molecular variants, namely G6PD Mediterranean (563 C→T, G6PD Chatham (1003 G→A, G6PD A- (202 G→A, G6PD Aures (143 T→C and G6PD Cosenza (1376 G→C, as well as the silent 1311 (C→T mutation. Results Among 580 random Iraqi male Kurds, 63 (10.9% had documented G6PD deficiency. Molecular studies performed on a total of 115 G6PD deficient males revealed that 101 (87.8% had the G6PD Mediterranean variant and 10 (8.7% had the G6PD Chatham variant. No cases of G6PD A-, G6PD Aures or G6PD Cosenza were identified, leaving 4 cases (3.5% uncharacterized. Further molecular screening revealed that the silent mutation 1311 was present in 93/95 of the Mediterranean and 1/10 of the Chatham cases. Conclusions The current study revealed a high prevalence of G6PD deficiency among Iraqi Kurdish population of Northern Iraq with most cases being due to the G6PD
Lam, Long Fung; Lawlis, Tanya R
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.
Devlieger, Roland; Guelinckx, Isabelle; Jans, Goele; Voets, Willy; Vanholsbeke, Caroline; Vansant, Greet
Background Studies report frequent micronutrient deficiencies after bariatric surgery, but less is known about micronutrient levels of pregnant women after bariatric surgery. Objective To prospectively evaluate micronutrient levels and supplement intake in pregnancy following bariatric surgery. Design A multicenter prospective cohort study including women with restrictive or malabsorptive types of bariatric surgery. Nutritional deficiencies, together with supplement intake, were screened during pregnancy. Results The total population included 18 women in the restrictive and 31 in the malabsorptive group. Most micronutrients were depleted and declined significantly during pregnancy. The proportion of women with low vitamin A and B-1 levels increased to respectively 58 and 17% at delivery (P = 0.005 and 0.002). The proportion of women with vitamin D deficiency decreased from 14% at trimester 1 to 6% at delivery (P = 0.030). Mild anemia was found in respectively 22 and 40% of the women at trimester 1 and delivery. In the first trimester, most women took a multivitamin (57.1%). In the second and third trimester, the majority took additional supplements (69.4 and 73.5%). No associations were found between supplement intake and micronutrient deficiencies. Conclusion Pregnant women with bariatric surgery show frequent low micronutrient levels. Supplementation partially normalizes low levels of micronutrients. PMID:25470614
Full Text Available Studies report frequent micronutrient deficiencies after bariatric surgery, but less is known about micronutrient levels of pregnant women after bariatric surgery.To prospectively evaluate micronutrient levels and supplement intake in pregnancy following bariatric surgery.A multicenter prospective cohort study including women with restrictive or malabsorptive types of bariatric surgery. Nutritional deficiencies, together with supplement intake, were screened during pregnancy.The total population included 18 women in the restrictive and 31 in the malabsorptive group. Most micronutrients were depleted and declined significantly during pregnancy. The proportion of women with low vitamin A and B-1 levels increased to respectively 58 and 17% at delivery (P = 0.005 and 0.002. The proportion of women with vitamin D deficiency decreased from 14% at trimester 1 to 6% at delivery (P = 0.030. Mild anemia was found in respectively 22 and 40% of the women at trimester 1 and delivery. In the first trimester, most women took a multivitamin (57.1%. In the second and third trimester, the majority took additional supplements (69.4 and 73.5%. No associations were found between supplement intake and micronutrient deficiencies.Pregnant women with bariatric surgery show frequent low micronutrient levels. Supplementation partially normalizes low levels of micronutrients.
Devlieger, Roland; Guelinckx, Isabelle; Jans, Goele; Voets, Willy; Vanholsbeke, Caroline; Vansant, Greet
Studies report frequent micronutrient deficiencies after bariatric surgery, but less is known about micronutrient levels of pregnant women after bariatric surgery. To prospectively evaluate micronutrient levels and supplement intake in pregnancy following bariatric surgery. A multicenter prospective cohort study including women with restrictive or malabsorptive types of bariatric surgery. Nutritional deficiencies, together with supplement intake, were screened during pregnancy. The total population included 18 women in the restrictive and 31 in the malabsorptive group. Most micronutrients were depleted and declined significantly during pregnancy. The proportion of women with low vitamin A and B-1 levels increased to respectively 58 and 17% at delivery (P = 0.005 and 0.002). The proportion of women with vitamin D deficiency decreased from 14% at trimester 1 to 6% at delivery (P = 0.030). Mild anemia was found in respectively 22 and 40% of the women at trimester 1 and delivery. In the first trimester, most women took a multivitamin (57.1%). In the second and third trimester, the majority took additional supplements (69.4 and 73.5%). No associations were found between supplement intake and micronutrient deficiencies. Pregnant women with bariatric surgery show frequent low micronutrient levels. Supplementation partially normalizes low levels of micronutrients.
Ahmed, Sundus; Finkelstein, Julia L.; Stewart, Anna M.; Kenneth, John; Polhemus, Mark E.; Endy, Timothy P.; Cardenas, Washington; Mehta, Saurabh
Dengue virus infection is the most widespread mosquito-borne viral infection in humans and has emerged as a serious global health challenge. In the absence of effective treatment and vaccine, host factors including nutritional status, which may alter disease progression, need investigation. The interplay between nutrition and other infections is well-established, and modulation of nutritional status often presents a simple low-cost method of interrupting transmission, reducing susceptibility, and/or ameliorating disease severity. This review examines the evidence on the role of micronutrients in dengue virus infection. We found critical issues and often inconsistent results across studies; this finding along with the lack of sufficient literature in this field have limited our ability to make any recommendations. However, vitamins D and E have shown promise in small supplementation trials. In summary, the role of micronutrients in dengue virus infection is an exciting research area and needs to be examined in well-designed studies with larger samples. PMID:25200269
Shill, Kumar B; Karmakar, Palash; Kibria, Md G; Das, Abhijit; Rahman, Mohammad A; Hossain, Mohammad S; Sattar, Mohammad M
Iron-deficiency anaemia (IDA) is a common health problem in rural women and young children of Bangladesh. The university students usually take food from residential halls, and the food value of their diets is not always balanced. This cross-sectional study was conducted to estimate the prevalence of iron-deficiency anaemia among the university students of Noakhali region, Bangladesh. Haemoglobin level of 300 randomly-selected students was measured calorimetrically, using Sahli's haemoglobinometer during October to December 2011. Statistical analysis was done by using SPSS software for Windows (version 16) (SPSS Inc., Chicago, IL, USA). In the study, 55.3% students were found anaemic, of whom 36.7% were male, and 63.3% were female. Students aged 20-22 years were more anaemic (43.4%) than other age-groups. Majority (51.3%) of male students showed their haemoglobin level in the range of 13-15 g/dL, followed by 26.0% and 21.3% with 10-12 g/dL and 16-18 g/dL respectively. Although 50.5% anaemic and 51.1% non-anaemic female students showed normal BMI--lower percentage than anaemic (60.7%) and non-anaemic (71.9%) male students, the underweight students were found more anaemic than the overweight and obese subjects. Regular breakfast-taking habit showed significant (p = 0.035, 95% CI 0.5-1.0) influence on IDA compared to non-regular breakfast takers. Consumption of meat, fish, poultry, eggs, or peanut butter regularly; junk food; multivitamins; and iron/iron-rich food showed insignificant (p = 0.097, 95% CI 0.5-1.1; p = 0.053, 95% CI 1.1-2.3; p = 0.148, 95% CI 0.6-1.2; and p = 0.487, 95% CI 0.7-1.4 respectively) role in provoking IDA. In the case of non-anaemic subjects, all of the above parameters were significant, except the junk food consumption (p = 0.342, 95% CI 0.5-1.2). Our study revealed that majority of university students, especially female, were anaemic that might be aggravated by food habit and lack of awareness. The results suggest that anaemia can be
K Ryan Wessells
Full Text Available BACKGROUND: Adequate zinc nutrition is essential for adequate growth, immunocompetence and neurobehavioral development, but limited information on population zinc status hinders the expansion of interventions to control zinc deficiency. The present analyses were conducted to: (1 estimate the country-specific prevalence of inadequate zinc intake; and (2 investigate relationships between country-specific estimated prevalence of dietary zinc inadequacy and dietary patterns and stunting prevalence. METHODOLOGY AND PRINCIPAL FINDINGS: National food balance sheet data were obtained from the Food and Agriculture Organization of the United Nations. Country-specific estimated prevalence of inadequate zinc intake were calculated based on the estimated absorbable zinc content of the national food supply, International Zinc Nutrition Consultative Group estimated physiological requirements for absorbed zinc, and demographic data obtained from United Nations estimates. Stunting data were obtained from a recent systematic analysis based on World Health Organization growth standards. An estimated 17.3% of the world's population is at risk of inadequate zinc intake. Country-specific estimated prevalence of inadequate zinc intake was negatively correlated with the total energy and zinc contents of the national food supply and the percent of zinc obtained from animal source foods, and positively correlated with the phytate: zinc molar ratio of the food supply. The estimated prevalence of inadequate zinc intake was correlated with the prevalence of stunting (low height-for-age in children under five years of age (r = 0.48, P<0.001. CONCLUSIONS AND SIGNIFICANCE: These results, which indicate that inadequate dietary zinc intake may be fairly common, particularly in Sub-Saharan Africa and South Asia, allow inter-country comparisons regarding the relative likelihood of zinc deficiency as a public health problem. Data from these analyses should be used to determine
Full Text Available The adhesin pertactin (Prn is one of the major virulence factors of Bordetella pertussis, the etiological agent of whooping cough. However, a significant prevalence of Prn-deficient (Prn(- B. pertussis was observed in Japan. The Prn(- isolate was first discovered in 1997, and 33 (27% Prn(- isolates were identified among 121 B. pertussis isolates collected from 1990 to 2009. Sequence analysis revealed that all the Prn(- isolates harbor exclusively the vaccine-type prn1 allele and that loss of Prn expression is caused by 2 different mutations: an 84-bp deletion of the prn signal sequence (prn1ΔSS, n = 24 and an IS481 insertion in prn1 (prn1::IS481, n = 9. The frequency of Prn(- isolates, notably those harboring prn1ΔSS, significantly increased since the early 2000s, and Prn(- isolates were subsequently found nationwide. Multilocus variable-number tandem repeat analysis (MLVA revealed that 24 (73% of 33 Prn(- isolates belong to MLVA-186, and 6 and 3 Prn(- isolates belong to MLVA-194 and MLVA-226, respectively. The 3 MLVA types are phylogenetically closely related, suggesting that the 2 Prn(- clinical strains (harboring prn1ΔSS and prn1::IS481 have clonally expanded in Japan. Growth competition assays in vitro also demonstrated that Prn(- isolates have a higher growth potential than the Prn(+ back-mutants from which they were derived. Our observations suggested that human host factors (genetic factors and immune status that select for Prn(- strains have arisen and that Prn expression is not essential for fitness under these conditions.
Full Text Available Glucose-6-Phosphate Dehydrogenase (G6PD enzyme deficiency is known to offer protection against malaria and an increased selection of mutant genes in malaria endemic regions is expected. However, anti-malarial drugs such as primaquine can cause haemolytic anaemia in persons with G6PD deficiency. We studied the extent of G6PD deficiency in selected persons attending Teaching Hospitals of Anuradhapura and Kurunegala, two previously high malaria endemic districts in Sri Lanka. A total of 2059 filter-paper blood spots collected between November 2013 and June 2014 were analysed for phenotypic G6PD deficiency using the modified WST-8/1-methoxy PMS method. Each assay was conducted with a set of controls and the colour development assessed visually as well as with a microplate reader at OD450-630nm. Overall, 142/1018 (13.95% and 83/1041 (7.97% were G6PD deficient in Anuradhapura and Kurunegala districts respectively. The G6PD prevalence was significantly greater in Anuradhapura when compared to Kurunegala (P0.05. Severe deficiency (<10% normal was seen among 28/1018 (2.75% in Anuradhapura (7 males; 21 females and 17/1041 (1.63% in Kurunegala (7 males; 10 females. Enzyme activity between 10-30% was observed among 114/1018 (11.20%; 28 males; 86 females in Anuradhapura while it was 66/1041 (6.34%; 18 males; 48 females in Kurunegala. Screening and educational programmes for G6PD deficiency are warranted in these high risk areas irrespective of gender for the prevention of disease states related to this condition.
Goncalves, Aurélie; Amiot, Marie-Josèphe
Purpose of review Metabolic syndrome (MetS) is associated with increased risk of obesity, type 2 diabetes mellitus and cardiovascular diseases. MetS prevalence has been associated with diet inadequacy. Conversely, the cumulative incidence of MetS has been inversely associated with a Mediterranean-style diet that includes many different health-beneficial nutrients. Adherence to a Mediterranean-style diet could reduce or at least stabilize metabolic risk factors. Recent findings Low serum level of fat-soluble micronutrients, such as carotenoids, vitamin (vit) A, D and E, has been linked to MetS. Fat-soluble micronutrients could contribute to prevent MetS thanks to their antioxidant and anti-inflammatory properties (vit E, carotenoids) or to their central role as hormone regulators (vit D) and/or lipid metabolism and glucose homeostasis sensors (vit D and E). Summary This review summarizes recent epidemiological studies linking fat-soluble micronutrients to MetS and highlights new evidence on their mechanisms of actions. PMID:28858890
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
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.
In order to assess the current nutrition status of Mongolian population, including rickets and vitamin D deficiency of children and women, the Fourth National Nutrition Cross-Sectional Survey was conducted in 21 aimags (provinces) of 4 economic regions of the country and capital city Ulaanbaatar in 2010. Children of age under five years, and non-pregnant women of reproductive age were used as subjects for assessing rickets and vitamin D deficiency. A total of 400 households were randomly selected from each of 4 economic regions and Ulaanbaatar city. Clinical examinations were performed on 706 children of age under five years. Interviews were used to assess vitamin D supplement use. The serum level of 25-hydroxyvitamin D was measured in 524 children aged 6-59 months and in 867 women of reproductive age. This survey found that 21.8% of children had vitamin D deficiency, 20.6% had low vitamin D reserve, and 30.0% of women had vitamin D deficiency and 22.2% had low vitamin D reserve. The prevalence of vitamin D deficiency in children (35.0%, 95% CI, 24.7-47.0) and women (54.9%, 95% CI 45.5-64.0) in the Eastern Region was (35.0%, 95% CI, 24.7-47.0) significantly higher than in the Western, Khangai, Central Regions, and Ulaanbaatar. Further it was found that 27.4% of children under-two years had received vitamin D supplementation. The proportion of children, who did not receive vitamin D supplementation had a higher prevalence of vitamin D deficiency than that of the children of the Eastern Region. None of the women who were involved in this survey had received vitamin D supplementation; 10.2% of them had delivered in the past 12 months, and 22.5% were breastfeeding. The prevalence of classic signs and symptoms of rickets were commonly reported among children of age under five, and skeletal abnormalities more commonly reported in children aged 12-47 months. In conclusion, there is a high prevalence of classic signs and symptoms of rickets in children of age under five
McGrice, Melanie A; Porter, Judi A
Patients who have undergone bariatric surgery have increased risks of developing micronutrient deficiencies. Translational research investigating the actual micronutrient intake of bariatric patients is limited. We examined the micronutrient intake of a multicentre cohort of laparoscopic adjustable gastric banding patients 1 year post-surgery. These data were compared to micronutrient recommendations for the general population. Consecutive patients from three bariatric surgery facilities in Melbourne, Australia, were invited to participate 12 months post-operatively. A validated food frequency questionnaire was posted to 215 prospective participants. Of the 52 participants, micronutrient intakes from food and fluids alone were below population recommendations for calcium, folate, magnesium, potassium, retinol equivalents, thiamin and vitamin E. Males did not meet the recommended intakes for zinc, and iron intakes in pre-menopausal women were insufficient. Intakes lower than recommended levels for these micronutrients suggest inadequate intake of foods from vegetable, dairy, lean meat (or alternatives) and wholegrains. Micronutrient intakes below recommended levels in this patient group can be further explained by their macronutrient intakes that suggested diets of poor nutrient density. Recommendations for supplementation in this group have wide variations, usually having been developed through the presence of clinical and biochemical deficiencies. Nutritional supplementation should be more extensive in scope and dosage than is currently recommended by some professional guidelines. Further long-term studies are needed to explore both macro- and micronutrient intakes on the morbidity and mortality of this patient population.
Amoah, Linda Eva; Opong, Akua; Ayanful-Torgby, Ruth; Abankwa, Joana; Acquah, Festus K
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked genetic disorder that results in impaired enzyme activity. Although G6PD deficiency is globally distributed it is more prevalent in malaria-endemic countries. Several mutations have been identified in the G6PD gene, which alter enzyme activity. The G6PD genotype predominantly found in sub-Saharan Africa is the G6PDB (G6PD376A) with (G6PD376G) and G6PDA- (G6PD376G/202A, G6PD376G/542T, G6PD376G/680T and G6PD376G/968C) occurring at lower frequencies. The aim of this study was to identify the prevalence of G6PD deficiency and asymptomatic Plasmodium falciparum carriage in children living in southern Ghana and determine whether G6PD deficiency influences asymptomatic carriage of P. falciparum parasites. Blood samples were obtained once a month from 170 healthy Ghanaian school children aged between 5 and 12 years from Basic schools in two communities Obom and Abura with similar rainfall patterns and malaria peak seasons. G6PD enzyme activity was assessed using the qualitative G6PD RDT kit (AccessBIO). G6PD genotyping and asymptomatic parasite carriage was determined by PCR followed by restriction fragment length polymorphism (RFLP) of DNA extracted from dried blood spots. The only sub-Saharan G6PD A- allele detected was the A376G/G202A found in 12.4 % (21/170), of the children and distributed as 4.1 % (7/170) A-, 1.8 % (3/170) A-/A- homozygous deficient males and females and 6.5 % (11/170) A/A- and B/A- heterozygous deficient females. Phenotypically, 10.6 % (15/142) of the children were G6PD deficient. The asymptomatic carriage of P. falciparum by PCR was 50, 29.4, 38.2 and 38.8 % over the months of February through May 2015, respectively, and 28.8, 22.4, 25.9 and 5.9 % by microscopy during the same periods. G6PD deficiency was significantly associated with a lowered risk of PCR-estimated asymptomatic P. falciparum carriage in children during the off peak malaria season in Southern Ghana.
Martínez-Torres, Javier; Meneses-Echavéz, José F; Ramírez-Vélez, Robinson
To examine the sociodemographic factors associated with subclinical vitamin A deficiency in a representative sample of Colombian children. Subjects and methods A cross-sectional, descriptive study was conducted of data from the 2010 National Nutrition Survey of Colombia (ENSIN 2010) on 4,279 children aged 12 to 59 months. Plasma vitamin A levels were measured using high resolution liquid chromatography (HRLC), and sociodemographic factors (sex, age, ethnicity, SISBEN score, and geographic region) were collected using a structured survey. Prevalence rates and associations were established using a multivariate regression model. Vitamin A levels ranged from 7.5-93.7 μg/dL (mean=26.2; 95% CI, 25.9 to 26.5μg/dL). Vitamin A levels less than 20 μg/dL (subclinical deficiency) were found in 24.3% of children. Children belonging to ethnic groups of African ascent, those living in the Orinoquia and Amazonia regions, and those aged 12-23 months had the greatest subclinical vitamin A deficiencies (29.5%, 31.1%, and 27.6% respectively. Regression models showed that age ranging from 12 and 23 months (OR 1.32; 95% CI, 1.01 to 1.73), a SISBEN score 1 (OR 1.66; 95% CI, 1.18 to 2.34), an African ascent (OR 1.35; 95% CI, 1.05 to 1.74), and living in the Orinoquia and Amazonia regions (OR 2.38; 95% CI, 1.62 to 3.51) were factors associated to subclinical vitamin A deficiency. The study population shows a high prevalence of subclinical vitamin A deficiency, and comprehensive interventions involving nutritional and educational components are therefore recommended. Copyright © 2014 SEEN. Published by Elsevier Espana. All rights reserved.
Frascari, Flora; Dreyfus, Isabelle; Rodriguez, Lauriane; Gennero, Isabelle; Ezzedine, Khaled; Salles, Jean-Pierre; Mazereeuw-Hautier, Juliette
To date, few studies have investigated serum vitamin D status in patients with inherited ichthyosis. The aim of this study was to determine the prevalence of vitamin D deficiency (defined as serum level ichthyosis, and phototypes IV-VI were identified as independent risk factors for vitamin D deficiency. Clinicians should be aware of the risk of vitamin D deficiency in the management of patients with inherited ichthyosis, especially in winter and spring, and in case of dark skin or severe disease.
Conclusion: Prevalence and symptom characteristics of KDS were found to increase consistently with increasing age and deteriorating health status. Kidney deficiency may be an important mechanism of aging in the subhealthy and chronic disease states.
Bendaoud, B; Hosni, I; Mosbahi, I; Hafsia, R; Prehu, C; Abbes, S
A previous study on G6PD deficiency carried out on Tunisian population, led to the finding of seven different mutations with the prevalence of G6PD A- variant. This present study reports 23 new unrelated deficient subjects studied at the molecular level to determine the mutation that causes G6PD deficiency. Using PCR-SSCP of coding regions followed by direct sequencing of abnormal pattern, three new mutations were detected. Two of them are polymorphic intronic mutations. The first is IVS-V 655C-->C/T, found in four female subjects with mild deficiency of class III variant. The second is IVS-VIII 43 G-->A, found in three male subjects with mild deficiency of class III variant. The third mutation is in the exon region so that it changes the primary structure of the molecule. It is cited for the first time and named G6PD Tunisia. This variant affects the exon 7 of the gene at genomic position 15435 G→T. Its cDNA position is 93 G→G/T, it changes arg 246 to leu. This mutation was found in one heterozygote female with deficiency of class II who have had hemolytic anemia due to ingestion of fava beans. Finally, G6PD Med variant, reported before in three cases, was also found in five other cases (four heterozygote females and one male hemizygote). These findings first enlarge the spectre of mutations to be ten variant mutations, characterizing the Tunisian population and also contribute with hemoglobin gene research in our laboratory to trace the whole genetic map of Tunisian population. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Mateo-Pascual, Carmen; Julián-Viñals, Rosa; Alarcón-Alarcón, Teresa; Castell-Alcalá, Maria Victoria; Iturzaeta-Sánchez, Jose Manuel; Otero-Piume, Angel
Vitamin D deficiency is common in the elderly, especially among institutionalized and/or hip fracture patients. However, there are few population studies on the prevalence of this deficiency in the general population over 64 years in our environment. The aim of this study was to determine the prevalence of vitamin D deficiency in an urban population cohort of over 64 years, and analyze its relationship with sociodemographic, climatic, and health factors. Cross-sectional study from «Peñagrande cohort», a population-based cohort consisting of people over 64 years. We determined 25-hydroxyvitamin D levels, and recorded sociodemographic data (age, sex, marital status, education, socioeconomic status), season of measurement and health variables (comorbidity, obesity, malnutrition, renal failure, cognitive impairment, vitamin D supplements, and disability). A total of 468 individuals with a mean age of 76.0 years (SD: 7.7) were included, of which 53.4% were women. The mean value of vitamin D was 20.3 ± 11.7 ng/mL. The large majority (86.3%, 95% CI: 83.0-89.5) had a vitamin insufficiency (≤ 30 ng/ml), and 35.2% (95% CI: 30.8-39.7) showed severe vitamin deficiency (≤ 15 ng/ml). Vitamin insufficiency increases linearly with age (OR 1.06; 95% CI: 1.01-1.11), and was associated with low socioeconomic status (OR 3.29; 95% CI: 1.55-6.95). Severe vitamin D deficiency increases with age (OR 1.06; 95% CI: 1.02-1.09), female gender (OR 1.80; 95% CI: 1.18-2.75) and with cognitive impairment (OR 1.71; 95% CI: 1.04-2.83). The prevalence of vitamin D deficiency in people over 65 years of age in our community is high. It would be advisable to determine the vitamin D values in the high risk elderly in order to introduce measures of pharmacological supplementation in those with inadequate levels. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.
Nouran M. Abaza
Full Text Available Background The emerging role of vitamin D in immunology and autoimmune disorders has been a worldwide interest in the last decade. Systemic lupus erythematosus (SLE patients are particularly at a delicate position predisposing them to suffer from vitamin D deficiency due to the multiple risk factors accompanying the disease. Whether vitamin D deficiency is also involved as a risk factor for developing SLE and affecting its course is a considerable concern. Objectives The objective of this study was to estimate the prevalence of vitamin D deficiency in SLE patients and its relation to disease. MATERIALS AND METHODS: In our observational cross-sectional study, serum levels of vitamin D [25(OHD] in 60 SLE patients and 30 age- and sex-matched healthy controls were assessed and estimated for deficiency and insufficiency at 10 and 30 ng/mL, respectively. Disease activity was evaluated by SLE disease activity index (SLEDAI, irreversible organ damage by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI, and severity by Severity of Disease Index. Fatigue was measured by visual analog scale. Results Significantly lower levels of 25(OHD were found in SLE patients (17.6 ± 6.9 ng/mL in comparison to controls (79.0 ± 28.7 ng/mL, with a statistically high significant difference ( t = -11.2, P < 0.001. High prevalence of vitamin D insufficiency and deficiency was detected as 73.3% and 23.3%, respectively. Vitamin D had a highly significant negative correlation with SLEDAI ( r = -0.495, P < 0.001, SLICC ( r = -0.431, P < 0.05, and fatigue ( r = -0.436, P < 0.05. Conclusion Vitamin D deficiency and insufficiency were found to be prevalent in SLE patients in our study and related to disease activity and fatigue. If needed, routine screening and consequent repletion of vitamin D are recommended in SLE patients. Restoring adequate vitamin D levels in SLE patients should be more explored as a potential
Leão, Ana Luisa Marcucci; dos Santos, Luana Caroline
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.
Nakhaee Ali Reza
Full Text Available Background: GLucose-6-phosphate dehydrogenase (G6PD deficiency is the most common known enzymopathy in human. G6PD deficiency is usually asymptomatic, however, deficient individuals are at increased risk of developing acute hemolytic anemia and hyperbilirubinemia following intake of oxidative agents and fava. The objective of present study was to detect prevalence of G6PD deficiency in admitted males for premarriage tests in Zahedan Reference Laboratory. Also, we compared blood indices of normal and G6PD deficient individuals.Materials and Methods: This descriptive study was carried out on 1340 admitted males in Zahedan Reference Laboratory from February 2008 to March 2009. G6PD activity was determined in EDTA containing blood samples by qualitative fluorescence spot test, then G6PD deficiency was confirmed by quantitative spectrophotometric method. Total leukocyte count and RBC indices of G6PD deficient samples and the same number of normal samples were compared. The differences between two groups were compared using Sigmaplot software and t-Student test. A P-value less than 0.05 was considered statistically significant.Results: G6PD deficiency was found in 84 individuals of total 1340 by fluorescence spot test and confirmed in 79 by quantitative method. Therefore, prevalence of G6PD deficiency in Zahedan was estimated to be 5.9%. Comparison of deficient and normal individuals did not show significant difference in WBC count, RBC count, hemoglobin concentration, hematocrit, mean corpuscular hemoglobin (MCH and RDW-SD. However, mean corpuscular volume (MCV was significantly high and mean corpuscular hemoglobin concentration (MCHC and RDW-CV were significantly low in G6PD deficient individuals compared to those with normal enzyme level.Discussion: Present study revealed that the prevalence of G6PD deficiency in Zahedan is 5.9%. Severity of G6PD deficiency in quantitative assay indicated that class I and II are probably dominant variants in
Conclusion: Vitamin D is highly deficient in Agh Ghala inhabitants; particularly in men. This requires transferring the necessary information to the community and persuading them to improve their life style.
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.
Xanthakos, Stavra A
The presence of nutritional deficiencies in overweight and obesity may seem paradoxical in light of excess caloric intake, but several micronutrient deficiencies appear to be higher in prevalence in overweight and obese adults and children. Causes are multifactorial and include decreased consumption of fruits and vegetables, increased intake of high-calorie, but nutritionally poor-quality foods, and increased adiposity, which may influence the storage and availability of some nutrients. As the obesity epidemic continues unabated and the popularity of bariatric surgery rises for severely obese adults and adolescents, medical practitioners must be aware of pre-existing nutritional deficiencies in overweight and obese patients and appropriately recognize and treat common and rare nutritional deficiencies that may arise or worsen following bariatric surgery. This article reviews current knowledge of nutritional deficits in obese and overweight individuals and those that commonly present after bariatric surgery and summarizes current recommendations for screening and supplementation.
Ramakrishnan, Usha; Goldenberg, Tamar; Allen, Lindsay H
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 (child morbidity, anemia, and 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.
Pinto Anna L. R.
Full Text Available INTRODUÇÃO: A deficiência de biotinidase é um erro inato do metabolismo caracterizado principalmente por ataxia, crise convulsiva retardo mental, dermatites, alopécia e susceptibilidade a infecções. É atribuída a esta deficiência enzimática a forma tardia de deficiência múltipla das carboxilases. Com o objetivo de verificar a prevalência da deficiência de biotinidase e validar o teste de triagem neonatal considerando a relação custo/benefício, elaborou-se estudo prospectivo na população de recém-nascidos no Estado do Paraná. MATERIAL E MÉTODO: Em um período de 8 meses foram triados 125.000 recém-nascidos. A amostra sangüínea foi a mesma obtida para os testes de triagem para fenilcetonúria e hipotireoidismo congênito, submetida ao teste semiquantitativo colorimétrico para atividade de biotinidase. As amostras consideradas suspeitas foram repetidas em duplicatas do mesmo cartão de papel de filtro, e as que permaneceram alteradas solicitou-se novo cartão. O teste quantitativo colorimétrico da doença foi realizado nos casos em que a segunda amostra testada em duplicata sugeriu deficiência de biotinidase. RESULTADOS: A taxa de repetição em duplicata variou de 0,9% a 0,5% do total de exames realizados por mês. A taxa de reconvocação do segundo cartão foi de 0,17%, sendo que destes 212 casos, 30% não retornaram o segundo cartão solicitado. Foram identificados 2 casos, um de deficiência total de biotinidase e outro de deficiência parcial. A prevalência da doença na população de estudo foi de 1:62.500 nascidos-vivos. A sensibilidade do teste semiquantativo colorimétrico foi calculada em 100% e a especificidade 99,88%. CONCLUSÃO: A prevalência da doença no Estado do Paraná foi de 1:125.000 nascidos-vivos para deficiência total da enzima, levando-se em consideração que 30% de casos suspeitos que repetiram novo teste. O teste semiquantitativo colorimétrico foi considerado efetivo em identificar os
Anna L. R. Pinto
Full Text Available INTRODUÇÃO: A deficiência de biotinidase é um erro inato do metabolismo caracterizado principalmente por ataxia, crise convulsiva retardo mental, dermatites, alopécia e susceptibilidade a infecções. É atribuída a esta deficiência enzimática a forma tardia de deficiência múltipla das carboxilases. Com o objetivo de verificar a prevalência da deficiência de biotinidase e validar o teste de triagem neonatal considerando a relação custo/benefício, elaborou-se estudo prospectivo na população de recém-nascidos no Estado do Paraná. MATERIAL E MÉTODO: Em um período de 8 meses foram triados 125.000 recém-nascidos. A amostra sangüínea foi a mesma obtida para os testes de triagem para fenilcetonúria e hipotireoidismo congênito, submetida ao teste semiquantitativo colorimétrico para atividade de biotinidase. As amostras consideradas suspeitas foram repetidas em duplicatas do mesmo cartão de papel de filtro, e as que permaneceram alteradas solicitou-se novo cartão. O teste quantitativo colorimétrico da doença foi realizado nos casos em que a segunda amostra testada em duplicata sugeriu deficiência de biotinidase. RESULTADOS: A taxa de repetição em duplicata variou de 0,9% a 0,5% do total de exames realizados por mês. A taxa de reconvocação do segundo cartão foi de 0,17%, sendo que destes 212 casos, 30% não retornaram o segundo cartão solicitado. Foram identificados 2 casos, um de deficiência total de biotinidase e outro de deficiência parcial. A prevalência da doença na população de estudo foi de 1:62.500 nascidos-vivos. A sensibilidade do teste semiquantativo colorimétrico foi calculada em 100% e a especificidade 99,88%. CONCLUSÃO: A prevalência da doença no Estado do Paraná foi de 1:125.000 nascidos-vivos para deficiência total da enzima, levando-se em consideração que 30% de casos suspeitos que repetiram novo teste. O teste semiquantitativo colorimétrico foi considerado efetivo em identificar os
Osman, Faiza Mohamed
iron deficiency anaemia (IDA) is a public health problem throughout the world. Childhood iron deficiency anaemia. A prospective survey (systematic, cluster sampling) was carried out among pre-school children in Alshigla area (Khartoum State), to study the prevalence and aetological factors of IDA. 170 children selected for general nutritional evaluation, 110 of them for haemoglobin levels and morphological classification of anaemia, 70 for further investigations(serum iron, unsaturated iron binding capacity, total iron binding capacity). The population at Alshigla were living in poor condition 85.3% relied on water brought by tankers which showed poor hygienic standard, 90% lived in extended families 54.1% had income level less than LS 3000/day irrespective of family size or mode of spending. A sample of 170 children showed (84.1%) normal nutritional status with 4.7% severe cases with high consumption of cereals low meat, fish and poultry group and vitamin C(22.9%). Disease episodes showed 67.7% had diarrhoea, 22.4% had giardia, 12.9% had malaria and 10.6% had worm infestation. This most probably due to unsanitary living condition. Haemoglobin analysis using Enzyme Linked Immunosorbent assay technique (ELISA) for 110 of the children, showed high prevalence of anaemia (96.4%), 66% prevalence of IDA. Further haematological investigations of 50 of the children confirmed them as IDA cases.Thus the high prevalence of IDA in Alshigla was multi-factorial, inadequate take of dietary iron and of vitamin C, high intake of cereals and legumes, low intake of meat, poultry and fish group (MPF),and high tea consumption, thus food provides inadequate supply of iron and were rich in inhibitors of iron absorption. In addition episodes of diseases that may influence food (hence iron) utilisation contributed to the prevalence of IDA
Regina Esteves Jordão
Full Text Available OBJETIVO: Revisar os estudos de prevalência de anemia no Brasil publicados entre janeiro de 1996 e janeiro de 2007. FONTES DE DADOS: Por meio de revisão sistemática nas bases de dados eletrônicas Medline e Lilacs, foram selecionados títulos científicos publicados no intervalo de onze anos referentes à prevalência de anemia no Brasil em crianças menores de cinco anos de idade. Foram excluídos artigos de revisão, relatos de caso e trabalhos que relacionaram anemia a outras doenças e ao período gestacional. Para a análise comparativa das variáveis categóricas de interesse nos artigos encontrados, realizou-se o teste do qui-quadrado e o teste exato de Fisher, levando-se em conta o nível de significância estatística de 5% (pOBJECTIVE: To conduct a systematic review on the prevalence of anemia due to iron-deficiency in Brazil from January 1996 to January 2007. DATA SOURCES: A systematic review was conducted in electronic databases (Medline and Lilacs in an eleven-year interval to verify the prevalence of iron deficiency anemia in children who were less than five years of age in Brazil. Reviews, case reports and studies related to anemia during pregnancy and anemia caused by others diseases were excluded. In order to describe the categorical variables according to the selected articles, the chi-square and Fisher exact tests were used. The significance level adopted was 5% (p<0.05. DATA SYNTHESIS: The median prevalence level of anemia was 53%, which is considered a high prevalence rate by the World Health Organization. Among the 53 analyzed studies, the age of the children was the variable strongly associated with anemia (p=0.012. CONCLUSIONS: A high prevalence of anemia, mostly in children less than two years of age, was observed in this review. However, most studies were carried out in day care centers or in Basic Health Care Units or were obtained by home interviews, suggesting that future research should focus populational studies.
Tanaka, Masahiro; Nakajima, Takeshi; Sugano, Kokichi; Yoshida, Teruhiko; Taniguchi, Hirokazu; Kanemitsu, Yukihide; Nagino, Masato; Sekine, Shigeki
The aim of this study was to examine the expression of mismatch repair (MMR) proteins in Lynch syndrome (LS)-associated colorectal adenomas and to evaluate their relationship with clinicopathological variables and potential utility in LS screening. We performed immunohistochemistry for MLH1, PMS2, MSH2 and MSH6 in 134 adenomas obtained from 26 genetically confirmed LS patients. MMR deficiency, as determined by loss of any MMR protein, was observed in 113 adenomas (84%). All the MMR-deficient adenomas exhibited homogeneous loss of MMR proteins, which reflected underlying germline mutations. MMR deficiency was more frequent in adenomas obtained from older patients (aged ≥60 years; 81 of 86, 94%), with larger tumour size (>5 mm; 71 of 73, 97%) and with high-grade dysplasia (50 of 51, 98%). Multivariate analyses indicated that increased age and larger tumour size were associated independently with MMR deficiency. This study shows that MMR deficiency is associated significantly with increased age, in addition to two previously reported factors-larger size and high-grade dysplasia. When adenomas are analysed during LS screening, high sensitivity is expected if the adenomas are associated with any of these three factors. © 2016 John Wiley & Sons Ltd.
Zhu, Tong; Liu, Tian-Jing; Ge, Xin; Kong, Juan; Zhang, Li-Jun; Zhao, Qun
Maternal vitamin D deficiency has been associated with a number of fetal and neonatal health problems. Preterm birth is one of the most detrimental, and the role of maternal vitamin D deficiency in preterm births has not been universally acknowledged. There had been limited epidemiological studies of vitamin D deficiency on the Chinese population. 1103 women delivered in Shengjing Hospital, China Medical University from January 1(st), 2012 to January 1(st), 2013. Finally, 821 mother-newborn pairs which contained 143 mother-newborn pairs who were preterm delivery were recruited for analysis. There was significant difference between spring and summer (Pwomen in very preterm group, compared with 36.61% in in-term group. Vitamin D nutritional status of pregnant women and their newborns in Shenyang were relatively good compared to cities in similar latitudes. Vitamin D deficiency was most severe in late spring and least in summer. Severe preterm births before 31 weeks of gestation was associated with maternal vitamin D deficiency.
Howes, Rosalind E; Chan, Ernest R; Rakotomanga, Tovonahary Angelo; Schulte, Seth; Gibson, John; Zikursh, Melinda; Franchard, Thierry; Ramiranirina, Brune; Ratsimbasoa, Arsène; Zimmerman, Peter A
The prevalence and variants of G6PD deficiency in the Plasmodium vivax-endemic zones of Madagascar remain unknown. The admixed African-Austronesian origins of the Malagasy population make it probable that a heterogeneous mix of genetic variants with a spectrum of clinical severity will be circulating. This would have implications for the widespread use of P. vivax radical cure therapy. Two study populations in the P. vivax-endemic western foothills region of Madagascar were selected for G6PD screening. Both the qualitative fluorescent spot test and G6PD genotyping were used to screen all participants. A total of 365 unrelated male volunteers from the Tsiroanomandidy, Mandoto, and Miandrivazo districts of Madagascar were screened and 12.9% were found to be phenotypically G6PD deficient. Full gene sequencing of 95 samples identified 16 single nucleotide polymorphisms, which were integrated into a genotyping assay. Genotyping (n = 291) found one individual diagnosed with the severe G6PD Mediterranean C563T mutation, while the remaining G6PD deficient samples had mutations of African origin, G6PD A- and G6PD A. Deployment of P. vivax radical cure in Madagascar must be considerate of the risks presented by the observed prevalence of G6PDd prevalence. The potential morbidity associated with cumulative episodes of P. vivax clinical relapses requires a strategy for increasing access to safe radical cure. The observed dominance of African G6PDd haplotypes is surprising given the known mixed African-Austronesian origins of the Malagasy population; more widespread surveying of G6PDd epidemiology across the island would be required to characterize the distribution of G6PD haplotypes across Madagascar.
Bal, Bikram S; Finelli, Frederick C; Shope, Timothy R; Koch, Timothy R
Lifestyle intervention programmes often produce insufficient weight loss and poor weight loss maintenance. As a result, an increasing number of patients with obesity and related comorbidities undergo bariatric surgery, which includes approaches such as the adjustable gastric band or the 'divided' Roux-en-Y gastric bypass (RYGB). This Review summarizes the current knowledge on nutrient deficiencies that can develop after bariatric surgery and highlights follow-up and treatment options for bariatric surgery patients who develop a micronutrient deficiency. The major macronutrient deficiency after bariatric surgery is protein malnutrition. Deficiencies in micronutrients, which include trace elements, essential minerals, and water-soluble and fat-soluble vitamins, are common before bariatric surgery and often persist postoperatively, despite universal recommendations on multivitamin and mineral supplements. Other disorders, including small intestinal bacterial overgrowth, can promote micronutrient deficiencies, especially in patients with diabetes mellitus. Recognition of the clinical presentations of micronutrient deficiencies is important, both to enable early intervention and to minimize long-term adverse effects. A major clinical concern is the relationship between vitamin D deficiency and the development of metabolic bone diseases, such as osteoporosis or osteomalacia; metabolic bone diseases may explain the increased risk of hip fracture in patients after RYGB. Further studies are required to determine the optimal levels of nutrient supplementation and whether postoperative laboratory monitoring effectively detects nutrient deficiencies. In the absence of such data, clinicians should inquire about and treat symptoms that suggest nutrient deficiencies.
Amrutha Veena, K; Kowsalya, S; Kothandapani, S
The present study aimed to evaluate the nutritional status of infants in Ramanathapuram district of Tamilnadu. The present study comprised a community-based cross-sectional study conducted in seven taluks of the Ramanathapuram district. A total of 2800 infants (female infants were selected from all the seven taluks of the Ramanathapuram district at random. Anthropometric parameters such as weight, crown heel length, head circumference, arm circumference and chest circumference were measured using standardised procedures. Clinical examinations for the manifestation of micronutrient deficiency signs were performed. Biochemical estimations of serum haemoglobin, vitamin A and urinary iodine were estimated for 5% of the infants. Low birth weight was obeserved among 33.5% of the infants, with 1.6% weighing female infants. Subclinical deficiency of haemoglobin, vitamin A and iodine were obeserved among 67.1%, 52.1% and 32.9% of the infants, respectively. Micronutrient deficiencies pertaining to the 'Big 3', namely vitamin A deficiency, iodine deficiency disorders and iron deficiency anaemia are still common among the infants of Ramanathapuram district, leading to the need for effective intervention measures. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.
Kirkegaard-Klitbo, Ditte Marie; Perslev, Kathrine; Andersen, Stine Linding
INTRODUCTION: Iodine is essential for the production of thyroid hormones. In pregnancy, physiological changes occur that can lead to iodine deficiency and impairment of fetal neurological development. We aimed to assess the iodine intake in pregnant women in Eastern Denmark, compare iodine levels...
ishak abdurrahman isik
Conclusion: Although vitamin B 12 levels of HP positive patients were lower than that of HP negative patients this differance was not statistically significant. Hereafter new studies with high number of patients will be helpful to investigate relation between HP infection and vitamin B 12 deficiency. [J Contemp Med 2015; 5(4.000: 221-225
Introduction: Diabetes Mellitus is the most common endocrine disorder and metformin is the most commonly prescribed oral hypoglycemic agent. Metformin is well known to cause viamin B12 deficiency due to effect on calcium-dependent membrane action in the terminal ileum leading to malabsorption of vitamin B12.
García-Carrasco, Mario; Mendoza-Pinto, Claudia; Etchegaray-Morales, Ivet; Soto-Santillán, Pamela; Jiménez-Herrera, Erick Alejandro; Robles-Sánchez, Viridiana; Rodríguez-Gallegos, Alma; Ramos-Varela, Araceli; Muñoz-Guarneros, Margarita; Ruiz-Argüelles, Alejandro
To determine and compare the prevalence of vitamin D insufficiency and deficiency in patients with systemic lupus erythematosus (SLE) with and without disease activity. We made a comparative, observational, cross-sectional, prospective study of 137 women with SLE according to American College of Rheumatology criteria. Patients with chronic kidney disease, cancer, hyperparathyroidism, pregnancy, and lactation were excluded. Disease activity was assessed using the MEX-SLEDAI score: a score of ≥3 was considered as disease activity. Data were collected on diabetes mellitus, the use of corticosteroids, chloroquine, and immunosuppressants, photoprotection and vitamin D supplementation. Vitamin D levels were measured by chemiluminescent immunoassay: insufficiency was defined as serum 25-hydroxyvitamin D D insufficiency and deficiency was found in 122(89.0%) and 4 (2.9%) patients, respectively. There was no significant difference in vitamin D levels between patients with and without active disease (19.3±4.5 versus 19.7±6.8; P=.75). No correlation between the MEX-SLEDAI score (P=.21), photosensitivity, photoprotection, prednisone or chloroquine use and vitamin D supplementation was found. Women with SLE had a high prevalence of vitamin D insufficient. No association between vitamin D levels and disease activity was found. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.
Claudine Juliana C Burkievcz
Full Text Available OBJETIVO: Estudar se a prevalência da deficiência de vitamina D em indivíduos com úlcera de perna de causa venosa é maior do que em população controle. MÉTODOS: Estudaram-se os níveis séricos de 25-OH-vitamina D por quimioluminescência em 27 portadores de úlcera venosa crônica e 58 controles do Hospital Universitário Evangélico de Curitiba. RESULTADOS: Os níveis de 25-OH-vitamina D3 eram inferiores a 8 ng/dl em 11,1% dos pacientes com úlcera e 3,4% dos controles; entre 8 e 20 ng/dl em 46,1% dos pacientes com úlcera e 25,8% dos controles; entre 21 e 30 ng/dl em 22.2% dos pacientes com úlcera e 27,5% dos controles e acima de 30 ng/dl em 43,1% dos controles e 18,5% dos pacientes com úlcera (p=0,04. CONCLUSÃO: Existe aumento de prevalência de deficiência de vitamina D em pacientes com úlceras venosas crônicas de pernas.
Ickowitz, Amy; Rowland, Dominic; Powell, Bronwen; Salim, Mohammad Agus; Sunderland, Terry
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
Hazart , J.; Le Guennec , D.; Accoceberry , M.; LEMERY , D.; Mulliez , A.; Farigon , N.; Lahaye , C.; Miolanne-Debouit , M.; Boirie , Yves
The aim is to compare the prevalence of maternal deficiencies in micronutrients, the obstetrical and neonatal complications after bariatric surgery according to surgical techniques, the time between surgery and conception, and BMI at the onset of pregnancy. A retrospective cohort study concerned 57 singleton pregnancies between 2011 and 2016 of 48 adult women who have undergone bariatric surgery. Small-for-gestational-age neonates were identified in 36.0% of pregnancies. With supplements inta...
Kirkegaard-Klitbo, Ditte Marie; Perslev, Kathrine; Andersen, Stine Linding
-containing supplements (86%). The median UIC was 118 (interquartile range (IQR): 79-196) µg/l in iodine supplement users and 82 (IQR: 41-122) µg/l in non-users (p education, non-Danish origin and pre-pregnancy obesity....... CONCLUSIONS: The iodine status in Danish pregnant women was below WHO recommendations. Iodine supplement non-users are at a particular risk of iodine deficiency. Low maternal education, non-Danish origin and pre-pregnancy obesity are predictors of non-iodine supplement use. An increase in iodine fortification......INTRODUCTION: Iodine is essential for the production of thyroid hormones. In pregnancy, physiological changes occur that can lead to iodine deficiency and impairment of fetal neurological development. We aimed to assess the iodine intake in pregnant women in Eastern Denmark, compare iodine levels...
Schuepbach, Reto A; Bestmann, Lukas; Béchir, Markus; Fehr, Jörg; Bachli, Esther B
Iron deficiency is known to cause symptoms such as fatigue, depression and restless legs syndrome resulting in impaired quality of life and working capacity. We sought to examine the iron status of reportedly healthy individuals by a framed study design in 58 highly educated Swiss hospital employees and to compare the use of non invasive tests for assessing iron deficiency (ID). A structured interview was used to assess health status, nutritional intake and potential blood loss, blood counts as well as parameters proposed to diagnose iron deficiency were determined. All subjects felt well and were working at their maximum capacity. The male subjects were neither anaemic nor had decreased iron parameters however 50% (23/46) of the women had a serum ferritin of below 22 μg/L, still 33% (15/46) of the women had a ferritin value below the more stringent cut off value of 15 μg/L. In 15% (7/46) of the women we diagnosed iron deficient anaemia. Red meat consumption correlated with ferritin values as did the menstrual blood loss which was estimated by asking the amount of tampons used. Of the additionally analysed iron parameters only the percentage of hypochromic erythrocytes, soluble transferrin receptor and transferrin values were significantly correlated with ferritin and reached an AUCROC of ≥0.7 indicating good predictive tests. Nevertheless neither soluble transferrin receptor nor transferrin showed diagnostic advantages for the diagnosis of ID compared to ferritin alone or together with erythrocyte parameters. Working in a hospital environment and having access to health education does not seem to correlate with prevention of ID or ID anaemia in female hospital employees.
Ho, Chen-Hsun; Jaw, Fu-Shan; Wu, Chia-Chang; Chen, Kuan-Chou; Wang, Chih-Yuan; Hsieh, Ju-Ton; Yu, Hong-Jeng; Liu, Shih-Ping
While the epidemiology of testosterone deficiency has been well described in men with previously known type 2 diabetes mellitus (T2DM), it was less reported in those with untreated, newly diagnosed T2DM. The aim of this study was to investigate the prevalence and the risk factors of testosterone deficiency of men with newly diagnosed T2DM. The cross-sectional study included 105 men (mean age: 61.2 ± 6.8 years) with previously known T2DM and another 81 (57.8 ± 8.8 years) with newly diagnosed T2DM. All received health checkup and sex hormone measurement at our institute in 2009. We calculated the prevalence and explored the risk factors of low total (testosterone in men with newly diagnosed and previously known T2DM. Men with previously known T2DM were older and had higher diastolic pressure and greater fasting glucose. There was no significant difference in total (358.0 [155.0] ng/dL vs. 363.0 [154.0] ng/dL, P=0.68) and free (7.2 [2.5] ng/dL vs. 7.4 [2.4]ng/dL, P=0.84) testosterone and sex-hormone binding globulin (SHBG) (27.3 [22.3]nmol/L vs. 28.7 [14.9]nmol/L, P=0.46). The prevalence of low total and free testosterone was 28.4% and 21.0%, respectively, in men with newly diagnosed T2DM, and was 26.7% and 19.0% in those with previously known T2DM. In men with previously known T2DM, better glycemic control (HbA1c testosterone and a lower risk of low total testosterone. Men with newly diagnosed and previously known T2DM shared similar risk factors of low total testosterone, including high HbA1c (≥ 7%), low SHBG (obesity, hyperuricemia, hypertriglycemia, and metabolic syndrome. Elevated prostate-specific antigen was a protective factor of low total testosterone. However, none of these factors was associated with low free testosterone. The prevalence and the risk factors of testosterone deficiency are similar between newly diagnosed and previously known type 2 diabetic men. © 2014 International Society for Sexual Medicine.
Iron deficiency (ID) and vitamin D deficiency (VDD) are two of the most common micronutrient deficiencies in young children worldwide and they contribute substantially to the global burden of disease due to their varied negative health consequences. Micronutrient deficiencies in European children
Steyn, Nelia P; Wolmarans, Petro; Nel, Johanna H; Bourne, Lesley T
A national survey found that micronutrient deficiencies are prevalent in South African children, particularly calcium, iron, zinc, riboflavin, niacin, vitamin B6, folate, vitamin A, E and C. Mandatory fortification of maize meal and wheat flour were introduced in 2003 to combat some of the deficiencies found in children. To date however, there has not been a national survey on dietary intake in adults. The main objectives of this study were to evaluate the micronutrient intake of the diet consumed by the average adult South African by means of secondary data analyses and secondly to evaluate the effects of fortification on selected nutrient intakes. Secondary data analysis was carried out with numerous dietary surveys on adults to create a database that included sampling (and weighting) according to ethnic/urban-rural residence in line with the population census, of which 79% were black Africans and the majority resided in rural areas. The effect of fortification was evaluated by substituting fortified foods in the diet for the unfortified products. The combined database used in this study comprised 3229 adults. Mean calcium, iron, folate and vitamin B6 intakes were very low particularly in women. Mean intakes of most micronutrients were lower in rural areas. Fortification of maize meal and wheat flour (bread) raised mean levels of thiamine, riboflavin, niacin, vitamin B6 and folate above the recommended nutrient intakes (RNIs). In women, despite fortification, mean iron intakes remained below the RNIs, as did calcium since it was not in the fortification mix. The average dietary intake of adults was of poor nutrient density, particularly in rural areas. Fortification of maize meal and wheat flour (bread) considerably improved mean vitamin B6, thiamine, riboflavin, niacin, folate and iron intakes as well as the overall mean adequacy ratio of the diet.
Abalkhail, Bahaa; Shawky, Sherine
Iron deficiency anaemia is one of most prevalent nutritional disorders worldwide. It is known to affect the health and cognitive ability of children and adolescents. Studies in Saudi Arabia concentrate only on the population of young children and pregnant females or girls. Studies on the whole school student population is lacking. The objectives of this study were to identify the nutritional habits and the prevalence of anaemia among school students in Jeddah, as well as to recognize the students' awareness of their anaemic nutritional status. Data were collected from a sample of Saudi school children in Jeddah City from 42 boys' and 42 girls' schools during the month of April 2000. Data collection was done by an in-person interview to collect socio-demographic factors, nutritional habits, weight and height. Haemoglobin was measured in a sample of 800 students selected at random from both genders and different age groups. Anaemia was defined according to the new WHO cut-off levels for haemoglobin as: blood haemoglobin breakfast was reported by 14.9% of students and this habit did not differ by age, sex, body mass index or social class. Skipping breakfast was more marked among students with poor school performance as compared to those with very good or excellent results. Only 34.1% of anaemic school students were aware of being anaemic. Awareness was nearly equal in all age groups and social classes but girls were more aware of their anaemic status than boys. Iron deficiency anaemia appears to be prevalent among school students. At age 12 years and over, low social class and menstruating girls constitute the high-risk groups. Screening is recommended for high-risk groups and school health programs are crucial to improve students' nutritional habits, knowledge and awareness.
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
Marly A Cardoso
Full Text Available Multiple micronutrients in powder (MNP are recommended by WHO to prevent anemia in young children. However, evidences for its effectiveness in different populations and improvements in other outcomes (e.g. linear growth and vitamin A deficiency are scarce.A multicentre pragmatic controlled trial was carried out in primary health centres. At study baseline, a control group (CG of children aged 10- to 14 months (n = 521 was recruited in the routine healthcare for assessing anemia, anthropometric and micronutrient status. At the same time, an intervention group (IG of infants aged 6- to 8 months (n = 462 was recruited to receive MNP daily in complementary feeding over a period of 60 days. Both study groups were compared when the IG infants reached the age of the CG children at enrolment.In CG, the prevalence of anemia [hemoglobin (Hb 8.3 mg/L, and vitamin A deficiency (VAD, serum retinol < 0.70μmol/L were 23.1%, 37.4%, and 17.4%, respectively. Four to six months after enrolment, when the IG participants had the same age of the controls at the time of testing, the prevalence of anemia, ID and VAD in IG were 14.3%, 30.1% and 7.9%, respectively. Adjusting for city, health centre, maternal education, and age, IG children had a lower likelihood of anemia and VAD [Prevalence Ratio (95% CI = 0.63 (0.45, 0.88 and 0.45 (0.29, 0.69, respectively] when compared with CG children. The adjusted mean distributions of Hb and length-for-age Z-scores improved by 2 SE in the IG compared to CG children.MNP effectively reduced anemia and improved growth and micronutrient status among young Brazilian children.Registro Brasileiro de Ensaios Clinicos RBR-5ktv6b.
Das, Jai K; Salam, Rehana A; Kumar, Rohail; Bhutta, Zulfiqar A
Background Vitamins and minerals are essential for growth and metabolism. The World Health Organization estimates that more than 2 billion people are deficient in key vitamins and minerals. Groups most vulnerable to these micronutrient deficiencies are pregnant and lactating women and young children, given their increased demands. Food fortification is one of the strategies that has been used safely and effectively to prevent vitamin and mineral deficiencies. Methods A comprehensive search wa...
Imtiaz, M.; Rashid, A.
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
Parthasarathy, Lavanya S; Chiplonkar, Shashi A; Khadilkar, Anuradha V; Khadilkar, Vaman V
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.
Full Text Available Aim: To determine the prevalence of testosterone deficiency syndrome (TDS in healthy Indian men employed in a hospital aged above 40 years. Materials and Methods: A general medical health check-up camp was organized for all male employees above 40 years age working in surgical departments. After clinical history and systemic inquiry, subjects were requested to fill the St. Louis University′s ADAM Questionnaire based on which the total and free-serum testosterone estimation was then done. Results: One hundred fifty seven healthy volunteers enrolled for the study (mean age 53.1 years; range 40-60. The androgen decline in the aging male (ADAM Questionnaire detected 106 men (67.5% to be symptomatic for TDS. Serum testosterone estimation in these subjects revealed 41/106 to have low free-serum testosterone levels and 32/106 to have low total-serum testosterone. In 11 and 6 cases, respectively, the serum free- and total-testosterone levels were found to be low although the subjects were asymptomatic for TDS. Conclusions: The prevalence of symptomatic biochemical hypogonadism was 26.1%. The higher prevalence of symptoms alone of TDS was unusual. It could be because of the nature of the questionnaire. Free-serum testosterone may be a better single test to diagnose symptomatic hypogonadism than total-serum testosterone.
(ROI)/reactive oxygen species (ROS) overcomes the endogenous. Abstract. 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 ...
Hollowell, Joseph G; Haddow, James E
To review the iodine status of women as assessed through National Health and Nutrition Examination Surveys from 1971 to 2002. National normative estimates of iodine status of the civilian, non-institutionalized population in the United States of America. Women of reproductive age and pregnant women. In the United States of America, iodine began to be added to the diet in the 1920s. An excessive iodine intake was documented by the first National Health and Nutrition Examination Survey (NHANES I) in the 1970s which reported a median urinary iodine (UI) concentration of 320 microg l-1. In the NHANES III survey, conducted between 1988 and 1994, the median UI concentration had decreased to 145 microg l-1, while 14.9% of women aged 15-44 years and 6.9% of pregnant women had a UI concentration 50 microg l-1. The concentrations of serum T4 and thyroid-stimulating hormone of women with a low UI concentration did not, however, indicate an iodine deficiency. Further studies of the association between iodine excretion and biochemical and physiological changes should be undertaken to better understand women's needs for iodine and to develop criteria to monitor them in pregnancy. Because of the potential harm caused by iodine deficiency during pregnancy, we support the use of iodine supplements for all pregnancies while these data are being collected.
Galatas, Beatriz; Mabote, Lurdes; Simone, Wilson; Matambisso, Gloria; Nhamussua, Lidia; Mañú-Pereira, María Del Mar; Menéndez, Clara; Saute, Francisco; Macete, Eusebio; Bassat, Quique; Alonso, Pedro; Aide, Pedro
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked hereditary enzymatic abnormality that affects more than 400 million people worldwide. Most deficient individuals do not manifest any symptoms; however, several precipitant agents-such as fava intake, infections, or several drugs-may trigger acute haemolytic anaemia. Countries should be informed of the prevalence of this enzymatic anomaly within their borders, in order to make safe and appropriate national decisions regarding the use of potentially unsafe drugs for G6PD deficient individuals. A school-based cross-sectional survey was conducted in three districts in Mozambique, namely Manhiça, located in the south; Mocuba in the centre; and Pemba in the northern tip of the country. G6PD deficiency was evaluated using the CareStart™ diagnostic test, and enzyme activity levels were measured through fluorescence spectrophotometry in deficient individuals. Chi squared and ANOVA tests were used to assess prevalence and mean enzyme activity differences, and logistic regression was used to identify risk factors associated to the deficiency. G6PD deficiency prevalence estimates were lowest in the northern city of Pemba (8.3%) and among Emakhuwas and Shimakondes, and higher in the centre and southern regions of the country (16.8 and 14.6%, respectively), particularly among Elomwes and Xichanganas. G6PD deficiency was significantly more prevalent among male students than females (OR = 1.4, 95% CI 1.0-1.8, p = 0.02), although enzyme activity levels were not different among deficient individuals from either gender group. Finally, median deficiency levels were found to be more severe among the deficient students from the north (0.7 U/gHg [0.2-0.7] p G6PD deficiency, that vary significantly across the country. This should be considered when planning national strategies for the use of licensed drugs that may be associated to haemolysis among G6PD individuals, or prior to the performance of future trials
Stagi, Stefano; Pucci, Neri; di Grande, Laura; de Libero, Cinzia; Caputo, Roberto; Pantano, Stefano; Seminara, Salvatore; de Martino, Maurizio; Novembre, Elio
Vernal keratoconjunctivitis (VKC) is a chronic conjunctivitis that mainly affects children living in temperate areas. The notable difference between genders and VKC's resolution with puberty have persistently suggested a role of hormonal factors in VKC development. To describe six cases of males with VKC and growth hormone deficiency (GHD) reported as a long-term follow-up during rhGH treatment. Six consecutive male patients (median age at GHD diagnosis 9.7, range 7.9 to 13.1 years) with VKC, were recruited from July 2005 to July 2013 at the Paediatric Endocrinology Unit of Anna Meyer Children's Hospital in Florence, Italy. In these patients, anthropometric data were collected periodically. In three of these patients, data were collected to near-adult or adult height. Familial history was uneventful for all patients. The target height was normal, ranging from 0.65 standard deviation scores (SDS) to 2.01 SDS. The patients showed a normal birth-weight (from -1.21 to 1.35 SDS) and birth-length (from -0.93 to 1.21 SDS). At GHD diagnosis, all of the patients exhibited demonstrated important growth retardation (from -2.05 to -2.78 SDS). Plasmatic concentrations of IGF-1 and IGFBP-3 were low (from -1.85 to -3 SDS and from -1.81 to -2.76 SDS, respectively). GH stimulation tests showed classic GHD symptoms in all of the patients. Pubertal onset was normal. All of the patients treated with rhGH responded well to rhGH treatment. Adult height, evaluated in three patients, was in accordance with their target height. To our current knowledge, we have described for the first time six patients affected by VKC with GH deficiency, in some of whom we performed a long-term follow-up to adult height. Further studies will be needed to establish whether GHD may be a common feature of VKC patients. Nevertheless, it appears to be useful to carefully follow statural growth of VKC patients, while the possibility of a GH deficiency must to be taken into account in the presence of growth
Al Hawsawi, Zakaria M; Al-Rehali, Sami A; Mahros, Amani M; Al-Sisi, Ali M; Al-Harbi, Khalid D; Yousef, Ahmed M
To determine the prevalence of iron deficiency anemia (IDA) in infants aged 6-24 months attending the well-baby clinic in primary health care centers (PHCCs). This cross-sectional epidemiological study was conducted in the Northwestern region of Saudi Arabia from April 2013 to January 2014 in 5 randomly selected PHCCs. The sample size comprised 500 infants, with 100 infants screened from each PHCC. Blood samples were obtained for estimation of hemoglobin and serum ferritin levels. Out of 500 infants, 246 (49%) cases had IDA with a mean age of 15.4 ± 6.5 months, with 130 (53%) males, and 116 (47%) females (p=0367). Out of 274 Saudi infants, 126 (51%) cases were diagnosed as IDA. Iron deficiency anemia is very common in Saudi infants aged 6-24 months. A national program directed for primary prevention and early discovery of IDA in Saudi infants is recommended at PHCCs system. Iron supplementation is to be given at early infancy with universal screening of hemoglobin and ferritin estimation to all infants at 12 months of age.
G. А. Karkashadze
Full Text Available Deficiency of micronutrients in a diet of the modern children increases risk of the formation of chronic neurologic and somatic pathology. Magnesium deficiency, which initiates a various neurologic symptomatology, has a particular importance in the progress of nervous system diseases at children. Diagnosis of neurologic manifestations of a micronutrient deficiency requires comprehension of the main mechanisms of their development, and also peculiarities of laboratory diagnostics. In treatment of consequences of a magnesium deficiency the special role belongs to the micronutrient stock replacement (medication, alimentary combined with traditional methods of treatment of neurologic disorders.
Kirkegaard-Klitbo, Ditte Marie; Perslev, Kathrine; Andersen, Stine Linding
in Eastern and Western Denmark and to identify potentially vulnerable groups. METHODS: This was a cross-sectional cohort study of pregnant Danish women (n = 240). Questionnaires and urine samples were collected at the Ultrasound Clinic, Hvidovre Hospital, Denmark, and urinary iodine concentrations (UIC) (µg......-containing supplements (86%). The median UIC was 118 (interquartile range (IQR): 79-196) µg/l in iodine supplement users and 82 (IQR: 41-122) µg/l in non-users (p education, non-Danish origin and pre-pregnancy obesity....... CONCLUSIONS: The iodine status in Danish pregnant women was below WHO recommendations. Iodine supplement non-users are at a particular risk of iodine deficiency. Low maternal education, non-Danish origin and pre-pregnancy obesity are predictors of non-iodine supplement use. An increase in iodine fortification...
González Alayón, Carlos; Pedrajas Crespo, Carolina; Marín Pedrosa, Sandra; Benítez, José Manuel; Iglesias Flores, Eva; Salgueiro Rodríguez, Isabel; Medina Medina, Rosario; García-Sánchez, Valle
Iron deficiency without anaemia (IDWA) is commonly found in outpatients with inflammatory bowel disease (IBD) in an even higher proportion than anaemia. However, its true prevalence and possible impact on health-related quality of life (HRQoL) are unknown. The objectives of this study were: to establish the prevalence of IDWA, identify possible associated factors and measure their impact on HRQoL. 127 patients with IBD in an outpatient setting were consecutively included in an observational, descriptive, cross-sectional study. IDWA was defined as ferritin levels of <100 ng/ml with inflammatory activity or ≤30 ng/ml without it, with transferrin saturation of ≤16%, and with normal haemoglobin levels. HRQoL was assessed using two questionnaires: the IBDQ-9 for symptoms related to IBD and the FACIT-F to measure the presence of fatigue. Fatigue was considered extreme with a score of ≤30 points. The prevalence of IDWA was 37%. Variables associated with its occurrence were female gender (OR=2.9; p=.015) and the presence of inflammatory activity (OR=9.4; p=.001). Patients with IDWA presented HRQoL questionnaires with lower overall scores; decreases of 6.6 (p<.001) and 4.3 (p=.037) points in the IBDQ-9 and the FACIT-F were recorded, respectively. In addition, an increase of 29.4% in the presence of extreme fatigue was observed. The prevalence of IDWA is considerable in outpatients with IBD. IDWA is associated with female gender and inflammatory activity. It has a clear negative impact on HRQoL. A more active approach is needed to treat this complication. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Klose, Marianne Christina; Stochholm, Kirstine; Janukonyté, Jourgita
was to assess the prevalence of GHD in patients admitted in 2008 with TBI, with concurrent assessment of methodological bias. DESIGN AND SETTING: We conducted a nationwide population-based cohort study at tertiary referral university hospitals. PARTICIPANTS: Participants were Danish patients with a head trauma...... diagnosis from the Danish Board of Health diagnostic code registry; 439 patients and 124 healthy controls underwent dynamic assessment of GH secretion 2.5 years (median) after TBI. MAIN OUTCOME: We evaluated the prevalence of GHD given use of 1) local versus guideline cutoffs, 2) insulin tolerance test (ITT...... testing of patients with TBI and stresses the importance of a proper control group and stringent GH testing including confirmatory testing in cohorts with low a priori likelihood of GHD such as in TBI. Our results question the evidence for newly introduced recommendations for routine pituitary assessment...
Duy T. Dao
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.
Pfisterer, Kaylen J; Sharratt, Mike T; Heckman, George G; Keller, Heather H
Vitamin B12 (B12) deficiency, although treatable, impacts up to 43% of community-living older adults; long-term care (LTC) residents may be at greater risk. Recommendations for screening require further evidence on prevalence and incidence in LTC. Small, ungeneralizable samples provide a limited perspective on these issues. The purposes of this study were to report prevalence of B12 deficiency at admission to LTC, incidence 1 year post-admission, and identify subgroups with differential risk. This multi-site (8), retrospective prevalence study used random proportionate sampling of resident charts (n = 412). Data at admission extracted included demographics, B12 status, B12 supplementation, medications, diagnoses, functional independence, cognitive performance, and nutrition. Prevalence at admission of B12 deficiency (B12 (>300 pmol/L). One year post-admission incidence was 4%. Better B12 status was significantly associated with supplementation use prior to LTC admission. Other characteristics were not associated with status. This work provides a better estimate of B12 deficiency prevalence than previously available for LTC, upon which to base protocols and policy. Prospective studies are needed to establish treatment efficacy and effect on health related outcomes.
García-Casal, Maria Nieves; Leets, Irene; Bracho, Carmen; Hidalgo, Mariana; Bastidas, Gilberto; Gomez, Ana; Peña, Ana; Pérez, Hilda
The objective of this work was to determine the prevalence of anemia and deficiencies of iron, folic acid and vitamin B12 in Betania del Topocho, a Piaroa community from Estado Amazonas, Venezuela, a zone with a high incidence of malaria. The group studied included 184 subjects of all ages that assisted to the local health center for malaria diagnosis. Analysis performed included hematology by coulter counter, ferritin quantification by ELISA with monoclonal antibodies and folic acid and vitamin B12 determinations by an immunoradiometric assay. It was found that the prevalence of anemia was 89.6% and deficiencies of iron, folic acid and vitamin B12 affected 37.1,70.3 and 12.4% of the population studied, respectively. Plasmodium infection was detected by molecular diagnosis in 53.2% of the cases, and 86% of them were anemic. The highest incidence of anemia was found in children, with a prevalence of 100% in infants of both sexes. The high prevalence of anemia, iron and folic acid deficiencies found, indicates an important health and nutrition problem that should be immediately and properly addressed. The number of cases of anemia due to iron deficiency could be underestimated, since ferritin concentration increased as a acute phase protein, although prevalence data was also analyzed with a cutoff point of 30 microg/L for ferritin concentration.
This study examined the prevalence of high blood pressure, heart disease, and medical diagnoses in relation to blood disorders, among 6,329 adolescent students (age 15 to 18 years) who reside in the United Arab Emirates (UAE). Findings indicated that the overall prevalence of high blood pressure and heart disease was 1.8% and 1.3%, respectively. Overall, the prevalence for thalassemia, sickle-cell anemia, and iron-deficiency anemia was 0.9%, 1.6%, and 5%, respectively. Bivariate analysis revealed statistically significant differences in the prevalence of high blood pressure among the local and expatriate adolescent population in the Emirate of Sharjah. Similarly, statistically significant differences in the prevalence of iron-deficiency anemia were observed among the local and expatriate population in Abu Dhabi city, the western region of Abu Dhabi, and Al-Ain. Multivariate analysis revealed the following significant predictors of high blood pressure: residing in proximity to industry, nonconventional substance abuse, and age when smoking or exposure to smoking began. Ethnicity was a significant predictor of heart disease, thalassemia, sickle-cell anemia, and iron-deficiency anemia. In addition, predictors of thalassemia included gender (female) and participating in physical activity. Participants diagnosed with sickle-cell anemia and iron-deficiency anemia were more likely to experience different physical activities.
Mueller, Nicolas J; Fux, Christoph A; Ledergerber, Bruno; Elzi, Luigia; Schmid, Patrick; Dang, Thanh; Magenta, Lorenzo; Calmy, Alexandra; Vergopoulos, Athanasios; Bischoff-Ferrari, Heike A
To evaluate the prevalence of 25-hydroxyvitamin D [25(OH)D] deficiency in HIV-positive patients, a population at risk for osteoporosis. Retrospective assessment of vitamin D levels by season and initiation of combined antiretroviral therapy (cART). 25(OH)D was measured in 211 HIV-positive patients: samples were taken before initiation of cART from February to April or from August to October as well as 12 (same season) and 18 months (alternate season) after starting cART. 1,25-Dihydroxyvitamin D [1,25(OH)2D] was measured in a subset of 74 patients. Multivariable analyses included season, sex, age, ethnicity, BMI, intravenous drug use (IDU), renal function, time since HIV diagnosis, previous AIDS, CD4 cell count and cART, in particular nonnucleoside reverse transcriptase inhibitor (NNRTI) and tenofovir (TDF) use. At baseline, median 25(OH)D levels were 37 (interquartile range 20-49) nmol/l in spring and 57 (39-74) nmol/l in the fall; 25(OH)D deficiency less than 30 nmol/l was more prevalent in spring (42%) than in fall (14%), but remained unchanged regardless of cART exposure. In multivariable analysis, 25(OH)D levels were higher in white patients and those with a longer time since HIV diagnosis and lower in springtime measurements and in those with active IDU and NNRTI use. 1-Hydroxylation rates were significantly higher in patients with low 25(OH)D. Hepatitis C seropositivity, previous AIDS and higher CD4 cell counts correlated with lower 1,25(OH)2D levels, whereas BMI and TDF use were associated with higher levels. In TDF-treated patients, higher 1,25(OH)2D correlated with increases in serum alkaline phosphatase. Based on the high rate of vitamin D deficiency in HIV-positive patients, systematic screening with consideration of seasonality is warranted. The impact of NNRTIs on 25(OH)D and TDF on 1,25(OH)2D needs further attention.
Nair, K Madhavan; Augustine, Little Flower
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.
Jolliffe, David A; Kilpin, Kate; MacLaughlin, Beverley D; Greiller, Claire L; Hooper, Richard L; Barnes, Neil C; Timms, Peter M; Rajakulasingam, Raj K; Bhowmik, Angshu; Choudhury, Aklak B; Simcock, David E; Hyppönen, Elina; Corrigan, Christopher J; Walton, Robert T; Griffiths, Christopher J; Martineau, Adrian R
Vitamin D deficiency is common in children with asthma, and it associates with poor asthma control, reduced forced expiratory volume in one second (FEV 1 ) and increased requirement for inhaled corticosteroids (ICS). Cross-sectional studies investigating the prevalence, determinants and clinical correlates of vitamin D deficiency in adults with asthma are lacking. We conducted a multi-centre cross-sectional study in 297 adults with a medical record diagnosis of ICS-treated asthma living in London, UK. Details of potential environmental determinants of vitamin D status, asthma control and medication use were collected by questionnaire; blood samples were taken for analysis of serum 25(OH)D concentration and DNA extraction, and participants underwent measurement of weight, height and fractional exhaled nitric oxide concentration (FeNO), spirometry and sputum induction for determination of lower airway eosinophil counts (n=35 sub-group). Thirty-five single nucleotide polymorphisms (SNP) in 11 vitamin D pathway genes (DBP, DHCR7, RXRA, CYP2R1, CYP27B1, CYP24A1, CYP3A4 CYP27A1, LRP2, CUBN, VDR) were typed using Taqman allelic discrimination assays. Linear regression was used to identify environmental and genetic factors independently associated with serum 25(OH)D concentration, and to determine whether vitamin D status was independently associated with Asthma Control Test (ACT) score, ICS dose, FeNO, forced vital capacity (FVC), FEV 1 or lower airway eosinophilia. Mean serum 25(OH)D concentration was 50.6nmol/L (SD 24.9); 162/297 (54.5%) participants were vitamin D deficient (serum 25(OH)D concentration D status was associated with higher body mass index (P=0.014), non-White ethnicity (P=0.036), unemployment (P for trend=0.012), lack of vitamin D supplement use (PP for trend P=0.030), but not with potential genetic determinants. Vitamin D status was not found to associate with any marker of asthma control investigated. Vitamin D deficiency is common among UK adults with
Gartner, Agnès; El Ati, Jalila; Traissac, Pierre; Bour, Abdellatif; Berger, Jacques; Landais, Edwige; El Hsaïni, Houda; Ben Rayana, Chiheb; Delpeuch, Francis
In North Africa, overnutrition has dramatically increased with the nutrition transition while micronutrient deficiencies persist, resulting in clustering of opposite types of malnutrition that can present a unique difficulty for public health interventions. We assessed the magnitude of the double burden of malnutrition among urban Moroccan and Tunisian women, as defined by the coexistence of overall or central adiposity and anemia or iron deficiency (ID), and explored the sociodemographic patterning of individual double burden. In cross-sectional surveys representative of the region around the capital city, we randomly selected 811 and 1689 nonpregnant women aged 20-49 y in Morocco and Tunisia, respectively. Four double burdens were analyzed: overweight (body mass index ≥25 kg/m(2)) or increased risk abdominal obesity (waist circumference ≥80 cm) and anemia (blood hemoglobin anemia, or ID. Any double burden combining adiposity and anemia or ID should therefore be taken into consideration in all women. This trial was registered at clinicaltrials.gov as NCT01844349.
Giovenale, Diletta; Meazza, Cristina; Cardinale, Giuliana M.; Sposito, Maddalena; Mastrangelo, Costanzo; Messini, Beatrice; Citro, Giuseppe; Delvecchio, Maurizio; Di Maio, Salvatore; Bozzola, Mauro
Objectives: To assess the occurrence of growth hormone deficiency (GHD) in patients with celiac disease (CD) referred for short stature. Design: A retrospective, multi-center study. A total of 7066 children with short stature were referred to a number of centers for second-line evaluation over a 5-year period. All patients were screened for CD by antiendomysial antibodies (EMA) and antitissue transglutaminase IgA.Those with positive sera underwent intestinal biopsy. The EMA-negative patients and the EMA-positive ones who did not grow after 1 year of gluten-free diet underwent endocrinological investigation. Results: Among the 7066 short children (age 2–14 years) evaluated, 650 (9.2%) had GHD and 44 (0.63%) had CD. An association of both CD and GHD was found in 16 short children (0.23%); these children did not grow after 1 year of gluten-free diet and therefore GH treatment was started. Conclusions: GH secretion should be evaluated in celiac patients showing no catch-up growth after an appropriate period on a gluten-free diet in spite of reversion to seronegativity for EMA. PMID:16988097
Layrisse, Miguel; García-Casal, María Nieves; Méndez-Castellano, Hernán; Jiménez, Maritza; Henry, Olavarría; Chávez, José E; González, Eglis
In Venezuela, a severe economic crisis starting in 1983 provoked a progressive reduction in the quantity and quality of food consumed by people from the low socioeconomic strata of the population. This situation resulted in a continuous increase in the prevalence of iron deficiency in the 1980s and 1990s. In 1993, an iron-fortification program was started, in which precooked corn and white wheat flours were enriched with iron, vitamin A, thiamine, niacin, and riboflavin. White wheat flour was enriched with the same nutrients, except for vitamin A. In 1996 we published the results of the impact of fortification of precooked corn and white wheat flours on the prevalence of anemia and iron deficiency in the population. A survey carried out in Caracas in 307 children aged 7, 11, and 15 years showed that the prevalence of iron deficiency measured by serum ferritin concentration dropped from 37% in 1992 to 16% in 1994, only one year after the iron-fortification program began. The prevalence of anemia, as measured by the hemoglobin concentration, diminished from 19% to 10% during the same period. This article reports the results of three other surveys carried out in 1997, 1998, and 1999 on children of the same age and socioeconomic groups that were evaluated in 1990, 1992, and 1994. There were no significant differences in anemia or iron deficiency among the last three surveys. The prevalence results from the last seven years seem to indicate that, after a dramatic reduction in 1994, iron deficiency tended to stabilize, while the prevalence of anemia increased to the same level found in 1992, before the fortification program started.
Fayet-Moore, Flavia; Petocz, Peter; Samman, Samir
Young women are at an increased risk of micronutrient deficiencies, particularly due to higher micronutrient requirements during childbearing years and multiple food group avoidances. The objective of this study was to investigate biomarkers of particular micronutrients in apparently healthy young women. Female students (n = 308; age range 18-35 year; Body Mass Index 21.5 ± 2.8 kg/m2; mean ± SD) were recruited to participate in a cross-sectional study. Blood samples were obtained from participants in the fasted state and analysed for biomarkers of iron status, vitamin B12, folate, homocysteine, selenium, zinc, and copper. The results show iron deficiency anaemia, unspecified anaemia, and hypoferritinemia in 3%, 7% and 33.9% of participants, respectively. Low vitamin B12 concentrations (0.34 μmol/L. Folate concentrations below the reference range were observed in 1.7% (serum) or 1% (erythrocytes) of participants, and 99.7% of the participant had erythrocyte-folate concentrations >300 nmol/L. Serum zinc concentrations selenium concentrations were below the reference range in 23% and 11% of participants, respectively. Micronutrient deficiencies including iron and vitamin B12, and apparent excess of folate are present in educated Australian female students of childbearing age, including those studying nutrition. The effects of dietary behaviours and food choices on markers of micronutrient status require further investigation.
Fayet-Moore, Flavia; Petocz, Peter; Samman, Samir
Young women are at an increased risk of micronutrient deficiencies, particularly due to higher micronutrient requirements during childbearing years and multiple food group avoidances. The objective of this study was to investigate biomarkers of particular micronutrients in apparently healthy young women. Female students (n = 308; age range 18–35 year; Body Mass Index 21.5 ± 2.8 kg/m2; mean ± SD) were recruited to participate in a cross-sectional study. Blood samples were obtained from participants in the fasted state and analysed for biomarkers of iron status, vitamin B12, folate, homocysteine, selenium, zinc, and copper. The results show iron deficiency anaemia, unspecified anaemia, and hypoferritinemia in 3%, 7% and 33.9% of participants, respectively. Low vitamin B12 concentrations (0.34 μmol/L. Folate concentrations below the reference range were observed in 1.7% (serum) or 1% (erythrocytes) of participants, and 99.7% of the participant had erythrocyte-folate concentrations >300 nmol/L. Serum zinc concentrations <10.7 μmol/L were observed in 2% of participants. Serum copper and selenium concentrations were below the reference range in 23% and 11% of participants, respectively. Micronutrient deficiencies including iron and vitamin B12, and apparent excess of folate are present in educated Australian female students of childbearing age, including those studying nutrition. The effects of dietary behaviours and food choices on markers of micronutrient status require further investigation. PMID:25401503
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
Assey, V D; Greiner, T; Mzee, R K; Abuu, H; Mgoba, C; Kimboka, S; Peterson, S
Iodine is an essential micronutrient for normal human growth and development. It is estimated that more than 1.6 billion people live in iodine-deficient environments, yet there are still some countries and areas where the prevalence of iodine-deficiency disorders is unknown. To establish the prevalence of iodine-deficiency disorders in the Zanzibar Islands, a community assumed to have ready access to iodine-rich seafoods. In a cross-sectional study, 11,967 schoolchildren were palpated for goiter prevalence, a subsample was evaluated for urinary iodine concentration, and the availability of iodated salt was assessed at the household and retail levels. The mean total goiter prevalence was 21.3% for Unguja and 32.0% for Pemba. The overall median urinary iodine concentration was 127.5 microg/L. For Unguja the median was 185.7 microg/L, a higher value than the median of 53.4 microg/L for Pemba (p Zanzibar Islands belies the common assumption that an island population with access to seafood is not at risk for iodine-deficiency disorders. We urge health planners to implement mandatory salt iodation and education efforts to alleviate the situation.
Timotijevic, Lada; Raats, Monique M.; Barnett, Julie
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. Results: 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...... 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....
Full Text Available BACKGROUND Vitamin D deficiency is highly prevalent among patients with chronic kidney disease (CKD. Accumulating evidence indicates the associations of vitamin D deficiency with morbidities and mortality in patients with CKD. The recent Kidney Disease Outcomes Quality Initiative (KDOQI Clinical Practice Guidelines for Bone Mineral Metabolism and Disease in Chronic Kidney Disease had recommended the measurements of 25-hydroxyvitamin D levels in patients with CKD who are not on dialysis. Little is known about the magnitude of vitamin D deficiency in patients with CKD living in rural South India. AIM To assess the prevalence of vitamin D deficiency among the patients with chronic kidney disease. METHODOLOGY The prevalence of 25-hydroxyvitamin D3 (25OHD deficiency (defined as a level <20 ng/ml were examined in 100 patients with CKD. Patients on dialysis and those receiving medication known to influence vitamin D, were excluded. CKD was diagnosed based on history, clinical features, USG abdomen and renal function test and eGFR. We examined the levels of 25OHD in 100 patients with CKD stages 3 and 4. Patients were investigated for hemogram, renal function tests, serum vitamin D level, fasting blood sugar and ECG. RESULTS The overall prevalence of vitamin D deficiency among the CRF patients in our study was 69% and the insufficiency was present in 17% of the CRF patients and only 14% of the study subjects had normal vitamin D levels. Among the various factor influencing the prevalence of vitamin D deficiency in CRF patients, diabetes and hypertension are the most important factors. In our study the mean levels of vitamin D was much lower in patients with diabetes and hypertension when compared to patients without diabetes and hypertension and the difference was found to be statistically significant (p=0.003. CONCLUSION Our study concluded that vitamin D deficiency is highly prevalent among CKD patients. Diabetes and hypertension are the most important
Segeja, M D; Mmbando, Bruno Paul; Kamugisha, M L
Glucose-6-phosphate dehydrogenase (G6PD) deficiency and haemoglobin S (HbS) are very common genetic disorders in sub Saharan Africa, where malaria is endemic. These genetic disorders have been associated with protection against malaria and are therefore under strong selection pressure...... by the disease. In November-December 2003, we conducted a cross-sectional survey to determine the prevalence of G6PD deficiency and HbS in the population and relate these to malaria infection and haemoglobin levels in lowland and highland areas of differing malaria transmission patterns of Muheza, Tanzania....... Blood samples from 1959 individuals aged 6 months to 45 years were collected. A total of 415 (21%) and 1181 (60%) samples were analysed for G6PD deficiency and HbS, respectively. Malarial parasite prevalence was 17.2% (114/1959) in the highlands and 39.6% (49/1959) in the lowlands. Lowlands had higher...
Piekutowska-Abramczuk, Dorota; Olsen, Rikke Katrine Jentoft; Wierzba, Jolanta
Isolated long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHADD) is associated with c.1528G>C substitution in the HADHA gene, since most patients have the prevalent mutation on at least one allele. As it is known that the disease is relatively frequent in Europe, especially around the Balt...
de Vries, H G; Niezen-Koning, K; Kliphuis, J W; Smit, G P; Scheffer, H; ten Kate, L P
The G985A mutation represents about 90% of all medium-chain acyl-CoA dehydrogenase (MCAD) allele mutations that cause the clinical symptoms of MCAD deficiency. The prevalence of carriers varies between different European populations, with high frequencies in the northwestern part of Europe. To
Ravilla D Ravindran
Full Text Available Studies from the UK and North America have reported vitamin C deficiency in around 1 in 5 men and 1 in 9 women in low income groups. There are few data on vitamin C deficiency in resource poor countries.To investigate the prevalence of vitamin C deficiency in India.We carried out a population-based cross-sectional survey in two areas of north and south India. Randomly sampled clusters were enumerated to identify people aged 60 and over. Participants (75% response rate were interviewed for tobacco, alcohol, cooking fuel use, 24 hour diet recall and underwent anthropometry and blood collection. Vitamin C was measured using an enzyme-based assay in plasma stabilized with metaphosphoric acid. We categorised vitamin C status as deficient (28 µmol/L. We investigated factors associated with vitamin C deficiency using multivariable Poisson regression.The age, sex and season standardized prevalence of vitamin C deficiency was 73.9% (95% confidence Interval, CI 70.4,77.5 in 2668 people in north India and 45.7% (95% CI 42.5,48.9 in 2970 from south India. Only 10.8% in the north and 25.9% in the south met the criteria for adequate levels. Vitamin C deficiency varied by season, and was more prevalent in men, with increasing age, users of tobacco and biomass fuels, in those with anthropometric indicators of poor nutrition and with lower intakes of dietary vitamin C.In poor communities, such as in our study, consideration needs to be given to measures to improve the consumption of vitamin C rich foods and to discourage the use of tobacco.
Richard, Aline; Rohrmann, Sabine; Quack Lötscher, Katharina C
Vitamin D deficiency in pregnancy has negative clinical consequences, such as associations with glucose intolerance, and has been shown to be distributed differently in certain ethnic groups. In some countries, a difference in the rate of vitamin D deficiency was detected in pregnant women depending on their skin color. We examined the prevalence of vitamin D deficiency (Switzerland and evaluated the association of skin color with vitamin D deficiency. In a single-center cohort study, the validated Fitzpatrick scale and objective melanin index were used to determine skin color. Of the 204 pregnant women included, 63% were vitamin D deficient. The mean serum 25-hydroxyvitamin D concentration was 26.1 ng/mL (95% confidence interval (CI) 24.8-27.4) in vitamin D-sufficient women and 10.5 ng/mL (95% CI 9.7-11.5) in women with deficiency. In the most parsimonious model, women with dark skin color were statistically significantly more often vitamin D deficient compared to women with light skin color (OR 2.60; 95% CI 1.08-6.22; adjusted for age, season, vitamin D supplement use, body mass index, smoking, parity). This calls for more intense counseling as one policy option to improve vitamin D status during pregnancy, i.e., use of vitamin D supplements during pregnancy, in particular for women with darker skin color.
Prevalência da deficiência da glicose-6-fosfato desidrogenase em doadores de sangue de Mossoró, Rio Grande do Norte Prevalence of glucose-6-phosphate dehydrogenase deficiency in blood donors of Mossoró, Rio Grande do Norte
Ulysses Madureira Maia
Full Text Available Glucose-6-phosphate dehydrogenase (G6PD deficiency is the most common human enzymopathy. It affects as many as 330 million individuals worldwide. This deficiency may determine neonatal jaundice, chronic nonspherocytic hemolytic anemia and acute hemolytic anemia induced by drugs, infections and broad bean ingestion. The efficacy of blood transfusion is decreased when the donor is G6PD deficient. In this study, we aimed at determining the prevalence of G6PD deficiency in blood donors of Mossoro, Brazil. Samples of 714 blood donors (576 men and 138 women; 343 white and 371 non-white with ages ranging from 18 to 62 years and that accepted to participate in the study were analyzed. All participants answered a standard questionnaire. G6PD activity was analyzed by the methemoglobin reduction test with deficiency being confirmed by the semiquantitative test. The overall prevalence of G6PD deficiency in blood donors was 3.8%, similar to the rate described for others regions of Brazil. There was no significant statistical difference in the frequency of G6PD deficiency between men and women, nor between white and non-white blood donors. This relatively high frequency of G6PD deficiency highlights a need to screen blood donors for this condition.
Diouf, S; Folquet, M; Mbofung, K; Ndiaye, O; Brou, K; Dupont, C; N'dri, D; Vuillerod, M; Azaïs-Braesco, V; Tetanye, E
Anemia and iron deficiency are major public health issues worldwide and particularly in Africa. Reliable information about their prevalence and associated factors is required to allow for effective actions. In this study, we used data from recent (2006-2012) large population health surveys, carried out in 11 French-speaking African countries (Benin, Burkina Faso, Cameroon, Congo Brazzaville, Ivory Coast, Gabon, Guinea, Mali, Niger, Democratic Republic of Congo, and Senegal). Hemoglobin (Hb) was assessed and demographic and health-related parameters were obtained from nation-representative samples of children aged 6-59 months. Anemia (Hbaffected by location (75.5% in rural areas versus 67.3% in towns), income (79.8% in lower quintile of income versus 62.3% in higher quintile), or maternal education (74.1% in children from non-educated mothers versus 62.4% in children whose mothers had secondary education). Nearly 50% of women of child-bearing age had anemia. In the countries that report this information, less than 50% (17-65%) of children consumed iron-rich foods regularly and only 12% (7.4-20.5%) received iron supplementation. Infection and parasitism are known to affect some markers of iron status, because of the inflammatory reaction, thereby making the diagnosis of iron deficiency difficult. In the study countries, acute respiratory diseases and diarrhea affected 6.2 and 15.6% of children aged between 6 and 59 months, respectively; their distribution according to age and location is very different from the one of anemia, which is also the case for the distribution of malaria. It is thus likely that a large part of the anemia observed in young children is due to iron deficiency, although further research is needed to confirm this. This fully justifies the nationwide programs of iron fortification of flour, currently undergoing in most countries of French-speaking Africa. Their formal evaluation is still pending but the initial data suggest some efficacy, although
Mariana Helcias Côrtes
Full Text Available A anemia ferropriva é conhecida como uma das principais deficiências nutricionais em todo o mundo e sua ocorrência pode ser observada em diversas populações. Alguns grupos populacionais ainda apresentam altas prevalências de anemia ferropriva, comprometendo diversas funções do organismo. Dentre esses grupos de risco, podem ser citadas as gestantes, que merecem especial atenção devido à sua vulnerabilidade à carência e ao aumento significativo de suas necessidades, que não são acompanhados por aumento suficiente no consumo ou na absorção de ferro. Este artigo analisa dados de artigos publicados nos últimos 40 anos nas línguas inglesa, espanhola ou portuguesa nos bancos de dados Lilacs e Medline sobre prevalência de anemia ferropriva na gestação. Em todas as pesquisas verificadas, a prevalência de anemia ferropriva na gestação apresenta valores elevados, o que caracteriza essa situação como um problema de saúde pública para o Brasil, mesmo com as políticas nacionais atuais de combate à deficiência.Iron-deficiency anemia is known as one of the main nutritional deficiencies around the world and its occurrence can be observed in many populations. Some groups still present a high prevalence of iron-deficiency anemia, compromising many body functions. Pregnant women are among the groups at risk given their vulnerability to deficiencies and the significant increase in their requirements, which are not accompanied by a sufficiently higher iron intake or absorption. This paper analyzes data from articles published in the last 40 years in English, Spanish or Portuguese found in the Lilacs and Medline databases about the prevalence of iron-deficiency anemia during pregnancy. Every paper found reports a high prevalence of anemia in pregnant women, characterizing this situation as a public health problem in Brazil, despite current Brazilian policies to fight iron deficiency.
Yakoob, Mohammad Yawar; Lo, Clifford W
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.
Clark, Katy M; Li, Ming; Zhu, Bingquan; Liang, Furong; Shao, Jie; Zhang, Yueyang; Ji, Chai; Zhao, Zhengyan; Kaciroti, Niko; Lozoff, Betsy
To assess associations between breastfeeding and iron status at 9 months of age in 2 samples of Chinese infants. Associations between feeding at 9 months of age (breastfed as sole milk source, mixed fed, or formula fed) and iron deficiency anemia (IDA), iron deficiency, and iron sufficiency were determined in infants from Zhejiang (n = 142) and Hebei (n= 813) provinces. Iron deficiency was defined as body iron infants had IDA compared with 0% of formula-fed infants. The odds of iron deficiency/IDA were increased in breastfed and mixed-fed infants compared with formula-fed infants: breastfed vs formula-fed OR, 28.8 (95% CI, 3.7-226.4) and mixed-fed vs formula-fed OR, 11.0 (95% CI, 1.2-103.2). In Hebei, 44.0% of breastfed infants had IDA compared with 2.8% of formula-fed infants. With covariable adjustment, odds of IDA were increased in breastfed and mixed-fed groups: breastfed vs formula-fed OR, 78.8 (95% CI, 27.2-228.1) and mixed-fed vs formula-fed OR, 21.0 (95% CI, 7.3-60.9). In both cohorts, the odds of iron deficiency/IDA at 9 months of age were increased in breastfed and mixed-fed infants, and iron deficiency/IDA was common. Although the benefits of breastfeeding are indisputable, these findings add to the evidence that breastfeeding in later infancy identifies infants at risk for iron deficiency/IDA in many settings. Protocols for detecting and preventing iron deficiency/IDA in breastfed infants are needed. ClinicalTrials.gov: NCT00642863 and NCT00613717. Copyright © 2016 Elsevier Inc. All rights reserved.
Ott, Claudia; Liebold, Anne; Takses, Angela; Strauch, Ulrike G.; Obermeier, Florian
Background. Iron-deficiency anemia is described to be a common problem in patients with inflammatory bowel disease (IBD), which is frequently associated with a reduced quality of life. Therefore, the aim of this study is to assess the prevalence of iron deficiency anemia in a population-based cohort at time of first diagnosis and during the early course of the disease. Methods. As far as available, lab values of patients registered in the population-based “Oberpfalz cohort” were screened. In anemic patients, we further investigated all laboratory results to differentiate between iron deficiency and other reasons for anemia. All patients with any kind of anemia were interviewed separately according to symptoms of iron-deficiency anemia and administration of iron. Results. In total, we evaluated hemoglobin values of 279 patients (183 Crohn's disease, 90 ulcerative colitis, and 6 indeterminate colitis). Lab data which allowed further differentiation of the type of anemia were available in 70% of anemic patients, in 34.4% values of iron, ferritin and transferrin saturation had been measured. At time of first diagnosis, an iron-deficiency anemia was diagnosed in 26 of 68 patients with anemia (38.2%, 20 CD, 4 UC, and 2 IC patients), but only 9 patients (34.6%) received subsequent iron therapy. After one year, 27 patients were identified to have an iron-deficiency anemia (19 CD, 8 UC), 20 of them were treated with iron (71.4%). Of 9 patients with proven iron-deficiency anemia at time of first diagnosis and subsequent administration of iron, 5 (55.5%) had iron-deficiency anemia despite permanent treatment after one year. In total, 38 patients (54.3%) did not receive any iron substitution at all despite of proven iron-deficiency anemia, and only 13 patients of 74 patients were treated with intravenous iron (17.6%). Conclusion. We found a high prevalence of iron-deficiency anemia at different points during the early course of disease in this population-based cohort of
Full Text Available Malnutrition and anemia affect large numbers of young children living in poor areas of China. Multi-micronutrient deficiencies may be related to the prevalence of anemia in different populations, and identifying the risk factors that render children susceptible to anemia is the first step in combating anemia effectively.In this cross-sectional study, a total of 1370 children under 3 years old were selected based on probability proportional to size sampling principles from poor counties of China. Basic characteristics data were collected by questionnaire; then anthropometrics and hemoglobin were measured in the field and anemia prevalence evaluated. Venous blood was drawn from children aged 12-35 months (N = 553 to evaluate micronutrient status. Logistic regression was used to identify the risk factors for children's anemia.Among children aged 0-35 months, the prevalence of stunting, low body weight and wasting was 17.5%, 8.6% and 5.1%, respectively, and 25.6% of the children were affected by anemia, with more anemic infants and younger children than older children (P <0.01. There were 26.5%, 12.8%, 14.1% and 20.0% of the children aged 12-35 months affected by iron deficiency, vitamin D deficiency, folic acid deficiency and vitamin B12 deficiency, respectively. For children aged 0-11 months who were breastfed, the mothers' anemic status was the only factor associated with the child's anemia (OR = 2.6; 95% CI: 1.2-5.4, P < 0.05. For children aged 12-35 months, multivariate logistic regression indicated that anemia was significantly associated with iron and vitamin B12 deficiency (OR = 5.3; 95% CI: 1.9-14.5, P < 0.01 and monotonous diet (OR = 2.3; 95% CI: 1.1-4.7, P < 0.05 after adjusting for age and gender.The prevalence of anemia was higher in children under 2 years old and requires urgent intervention. An effective intervention strategy should include iron and vitamin B12 supplements, improving dietary diversity and controlling breastfeeding
Ferri, Cláudia; Procianoy, Renato S; Silveira, Rita C
To determine the prevalence of iron-deficiency anemia and iron deficiency at 1 year of corrected age (CA) in preterm very-low-birth-weight infants, and to identify risk factors for iron-deficiency anemia. A cohort of infants with birth weight Anemia diagnosis was based on hemoglobin infant formula); hospitalizations during the first year and weight, head circumference, body mass index and length at 12 months' CA were analyzed. Prevalence of anemia in 310 participants was 26.5% [95% confidence interval (CI) 21.8-31.6%] and of iron deficiency was 48% (95% CI 39.0-56.9%). Increased consumption of cow's milk at 6 months [relative risk (RR) 1.687; 95% CI 1.146-2.483], lower maternal age (RR 0.953; 95% CI 0.923-0.983), high number of pregnancies (RR 1.256; 95% CI 1.122-1.406) and being born small for gestational age (RR 1.578; 95% CI 1.068-2.331) were independently associated with anemia after adjustments. Prevalence of anemia is high at 1 year of CA. Dietary and environmental education strategies may help prevent anemia after discharge.
Full Text Available Evidence on vitamin D status and related risk factors in Luxembourg adults is lacking. This study aimed to determine the prevalence of vitamin D deficiency and insufficiency and related risk factors among healthy adults in Luxembourg. Based on clinicians’ observations, it was hypothesized that vitamin D deficiency and insufficiency might be common in our population, constituting a significant public health concern. A nationally representative random sample of 1432 adults was enrolled in the ORISCAV-LUX study, 2007–2008. The participants were divided into four categories according to their serum concentrations of 25-hydroxyvitamin D [25(OHD]. Descriptive, univariate and multivariate statistical analyses used weighted methods to account for the stratified sampling scheme. Only 17.1% of the population had a “desirable” serum 25(OHD level ≥75 nmol/L, whereas 27.1% had “inadequate” [serum 25(OHD level 50–74 nmol/L], 40.4% had “insufficient” [serum 25(OHD level 25–49 nmol/L], and 15.5% had “deficient” [serum 25(OHD level <25 nmol/L]. The prevalence of vitamin D deficiency was greater among current smokers, obese subjects, those having reduced HDL-cholesterol level and fair/poor self-perception of health, compared to their counterparts. The prevalence of vitamin D insufficiency was additionally higher among nondrinkers of alcohol, Portuguese and subjects from non-European countries. The final multivariate logistic regression analyses revealed that smoking status and obesity were independent correlates of vitamin D deficiency and insufficiency, respectively. Inadequate vitamin D status is highly prevalent among adults in Luxembourg and is associated with specific lifestyle factors. Along with the effect of vitamin D deficiency and insufficiency on the risk of several diseases, cancer and mortality, our findings have practical implications for public health dietary recommendations, and of particular importance for healthcare
Full Text Available Multiple micronutrient deficiencies are highly prevalent among preschool children and often lead to anemia and growth faltering. Given the limited success of supplementation and health education programs, fortification of foods could be a viable and sustainable option. We report results from a community based double-masked, randomized trial among children 1-4 years evaluating the effects of micronutrients (especially of zinc and iron delivered through fortified milk on growth, anemia and iron status markers as part of a four group study design, running two studies simultaneously.Enrolled children (n = 633 were randomly allocated to receive either micronutrients fortified milk (MN = 316 or control milk (Co = 317. Intervention of MN milk provided additional 7.8 mg zinc, 9.6 mg iron, 4.2 microg selenium, 0.27 mg copper, 156 microg vitamin A, 40.2 mg vitamin C, and 7.5 mg vitamin E per day (three serves for one year. Anthropometry was recorded at baseline, mid- and end-study. Hematological parameters were estimated at baseline and end-study. Both groups were comparable at baseline. Compliance was over 85% and did not vary between groups. Compared to children consuming Co milk, children consuming MN milk showed significant improvement in weight gain (difference of mean: 0.21 kg/year; 95% confidence interval [CI] 0.12 to 0.31, p<0.001 and height gain (difference of mean: 0.51 cm/year; 95% CI 0.27 to 0.75, p<0.001. Mean hemoglobin (Hb (difference of 13.6 g/L; 95% CI 11.1 to 16.0, p<0.001 and serum ferritin levels (difference of 7.9 microg/L; 95% CI 5.4 to 10.5, p<0.001 also improved. Children in MN group had 88% (odds ratio = 0.12, 95% CI 0.08 to 0.20, p<0.001 lower risk of iron deficiency anemia.Milk provides an acceptable and effective vehicle for delivery of specific micronutrients, especially zinc and iron. Micronutrient bundle improved growth and iron status and reduced anemia in children 1-4 years old.
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.
Isanaka, Sheila; Mugusi, Ferdinand; Urassa, Willy; Willett, Walter C.; Bosch, Ronald J.; Villamor, Eduardo; Spiegelman, Donna; Duggan, Christopher; Fawzi, Wafaie W.
Many studies have documented a high prevalence of anemia among tuberculosis (TB) patients and anemia at TB diagnosis has been associated with an increased risk of death. However, little is known about the factors contributing to the development of TB-associated anemia and their importance in TB disease progression. Data from a randomized clinical trial of micronutrient supplementation in patients with pulmonary TB in Tanzania were analyzed. Repeated measures of anemia with iron deficiency, anemia without iron deficiency, and iron deficiency without anemia were assessed as risk factors for treatment failure, TB recurrence, and mortality. The prevalence of anemia (hemoglobin iron deficiency (mean corpuscular volume , 80 fL). We found no evidence of an association between anemia (with or without iron deficiency) or iron deficiency without anemia at baseline and the risk of treatment failure at 1 mo after initiation. Anemia without iron deficiency was associated with an independent, 4-fold increased risk of TB recurrence [adjusted RR = 4.10 (95% CI = 1.88, 8.91); P Iron deficiency and anemia (with and without iron deficiency) were associated with a 2- to nearly 3-fold independent increase in the risk of death [adjusted RR for iron deficiency without anemia = 2.89 (95% CI = 1.53, 5.47); P = 0.001; anemia without iron deficiency = 2.72 (95% CI = 1.50, 4.93); P = 0.001; iron deficiency anemia = 2.13 (95% CI = 1.10, 4.11); P = 0.02]. Efforts to identify and address the conditions contributing to TB-associated anemia, including iron deficiency, could play an important role in reducing morbidity and mortality in areas heavily affected by TB. PMID:22190024
Luabeya Kany-Kany A
Full Text Available Abstract Background The benefits of zinc or multiple micronutrient supplementations in African children are uncertain. African children may differ from other populations of children in developing countries because of differences in the prevalence of zinc deficiency, low birth weight and preterm delivery, recurrent or chronic infections such as HIV, or the quality of complementary diets and genetic polymorphisms affecting iron metabolism. The aim of this study was to ascertain whether adding zinc or multiple micronutrients to vitamin A supplementation improves longitudinal growth or reduces prevalence of anemia in children aged 6-24 months. Methods Randomized, controlled double-blinded trial of prophylactic micronutrient supplementation to children aged 6-24 months. Children in three cohorts - 32 HIV-infected children, 154 HIV-uninfected children born to HIV-infected mothers, and 187 uninfected children born to HIV-uninfected mothers - were separately randomly assigned to receive daily vitamin A (VA [n = 124], vitamin A plus zinc (VAZ [n = 123], or multiple micronutrients that included vitamin A and zinc (MM [n = 126]. Results Among all children there were no significant differences between intervention arms in length-for-age Z scores (LAZ changes over 18 months. Among stunted children (LAZ below -2 [n = 62], those receiving MM had a 0.7 Z-score improvement in LAZ versus declines of 0.3 in VAZ and 0.2 in VA (P = 0.029 when comparing effects of treatment over time. In the 154 HIV-uninfected children, MM ameliorated the effect of repeated diarrhea on growth. Among those experiencing more than six episodes, those receiving MM had no decline in LAZ compared to 0.5 and 0.6 Z-score declines in children receiving VAZ and VA respectively (P = 0.06 for treatment by time interaction. After 12 months, there was 24% reduction in proportion of children with anemia (hemoglobin below 11 g/dL in MM arm (P = 0.001, 11% in VAZ (P = 0.131 and 18% in VA (P = 0
Optimizing micronutrient intake of lactating women through increased wild edible plant consumption in Kwazulu-Natal, South Africa. ... current micronutrient intake measured in a sample of lactating women and Estimated Average Requirements (EAR) and the creation of composite nutrient profiles for groups of wild edible ...
Rosales, C.M.; Cabildo, M.S.
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
de Gier, Brechje; Nga, Tran Thuy; Winichagoon, Pattanee
with vitamin A. Trichuris and hookworm infections were associated with lower hemoglobin concentration, but not with plasma ferritin. Trichuris-infected children had zinc deficiency less often than uninfected children. In conclusion, our study shows species-specific associations between STH infections...... and micronutrient status in children. The different life cycles of STH species might have specific effects on the absorption or loss of specific micronutrients. Tailor-made combinations of deworming and nutritional interventions may be needed to improve child health and nutrition....
Ignacio Jáuregui-Lobera Department of Nutrition and Bromatology, Pablo de Olavide University, Seville, Spain Abstract: Micronutrient deficiencies, especially those related to iodine and iron, are linked to different cognitive impairments, as well as to potential long-term behavioral changes. Among the cognitive impairments caused by iron deficiency, those referring to attention span, intelligence, and sensory perception functions are mainly cited, as well as those associated with...
Gaur, Sumit; Agnihotri, Rupali
Trace mineral micronutrients are imperative for optimum host response. Populations worldwide are prone to their insufficiency owing to lifestyle changes or poor nutritional intake. Balanced levels of trace minerals like iron (Fe), zinc (Zn), selenium (Se) and copper (Cu) are essential to prevent progression of chronic conditions like periodontitis. Their excess as well as deficiency is detrimental to periodontal health. This is specifically true in relation to Fe. Furthermore, some trace elements, e.g. Se, Zn and Cu are integral components of antioxidant enzymes and prevent reactive oxygen species induced destruction of tissues. Their deficiency can worsen periodontitis associated with systemic conditions like diabetes mellitus. With this background, the present review first focusses on the role of four trace minerals, namely, Fe, Zn, Se and Cu in periodontal health followed by an appraisal of the data from case control studies related to their association with chronic periodontitis.
Song, Hye-Rim; Kweon, Sun-Seog; Choi, Jin-Su; Rhee, Jung-Ae; Lee, Young-Hoon; Nam, Hae-Sung; Jeong, Seul-Ki; Park, Kyeong-Soo; Ryu, So-Yeon; Choi, Seong-Woo; Shin, Min-Ho
Vitamin D plays an important role in bone metabolism and maintaining bone health. Recently, new evidence has revealed that vitamin D affects chronic diseases such as autoimmune diseases, cardiovascular diseases and certain cancers. The aim of this study was to evaluate the vitamin D status and the prevalence of vitamin D deficiency in an urban Korean population. This study included 8,976 participants (3,587 men and 5,389 women) aged 50 yr and older. Serum 25(OH)D level was measured by chemiluminescent microparticle immunoassay. The prevalence of vitamin D deficiency [25(OH)D < 20 ng/mL] was 59.7% and 86.5% in men and women, respectively. The prevalence of vitamin D deficiency increased significantly with age in men, but not in women and it decreased from April to July, more prominently in men than in women. These results suggest that sun exposure, intake of vitamin D supplement, and regular physical activities is recommended in an urban Koreans, especially in women.
Srimani, Soumi; Saha, Indranil; Chaudhuri, Debnath
Prevalence of metabolic syndrome (MS) and vitamin D deficiency was reported among postmenopausal women (PMW) in India. However, no report is available regarding the association of MS and 25-hydroxyvitamin D [25(OH)D] among PMW in India. This study aimed to find out the prevalence of MS and 25(OH)D status as well as their association among rural PMW of West Bengal, India. This cross-sectional study was conducted among 222 randomly selected rural PMW in Singur Block, West Bengal, India. Serum 25(OH)D, Blood pressure (BP), waist circumference (WC), fasting blood glucose (FBG), triglycerides (TG) and high density lipoprotein cholesterol (HDL-C) were measured using standard procedures. MS was defined as per International Diabetes Federation, 2005 (for Asian-Indians) criteria. Statistical tests were done using SPSS software. Prevalence of metabolic syndrome was 46%. 51% and 19% PMW were vitamin D insufficient and deficient, respectively. 22% and 53% women having MS were vitamin D insufficient and deficient, respectively. Among the PMW, 21% and 47% with WC≥80cm; 22% and 62% with FBG≥110mg/dl; 21% and 54% with TG≥150mg/dl; 23% and 51% with HDL-CWest Bengal, India. 25(OH)D had significant inverse and direct relationship with FBG and WC. Low 25(OH)D may be one of the potential risk factors for developing MS in PMW or vice-versa.
Full Text Available Little is known about the micronutrient status of women and children in the Democratic Republic of the Congo, which is critical for the design of effective nutrition interventions. We recruited 744 mother-child pairs from South Kivu (SK and Kongo Central (KC. We determined hemoglobin (Hb, serum zinc, vitamin B12, folate, ferritin, soluble transferrin receptor (sTfR, retinol binding protein (RBP, C-reactive protein, and α-1 acid glycoprotein concentrations. Anemia prevalence was determined using Hb adjusted for altitude alone and Hb adjusted for both altitude and ethnicity. Anemia prevalence was lower after Hb adjustment for altitude and ethnicity, compared to only altitude, among women (6% vs. 17% in SK; 10% vs. 32% in KC, children 6–23 months (26% vs. 59% in SK; 25% vs. 42% in KC, and children 24–59 months (14% vs. 35% in SK; 23% vs. 44% in KC, respectively. Iron deficiency was seemingly higher with sTfR as compared to inflammation-adjusted ferritin among women (18% vs. 4% in SK; 21% vs. 5% in KC, children 6–23 months (51% vs. 14% in SK; 74% vs. 10% in KC, and children 24–59 months (23% vs. 4% in SK; 58% vs. 1% in KC. Regardless of indicator, iron deficiency anemia (IDA never exceeded 3% in women. In children, IDA reached almost 20% when sTfR was used but was only 10% with ferritin. Folate, B12, and vitamin A (RBP deficiencies were all very low (<5%; RBP was 10% in children. The prevalence of anemia was unexpectedly low. Inflammation-adjusted zinc deficiency was high among women (52% in SK; 58% in KC, children 6–23 months (23% in SK; 20% in KC, and children 24–59 months (25% in SK; 27% in KC. The rate of biochemical zinc deficiency among Congolese women and children requires attention.
Fall, Caroline H D; Fisher, David J; Osmond, Clive; Margetts, Barrie M
Multiple micronutrient deficiencies are common among women in low-income countries and may adversely affect pregnancy outcomes. This meta-analysis reports the effects on newborn size and duration of gestation of multiple micronutrient supplementation mainly compared with iron plus folic acid during pregnancy in recent randomized, controlled trials. Original data from 12 randomized, controlled trials in Bangladesh, Burkina Faso, China, Guinea-Bissau, Indonesia, Mexico, Nepal, Niger, Pakistan, and Zimbabwe, all providing approximately 1 recommended dietary allowance (RDA) of multiple micronutrients to presumed HIV-negative women, were included. Outcomes included birthweight, other birth measurements, gestation, and incidence of low birthweight (LBW) (birth (SGA, birthweight below the within-each-population 10th percentile), large-for-gestational age birth (LGA, birthweight above the within-each-population 90th percentile), and preterm delivery (supplementation (mainly with iron-folic acid), multiple micronutrient supplementation was associated with an increase in mean birthweight (pooled estimate: +22.4 g [95% CI, 8.3 to 36.4 g]; p = .002), a reduction in the prevalence of LBW (pooled OR = 0.89 [95% CI, 0.81 to 0.97]; p = .01) and SGA birth (pooled OR = 0.90 [95% CI, 0.82 to 0.99]; p = .03), and an increase in the prevalence of LGA birth (pooled OR = 1.13 [95% CI, 1.00 to 1.28]; p = .04). In most studies, the effects on birthweight were greater in mothers with higher body mass index (BMI). In the pooled analysis, the positive effect of multiple micronutrients on birthweight increased by 7.6 g (95% CI, 1.9 to 13.3 g) per unit increase in maternal BMI (p for interaction = .009). The intervention effect relative to the control group was + 39.0 g (95% CI, +22.0 to +56.1 g) in mothers with BMI of 20 kg/m2 or higher compared with -6.0 g (95% CI, -8.8 to +16.8 g) in mothers with BMI under 20 kg/m2. There were no significant effects of multiple micronutrient supplementation
Schmidt, Sidsel Birkelund; Jensen, Poul Erik; Husted, Søren
Manganese (Mn) is an essential plant micronutrient with an indispensable function as a catalyst in the oxygen-evolving complex (OEC) of photosystem II (PSII). Even so, Mn deficiency frequently occurs without visual leaf symptoms, thereby masking the distribution and dimension of the problem...... restricting crop productivity in many places of the world. Hence, timely alleviation of latent Mn deficiency is a challenge in promoting plant growth and quality. We describe here the key mechanisms of Mn deficiency in plants by focusing on the impact of Mn on PSII stability and functionality. We also address...... the mechanisms underlying the differential tolerance towards Mn deficiency observed among plant genotypes, which enable Mn-efficient plants to grow on marginal land with poor Mn availability....
Full Text Available To study the effect of micronutrients and irrigation cutback at different development stages on vegetative characteristics and yield of pinto bean (Talash cultivar, an experiment was carried out at Agricultural Research Station of Khoy in 2009. This experiment was performed as strip split plots based on randomized complete blocks design with 3 replications. Treatments included irrigation as the main factor at 3 levels (conventional irrigation (control, irrigation cutback at podding stage, irrigation cutback at seed-filling stage, and application of micronutrients (boron, zinc and manganese as sub factor at 4 levels (soil treatment, one foliar application, two foliar applications, and control (no micronutrients application. According to the results, irrigation levels had significant effects on height of the first branch above the ground, stem diameter, seed yield, biological yield and protein content of the seeds. By irrigation cutback at podding and seed-filling stages, the seed yield decreased from 2647 kg/ha to 1269 and 1920 kg/ha, respectively. Micronutrients treatments had also significant effects on number of branches per plant, height of the first branch above the ground, stem diameter, seed yield, biological yield and protein percent. The highest seed yield (2379 kg/ha was in two foliar applications, which was 893 kg/ha more than control (no micronutrients application. The highest protien content (26.8% belonged to irrigation at control level and two foliar applications of micronutrients. The general result of this research shows that due to high sensitivity of pinto bean to water deficiency, irrigation at conventional level with two foliar applications of micronutrients is recommendable to improve its growth.
Boneh, A; Andresen, B S; Gregersen, N
We diagnosed six newborn babies with very long-chain acyl-CoA dehydrogenase deficiency (VLCADD) through newborn screening in three years in Victoria (prevalence rate: 1:31,500). We identified seven known and two new mutations in our patients (2/6 homozygotes; 4/6 compound heterozygotes). Blood sa...
Grimm, Kirsten A; Sullivan, Kevin M; Alasfoor, Deena; Parvanta, Ibrahim; Suleiman, Ali Jaffer Mohammed; Kaur, Meenu; Al-Hatmi, Fatima Obaid; Ruth, Laird J
Iron deficiency is estimated to impact more than 1.6 billion individuals worldwide, affecting child, maternal, and perinatal mortality. Iron supplementation, fortification, and dietary diversification are strategies to reduce the prevalence of iron deficiency. However, there are relatively few studies demonstrating the effectiveness of iron-fortified wheat flour as an intervention. To assess the relationship between average monthly per capita household consumption of iron-fortified wheat flour and iron deficiency among women of childbearing age in Oman. Data were obtained from the National Micronutrient Status and Fortified Food Coverage Survey, 2004. Iron deficiency status was compared between women living in households with a monthly per capita consumption of iron-fortified wheat flour of 1 kg or more and women living in households with a monthly per capita consumption of iron-fortified wheat flour of less than 1 kg. The analyses excluded women with elevated or unknown levels of C-reactive protein and controlled for characteristics of the women and household demographics. Consumption of iron-fortified wheat flour was associated with a lower prevalence of iron deficiency among women in our sample (adjusted odds ratio, 0.60), after controlling for age, employment status, marital status, intake of iron or multivitamin supplements, self-reported presence of a blood disorder, household income, educational level of head of household, and family size. These results suggest that women in our study living in households with a greater consumption of iron-fortified wheat flour have a lower prevalence of iron deficiency; however, additional study is needed.
D. E. Soboleva
Full Text Available The purpose of the study is the assessment of iodine status and effectiveness of iodine prophylaxis among the population of reproductive age. In this regard, we examined 200 individuals from 18 up to 44 years old living in Saint Petersburg for more than 3 years permanently. Most of the examined individuals had mild iodine deficiency, less than half of people of reproductive age (46 % used iodized salt at home. Goiter was found by palpation in 8 % of participants. More than half of the surveyed individuals are women of reproductive age who are at risk for the development of iodine deficiency disorders. Our data reflect an unfavorable situation in fight against iodine deficiency disorders in Saint Petersburg. Probably, the voluntary model of using iodized salt as the prevention of iodine deficiency in the Russian Federation is not effective enough.
Murphy, S.P.; Gewa, C.; Grillenberger, M.; Bwibo, N.O.; Neumann, C.G.
Three snacks were designed to improve nutrient intakes among school-age children living in rural Kenya. Snacks containing animal-source foods (milk and meat) provided more nutrients than an equicaloric vegetarian snack. The vegetarian snack provided extra vitamin A (primarily from fortified cooking
Veer, van 't P.; Grammatikaki, E.; Matthys, C.; Raats, M.M.; Contor, L.
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
Yusufali, Rizwan; Sunley, Nigel; de Hoop, Maude; Panagides, Dora
Fortification of staple foods is an effective strategy to deliver and increase the intake of micronutrients in the diet and can reduce micronutrient deficiencies. It is important to ensure that the food vehicle consistently contains adequate amounts of nutrients at the point of consumption for effective impact. This survey aimed to gauge the level of fortification of maize and wheat flour at the retail level compared with staple food fortification regulations in South Africa to better understand the current obstacles to effective delivery of micronutrients through flour fortification and consider approaches to strengthening the program. White bread flour and maize meal samples were collected from retail points across all provinces and analyzed for vitamin A, iron, and nicotinamide, and a database capturing the origins of the sample was populated. Nicotinamide and vitamin A results were compared against each other and evaluated against food regulations. The level of compliance with statutory fortification requirements was low, both for bread flour and for maize meal. There is evidence of insufficient addition of premix as opposed to losses due to vitamin A stability as seen from the strong correlation between vitamin A and nicotinamide in maize meal. The current levels of micronutrients added to maize meal and bread flour are unsatisfactory. This is likely to be because of insufficient addition of premix at the mills. This affects the availability and intake by consumers of fortified product and potentially prevents the desired reduction in vitamin and mineral deficiencies expected from the flour fortification program.
Whitfield, Kyly C; Smith, Geoffry; Chamnan, Chhoun
cut-offs from literature. Women were mean (SD) 30 (6) y, and children (46% girls) were 41 (17) mo. Women had lower mean (95% CI) eThDP of 150 nmol/L (146-153) compared to children, 174 nmol/L (171-179; P cut-off of eThDP ...% of children were thiamine deficient, however prevalence rates of deficiency were as high as 78% for mothers and 58% for children using a cut-off of cut-off (.../L). CONCLUSIONS/SIGNIFICANCE: There is a lack of consensus on thiamine status cut-offs; more research is required to set clinically meaningful cut-offs. Despite this, there is strong evidence of suboptimal thiamine status among Cambodian mothers and their children, with infants
Bailey, Regan L.; Fulgoni, Victor L.; Keast, Debra R.; Lentino, Cindy V.; Dwyer, Johanna T.
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
Bailey, Regan L; Fulgoni, Victor L; Keast, Debra R; Lentino, Cindy V; Dwyer, Johanna T
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% (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 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.
De Steur, Hans; Feng, Shuyi; Xiaoping, Shi; Gellynck, Xavier
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.
Iron deficiency is an important nutritional global problem. This paper contains summery of information gathered from a dietary survey as iron deficiency anaemia is major public health problem in many developing countries including Pakistan. Comparison of anaemia in different age group and sex versus various regions in the world are given. In Pakistan also anaemia is widespread. According to the report of Micro-Nutrient survey of Pakistan 40% of the population are found to have low level of haemoglobin, more than half of pregnant women suffered from marginal or deficient haemoglobin. (A.B.)
Krishna Kishore Sukla
Full Text Available BACKGROUND & AIMS: Indian subcontinent has the highest child mortality rates along with a very high frequency of low birthweight (LBW. Folate and vitamin B12 (Vit-B12 are necessary during foetal development and their deficiency prevalence in Indians is very high. The objective of the present paper is to assess whether foetal homocysteine (Hcy/folate metabolic pathway genes, their cofactors and homocysteine level independently (or collectively predispose children to Low birth weight. METHODS: Cord blood was collected for the study. Frequency of 5 SNPs in 4-Hcy-pathway genes, and levels of Hcy, Vit-B12 and folate were evaluated. RESULTS: Of the 421 newborns recruited for the study, 38% showed low birth weight (<2.5 kg and 16% were preterm babies. 101 neonates developed neonatal hyperbilirubinemia (NNH. High prevalence of Vit-B12 (65% and folate (27% deficiency was observed in newborns along with hyperhomocystinemia (hypHcy-25%. Preterm delivery, micronutrient deficiency, hypHcy and MTHFR 677T SNP are associated as risk factor while G allele of TCN2 C776G is protective against LBW. MTHFR 677T allele and folate deficiency are also independent risk factors for NNH. CONCLUSION: We record the highest incidence of Vit-B12, folate deficiency and elevated Hcy levels, of all the studies so far reported on neonates. These together with MTHFR 677T are potential risk factors for LBW. Association of impaired folate/Hcy metabolism with NNH is reported for the first time and the possible way of interaction is discussed. It appears that proper nutritional management during pregnancy would reduce the risk of complex clinical outcomes.
Gupta, Raj Kishor; Gangoliya, Shivraj Singh; Singh, Nand Kumar
More than half of the world populations are affected by micronutrient malnutrition and one third of world's population suffers from anemia and zinc deficiency, particularly in developing countries. Iron and zinc deficiencies are the major health problems worldwide. Phytic acid is the major storage form of phosphorous in cereals, legumes, oil seeds and nuts. Phytic acid is known as a food inhibitor which chelates micronutrient and prevents it to be bioavailabe for monogastric animals, including humans, because they lack enzyme phytase in their digestive tract. Several methods have been developed to reduce the phytic acid content in food and improve the nutritional value of cereal which becomes poor due to such antinutrient. These include genetic improvement as well as several pre-treatment methods such as fermentation, soaking, germination and enzymatic treatment of grains with phytase enzyme. Biofortification of staple crops using modern biotechnological techniques can potentially help in alleviating malnutrition in developing countries.
Ahmed E. Mansour
Conclusion: The prevalence of spontaneous bacterial pleuritis in the studied group of patients with hepatic hydrothorax was 14.3%. Patients with advanced liver disease, low pleural fluid protein, or SBP are at risk for spontaneous bacterial pleuritis.
Prevalência de deficiência de ferro em gestantes de primeira consulta em centros de saúde de área metropolitana, Brasil: etiologia da anemia The prevalence of iron deficiency in pregnant women at their first consultation in health centers in a metropolitan area, Brazil: etiology of anemia in anemic pregnant women
Elvira Maria Guerra
Full Text Available No período compreendido entre abril e outubro de 1988, foram estudadas 363 gestantes de primeira consulta , que estavam inscritas no Programa de Atendimento à Gestante em oito Centros de Saúde da Secretaria da Saúde do Estado de São Paulo (Brasil. Na ocasião da coleta de material estas gestantes não faziam uso de medicamentos que continham ferro, ácido fólico, vitamina B12 ou associações destes. A idade média das gestantes foi de 25 anos; 65,9% delas pertenciam a famílias com renda de até um SMPC (salário mínimo per capita e apenas 3,1% pertenciam a famílias com renda superior a 3 SMPC. Tomando-se a saturação da transferrina inferior a 15% como índice mínimo para definir a deficiência de ferro, a prevalência de deficiência de ferro no primeiro trimestre (4,6% foi significativamente menor do que a observada no segundo (17,3%, e esta foi menor do que no terceiro trimestre (42,8%. A prevalência de deficiência de ferro total agrupada nos três trimestres foi de 12,4%. Não houve diferença significativa entre as prevalências de deficiência de ferro segundo o número de partos. Esta prevalência foi maior no grupo das gestantes que pertenciam a famílias com renda de até 0,5 SMPC. Nas gestantes anêmicas, 46,7% eram deficientes de ferro, 44,4% de ácido fólico, 20,0% de ferro e ácido fólico e nenhuma delas eram deficientes de vitamina B12.Three hundred and sixty-three pregnant women enrolled in the Pregnancy Medical Care Program of S. Paulo Health Department in the district of Butantan, S. Paulo city, Brazil, were studied at their first routine consultation between April and October, 1988. Their average age was 25 and 65,9% of them belonged to families with a monthly income below US$ 50.00 per capita. Only 3.1% presented an income above US$ 150.00 per capita. Taking the minimum transferrin saturation threshold of 15% as determining iron deficiency, a 4.6% prevalence of iron deficiency was observed in the first
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
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
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 growth and
Mockenhaupt, Frank P.; Mandelkow, Jantina; Till, Holger; Ehrhardt, Stephan; Eggelte, Teunis A.; Bienzle, Ulrich
Glucose-6-phosphate dehydrogenase (G6PD) deficiency confers protection against malaria in children, yet its role in malaria in pregnancy is unknown. In a cross-sectional study among 529 pregnant Ghanaian women, Plasmodium falciparum infection, anaemia and G6PD genotypes were assessed. Of these,
Stein, Alexander J.
Millions of people worldwide suffer from micronutrient malnutrition or ?hidden hunger?. The related deficiencies can have devastating consequences for the life, health and well-being of the affected individuals, but they may also perpetuate a vicious circle of undernutrition, low economic productivity and poverty. Hence, in many developing countries vitamin and mineral deficiencies are public health problems of primary concern. While economic development and rising incomes can only address un...
Isaac, IZ; Mainasara, AS; Erhabor, Osaro; Omojuyigbe, ST; Dallatu, MK; Bilbis, LS; Adias, TC
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the most common human enzyme deficiencies in the world. It is particularly common in populations living in malaria-endemic areas, affecting more than 400 million people worldwide. This present study was conducted with the aim of determining the prevalence of G6PD deficiency among children visiting the Emergency Paediatric Unit of Usmanu Danfodiyo University Teaching Hospital for pediatric-related care. The study included 118 children, made up of 77 (65.3%) males and 41 (34.7%) females aged ≤5 years with mean age of 3.26 ± 1.90 years. Randox G6PD quantitative in vitro test screening was used for the diagnosis of G6PD deficiency. Of the 118 children tested, 17 (14.4%) were G6PD-deficient. Prevalence of G6PD deficiency was concentrated predominantly among male children (22.1%). Male sex was significantly correlated with G6PD deficiency among the children studied (r = 7.85, P = 0.01). The highest prevalence occurred among children in the 2- to 5-year age-group. Of the 17 G6PD-deficient children, twelve (70.2%) were moderately deficient, while five (29.4%) were severely deficient. Blood film from G6PD-deficient children indicated the following morphological changes; Heinz bodies, schistocytes, target cells, nucleated red cells, spherocytes, and polychromasia. This present study has shown a high prevalence of G6PD deficiency among children residing in Sokoto in the northwestern geopolitical zone of Nigeria. The study indicated a male sex bias in the prevalence of G6PD deficiency among the children studied. There is a need for the routine screening of children for G6PD deficiency in our environment, to allow for evidence-based management of these children and to ensure the avoidance of food, drugs, and infective agents that can potentially predispose these children to oxidative stress as well as diseases that deplete micronutrients that protect against oxidative stress. There is need to build capacity in our
Full Text Available IZ Isaac,1 AS Mainasara,2 Erhabor Osaro,1 ST Omojuyigbe,1 MK Dallatu,3 LS Bilbis,3 TC Adias4 1Department of Haematology and Transfusion Medicine, 2Department of Chemical Pathology, 3Department of Biochemistry, Usmanu Danfodiyo University, Sokoto, Nigeria; 4Bayelsa State College of Health Technology, Ogbia, Nigeria Abstract: Glucose-6-phosphate dehydrogenase (G6PD deficiency is one of the most common human enzyme deficiencies in the world. It is particularly common in populations living in malaria-endemic areas, affecting more than 400 million people worldwide. This present study was conducted with the aim of determining the prevalence of G6PD deficiency among children visiting the Emergency Paediatric Unit of Usmanu Danfodiyo University Teaching Hospital for pediatric-related care. The study included 118 children, made up of 77 (65.3% males and 41 (34.7% females aged ≤5 years with mean age of 3.26 ± 1.90 years. Randox G6PD quantitative in vitro test screening was used for the diagnosis of G6PD deficiency. Of the 118 children tested, 17 (14.4% were G6PD-deficient. Prevalence of G6PD deficiency was concentrated predominantly among male children (22.1%. Male sex was significantly correlated with G6PD deficiency among the children studied (r = 7.85, P = 0.01. The highest prevalence occurred among children in the 2- to 5-year age-group. Of the 17 G6PD-deficient children, twelve (70.2% were moderately deficient, while five (29.4% were severely deficient. Blood film from G6PD-deficient children indicated the following morphological changes; Heinz bodies, schistocytes, target cells, nucleated red cells, spherocytes, and polychromasia. This present study has shown a high prevalence of G6PD deficiency among children residing in Sokoto in the northwestern geopolitical zone of Nigeria. The study indicated a male sex bias in the prevalence of G6PD deficiency among the children studied. There is a need for the routine screening of children for G6PD
Bromage, Sabri; Ahmed, Tahmeed; Fawzi, Wafaie W
Bangladesh incurs among the highest prevalence of stunting and micronutrient deficiencies in the world, despite efforts against diarrheal disease, respiratory infections, and protein-energy malnutrition which have led to substantial and continuous reductions in child mortality over the past 35 years. Although programs have generally paid more attention to other micronutrients, the local importance of calcium to health has been less recognized. To synthesize available information on calcium deficiency in Bangladesh in order to inform the design of an effective national calcium program. We searched 3 online databases and a multitude of survey reports to conduct a narrative review of calcium epidemiology in Bangladesh, including population intake, determinants and consequences of deficiency, and tested interventions, with particular reference to young children and women of childbearing age. This was supplemented with secondary analysis of a national household survey in order to map the relative extent of calcium adequacy among different demographics. Intake of calcium is low in the general population of Bangladesh, with potentially serious and persistent effects on public health. These effects are especially pertinent to young children and reproductive-age women, by virtue of increased physiologic needs, disproportionately poor access to dietary calcium sources, and a confluence of other local determinants of calcium status in these groups. A tablet supplementation program for pregnant women is an appealing approach for the reduction in preeclampsia and preterm birth. Further research is warranted to address the comparative benefit of different promising approaches in children for the prevention of rickets. © The Author(s) 2016.
Santos, Betânia R; Mascarenhas, Luis P G; Satler, Fabíola; Boguszewski, Margaret C S; Spritzer, Poli Mara
Vitamin D deficiency has been associated with a multitude of disorders including diabetes, defective insulin secretion as well as rickets and poor bone health. Vitamin D is also a concern during childhood and adolescence and has been reported in girls from South Brazil. We determined the prevalence of vitamin D deficiency in girls from South Brazil and investigated whether the genotypic distribution of the BsmI, ApaI and TaqI polymorphisms of the VDR gene and their haplotypes were associated with vitamin D levels. Cross-sectional study including 234 apparently healthy girls aged 7 to 18 years. Height and weight were measured for calculation of body mass index (BMI) percentiles for age. Plasma levels of 25-hydroxyvitamin D [25(OH)D] were assessed. Participants were genotyped for ApaI (rs7975232), TaqI (rs731236), and BsmI (rs1544410) SNPs. The median and interquartile range (25-75%) of BMI percentile was 62.0 (33.3 - 84.9). The frequency of overweight/obesity was 24.9%. Circulating levels of 25(OH)D (≥ 30 ng/mL) were adequate in 9.4%; insufficient in 54.3% (20-29 ng/mL); and deficient in 36.3% (children and adolescents.
Suzuki, Okihide; Eguchi, Hidetaka; Chika, Noriyasu; Sakimoto, Takehiko; Ishibashi, Keiichiro; Kumamoto, Kensuke; Tamaru, Jun-Ichi; Tachikawa, Tetsuhiko; Akagi, Kiwamu; Arai, Tomio; Okazaki, Yasushi; Ishida, Hideyuki
To clarify the prevalence and clinicopathologic/molecular characteristics of mismatch repair (MMR)-deficient colorectal cancer in the young Japanese population. Immunohistochemical analyses for MMR proteins (MLH1, MSH2, MSH6, and PMS2) were performed in formalin-fixed paraffin-embedded sections prepared from the resected CRC specimens of 119 consecutive patients aged <50 years old, who underwent resection of the primary tumor at our institution between 1996 and 2015. Analyses for somatic BRAF V600E mutation, somatic hypermethylation of the MLH1 promoter, and germline MMR gene mutations were undertaken where indicated. MMR protein loss was found in 10 patients (8.4%), 7 (5.9%) of whom were subsequently identified to have Lynch syndrome (LS). The remaining 3 patients were categorized as having sporadic MMR-deficient CRC (n = 2) or "possible LS (n = 1)". In multivariate logistic regression analysis, the presence of tumor-infiltrating lymphocytes (P < 0.01), right-sided location of the tumor (P = 0.01), and a history of LS-associated tumors in the first-degree relatives (P < 0.01) were identified as independent factors predictive of MMR-deficient CRC. These results are of value in the clinical management of patients with the early onset CRC under circumstances where universal tumor screening approaches for LS are still not available, like in Japan.
Lefebvre, Patrick; Letois, Flavie; Sultan, Ariane; Nocca, David; Mura, Thibaut; Galtier, Florence
Nutritional deficiencies are common after bariatric surgery, but few studies have examined them preoperatively. The objective of this study was to evaluate several vitamins, nutrients, and nutritional markers and their determinants in patients with obesity considering bariatric surgery. Preoperative values of fasting plasma glucose, insulin, lipid profile, 25-hydroxyvitamin D (25(OH)D), parathyroid hormone, thyroid-stimulating hormone, calcium, phosphate, albumin, magnesium, total proteins, liver function tests, iron, ferritin, folate, vitamin A, vitamin B12, selenium, and zinc were evaluated in 267 Caucasian outpatients (74.2% women, aged 40.5±12.6 years) who were considering bariatric surgery. The determinants of nutrient variability were analyzed by linear regression for nutrients with a prevalence of deficiency>10%, i.e., serum 25(OH)D, iron, phosphate, magnesium, and vitamin A. Prevalence of inadequate concentrations was high for 25(OH)D (67.9% with values ≤ 20 ng/mL), magnesium (35.4%), phosphate (21.6%), iron (18.8%), and vitamin A (16.9%). Multiple deficiencies were common; 28.5%, 12.1%, and 6.3% of patients had 2, 3, and 4 deficiencies, respectively. In multivariate analyses, metabolic characteristics had an important impact on deficiencies, with lower values of 25(OH)D and vitamin A with increasing body mass index, lower values of 25(OH)D and magnesium with increasing fasting plasma glucose, and a positive correlation between vitamin A and triglycerides. Elevated TSH was associated with low iron concentrations. At all ages, micronutrient deficiencies were common, with high prevalence of concentration inadequacies for 25(OH)D, magnesium, phosphate, iron, and vitamin A. High body mass index and high fasting plasma glucose increased the risk of deficiencies, particularly for 25(OH)D. Preoperative screening and correction of deficiencies should be advised. © 2014 American Society for Bariatric Surgery Published by American Society for Metabolic and
Santos Betânia R
Full Text Available Abstract Background Vitamin D deficiency has been associated with a multitude of disorders including diabetes, defective insulin secretion as well as rickets and poor bone health. Vitamin D is also a concern during childhood and adolescence and has been reported in girls from South Brazil. We determined the prevalence of vitamin D deficiency in girls from South Brazil and investigated whether the genotypic distribution of the BsmI, ApaI and TaqI polymorphisms of the VDR gene and their haplotypes were associated with vitamin D levels. Methods Cross-sectional study including 234 apparently healthy girls aged 7 to 18 years. Height and weight were measured for calculation of body mass index (BMI percentiles for age. Plasma levels of 25-hydroxyvitamin D [25(OHD] were assessed. Participants were genotyped for ApaI (rs7975232, TaqI (rs731236, and BsmI (rs1544410 SNPs. Results The median and interquartile range (25-75% of BMI percentile was 62.0 (33.3 – 84.9. The frequency of overweight/obesity was 24.9%. Circulating levels of 25(OHD (≥ 30 ng/mL were adequate in 9.4%; insufficient in 54.3% (20–29 ng/mL; and deficient in 36.3% (vs. GA + AA, two-tailed Student’s t-test p vs. GT + TT, two-tailed Student’s t-test p = 0.031 and TaqI (TT vs. TC + CC, two-tailed Student’s t-test p = 0.005 SNPs and the GGT haplotype (two-tailed Student’s t-test p = 0.036 were significantly associated with lower 25(OHD levels. Conclusions 25-hydroxyvitamin D deficiency and insufficiency were highly prevalent in this sample. The BsmI, ApaI and TaqI wild variants of the VDR gene, as well as the GGT haplotype, were associated with lower vitamin D levels, suggesting that VDR gene polymorphisms could be linked to higher susceptibility to vitamin D deficiency in a sub-population of children and adolescents.
Clark Tamara D
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.
Elcio Ferreira dos Santos
Full Text Available Few studies in Brazil have addressed the need for micronutrients of physic nut focusing on physiological responses, especially in terms of photosynthesis. The objective of this study was to evaluate the effects of omission of boron (B, copper (Cu, iron (Fe, manganese (Mn and zinc (Zn on Jatropha curcas L.. The experimental design was a randomized block with four replications. The treatments were complete solution (control and solution without B, Cu, Fe, Mn, and Zn. We evaluated the chlorophyll content (SPAD units, photosynthetic rate, dry matter production and accumulation of micronutrients in plants, resulting from different treatments. The first signs of deficiency were observed for Fe and B, followed by Mn and Zn, while no symptoms were observed for Cu deficiency. The micronutrient omission reduced the dry matter yield, chlorophyll content and photosynthetic rate of the plants differently for each omitted nutrient. It was, however, the omission of Fe that most affected the development of this species in all parameters evaluated. The treatments negatively affected the chlorophyll content, evaluated in SPAD units, and the photosynthetic rate, except for the omission of B. However this result was probably due to the concentration effect, since there was a significant reduction in the dry matter production of B-deficient plants.
Oguzhan Sıtkı Dizdar
Full Text Available Malnutrition has been associated with increased morbidity and mortality. The objective of this study was to determine the nutritional status and micronutrient levels of hospitalized patients in an infectious disease clinic and investigate their association with adverse clinical outcomes. The nutritional status of the study participants was assessed using the Nutritional Risk Screening 2002 (NRS 2002 and micronutrient levels and routine biochemical parameters were tested within the first 24 h of the patient’s admission. The incidence of zinc, selenium, thiamine, vitamin B6, vitamin B12 deficiency were 66.7% (n = 40, 46.6% (n = 29, 39.7% (n = 27, 35.3% (n = 24, 14.1% (n = 9, respectively. Selenium levels were significantly higher in patients with urinary tract infections, but lower in soft tissue infections. Copper levels were significantly higher in patients with soft tissue infections. In the Cox regression models, lower albumin, higher serum lactate dehydrogenase levels and higher NRS-2002 scores were associated with increased death. Thiamine, selenium, zinc and vitamin B6 deficiencies but not chromium deficiencies are common in infectious disease clinics. New associations were found between micronutrient levels and infection type and their adverse clinical outcomes. Hypoalbuminemia and a high NRS-2002 score had the greatest accuracy in predicting death, systemic inflammatory response syndrome and sepsis on admission.
Werner, Sean R.; Prahalad, Agasanur K.; Yang Jieping; Hock, Janet M.
Rothmund-Thomson syndrome (RTS) is a heterogeneous disease, associated with increased prevalence of osteosarcoma in very young patients with a mutated RECQL4 gene. In this study, we tested the ability of RECQL4 deficient fibroblasts, derived from a RTS patient to recover from hydrogen peroxide (H 2 O 2 )-induced oxidative stress/damage. Immunoperoxidase staining for 8-oxo-deoxyguanosine (8-oxo-dG) formation in RTS and normal human fibroblasts were compared to assess DNA damage. We determined DNA synthesis, cell growth, cell cycle distribution, and viability in RTS and normal human fibroblasts before and after H 2 O 2 treatment. H 2 O 2 induces 8-oxo-dG formation in both RTS and normal fibroblasts. In normal human fibroblasts, RECQL4 was predominantly localized to cytoplasm; nuclear translocation and foci formation occurred in response to oxidant stimulation. After recovery from oxidant exposure, viable RTS fibroblasts showed irreversible growth arrest compared to normal fibroblasts. DNA synthesis decreased significantly in treated RTS cells, with concomitant reduction of cells in the S-phase. These results suggest that enhanced oxidant sensitivity in RECQL4 deficient fibroblasts derived from RTS patients could be attributed to abnormal DNA metabolism and proliferation failure. The ramifications of these findings on osteosarcoma prevalence and heterogeneity in RTS are discussed
Tejas, A R; Wyatt, C J; Ramírez, M J
Lack of adequate food and in particular high quality protein, is one of the causes of malnutrition in children which could result in retarded growth. Iron deficiency is common in populations where protein sources are of vegetable origin; however in northern Mexico where the bean consumption is high, anemia is not a problem. The primary staples in the Mexican diet are corn tortillas and beans. The objective of this study was to evaluate the anthropometric condition of children 4-6 years old living in the city of Oaxaca, Oaxaca, Mexico and to determine the prevalence of anemia. Mean Z scores for children 4-6 years old living in poor conditions in the city of Oaxaca, Oaxaca, Mexico showed significant differences between socioeconomic groups (p<0.002) for height/age (H/A) and weight/age (W/A) (p<0.001) after adjusting for age and sex. Weight/height (W/H) was not different (p=0.30). By using the Waterlow classification system, 28.8% of the pre-school children of this study were stunted and only 0.9% were classified as wasted. There were no children that presented both stunting and wasting. Iron deficiency was very prevalent in both boys and girls, ranging from 56-79% depending on the indicator used. When classified by the combination of serum ferritin, % transferrin saturation and hemoglobin values, 23.7% of the children were classified as anemic, 11.9% in a state of iron deficiency and 13.6% with low iron reserves.
Wieringa, F.T.; Dijkhuizen, M.A.; West, C.E.; Thurnham, D.I.; Muhilal,; Meer, van der J.W.M.
Background: Deficiencies of iron and vitamin A are prevalent worldwide. Single-micronutrient supplementation is widely used to combat these deficiencies. However, micronutrient deficiencies often occur concurrently, and there are many interactions between micronutrients. Objective: This study
Wieringa, F.T.; Dijkhuizen, M.A.; West, C.E.; Thurnham, D.I.; Muhilal, .; Meer, J.W.M. van der
BACKGROUND: Deficiencies of iron and vitamin A are prevalent worldwide. Single-micronutrient supplementation is widely used to combat these deficiencies. However, micronutrient deficiencies often occur concurrently, and there are many interactions between micronutrients. OBJECTIVE: This study
Millimono, Tamba S; Loua, Kovana M; Rath, Silvia L; Relvas, Luis; Bento, Celeste; Diakite, Mandiou; Jarvis, Martin; Daries, Nathalie; Ribeiro, Leticia M; Manco, Licínio; Kaeda, Jaspal S
Reliable and accurate epidemiological data is a prerequisite for a cost effective screening program for inherited disorders, which however, is lacking in a number of developing countries. Here we report the first detailed population study in the Republic of Guinea, a sub-Saharan West African country, designed to assess the frequency of glucose-6-phosphate dehydrogenase (G6PD) deficiency and hemoglobinopathies, including screening for thalassemia. Peripheral blood samples from 187 Guinean adults were screened for hemoglobin (Hb) variants by standard hematological methods. One hundred and ten samples from males were screened for G6PD deficiency by the fluorescent spot test. Molecular analysis was performed for the most common α-thalassemia (α-thal) deletions, β-globin gene mutations, G6PD variants B (376A), A (376G), A- (376G/202A) and Betica (376G/968C), using polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP) or sequencing. Of the 187 subjects screened, 36 were heterozygous for Hb S [β6(A3)Glu→Val, GAG>GTG] (allele frequency 9.62%). Sixty-four subjects were heterozygous and seven were homozygous for the -α(3.7) kb deletion (allele frequency 20.85%). β-Thalassemia alleles were detected in five subjects, four with the -29 (A>G) mutation (allele frequency 1.07%) and one with codon 15 (TGG>TAG) (allele frequency 0.96%). The G6PD A- and G6PD Betica deficient variants were highly prevalent with a frequency of 5.7 and 3.3%, respectively. While we did not test for ferritin levels or α(0)-thal, four females (5.2%) had red cell indices strongly suggestive of iron deficient anemia: Hb 19.8%. Our results are consistent with high frequency of alleles such as Hb S, α-thal and G6PD deficient alleles associated with malaria resistance. Finding a 9.6% Hb S allele frequency supports the notion for a proficient neonatal screening to identify the sickle cell patients, who might benefit from early prophylactic treatment for infections. The
Conclusion: Results indicated that dental caries prevalence among school children in Qatar has reached critical levels, and is influenced by socio-demographic factors. The mean decayed, missing, and filled teeth values obtained in this study were the second highest detected in the Eastern Mediterranean region.
Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is a major nosocomial pathogen worldwide. Malta is one of the countries with the highest MRSA prevalence in Europe, as identified from hospital blood cultures . However, community prevalence of MRSA has never previously been investigated. This study aimed at establishing the prevalence of community MRSA nasal colonization in Maltese individuals and identifying the clonal characteristics of the detected isolates. Nasal swabs were collected from 329 healthy individuals who were also asked to complete a brief questionnaire about risk factors commonly associated with MRSA carriage and infection. The swabs were transported and enriched in a nutrient broth supplemented with NaCl. The presence of MRSA was then determined by culturing on MRSA Select chromogenic agar and then confirming by several assays, including catalase, coagulase and PBP2a agglutination tests. The isolates were assayed for antibiotic susceptibilities and typed by microarray analysis to determine the clonal characteristics of each strain. The prevalence of MRSA nasal colonization in the healthy Maltese population was found to be 8.81% (95% confidence interval [CI], 5.75–11.87%, much higher than that found in other studies carried out in several countries. No statistical association was found between MRSA carriage and demographics or risk factors; however, this was hindered by the small sample size. Almost all the isolates were fusidic-acid resistant. The majority were found to belong to a local endemic clone (CC5 which seems to be replacing the previously prevalent European clone UK-EMRSA-15 in the country. A new clone (CC50-MRSA-V was also characterized. The presence of such a significant community reservoir of MRSA increases the burdens already faced by the local healthcare system to control the MRSA epidemic. Colonization of MRSA in otherwise healthy individuals may represent a risk for endogenous infection and transmission to
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
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
Oerton, Juliet; Khalid, Javaria M; Besley, Guy; Dalton, R Neil; Downing, Melanie; Green, Anne; Henderson, Mick; Krywawych, Steve; Leonard, James; Andresen, Brage S; Dezateux, Carol
Medium chain acyl-CoA dehydrogenase deficiency (MCADD) is a rare, life-threatening condition. Early diagnosis by screening asymptomatic newborns may improve outcome, but the benefit to newborns identified with variants not encountered clinically is uncertain. To estimate, overall and by ethnic group: screen-positive prevalence and predictive value (PPV); MCADD prevalence; proportion MCADD variants detected of predicted definite or uncertain clinical importance. All births in areas of high ethnic minority prevalence in England. Prospective multicentre pilot screening service; testing at age five to eight days; standardized screening, diagnostic and management protocols; independent expert review of screen-positive cases to assign MCADD diagnosis and predicted clinical importance (definite or uncertain). Approximately 1.5 million babies (79% white; 10% Asian) were screened. MCADD was confirmed in 147 of 190 babies with a positive screening result (screen-positive prevalence: 1.20 per 10,000; MCADD prevalence: 0.94 per 10,000; PPV 77% [95% CI 71-83]), comprising 103 (70%) with MCADD variants of definite clinical importance (95 white [95%]; 2 Asian [2%]) and 44 (30%) with variants of uncertain clinical importance (29 white [67%]; 12 Asian [28%]). One baby in every 10,000 born in England is diagnosed with MCADD by newborn screening; around 60 babies each year. While the majority of MCADD variants detected are predicted to be of definite clinical importance, this varies according to ethnic group, with variants of uncertain importance most commonly found in Asian babies. These findings provide support for MCADD screening but highlight the need to take account of the ethnic diversity of the population tested at implementation.
Adam R. Wiltgren
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.
Gurmu, Fekadu; Hussein, Shimelis; Laing, Mark
Vitamin A deficiency is among major health problems worldwide that leads to blindness, retarded growth and death, particularly in developing countries. In these countries, vitamin A deficiency largely affects pre-school children, pregnant and lactating mothers, and the rural poor. For instance, the predicted prevalence of vitamin A deficiency for 36 sub-Saharan African countries is 19.1%. Different strategies, including vitamin A supplementation, food fortification and dietary diversification, have been used to combat this problem. However, these strategies are not sustainable due to their high costs. Orange-fleshed sweet potato (Ipomoea batatas L. Lam) is a low priced crop, which is part of staple foods in most of sub-Saharan Africa that can be a year-round source of vitamin A. Most of the orange-fleshed sweet potato varieties contain 3000-16000 μg 100 g(-1) of β-carotene and this contributes to 250 to 1300 μg 100 g(-1) Retinol Activity Equivalents (RAE). Therefore, by using orange-fleshed sweet potato, it is possible to improve vitamin A status, increase the bio-availability of different micro-nutrients such as Fe, Zn, Ca and Mg, reduce vitamin A deficiency and hence reduce child mortality rates by 23 to 30%. The article highlights the significance of vitamin A for human nutrition, the effect of vitamin A deficiency, the different prevention methods and the potential of orange- fleshed sweet potato as a food crop to prevent vitamin A deficiency.
Deficiência de ferro, prevalência de anemia e fatores associados em crianças de creches públicas do oeste do Paraná, Brasil Iron deficiency and prevalence of anemia and associated factors in children attending public daycare centers in western Paraná, Brazil
Valdete Carreira Rodrigues
Full Text Available OBJETIVO: Avaliar o estado nutricional de ferro, a prevalência de anemia e fatores associados, em crianças de 6 a 24 meses frequentadoras de creche pública em Cascavel, Região Oeste do Paraná, Brasil. MÉTODOS: O estudo transversal foi realizado com amostra aleatória de 256 crianças. A coleta de dados (questionário, medidas antropométricas e amostras de sangue ocorreu de julho a setembro de 2007. A deficiência de ferro foi avaliada em termos de transferrina, hemoglobina, volume corpuscular médio, ferro sérico e eosinófilos. Na análise estatística dos dados foram obtidas as odds ratio bruta e ajustada (regressão logística, bem como os respectivos níveis de significância (p-valor. Para identificar diferenças significativas entre as medidas quantitativas, adotou-se a Análise de Variância e o teste de comparação múltipla de Tukey. RESULTADOS: A prevalência da anemia foi de 29,7%, sendo que 77,3% das amostras apresentaram baixa concentração de ferro. A antropometria não apontou deficiência de macronutrientes, porém mostrou obesidade acima dos índices médios. Os fatores associados à anemia e à deficiência de ferro foram: doenças frequentes na família (OR=10,02, condições de moradia (OR=5,05, tempo de creche (OR=3,05, número de moradores na residência (OR=2,83 e falta de saneamento (OR=2,20. CONCLUSÃO: A prevalência de anemia e a elevada deficiência de ferro detectada evidenciam um grave problema de saúde pública entre os pré-escolares do município de Cascavel, Paraná. Apesar da amplitude do problema, a anemia não está sendo reconhecida, prevenida e tratada adequadamente. Neste estudo são sugeridas algumas possíveis intervenções.OBJECTIVE: This study assessed the iron levels and prevalence of anemia and associated factors in children aged 6 to 24 months attending public daycare centers in Cascavel, Western Paraná, Brazil. METHODS: This cross-sectional study included 256 randomly sampled children
Das, Jai K; Salam, Rehana A; Kumar, Rohail; Bhutta, Zulfiqar A
Vitamins and minerals are essential for growth and metabolism. The World Health Organization estimates that more than 2 billion people are deficient in key vitamins and minerals. Groups most vulnerable to these micronutrient deficiencies are pregnant and lactating women and young children, given their increased demands. Food fortification is one of the strategies that has been used safely and effectively to prevent vitamin and mineral deficiencies. A comprehensive search was done to identify all available evidence for the impact of fortification interventions. Studies were included if food was fortified with a single, dual or multiple micronutrients and impact of fortification was analyzed on the health outcomes and relevant biochemical indicators of women and children. We performed a meta-analysis of outcomes using Review Manager Software version 5.1. Our systematic review identified 201 studies that we reviewed for outcomes of relevance. Fortification for children showed significant impacts on increasing serum micronutrient concentrations. Hematologic markers also improved, including hemoglobin concentrations, which showed a significant rise when food was fortified with vitamin A, iron and multiple micronutrients. Fortification with zinc had no significant adverse impact on hemoglobin levels. Multiple micronutrient fortification showed non-significant impacts on height for age, weight for age and weight for height Z-scores, although they showed positive trends. The results for fortification in women showed that calcium and vitamin D fortification had significant impacts in the post-menopausal age group. Iron fortification led to a significant increase in serum ferritin and hemoglobin levels in women of reproductive age and pregnant women. Folate fortification significantly reduced the incidence of congenital abnormalities like neural tube defects without increasing the incidence of twinning. The number of studies pooled for zinc and multiple micronutrients for
Iodine deficiency (IDD) is one of the common problem in the diet. Iodine deficiency as prevalence of goiter in population occurs in the mountainous areas. There is consensus that 800 million people are at risk of IDD from living in iodine deficient area and 190 million from goiter. Very high prevalence of IDD in different parts of the world are striking. It has generally observed that in iodine-deficient areas about 50% are affected with goiter, 1-5% from cretinsim and 20% from impaired mental and/or mortor function. (A.B.)
Yagob Mohamed, T.I.; Bode, P.; van de Wiel, A.; Ismail, Fadwa; Wolterbeek, H.T.
Iron deficiency anaemia is a major health problem worldwide, but may be complicated in underdeveloped nations by deficiencies of other micronutrients with consequences for adequate treatment. The World Health Organization (WHO) estimates that 2 billion people – over 30% of the world’s population –
Measuring micronutrient intakes at different levels of sugar consumption in a population in transition: the Transition and Health during Urbanisation in South Africa (THUSA) study. ... Objective: The objective was to investigate the absolute micronutrient intake and the possibility of micronutrient dilution of added sugar in the
Postema, Sietke G.; Bongers, Raoul M.; Brouwers, Michael A.; Burger, Helena; Norling-Hermansson, Liselotte M.; Reneman, Michiel F.; Dijkstra, Pieter U.; van der Sluis, Corry K.
Objective: (1) To determine the prevalence of musculoskeletal complaints (MSCs) in individuals with upper limb absence in The Netherlands, (2) to assess the health status of individuals with upper limb absence in general and in relation to the presence of MSCs, and (3) to explore the predictors of
Home; Journals; Resonance – Journal of Science Education; Volume 8; Issue 7. Chelates for Micronutrient Nutrition among Crops. B S Sekhon. General Article Volume 8 Issue 7 July 2003 pp 46-53. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/008/07/0046-0053. Keywords.
Micronutrient Fortiﬁcation of Foods: Developing A Program. Mahshid Lotti, M.G. Venkatesh Manar, Richard J. H. M. .... Develop the fortiﬁcation technology. 11. Perform studies on interactions, potency, stability, ... Fortiﬁcation with vitamin A is a long-term strategy capable of maintaining adequate vitamin A status over time.
lated metals could supply many of the micronutrient require- ments of plants. These chelates find use in a wide variety of agricultural crops. Applications for chelates vary from fertilizer additives, seed dressing to foliar sprays and hydroponics. Chelates and Chelating Agents. A chelate describes a kind of organic chemical ...
The three main classes of micronutrient sources are inorganic, synthetic chelates and organic complexes. Inorganic sources such as sulphates of Cu, Mn, Fe and Zn are the most common metallic salts used in the fertilizer industry because of their ready plant availability and water solubility. In the past 35-40 years, it has ...
Lykkesfeldt, Jens; Trueba, Gilberto Perez; Poulsen, Henrik E.
Neonates are particularly susceptible to malnutrition due to their limited reserves of micronutrients and their rapid growth. In the present study, we examined the effect of vitamin C deficiency on markers of oxidative stress in plasma, liver and brain of weanling guinea pigs. Vitamin C deficiency...... increased, while protein oxidation decreased (P¼0003). The results show that the selective preservation of brain ascorbate and induction of DNA repair in vitamin C-deficient weanling guinea pigs is not sufficient to prevent oxidative damage. Vitamin C deficiency may therefore be particularly adverse during...
Xue, Jiao; Chang, Xingzhi; Zhang, Yuehua; Yang, Zhixian
To analyze the clinical and genetic characteristics of Chinese patients with pyridox(am)ine-5'-phosphate oxidase (PNPO) deficiency. The clinical presentations and the responses to treatments were analyzed in 4 patients. Blood and urinary metabolic screenings, electroencephalogram (EEG), brain magnetic resonance imaging (MRI) and epilepsy-related genes detection were performed in all patients. Patient 1 and 2 were identical twin brothers, who were born at 35 +5 w gestation with a sign of encephalopathy. Their seizures started within the first day and could not be controlled by pyridoxine or pyridoxal-5'-phosphate (PLP) completely. Patient 3 presented seizures at 5 months, responding well to pyridoxine. Seizures in patient 4 began at 40 days after birth and were controlled by valproic acid and topiramate. EEG showed atypical hypsarrhythmia or multifocal epileptiform discharges in 3 patients, and showed normality in patient 4. MRI showed nonspecific abnormality or normality. Blood metabolic screening showed multiple amino acids level abnormalities in all cases. Urinary metabolic screening showed vanillactic acid prominently elevated in 3 patients. Genetic analysis revealed 5 mutations of PNPO, three of which were novel. The mutation c.445_448del was carried by the twins and patient 3. Assessment of psychomotor development indicated severe delay in 3 patients and borderline to mild delay in patient 3. This is the first time to report patients with PNPO deficiency diagnosed by gene analysis in China. The novel clinical characteristics and novel mutations found here expanded the phenotypes and genotypes of this disease. Further, the frameshift mutation c.445_448del might be high prevalence in PNPO deficiency in Chinese patients.
Jolliffe, David A; James, Wai Yee; Hooper, Richard L; Barnes, Neil C; Greiller, Claire L; Islam, Kamrul; Bhowmik, Angshu; Timms, Peter M; Rajakulasingam, Raj K; Choudhury, Aklak B; Simcock, David E; Hyppönen, Elina; Walton, Robert T; Corrigan, Christopher J; Griffiths, Christopher J; Martineau, Adrian R
Vitamin D deficiency is common in patients with chronic obstructive pulmonary disease (COPD), yet a comprehensive analysis of environmental and genetic determinants of serum 25-hydroxyvitamin D (25[OH]D) concentration in patients with this condition is lacking. We conducted a multi-centre cross-sectional study in 278 COPD patients aged 41-92 years in London, UK. Details of potential environmental determinants of vitamin D status and COPD symptom control and severity were collected by questionnaire, and blood samples were taken for analysis of serum 25(OH)D concentration and DNA extraction. All participants performed spirometry and underwent measurement of weight and height. Quadriceps muscle strength (QS) was measured in 134 participants, and sputum induction with enumeration of lower airway eosinophil and neutrophil counts was performed for 44 participants. Thirty-seven single nucleotide polymorphisms (SNP) in 11 genes in the vitamin D pathway (DBP, DHCR7, CYP2R1, CYP27B1, CYP24A1, CYP27A1, CYP3A4, LRP2, CUBN, RXRA, and VDR) were typed using Taqman allelic discrimination assays. Linear regression was used to identify environmental and genetic factors independently associated with serum 25(OH)D concentration and to determine whether vitamin D status or genetic factors independently associated with % predicted forced expiratory volume in one second (FEV 1 ), % predicted forced vital capacity (FVC), the ratio of FEV 1 to FVC (FEV 1 :FVC), daily inhaled corticosteroid (ICS) dose, respiratory quality of life (QoL), QS, and the percentage of eosinophils and neutrophils in induced sputum. Mean serum 25(OH)D concentration was 45.4nmol/L (SD 25.3); 171/278 (61.5%) participants were vitamin D deficient (serum 25[OH]D concentration D status was independently associated with higher body mass index (P=0.001), lower socio-economic position (P=0.037), lack of vitamin D supplement consumption (PP for trend=0.006) and lack of a recent sunny holiday (P=0.002). Vitamin D deficiency
Mejia, Luis A; Bower, Allyson M
Fortification of staple foods has been a successful strategy for combatting micronutrient deficiency. Recently, fortification of condiments and seasonings has been considered as a new approach to mitigate micronutrient deficiencies worldwide. The regulatory environment of already existing programs must be examined to assess their safety, efficacy, and sustainability as this strategy expands globally. The objective of this review is to summarize the global regulatory landscape for the fortification of condiments and seasonings. Presently, legislation regarding the fortification of condiments and seasonings is primarily voluntary and limited to a few nations in Asia. The only dietary vehicles addressed are salt, soy sauce, and fish sauce, and the micronutrients addressed are iron and iodine. A marketing-driven introduction of fortified seasoning powders with iron, and indirectly with iodine, is also gaining popularity in Africa, Central America, and Caribbean countries. It is recommended that legislation regarding food fortification be mandatory in nature and follow established CODEX and World Trade Organization principles as well as World Health Organization/Food and Agriculture Organization of the United Nations fortification guidelines to ensure that these programs are safe, effective, and sustainable. © 2015 New York Academy of Sciences.
Olney, Deanna K; Rawat, Rahul; Ruel, Marie T
This article reviews the potential of four broad types of platforms, health, agriculture, market-based, and social protection programs, to deliver multiple micronutrient (MMN) interventions (supplementation, fortification, and dietary modification). We assessed the platforms' potential based on seven performance criteria related to programs within these platforms: 1) targeting, 2) efficacy of interventions, 3) quality of implementation, 4) utilization, 5) impact, 6) coverage, and 7) sustainability. We highlight one type of program per platform to illustrate strengths and weaknesses for delivering MMN interventions, identify critical knowledge gaps, and highlight what is needed to increase effectiveness for delivering MMN interventions. We found that all four platforms have the potential to effectively deliver MMN interventions if the following key program elements are addressed: 1) strong behavior change communication strategies to increase demand and proper utilization of services/products; 2) supply side interventions to ensure consistent availability of high quality interventions, products, and well-trained staff; 3) rigorous evaluations of effectiveness, quality of delivery, and impact pathways to generate best practices for replication and scale-up; and 4) timely dissemination of evaluation results to ensure use by program implementers and policy makers. The diversification of delivery platforms, which simultaneously addresses multiple determinants of MMN deficiencies and expands coverage, is needed to accelerate progress in reducing MMN deficiencies.
Gould, Jacqueline F
The period of complementary feeding (6-24 months of age) can be a challenging and vulnerable time for infant nutrition due to disproportionately high requirements for metabolic processes, rapid developmental processes, and limited gastric capacity. This is a period of crucial brain development where high caloric intake is necessary to allow synaptogenesis (creation of channels between neurons for communication), and maintenance of established synapses, myelination (laying the myelin sheath around neuronal axons) and everyday psychological functioning. Key nutrients needed for infant brain development include iron (required for oxygen provision to metabolize energy), fatty acids (for cellular membranes and myelin) and protein (for structural support, such as in myelin). Deficiencies in key nutrients during the complementary feeding period have been consistently linked to child development outcomes. Observational studies have consistently demonstrated links between nutrient deficiencies and impairments in intellectual abilities, work capacity, behavioral functioning and even delayed mental and motor development. Yet results from a number of interventions using food, individual nutrients or multiple micronutrients with child development assessments are mixed, possibly partly due to differences in interventions (nutrients and timing), populations, baseline nutrient status, sample sizes, attrition and method of assessment. © 2017 Nestec Ltd., Vevey/S. Karger AG, Basel.
Impacto de orientação dietética sistemática no primeiro ano de vida nas prevalências de anemia e deficiência de ferro aos 12-16 meses The impact of systematic dietary counseling during the first year of life on prevalence rates of anemia and iron deficiency at 12-16 months
Gisele Ane Bortolini
Full Text Available OBJETIVO: Avaliar o impacto de uma intervenção baseada em orientação dietética na prevalência de deficiência de ferro, anemia e anemia por deficiência de ferro entre crianças na idade de 12 a 16 meses. MÉTODOS: Recém-nascidos foram randomizados para compor os grupos intervenção e controle. As mães do grupo intervenção receberam orientações dietéticas durante 10 visitas domiciliares realizadas nos primeiros 10 dias após o parto, mensalmente até os 6 meses e, posteriormente, aos 8, 10 e 12 meses; o grupo controle recebeu apenas visitas para coletas de dados nas idades de 6 e 12 meses. Quando as crianças apresentaram idade de 12 a 16 meses, realizou-se inquérito alimentar recordatório de 24 horas, hemograma e ferritina. RESULTADOS: Os resultados mostraram que não houve evidência de efeito da intervenção sobre a ocorrência de anemia, a qual foi de 66,5% no grupo intervenção e de 61,8% no grupo controle. Também não houve diferença na prevalência de deficiência de ferro e anemia por deficiência de ferro entre os grupos. No entanto, foi evidenciado melhor padrão alimentar nas crianças do grupo intervenção. Maior proporção de crianças do grupo intervenção foi amamentada exclusivamente na idade de 4 a 6 meses e amamentada nas idades de 6 a 12 meses. Além de apresentar maior consumo de carne e dietas com maior biodisponibilidade em ferro, também apresentaram menor consumo de leite de vaca e cálcio do que as crianças do grupo controle. CONCLUSÃO: A intervenção não resultou em redução na prevalência de anemia, deficiência de ferro e anemia por deficiência de ferro. Número de identificação de registro de ensaios clínicos: NCT00629629.OBJECTIVE: To evaluate the impact that a program based on maternal dietary counseling covering breastfeeding and healthy complementary feeding had on the prevalence of iron deficiency, anemia and iron deficiency anemia in children aged 12 to 16 months. METHODS
Epidemiological and animal data have conclusively linked adverse cardiovascular outcomes to air pollution exposure. As such, cardiovascular function is maintained by adequate levels of certain essential micronutrients like vitamin D. Unfortunately, vitamin D deficiency (VDD) has ...
Vizzi, Esmeralda; Bastidas, Gilberto; Hidalgo, Mariana; Colman, Laura; Pérez, Hilda A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency causes acute haemolytic anaemia triggered by oxidative drugs such as primaquine (PQ), used for Plasmodium vivax malaria radical cure. However, in many endemic areas of vivax malaria, patients are treated with PQ without any evaluation of their G6PD status. G6PD deficiency and its genetic heterogeneity were evaluated in northeastern and southeastern areas from Venezuela, Cajigal (Sucre state) and Sifontes (Bolívar state) municipalities, respectively. Blood samples from 664 randomly recruited unrelated individuals were screened for G6PD activity by a quantitative method. Mutation analysis for exons 4-8 of G6PD gen was performed on DNA isolated from G6PD-deficient (G6PDd) subjects through PCR-RFLP and direct DNA sequencing. Quantitative biochemical characterization revealed that overall 24 (3.6%) subjects were G6PDd (average G6PD enzyme activity 4.5 ± 1.2 U/g Hb, moderately deficient, class III), while DNA analysis showed one or two mutated alleles in 19 of them (79.2%). The G6PD A-(202A/376G) variant was the only detected in 17 (70.8%) individuals, 13 of them hemizygous males and four heterozygous females. Two males carried only the 376A → G mutation. No other mutation was found in the analysed exons. The G6PDd prevalence was as low as that one shown by nearby countries. This study contributes to the knowledge of the genetic background of Venezuelan population, especially of those living in malaria-endemic areas. Despite the high degree of genetic mixing described for Venezuelan population, a net predominance of the mild African G6PD A-(202A/376G) variant was observed among G6PDd subjects, suggesting a significant flow of G6PD genes from Africa to Americas, almost certainly introduced through African and/or Spanish immigrants during and after the colonization. The data suggest that 1:27 individuals of the studied population could be G6PDd and therefore at risk of haemolysis under precipitating factors
Kelly, Owen J; Gilman, Jennifer C; Kim, Youjin; Ilich, Jasminka Z
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.
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
Horas, Konstantin; Fraissler, Lukas; Maier, Gerrit; Jakob, Franz; Seefried, Lothar; Konrads, Christian; Rudert, Maximilian; Walcher, Matthias
Bone marrow edema syndrome (BMOS) is a phenomenon primarily affecting the lower extremity. It is characterized by a sudden onset of pain and an ill-defined osseous hyperintense signal in magnetic resonance imaging. The main cause of BMOS is still largely unknown. Its pathophysiology is presumably multifactorial and it has recently been demonstrated that it usually involves an increase in bone turnover and alterations within the bone microenvironment. Vitamin D plays a pivotal role in maintaining a healthy and well-balanced bone microenvironment. However, to date only limited information has been reported on vitamin D status in patients with BMOS. Moreover, it is still uncertain whether hypovitaminosis D is associated with the etiology and course of the disease. For this reason, the aim of this study was to determine serum vitamin D levels (25(OH)D) of patients diagnosed with BMOS of the foot and ankle. Patients were identified and laboratory results collected by retrospective review of the medical records between year 2011 and 2015. Diagnosis was based on clinical examination, the existence of prolonged foot pain, the presence of abnormal bone marrow signal intensity in T1- and T2-weighted magnetic resonance imaging, and the patient's medical history. All patients who demonstrated other concomitant diagnoses were excluded from the study. Overall, 31 patients were affected by BMOS with a mean age of 44.4 (range, 18-76) years. Notably, 84% of patients (26/31) had low vitamin D levels with a mean 25(OH)D level of 19.03 ng/mL. Specifically, 61% of patients (19/31) were vitamin D deficient, 23% (7/31) vitamin D insufficient, and only 5 patients (16%) had sufficient vitamin D levels. Statistical analysis showed no significant difference comparing vitamin D levels with patient age, sex, and time of diagnosis. Moreover, there was no correlation between vitamin D status and the number of bony foci or location of BMOS. We found a widespread rate of vitamin D deficiency in
Bürger, Anna; Jensen, Henning Høgh; Gondah, Jadah
for Fe and Zn, indicate a high potential for biofortification of WCA pearl millet. However, screening of additional landraces or introgression of favorable alleles from highly nutrient dense Indian germplasm could expedite achievement of higher densities. Genotype-by environment interaction effects were......Pearl millet (Cenchrus americanus (L.) Morrone) is one of the most important cereals in West and Central Africa (WCA). Human populations in WCA are strongly affected by micronutrient deficiencies. Biofortification, the development of pearl millet varieties with enhanced micronutrient levels...... is recognized as a suitable approach to reduce this widespread health problem. To assess the potential of biofortification of WCA pearl millet germplasm, we studied quantitative-genetic parameters of eight mineral densities in whole and decorticated grains, their stability over environments and the correlations...
Akkermans, Marjolijn D.; van der Horst-Graat, Judith M.; Eussen, Simone R. B. M.; van Goudoever, Johannes B.; Brus, Frank
Iron deficiency (ID) and vitamin D deficiency (VDD) are the 2 most common micronutrient deficiencies in young children worldwide and may lead to impaired neurodevelopment and rickets, respectively. Risk factors for ID and VDD differ between populations. The objective of this study was to determine
Wongprachum, Kasama; Sanchaisuriya, Kanokwan; Sanchaisuriya, Pattara; Siridamrongvattana, Sirivara; Manpeun, Suwanna; Schlep, Frank P
The study aimed to determine the proportion of iron deficiency (ID) anemia (IDA) among vegans in northeast Thailand and to explore whether mathematical formulas derived from red blood cell (RBC) indices are applicable for IDA screening in the study population. Blood samples from 234 individuals (age 6-45 years) living in a vegan community were taken. Complete blood cell count, serum ferritin, hemoglobin profiles and DNA analysis for α-thalassemia were determined. Anemia was defined using the WHO criteria adjusted for age and sex. Serum ferritin thalassemia and hemoglobinopathies was 56.4% (95% CI = 49.8-62.9%). Of the anemic participants, 45.4% had ID. Based on the receiver-operating characteristic curve analysis, 4 formulas were applicable for predicting ID among anemic individuals (highest sensitivity of 86.4%). The proposed formulas might be used as proxy indicators for the identification of ID among anemic children and adult vegans if more sophisticated laboratory determinations are not available due to limited financial resources. Copyright © 2012 S. Karger AG, Basel.
De-Regil, Luz Maria; Suchdev, Parminder S; Vist, Gunn E; Walleser, Silke; Peña-Rosas, Juan Pablo
independently assessed the eligibility of studies against the inclusion criteria, extracted data from included studies and assessed the risk of bias of the included studies. We included eight trials (3748 participants) conducted in low income countries in Asia, Africa and the Caribbean, where anaemia is a public health problem. The interventions lasted between two and 12 months and the powder formulations contained between five and 15 nutrients. Six trials compared the use of MNP versus no intervention or a placebo and the other two compared the use of MNP versus daily iron drops. Most of the included trials were assessed as at low risk of bias. Home fortification with MNP reduced anaemia by 31% (six trials, RR 0.69; 95% CI 0.60 to 0.78) and iron deficiency by 51% (four trials, RR 0.49; 95% CI 0.35 to 0.67) in infants and young children when compared with no intervention or placebo, but we did not find an effect on growth. In comparison with daily iron supplementation, the use of MNP produced similar results on anaemia (one trial, RR 0.89; 95% CI 0.58 to 1.39) and haemoglobin concentrations (two trials, MD -2.36 g/L; 95% CI -10.30 to 5.58); however, given the limited amount of data these results should be interpreted cautiously. No deaths were reported in the trials and information on side effects and morbidity, including malaria, was scarce. It seems that the use of MNP is efficacious among infants and young children six to 23 months of age living in settings with different prevalences of anaemia and malaria endemicity, regardless of whether the intervention lasts two, six or 12 months or whether recipients are male or female. Home fortification of foods with multiple micronutrient powders is an effective intervention to reduce anaemia and iron deficiency in children six months to 23 months of age. The provision of MNP is better than no intervention or placebo and possibly comparable to commonly used daily iron supplementation. The benefits of this intervention as a child