Adequate Intake Of Vitamin Research Articles

Exploring the Vital Role of Vitamins in Disease Prevention and Health Maintenance

The human body relies on vitamins to carry out fundamental functions, yet it is unable to produce them on its own. Certain nutrients, like phytochemicals, are considered essential as the body cannot produce them in sufficient quantities. While ideally vitamins are obtained through a healthy diet, supplements are often necessary. Vitamins are crucial for growth, metabolism, and overall health, with vitamin D being the only one the body can produce. Vitamers, related molecules with similar vitamin activity, make up the bulk of vitamins. Vitamin C is a potent antioxidant drug used in dermatology to treat photoageing and hyperpigmentation. L-ascorbic acid is the active form, with limited oral absorption, making topical application more effective. Its electron-donating ability is crucial for various physiological processes, and its deficiency can lead to scurvy. Vitamin E (tocopherols and tocotrienols) has demonstrated significant biological effects on enhancing human health and play a promising role in food systems Supplementation of α-tocopherol up to 0.2% in oils provides higher oxidative stability, making vitamin E a valuable functional ingredient for food preservation and nutritional quality enhancement.This study investigates the roles of vitamins C and E in disease prevention and management, highlighting their antioxidant properties and physiological functions. Both vitamins are crucial for neutralizing free radicals, thereby reducing oxidative stress linked to various diseases, including cardiovascular conditions, cancer, and neurodegenerative disorders. Vitamin C supports immune function and collagen synthesis, while Vitamin E contributes to cellular integrity and skin health. The research underscores the synergistic effects of these vitamins, which enhance each other's antioxidant capabilities and may improve overall health outcomes. By addressing their roles in disease processes, the study emphasizes the importance of adequate vitamin intake for promoting health and preventing illness

Micronutrient intake and status in young vegans, lacto-ovo-vegetarians, pescatarians, flexitarians, and omnivores.

Whether youth who follow plant-based diets in Nordic countries meet their dietary needs for micronutrients remains unclear. This study aims to evaluate micronutrient intake and status in Norwegian youth following vegan, lacto-ovo-vegetarian, pescatarian, flexitarian and omnivore diets. Cross-sectional design, with healthy 16-to-24-year-olds (n = 165). Participants were asked to complete a questionnaire and four 24-hour dietary recalls. Dried blood spots (DBS) and spot-urine samples were collected for analysis of methyl malonic acid (MMA) (n = 65), haemoglobin (Hb) (n = 164) and urinary iodine concentration (UIC) (n = 163). Vegans reported highest habitual supplement usage of multivitamin (58%), B12 (90%) and macroalgae consumption (32%), while flexitarians reported highest habitual usage of omega-3 supplements (56%). For daily supplement usage, vegans reported highest use of multivitamins (42%), B12 (79%), iodine (37%) and iron (63%). Increased risk of inadequate intake (energy-adjusted) were found for vitamin D (60% within lacto-ovo-vegetarians), selenium (70% within lacto-ovo-vegetarians, 65% within omnivores), and iodine (63% within vegans). Median MMA levels suggest low risk of insufficient B12 status across all groups (MMA 0.04‒0.37µmol/l) and 2% had MMA levels indicating possible B12 deficiency and 8% had elevated levels. Median Hb levels indicated low risk of anemia across all groups (≥ 12.0 females, ≥ 13.0g/dl males), though 7% had Hb values indicating risk of mild anemia and 4% risk of moderate anemia. The median UIC indicates mild iodine deficiency in all groups (UIC < 100µg/l), except vegans, who were moderately iodine deficient (UIC < 50µg/l). Our study indicated that the participating youth had low risk of inadequate intake of most micronutrients, partly due to high supplement usage. However, for iodine, vitamin D, and selenium higher risk of inadequate intake was found. UIC corroborated the low iodine intake among vegans. Thus, we suggest iodine status of youth in Norway should be monitored, especially among young fertile women who omits dietary iodine sources, until a mandatory iodine fortification program is implemented. Furthermore, we suggest that food education on how to secure sufficient nutrients from food in general should be provided to the Norwegian youth population, especially how to secure adequate intake of vitamin D, selenium and iodine.

Managing Micronutrient Deficiencies in High-Risk Patients: No Small Feat!

Micronutrients are vital dietary components for growth and development. Adequate intake of vitamins and minerals through diet is crucial for proper biomolecular and cellular functioning. Many developed countries supplement foods and micronutrient deficiencies are less common. However, many disease states impair micronutrient absorption, metabolism, and excretion. Thus, early recognition of the signs and symptoms of micronutrient deficiencies is critical for providers to improve quality of life and prevent complications in high-risk patients. This article reviews the basic function of micronutrients, recognizes the symptoms of each micronutrient deficiency, provides natural sources of intake, and discusses the diagnosis and supplementation of each micronutrient. High risk patients based on disease state for each micronutrient is discussed. In addition, Bariatric patients are a specific group at high risk of micronutrient deficiency and their management and supplementation for treatment is also covered. Micronutrients play a vital role in antioxidant defense, especially in critically ill patients, due to an increase in oxidative stress. Early intervention with high-dose supplementation with vitamin C, vitamin E, zinc and selenium may have beneficial effects. Micronutrients deficiency remains an issue for patients in the developed world. Providers should recognize patients who are at high risk for micronutrients deficiencies and provide proper screening and prompt supplementation after diagnosis to prevent complications of micronutrient deficiencies.

Projecting the Contribution of Provitamin A Maize Biofortification and Other Nutrition Interventions to the Nutritional Adequacy and Cost of Diets in Rural Zimbabwe

BackgroundEvidence of the effectiveness of biofortified maize with higher provitamin A (PVA) to address vitamin A deficiency in rural Africa remains scant. ObjectivesThis study projects the impact of adopting PVA maize for a diversity of households in an area typical of rural Zimbabwe and models the cost and composition of diets adequate in vitamin A. MethodsHousehold-level weighed food records were generated from 30 rural households during a week in April and November 2021. Weekly household intakes were calculated, as well as indicative costs of diets using data from market surveys. The impact of PVA maize adoption was modeled assuming all maize products contained observed vitamin A concentrations. The composition and cost of the least expensive indicative diets adequate in vitamin A were calculated using linear programming. ResultsVery few households would reach adequate intake of vitamin A with the consumption of PVA maize. However, from a current situation of 33%, 50%–70% of households were projected to reach ≥50% of their requirements (the target of PVA), even with the modest vitamin A concentrations achieved on-farm (mean of 28.3 μg RAE per 100 g). This proportion would increase if higher concentrations recorded on-station were achieved. The estimated daily costs of current diets (mean ± standard deviation) were USD 1.43 ± 0.59 in the wet season and USD 0.96 ± 0.40 in the dry season. By comparison, optimization models suggest that diets adequate in vitamin A could be achieved at daily costs of USD 0.97 and USD 0.79 in the wet and dry seasons, respectively. ConclusionsThe adoption of PVA maize would bring a substantial improvement in vitamin A intake in rural Zimbabwe but should be combined with other interventions (e.g., diet diversification) to fully address vitamin A deficiency.

Causal role of vitamin E in atopic dermatitis risk: A Mendelian randomization study.

Prior studies suggested that vitamin E might be beneficial in alleviating atopic dermatitis, but confirming a causal link was hindered by limitations such as sample sizes and unaccounted confounders. The present study aimed to clarify this through Mendelian randomization (MR) analysis. GWAS summary statistics was obtained from public databases encompassing a study on vitamin E and two studies related to atopic dermatitis. Two sets of instrumental variables (IVs) were selected using lenient (p < 1e-5) and strict (p < 5e-6) thresholds for separate MR analyses. Inverse variance weighted (IVW) was used as the primary MR method, supplemented by six additional MR methods, and followed by a meta-analysis to consolidate the impact of vitamin E on atopic dermatitis from two independent studies. Furthermore, various sensitivity tests were performed to assess the reliability of the MR results. A meta-analysis of IVW analyses deriving from two different atopic dermatitis cohorts under lenient IV selection thresholds demonstrated that vitamin E exhibited a significant lowering risk of atopic dermatitis effect (OR = 0.817, 95% CI: 0.673-0.991, p = .041), which was validated under strict IV selection thresholds (OR = 0.822, 95% CI: 0.709-0.954, p = .010). In addition, six other MR methods remained parallel to IVW (OR > 1). Multiple sensitivity tests showed that MR analyses were not affected by heterogeneity and horizontal pleiotropy. Overall, this MR study supported vitamin E reducing the risk of atopic dermatitis. Consequently, maintaining an adequate intake of vitamin E could potentially serve as an effective preventive measure against atopic dermatitis.

Interrelationships between sarcopenia, bone turnover markers and low bone mineral density in patients on hemodialysis

Background Hemodialysis (HD) patients are at risk for sarcopenia (SP) and bone loss, which may impact falls and bone fragility and lead to poor prognosis. Patients with HD and those with osteoporosis (OP) are still underdiagnosed and untreated. The aims of the present study were to evaluate the factors that affect bone mineral density (BMD) loss in HD patients, and explore traditional and novel approaches to manage chronic kidney disease–mineral-bone disorder (CKD-MBD). Methods Patients who underwent regular HD at the First Affiliated Hospital of Soochow University were retrospectively evaluated. According to the WHO osteoporosis criteria, patients were categorized into three groups: normal BMD, osteopenia, and osteoporosis. Demographic and clinical data, skeletal muscle mass, and bone turnover markers(BTM) were compared between the three groups. The correlation between bone density and muscle mass was calculated, and related risk factors were analyzed. Results This study enrolled 130 HD patients, 36 patients were diagnosed with sarcopenia (27.7%), 44 patients were diagnosed with osteopenia (33.8%), 19 patients were diagnosed with osteoporosis (14.6%), and 23 patients were diagnosed with osteosarcopenia (17.7%). The SMI was positively correlated with the BMD of the lumbar spine (r = 0.23, p < 0.01) and femoral neck (r = 0.22, p < 0.05). In ordinal logistic regression analysis, the odds ratio (OR) for low BMD was high for patients with sarcopenia (OR = 5.894, 95% CI 1.592–21.830, p < 0.01), older age (OR = 1.095, 95% CI 1.041–1.153, p < 0.001), higher TRACP-5b levels (OR = 1.597, 95% CI 1.230–2.072, p < 0.01), and lower 25-OH vitamin D levels (OR = 0.631, 95% CI 0.544–0.733, p < 0.001). Conclusion The preservation of skeletal muscle mass could be important to prevent a BMD decrease in HD patients. Adequate intake of vitamin D and control of TRACP-5b levels will help reduce the occurrence and progression of osteopenia/sarcopenia in HD patients.

Placental Transport of Retinol in Sheep

Six ewes in the last trimester of pregnancy were maintained on adequate intakes of vitamin A. Indwelling catheters were implanted surgically in fetal jugular veins and carotid arteries. Three ewes and three fetal lambs received intravenous [15-3H]retinol 19 days prior to parturition, followed by sequential sampling of maternal and fetal blood. Fetal plasma retional was found to be complexed with retinol-binding protein and another protein other than prealbumin, with a total molecular weight of 30,000 to 35,000. Transfer of labeled retinol from ewe to fetus peaked at 24 hours after maternal injection. Calculation of plasma retinol transport rate from the areas under the radioactivity-time curves showed that transport in the fetus averaged 5% of that in the ewe. Approximately 260 µg of retinol was transferred daily from ewes to fetal lambs and 50 µg/day carried back to mothers. The study suggested that the carrier system of retinol in blood may not be the same in the fetal lamb as in adults, and demonstrated that retinol transfer is appreciable from fetus to ewe.vitamin A fetus placental transfer retinol

한국형 총식이조사 및 UV/태양광 조사 버섯에서의 비타민 D 분석

This study was conducted to evaluate vitamin D intake of Koreans in a total diet study (TDS) and to determine the effect of irradiation on vitamin D synthesis in mushrooms. For analysis, sample were saponified and extracted with hexane, and vitamin D was quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Based on the validation results, the recovery of the National Institute of Standards and Technology (NIST) standard reference sample (SRM) 1849a was 96.7% and the z-score of −1.6 was obtained by the Food Analysis Performance Assessment Scheme (FAPAS) proficiency test (PT) 21115. Vitamin D2 was not detected in any samples, and the highest level of vitamin D3 was detected in mackerel and anchovies ranging from 24.2 to 120.2 μg/kg. The mean daily intake of vitamin D was 0.99 μg/day, as estimated from the vitamin D contents of the analyzed foods and their corresponding intake. The adequate intake (AI) of vitamin D based on the Dietary reference intakes for Koreans provided by the Ministry of Health and Welfare is 5-15 μg/day for Koreans aged 6 to 75 years. Compared with this AI, vitamin D intake of Koreans estimated in this study was inadequate. For that, the increased vitamin D content in ultraviolet (UV)/sun light irradiated mushrooms warrants further research to increase vitamin D intake of Koreans through diet.

Nutrition Interventions for the Management of Gout

Nutrition Interventions for the Management of Gout

The Role of Micronutrients with the Trends of Exposure to Covid-19 in Adults in Medan Estate Deli Serdang

Background: COVID-19 caused by SARS-Cov2 was reported by WHO that have infected people around the world and caused death. Indonesia was the country with the highest mortality compared to countries in Asia at around 7.2%. COVID-19 caused the decrease in body's immunity so that an adequate intake of vitamins A, E, C as well as iron and zinc minerals was needed to prevent the easy transmission of the COVID-19 virus. Objective: Assesing the role of micronutrients with the exposure tendency to COVID 19 in adults in Medan Estate, Deli Serdang. Methods: The research was observational with a cross sectional design. The population aged 30-58 years amounted to 158 people, while the sample was determined based on simple random sampling method and obtained sample of 61 people. Vitamins A, C, E intake as well as zinc and iron minerals were obtained using food recall for 3 days, then processed with Nutrisurvey. Meanwhile, the exposure tendency to COVID-19 was obtained by filling out a form about the symptoms experienced during the pandemic. Results: The results showed that the intake of vitamin A was in sufficient category of 58%, vitamin C was in less category of 69%, vitamin E was in less category of 61%, zinc was in less category of 54%, and iron in sufficient category of 53%. The results of statistical tests showed that there was correlation between intake of vitamins A, C and iron minerals to the exposure tendency to COVID 19, while vitamin E and zinc were not related to the exposure tendency to COVID 19. Conclusions: There was correlation between intake of vitamins A, C and iron minerals with a exposure tendency to COVID 19, while vitamin E and zinc were not associated with exposure tendency to COVID 19. Required adequate intake of nutrients in preventing transmission of Covid 19, also continues with obligation to comply health protocol that recommended by the Government.

Vitamin intake in obesity and hypertension: A population-based study from Haryana, North India

BackgroundObesity and hypertension are two highly prevalent health conditions and important risk factors for several health adversities. Adequate intake of certain vitamins has been reported to play a protective role in obesity and hypertension. Since dietary pattern, among other factors, delineates the status of vitamin intake in a population, it is pertinent to validate the relationship between vitamin intake, obesity, and hypertension in populations with unique dietary patterns. This study aimed to explore the interrelationship between intake of selected vitamins, obesity, and hypertension among adults of a lacto-vegetarian population. MethodsA total of 488 participants, aged 30–70 years of either sex, were recruited from Palwal, Haryana, India. Data on socio-demographic variables and dietary intake was collected using a pretested interview schedule & food-frequency questionnaire (FFQ) respectively. Body mass index (BMI), and blood pressure (BP) were determined using standard techniques. Statistical analysis was performed using SPSS. ResultsWhile inadequacy in vitamin B9 intake was found to be positively associated with hypertension, inadequate vitamin C intake was found to be positively associated with both overweight/obesity and hypertension. In stratified analyses for BMI and BP categories, adequate intake of vitamin B9 and C was found to be protective against hypertension only among non-overweight/obese individuals; however, regardless of BP status, adequate vitamin C intake was inversely associated with overweight/obesity. ConclusionsAdequate intake of vitamin C can help in reducing the burden of obesity in general and hypertension among non-obese individuals. Further, adequate intake of vitamin B9 may be protective against hypertension.

Dietary Total Vitamin A, β-carotene, and Retinol Intake and the Risk of Diabetes in Chinese Adults with Plant-based Diets.

Epidemiologic evidence regarding the role of dietary vitamin A in the development of diabetes is limited and inconsistent. This study was to explore the association between vitamin A intake and diabetes risk in Chinese adults. A prospective cohort study was conducted among 17 111 adults (8537 men and 8577 women) who participated in the China Health and Nutrition Survey between 1989 and 2015. Dietary intakes were assessed by 3 consecutive 24-hour dietary recalls combined with a household food inventory. Diabetes was determined by self-reported diagnosis, diabetes medication use, or additional criterion in 2009 of fasting blood glucose or hemoglobin A1c. We analyzed the association of vitamin A intake (total, β-carotene, retinol) with diabetes risk using Cox proportional hazards models. A total of 519 men and 531 women developed diabetes during a median of 11 years of follow-up. Higher dietary total vitamin A intakes were associated with a lower risk of diabetes in both men (quintile 5 [Q5] vs Q1: hazard ratio [HR] = 0.69, 95% CI, 0.49-0.97, P-trend = 0.079) and women (Q5 vs Q1: HR = 0.63; 95% CI, 0.45-0.89; P-trend = 0.039). An inverse relation with diabetes risk was observed for dietary intakes of β-carotene (Q5 vs Q1: HR = 0.71; 95% CI, 0.52-0.97) and retinol (Q5 vs Q1: HR = 0.58; 95% CI, 0.39-0.85) among men, but not women. Dose-response analyses showed the association of dietary intakes of total vitamin A, β-carotene, and retinol with diabetes risk in men was L-shaped (P-nonlinearity = 0.043), reverse J-shaped (P-nonlinearity = 0.001), and linear, respectively. Our findings suggest that adequate intake of vitamin A may help protecting against diabetes, especially for men.

Nutritional adequacy of essential vitamins and minerals consumed by edentulous elderly at Little Sisters of the Poor in Enugu, Enugu State, Nigeria

Edentulism is having few or no teeth in the oral cavity, which is an irreversible condition. It has been shown to be more prevalent in the aged especially among the female. Edentulism which is an age related problem is associated with inability to eat, which render the aged deficient of essential vitamins and minerals. The aim of study is to determine the Nutritional Adequacy of Essential Vitamins and Minerals consumed by Edentulous Elderly at Little Sisters of the Poor, Home for the Elderly, Enugu. The home houses 54 inmates. All inclusive sampling technique was adopted for the study. Oral examination was conducted using mouth mirror to ascertain the number of elderly with tooth loss. The food menu used for feeding the inmates was collected from the home and it served as a guide for collection of food samples for chemical analysis to determine the adequacy of essential vitamins and minerals (vitamin D, vitamin B12, calcium, potassium and magnesium). Minerals and Vitamin D and Vitamin B12 were analyzed using Wet Ashing method. The result showed that out of 54 elderly inmates, 44 inmates are edentulous of which females are mostly affected. The result from chemical analysis of food showed 32.5 mcg intake of vitamin D,12.2 mcg intake of vitamin B12, 0.017 mg intake of calcium, 0.346 mg intake magnesium and 0.034 mg intake of potassium and this as compared with recommended daily intake that there is adequate intake of vitamin D, excessive intake of vitamin B12 but inadequate intake of calcium, magnesium and potassium. This in turn shows that there is inadequate consumption of essential vitamins and minerals by edentulous elderly at Little Sisters of the Poor, Home for the Elderly, Enugu. This shows that there is need to include food rich in essential vitamins and minerals and also give supplement that are in form of medicine to the inmates to meet the adequacy.

Effect of Vitamin K on Bone Mineral Density and Fracture Risk in Adults: Systematic Review and Meta-Analysis.

Summary: Recent studies have proposed that adequate intake of Vitamin K (VK) is associated with a low risk of fracture and high bone mineral density (BMD) to improve skeletal health in adults. This systematic review was designed to summarize the most relevant and updated evidence discussing the relationship between VK and bone. It explores the effect of VK deficiency and its supplementation on various bone parameters. Methods: The distinct databases such as PubMed, the Cochrane Library, Google Scholar, National Clinical Trials, Current Controlled Trials, and Clinical Trials were searched up to Jan 2020 to identify eligible trials. All relevant randomized controlled trial studies with any oral dosage form of VK supplement administered for at least six months and assessing BMD or fracture in adults were extracted. Finally, two independent reviewers identified 20 relevant citations for the systematic review and extracted data in tabular form. Results: The meta-analysis was performed with all studies, including postmenopausal and osteoporotic females, for both total clinical and vertebral fracture outcomes. The quantitative analysis showed that the odds ratios (OR) of any fracture were lower for VK as compared to control [OR 0.42 (95% CI 0.27 to 0.66)] for vertebral fractures and OR of 0.44 (95% CI 0.23 to 0.88) for clinical fracture. For the BMD, a meta-analysis of the pooled effect of interventional studies suggested a non-significant association between the use of VK and improvement in femoral BMD (CI 95%, p = 0.08 [−0.03–0.20]). Conclusion: VK decreases general fracture risk, and it can be an option to counter bone loss disorders. However, insufficient evidence is available regarding the significant impact of VK on femoral neck BMD. Therefore, further studies are required to establish the therapeutic value of VK as a treatment for osteoporosis.

Assessing the Relationship between Individual Level Dietary Intake and the Occurrence of Preeclampsia/Eclampsia and Haemorrhage among Pregnant Women in Eastern Region of Ghana: A Prospective Cohort Study

Pre-eclampsia/eclampsia (PE-E) and haemorrhage are dangerous diseases that occur in pregnancy. This study seeks to assess the relationship between individual-level dietary intake and the occurrence of pre-eclampsia/eclampsia and haemorrhage among pregnant women in the Eastern Region of Ghana. The prospective cohort study involved all pregnant women in their third trimester of pregnancy (&gt;28 weeks gestational age) reporting for antenatal care (ANC) in seven Hospitals in the Eastern Region of Ghana. The study used a 24-hour repeated dietary recall to elicit dietary intake information from pregnant women until delivery. The majority of pregnant women in this study had adequate consumption of phosphorus far above the RDI, coupled with an inadequate intake of calcium, excess intake of sodium, and manganese. The average dietary intake for carbohydrates in this study was rather higher than the RDA. There was a statistically significant association between PE-E and the intake of vitamin C. A statistically significant association exists between the intake of calcium and vitamin A and haemorrhage. The findings show that pregnant women who consumed adequate and excess amounts of vitamin C reduced their odds of developing PE-E by 41.7% and 39.8%, respectively. The results show that pregnant women who had an excess intake of calcium were 6.128 times the odds of developing haemorrhage compared to those who had inadequate intake. Again, pregnant women who had adequate intake of vitamin A were 4.351 times the odds of developing haemorrhage compared to those who had inadequate intake. It is recommended that more nutrition specialists to be trained and posted to counsel pregnant women on nutrition in pregnancy to avert the consequences of PE-E and haemorrhage.

Maternal diet during pregnancy and risk of allergic diseases in children up to 7–9 years old from Polish Mother and Child Cohort study

BackgroundThe impact of maternal diet during pregnancy on the risk of allergic diseases in childhood is an increasing scientific and public health concern. We evaluated the associations of maternal type of diet and essential elements and vitamins intake during pregnancy with offspring allergic and respiratory outcomes. MethodsThe study population included 557 mother-child pairs from Polish Mother and Child Cohort (REPRO_PL). Based on the Food Frequency Questionnaire filled in between the 20th–24th week of pregnancy, overall maternal diet was evaluated as the difference between the Prudent Dietary Pattern (PDP) score and Western Dietary Pattern (WDP) score ((PDP-WDP) score) and maternal achievement of dietary recommendations (estimated average requirement, EAR) for essential elements and vitamins was assessed. Children's health examination at age of 1, 2, and 7–9 years covered the following symptoms: infections, wheezing/asthma, food allergy, allergic rhinitis, and atopic dermatitis. At age of 7–9 years, children underwent spirometry and skin-prick tests. ResultsChildren of the mothers who were not achieving adequate intake of vitamin C during pregnancy had a higher risk of wheezing and having more than two infections within the first two years of life comparing to those who met EAR (OR = 2.6, p = 0.05, and OR = 2.3, p = 0.04, respectively). Inadequate intake of vitamin E during pregnancy was related to a higher risk of atopic dermatitis (OR = 2.7, p = 0.04), whereas inadequate intake of magnesium during pregnancy was associated with the risk of wheezing in the offspring at age of two years (OR = 3.7, p = 0.03). A lower (PDP-WDP) score during pregnancy (indicating unhealthier diet) was associated with a higher risk of infections (OR = 1.5, p = 0.007) but a lower risk of atopic dermatitis (OR = 0.7, p = 0.02) at age of 7–9 years. ConclusionsThese results may contribute to the body of evidence for the impact of maternal diet during pregnancy for children's optimal health, however further studies are needed before drawing conclusions and recommendations for clinical practice.

A rare genetic disorder of osteopoikilosis

A 30-year-old male patient admitted to a hospital experienced pain in the left knee for 10 years and right knee for 1 month which increased strenuous activity, with a history of COVID-19 1 year back. Multiple areas of sclerosis were seen on epiphysio metaphyseal area in the X-rays of the bilateral knee and the hip joints (A, B). In the X-ray of the vertebra, lipping of vertebrae was seen (C). Sclerotic lesions were seen in (A, B, C, D). The clinical signs and radiological features, sclerotic lesions, and low bone mineral density levels, all led to the diagnosis of a rare genetic case of osteopoikilosis (A, B, C, D). The patient began treatment with regular intake of calcium; 1000 milligrams per day, adequate intake of vitamin D; 800 milligrams per day, and 50 milligrams of intravenous methylprednisolone, with mild to moderate level of physiotherapy rehabilitation program. It is a rare disease of the bones, affecting 1 in 50,000, equally in both sexes, autosominal dominant, with all patients having LEMD3 gene mutation. It is usually an incidental finding, not associated with symptoms, but pain, joint stiffness, and joint effusion seen in 20 percent of patients.

Nutritivne preporuke tokom dugotrajne primene glukokortikoida

Glucocorticoids are highly effective medications used for the treatment of inflammatory and autoimmune disorders in rheumatology, pulmonology and neurology. However, using these medications for a long period of time, or in excessive doses, carries the risk of unwanted effects. Most typical sideeffects can be successfully prevented or reduced with adequate nutritional strategies. Increased appetite and weight gain can be reduced with regular meals with a selection of fresh, unprocessed foods in accordance with the principles of proper nutrition. Hypertension requires a reduced salt intake by &lt; 3.75 g (1/2 teaspoon), along with the use of other herbs spices. Insulin resistance and elevated blood sugar levels can be reduced, by avoiding foods rich in simple carbohydrates, sugar and by preferring complex carbohydrates (whole grains, starchy foods, fruits, vegetables). Due to the high risk of osteoporosis, it is recommended to consume three servings of dairy products and fish per day in order to obtain an adequate intake of vitamin D. However, patients may find these recommendations unclear or overly strict, and they may require assistance, motivation, and repetition of information for practical application of these advice in everyday life.

Prevention of micronutrient deficiencies in the elderly

&amp;lt;jats:p&amp;gt;The ageing process is characterized by numerous changes in the body that negatively affect the health, lifestyle and diet of the elderly. An adequate and balanced diet plays a vital role in the quality of life of the elderly, including physical, mental and social health. Physiological decline in food intake in the elderly is a risk factor for certain micronutrient deficiencies such as osteoporosis, anaemia and decreased immunity. To prevent these public health diseases, it is suggested to promote the intake of foods of animal origin (offal, meat) to prevent iron and vitamin B group deficiency. An adequate intake of anthocyanidins, fruits and vegetables with blue-purple pigments is recommended for the prevention of anaemia. Adequate intake is also important, i.e. intake of at least two portions of dairy products per day and fish products per week in combination with physical activity can provide adequate intake of calcium and vitamin D for the prevention of osteoporosis. The intake of fresh or minimally processed foods has played a significant role in ensuring an adequate intake of vitamin C, which, in addition to improving iron absorption and preventing anaemia, also affects the proper functioning of the immune system. For the same reason, it is recommended to take vitamin A from offals or beta-carotene from yellow-brown and orange fruits and vegetables. In general, appropriate nutritional interventions can be effective and financially effective forms of preventing and treating micronutrient deficits, thus improving the overall quality of life of the elderly&amp;lt;/jats:p&amp;gt;

English

BACKGROUND Exclusive breastfeeding is recommended up to 6 months of age with all its beneficial effects on child survival. Several studies have shown that adequate intake of vitamin D cannot be met with human milk as the sole source of vitamin D, although risk factors for developing vitamin D deficiency may be low maternal levels of vitamin D, indoor confinement during the day, living at higher altitudes, living in urban areas with tall buildings, air pollution, darker skin pigmentation, use of sunscreen and covering much over the body when outside. An infant who is entirely on breastfeeding and has minimal to no exposure to sunlight is more prone to the development of hypovitaminosis-D. The main purpose of the study was to identify the prevalence &amp; high-risk groups of hypovitaminosis D in exclusively breastfed babies. METHODS It was a cross-sectional observational study consisting of 30 entirely breastfed healthy full-term babies with a birth weight &gt; 2.5 kg. Babies born to mothers with a history of pre-eclampsia, gestational diabetes, antepartum haemorrhage, tuberculosis, and other chronic medical illnesses were excluded from the study. The period of study was from 1st August 2019 to 30th September 2019. Their serum vitamin D3, serum calcium, serum phosphate, and alkaline phosphatase levels were measured using appropriate methods. RESULTS In our study, 25 infants out of 30 came out as vitamin D deficient. The prevalence of vitamin D3 was found to be 83 %. CONCLUSIONS Breastfeeding is of utmost importance but the nutritional status of the mother, proper exposure to the sun, and vitamin D supplementation are the factors that should be taken care of for the prevention of hypovitaminosis D. KEY WORDS Vitamin D3, Hypovitaminosis D, Exclusive Breast Feeding, term babies, infants, Sun Exposure, Rickets