Average Requirement Research Articles

Desain PLTS On-Grid 7 kW Di Gedung Kantor Polisi Pamong Praja Kabupaten Ende

PLTS converts electromagnetic energy from sunlight into electrical energy. On-Grid PLTS Design at the Civil Service Police Office of Ende Regency generates 7 kWp of power, with 35 panels used, each with a capacity of 200 Wp. The triangular roof area is 44m2. The inverter used is 1 unit with a capacity of 4 kW. The purpose of this study is to reduce the use of conventional PLN energy to meet energy needs at the Civil Service Police Station, Ende Regency. This plan requires a cost of Rp. 130.935.000. From the average daily load requirement of 35302 W/h, this plan produces 34450 W/h to meet 97% of the needs of the Ende District Civil Service Police Station.

The Prevalence and Risk Factors Associated with Iodine Deficiency in Canadian Adults.

Iodine is a trace micronutrient that is critical for normal thyroid function and human health. Inadequate dietary intake is associated with cognitive impairment, infertility, growth retardation and iodine deficiency disorders in affected populations. Herein, we examined the prevalence of iodine deficiency in adults (median age of 61 years) based on the analysis of 24 h urine samples collected from 800 participants in four clinical sites across Canada in the Prospective Urban and Rural Epidemiological (PURE) study. Urinary iodide together with thiocyanate and nitrate were measured using a validated capillary electrophoresis assay. Protective/risk factors associated with iodine deficiency were identified using a binary logistic regression model, whereas daily urinary iodine concentration (24 h UIC, μg/L) and urinary iodine excretion (24 h UIE, μg/day) were compared using complementary statistical methods with covariate adjustments. Overall, our Canadian adult cohort had adequate iodine status as reflected by a median UIC of 111 μg/L with 11.9% of the population <50 μg/L categorized as having moderate to severe iodine deficiency. Iodine adequacy was also evident with a median 24 h UIE of 226 μg/day as a more robust metric of iodine status with an estimated average requirement (EAR) of 7.1% (< 95 μg/day) and a tolerable upper level (UL) of 1.8% (≥1100 μg/day) based on Canadian dietary reference intake values. Participants taking iodine supplements (OR = 0.18; p = 6.35 × 10−5), had greater 24 h urine volume (OR = 0.69; p = 4.07 × 10−4), excreted higher daily urinary sodium (OR = 0.71; p = 3.03 × 10−5), and/or were prescribed thyroxine (OR = 0.33; p = 1.20 × 10−2) had lower risk for iodine deficiency. Self-reported intake of dairy products was most strongly associated with iodine status (r = 0.24; p = 2.38 × 10−9) after excluding for iodine supplementation and T4 use. Participants residing in Quebec City (OR = 2.58; p = 1.74 × 10−4) and Vancouver (OR = 2.54; p = 3.57 × 10−4) were more susceptible to iodine deficiency than Hamilton or Ottawa. Also, greater exposure to abundant iodine uptake inhibitors from tobacco smoking and intake of specific goitrogenic foods corresponded to elevated urinary thiocyanate and nitrate, which were found for residents from Quebec City as compared to other clinical sites. Recent public health policies that advocate for salt restriction and lower dairy intake may inadvertently reduce iodine nutrition of Canadians, and further exacerbate regional variations in iodine deficiency risk.

Inadequate intake of vitamins and minerals among high-school pupils in the Moroccan Rif region

BACKGROUND: Inadequate nutrient intakes in adolescents may negatively affect their future health. The identification of inadequate micronutrient intakes by dietary study provides essential information to guide educational strategies for promoting healthy eating habits. OBJECTIVE: To assess the daily micronutrient intake and the prevalence of inadequacy in a sample of middle and high-school pupils in the Rif region of Morocco. METHODS: A cross-sectional study collected dietary information from food records over three non-consecutive days in a sample (n = 302) of Moroccan Riffian adolescents (12–18 years). The DIAL software, adapted for commonly eaten Moroccan foods, was used to estimate micronutrient intakes. The proportion of individuals with intakes below the Estimated Average Requirement (EAR) or the Adequate Intake (AI) level and the probability approach were used to estimate the prevalence of inadequacy. RESULTS: Regardless of gender and age group, our subjects were found to be particularly at risk of inadequate intakes of vitamins E and D, calcium and potassium. Older adolescents (14–18 years) also showed a risk of inadequate intake of folate, biotin, magnesium, iodine and zinc (among boys). CONCLUSION: For many nutrients, the daily diets of our Riffian adolescents do not meet the recommended intake levels. We emphasize the need for monitoring the dietary habits of adolescents and the development of nutrition education programs. Further studies which include the clinical and biological assessment of nutritional status, as well as the regular collection of quality and nationally representative micronutrient data, are recommended.

Abstract 5894: Synergism between medium-chain fatty acid intake and global magnesium status on the risk of cancer mortality in the National Health and Nutrition Examination Survey (NHANES) 2005-2014

Abstract Medium-chain fatty acids (MCFAs), a class of saturated fatty acids that exist naturally in dairy products and tropical oils, can regulate inflammation, insulin resistance, and immune response. Furthermore, in vitro and in vivo studies found MCFAs have strong anticarcinogenic properties. Recent evidence reveals MCFAs inhibits aerobic glycolysis in tumor cells. It is conceivable that MCFAs have an “anti-Warburg effect”. In a double-blind randomized trial (Personalized Prevention of Colorectal Cancer; NCT01105169), we found that 12-week personalized magnesium (Mg) supplementation led to significantly increased circulating levels of MCFAs, particularly caprylic acid (C8:0), which was due to enhanced microbial production. These novel findings suggest individuals with Mg sufficiency can receive supplies of MCFAs from microbiome whereas people with Mg deficiency cannot and so need MCFAs from intake. Thus, we hypothesized that the associations between intakes of C8:0 and risk of cancer mortality are modified by body Mg status. We tested this hypothesis in the NHANES, a nationally representative study. We recently developed the Mg depletion score (MDS) to assess Mg status and validated it against the invasive gold standard measure of Mg status. MDS performs better than either serum Mg or Mg intake at predicting Mg deficiency. We also found higher Mg intake was associated with reduced risks of inflammation and total mortality only among those with higher MDS scores, i.e., higher risk of losing Mg in the kidney. Thus, we examined if MDS modified the associations between intakes of MCFAs and risk of cancer mortality. Among 11,890 US adults aged ≥20 years over a median follow-up of 70 person-months, the associations between C8:0 intake and cancer mortality risk differed by MDS (Pinteraction=0.12). Higher C8:0 intake was associated with increased cancer mortality risk when MDS=0 (no risk of losing Mg; P-trend=0.03) after adjusting for all covariates, including dairy product intake. C8:0 intake was not related to risk of cancer mortality when MDS=1. Conversely, C8:0 intake may be associated with a reduced cancer mortality risk among those with MDS&amp;gt;1(high risk of losing Mg). In particular, higher C8:0 intake was significantly associated with a reduced risk of cancer mortality (P-trend&amp;lt;0.01) with an HR (95% CI) of 0.11 (0.02-0.84) for the highest quartile of C8:0 intake when Mg intake was above the Estimated Average Requirement. No associations were found for intakes of C6:0, C10:0 and C12:0. In summary, C8:0 can be generated by human gut microbiome through optimized Mg consumption; dietary intakes of C8:0 were associated with a reduced risk of cancer mortality among those at high risk of losing Mg, but with adequate Mg consumption; and intakes of C8:0 were related to an increased risk of cancer mortality among those with no risk of losing Mg. Citation Format: Lei Fan, Xiangzhu Zhu, Alexandra Shingina, Lihua Shu, Martha Shrubsole, Qi Dai. Synergism between medium-chain fatty acid intake and global magnesium status on the risk of cancer mortality in the National Health and Nutrition Examination Survey (NHANES) 2005-2014 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5894.

A 3‐D approach to personalised nutrition

A <scp>3‐D</scp> approach to personalised nutrition

Assessment of vaccination service delivery and quality: a cross-sectional survey of over 1300 health facilities from 29 districts in Sindh, Pakistan conducted between 2017–18

BackgroundRoutine childhood immunization coverage in Pakistan remains sub-par, in part, due to suboptimal utilization of existing vaccination services. Quality of vaccine delivery can affect both supply and demand for immunization, but data for immunization center quality in Pakistan is sparse and in Sindh province in Southern Pakistan, no comprehensive health facility assessment has ever been conducted at a provincial level. We assessed health facilities, specifically immunization centers, and their associated health workers throughout the province to summarize quality of immunization centers. MethodsAn exhaustive list of health facilities obtained from Sindh’s provincial government was included in our analysis, comprising a total of 1396 public, private, and public-private health facilities. We adapted a health facility and health worker assessment survey developed by BASICS and EPI-Sindh to record indicators pertaining to health facility infrastructure, processes and human resources. Using expert panel ranking, we developed critical criteria (the presence of a cold box/refrigerator, vaccinator and vaccination equipment at the immunization center) to indicate the bare minimum items required by immunization centers to vaccinate children. We also categorized other infrastructure, process, and human resource items to determine high, low and moderate function requirements to ascertain quality. We evaluated presence of critical criteria, calculated scores for high, moderate and low function requirements, and displayed frequencies of infrastructure, process and human resource indicators for all immunization centers across Sindh. We analyzed results at the division level and utilized a two-sample independent clustered t-test to test differences in average function requirement scores between facilities that met critical criteria and those that did not.ResultsOut of the 1396 health facilities assessed across Sindh province from October 2017 to January 2018, 1236 (88.5%) were operational while 1209 (86.6%) offered vaccination services (immunization centers). Only 793 (65.6%; 793/1209) immunization centers met the critical criteria of having all the following items: vaccinator, a cold box or refrigerator and vaccine supplies. Of the 416 (34.4%; 416/1209) immunization centers that did not meet the critical criteria, most of the centers did not have a cold box or refrigerator (28.3%; 342/1209), followed by lack of vaccines (19.9%; 240/1209), and a vaccinator (13.0%; 157/1209). Of the 2153 healthcare workers interviewed, 1875 (87.1%) were vaccinators, of which 1745 (81.0%; 1745/2153) were male, and had an average of 12.4 years of schooling. A total of 1805 (96.3%; 1805/1875), 1655 (88.3%; 1655/1875) and 1387 (74.0%; 1387/1875) of the vaccinators were trained in vaccination, cold chain and inventory management respectively.ConclusionOne out of three immunization centers in Sindh lack the critical components essential for quality vaccination services. While the majority of health workers (>80%) were trained on vaccination and cold chain management, the proportion trained on inventory management was comparatively low. Our findings therefore suggest that suboptimal immunization center quality is partly due to inadequate infrastructure and inefficient processes contributed to an extent, by low levels of inventory management training among vaccinators. Our study presents critical research findings with high-impact policy implications for identifying and addressing gaps to improve vaccination uptake within a low-middle income country setting.

Significant Loss of Skeletal Muscle Mass Occurs After High-Energy Trauma in Young Adults

ObjectivesSignificant loss of skeletal muscle mass occurs early after high-energy trauma, leading directly to prolonged functional limitations. As we investigate nutrition interventions to reduce loss of muscle mass, we need to quantify changes in muscle mass after these devastating injuries. The aim of this study was to characterize baseline nutrition and changes in muscle mass after high-energy trauma in a young adult population.MethodsWe enrolled patients 18–55 years old indicated for operative fixation of either, an open pelvic or extremity fracture, or ≥2 pelvic and/or extremity fractures due to a high-energy mechanism. Baseline assessment of body composition (Lean Body Mass [LBM], Skeletal Muscle Mass [SMM]), was measured within 72 hours of admission using bioelectrical impedance and repeated 6 weeks after injury. Results are reported as median (IQR). Changes in LBM and SMM were evaluated using Wilcoxon Signed Rank tests. Sarcopenia was defined by gender-specific cutoffs for appendicular skeletal mass index. Dietary intake was evaluated using food frequency questionnaires. Inadequate protein intake was classified using the Estimated Average Requirement cut-point method, while inadequate caloric intake was defined as intake below basal metabolic rate.ResultsSixteen subjects (14 male) age 38.4 ± 9.6 years were enrolled. At baseline, 3 reported inadequate protein intake and 5 reported inadequate caloric intake. Six weeks after injury participants experienced significant losses in LBM (−4.5kg (−8.8 to −1.4), P = 0.019) and SMM (−3.1kg (−5.6 to −0.3), P = 0.043). The injured extremity had significantly greater loss of LBM compared to the uninjured extremity (−4.0 (−17.1–3.5), P = 0.0495). Five were baseline sarcopenic, with one additional participant meeting the criteria by 6 weeks. Baseline protein and calorie deficiency was not significantly associated with muscle loss.ConclusionsThis study documented devastating loss of lean body mass and skeletal muscle mass after high-energy trauma in young adults. These losses are likely a combination of immobilization and catabolic response for wound and fracture healing. Understanding loss of muscle mass after injury is important to design impactful rehabilitative and nutrition interventions in this complicated patient population.Funding SourcesNone.

Amino Acid Intake and Conformance with the Dietary Reference Intakes in the United States: Analysis of the National Health and Nutrition Examination Survey, 2001–2018

ObjectivesThe lack of complete amino acid composition data in food composition databases has made determining population-wide amino acid intake difficult. This cross-sectional study characterizes habitual intakes of each amino acid and adherence to dietary requirements for each essential amino acid (EAA) by age, gender, and race/ethnicity in the US population.MethodsFood and Nutrient Database for Dietary Studies ingredient codes with missing amino acid composition data were matched to similar ingredients with available data, so that amino acid composition could be determined for virtually 100% of foods reported in What We Eat in America, the dietary intake assessment component of NHANES. Amino acid intakes during 2-y cycles of NHANES 2001–2018 (n = 84,629; ≥ 2 y) were calculated as relative [mg/kg of ideal body weight (IBW)/d] and absolute (g/d) intakes. Data from NHANES 2011–2018 were used to determine the percentage of the population consuming less than the Dietary Reference Intakes for each EAA by age, sex, and race/ethnicity.ResultsRelative intakes of EAAs were greatest in those 2–3 y (females: 1552 ± 9 and males: 1659 ± 9 mg/kg IBW/d) and lowest in those ≥80 y (females: 446 ± 2 and males: 461 ± 3 mg/kg IBW/d). Absolute intakes of EAAs were greatest in those 31–50 y (females: 31.4 ± 0.1 and males: 45.5 ± 0.1 g/d) and lowest in those 2–3 y (females: 22.4 ± 0.1 and males: 26.0 ± 0.1 g/d). In individuals 2–18 y and ≥19 y, relative intakes of EAAs were lowest in the NHB population (860 ± 16 and 505 ± 5 mg/kg IBW/d, respectively) and highest in the Asian population (994 ± 35 and 580 ± 7 mg/kg IBW/d, respectively). Less than 1% of individuals ≥19 y were not meeting the Estimated Average Requirements for each EAA.ConclusionsIndividual amino acid intakes in the US population exceed recommended minimum population requirements. Future studies can use the method described here to quantify habitual amino acid intake and examine relationships with health and disease.Funding SourcesInstitute for the Advancement of Food and Nutrition Sciences (IAFNS) Protein Committee, US Army Medical Research and Development Command, and the Department of Defense Center Alliance for Nutrition and Dietary Supplements Research.

Coverage and Seasonality Use of Fortifiable Maize Flour in Morogoro, Tanzania

ObjectivesMaize flour is a staple consumed by 93% of the population in Tanzania. In 2011, Tanzania aimed to reduce micronutrient deficiencies and neural tube defects by introducing mandatory fortification of large-scale industrially produced wheat and maize flour. However, maize production is often fragmented (produced at smaller commercial mills) that are not required to fortify under the existing mandate. Objective: 1. Ascertain the proportion of the population of Morogoro region, Tanzania, that consumes packaged maize flour from commercial, ills; 2. understand if consumption of packaged maize flour is affected by changes in seasons and 3. determine who might potentially be reached by point-of-milling fortification in smaller packaging mills. MethodsIn 2018, a regional, multistage cluster probability study was conducted among residents in Morogoro region, Tanzania, living in households that reported consuming maize flour as the main staple. Interviews collected information on socio-demographic factors and patterns of household flour consumption. Weighted medians estimated daily individual flour intake [g/day/Adult Male Equivalent (AME)]. Daily estimated intake of folic acid was reported in μg and as percentages of the estimated average requirements (EAR) according to age. ResultsInformation was collected on 711 households (out of 984 households selected). Use of wheat flour was reported by 49.5% of households. Package maize flour was purchased 10–12 months, 6–9 months, and 1–5 months of the year by 22.9%, 17.6% and 25.1% of households, respectively; and 34.4% of households never purchased package maize flour. Per capita median daily consumption of any maize flour (including non-packaged flour) was 209.7 g/d/AME. Median daily intake was 230.1 g/d/AME among females. If all packaded maize flour were fortified according to mandate standards, those consuming packaded maize flour 10–12 months of the year would intake 199.9 μg folic acid/d representing 49.7% of daily EAR requirements. ConclusionsFortifying maize flour at small- and medium-packaging scale mills is a promising strategy for increasing household access to micronutrients including folic acid in Tanzania. Funding SourcesN/A.

Techno-economy Analysis of Shallot Seedling Production form TSS (True Shallot Seed) with LCAC (Low Cost Aeroponic Chamber) Technology

The decline in the productivity of shallots occurred in almost all areas of shallot production centres in Indonesia. One of the factors in the decline in productivity is that farmers are still dependent on tuber seeds that are produced by themselves from generation to generation without any risk of carrying degenerative diseases from previous shallots. Another problem is that the cost of providing seeds is quite high, reaching 40% of the total production cost, with an average requirement of 1-1.5 tons/hectare. Planting shallots using TSS (True Shallot Seed) is an alternative solution, in terms of seed requirements, only 3-5 kg/ha is needed. However, an initial activity is needed in the form of the production of shallot planting material before it is transferred to the land. This study aims to conduct a technoeconomic analysis of shallot planting material production from TSS with LCAC (Low Cost Aeroponic Chamber) technology. Techno-economic analysis is carried out by calculating the basic costs for producing shallot seeds, and economic analysis related to NPV, IRR, Net BC Ratio and Payback Period. This study uses a scenario design of production scales of 200, 500, 1000 trays, and 1 million seeds on a production schedule of 3 cycles per year and 6 cycles per year. The NPV calculation yields profits ranging from 4,750,650 - 822,448,953 IDR, IRR 9.87 - 65.40% above the discount rate used of 6%. Net B/C ratio 1.12 - 2.24 and initial investment will return to investors in the range of 5.23 to 1.28 years after production starts.

Energy and Nutrient Intake Status Among Indonesia Children Aged 1–5 Years With Different Dairy Food Consumption Patterns

ObjectivesDairy foods are an important food source of energy and nutrients for young children. We hypothesized that the intakes of energy and nutrients would be different in children aged 1–5 years who consumed different types of dairy foods in Indonesia.MethodsIn the current study, we analyzed dietary intake data of Indonesian children aged 1–5 years (n = 11,020) in the Survei Diet Total (SDT) survey conducted in 2014. First, energy and nutrient intakes of each child were estimated based on 1 day 24-hour dietary recall using Nutri-Survey software. Then we compared the energy and nutrient intakes of children who consumed different types of dairy foods. SDT 2014 classification approach of energy and protein intake status, and WHO estimated average requirements (EAR) were applied to defined inadequate intakes in this study.ResultsWe found that 57.3% of Indonesian children aged 1–5 years consumed dairy foods, with the highest percentages of consumption in 36–47m (82.6%) and the lowest in 48–60m (44.4%) children. The top 3 commonly consumed dairy foods were young children milk (YCM, 37.0%), condensed milk (12.3%) and cow's milk (6.9%). We then analyzed the nutrient intakes of all children, non-dairy consumers, YCM consumers, cow's milk consumers and condensed milk consumers separately. Over 50% of the children were inadequate in energy intake in this population, especially among non-dairy food consumers. In general, the micronutrient intake status was challenging, over 50% children had inadequate intakes of iron, calcium, zinc, vitamins A, D and Bs. Compared to dairy consumers, non-dairy consumers had lower intakes of many micronutrients across age groups. Among children across the age range who consumed different types of dairy foods, the percentages of children with inadequate intakes of iron, zinc, vitamins A, C and D were the lowest in YCM consumers.ConclusionsIn this study we found that children who consumed dairy foods, especially YCM, had lower proportion of children below nutrient intake recommendations compared to non-dairy consumers. Nutrition education and promotion of nutrient rich foods consumption, such as dairy, could improve the nutrient adequacy in Indonesian children aged 1–5 years.Funding SourcesThis study is funded by Société des Produits Nestlé SA.

Trait Stacking Simultaneously Enhances Mineral and Provitamin a Carotenoid Bioaccessibility in Biofortified Sorghum bicolor

ObjectivesVitamin A, iron, and zinc deficiencies represent major dietary inadequacies in Sub-Saharan Africa and disproportionately affect women and children. Biotechnology strategies have been tested to individually improve carotenoid or mineral content and/or bioaccessibility in relevant cereal crops such as sorghum (Sorghum bicolor). However, approaches combining carotenoid and mineral enhancement in the same event have not been thoroughly evaluated. This work evaluated genetically engineered sorghum events that simultaneously enhanced provitamin A carotenoid accumulation and reduced the mineral limiting antinutrient phytate.MethodsTwo sorghum transformation constructs containing HGGT, to increase vitamin E accumulation and stabilize provitamin A carotenoids during grain storage, CRTI, to increase provitamin A biosynthesis, PSY1 or CRTB, to increase flux through the carotenoid pathway, and PhyA, to decrease phytate, were engineered to produce transgenic events. These sorghum events were processed into model porridges and evaluated for carotenoid and mineral content as well as bioaccessibility.ResultsAll transgenic events produced markedly higher amounts of carotenoids compared to corresponding null segregants and wild-type control (Tx430). A steeping step prior to porridge production to pre-activate phytase drastically reduced phytate content, altered the profile of inositol phosphate conversion products, and reduced molar ratios of phytate to iron and zinc; preventing the chelation of minerals by phytate and enhancing their bioaccessibility. The subsequent release of minerals did not affect micellarization efficiency and the bioaccessible fraction of provitamin A carotenoids were over 2300% greater in transgenic events compared to corresponding null segregants and wild-type controls; providing 53.7% of a 4–8-year-old child's vitamin A estimated average requirement in a standard 200 g serving of porridge.ConclusionsThese data suggest that a combination of strategies to enhance micronutrient content and bioaccessibility are feasible and warrant further assessment in human studies.Funding SourcesThis work was supported in part by the U.S. Department of Agriculture, Agricultural Research Service as well as the Bill and Melinda Gates Foundation.

Main nutritional deficiencies.

Nutrition is the source of energy that is required to carry out all the processes of human body. A balanced diet is a combination of both macro- and micronutrients. "Nutritional inadequacy" involves an intake of nutrients that is lower than the estimated average requirement, whereas "nutritional deficiency" consists of severely reduced levels of one or more nutrients, making the body unable to normally perform its functions and thus leading to an increased risk of several diseases like cancer, diabetes, and heart disease. Malnutrition could be caused by environmental factors, like food scarcity, as well as disease conditions, like anorexia nervosa, fasting, swallowing inability, persistent vomiting, impaired digestion, intestinal malabsorption, or other chronic diseases. Nutritional biomarkers - like serum or plasma levels of nutrients such as folate, vitamin C, B vitamins, vitamin D, selenium, copper, zinc - could be used for the evaluation of nutrient intake and dietary exposure. Macronutrients deficiencies could cause kwashiorkor, marasmus, ketosis, growth retardation, wound healing, and increased infection susceptibility, whereas micronutrient - like iron, folate, zinc, iodine, and vitamin A - deficiencies lead to intellectual impairment, poor growth, perinatal complications, degenerative diseases associated with aging and higher morbidity and mortality. Preventing macro- and micronutrient deficiency is crucial and this could be achieved through supplementation and food-based approaches.

Iodine Status of Mother-Infant Dyads from Montréal, Canada: Secondary Analyses of a Vitamin D Supplementation Trial in Breastfed Infants

BackgroundMost pregnant or lactating women in Canada will not meet iodine requirements without iodine supplementation. ObjectivesTo assess the iodine status of 132 mother-infant pairs based on secondary analyses of a vitamin D supplementation trial in breastfed infants from Montréal, Canada. MethodsMaternal iodine status was assessed using the breastmilk iodine concentration (BMIC). Singleton, term-born infants were studied from 1–36 months of age. Usual (adjusted for within-person variation) iodine intakes were estimated from urinary iodine and creatinine concentrations. Iodine status was assessed using median urinary iodine concentrations (UICs) and by estimating inadequate intakes by the cut-point method using a proposed Estimated Average Requirement for infants 0–6 months of age (72 μg/d). ResultsAt 1, 3, and 6 months of age, 70%, 63%, and 3% of infants, respectively, were exclusively breastfed. From 1–36 months of age (n = 82–129), the median UICs were ≥100 μg/L (range, 246–403 μg/L), which is the cutoff for adequate intakes set by the WHO for children <2 years. Almost all (98%–99%) infants at 1 and 2 months, 2 and 3 months, and 3 and 6 months of age had usual creatinine-adjusted iodine intakes ≥ 72 μg/d. The median BMIC was higher (P < 0.001) at 1 month compared to 6 months of lactation [1 month, 198 μg/kg (IQR, 124–274; n = 105) and 6 months, 109 μg/kg (IQR, 67–168; n = 78)]. At 1 and 6 months, 96% and 79% of mothers, respectively, had a BMIC ≥ 60 μg/kg, the lower limit of a normal reference range. The percentages of mothers that used a multivitamin-mineral (MVM) supplement containing iodine were 90% in pregnancy and 79% and 59% at 1 and 6 months of lactation, respectively. ConclusionsThe iodine status of infants was adequate throughout infancy. These results support a recommendation that all women who could become pregnant, who are pregnant, or who are breastfeeding take a daily MVM supplement containing iodine.

Maize nutrient yield response and requirement in the maize belt of Nigeria

Absence of site-specific nutrient recommendation and high spatial variability of soil fertility are major factors affecting maize response to applied nutrients in Nigeria. In this study, we assessed maize response to applied nutrients and nutrient use efficiency in different management zones (MZs), for designing site-specific nutrient management recommendations for maize in the maize belt of Nigeria. The maize belt in Nigeria was earlier delineated into four MZsMZs (MZ1 to MZ4) based on soil properties. In the current study, data from two different trials, nutrient omission trials (N = 293) and fertilizer response trial (N = 705), conducted in the years 2015–2017, were extracted for MZ1 to MZ3; to analyze maize yield responses to application of N, P and K, and secondary and micro-nutrients. Maize yield response to K application was only positive in MZ1. Responses to N and P application were positive for all MZs. However, the magnitude of maize response to P varied between the MZs, indicating a differentiation in the degree to which P is limiting maize production in the study area. Average nitrogen requirement was higher for MZ3 (138 kg ha−1), than for MZ2 and MZ1 (121 and 83 kg ha−1, respectively). Average P requirement was higher for MZ3 (45 kg ha−1) than for the other zones. Potassium requirement was 26% and 28% higher in MZ2 and MZ3 compared with MZ1 (∼15 kg ha−1). The use of the specific nutrient rates for the MZs may reduce risks and uncertainties in crop production. The delineated MZs of the maize belt of Nigeria that incorporates spatial variability in soil fertility conditions are useful for nutrient management for larger areas.

Estimation of regional farmland irrigation water requirements and water balance in Northeast China.

Agricultural water use has long accounted for more than 70% of water consumption in Northeast China. Estimating farmland irrigation water requirements and water balance is essential to ensure safe agricultural water and promote rational development and utilization of regional water resources. In this study, based on the modified Penman-Monteith equation recommended by the Food and Agriculture Organization (FAO) and Geographic Information System (GIS) technology, the net crop irrigation water requirements for four main crops in Northeast China were calculated, and the spatiotemporal distribution characteristics were also analyzed. Additionally, regional farmland irrigation water requirements were estimated, water balance in a typical year was determined, and the dominant factors affecting farmland irrigation water requirements in different regions were analyzed. From 1986 to 2020, the net irrigation water requirements for four main crops all showed the temporal trend of no significant increase and the spatial distribution characteristic of being high in the west and low in the east. The farmland irrigation water requirement decreased, and the monthly average farmland irrigation water requirement peaked in July during 2010-2019. Compared with 2010, in 2019, the irrigation water requirement per cultivated land grid cell in 20 cities increased and that in 16 cities decreased. Most cities were facing varying degrees of water shortage. Precipitation had the greatest direct effect on the farmland irrigation water requirement in different regions. These results quantify the farmland irrigation water requirement and water balance in Northeast China, and provide a reference for water resources and related environmental governance.

Food consumption patterns and nutrient intakes of infants and young children amidst the nutrition transition: the case of Lebanon

BackgroundThis is the first study on dietary intakes of infants and young children in the Eastern Mediterranean Region, a region that is currently witnessing the nutrition transition. It aims at characterizing food consumption patterns amongst 0–4 year old children in Lebanon, evaluating their macro- and micronutrient intakes and assessing adherence to dietary recommendations.MethodsBased on a national cross-sectional survey in 2012 (n = 866), the study collected data on sociodemographic and anthropometric characteristics, and one 24-hour dietary recall was administered. Nutrient intakes were compared with reference values: Estimated Average Requirement (EAR), Adequate Intake (AI) and Acceptable Macronutrient Distribution Range (AMDR).ResultsMilk was the highest contributor to energy intake (EI) in infants (95.8 and 56.5% in 0–5.9 months and 6–11.9 months old infants, respectively), while its intake was lower among toddlers and preschoolers (35.4 and 15.1%, respectively). In contrast, intakes of sweets and sweetened beverages were the highest in preschoolers compared to younger children, contributing 18.5% EI in preschoolers. Compared to dietary guidelines, the lowest dietary adherence was found for vegetables (17.8–20.7%) and fruits (14.4–34.3%). Protein intake was within the recommendations for the vast majority of children. Although total fat intake was lower in toddlers and preschoolers compared to infants, more than 40% of toddlers and preschoolers exceeded the AMDR for fat and 87.3% of preschoolers exceeded the upper limit for saturated fat. Only 3.6% of toddlers and 11.5% of preschoolers exceeded the AI level for dietary fiber. Micronutrient intake assessment showed that mean intakes in infants exceeded the AI for all micronutrients, except for vitamin D and magnesium. In toddlers, vitamin D and calcium were below the EAR among 84.7, and 44.6%, respectively. In preschoolers, most of the children (91.9%) had inadequate intakes of vitamin D, and a third had inadequate intakes of folate, calcium and vitamin A.ConclusionsThis study identified priority issues for nutrition intervention in infants and young children in Lebanon. Concerted multi-stakeholder efforts are needed to instill heathier food consumption and nutrient intake patterns early in life.

Patterns of Opioid Usage and Predictors of Utilization Following Endoscopic Skull Base Surgery.

Pain control is an important topic that has not been extensively studied in patients undergoing endoscopic skull base surgery (ESBS). The purpose of this study is to identify opioid requirements after ESBS and the risk factors predictive of increased use. This study was a retrospective review of all patients undergoing ESBS at a tertiary academic skull base surgery program between July 2018 and August 2020. The primary outcome variable was total morphine equivalent dose (MED) requirements after surgery, calculated as the sum of all morphine milligram equivalents over a 24-h period, and summated across the duration of each participant's hospital course. 94 patients were included in this review. Average daily MED requirements were 14.00 ± 6.79 mg. Average total MED requirements were 83.78 ± 92.99 mg during hospitalization. Average length of stay (LOS) was 5.71 ± 4.42 days, with 22 (23.4%) patients not requiring opioid use upon discharge. On multivariate analysis, female sex (β=49.62; 95% CI [13.53, 85.71], p=0.008), nasoseptal flap (NSF) reconstruction (β=49.56; 95% CI [13.51, 85.61], p=0.008) and LOS (β=4.02; 95% CI [0.001, 8.04], p=0.050) were independently associated with higher total MED requirements. We report average total MED requirements of 83.78 mg after ESBS, with female sex, intraoperative use of an NSF, and increased LOS as predictors of higher MED use. This data indicates a subset of patients who may benefit from more aggressive pain control strategies upfront, including consideration of non-opioid, multimodal pain regimens. 3 Laryngoscope, 132:1939-1945, 2022.

Precision in prescription: multiple micronutrient supplements in pregnancy

Precision in prescription: multiple micronutrient supplements in pregnancy

Food and nutrient intake of school-aged children in Lebanon and their adherence to dietary guidelines and recommendations

BackgroundLebanon, an Eastern Mediterranean country, is witnessing a remarkable nutrition transition, and the diets of school-aged children may be amongst those most affected. However, limited studies have examined the food consumption patterns and nutrient adequacy in this age group.ObjectivesThe present study aimed to evaluate the dietary intakes of school-aged children in Lebanon and assess their adherence to nutrition guidelines and recommendations.MethodsThis study used data for 4–13 y-old children (n = 711) from a national cross-sectional survey conducted in 2014–2015 on a representative sample of Lebanese households with children. Dietary intake was assessed using single 24-h recall method. Estimated food group and nutrient intakes were compared to dietary recommendations and age-specific dietary reference intakes (DRI), including Estimated Average Requirements (EAR) and Acceptable Macronutrient Distribution Range (AMDR). Food group, energy, macro- and micro-nutrient intakes were presented for all children in the sample and stratified by age (4–8 y and 9–13 y) and sex.ResultsMean energy intake of 4–13-year-old children was 1804 kcal/d. Almost half of the energy was provided by carbohydrates while 12% of children had protein intakes below EAR. Approximately three-quarters of children (4–13 y) exceeded the AMDR for total fat and saturated fats, and a similar proportion over consumed added sugars. The main sources of energy intake (EI) among children were the sweets, sweetened beverages and desserts followed by grains and mixed dishes. No significant differences were noted in %EI from different food groups, by sex, in either age groups. The highest adherence of children to food group recommendations was observed for the grains’ food group (47.2–54.4%EI), while the lowest adherence was found for vegetables (3.1–14.1%EI). A high prevalence of vitamin and mineral inadequacies was noted amongst 4–13 y old children for key micronutrients, including vitamin D (99%), calcium (81%), and vitamin A (69.5%). Risk of inadequate micronutrient intakes was significantly increased among the older age group (p-value < 0.05).ConclusionNutrient intakes of school-aged children in Lebanon reflect suboptimal nutrition. Educational and public health interventions are needed to promote healthier diets among children and prevent micronutrient deficiencies during this critical phase.