Common Nutrient Deficiency Research Articles

Nutritional Management of Patients after Bariatric Surgery

Bariatric surgery is currently the most effective method of sustainable weight loss among morbidly obese patients. The types of bariatric surgeries can be divided into three categories: restrictive procedures, malabsorptive procedures, and combination (restrictive and malabsorption) procedures. In general, patients undergoing restrictive procedures have the least risk for long-term diet-related complications, whereas patients undergoing malabsorptive procedures have the highest risk. For many patients, the benefits of weight loss, such as decreased blood glucose, lipids, and blood pressure and increased mobility, will outweigh the risks of surgical complications. Most diet-related surgical complications can be prevented by adhering to strict eating behavior guidelines and supplement prescriptions. Eating behavior guidelines include restricting portion sizes, chewing foods slowly and completely, eating and drinking separately, and avoiding foods that are poorly tolerated. Supplement prescriptions vary among practitioners and usually involve at least a multivitamin with minerals. Some practitioners may add other supplements only as needed for diagnosed deficiencies; others may prescribe additional prophylactic supplements. The most common nutrient deficiencies are of iron, folate, and vitamin B12. However, deficiencies of fat-soluble vitamins have been reported in patients with malabsorption procedures, and thiamin deficiency has been reported among patients with very poor intake and/or nausea and vomiting. Frequent monitoring of nutrition status for all patients can aid in preventing severe clinical deficiencies.

Boron Fertilization Influences on Soybean Yield and Leaf and Seed Boron Concentrations

Soybean [Glycine max (Merr.) L.] is considered relatively insensitive to B deficiency. However, B deficiency has recently become a common nutrient deficiency of soybean in northeast Arkansas. Field studies were conducted on four alkaline silt‐loam soils in northeast Arkansas to determine the influence of B application time and rate on soybean growth, tissue B concentration, and seed yield. Boron fertilizer was applied at 0, 0.28, 0.56, 1.12, and 2.24 kg B ha−1 near the V2 or R2 growth stages. Boron fertilization had no significant effect on soybean yield at one site but increased seed yields from 4 to 130% at three sites. At the most responsive site, B application at V2 increased yields by 13% compared with applications at R2. In contrast, at a site where leaf B concentrations were sufficient for soybean receiving no B, B applied at the R2 stage significantly increased seed yields by 5% compared with V2 B applications. Trifoliate leaf B concentrations at the R2 stage increased as B rate increased. Seed B concentrations also increased as B rate increased. Boron applied at the R2 stage resulted in equal or greater seed B concentrations than B applied at the V2 stage. Application of 0.28 to 1.12 kg B ha−1 during early vegetative or reproductive growth was sufficient to produce near maximal yields. The expected severity of B deficiency plus fertilizer and application costs associated with B fertilization should be considered when selecting the most appropriate B fertilization strategy.

Iron Status Indicators in Women with Prior Neural Tube Defect-Affected Pregnancies

Iron deficiency is the most common nutrient deficiency in pregnant women and has been linked to negative impacts on the fetus. We describe the association of various iron-deficiency indices with risk of neural tube defect (NTD) among a high-risk Mexican-American population. The study included 158 case-women (NTD-affected pregnancies) and 189 control-women (normal births) who were residents of the 14 Texas-Mexico border counties and delivered or terminated pregnancies during 1995-2000. In-person interviews and laboratory assays provided data. Case-women had higher odds of having minimal or no iron stores (serum ferritin <30 microg/L) compared to control-women (OR = 1.8, 95% CI = 1.0-3.3). The risk effect was not explained by low folate or B12 or other risk factors. Low serum ferritin may reflect the additive effect of multiple long-term factors, many of them related to poverty such as poor quality diet, lack of supplementation, and frequent pregnancies. Interpartum care is indicated in this population.

Effect of suboptimal nutrition during lactation on milk protein gene expression in the rat

Human milk provides infants with proteins that aid in the prevention of infections and facilitate the digestion and absorption of other nutrients. Maternal diet is not believed to affect the protein concentration of breast milk. However, the maternal factors that regulate the expression of genes for specific milk proteins are not well characterized. We hypothesized that nutrition could be one of the factors. We fed Sprague–Dawley rats five diets representing common nutrient deficiencies and energy deficiency during pregnancy and lactation: low-zinc (Zn; 7 μg/g), low-iron (Fe; 6 μg/g), low-protein (12.5% albumin), pair-fed control diet (lactation only, 20% less kcal) and control diet (Zn, 25 μg/g; Fe, 100 μg/g; protein, 21%) ad libitum. At day 10 of lactation, the mammary gland was removed for RNA extraction. Northern blots of mRNA from the different groups were performed by hybridization with β-casein and whey acidic protein (WAP) cDNA probes. The expression of β-casein mRNA in rat mammary gland was significantly ( P<.005) increased in the pair-fed group when compared to the control group. The expression of WAP mRNA was also significantly ( P<.005) increased in the pair-fed group as well as in the low-Fe group when compared to the control group. The concentration of β-casein in milk was significantly higher for the low-zinc and the pair-fed groups only. The concentration of WAP in milk was not different among groups. These results suggest that compromised maternal nutrition can affect the expression of two individual milk proteins and may have functional implications with regard to bioactive proteins in milk.

Iron deficiency in young-adult women attending Utah State University

To increase the awareness of iron deficiency in college age women. Iron deficiency, the most common nutrient deficiency worldwide, remains a problem in developed countries including the United States. Women of childbearing age are at high risk due to menstruation. This study was conducted on a sample of 25 women aged 18–38 enrolled in a junior nutrition course at Utah State University. Blood samples were analyzed for iron status biomarkers including ferritin, hematocrit, and hemoglobin. Participants completed three-day dietary records, a 15-minute survey that included questions about health, diet, physical activity, nutritional supplement use, and menstrual history. Twelve of the 25 subjects had serum ferritin concentrations <20 ng/mL, indicative of depleted iron stores. Of the 12 with depleted iron stores, 10 had iron deficiency anemia. Compared to iron replete women, the iron deficient subjects started menstruating earlier (13 vs. 14 yrs; p=.05), more reported heavy bleeding during menstruation (67% vs. 31%; p=.07), feeling cold (73%, 46%), feeling weak (55%, 30%), having a loss of appetite (36%, 9%), having pale skin (27%, 0%), craving non-food substances (27%, 9%), consumed less total iron (8mg/day, 15 mg/day), less red meat (.19 servings/day vs. .21 servings/day) and none took an iron containing multivitamin/mineral supplement (0% vs. 36%). In conclusion, young-adult women attending college may be at increased risk of iron deficiency. Iron deficiency may have a negative impact on performance at work, home, and school. Young adult women at increased risk need to be made more aware of the risk factors and consequences as well as treatment for iron deficiency.

Duration of exclusive breastfeeding and risk of anemia in a cohort of Mexican infants.

Iron deficiency is the most common nutrient deficiency associated with anemia in childhood (CDC 1998), affecting more than half of infants in developing countries (WHO 2001). Bioavailability of iron in human milk is high, yielding about 50% absorption (Dallman 1988; Oski 1993; Saarinen et al. 1977; Krebs 2001). Iron available for absorption is at its highest in early transitional milk and steadily decreases over the course of lactation (Siimes et al. 1979). By six months, complementary foods are needed to provide the nutrients necessary for infant development (Picciano 2001; Dewey 2001). It is not known if a critical period of vulnerability towards iron deficiency exists in infants.

Low sodium diet: nutritional adequacy and factors limiting adherence

Background: Existing data suggest that nonadherence to low-sodium diet (LSD) is the most common cause of rehospitalization among heart failure (HF) patients. Yet, little is known about specific factors that affect patients’ ability to follow this commonlyprescribed measure. Further, many have expressed concern that patients who follow a LSD may suffer nutritional deficits that could counterbalance any positive effects of the LSD. Method and Results: The specific aims of this prospective, comparative study were to: a) describe factors that influence the ability of participants to follow a LSD, b) determine the relationship between self-reported adherence to prescribed LSD and actual sodium intake, and c) determine the nutritional adequacy of a LSD. Patients recruited from two Midwestern HF clinics filled out a questionnaire that measured perceptions about ability to follow a LSD and identified factors that limit ability to follow the diet. Thirty days later, they filled out a 4-day food diary and completed a 24-hour urine collection to measure urine sodium. Twelve males and 11 females with a mean age of 65 yrs and NYHA functional class II or III participated in the study. Sodium intake was 3.2 g for those who reported always following a LSD, 2.6 g for those who followed it most of the time, and 4.1 g. for those who never followed it. Thirty-three percent said it was difficult to follow the LSD, while 66% reported it was easy. Sodium intake on 4-day food diary and 24-hour urine sodium were strongly correlated (r 0.55, p 0.05). The factors reported most to hinder ability to follow the LSD were: friends/relatives don’t serve low sodium foods; difficult to find appetizing low sodium food, to keep track of total daily sodium intake, and to identify low sodium foods in restaurants. No relationship between perceived difficulty following the LSD and actual sodium intake was found. Individual daily caloric intake ranged from a low of 318 kcal to a high of 3,373 kcal, with a four-day group average intake of 1,548 ( 361) kcal. The percent of calories from fat ranged from 21 percent to 50 percent, with a mean of 34 ( 7) percent. The percent of calories derived from carbohydrate sources ranged from 23 percent to 61 percent, with a mean of 50 ( 10) percent. The percent of calories from protein sources ranged from 9 to 27 percent with a mean of 17 ( 4) percent. The only macronutrient related to sodium intake was protein (r 0.58, p 0.05). Protein intake of patients with high sodium intake ( 3g) was significantly greater than those with low sodium intake. All diets were deficient in at least one nutrient, regardless of sodium intake. Themost common nutrient deficiency was magnesium (76%), followed by vitamin A (74%), calcium (71%), and vitamin D (65%). Conclusions: Some patients were able to limit sodium intake, however actual sodium intake was not related to perceived ability to follow a LSD nor selfreported adherence. Further, many individuals with HF may have multiple nutritional inadequacies regardless of their level of sodium intake, although protein deficiencies are prominent in those most closely following a LSD. Modulating the Cost of Prolonged Survival in Heart Failure: Long-Term Benefits of a Nurse-Led, Multidisciplinary, Home-Based Intervention Simon Stewart1—School of Nursing & Midwfery, University of South Australia, Adelaide, South Austrlia, Australia

Nutrient Deficiencies of Agricultural Crops in Papua New Guinea

In Papua New Guinea the population is growing faster than the area under cultivation. As a result, land use is being intensified and soil nutrient depletion may occur, resulting in nutrient deficiencies of agricultural crops. This paper reviews nutrient deficiencies in the agricultural crops of Papua New Guinea using the literature on agronomic trials, expert knowledge and Geographical Information System (GIS) soil fertility databases. One of the aims of this overview is to discuss the spatial distribution of common nutrient deficiencies, which will facilitate the formulation of future strategies on integrated nutrient management research. Nutrient deficiencies have been investigated systematically since the mid-1950s. Research has mainly focused on export tree crops, and relatively little information is available on food crops. Literature analysis and expert knowledge showed consistent trends with deficiencies of B and P in large parts of the highlands. GIS soil fertility databases confirm these observations. The authors' method has been shown to be useful in delineating areas in which nutrient deficiencies occur, and these findings could be used for the planning of nutrient management research and extension activities.

Nutrition in pediatric inflammatory bowel disease

Nutrition in pediatric inflammatory bowel disease

Practice and Knowledge of Primary Caregivers Regarding Infant Feeding

Mothers and other care givers may not have complete knowledge or understanding of infant nutrition requirements. A survey was completed with caregivers of infants 3-36 months of age to determine current knowledge about feeding infants and actual practices. The validated survey was randomly mailed to 500 caregivers across the state of Nebraska. Respondents n=270 (54%) tended to be well educated, white (non-Hispanic), middle income, with only 17% participating in supplemental food programs. Caregivers lacked knowledge regarding appropriate serving sizes, common nutrient deficiencies, infant growth patterns, and the appropriateness of adding additional foods to the infant's bottle. Reported caregiver practices indicated approximately one-fourth allowed the infant to fall asleep with a bottle, added cereal with formula in a bottle, offered more food to the child than he/she would be expected to consume, and gave more than 4 ounces of juice daily to a young infant. Correlation analysis indicated relationships between knowledge and practices for portion sizes (r=−.18; p<0.05), and mixing cereal with infant formula in a bottle (r=.32; p<0.05). Main sources of nutrition information included newspapers, magazines, or books, and physicians. When asked about the type of information desired, the caregivers indicated a need for guidelines on feeding development and readiness to eat, overall nutritional needs, and tips for making mealtime a pleasant experience. Knowledge of current feeding practices by caregivers should better enable dietitians to have a positive impact on the establishment of sound eating patterns in young children.

Behavior of Infants with Iron‐Deficiency Anemia

This study tested the hypothesis that infants with iron-deficiency anemia show behaviors, such as increased proximity to caregivers, increased wariness or hesitance, and decreased activity, that could contribute to "functional isolation." The behavior of 52 Costa Rican 12- to 23-month-old infants with iron-deficiency anemia was contrasted with that of 139 comparison group infants with better iron status during free play and mental and motor testing and in the home. Infants with iron-deficiency anemia maintained closer contact with caregivers; showed less pleasure and delight; were more wary, hesitant, and easily tired; made fewer attempts at test items; were less attentive to instructions and demonstrations; and were less playful. Adult behavior also differed. The results indicate that iron-deficiency anemia in infancy is associated with alterations in affect and activity, suggesting that functional isolation is a useful framework for understanding poorer developmental outcome in iron-deficiency anemia, the world's most common single nutrient deficiency.

Formulated Diets versus Seed Mixtures for Psittacines

Psittacines are often classified as seed eaters despite studies that have established great diversity in food habits in the wild. While seeds are consumed, so are flowers, buds, leaves, fruits and cambium. Some psittacines consume part of greater than 80 species of grasses, forbs, shrubs and trees. In addition, insects may be important. Although there are few controlled studies of the requirements of psittacines, it is probable that most nutrient needs are comparable to those of domesticated precocial birds that have been thoroughly studied. Commercial seed mixes for psittacines commonly contain corn, sunflower, safflower, pumpkin and squash seeds, wheat, peanuts, millet, oat groats and buckwheat, although other seeds may be present. Because hulls/shells comprise 18-69% of these seeds and they are removed before swallowing, a significant proportion of typical seed mixtures is waste. Some of the seeds also are very high in fat and promote obesity. Common nutrient deficiencies of decorticated seeds include lysine, calcium, available phosphorus, sodium, manganese, zinc, iron, iodine, selenium, vitamins A, D, E and K, riboflavin, pantothenic acid, available niacin, vitamin B-12 and choline. Attempts to correct these deficiencies by incorporating pellets into seed mixes are usually thwarted by rejection of the pellets and disproportionate consumption of items that are more highly favored. An extruded diet formulated to meet the projected nutrient needs of psittacines was fed with fruits and vegetables to eight species of psittacines for 1 y. Fledging percentage was increased to 90% from the 66% observed during the previous 2 y when these psittacines were fed seeds, fruits and vegetables. Although this extruded diet was well accepted in a mixture of fruits and vegetables and met nutrient needs, analyses have shown that not all commercial formulated diets are of equal merit.

Soil Nitrogen Mineralization Potential in a Fertilized Loblolly Pine Plantation

Nitrogen deficiency is the most common nutrient deficiency in natural pine (Pinus spp.) stands and plantations of the southern USA. This study was conducted to identify a soil test of available N that correlates well with tree growth volume response to N fertilization. We evaluated the utility of 98-d aerobic incubation for assessing changes in soil N availability resulting from fertilization of a loblolly pine (P. taeda L.) plantation. Results were compared with results from a 30-d incubation and correlated with tree volume growth. Seven months after fertilization with 224 kg N ha−1 as urea, significant increases (P > 0.0312) in N-mineralization potential (Nφ) were found in surface (0–15 cm) soils, but not subsurface (15–50 cm) soils. The increase was also significant in subsequent incubations up to 16 mo after fertilization. A concurrent short-term aerobic-incubation study did not detect significant increases due to fertilization after 7 mo, illustrating the greater sensitivity of the long-term incubation to differences in available N. No differences in Nφ were attributed to P fertilization at 56 kg ha−1, although significant increases occurred when P was included in nutrient leaching solutions in the incubated soils following CaCl2 extraction for inorganic N. Differences in Nφ occurred among seasons, with maximum mineralization occurring in spring and minimum in autumn. Nitrogen-mineralization potential correlated with 2-yr tree volume growth, with the best correlation at the spring sampling date (r = 0.81, P > 0.0002). The linear relationship between volume growth and Nφ was improved with the addition of tree stand stocking as a covariate (r = 0.85). Nitrogen-mineralization potential was also correlated with soil Kjeldahl N, organic C, and exchangeable acidity.

Disappearance of iron-deficiency anemia in a high-risk infant population given supplemental iron.

Iron deficiency is the most common single nutrient deficiency in the world. Studies in the United States have shown that the prevalence of overt iron-deficiency anemia is 5 to 15 per cent in American infants and children 9 to 36 months old.1 2 3 Although iron-deficiency anemia is most prevalent among the poor, owing to feeding practices and dietary inadequacy of foods rich in iron, which tend to be expensive, it cuts across socioeconomic barriers. It is particularly frequent during the second year of life because of exhaustion of transplacental iron reserves, rapid growth, and consumption of large amounts of iron-poor milk. . . .