Inadequate Dietary Intake Research Articles

P098 RELATIONS BETWEEN HEALTH BEHAVIORS, BODY COMPOSITION AND DISEASE STATUS IN PEDIATRIC PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Lean body mass (LBM) deficits in youth with Inflammatory Bowel Disease (IBD) are well-established and persist despite achievement of remission and restoration of body mass. LBM deficits are associated with both short and long-term health outcomes including sarcopenia, metabolic dysregulation, and development of osteopenia/osteoporosis. LBM deficits are multifactorial though largely explained by inflammatory processes, inadequate dietary intake, and increased energy needs. Physical activity (PA) may also play a role in LBM deficits. Unfortunately, PA and diet in youth with IBD have been understudied. The present cross-sectional study describes relations between PA, diet, body composition, and disease status in a sample of youth with IBD. 40 patients with IBD aged 8-17 (M=14.58 years; 60% female; 78% Caucasian; 60% Crohn’s) completed the study. Measures included: Moderate to Vigorous PA (MVPA; Godin Leisure Time Exercise Questionnaire), Diet (4-day Food Record), Body Composition and Bone Mineral Density (BMD; Dual-energy X-ray Absorptiometry), and Disease Status (Physician Global Assessment). Analyses included independent samples t-test and two-tailed pearson correlations. Data collection is ongoing. No differences were found on variables based on group. Correlational analyses (N = 40) revealed that greater MVPA was associated with higher LBM (r = .39) and lower fat mass (r = -.38). Average percent protein intake was associated with older age (r = .38), lower percent carbohydrate intake (r = -.72) and higher BMD (r = .37). Less active disease was associated with higher BMI (r = -.38), higher BMD (r = -.46), and higher LBM (r = -.48). Interestingly, disease status was not associated with health behavior engagement. The present study suggests the need for further research into physical activity and diet as a means of improving outcomes for pediatric patients with IBD through improvements in LBM.

The nutritional and dietary intake among community-dwelling elderly female users of mobile vendor vehicles

We compared the nutritional and dietary intakes of users of mobile vendor vehicles and users of stores to clarify the problems in the nutritional intake of users of mobile vendor vehicles. We conducted a questionnaire about the food accessibility among 257 elderly women (age: ≥65 years) who used mobile vendor vehicles and/or stores to shop. The nutritional intake was assessed using the 24-hour recall method. We used an analysis of covariance (ANCOVA) to calculate the age-adjusted mean values for the total nutritional intake. The nutritional intake among users of mobile vendor vehicles included significantly lower intakes of energy (168 kcal), green vegetables, other vegetables, and meats. Furthermore, those who only shopped at mobile vendor vehicles consumed less energy and fewer nutrients than those who shopped at places other than mobile vendor vehicles. The comparison of the shopping frequency and nutritional intake of the subjects who used mobile vendor vehicles alone revealed that the energy and protein intakes of those who shopped once per week was significantly lower in comparison to those who shopped twice per week. Users of mobile vendor vehicles had lower intakes of macronutrients and various minerals and vitamins. Among the food groups, intakes of vegetables, meat, and dairy products were low. These findings suggest that the lack of means of shopping other than mobile vendor vehicles and shopping once per week may be associated with an inadequate dietary intake among users of mobile vendor vehicles. It would be desirable to develop the shopping environment is desirable.

Dietary Intake, Prevalence, and the Effect of Anemia on Various Morphophysiological Variables of Postmenopausal Women of North India.

Context:Anemia has a high prevalence among postmenopausal Indian females.Aim and Objective:The aim of this study was to evaluate dietary intake, prevalence, and the effect of anemia on various morphophysiological variables among postmenopausal women.Setting and Design:This was a community-based sample survey.Materials and Methods:A total of 250 postmenopausal women aged 45–80 years from various parts of North India participated in the study. Anthropometric measurements, hemoglobin concentration, and bone mineral density (BMD) (using dual-energy X-ray absorptiometry) of each participant were assessed. A 24-h dietary recall method for three consecutive days was employed.Statistical Analysis:The Statistical Package for the Social Sciences version 20 was used for statistical considerations.Results:An age-associated decline in the mean values of hemoglobin concentration and the prevalence of anemia was reported to be 85.2% among postmenopausal women. Anemic women were lighter and had lesser circumferential measurements as well as lower BMD than their nonanemic counterparts. The intake of nutrients such as protein, calcium, and iron and energy was lower among anemic women than nonanemic women. Binary logistic regression analysis identified age (odds ratio = 1.04, 95% confidence interval = 1.00–1.09)* as the possible predictor of anemia.Conclusions:Anemia was not only the result of aging process but also inadequate and unbalanced dietary intake.

The Relation between Serum Homocystiene Level and Recurrent Abortion in Egyptian Women

Background: Early pregnancy loss is defined as the termination of pregnancy before 20 weeks' gestation or with a fetal weight of <500 g. Of those that are recognized, 15-20% result in spontaneous abortions (SABs) or ectopic pregnancies. Approximately 5% of couples trying to conceive have two consecutive miscarriages, and approximately 1% of couples have three or more consecutive early pregnancy loss. Increased levels of homocysteine may be due to inadequate dietary intake of folate and vitamin B12 and inherited defects within the methionine-hmocysteine pathway such as MTHFR c677T gene polymorphism. Hyperhomocysteinemia is associated with the syndromes of repeated miscarriage. Objective: The aim of the current study is to estimate the serum levels of Homocystine and vitamin B12 and their relation to prevalence of recurrent spontaneous abortion in pregnancies with history of recurrent miscarriage. Subjects and Methods: In this study 80 pregnant women classified into two groups: GroupI:60 consecutive pregnant women who had suffered from two or more miscarriages, and Group II: 20 pregnant women with no history of abortion .The following estimations were done (for each woman in the study): serum homocysteine and vitaminB12 were estimated using ELISA technique. Results: Results showed a significant increase in serum level of homocysteine in the first group compared to control group(p<0.0001) and a low serum level of vitamin B12 which was significantly decreased in the study group (group 1) compared to control group(p<0.0001). Moreover, Our results showed a negative correlation between homocysteine and vitamin B12. Conclusion: The elevated serum homocysteine levels during pregnancy were significantly associated with recurrent pregnancy losses. Moreover, reduced serum vitamin B12 level was considered a risk for recurrent miscarriage. Homocysteine is most sensitive and specificparameters in the recurrent pregnancy losses.

Relationship between dietary intakes and the double burden of malnutrition in adults of Malang, Indonesia: An exploratory study.

BACKGROUND/OBJECTIVESUrbanization and lifestyle changes have resulted in nutrition transition. Over-nutrition causes obesity increase, although malnutrition still exists. This phenomenon is called a double burden of malnutrition (DBM). This study was conducted to confirm the existence of DBM and to investigate the dietary factors related to DBM in Indonesian adults.SUBJECTS/METHODSData for the subjects (51 men and 89 women) who are the adults resided in Malang, Indonesia were collected between July 17 and August 14, 2017, by using questionnaire. Height, weight, waist and hip circumference, blood pressure, blood glucose, total cholesterol, and hemoglobin were also measured for the subjects.RESULTSThe average age of the subjects was 47.2 years. The average height, weight, and body mass index for men were 160.08 cm, 62.6 kg and 25.45 kg/m2, respectively, and those for women were 148.74 cm, 58.09 kg, and 26.21 kg/m2, respectively. Of the subjects, 3.6% were underweight, 24.3% were normal or healthy weight, while 72.2% were overweight and obese. Analysis of the dietary intakes revealed high for cereal (7.73 points), but very low for milk (0.25 points) and fruits (0.51 points). Dietary diversity was very few overall (< 5). The occurrence of both anemia (23.6%) and chronic diseases such as hypertension (57.1%), diabetes (12.1%), and hypercholesterolemia (3.6%) was considerably high. The existence of DBM was confirmed by 16.4% of the subjects. DBM was observed significantly higher in women than in men. Dietary diversity and DBM occurrence were inversely correlated. On average, the number of chronic diseases was 1.08 in men and 1.79 in women. Dietary diversity inversely affected systolic blood pressure.CONCLUSIONSDBM existed in adults in Malang, Indonesia due to inadequate dietary intakes, and a high rate of chronic diseases.

Dietary approach to improving the nutritional status in institutionalized elderly hemodialysis patients with a poor dietary intake: a single-arm pilot study

The hemodialysis (HD) diet, which is a high-calorie and high-fat regimen, may inadvertently lead to an inadequate dietary intake, resulting in undernutrition among elderly HD patients. Therefore, an attempt was made to improve the dietary intake by implementing a modified diet regimen in eligible elderly HD patients. Elderly HD patients who had ingested < 50% of the meals provided and were diagnosed with undernutrition among all elderly patients institutionalized at the special elderly nursing home annexed to Nagasaki Kidney Hospital between June and November 2012. Of the elderly HD patients in the nursing home (n = 27), the study included a total of 7 consecutive patients (male/female, 1/6; mean age, 84.1±6.4 years old; duration of HD, 4.3±3.8 years; geriatric nutritional index [GNRI], 83.5±8.3; normalized protein catabolic ratio [nPCR], 0.78±0.14). The modified diet regimen, which involved reducing food portion sizes and incorporating a liquid diet, led to a significant increase in their dietary intake from 48.1% at baseline to 97.1% of the meals provided 3 months after the start of the modified HD diet regimen. Their GNRI also significantly increased from 83.5±8.3 to 86.1±10.2, and their serum albumin levels significantly increased from 3.2±0.2 g/dL to 3.4±0.4 g/dL, suggesting improvements in their nutritional status. The attempted dietary approach for elderly HD patients was shown to potentially increase their dietary intake and improve their nutritional status without affecting the efficiency of HD being implemented.

The role of urinary hepcidin in early detection of iron deficiency anemia

Iron deficiency anemia (IDA) is one of the most severe and important nutritional deficiencies, especially in children all over the world. Iron deficiency may occur because of inadequate dietary intake, increase in physiological needs of the nutrient, and/or increased losses, which may lead to anemia. IDA has been associated with cognitive, motor, and behavioral impairment in children. The most commonly used tests to determine iron status include serum iron levels, ferritin, and others. However, these test have limited role in diagnosis of IDA. For this reason, there is great interest in investigating effective method for the diagnosis of IDA. The use of urinary hepcidin as a biomarker for the regulation of iron metabolism and its level decreased with IDA.

National control programme against nutritional blindness due to vitamin A deficiency: Current status & future strategy.

Vitamin A deficiency (VAD) among 1-5 yr old children is reported to be widely prevalent in Southeast Asia and some parts of Africa. It is the leading cause of preventable blindness in young children in the low-income countries in the world. Children even with milder signs of VAD have higher risk of morbidity and mortality. Inadequate dietary intakes of vitamin A with poor bioavailability associated with frequent infections are the primary contributory factors. Currently available approaches to control VAD are ensuring adequate intakes of vitamin A in daily diets, fortification of foods consumed regularly particularly among the low-income communities and periodic administration of massive dose of vitamin A supported by public health interventions and reinforced by behaviour change communication. Under the National Programme in India, six monthly administration of mega dose of vitamin A to 6-59 month old children has been implemented since 1970, to prevent particularly blindness due to VAD and control hypovitaminosis A. Despite inadequate coverage and poor implementation of the programme, blindness due to VAD in children has almost disappeared, though subclinical VAD is still widely prevalent. Based on the results of meta-analysis of eight trials, which indicated that vitamin A supplementation to children aged 6-59 months reduced child mortality rates by about 23 per cent, the World Health Organization made a strong recommendation that in areas with VAD as a public health problem, vitamin A supplementation should be given to infants and children of 6-59 months of age as a public health intervention to reduce child morbidity and improve child survival. At present, in India, there is a need for change in policy with respect to the national programme to opt for targeted instead of universal distribution. However, NITI (National Institution for Transforming India) Aayog, which formulates policies and provides technical support to the Government of India, recommends strengthening of the National Programme for control of VAD through six monthly vitamin A supplementation along with health interventions. Eventually, the goal is to implement food based and horticulture-based interventions harmonizing with public health measures, food fortification and capacity building of functionaries for elimination of VAD.

Zinc Content of Staple Grains and Domestic Water from Kanam Local Government Area, North-Central Nigeria

Zinc is one of the essential trace elements in human nutrition. Adequate zinc nutrition is essential for human health because of zinc’s critical structural and functional roles in many enzyme systems that are involved in gene expression, cell division and growth and immunologic and reproductive functions. On account of its very important roles in strategic biologic functions in the body, inadequate dietary intake of zinc has serious health consequences. Samples of five grains (maize, guinea corn, millet, cowpea and groundnut) and domestic water sources from Kanam Local Government Area, Nigeria; a population of suspected zinc deficiency, were analyzed for their zinc content using inductively coupled plasma-mass spectrophotometry. The samples were wet-ashed according to the protocol of Hill et al. before the analysis. The objective of the study was to investigate the levels of zinc in various staple grains grown in Kanam LGA, Nigeria. Results were expressed as mean ± standard deviation. The results showed wide variation in the zinc content of the grains. The mean zinc content was highest in cowpea (40.34 ± 1.32 μg/g), followed by groundnuts (32.75 ± 0.66 μg/g), and least in yellow maize (22.35 ± 1.17 μg/g). Other samples such as red and white sorghum, white maize, and millet had zinc contents varying from 23.82 to 25.89 μg/g. Zinc content of hand-dug well water sources also varied widely from 1.921 ± 0.060 to 4.940 ± 0.103 mg/l. Phytate/zinc ratio was determined to ascertain the level of bioavailability of zinc in the foodstuffs. Based on the phytate/zinc molar ratio, cowpea appears to have the most bioavailable zinc followed by red and white sorghum, while groundnut has the least. The results are discussed and it is concluded that the staple grains, except cowpea and domestic water sources, may not be good sources of dietary zinc.

Disturbed Vitamin A Metabolism in Non-Alcoholic Fatty Liver Disease (NAFLD).

Vitamin A is required for important physiological processes, including embryogenesis, vision, cell proliferation and differentiation, immune regulation, and glucose and lipid metabolism. Many of vitamin A’s functions are executed through retinoic acids that activate transcriptional networks controlled by retinoic acid receptors (RARs) and retinoid X receptors (RXRs).The liver plays a central role in vitamin A metabolism: (1) it produces bile supporting efficient intestinal absorption of fat-soluble nutrients like vitamin A; (2) it produces retinol binding protein 4 (RBP4) that distributes vitamin A, as retinol, to peripheral tissues; and (3) it harbors the largest body supply of vitamin A, mostly as retinyl esters, in hepatic stellate cells (HSCs). In times of inadequate dietary intake, the liver maintains stable circulating retinol levels of approximately 2 μmol/L, sufficient to provide the body with this vitamin for months. Liver diseases, in particular those leading to fibrosis and cirrhosis, are associated with impaired vitamin A homeostasis and may lead to vitamin A deficiency. Liver injury triggers HSCs to transdifferentiate to myofibroblasts that produce excessive amounts of extracellular matrix, leading to fibrosis. HSCs lose the retinyl ester stores in this process, ultimately leading to vitamin A deficiency. Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and is a spectrum of conditions ranging from benign hepatic steatosis to non-alcoholic steatohepatitis (NASH); it may progress to cirrhosis and liver cancer. NASH is projected to be the main cause of liver failure in the near future. Retinoic acids are key regulators of glucose and lipid metabolism in the liver and adipose tissue, but it is unknown whether impaired vitamin A homeostasis contributes to or suppresses the development of NAFLD. A genetic variant of patatin-like phospholipase domain-containing 3 (PNPLA3-I148M) is the most prominent heritable factor associated with NAFLD. Interestingly, PNPLA3 harbors retinyl ester hydrolase activity and PNPLA3-I148M is associated with low serum retinol level, but enhanced retinyl esters in the liver of NAFLD patients. Low circulating retinol in NAFLD may therefore not reflect true “vitamin A deficiency”, but rather disturbed vitamin A metabolism. Here, we summarize current knowledge about vitamin A metabolism in NAFLD and its putative role in the progression of liver disease, as well as the therapeutic potential of vitamin A metabolites.

Oligofructose Provides Laxation for Irregularity Associated with Low Fiber Intake.

Inadequate dietary fiber intake contributes to the prevalent irregularity and constipation in Western countries. Although eating adequate amounts of fibers from fiber-rich foods, foods with added fibers and dietary fiber supplements is considered the first option for improving laxation, the efficacy can vary among types of fibers. The present study is a randomized control trial that included healthy adult participants with ≤3 bowel movements/week and a habitual low dietary fiber intake in a parallel design to evaluate the benefits for laxation by supplementing the daily diet with oligofructose (Orafti® P95; OF), a fermentable source of fiber and established prebiotic (n = 49); maltodextrin was the placebo (n = 48). After a run-in phase, OF was initially provided at 5 g/day, then increased to 10 and 15 g/day with four weeks for each phase. Stool frequency (bowel movements per week) for the OF and maltodextrin (MD) groups were initially similar (3.98 ± 1.49 vs. 4.06 ± 1.48), did not change for the placebo group, but increased for the OF group with the difference significant at 15 g/day (p = 0.023). Stool consistency was similar and remained unchanged at all doses for both groups. Gastrointestinal sensations were low for both groups. Laxation benefits were especially pronounced for participants with >13 g/day habitual dietary fiber intake, with significant laxation at 10 g and 15 g OF/day (p = 0.04 and p = 0.004, respectively) A daily supplement with a short-chain inulin-type fructan derived from chicory roots, i.e., oligofructose (Orafti® P95) provided a laxation effect without causing gastrointestinal (GI) distress for healthy participants with irregularity associated with low dietary fiber intake.

Complementary feeding with cowpea reduces growth faltering in rural Malawian infants: a blind, randomized controlled clinical trial

Background: Growth faltering is common in rural African children and is attributed to inadequate dietary intake and environmental enteric dysfunction (EED).Objective: We tested the hypothesis that complementary feeding with cowpea or common bean flour would reduce growth faltering and EED in 6-mo-old rural Malawians compared with the control group receiving a corn-soy blend.Design: A prospective, double-blind, randomized controlled clinical trial was conducted in which children received daily feeding for 6 mo (200 kcal/d when 6-9 mo old and 300 kcal/d when 10-12 mo old). The primary outcomes were change in length-for-age z score (LAZ) and improvements in EED, as measured by percentage of lactulose excretion (%L). %L <0.2% was considered normal. Anthropometric measurements and %L through urine were compared between each legume group and the control group with Student's t test.Results: Of the 355 infants enrolled, 291 infants completed the trial, and 288 were breastfed throughout the duration of the study. Cowpea and common bean added 4.6-5.2 g protein/d and 4-5 g indigestible carbohydrate/d to the diet. LAZ and weight-for-height z score were reduced in all 3 groups from 6 to 12 mo of age. The changes in LAZ [mean (95% CI)] for the cowpea, common bean, and control groups from 6 to 9 mo were -0.14 (-0.24, -0.04), -0.27 (-0.38, -0.16), and -0.27 (-0.35, -0.19), respectively. LAZ was reduced less in infants receiving cowpea than in those receiving control food from 6 to 9 mo (P = 0.048). The absolute value of %L did not differ between the dietary groups at 9 mo of age (mean ± SD: 0.30 ± 0.43, 0.23 ± 0.21, and 0.26 ± 0.31 for cowpea, common bean, and control, respectively), nor did the change in %L from 6 to 9 mo.Conclusion: Addition of cowpea to complementary feeding in Malawian infants resulted in less linear growth faltering. This trial was registered at clinicaltrials.gov as NCT02472262.

Moderate iodine deficiency among pregnant women in Hong Kong: revisit the problem after two decades.

A survey conducted during 2005 to 2007 by the Centre for Food Safety in Hong Kong suggested that only 5% of the local population had a sufficient dietary intake of iodine. The study, however, was limited as biochemical data (ie urinary iodine concentration) were lacking. Pregnant women are vulnerable to iodine deficiency because of their increased requirement. Recent studies have shown that iodine deficiency in early pregnancy is associated with poorer cognitive development in early childhood. This study reports the iodine status of women during early gestation at an obstetric unit in Hong Kong. Healthy pregnant women with no history of hyperemesis gravidarum were enrolled into a study when they first made a booking in an antenatal clinic of a public hospital to investigate their iodine status during early pregnancy. All subjects were asked to collect their morning urine for measurement of iodine and creatinine levels. Daily dietary intake of iodine was assessed in a subgroup of participants by structured interview using a standard food frequency questionnaire. A total of 600 pregnant women were enrolled at a median of 7.0 weeks of gestation. The median urinary iodine concentration and urinary iodine-to-creatinine ratio were 100 μg/L and 98 μg/g, respectively; 429 (71.5%) participants had iodine insufficiency according to the World Health Organization classification. Daily dietary intake of iodine was assessed in 146 participants. The median daily intake of iodine was 69.5 μg and 122 (83.6%) participants had an intake below the 250 μg recommended during pregnancy by the World Health Organization. Local pregnant women continue to have an inadequate dietary intake of iodine and remain iodine-deficient.

Dietary Intake and Socioeconomic Factors among a Group of Stunted Preschool Children in Cairo

The optimal growth and development of infants and young children are fundamental for their future. Stunting is one of the most important public health problems in developing countries. This study explores the socio-economic determinants of stunting among a sample of under-five years children. Subjects & Methods: This study is a cross sectional descriptive one ,for which the study population was recruited from out patients clinic of stunting in Na-tional Nutrition Institute (NNI) after taking the ethical agreements of their par-ents. The study included 50 preschool children (31 boys and 19 girls). Their age ranged from 2-5 year both boys and girls was included. Their parents were interviewed by using special questionnaire for assessment of the socioeconomic factors. Anthropometric measurements were performed. Dietary Assessment was performed using 24H, recall and food frequency of selected food items. Re-sults: Among the sample, the children were 62%.boys and 38% girls. The cur-rent data showed inadequate dietary intake, as there was unsafe level of con-sumption of total calories and carbohydrate, vitamin A, calcium, zinc, unac-cepted level of consumption of protein and iron. The most important determina-ble socioeconomic factors of stunting were educational level, occupation, family size and family income. Conclusion: This study was successful in identifying priority nutrients for dietary intervention including total caloric intake, macro and some micronutrients This study also determine some of socioeconomic factors of stunting which were educational level, occupation, family size and family income.

Effect of Ruta chalepensis on Zinc, Lipid Profile and Antioxidant Levels in the Blood and Tissue of Streptozotocin-Induced Diabetes in Rats Fed Zinc-Deficient Diets.

In diabetes, oxidative stress and lipid abnormalities are common and pronounced and represent important factors that are involved in the development of complications of diabetes. Zinc deficiency generally induces oxidative stress, but it is well known that the antioxidant Ruta chalepensis has an effective modulator role in oxidative stress in metabolic diseases. The aim of this study was to investigate the effect of R. chalepensis extract on blood biochemical parameters, tissue zinc status and antioxidant systems in rats with diabetes that were fed zinc-deficient diets. We divided 28 male albino Wistar rats into 4 groups: 2 groups (1 group with diabetes, 1 group without diabetes) were fed zinc-sufficient diets, while the other 2 groups of rats with diabetes were fed zinc-deficient diets. One group was not treated, and the other was treated with the extract of R. chalepensis. After 3 weeks of dietary manipulation, the fasting animals were killed. The body-weight gains of the zinc-deficient animals with diabetes were lower than those of the zinc-adequate animals with diabetes. It was noticed also that inadequate dietary zinc intake increased the glucose, cholesterol, triglyceride, urea, uric acid, creatinine and lipid peroxidation levels. In addition, the zinc-deficient diet led to a decrease in zinc tissues (femur, liver, kidney), glutathione concentration and both glutathione peroxidase and glutathione-S-transferase activities. However, R. chalepensis treatment ameliorated all the previous parameters approximately to their normal levels. It seems that R. chalepensis supplementation is a potent factor in reducing the oxidative severity of zinc deficiency in experimental diabetes through its hypoglycemic and antioxidant actions.

CHARD (BETA VULGARIS VAR. CICLA) EXTRACT MODULATES ZINC STATUS, GLUCOSE LEVEL AND ANTIOXYDANT VALUES IN DIABETIC RATS FED ZINC DEFICIENCY DIET

Objective: Oxidative stress which comes from hyperglycemia, it accelerates the development of cellular and vascular damage complications in diabetes, but the antioxidants may play a beneficial role in its prevention. Several plants extracts have an antioxidant activity and the ability to reduce oxidative stress in diabetes. Thus this study was conducted to investigate the effect of Beta vulgaris var cicla extract on zinc status, glucose concentration and antioxidant parameters in streptozotocin-diabetic rats fed zinc deficiency diet.Methods: Twenty-eight male albino (Wistar) rats were divided into four groups: two groups fed a zinc-sufficient diet one non-diabetic and the other diabetic, while the others two diabetic groups were fed a zinc-deficient diet, one non-treated group and the other treated with the extract of Beta vulgaris var cicla. After 21 d of dietary manipulation, fasting animals were scarified. Blood glucose, tissues zinc (femur, liver, kidney), malondialdehyde (MDA), reduced glutathione (GSH), glutathione peroxidase (GSH-Px) and glutathione-S-transferase (GST) were evaluated.Results: Body weight gain of zinc-deficient diabetic animals was lower than that of zinc-adequate diabetic animals. It was noticed also that inadequate dietary zinc intake increased glucose and MDA levels. In addition, zinc deficiency diet led to a decrease in zinc tissues, GSH concentration both GST and GSH-Px activities. However, Oral administration of Beta vulgaris extract significantly decreased both serum glucose and MDA (p&lt;0.001) levels, with a significant increase in body weight gain (p&lt;0.001), GSH concentration (p&lt;0.05, P&lt;0.001), GST (p&lt;0.05, p&lt;0.001) and GSH-Px (p&lt;0.001) activities.Conclusion: The present study showed that Beta vulgaris var cicla supplementation presumably acting as an antioxidant, and it can be a natural source for the reduction of diabetes development caused by zinc deficiency.

Evidence for potential underestimation of clinical folate deficiency in resource-limited countries using blood tests.

Although a low serum folate concentration is a useful biomarker of pure folate deficiency, the presence of vitamin B12 deficiency or hemolysis or both in individuals with low folate status predictably raises serum folate levels. Therefore, in resource-limited settings where dietary folate deficiency can coexist with vitamin B12 deficiency or malaria or both, the serum folate concentration can range from normal to high, leading to serious underestimation of tissue folate status. This review traces the genesis of an inappropriate overreliance on the serum folate concentration to rule out folate deficiency in vulnerable populations of women and children. Of significance, without due consideration of a chronically inadequate dietary folate intake, authors of influential studies have likely wrongly judged these populations to have an adequate folate status. Through repetition, this error has led to a dangerous entry into the contemporary medical literature that folate deficiency is rare in women and children. As a consequence, many millions of under-resourced women and children with mild to moderate tissue folate deficiency may have been deprived of folate replacement. This review uses historical documents to challenge earlier conclusions and re-emphasizes the need for contextual integration of clinical information in resource-limited settings.

Iron deficiency in adolescence

The prevalence of iron deficiency anemia is estimated at 2-5% among reproductive age women, with perhaps 3 times that number having deficient iron stores that may contribute to fatigue, cognitive deficits, and other symptoms even in the absence of overt anemia. The combination of rapid growth, menstrual blood loss, and often inadequate dietary intake of iron places adolescent females at particular risk. Although general recommendations in favor of routine screening for iron deficiency have been made by the Centers for Disease Control and Prevention, the current US Preventive Services Task Force guidelines state that there is insufficient evidence to recommend universal laboratory screening for iron deficiency in nonpregnant women. In older women, dietary iron intake and menstrual blood loss have been shown to correlate with iron deficiency, and questions targeting those areas are included in the American Academy of Pediatrics' Bright Futures adolescent previsit questionnaire. However, these screening questions have not been validated in adolescent females, whose risk factors for iron deficiency differ from older women. In this volume of The Journal, Sekhar et al report on a cross-sectional study of 96 adolescent females in whom laboratory evaluation of iron status was compared to the results of the 4 questions from the Bright Futures questionnaire, as well as an expanded model that also incorporated body mass index along with self-reported measures of depression, attention, food insecurity, and daytime sleepiness. Disappointingly, neither model proved predictive of iron status or anemia; indeed, most cases of anemia were missed by the questionnaires, while most patients identified at risk for anemia had normal iron studies. These results lend support to the Centers for Disease Control and Prevention's recommendation for routine laboratory evaluation of iron status in adolescent women, although the optimal methodology and frequency of testing are still to be defined. Article page 194 ▶ Risk-Based Questionnaires Fail to Detect Adolescent Iron Deficiency and AnemiaThe Journal of PediatricsVol. 187PreviewTo evaluate the predictive ability of screening questionnaires to identify adolescent women at high-risk for iron deficiency or iron deficiency anemia who warrant objective laboratory testing. Full-Text PDF

Agronomic biofortification of cereals with zinc: a review

SummaryZinc (Zn) still represents an important health problem in developing countries, caused mainly by inadequate dietary intake. A large consumption of cereal‐based foods with small concentrations and low bioavailability of Zn is the major reason behind this problem. Modern cultivars of cereals have inherently very small concentrations of Zn and cannot meet the human need for Zn. Today, up to 50% of wheat‐cultivated soil globally is considered poor in bioavailable Zn. Agricultural strategies that are used to improve the nutritional value of crop plants are known as biofortification strategies. They include genetic biofortification, which is based on classical plant breeding and genetic engineering for larger nutrient concentrations, and greater agronomic biofortification, which is based on optimized fertilizer applications. This review focuses on agronomic biofortification with Zn, which has proved to be very effective for wheat and also other cereal crops including rice. Molecular and genetic research into Zn uptake, transport and grain deposition in cereals are critically important for identifying ‘bottlenecks’ in the biofortification of food crops with Zn. Transgenic plants with large Zn concentrations in seeds are often tested under controlled laboratory or glasshouse conditions with sufficient available Zn in the growth medium for the entire growth period. However, they might not always show the same performance under ‘real‐world’ conditions with limited chemical availability of Zn and various stress factors such as drought. What purpose can an upgraded transport and storage system serve if the amount of goods to be transported and stored is limited anyway? Given the fact that the Zn concentrations required to achieve a measurable impact on human health are well above those required to avoid any loss of yield from Zn deficiency, providing crop plants with sufficient Zn through the soil and foliar fertilizer strategy under field conditions is critically important for biofortification efforts.Highlights Zinc malnutrition is a major global health issue associated with cereal‐based diets. Agronomic biofortification with Zn aims to provide edible parts of crop plants with sufficient Zn. Biofortification with Zn fertilizers, particularly foliar applications, works well for wheat and other cereals. Agronomic biofortification with Zn provides a practical and cost‐effective option to tackle the global Zn malnutrition problem.

The influence of food consumption and socio-economic factors on the relationship between zinc and iron intake and status in a healthy population.

To examine Zn and Fe nutritional status of a healthy population by means of anthropometric, dietary and biochemical measurements and to investigate the relationship of usual Zn and Fe dietary intakes to Zn and Fe status. In addition, to examine the impact of food choices and socio-economic factors on Fe and Zn dietary intakes and status with the aim to identify groups at risk of dietary deficiency and suggest factors that may influence the status of these nutrients. Food consumption was assessed by 24 h recall questionnaires. Twenty biochemical parameters were measured, of which Hb, haematocrit, erythrocyte count and plasma concentrations of Fe and Zn were directly related to Fe and Zn nutrition. The prevalence of study participants with inadequate micronutrient intakes was calculated using the Estimated Average Requirement cut-point method. Serbia, Europe. Apparently healthy adults (25-65 years of age). Mean daily Zn and Fe intakes were 9·1 mg and 11·6 mg for males and 7·3 mg and 9·4 mg for females, respectively. Five per cent of the study population had inadequate dietary Fe intake and 15-25 % had inadequate Zn intake. Lower Hb concentrations were measured in women with lower Zn intakes. No differences in Fe and Zn intakes and status among various socio-economic groups were observed, except for Fe intake between the low-income and affluent groups. Regular follow-ups are needed to ensure that potential deficiencies of Zn and Fe do get recognized and addressed in a timely manner.