Inadequate Vitamin Research Articles

Vitamin D status of 3-year-old children in Denmark: determinants and associations with bone mineralisation and blood lipids.

Low vitamin D status is a global problem and has been associated with reduced skeletal and cardiometabolic health. However, evidence in young children is lacking. We, therefore, aimed to characterise vitamin D status in toddlers, identify its determinants, and explore if vitamin D status was associated with bone mineralisation and lipid profile. We used cross-sectional data from 3-year-old children (n = 323) living in Denmark (latitude: 55°N). Bone mineralisation (n = 108) was measured by DXA. Blood samples were analysed for serum 25-hydroxyvitamin D (s-25(OH)D) by LC-MS/MS, triacylglycerol, and total, low- and high density lipoprotein cholesterol. Mean ± SD s-25(OH)D was 69 ± 23nmol/L, but varied with season. During winter, 38% had inadequate s-25(OH)D (< 50nmol), whereof 15% had deficiency (< 30nmol/L); these numbers were only 7 and 1% during summer. In terms of status determinants, supplement use (66% were users) was associated with s-25(OH)D (P < 0.001), whereas dietary vitamin D intake (median [25-75th percentile] of 1.3 [0.9-1.9] µg/d), sex, parental education, BMI, and physical activity were not. There were no associations between s-25(OH)D and blood lipids or bone measurements, using either unadjusted or adjusted regression models. More than 1/3 of Danish toddlers had inadequate vitamin D intake during winter, but acceptable mean vitamin D status. In addition to season, supplement use was the main determinant of vitamin D status, which was, however, not associated with bone mineralisation or lipid profile. The results support recommendations of vitamin D supplements during winter at northern latitudes, but potential health effects need further investigation.

Aspirin for the primary prevention of breast cancer: an unforeseen advantage

Aspirin for the primary prevention of breast cancer: an unforeseen advantage

Association of sun exposure and seasonality with vitamin D levels in Brazilian children and adolescents.

This study aimed to verify vitamin D concentration in children and adolescents during the seasons of the year and to compare vitamin D concentration between children engaged in outdoor activities and those engaged in indoor activities. This is a cross-sectional study with a sample of 708 children and adolescents (aged 6-18 years), excluding 109 (16 were over 19 years old; 39 had a disease that required continuous treatment; 20 were on continuous medication; and 34 had no vitamin D data), ending with 599. The plasma concentration of 25-hydroxyvitamin D2 was measured with commercial kits following manufacturer instructions. Participants who engaged in outdoor activities, as well as those who had data collected during summer and spring, had higher levels of vitamin D. According to the Poisson regression, the proportion of participants with inadequate levels of vitamin D was greater in the participants whose vitamin D was measured during spring (PR 1.15, 95%CI 1.03-1.29) and winter (PR 1.18, 95%CI 1.05-1.32). Also, a greater proportion of inadequate vitamin D was observed for those engaged in indoor activities (PR 1.08, 95%CI 1.01-1.15). Participants who measured the vitamin during the summer and autumn had a lower prevalence of hypovitaminosis D. Even in regions with high solar incidence throughout the year, vitamin D levels can vary significantly during the period's seasons.

EVALUATION OF SERUM VITAMIN B12 LEVELS IN TYPE 2 DIABETES MELLITUS PATIENT ON METFORMIN THERAPY ATTENDING A TERTIARY CARE HOSPITAL

Background: Metformin for type 2 diabetes mellitus has more beneficial effect with few side effects like vitamin B12 deficiency. So, this study aimed to determine the level of vitamin B12 in patients with type 2 diabetes mellitus using metformin and its association with dose and duration of metformin use. Methods: This was descriptive, cross-sectional, hospital-based study. A total of 128 diabetic patients using metformin for more than 6 months were enrolled. After taking informed consent, considering exclusion criteria, level of serum B12 were quantified by chemiluminescent enzyme immunoassay. Vitamin B12 level &lt;300pg/dl as inadequate and ≥300pg/dl as adequate; metformin 1000mg as low dose; more than 1000mg as high dose were considered. Also, metformin used 1000mg /day taken as constant and comparing it with duration of &gt; 10 years with duration of &gt; 10 years. Data were entered in Microsoft Excel 2013 and analyzed on SPSS V25. Results: Our study results 62.5% had adequate (&gt;300pmol/l) and 37.5% had inadequate (≤300pmol/l) vitamin B12 level in patients with type 2 diabetes using metformin. Level of vitamin B12 deficiency was statistically associated with increasing dose of metformin used (p&lt;0.001) and long term used of metformin used (p&lt;019). Conclusions: This study concluded that there is prevalence of deficiency of Vit B12 level in type 2 diabetes mellitus patients using metformin. Also, this deficiency level depends on use of dose of metformin.

Effect of different schemes of androgen deprivation therapy on bone mass density in prostate cancer patients

ObjectivesTo evaluate aspects of the basal bone health status in prostate cancer patients. Furthermore, to evaluate in a real-world setting the effect of different schemes (intermittent or continuous) of androgen deprivation therapy (ADT) and the effect of denosumab in bone mass density (BMD). MethodsObservational, retrospective study of a cohort of prostate cancer patients in treatment with luteinizing hormone-releasing hormone (LH-RH) agonists, evaluated in the rheumatology department of a tertiary center. Demographics, FRAX score, LH-RH treatment scheme, osteoporosis treatment, laboratory data and BMD were collected. Mixed effect regression models to analyze the interaction between LH-RH treatment scheme, denosumab and BMD evolution were used. Results83 patients (mean age 71 ± 8 years) were included. At the basal evaluation, 16% of patients presented densitometric osteoporosis and 27% of patients presented high fracture risk. 80% of patients had inadequate vitamin D levels. Vitamin D > 30 ng/mL was correlated with higher T-scores. There was no association between LH-RH treatment scheme and BMD evolution, however there was a positive association with denosumab. ConclusionA high proportion of patients presented elevated fracture risk or inadequate vitamin D levels, not previously recognized. Bone health assessment and fracture risk evaluation are convenient in these patients. In a real-world setting, the effect of denosumab in BMD is detected, however the effect of intermittent LH-RH schema treatment is less evident.

Inadequacy of Vitamin D Does Not Interfere with Body Weight Loss in Women of Reproductive Age after Roux-en-Y Gastric Bypass.

To assess the influence of vitamin D on body weight loss in women who had previously undergone Roux-en-Y gastric bypass (RYGB). This is an analytical, longitudinal and retrospective study comprising 40 women of reproductive age who had previously undergone RYGB. To investigate the influence of the serum concentrations of vitamin D on body weight reduction, the variables were analyzed in the pre-operative period (T0), in the first (T1) and in the second postoperative year (T2) and were stratified according to the BMI measured in T1 and T2. In addition, in the pre-operative period, participants were subdivided into groups based on adequacy (G1), deficiency (G2) and insufficiency (G3), according to their serum concentrations of vitamin D. Although weight loss occurred in a substantial way in T1, it continued to decrease in T2 (p = 0.017). The women who reached normal weight within two years of surgery showed the lowest vitamin D concentrations preoperatively when compared to those who were overweight (p = 0.011). Women with preoperative vitamin D deficiency showed increased concentrations in the assessed times (p &lt; 0.001), while the opposite (p = 0.001) occurred in women with adequacy. The study showed that inadequacy of vitamin D does not interfere with weight loss in the two-year-follow-up after RYGB and highlights that vitamin D can present a differentiated response postoperatively, to the detriment of the pre-operative period.

Children Aged 5–6 Years in Vancouver, Canada Meet Dietary Recommendations for Folate and Vitamin B12 but not Choline

BackgroundCholine, folate, and vitamin B12 are required for growth and development, but there is limited information on the intakes and relationships to biomarkers of status in children. ObjectivesThe objective of this study was to determine the choline and B-vitamin intakes and relationship to biomarkers of status in children. MethodsA cross-sectional study was conducted in children (n = 285, aged 5–6 y) recruited from Metro Vancouver, Canada. Dietary information was collected by using 3 24-h recalls. Nutrient intakes were estimated by using the Canadian Nutrient File and United States Department of Agriculture database for choline. Supplement information was collected by using questionnaires. Plasma biomarkers were quantified by using mass spectrometry and commercial immunoassays, and relationships to dietary and supplement intake were determined by using linear models. ResultsDaily dietary intakes of choline, folate, and vitamin B12 were [mean (SD)] 249 (94.3) mg, 330 (120) DFE μg, and 3.60 (1.54) μg, respectively. Top food sources of choline and vitamin B12 were dairy, meats, and eggs (63%–84%) and for folate, were grains, fruits, and vegetables (67%). More than half of the children (60%) were consuming a supplement containing B-vitamins, but not choline. Only 40% of children met the choline adequate intake (AI) recommendation for North America (≥250 mg/d); 82% met the European AI (≥170 mg/d). Less than 3% of children had inadequate folate and vitamin B12 total intakes. Some children (5%) had total folic acid intakes above the North American tolerable upper intake level (UL; >400 μg/d); 10% had intakes above the European UL (>300 μg/d). Dietary choline intake was positively associated with plasma dimethylglycine, and total vitamin B12 intake was positively associated with plasma B12 (adjusted models; P < 0.001). ConclusionsThese findings suggest that many children are not meeting the dietary choline recommendations, and some children may have excessive folic acid intakes. The impact of imbalanced one-carbon nutrient intakes during this active period of growth and development requires further investigation.

Dietary inadequacies overestimate the blood deficiencies of magnesium, zinc, and vitamins A, C, E, and D among residents of Sao Paulo

We aimed to estimate the prevalence of the inadequate intake and status of magnesium, zinc, and vitamins A, C, E, and D and identify factors associated with micronutrient deficiency in serum/plasma among residents of São Paulo, Brazil. Data from 824 individuals aged ≥14 years were obtained from the 2015 ISA-Nutrition, a population-based, cross-sectional survey. Dietary and supplement intakes were assessed using two 24-h dietary recalls, and the micronutrient inadequacies were estimated using the National Cancer Institute method. Micronutrient status was measured in serum or plasma, and deficiency was established according to the lower limit of the reference values. Receiver operating characteristic curve analysis was used to identify the effect of intake on the micronutrient status in serum/plasma. Logistic regression analysis was applied to assess the association between micronutrient status and individual characteristics. More than 80% of the population had an inadequate dietary intake of magnesium, vitamin E, and vitamin D. Males had a high prevalence of inadequate dietary intake of vitamin A and zinc. A high-to-moderate prevalence of inadequate vitamin C intake was observed. Vitamin D was the only nutrient with a deficient status comparable to its dietary inadequacy. The other nutrients demonstrated a lower deficiency prevalence compared to dietary inadequacy, and vitamin A demonstrated the lowest prevalence of deficiency in plasma. Generally, dietary intake showed a non-notable association with micronutrient deficiency in serum/plasma. Individuals with fasting glucose concentrations ≥100mg/dL and those using diuretic drugs had a higher risk of serum magnesium deficiency. Those using lipid-lowering drugs and those with high plasma adiponectin concentrations had a higher risk of serum zinc deficiency. Individuals who smoked and those with hypertension showed a higher risk of plasma vitamin C deficiency. Individuals with average leptin concentrations had a higher risk of plasma vitamin E deficiency. Finally, those with sufficient leisure-time physical activity had a lower risk of serum vitamin D deficiency. Residents of the urban areas of São Paulo demonstrated substantially inadequate intakes of most of the assessed micronutrients; however, micronutrient deficiency in serum/plasma was not associated with dietary inadequacy, and it usually demonstrated a lower prevalence than dietary indicators. Thus, using micronutrient intake to determine the serum/plasma profile should be done with caution. The status of the micronutrients varied according to individual characteristics, indicating the interplay of complex mechanisms underlying micronutrient balance.

Calcium and vitamin D supplements for the treatment and prevention of osteoporosis. Should it be widely used?

Osteoporosis is the most common age-related skeletal diseases, which is characterized by the rapid loss of bone mineral density and increased risk of fragility fractures. The social significance of osteoporosis is attributed to its complications, which increase disability and mortality rates mostly among older people. Inadequate dietary calcium intake and vitamin D deficiency are well-known risk factors for osteoporosis. Thus, for many years, calcium and vitamin D have been considered crucial in the prevention and treatment of osteoporosis. However, in recent years, the efficacy and safety of calcium and vitamin D have been questioned because some randomized clinical trials have reported only a weak positive effect of calcium with or without vitamin on reducing fragility fracture risks. On the contrary, besides the gastrointestinal side effects of calcium supplements and the risk of kidney stones related to the co-administration of calcium and vitamin D supplements, other recent data suggested that calcium supplementation has potential adverse cardiovascular effects. This study focused on the evidence regarding the possible usefulness for bone health and the potential harmful effects of calcium and/or calcium with vitamin D supplementation.

Orthopaedic Diagnoses in the Black Pediatric Population.

The Black pediatric population is one that has been historically underserved and continues to have unmet needs. Factors including lack of diversity in orthopaedic studies and in historical standards, such as bone age, may inadvertently lead to inferior care. There are certain conditions in this population for which the practicing orthopaedic surgeon should have a higher degree of suspicion, including slipped capital femoral epiphysis, Blount disease, and postaxial polydactyly. Systemic diseases with higher rates in this population have orthopaedic manifestations, including sickle cell disease, vitamin D deficiency, and obesity. Racial discrepancies in access to prenatal care can have orthopaedic consequences for babies, especially cerebral palsy and myelodysplasia. Racial discrepancy exists in evaluation for nonaccidental trauma. Increased awareness of these issues better prepares practitioners to provide equitable care.

Association of Vitamin D with Obesity in Premenstrual Syndrome: A Study of Female Population of Hyderabad, Sindh

Introduction/Objectives: The affiliation between decreased vitamin D and obesity is well built up. Females with Premenstrual Syndrome (PMS) are more prone to gain weight. Obese women's low calcifediol levels are impacted by diets and inactive lifestyles. The study focused to discover out the relationship between vitamin D and obesity in premenstrual syndrome females. Study design: Cross-sectional study Place and Duration: OPD-Gynecology, Liaquat University of Medical &amp;Health Sciences (LUMHS), Jamshoro and Hyderabad in collaboration with Physiology Department LUMHS Jamshoro and Diagnostic and Research lab Hyderabad. Materials &amp; Methods: Two hundred fifty (250) females between15-45 years with a history of PMS were selected for this study. Information was collected on marital status, vitamin D3 levels, PMS intensity, and BMI. The Chi-square test compared the vitamin D levels with BMI and PMS scores. Results: Mean age of the patients was 29.89±5.206 years. 64.8% of patients were married. 42.8% had normal weight and 40.8%were obese. 35.2% of patients had mild PMS scores and 36.4% had extreme PMS. 61.2% of patients had vitamin D lack with only 4.8% having adequate serum vitamin D levels. 22.8% of normal-weight patients had inadequate serum vitamin D levels. 35.6% of obese patients had vitamin insufficiency in their blood. The relationship between obesity and vitamin D levels was significant (P-value: 0.001). 18.8% of patients who had mild PMS scores had deficient serum vitamin D levels. The relationship between PMS scores and vitamin D levels was remarkable (P-value: 0.001). Practical implication The advantages of 25(OH) D supplementation/repletion on bone health are well known. Although there is a biological plausibility linking the status of vitamin D and obesity supported by basic and clinical research findings, basic research is necessary to know the molecular pathways involved in this association. Also this study will help the community to decrease the PMS symptoms by taking vitamin D supplements. Those females who take the vit D prior their PMS stage will be prevented from severe symptoms. Conclusion: We found a significant, inverse relationship between vitamin D levels and BMI, showing that losing weight through vitamin D and calcium-enriched diets may result in typical vitamin D levels, and so PMS may be treated. Keywords: Vitamin D (Vit D), Premenstrual Syndrome, body-mass index (BMI), obesity, women

A Systematic Review of Positional Plagiocephaly Prevention Methods for Patients in Development

Positional plagiocephaly is an asymmetrical skull deformation caused by various factors. Although it is not responsible for abnormal brain development in infants and is not related to the onset of neurophysiological problems, it is critical to prevent skull deformity to avoid aesthetic and functional consequences. The purpose of the study is to investigate the relevance of preventive procedures to the onset of positional plagiocephaly, such as the use of passive mattresses, which is primarily correlated with the need for newborns and infants to sleep and rest in proper posture. PubMed, Web of Science, Google Scholar, Scopus, Cochrane Library, and Embase were searched for papers that matched our topic, dating from January 2012 to 22 October 2022, with an English language restriction, using the following Boolean keywords: (“positional plagiocephaly” AND “prevention”). A total of 11 papers were included as relevant papers matching the purpose of our investigation. According to the research results, inadequate vitamin D and folic acid intake during pregnancy may increase the risk of skull deformation. Furthermore, babies should sleep on their backs and spend at least 30 min in tummy time. Using a passive sleep curve mattress has several advantages such as low cost, easy handling, no compliance system, and a marked improvement in head shape, allowing harmonious skull growth guided by normal brain expansion.

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

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

Vitamin D status in chimpanzees in human care: a Europe wide study

While vitamin D deficiency is a public health concern in humans, comparatively little is known about vitamin D levels in non-human primates. Vitamin D plays a crucial role in overall health and its deficiency is associated with a range of disorders, including cardiovascular disease, which is a leading cause of death in great apes. Serum samples (n = 245) from chimpanzees (Pan troglodytes) housed at 32 European zoos were measured for 25-hydroxyvitamin D2, 25-hydroxyvitamin D3 and total 25-hydroxyvitamin D (25-OHD) using liquid chromatography and tandem mass spectrometry. Of these samples, 33.1% indicated inadequate vitamin D status, using the human reference interval (25-OHD < 50 nmol/L). The season of the year, health status of the animal, and the provision of daily outdoor access had a significant effect on vitamin D status. This is the first large-scale study on vitamin D status of non-human great apes in human care. Inadequate 25-OHD serum concentrations are widespread in the chimpanzee population in Europe and could be a risk factor for the development of idiopathic myocardial fibrosis, a major cause of mortality in this species, as well as other diseases. A review of husbandry and nutrition practices is recommended to ensure optimal vitamin D supply for these endangered animals.

The Food and Nutrition Security for Manitoba Youth (FANS) study: rationale, methods, dietary intakes and body mass index

BackgroundGood nutrition and access to healthy foods are essential for child growth and development. However, there are concerns that Canadian children do not have a healthy diet, which may be related to dietary choices as well as lack of access to healthy foods. The FANS (Food and Nutrition Security for Children and Youth) study examined the nutrition and food security status of youth in the province of Manitoba, Canada. This paper describes methods, dietary intakes, and body mass index for the FANS study. MethodsThis cross-sectional study included 1587 Manitoba grade nine students who completed a self-administered web-based survey. Data was collected on demographic characteristics, dietary intake (24-h recall), food behaviors, food security, and self-report health indicators. Dietary data was compared to national dietary guidelines (Dietary Reference Intakes and Canada’s Food Guide). Mean and median nutrient and food group intakes were calculated with corresponding measures of variability. Chi-square tests compared percentage of respondents not meeting key nutrients and food groups. Significant differences in percentage of total servings for each food group were determined by a Kruskal–Wallis test, and differences between different caloric groups were assessed using Dunn’s test for post-hoc comparisons. ResultsHalf of study respondents were female (50.5%). Median energy intake was higher in males (2281 kcal) compared with females (1662 kcal), with macronutrient distribution of 52%, 16%, and 32% for carbohydrates, protein, and fats respectively. Most participants consumed inadequate fibre (94%), vitamin D (90%), and calcium (73%), while median sodium intakes exceeded recommendations for males but not females. A majority of participants did not meet Health Canada’s recommendations for food group servings: Vegetables and Fruit (93%), Milk and Alternatives (74%), Meat and Alternatives (57%) and Grain Products (43%). Other Foods, including sugar sweetened beverages and juice, were consumed by most participants. Higher energy consumers had a greater proportion of food servings coming from Other Foods. 72.1% of students were classified as having a healthy weight and 25% were classified as overweight or obese.ConclusionPoor dietary intakes and body mass index values indicate an urgent need for policy and program strategies to support healthy eating habits and food awareness in Manitoba youth.

The effect of antiretroviral therapy initiation on vitamin D levels and four oral diseases among Kenyan children and adolescents living with HIV.

ObjectivesThe impact of antiretroviral treatment (ART) on the occurrence of oral diseases among children and adolescents living with HIV (CALHIV) is poorly understood. The aim of this study was to determine the effect of ART timing on vitamin D levels and the prevalence of four oral diseases (dry mouth, dental caries, enamel hypoplasia, and non-herpes oral ulcer) among Kenyan CALHIV from two pediatric HIV cohorts.MethodsThis nested cross-sectional study was conducted at the Kenyatta National Hospital, Nairobi, Kenya. CALHIV, 51 with early-ART initiated at <12 months of age and 27 with late-ART initiated between 18 months-12 years of age, were included. Demographics, HIV diagnosis, baseline CD4 and HIV RNA viral load data were extracted from the primary study databases. Community Oral Health Officers performed oral health examinations following standardized training.ResultsAmong 78 CALHIV in the study, median age at the time of the oral examination was 11.4 years old and median ART duration at the time of oral examination was 11 years (IQR: 10.1, 13.4). Mean serum vitamin D level was significantly higher among the early-ART group than the late-ART group (29.5 versus 22.4 ng/mL, p = 0.0002). Children who received early-ART had a 70% reduction in risk of inadequate vitamin D level (<20 ng/mL), compared to those who received late-ART (p = 0.02). Although both groups had similar prevalence of oral diseases overall (early-ART 82.4%; late-ART 85.2%; p = 0.2), there was a trend for higher prevalence of dry mouth (p = 0.1) and dental caries (p = 0.1) in the early versus late ART groups. The prevalence of the four oral diseases was not associated with vitamin D levels (p = 0.583).ConclusionsAfter >10 years of ART, CALHIV with early-ART initiation had higher serum vitamin D levels compared to the late-ART group. The four oral diseases were not significantly associated with timing of ART initiation or serum vitamin D concentrations in this cohort. There was a trend for higher prevalence of dry mouth and dental caries in the early-ART group, probably as side-effects of ART.

The Correlation between Vitamin D Intake and Quality of Life in the 17-35 Age Group

Vitamin D testing increased significantly during the Coronavirus Disease-19 (COVID-19) pandemics due to its role in regulating the immune system. Therefore, vitamin D deficiency is associated with susceptibility to various diseases that may affect the quality of life regarding physical health, psychological well-being, social and environmental aspects. The study aimed to determine whether there is an association between vitamin D intake and quality of life in the 17 to 35-year-old age group. A cross-sectional study was conducted from April to November 2021. The sample consisted of students from the School of Medicine and Health Sciences Atma Jaya Catholic University of Indonesia, and their relatives in the same age group, who were selected using a consecutive sampling. Vitamin D intake was measured using Vitamin D Estimation Only - Food Frequency Questionnaire (VIDEO-FFQ). At the same time, the quality of life was assessed using the World Health Organization Quality of Life (WHOQOL)-BREF questionnaire. Data analysis was performed using the Chi-square test. Of the 127 respondents, the results showed that most of respondents had inadequate vitamin D intake and good quality of life (68.50%;59.10%). The highest mean of the four quality of life domains belongs to the environmental domain (3.94) with a standard deviation (SD) of ± 0.83. Data analysis showed no significant correlation between vitamin D intake and quality of life (p&gt;0.05). The conclusion shows that there was no correlation between vitamin D intake and quality of life in the 17–35-year age group.

The Magnitude of Hidden Hunger and Cognitive Deficits among Children Living in Orphanages in Kumasi, Ghana

This study assessed the magnitude of hidden hunger (micronutrient deficiencies) and cognitive deficits of 130 school-aged children (6–13 years old) living in three selected orphanages in Kumasi, Ghana. Sociodemographic data assessment, anthropometric assessment (BMI for age and height for age), dietary assessment (3-day repeated 24-hour dietary recall), urinary iodine level assessment, and cognitive performance assessment (Raven’s Coloured Progressive Matrices) were performed. Boys formed 50.8% of the study population, while girls formed 49.2%. The median age of participants was 10.50 years. About 12.3%, 7%, and 10.0% of participants were stunted, thin, and overweight/obese, respectively. The prevalence of mild iodine deficiency (i.e., 50–99 μg/L) was 16.2%. Iodine deficiency was significantly higher (23.6%) in participants who had lived for at least 7 years in the orphanage compared to those who had lived less than 7 years (10.7%) ( p = 0.047 ). About 17% of the participants performed poorly (&lt;50%) on the cognition test. Mean cognition test scores were significantly different among the orphanages ( p = 0.027 ). The majority of participants, 89.2%, 54.6%, 76.9%, and 77.7%, had adequate intake of iron, zinc, vitamin C, and folate, respectively, whereas intake of vitamins A and B12 was inadequate for the majority of participants (90.8% and 50.8%, respectively). There was no significant correlation between micronutrient intake and cognitive performance. However, mean cognition test scores were significantly different between participants with adequate and inadequate iron and vitamin A intake ( p = 0.007 and p &lt; 0.001 , respectively). The findings of this study warrant a closer look at nutritional intakes in orphanages to improve hidden hunger and cognitive performance.

Osteoporosis — Are we aware?

The number of women with osteoporosis, a condition characterized with reduced bone mass and the disruption of bone architecture is on the rise in India. Deficiency of calcium and low vitamin D levels are important risk factors for the development of osteoporosis. Low sun exposure, inadequate dietary vitamin D intake, lack of food fortification with vitamin D, pigmented skin, environmental pollution, and traditional dress code further aggravate the condition. Age, gender (female), Asian origin, low BMI also act as a threat for the disorder. It is estimated that maximum bone loss occurs in women during perimenopause and menopause, indicating the prevalence of osteoporosis to increase with advancing age, resulting in a geriatric female population prone to fractures and related morbidities. For the proper management of any disorder, it is imperative that the patient should have an understanding of the disease, which begins with awareness. However, owing to societal pressures the elderly Indian female population rarely prioritizes osteoporosis as a major health issue. In the last few decades the life expectancy has increased giving rise to a larger geriatric population. It is necessary to ensure proper health status for this populace, in order to improve their quality of life which will uplift the national health benchmark. The key to effective and compliant therapy is adequate knowledge of the disorder among the target subjects. The current review highlights the prevalence, etiology and awareness of osteoporosis among Indian women. Keywords: Osteoporosis, Indian women, Awareness

Perspective: School Meal Programs Require Higher Vitamin D Fortification Levels in Milk Products and Plant-Based Alternatives—Evidence from the National Health and Nutrition Examination Surveys (NHANES 2001–2018)

Poor vitamin D status impairs bone growth and immune defense in school-aged children and adolescents, particularly in minorities. Vitamin D insufficiency/deficiency increases the risk of acute viral respiratory infection, underscoring the need for adequate vitamin D intakes during school sessions when viral exposure may be greatest. We studied available vitamin D-related survey data and published findings based on NHANES (2001-2018) to assess the dependency of vitamin D status {25-hydroxyvitamin D [25(OH)D]; in nmol/L} on vitamin D intake (μg/d) in elementary school-aged children (4-8 y), middle school children (9-13 y), and high school adolescents (14-18 y). We sought evidence supporting the need for school programs to facilitate vitamin D adequacy. Usual vitamin D intakes from food and beverages by children/adolescents (NHANES 2015-2018) examined at the 50th percentile intake by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic) showed all age groups consumed less than half of the Estimated Average Requirement (EAR) for vitamin D (10μg/d), independent of race/ethnicity. NHANES (2001-2010) analyses show evidence of lower vitamin D status in school-aged children that is linked to lower intakes of fortified milk varying over race/ethnicity and age. Adolescents had lower vitamin D status and milk intake than younger children. A total of 22-44% of vitamin D intakes occurred away from home, with larger percentages of total intakes at breakfast and lunch, at times consistent with school meals. Ever-present inadequate vitamin D intakes with a large percentage consumed away from home together with well-established benefits to growth, bone, and immune defense from enriched vitamin D-fortified milk in school intervention trials provide strong justification to require enriched vitamin D-fortified foods in school meals. An easy to implement plan for improving vitamin D intakes is possible through the FDA's amendment allowing higher vitamin D fortification levels of dairy and plant-based milk alternatives that could increase vitamin D intakes beyond the EAR with just 2 daily servings.