Micronutrient Deficiencies Research Articles

Investigating the potential association between micronutrient levels and non-dipper hypertension patterns in the elderly population: A retrospective analysis.

The goal is to provide foundational data that could spearhead more extensive, prospective research into understanding the influences of micronutrient levels on the nocturnal patterns of hypertension, possibly aiding in identifying potential therapeutic strategies to reduce cardiovascular risk in this demographic. The research employed a retrospective design to analyze the micronutrient levels, including ferritin, folic acid, vitamin B12, and vitamin D, in a limited sample size from a single hospital. However, it is worth noting that the study did not scrutinize other potentially relevant micronutrients and biomarkers and lacked information on potential confounding factors such as lifestyle and dietary habits, physical activity levels, and specific details on antihypertensive medications used. The preliminary findings highlight a significant difference in ferritin levels between dipper and non-dipper groups, indicating a potential role in the development of non-dipper hypertension. Surprisingly, no notable difference was observed in vitamin D levels between the groups. The study underscores the increasing prevalence of hypertension and micronutrient deficiencies as age progresses. Despite its limitations, including limited sample size and potential influences from unaccounted variables, the study hints at a potential relationship between micronutrient levels and non-dipper hypertension. It emphasizes the necessity for larger scale, prospective research to delve deeper into the nature of this relationship, potentially fostering new therapeutic approaches in cardiovascular risk management within the elderly population.

Micronutrient intake inadequacies in Northwest Ethiopian children aged 6–23 months

The early stages of childhood are a crucial period of life for health, with inadequate nutrition impacting physical growth, cognitive development, and the immune system. A considerable proportion of children are affected by micronutrient intake inadequacy and deficiency across the globe. Evidence on micronutrient intake among children aged 6–23 months is limited in Northwest Ethiopia, where there is a divergence between production and dietary consumption practices compared to other regions of the country. This study aimed to determine micronutrient inadequacy and associated factors among children aged 6–23 months. From February 1 to February 18, 2023, 435 children aged 6–23 months participated in a community-based cross-sectional study in the North Mecha District of the Amhara Region, Northwest Ethiopia. The study participants were selected using a multistage sampling technique. A multiphasic interactive 24-h dietary recall was used to collect dietary intake data via an interviewer-administered questionnaire. The interviews were conducted with the mothers of the selected children. Nutrient values for the selected 12 micronutrients were calculated using the NutriSurvey 2007 software and food composition tables from Ethiopia, Tanzania, and Kenya. SPSS version 25 was used for the remaining parts of the analysis. The Nutrient Adequacy Ratio and Mean Adequacy Ratio were calculated to evaluate the nutrient intakes. To identify the factors associated with overall micronutrient intake inadequacy, a binary logistic regression analysis was performed, with statistical significance determined at a p-value < 0.05. The overall prevalence of micronutrient intake inadequacy was 64.7% (95% CI 59.9, 69.2). The odds of inadequacy of micronutrient intake were 2.8 times higher among children aged 6–8 months than children aged 9–23 months (AOR = 2.80, 95% CI 1.71, 4.59). Children with paternal education unable to read and write and primary school incomplete were 3.1 (AOR = 3.12, 95% CI 1.26, 7.70) and 2.4 (AOR = 2.40, 95% CI 1.01, 5.73) times more likely to have micronutrient intake inadequacy, respectively, compared to children with paternal education of primary school completed and above. The likelihood of micronutrient intake inadequacy was 1.8 times higher among children from mothers who had an unfavorable nutrition-related attitude than those from mothers who had a favorable attitude (AOR = 1.76, 95% CI 1.02, 3.05). Inadequate intake of micronutrients was shown to be highly prevalent among children aged 6–23 months. Child age, paternal education, and maternal nutrition-related attitude were significantly associated with micronutrient intake inadequacy. Integrating community-guided nutrition interventions targeting nutrition-related knowledge and attitudes of parents is critical in addressing the inadequate micronutrient intake of children in the study community, where production is not a major problem.

Adesão ao uso da estratégia NutriSUS para fortificação alimentar infantil em municípios de Goiás

Introduction: The high demand for nutrients in children under five years of age, added to low nutritious diets, makes them vulnerable to micronutrient deficiencies. The NutriSUS Strategy, launched as part of the School Health Program (PSE) in 2014, aims to combat these deficiencies through the distribution of micronutrient sachets. The effectiveness of this strategy in Goiás, considering the weaknesses in the municipalities, needs to be evaluated. The objective of this study was to verify adherence to the NutriSUS Strategy in municipalities in the state of Goiás and the list of sachets used by agreed and added day care centers. Methods: A retrospective observational study analyzed data on micronutrient supplementation provided by the NutriSUS Strategy in the state of Goiás, between 2017 and 2019. The database available on the Ministry of Health website was used to identify adherence and coverage of the program in 10 regional health departments. The inclusion criteria were municipalities that implemented the strategy during the period studied, while those that did not adhere or did not show interest were excluded. The analysis was performed using absolute and relative frequencies in the EPI Info 7.2.6.0 program. Results: The NutriSUS Strategy was implemented in 35 (14.23%) of the total municipalities (n=246). Micronutrient supplementation targets were constant throughout the period from 2017 to 2019, with some cities, such as Araguapaz, Britânia, and Santa Helena de Goiás, exceeding their supplementation targets in some of the periods, while others, such as Aragarças, Hidrolândia, Piracanjuba, São Luís de Montes Belos, and Buriti Alegre, did not reach the expected targets. The analysis, by semester of supplementation coverage in daycare centers, showed significant fluctuations: a drop in 2017 from 45.44% to 32.60% from the first to the second semester. In 2018, the percentage was 34.43% in the first half of the year, but there was a significant increase to 52.37% in the second half of the year. In 2019, coverage rose to an average of 61.63% in the first half, followed by a drop to 35.74% in the second half. The data also revealed variations in standard deviation, reflecting fluctuations in program adherence. Conclusion: The NutriSUS Strategy showed a variable implementation in the municipalities of Goiás in the period studied, with fluctuations in supplementation coverage over time. The analysis highlighted both success in some locations and difficulties in others, highlighting the importance of continuously monitoring and adjusting supplementation strategies to ensure that all counties adequately benefit children from micronutrient supplementation.

Integrating Antixenosis Against Helicoverpa armigera (Lepidoptera: Noctuidae) and Micronutrition in Kabuli Chickpea (Cicer arietinum L.) Genotypes

ABSTRACTThe leguminous chickpea is a good source of protein, but its yield potential is frequently constrained by biotic stresses, primarily Helicoverpa armigera, a major havoc for cultivation of the crop. To develop host plant resistance for minimizing the losses due to the pod borer, five kabuli parents with desired traits for pod borer tolerance were crossed in diallel mating design to produce 10 crosses which were analysed for traits related to pod borer and nutrition. Based on correlation studies, trichome density was found positively correlated with phenol content, but both the traits were negatively associated with number of damaged seeds. Therefore, the tolerant genotypes were identified on the basis of phenol content, trichome density, number of damaged seeds and field rating. Among parents ICC 12197 was found superior in terms of yield and borer tolerance features with an intermediate pest resistance susceptible rating in addition to higher Fe content. However, significant sca effects for higher phenol content and seed yield in ICC 11764 × ICC 14190 were recorded with reduced number of damaged seeds in addition to higher Fe and Zn content. It was observed that the specific combination involved good and poor combiners for each trait. The same cross also showed significant standard heterosis in desirable direction for phenol content, trichome density, number of damaged seeds and seed yield. Additionally, the ratio of σ2 GCA to σ2 SCA revealed nonadditive gene action in controlling the expression of phenol content, trichome density, number of damaged seeds and Fe and Zn content. Thus, breeder may focus efforts on desirable cross utilizing selection in further segregating generations for higher phenol content, trichome density and Fe and Zn content in addition to yield‐related traits while lesser number of damaged seeds per plant to concentrate for development of pod borer resilient high yielding kabuli genotypes to combat micronutrient deficiency.

Evaluation of serum vitamin B12 and D, iron, ferritin, folate, calcium, phosphorus and magnesium levels in children in palliative care clinic: a single-center cross-sectional study

BackgroundPediatric palliative care (PPC) patients are at an elevated risk of malnutrition. Nutritional inadequacy can also cause micronutrient deficiencies. These factors can lead to weight loss, stunted growth, and poor quality of life. Despite the prevalence of these issues, limited research exists in the micronutrient status of PPC patients. The purpose of this study was to determine the vitamin B12 and D, iron, ferritin, folate, calcium, phosphorus, and magnesium levels of PPC patients to contribute to a better understanding of their micronutrient needs as well as the appropriate management of diet and treatment approaches.MethodsThis was a single-center observational cross-sectional retrospective study. This study evaluated the levels of vitamin B12, 25-hydroxyvitamin D, iron, ferritin, folate, calcium, phosphorus, and magnesium in PPC patients. The patients were classified according to the Chronic Complex Conditions (CCC) v2 and then compared.ResultsA total of 3,144 micronutrient data points were collected from 822 hospitalizations of 364 patients. At least one micronutrient deficiency was identified in 96.9% of the patients. The most prevalent deficiencies were observed for iron, calcium, and phosphate. In addition, 25-hydroxyvitamin D deficiency was observed in one-third of patients. Calcium, magnesium, phosphorus, folate, and 25-hydroxyvitamin D were negatively correlated with age.ConclusionThe results of this study indicate that micronutrient deficiencies are highly prevalent in PPC patients. These findings have the potential to contribute to improvements in the nutritional and therapeutic management of patients.

Biofortification in garden peas through multi-micronutrient formulations

Soil micronutrient deficiencies lead to crops with low essential element concentrations, affecting human health through micronutrient malnutrition. Effective practices, like foliar nutrient application, improve crop quality and reduce malnutrition. The garden pea (Pisum sativum L. var. hortense) is cultivated worldwide for its nutritional value and such nutrient-rich crops, through agronomic biofortification, offer a sustainable solution to global health issues by addressing micronutrient deficiencies. Four liquid micronutrient formulations [Treatment 1 (T1), Treatment 2 (T2), Treatment 3 (T3), and Treatment 4 (T4)] were prepared using either water or vermiwash as a carrier, with variations that included the presence or absence of plant growth regulators (GA3 + NAA)] and evaluated along with commercially available formulations [Arka Vegetable Special (T5) and ProKissan (T6)]. Micronutrient formulations, particularly T3, demonstrated notable effects on various parameters, including plant height, biomass, root characteristics, pod weight, and micronutrient contents in seeds of garden pea var. Kashi Nandini. T3 significantly outperformed other formulations in promoting plant growth, resulting in higher values for plant height, biomass, branches per plant, nodule mass, root biomass, surface area, volume, and density. Yield parameters such as pod length, weight, number of pods, and seeds per pod were also positively influenced by micronutrient treatments, with T3 leading to the highest overall yield, with a 24.09 % increase per plant and a 13.39 % increase per hectare compared to the control. Additionally, foliar application of micronutrients increased the concentration of copper, zinc, iron, and manganese in seeds, positively impacting seed quality. Quality parameters, including total soluble solids, protein, total phenol, and total flavonoid contents, were significantly improved by micronutrient treatments, with T3 showing the most favorable outcomes. Texture analysis indicated that peas treated with T3 had lower firmness values, suggesting maintained tenderness and sweetness. Correlation analysis revealed strong positive associations between various growth parameters, yield traits, and micronutrient contents. Overall, foliar micronutrient application proved to be a valuable biofortification strategy for enhancing the performance and quality of garden peas.

Nutrient-Dense African Indigenous Vegetables and Grains in the FAO Food Composition Table for Western Africa (WAFCT) Identified Using Nutrient-Rich Food (NRF) Scores.

Nutrient profiling (NP) models that assess nutrient density of foods can help remedy micronutrient deficiencies. We used NP methods to identify the most nutrient-rich foods in the 2019 FAO/INFOODS Western Africa Food Composition Table (WAFCT). The WAFCT had complete data for 909 foods. Three versions of the well-established Nutrient-Rich Food (NRF) model were used: (1) the original NRF9.3 based on 9 micronutrients (protein, fiber, calcium, iron, potassium, magnesium, vitamin A, vitamin C, and vitamin D); (2) a new NRF6.3 based on 6 priority micronutrients (iron, zinc, calcium, folate, vitamin A, vitamin B12); and (3) NRF 15.3, based on 15 nutrients to encourage (NRF6.3 nutrients + vitamin D, vitamin E, vitamin C, vitamin B1, vitamin B2, vitamin B3, vitamin B6, copper, and magnesium). Data analyses used one-way ANOVAs and independent t-tests, with significance at α = 0.05. Animal-source foods were rated higher by NRF6.3 priority micronutrient and NRF15.3 NP models than by the NRF9.3 model. African indigenous vegetables had higher protein content and higher nutrient density compared to non-indigenous vegetables, and African indigenous grains had higher nutrient density compared to non-indigenous grains. Though animal-source foods received some of the highest scores, NP models adapted to the West African context showed that African indigenous vegetables and grains were also nutrient rich. Indigenous foods could be important sources of priority micronutrients for the region.

Strategies and bibliometric analysis of legumes biofortification to address malnutrition.

Biofortification of legumes using diverse techniques such as plant breeding, agronomic practices, genetic modification, and nano-technological approaches presents a sustainable strategy to address micronutrient deficiencies of underprivileged populations. The widespread issue of chronic malnutrition, commonly referred to as "hidden hunger," arises from the consumption of poor-quality food, leading to various health and cognitive impairments. Biofortified food crops have been a sustainable solution to address micronutrient deficiencies. This review highlights multiple biofortification techniques, such as plant breeding, agronomic practices, genetic modification, and nano-technological approaches, aimed at enhancing the nutrient content of commonly consumed crops. Emphasizing the biofortification of legumes, this review employs bibliometric analysis to examine research trends from 2000 to 2023. It identifies key authors, influential journals, contributing countries, publication trends, and prevalent keywords in this field. The review highlights the progress in developing biofortified crops and their potential to improve global nutrition and help underprivileged populations.

Envirotyping helps in better understanding the root cause of success and limitations of rainfed production systems

The current diagnostic agronomy study of the Bankura region of West Bengal, India, examined the variations in crop yields through a socio-ecological analysis of multiple production system components. Envirotyping for root cause analysis was employed to delve into the variables that affect the performance of rainfed production systems. Mother Earth, man, machine, management, and materials (5Ms concept) were the five indicators under which the variables were grouped. Findings demonstrated the fragility of the region’s soils due to its undulating terrain, unpredictable rainfall patterns, and frequent drought scenarios. The LULC’s NDVI showed that the agricultural area is about 60% and 43% of the total geographical area in the Hirbandh and Ranibandh blocks, respectively. Soils are acidic and diagnosed with deficiency of both macro and micronutrients (phosphorous, sulfur, and boron) having poor water holding capacity (35 to 55 mm for a 50 cm soil depth). The sand and soil organic carbon contents ranged between 43.04%–82.32% and 0.17%–1.01%, respectively with a low bacterial population. These factors are the root cause for low cropping intensity (106%) and low paddy productivity (3,021 kg/ha). Overall, the study contributes to designing and scaling-up of sustainable landscape management practices that could ensure higher cropping intensity and system productivity in similar agro-ecologies with limited evidence.

Soil zinc surveillance frameworks can inform human nutrition studies: opportunities in India

Mineral micronutrient deficiencies are widespread in global food systems and can affect plant growth, crop quality, and human and livestock health. The mapping of soils and soil properties linked to micronutrient supply in food systems is now enabling us to better understand the linkages between soil health and function and its relationship with food quality and human health. Zinc (Zn) deficiencies in Indian soils are of particular concern in the context of crop yields and food quality. This current review aims to understand the data landscapes on soil Zn and related soil properties in India, with a particular focus on three states: Uttar Pradesh (UP), Bihar, and Odisha. The scope of the review is to identify and describe data sets from national and state-wide programmes and research experiments in which soil Zn has been reported, which could be used to provide a framework for integrated surveys and would combine wider agriculture, food systems, nutrition, and public health sectors. The largest data set on soil Zn was collected under a soil health management (SHM) programme, during which the Indian government analysed more than 30 million soil samples for Zn concentration (mg/kg) from 2015 to 2019. This study showed that 39% of Indian soils are considered Zn deficient for crop production (i.e., based on a threshold of &amp;lt;0.6 mg/kg); soil Zn deficiency varied from 2% to 67% across different Indian states. From this survey, soil Zn deficiency was 29%, 67%, and 48% in UP, Bihar, and Odisha, respectively. Individual data points are available for re-use at the Government of India soil health card website (https://www.soilhealth.dac.gov.in/). In addition, the All India Coordinated Research Project on Micro and Secondary Nutrients and Pollutant Elements in Soils and Plants (AICRP-MSPE) programme under the Indian Council of Agricultural Research (ICAR) analysed &amp;gt;240,000 soil samples from 2012 to 2018 from 28 states of India and reported ~38% soil Zn deficiency in the Indian soils. There is no programme in India that currently maps micronutrients in soil and crops together using “GeoNutrition” approaches recently reported in two countries in Africa, Ethiopia, and Malawi. Future co-ordinated soil and crop micronutrient mapping in India can help us to understand better the movement of Zn (and other micronutrients) in food systems and to inform strategies to improve the Zn status in the soil, e.g., the use of Zn fertilisers for yield and agronomic biofortification, and in the edible tissues of crops, e.g., through genetic biofortification.

Consumer Perception and Willingness to Pay for Vitamin A Fortified Garri in Ibadan North Local Government Area of Oyo State, Nigeria

Vitamin A deficiency is one of the major micronutrient deficiencies contributing to child mortality globally. This study assessed consumers’ perception and willingness to pay (WTP) for vitamin A fortified garri in Ibadan North Local Government Area, Ibadan, Oyo State, Nigeria. A total of 170 respondents were interviewed. Socioeconomic characteristics of respondents, perception of and factors that influence their willingness to pay for fortified vitamin A garri and the mean willingness to pay (MWTP) were all analysed. The study revealed that most of the respondents were aware of vitamin A fortified garri but they hardly purchased it. The computed MWTP for vitamin A fortified garri was ₦190 ($0.35) indicating a positive mean willingness to pay. The result of the logistic regression analysis showed that out of the twelve variables examined, four were statistically significant at various levels. Specifically, sex, ethnicity and marital status were all negatively significant at 10%, 5% and 10% respectively while health status was positively significant at 1%. It was concluded that a higher proportion of the respondents perceived vitamin A fortified garri to be healthier and more nutritious and were also willing to pay it. The paper recommended that efforts should be geared towards encouraging production and consumption of vitamin A fortified garri by creating more markets for the product.

HUMAN HEALTH AND IMPORTANCE OF NUTRITION

In addition to maintaining normal physical processes, nutrition also promotes growth and development and lowers the risk of chronic illnesses. It is necessary for optimum health and vigour that we get a diet rich in essential nutrients and well-balanced. Nutritious food can enhance physical and mental potential. Macro-nutrients and micro-nutrients are the two main categories of nutrients found in a diet. Diet is an important contributor to human health, and public health bodies are issuing guidelines aimed at favouring healthy food choices. Low food intake and infections are the immediate causes of malnutrition. Many countries struggle with malnutrition or caloric deficits, while others encounter difficulties with caloric overconsumption and micronutrient deficiencies. A multitude of factors contribute to this global problem. Considering the health challenges facing our world population, the need is clear for continually improving recommendations and strategies to promote human health. The purpose of this study was to provide information on the functions of different nutrients, the conditions caused by their deficiency, the components of a healthy diet, and the complications of different types of malnutrition. A lot of research is being done, and new findings are published every day to increase our knowledge about food and nutrition and to find ways to apply this knowledge in choosing the right foods to eat so that our body is well nourished and healthy. For the maintenance of health and growth and to develop greater resistance against infections, one must consume balanced food that contains all the nutrients in the correct proportion.

Effects of dietary intake on cognitive skills of physically challenged children.

Objective: To determine how a child’s dietary intake affected their growth and cognitive skills when physically challenged in Faisalabad City, Pakistan. Study Design: Cross Sectional Study. Setting: Tanzeem ul Lisan, the Government Special Education Center, Al Faisal Markaz e Nabina, and Government National Special Education Center. Period: January 2023 to December 2023. Method: One hundred special children were selected randomly, face-to-face interviews were conducted, and collected data were analysed using Statistical Package for Social Sciences (SPSS). Results: Indicated that male participants aged 10 to 15 years were prominent, whereas 20% each had ADHD, autism, blindness, and deafness. Many participants maintain an active or very active lifestyle despite a significant portion not engaging in regular exercise. Preference for home-cooked meals, moderate consumption of dietary supplements, variation in water intake, and frequency of eating out were found. Respondents' Common issues include difficulty making decisions, remembering personal information, and learning new content. Based on the results, cognitive training programs are recommended to increase awareness among children and their families. Conclusion: In the nutshell, results concluded that dietary intake of special children were associated with physical growth and cognitive skills. Majority of the children were not following normal dietary pattern and the chances of micronutrient deficiencies was higher. Results showed that socioeconomic conditions, type of disorder/ disability, low education of parents, awareness about good nutrition were significantly associated with healthy eating habits and physical growth of special children.

Productivity and Profitability of Diversified Legume-based Cropping Systems in the Indo-gangetic Plains of India as Influenced by Nutrient Management

Background: The continuing adoption of the rice-wheat cropping system (RWCS) and indiscriminate use of inorganic fertiliser has led to a decrease in soil fertility, an increase in multiple micronutrient deficiencies, a decrease in the water table and excessive greenhouse gas emissions, especially in the Indo Gangetic Plains. Adoption of crop diversification strategies, including legumes in cropping systems with integrated use of organic and inorganic nutrient sources, could be a viable option for achieving higher fodder tonnage and sustainable crop production in aforesaid ecologies. Methods: A field experiment was conducted during the kharif, rabi and summer seasons of 2018-19 and 2019-20 in a split-plot design comprising four cropping systems (CS) i.e., rice-wheat, rice-berseem, pearl millet-oats-moong bean and maize-cowpea-wheat in main plots; and four nutrient management (NM) practices i.e., 100% RDF (recommended dose of fertiliser), 100% RDF + cow urine (foliar spray), 100% RDF + PGPR (seed treatments) and 75% RDF + cow urine + PGPR were assigned in sub-plots with three replications of each treatment. Result: Investigations revealed that the significantly highest system productivity, net returns and higher nutrient availability were obtained under the rice-berseem cropping system with 100% RDF + PGPR treatment. The magnitude of increment in system productivity of the rice–berseem cropping system was 35.06, 57.87 and 87.29% over rice-wheat, maize-cowpea-wheat and pearl millet-oats-moong bean cropping system, respectively. The legume-based cropping system has strengthened and sustained crop productivity and profitability. The results of the present work confirmed that the adoption of legume-based crop diversification has significantly alleviated the crop yield of dairy-based farming systems.

407. MICRONUTRIENT INSUFFICIENCY AFTER SURGERY FOR OESOPHAGOGASTRIC NEOPLASMS: A PROSPECTIVE INTERVENTION STUDY CALLED THE VITAMIN STUDY

Abstract Background Oesophageal and gastric cancer have major impact on nutritional status and quality of life (QoL). Preoperative malnutrition is reported in 42–80%. However, studies investigating postoperative nutritional status are scarce and postoperative identification and treatment of micronutritional deficiencies are currently lacking in (inter-)national guidelines. The aim of this study is to identify micronutrient deficiencies after surgery for oesophagogastric neoplasms and target them by supplementation. Methods This is a recently closed multicenter trial in the Netherlands. Patients receive a tailormade multivitamin supplement which differs per group and a calcium supplement. Baseline measurements consist of blood withdrawal, faecal elastase-1 (FE-1) analysis, QoL questionnaires and dietary behaviour. After 6 (T=1), 12 (T=2) and 24 (T=3) months from baseline, measurements are repeated, and a supplement questionnaire is added. The primary objective is micronutrient deficiency (yes/no). Secondary objectives include occurrence and symptoms of exocrine pancreas insufficiency (EPI) and QoL. Results Inclusion spanned from December 2021 to December 2023. Preliminary results from 95 patients are available, whereby 68 patients underwent oesophagectomy and 27 gastrectomy. Of these, 55 patients received 6 months of supplementation (T=1). At T=0, 77.0% had at least one micronutrient deficiency. Identified deficiencies are shown in table 1. Deficiencies were more common in patients undergoing gastrectomy compared to those undergoing oesophagectomy (88.0% vs. 72.1%). Reduced FE-1 (&amp;lt;200 mg/kg) was found in 22.2% at baseline and 26.7% at T=1. 16.7% experienced EPI symptoms at baseline, which resolved at follow-up. Conclusion The most common micronutrient deficiencies decreased substantially after 6 months of supplementation. The follow-up extends until November 2024. Routine monitoring and supplementation could potentially be implemented in standard postoperative care for gastric and oesophageal cancer.

215. MALNUTRITION AND VITAMIN DEFICIENCIES AFTER ONCOLOGICAL GASTRIC OR ESOPHAGEAL RESECTION

Abstract Background Patients receiving oncological esophagectomy or gastrectomy are known to be at high risk for vitamin and micronutrient deficiency before, during and after surgery. However, there are no clear guidelines for these cancer patients regarding postoperative vitamin supplementation. preoperative malnutrition has been shown to be associated with a higher risk of perioperative complications. In addition, malnutrition has shown to be an independent risk factor for reduced survival in cancer patients and early cancer recurrence. Methods This meta-analysis examines the prevalence of postoperative malnutrition, vitamin, and micronutrient deficiencies in patients who underwent gastrectomy or esophagectomy. A computer-based literature search was performed in several different databases with the The following search terms were used: vitamin, nutrition, deficienc*, malnutrition, osteoporos*, sarcopenia, esophagectom*, oesophagectom*, gastrectomy*, gastric, surg*, resect*, operat*, removal, excision, neoplas*, tumor, tumour, cancer, malign*adenocarcinom* squamous cell carcinom*. Out of 1611 studies, 42 documented relevant information, but only 17 provided 95% confidence intervals. After excluding seven studies due to insufficient data, the meta-analysis included 947 patients from 10 studies. Results The studies recorded vitamin and micronutrient blood levels from 3 months to 10 years post-surgery. The analysis found significant deficiencies in 25-OH Vitamin D3, Vitamin B12, and Serum Calcium levels. Patients had significantly lower Vitamin D3 levels compared to the healthy population, with mean levels in the lower normal range or lower. Serum Calcium levels were also significantly lower than the mean levels of the healthy population but stayed within the normal range. Mean Serum B12 levels were significantly lower than mean B12 levels in the standard population, but standard deviations stayed within the normal range. Serum albumin levels showed no signs of deficiency when compared to the healthy population. Similarly, no deficiency was detected in serum ferritin levels. Other vitamins and micronutrients studies included serum phosphorous, Vitamin A and Vitamin E, but data was insufficient for metanalysis. Discussion The study underscores the need for further research and guidelines to address postoperative nutritional deficiencies in these patients. Particularly, patients often develop a deficiency in Vitamin D3 after surgery, despite supplementation. Vitamin D3 insufficiency may increase perioperative risk and is concerning given the reduced calcium levels and bone marrow density. In conclusion there is a clear need for Vitamin D3 supplementation, both postoperatively and during the perioperative period. The study supports previous data indicating a high prevalence of postoperative micronutrient deficiency in esophagectomy patients. Given the high risk of malnutrition, screening should be a routine part of follow-up care. More data, particularly regarding deficiencies and supplementation after esophagectomy, is necessary.

Impact on Incorporation of Purple Yam Flour (Dioscorea alata var. Purpurea) in Development of Multigrain Nutri-Bar

Consumption of wholesome and healthy diet is the most effective way to combat protein-energy malnutrition and micro-nutrient deficiencies. Present study was carried out to develop a nourishing and cost effective nutri-bar from selected locally available yams, cereals, legumes and oil seeds. Incorporation of purple yam flour at 20% (F1), 15% (F2) and 10% (F3) was performed with changing only the ratio of processed rice flour.The highest mean rank scores for all tested sensory properties of appearance, taste, texture, aroma and overall acceptability were observed in F1. Proximate composition of ash, protein, fat, crude fiber, carbohydrate and calorie contents of products ranged 1.26-1.37%, 11.20-12.02%, 6.57-7.29%, 2.69-3.58%, 73.28-73.41% and 397.57 - 406.81 kcal/100g respectively. The highest values for total sugar, crude-fibre, potassium, sodium, calcium were recorded in F1 with 20.06±0.12%, 3.55±0.08%, 3903±2.8mg/kg, 396.50±10.60mg/kg, 305.00±29.70mg/kg respectively. F1 had the highest TPC- 4.120 mg GAE/g, TFC- 0.179 mg QE/g, anthocyanin content- 0.225 mg/g and antioxidant potential through DPPH assay- 3.142 mg TE/g followed by F2 and F3. The anthocyanin content of three formulas showed significantly positive correlation with antioxidant capacity (r =1.00, p&lt;0.05). In conclusion, nutri-bars are the excellent source of nutrients supplements especially for undernourished population.

Preoperative Micronutrient Repletion Strategies in Metabolic and Bariatric Surgery: A Systematic Review

BackgroundEvidence is lacking to inform how micronutrient deficiencies should be prevented and treated before metabolic-bariatric surgery to optimize patient outcomes. ObjectiveThis systematic review aimed to examine the effect of preoperative repletion strategies for micronutrient deficiencies on micronutrient biochemistry, quality of life, and complication rates among candidates for metabolic and bariatric surgery compared with usual care, alternate strategies, or no treatment. MethodsPubMed, Embase, CINAHL, and CENTRAL was searched in April 2024. A grey literature search was updated in April 2024 via Google search. Eligible observational and interventional studies were those that provided micronutrient repletion before the surgery and measured micronutrient status pre- and/or postsurgery. Studies with participants who were pregnant, lactating, or elected jejunocolic bypass, jejunoileal bypass, vertical banded gastroplasty, and biliopancreatic diversion were excluded. Risk of bias was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Findings were narratively synthesized and the Grading of Recommendation, Assessment, Development and Evaluations was adopted when applicable. Twenty studies (n = 27 groups) were included (n = 15 observational; n = 5 interventional). ResultsStrategies targeted vitamins A, D, E, B6, B12, C, thiamin, folate, calcium, iron, selenium, and zinc, including chronic dosing of oral supplements and multivitamins (n = 21), megadoses of oral supplements (n = 1), intramuscular injection (n = 1), intravenous infusion (n = 1), and a mix of injection and oral supplements (n = 3). Preoperative repletion strategies varied in efficacy. Chronic dosing of oral supplements increased vitamin D levels (n = 4 interventional studies; Grading of Recommendation, Assessment, Development and Evaluations rating: moderate). Multivitamins did not improve vitamin B12 status but improved status of vitamin B6, vitamin C, and folate. Iron infusion (n = 1) increased ferritin levels, despite small sample size and low adherence rate, whereas oral iron supplementation resulted in unchanged (n = 4) or decreased (n = 1) ferritin levels. ConclusionsProactive and personalized micronutrient repletion schedules may decrease the risk of preoperative and early postoperative deficiency.

Prevalence and socio-demographic factors associated with double and triple burden of malnutrition among mother-child pairs in India: Findings from a nationally representative survey (NFHS-5)

IntroductionImproper consumption of food leads to various forms of malnutrition such as undernutrition, overnutrition and micronutrient deficiency. The coexistence of various malnutrition forms in the same household is a public health concern in developing countries. Very little research has been done on exploring the burden and risk factors associated with double (DBM) and triple burden of malnutrition (TBM). MethodsSecondary analysis was done using data from India's National Family Health Survey-5 (NFHS-5), 2019-21. Mothers and under-five children were paired at the household level as a unit of analysis. DBM and TBM were interpreted from children's height-for-age, weight-for-height, weight-for-age and anaemia status and mothers' body-mass-index. Stratification and clustering in the sample design were accounted for during the analysis in STATA v14.2. DBM and TBM were summarized as weighted proportions with 95 % confidence interval (CI) and the risk factors associated were reported as adjusted odds ratio (aOR) with 95%CI using mixed effects logistic regression. ResultsWe included 167,380 mother-child pairs for analysis. In India, the prevalence of DBM was 7.7 % (95 % CI: 7.5–7.9 %) and TBM was 5.1 % (5.0–5.3 %) at the household level among mother-child dyads. Mothers' age, age at first birth, educational levels, current breastfeeding habits, mode of delivery, child's age, gender, twin birth, birth weight, geographical region, residence, caste and religion, and wealth index were associated with both DBM and TBM. ConclusionBoth DBM and TBM are public health concerns in India. Thus, scaling-up of health intervention, effective implementation of nutritional programmes and life-course approach are needed to control malnutrition.

Using Mine Tailings as a Soil Improver to Reduce Micronutrient Deficiencies in Wheat Crops, Western Morocco

Using Mine Tailings as a Soil Improver to Reduce Micronutrient Deficiencies in Wheat Crops, Western Morocco