Micronutrient Status In Children Research Articles

Changing clinical characteristics of pediatric inpatients with pneumonia during COVID-19 pandamic: a retrospective study

BackgroundThe COVID-19 pandemic have impacts on the prevalence of other pathogens and people’s social lifestyle. This study aimed to compare the pathogen, allergen and micronutrient characteristics of pediatric inpatients with pneumonia prior to and during the COVID-19 pandemic in a large tertiary hospital in Shanghai, China.MethodsPatients with pneumonia admitted to the Department of Pediatric Pulmonology of Xinhua Hospital between March-August 2019 and March-August 2020 were recruited. And clinical characteristics of the patients in 2019 were compared with those in 2020.ResultsHospitalizations for pneumonia decreased by 74% after the COVID-19 pandemic. For pathogens, virus, mycoplasma pneumoniae (MP) and mixed infection rates were all much lower in 2020 than those in 2019 (P < 0.01). Regarding allergens, compared with 2019, the positive rates of house dust mite, shrimp and crab were significantly higher in 2020 (P < 0.01). And for micronutrients, the levels of vitamin B2, B6, C and 25-hydroxyvitamin D (25(OH)D) in 2020 were observed to be significantly lower than those in 2019 (P < 0.05). For all the study participants, longer hospital stay (OR = 1.521, P = 0.000), milk allergy (OR = 6.552, P = 0.033) and calcium (Ca) insufficiency (OR = 12.048, P = 0.019) were identified as high-risk factors for severe pneumonia by multivariate analysis.ConclusionsThe number of children hospitalized with pneumonia and incidence of common pathogen infections were both reduced, and that allergy and micronutrient status in children were also changed after the outbreak of the COVID-19 pandemic.

Micronutrient status in children with short bowel syndrome

Micronutrient status in children with short bowel syndrome

Micronutrient status in children and adolescents with Down syndrome: systematic review and meta-analysis.

Down syndrome (DS) is the most common genetic disorder. To date, the scientific literature regarding micronutrient status in children and adolescents with DS has not been systematically reviewed. Therefore, our aim was to provide a systematic review and meta-analysis on this topic. We identified all relevant case-control studies published by 1 January 2022, by searching the PubMed and Scopus databases for original English-language articles analysing the micronutrient status of individuals with DS. Forty studies were included in the systematic review and 31 in the meta-analysis. Statistically significant differences between individuals with DS (cases) and non-DS (controls) (P≤0.05) were obtained for zinc, selenium, copper, vitamin B12, sodium and calcium. Serum, plasma and whole blood analyses showed lower zinc levels in cases than controls {standardised mean difference [SMD] serum [95% confidence interval (CI)]=-2.32 [-3.22, -1.41], P<0.00001; SMD plasma [95% CI]=-1.29 [-2.26, -0.31], P<0.01; SMD blood [95% CI]=-1.59 [-2.29, -0.89], P<0.00001}. Similarly, plasma and blood selenium concentrations were significantly lower in cases than controls (SMD plasma [95% CI]=-1.39 [-2.26, -0.51], P=0.002; SMD blood [95% CI]=-1.86 [-2.59, -1.13], P<0.00001). Intraerythrocytic copper and serum B12 were higher in cases than controls (SMD Cu [95% CI]=3.33 [2.19, 4.46], P<0.00001; SMD B12 [95% CI]=0.89 [0.01, 1.77], P=0.048). Blood calcium was lower in cases than controls (SMD Ca [95% CI]=-0.77 [-1.34, -0.21], P=0.007). This study provides the first systematic overview of micronutrient status in children and adolescents with DS and has shown that relatively little consistent research has been executed in this field. There is a clear need for more well-designed, clinical trials to study the micronutrient status and effects of dietary supplements in children and adolescents with DS.

Status and correlates of micronutrient deficiencies in slum and non-slum areas of India's four metropolitan cities: Investigation from CNNS

Micronutrient malnutrition is an emerging public health concern globally. It affects people of all ages and socioeconomic groups; however, the most marginalized are the worst affected. Using data from the Comprehensive National Nutrition Survey 2016–18, we determined the magnitude of deficiencies (of iron, zinc, vitamin A, folate, vitamins B12 and D) among children and adolescents (1–19 years of age) living in four metropolitan cities of India. Separate estimates by residence in slum and non-slum areas were derived for pre-school and school-aged children and adolescents. The association between each micronutrient deficiency (MND) and place of residence, exposure to progarmmes, socioeconomic, and demographic variables was assessed using Poisson regression. Of all children in the sample, at least seven out of 10 children suffered from some kind of MND. Anaemia was prevalent among all children but at different levels among various age-groups. Folate deficiency was highly prevalent among children in slums whereas deficiencies of vitamin D and zinc were more prevalent among non-slum children. Dietary diversity reduced the risk of deficiencies- Vitamin A in children 1–9, anaemea in 1–4 age, folate in children 5–19. Exposure to government-sponsored nutrition programmes such as mid-day meal, and IFA did not show any significant effect on reducing deficiencies. However, adolescents exposed to IFA supplementation programmes were less likely to be folate deficient. Overall, government schemes that have been running for decades, and intensified lately, are yet to show noticeable positive effect on micronutrient status of children. Nevertheless, differential estimates by slum/non-slum residence and by age-groups calls for devising different strategies for different sub-groups to address the issue of MNDs among children and adolescents. Nutrition education not only for slum residents but also for those from non-slum areas is an urgent need to check the spread of MNDs.

Assessment of Anthropometric Indices and Micronutrient Status of Children under Five in Orphanages of Kaduna Metropolis

Children who are orphaned are faced with an increasing risk of malnutrition, which is attributed from poor feeding practices, inadequate food supply, utilization coupled with limited access to treatment facilities. In this study, the Anthropometric indices and Micronutrient status of children under five in orphanages of Kaduna metropolis, was assessed. Some standard methods were used for the sampling, anthropometric measurements and micronutrient analysis. Results revealed that the demographic characteristics of the orphan children were mostly aged between 13 to 24 months (37.93%) with the female (52.87%) and the male (47.13%). Anthropometric measurements of the children in the orphanages revealed mean z scores for Weight for Height (WHZ/Acute Malnutrition) as -1.74±1.84, -2.59±1.65 for Weight for Age (WAZ/Underweight) and -2.32±2.23 for Height for Age (HAZ/Stunting). Prevalence of Severe Acute Malnutrition among the orphans was (36%), Severe Underweight (36.1%) and severely stunted (44.8%). Micronutrient status of the under five orphan children indicate mean concentrations of Vitamin A (26.88ug/l ± 66.54), Iron (21.78ug/l ± 12.85) and Zinc (62.65 ± 29.25 ug/dl). The orphans’ micronutrient status and anthropometric indices showed significant association between the Iron and Vitamin A concentrations, WHZ and WAZ (r = 0.681) and between WAZ and HAZ (r = 0.467). The outcome of this research will contribute to improving the nutritional status and address micronutrient deficiencies among orphans in orphanages of Kaduna Metropolis.

Micronutrient deficiencies in children with coeliac disease; a double-edged sword of both untreated disease and treatment with gluten-free diet

In coeliac disease (CD) micronutrient deficiencies may occur due to malabsorption in active disease and diminished intake during treatment with a gluten-free diet (GFD). This study assessed the micronutrient status in children with CD at diagnosis and follow-up. Fifteen micronutrients were analysed in 106 blood samples from newly diagnosed CD and from patients on a GFD for <6 months, 6-12 months and with longstanding disease (>12 months). Predictors of micronutrient status included: demographics, disease duration, anthropometry, gastrointestinal symptoms, raised tissue transglutaminase antibodies (TGA), multivitamin use and faecal gluten immunogenic peptide (GIP). Micronutrient levels were compared against laboratory reference values. At CD diagnosis (n=25), low levels in ≥10% of patients were observed for: vitamins E (88%), B1 (71%), D (24%), K (21%), A (20%) and B6 (12%), ferritin (79%), and zinc (33%). One year post-diagnosis, repletion of vitamins E, K, B6 and B1 was observed (<10% patients). In contrast, deficiencies for vitamins D, A and zinc did not change significantly post-diagnosis. Copper, selenium and magnesium did not differ significantly between diagnosis and follow-up. All samples for B2, folate, vitamin C (except for one sample) and B12 were normal. A raised TGA at follow-up was associated with low vitamins A and B1 (raised vs normal TGA; vitamin A: 40% vs 17%, p=0.044, vitamin B1: 37% vs 13%, p=0.028). Low vitamin A (p=0.009) and vitamin D (p=0.001) were more common in samples collected during winter. There were no associations between micronutrient status with GIP, body mass index, height, socioeconomic status, or gastrointestinal symptom. Multivitamin use was less common in patients with low vitamin D. Several micronutrient deficiencies in CD respond to a GFD but others need to be monitored long-term and supplemented where indicated.

Vegan diet in young children remodels metabolism and challenges the statuses of essential nutrients.

Vegan diets are gaining popularity, also in families with young children. However, the effects of strict plant‐based diets on metabolism and micronutrient status of children are unknown. We recruited 40 Finnish children with a median age 3.5 years—vegans, vegetarians, or omnivores from same daycare centers—for a cross‐sectional study. They enjoyed nutritionist‐planned vegan or omnivore meals in daycare, and the full diets were analyzed with questionnaires and food records. Detailed analysis of serum metabolomics and biomarkers indicated vitamin A insufficiency and border‐line sufficient vitamin D in all vegan participants. Their serum total, HDL and LDL cholesterol, essential amino acid, and docosahexaenoic n‐3 fatty acid (DHA) levels were markedly low and primary bile acid biosynthesis, and phospholipid balance was distinct from omnivores. Possible combination of low vitamin A and DHA status raise concern for their visual health. Our evidence indicates that (i) vitamin A and D status of vegan children requires special attention; (ii) dietary recommendations for children cannot be extrapolated from adult vegan studies; and (iii) longitudinal studies on infant‐onset vegan diets are warranted.

Effect of Milk-Based Infant Formula Fortified with PUFAs on Lipid Profile, Growth and Micronutrient Status of Young Children: A Randomized Double-Blind Clinical Trial.

Background: Polyunsaturated fatty acids (PUFAs) are essential to child growth and development. Objective: To assess the effect of PUFAs-fortified infant formula on lipid profile, growth and micronutrient status in children 12 to 30 months old. Methods: This study is a double-blind randomized controlled clinical trial. Two study groups were assessed: (a) milk-based infant formula with micronutrients and PUFAs (PUFAs) and (b) milk-based infant formula with micronutrients, no PUFAs added (Non-PUFAs). Children received prepared formula (240 mL) twice a day, according to the color-code assigned to each infant. Anthropometric measurements and venous blood samples were taken at each day-care center at baseline, and again after four months. Total serum lipid extraction was 0.5 mL. Samples were treated and modified by the Folch method and analyzed with gas chromatography. Results: Changes in serum lipid profile (expressed as % FA) between baseline and four months showed a statistically significant increase in docosahexaenoic acid (DHA) (0.22 vs. −0.07, p < 0.05) and Alpha-Linoleic acid (0.08 vs. 0.02, p < 0.05) in infants who consumed PUFAs-fortified formula compared to Non-PUFAs-fortified formula. Infants increased their length/height-for-age Z-score: median change for the PUFAs group was 0.16 (95% CI = 0.08, 0.28) and 0.23 (95% CI = 0.14, 0.33) for Non-PUFAs, with no differences between groups. Median folate level was significantly higher among the PUFAs group compared to Non-PUFAs: −0.87 (95% CI = −1.38, −0.44) and −3.83 (95% CI = −4.65, −3.03) respectively. Consumption of both supplements was adequate and stable during the intervention. Conclusion: A significant improvement was observed in the lipid profile of children who received the PUFAs-fortified milk-based formula.

Serum trace element and amino acid profile in children with cerebral palsy

BackgroundThe existing data demonstrate that both trace elements and amino acids play a significant role in neurodevelopment and brain functioning. Certain studies have demonstrated alteration of micronutrient status in children with cerebral palsy, although multiple inconsistencies exist. The objectiveof the present study was to assess serum trace element and mineral, as well as amino acid levels in children with cerebral palsy. Methods71 children with cerebral palsy (39 boys and 32 girls, 5.7 ± 2.3 y.o.) and 84 healthy children (51 boys and 33 girls, 5.4 ± 2.3 y.o.) were enrolled in the present study. Serum trace element and mineral levels were assessed using inductively-coupled plasma mass-spectrometry (ICP-MS). Amino acid profile was evaluated by means of high-pressure liquid chromatography (HPLC). ResultsChildren with cerebral palsy are characterized by significantly lower Cu and Zn levels by 6% and 8%, whereas serum I concentration exceeded the control values by 7%. A tendency to increased serum Mn and Se levels was also observed in patients with cerebral palsy. Serum citrulline, leucine, tyrosine, and valine levels were 15 %, 23 %, 15 %, and 11 % lower than those in healthy controls. Nearly twofold lower levels of serum proline were accompanied by a 44 % elevation of hydroxyproline concentrations when compared to the control values. In multiple regression model serum I, Zn, and hydroxyproline levels were found to be independently associated with the presence of cerebral palsy. Correlation analysis demonstrated a significant correlation between Cu, Mn, Se, I, and Zn levels with hydroxyproline and citrulline concentrations. ConclusionThe observed alterations in trace element and amino acid metabolism may contribute to neurological deterioration in cerebral palsy. However, the cross-sectional design of the study does not allow to estimate the causal trilateral relationships between cerebral palsy, altered trace element, and amino acid metabolism.

Micronutrient status in children with anorexia nervosa: high frequency of early copper and selenium deficiencies

Micronutrient status in children with anorexia nervosa: high frequency of early copper and selenium deficiencies

Micronutrient status of children and adolescents with cancer in scotland

Rationale: Research reporting plasma micronutrient status in paediatric cancer is scarce. Therefore, this study investigated the prevalence of plasma micronutrient deficiencies in this population.

Proximate and Mineral Composition of Traditional, Composite Foods Consumed in Rural Areas of Bauchi State, Nigeria

Abstract Objectives High levels of stunting (49.1%), underweight (29.9%) and anemia (70.4%) are common in children &amp;lt;5 years of age in northeastern Nigeria. The nutritional composition of diets fed in the home is of prime importance for the anthropometric and micronutrient status of children. Yet there is paucity of data on the nutrient profile of numerous foods that are part of traditional diets in northeastern Nigeria. This study evaluated the proximate and mineral content of 31 traditional, composite foods consumed in Bauchi state, Nigeria. Methods Proximate analysis was conducted via a modified version of the AOAC International (2006) method. Iron (Fe), zinc (Zn), copper (Cu), and calcium (Ca) concentrations were determined from samples by atomic absorption spectrophotometry. Results Of three types of danwake (cooked cereal dough balls/dumplings), danwake wake da dawa (beans with sorghum) had the highest protein (4.78%). Danwake gujia da masara (Bambara nuts with maize) had the greatest Fe (3.97 mg), with Zn (1.20 mg) and Cu (0.28 mg)/100 g). Dambun tsakin masara (maize grits, peanut cake and spinach) had the highest protein (9.12%) of five types of dambu (granulated cereal dumplings). Per 100 g of dambu, Fe (6.01 mg), Zn (1.57 mg), Cu (0.31 mg) and Ca (89.64 mg) of dambun gero da zogale (millet, moringa and peanut cake) was the highest. Of nine soups, miyan kubewa (okra) was lowest in protein (1.90%), while miyan karago (peanut cake) was highest in protein (11.40%), with Fe, Zn and Cu (5.49, 1.30 and 0.33 mg, respectively). Shredded, fried, mutton (dambun naman rago) and soy curds (awara) were excellent sources of protein (49.31% and 16.86%), Fe (9.20 and 8.32 mg), Zn (7.54 and 1.72 mg), and Ca (138.76 and 52.40 mg)/100 g). Of ten cereal puddings, paps and porridges, chanchangan dawa (sorghum, beans and peanut) and danmalele [maize and palm oil pap (used as a weaning food], had the highest (6.43%) and lowest (1.22%) protein, respectively. Porridge made from leftover pudding crust (gwaten kanzo) was high in Fe (3.12 mg/100 g). Conclusions Foods prepared with two different legumes in addition to cereals, were the richest sources of protein and micronutrients compared to other mixtures. Peanut cake and soy curds are cheap sources of protein and minerals, which can improve diets in northern Nigeria, when combined with starchy staples. Funding Sources This study was funded by Oxfam LINE Project, Bauchi.

Review on Dietary Contribution of Wild Edible Food Biodiversity to Food Security and Micronutrient Status of Children in Ethiopia

Deficiencies in key vitamins and minerals are placed among the major public health problems. In Ethiopia, children aged 6–59 months are dramatically affected by vitamin A deficiency and iron deficiency anemia, which accounts 61% and 54%, respectively. Nationally, the prevalence of anemia among children under two years was 56%. The objective of this review was to document current information regarding dietary contribution of wild edible food biodiversity to food security and micronutrient status of children in Ethiopia. Magnitude of under nutrition, low dietary diversity and food insecurity in Ethiopia is very high in rural communities where livelihood depends on backward farming system. The nutritional consequences of food insecurity experience include under nutrition depending on a broad range of contextual, economic and socio cultural factors. Although, Ethiopia is among the regions producing adequate wild edible food biodiversity in the Africa, it is reported that there is high prevalence rate of micronutrient deficiencies compared to prevalence in less productive regions of Africa. Therefore, all responsible bodies should be intensified and incorporated to reduce food insecurity and micronutrient deficiencies through nutrition education intervention. In the future, researchers should also conduct the nutritional composition, phytochemicals and antioxidants of each wild edible food biodiversity in Ethiopia.

Multi-criteria Mapping of Stakeholders' Viewpoints in Five Southeast Asian Countries on Strategies to Reduce Micronutrient Deficiencies Among Children and Women of Reproductive Age: Findings from the SMILING Project.

Despite scientific evidence on the potential impact or importance of specific interventions to improve micronutrient status of vulnerable groups, political commitment and extensive support from national stakeholders is paramount to support introduction and implementation of these interventions at national level. In order to develop efficient nutritional strategies to improve the micronutrient status of children < 5years of age and women of reproductive age that will be supported by a wide range of stakeholders, a better understanding of viewpoints on the nutrition politics and strategies is necessary. Multi-criteria mapping (MCM) was successfully used to assess the stakeholder's viewpoint in a wide variety of contexts since the late 1990s. The objective of the present study was to assess the viewpoints of stakeholders on a wide range of potential nutritional interventions in the five Southeast Asian countries participating in the SMILING project. MCM methodology was used to appraise the stakeholder's viewpoints in five countries. The results show that the overall stakeholders' preference was for actions already implemented in their country rather than for new, innovative options, even for supplementation. Indirect interventions such like food fortification (except in Indonesia), delayed cord clamping or food-based approaches were generally less favored by the stakeholders. However, the majority of stakeholders agreed that new approaches should be considered and put in place in the future provided that evidence of their impact was demonstrated, that they received adequate technical support for their implementation and their monitoring, and that they will be accompanied by strong advocacy among decision-makers, civil society and beneficiaries. To conclude, for the introduction of new, innovative strategies to reduce micronutrient deficiencies in South-East Asia, convincing stakeholders appears to be the first hurdle to be taken.

What Approaches are Most Effective at Addressing Micronutrient Deficiency in Children 0\u20135 Years? A Review of Systematic Reviews

Introduction Even though micronutrient deficiency is still a major public health problem, it is still unclear which interventions are most effective in improving micronutrient status. This review therefore aims to summarize the evidence published in systematic reviews on intervention strategies that aim at improving micronutrient status in children under the age of five. Methods We searched the literature and included systematic reviews that reported on micronutrient status as a primary outcome for children of 0–5 years old, had a focus on low or middle income countries. Subsequently, papers were reviewed and selected by two authors. Results We included 4235 reviews in this systematic review. We found that (single or multiple) micronutrient deficiencies in pre-school children improved after providing (single or multiple) micronutrients. However home fortification did not always lead to significant increase in serum vitamin A, serum ferritin, hemoglobin or zinc. Commercial fortification did improve iron status. Cord clamping reduced the risk of anemia in infants up to 6 months and, in helminth endemic areas, anthelminthic treatment increased serum ferritin levels, hemoglobin and improved height for age z-scores. Anti-malaria treatment improved ferritin levels. Discussion Based on our results the clearest recommendations are: delayed cord clamping is an effective intervention for reducing anemia in early life. In helminth endemic areas iron status can be improved by anthelminthic treatment. Anti-malaria treatment can improve ferritin. In deficient populations, single iron, vitamin A and multimicronutrient supplementation can improve iron, vitamin A and multimicronutrient status respectively. While the impact of home-fortification on multimicronutrient status remains questionable, commercial iron fortification may improve iron status.

Education and micronutrient deficiencies: an ecological study exploring interactions between women\u2019s schooling and children\u2019s micronutrient status

BackgroundFormal education can be a nutrition-sensitive intervention that supports the scale-up and impact of nutrition-specific actions. Maternal education has long been linked to child survival, growth, and development while adult earnings and nutrition are tied to years in school as a child. However, less is known about the relationship between maternal education and the micronutrient status of children, women and the general population.MethodsUsing country-level data and an ecological study design, we explored the global associations between women’s educational attainment and: a) anemia and vitamin A deficiency (VAD) in children aged 6–59 months; b) anemia in non-pregnant women; and c) zinc deficiency, urinary iodine excretion (UIE), and the proportion of infants protected against iodine deficiency in the general population Cross-sectional relationships (2005–2013) were assessed using linear regression models.ResultsPercentage of women without schooling was negatively associated with all outcomes. Number of years of schooling among women was positively associated with all outcomes except for UIE and the proportion of infants protected against iodine deficiency. Income level was a significant effect modifier of the effect of years of women’s schooling on child anemia as well as of the proportion of women without formal education on zinc deficiency in the population. The relationship was strongest in low-income countries for child anemia, and was not significant in upper middle-income countries. For zinc deficiency, the relationship was not significant in low or lower middle income countries, which may suggest that a minimum threshold of resources needs to be reached before education can influence zinc status.ConclusionsWhile relationships between maternal schooling and micronutrient outcomes vary around the globe, more schooling is generally linked to lower rates of deficiency. These findings draw policy-relevant connections between formal education and anemia and micronutrient status globally. It is necessary to examine the mechanisms through which this relationship may be working at both household and country level.

Hair Mineral and Trace Element Contents as Reliable Markers of Nutritional Status Compared to Serum Levels of These Elements in Children Newly Diagnosed with Inflammatory Bowel Disease.

Patients with inflammatory bowel disease (IBD) are at high risk for nutritional deficiencies because of long-term inflammation in the gut mucosa and decreased oral intake. Because inflammation responses affect serum micronutrient concentrations, serum levels are limited in reflecting body nutrient status in acute and chronic illness. We investigated the usefulness of measuring trace elements in hair as reliable markers of nutritional status compared to serum levels in children with IBD. We retrospectively analyzed pediatric patients newly diagnosed with Crohn's disease (n = 49) and ulcerative colitis (n = 16) and controls (n = 29) from 2012 to 2016. Serum micronutrient levels, inflammatory markers, and hair trace element content were evaluated and compared at the time of diagnosis and before initiating treatment. Serum calcium (p < 0.001), iron (p < 0.001), zinc (p = 0.013), selenium (p = 0.008), albumin (p < 0.001), prealbumin (p < 0.001), hemoglobin and hematocrit (p < 0.001), and WBC (p = 0.001) and lymphocytes (p < 0.001) differed significantly between the groups. After adjustment for the erythrocyte sedimentation rate, serum zinc and selenium levels were no longer significantly different between the groups (p < 0.062 and p < 0.057, respectively). Following hair analysis for mineral and trace elements, iron (p = 0.033), selenium (p = 0.017), and manganese (p = 0.009) differed significantly between the groups. Serum micronutrient levels need cautious interpretation in conjunction with inflammatory markers. Hair mineral and trace element measurement may support understanding micronutrient status in children with IBD.

Evaluation of body composition, resting energy expenditure and micronutrient status in children with cerebral palsy

Evaluation of body composition, resting energy expenditure and micronutrient status in children with cerebral palsy

Hair Mercury Level is Associated with Anemia and Micronutrient Status in Children Living Near Artisanal and Small-Scale Gold Mining in the Peruvian Amazon.

Anemia has been widely studied in global health contexts because of severe nutritional deficiency, and more recently, inflammatory status, but chemical exposures are rarely considered. Until recently, "anemia" was used synonymously with "iron deficiency anemia (IDA)" in global health settings. However, only 50% of anemia cases worldwide are IDA. Environmental toxicology studies of anemia risk have generally focused on populations in developed countries, albeit with high exposure to environmental toxicants, such as lead or cadmium. In the developing world, toxicant exposures commonly coexist with other risk factors for anemia. In particular, artisanal and small-scale gold mining (ASGM) communities are at risk for dietary methylmercury exposure through contaminated fish consumption, and for anemia due to food insecurity and infectious and chronic diseases. Here, we report analysis of total hair mercury content, hemoglobin, and serum micronutrient levels in children < 12 years of age (N = 83) near ASGM in the Peruvian Amazon. Forty-nine percent (N = 29/59) of those aged < 5 years were anemic (< 11 g/dL) and 52% (N = 12/23) of those aged 5-11 years (< 11.5 g/dL). Few children were stunted, wasted, or micronutrient deficient. Median total hair mercury was 1.18 μg/g (range: 0.06-9.70 μg/g). We found an inverse association between total mercury and hemoglobin (β = -0.12 g/dL, P = 0.06) that persisted (β = -0.14 g/dL, P = 0.04) after adjusting for age, sex, anthropometrics, and vitamin B12 in multivariate regression. This study provides preliminary evidence that methylmercury exposure is associated with anemia, which is especially relevant to children living near ASGM.

The Effect of Low Dose Iron and Zinc Intake on Child Micronutrient Status and Development during the First 1000 Days of Life: A Systematic Review and Meta-Analysis.

Adequate supply of micronutrients during the first 1000 days is essential for normal development and healthy life. We aimed to investigate if interventions administering dietary doses up to the recommended nutrient intake (RNI) of iron and zinc within the window from conception to age 2 years have the potential to influence nutritional status and development of children. To address this objective, a systematic review and meta-analysis of randomized and quasi-randomized fortification, biofortification, and supplementation trials in women (pregnant and lactating) and children (6–23 months) delivering iron or zinc in doses up to the recommended nutrient intake (RNI) levels was conducted. Supplying iron or zinc during pregnancy had no effects on birth outcomes. There were limited or no data on the effects of iron/zinc during pregnancy and lactation on child iron/zinc status, growth, morbidity, and psychomotor and mental development. Delivering up to 15 mg iron/day during infancy increased mean hemoglobin by 4 g/L (p < 0.001) and mean serum ferritin concentration by 17.6 µg/L (p < 0.001) and reduced the risk for anemia by 41% (p < 0.001), iron deficiency by 78% (ID; p < 0.001) and iron deficiency anemia by 80% (IDA; p < 0.001), but had no effect on growth or psychomotor development. Providing up to 10 mg of additional zinc during infancy increased plasma zinc concentration by 2.03 µmol/L (p < 0.001) and reduced the risk of zinc deficiency by 47% (p < 0.001). Further, we observed positive effects on child weight for age z-score (WAZ) (p < 0.05), weight for height z-score (WHZ) (p < 0.05), but not on height for age z-score (HAZ) or the risk for stunting, wasting, and underweight. There are no studies covering the full 1000 days window and the effects of iron and zinc delivered during pregnancy and lactation on child outcomes are ambiguous, but low dose daily iron and zinc use during 6–23 months of age has a positive effect on child iron and zinc status.