Micronutrient Deficiencies Research Articles

FORECASTING THE MICRONUTRIENT CONTENTS IN FETUSES OF DOWN CALVERS

It is believed that the level of nutrition and maternal tissue depots determine the intrauterine supply of micronutrients necessary for the normal formation and development of fetuses in large cattle. Disturbances in micronutrient nutrition negatively affect the fetus's health and, after birth, limit its growth and predispose it to a range of somatic diseases. Therefore, forecasting and timely correction of micronutrient deficiencies in the fetuses of large cattle is important in veterinary science. In this study, the authors attempted for the first time to forecast the accumulation levels of Se, Cu, Zn, Fe, Cr, Sr, Mo, Co, Ni, As, and Mn in a fetus's body based on these micronutrient contents in the mother's hair 60 days before the expected calving. Thirty-five clinically healthy Simmental cows with singleton pregnancies were examined, and calves were obtained from them (18 males and 17 females). Hair samples obtained from the calves shortly after birth were analyzed for a retrospective assessment of the fetal micronutrient status. Micronutrients (Se, Cu, Zn, Fe, Cr, Sr, Mo, Co, Ni, As, and Mn) were quantitatively deter-mined in the hair samples using inductively coupled plasma mass spectrometry (Nexion 300D, Perkin Elmer, USA). The distribution patterns of micronutrients in the "mother–fetus" system in large cattle were not related to the newborn’s gender. Dependencies be-tween the micronutrient contents in the mother's hair and in the newborn were described by first-order (for Sr), second-order (for Co and Mn), and third-order (for Se, Cu, Zn, Fe, and As) polynomials. For four micronutrients (Se, Cu, Fe, and Co), graphs and analytical expressions were prepared, allowing the prediction of their contents in the fetus's body based on maternal indicators with a level of statistical significance of P = 0.05. For the other four micronutrients (Zn, Sr, As, and Mn), this was achieved with a level of P = 0.10–0.15. No statistically significant dependencies were found between the contents in the mother's hair and the newborn for Mo, Cr, and Ni. Based on the predictions, optimal content ranges were determined for 8 of 11 investigated micronutrients (Se, Cu, Fe, Co, Zn, Sr, As, and Mn) in the cow's hair 60 days before the expected calving, ensuring an optimal level of their accumulation in the fetus's body.

IMPACT OF MICRONUTRIENT DEFICIENCIES ON CHILD DEVELOPMENT

Micronutrient deficiencies pose a significant threat to child development, affecting millions of children globally. This paper explores the critical role of essential vitamins and minerals in the physical, cognitive, and emotional growth of children. It highlights the prevalence and impact of deficiencies in key micronutrients such as iron, vitamin A, iodine, and zinc. The study examines how these deficiencies can lead to severe developmental issues, including impaired cognitive function, stunted growth, and weakened immune systems. By analyzing various case studies and intervention programs, the paper underscores the importance of addressing micronutrient deficiencies through comprehensive public health strategies. It advocates for policy initiatives aimed at improving nutrition education, fortifying foods, and ensuring equitable access to supplements, particularly in low- and middle-income countries. The findings emphasize that mitigating micronutrient deficiencies is crucial for fostering healthy development and unlocking the full potential of children worldwide

The prevalence of anemia during pregnancy and its correlates vary by trimester and hemoglobin assessment method in Eastern Maharashtra, India.

Approximately half of pregnant women in India are anemic, representing over 7.5 million women. Few studies have assessed the relationship between multiple micronutrient deficiencies and anemia during pregnancy or the trajectory of hemoglobin (Hb) during pregnancy in low-resource settings. We enrolled 200 pregnant women from the Maternal and Newborn Health (MNH) registry, a population-based pregnancy and birth registry in Eastern Maharashtra, India to address these gaps. The women provided capillary (finger-prick) and venous blood specimens at enrollment (<15 weeks), and a second capillary specimen in the 3rd trimester (>27 weeks). Capillary specimens were analyzed at the time of collection with a HemoCue Hb 201+; venous specimens were shipped on dry ice to a laboratory for cyanmethemoglobin assessment. In the 1st trimester, mean Hb concentration and anemia (Hb<11.0 g/dL) prevalence using capillary specimens were 10.9 ± 1.5 g/dL and 51.1%; mean Hb concentration using venous blood specimens was estimated to be 11.3 ± 1.3 g/dL and anemia prevalence was 37.5%. The prevalence of iron, vitamin B12 and folate deficiencies were 40%, 30% and 0%, respectively. Among women with anemia in the 1st trimester (venous blood), 56% had concurrent iron deficiency (inflammation-adjusted serum ferritin <15 µg/L) indicating that their anemia may be amenable to iron supplementation. In total, 21% of women had ID and anemia, 19% ID in the absence of anemia, 16.5% anemia in the absence of ID and 43.5% had neither. By the 3rd trimester, mean Hb from capillary specimens had declined to 10.1 ± 1.35 g/dL and anemia prevalence increased to 70.7%, despite 99.4% mothers reporting receipt of iron-folic acid (IFA) supplements during her current pregnancy, and 83.9% reporting IFA consumption the previous day. Significant predictors of anemia in the 1st trimester (both venous and capillary) included the number of weeks gestation at the time of Hb assessment and inflammation-adjusted serum ferritin. For 3rd trimester anemia, significant predictors included 1st trimester height, BMI and IFA consumption during the 3rd trimester (but not 1st trimester micronutrient biomarkers), indicating that IFA supplementation over the course of pregnancy may have influenced micronutrient status and anemia risk. Our findings highlight the severity of the burden of anemia and micronutrient deficiencies in Eastern Maharashtra, but also highlight that in many cases, ID and anemia affect different individuals. Preventing and managing anemia in pregnancy in India will require strengthening both clinical and community-based strategies targeting iron deficiency, as well as other causes of anemia.

A Comprehensive Review of Dietary Approaches in Maintaining Remission of Inflammatory Bowel Diseases in Adults.

Inflammatory bowel disease (IBD) poses significant challenges in its management, encompassing a spectrum of conditions from Crohn's disease to ulcerative colitis. Dietary interventions have emerged as integral components of the multidisciplinary approach to IBD management, with implications ranging from disease prevention to treatment of active manifestations and addressing complications such as malnutrition. While dietary interventions show promise in improving outcomes for some patients with IBD, there is no consensus in the existing literature regarding remission maintenance in those patients. Furthermore, many patients explore dietary modifications often guided by anecdotal evidence or personal experiences and this could lead to malnutrition and decreased quality of life. This comprehensive review synthesizes existing literature to elucidate the complex interplay between diet and IBD, offering insights into the efficacy and safety of various dietary modalities in maintaining disease remission. It also highlights the importance of patient education in navigating dietary choices and potential risks associated with food avoidance, including the heightened risk of micronutrient deficiencies. Furthermore, it emphasizes the pivotal role of a multidisciplinary care team comprising clinicians and dietitians in providing personalized dietary guidance tailored to individual patient needs and goals. By synthesizing the latest evidence and providing insights into both the potential benefits and risks of dietary interventions, this review could be used as a resource for healthcare professionals and patients alike in navigating the complex landscape of dietary management in IBD.

Association of Simple Febrile Seizure with Iron Deficiency Anemia in Children: A Case Control Study

Abstract: Background: Febrile seizure is an established entity in Pediatrics which characterizes with absence of any intracranial infection or metabolic disorders. Simple febrile seizure carries a favorable prognosis without any sequelae. Still, it emerges as the most common etiology of seizure till the age of five years. Iron deficiency anemia is a commonly witnessed micro-nutrient deficiency with a worldwide distribution. Objective: To establish relation of simple febrile seizure with iron deficiency anemia in paediatric population. Materials and Methods: Case-control study, conducted in Pediatric Medicine Department, King Fahad Armed Forces Hospital Southern Region, Khamis Mushayat, Kingdom of Saudi Arabia, from1st January 2022 to 30th June 2023. The 102 children, having age six months to five years, with a diagnosis of first simple febrile seizure were assessed. Likewise, the control group included 102 febrile children without convulsion. The hematological parameters evaluated for diagnosis of iron deficiency anemia included hemoglobin, mean corpuscular volume, serum ferritin, serum iron, total iron binding capacity &amp; red cell distribution width. Result: The mean age for first simple febrile seizure was 23 months. Acute respiratory infection was the most common etiology (80%). Iron deficiency anemia was identified in 17% of cases of simple febrile seizure, in contrary to 6% of cases with febrile illness without seizure, with odds ratio of 3.2. Conclusion: This study demonstrated that the children with iron deficiency anemia are at significantly higher risk of having febrile convulsions compare to control group with fever but without anemia. Keywords: Fever, Febrile seizure, Iron Deficiency anemia, Serum ferritin, Hemoglobin, Convulsion, Mean corpuscular hemoglobin.

Low Dietary Diversity and Low Haemoglobin Status in Ghanaian Female Boarding and Day Senior High School Students: A Cross-Sectional Study.

Background and Objectives: Anaemia is one of the most common forms of malnutrition globally, with most anaemia cases related to micronutrient deficiency. Diets with higher dietary diversity scores (DDS) are usually nutritionally diverse and could positively impact micronutrient status, including haemoglobin (Hb) concentration improvement. The study aimed to determine DDS and its association with the Hb concentration of Boarding and Day adolescent Senior High School students in Ghana. Materials and Methods: A semi-structured and three 24 h dietary recalls were used to obtain the participants' demographic and diet intake data, respectively. Hb concentration was assessed using a validated portable haemoglobinometer. DDS was evaluated using the Minimum Dietary Diversity for Women (MDD-W) approach. Results: A significant difference in the DDS between Boarding and Day students existed. Only 22% of the Boarding students had adequate dietary diversity, whereas 64% of the Day students had adequate dietary diversity. A significantly smaller proportion of the Boarding students consumed nuts and seeds, dairy, flesh foods, eggs, vitamin A-rich vegetables and fruits, other vegetables, and other fruits compared to Day students (p < 0.05, all). No significant difference (p = 0.925) in mean (±SD) Hb concentrations between Boarding (11.9 ± 1.1 g/dL) and Day (11.9 ± 1.1 g/dL) students was found. Additionally, no significant correlation between mean DDS and Hb concentration (p = 0.997) was recorded. Using Hb < 12 g/dL as the determination of anaemia, 55.1% Boarding and 57.8% Day students had anaemia. Conclusions: Low dietary diversity in Boarding students highlighted inadequate nutrition provided by school meals. Strategies to increase meal diversity should be prioritised by stakeholders in Ghana's educational sector.

Underutilized Vegetable Crops: Potential Sources of Nutrition and Livelihood Security

Vegetables are essential components of a balanced diet, offering a myriad of nutrients crucial for maintaining health and preventing diseases. Vegetable has low calorie counts and high fiber content, they aid in weight management by promoting satiety and controlling appetite. Underutilized vegetable crops are ones that are not widely cultivated and consumed compared to other vegetable crops. Underutilized vegetables play a significant role in enhancing dietary diversity, supporting local food systems, and fortifying food security. Cultivating underutilized vegetables enhances the biodiversity, resilience, and sustainability by reducing reliance on a limited range of crops, especially in the face of environmental challenges like diseases, pests, and climate change. Underutilized vegetables contribute to agricultural biodiversity, cultural heritage preservation, and economic opportunities for small-scale farmers. Embracing and promoting the cultivation, consumption, and conservation of underutilized vegetables are imperative for sustaining diverse diets, supporting sustainable agriculture, and addressing malnutrition and micronutrient deficiencies.

Micronutrient deficiencies and anemia in the follow-up after gastroesophageal cancer surgery.

Due to insufficient dietary intake and altered digestion and absorption of nutrients, patients after gastroesophageal cancer surgery are at risk of becoming malnourished and consequently develop micronutrient deficiencies. The aim of this study was to determine the prevalence of micronutrient deficiencies and anemia during follow-up after gastroesophageal cancer surgery. This single-center cross-sectional study included patients after resection for esophageal or gastric cancer visiting the outpatient clinic in 2016 and 2017. Only patients without signs of recurrent disease were included. All patients were guided by a dietician in the pre- and postoperative phase. Dietary supplements or enteral tube feeding was prescribed in case of inadequate dietary intake. Blood samples were examined for possible deficiencies or abnormalities in hemoglobin, prothrombin time, iron, ferritin, folic acid, calcium, zinc, vitamin A, vitamin B1, vitamin B6, vitamin B12, vitamin D and vitamin E. The percentage of patients with micronutrient deficiencies were scored. Of the 335 patients visiting the outpatient clinic, measurements were performed in 263 patients (221 after esophagectomy and 42 after gastrectomy), resulting in an inclusion rate of 79%. In the esophagectomy group, deficiencies in iron (36%), vitamin D (33%) and zinc (20%) were most prevalent. After gastric resection, deficiencies were most frequently observed in vitamin D (52%), iron (33%), zinc (28%) and ferritin (17%). Low levels of hemoglobin were found in 21% of patients after esophagectomy and 24% after gastrectomy. Despite active nutritional guidance, deficiencies in vitamin D, iron, zinc and ferritin, as well as low levels of hemoglobin, are frequently observed following gastroesophageal resection for cancer. These micronutrients should be periodically checked during follow-up and supplemented if needed.

Faecal microbiota of schoolchildren is associated with nutritional status and markers of inflammation: a double-blinded cluster-randomized controlled trial using multi-micronutrient fortified rice

Faecal microbiota plays a critical role in human health, but its relationship with nutritional status among schoolchildren remains under-explored. Here, in a double-blinded cluster-randomized controlled trial on 380 Cambodian schoolchildren, we characterize the impact of six months consumption of two types of rice fortified with different levels of vitamins and minerals on pre-specified outcomes. We investigate the association between the faecal microbiota (16SrRNA sequencing) and age, sex, nutritional status (underweight, stunting), micronutrient status (iron, zinc and vitamin A deficiencies, anaemia, iron deficient anaemia, hemoglobinopathy), inflammation (systemic, gut), and parasitic infection. We show that the faecal microbiota is characterised by a surprisingly high proportion of Lactobacillaceae. We discover that deficiencies in specific micronutrients, such as iron and vitamin A, correlate with particular microbiota profiles, whereas zinc deficiency shows no such association. The nutritional intervention with the two rice treatments impacts both the composition and functions predicted from compositional analysis in different ways. (ClinicalTrials.gov (Identifier: NCT01706419))

Bringing nutritional ketosis to the table as an option for healing the pediatric brain.

Our core premise is that personalized variations of a ketogenic diet are likely to benefit pediatric patients with neuropsychiatric symptoms across multiple domains. Although pediatric epilepsy is currently a well-accepted indication for a strict ketogenic diet, there is a dearth of knowledge and therefore clinical guidelines upon which to recommend nutritional ketosis for pervasive pediatric conditions such as autism spectrum disorder and ADHD, even when comorbid epilepsy is present. However, there are published cohort studies and current clinical trials implementing medical ketogenic therapies for cognitive impairment, psychiatric comorbidities, motor disability, and even neuroinflammation. As holistic practitioners, it is imperative that we consider the health of a child in its entirety - and additionally offer the ketogenic diet as a therapeutic option when it may be synergistic in treating extra-neurologic diseases such as obesity. While there are uniquely pediatric potential adverse side effects such as linear growth deceleration and micronutrient deficiencies, previous trials in epilepsy and our center's experience have already proven the ketogenic diet to be a low-risk intervention when optimized with appropriate patient monitoring and support.

Association between meal skipping and the double burden of malnutrition among university students

Background: The study delves into the nuanced relationship between meal skipping and the double burden of malnutrition among university students. It addresses a critical gap in understanding how young adults' irregular dietary patterns contribute to undernutrition and overnutrition, phenomena typically studied in isolation. Aims: This research aimed to shed light on the broader implications of meal skipping within the context of student health and well-being. Subjects and Methods: The study surveyed a representative sample of undergraduate students from various academic disciplines at Lead City University in Ibadan, Nigeria, utilizing a descriptive cross-sectional approach. Detailed questionnaires were administered to assess the frequency of meal skipping, dietary habits, and associated lifestyle factors. Body mass index (BMI) and self-reported health data were also collected. Statistical analyses, including univariate and bivariate analysis, were employed to identify the nutritional status and meal patterns of the students, Principal component analysis was employed to identify the dietary patterns prevalent among the students from the food frequency questionnaire administered. Results: The findings reveal a significant correlation between meal skipping and the risk of undernutrition and overnutrition. Students who regularly skip meals are likely at an increased risk of undernutrition, characterized by lower BMI and potential micronutrient deficiencies, and overnutrition, indicated by higher BMI and associated health risks. This dual risk factor challenges existing perceptions of nutrition among young adults, suggesting that meal skipping can be a critical determinant of diverse and complex nutritional outcomes. Conclusion: The study highlights the urgent need for comprehensive nutritional strategies at university campuses, focusing on educating students about the risks associated with inconsistent eating patterns. It calls for implementing targeted interventions and policy changes to address the double burden of malnutrition, promoting healthier lifestyles, and preventing long-term health issues among university students. Keywords: Meal skipping, double burden of malnutrition, university students, nutritional status, dietary patterns, public health interventions, young adult health.

Small Fish Big Impact: Improving Nutrition during Pregnancy and Lactation, and Empowerment for Marginalized Women.

Undernutrition and micronutrient deficiencies such as anemia are considered significant public health challenges in Bangladesh, which enhancing fish consumption is a well-established food-based intervention to address these. This paper documents the establishment of community-based fish chutney production and reports the impact of its consumption on mid-upper arm circumference (MUAC) and hemoglobin (Hb) levels among targeted 150 pregnant and lactating women (PLW) in rural Bangladesh. A fish chutney was developed using locally available ingredients followed by a series of laboratory tests, including nutrient composition, shelf-life and food safety. A community-based fish chutney production process was designed to: (1) supply locally available ingredients for processing; (2) establish two fish drying sites; (3) initiate a community-based production site; and (4) distribute fish chutney to PLW for one year by six women nutrition field facilitators. Then a pre- and post-intervention study was designed for a selected 150 PLW to receive 30 g of fish chutney daily for 12 months. Differences in mean MUAC and Hb levels pre- and post-consumption were analyzed using one-way analysis of variance. Consumption of 30 g of fish-chutney resulted in significant increases of the mean values of Hb levels and MUAC among the targeted PLW.

Compliance level and associated factors of iron folic acid supplementation among pregnant women in North Shoa Zone, Ethiopia

Iron deficiency is a widespread micronutrient deficiency, impacting over 30% of the global population. Iron Folic Acid supplement is recommended for pregnant women to counter iron deficiency anemia and neural tube anomalies. Although Iron Folic Acid supplementation is integral to Ethiopian antenatal care, one in four women in Ethiopia experiences anemia during pregnancy suggesting poor compliance. This study aimed to investigate compliance level and associated factors of Iron Folic Acid supplementation among pregnant women attending antenatal care in Wuchale Woreda of North Shoa Zone, Ethiopia. An institutional-based cross-sectional study was conducted among 302 pregnant women from March 20 to April 5, 2021, who were selected using a systematic random sampling technique. Data were collected through face-to-face interview, entered epi-data, and exported to Statistical Package for the Social Sciences for analysis. A multivariable logistic regression was used to identify factors associated with compliance level. All the results were presented with 95% confidence intervals. The compliance with Iron Folic Acid supplementation was 47.0%. Residing nearest to the health facility (AOR = 2.46; 95% CI 1.32, 4.57), initiating antenatal care at health center (AOR = 2.23; 95% CI 1.17, 4.51), having a family size of 4 and above (AOR = 4.99; 95% CI 2.43, 10.24), and receiving information from health extension workers (AOR = 5.52; 95% CI 1.30, 23.54) increased compliance with Iron Folic Acid supplementation. Less than half of the pregnant women were compliant with Iron Folic Acid utilization. There is a need to prioritize promoting the importance of Iron Folic Acid supplementation through health education particularly by targeting pregnant women with identified factors.

Does Dietary Supplement Use Increase Micronutrient Intake Adequacy in Healthy Adults with Habitual Omnivorous, Vegetarian, Vegan, and Low-Carbohydrate High-Fat Diets?

Diets omitting whole food groups pose a risk for micronutrient insufficiencies, but there are no data as to whether those are suitably attenuated with dietary supplements (DS). Micronutrient intakes with food and DSs were analyzed in 130 healthy adults: 32 vegans, 37 vegetarians, 24 following low-carbohydrate high-fat diet (LCHF), and 37 omnivores. A total of 63% used DS (84% of vegans, 75% of LCHF, 54% of vegetarians, and 46% of omnivores); however, a DS did not always tackle dietary insufficiencies. Vitamin B12 was often supplemented in vegans in doses substantially higher than recommended, but it was supplemented less often in vegetarians, despite the low prevalence of sufficient intake. Only 43% of participants supplemented vitamin D in wintertime, 23% of them with an insufficient dose. Supplementation of potassium, calcium, and iodine was rare, despite low intake adequacy with food alone in all groups. Some micronutrients were supplemented unnecessarily, such as vitamin K, riboflavin, biotin, and iron. Multimicronutrient DSs were used often; they increased intake adequacy of group B vitamins but failed to sufficiently supplement vitamin D, potassium, calcium, and iodine. Although DS use increased micronutrient intake sufficiency when used properly, the knowledge on micronutrient inadequacy in all dietary patterns should be increased and the public should be educated on the proper use of DSs. Multimicronutrient DSs should be reformulated to tackle the insufficiencies.

Double malnutrition and associated factors in a middle-aged and older, rural South African population

IntroductionDouble malnutrition (co-existing overnutrition and undernutrition) is increasingly prevalent in sub-Saharan Africa due to rapid epidemiological and nutritional transitions. In this region, studies of double malnutrition have largely been conducted at country and household level, with individual-level studies primarily limited to children and women of reproductive age. We investigated the prevalence and determinants of individual-level double malnutrition in middle-aged and older adults who constitute an increasing proportion of the sub-Saharan African population.Methods250 individuals aged 40–70 years (50% women) and resident in the Agincourt Health and socio-Demographic Surveillance System in rural Mpumalanga province, South Africa, were randomly selected. Double malnutrition was defined as overweight/obesity and anaemia only, overweight/obesity and iodine insufficiency, or overweight/obesity and any micronutrient deficiency (anaemia and/or iodine insufficiency). The Chi-squared goodness of fit test was used to compare the expected and observed numbers of individuals with the type of double malnutrition. Logistic regression was used to investigate determinants of each type of double malnutrition.ResultsDouble malnutrition was present in 22–36% of participants, depending on the definition used. All types of double malnutrition were more common in women than in men (overweight/obesity and anaemia: 34% vs. 10.2%, p < 0.01; overweight/obesity and iodine insufficiency: 32% vs. 12.2%, p < 0.01 and overweight/obesity and any micronutrient deficiency: 50.5% vs. 20.4%, p < 0.01). There were no differences between the overall expected and observed numbers of individuals with combinations of overweight and micronutrient deficiencies [overweight/obesity and anaemia (p = 0.28), overweight/obesity and iodine insufficiency (p = 0.27) or overweight/obesity and any micronutrient deficiency (p = 0.99)]. In models adjusted for socio-demographic factors, HIV and antiretroviral drug status, and food security or dietary diversity, men were 84–85% less likely than women to have overweight/obesity and anaemia, 65% less likely to have overweight/obesity and iodine insufficiency and 74% less likely to have overweight/obesity and any micronutrient deficiency.ConclusionsIndividual-level double malnutrition is prevalent in middle-aged and older adults in a rural sub-Saharan African community. Interventions to improve nutrition in similar settings should target individuals throughout the life course and a focus on women may be warranted.

Changes in Serum Level of Vitamin D Four Years After Sleeve Gastrectomy in Patients with Morbid Obesity: A Single-Center Study

Background: Bariatric procedures are associated with various micronutrient and vitamin deficiencies, including vitamin D. Objectives: The aim of the study was to assess the effect of laparoscopic sleeve gastrectomy (LSG) on serum vitamin D levels in a 4-year follow-up of obese patients. Methods: All obese patients undergoing LSG at Modarres Hospital were included in this study. Patients were evaluated 4 years after surgery, and their serum levels of calcium, parathyroid hormone (PTH), and vitamin D were measured. Results: Analytical analysis demonstrated a statistically significant difference in vitamin D and calcium levels before and after LSG (P-value &lt; 0.001 for both). However, the change in PTH levels before and after LSG was not statistically significant. Additionally, the analysis showed no statistically significant relationship between vitamin D levels and PTH levels. Conclusions: The results of the present study showed that, four years after LSG, vitamin D and calcium levels significantly increased in patients with morbid obesity, although the observed increase in PTH levels was not statistically significant.

The Association of Infant Birth Sizes and Anemia under Five Years Old: A Population-Based Prospective Cohort Study in China.

Infant birth sizes are vital clinical parameters to predict poor growth and micronutrient deficiency in early life. However, their effects on childhood anemia remain unclear. We aimed to explore the associations between birth weight, crown-heel length, and head circumference with anemia in early childhood, as well as potential modification factors. This population-based prospective cohort study included 204,556 participants with singleton live births delivered at gestational ages of 28-42 weeks. A logistic regression model was used to estimate the associations of the measures of infant birth size and their Z-score with anemia under five years old. There were 26,802 (13.10%) children under five years old who were diagnosed has having anemia. Compared with children who did not have anemia, children who had anemia had a lower birth weight and smaller head circumference and a longer crown-heel length (all p-values < 0.05). After adjusting for confounders, not only birth weight (β coefficient, -0.008; 95% CI, -0.011--0.004; p < 0.001) and head circumference (β coefficient, -0.004; 95% CI, -0.007--0.001; p = 0.009), but also the related Z-scores were negatively associated with childhood anemia, while the trends for crown-heel length were the opposite. We further found significant interactions of folic acid use and maternal occupation with infant birth sizes. In conclusion, infants having abnormal sizes at birth are significantly associated with the risk for childhood anemia, which can be modified by folic acid use during pregnancy and maternal occupation.

Modeling the Contribution of Multiple Micronutrient Fortification of Salt to Daily Nutrient Intake Among the Ethiopian Population

BackgroundSalt is an affordable commodity and has wide coverage regardless of economic and social status and, hence, could be suitable vehicle for multiple micronutrient fortification. ObjectivesThis study aimed to simulate the contribution folic acid and zinc fortification of iodized salt to nutrient intake among the Ethiopian population. MethodsThe 2013 Ethiopian National Food Consumption Survey and various food composition tables were used to estimate baseline individual-level micronutrient intake. Usual intake was estimated using the Simulating Intake of Micronutrients for Policy Learning and Engagement macro tool. Discretionary salt consumption was calculated from total salt intake estimated using urinary sodium excretion. Fortificant addition rates were set to obtain maximum nutrient intake while simultaneously constraining that population with intake above the tolerable upper intake level to <5%. Addis Ababa and Somali (N = 2271), the regions with relatively the lowest and highest micronutrient deficiency prevalence in Ethiopia, were selected. ResultBaseline median intake of Zn was below the estimated average requirement for all demographic groups. Inadequate Zn intake ranged from 73% to 99%, the highest prevalence being observed among women in lower class of wealth quintiles from Somali region. Dietary folate inadequacy was as low as 2% among men in Addis Ababa but almost all (99%) women from Somali region had inadequate folate intake. Calculated discretionary salt intake was 7.5 g/d for adult men and women and 3.4 g/d for children. With addition 0.8 mg Zn and 30 μg of folic acid per gram of salt, multiple salt fortification is estimated to reduce Zn inadequacy by 38 percentage points in urban areas and19 percentage points in rural areas. Modeled reduction in folate inadequacy were 18% in urban areas and 22% in rural areas. ConclusionsMultiple salt fortification could be an effective approach to address micronutrient adequacy in Ethiopia given efficacious, technological, and economical feasibility.

Molecular characterization of QTL for grain zinc and iron concentrations in wheat landrace Chinese Spring.

Three stable QTL for grain zinc concentration were identified in wheat landrace Chinese Spring. Favorable alleles were more frequent in landraces than in modern wheat cultivars. Wheat is a major source of dietary energy for the growing world population. Developing cultivars with enriched zinc and iron can potentially alleviate human micronutrient deficiency. In this study, a recombinant inbred line (RIL) population with 245 lines derived from cross Zhou 8425B/Chinese Spring was used to detect quantitative trait loci (QTL) for grain zinc concentration (GZnC) and grain iron concentration (GFeC) across four environments. Three stable QTL for GZnC with all favorable alleles from Chinese Spring were identified on chromosomes 3BL, 5AL, and 5BL. These QTL explaining maxima of 8.7%, 5.8%, and 7.1% of phenotypic variances were validated in 125 resequenced wheat accessions encompassing both landraces and modern cultivars using six kompetitive allele specific PCR (KASP) assays. The frequencies of favorable alleles for QGZnCzc.caas-3BL, QGZnCzc.caas-5AL and QGZnCzc.caas-5BL were higher in landraces (90.4%, 68.0%, and 100.0%, respectively) compared to modern cultivars (45.9%, 35.4%, and 40.9%), suggesting they were not selected in breeding programs. Candidate gene association studies on GZnC in the cultivar panel further delimited the QTL into 8.5Mb, 4.1Mb, and 47.8Mb regions containing 46, 4, and 199 candidate genes, respectively. The 5BL QTL located in a region where recombination was suppressed. Two stable and three less stable QTL for GFeC with favorable alleles also from Chinese Spring were identified on chromosomes 4BS (Rht-B1a), 4DS (Rht-D1a), 1DS, 3AS, and 6DS. This study sheds light on the genetic basis of GZnC and GFeC in Chinese Spring and provides useful molecular markers for wheat biofortification.

Celiac Disease and the Risk of Micronutrient Deficiencies in Ethnic Minority Populations: A Retrospective Cohort Study

Introduction: Celiac disease (CD) is a chronic immune-mediated disorder triggered by gluten ingestion in genetically predisposed individuals. Historically, CD was primarily recognized and described as a disease of the Caucasian population. Data from a national survey in 2015 revealed that 0.79% of the population was formally diagnosed with celiac disease, with the non-Hispanic white population having a prevalence of 4–8 times higher than other underrepresented races. Although there is evidence that CD affects minorities at higher than reported rates, there is little data on its effects on minority populations. Our study aimed to characterize celiac-related complications among underrepresented populations in a large health database. Methods: We performed a cohort study among patients aged ≥18, utilizing the TriNetX US Collaborative Network. Two cohorts of patients (minority and non-Hispanic white) with CD were identified between 2016 and 2021. Cohorts were propensity scores matched on demographics and baseline clinical characteristics. Outcomes were assessed up to 1 year after the index event (CD diagnosis), including vitamin/mineral deficiencies and hospital visits. Data were analyzed using the TriNetX Analytics function. Results: Each group was matched with 817 patients. Compared to the non-Hispanic white population, the minority group had a similar incidence of iron, vitamin B, and zinc deficiencies. The minority group had a higher risk of vitamin D deficiency, anemia secondary to iron deficiency, inpatient hospital stays, and emergency department visits. Conclusion: Our results indicate that minority patients with celiac disease have a higher incidence of vitamin D and iron deficiency.