Nutritional Deficiency Diseases Research Articles

Bioactive vegetable proteins and peptides in lipid-lowering; nutraceutical potential.

As the last century saw a decline in the burden of nutritional deficiency and infectious disease, the global burden of chronic disease, cardiovascular disease (CVD) in particular, is increasing. CVD is the leading cause of death in the developed countries. Significant research efforts on the prevention and treatment of this disease have identified elevated plasma cholesterol as a primary risk factor for CVD. Although CVD progresses with hypercholesterolemia, it seems possibility to delay and prevent its development through improvement of diet. Recent findings demonstrate that protein concentrates, protein hydrolysates, and peptides derived from vegetables may promote a significant decrease in blood cholesterol concentration. This reduction in cholesterol and lipid levels by protein, protein hydrolysates, and peptides can be the result of dietary changes, reduced cholesterol biosynthesis, changes in bile acid synthesis, and reduced absorption of lipid cholesterol and bile acid. Combination drug/diet therapies may reduce the number of drug prescriptions, the progressive rise in "optimal" drug dosage and costs associated with pharmaceutical management of disease. These bioactive vegetable proteins, hydrolysates and peptides may be used in formulation of functional foods, nutraceuticals, and natural drugs because of their health benefit effects suggesting their use as an alternative in treatment of various dyslipidemias, and a potential agent for reducing cardiovascular diseases risk factors.

Heifer fertility and carry over consequences for life time production in dairy and beef cattle

The rearing period has a key influence on the later performance of cattle, affecting future fertility and longevity. Producers usually aim to breed replacement heifers by 15 months to calve at 24 months. An age at first calving (AFC) close to 2 years (23 to 25 months) is optimum for economic performance as it minimises the non-productive period and maintains a seasonal calving pattern. This is rarely achieved in either dairy or beef herds, with average AFC for dairy herds usually between 26 and 30 months. Maintaining a low AFC requires good heifer management with adequate growth to ensure an appropriate BW and frame size at calving. Puberty should occur at least 6 weeks before the target breeding age to enable animals to undergo oestrous cycles before mating. Cattle reach puberty at a fairly consistent, but breed-dependent, proportion of mature BW. Heifer fertility is a critical component of AFC. In US Holsteins the conception rate peaked at 57% at 15 to 16 months, declining in older heifers. Wide variations in growth rates on the same farm often lead to some animals having delayed first breeding and/or conception. Oestrous synchronisation regimes and sexed semen can both be used but unless heifers have been previously well-managed the success rates may be unacceptably low. Altering the nutritional input above or below those needed for maintenance at any stage from birth to first calving clearly alters the average daily gain (ADG) in weight. In general an ADG of around 0.75 kg/day seems optimal for dairy heifers, with lower rates delaying puberty and AFC. There is some scope to vary ADG at different ages providing animals reach an adequate size by calving. Major periods of nutritional deficiency and/or severe calfhood disease will, however, compromise development with long-term adverse consequences. Infectious disease can also cause pregnancy loss/abortion. First lactation milk yield may be slightly lower in younger calving cows but lifetime production is higher as such animals usually have good fertility and survive longer. There is now extensive evidence that as long as the AFC is >23 months then future performance is not adversely influenced. On the other hand, delayed first calving >30 months is associated with poor survival. Underfeeding of young heifers reduces their milk production potential and is a greater problem than overfeeding. Farmers are more likely to meet the optimum AFC target of 23 to 25 months if they monitor growth rates and adjust feed accordingly.

Oral Hygiene, Aspiration, and Aspiration Pneumonia: From Pathophysiology to Therapeutic Strategies

Oropharyngeal dysphagia (OD) is a very prevalent condition in patients with neurological disorders and in the elderly, and has been shown to play a key role in the pathophysiology of aspiration pneumonia (AP), a frequent and severe complication in patients with OD. The pathophysiology of AP includes three main elements: (1) OD with impaired safety of swallow, aspirations, and frequently, impaired cough reflex; (2) poor oral health and oropharyngeal colonization by respiratory pathogens; and (3) frailty with malnutrition and poor immunity. Respiratory infections and AP lead to readmissions and high mortality among patients at risk, and appropriate management is important to avoid these complications. We have developed a therapeutic intervention including early screening, assessment, and treatment of patients at risk of OD. Those with OD are further assessed and treated for nutritional deficiency, oral hygiene, and oral diseases. This will reduce complications and morbidity and mortality among these patients.

CLINICAL DISEASES OF RUMINANTS RECORDED AT THE PATUAKHALI SCIENCE AND TECHNOLOGY UNIVERSITY VETERINARY CLINIC

This study was conducted at the Patuakhali Science and Technology University Veterinary Clinic, Babugonj, Barisal during the period from January 2008 to December 2011 to report the four years clinical diseases of ruminants. A total of 1241 clinical cases (793 cattle and 448 goats) were recorded and analyzed. Diagnosis of each of the clinical cases was made on clinical history, clinical signs, and faecal examination for parasitic cases. The clinical cases were primarily categorized into three major groups, namely, (1) Medicinal, (2) Gynaeco-obstetrical and (3) Surgical cases. Medicinal cases constituted highest percentage (cattle 84.1% and goats 81.0%) in comparison to gynaeco-obstetrical (cattle 4.7% and goats 1.1%) and surgical (cattle 11.2% and goats 17.9%) cases. Among the medicinal cases in cattle, highest percentage of cases was recorded with parasitic diseases (50.4%), followed by general systemic states (14.8%) and digestive disorders (14.2%). Other cases were respiratory disorders (5.5%), infectious diseases (4.6%), skin conditions (3.4%), eye disease (3.1%), urogenital disorders (1.5%), metabolic diseases (1.3%) and musculo-skeletal disorders (0.9%). In case of goats, the highest cases was recorded with digestive disorders (22.9%), followed by parasitic diseases (20.4%) and respiratory disorders (16.8%). Other Medicinal cases in goats were eye diseases (13.5%), infectious diseases (11.8%), general systemic states (9.6%), musculo-skeletal disorder (3.3%), skin diseases (0.8%) and nutritional deficiency diseases (0.8%). Among the gynaeco-obstetrical cases, anestrus (59.5%) in cattle and metritis (40.0%) in goats were recognized as the major gynaeco-obstetric problems. Traumatic wounds (cattle - 52.8%, goat - 28.8%) and castration (31.3%) in goats were recognized as the main disorders which required surgical interventions. It may be concluded that a number of diseases with various percentages have been occurring in the Babugonj upazila and this report will help to prioritize any control measures against major disease conditions reported in this study. However, it is required to estimate the prevalence of diseases in the population of that upazila to have more comprehensive information on the diseases of cattle and goat.DOI: http://dx.doi.org/10.3329/bjvm.v10i1-2.15648

Factors Influencing Anemia and Night Blindness among Children Less than Five Years Old (0 - 4.11 Years) in Khartoum State, Sudan

This study investigated factors influencing nutritional status of children less than five years old suffering anemia and night blindness in Khartoum State. Sample size was 138 children determined by 10% rate of prevalence of nutritional deficiency diseases among children living in Khartoum State. In addition, testing hemoglobin and anthropometric measurements were done. Results depicted that, illiteracy was prevailing, and household monthly income averaged 100 USD. Symptoms of anemia included loss of appetite (8777%), paleness (9375%), and eating clay (29%), while for night blindness they were xerophthalmia (20%); Pinot spots (52%); karatomalacia (12%), and Cornea ulceration (4%). Children suffering these two diseases had hemoglobin concentration below 60% standard, indicated to Iron deficiency anemia and cute malnutrition constitute 63% of the cases. Females are less malnourished compared to males. Significant relationship exists between household monthly income and number of meals per day taken by a child (P=0 .0003); and between nutritional status of children and number of meals taken by a child per day (P=0 .003); and between household monthly income and frequency of daily intake of energy, protein, iron by a child (0.04; 0.01; 0.07 respectively). Nutritional status of pregnant women and nutritional status of the family are significantly correlated (P= 0.0056); and hemoglobin and intake of animal and plant protein is significant correlated (P= 0.03 and 0.01 respectively). Big family size of children suffering anemia and night blindness had reduced their share of energy, protein, iron and vitamin A. The authors suggested some recommendations to alleviate these two diseases in Khartoum State.

Diseases of Mariculture Finfish Species: A Review

Mariculture has been steadily growing over the last few decades. To satisfy the increasing demand of local and export markets for fish and to control overexploitation of marine fish species, many countries are expanding mariculture activities. Disease is one of the most limiting factors in mariculture. Intensification of mariculture favors pathogens, which increase disease outbreaks. Diseases are broadly classified into infectious and noninfectious diseases. Infectious diseases are further divided into four groups based on the nature of the pathogen: viral, bacterial, parasitic, or fungal. Noninfectious diseases are divided into neoplastic diseases, genetic and environmentally induced diseases, and nutritional deficiency diseases. This paper provides detailed information regarding prevalent diseases of maricultured finfish species.

Skin manifestations of nutritional deficiency disease in children: modern day contexts

Nutritional deficiency syndromes, such as scurvy, pellagra, and beriberi are of historical significance but have largely disappeared from modern society. However, certain populations of children in modern society are at risk of severe nutritional complications. The rarity of these syndromes and lack of understanding about modern-day risk factors for nutritional deficiency often delays diagnosis. Dermatologists must maintain an appropriate index of suspicion for these characteristic syndromes as many of the deficiency states present with cutaneous manifestations. Here we review the cutaneous manifestations of macronutrient and micronutrient deficiency syndromes as well as those populations of children that remain at risk for developing severe disease.

Causes of visual disability among Central Africans with diabetes mellitus

Diabetic Retinopathy (DR) remains a common and one of the major causes of blindness in the developed and western societies. The same situation is shown in emerging economic areas (5,6). In sub-Saharan Africa (SSA) however, the issues of visual disability due to diabetes mellitus (DM) are overshadowed by the presence of the prevalent and common nutritional deficiency diseases and eye infections This clinic-based study was conducted to determine whether diabetic retinopathy is independently related to visual disability in black patients with diabetes mellitus (DM) from Kinshasa, Congo. A total of 299 urban patients with DM and low income including 108 cases of visual disability and matched for time admission and DM type to 191 controls, were assessed. Demographic, clinical, and ophthalmic data were assessed using univariate and multivariate analyses. Age ≥60 years, female sex, presence of diabetic retinopathy (DR), proliferative DR, shorter DM duration, glaucoma, macular oedema, diabetic nephropathy were the univariate risk factors of visual disability. Using logistic regression model, visual disability was significantly associated with female sex and diabetic retinopathy. The risk of visual disability is 4 times higher in patients with diabetic retinopathy and 2 times higher in females with DM. Therefore, to prevent further increase of visual disability, the Congolese Ministry of Health should prioritize the eye care in patients with DM.

PMO-047 Diversion colitis treatment with rapidly fermentable fibre-suppositories

IntroductionDiversion colitis, a nutritional deficiency disease of short chain fatty acids (SCFAs) in the defunctioned rectum, responds to butyrate enemas but these are impracticable due to unpleasant malodour. Treatment with...

Prevalence and etiology of anemias in the adult Turkish population

Anemia is common in the general population and one of the most frequently observed nutritional deficiency diseases in the world today. The aim of this study was to investigate the prevalence and etiology of anemias in a large cohort representing the Turkish nation. Materials and methods: The study population comprised 2187 subjects. Serum iron, iron binding capacity, ferritin, vitamin B12, and folic acid analyses were conducted with autoanalyzers using commercial kits. Results: A total of 565 (25.8%) subjects (423 females and 142 males) were diagnosed as anemic. The prevalence of anemia was 30.0% in female and 18.2% in male participants. Iron deficiency was present in 26.7%. Two hundred sixty-five (46.9%) had microcytic, 297 (52.6%) had normocytic, and 3 (0.5%) had macrocytic anemia. Although 29.3% had B12 and 2.2% had folic acid deficiency, in only 3 cases was macrocytosis determined. Conclusion: The results of the present study showed that the prevalence of anemia in Turkey is higher than that reported in previous studies. Moreover, mean corpuscular volume is not always an available guide, and should not be used alone in the diagnosis of megaloblastic anemia, and it should be kept in mind that iron deficiency can cover macrocytosis.

Risks of iron deficiency among vegetarian college women

Iron deficiency anemia is the most common nutritional deficiency disease worldwide and poses a major threat in women of child-bearing age and those who follow a vegetarian diet. The objective of this study was to ascertain whether differences exist in iron status markers between female university students following a vegetarian and non-vegetarian diet. This study took a cross sectional analysis of 39 female students at California Polytechnic State University (Cal Poly State University) in San Luis Obispo, CA between the ages of 18 and 22. Of the participants, 19 followed a vegetarian diet and 20 followed a nonvegetarian diet. Characteristic, demographic, and anthropometric data were collected and analyzed. The results showed no significant difference in iron intake between the two groups. However, nearly 66% of vegetarians and 65% of non-vegetarians failed to meet the Recommended Daily Allowance for iron. No significant difference was found for serum iron, serum ferritin, transfer-rin saturation, and total iron binding capacity between subjects. Serum ferritin tended to be lower for vegetarians compared to non-vegetarians. Both vegetarians and non-vegetarians were in stage IV negative iron balance, with more vegetarians tending to be in stage IV negative iron balance than non-vegetarians. Thus, female college students, irrespective of their meat intake, may be at higher risk of developing negative iron balance and should be educated about iron deficiency anemia and the prevention of iron depletion.

Anemia in Elderly Koreans

Recently, the geriatric population in Korea has grown to comprise approximately 10% of the total population, and anemia has become a significant problem among elderly patients. Many elderly patients have anemia due to nutritional deficiency, chronic inflammation, or comorbid diseases; however, in a significant fraction of the patients with anemia, the cause remains obscure. Anemia of any degree is recognized as a significant independent contributor to morbidity and mortality in elderly patients. This article summarizes the patterns of anemia in Korean geriatric patients.

Assessment and Management of Pressure Ulcers in the Elderly

Pressure ulcers (pressure sores) continue to be a common health problem, particularly among the physically limited or bedridden elderly. The problem exists within the entire health framework, including hospitals, clinics, long-term care facilities and private homes. For many elderly patients, pressure ulcers may become chronic for no apparent reason and remain so for prolonged periods, even for the remainder of the patient's lifetime. A large number of grade 3 and 4 pressure ulcers become chronic wounds, and the afflicted patient may even die from an ulcer complication (sepsis or osteomyelitis). The presence of a pressure ulcer constitutes a geriatric syndrome consisting of multifactorial pathological conditions. The accumulated effects of impairment due to immobility, nutritional deficiency and chronic diseases involving multiple systems predispose the aging skin of the elderly person to increasing vulnerability. The assessment and management of a pressure ulcer requires a comprehensive and multidisciplinary approach in order to understand the patient with the ulcer. Factors to consider include the patient's underlying pathologies (such as obstructive lung disease or peripheral vascular disease), severity of his or her primary illness (such as an infection or hip fracture), co-morbidities (such as dementia or diabetes mellitus), functional state (activities of daily living), nutritional status (swallowing difficulties), and degree of social and emotional support; focusing on just the wound itself is not enough. An understanding of the physiological and pathological processes of aging skin throws light on the aetiology and pathogenesis of the development of pressure ulcers in the elderly. Each health discipline (nursing staff, aides, physician, dietitian, occupational and physical therapists, and social worker) has its own role to play in the assessment and management of the patient with a pressure ulcer. The goals of treating a pressure ulcer include avoiding any preventable contributing circumstances, such as immobilization after a hip fracture or acute infection. Once a pressure ulcer has developed, however, the goal is to heal it by optimizing regional blood flow (by use of a stent or vascular bypass surgery), managing underlying illnesses (such as diabetes, hypothyroidism or congestive heart failure) and providing adequate caloric and protein intake (whether through use of dietary supplements by mouth or by use of tube feeding). If the ulcer has become chronic, the ultimate goal changes from healing the wound to controlling symptoms (such as foul odour, pain, discomfort and infection) and preventing complications, thereby contributing to the patient's overall well-being; providing support for the patient's family is also important. Recent advances in wound dressings allow for greater control of symptoms and prevention of complications, and have also enabled the affected patient to be integrated more readily into the family setting and in the community at large. Ethical and end-of-life issues must also be addressed soon after the wound has become chronic. This article discusses the pathogenesis of pressure ulcer development in the elderly in relation to concomitant diseases, risk factor assessment and the management of such ulcers.

Ichthyosiform Irritant Contact Dermatitis Caused by Antiseptics for Personal Hygiene

Background: Antiseptics are commonly used for personal hygiene in Taiwan. We have previously reported a series of ichthyosiform irritant contact dermatitis induced by cetrimide-containing antiseptics. Objectives: To report a new series of antiseptics-induced ichthyosiform irritant contact dermatitis and bring attention to the potential irritation effects of antiseptics. Methods: We reviewed the clinicopathologic features of cases of cetrimide dermatitis, Savlon dermatitis or ichthyosiform irritant contact dermatitis diagnosed in our department (October 1993-August 2008). Cases with characteristic ichthyosiform, scarlet to dusky red or chemical burn-like skin lesions, primarily affecting the flexures and/or genital areas, and relevant exposure histories were included. Results: There were 35 patients (14 men and 21 women), aged from 3 to 79 years (mean 45 years) Most patients were seen in summer with a recognizable underlying pruritic dermatosis, and had used commercial products containing cetrimide. The exposure time was from 4 days to 2 months (mean 3.4 weeks). The great majority (80%) had moderate or severe skin lesions characterized by scarlet to dusky red or brownish lesions with a collodion membrane-like surface, and showed a preferential involvement of the flexural and genital areas, especially the groin and axilla where the lesions often manifested centrifugal rings. In no case was antiseptics-related dermatitis suspected by the clinicians or the patients. Skin biopsy was performed in 5 patients; all revealed changes consistent with cetrimide ichthyosiform irritant contact dermatitis. Conclusions: Our study showed that self-application of cetrimide-containing antiseptics is still an important cause of irritant contact dermatitis in southern Taiwan. This dermatitis should be differentiated from ichthyosis, tinea circinata, erythema annulare centrifugum, and nutritional deficiency diseases. Recognition of the clinical characteristics can prompt clinicians to inquire about exposure to antiseptics and facilitate correct diagnosis.

Dysautonomia, a heuristic approach to a revised model for etiology of disease.

Dysautonomia refers to a disease where the autonomic nervous system is dysfunctional. This may be a central control mechanism, as in genetically determined familial dysautonomia (Riley-Day Syndrome), or peripherally in the distribution of the sympathetic and parasympathetic systems. There are multiple reports of a number of different diseases associated with dysautonomia. The etiology of this association has never been explained. There are also multiple publications on dysautonomia associated with specific non-caloric nutritional deficiencies. Beriberi is the prototype of autonomic dysfunction. It is the best known nutritional deficiency disease caused by an imbalance between ingested calories and the vitamins required for their oxidation, particularly thiamin. Long thought to be abolished in modern medical thinking, there are occasional isolated reports of the full-blown disease in developed Western cultures.Apart from genetically and epigenetically determined disease, evidence is presented that marginal high calorie malnutrition, particularly with reference to simple carbohydrates, is responsible for widespread dysautonomia. The brain and heart are the organs that have a fast rate of oxidative metabolism and are affected early by any mechanism that reduces oxidative efficiency. It is hypothesized that this results in a chaotic state of the hypothalamic/autonomic/endocrine axis. Due to the lack of adequate automatic controls, this may be responsible in some cases for breakdown of organ systems through long-standing energy deficiency, thus leading eventually to organic disease.

Dental trauma and antemortem tooth loss in prehistoric Canary Islanders: prevalence and contributing factors

AbstractDifferential diagnosis of the aetiology of antemortem tooth loss (AMTL) may yield important insights regarding patterns of behaviour in prehistoric peoples. Variation in the consistency of food due to its toughness and to food preparation methods is a primary factor in AMTL, with dental wear or caries a significant precipitating factor. Nutritional deficiency diseases, dental ablation for aesthetic or ritual reasons, and traumatic injury may also contribute to the frequency of AMTL. Systematic observations of dental pathology were conducted on crania and mandibles at the Museo Arqueologico de Tenerife. Observations of AMTL revealed elevated frequencies and remarkable aspects of tooth crown evulsion. This report documents a 9.0% overall rate of AMTL among the ancient inhabitants of the island of Tenerife in the Canary Archipelago. Sex‐specific tooth count rates of AMTL are 9.8% for males and 8.1% for females, and maxillary AMTL rates (10.2%) are higher than mandibular tooth loss rates (7.8%) Dental trauma makes a small but noticeable contribution to tooth loss among the Guanches, especially among males. In several cases of tooth crown evulsion, the dental root was retained in the alveolus, without periapical infection, and alveolar bone was in the initial stages of sequestering the dental root. In Tenerife, antemortem loss of maxillary anterior teeth is consistent with two potential causal factors: (a) accidental falls while traversing volcanic terrain; and (b) interpersonal combat, including traditional wrestling, stick‐fighting and ritual combat. Steep‐walled valleys (barrancos) and lava fields (malpaís) required agile locomotion and occasional vaulting with the aid of a wooden staff. Accidental falls involving facial injury may have contributed to AMTL. Traditional conflict resolution involved competitive wrestling (lucha canaria), stick‐fighting (juego del palo), and ritualised contests involving manual combat. These activities made a small but recognisable impact on anterior dental trauma and tooth loss. Inter‐personal behaviours of such intensity leave their mark on skeletal and dental remains, thereby providing insight into the lives and cultural traditions of the ancient Guanches. Copyright © 2006 John Wiley & Sons, Ltd.

Dietary Status of Children of Udaipur District

In India a staggering 320 billion people live below the poverty line resulting in widespread prevalence of undernutrition. The growing childhood years are more critical since the curse of undernutrition is more pronounced. Nearly 50 per cent children below 5 years are malnourished. Since the mothers are malnourished one third of the new born are of low weight and the nutritional deficiency diseases such as anemia iodine deficiency disorders vitamin A deficiency and PEM still exist and by adversely affecting the working capacity of the man power is creating a dent on national economy. Although in the last two decades we have witnessed phenomenal progress in the sphere of agricultural production. The green revolution has enabled us to increase the food grains production from 50.9 million tones in 1950 to 198.2 million tones in 1999. Similarly white revolution has made India number one in milk production and sufficient increase is reported in marine and freshwater fishes due to success in blue revolution. We are also largest producer of vegetables and fruits. (excerpt)

Risk factor criteria.

The concept of the risk factor for chronic diseases, such as cardiovascular disorders, is derived from the application of epidemiological methods initially developed for infectious and nutritional deficiency diseases to chronic conditions to identify the factor(s) linked to the development of the chronic disease. Typically in infectious or nutritional deficiency conditions, a single causative agent or primary cause is identified. Thus, the cause of tuberculosis is the tubercle bacillus, and the cause of pellagra is niacin deficiency. However, for cardiovascular diseases, in which causes are usually complex and multifactorial, new concepts were required. For example, individuals with hypertension have a far greater risk for cardiovascular disease than those without hypertension, but many individuals with hypertension never have clinical sequelae, and many individuals with diagnosed cardiovascular diseases have no hypertension. One can also argue that many individuals who are exposed to the tubercle bacillus do not develop clinical tuberculosis, but the converse is not true; no one has tuberculosis without the tubercle bacillus. This provides a clear distinction between multifactorial diseases, such as coronary disease where the risk factor concept is paramount, and other health conditions. The initial application of the risk factor concept was well developed long before the term was coined. Early in the previous century, insurance companies noted that individuals with high blood pressure were at higher risk for premature mortality1 and therefore would be accepted for life insurance only on payment of an additional premium. Insurance companies also recognized the related risk factor of obesity, and imposed higher premiums on overweight clients. In this context, risk factors are used as predictors of disease and mortality. Surprisingly, insurance companies failed to recognize the enormous contribution of smoking to cardiovascular risk until later. Although the underlying concept had been widely discussed and applied, the term “risk factor” was …

Prevalence of micronutrient deficiency based on results obtained from the national pilot program on control of micronutrient malnutrition.

Micronutrient deficiency is a serious public health concern in most developing countries. In India, iron deficiency, vitamin A deficiency, and iodine deficiency disorder are of greatest public health significance. In addition, subclinical zinc deficiency, flourosis, and fluoride-deficient dental caries are important areas of concern. The National Pilot Program on Control of Micronutrient Malnutrition was launched in 1995 to address these problems and the Department of Biochemistry and Nutrition of the All India Institute of Hygiene and Public Health (Calcutta) was entrusted to coordinate its activities. The program presently covers one northeastern and four eastern states, namely Assam, Bihar (Jharkhand), Orissa, West Bengal, and Tripura. Baseline analyses were conducted on demographic situation, food and nutrient intake pattern, nutritional deficiency diseases (e.g., iron deficiency anemia), iodine deficiency disorder, and vitamin A deficiency. It was observed that except for cereals, the diet was deficient in all other food groups. Nutrient intake (i.e., energy, protein, vitamins, and minerals) was also deficient in almost the entire state. Anthropometric indices (e.g., weight-for-age and height-for-age data) indicated that large percentages of <5-year-old and 6-14-year-old children were in grade II or III malnutrition. Mean dietary zinc intakes in all the surveyed districts were much lower than the RDA. Large percentages of salt samples had iodine levels less than 15 ppm. The point prevalence of anemia in various age groups was found to be high. Bitot's spot was mainly noted in the age group of 6-71 months. Nightblindness was noted in young children as well as the children 24-71 months old. High prevalence of nightblindness in pregnant women is a point of concern. Actions needed to control micronutrient deficiencies include: intervention strategies, extensive nutrition and health education through innovative IEC materials to support problem-specific programs, strengthening of various state government programs and the role of NGOs.

History of Cereal-Grain Product Fortification in the United States

In response to the prevalent nutritional deficiency diseases in the first half of the 20th century, cereal-grain products fortification activities were launched in the United States close to 1940 voluntarily and through state laws and federal regulations/policies. This article presents a detailed history of the development of cereal-grain products fortification laws, policies, and movements in the United States and its territories from the mid-1930s to present.