Prevalence Of Micronutrient Deficiencies Research Articles

An International Nutrition Index – Successes and Failures in Addressing Hunger and Malnutrition

At international conferences in the 90s, the international community reconfirmed the elimination of hunger and malnutrition as high priority. The Nutrition Index (NI) presented in this paper has been designed to assess the effectiveness of actions taken towards achieving this goal. The Nutrition Index reflects complementary dimensions of a country’s nutrition situation by including the following indicators: 1) the percentage of undernourished in the population, 2) the prevalence of underweight in children under the age of five, and 3) the under-five-mortality rate, indicating the deadly synergy between inadequate food intake and unhealthy living conditions. After data refinement and several estimation procedures to supplement lacking data, data availability permits NI calculation for the vast majority of developing countries and at different points in time (1981, 1992 and 1997). The NI serves as a comprehensive measure to analyse performance and trends in combating hunger and malnutrition in single countries and in regions. In North Africa and the Near East, as well as in Latin America and the Caribbean, a nearly satisfactory nutrition situation has been achieved. The nutrition situation is still bad in South Asia and no better than mixed in most of Southeast Asia, but very promising upward trends have been observed in this region since the beginning of the 80s. In large parts of Sub-Saharan Africa, the nutrition situation is bad or even extremely bad, and recent trends do not provide much scope for optimism either. In further analyses, significant correlations between NI values and the prevalence of micro-nutrient deficiencies are found, and the tight connection of macroeconomic performance and people’s ability to be free from hunger and malnutrition is demonstrated. In spite of this, the comparison of NI and GNP per capita also reveals that much economic scope for policies to relieve hunger and malnutrition still remains untapped in many countries. The Nutrition Index, in its function as an international monitoring tool, is hoped to make countries more accountable to their commitments and to help speeding up necessary nutritional improvements.

Iron deficiency anemia as a predictor of coronary artery abnormalities in Kawasaki disease.

PurposeCoronary artery abnormalities (CAA) are the most important complications of Kawasaki disease (KD). Iron deficiency anemia (IDA) is a prevalent micronutrient deficiency and its association with KD remains unknown. We hypothesized that presence of IDA could be a predictor of CAA.MethodsThis retrospective study included 173 KD patients, divided into 2 groups according to absence (group 1) and presence (group 2) of CAA. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a logistic regression model to estimate the association between CAA and other indicators. Due to collinearity between indicators of IDA, each indicator was paired with anemia in 3 models.ResultsSerum iron, iron saturation, and ferritin concentration, the 3 indicators of IDA, were significantly higher in group 1 than in group 2. Three sets of models including anemia with iron indicators produced the OR of CAA of 3.513, 3.171, and 2.256, respectively. The 3 indicators of IDA were negatively associated with CAA, by OR of 0.965, 0.914, and 0.944, respectively. The areas under the curve (AUCs) of ferritin concentration, iron saturation, serum iron, anemia, and Kobayashi score were 0.907 (95% CI, 0.851–0.963), 0.729 (95% CI, 0.648–0.810), 0.711 (95% CI, 0.629–0.793), 0.638 (95% CI, 0.545–0.731), and 0.563 (95% CI, 0.489–0.636), respectively.ConclusionIndicators of IDA, especially ferritin, were highly associated with CAA; therefore, they were stronger predictors of CAA than Kobayashi scores. IDA indicators can be used to predict CAA development and to suggest requirements for early interventions.

Role of Red Cell Distribution Width (RDW) in the Diagnosis of Iron Deficiency Anemia

Background: Iron deficiency anemia (IDA) is the most prevalent micronutrient deficiency in the world. Morphologically, IDA is microcytic and hypochromic as is anemia on chronic disease (ACD) thereby creating confusion on peripheral blood smear examination. Red cell distribution width (RDW) has been proposed to be a more sensitive indicator to establish the possible origin of microcytic hypochromic anemia. Various previous studies have debated the role of RDW in diagnosis of IDA, with no conclusive word on the utility of RDW in diagnosing iron deficiency anemia.Objective. To study the utility of RDW in the diagnosis of IDAMethods: 93 patients with microcytic (MCV<80 fl) anemia were classified into iron deficient (IDA) and anemia on chronic disease (ACD/non-IDA) on the basis of serum ferritin and total iron binding capacity (TIBC). RDW values were obtained on an automated hematology analyzer. Receiver operator curves (ROC) were constructed and the utility of RDW in diagnosis of iron deficiency was studied. Results: The mean RDW value was 20.07±7.67% in IDA group (57 patients) compared to 17.60±3.23 % in the ACD group (36 patients) (p<0.001; CI 95%: 4,14-33,42). At a cut-off value of 17,35%, as obtained from the ROC curve, the sensitivity and specificity of RDW in diagnosis of IDA were 85,96% and 69,44% and a positive and negative predictive value of 81,66% and 75,75% respectively. Conclusions: RDW has a good sensitivity for screening diagnosis of IDA among patient with microcytic hypochromic anemia.

Factors affecting low coverage of the vitamin A supplementation program among young children admitted in an urban diarrheal treatment facility in Bangladesh

ABSTRACTBackground: Vitamin A deficiency (VAD) is one of the most prevalent micronutrient deficiencies in the world. About 2% of all deaths among children under five years of age (U-5) are attributable to VAD. Currently evidence-based knowledge is grossly lacking about the factors associated with low coverage of VAS.Objective: This study aims to determine the factors affecting low coverage of the vitamin A supplementation program among the young children admitted to a diarrheal hospital.Methods: We extracted data from the Diarrhoeal Diseases Surveillance System (DDSS) on children aged 12–59 months admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh, from 1996 to 2014. A logistic regression model was constructed to identify the factors that were significantly associated with non-compliance to vitamin A supplementation (VAS). Strength of association was determined by calculating adjusted odds ratios (aORs) and their 95% confidence intervals.Results: A total of 8649 children were enrolled and comprised the analyzable sample. Their mean ± SD age was 25.2 ± 12.8 months and 40% were female. Around 68% of them had received VAS in the previous 6 months. In the logistic regression analysis, older (>24 months) children (aOR: 1.38; 95% CI: 1.24–1.53), having an illiterate mother (aOR: 1.43; 95% CI: 1.27–1.64), having an illiterate father (aOR: 1.3; 95% CI: 1.16–1.50), coming from the two lowest wealth quintiles (aOR:1.13; 95% CI: 1.02–1.27), with an average monthly household income <10,000 BDT, (1 USD = 60 BDT) and children who had not received the measles vaccine (aOR: 1.87; 95% CI: 1.63–2.19) were more likely not to have received VAS in the preceding six months. We also observed an increase in coverage of VAS from 61% to 76% over the last 18 years (p < 0.001).Conclusions: Non-compliance to VAS was found to be associated with older children, parents without formal schooling, family with greater poverty, low family income, and lack of measles vaccination. Specific programmatic approaches including prioritizing vulnerable children may enhance vitamin A coverage.

Prevalence of goiter and its association with iodine status among the women of reproductive age group in coastal villages of Udupi Taluk, Karnataka, India.

Iodine deficiency is one of the most prevalent micronutrient deficiencies globally. Women in reproductive age group are vulnerable to develop iodine deficiency as there is an increase in demand for iodine, especially during pregnancy. The objective is to assess the prevalence of goiter and its association with iodine status and salt usage practices among the women of reproductive age group. A community-based cross-sectional study was conducted from August 2015 to July 2017 among 1500 women of reproductive age group in five villages of Udupi Taluk. Stratified sampling design and proportion to population size of the reproductive age women in the study area was used to select the study participants. A pretested semi-structured questionnaire was used for data collection. Goiter was assessed clinically and graded as per the recommended criteria of the WHO. Salt samples from every household were collected for iodine estimation. Blood and urine samples were collected from subsample to estimate thyroid-stimulating hormone levels and urinary iodine excretion levels, respectively. The overall prevalence of goiter was 13% with 11.5% being Grade 1 and 1.5% being Grade 2. No significant association of goiter with urinary iodine, salt iodine levels, and salt usage practices was found. Median urinary iodine among the women with goiter indicates iodine sufficiency and no significant difference observed in urinary iodine levels between women with and without goiter.

Accelerating progress for complementary feeding in Kenya: Key government actions and the way forward.

Optimal complementary feeding practices, a critical component of infant and young child feeding, has been demonstrated to prevent micronutrient deficiencies, stunting, overweight, and obesity. In Kenya, while impressive gains have been made in exclusive breastfeeding, progress in complementary feeding has been slow, and the country has failed to meet targets. Recent 2014 Kenya Demographic and Health Survey reveal that only 22% of Kenyan children, 6–23 months, met criteria for a minimum acceptable diet. This case study describes key actions for complementary feeding put in place by the Kenya Ministry of Health as well as approaches for improving and monitoring complementary feeding within existing health platforms. Experience from USAID's Maternal and Child Survival Program and Ministry of Health on development of 23 complementary feeding recipes through application of a national guide for recipe development and Trials of Improved Practices is described. Challenges in how to prepare, modify, and cook foods, including meat, for young children 6–23 months of age was relayed by mothers. Addressing cultural beliefs around complementary feeding meant providing reassurance to mothers that young children are developmentally able to digest fruit and vegetables and ready to consume animal‐source protein. Through the Baby Friendly Community Initiative platform, cooking demonstrations and key hygiene actions were integrated with complementary feeding messages. Future programming for complementary feeding should consider development of context specific counselling messages on consumption of animal source foods, strengthen production and use of local foods through agriculture‐nutrition linkages, and include complementary indicators through routine health monitoring systems to track progress.

Compared with Cow Milk, a Growing-Up Milk Increases Vitamin D and Iron Status in Healthy Children at 2 Years of Age: The Growing-Up Milk–Lite (GUMLi) Randomized Controlled Trial

Iron deficiency (ID) and vitamin D deficiency (VDD) are significant pediatric health issues in New Zealand and Australia and remain prevalent micronutrient deficiencies in young children globally. We aimed to investigate the effect of a micronutrient-fortified, reduced-energy growing-up milk (GUMLi) compared with cow milk (CM) consumed for 1 y on dietary iron and vitamin D intakes and the status of New Zealand and Australian children at 2 y of age. The GUMLi Trial was a multicenter, double-blind, randomized controlled trial in 160 healthy 1-y-old New Zealand and Australian children conducted in 2015-2017. Participants were randomly assigned 1:1 to receive GUMLi (1.7 mg Fe/100 mL; 1.3 µg cholecalciferol/100 mL) or CM (0.02 mg Fe/100 mL; 0.06 µg cholecalciferol/100 mL) for 12 mo. Secondary outcomes, reported here, included change in dietary iron and vitamin D intakes, iron status, and 25-hydroxyvitamin D [25(OH)D] concentrations from blood samples at age 2 y. All regression models were adjusted for baseline outcome and study center. GUMLi was a large contributor to dietary intakes of iron and vitamin D after 12 mo when compared with intakes from food and CM. The adjusted mean difference between groups for serum ferritin concentrations was 17.8 µg/L (95% CI: 13.6, 22.0 µg/L; P<0.0001), and for 25(OH)D it was 16.6 nmol/L (95% CI: 9.9, 23.3 nmol/L; P<0.0001). After 12 mo, ID was present in 16 (24%) participants in the CM group and 5 (7%) participants in the GUMLi group (P=0.009), and the prevalence of VDD in the CM group increased to 14% (n=10) and decreased to 3% (n=2) (P=0.03) in the GUMLi group. In comparison with CM, GUMLi significantly improved dietary iron and vitamin D intakes and the iron and vitamin D status of healthy children at 2 y of age. This trial was registered with the Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) as ACTRN12614000918628.

Cognitive Performance in Indian School-Going Adolescents Is Positively Affected by Consumption of Iron-Biofortified Pearl Millet: A 6-Month Randomized Controlled Efficacy Trial

BackgroundIron deficiency remains the most prevalent micronutrient deficiency globally, but few studies have examined how iron status relates to cognition in adolescents. Iron biofortification of staple food crops is being scaled up, yet it is unknown whether consuming biofortified crops can benefit cognition. ObjectiveOur objective was to determine the efficacy of iron-biofortified pearl millet in improving attention and memory in Indian school-going adolescents. MethodsA double-blind, randomized, intervention study was conducted in 140 Indian boys and girls, aged 12–16 y, who were assigned to consume iron-biofortified [Fe = 86 parts per million (ppm)] or conventional (Fe = 21–52 ppm) pearl millet. Hemoglobin, ferritin, and transferrin receptor (TfR) were measured and body iron (BI) was calculated at baseline and after 4 and 6 mo. Five measures of cognitive function were obtained at baseline and 6 mo: simple reaction time (SRT), Go/No-Go (GNG) task, Attentional Network Task (ANT), Composite Face Effect (CFE) task, and Cued Recognition Task (CRT). Intention-to-treat analysis was used. ResultsDaily iron intake from pearl millet was higher in those consuming biofortified compared with conventional pearl millet (19.6 compared with 4.8 mg/d). Effects on ferritin, TfR, and BI at 4 mo, and on TfR at 6 mo (all P < 0.05), indicated efficacy of biofortified pearl millet over conventional pearl millet in improving iron status. Compared with conventional pearl millet, the consumption of biofortified pearl millet resulted in greater improvement in attention (SRT, GNG, and ANT) and memory (CFE and CRT). Reaction time decreased twice as much from 0 to 6 mo in those consuming biofortified compared with conventional pearl millet on attention tasks (SRT: −123 compared with −63 ms; GNG: −67 compared with −30 ms; ANT double cue: −74 compared with −32 ms; all P < 0.01). ConclusionsConsuming iron-biofortified pearl millet improves iron status and some measures of cognitive performance in Indian adolescents. This trial was registered at http://www.clinicaltrials.gov as NCT02152150.

A Systematic Review of Micronutrient Deficiencies in Pediatric Inflammatory Bowel Disease.

This systematic review critically analyzes the current research on micronutrient deficiency in children with inflammatory bowel disease (IBD) and synthesizes these data to provide evidence-based guidelines for nutritional surveillance in this population. We searched 5 databases (Ovid Medline, PubMed, Scopus, CINAHL, and Cochrane Library) for studies evaluating micronutrients in patients with IBD using the following inclusion criteria: 1) original research, 2) published 1996 or later; 3) published in English; 4) human subjects; and 5) containing pediatric data. Studies were reviewed and included based on the strength of research methods. Data on the prevalence of micronutrient deficiencies in pediatric patients with IBD and risk factors for micronutrient deficiency in these patients were extracted from included studies and compared and discussed in preparation of the proposed guidelines and manuscript. A total of 39 studies were included in the final review. The data presented in these studies show that iron deficiency and vitamin D deficiency are common in pediatric patients with IBD. Vitamin B12 and folate deficiency are rare. Zinc deficiency, while not common, occurs at a higher rate in patients with Crohn's disease than in healthy controls. There was limited data on vitamins A, E, and C, and selenium, but deficiency of these micronutrients seems rare. We recommend annual surveillance of iron and vitamin D in pediatric patients with IBD regardless of disease activity or phenotype. Zinc should be monitored annually in patients with Crohn's disease. There is insufficient evidence to support routine screening for other micronutrient deficiencies.

The cognitive dissonance

The first 1000 days of life (the period between conception and the second birthday) is a window of opportunity for brain development, a unique period when the foundations for optimal growth and development of the nervous system are laid throughout the entire life. Previously it was believed that the main factor that negatively affects the psychomotor development of a child is maternal hypothyroidism in the early stages of pregnancy. However, numerous experimental and epidemiological studies have shown that the development of the nervous system of the fetus is disrupted when a woman has isolated hypothyroxinemia in early pregnancy. The cause of neuropsychiatric disorders in this case is the inadequate availability of maternal thyroxin for the developing brain. Universal salt iodization and fortification of flour with folic acid and iron is a reliable means of preventing micronutrient deficiency in the first 1000 days of life. It is important that this prevention begins before conception and lasts until the end of the neurogenesis period. However, in practice, effective mass methods of prevention are ignored in favor of certain “individual” approaches, the possibilities of which are severely limited.

Effect of various calcium salts on non-heme iron bioavailability in fasted women of childbearing age

IntroductionMicronutrient deficiencies are one of the most important public health issues worldwide and iron (Fe) deficiency anemia is the most prevalent micronutrient deficiency. Iron deficiency often coexists with calcium deficiency and iron and calcium supplementation often overlap. This has led to investigations into the interaction between these two minerals, and whether calcium may inhibit iron absorption in the gut. ObjectiveTo determine the effect of various calcium salts on non-heme iron bioavailability in fasted women of childbearing age. MethodsA randomized and single blinded trial was conducted on 27 women of childbearing age (35–45 years old) divided into 2 groups (n1 = 13 and n2 = 14, respectively). On four different days, after an overnight fast, they received 5 mg of Fe as FeSO4 (labeled with 55Fe or 59Fe) with 800 mg of elemental calcium in the form of either calcium chloride, calcium gluconate, calcium citrate, calcium carbonate, calcium lactate, calcium sulfate or calcium phosphate. Calcium chloride was used as the control salt in both groups. Iron was labeled with the radioisotopes 59Fe or 55Fe, and the absorption of iron was measured by erythrocyte incorporation of radioactive Fe Results800 mg of elemental calcium as calcium citrate produced a significant decrease in non-heme iron bioavailability (repeated measures ANOVA, F = 3.79, p = 0.018). ConclusionOf the various calcium salts tested, calcium citrate was the only salt that decreased non-heme iron bioavailability relative to the calcium chloride control when taken on an empty stomach. These results suggest that inhibition of non-heme iron absorption in fasted individuals is dependent upon the calcium salt in question and not solely dependent on the presence of calcium.

Business-Based Strategies for Improved Nutrition: The Case of Grameen Danone Foods

There is increasing interest in the role that businesses can play in promoting the consumption of nutrient-dense foods as part of strategies to reduce the prevalence of micronutrient deficiencies in developing countries. To date, however, there has been little in-depth analysis of the extent to which viable business opportunities exist for nutrient-dense foods in the context of markets catering to communities. Furthermore, whether businesses can deliver sustainable improvements in the nutrition of poor populations at scale is not yet evident. This article examines the case of Grameen Danone Foods Ltd, a social enterprise that specifically aims to bring about improvements in the micronutrient status of poor children in Bangladesh through the sale of fortified yogurt. The article examines the degree to which this business has been successful at establishing a viable market for fortified yogurt amongst poor communities, and the challenges it has faced in trying to achieve this.

PENINGKATAN KETERSEDIAAN NUTRISI MIKRO PADA TANAMAN: UPAYA MENGURANGI MALNUTRISI PADA MANUSIA

&lt;div class="WordSection1"&gt;&lt;p&gt;&lt;em&gt;Malnutrition is still one of the big problems the majority of devel&lt;strong&gt;op&lt;/strong&gt;ing countries including Indonesia. Malnutrition is the result of insufficient intake of available nutrients in the human diet. The availability of nutrients is mainly determined by the output of food produced from agricultural systems. Plants provide almost all the necessary vitamins and minerals, but due to low mineral content in staple crops, resulting in the intake becomes less and lead to malnutrition or lack of nutrients. Unfortunately, as a result of population pressure, a lot of the current global food system does not provide enough micronutrients to ensure adequate micronutrient intake for everyone. This has resulted in an increase in the prevalence of micro-nutrient deficiencies (for example, iron deficiency, vitamin A deficiency, and iodine), which now afflicts many poor women resources, infants and children in developing countries. To get a balanced nutrition and adequate then improve the quality of agriculture as a food ingredient indispensable. Various attempts to overcome nutritional deficiencies especially regarding micro nutrient deficiencies, such as supplementation, food fortification and diversification of the food has a lot to do, but did not provide maximum results. Another alternative approach to address the problem of shortage of micronutrients is biofortification, genetic biofortification or agronomic biofortification. This approach emerged due to health and human well-being depends entirely on the plants, either directly or indirectly.&lt;/em&gt;&lt;/p&gt;&lt;/div&gt;

Stunting, Micronutrient Deficiencies, and Worm Infections Among Primary School Children at Low and Lower-Middle Income Countries in Asia and Africa: A Systematic Review

Most of stunting and children with micronutrient deficiencies lived in Asia and in Africa region. In many developing countries, any nutritional disorders are aggravated by some infectious diseases such as worm infections especially among children aged 5 to 15 years. The aim of this review study was to describe and compare the prevalence of stunting, micronutrient deficiencies, and worm infections prevalence among primary school children at low and lower-middle income countries in Asia and Africa from 2007 to 2017. The methodology of this research was systematic review, with target population is primary school children aged 6-15 years. The resources of this review study came from online and offline databases; included PubMed, Cochrane Library, Google and Google Scholars. Selected studies should be published journals from low and low-middle income countries in Asia and Africa in last 10 years. A total of 450 selected articles from the various resources were exported to Endnote. Then all the references were filtered by reading the tittles to exclude duplicate resources and the abstracts to exclude resources with unmatched criteria such as children’s age range. Remaining references then were appraised by using appraisal tool and extraction tools from JBI. All these steps were recorded in PRISMA flow diagram (figure 1). Finally, there were 57 of 450 references were selected in this review study. The result of this research showed the prevalence of stunting and micronutrient deficiencies among primary school children in low income countries was higher from Asia. Meanwhile, in lower-middle income countries stunting and micronutrient deficiencies prevalence among primary school children were higher in Africa. Different to stunting and micronutrient deficiencies, prevalence of worm infections in both income country groups was higher in Africa than in Asia. Based on the region, more stunting primary school children were found in Asia than Africa. In contrast, prevalence of micronutrient deficiencies and worm infections were higher among primary school children from Africa. Based on income country group, prevalence of stunting was slightly similar in low and lower-middle income countries. On the other hand, prevalence of micronutrient deficiencies and worm infections were much higher in primary school children from low income countries. In conclusion, this researched stated that primary school children in Asia and Africa have the same nutritional problems and economic level of a country can’t be a single variable to describe the burden of stunting, micronutrient deficiencies, and worm infections among primary school children.

A School-Based Cluster Randomized Controlled Trial to Evaluate the Effectiveness of Nutrition Behavior Change Communication Interventions in Improving Nutritional Status and Academic Performance of Schoolchildren in South Ethiopia: Study Protocol

Background: School aged children in developing countries are vulnerable to malnutrition, which leads to stunting and can have adverse effects on mental development and academic performance at school. Despite several decades of work in improving childhood nutrition in Ethiopia, stunting remains a major public health concern with lack of evidence on its effect on school performance. The primary aim of this study is to addresses this gap by evaluating the effect of behavior change communication intervention on nutritional status and academic performance among school aged children in Meskan District of South Ethiopia.Methods: This school-based cluster randomized trial (c-RCT) compares the intervention arm with control arm. The intervention arm receives behavior change communication (BCC) on essential nutrition actions. The control arm receives only routine health and nutrition services. From a Meskan District, 10 clusters were selected and randomly assigned to the two study arms by randomization. The study participants will be children 10-15 years of age. Total sample size was 408 study participants. Anthropometric measurements, academic performance, nutritional knowledge, and dietary diversity will be measured at both baseline and end line. A behavior change and key poster message was providing based on essential nutrition actions for science teachers and students using class sessions and school visits. A binary logistic regression analysis will be used to identify independent predictors of nutritional status and academic performance of schoolchildren after controlling for confounding variables. The effect of BCC on micronutrient will be determined using generalized estimating equations (GEE) and or linear mixed effects models.Results: A total of 378 primary schoolchildren (10-15 years of age) were involved in the study giving a response rate of 93%. The mean age of the students was 12.8 years (SD ± 1.3 years). The prevalence of stunting and underweight was 16.9% and 37.3% respectively. The mean score of overall grades was 64.52 ± 8.45.Discussion: The findings of this study will provide sufficient evidence to develop policies and programs aimed to improve dietary diversity in children as well as nutritional knowledge (10-15 years) and to prevent micronutrient deficiencies and poor academic performance in school settings. It will also provide recommendations for strengthening the school nutrition component of behavior change communication in child health and nutrition programs.Trial registration: The study was retrospectively registered on October 28, 2016 and is available online at ClinicalTrials.gov (ID: NCT02956941).

Hidden hunger in South Asia: a review of recent trends and persistent challenges.

'Hidden hunger' is a term used to describe human deficiencies of key vitamins and minerals, also known as micronutrients. While global in scale, the prevalence of micronutrient deficiencies is particularly high in South Asia despite recent successes in economic growth, agricultural output and health care. The present paper reviews the most recent evidence on patterns and trends of hidden hunger across the region, with a focus on the most significant deficiencies - iodine, Fe, vitamin A and Zn - and interprets these in terms of health and economic consequences. The challenge for South Asian policy makers is to invest in actions that can cost-effectively resolve chronic nutrient gaps facing millions of households. Appropriate solutions are available today, so governments should build on evidence-based successes that combine targeted health system delivery of quality services with carefully designed multisector actions that help promote healthier diets, reduce poverty and ensure social protection simultaneously.

Association of micronutrients and child growth in children aged 7-15 years from Qwa-Qwa, South Africa

Objectives: This study investigated the possible associations between micronutrient deficiencies and child growth in the rural community of Qwa-Qwa in the Free State province of South Africa (SA).Design: Cross-sectional observational baseline survey.Setting: Rural Qwa-Qwa, Free State, SA.Subjects: Children 7- 15 years of age (n = 73; randomly selected).Outcome Measures: Nutritional status in terms of height and weight measurements, and serum haemoglobin, vitamins A and E and zinc.Results and conclusions: The results of this study showed that there was no significant difference between the mean age of the two genders (p = 0.94). The prevalence of micronutrient deficiencies were 47.3% vitamin E, 25.0% zinc, 3.9% iron deficiency haemoglobin and 1.4% vitamin A. The prevalence of wasting, stunting and underweight was 19.2, 13.7 and 11.4%, respectively. Linear regression analysis showed statistically significant positive correlations between weight-for-age (WAZ) and haemoglobin (r = 0.38, p = 0.049), zinc (r = 0.71, p = 0.008) and vitamin E (r = 0.43, p = 0.029) levels, while there were no significant correlations between vitamin A with WAZ, height-for-age (HAZ) and body mass index-(BMI)-for-age (BAZ). This study shows that there are some associations between child growth and certain micronutrient deficiencies that affects the growth and well-being. Therefore, regular and continued monitoring is recommended for the benefit of, specifically South African children, but also the general population, researchers and the government.

Severely inadequate micronutrient intake among children 9-24months in Nepal-The MAL-ED birth cohort study.

Prevalence of micronutrient deficiencies is high among infants and children in low- and middle income countries, but knowledge about nutrient adequacy across the complementary feeding period is limited. We investigated probability of adequacy (PA) of breast milk and complementary food combined and nutrient density adequacy (NDA) of complementary food and tracking of NDA over time among 229 children from 9-24 months of age in Bhaktapur, Nepal. Monthly, 24h dietary recalls (16 in total) were performed and subgrouped into four 4-month time periods. Ten micronutrients (thiamin, riboflavin, niacin, vitamin B6 , folate, vitamin C, vitamin A, calcium, iron, and zinc) were assessed. Nutrient density was defined as the amount of a nutrient in a child's complementary food per 100kcal, whereas NDA was the nutrient density as percentage of the context specific desired nutrient density. Tracking of NDA was investigated using generalized estimating equations models. PA for B vitamins (except riboflavin), vitamin A, calcium, iron, and zinc (low absorption group) was very low (0% to 8%) at all time slots. Median (IQR) mean PA (of all 10 micronutrients) increased from 11% (9, 15) in the second to 21% (10, 35) in the last time slot. Median value for mean nutrient density adequacy of all micronutrients varied between 42% and 52%. Finally, tracking of NDA was low (correlation <0.30) or moderate (0.30-0.60) indicating poor association between the first and subsequent measurements of NDA. These findings raise grave concerns about micronutrient adequacy among young children in Nepal. Urgent interventions are needed.

Use of commercial infant cereals as complementary food in infants and young children in Ghana

BackgroundTypical complementary foods in developing countries are often inadequate in multiple micronutrients. One way of preventing micronutrient deficiency among infants and young children (IYC) is to feed them a variety of nutrient dense foods. The use of commercial infant cereals (CIC) as complementary food is increasing in Ghana. However, it is unknown whether giving CIC may discourage inclusion of other locally available and nutritious foods as mothers may hold the notion that CIC is superior. This study therefore examined the use of CIC as complementary food, the micronutrient intake from CIC and reasons for its use.MethodsA cross-sectional study was conducted involving mothers with IYC aged 6-23 months who give CIC as complementary food. Questionnaires were administered to estimate the usual daily frequencies and quantities of CIC. Micronutrient intakes from CIC were calculated. We also calculated the proportion of the recommended nutrient intake (RNI) contributed by micronutrients from CIC.ResultsOf the 384 children sampled, 64.6% were aged 13-23 months and 50.3% were females. More than half of the mothers earned income through trading (55.2%) and nearly one quarter of them had senior high school education (24.7%). Majority of the children consumed 3–4 tablespoons (52.3%) of CIC in a feeding moment. Younger children (6–12 months) were served CIC more frequent than older children (13–23 months). The mean ± SD of micronutrients from CIC were 6.76 ± 2.67 mg, 4.79 ± 1.70 mg, 384.12 ± 139.69 mg, 266.70 ± 100.74 mg and 69.11 ± 24.65 μg for the minerals Fe, Zn, Ca, P and I respectively. The vitamin intakes were: 337.17 ± 119.70 μg, 42.88 ± 15.28 mg, 0.84 ± 0.31 μg, 34.24 ± 12.22 μg and 2.70 ± 1.03 mg for vitamin A, vitamin C, vitamin B12, folic acid and niacin respectively. Micronutrients from CIC consumption contributed to at least 70% of the RNIs for Fe, Zn, Ca, I, vitamin A, vitamin C and vitamin B12. Mothers believed that CIC alone could meet the nutritional needs of children and ensure optimal growth and health.ConclusionThe results of present study show that use of CIC as complementary food was high among mothers with IYC 6–12 months. Mothers believed that CIC was nutritionally adequate for their children and did not see the need to include or enrich other locally available complementary foods. Mothers should be educated on the need to include other foods with CIC to increase the dietary quality of IYC.

The Role of the World Health Organization in Eliminating Iodine Deficiency Worldwide.

Iodine deficiency has been one of the most prevalent micronutrient deficiencies in the world, causing many health disorders, particularly in pregnant women and children. Despite increased salt iodization in some countries and regions, the process has lacked global coordination and sustainability, two prerequisites for reaching the aim of eliminating iodine deficiency. This goal can be reached only by evidence-based, effectively monitored joint and committed actions of all countries. The aim of the article is to present the role of WHO in leading and coordinating public health actions aiming elimination of iodine deficiency. WHO was given a mandate to coordinate such public health actions, including developing and strengthening relevant public health legislation, issuing technically sound and evidence-based norms and standards, and monitoring the health situation and trends. WHO has coordinated and fostered collaboration between countries, international organizations, scientific associations and non-governmental organization to reach the goal of eliminating iodine deficiency. No recent patents are discussed for this WHO report.