scholarly journals Micronutrient Status and Intervention Programs in Malaysia

2005 ◽  
Vol 26 (2_suppl2) ◽  
pp. S281-S285 ◽  
Author(s):  
Geok Lin Khor
Keyword(s):  
Vitamin A ◽  
Urban Areas ◽  
Socioeconomic Development ◽  
Vitamin A Deficiency ◽  
Nutrition Transition ◽  
Nutrition Intervention ◽  
Deficiency Anemia ◽  
Government Sector ◽  
Micronutrient Status ◽  
The Government

Approximately 70% of the world's malnourished children live in Asia, giving that region the highest concentration of childhood malnutrition worldwide. Prevalence of stunting and underweight are high especially in south Asia where one in every two preschool children is stunted. Iron-deficiency anemia affects 40%–50% of preschool and primary schoolchildren. Nearly half of all vitamin A deficiency and xerophthalmia in the world occurs in south and southeast Asia. Iodine deficiency disorders have resulted in high goiter rates in India, Pakistan, and parts of Indonesia. Compared with other developing countries in Asia, the nutrition situation in Malaysia is considerably better, owing to rapid economic and socioeconomic development that has occurred since Malaysia gained its independence in 1957. Prevalence of undernutrition and micronutrient deficiency is markedly lower in Malaysian children. Nonetheless, undernutrition in the form of underweight, stunting, and anemia can be found in poor communities throughout the country. A prevalence of 25% underweight and 35% stunting is reported among young children from poor rural households. Anemia and subclinical forms of vitamin A deficiency were reported in children under 5 years old. Typical of a country in nutrition transition, Malaysia faces the dual burden of malnutrition in children, with the persistence of undernutrition problems especially among the poor and the emerging overweight problem especially in urban areas. Since 1996, nutrition programs of the government sector are coordinated under the National Plan of Action for Nutrition. These activities and other nutrition intervention efforts by other agencies are discussed in this paper.

scholarly journals Complementary Feeding Indicators in Relation to Micronutrient Status of Ghanaian Children Aged 6–23 Months: Results from a National Survey

Life ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 969
Author(s):  
William E. S. Donkor ◽  
Seth Adu-Afarwuah ◽  
Rita Wegmüller ◽  
Helena Bentil ◽  
Nicolai Petry ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Vitamin A ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Vitamin A Deficiency ◽  
Deficiency Anemia ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Micronutrient Status ◽  
Increased Risk

Background: Optimal complementary feeding is critical for adequate growth and development in infants and young children. The associations between complementary feeding and growth have been studied well, but less is known about the relationship between complementary feeding and micronutrient status. Methods: Using data from a national cross-sectional survey conducted in Ghana in 2017, we examined how multiple WHO-recommended complementary feeding indicators relate to anemia and the micronutrient status of children aged 6–23 months. Results: In total, 42%, 38%, and 14% of the children met the criteria for minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD), respectively. In addition, 71% and 52% of the children consumed iron-rich foods and vitamin A-rich foods, respectively. The prevalence of anemia, iron deficiency (ID), iron deficiency anemia (IDA) and vitamin A deficiency (VAD) was 46%, 45%, 27%, and 10%, respectively. Inverse associations between MMF and socio-economic status were found, and MMF was associated with an increased risk of ID (55%; p < 0.013) and IDA (38%; p < 0.002). Conclusion: The pathways connecting complementary feeding and micronutrient status are complex. Findings related to MMF should be further investigated to ensure that complementary feeding programs account for the potential practice of frequent feeding with nutrient-poor foods.

scholarly journals SEANUTS: the nutritional status and dietary intakes of 0.5–12-year-old Thai children

2013 ◽  
Vol 110 (S3) ◽  
pp. S36-S44 ◽  
Author(s):  
Nipa Rojroongwasinkul ◽  
Kallaya Kijboonchoo ◽  
Wanphen Wimonpeerapattana ◽  
Sasiumphai Purttiponthanee ◽  
Uruwan Yamborisut ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin A ◽  
Nutritional Status ◽  
Rural Areas ◽  
Urban Areas ◽  
Vitamin A Deficiency ◽  
Public Health Problem ◽  
Rural Children ◽  
Major Public Health Problem ◽  
Serum Retinol

In the present study, we investigated nutritional status and health-related factors in a multistage cluster sample of 3119 Thai urban and rural children aged 0·5–12·9 years. In a subsample, blood samples were collected for the measurement of Hb, transferrin receptor, vitamin A and vitamin D concentrations. The prevalence of stunting and underweight was higher in rural children than in urban children, whereas the wasting rate was similar in both rural and urban areas. Among children aged 3·0–5·9 years, the prevalence of overweight was significantly higher in urban areas than in rural areas and so was the obesity rate in children aged 6·0–12·9 years. Protein intakes of all age groups were relatively high in both the areas. Intakes of Ca, Fe, Zn and vitamin C were significantly higher in urban areas than in rural areas. The prevalence of anaemia in rural areas was twice as high as that in urban areas, particularly in infants and young children. However, the prevalence of Fe-deficiency anaemia was similar in both urban and rural areas. While the prevalence of vitamin A deficiency (by serum retinol cut-off < 0·7 μmol/l) seemed to be very low, vitamin A insufficiency (by serum retinol cut-off < 1·05 μmol/l) was more prevalent (29·4–31·7 %) in both the areas. The prevalence of vitamin D insufficiency ranged between 27·7 and 45·6 % among the children. The present study indicates that the double burden of malnutrition is still a major public health problem in Thailand. Further studies need to explore the associated risk factors for these nutrient deficiencies. Effective strategies and actions are needed to tackle the nutritional problems in Thai children.

scholarly journals Identifying the Planning Priorities for Green Infrastructure within Urban Environments Using Analytic Hierarchy Process

2020 ◽  
Vol 12 (13) ◽  
pp. 5468
Author(s):  
Yeeun Shin ◽  
Suyeon Kim ◽  
Sang-Woo Lee ◽  
Kyungjin An
Keyword(s):  
Analytic Hierarchy Process ◽  
Green Infrastructure ◽  
Urban Areas ◽  
Urban Environments ◽  
Analytic Hierarchy ◽  
Urban Green Spaces ◽  
Government Sector ◽  
The Government ◽  
Hierarchy Process ◽  
Design And Construction

Urban environmental issues such as declining air quality and increasing urban heat island effects can be managed by the effective use of urban green spaces. Consequently, the importance of green infrastructure (GI) has rapidly increased over time. While the various functions of GI have been investigated in numerous studies, limited research has focused on prioritizing those factors which impact the planning and development of GI. This study used literature reviews, expert surveys, and an analytic hierarchy process methodology to identify and prioritize the critical factors influencing GI during the design and construction process to enhance the role of GI in urban areas. Experts were asked to prioritize four primary (ecological, landscape, usability, and economic factors) and 16 secondary aspects of GI design. Respondents strongly agreed on the importance of the ecological aspects of GI, while the government sector also highlighted the importance of economic concerns, such as ongoing maintenance. Results indicated that the priorities for creating GI require further analysis and mediation between stakeholders. Further empirical evidence should be accumulated regarding the functions of GI for policy implementation in design and construction.

scholarly journals Human milk sIgA antibody in relation to maternal nutrition and infant vulnerability in northern Kenya

2019 ◽  
Vol 2019 (1) ◽  
pp. 201-211 ◽  
Author(s):  
Masako Fujita ◽  
Katherine Wander ◽  
Nerli Paredes Ruvalcaba ◽  
Eleanor Brindle
Keyword(s):  
Vitamin A ◽  
Human Milk ◽  
Maternal Nutrition ◽  
Diarrheal Disease ◽  
Vitamin A Deficiency ◽  
Microbial Colonization ◽  
Deficiency Anemia ◽  
Immune Protection ◽  
Northern Kenya ◽  
Arm Circumference

Abstract Background The maternal buffering hypothesis posits that human lactation biology can buffer milk against the mild-to-moderate malnutrition that occurred routinely in evolutionary history through the mobilization of maternal body reserves. This perspective may provide insights for understanding human milk immune content variation, such as milk sIgA, which protects infants’ intestines from microbial colonization and prevents diarrheal disease. Objective To investigate how maternal delivery of sIgA to milk may vary in a way that can buffer milk against maternal malnutrition, while taking into consideration infants’ varying needs for immune protection across age or by sex. Methodology A cross-sectional study analyzed archived milk specimens from breastfeeding mothers in Ariaal communities of northern Kenya surveyed during the 2006 Horn-of-Africa drought. Multiple regression models for ln-transformed sIgA were constructed using maternal nutrition, infant age/sex and their interactions as predictors. Maternal nutrition variables included iron-deficiency anemia (IDA), vitamin A deficiency (VAD) and mid-upper arm circumference (MUAC). Infant vulnerability was considered high in young age and/or male sex. Results and implications Milk sIgA did not significantly differ by maternal IDA. Milk sIgA increased with infant age and maternal MUAC (n = 202). Significant interactions were observed between infant age and maternal VAD and between infant sex and maternal MUAC, such that milk sIgA content was low for younger infants particularly among VAD mothers, while among mothers with low MUAC, sIgA was lower for male infants. Results imply that mothers’ ability to deliver/buffer milk sIgA may be lowered when nutritional stress is combined with high infant vulnerability to infection. Lay Summary Human milk sIgA antibody content was low for younger infants among vitamin A deficient mothers. Among mothers with small arm-circumference, milk sIgA was lower for sons. Double burden of raising young or male infants with high needs for immune protection and being malnourished, might lower maternal sIgA delivery to milk.

scholarly journals Societal Costs of Micronutrient Deficiencies in 6- to 59-month-old Children in Pakistan

2017 ◽  
Vol 38 (4) ◽  
pp. 485-500 ◽  
Author(s):  
Simon Wieser ◽  
Beatrice Brunner ◽  
Christina Tzogiou ◽  
Rafael Plessow ◽  
Michael B. Zimmermann ◽  
...  
Keyword(s):  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Large Population ◽  
Cost Effective ◽  
Medical Costs ◽  
Deficiency Anemia ◽  
Micronutrient Deficiencies ◽  
Societal Costs ◽  
Life Years ◽  
Production Losses

Background: In Pakistan, nearly half of children younger than 5 years are stunted, and 1 in 3 is underweight. Micronutrient deficiencies, a less visible form of undernutrition, are also endemic. They may lead to increased morbidity and mortality as well as to impaired cognitive and physical development. Objective: To estimate the lifetime costs of micronutrient deficiencies in Pakistani children aged between 6 and 59 months. Methods: We develop a health economic model of the lifetime health and cost consequences of iodine, iron, vitamin A, and zinc deficiencies. We assess medical costs, production losses in terms of future incomes lost, and disability-adjusted life-years (DALYs). The estimation is based on large population surveys, information on the health consequences of micronutrient deficiencies extracted from randomized trials, and a variety of other sources. Results: Total societal costs amount to US$46 million in medical costs, US$3,222 million in production losses, and 3.4 million DALYs. Costs are dominated by the impaired cognitive development induced by iron-deficiency anemia in 6- to 23-month-old children and the mortality caused by vitamin A deficiency. Costs are substantially higher in poorer households. Conclusions: Societal costs amounted to 1.44% of gross domestic product and 4.45% of DALYs in Pakistan in 2013. These costs hinder the country's development. They could be eliminated by improved nutrition of 6- to 59-month-old children and public health measures. Our results may contribute to the design of cost-effective interventions aiming to reduce micronutrient deficiencies in early childhood and their lifetime consequences.

scholarly journals Improved Effect of School Meals with Micronutrient Supplementation and Deworming

2005 ◽  
Vol 26 (2_suppl2) ◽  
pp. S220-S229 ◽  
Author(s):  
Tara Gopaldas
Keyword(s):  
Vitamin A ◽  
Tamil Nadu ◽  
Vitamin A Deficiency ◽  
Parasite Prevalence ◽  
Micronutrient Supplementation ◽  
School Year ◽  
The Sixties ◽  
Health Inputs ◽  
The Government ◽  
The Cost

A mid-day meal or school lunch program commenced in Gujarat, India from the sixties. In 1994, it was serving approximately 3 million schoolchildren. In 1994, the program was improved with the addition of a “package” of health inputs, including anthelmintics and micronutrient supplementation of iron and vitamin A, and iodine fortified salt. Tara Consultancy Services (TCS), India, a member of the Partnership of Child Development, Oxford University, evaluated Gujarat's improved midday meal program from 1993 to 1996. The program was implemented by the Commissionerate of the mid-day meal program, part of the government of Gujarat. The cost of the 'health package' in 1994, per child per year was 35 US cents (1 US $ = Rs.30). The study to evaluate the improved program included the following components: Focus group discussions Government officials, teachers, students, parents, and community members participated in focus groups to elicit opinions on the proposed program which were predominantly positive. Process evaluation Logistical delivery defined as the adequacy, timeliness and cost of procurement of the anthelmintic drugs and micronutrients and the cost of this 'health package' per schooler per school year by the pharmaceutical companies was 100%. Efficiency of logistics to the schools, defined as the efficiency and cost of logistical delivery of the 'Health Package', from the State Head Quarters to the District to the Taluka to the School was 100%. Coverage defined as consumption of the 'Health Package' by schooler at least once in the 6–9 months of the school year, as stated by the implementing agency was 94%–100% (urban) and 42%–94% (rural); coverage as stated by the schoolchildren was 71%–79% (urban) and 50%–67% (rural). Impact evaluation On average, students who received supplements were 1.1 kg heavier and 1.1 cm taller than those who did not; hemoglobin (Hb) levels were > 12 g/dL intestinal parasite prevalence rates dropped from 71% to 39%; prevalence of night blindness and vitamin A deficiency were reduced from 67% to 34%. Lesson learned Since 2003, 4 states in India, namely, Gujarat, Andhra Pradesh, Karnataka, and Tamil Nadu covering approximately 30 million schoolers have adopted the “Gujarat Model.”

Biological evidence to define a vitamin A deficiency cutoff using total liver vitamin A reserves

2021 ◽  
pp. 153537022199273
Author(s):  
Sherry A Tanumihardjo
Keyword(s):  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Biological Response ◽  
Population Based ◽  
Total Liver ◽  
Long Term Storage ◽  
Micronutrient Status ◽  
Term Storage ◽  
Liver Vitamin

Vitamin A is a fat-soluble vitamin involved in essential functions including growth, immunity, reproduction, and vision. The vitamin A Dietary Reference Intakes (DRIs) for North Americans suggested that a minimally acceptable total liver vitamin A reserve (TLR) is 0.07 µmol/g, which is not explicitly expressed as a vitamin A deficiency cutoff. The Biomarkers of Nutrition for Development panel set the TLR cutoff for vitamin A deficiency at 0.1 µmol/g based on changes in biological response of several physiological parameters at or above this cutoff. The criteria used to formulate the DRIs include clinical ophthalmic signs of vitamin A deficiency, circulating plasma retinol concentrations, excretion of vitamin A metabolites in the bile, and long-term storage of vitamin A as protection against vitamin A deficiency during times of low dietary intake. This review examines the biological responses that occur as TLRs are depleted. In consideration of all of the DRI criteria, the review concludes that induced biliary excretion and long-term vitamin A storage do not occur until TLRs are >0.10 µmol/g. If long-term storage is to continue to be part of the DRI criteria, vitamin A deficiency should be set at a minimum cutoff of 0.10 µmol/g and should be set higher during times of enhanced requirements where TLRs can be rapidly depleted, such as during lactation or in areas with high infection burden. In population-based surveys, cutoffs are important when using biomarkers of micronutrient status to define the prevalence of deficiency and sufficiency to inform public health interventions. Considering the increasing use of quantitative biomarkers of vitamin A status that indirectly assess TLRs, i.e. the modified-relative-dose response and retinol-isotope dilution tests, setting a TLR as a vitamin A deficiency cutoff is important for users of these techniques to estimate vitamin A deficiency prevalence. Future researchers and policymakers may suggest that DRIs should be set with regard to optimal health and not merely to prevent a micronutrient deficiency.

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