Association of dietary intake below recommendations and micronutrient deficiencies during pregnancy and low birthweight

2019 ◽  
Vol 47 (7) ◽  
pp. 724-731 ◽  
Author(s):  
Hari Shankar ◽  
Neeta Kumar ◽  
Rajat Sandhir ◽  
Mrigendra Pal Singh ◽  
Suneeta Mittal ◽  
...  
Keyword(s):  
Vitamin A ◽  
Dietary Intake ◽  
Low Birthweight ◽  
Magnesium Deficiency ◽  
Zn Deficiency ◽  
Micronutrient Deficiencies ◽  
Deficient Diet ◽  
Dietary Recall ◽  
Micronutrient Status ◽  
Chi Squared

Abstract Background Pregnancy is associated with biochemical changes leading to increased nutritional demands for the developing fetus that result in altered micronutrient status. The Indian dietary pattern is highly diversified and the data about dietary intake patterns, blood micronutrient profiles and their relation to low birthweight (LBW) is scarce. Methods Healthy pregnant women (HPW) were enrolled and followed-up to their assess dietary intake of nutrients, micronutrient profiles and birthweight using a dietary recall method, serum analysis and infant weight measurements, respectively. Results At enrolment, more than 90% of HPW had a dietary intake below the recommended dietary allowance (RDA). A significant change in the dietary intake pattern of energy, protein, fat, vitamin A and vitamin C (P < 0.001) was seen except for iron (Fe) [chi-squared (χ2) = 3.16, P = 0.177]. Zinc (Zn) deficiency, magnesium deficiency (MgDef) and anemia ranged between 54–67%, 18–43% and 33–93% which was aggravated at each follow-up visit (P ≤ 0.05). MgDef was significantly associated with LBW [odds ratio (OR): 4.21; P = 0.01] and the risk exacerbate with the persistence of deficiency along with gestation (OR: 7.34; P = 0.04). Pre-delivery (OR: 0.57; P = 0.04) and postpartum (OR: 0.37; P = 0.05) anemia, and a vitamin A-deficient diet (OR: 3.78; P = 0.04) were significantly associated with LBW. LBW risk was much higher in women consuming a vitamin A-deficient diet throughout gestation compared to vitamin A-sufficient dietary intake (OR: 10.00; P = 0.05). Conclusion The studied population had a dietary intake well below the RDA. MgDef, anemia and a vitamin A-deficient diet were found to be associated with an increased likelihood of LBW. Nutrient enrichment strategies should be used to combat prevalent micronutrient deficiencies and LBW.

scholarly journals Interrelations Between School-Based Services, Dietary Intake and Micronutrient Deficiencies Among School-Going Children and Adolescents Aged 5–19 Years in India

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1786-1786
Author(s):  
Mansi Chopra ◽  
Anwesha Lahiri ◽  
Priyanshu Rastogi ◽  
Arti Bhanot ◽  
Anjani Bakshi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin A ◽  
Dietary Intake ◽  
Parental Education ◽  
Plasma Concentrations ◽  
Leafy Vegetables ◽  
Micronutrient Deficiencies ◽  
School Meals ◽  
Lower Odds ◽  
School Based

Abstract Objectives India is home to 119 million children (CH; 5–9 y) and 253 million adolescents (AD; 10–19 y), a majority of whom suffer from multiple micronutrient deficiencies (MND). Given high school enrolment levels in India (90% of CH and 75% of AD) schools are a good platform for services and behavior change interventions targeted toward this age group. We sought to analyze the prevalence and predictors of MND in school going CH and AD in India. Methods Data from India's Comprehensive National Nutrition Survey 2016–18 were analyzed separately for CH aged 5–9 y (n = 10,640), AD aged 10–14 y (n = 5390) and AD aged 15–19 y (n = 3693). Serum/plasma concentrations of ferritin, retinol, B12, erythrocyte folate, 25-hydroxyvitamin D, zinc and C-reactive protein were measured. We assessed the weighted prevalence of each MND using established WHO cutoffs, after adjusting ferritin and retinol for inflammation. Primary predictors of MND were dietary intake and access to school services. Multivariable logistic regression models were used to examine associations between these factors and each MND, controlling for socio-demography (sex, residence, wealth quintile, ethnicity, parental education, siblings) and hygiene-sanitation services. Results The top three micronutrient deficiencies were folate (29%), vitamin A (22%), vitamin D (19%) among CH and folate (38%), zinc and B12 (31% each) in AD. One or more MND affected 69% of CH and 83% of AD. In CH, deworming was associated with reduced odds of folate deficiency (AOR and 95% CI: 0.80, 0.68–0.94) and health camps were associated with vitamin A deficiency (0.68, 0.51–0.91). In AD 10–14y, receipt of free school meals had lower odds of B12 deficiency (0.66, 0.49–0.88). In AD 15–19y, health camps were inversely associated with vitamin D deficiency (0.69, 0.51–0.95). CH and AD who consumed green leafy vegetables, pulses and fruits daily had reduced odds of iron, folate or vitamin D deficiencies (AORs: 0.58–0.81). Consumption of fish, chicken or meat (≥2 times/week) was associated with lower odds of almost all MND in CH (AORs: 0.39–0.75), and of iron and B12 deficiencies in AD (AORs: 0.42–0.66). Conclusions Most CH and AD in India suffer from multiple MND. Improving diet quality through school meals and strengthening school-based health services may contribute to MND reductions in this population. Funding Sources UNICEF, POSHAN.

scholarly journals Biofortified Crops for Combating Hidden Hunger in South Africa: Availability, Acceptability, Micronutrient Retention and Bioavailability

Foods ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 815
Author(s):  
Muthulisi Siwela ◽  
Kirthee Pillay ◽  
Laurencia Govender ◽  
Shenelle Lottering ◽  
Fhatuwani N. Mudau ◽  
...  
Keyword(s):  
South Africa ◽  
Vitamin A ◽  
Nutrition Education ◽  
Large Scale ◽  
Genetic Manipulation ◽  
Target Population ◽  
Provitamin A ◽  
Zn Deficiency ◽  
Micronutrient Deficiencies ◽  
Nutrient Deficiencies

In many poorer parts of the world, biofortification is a strategy that increases the concentration of target nutrients in staple food crops, mainly by genetic manipulation, to alleviate prevalent nutrient deficiencies. We reviewed the (i) prevalence of vitamin A, iron (Fe) and zinc (Zn) deficiencies; (ii) availability of vitamin A, iron and Zn biofortified crops, and their acceptability in South Africa. The incidence of vitamin A and iron deficiency among children below five years old is 43.6% and 11%, respectively, while the risk of Zn deficiency is 45.3% among children aged 1 to 9 years. Despite several strategies being implemented to address the problem, including supplementation and commercial fortification, the prevalence of micronutrient deficiencies is still high. Biofortification has resulted in the large-scale availability of βcarotene-rich orange-fleshed sweet potatoes (OFSP), while provitamin A biofortified maize and Zn and/or iron biofortified common beans are at development stages. Agronomic biofortification is being investigated to enhance yields and concentrations of target nutrients in crops grown in agriculturally marginal environments. The consumer acceptability of OFSP and provitamin A biofortified maize were higher among children compared to adults. Accelerating the development of other biofortified staple crops to increase their availability, especially to the target population groups, is essential. Nutrition education should be integrated with community health programmes to improve the consumption of the biofortified crops, coupled with further research to develop suitable recipes/formulations for biofortified foods.

scholarly journals Iron, zinc, vitamin A and selenium status in a cohort of Indonesian infants after adjusting for inflammation using several different approaches

2017 ◽  
Vol 118 (10) ◽  
pp. 830-839 ◽  
Author(s):  
Aly Diana ◽  
Jillian J. Haszard ◽  
Dwi M. Purnamasari ◽  
Ikrimah Nurulazmi ◽  
Dimas E. Luftimas ◽  
...  
Keyword(s):  
Vitamin A ◽  
Geometric Mean ◽  
Retinol Binding Protein ◽  
Fe Deficiency ◽  
Zn Deficiency ◽  
Low Grade ◽  
Serum Retinol ◽  
Reactive Protein ◽  
Micronutrient Status ◽  
Regression Adjustment

AbstractInflammation confounds the interpretation of several micronutrient biomarkers resulting in estimates that may not reflect the true burden of deficiency. We aimed to assess and compare the micronutrient status of a cohort of Indonesian infants (n 230) at aged 6, 9 and 12 months by ignoring inflammation (unadjusted) and adjusting four micronutrient biomarkers for inflammation with C-reactive protein (CRP) and α-1-glycoprotein (AGP) using the following methods: (1) arithmetic correction factors with the use of a four-stage inflammation model; and (2) regression modelling. Prevalence of infants with any inflammation (CRP>5 mg/l and/or AGP>1 g/l) was about 25% at each age. Compared with unadjusted values, regression adjustment at 6, 9 and 12 months generated the lowest (P<0·001) geometric mean (GM) for serum ferritin (26·5, 14·7, 10·8 μg/l) and the highest GM for serum retinol-binding protein (0·95, 1·00, 1·01 μmol/l) and Zn (11·8, 11·0, 11·5 μmol/l). As a consequence, at 6, 9 and 12 months regression adjustment yielded the highest prevalence of Fe deficiency (20·3, 37·8, 59·5 %) and the lowest prevalence of vitamin A (26·4,16·6, 17·3 %) and Zn (16·9, 20·6, 11·0 %) deficiency, respectively. For serum Se, irrespective of adjustment, GM were low (regression: 0·73, 0·78, 0·81 μmol/l) with prevalence of deficiency >50 % across all ages. In conclusion, without inflammation adjustment, Fe deficiency was grossly under-estimated and vitamin A and Zn deficiency over-estimated, highlighting the importance of correcting for the influence of such, before implementing programmes to alleviate micronutrient malnutrition. However, further work is needed to validate the proposed approaches with a particular focus on assessing the influence of varying degrees of inflammation (i.e. recurrent acute infections and low-grade chronic inflammation) on each affected nutrient biomarker.

scholarly journals Trends in Iron, Zinc, and Vitamin A Status Biomarkers Among Colombian Children: Results From 2 Nationally Representative Surveys

2017 ◽  
Vol 38 (2) ◽  
pp. 146-157 ◽  
Author(s):  
Wenchao Li ◽  
Oscar F. Herrán ◽  
Eduardo Villamor
Keyword(s):  
Vitamin A ◽  
Maternal Education ◽  
Nutrition Transition ◽  
Serum Zinc ◽  
Wealth Index ◽  
Micronutrient Deficiencies ◽  
Cross Sectional ◽  
Micronutrient Status ◽  
Region Of Residence ◽  
Nationally Representative

Background: Micronutrient deficiencies are still highly prevalent in countries undergoing the nutrition transition, but nationally representative data documenting their burden in children are exceedingly rare. Objective: To examine the distribution and recent trends in micronutrient status biomarkers of Colombian children. Methods: We compared the distributions of plasma ferritin, serum zinc, and vitamin A in Colombian children between 2005 and 2010 using 2 cross-sectional, nationally representative surveys overall and by categories of sociodemographic variables. Analysis for ferritin included boys and nonpregnant girls aged 1 to 17 years. Analyses for zinc and vitamin A included children aged 1 to 4 years. Results: The mean 2010 to 2005 differences in ferritin, zinc, and vitamin A were 2.5 µg/L (95% confidence interval [CI]: 1.3 to 3.7), −34.9 µg/dL (95% CI: −39.6 to −30.2), and −11.5 µg/dL (95% CI: −12.3 to −10.7), respectively, after adjusting for sociodemographic characteristics. These differences varied significantly by region of residence. In 2010, region of residence was a significant correlate for all 3 micronutrients. Other important correlates included age and maternal education for ferritin and body mass index-for-age Z score, maternal education, wealth index, food insecurity, and urbanicity for vitamin A. Conclusions: Plasma ferritin was slightly higher in 2010 than in 2005, whereas serum zinc and vitamin A were substantially lower in 2010. In the absence of obvious causal explanations, it is uncertain whether this decline represents a worsening of micronutrient status in Colombian children or an artifact due to systematic laboratory or data management errors incurred in the surveys.

scholarly journals Disadvantaged black and coloured infants in two urban communities in the Western Cape, South Africa differ in micronutrient status

2002 ◽  
Vol 5 (2) ◽  
pp. 289-294 ◽  
Author(s):  
A Oelofse ◽  
JMA Van Raaij ◽  
AJS Benadé ◽  
MA Dhansay ◽  
JJM Tolboom ◽  
...  
Keyword(s):  
South Africa ◽  
Dietary Intake ◽  
Community Intervention ◽  
Vitamin A Deficiency ◽  
Psychomotor Development ◽  
Western Cape ◽  
Micronutrient Deficiencies ◽  
Serum Retinol ◽  
Cross Sectional ◽  
Micronutrient Status

AbstractObjectives:To determine the nutritional and health status of urban infants in two disadvantaged communities in the Western Cape, South Africa with special reference to micronutrient status. The results of this study will serve to plan an intervention study in these communities in the same age group.Design:Cross-sectional study.Setting:Two disadvantaged urban black and ‘coloured’ communities in the Western Cape, South Africa.Subjects:Sixty infants aged 6–12 months from each community.Outcome measures:Dietary intake, anthropometric measurements, micronutrient status and psychomotor development.Results:Stunting and underweight were more prevalent in coloured infants (18% and 7%, respectively) than in black infants (8% and 2%, respectively). Anaemia (haemoglobin (Hb)<11 g dl−1) was prevalent in 64% of coloured and 83% of black infants. Iron-deficiency anaemia ( Hb<11 g dl−1and ferritin < 10 ng ml−1) was found in 32% of coloured infants and in 46% of black infants. Zinc deficiency was prevalent in 35% and 33% of the coloured and black infants, respectively. Marginal vitamin A deficiency (serum retinol < 20 μg dl−1) was observed in 23% of black infants compared with 2% of coloured infants. Of black infants, 43% and of coloured infants 6% were deficient in two or more micronutrients. Six per cent of coloured infants had C-reactive protein concentrations above 5 mg l−1compared with 38% of the black infants. The dietary intake of micronutrients was in general lower in black infants than in coloured infants. The overall psychomotor development, assessed by the Denver Developmental Screening Test, was different between the two groups. The coloured infants scored higher in three out of the four categories as well as in their overall score.Conclusions:This study shows that information on stunting and wasting only in urban disadvantaged infants is not sufficient to make recommendations about specific community intervention programmes. Information on the micronutrient status, independent of wasting and stunting, is necessary to design nutrition programmes for different communities. The study also showed a substantially higher prevalence of micronutrient deficiencies among black infants.

The Effect of Vitamin A on the Intermittent Nitrogen Dioxide Gas Exposure in Hamsters

1976 ◽  
Vol 34 ◽  
pp. 176-177
Author(s):  
J.C.S. Kim ◽  
M.G. Jourden ◽  
E.S. Carlisle
Keyword(s):  
Electron Microscopy ◽  
Vitamin A ◽  
Nitrogen Dioxide ◽  
Chronic Exposure ◽  
Light And Electron Microscopy ◽  
Specific Effect ◽  
Deficient Diet ◽  
Intermittent Exposure ◽  
Hypovitaminosis A ◽  
Gas Exposure

Chronic exposure to nitrogen dioxide in rodents has shown that injury reaches a maximum after 24 hours, and a reparative adaptive phase follows (1). Damage occurring in the terminal bronchioles and proximal portions of the alveolar ducts in rats has been extensively studied by both light and electron microscopy (1).The present study was undertaken to compare the response of lung tissue to intermittent exposure to 10 ppm of nitrogen dioxide gas for 4 hours per week, while the hamsters were on a vitamin A deficient diet. Ultrastructural observations made from lung tissues obtained from non-gas exposed, hypovitaminosis A animals and gas exposed animals fed a regular commercially prepared diet have been compared to elucidate the specific effect of vitamin A on nitrogen dioxide gas exposure. The interaction occurring between vitamin A and nitrogen dioxide gas has not previously been investigated.

Review of the Micronutrient Situation in Rwanda

2021 ◽  
Vol 42 (1) ◽  
pp. 133-154
Author(s):  
Joanne E. Arsenault ◽  
Deanna K. Olney
Keyword(s):  
Life Cycle ◽  
Young Children ◽  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Grey Literature ◽  
Age Groups ◽  
Reproductive Age ◽  
Micronutrient Deficiencies ◽  
Micronutrient Malnutrition ◽  
Context Specific

Background: Rwanda’s commitment to reducing malnutrition is evident in their multisectoral nutrition policy and wide array of nutrition partners. However, the prevalence of micronutrient deficiencies and the suitability of current strategies to address existing deficiencies is unclear. Objective: To review the available evidence related to the prevalence of micronutrient deficiencies across the life cycle and strategies in place to address them. Methods: We reviewed scientific and grey literature on nutritional problems in Rwanda, emphasizing micronutrient deficiencies and anemia, and current strategies to address micronutrient malnutrition. Results: Overall, there is scant evidence related to the types and prevalence of micronutrient deficiencies among populations across the life cycle in Rwanda. Existing evidence is primarily limited to outdated or small regional surveys focusing on iron or vitamin A among women and young children. Surveys have assessed the prevalence of anemia and indicate that anemia is very high among young children and moderately high among other age-groups. However, there are limited data on the context-specific causes of anemia in Rwanda across population groups. Current nutrition strategies mainly target women and young children and are primarily designed to reduce vitamin A deficiency and/or anemia caused by micronutrient deficiencies. Conclusions: Rwanda has many nutrition programs in place that address micronutrient deficiencies in young children and a few for women of reproductive age. However, gaps exist in knowledge of the extent of different types of micronutrient deficiencies among all populations across the life cycle and whether the delivery of nutrients through current programs is meeting actual needs.

scholarly journals Assessment of a combined strategy of seasonal malaria chemoprevention and supplementation with vitamin A, zinc and Plumpy’Doz™ to prevent malaria and malnutrition in children under 5 years old in Burkina Faso: a randomized open-label trial (SMC-NUT)

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Paul Sondo ◽  
Marc Christian Tahita ◽  
Toussaint Rouamba ◽  
Karim Derra ◽  
Bérenger Kaboré ◽  
...  
Keyword(s):  
Vitamin A ◽  
Burkina Faso ◽  
Malaria Incidence ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Micronutrient Deficiencies ◽  
Open Label ◽  
Link Type ◽  
Potential Factors ◽  
Combined Strategy

Abstract Background Malaria and malnutrition represent major public health concerns worldwide especially in Sub-Sahara Africa. Despite implementation of seasonal malaria chemoprophylaxis (SMC), an intervention aimed at reducing malaria incidence among children aged 3–59 months, the burden of malaria and associated mortality among children below age 5 years remains high in Burkina Faso. Malnutrition, in particular micronutrient deficiency, appears to be one of the potential factors that can negatively affect the effectiveness of SMC. Treating micronutrient deficiencies is known to reduce the incidence of malaria in highly prevalent malaria zone such as rural settings. Therefore, we hypothesized that a combined strategy of SMC together with a daily oral nutrients supplement will enhance the immune response and decrease the incidence of malaria and malnutrition among children under SMC coverage. Methods Children (6–59 months) under SMC coverage receiving vitamin A supplementation will be randomly assigned to one of the three study arms (a) SMC + vitamin A alone, (b) SMC + vitamin A + zinc, or (c) SMC + vitamin A + Plumpy’Doz™ using 1:1:1 allocation ratio. After each SMC monthly distribution, children will be visited at home to confirm drug administration and followed-up for 1 year. Anthropometric indicators will be recorded at each visit and blood samples will be collected for microscopy slides, haemoglobin measurement, and spotted onto filter paper for further PCR analyses. The primary outcome measure is the incidence of malaria in each arm. Secondary outcome measures will include mid-upper arm circumference and weight gain from baseline measurements, coverage and compliance to SMC, occurrence of adverse events (AEs), and prevalence of molecular markers of antimalarial resistance comprising Pfcrt, Pfmdr1, Pfdhfr, and Pfdhps. Discussion This study will demonstrate an integrated strategy of malaria and malnutrition programmes in order to mutualize resources for best impact. By relying on existing strategies, the policy implementation of this joint intervention will be scalable at country and regional levels. Trial registration ClinicalTrials.gov NCT04238845. Registered on 23 January 2020 https://clinicaltrials.gov/ct2/show/NCT04238845

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