Prevalensi dan Faktor Risiko Anemia pada Anak di Negara Maju

Background: Anemia is a global public health problem that occurs in developed countries or in developing countries. The prevalence of anemia in children aged 1-5 years in the United States is 3.9% and iron anemia is 1.1%. This review discussed prevalence and the risk factors and anemia in children in developed countries. Method: The method used is a literature review, the data source in the form of research articles is obtained from online databases, namely Google Scholar and Science Direct. The articles reviewed were 10 articles that met the inclusion criteria. Result: Based on several studies, iron deficiency or deficiency is the most common cause in children in developed countries. 8% of children under five in the United States have iron deficiency, and 2-3% of them are iron deficiency anemia. Risk factors for anemia include lack of serum zinc, low levels of 25 (OH) D, exclusive breastfeeding without iron fortification, Low Birth Weight (LBW), food intake factors, history of asthma and eczema, and maternal education. Iron deficiency anemia in childhood has been shown to have a negative effect on cognitive and psychomotor development. Prevention of anemia that can be done include giving iron supplements and food recommendations. Conclusion: Risk factors for anemia include lack of serum zinc, low 25 (OH) D levels, exclusive breastfeeding without iron fortification, Low Birth Weight (LBW), food intake factors, history of asthma and eczema, and maternal education.

Is iron status associated with markers of non-communicable disease in Indian children?

BackgroundHigh body iron stores have been associated with risk for non-communicable diseases (NCD) like diabetes (high fasting blood sugar, FBS), hypertension (HTN) or dyslipidaemia (high total cholesterol, TC) in adults, but not in adolescent children. This is relevant to iron supplementation and food iron fortification programs that are directed at Indian children. MethodsThe association of NCD with serum ferritin (SF) was examined using logistic additive models, adjusted for confounders such as age, Body Mass Index, C-Reactive Protein, haemoglobin and sex, in adolescent (10-19 years old) participants of the Indian Comprehensive National Nutrition Survey. The interaction of these associations with wealth and co-existing prediabetes was also examined. A scenario analysis was also done to understand the impact of iron fortification of cereals on the prevalence NCD among adolescents.ResultsThe odds ratio (OR) of high FBS, HTN and TC were 1.05 (95% CI 1.01-1.08), 1.02 (95% CI: 1.001-1.03) and 1.04 (95% CI: 1.01-1.06) respectively for every 10µg/L increase in SF. The odds for high TC increased with co-existing prediabetes. The scenario analysis showed that providing 10 mg of iron/day by fortification could increase the prevalence of high FBS by 2%-14% across states of India. Similar increments in HTN and TC can also be expected.ConclusionsHigh SF is associated with a significant risk for NCD in adolescents, and this is dependent on the wealth class, and on co-existing prediabetes. This should be considered when evaluating the benefits and harms of enhancing iron intake in anaemia prevention programs.

Microencapsulation of Fe2+ in Spray-Dried Lactose for Improved Bioavailability

The development of spray drying technology has been widely used for drying and preservation of food products. Though infant milk powder iron fortification is necessary for infants and children, iron fortification is accompanied by some limitations that reduce its quality and oxidation of Fe2+ into Fe3+, causing sensory problems and even a decrease in iron absorption, which does not meet the normal requirements of infant and child body development. To overcome this adverse effect and to improve the bioavailability of iron, a spray drying method was used to simulate the milk powder production process by codrying a mixture of ascorbic acid and ferrous sulfate, where ascorbic acid was uniformly coated on the outer layer of ferrous sulfate. It was demonstrated that ascorbic acid had a very obvious inhibitory effect on the oxidation of ferrous iron and could maintain the stability of ferrous iron in solid and solution for a long time, thus improving the bioavailability of iron.

Development and quality mapping of iron fortified jamun (Syzygium cumini) leather

Focused on the iron-fortification of underutilized food sources of Pakistan, jamun was selected as a vehicle fruit for iron supplementation in the form of jamun leather. Iron-fortified jamun leather was prepared from two varieties available in Pakistan i.e., Desi jamun (V1) and Ra jamun (V2) using ferrous sulfate as a fortificant. The treatments prepared were V1T1, V1T2, V2T1 and V2T2 having iron value of 40% (T1) and 60% (T2) recommended daily allowance (RDA). The analyses as physiochemical, phytochemicals, mineral and sensory evaluations were conducted at 0, 30th, 60th, 90th and 120th day. During the study, pH, ascorbic acid, total phenolic contents (TPC) and (2,2-diphenyl-1-picrylhydrazyl) DPPH showed a declining trend, whereas reducing sugar, acidity and brix value increased during storage period. During the study, the highest reduction of pH was observed in V1T1 (3.38±0.021), maximum ascorbic acid was determined in Desi jamun (V1) in a range of 6.81- 6.94 mg/100g. Similarly, Desi jamun (V1) had more total phenolic contents i.e., 1372 mg GAE/100g and remarkable DPPH antioxidant activity as 85% as compared to Ra jamun (V2). The sensory parameters such as color, flavor, taste and overall acceptability showed varying preferences of iron fortification among treatments. Based on analyses outcome, V1T1 and V1T2 were most appropriate treatments having the maximum chemical and organoleptic analysis score amongst all the treatments.

Impact of IgG response to malaria-specific antigens and immunity against malaria in pre-school children in Ghana. A cluster randomized, placebo-controlled trial

Background Iron fortification and micronutrient initiatives, specifically, vitamin A, and zinc supplementation are the most cost-effective developmental strategies against malnutrition and health emergencies in pre-school children. Iron-deficiency among pre-school children have been documented, however, studies evaluating the impact of immunoglobulin G (IgG) isotype responses among iron-fortified pre-school children in malaria endemic communities has not been assessed. We evaluated the impact of iron fortification on the IgG responses to GLURP R0, GLURP R2 and MSP3 FVO malaria-specific antigens among pre-school children in malaria endemic areas. Methods This community-based, placebo-controlled, double-blinded, cluster-randomized trial study was conducted in Wenchi Municipal and Tain District of Bono Region. The trial was registered at ClinicalTrials.gov-registered trial (Identifier: NCT01001871). Ethical approval was obtained and informed consent were sought from each participant parents/guardian. For the current objective, 871 children aged 6–35 months were screened, from which 435 children received semi-liquid home-made meals mixed with 12.5 mg of iron daily (intervention group), and 436 received micronutrient powder without iron (placebo group) for 5 months. Standardized clinical and epidemiological questionnaires were administered and blood samples taken to measure IgG responses to GLURP R0, GLURP R2 and MSP3 FVO recombinant antigens using the Afro Immunoassay (AIA) protocol. Results Baseline anthropometry, malaria diagnosis, anaemia and iron status, demographic features and dietary intake were identical among the groups (p > 0.05). After the intervention, there was no significant difference in the IgG response against GLUP R0, GLUP R2 and MSP3 FVO between the iron-containing micronutrient and placebo groups (p > 0.05). The iron-containing micronutrient powder group who were iron-sufficient or iron replete had significantly higher IgG response to GLURP R0 and GLURP R2 compared to iron-deficient and iron-deficiency anaemia in the same group (p < 0.05). The IgG responses to all the three malaria specific antigens were low among children without malaria episode but high among those with two and four episodes due to exposure differences. Conclusion Iron fortification did not influence antibody response against endogenous malaria specific antigens among pre-school children in malaria endemic areas, however, IgG response to malaria specific antigens were high among children with sufficient iron status.

The Cost-Effectiveness of Existing and Hypothetical Iron Fortification Programs in Haiti

Objectives Our objectives were to estimate apparent intake of iron in Haiti, to assess the adequacy of iron intake among women of reproductive age (WRA), and to model the cost-effectiveness of fortifying alternative food vehicles for reducing inadequate intake. Methods We analyzed the most recent Haiti household food consumption data (2012 ECVMAS) to estimate adequacy of apparent iron intake from dietary sources (using the adult male equivalent method; assuming 10% absorption) and modeled the impacts of fortifying currently mandated (wheat flour, applying local data on current compliance) and hypothetical (bouillon and rice) food vehicles on reductions in the prevalence of inadequate iron intake (effective coverage). We built activity-based cost models to estimate large scale food fortification (LSFF) program establishment and management costs, based on key informant interviews and on published cost estimates from other settings adapted to fit the Haitian case. Results The prevalence of inadequate dietary intake of iron among WRA was 79% (100% among pregnant women). Iron-fortified wheat flour was the most cost-effective vehicle: $4.32 and $4.75 per WRA-year effectively covered at current (75% of flour fortified to the standard of 30 mg/kg) and target (90% fortified to the standard) fortification levels. Fortified wheat flour effectively covered 11–13% of non-pregnant WRA, but almost no pregnant women. Although bouillon was consumed by &gt; 98% of households, low estimated iron absorption from fortified bouillon (2%) led to low effective coverage. Iron-fortified rice (90% fortified at 120 mg/kg) was predicted to effectively cover the largest number of WRA (reducing inadequate intake to ∼30%), but at a cost of $7.80 per WRA-year effectively covered. Conclusions Of the food vehicles modeled, wheat flour was the most cost-effective for reducing inadequate iron intake. Modeling iron fortification of individual and combinations of food vehicles showed that well-designed LSFF programs can contribute to improving iron status among non-pregnant women, but eliminating inadequate iron intake among all WRA will require complementary iron interventions. Funding Sources This work was supported by grants to UC Davis from the Global Alliance for Improved Nutrition (GAIN) and to Partners of the Americas from the United States Agency for International Development (USAID).