Nutrition Uptake and Disease of Children with Anemia in Peru, A Cross-Sectional Analysis
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Abstract Anemia is a multicausal problem affecting 41.7% of children under 5 worldwide. The prevalence of anemia in Peru has decreased only 6.8% from 2009 to 2017, despite great efforts made to distribute free multi-micronutrient supplements and promote the consumption of iron rich foods. The current study investigates the nutritional uptake and incidence of disease in children with anemia in Peru to better understand what is driving the high rates of anemia. METHODS A cross-sectional analysis of secondary data was conducted. Data from two national surveys were linked to evaluate the predictors of anemia. The associations were tested with Chi-square analysis and logistic multivariate regression analysis. RESULTS The sample included 586 children under 3. The prevalence of anemia was 53.2%, while 51.9% of the children consumed sufficient micronutrients to meet the daily recommended level for their age. Of those with anemia, 45.1% consumed sufficient micronutrients to meet the recommended level (p<0.001). The children with anemia were more likely to have an infectious or parasitic disease in the last year and less likely to have access to safe drinking water (p=0.057, p=0.002, respectfully). The logistic analysis displayed that having an infectious or parasitic disease increased the odds of having anemia (OR=1.6, p=0.043), and having access to safe drinking waters decreased the odds of having anemia (OR=0.58, p=0.044), while controlling for micronutrient uptake. CONCLUSIONS Nearly half of the children with anemia in Peru already consume sufficient nutrients to meet their daily requirement. However, they continue to have anemia, likely due to infectious diseases and parasites.Keywords:
Cross-sectional study
Odds
Micronutrient deficiency
Anaemia in pregnancy is a common and worldwide problem that deserves more attention. For many developing countries, prevalence rates of up to 75% are reported. Anaemia is frequently severe in these situations and can be expected to contribute significantly to maternal mortality and morbidity. After a discussion of definitions, screening for anaemia and prevalence, the relationship between anaemia and maternal mortality and morbidity will be reviewed. Micronutrient deficiency and especially iron deficiency is believed to be the main underlying cause for anaemia. More recently the role of vitamin A deficiency as a contributing factor to anaemia has also been examined. The difficulties of assessment of micronutrient sufficiency or deficiency in pregnancy are described, as is the interaction between infection and micronutrient deficiency states.
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Phytosiderophore (PS) release, which occurs mainly under iron deficiencies in the representative Poaceae, has been speculated to be a general adaptive response to enhance the acquisition of micronutrient metals. However, it is very common to encounter deficiency of micronutrients other than iron (Fe) in soils and interactions with respect of multi-micronutrient deficiency to effect on PS release are not known. Further, the diurnal rhythm for the release of PS may also be affected under multiple micronutrient deficiency. PS release capacity and PS content of roots and the diurnal rhythm of PS release was measured in selected efficient and inefficient wheat genotypes varied on individual and combined deficiency of Fe, zinc (Zn), copper (Cu) and manganese (Mn) in nutrient solution culture. A nutrient sufficient treatment was also taken as experimental control. Lack of Fe in the nutrient medium caused a significantly higher release of PSs followed by Zn, Mn and Cu in the same order. The diurnal rhythm of PS release was similar in the absence of either of the micronutrients or under their combined deficiency. Micronutrient sufficient control did not release any PS. Fe-use-efficient cultivars produced and released a larger amount of PS and differed from the inefficient cultivars in terms of the PS release but not in the PS biosynthesis in the roots. Thus, indicating that the limitation at the level of release of the PS is responsible for low Fe use efficiency of the Fe deficiency susceptible cultivars. Further, the diurnal variation in the PS release was similar for all the investigated wheat cultivars and did not influence the variation in the Fe use efficiency.
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Introduction: Adolescents contribute to one fifth of the world's population and is a high priority lifecycle stage for nutrition needs and intervention. Nutritional deficiency, including micronutrients, hinders their normal growth and development. Improving adolescent girls’ nutrition has reproduction-related benefits and serves as a unique opportunity to break the vicious cycle of intergenerational structural problems. The objective is to estimate the prevalence of anaemia, micronutrient deficiency and nutritional status among adolescent girls in rural India. Methods: A community-based cross-sectional study was conducted among 241 adolescent girls in rural Tirunelveli, India with 220 blood samples. Results: The mean age of 241 adolescent girls was 13.8±1.4 years and nutritional status was normal, overweight, obese, thin and stunted in 81.7%, 14.5%, 3.3%,0.4% and 4.6% respectively. The prevalence of anaemia, iron deficiency and iron-deficiency anaemia were 37.2%, 34.5% and 12.3%. Except for selenium, the estimated micronutrient deficiency levels were Vitamin B12 - 40.9%, Copper-30.9%, Zinc-13.6% and Iodine- 11%. Only 19.1% girls had adequate levels of all micronutrients. Vitamin B12 deficiency was more in girls who were overweight (p<0.05). Conclusion: Multiple micronutrient deficiency with normal nutritional status is high among adolescent girls with Vitamin B12 deficiency higher than Iron. Multipronged strategies, including introducing micronutrient fortified healthy snacks in schools, might bring greater acceptance and improvement in nutritional health among these girls.
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The problem of vitamin and micronutrient deficiency is relevant to all regions of the Russian Federation.The present article evaluates actual features of the prevalence of micronutrient deficiencies in the Saratov region.Based on an integrated approach, the development of a controlled system is proposed for identification, correction and prevention of children's health disorders related to the risk of micronutrient deficiency.
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Data regarding micronutrient deficiencies in children with cancer are lacking. We measured micronutrients in a subset of children with cancer (n = 23) participating in a randomized trial of the neutropenic diet. Ninety-six percent of children had ≥1 micronutrient deficiency and 39% had ≥3 micronutrient deficiencies. Eighty-six percent of children had vitamin C deficiency, 87% had 25-hydroxyvitamin D deficiency, 50% had zinc deficiency, and 13% had vitamin A deficiency. Dietary intake did not correlate with micronutrient deficiency status. More data are needed regarding the prevalence and etiology of micronutrient deficiencies in children with cancer to further understand their implications and treatment.
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Micronutrient deficiencies are the most prevalent form of malnutrition worldwide. Although commonly related to underweight, micronutrient deficiencies can occur in both normal and overweight children in medium- and low-income populations undergoing nutritional transition.To describe haemoglobin and micronutrient levels in infants from a low-income area in Brazil in relation to their weight-for-length Z-score.A cross-sectional survey was undertaken of 2-11-month-old infants in Laranjeiras, a small urban community in North-east-Brazil between April 2009 and February 2010. Anthropometry and assays for haemoglobin, ferritin, plasma zinc, copper and selenium and erythrocyte zinc and copper concentrations were investigated.The total number of full-term infants born in the study period was 222, of whom 153 were available for the study. Three (2%) children were wasted, 98 (66%) were of normal weight, 37 (25%) were at risk of overweight and 11 (7%) were overweight or obese. Nearly all (97%) children had at least one micronutrient deficiency, 102 (67%) had anaemia, 86 (58%) and 100 (67%) had plasma and erythrocyte zinc deficiency, respectively, and 7 (5%) and 113 (76%) had plasma and erythrocyte copper deficiency, respectively. 138 (91%) children had selenium deficiency. Except for plasma zinc, the proportion of infants with micronutrient deficiencies did not differ by weight-for-length status.The increased risk of overweight and micronutrient deficiencies in this population highlights the need to address the double burden of excess weight with micronutrient deficiencies in medium- and low-income settings.
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Infants are prone to micronutrient deficiency and indeed millions of infants worldwide are deficient in at least one micronutrient [1], although most infants are deficient in several micronutrients at the same time [2]. An important reason why micronutrient deficiencies often occur concurrently is that the same causal factors to some degree underlie deficiencies of many different nutrients. Monotonous and unbalanced diets, lack of animal-based food products in the diet, and anti-nutritional or absorption-inhibiting factors in the diet will all reduce the nutritional value of a diet [3]. For instance, potent cation-binding substances such as phytates, which are commonly found in cereal diets, make those diets have a particularly low bioavailability for iron as well as for zinc [3, 4]. Such dietary flaws are associated with poverty, and will result in nutritional deficiencies, even when basic energy and protein needs are met, which is often not even the case. As a result, infants and children are at risk for deficiency of not just a single micronutrient but often a whole range of micronutrients to varying extents, the exact combinations determined by the general dietary pattern (e.g., rice-based or maize-based) and the gaps between intake and requirement.
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Micronutrient deficiencies are a major problem throughout the world and hundreds of millions of the world's population are affected by micronutrient deficiency disorders. In Europe the prevalence of clinical micronutrient deficiency disorders is less than that in the Third World. However, marginal deficiency of some of the micronutrients might be involved in the aetiology of many of the so-called lifestyle diseases, e.g. cancer, cardiovascular diseases, diabetes, osteoporosis. Supplementing domestic animals with micronutrients in excess of their needs could be one strategy to increase the intake and, thereby, status of micronutrients in the human population. This approach should, however, be considered carefully, in relation to both animal and human welfare. Many micronutrients that may accumulate in animal foods are toxic in high doses. It would also be unethical to expose animals to doses that might have deleterious effects on their health, and concentrations in animal products that might have adverse effects when consumed by man should be avoided. Furthermore, food quality should not be impaired by the supplement. On the other hand, to be relevant in relation to human nutrition, the given micronutrient should accumulate in animal tissue in concentrations that make an important contribution to total intake. Finally, the micronutrient should be incorporated in a way and in a form that is bioavailable to man, i.e. is well absorbed and utilized.
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In patients with obesity, micronutrient deficiencies have been reported both before and after bariatric surgery (BS). Obesity is a chronic pro-inflammatory status, and inflammation increases the risk of micronutrient malnutrition. Our objective was to assess in pre-BS patients the prevalence of micronutrient deficiencies and their correlation with blood values of C-reactive protein (CRP).Anthropometric data, instrumental examinations, and blood variables were centrally measured in the first 200 patients undergoing a pre-BS evaluation at the "Città della Salute e della Scienza" Hospital of Torino, starting from January 2018.At least one micronutrient deficiency was present in 85.5% of pre-BS patients. Vitamin D deficiency was the most prevalent (74.5%), followed by folate (33.5%), iron (32%), calcium (13%), vitamin B12 (10%), and albumin (5.5%) deficiency. CRP values were high (> 5 mg/L) in 65% of the patients. These individuals showed increased rate of iron, folate, vitamin B12 deficiency, and a higher number of micronutrient deficiencies. In a multiple logistic regression model, increased CRP levels were significantly associated with deficiencies of vitamin B12 (OR = 5.84; 95% CI 1.25-27.2; p = 0.024), folate (OR = 4.02; 1.87-8.66; p < 0.001), and with the presence of ≥ 2 micronutrient deficiencies (OR = 2.31; 1.21-4.42; p = 0.01).Micronutrient deficiencies are common in patients with severe obesity undergoing BS, especially when inflammation is present. In the presence of increased CRP values before surgery, it might be advisable to search for possible multiple micronutrient deficiencies.
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