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Ngusie HS, Enyew EB, Walle AD, Tilahun Assaye B, Kasaye MD, Tesfa GA, Zemariam AB. Employing machine learning techniques for prediction of micronutrient supplementation status during pregnancy in East African Countries. Sci Rep 2024; 14:23827. [PMID: 39394461 PMCID: PMC11470067 DOI: 10.1038/s41598-024-75455-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 10/04/2024] [Indexed: 10/13/2024] Open
Abstract
Micronutrient deficiencies, known as "hidden hunger" or "hidden malnutrition," pose a significant health risk to pregnant women, particularly in low-income countries like the East Africa region. This study employed eight advanced machine learning algorithms to predict the status of micronutrient supplementation among pregnant women in 12 East African countries, using recent demographic health survey (DHS) data. The analysis involved 138,426 study samples, and algorithm performance was evaluated using accuracy, area under the ROC curve (AUC), specificity, precision, recall, and F1-score. Among the algorithms tested, the random forest classifier emerged as the top performer in predicting micronutrient supplementation status, exhibiting excellent evaluation scores (AUC = 0.892 and accuracy = 94.0%). By analyzing mean SHAP values and performing association rule mining, we gained valuable insights into the importance of different variables and their combined impact, revealing hidden patterns within the data. Key predictors of micronutrient supplementation were the mother's education level, employment status, number of antenatal care (ANC) visits, access to media, number of children, and religion. By harnessing the power of machine learning algorithms, policymakers and healthcare providers can develop targeted strategies to improve the uptake of micronutrient supplementation. Key intervention components involve enhancing education, strengthening ANC services, and implementing comprehensive media campaigns that emphasize the importance of micronutrient supplementation. It is also crucial to consider cultural and religious sensitivities when designing interventions to ensure their effectiveness and acceptance within the specific population. Furthermore, researchers are encouraged to explore and experiment with various techniques to optimize algorithm performance, leading to the identification of the most effective predictors and enhanced accuracy in predicting micronutrient supplementation status.
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Affiliation(s)
- Habtamu Setegn Ngusie
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Woldia University, PO Box 400, Woldia, Amhara, Ethiopia.
| | - Ermias Bekele Enyew
- Department of Health Informatics, College of Medicine and Health Science, Wollo University, Desie, Ethiopia
| | - Agmasie Damtew Walle
- Department of Health Informatics, College of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Bayou Tilahun Assaye
- Department of Health Informatics, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Mulugeta Desalegn Kasaye
- Department of Health Informatics, College of Medicine and Health Science, Wollo University, Desie, Ethiopia
| | | | - Alemu Birara Zemariam
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Science, Woldia University, Woldia, Ethiopia
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Mediratta S, Ghosh S, Mathur P. Intake of ultra-processed food, dietary diversity and the risk of nutritional inadequacy among adults in India. Public Health Nutr 2023; 26:2849-2858. [PMID: 37781767 PMCID: PMC10755415 DOI: 10.1017/s1368980023002112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 08/22/2023] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE This study assessed diet diversity and consumption of ultra-processed foods and explored its impact on macronutrient intake and risk of micronutrient inadequacy. DESIGN Cross-sectional, non-probability snowball sampling. SETTING Nutrient intake was assessed using 24-h dietary recall method and diet diversity through FAO-diet diversity score (DDS). Mann-Whitney U test was used to assess differences in risk of inadequacy across gender. Spearman's rank correlation assessed associations between energy contributed by ultra-processed food and risk of nutrient inadequacy. PARTICIPANTS A total of 589 adults (20-40 years) belonging to upper-middle and high-income groups. RESULTS The average individual DDS was 4·4 ± 0·6. Most of the participants (>80 %) had intakes less than national recommendations of pulses/eggs/flesh foods, milk/milk products, fruits, vegetables and nuts. Ultra-processed foods contributed to 17 % of total energy intake, 12 % of protein, 17 % of carbohydrate, 29 % of added sugar, 20 % of total fat and 33 % of Na intake. The average risk of nutrient inadequacies for Zn (98 % v. 75 %), folate (67 % v. 22 %) and niacin (83 % v. 44 %) was higher among males than females (P < 0·001). The average risk of nutrient inadequacies for Fe (58 % v. 7 %), vitamin B6 (95 % v. 90 %) and vitamin A (68 % v. 44 %) was higher among females than males (P < 0·001). There was a positive correlation between energy contributed by ultra-processed food and risk of niacin (ρ = 0·136, P = 0·001) and folate (ρ = 0·089, P = 0·049) inadequacy. CONCLUSION Reformulating ultra-processed food to reduce fat, sugar and salt and increase micronutrients and behaviour change communication strategies that promote dietary diversity will improve micronutrient adequacy and diet quality.
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Affiliation(s)
- Srishti Mediratta
- Department of Food and Nutrition and Food Technology, Lady Irwin College, University of Delhi, New Delhi, India
| | - Santu Ghosh
- Department of Biostatistics, St John’s Medical College, Bangalore, India
| | - Pulkit Mathur
- Department of Food and Nutrition and Food Technology, Lady Irwin College, University of Delhi, Sikandra Road, Mandi House, New Delhi, 110001, India
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Shalini T, Pullakhandam R, Ghosh S, Kulkarni B, Rajkumar H, Sachdev HS, Kurpad AV, Reddy GB. Prevalence of Vitamin B 12 and Folate Deficiencies in Indian Children and Adolescents. Nutrients 2023; 15:3026. [PMID: 37447351 DOI: 10.3390/nu15133026] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Deficiencies of vitamin B12 (B12) and folate (FA) are of particular interest due to their pleiotropic role in 1-carbon metabolism. In addition to adverse birth outcomes, deficiencies of B12 and FA, or an imbalance in FA/B12 status, are linked to metabolic disorders. Indian diets that are predominantly plant food-based could be deficient in these vitamins, but there are no national estimates of the prevalence of B12 and FA deficiency in Indian children and adolescents, nor their associations with age, sex and growth indicators. The recent Comprehensive National Nutrition Survey (CNNS-2016-18) provided estimates of the prevalence of B12 and FA deficiency at the national and state levels among preschool (1-4 years: 9976 and 11,004 children, respectively), school-age children (5-9 years: 12,156 and 14,125) and adolescents (10-19 years: 11,748 and 13,621). Serum B12 and erythrocyte FA were measured by the direct chemiluminescence method and their deficiency was defined using WHO cut-offs. The prevalence of B12 and FA deficiency was high among adolescents (31.0%, CI: 28.7-33.5 and 35.6%, CI: 33.1-8.2) compared to school-age (17.3%, CI: 15.4-19.3 and 27.6%, CI: 25.5-29.9) and preschool children (13.8%, CI: 11.7-16.2 and 22.8%, CI: 20.5-25.2, respectively). The prevalence of both B12 and FA deficiency was significantly higher by 8% and 5%, respectively, in adolescent boys compared to girls. There was no association between anthropometric undernutrition and B12 and FA deficiency. There was wide regional variation in the prevalence of B12 and FA deficiency, but no rural-urban differences were observed across all age groups. The national prevalence of B12 deficiency among preschool or school-age children was <20% (the cut-off that indicates a public health problem). However, FA deficiency in these age groups and both FA and B12 deficiencies in adolescents were >20%, warranting further investigation.
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Affiliation(s)
- Tattari Shalini
- National Institute of Nutrition, Jamai-Osmania, Tarnaka, Hyderabad 500007, India
| | - Raghu Pullakhandam
- National Institute of Nutrition, Jamai-Osmania, Tarnaka, Hyderabad 500007, India
| | - Santu Ghosh
- St. John's Medical College, Bangalore 560034, India
| | - Bharati Kulkarni
- National Institute of Nutrition, Jamai-Osmania, Tarnaka, Hyderabad 500007, India
| | - Hemalatha Rajkumar
- National Institute of Nutrition, Jamai-Osmania, Tarnaka, Hyderabad 500007, India
| | - Harshpal S Sachdev
- Sitaram Bhartia Institute of Science and Research, New Delhi 110016, India
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Finkelstein JL, Fothergill A, Guetterman HM, Johnson CB, Bose B, Qi YP, Rose CE, Williams JL, Mehta S, Kuriyan R, Bonam W, Crider KS. Iron status and inflammation in women of reproductive age: A population-based biomarker survey and clinical study. Clin Nutr ESPEN 2022; 49:483-494. [PMID: 35623855 PMCID: PMC10878764 DOI: 10.1016/j.clnesp.2022.02.123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/18/2022] [Accepted: 02/28/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Women of reproductive age (WRA) are at increased risk for anemia and iron deficiency. However, there is limited population-level data in India, which could help inform evidence-based recommendations and policy. AIMS To conduct a population-based biomarker survey of anemia, iron deficiency, and inflammation in WRA in Southern India. METHODS Participants were WRA (15-40 y) who were not pregnant or lactating. Blood samples (n = 979) were collected and analyzed for hemoglobin (Hb), serum ferritin (SF), soluble transferrin receptor (sTfR), C-reactive protein (CRP), and alpha-1 acid glycoprotein (AGP). Anemia and severe anemia were defined as Hb < 12.0 and < 8.0 g/dL. Serum ferritin was adjusted for inflammation using BRINDA methods. Iron deficiency was defined as SF <15.0 μg/L, iron insufficiency was defined as SF < 20.0 and < 25.0 μg/L, and iron deficiency anemia was defined as Hb < 12.0 g/dL and SF < 15.0 μg/L. Inflammation was defined as CRP > 5.0 mg/L or AGP > 1.0 g/L. Restricted cubic spline regression models were also used to determine if alternative SF thresholds should be used t to classify iron deficiency. RESULTS A total of 41.5% of WRA had anemia, and 3.0% had severe anemia. Findings from spline analyses suggested a SF cut-off of < 15.0 μg/L, consistent with conventional cut-offs for iron deficiency. 46.3% of WRA had SF < 15.0 μg/L (BRINDA-adjusted: 61.5%), 55.0% had SF < 20.0 μg/L (72.7%), 61.8% had SF < 25.0 μg/L (81.0%), and 30.0% had IDA (34.5%). 17.3% of WRA had CRP > 5.0 mg/L and 22.2% had AGP > 1.0 g/L. The prevalence of ID (rural vs. urban: 49.1% vs. 34.9%; p = 0.0004), iron insufficiency (57.8% vs. 43.8%; p = 0.0005), and IDA (31.8% vs. 22.4%; p = 0.01) were significantly higher in rural areas, although CRP levels were lower and there were no differences in elevated CRP or AGP. CONCLUSIONS The burden of anemia and iron deficiency in this population was substantial, and increased after adjusting for inflammation, suggesting potential to benefit from screening and interventions. REGISTRATION NUMBER NCT04048330.
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Affiliation(s)
- Julia L Finkelstein
- Division of Nutritional Sciences, Cornell University, Ithaca NY, USA; Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA; Institute for Nutritional Sciences, Global Health, and Technology, Cornell University, Ithaca, NY, USA; St. John's Research Institute, Bangalore, Karnataka, India.
| | - Amy Fothergill
- Division of Nutritional Sciences, Cornell University, Ithaca NY, USA
| | | | | | - Beena Bose
- St. John's Research Institute, Bangalore, Karnataka, India
| | - Yan Ping Qi
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Charles E Rose
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer L Williams
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca NY, USA; Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA; Institute for Nutritional Sciences, Global Health, and Technology, Cornell University, Ithaca, NY, USA
| | | | - Wesley Bonam
- Arogyavaram Medical Centre, Andhra Pradesh, India
| | - Krista S Crider
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract
Telomeres are non-coding nucleoprotein structures consisting of a highly conserved tandem repeat DNA sequence that caps the ends of chromosomes in eukaryotes. Telomeres confer chromosomal stability, protect the genome from nucleolytic degradation, avoid aberrant recombination and improper repair, and prevent random fusion of chromosomes. The end-replication problem results in telomere shortening with every cell division, eventually leading to cellular senescence and aging. Telomere length (TL) is thereby an ideal candidate for "biological aging." Telomeres possess guanine-rich repeats, which are highly susceptible to oxidative stress. Epidemiological studies have indicated the association of telomere attrition with mortality and various age-related diseases. Micronutrients comprising vitamins and minerals act as potential modulators of stress and can influence TL. Research has indicated that vitamin B12 (B12) regulates oxidative stress and maintains genomic stability, thereby influencing telomere integrity and cellular aging. The deficiency of B12 leads to elevated levels of homocysteine, which reduces the methylation potential and increases oxidative stress, thereby compromising the TL. Telomere shortening and mitochondrial dysfunction are independently linked to aging. However, they are connected through telomerase reverse transcriptase activity, which regulates mitochondrial biogenesis. Further, experimental evidence indicated the positive association of B12 with relative TL and mitochondrial DNA copy number, an indirect index of mitochondrial biogenesis. The present chapter provides some insights into the role of B12 in influencing TL. Exploring their association might open new avenues to understand the pathophysiology of aging and age-related diseases.
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Shalini T, Jose SS, Prasanthi PS, Balakrishna N, Viswanath K, Reddy GB. Carotenoid status in type 2 diabetes patients with and without retinopathy. Food Funct 2021; 12:4402-4410. [PMID: 33928954 DOI: 10.1039/d0fo03321a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Diabetic retinopathy (DR) is one of the leading causes of blindness. Carotenoids are plant-derived pigments required for general health and particularly for vision. In this study, we evaluated the dietary intake and blood carotenoid levels of type 2 diabetes (T2D) patients with and without DR. A cross-sectional case-control study was conducted among 151 age-matched controls and 344 T2D patients, of which 194 had DR and 150 had no DR (NDR). After a complete ophthalmic examination, the demographic, anthropometric and clinical profiles were obtained. Carotenoids in the plasma were measured by HPLC and dietary intakes were obtained using a food frequency questionnaire. The mean plasma levels of carotenoids (except γ-carotene) were significantly lower in the DR group compared to the Control and NDR groups. The dietary intakes of zeaxanthin, lycopene, α-carotene and β-carotene were significantly lower in the NDR group compared to the Control group, and were further lower in the DR group compared to the NDR group. Plasma carotenoid levels were significantly inversely associated with the duration of diabetes, RBS and HbA1c but positively associated with HDL. This study demonstrated decreased plasma levels and lower dietary intakes of carotenoids in DR subjects.
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Affiliation(s)
- T Shalini
- ICMR-National Institute of Nutrition, Hyderabad, India.
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Iron deficiency: a modern primer to diagnosis and management. Curr Opin Gastroenterol 2021; 37:121-127. [PMID: 33315792 DOI: 10.1097/mog.0000000000000702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
PURPOSE OF REVIEW Iron deficiency with anemia (IDA) and without anemia remain a diagnostic and management challenge. Iron deficiency has a broad spectrum of causes, including gastrointestinal malignancy. The purpose of this review is to summarize the value and limitations of current methods to diagnose iron deficiency and underline the relevance of contemporaneous evidence to guide the pretest probability of gastrointestinal disease. RECENT FINDINGS A number of biomarkers for iron deficiency exist, and all have their caveats. Serum ferritin remains the most pragmatic means of diagnosing iron deficiency. Hepcidin holds future promise as a marker of iron status during inflammatory states. Men and postmenopausal women with IDA have the highest overall prevalence of gastrointestinal malignancy (∼11%), while premenopausal women with IDA (<1.5%) and those with iron deficiency without anemia (<0.5%) have a very low risk. Noninvasive investigation with fecal immunochemical test and fecal calprotectin hold promise to guide further investigations in lower risk groups. SUMMARY Confirmation of iron deficiency remains a challenge. Appropriate risk stratification is the key to guiding judicious gastrointestinal investigation. Use of noninvasive tests may play an important role in lower risk groups. Risk prediction tools applicable to relevant populations are required.
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Malik A, Trilok-Kumar G. Status of Vitamin B 12 among Healthy Adult and Elderly Population in India: A Review. J Nutr Sci Vitaminol (Tokyo) 2021; 66:S361-S368. [PMID: 33612626 DOI: 10.3177/jnsv.66.s361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Vitamin B12 is a water soluble micronutrient found in animal foods. Its deficiency is not uncommon in India owing to vegetarianism but often unrecognized due to diverse clinical manifestations. This review aims to collate the current data on vitamin B12 status in healthy Indian adult and elderly population. Online database Pubmed was searched for articles published in English between 2000 and 2019. Inclusion criteria consisted of original studies conducted on apparently healthy adult and elderly Indian population reporting serum/plasma vitamin B12 levels. Comprehensive literature search identified 14 studies eligible for inclusion. The deficiency prevalence reached 78.5% and 61.7% among adults and elderly, respectively, based on varying cut offs. Higher vitamin B12 levels were reported in women than men. Hyperhomocysteinemia (Hcy >15 μmol/L) was lower in females as compared to males (60% vs 90%, 14.9% vs 57.4% and 3.6% vs 20.9% respectively in three studies). Vitamin B12 deficiency was higher in vegetarians. The results indicate that inadequate vitamin B12 status is a wide spread problem in the Indian population. However, variety of laboratory methods and cut-offs of vitamin B12 deficiency and the heterogeneity in results pose challenges to draw clear conclusions on the extent of vitamin B12 deficiency in India. This review, therefore, highlights the need for more evidence based research to define age and sex specific cut offs for defining vitamin B12 deficiency.
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Affiliation(s)
- Anku Malik
- Institute of Home Economics (University of Delhi)
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Madhari RS, Boddula S, Ravindranadh P, Jyrwa YW, Boiroju NK, Pullakhandam R, Mamidi RS, Nimmathota A, Kulkarni B, Thingnganing L. High dietary micronutrient inadequacy in peri-urban school children from a district in South India: Potential for staple food fortification and nutrient supplementation. MATERNAL & CHILD NUTRITION 2020; 16 Suppl 3:e13065. [PMID: 33347729 PMCID: PMC7752122 DOI: 10.1111/mcn.13065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 06/23/2020] [Accepted: 07/01/2020] [Indexed: 12/04/2022]
Abstract
Multiple micronutrient deficiencies (MNDs) co-exist, often because of poor intakes and adversely impact health. Habitual diets were assessed in 300 school children (6-17 years old) recruited from two government schools by simple random sampling. Probability of adequacy (PA) for 11 micronutrients and mean probability of adequacy (MPA) was calculated. Haemoglobin, plasma ferritin, folic acid, vitamin B12 and C-reactive protein were estimated. Descriptive statistics and regression analysis were used to estimate magnitude and factors associated with MNDs. The contribution of fortified foods and/or supplements in addressing inadequacies and excessive intakes was modelled. The PA ranged from 0.04 for folate to 0.70 for zinc, and the MPA was 0.27. Prevalence of anaemia (53%), iron deficiency (57%; ID), iron deficiency anaemia (38%; IDA), folate deficiency (24%) and B12 deficiency (43%) was high. Dietary inadequacy of iron, zinc and a low MPA was associated with anaemia and IDA. Inclusion of double fortified salt (DFS), fortified rice (FR) or iron folic acid (IFA) supplements individually in habitual diet reduced probability of iron inadequacy significantly from 82% to ≤13%. Inclusion of DFS and FR simultaneously led to disappearance of iron inadequacy, but risk of excessive intake increased to 16%. Inclusion of DFS, FR and IFA together increased risk of excess iron intake to 40%. Nevertheless, intakes of folate and B12 remained inadequate even with FR and/or IFA. These results indicate a high risk of dietary MNDs in children and suggest need for more systematic intake measurements in representative sample and adjustment of iron dosages to avoid excessive intakes.
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Affiliation(s)
- Radhika S. Madhari
- Department of DieteticsICMR‐National Institute of NutritionHyderabadIndia
| | - Swetha Boddula
- Department of DieteticsICMR‐National Institute of NutritionHyderabadIndia
| | | | | | | | | | - Raja Sriswan Mamidi
- Division of Clinical EpidemiologyICMR‐National Institute of NutritionHyderabadIndia
| | - Arlappa Nimmathota
- Division of Public Health NutritionICMR‐National Institute of NutritionHyderabadIndia
| | - Bharati Kulkarni
- Division of Maternal and Child HealthICMR‐National Institute of NutritionHyderabadIndia
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Jyrwa YW, Palika R, Boddula S, Boiroju NK, Madhari R, Pullakhandam R, Thingnganing L. Retention, stability, iron bioavailability and sensory evaluation of extruded rice fortified with iron, folic acid and vitamin B 12. MATERNAL & CHILD NUTRITION 2020; 16 Suppl 3:e12932. [PMID: 33347722 PMCID: PMC7752130 DOI: 10.1111/mcn.12932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 11/18/2019] [Accepted: 11/26/2019] [Indexed: 11/27/2022]
Abstract
Fortification of rice with micronutrients using extrusion technology is considered a sustainable strategy to prevent nutritional deficiencies in general population. The objective of the present study is to assess the retention, stability and iron bioavailability from indigenously developed triple fortified rice (iron, folic acid and vitamin B12 ) during rinsing and different cooking methods. Further, we also assessed the acceptability of fortified rice in adult human volunteers. The retention of iron during rinsing with excess water was ≥90%, whereas folic acid and vitamin B12 levels were reduced by ~25% during rinsing. Watertight cooking of rice (in electric cooker or on flame) had no additional effect on the nutrient levels as compared with rinsed rice, implying their stability during cooking. However, cooking with excess water followed by decanting led to loss of 45% iron and ≥70% folic acid and vitamin B12 . The dialyzable iron and ferritin synthesis in Caco-2 cells was significantly (P < .01) higher from fortified rice compared with unfortified rice. In addition, inclusion of ascorbic acid significantly (P < .01) increased the iron bioavailability from the fortified rice. Triangle tests in adult human subjects revealed that there are no significant sensory differences among fortified and unfortified rice. Further, fortified rice consumption appears to bridge the gaps in dietary iron intake deficits in children and women of reproductive age. These results suggest that the iron-, folic acid- and vitamin B12 -fortified rice has higher retention and stability of fortified nutrients and is acceptable for consumption in adult human volunteers.
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Affiliation(s)
- Yvette Wilda Jyrwa
- Micronutrient Research Group, Biochemistry DivisionNational Institute of NutritionHyderabadIndia
| | - Ravindranadh Palika
- Micronutrient Research Group, Biochemistry DivisionNational Institute of NutritionHyderabadIndia
| | - Swetha Boddula
- Clinical DivisionNational Institute of NutritionHyderabadIndia
| | | | - Radhika Madhari
- Clinical DivisionNational Institute of NutritionHyderabadIndia
| | - Raghu Pullakhandam
- Micronutrient Research Group, Biochemistry DivisionNational Institute of NutritionHyderabadIndia
| | - Longvah Thingnganing
- Food Chemistry DivisionNational Institute of Nutrition, Indian Council of Medical ResearchHyderabadIndia
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Loukrakpam B, Rajendran A, Madhari RS, Boiroju NK, Longvah T. Dietary adequacy and nutritional status of Meitei community of Manipur, Northeast India. MATERNAL & CHILD NUTRITION 2020; 16 Suppl 3:e13046. [PMID: 33347718 PMCID: PMC7752124 DOI: 10.1111/mcn.13046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 05/11/2020] [Accepted: 05/21/2020] [Indexed: 11/29/2022]
Abstract
Meitei is the main ethnic community that belongs to the north-eastern state of Manipur in India. This community is bestowed with rich biodiverse resources with indigenous foods still form an integral part of their diet. However, limited data on the food and nutrient consumption as well as nutritional status of this community are available. This study was carried out on the children, adolescents and women of reproductive age (WRA) of this community from 12 villages, to determine their food consumption pattern and nutritional status. Basic anthropometry and 24-h dietary intake assessment was conducted. The prevalence of underweight was 27%, stunting was 45% and wasting was 12% in children below 5 years. Stunting was observed among 34% of children 5-17 years of age. About 7% of WRA were undernourished, while 28% were overweight or obese. About 55% of 1-7 year-old children had mean probability adequacy of 12 micronutrients <0.5, and the adequacy of individual micronutrients namely vitamin A, E and calcium were low. Dietary determinants such as low dietary diversity score, dietary species richness and the lowest tertiles of different food groups' intake (except for sugars, fish and sea foods and spices and condiments) predicted micronutrient inadequacy. In addition to a high prevalence of undernutrition in children and adolescents and overnutrition in WRA, the effect of various dietary determinants on micronutrient adequacy in the study group of the Meitei community are reported.
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Affiliation(s)
| | - Ananthan Rajendran
- Food Chemistry DivisionICMR‐National Institute of NutritionSecunderabadIndia
| | - Radhika S. Madhari
- Division of Maternal and Child HealthICMR‐National Institute of NutritionSecunderabadIndia
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Frailty and Nutritional Status among Urban Older Adults in South India. J Aging Res 2020; 2020:8763413. [PMID: 32695510 PMCID: PMC7368949 DOI: 10.1155/2020/8763413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 05/14/2020] [Accepted: 06/13/2020] [Indexed: 12/21/2022] Open
Abstract
The purpose of this study was to assess the prevalence of frailty and nutritional status among older adults. This population-based cross-sectional study was conducted in 163 subjects aged 60–88 years, from Hyderabad City, South India. Data were obtained on sociodemographic details and anthropometry and biochemical parameters. Dietary intake was assessed by a three-day 24 h dietary recall, and the probability of adequacy (PA) was calculated using the estimated average requirements. Frailty indicators were as follows: handgrip strength was measured by using a Jamar dynamometer, gait speed was measured by a ten-meter length walk test, and low physical activity level, weight loss, and exhaustion were assessed using a questionnaire. Among the study population, 20% of the participants were frail and 80% were nonfrail. The prevalence of frailty is higher in older (30.1%) than the younger (12.2%) age groups, and it is more so in women (32.4%) than in men (10.1%). The lower educational status and income were associated with frailty. The PA of most of the nutrients was low in the frail group. Noticeably, the mean PA (MPA) across the fourteen micronutrients was significantly higher in nonfrail (38%) compared to the frail group (25%). The prevalence of frailty was higher in the lowest tertile of most of the food groups and nutrient intake compared to the highest tertile. The study revealed a 20% prevalence of frailty among urban older adults and provided evidence that inadequate intake of nutrients is independently associated with frailty.
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Sang-Ngoen D, Hutchinson C, Satheannoppakao W, Tipayamongkholgul M. Dietary Iron Intake and Availability in Hill Tribe and Urban Women, Chiang Rai Province, Northern Thailand. Ecol Food Nutr 2020; 59:399-419. [PMID: 32129676 DOI: 10.1080/03670244.2020.1737041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Data were collected as part of a cross-sectional study. The objectives were to compare dietary intakes of iron and enhancers and inhibitors of non-heme iron absorption in hill tribe and urban women of Chiang Rai province, northern Thailand, and compare iron- and vitamin C- containing foods sold in markets in both settings. Dietary data were collected using three 24- hour recalls from 128 women aged 19-50 years (hill tribe: n = 65; urban n = 63), and proportions of low-, medium- and high-iron/vitamin C containing foods were surveyed in local markets. Hill tribe women consumed less iron, animal protein, vitamin C and calcium, but market availability of iron/vitamin C foods was similar. Future interventions should focus on food choice modification, to improve intakes of iron and foods that enhance its absorption, especially among hill tribe women.
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Affiliation(s)
- Doungtawan Sang-Ngoen
- Department of Nutrition, Faculty of Public Health, Mahidol University , Bangkok, Thailand
| | - Carol Hutchinson
- Department of Nutrition, Faculty of Public Health, Mahidol University , Bangkok, Thailand
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