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Bassey C, Crooks H, Paterson K, Ball R, Howell K, Humphries-Cuff I, Gaffigan K, Rao N, Whitty JA, Hooper L. Impact of home food production on nutritional blindness, stunting, wasting, underweight and mortality in children: a systematic review and meta-analysis of controlled trials. Crit Rev Food Sci Nutr 2020; 62:1856-1869. [PMID: 33272038 DOI: 10.1080/10408398.2020.1848786] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Vitamin A deficiency is highly prevalent and remains the major cause of nutritional blindness in children in low-and middle-income countries, despite supplementation programmes. Xeropthalmia (severe drying and thickening of the conjunctiva) is caused by vitamin A deficiency and leads to irreversible blindness. Vitamin A supplementation programmes effectively reduce vitamin A deficiency but many rural children are not reached. Home food production may help prevent rural children's vitamin A deficiency. We aimed to systematically review trials assessing effects of home food production (also called homestead food production and agricultural interventions) on xeropthalmia, nightblindness, stunting, wasting, underweight and mortality (primary outcomes). We searched Medline, Embase, Scopus, Cochrane CENTRAL and trials registers to February 2019. Inclusion of studies, data extraction and risk of bias were assessed independently in duplicate. Random-effects meta-analysis, sensitivity analyses, subgrouping and GRADE were used. We included 16 trials randomizing 2498 children, none reported xerophthalmia, night-blindness or mortality. Home food production may slightly reduce stunting (mean difference (MD) 0.13 (z-score), 95% CI 0.01 to 0.24), wasting (MD 0.05 (z-score), 95% CI -0.04 to 0.14) and underweight (MD 0.07 (z-score), 95% CI -0.01 to 0.15) in young children (all GRADE low-consistency evidence), and increase dietary diversity (standardized mean difference (SMD) 0.24, 95% CI 0.15 to 0.34). Home food production may usefully complement vitamin A supplementation for rural children. Large, long-duration trials with good randomization, allocation concealment and correct adjustment for clustering are needed to assess effectiveness of home food production on nutritional blindness in young children.
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Affiliation(s)
- Chizoba Bassey
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Harriet Crooks
- Student Services, University of East Anglia, Norwich, UK
| | - Katherine Paterson
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Rachel Ball
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Kristoffer Howell
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Iona Humphries-Cuff
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Kirsty Gaffigan
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Nitya Rao
- School of Developmental Studies, University of East Anglia, Norwich, UK
| | - Jennifer A Whitty
- Norwich Medical School, University of East Anglia, Norwich, UK.,National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England, UK
| | - Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich, UK
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Azlaf M, El Hamdouchi A, Benjeddou K, Zahrou FZ, El Menchawy I, El Kari K, El Mzibri M, Belghiti H, Barkat A, Rjimati EA, El Haloui N, Aguenaou H. School fortified milk improves vitamin A status of rural children in Morocco: A longitudinal interventional and controlled study1. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2017. [DOI: 10.3233/mnm-16107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Mehdi Azlaf
- Joint Unit of Nutrition and Food Research, URAC39 (Ibn Tofaïl University-CNESTEN), Regional Designated Center of Nutrition (AFRA/IAEA), Rabat-kénitra, Morocco
| | - Asmaa El Hamdouchi
- Joint Unit of Nutrition and Food Research, URAC39 (Ibn Tofaïl University-CNESTEN), Regional Designated Center of Nutrition (AFRA/IAEA), Rabat-kénitra, Morocco
| | - Kaoutar Benjeddou
- Joint Unit of Nutrition and Food Research, URAC39 (Ibn Tofaïl University-CNESTEN), Regional Designated Center of Nutrition (AFRA/IAEA), Rabat-kénitra, Morocco
| | - Fatima Zahra Zahrou
- Joint Unit of Nutrition and Food Research, URAC39 (Ibn Tofaïl University-CNESTEN), Regional Designated Center of Nutrition (AFRA/IAEA), Rabat-kénitra, Morocco
| | - Imane El Menchawy
- Joint Unit of Nutrition and Food Research, URAC39 (Ibn Tofaïl University-CNESTEN), Regional Designated Center of Nutrition (AFRA/IAEA), Rabat-kénitra, Morocco
| | - Khalid El Kari
- Joint Unit of Nutrition and Food Research, URAC39 (Ibn Tofaïl University-CNESTEN), Regional Designated Center of Nutrition (AFRA/IAEA), Rabat-kénitra, Morocco
| | - Mohamed El Mzibri
- Joint Unit of Nutrition and Food Research, URAC39 (Ibn Tofaïl University-CNESTEN), Regional Designated Center of Nutrition (AFRA/IAEA), Rabat-kénitra, Morocco
| | | | - Amina Barkat
- Children Hospital, University Hospital Center, Mohammed V University, Rabat, Morocco
| | | | - Nourredine El Haloui
- Joint Unit of Nutrition and Food Research, URAC39 (Ibn Tofaïl University-CNESTEN), Regional Designated Center of Nutrition (AFRA/IAEA), Rabat-kénitra, Morocco
| | - Hassan Aguenaou
- Joint Unit of Nutrition and Food Research, URAC39 (Ibn Tofaïl University-CNESTEN), Regional Designated Center of Nutrition (AFRA/IAEA), Rabat-kénitra, Morocco
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Sub-clinical vitamin A deficiency among under-five children: Current scenario and future perspectives. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2016. [DOI: 10.1016/j.injms.2016.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Carence en vitamine A chez un groupe d’enfants sains âgés de 1 à 23mois de la région de Blida, Algérie. NUTR CLIN METAB 2014. [DOI: 10.1016/j.nupar.2013.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sherwin JC, Reacher MH, Dean WH, Ngondi J. Epidemiology of vitamin A deficiency and xerophthalmia in at-risk populations. Trans R Soc Trop Med Hyg 2012; 106:205-14. [DOI: 10.1016/j.trstmh.2012.01.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 01/11/2012] [Accepted: 01/11/2012] [Indexed: 10/14/2022] Open
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Pereira Netto M, Priore SE, Sant'Ana HMP, Peluzio MDCG, Sabarense CM, Franceschini SDCC. Fatores associados à concentração de retinol sérico em lactentes. REVISTA PAULISTA DE PEDIATRIA 2012. [DOI: 10.1590/s0103-05822012000100005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Verificar os fatores associados à concentração de retinol em lactentes atendidos em serviço público de saúde. MÉTODOS: Estudo de corte transversal realizado com 101 crianças de 18 a 24 meses, atendidas no serviço público de saúde da área urbana da cidade de Viçosa. A análise da concentração de retinol no sangue venoso foi realizada por cromatografia líquida de alta eficiência. Para avaliação da prática alimentar, utilizou-se o recordatório de 24 horas. As entrevistas foram realizadas com os pais ou responsáveis pelas crianças em seus domicílios. Para avaliar as variáveis associadas ao retinol sérico, foi utilizada análise de regressão linear múltipla. RESULTADOS: Identificou-se 39,6% de prevalência da deficiência de vitamina A. Os fatores associados positivamente ao nível sérico de retinol foram tempo de escolaridade paterna e ingestão de proteína. Por outro lado, o número de moradores no domicílio e a idade da criança estiveram negativamente associados. CONCLUSÕES: A hipovitaminose A se apresenta como um problema de Saúde Pública entre os lactentes do município de Viçosa. Fatores socioeconômicos, dietéticos e biológicos se associam à deficiência da vitamina A na população infantil.
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Al-Mekhlafi HM, Surin J, Sallam AA, Abdullah AW, Mahdy MAK. Giardiasis and poor vitamin A status among aboriginal school children in rural Malaysia. Am J Trop Med Hyg 2010; 83:523-7. [PMID: 20810815 DOI: 10.4269/ajtmh.2010.09-0371] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A cross-sectional study was carried out on 241 primary schoolchildren in Pahang, Malaysia to update their vitamin A status and to investigate the association of poor vitamin A status with their health and socioeconomic factors. All children were screened for intestinal parasitic infections. Blood samples were collected and vitamin A status was assessed. Socioeconomic data were collected by using pre-tested questionnaires. The results showed that 66 (27.4%) children had low serum retinol levels (< 0.70 micromol/L). Giardiasis and severe ascariasis were significantly associated with low serum retinol levels (P = 0.004 and P = 0.018, respectively). Logistic regression confirmed the significant association of giardiasis with low serum retinol (odds ratio = 2.7, 95% confidence interval = 1.3-5.5). In conclusion, vitamin A deficiency is still a public health problem in rural Malaysia. Vitamin A supplementation and treatment of intestinal parasitic infections should be distributed periodically to these children to improve their health and nutritional status.
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Affiliation(s)
- Hesham M Al-Mekhlafi
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Klemm RDW, West KP, Palmer AC, Johnson Q, Randall P, Ranum P, Northrop-Clewes C. Vitamin A fortification of wheat flour: considerations and current recommendations. Food Nutr Bull 2010; 31:S47-61. [PMID: 20629352 DOI: 10.1177/15648265100311s105] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Vitamin A deficiency is a major public health nutrition problem, affecting an estimated 190 million preschool-aged children and 19 million pregnant and lactating women globally, and 83 million adolescents in Southeast Asia alone. Its consequences (disorders) include xerophthalmia (the leading cause of early childhood blindness), increased severity of infection, anemia, and death. Because vitamin A deficiency is largely due to chronic dietary insufficiency of preformed vitamin A and proactive carotenoids, food fortification can offer an effective approach to prevention. OBJECTIVE To provide guidance on fortifying wheat and maize flour milled in industrial rollers for national fortification programs in countries where vitamin A deficiency is considered a public health problem. METHODS Critical review of the literature on the dietary gap in vitamin A intake and levels of wheat flour intake among risk groups as a basis for determining vitamin A fortificant levels. Additional review of efficacy evidence, safety and cost considerations, and country experiences related to wheat-flour fortification with vitamin A. RESULTS Mill-rolled wheat flour is a technically fortifiable, centrally processed food vehicle that, where routinely and adequately consumed by target groups, should be considered a candidate for fortification. Vitamin A can be stable in flour under typical, ambient conditions, with processing losses estimated at approximately 30%, depending on source and premix conditions. CONCLUSIONS Factors to guide a decision to fortify flour with vitamin A include the extent of deficiency, availability of other food vehicle options, the centrality of milling, market reach and population intake distributions of the flour products, the dietary vitamin A intake required, and associated costs. Large gaps persist in knowledge of these factors, which are needed to enable evidence-based fortification in most countries, leaving most decisions to fortify guided by assumptions. Where flour can and should be fortified, guidelines are given for providing nearly 25% of the Recommended Dietary Allowance for vitamin A to vulnerable groups consuming varying ranges of flour products. The costs will vary according to the level of fortification.
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Affiliation(s)
- Rolf D W Klemm
- Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., W2505, Baltimore, MD 21205, USA
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El-Sayed AM, Hadley C, Tessema F, Tegegn A, Cowan JA, Galea S. Back and neck pain and psychopathology in rural sub-Saharan Africa: evidence from the Gilgel Gibe Growth and Development Study, Ethiopia. Spine (Phila Pa 1976) 2010; 35:684-9. [PMID: 20139812 PMCID: PMC2891327 DOI: 10.1097/brs.0b013e3181b4926e] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Community-based cross-sectional analysis of the relation between symptoms of psychopathology and back pain (BP) or neck pain (NP) in rural southwest Ethiopia. OBJECTIVE Using data from a community-based sample, we assessed the prevalence and psychopathologic correlates of BP or NP in rural sub-Saharan Africa. SUMMARY OF BACKGROUND DATA BP and NP are among the most prevalent pain conditions. Psychopathology has been shown to be associated with both BP and NP in developed and urban developing contexts. Little is known about the relation between psychopathology and BP or NP in the rural, developing context. METHODS Data on self-reported BP and NP, symptoms of depression, anxiety, and post-traumatic stress (PTS), gender, age, and socioeconomic status were collected from a representative cohort sample (N = 900) in rural southwest Ethiopia. We calculated univariate statistics to assess the prevalence of BP and NP. We used bivariate χ2 tests and multivariate logistic regression models to assess the relation between psychopathology and BP and NP. RESULTS The prevalence of BP was 16.7%; that of NP was 5.0%. In χ2 analyses, symptoms of depression, anxiety, and PTS were significantly associated with increased risk for each outcome. In models adjusted for age, household assets, and gender, depression symptomatology was associated with increased risk for BP (OR = 3.44, 95% CI: 2.37-5.00) and NP (OR = 4.92, 95% CI: 2.49-9.74). Anxiety symptomatology was also associated with increased risk for BP (OR = 2.88, 95% CI: 1.98-4.20) and NP (OR = 2.67, 95% CI: 1.41-5.09). PTS symptomatology was associated with increased risk for BP (OR = 2.89, 95% CI: 1.78-4.69). CONCLUSION In the first known study about the relation between psychopathologic symptomatology and BP and NP in a rural context in a developing country, the prevalence of BP and NP were comparable to published data in developed and developing countries. Symptoms of depression and anxiety were correlates of BP and NP, and symptoms of PTS were a correlate of BP. Comparative studies about the relation between psychopathology and chronic pain conditions between rural and urban contexts in the global south are needed.
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Affiliation(s)
- Abdulrahman M El-Sayed
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan, Ann Arbor, MI, University of Michigan Medical School, Ann Arbor, MI
| | - Craig Hadley
- Department of Anthropology, Emory University, Atlanta, GA
| | | | | | - John A Cowan
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI
| | - Sandro Galea
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan, Ann Arbor, MI, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, Center for Global Health, University of Michigan, Ann Arbor, MI
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Bukhari MH, Qureshi SS, Niazi S, Asef M, Naheed M, Khan SA, Chaudhry NA, Tayyab M, Hasan M. Chemotherapeutic/chemopreventive role of retinoids in chemically induced skin carcinogenesis in albino mice. Int J Dermatol 2008; 46:1160-5. [PMID: 17988335 DOI: 10.1111/j.1365-4632.2007.03425.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To determine the chemotherapeutic effect of retinoids on albino mouse skin. METHODS Eighty albino mice were selected for this study and were divided into four groups (A-D, 20 mice in each group). 7,12-Dimethylbenz(a)anthracene (DMBA) and tetradecanoylphorbal-13-acetate (TPA) were given for 15 weeks to produce tumors. Retinoids were given topically and orally after the development of tumors for the following 15 weeks. RESULTS Of the 80 mice, 69 (86.25%) developed different types of lesion and 11 (13.75%) remained lesion free. Of the 69 mice that developed lesions, 50 (62.50%) developed benign lesions and 19 (23.75%) developed malignant lesions. In all groups of mice, treatment with retinoids was effective against all benign lesions and the early stages of carcinogenesis of the skin. The chemotherapeutic effect against malignant tumors was not satisfactory. CONCLUSION This study demonstrates that retinoids are effective as chemopreventive agents in premalignant lesions of the skin, but have a very weak chemotherapeutic role in malignant neoplasms. If retinoids are given at an early stage, they can cause regression of premalignant lesions of the skin. They are best administered both orally and parenterally. These agents should be recommended as they reduce the potential effects of carcinogenesis.
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Affiliation(s)
- Mulazim H Bukhari
- Department of Pathology and Medicine, King Edward Medical University, Lahore, Pakistan.
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