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Huayta VMR, Pradeilles R, Creed-Kanashiro HM, Rousham E, Delgado D, Pareja R, Landais E, Verdezoto N, Haycraft E, Holdsworth M. Identifying priority double-duty actions to tackle the double burden of malnutrition in infants and young children in Peru: Assessment and prioritisation of government actions by national experts. PLoS One 2024; 19:e0303668. [PMID: 38768151 PMCID: PMC11104715 DOI: 10.1371/journal.pone.0303668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/29/2024] [Indexed: 05/22/2024] Open
Abstract
Multiple forms of malnutrition coexist in infants and young children (IYC) in Peru. The World Health Organization has proposed double-duty actions (DDAs) to simultaneously address undernutrition and overweight/obesity. We assessed current implementation of- and priority for- government-level actions to tackle multiple forms of malnutrition in IYC in Peru. Mapping of current policy activity was undertaken against 47 indicators of good practice for five DDAs (exclusive breastfeeding, complementary feeding, food marketing, maternal nutrition, preschool nutrition; assessed by 27 indicators) and for the enabling policy environment, i.e., 'infrastructure support' (health in all policies, platforms for interactions, financing, monitoring, governance, leadership; assessed by 20 indicators). Interviews with 16 national experts explored views on the level of and barriers to implementation of DDAs and infrastructure support, as well as their prioritisation based on likely impact and feasibility. The level of implementation of actions was categorised into two groups (agenda setting/formulation vs. implementation/evaluation). Mean scores were generated for prioritisation of DDAs and infrastructure support. Deductive qualitative analysis was undertaken to identify barriers that influence policy implementation. Only 5/27 DDA indicators were reported as fully implemented by all national experts (international code that regulates the marketing of breastmilk substitutes, iron supplementation for IYC, micronutrient powders in IYC, iron/folic acid supplementation in pregnant women, paid maternity leave). Only 1/20 infrastructure support indicator (access to nutrition information) was rated as fully implemented by all experts. Barriers to implementing DDAs and infrastructure support included: legal feasibility or lack of regulations, inadequate monitoring/evaluation to ensure enforcement, commercial influences on policymakers, insufficient resources, shifting public health priorities with the COVID-19 pandemic and political instability. The experts prioritised 12 indicators across all five DDAs and eight infrastructure support indicators. Experts highlighted the need to improve implementation of all DDAs and identified ways to strengthen the enabling policy environment.
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Affiliation(s)
| | - Rebecca Pradeilles
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-Food Systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
| | | | - Emily Rousham
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Doris Delgado
- Facultad de Medicina, Departamento de Nutrición, Universidad Nacional Mayor de San Marcos (UNMSM), Lima, Perú
| | | | - Edwige Landais
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-Food Systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
| | - Nervo Verdezoto
- School of Computer Science and Informatics, Cardiff University, Cardiff, United Kingdom
| | - Emma Haycraft
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-Food Systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
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Alvarez-Bustamante JA, Muñoz AM. Modeling Zinc Absorption in the Adult Population of Colombia: Insights for Nutritional Evaluation and Intervention Strategies. Biol Trace Elem Res 2024:10.1007/s12011-024-04180-x. [PMID: 38739259 DOI: 10.1007/s12011-024-04180-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/08/2024] [Indexed: 05/14/2024]
Abstract
Zinc is a vital trace element, yet its deficiency is common in various populations. This study addresses the gap in understanding zinc intake and its relationship with key nutritional parameters in a Colombian population. We analyzed data from 12,987 individuals, focusing on the daily intake of zinc, phytate, protein, and calcium, and used the phytate/zinc molar ratio as an input parameter in the Miller et al. (2013) model. This model was employed to estimate the total absorbed zinc (TAZ) and the fractional absorption of zinc (FAZ). Our findings highlight a general trend towards insufficient intake compared to the standards of the Institute of Medicine (IOM) and Colombia, with a significant percentage of the population falling below the estimated average requirement (EAR) and recommended daily allowance (RDA) for zinc, underscoring the need for targeted nutritional strategies. Our study contributes to a broader understanding of zinc nutrition and public health implications in Colombia, providing a basis for future dietary guidelines and health interventions.
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Berti TL, de Castro IR, Pedrosa LF, Normando P, Farias DR, Lacerda EM, Oliveira N, Alves-Santos NH, Kac G. Serum Zinc Concentrations by Inflammation Status, Time of Day, and Fasting Status for Estimating Zinc Deficiency in 6-59-Mo-Old Children: Results from the Brazilian National Survey on Child Nutrition (ENANI-2019). J Nutr 2024; 154:994-1003. [PMID: 38218540 DOI: 10.1016/j.tjnut.2024.01.004] [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: 09/18/2023] [Revised: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Serum zinc concentration (SZC) is considered the best biomarker of zinc status in population-level evaluations. However, zinc deficiency (ZD) estimations can be biased if they do not consider blood collection timing, inflammation, and fasting status. OBJECTIVES The objectives of this study were to determine SZC without and with adjustment for inflammation, according to blood collection timing and fasting status, estimate ZD prevalence, and evaluate the associated factors with ZD in a representative sample of Brazilian children aged <5 y. METHODS Population-based study with 7597 children aged 6-59 mo surveyed by the Brazilian National Survey on Child Nutrition. SZC was adjusted for inflammation using the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia regression correction approach, with high-sensitive C-reactive protein, assessed according to blood collection timing (morning/afternoon) and fasting status (<8 and ≥8 h). SZC <65 μg/dL (morning collection) or SZC <57 μg/dL (afternoon collection) were classified as ZD. The analysis between associated factors and ZD used the adjusted prevalence ratio (PR). RESULTS After adjusting for inflammation, SZC was higher in all percentiles and varied according to collection timing and fasting status. Children who had blood collected in the morning without fasting or in the afternoon had lower SZC than those assessed in the morning with fasting. The differences in adjusted SZC according to the timing of collection and fasting status were greater in the higher percentiles of the distribution, with the greatest absolute difference observed when comparing the 95th percentile of morning fasting compared with nonfasting (20.3 μg/dL). The prevalence of ZD estimated without and with adjusting SZC for inflammation was 17.8% and 13.8%, respectively. The occurrence of diarrhea, fever, or respiratory symptoms in the 15 d before blood collection was associated with a higher prevalence of ZD (PR: 1.42; 95% confidence interval: 1.04, 1.94). CONCLUSIONS Adjusting SZC for inflammation and considering fasting status is important to avoid overestimating the prevalence of ZD.
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Affiliation(s)
- Talita L Berti
- Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Inês Rr de Castro
- Department of Social Nutrition, Nutrition Institute, State University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucia Fc Pedrosa
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Paula Normando
- Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Dayana R Farias
- Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elisa Ma Lacerda
- Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Natália Oliveira
- Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Gilberto Kac
- Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
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Lu J, Zhang H, Cao W, Jiang S, Fang H, Yu D, Yang L. Study on the Zinc Nutritional Status and Risk Factors of Chinese 6–18-Year-Old Children. Nutrients 2023; 15:nu15071685. [PMID: 37049525 PMCID: PMC10096995 DOI: 10.3390/nu15071685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Zinc is an essential micronutrient that is involved in several metabolic processes, especially children’s growth and development. Although many previous studies have evaluated the zinc nutritional status of children, there are very few reports on children aged 6–18 years old. Furthermore, there are few reports on children’s zinc nutrition status based on the Chinese population. According to WHO data, the prevalence of zinc deficiency in Asian countries is rather high and has resulted in high child mortality. In this study, we aimed to comprehensively assess zinc nutritional status and the prevalence of zinc deficiency among children aged 6–18 years in China based on nationally representative cross-sectional data. Subgroup comparisons were made under possible influencing factors. The potential risk factors of zinc deficiency were also discussed. A total of 64,850 children, equally male and female, were recruited from 150 monitoring sites in 31 provinces through stratified random sampling from China National Nutrition and Health Survey of Children and Lactating Mothers (CNNHS 2016–2017). Median and interquartile intervals were used to represent the overall zinc concentration levels and different subgroups. A Chi-square test was used to compare serum zinc levels and the prevalence of zinc deficiency in children under different group variables. In order to study the influencing factors of zinc deficiency, multiple logistic regression was utilized. It was found that the median concentration of serum Zn was 88.39 μg/dL and the prevalence of Zn deficiency was 9.62%. The possible influence factors for Zn deficiency were sex, anemia, nutritional status, city type and income. By conducting a subgroup analysis of the factors, it was found that males; those with anemia, stunting and low income; and children living in rural areas have a higher risk of Zn deficiency. This study offers a comprehensive analysis of Zn nutritional status among Chinese children, which provides reliable data for policy formulation to improve the zinc nutrition status of children.
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Hermes Sales C, de Mello Fontanelli M, Macedo Rogero M, Mori Sarti F, Fisberg RM. Dietary inadequacies overestimate the blood deficiencies of magnesium, zinc, and vitamins A, C, E, and D among residents of Sao Paulo. Clin Nutr ESPEN 2023; 53:196-205. [PMID: 36657914 DOI: 10.1016/j.clnesp.2022.12.015] [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: 07/04/2022] [Revised: 11/03/2022] [Accepted: 12/10/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND & AIMS We aimed to estimate the prevalence of the inadequate intake and status of magnesium, zinc, and vitamins A, C, E, and D and identify factors associated with micronutrient deficiency in serum/plasma among residents of São Paulo, Brazil. METHODS Data from 824 individuals aged ≥14 years were obtained from the 2015 ISA-Nutrition, a population-based, cross-sectional survey. Dietary and supplement intakes were assessed using two 24-h dietary recalls, and the micronutrient inadequacies were estimated using the National Cancer Institute method. Micronutrient status was measured in serum or plasma, and deficiency was established according to the lower limit of the reference values. Receiver operating characteristic curve analysis was used to identify the effect of intake on the micronutrient status in serum/plasma. Logistic regression analysis was applied to assess the association between micronutrient status and individual characteristics. RESULTS More than 80% of the population had an inadequate dietary intake of magnesium, vitamin E, and vitamin D. Males had a high prevalence of inadequate dietary intake of vitamin A and zinc. A high-to-moderate prevalence of inadequate vitamin C intake was observed. Vitamin D was the only nutrient with a deficient status comparable to its dietary inadequacy. The other nutrients demonstrated a lower deficiency prevalence compared to dietary inadequacy, and vitamin A demonstrated the lowest prevalence of deficiency in plasma. Generally, dietary intake showed a non-notable association with micronutrient deficiency in serum/plasma. Individuals with fasting glucose concentrations ≥100 mg/dL and those using diuretic drugs had a higher risk of serum magnesium deficiency. Those using lipid-lowering drugs and those with high plasma adiponectin concentrations had a higher risk of serum zinc deficiency. Individuals who smoked and those with hypertension showed a higher risk of plasma vitamin C deficiency. Individuals with average leptin concentrations had a higher risk of plasma vitamin E deficiency. Finally, those with sufficient leisure-time physical activity had a lower risk of serum vitamin D deficiency. CONCLUSIONS Residents of the urban areas of São Paulo demonstrated substantially inadequate intakes of most of the assessed micronutrients; however, micronutrient deficiency in serum/plasma was not associated with dietary inadequacy, and it usually demonstrated a lower prevalence than dietary indicators. Thus, using micronutrient intake to determine the serum/plasma profile should be done with caution. The status of the micronutrients varied according to individual characteristics, indicating the interplay of complex mechanisms underlying micronutrient balance.
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Affiliation(s)
- Cristiane Hermes Sales
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
| | | | - Marcelo Macedo Rogero
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
| | - Flávia Mori Sarti
- School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo 03828-000, Brazil.
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
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Ofori KF, Antoniello S, English MM, Aryee ANA. Improving nutrition through biofortification-A systematic review. Front Nutr 2022; 9:1043655. [PMID: 36570169 PMCID: PMC9784929 DOI: 10.3389/fnut.2022.1043655] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/30/2022] [Indexed: 12/14/2022] Open
Abstract
Nutritious foods are essential for human health and development. However, malnutrition and hidden hunger continue to be a challenge globally. In most developing countries, access to adequate and nutritious food continues to be a challenge. Although hidden hunger is less prevalent in developed countries compared to developing countries where iron (Fe) and zinc (Zn) deficiencies are common. The United Nations (UN) 2nd Sustainable Development Goal was set to eradicate malnutrition and hidden hunger. Hidden hunger has led to numerous cases of infant and maternal mortalities, and has greatly impacted growth, development, cognitive ability, and physical working capacity. This has influenced several countries to develop interventions that could help combat malnutrition and hidden hunger. Interventions such as dietary diversification and food supplementation are being adopted. However, fortification but mainly biofortification has been projected to be the most sustainable solution to malnutrition and hidden hunger. Plant-based foods (PBFs) form a greater proportion of diets in certain populations; hence, fortification of PBFs is relevant in combating malnutrition and hidden hunger. Agronomic biofortification, plant breeding, and transgenic approaches are some currently used strategies in food crops. Crops such as cereals, legumes, oilseeds, vegetables, and fruits have been biofortified through all these three strategies. The transgenic approach is sustainable, efficient, and rapid, making it suitable for biofortification programs. Omics technology has also been introduced to improve the efficiency of the transgenic approach.
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Affiliation(s)
- Kelvin F. Ofori
- Department of Human Ecology, Delaware State University, Dover, DE, United States
| | - Sophia Antoniello
- Department Human Nutrition, Saint Francis Xavier University, Antigonish, NS, Canada
| | - Marcia M. English
- Department Human Nutrition, Saint Francis Xavier University, Antigonish, NS, Canada
| | - Alberta N. A. Aryee
- Department of Human Ecology, Delaware State University, Dover, DE, United States,*Correspondence: Alberta N. A. Aryee,
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Hernández-Ruiz Á, Madrigal C, Soto-Méndez MJ, Gil Á. Challenges and perspectives of the double burden of malnutrition in Latin America. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2022; 34 Suppl 1:S3-S16. [PMID: 35153111 DOI: 10.1016/j.arteri.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Abstract
Nutrition is a key factor in the development of non-communicable chronic diseases (NCCDs), especially cardiovascular diseases (CVD) and their risk factors. The "double burden of malnutrition" (DBM) is the coexistence of undernutrition and overnutrition in the same population across the life-course. In Latin America, the transition from a predominantly underweight to an overweight and obese population has increased more rapidly than in other regions in the world. Undernutrition and the micronutrient deficiencies particularly iron, zinc, and vitamins A and D, present high heterogeneity in Latin American countries, and are currently considered important public health problems. In this region, NCCDs account for 50% of the disability-adjusted life-years, led by CVD. The most prevalent cardiovascular risk factors are overweight, obesity, hypertension, dyslipidemia and type 2 diabetes mellitus. Because of the cost of treatment and the potential years of life lost due to premature death, CVD is known to affect the poorest segments of the population, affecting communities, and governments. More than 80% of CVD deaths occur in low- and middle-income countries. The persistence of damage in some cells due to undernutrition may explain certain findings regarding the increase in NCCD. These aspects together with epigenetic changes have highlighted the importance of a lifelong approach to nutritional policy development. Reducing DBM requires major societal interventions in public health and nutrition to achieve holistic change that can be sustained over the long term and spread throughout the global food system. The implementation of effective state policies of double impact actions should influence both sides of the burden and be considered an urgent priority, considering country-specific inequalities and socio-demographic differences in the Latin American region, using diverse and multidisciplinary strategies.
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Affiliation(s)
- Ángela Hernández-Ruiz
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3.ª pta., Armilla 18016, Granada, Spain
| | - Casandra Madrigal
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3.ª pta., Armilla 18016, Granada, Spain; Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, Granada, Spain
| | - María José Soto-Méndez
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3.ª pta., Armilla 18016, Granada, Spain
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3.ª pta., Armilla 18016, Granada, Spain; Department of Biochemistry and Molecular Biology II University of Granada, University of Granada, Granada, Spain; Institute of Nutrition and Food Technology "José Mataix," Biomedical Research Center, University of Granada, Granada, Spain; Biosanitary Research Institute IBS.GRANADA, Granada University Hospital Complex, Granada, Spain; CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain.
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Tsuchiya H. Gustatory and Saliva Secretory Dysfunctions in COVID-19 Patients with Zinc Deficiency. Life (Basel) 2022; 12:life12030353. [PMID: 35330104 PMCID: PMC8950751 DOI: 10.3390/life12030353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 02/25/2022] [Accepted: 02/25/2022] [Indexed: 12/22/2022] Open
Abstract
Given the ever-progressing studies on coronavirus disease 2019 (COVID-19), it is critical to update our knowledge about COVID-19 symptomatology and pathophysiology. In the present narrative review, oral symptoms were overviewed using the latest data and their pathogenesis was hypothetically speculated. PubMed, LitCovid, ProQuest, and Google Scholar were searched for relevant studies from 1 April 2021 with a cutoff date of 31 January 2022. The literature search indicated that gustatory dysfunction and saliva secretory dysfunction are prevalent in COVID-19 patients and both dysfunctions persist after recovery from the disease, suggesting the pathogenic mechanism common to these cooccurring symptoms. COVID-19 patients are characterized by hypozincemia, in which zinc is possibly redistributed from blood to the liver at the expense of zinc in other tissues. If COVID-19 induces intracellular zinc deficiency, the activity of zinc-metalloenzyme carbonic anhydrase localized in taste buds and salivary glands may be influenced to adversely affect gustatory and saliva secretory functions. Zinc-binding metallothioneins and zinc transporters, which cooperatively control cellular zinc homeostasis, are expressed in oral tissues participating in taste and saliva secretion. Their expression dysregulation associated with COVID-19-induced zinc deficiency may have some effect on oral functions. Zinc supplementation is expected to improve oral symptoms in COVID-19 patients.
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Kido T, Suka M, Yanagisawa H. Effectiveness of interleukin-4 administration or zinc supplementation in improving zinc deficiency-associated thymic atrophy and fatty degeneration and in normalizing T cell maturation process. Immunology 2022; 165:445-459. [PMID: 35138640 DOI: 10.1111/imm.13452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 01/25/2022] [Accepted: 01/30/2022] [Indexed: 11/28/2022] Open
Abstract
Nutritional zinc deficiency induces thymic atrophy, but the underlying mechanisms remain unknown. In this study, we investigated the mechanism of thymic atrophy and fatty degeneration associated with zinc deficiency, and its effect on T cell maturation. Building on previous research demonstrating the beneficial effect of IL-4 administration or zinc supplementation on the spleen in zinc deficiency rats, we further examined whether these supplements also improve thymic atrophy. Five-week-old male Sprague-Dawley rats were fed a standard diet, zinc-deficient diet (n = 16 each) with either saline or IL-4, or a zinc-deficient diet for 6 weeks followed by a standard diet for 4 weeks. Relative thymus weights, serum thymulin concentrations, and the number of cytokeratin-8-positive cells, AIRE-positive cells, IL-7-positive cells, CD8+ T cells, CD4+ T cells, pre T cells, and CD25+ CD44+ (DN3) cells in the thymus of zinc deficiency rats significantly decreased compared with those in all other groups. Conversely, PPAR-γ-positive cells, oil red O-positive areas, pro T cells, CD25- CD44+ cells, TUNEL positive cells, Viobility 405/452 Fixable Dye-positive cells, CD68-, CD163- or CD169- macrophages, and IL-1β concentrations were significantly increased in the thymus of zinc deficiency rats as compared to those in the other groups. After IL-4 administration or zinc supplementation for zinc deficiency, all the measurement indices were recovered to levels in standard rats. It was demonstrated that zinc deficiency caused thymic atrophy, accompanied by fatty degeneration in the cortical regions and affected T cell maturation. IL-4 administration or zinc supplementation for zinc deficiency ameliorated thymic fatty degeneration.
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Affiliation(s)
- Takamasa Kido
- Department of Public Health and Environmental Medicine, Faculty of Medicine, The Jikei University School of Medicine
| | - Machi Suka
- Department of Public Health and Environmental Medicine, Faculty of Medicine, The Jikei University School of Medicine
| | - Hiroyuki Yanagisawa
- Department of Public Health and Environmental Medicine, Faculty of Medicine, The Jikei University School of Medicine
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Ahsan AK, Tebha SS, Sangi R, Kamran A, Zaidi ZA, Haque T, Ali Hamza MS. Zinc Micronutrient Deficiency and Its Prevalence in Malnourished Pediatric Children as Compared to Well-Nourished Children: A Nutritional Emergency. Glob Pediatr Health 2021; 8:2333794X211050316. [PMID: 34660849 PMCID: PMC8511936 DOI: 10.1177/2333794x211050316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/10/2021] [Indexed: 11/20/2022] Open
Abstract
Pediatric populations from lower-income countries may experience a higher
incidence of zinc deficiency, which may cause physical and neurological
dysfunctions. This case control study aims to assess different levels of zinc
between malnourished and well-nourished children. Our study included 108
participants, all children less than 12 years of age. Out of the 108, 54 were
malnourished children (cases), while 54 were well nourished (control group) and
were screened for zinc deficiencies. Zinc deficiencies were 4 times more common
in malnourished cases than in controls (OR: 3.89 95% CI: 1.1-14.9) with median
value of zinc in cases being 91.69 and that of controls was 117.6. Our findings
indicate significant deficiencies in malnourished children as compared to
well-nourished children. Additionally, our findings support literature surveyed
that suggest dietary changes alone would not be able to replenish zinc levels in
children.
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Affiliation(s)
| | | | - Rumana Sangi
- Chandka Medical Teaching Hospital, Larkana, Pakistan
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Santos HO. Therapeutic supplementation with zinc in the management of COVID-19-related diarrhea and ageusia/dysgeusia: mechanisms and clues for a personalized dosage regimen. Nutr Rev 2021; 80:1086-1093. [PMID: 34338769 PMCID: PMC8385805 DOI: 10.1093/nutrit/nuab054] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Zinc supplementation is indicated for diarrhea and taste disorders, which are both features of COVID-19. Nevertheless, this strategy has not been tested for the treatment of these secondary complications in the current pandemic. Through an updated review, a practical appraisal was considered as a means of providing a medical nexus of therapeutic zinc regimens as an adjunct in the management of COVID-19–related diarrhea and ageusia/dysgeusia. While diarrhea and taste disorders are consequences of COVID-19, zinc supplementation is useful for non–COVID-19 patients with these clinical problems. The overwhelming evidence for supplementing with zinc in diarrhea and pneumonia is associated with the treatment of children, while for taste disorders the use of supplementing with zinc is more examined in adults. Whereas COVID-19 is more prevalent in adults, precautions should be exercised not to translate the zinc dosage used for children with diarrhea and taste disorders into the current pandemic. Therapeutic doses of zinc used for adults (∼50–150 mg/day of elemental zinc) could be included in the treatment strategies for COVID-19, but this proposal should be examined through randomized studies.
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Affiliation(s)
- Heitor O Santos
- H.O. Santos is with the School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
- H.O. Santos, School of Medicine, Federal University of Uberlandia (UFU), Para Street, 1720, Umuarama, Block 2H, Uberlandia, 38400-902 MG, Brazil. E-mail:
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Abstract
Zinc is an essential trace element involved in catalytic, structural, and regulatory functions, participating also in the metabolism of nutrients. Its role in insulin resistance appears to be of great importance, as it is involved in oxidative stress, the endocrine regulation of insulin, and the regulation of glucose uptake. For this reason, both intake and serum levels of zinc are inversely related to insulin resistance. Currently, zinc intake in children is low, and zinc deficiency exists in a significant proportion. Zinc can be found in meat, fish, eggs, and dairy products. Although it certainly is present in foods of plant origin, their high phytate contents generally reduce its bioavailability. For this reason, it is important to monitor intake throughout childhood, and to consider supplementation in children with insulin resistance or obesity.
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Abstract
Since the discovery of manifest Zn deficiency in 1961, the increasing number of studies demonstrated the association between altered Zn status and multiple diseases. In this chapter, we provide a review of the most recent advances on the role of Zn in health and disease (2010-20), with a special focus on the role of Zn in neurodegenerative and neurodevelopmental disorders, diabetes and obesity, male and female reproduction, as well as COVID-19. In parallel with the revealed tight association between ASD risk and severity and Zn status, the particular mechanisms linking Zn2+ and ASD pathogenesis like modulation of synaptic plasticity through ProSAP/Shank scaffold, neurotransmitter metabolism, and gut microbiota, have been elucidated. The increasing body of data indicate the potential involvement of Zn2+ metabolism in neurodegeneration. Systemic Zn levels in Alzheimer's and Parkinson's disease were found to be reduced, whereas its sequestration in brain may result in modulation of amyloid β and α-synuclein processing with subsequent toxic effects. Zn2+ was shown to possess adipotropic effects through the role of zinc transporters, zinc finger proteins, and Zn-α2-glycoprotein in adipose tissue physiology, underlying its particular role in pathogenesis of obesity and diabetes mellitus type 2. Recent findings also contribute to further understanding of the role of Zn2+ in spermatogenesis and sperm functioning, as well as oocyte development and fertilization. Finally, Zn2+ was shown to be the potential adjuvant therapy in management of novel coronavirus infection (COVID-19), underlining the perspectives of zinc in management of old and new threats.
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Affiliation(s)
- Anatoly V Skalny
- IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; Yaroslavl State University, Yaroslavl, Russia
| | - Michael Aschner
- IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Alexey A Tinkov
- IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; Yaroslavl State University, Yaroslavl, Russia.
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14
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Woods BJ, Gallego-Castillo S, Talsma EF, Álvarez D. The acceptance of zinc biofortified rice in Latin America: A consumer sensory study and grain quality characterization. PLoS One 2020; 15:e0242202. [PMID: 33175890 PMCID: PMC7657500 DOI: 10.1371/journal.pone.0242202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/28/2020] [Indexed: 01/14/2023] Open
Abstract
Zinc deficiency is a major public health problem in vulnerable populations of Latin America and the Caribbean. Biofortification of rice (Oryza sativa L.) with zinc has the potential to alleviate zinc deficiencies. However, as plant breeding processes can alter grain culinary quality and favorable sensory attributes, grain quality and consumer acceptability need to be assessed prior to releasing a variety to the public. A grain quality characterization and a sensory acceptability analysis were carried out with two varieties of zinc biofortified rice and a local control both in Bolivia and Colombia. The aim of this study was to evaluate the physicochemical parameters that are significant in consumer acceptance and to determine the acceptability of zinc biofortified rice by consumers. Results of physicochemical parameters were analyzed using ANOVA. The sensory acceptability was evaluated in 243 adults utilizing a 7-point hedonic scale and a Wilcoxon's signed rank test was used to determine the overall acceptability of the varieties. Biofortified rice variety T2-11 and MAC-18 -control 1- were equally accepted by consumers in Bolivia with no significant differences (p<0.05). The grain quality analysis reported that both presented long and slender rice grains (L>7.5 mm and L/B>3), an intermediate to high amylose content (>25%) and a similar level of chalkiness. In Colombia, the biofortified variety 035 presented a higher score in overall acceptance in comparison to biofortified variety 021 and the local variety CICA4 -control 2-. However, no significant differences were observed (p<0.05). Conversely to the other two varieties, the biofortified variety 035 presented the largest size grain (L/B = 2.97), a lower chalkiness and an amylose content above 25%. This study shows that the grain quality properties of rice have an influence on acceptability and that zinc biofortified rice varieties are accepted by consumers.
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Affiliation(s)
- Bo-Jane Woods
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Sonia Gallego-Castillo
- HarvestPlus, c/o The Alliance of Bioversity International and the International Center for Tropical Agriculture (CIAT), Cali, Colombia
| | - Elise F. Talsma
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Daniel Álvarez
- HarvestPlus, c/o The Alliance of Bioversity International and the International Center for Tropical Agriculture (CIAT), Cali, Colombia
- * E-mail:
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15
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Pinzón-Rondón ÁM, Hoyos-Martínez A, Parra-Correa D, Pedraza-Flechas AM, Ruiz-Sternberg ÁM. Association of nutritional support programs with zinc deficiency in Colombian children: a cross-sectional study. BMC Nutr 2019; 5:42. [PMID: 32153955 PMCID: PMC7050802 DOI: 10.1186/s40795-019-0305-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 08/06/2019] [Indexed: 01/13/2023] Open
Abstract
Background Zinc is an essential trace element that plays a key role in the immune, gastrointestinal, respiratory and nervous systems. In Colombia, a vast percentage of children live in low-income households with food insecurity and nutritional deficiencies, including zinc. In an effort to improve children’s well-being, public health measures such as nutritional support programs that provide meals have targeted the poorest populations. The aim of the present study was to assess the role of nutritional support programs on zinc deficiency in Colombian children, while considering their wealth and food security. Methods Cross-sectional study using data from the 2010 Colombian National Nutrition Survey, a population-based study representative of Colombia. A total of 4275 children between 12 and 59 months of age were included in the study. Stepwise logistic regressions were modelled with SPSS, first for zinc deficiency on wealth and food security, then adding enrolment in a nutritional support program, and finally, adjusting for socio-demographic variables. Results A zinc deficiency prevalence of 49% was found. The adjusted models showed an association of wealth quintiles: very poor (OR = 1.48) and poor (OR = 1.39), food security (OR = 0.75) and enrolment in a nutritional support program (OR = 0.76) with zinc deficiency. Enrolment in nutritional programs did not modify the relationship of wealth and food security to zinc deficiency. Conclusion Zinc deficiency is associated with wealth, food security and enrolment in nutritional support programs. Nutritional programs may be a good alternative against zinc deficiency, if they focus appropriately on the needs of children according to their wealth and food security.
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Affiliation(s)
- Ángela María Pinzón-Rondón
- 1Grupo de investigación clínica. Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario sede Quinta de Mutis, Carrera 24 #6 3C-69, Bogotá, Colombia
| | | | - Daniela Parra-Correa
- 3Grupo de Salud Pública. Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Ana María Pedraza-Flechas
- 1Grupo de investigación clínica. Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario sede Quinta de Mutis, Carrera 24 #6 3C-69, Bogotá, Colombia
| | - Ángela María Ruiz-Sternberg
- 1Grupo de investigación clínica. Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario sede Quinta de Mutis, Carrera 24 #6 3C-69, Bogotá, Colombia
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16
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Palacios AM, Hurley KM, De-Ponce S, Alfonso V, Tilton N, Lambden KB, Reinhart GA, Freeland-Graves JH, Villanueva LM, Black MM. Zinc deficiency associated with anaemia among young children in rural Guatemala. MATERNAL AND CHILD NUTRITION 2019; 16:e12885. [PMID: 31595712 PMCID: PMC7038871 DOI: 10.1111/mcn.12885] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 08/05/2019] [Accepted: 08/12/2019] [Indexed: 11/29/2022]
Abstract
One in four children younger than age five in Guatemala experiences anaemia (haemoglobin <11.0 g/dl). This study characterized the factors and micronutrient deficiencies associated with anaemia in a baseline cross‐sectional sample of 182 Guatemalan infants/toddlers and 207 preschoolers, using generalized linear mixed models. Associations between anaemia and maternal, child and household variables, and biomarkers (soluble transferrin receptor, ferritin, zinc, folate, vitamin B12, C‐reactive protein, and α1‐acid glycoprotein) were explored. Rates of anaemia were 56% among infants/toddlers and 12.1% among preschoolers. In children with anaemia, rates of iron deficiency (low ferritin based on inflammation status, and/or high soluble transferrin receptor, ≥1.97 mg/L) and zinc deficiency (serum zinc <65 μg/dl) were 81.1% and 53.7%, respectively. Folate deficiency (either plasma folate <3 ng/ml or erythrocyte folate <100 ng/ml) was 3.3%. Vitamin B12 deficiency (plasma vitamin B12 <148 pmol/L) was 7.5%. For infants and toddlers (<24 months), the odds ratio of anaemia was lower when higher number of adults lived in the household (OR = 0.69; 95% CI [0.53, 0.90]), and higher when children were zinc deficient (OR = 3.40; 95% CI [1.54, 7.47]). For preschoolers (36–60 months), the odds ratio of anaemia was lower for every additional month of age (OR = 0.90; 95% CI [0.81, 1.00]). Findings suggest that micronutrient deficiencies coexist in Guatemalan rural children, and zinc deficiency is associated with anaemia in children <24 months, highlighting the need of continued multidisciplinary interventions with multiple micronutrients. Further research examining how household composition, feeding practices, and accessibility to micronutrient supplements and to animal source foods is needed to incorporate strategies to improve the nutritional status of Guatemalan children.
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Affiliation(s)
- Ana M Palacios
- The Mathile Institute for the Advancement of Human Nutrition, Dayton, Ohio.,Department of Nutritional Sciences, The University of Texas at Austin, Austin, Texas
| | - Kristen M Hurley
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Silvia De-Ponce
- Asociación para la Prevención y Estudio del VIH/SIDA, Retalhuleu, Guatemala
| | - Víctor Alfonso
- Asociación para la Prevención y Estudio del VIH/SIDA, Retalhuleu, Guatemala
| | - Nicholas Tilton
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Kaley B Lambden
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Gregory A Reinhart
- The Mathile Institute for the Advancement of Human Nutrition, Dayton, Ohio
| | | | - Lisa M Villanueva
- The Mathile Institute for the Advancement of Human Nutrition, Dayton, Ohio
| | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.,RTI International, Research Triangle Park, North Carolina
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17
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Kido T, Ishiwata K, Suka M, Yanagisawa H. Inflammatory response under zinc deficiency is exacerbated by dysfunction of the T helper type 2 lymphocyte-M2 macrophage pathway. Immunology 2019; 156:356-372. [PMID: 30552817 DOI: 10.1111/imm.13033] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/19/2018] [Accepted: 11/25/2018] [Indexed: 12/18/2022] Open
Abstract
Nutritional zinc deficiency leads to immune dysfunction and aggravates inflammation. However, the underlying mechanism remains unknown. In this study, the relationship between macrophage subtypes (M1 and M2) and helper T lymphocytes (Th1 and Th2) was investigated using the spleen from rats fed zinc-deficient or standard diet. In experiment I, 5-week-old male Sprague-Dawley rats were fed a zinc-deficient diet (without zinc additives) or a standard diet (containing 0·01% zinc) for 6 weeks. In experiment II, the rats were divided into four groups: one group was fed a standard diet for 6 weeks; two groups were fed zinc-deficient diets and were injected three times a week with either saline or interleukin-4 (IL-4) (zinc-deficient/IL-4 i.p.); a fourth group (zinc-deficient/standard) was fed a zinc-deficient diet for 6 weeks followed by a standard diet for 4 weeks. In experiment I; GATA-binding protein 3 (GATA-3) protein level, M2 macrophage, CD3+ CD8+ cells, and IL-4/IL-13-positive cells significantly decreased in the spleens of the zinc-deficient group. Additionally, IL-1β and macrophage inflammatory protein-1α (MIP-1α) mRNA levels significantly increased in the splenic macrophages of the zinc-deficient group. In experiment II; M2 macrophages, CD3+ CD8+ cells, IL-4/IL-13-positive cells, and GATA-3 protein levels significantly increased in the spleens of the zinc-deficient/IL-4 i.p. and zinc-deficient/standard groups. Furthermore, IL-1β and MIP-1α mRNA levels decreased in the splenic macrophages of the zinc-deficient/IL-4 i.p. and zinc-deficient/standard groups. Zinc deficiency-induced aggravated inflammation is related to Th2 lymphocytes and followed by the association with loss of GATA-3, IL-4 and anti-inflammatory M2 macrophages. Importantly, IL-4 injection or zinc supplementation can reverse the effects of zinc deficiency on immune function.
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Affiliation(s)
- Takamasa Kido
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenji Ishiwata
- Department of Tropical Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroyuki Yanagisawa
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan
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18
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Li W, Herrán OF, Villamor E. Trends in Iron, Zinc, and Vitamin A Status Biomarkers Among Colombian Children: Results From 2 Nationally Representative Surveys. Food Nutr Bull 2017; 38:146-157. [PMID: 28359210 DOI: 10.1177/0379572117700976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
- Wenchao Li
- 1 Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Oscar F Herrán
- 2 Faculty of Health, Industrial University of Santander, Bucaramanga, Colombia
| | - Eduardo Villamor
- 1 Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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19
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López de Romaña D, Olivares M, Brito A. Introduction: Prevalence of Micronutrient Deficiencies in Latin America and the Caribbean. Food Nutr Bull 2015; 36:S95-7. [PMID: 26125199 DOI: 10.1177/0379572115585736] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This Food and Nutrition Bulletin supplement summarizes updated prevalence data on micronutrient deficiencies in Latin America and the Caribbean (LAC). In order to provide an updated view of micronutrient status in LAC, systematic reviews were performed utilizing national health surveys and research-oriented studies focused on the prevalence of deficiencies of vitamin A, folate, anemia (as a proxy of iron deficiency), and zinc. Results show that the prevalence of vitamin A deficiency has been reduced in many countries, folate deficiency is now almost non-existent, low or marginal vitamin B12 status is still prevalent in most locations, anemia remains a public health problem among children under 6 years of age and women of childbearing age in most surveyed countries, and there is a high prevalence of zinc deficiency in children under 6 years of age and girls and women 12 to 49 years of age. Thus, regardless of improvements in the overall rates of economic growth in LAC, deficiencies of these micronutrients still remain a public health problem.
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