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Kumar R, Oruna-Concha MJ, Niranjan K, Vimaleswaran KS. A review on vitamin A deficiency and depleted immunity in South Asia: From deficiency to resilience. Nutrition 2024; 124:112452. [PMID: 38669831 DOI: 10.1016/j.nut.2024.112452] [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: 01/17/2024] [Revised: 03/19/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024]
Abstract
In the developing world, the twin challenges of depleted health and growing issue of food waste management loom large, demanding simultaneous attention and innovative solutions. This review explores how these issues can be effectively mitigated while shedding light on the transformative impact of food waste valorization on health management. A spotlight is cast on vitamin A deficiency (VAD), an acute public health concern, especially prevalent in South Asia, driven by economic constraints, sociocultural factors, inadequate diets, and poor nutrient absorption. VAD's devastating effects are exacerbated by limited education, lack of sanitation, ineffective food regulations, and fragile monitoring systems, disproportionately affecting children and women of childbearing age. Recent studies in South Asian countries have revealed rising rates of illness and death, notably among children and women of childbearing age, due to VAD. To address inadequate dietary intake in children utilizing vegetable waste, particularly from carrots and beetroot, which are rich in β-carotene, and betalains, respectively, offers a sustainable solution. Extracting these compounds from vegetable waste for supplementation, fortification, and dietary diversification could significantly improve public health, addressing both food waste and health disparities economically. This approach presents a compelling avenue for exploration and implementation. In summary, this review presents an integrated approach to tackle health and food waste challenges in the developing world. By tapping into the nutritional treasure troves within vegetable waste, we can enhance health outcomes while addressing food waste, forging a brighter and healthier future for communities in need.
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Affiliation(s)
- Rahul Kumar
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | | | - Keshavan Niranjan
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Karani S Vimaleswaran
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK; Institute for Food, Nutrition and Health (IFNH), University of Reading, Reading, UK.
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Endawkie A, Gedefie A, Muche A, Mohammed A, Ayres A, Melak D, Abeje ET, Bayou FD, Belege Getaneh F, Asmare L. Household- and community-level factors of zero vegetable or fruit consumption among children aged 6-23 months in East Africa. Front Nutr 2024; 11:1363061. [PMID: 38962433 PMCID: PMC11220493 DOI: 10.3389/fnut.2024.1363061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/29/2024] [Indexed: 07/05/2024] Open
Abstract
Introduction The World Health Organization recommends that children aged 6-23 months should consume a diversified diet, including fruits and vegetables, during each meal. However, low consumption of fruits and vegetables contributes to 2.8% of child deaths globally. The literature review indicates limited research on factors that affect zero vegetable or fruit consumption among children aged 6-23 months in East Africa. Therefore, this study aimed to investigate the household- and community-level factors determining zero vegetable or fruit consumption among children aged 6-23 months in East Africa. Method The study analyzed cross-sectional secondary data from the recent rounds of demographic and health surveys conducted in East Africa from 2015 to 2023. The weighted sample comprised 113,279 children aged 6-23 months. A multilevel mixed-effect analysis was used, measuring the random variation between the clusters based on the intra-cluster correction coefficient, median odds ratio, and proportional change variance. Adjusted odds ratio with a 95% confidence interval was reported while considering variables having a p < 0.05 as statistically significant. Results The overall prevalence of zero vegetable or fruit consumption among children aged 6-23 months in East Africa was 52.3%, with Ethiopia showing the highest prevalence (85.9%). The factors associated with zero vegetable or fruit consumption were maternal educational level, number of household members, short birth interval, multiple births, sex of the household head, household wealth index, community-level maternal literacy, community-level wealth index, and countries. Conclusion Considering the high overall prevalence of zero vegetable or fruit consumption among children aged 6-23 months in East Africa, overlooking this nutritional gap among children is a serious oversight. Therefore, efforts should be geared toward improving individual- and community-level maternal literacy. In particular, nutrition and public health organizations should support low-income communities to achieve vegetable or fruit consumption for infants and young children.
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Affiliation(s)
- Abel Endawkie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alemu Gedefie
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Amare Muche
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Anissa Mohammed
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Aznamariam Ayres
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Dagnachew Melak
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Eyob Tilahun Abeje
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Fekade Demeke Bayou
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Fekadeselassie Belege Getaneh
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Lakew Asmare
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Lourenço BH, Castro MC, de Morais Sato P, Neves PAR, Vivanco E, Lima DL, Cardoso MA. Exposure to ultra-processed foods during pregnancy and ultrasound fetal growth parameters. Br J Nutr 2023; 130:2136-2145. [PMID: 37190988 DOI: 10.1017/s0007114523001204] [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] [Indexed: 05/17/2023]
Abstract
Periconceptional maternal ultra-processed food (UPF) consumption impairs embryonic growth. Impacts of exposure to UPF on distinct components of fetal growth in late pregnancy are unknown. We investigated the influence of frequency of UPF consumption during pregnancy on fetal head circumference (HC), abdominal circumference (AC) and femur length (FL). This study included 417 live-born singleton pregnancies prospectively followed-up since the antenatal period in the MINA-Brazil Study, with an available ultrasound scan at >24 gestational weeks. Frequency of food groups consumption in the previous month was categorised as no/monthly, weekly or daily. Ultrasound scans were conducted at 27·8 (sd: 1·7) gestational weeks. HC, AC and FL z-scores were calculated for gestational age using the INTERGROWTH-21st Project standards. Simultaneous-quantile regression models were fitted at the 10th, 50th and 90th percentiles of the distribution of each ultrasound parameter according to UPF consumption, with adjustment for potential confounders. Participants were aged on average 24·7 (sd: 6·5) years, 44·8 % were primiparous, and 26·9 % and 24·9 %, respectively, had weekly and daily UPF consumption. Compared with no/monthly intake, daily UPF consumption impaired HC across its distribution, with significant effect sizes varying from -0·24 to -0·40 z-score. Weekly UPF consumption decreased HC at the 90th percentile by -0·39 z-score (95 % CI: -0·78, -0·01) and FL at the 50th percentile by -0·32 z-score (95 % CI: -0·60, -0·04). No association was noted with AC. Frequency of UPF consumption was negatively associated with skeletal components of fetal growth in late pregnancy. Infant body composition may benefit from healthy food practices since pregnancy.
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Affiliation(s)
- Bárbara Hatzlhoffer Lourenço
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marcia C Castro
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Priscila de Morais Sato
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, BA, Brazil
| | | | - Edwin Vivanco
- Juruá Women's and Children's Hospital, Cruzeiro do Sul, AC, Brazil
| | - Daniel Leal Lima
- Juruá Women's and Children's Hospital, Cruzeiro do Sul, AC, Brazil
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
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Lobo LMDC, Hadler MCCM. Vitamin E deficiency in childhood: a narrative review. Nutr Res Rev 2023; 36:392-405. [PMID: 35929460 DOI: 10.1017/s0954422422000142] [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] [Indexed: 11/05/2022]
Abstract
Vitamin E is an important nutrient from the earliest stages of life. It plays key roles as an antioxidant and in the maintenance of the immune system, among others. Vitamin E deficiency (VED), which occurs more frequently in children, is rarely addressed in the literature. This narrative review aims to summarise the chemistry, biology, serum indicators and clinical trials that have evaluated the impact of fortification and other relevant aspects of vitamin E, in addition to the prevalence of its deficiency, in children worldwide. Vitamin E intake in recommended amounts is essential for this nutrient to perform its functions in the body. Serum α-tocopherol is the most widely used biochemical indicator to assess the prevalence of VED. VED has been associated with symptoms secondary to fat malabsorption and may lead to peripheral neuropathy and increased erythrocyte haemolysis. Reduced concentrations of α-tocopherol may be caused by the combination of diets with low amounts of vitamin E and inadequate consumption of fats, proteins and calories. The lowest prevalence of VED was found in Asia and the highest in North America and Brazil. High proportions of VED provide evidence that this nutritional deficiency is a public health problem in children and still little addressed in the international scientific literature. The planning, evaluation and implementation of health policies aimed at combatting VED in the paediatric population are extremely important.
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Affiliation(s)
| | - Maria Claret Costa Monteiro Hadler
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, Goiás, Brazil
- Graduate Program in Nutrition and Health, Faculty of Nutrition, Federal University of Goiás, Goiânia, Goiás, Brazil
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Yang X, Qiu M, Yang Y, Yan J, Tang K. Maternal postnatal confinement practices and postpartum depression in Chinese populations: A systematic review. PLoS One 2023; 18:e0293667. [PMID: 37903136 PMCID: PMC10615300 DOI: 10.1371/journal.pone.0293667] [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: 08/08/2023] [Accepted: 10/14/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND The postpartum period is critical for maternal health status after childbirth. The traditional Chinese postpartum confinement practice, "doing-the-month", is considered especially effective in helping mothers recover during the postpartum period. However, research has not provided evidence to confirm its benefits. Postpartum depression is a common postpartum disease that seriously threatens maternal health. The systematic review aims to explore the association between "doing-the-month" and postpartum depression in the Chinese female population and to provide a scientific foundation for evidence-based postpartum maternal care. METHODS Five databases (PubMed, Embase, Web of Science, Scopus, Cochrane, PsycINFO, and Web of Science) were searched according to the protocol (INPALSY202320102). The JBI assessment tool was used to assess the quality of the included studies. RESULTS Sixteen quantitative studies from China and Chinese female immigrants in other countries, including 15 cross-sectional studies and 1 randomized controlled study, were identified. Four studies indicated that "doing-the-month" rituals reduced postpartum depression risk while 2 studies showed opposite results; 10 studies did not show a significant association between "doing-the-month" practices and postpartum depression. CONCLUSION There is conflicting evidence regarding the association between "doing-the-month" and the likelihood of developing postpartum depression. Some studies have explored the impact of family ties, particular rituals, and specific stressors during the postpartum period on the occurrence of postpartum depression in Chinese women. According to current research, "doing-the-month" practice failed to show a significant protective effect on postpartum depression in the Chinese maternal population. Evidence-based medical health education for the Chinese postpartum female community is urgently needed.
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Affiliation(s)
- Xiao Yang
- Health Policy and Management Department, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Mujie Qiu
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Yichun Yang
- Department of Obstetrics, Longgang District Central Hospital of Shenzhen, Shenzhen, China
| | - Junlin Yan
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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Total Usual Nutrient Intakes and Nutritional Status of United Arab Emirates Children (4 Years-12.9 Years): Findings from the Kids Nutrition and Health Survey (KNHS) 2021. Nutrients 2023; 15:nu15010234. [PMID: 36615891 PMCID: PMC9824044 DOI: 10.3390/nu15010234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/27/2022] [Accepted: 12/30/2022] [Indexed: 01/04/2023] Open
Abstract
This study aims at investigating the anthropometric status and food consumption patterns of children in the United Arab Emirates (UAE) and assessing their adherence to nutrient and dietary recommendations. It is a population-based cross-sectional survey of 690 children (4-12.9 years), from 3 major Emirates. Socio-demographic and anthropometric characteristics were collected. Dietary intakes were assessed using the 24-hour recall approach. Of the total sample, 4% were stunted, 8% were wasted and 28% were overweight/obese. A third of participating children consumed above the Estimated Energy Requirement, while the majority's intakes carbohydrate, total fat, and protein were within the recommendations; whereas over 70% and 90% of participants consumed above the WHO daily limits of free sugars and saturated fats, respectively. Inadequate intakes of linoleic acid (36% of children), alpha-linolenic acid (91%) and dietary fiber (100%) were observed. All children failed to meet the recommendation for vitamin D and considerable proportions had inadequate intakes of vitamin A, calcium, zinc, folate, and magnesium. Compared with the American Heart Association/American Academy of Pediatrics recommendations, low dietary adherence was noted for fruits (9%), vegetables (4%), and milk/dairy (14%). These findings may be used in the development of nutritional policies aimed at improving the diets of children in the UAE.
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Malta MB, Neves PAR, Lourenço BH, Benício MHDA, Werneck GL, Castro MC, Cardoso MA. Leisure-time physical activity in Amazonian pregnant women and offspring birth weight: A prospective cohort study. PLoS One 2022; 17:e0265164. [PMID: 35294475 PMCID: PMC8926278 DOI: 10.1371/journal.pone.0265164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/24/2022] [Indexed: 11/18/2022] Open
Abstract
Compelling evidence supports the current international recommendation of at least 150 min/week of leisure-time physical activity (LTPA) during pregnancy. However, the potential relationship between LTPA and birth weight (BW) remains unclear in low- and middle-income countries. The purpose of this study was to examine the association between LTPA during pregnancy and offspring BW in an Amazonian population. Prospective cohort study was carried-out with 500 pregnant women and their offspring followed-up in the MINA-Brazil study, which was conducted in Cruzeiro do Sul, Western Brazilian Amazon. LTPA was assessed in the second (mean 19.6, SD 2.4 weeks) and third (mean 27.8, SD 1.6 weeks) gestational trimesters by a standardised interview and categorised according to the recommended cut-off of at least 150 min/week. We calculated offspring BW z-scores by sex and gestational age. We then explored the effect of LTPA during pregnancy on offspring BW, the association between LTPA and small-for-gestational-age (SGA) or large-for-gestational-age (LGA) births, and the mediating role of excessive and insufficient gestational weight gain (GWG). At least 150 min/week of LTPA during the third gestational trimester was associated with an offspring BW decrease of -0.35 z-score (95% CI: -0.65, -0.05) or -147.9 grams (95% CI: -260.9, -14.8), without increasing the frequency of SGA foetuses either in the second or third gestational trimester (p > 0.05). Excessive GWG mediated the effect of LTPA on the offspring BW (indirect effect = -0.05 z-score [95% CI: -0.10, -0.00] or -34.7 grams (95% CI: -66.1, -3.3]). This mediation effect was not observed for insufficient GWG. LTPA in the third, but not in the second, trimester of pregnancy was inversely associated with offspring BW without increasing the frequency of SGA, an effect that was partly mediated by excessive GWG.
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Affiliation(s)
- Maíra B. Malta
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Paulo A. R. Neves
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Bárbara H. Lourenço
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Guilherme L. Werneck
- Institute of Studies in Public Health, Federal University of Rio de Janeiro, Ilha do Fundão–Cidade Universitária, Rio de Janeiro, RJ, Brazil
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Maracanã, Rio de Janeiro, RJ, Brazil
| | - Marcia C. Castro
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Marly A. Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Costa SA, Ribeiro CCC, de Oliveira KR, Alves CMC, Thomaz EBAF, Casarin RCV, Souza SDFC. Low bone mineral density is associated with severe periodontitis at the end of the second decade of life: A population-based study. J Clin Periodontol 2021; 48:1322-1332. [PMID: 34288024 DOI: 10.1111/jcpe.13525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the association between low bone mineral density (BMD) and severe periodontitis at the end of the second decade of life. MATERIALS AND METHODS This population-based study analysed 2032 youngers (18-19 years old) of the RPS cohort. BMD of lumbar spine (BMD-LS) and of the whole body (BMD-WB) were assessed by dual x-ray emission densitometry. Low BMD-LS (Z-score ≤ -2) and low BMD-WB (Z-score ≤ -1.5) were correlated with severe periodontitis. The extent of periodontal disease was also evaluated as the following outcomes: proportions of teeth affected by clinical attachment loss ≥5 mm and probing depth ≥5 mm. Multivariate models by sex, education, family income, risk of alcohol dependence, smoking, plaque, bleeding index, and body mass index were estimated through logistic regression (binary outcomes) and Poisson regression (continuous outcomes). RESULTS The prevalence of severe periodontitis was 10.97%. Low BMD-LS (odds ratio [OR] = 2.08, confidence interval [CI] = 1.12-3.85, p = .01) and low BMD-WB (OR = 1.34, CI = 1.001-1.81, p = .04) were associated with severe periodontitis in the final multivariate models. Low BMD-LS and BMD-WB were also associated with a greater extent of periodontitis (p < .05). CONCLUSIONS Low BMD was found to be associated with the severity and extent of periodontitis in adolescents. Adolescents at peak bone mass age presenting low BMD are more likely to be affected by severe periodontitis.
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Collese TS, Norde MM, Nascimento-Ferreira MV, Kim H, Marchioni DM, Carvalho HB, Giovannucci E. Which blood cutoff value should be used for vitamin A deficiency in children aged 3-10 years? A systematic review. Nutr Rev 2020; 79:777-787. [PMID: 33382883 DOI: 10.1093/nutrit/nuaa133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
CONTEXT Blood cutoff values for vitamin A deficiency in children aged 3-10 years have not been addressed in the literature. OBJECTIVE To identify blood retinol concentrations for determining severe vitamin A deficiency in children aged 3-10 years. DATA SOURCES The MEDLINE, Web of Science, Embase, and Scopus databases were searched. DATA EXTRACTION Two reviewers independently extracted article data and assessed quality. DATA ANALYSIS The hierarchical summary receiver operating characteristic models were applied for the diagnostic accuracy meta-analysis. This review is registered at PROSPERO (identifier: CRD42020149367). RESULTS A total of 15 articles met the eligibility criteria, and 9 were included in the diagnostic accuracy meta-analysis. The summary estimates (95%CI) were: Sensitivity, 0.39 (0.20-0.62); specificity, 0.79 (0.65-0.88); positive likelihood ratio, 1.85 (1.33-2.57); and negative likelihood ratio, 0.77 (0.60-0.99). The area under the curve of the overall analysis was 0.68 (95%CI 0.63-0.72). CONCLUSIONS Blood retinol concentrations have low diagnostic accuracy for severe vitamin A deficiency in children aged 3-10 years. Therefore, there is unclear evidence about the preferable cutoff point for determining severe vitamin A deficiency in children in this age group.
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Affiliation(s)
- Tatiana S Collese
- Youth/Child Cardiovascular Risk and Environmental (YCARE) Research Group, Department of Preventive Medicine, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Marina M Norde
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Marcus V Nascimento-Ferreira
- Youth/Child Cardiovascular Risk and Environmental (YCARE) Research Group, Department of Preventive Medicine, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Hanseul Kim
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Dirce M Marchioni
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Heráclito B Carvalho
- Youth/Child Cardiovascular Risk and Environmental (YCARE) Research Group, Department of Preventive Medicine, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
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Sahasrabudhe N, Lee JS, Scott TM, Punnett L, Tucker KL, Palacios N. Serum Vitamin D and Depressive Symptomatology among Boston-Area Puerto Ricans. J Nutr 2020; 150:3231-3240. [PMID: 33025014 PMCID: PMC7726122 DOI: 10.1093/jn/nxaa253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/08/2020] [Accepted: 07/30/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Low vitamin D status, assessed using serum 25-hydroxyvitamin D [25(OH)D] concentration, has been associated with depression, but research among minority populations, such as Puerto Ricans is limited. We examined the association between serum 25(OH)D and self-reported depressive symptomatology across 3 waves of follow-up in a cohort of Puerto Rican adults residing in Massachusetts. OBJECTIVES We evaluated the cross-sectional and longitudinal associations between serum 25(OH)D and self-reported depressive symptoms in the Boston Puerto Rican Health Study (BPRHS) cohort. METHODS Participants of the BPRHS were evaluated for depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D). Serum 25(OH)D was measured at baseline (n = 1434), year 2 (n = 1218), and year 5 (n = 914). We categorized serum 25(OH)D concentration as sufficient (≥20 ng/mL), insufficient (12 to <20 ng/mL), and deficient (<12 ng/mL). Multivariable linear regression was used for cross-sectional analyses at baseline, and repeated measures mixed effects modeling was used over 3 waves of follow-up for longitudinal analyses. We conducted sensitivity analyses in vitamin D supplement nonusers and participants with complete data on baseline serum 25(OH)D and CES-D at all 3 visits. RESULTS Serum 25(OH)D concentration was not associated with CES-D score in cross-sectional analysis [β = -0.85; 95% CI: -2.80, 1.10 for deficient compared with sufficient 25(OH)D; P-trend = 0.59] or in longitudinal analyses over 5 y [β = -0.41; 95% CI: -1.95, 1.13 for deficient compared with sufficient 25(OH)D; P-trend = 0.93]. Results were similar in sensitivity analyses restricted to vitamin D supplement nonusers (n = 1371) and in analyses conducted in participants with complete measures of baseline serum 25(OH)D and CES-D score at all 3 visits (n = 887) [β = -0.12; 95% CI: -1.98, 1.74 for deficient compared with sufficient 25(OH)D; P-trend = 0.93]. CONCLUSIONS We did not observe a significant association between serum 25(OH)D and depressive symptomatology in the BPRHS cohort.
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Affiliation(s)
- Neha Sahasrabudhe
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Jong Soo Lee
- Department of Mathematical Sciences, University of Massachusetts Lowell, Lowell, MA, USA
- Geriatric Research Education Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
| | - Tammy M Scott
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Laura Punnett
- Department of Biomedical Engineering, University of Massachusetts Lowell, Lowell, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Natalia Palacios
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
- Geriatric Research Education Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
- Department of Nutrition, Harvard University School of Public Health, Boston, MA, USA
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Associations of dietary diversity with anaemia and iron status among 5- to 12-year-old schoolchildren in South Africa. Public Health Nutr 2020; 24:2554-2562. [PMID: 32618231 DOI: 10.1017/s1368980020000543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To examine the associations of dietary diversity with anaemia and iron status among primary school-aged children in South Africa. DESIGN An analysis was conducted with pooled individual data from the baseline surveys from three previously conducted independent intervention studies. Two different dietary diversity scores (DDS) were calculated based on data from 1-day (1-d) and 3-day (3-d) dietary recall periods, respectively. Logistic regression analysis was performed to examine the associations of dietary diversity with anaemia and iron status. SETTING KwaZulu-Natal and North West provinces, South Africa. PARTICIPANTS Children (n 578) 5- to 12-year-old. RESULTS A DDS ≤ 4 was associated with higher odds of being anaemic (1-d P = 0·001; 3-d P = 0·006) and being iron deficient (ID) (3-d P < 0·001). For both recall periods, consumption of 'vegetables and fruits other than vitamin A-rich' and 'animal-source foods (ASF)' was associated with lower odds of being anaemic (both P = 0·002), and 'organ meats' with lower odds of being ID (1-d P = 0·045; 3-d P < 0·001). Consumption of 'meat, chicken and fish' was associated with lower odds of being anaemic (P = 0·045), and 'vegetables and fruits other than vitamin A-rich', 'legumes, nuts and seeds' and 'ASF' with lower odds of being ID for the 3-d recall period only (P = 0·038, P = 0·020 and P = 0·003, respectively). CONCLUSION In order to improve anaemia and iron status among primary school-aged children, dietary diversification, with emphasis on consumption of vegetables, fruits and ASF (including organ meats), should be promoted.
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M. C. Lobo L, M. Schincaglia R, G. Peixoto MDR, C. M. Hadler MC. Multiple Micronutrient Powder Reduces Vitamin E Deficiency in Brazilian Children: A Pragmatic, Controlled Clinical Trial. Nutrients 2019; 11:nu11112730. [PMID: 31717948 PMCID: PMC6893530 DOI: 10.3390/nu11112730] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 11/06/2019] [Accepted: 11/06/2019] [Indexed: 11/22/2022] Open
Abstract
Multiple micronutrient powder supplementation is a health promotion strategy, but data on its effectiveness regarding vitamin E are rare. The objective was to evaluate the impact of home fortification with powdered micronutrients on α-tocopherol concentrations, growth, and inflammation in Brazilian children aged 6–15 months. This is a pragmatic, controlled clinical trial, in which the intervention group received micronutrient powder sachets for up to 3 months. Vitamin E deficiency was considered when α-tocopherol was less than 11.6 µmol/L. The Poisson regression model was used to estimate adjusted values for prevalence ratios (PR) for the outcome variable. A total of 224 children participated in the study. The intervention group had a higher median α-tocopherol level (17.2 versus 3.6 µmol/L; p < 0.001) and an 82.0% reduction in the prevalence of vitamin deficiency (PR = 0.18; 95% CI 0.11–0.30) when compared with the control group. Consumption of multiple micronutrients in powder increases serum α-tocopherol concentrations, promotes better linear growth, and reduces morbidity in children.
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Affiliation(s)
- Lina M. C. Lobo
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, Goiás 74605-020, Brazil; (L.M.C.L.); (R.M.S.)
| | - Raquel M. Schincaglia
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, Goiás 74605-020, Brazil; (L.M.C.L.); (R.M.S.)
- Graduate Program in Nutrition and Health, Faculty of Nutrition, Federal University of Goiás, Goiânia, Goiás 74605-080, Brazil;
| | - Maria do Rosário G. Peixoto
- Graduate Program in Nutrition and Health, Faculty of Nutrition, Federal University of Goiás, Goiânia, Goiás 74605-080, Brazil;
| | - Maria Claret C. M. Hadler
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, Goiás 74605-020, Brazil; (L.M.C.L.); (R.M.S.)
- Graduate Program in Nutrition and Health, Faculty of Nutrition, Federal University of Goiás, Goiânia, Goiás 74605-080, Brazil;
- Correspondence: ; Tel.: +55-062-98261-1506
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Kirk B, Melloy B, Iyer V, Jaacks LM. Variety, Price, and Consumer Desirability of Fresh Fruits and Vegetables in 7 Cities around the World. Curr Dev Nutr 2019; 3:nzz085. [PMID: 31463423 PMCID: PMC6704388 DOI: 10.1093/cdn/nzz085] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 01/04/2023] Open
Abstract
Few studies have attempted to quantify the variety, price, and consumer desirability of fruits and vegetables (F&Vs) across a diversity of cities. We implemented a market basket survey of F&Vs from December 2018 to February 2019 in middle-income neighborhoods of the following cities: Visakhapatnam, India; Kathmandu, Nepal; Addis Ababa, Ethiopia; Dar es Salaam, Tanzania; Mexico City, Mexico; Bangkok, Thailand; and Brookline, United States. The total variety of fruits ranged from 4.1 in Visakhapatnam to 17.3 in Brookline, and of vegetables from 6.1 in Dar es Salaam to 20.3 in Brookline. Of the 3 fruits for which price data were collected, apples tended to be the most expensive, and bananas the least expensive. For vegetables, capsicum tended to be the most expensive and eggplants the least expensive. Tablet-based market basket surveys are a useful tool for evaluating food environments. These pilot data provide further evidence of the homogenization of global diets.
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Affiliation(s)
- Brenna Kirk
- Harvard TH Chan School of Public Health, Boston, MA
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Vitamin D sufficiency in young Brazilian children: associated factors and relationship with vitamin A corrected for inflammatory status. Public Health Nutr 2019; 23:1226-1235. [PMID: 31439064 DOI: 10.1017/s1368980019002283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess sociodemographic, nutritional and health conditions associated with vitamin D sufficiency among young Brazilian children living at different latitudes. DESIGN Cross-sectional analysis with a four-level model of inflammation to correct micronutrient concentrations. Prevalence ratios (PR; 95 % CI) were estimated for factors associated with vitamin D sufficiency (≥50 nmol/l), adjusting for child's sex, age, skin colour, stunting and vitamin A+D supplementation. SETTING Primary health-care units in four Brazilian cities located at lower (7°59'26·9016″S and 9°58'31·3864″S) and higher latitudes (16°41'12·7752″S and 30°2'4·7292″S). PARTICIPANTS In total 468 children aged 11-15 months were included in the analysis. RESULTS Only 31·8 % of children were vitamin D sufficient (concentration <30 nmol/l and <50 nmol/l among 32·9 and 68·2 %, respectively). Living at higher latitudes was associated with reduced prevalence of vitamin D sufficiency compared with lower latitudes (PR = 0·65; 95 % CI 0·49, 0·85). Maternal education ≥9 years positively influenced a sufficient vitamin D status in children. After correction for inflammatory status, each increase of 1 µmol/l in vitamin A concentration was associated with a 1·38-fold higher prevalence of vitamin D sufficiency (95 % CI 1·18, 1·61). Progressive decline in the prevalence of vitamin D sufficiency was associated with marginal and deficient status of vitamin A (Ptrend = 0·001). CONCLUSIONS Lower latitude, higher maternal education and vitamin A concentration were positively associated with vitamin D sufficiency in young Brazilian children. These findings are relevant for planning public health strategies for improving vitamin D status starting in early infancy.
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Effect of Vitamin A status during pregnancy on maternal anemia and newborn birth weight: results from a cohort study in the Western Brazilian Amazon. Eur J Nutr 2018; 59:45-56. [PMID: 30560301 DOI: 10.1007/s00394-018-1880-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 12/07/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Inadequate Vitamin A (VA) status during pregnancy has been associated with maternal anemia and suboptimal newborn birth weight (BW). We assessed the effect of gestational serum retinol and β-carotene (µmol/L), in different moments during pregnancy, on maternal hemoglobin (Hb, g/L) and anemia (Hb < 110.0 g/L) at delivery, and newborn BW (kg). METHODS In a prospective cohort study in Cruzeiro do Sul, Western Brazilian Amazon, biomarkers of the VA status were assessed in the second and third trimesters in pregnancy. Serum retinol and β-carotene were analyzed considering their effects in each and in both assessments (combined VA status), and the difference of serum values between assessments. Multiple linear and Poisson regression models were used with a hierarchical selection of covariates. RESULTS A total of 488 mother-newborn pairs were surveyed. Combined VA deficiency status increased the risk for maternal anemia (adjusted prevalence ratio: 1.39; 95% CI 1.05-1.84), and was negatively associated with maternal Hb (β - 3.30 g/L; 95% CI - 6.4, - 0.20) and newborn BW (β - 0.10 kg; 95% CI - 0.20, - 0.00), adjusted for socioeconomic, environmental, obstetric, and antenatal characteristics, and nutritional indicators. However, the association for newborn BW was no longer significant after further adjustment for plasma ferritin. There were no significant associations between serum β-carotene and the outcomes studied. CONCLUSION Poor serum retinol status throughout pregnancy was associated with maternal anemia at delivery in Amazonian women. The current World Health Organization protocols for supplementation during antenatal care should consider VA status for planning recommendations in different scenarios.
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Abstract
Determining the predictors of serum retinol at mid-pregnancy is relevant for planning interventions aimed at improving vitamin A status of pregnant women and their offspring. This prospective study assessed predictors of serum retinol at the beginning of the third trimester of pregnancy. We enrolled 442 pregnant women living in the urban area of Cruzeiro do Sul, Western Brazilian Amazon. Demographic, socio-economic, environmental and clinical characteristics as well as obstetric history, anthropometric, dietary and biochemical data, including serum retinol, were gathered between 16 and 20 gestational weeks. Serum retinol also measured at the beginning of the third trimester of pregnancy (approximately 28 gestational weeks) was the outcome of interest. Multiple linear regression models were used to evaluate associations with the outcome. Overall, the following variables explained serum retinol at the beginning of the third trimester of pregnancy in the adjusted model (R 2 = 11·1 %): seasonality (winter season - November to April; β=0·134; 95 % CI 0·063, 0·206), weekly consumption of Amazonian fruits (β=0·087; 95 % CI 0·012, 0·162) and retinol concentrations between 16 and 20 gestational weeks (β=0·045; 95 % CI 0·016, 0·074) were positively associated, whereas having a smoker in the house was negatively associated (β=-0·087; 95 % CI: -0·166, -0·009). Consumption of pro-vitamin A-rich fruits by pregnant women should be encouraged. Passive smoking may play a role in decreasing vitamin A status as a proxy of smoking exposure during pregnancy.
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Sekulic MR, Stajic D, Djonovic N. The Analysis of Nutritional Predictors of Anemia Combined with Obesity in Primary School-Age Children. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2018. [DOI: 10.1515/sjecr-2016-0089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
The consumption and amounts of a variety of food products used in a diet affect the incidence of anemia and different levels of nutritional status among school-age children. The prevalence of food intake comprised of fats, carbohydrates and sodium (salt) is a significant contributing factor to the incidence of excessive weight. Apart from nutrition, a leisure-time physical activity and the time spent in front of the TV or computer may contribute to an increase in anemia and obesity rates. The objective of this paper was to examine nutritional status, dietary habits and anemia among school-age children in the central Serbia region (the city of Kragujevac). It was established that 47.3% of the surveyed children fell into the normal weight group, 24.5% of the children are considered to be at risk of being overweight, 21.4 % of the children are considered as obese, whereas 6.8% of the children fell into the under-weight group. The incidence of anemia was noted in 10.8% of the cases, whereas anemia in obese children was observed in 21.6% of the cases (n=114; during the school year of 2014-2015). The obtained results show a statistically significant correlation between an increase in the consumption of fast food and anemia in children, whereas the amount of time children spend in front of the TV is also associated with the higher percentage of anemia and obesity.
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Affiliation(s)
- Marija R. Sekulic
- University of Kragujevac , Serbia , Faculty of Medical Sciences, Department of Hygiene and ecology
| | - Dalibor Stajic
- University of Kragujevac , Serbia , Faculty of Medical Sciences, Department of Hygiene and ecology
| | - Nela Djonovic
- University of Kragujevac , Serbia , Faculty of Medical Sciences, Department of Hygiene and ecology
- Institute of Public Health , Kragujevac , Serbia
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Ghose B, Yaya S. Fruit and vegetable consumption and anemia among adult non-pregnant women: Ghana Demographic and Health Survey. PeerJ 2018; 6:e4414. [PMID: 29492346 PMCID: PMC5826990 DOI: 10.7717/peerj.4414] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 02/05/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Anemia is the most widely prevalent form of micronutrient deficiency that affects over a quarter of the global population. Evidence suggests that the burden of anemia is higher in the developing countries with women of reproductive age and children being the most at-risk groups. The most common causes are believed to be malnutrition and low bioavailability of micronutrients, which usually result from poor dietary habits and inadequate intake of food rich in micronutrients such as fresh fruits and vegetables. Regular consumption of F&V was shown to have protective effect against NCDs; however, evidence on this protective effect against micronutrient deficiency diseases are limited. OBJECTIVES (1) To measure the prevalence of anemia among adult non-pregnant women in Ghana, and (2) to investigate if there is any cross-sectional relationship between F&V consumption and anemia. METHODS This is a cross-sectional study based on data extracted from the Ghana Demographic and Health Survey, 2008. Subjects were 4,290 non-pregnant women aged between 15 and 49 years. Hemoglobin levels were measured by HemoCue® hemoglobin-meter. Association between anemia and F&V consumption was assessed by multivariable regression methods. RESULTS Findings indicate that well over half (57.9%) of the women were suffering from anemia of some level. The percentage of women consuming at least five servings of fruits and vegetables a day were 5.4% and 2.5% respectively. Results of multivariable analysis indicated that among urban women, consumption of <5 servings fruits/day was associated with significantly higher odds of severe [AOR = 9.27; 95% CI [5.15-16.70]] and moderate anemia [AOR = 6.63; 95% CI [4.21-10.44]], and consumption of <5 servings of vegetables/day was associated with higher odds of moderate anemia [AOR = 2.39; 95% CI [1.14-5.02]] compared with those who consumed >5 servings/day. CONCLUSION The findings indicate that urban women who did not maintain WHO recommended level of F&V consumption bear a significantly higher likelihood of being moderate to severely anemic.
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Affiliation(s)
- Bishwajit Ghose
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
| | - Sanni Yaya
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
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Soudy ID, Minet-Quinard R, Mahamat AD, Ngoua HF, Izzedine AA, Tidjani A, Ngo Bum E, Lambert C, Pereira B, Desjeux JF, Sapin V. Vitamin A status in healthy women eating traditionally prepared spirulina (Dihé) in the Chad Lake area. PLoS One 2018; 13:e0191887. [PMID: 29377934 PMCID: PMC5788361 DOI: 10.1371/journal.pone.0191887] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 01/12/2018] [Indexed: 12/02/2022] Open
Abstract
Background Chad Lake is a central place in a region with a high prevalence of vitamin A deficiency. Spirulina, a natural source of β-carotene, is traditionally produced and eaten as “Dihé” around Chad Lake. β-carotene spirulina has been found to have a high conversion factor to retinol. The aim of the study was to assess if the retinol status between healthy women eating spirulina Dihé daily (SPI+) and not (SPI-) in the Chad Lake area was different. Methods This study was observational: 88 healthy women were recruited and selected according to clinical criteria and their willingness to participate. They were divided in two groups according to their Dihé daily consumption: those who eat Dihé (SPI+; n = 35) and those who do not (SPI-; n = 35). After anthropometric and dietary assessments, blood retinol, β-carotene, retinol binding, and inflammatory/nutritional proteins were measured. Results The diet between groups was identical, except for β-carotene consumption, which was higher in SPI+ than in SPI- (10.8 vs. 1.8 mg/day). The serum retinol and β-carotene concentrations were significantly higher in SPI+ than in SPI- at 1.26 ± 0.36 μmol/l versus 1.03 ± 0.31 μmol/l (p = 0.008) and 0.59 ±0.37 μmol/l versus 0.46± 0.31 μmol/l (p = 0.04), respectively. Seventy-seven percent of SPI+ versus 29% of SPI- had an adequate blood retinol value (p = 0.01). Conclusion The results confirm that β-carotene in spirulina is an effective positive modulator of blood retinol status. Dihé is a potential natural source of β-carotene to achieve a proper vitamin A status in healthy women living near Chad Lake.
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Affiliation(s)
- Imar Djibrine Soudy
- Institut National Supérieur des Sciences et Techniques d’Abéché (INSTA-Tchad), Abéché, Tchad
- Institut de Recherche en Élevage pour le Développement (IRED), N’Djamena, Tchad
- * E-mail:
| | | | - Alhadj Djidda Mahamat
- Institut National Supérieur des Sciences et Techniques d’Abéché (INSTA-Tchad), Abéché, Tchad
| | | | - Abdelaziz Arada Izzedine
- Institut de Recherche en Élevage pour le Développement (IRED), N’Djamena, Tchad
- Faculté des Sciences de l’Université de Ngaoundéré, Ngaoundéré, Cameroun
| | | | - Elisabeth Ngo Bum
- Institut de Recherche en Élevage pour le Développement (IRED), N’Djamena, Tchad
| | - Céline Lambert
- Unité Biostatistiques, DRCI, CHU, Clermont-Ferrand, France
| | - Bruno Pereira
- Unité Biostatistiques, DRCI, CHU, Clermont-Ferrand, France
| | | | - Vincent Sapin
- Biochimie et Biologie Moléculaire, CHU, Clermont-Ferrand, France
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20
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Aibana O, Franke MF, Huang CC, Galea JT, Calderon R, Zhang Z, Becerra MC, Smith ER, Contreras C, Yataco R, Lecca L, Murray MB. Vitamin E Status Is Inversely Associated with Risk of Incident Tuberculosis Disease among Household Contacts. J Nutr 2018; 148:56-62. [PMID: 29378042 PMCID: PMC6251539 DOI: 10.1093/jn/nxx006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/21/2017] [Accepted: 10/02/2017] [Indexed: 01/21/2023] Open
Abstract
Background Few studies have previously assessed how pre-existing vitamin E status is associated with risk of tuberculosis (TB) disease progression. Objective We evaluated the association between baseline plasma concentrations of 3 vitamin E isomers (α-tocopherol, γ-tocopherol, and δ-tocopherol) and TB disease risk. Methods We conducted a case-control study nested within a longitudinal cohort of household contacts (HHCs) of pulmonary TB cases in Lima, Peru. We defined cases as HHCs who developed active TB disease ≥15 d after the diagnosis of the index patient, and we matched each case to 4 control cases who did not develop active TB based on age by year and gender. We used univariate and multivariate conditional logistic regression to calculate ORs for incident TB disease by plasma concentrations of α-tocopherol, γ-tocopherol, and δ-tocopherol. Results Among 6751 HIV-negative HHCs who provided baseline blood samples, 180 developed secondary TB during follow-up. After controlling for possible confounders, we found that baseline α-tocopherol deficiency conferred increased risk of incident TB disease (adjusted OR: 1.59; 95% CI: 1.02, 2.50; P = 0.04). Household contacts in the lowest tertile of δ-tocopherol were also at increased risk of progression to TB disease compared to those in the highest tertile (tertile 1 compared with tertile 3, adjusted OR: 2.29; 95% CI: 1.29, 4.09; P-trend = 0.005). We found no association between baseline concentration of γ-tocopherol and incident TB disease. Conclusions Vitamin E deficiency was associated with an increased risk of progression to TB disease among HHCs of index TB cases. Assessment of vitamin E status among individuals at high risk for TB disease may play a role in TB control efforts.
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Affiliation(s)
- Omowunmi Aibana
- Division of General Internal Medicine, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX
- Division of Infectious Diseases, The Miriam Hospital, Warren Alpert School of Medicine at Brown University, Providence, RI
| | - Molly F Franke
- Department of Global Health and Social Medicine, and Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Chuan-Chin Huang
- Department of Global Health and Social Medicine, and Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Jerome T Galea
- Department of Global Health and Social Medicine, and Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Partners In Health, Socios En Salud Sucursal Peru, Lima, Peru
| | - Roger Calderon
- Partners In Health, Socios En Salud Sucursal Peru, Lima, Peru
| | - Zibiao Zhang
- Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Mercedes C Becerra
- Department of Global Health and Social Medicine, and Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Emily R Smith
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA
| | | | - Rosa Yataco
- Partners In Health, Socios En Salud Sucursal Peru, Lima, Peru
| | - Leonid Lecca
- Department of Global Health and Social Medicine, and Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Partners In Health, Socios En Salud Sucursal Peru, Lima, Peru
| | - Megan B Murray
- Department of Global Health and Social Medicine, and Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Hutchison ML, Harrison D, Heath JF, Monaghan JM. Fate of Escherichia coli O145 present naturally in bovine slurry applied to vegetables before harvest, after washing and simulated wholesale and retail distribution. J Appl Microbiol 2017; 123:1597-1606. [PMID: 28948664 DOI: 10.1111/jam.13593] [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] [Received: 08/17/2017] [Revised: 09/08/2017] [Accepted: 09/20/2017] [Indexed: 11/30/2022]
Abstract
AIMS To determine the fate of Escherichia coli on vegetables that were processed through commercial wash treatments and stored under simulated retail conditions at 4°C or wholesale at fluctuating ambient temperatures (0-25°C, dependent on season). METHODS AND RESULTS Bovine slurry that was naturally contaminated with E. coli O145 was applied without dilution or diluted 1:10 using borehole water to growing potatoes, leeks or carrots. Manure was applied 1 week prior to harvest to simulate a near-harvest contamination event by manure deposition or an application of contaminated water to simulate a flooding event or irrigation from a contaminated water source. At harvest, crops were contaminated at up to 2 log cfu g-1 . Washing transferred E. coli into the water of a flotation tank used for potato washing and did not completely remove all traces of contamination from the crop. Manure-contaminated potatoes were observed to contain 0·72 cfu E. coli O145 g-1 after processing and retail storage. Manure-contaminated leeks harboured 0·73-1·55 cfu E. coli O145 g-1 after washing and storage. There was no cross-contamination when leeks were spray washed. Washing in an abrasive drum resulted in less than perfect decontamination for manure-contaminated carrots. There were five post-distribution isolations from carrots irrigated with contaminated water 24 h prior to harvest. CONCLUSIONS Standard commercial washing and distribution conditions may be insufficient to reliably control human pathogenic E. coli on fresh produce. SIGNIFICANCE AND IMPACT Previous speculation that the cause of a UK foodborne disease outbreak was soil from imperfectly cleaned vegetables is plausible.
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Affiliation(s)
- M L Hutchison
- Hutchison Scientific Ltd, Dundee, UK.,School of Veterinary Sciences, Food Microbiology, University of Bristol, Langford, UK
| | - D Harrison
- School of Veterinary Sciences, Food Microbiology, University of Bristol, Langford, UK
| | - J F Heath
- Department of Crop and Environment Science, Fresh Produce Research Centre, Harper Adams University, Newport, Shropshire, UK
| | - J M Monaghan
- Department of Crop and Environment Science, Fresh Produce Research Centre, Harper Adams University, Newport, Shropshire, UK
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Caffarelli C, Santamaria F, Di Mauro D, Mastrorilli C, Mirra V, Bernasconi S. Progress in pediatrics in 2015: choices in allergy, endocrinology, gastroenterology, genetics, haematology, infectious diseases, neonatology, nephrology, neurology, nutrition, oncology and pulmonology. Ital J Pediatr 2016; 42:75. [PMID: 27566421 PMCID: PMC5002164 DOI: 10.1186/s13052-016-0288-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 08/10/2016] [Indexed: 12/29/2022] Open
Abstract
This review focuses key advances in different pediatric fields that were published in Italian Journal of Pediatrics and in international journals in 2015. Weaning studies continue to show promise for preventing food allergy. New diagnostic tools are available for identifying the allergic origin of allergic-like symptoms. Advances have been reported in obesity, short stature and autoimmune endocrine disorders. New molecules are offered to reduce weight gain and insulin-resistance in obese children. Regional investigations may provide suggestions for preventing short stature. Epidemiological studies have evidenced the high incidence of Graves' disease and Hashimoto's thyroiditis in patients with Down syndrome. Documentation of novel risk factors for celiac disease are of use to develop strategies for prevention in the population at-risk. Diagnostic criteria for non-celiac gluten sensitivity have been reported. Negative effect on nervous system development of the supernumerary X chromosome in Klinefelter syndrome has emerged. Improvements have been made in understanding rare diseases such as Rubinstein-Taybi syndrome. Eltrombopag is an effective therapy for immune trombocytopenia. Children with sickle-cell anemia are at risk for nocturnal enuresis. Invasive diseases caused by Streptococcus pyogenes are still common despite of vaccination. No difference in frequency of antibiotic prescriptions for acute otitis media between before the publication of the national guideline and after has been found. The importance of timing of iron administration in low birth weight infants, the effect of probiotics for preventing necrotising enterocolitis and perspectives for managing jaundice and cholestasis in neonates have been highlighted. New strategies have been developed to reduce the risk for relapse in nephrotic syndrome including prednisolone during upper respiratory infection. Insights into the pathophysiology of cerebral palsy, arterial ischemic stroke and acute encephalitis may drive advances in treatment. Recommendations on breastfeeding and complementary feeding have been updated. Novel treatments for rhabdomyosarcoma should be considered for paediatric patients. Control of risk factors for bronchiolitis and administration of pavilizumab for preventing respiratory syncytial virus infection may reduce hospitalization. Identification of risk factors for hospitalization in children with wheezing can improve the management of this disease. Deletions or mutations in genes encoding proteins for surfactant function may cause diffuse lung disease.
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Affiliation(s)
- Carlo Caffarelli
- Clinica Pediatrica, Department of Clinical and Experimental Medicine, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Dora Di Mauro
- Clinica Pediatrica, Department of Clinical and Experimental Medicine, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Carla Mastrorilli
- Clinica Pediatrica, Department of Clinical and Experimental Medicine, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Virginia Mirra
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Sergio Bernasconi
- Pediatrics Honorary Member University Faculty, G D’Annunzio University of Chieti-Pescara, Chieti, Italy
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da Silva Ferreira H, de Assunção Bezerra MK, Lopes de Assunção M, Egito de Menezes RC. Prevalence of and factors associated with anemia in school children from Maceió, northeastern Brazil. BMC Public Health 2016; 16:380. [PMID: 27164974 PMCID: PMC4862163 DOI: 10.1186/s12889-016-3073-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 05/04/2016] [Indexed: 11/30/2022] Open
Abstract
Background Anemia is a major public health problem in preschool children in Alagoas, Brazil, especially in the younger population, because of a positive correlation between hemoglobin level and age. However, due to the lack of studies, it is not known how widespread this condition is among older children or how it is associated with socioeconomic status. The aim of this study was to investigate the prevalence of and factors associated with anemia in school children from the city of Maceió, Alagoas state, Brazil. The analysis was stratified to identify any effect modification according to whether they attend public or private schools. Methods A cross-sectional study was conducted using probability sampling of 1518 children (9.8 ± 0.5 years of age) attending public (n = 931) and private (n = 587) elementary schools in the municipality. Semi-structured questionnaires were used to obtain socioeconomic, demographic, anthropomorphic, hemoglobin (Hb), and dietary data. Anemia (Hb <11.5 g/dL) was the dependent variable. The measure of association used was prevalence ratio (PR) and respective CI95 %, calculated by Poisson regression with robust variance adjustment, for the crude and adjusted analyses. Results The prevalence of anemia was found to be higher amongst the public school children than the private school children (10.8 % vs. 7.0 %; PR = 1.54; CI95 %: 1.1; 2.2). At the public schools, the variables that remained significantly associated with anemia after the multivariate analysis were “consumption of fruits/fruit juices < 2 portions/day” (PR = 2.19; CI95 %: 1.18; 4.06) and “male” (PR = 1.51; CI95 %: 1.001; 2.30). At the private schools, these variables were “working mother” (PR = 2.83; CI95 %: 1.23; 6.52) and “monthly school fees < R$ 188.00” (PR = 3.20; CI95 %: 1.46; 7.03). Conclusions In the population under study, anemia constitutes a major health problem, especially among children from public schools. Considering the associated factors and the fact that these children are in a school environment, the promotion of healthy eating habits could constitute an important approach for reducing the prevalence of anemia.
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Affiliation(s)
- Haroldo da Silva Ferreira
- Faculty of Nutrition, Federal University of Alagoas, Campus A.C. Simões, BR 104 Norte - Km 96.7 - Tabuleiro do Martins, CEP: 57072-970, Maceió, AL, Brazil.
| | - Myrtis Katille de Assunção Bezerra
- Centro de Pesquisa Aggeu Magalhães, Fundação Oswaldo Cruz, Av. Prof. Moraes Rego, s/n - Campus da UFPE - Cidade Universitária, Recife, PE, Brazil
| | - Monica Lopes de Assunção
- Faculty of Nutrition, Federal University of Alagoas, Campus A.C. Simões, BR 104 Norte - Km 96.7 - Tabuleiro do Martins, CEP: 57072-970, Maceió, AL, Brazil
| | - Risia Cristina Egito de Menezes
- Faculty of Nutrition, Federal University of Alagoas, Campus A.C. Simões, BR 104 Norte - Km 96.7 - Tabuleiro do Martins, CEP: 57072-970, Maceió, AL, Brazil
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Alaofè H, Burney J, Naylor R, Taren D. Solar-Powered Drip Irrigation Impacts on Crops Production Diversity and Dietary Diversity in Northern Benin. Food Nutr Bull 2016; 37:164-75. [DOI: 10.1177/0379572116639710] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Meeting the food needs of Africa's growing population will require innovative and appropriate technologies whose effectiveness needs to be assessed. Objective: To evaluate the impact of Solar Market Gardens (SMGs) on crops production diversity and dietary diversity in the Kalalé district of Northern Benin. Methods: In 2007, SMGs were installed in 2 villages for women's agricultural groups as a strategy for enhancing food and nutrition security. Data were collected through interviews at installation and 1 year later from all women's group households (30–35 women/group) and from a random representative sample of 30 households in each village, for both treatment and matched-pair comparison villages. Results: Comparison of baseline and endline data indicated increases in the variety of fruits and vegetables produced and consumed by SMG women's groups compared to other groups. The proportion of SMG women’s group households engaged in vegetable and fruit production significantly increased by 26% and 55%, respectively ( P < .05). After controlling for baseline values, SMG women's groups were 3 times more likely to increase their fruit and vegetable consumption compared with comparison non-women's groups ( P < .05). In addition, the percentage change in corn, sorghum, beans, oil, rice and fish purchased was significantly greater in the SMG women’s groups compared to other groups. At endline, 57% of the women used their additional income on food, 54% on health care, and 25% on education. Conclusions: Solar Market Gardens have the potential to improve household nutritional status through direct consumption and increased income to make economic decisions.
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Benzecry SG, Alexandre MA, Vítor-Silva S, Salinas JL, de Melo GC, Marinho HA, Paes ÂT, de Siqueira AM, Monteiro WM, Lacerda MVG, Leite HP. Micronutrient Deficiencies and Plasmodium vivax Malaria among Children in the Brazilian Amazon. PLoS One 2016; 11:e0151019. [PMID: 26963624 PMCID: PMC4786135 DOI: 10.1371/journal.pone.0151019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/23/2016] [Indexed: 02/07/2023] Open
Abstract
Background There is a growing body of evidence linking micronutrient deficiencies and malaria incidence arising mostly from P. falciparum endemic areas. We assessed the impact of micronutrient deficiencies on malaria incidence and vice versa in the Brazilian state of Amazonas. Methodology/Principal Findings We evaluated children <10 years old living in rural communities in the state of Amazonas, Brazil, from May 2010 to May 2011. All children were assessed for sociodemographic, anthropometric and laboratory parameters, including vitamin A, beta-carotene, zinc and iron serum levels at the beginning of the study (May 2010) and one year later (May 2011). Children were followed in between using passive surveillance for detection of symptomatic malaria. Those living in the study area at the completion of the observation period were reassessed for micronutrient levels. Univariate Cox-proportional Hazards models were used to assess whether micronutrient deficiencies had an impact on time to first P. vivax malaria episode. We included 95 children median age 4.8 years (interquartile range [IQR]: 2.3–6.6), mostly males (60.0%) and with high maternal illiteracy (72.6%). Vitamin A deficiencies were found in 36% of children, beta-carotene deficiency in 63%, zinc deficiency in 61% and iron deficiency in 51%. Most children (80%) had at least one intestinal parasite. During follow-up, 16 cases of vivax malaria were diagnosed amongst 13 individuals. Micronutrient deficiencies were not associated with increased malaria incidence: vitamin A deficiency [Hazard ratio (HR): 1.51; P-value: 0.45]; beta-carotene [HR: 0.47; P-value: 0.19]; zinc [HR: 1.41; P-value: 0.57] and iron [HR: 2.31; P-value: 0.16]). Upon reevaluation, children with al least one episode of malaria did not present significant changes in micronutrient levels. Conclusion Micronutrient serum levels were not associated with a higher malaria incidence nor the malaria episode influenced micronutrient levels. Future studies targeting larger populations to assess micronutrients levels in P. vivax endemic areas are warranted in order to validate these results.
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Affiliation(s)
- Silvana Gomes Benzecry
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Márcia Almeida Alexandre
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
- Gerência de Malária, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Sheila Vítor-Silva
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
- Gerência de Malária, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Jorge Luis Salinas
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, United States of America
| | - Gisely Cardoso de Melo
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
- Gerência de Malária, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | | | | | - André Machado de Siqueira
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
- Gerência de Malária, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
- Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil
| | - Wuelton Marcelo Monteiro
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
- Gerência de Malária, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Marcus Vinícius Guimarães Lacerda
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
- Gerência de Malária, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
- Instituto de Pesquisas Leônidas & Maria Deane, Fundação Oswaldo Cruz, Manaus, Brazil
- * E-mail: (ML); (HPL)
| | - Heitor Pons Leite
- Department of Pediatrics, Discipline of Nutrition and Metabolism, Federal University of São Paulo, São Paulo, Brazil
- * E-mail: (ML); (HPL)
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Cobayashi F, Lourenço BH, Cardoso MA. 25-Hydroxyvitamin D3 Levels, BsmI Polymorphism and Insulin Resistance in Brazilian Amazonian Children. Int J Mol Sci 2015; 16:12531-46. [PMID: 26047339 PMCID: PMC4490459 DOI: 10.3390/ijms160612531] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/12/2015] [Accepted: 05/18/2015] [Indexed: 01/11/2023] Open
Abstract
Vitamin D is associated with a wide range of other functions beyond bone development. We evaluated the factors associated with 25-hydroxyvitamin D levels in 974 children aged ≤ 10 years and the impact of BsmI polymorphism of the vitamin D receptor (VDR) gene (rs1544410) on metabolic parameters in a subsample (n: 430) with a follow-up 2 years later from the initial population-based cross-sectional study. Multiple linear regression models were used in the analyses. The prevalence (95% CI) of vitamin D deficiency, insufficiency and sufficiency of children was 11.1% (9.2-13.2), 21.8% (19.2-24.5) and 67.2% (64.1-70.1), respectively. Overall, 23% of the variation in serum 25-hydroxyvitamin D concentrations was accounted for by BsmI polymorphism β = -0.053 (95% CI) (-0.100, -0.006), maternal schooling (≥ 9 years) β = 0.100 (0.039, 0.161), serum vitamin E β = 0.478 (0.381, 0.574), total cholesterol concentration β = 0.232 (0.072, 0.393) and serum folate β = 0.064 (0.013, 0.115). BsmI polymorphism was positively associated with HOMA-IR β = 0.122 (0.002, 0.243) and fasting glucose concentration β = 1.696 (0.259, 3.133). In conclusion, variables related to socioeconomic level, the presence of the allele risk for BsmI and other nutrient concentrations were associated with serum 25-hydroxyvitamin D concentrations. Our results suggest that BsmI polymorphism is correlated with metabolic outcomes.
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Affiliation(s)
- Fernanda Cobayashi
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, CEP 01246-904 São Paulo, Brazil.
| | - Bárbara Hatzlhoffer Lourenço
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, CEP 01246-904 São Paulo, Brazil.
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, CEP 01246-904 São Paulo, Brazil.
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