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Kumar V, Kalita J, Misra UK, Parashar V. Stunting and wasting in neurological Wilson disease: Role of copper, zinc, and insulin-like growth factor-I. Int J Dev Neurosci 2023; 83:653-664. [PMID: 37580872 DOI: 10.1002/jdn.10293] [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: 03/07/2023] [Revised: 06/23/2023] [Accepted: 07/24/2023] [Indexed: 08/16/2023] Open
Abstract
OBJECTIVES Copper (Cu) and zinc (Zn) are important trace elements for the growth and development of children. In Wilson disease (WD), impaired Cu metabolism may affect growth. This study was conducted to evaluate the height and weight of children with neurological WD and correlate these with serum Cu, Zn, and insulin-like growth factor-I (IGF-I). METHODS This prospective cohort study was conducted in a tertiary care teaching institute. Children with neurologic WD were included. The height, weight, and body-mass index of each child were measured and categorized according to the revised national growth chart. Serum Cu, Zn, calcium, alkaline phosphatase, albumin, thyroid-stimulating hormone, and urinary-Cu were measured. Serum IGF-1 was measured by enzyme-linked immunosorbent assay. The relationship between height and weight with trace elements and IGF was analyzed using parametric or non-parametric tests. RESULTS There were 52 children (5-18 years) with neurologic WD. Thirty-six (69.2%) children had normal height, 12 (23.1%) were tall, and 4 (7.7%) were stunted. Forty-six (88.5%) children had normal weight and six (11.5%) children were underweight. IGF-1 correlated with height, weight, duration of treatment, and serum Zn level. About 15.4% of children had stunting and/or wasting, which was associated with low levels of serum IGF-I, Zn, and calcium. CONCLUSIONS Stunting and/or wasting occurs in 15.4% of children with neurologic WD and is associated with reduced serum IGF-I, Zn, and calcium concentration. Adjunctive Zn and calcium treatment may help in achieving normal growth.
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Affiliation(s)
- Vijay Kumar
- Department of Orthopedics Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jayantee Kalita
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Usha Kant Misra
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
- Apollomedic Super Specialty Hospital, Lucknow, Uttar Pradesh, India
| | - Vasudev Parashar
- Department of Neurology, SMS Medical College & Hospital, Jaipur, India
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Ernawati F, Efriwati, Nurjanah N, Aji GK, Hapsari Tjandrarini D, Widodo Y, Retiaty F, Prihatini M, Arifin AY, Sundari D, Rachmalina R, Salimar, Julianti ED, Aidi MN, Syauqy A. Micronutrients and Nutrition Status of School-Aged Children in Indonesia. J Nutr Metab 2023; 2023:4610038. [PMID: 37705875 PMCID: PMC10497362 DOI: 10.1155/2023/4610038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 07/21/2023] [Accepted: 08/26/2023] [Indexed: 09/15/2023] Open
Abstract
Micronutrient deficiencies (MNDs) in school-aged children are still a major health problem in Indonesia. This study was designed to examine the status of micronutrients and their relationship to the nutritional status of children aged 5-12 years since an up-to-date database on the micronutrient status of children aged 5-12 years is needed. Data from the 2018 Indonesian Basic Health Research (Riskesdas) were used in this study, with 2456 subjects for analysis. Micronutrient analysis was carried out, including iron status (ferritin, C reactive protein (CRP)), levels of zinc, vitamin D, calcium, and vitamin A (retinol) in school-aged children (5-12 years). The ELISA measurement was applied to measure CRP, ferritin, and vitamin D. Zinc levels were analysed with atomic absorbance spectroscopy (AAS). Moreover, high-performance liquid chromatography (HPLC) was applied to calculate vitamin A. In addition, stunting and thinness data were also obtained from the Riskesdas study. The results showed that the prevalence of stunting and thinness in school-aged children was 11.4% and 9.2%, respectively, showing that the stunting prevalence in the city was lower than in the village (4.5% vs. 6.9%, P = 0.000, respectively). In addition, the prevalence of MNDs in Indonesian children was 13.4%, 19.7%, 4.2%, 3%, and 12.7% for ferritin, zinc, calcium, vitamin A, and vitamin D, respectively. The mean serum level of vitamin A and zinc was significantly lower in stunted children compared to normal school children (P = 0.010 and P = 0.014). The serum concentration of vitamin D was significantly lower in overweight children compared to thin and normal children (P = 0.000). Serum values of ferritin, zinc, and vitamin A were significantly higher in overweight children compared to thin and normal children (P = 0.000). A poor correlation was observed between the z-score of height-for-age (HAZ) and the levels of zinc (r = 0.089, P = 0.000), vitamin A (r = 0.105, P = 0.000), and vitamin D (-0.073, P = 0.000). In addition, very weak correlations between z-scores of body mass index-for-age (BAZ) and the serum concentrations of ferritin (0.091, P = 0.000), zinc (r = 0.115, P = 0.000), vitamin A (r = 0.137, P = 0.000), and vitamin D (r = -0.112, P = 0.000) were also seen. In conclusion, school-aged children in Indonesia experienced stunting, thinness, and micronutrient deficiency. Furthermore, stunting and thinness were also related to micronutrient deficiencies.
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Affiliation(s)
- Fitrah Ernawati
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Efriwati
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Nunung Nurjanah
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Galih Kusuma Aji
- Research Center for Agroindustry, National Research and Innovation Agency, BJ Habibie Science Center, Setu, Kota Tangerang Selatan, Banten 15314, Indonesia
| | - Dwi Hapsari Tjandrarini
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Yekti Widodo
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Fifi Retiaty
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Mutiara Prihatini
- Health Policy Agency (BKPK), Ministry of Health, Jl. Percetakan Negara, Jakarta Pusat 10560, Indonesia
| | - Aya Yuriestia Arifin
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Dian Sundari
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Rika Rachmalina
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Salimar
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Elisa Diana Julianti
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Muhammad Nur Aidi
- Department of Statistics, IPB University, Jalan Meranti Wing 22 Level 4, Babakan, Dramaga, Kabupaten Bogor, Jawa Barat 16680, Indonesia
| | - Ahmad Syauqy
- Department of Nutrition Science, Diponegoro University, Jl. Prof Sudarto, Tembalang, Kota Semarang 50275, Indonesia
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Coppola S, Carucci L, Oglio F, Di Sarra C, Ozen G, Berni Canani R. Nutritional Strategies for the Prevention and Management of Cow's Milk Allergy in the Pediatric Age. Nutrients 2023; 15:3328. [PMID: 37571266 PMCID: PMC10421120 DOI: 10.3390/nu15153328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/22/2023] [Accepted: 07/23/2023] [Indexed: 08/13/2023] Open
Abstract
Cow's milk allergy (CMA) is one of the most common pediatric food allergies. The prevalence and severity of CMA have increased dramatically in the last decades, under the pressure of environmental factors in genetically predisposed individuals. Among the environmental influences, nutritional factors play a crucial role. Diet is the most modifiable factor, representing a potential target for the prevention and treatment of CMA. In this review, we report the most scientific-based nutritional strategies for preventing and managing pediatric CMA. In addition, we propose the most complete supplement of compounds able to prevent nutrient deficiencies in CMA pediatric patients and to positively influence the disease course.
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Affiliation(s)
- Serena Coppola
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy; (S.C.); (L.C.); (F.O.); (C.D.S.); (G.O.)
- Immunonutrition Lab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, 80131 Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy; (S.C.); (L.C.); (F.O.); (C.D.S.); (G.O.)
- Immunonutrition Lab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, 80131 Naples, Italy
| | - Franca Oglio
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy; (S.C.); (L.C.); (F.O.); (C.D.S.); (G.O.)
- Immunonutrition Lab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, 80131 Naples, Italy
| | - Claudia Di Sarra
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy; (S.C.); (L.C.); (F.O.); (C.D.S.); (G.O.)
- Immunonutrition Lab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, 80131 Naples, Italy
| | - Gulsum Ozen
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy; (S.C.); (L.C.); (F.O.); (C.D.S.); (G.O.)
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy; (S.C.); (L.C.); (F.O.); (C.D.S.); (G.O.)
- Immunonutrition Lab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, 80131 Naples, Italy
- European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, 80131 Naples, Italy
- Task Force for Microbiome Studies, University of Naples Federico II, 80131 Naples, Italy
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Huertas R, Karpinska B, Ngala S, Mkandawire B, Maling'a J, Wajenkeche E, Kimani PM, Boesch C, Stewart D, Hancock RD, Foyer CH. Biofortification of common bean ( Phaseolus vulgaris L.) with iron and zinc: Achievements and challenges. Food Energy Secur 2023; 12:e406. [PMID: 38440694 PMCID: PMC10909572 DOI: 10.1002/fes3.406] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/01/2022] [Accepted: 06/08/2022] [Indexed: 03/06/2024] Open
Abstract
Micronutrient deficiencies (hidden hunger), particularly in iron (Fe) and zinc (Zn), remain one of the most serious public health challenges, affecting more than three billion people globally. A number of strategies are used to ameliorate the problem of micronutrient deficiencies and to improve the nutritional profile of food products. These include (i) dietary diversification, (ii) industrial food fortification and supplements, (iii) agronomic approaches including soil mineral fertilisation, bioinoculants and crop rotations, and (iv) biofortification through the implementation of biotechnology including gene editing and plant breeding. These efforts must consider the dietary patterns and culinary preferences of the consumer and stakeholder acceptance of new biofortified varieties. Deficiencies in Zn and Fe are often linked to the poor nutritional status of agricultural soils, resulting in low amounts and/or poor availability of these nutrients in staple food crops such as common bean. This review describes the genes and processes associated with Fe and Zn accumulation in common bean, a significant food source in Africa that plays an important role in nutritional security. We discuss the conventional plant breeding, transgenic and gene editing approaches that are being deployed to improve Fe and Zn accumulation in beans. We also consider the requirements of successful bean biofortification programmes, highlighting gaps in current knowledge, possible solutions and future perspectives.
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Affiliation(s)
- Raul Huertas
- Environmental and Biochemical SciencesThe James Hutton InstituteDundeeUK
| | - Barbara Karpinska
- School of Biosciences, College of Life and Environmental SciencesUniversity of BirminghamEdgbastonUK
| | - Sophia Ngala
- Department of Plant Science and Crop Protection, College of Agriculture and Veterinary SciencesUniversity of NairobiNairobiKenya
| | - Bertha Mkandawire
- The Food, Agriculture and Natural Resources Policy Analysis Network (FANRPAN)PretoriaSouth Africa
| | - Joyce Maling'a
- Kenya Agriculture and Livestock Research Organization (KALRO)Food Crops Research InstituteKitaleKenya
| | - Elizabeth Wajenkeche
- Kenya Agriculture and Livestock Research Organization (KALRO)Food Crops Research InstituteKitaleKenya
| | - Paul M. Kimani
- Department of Plant Science and Crop Protection, College of Agriculture and Veterinary SciencesUniversity of NairobiNairobiKenya
| | | | - Derek Stewart
- Environmental and Biochemical SciencesThe James Hutton InstituteDundeeUK
- School of Engineering and Physical SciencesHeriot‐Watt UniversityEdinburghUK
| | | | - Christine H. Foyer
- School of Biosciences, College of Life and Environmental SciencesUniversity of BirminghamEdgbastonUK
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5
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Development of Food Multi-Mix Using a Linear Programming Approach to Fill the Nutrient Gap of Amino Acids and Micronutrients for Stunted Non-Wasted Children. Foods 2022; 12:foods12010064. [PMID: 36613280 PMCID: PMC9818143 DOI: 10.3390/foods12010064] [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: 09/30/2022] [Revised: 11/10/2022] [Accepted: 11/26/2022] [Indexed: 12/24/2022] Open
Abstract
Food-based approaches using locally available food escalates the feasibility and the sustainability of nutrition intervention. A complementary feeding recommendation (CFR) integrated with the food multi-mix (FMM) formulation was targeted to fulfill micronutrient and amino acid requirements for stunted non-wasted (SNW) children aged 12-23 months living in agricultural areas. A seven-day estimated food record (EFR) of 87 children was used to design the CFR and 4 identified underutilized foods were integrated as the FMM. A linear programming approach using Optifood was applied to optimize the CFR and FMM. CFR alone successfully fulfills the vitamin C, riboflavin, iron, and zinc, but it cannot fulfill calcium, thiamin, niacin, vitamin B6, folate, vitamin B12, and histidine. With the incorporation of the selected underutilized cowpea, buncis batik, wader fish, and cows' milk in the FMM development, the nutrients that are challenging in CFR development, can be fulfilled. Therefore, these findings present evidence that food multi-mix developed based on locally available nutrient-dense food sources can help to meet the nutrient gaps, which often remained even after a complementary feeding diet is optimized. Efficacy study using the developed CFR and FMM is recommended to assess effect in improving intake of micronutrients and amino acids and improving the linear growth of stunted, non-wasted children.
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Jepleting N, N. Sila D, N. Orina I. Nutritional Composition and Antinutrient to Mineral Molar Ratios of Selected Improved Common Beans Grown in Kenya. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2022. [DOI: 10.12944/crnfsj.10.3.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A decline in common bean production has been ascribed to climate change. The adoption of improved beans aims to increase productivity, profitability, and consumption, thus reducing food and nutrition insecurity in the country. The aim of this study was to determine the proximate composition, antinutrient content, mineral content, and bioaccessibility of zinc and iron in two improved bean varieties grown in Kenya; Faida (biofortified) and RM 01 (drought tolerant)). The protein content of RM 01 (22.48%) was significantly higher than the Faida bean variety (20.90%). RM 01 bean variety had higher crude fat (4.20%) and crude fiber (4.31%) content compared to Faida which had 3.78% and 3.31% for crude fat and crude fiber respectively. Faida recorded significantly higher levels of iron (61.5 mg/kg) and zinc (26.8 mg/kg) content. Faida beans also had significantly (p< 0.05) high levels of phytates (11.70 mg/g) and tannins (4.39 mg CE/g). Phytate to iron ratio for Faida was 17.08 and RM 01 was 15.19 while the phytate-to-zinc ratio was 42.26 and 35.36 for Faida and RM 01 respectively. The RM 01 bean variety had iron bioaccessibility of 35% and zinc bioaccessibility of 65% compared to the Faida bean variety which had bioaccessibility of 29% and 42% for iron and zinc respectively. In conclusion, RM 01 variety is a better source of iron, zinc, and protein compared to the Faida variety.
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Affiliation(s)
- Nancy Jepleting
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Daniel N. Sila
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Irene N. Orina
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
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7
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Iron and zinc bioavailability in common bean (Phaseolus vulgaris) is dependent on chemical composition and cooking method. Food Chem 2022; 387:132900. [DOI: 10.1016/j.foodchem.2022.132900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/22/2022] [Accepted: 04/03/2022] [Indexed: 02/08/2023]
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8
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Alesci A, Pergolizzi S, Fumia A, Miller A, Cernigliaro C, Zaccone M, Salamone V, Mastrantonio E, Gangemi S, Pioggia G, Cicero N. Immune System and Psychological State of Pregnant Women during COVID-19 Pandemic: Are Micronutrients Able to Support Pregnancy? Nutrients 2022; 14:nu14122534. [PMID: 35745263 PMCID: PMC9227584 DOI: 10.3390/nu14122534] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/04/2022] [Accepted: 06/16/2022] [Indexed: 02/04/2023] Open
Abstract
The immune system is highly dynamic and susceptible to many alterations throughout pregnancy. Since December 2019, a pandemic caused by coronavirus disease 19 (COVID-19) has swept the globe. To contain the spread of COVID-19, immediate measures such as quarantine and isolation were implemented. These containment measures have contributed to exacerbate situations of anxiety and stress, especially in pregnant women, who are already particularly anxious about their condition. Alterations in the psychological state of pregnant women are related to alterations in the immune system, which is more vulnerable under stress. COVID-19 could therefore find fertile soil in these individuals and risk more severe forms. Normally a controlled dietary regimen is followed during pregnancy, but the use of particular vitamins and micronutrients can help counteract depressive-anxiety states and stress, can improve the immune system, and provide an additional weapon in the defense against COVID-19 to bring the pregnancy to fruition. This review aims to gather data on the impact of COVID-19 on the immune system and psychological condition of pregnant women and to assess whether some micronutrients can improve their psychophysical symptoms.
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Affiliation(s)
- Alessio Alesci
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
- Correspondence: (A.A.); (A.F.); (N.C.)
| | - Simona Pergolizzi
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
| | - Angelo Fumia
- Department of Clinical and Experimental Medicine, University of Messina, 98147 Messina, Italy;
- Correspondence: (A.A.); (A.F.); (N.C.)
| | - Anthea Miller
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy;
| | - Caterina Cernigliaro
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Maria Zaccone
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Vanessa Salamone
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Enza Mastrantonio
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, University of Messina, 98147 Messina, Italy;
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98125 Messina, Italy;
| | - Nicola Cicero
- Department of Biomedical and Dental Science and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
- Correspondence: (A.A.); (A.F.); (N.C.)
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Li J, Cao D, Huang Y, Chen B, Chen Z, Wang R, Dong Q, Wei Q, Liu L. Zinc Intakes and Health Outcomes: An Umbrella Review. Front Nutr 2022; 9:798078. [PMID: 35211497 PMCID: PMC8861317 DOI: 10.3389/fnut.2022.798078] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/10/2022] [Indexed: 12/19/2022] Open
Abstract
It is widely accepted that the zinc element is crucial in human beings. Zinc has gained more attention during the COVID-19 pandemic due to its utilization for the treatment and prevention of respiratory tract infections. However, some studies also pointed out that zinc intake might cause unwanted side effects and even be dangerous when overdosed. To reveal the relationship between zinc intake and health outcomes, we performed an umbrella review from human studies. In total, the umbrella review included 43 articles and identified 11 outcomes for dietary zinc intake and 86 outcomes for supplementary zinc intake. Dietary zinc intake in the highest dose would decrease the risk of overall and specific digestive tract cancers, depression, and type 2 diabetes mellitus (T2DM) in adults. Supplementary zinc consumption in adults was linked to an improvement of depression, antioxidant capacity and sperm quality, higher serum zinc concentration, and lower concentration of inflammatory markers. Zinc supplementation in children would reduce the incidence of diarrhea and pneumonia, improve zinc deficiency and boost growth. However, zinc might not decrease all-cause mortality in adults or the in-hospital mortality of COVID-19. And better maternal and neonatal outcomes may not derive from pregnant women who consumed higher or lower doses of zinc supplementation (>20 mg/day and <20 mg/day, respectively). Dose-response analyses revealed that a daily 5 mg increment of zinc would lower the risk of colorectal and esophageal cancer, whereas a large dose of zinc supplementation (daily 100 mg) showed no benefit in reducing prostate cancer risk.
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Affiliation(s)
- Jin Li
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Dehong Cao
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yin Huang
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Bo Chen
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Zeyu Chen
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Ruyi Wang
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Dong
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Qiang Wei
| | - Liangren Liu
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Liangren Liu
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Chitekwe S, Parajuli KR, Paudyal N, Haag KC, Renzaho A, Issaka A, Agho K. Individual, household and national factors associated with iron, vitamin A and zinc deficiencies among children aged 6-59 months in Nepal. MATERNAL & CHILD NUTRITION 2022; 18 Suppl 1:e13305. [PMID: 34897980 PMCID: PMC8770653 DOI: 10.1111/mcn.13305] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 12/23/2022]
Abstract
Iron, vitamin A and zinc deficiencies are the top three micronutrients contributing to disability-adjusted life years globally. The study assessed the factors associated with iron, vitamin A, and Zinc deficiencies among Nepalese children (n = 1709) aged 6-59 months using data from the 2016 Nepal National Micronutrient Status Survey. The following cut-off points were applied: iron deficiency [ferritin < 12 μg/L or soluble transferrin receptor (sTfR) > 8.3 mg/L], vitamin A deficiency (retinol-binding protein < 0.69 μmol/L) and zinc deficiency (serum zinc < 65 μg/dl for morning sample and <57 μg/dl for afternoon sample). We used multiple logistic regression adjusted for sampling weights and clustering to examine the predictors of micronutrient deficiencies. The prevalence of iron depletion (ferritin), tissue iron (sTfR), vitamin A and zinc deficiencies were 36.7%, 27.6%, 8.5% and 20.4%, respectively. Children were more likely to be iron deficient (ferritin) if aged 6-23 months, stunted, and in a middle-wealth quintile household. Vitamin A deficiency was associated with development region and was higher among children living in severe food-insecure households and those who did not consume fruits. Zinc deficiency was higher among children in rural areas and the poorest wealth quintile. The Government of Nepal should focus on addressing micronutrient deficiencies in the early years, with emphasis on improving food systems, promote healthy diets, among younger and stunted children and provide social cash transfer targeting high-risk development regions, poorest and food insecure households.
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Affiliation(s)
- Stanley Chitekwe
- Nutrition SectionUnited Nations Children's Fund (UNICEF)KathmanduNepal
| | | | - Naveen Paudyal
- Nutrition SectionUnited Nations Children's Fund (UNICEF)KathmanduNepal
| | | | - Andre Renzaho
- School of Social Sciences and PsychologyWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Abukari Issaka
- School of ScienceWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Kingsley Agho
- School of Health SciencesWestern Sydney UniversityPenrithNew South WalesAustralia
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Parikh P, Semba R, Manary M, Swaminathan S, Udomkesmalee E, Bos R, Poh BK, Rojroongwasinkul N, Geurts J, Sekartini R, Nga TT. Animal source foods, rich in essential amino acids, are important for linear growth and development of young children in low- and middle-income countries. MATERNAL AND CHILD NUTRITION 2021; 18:e13264. [PMID: 34467645 PMCID: PMC8710096 DOI: 10.1111/mcn.13264] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/02/2021] [Accepted: 08/02/2021] [Indexed: 11/28/2022]
Abstract
Growth faltering under 5 years of age is unacceptably high worldwide, and even more children, while not stunted, fail to reach their growth potential. The time between conception and 2 years of age is critical for development. The period from 6 to 23 months, when complementary foods are introduced, coincides with a time when growth faltering and delayed neurocognitive developments are most common. Fortunately, this is also the period when diet exercises its greatest influence. Growing up in an adverse environment, with a deficient diet, as typically seen in low‐ and middle‐income countries (LMICs), hampers growth and development of children and prevents them from realising their full developmental and economic future potential. Sufficient nutrient availability and utilisation are paramount to a child's growth and development trajectory, especially in the period after breastfeeding. This review highlights the importance of essential amino acids (EAAs) in early life for linear growth and, likely, neurocognitive development. The paper further discusses signalling through mammalian target of rapamycin complex 1 (mTORC1) as one of the main amino acid (AA)‐sensing hubs and the master regulator of both growth and neurocognitive development. Children in LMICs, despite consuming sufficient total protein, do not meet their EAA requirements due to poor diet diversity and low‐quality dietary protein. AA deficiencies in early life can cause reductions in linear growth and cognition. Ensuring AA adequacy in diets, particularly through inclusion of nutrient‐dense animal source foods from 6 to 23 months, is strongly encouraged in LMICs in order to compensate for less than optimal growth during complementary feeding.
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Affiliation(s)
| | - Richard Semba
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mark Manary
- Department of Paediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sumathi Swaminathan
- St John's Research Institute, St John's National Academy of Health Sciences, Bangalore, Karnataka, India
| | | | - Rolf Bos
- FrieslandCampina, Amersfoort, The Netherlands
| | - Bee Koon Poh
- Nutritional Sciences Programme & Centre for Community Health, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Jan Geurts
- FrieslandCampina, Amersfoort, The Netherlands
| | - Rini Sekartini
- Faculty of Medicine, Department of Pediatrics, University of Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Tran Thuy Nga
- Department of Occupational and School Nutrition, National Institute of Nutrition (NIN), Hanoi, Vietnam
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12
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Abstract
The aim of this review paper is to explore the strategies employed to tackle micronutrient deficiencies with illustrations from field-based experience. Hidden hunger is the presence of multiple micronutrient deficiencies (particularly iron, zinc, iodine and vitamin A), which can occur without a deficit in energy intake as a result of consuming an energy-dense, but nutrient-poor diet. It is estimated that it affects more than two billion people worldwide, particularly in low- and middle-income countries where there is a reliance on low-cost food staples and where the diversity of the diet is limited. Finding a way to improve the nutritional quality of diets for the poorest people is central to meeting the UN sustainable development goals particularly sustainable development goal 2: end hunger, achieve food security and improved nutrition and promote sustainable agriculture. As we pass the midpoint of the UN's Decade for Action on Nutrition, it is timely to reflect on progress towards achieving sustainable development goal 2 and the strategies to reduce hidden hunger. Many low- and middle-income countries are falling behind national nutrition targets, and this has been exacerbated by the COVID-19 pandemic as well as other recent shocks to the global food system which have disproportionately impacted the world's most vulnerable communities. Addressing inequalities within the food system must be central to developing a sustainable, cost-effective strategy for improving food quality that delivers benefit to the seldom heard and marginalised communities.
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Staub E, Evers K, Askie LM. Enteral zinc supplementation for prevention of morbidity and mortality in preterm neonates. Cochrane Database Syst Rev 2021; 3:CD012797. [PMID: 33710626 PMCID: PMC8092450 DOI: 10.1002/14651858.cd012797.pub2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Preterm and low birth weight infants are born with low stores in zinc, which is a vital trace element for growth, cell differentiation and immune function. Preterm infants are at risk of zinc deficiency during the postnatal period of rapid growth. Systematic reviews in the older paediatric population have previously shown that zinc supplementation potentially improves growth and positively influences the course of infectious diseases. In paediatric reviews, the effect of zinc supplementation was most pronounced in those with low nutritional status, which is why the intervention could also benefit preterm infants typically born with low zinc stores and decreased immunity. OBJECTIVES To determine whether enteral zinc supplementation, compared with placebo or no supplementation, affects important outcomes in preterm infants, including death, neurodevelopment, common morbidities and growth. SEARCH METHODS Our searches are up-to-date to 20 February 2020. For the first search, we used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2017, Issue 8), MEDLINE via PubMed (1966 to 29 September 2017), Embase (1980 to 29 September 2017), and CINAHL (1982 to 29 September 2017). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials (RCTs) and quasi-RCTs. We ran an updated search from 1 January 2017 to 20 February 2020 in the following databases: CENTRAL via CRS Web, MEDLINE via Ovid, and CINAHL via EBSCOhost. SELECTION CRITERIA We included RCTs and quasi-RCTs that compared enteral zinc supplementation versus placebo or no supplementation in preterm infants (gestational age < 37 weeks), and low birth weight babies (birth weight < 2500 grams), at any time during their hospital admission after birth. We included zinc supplementation in any formulation, regimen, or dose administered via the enteral route. We excluded infants who underwent gastrointestinal (GI) surgery during their initial hospital stay, or had a GI malformation or another condition accompanied by abnormal losses of GI juices, which contain high levels of zinc (including, but not limited to, stomas, fistulas, and malabsorptive diarrhoea). DATA COLLECTION AND ANALYSIS We used the standard methods of Cochrane Neonatal. Two review authors separately screened abstracts, evaluated trial quality and extracted data. We synthesised effect estimates using risk ratios (RR), risk differences (RD), and standardised mean differences (SMD). Our primary outcomes of interest were all-cause mortality and neurodevelopmental disability. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS We included five trials with a total of 482 preterm infants; there was one ongoing trial. The five included trials were generally small, but of good methodological quality. Enteral zinc supplementation compared to no zinc supplementation Enteral zinc supplementation started in hospitalised preterm infants may decrease all-cause mortality (between start of intervention and end of follow-up period) (RR 0.55, 95% CI 0.31 to 0.97; 3 studies, 345 infants; low-certainty evidence). No data were available on long-term neurodevelopmental outcomes at 18 to 24 months of (post-term) age. Enteral zinc supplementation may have little or no effect on common morbidities such as bronchopulmonary dysplasia (RR 0.66, 95% CI 0.31 to 1.40, 1 study, 193 infants; low-certainty evidence), retinopathy of prematurity (RR 0.14, 95% CI 0.01 to 2.70, 1 study, 193 infants; low-certainty evidence), bacterial sepsis (RR 1.11, 95% CI 0.60 to 2.04, 2 studies, 293 infants; moderate-certainty evidence), or necrotising enterocolitis (RR 0.08, 95% CI 0.00 to 1.33, 1 study, 193 infants; low-certainty evidence). The intervention probably improves weight gain (SMD 0.46, 95% CI 0.28 to 0.64; 5 studies, 481 infants; moderate-certainty evidence); and may slightly improve linear growth (SMD 0.75, 95% CI 0.36 to 1.14, 3 studies, 289 infants; low-certainty evidence), but may have little or no effect on head growth (SMD 0.21, 95% CI -0.02 to 0.44, 3 studies, 289 infants; moderate-certainty evidence). AUTHORS' CONCLUSIONS Enteral supplementation of zinc in preterm infants compared to no supplementation or placebo may moderately decrease mortality and probably improve short-term weight gain and linear growth, but may have little or no effect on common morbidities of prematurity. There are no data to assess the effect of zinc supplementation on long-term neurodevelopment.
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Affiliation(s)
- Eveline Staub
- Department of Neonatology, Royal North Shore Hospital, St Leonards, Australia
| | - Katrina Evers
- University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Lisa M Askie
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
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14
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Farias PM, Marcelino G, Santana LF, de Almeida EB, Guimarães RDCA, Pott A, Hiane PA, Freitas KDC. Minerals in Pregnancy and Their Impact on Child Growth and Development. Molecules 2020; 25:molecules25235630. [PMID: 33265961 PMCID: PMC7730771 DOI: 10.3390/molecules25235630] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/15/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022] Open
Abstract
During pregnancy, women undergo metabolic and physiological changes, and their needs are higher, to maintain growth and development of the fetus. If the nutritional status of the expectant mother is not satisfactory, some maternal and neonatal complications can occur. In the second and third trimester of pregnancy, there is a reserve of nutrients in the fetus that can be utilized after birth; thereby, children present an accelerated growth in the first years of life, which is a proven response to the available nutrition pattern. However, if such a pattern is insufficient, there will be deficits during development, including brain function. Therefore, despite many recent published works about gestational nutrition, uncertainties still remain on the mechanisms of absorption, distribution, and excretion of micronutrients. Further elucidation is needed to better understand the impacts caused either by deficiency or excess of some micronutrients. Thus, to illustrate the contributions of minerals during prenatal development and in children, iodine, selenium, iron, zinc, calcium, and magnesium were selected. Our study sought to review the consequences related to gestational deficiency of the referred minerals and their impact on growth and development in children born from mothers with such deficiencies
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Affiliation(s)
- Patricia Miranda Farias
- Graduate Program in Health and Development in the Central-West Region of Brazil, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil; (P.M.F.); (G.M.); (L.F.S.); (R.d.C.A.G.); (P.A.H.)
| | - Gabriela Marcelino
- Graduate Program in Health and Development in the Central-West Region of Brazil, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil; (P.M.F.); (G.M.); (L.F.S.); (R.d.C.A.G.); (P.A.H.)
| | - Lidiani Figueiredo Santana
- Graduate Program in Health and Development in the Central-West Region of Brazil, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil; (P.M.F.); (G.M.); (L.F.S.); (R.d.C.A.G.); (P.A.H.)
| | - Eliane Borges de Almeida
- Biologist, Hematology Laboratory, State Secretariat of Health of Mato Grosso do Sul, Campo Grande 79084-180, Mato Grosso do Sul, Brazil;
| | - Rita de Cássia Avellaneda Guimarães
- Graduate Program in Health and Development in the Central-West Region of Brazil, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil; (P.M.F.); (G.M.); (L.F.S.); (R.d.C.A.G.); (P.A.H.)
| | - Arnildo Pott
- Graduate Program in Biotechnology and Biodiversity in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil;
| | - Priscila Aiko Hiane
- Graduate Program in Health and Development in the Central-West Region of Brazil, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil; (P.M.F.); (G.M.); (L.F.S.); (R.d.C.A.G.); (P.A.H.)
| | - Karine de Cássia Freitas
- Graduate Program in Health and Development in the Central-West Region of Brazil, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil; (P.M.F.); (G.M.); (L.F.S.); (R.d.C.A.G.); (P.A.H.)
- Correspondence: ; Tel.: +55-67-3345-7416
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15
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Meat eating by nonhuman primates: A review and synthesis. J Hum Evol 2020; 149:102882. [PMID: 33137551 DOI: 10.1016/j.jhevol.2020.102882] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 12/13/2022]
Abstract
Most nonhuman primates prey on vertebrates. Meat-eating, defined as ingestion of vertebrate tissue, occurs in 12 families, ≥39 genera, and ≥89 species. It is most common in capuchins (Cebus and Sapajus spp.), baboons (Papio spp.), bonobos (Pan paniscus), and chimpanzees (Pan troglodytes) and modestly common in blue monkeys (Cercopithecus mitis), callitrichids (Callithrix spp. and Saguinus spp.), and squirrel monkeys (Saimiri spp.). It is uncommon in other cercopithecines, rare in other haplorhines and in lemurs, and virtually absent in colobines. Birds are the prey class eaten by the most species (≥53), followed by reptiles (≥48), amphibians (≥38), mammals (≥35), and fish (≥7). Major hypotheses for the importance of meat eating are that it is (1) mainly an energy source, especially (1a) when plant-source foods (PSFs) with high energy return rates are scarce (energy shortfall hypothesis); (2) mainly a protein source; and (3) mainly a source of micronutrients scarce in PSFs. Meat eating bouts sometimes provide substantial energy and protein, and some chimpanzees gain substantial protein from meat monthly or annually. However, meat typically accounts for only small proportions of feeding time and of total energy and protein intake, and quantitative data are inconsistent with the energy shortfall hypothesis. PSFs and/or invertebrates are presumably the main protein sources, even for chimpanzees. Support is strongest for the micronutrient hypothesis. Most chimpanzees eat far less meat than recorded for hunter-gatherers, but the highest chimpanzee estimates approach the lowest for African hunter-gatherers. In fundamental contrast to the human predatory pattern, other primates only eat vertebrates much smaller than they are, tool-assisted predation is rare except in some capuchins and chimpanzees, and tool use in carcass processing is virtually absent. However, harvesting of small prey deserves more attention with reference to the archaeological and ethnographic record.
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Moody EC, Colicino E, Wright RO, Mupere E, Jaramillo EG, Amarasiriwardena C, Cusick SE. Environmental exposure to metal mixtures and linear growth in healthy Ugandan children. PLoS One 2020; 15:e0233108. [PMID: 32413070 PMCID: PMC7228047 DOI: 10.1371/journal.pone.0233108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/28/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Stunting is an indicator of poor linear growth in children and is an important public health problem in many countries. Both nutritional deficits and toxic exposures can contribute to lower height-for-age Z-score (HAZ) and stunting (HAZ < -2). OBJECTIVES In a community-based cross-sectional sample of 97 healthy children ages 6-59 months in Kampala, Uganda, we examined whether exposure to Pb, As, Cd, Se, or Zn were associated with HAZ individually or as a mixture. METHODS Blood samples were analyzed for a mixture of metals, which represent both toxins and essential nutrients. The association between HAZ and metal exposure was tested using multivariable linear regression and Weighted Quantile Sum (WQS) regression, which uses mixtures of correlated exposures as a predictor. RESULTS There were 22 stunted children in the sample, mean HAZ was -0.74 (SD = 1.84). Linear regression showed that Pb (β = -0.80, p = 0.021) and Se (β = 1.92, p = 0.005) were significantly associated with HAZ. The WQS models separated toxic elements with a presumed negative effect on HAZ (Pb, As, Cd) from essential nutrients with presumed positive effect on HAZ (Se and Zn). The toxic mixture was significantly associated with lower HAZ (β = -0.47, p = 0.03), with 62% of the effect from Pb. The nutrient WQS index did not reach statistical significance (β = -0.47, p = 0.16). DISCUSSION Higher blood lead and lower blood selenium level were both associated with lower HAZ. The significant associations by linear regression were reinforced by the WQS models, although not all associations reached statistical significance. These findings suggest that healthy children in this neighborhood of Kampala, Uganda, who have a high burden of toxic exposures, may experience detrimental health effects associated with these exposures in an environment where exposure sources are not well characterized.
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Affiliation(s)
- Emily C. Moody
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Ezekiel Mupere
- Department of Paediatrics & Child Health, Mulago Hospital, Kampala, Uganda
| | - Ericka G. Jaramillo
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Chitra Amarasiriwardena
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Sarah E. Cusick
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, United States of America
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17
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Sharif Y, Sadeghi O, Dorosty A, Siassi F, Jalali M, Djazayery A, Shokri A, Mohammad K, Parsaeian M, Abdollahi Z, Heshmat R, Yarparvar A, Pouraram H, Esmaillzadeh A. Association of vitamin D, retinol and zinc deficiencies with stunting in toddlers: findings from a national study in Iran. Public Health 2019; 181:1-7. [PMID: 31887436 DOI: 10.1016/j.puhe.2019.10.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 09/30/2019] [Accepted: 10/31/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the association of serum levels of 25(OH)D3 (vitamin D), retinol (vitamin A) and zinc with stunting in a large sample of Iranian toddlers. STUDY DESIGN This was a cross-sectional study. METHODS A total of 4261 children, aged 10-36 months, who had Iranian birth certificates were included in the present study. Weight and height were measured by experienced professionals in accordance with standard protocols. Stunting was defined as a height-for-age z-score of <-1 standard deviation (SD) based on the World Health Organization (WHO) criteria (the WHO Child Growth Standards median). Serum levels of 25(OH)D3, retinol and zinc were examined based on standard methods. RESULTS The mean age of the study participants was 19.2 ± 8.4 months. A significant inverse association was found between serum retinol concentrations and the odds of stunting such that after controlling for potential confounders, toddlers in the highest quartile of serum retinol levels had 29% lower odds of stunting than those in the lowest quartile (odds ratio [OR]: 0.71, 95% confidence interval [CI]: 0.53-0.97). Furthermore, a significant inverse association was found between serum levels of retinol and stunting in girls (OR: 0.57, 95% CI: 0.34-0.94), urban toddlers (OR: 0.66, 95% CI: 0.44-0.99) and those who did not use nutritional supplements (OR: 0.70, 95% CI: 0.52-0.95). Although serum 25(OH)D3 levels were not significantly associated with stunting in the overall study population, we found a positive association among toddlers who used nutritional supplements. No significant association was found between serum levels of zinc and stunting. CONCLUSION We found a significant inverse association between serum levels of retinol and stunting in toddlers aged 10-36 months.
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Affiliation(s)
- Y Sharif
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - O Sadeghi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - A Dorosty
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - F Siassi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - M Jalali
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - A Djazayery
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - A Shokri
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran; Gerash University of Medical Sciences, Gerash, Iran
| | - K Mohammad
- School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - M Parsaeian
- School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Z Abdollahi
- Nutrition Department, Under-secretary for Health, Ministry of Health & Medical Education, Tehran, Iran
| | - R Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - A Yarparvar
- Health and Nutrition Unit, UNICEF, Tehran, Iran
| | - H Pouraram
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - A Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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18
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Bush LA, Hutchinson J, Hooson J, Warthon-Medina M, Hancock N, Greathead K, Knowles B, Vargas-Garcia EJ, Gibson LE, Margetts B, Robinson S, Ness A, Alwan NA, Wark PA, Roe M, Finglas P, Steer T, Page P, Johnson L, Roberts K, Amoutzopoulos B, Greenwood DC, Cade JE. Measuring energy, macro and micronutrient intake in UK children and adolescents: a comparison of validated dietary assessment tools. BMC Nutr 2019; 5:53. [PMID: 32153966 PMCID: PMC7050749 DOI: 10.1186/s40795-019-0312-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 09/30/2019] [Indexed: 12/15/2022] Open
Abstract
Background Measuring dietary intake in children and adolescents can be challenging due to misreporting, difficulties in establishing portion size and reliance on recording dietary data via proxy reporters. The aim of this review was to present results from a recent systematic review of reviews reporting and comparing validated dietary assessment tools used in younger populations in the UK. Methods Validation data for dietary assessment tools used in younger populations (≤18 years) were extracted and summarised using results from a systematic review of reviews of validated dietary assessment tools. Mean differences and Bland-Altman limits of agreement (LOA) between the test and reference tool were extracted or calculated and compared for energy, macronutrients and micronutrients. Results Seventeen studies which reported validation of 14 dietary assessment tools (DATs) were identified with relevant nutrition information. The most commonly validated nutrients were energy, carbohydrate, protein, fat, calcium, iron, folate and vitamin C. There were no validated DATs reporting assessment of zinc, iodine or selenium intake. The most frequently used reference method was the weighed food diary, followed by doubly labelled water and 24 h recall. Summary plots were created to facilitate comparison between tools. On average, the test tools reported higher mean intakes than the reference methods with some studies consistently reporting wide LOA. Out of the 14 DATs, absolute values for LOA and mean difference were obtained for 11 DATs for EI. From the 24 validation results assessing EI, 16 (67%) reported higher mean intakes than the reference. Of the seven (29%) validation studies using doubly labelled water (DLW) as the reference, results for the test DATs were not substantially better or worse than those using other reference measures. Further information on the studies from this review is available on the www.nutritools.org website. Conclusions Validated dietary assessment tools for use with children and adolescents in the UK have been identified and compared. Whilst tools are generally validated for macronutrient intakes, micronutrients are poorly evaluated. Validation studies that include estimates of zinc, selenium, dietary fibre, sugars and sodium are needed.
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Affiliation(s)
- Linda A Bush
- 1Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LS2, 9JT, Leeds, UK
| | - Jayne Hutchinson
- 1Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LS2, 9JT, Leeds, UK
| | - Jozef Hooson
- 1Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LS2, 9JT, Leeds, UK
| | - Marisol Warthon-Medina
- 1Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LS2, 9JT, Leeds, UK.,2Quadram Institute Bioscience, Norwich, NR4 7UA UK.,3EuroFIR AISBL, 40 Rue Washington, 1050 Brussels, Belgium
| | - Neil Hancock
- 1Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LS2, 9JT, Leeds, UK
| | - Katharine Greathead
- 1Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LS2, 9JT, Leeds, UK
| | - Bethany Knowles
- 1Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LS2, 9JT, Leeds, UK
| | - Elisa J Vargas-Garcia
- 1Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LS2, 9JT, Leeds, UK
| | - Lauren E Gibson
- 1Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LS2, 9JT, Leeds, UK
| | - Barrie Margetts
- School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD UK
| | - Sian Robinson
- 5NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, UK.,6National Institute of Health (NIHR) Bristol Biomedical Research Centre, Nutrition Theme, University, Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, BS2 8AE UK
| | - Andy Ness
- 7NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton NHS Foundation Trust, Southampton, UK
| | - Nisreen A Alwan
- School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD UK.,8Centre for Innovative Research Across the Life Course (CIRAL), Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 5FB UK
| | - Petra A Wark
- 9Global eHealth Unit, Department of Primary Care and Public Health, Imperial College London, London, SW7 2AZ UK.,10AGE Research Group, Newcastle University, Newcastle, UK
| | - Mark Roe
- 2Quadram Institute Bioscience, Norwich, NR4 7UA UK.,3EuroFIR AISBL, 40 Rue Washington, 1050 Brussels, Belgium
| | - Paul Finglas
- 2Quadram Institute Bioscience, Norwich, NR4 7UA UK.,3EuroFIR AISBL, 40 Rue Washington, 1050 Brussels, Belgium
| | - Toni Steer
- 11MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL UK
| | - Polly Page
- 11MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL UK
| | - Laura Johnson
- 12Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 1TH UK.,11MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL UK
| | - Katharine Roberts
- 13Public Health Section, School of Health and Related Research (ScHARR), University of Sheffield, S10 2TN, Sheffield, UK.,14Public Health England, London, SE1 8UG UK
| | | | - Darren C Greenwood
- 15Faculty of Medicine and Health, Division of Biostatistics, University of Leeds, Leeds, LS2 9JT UK
| | - Janet E Cade
- 1Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LS2, 9JT, Leeds, UK
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Lee D, Lee SH, Lee M, Lee SH, Shin YJ, Lee JY, Kim H, Kim YS, Song J. Effects of Siwu decoction on chondrocyte proliferation of growth plate in adolescent rats. JOURNAL OF ETHNOPHARMACOLOGY 2019; 236:108-113. [PMID: 30849503 DOI: 10.1016/j.jep.2019.01.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 01/15/2019] [Accepted: 01/21/2019] [Indexed: 06/09/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE According to traditional Korean medicine theory in which children's growth retardation is attributed to blood deficiency, Siwu decoction (SWD), a representative treatment for blood deficiency, was chosen as a sample. AIM OF THE STUDY To evaluate the effects of SWD on chondrocyte proliferation of growth plate in adolescent female rats. MATERIALS AND METHODS Female adolescent rats were allocated to one of the following four groups; SWD 100 and 300 mg/kg, recombinant human growth hormone, and vehicle for 4 days. Tetracycline was intraperitoneally injected at 48 h before sacrifice to obtain a band exhibiting fluorescence by binding newly formed bone. Bromodeoxyuridine was injected at day 2-4 to mark proliferating chondrocytes. To evaluate possible mechanisms of SWD, expressions of insulin-like growth factor-1 (IGF-1) and bone morphogenetic protein-2 (BMP-2) in the growth plate were examined by immunohistochemistry. RESULTS Treatment with SWD significantly increased the number of BrdU-positive chondrocytes and the new bone formation in the proximal growth plate of tibia compared to the vehicle treated control group. SWD also increased the expression of IGF-1 and BMP-2 in the proliferative and hypertrophic zones of the growth plate. CONCLUSIONS SWD 300 mg/kg stimulates chondrocyte proliferation and new bone formation in the growth plate. Immunohistochemical studies indicate that the effects of SWD may be due to upregulation of local IGF-1 and BMP-2 expression in the growth plate, which may be considered as a GH-dependent paracrine-autocrine pathway.
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Affiliation(s)
- Donghun Lee
- Department of Herbal Pharmacology, College of Korean Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Seongnam-si, Gyeonggi-do, 13120, Republic of Korea
| | - Sun Haeng Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Minwoo Lee
- Department of Herbal Pharmacology, College of Korean Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Seongnam-si, Gyeonggi-do, 13120, Republic of Korea
| | - Sung Hyun Lee
- Korea Institute of Science and Technology for Eastern Medicine (KISTEM) NeuMed Inc, 88 Imun-ro, Dongdaemun-gu, Seoul, 02440, Republic of Korea
| | - Yu Jeong Shin
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Jin Yong Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Hocheol Kim
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Young-Sik Kim
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
| | - Jungbin Song
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
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20
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Assessing dietary intakes from household budget surveys: A national analysis in Bangladesh. PLoS One 2018; 13:e0202831. [PMID: 30148863 PMCID: PMC6110494 DOI: 10.1371/journal.pone.0202831] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 08/09/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Accurate national information on dietary intakes, including heterogeneity among individuals, is critical to inform health implications and policy priorities. In low- and middle-income countries, household expenditure surveys constitute the major source of food data, but with uncertain validity for individual-level intakes. OBJECTIVE To investigate how individualized dietary consumption estimated from household survey data compared with individual-level 24-hr dietary recalls (24hR); and to assess potential heterogeneity by method for individualizing household intakes, dietary indicator, and individual characteristics (age, sex, education, religion, household income). METHODS We evaluated data from the 2011-2012 Bangladesh Household Integrated Survey (BIHS), which included household-level consumption data (5,503 households) and individual-level dietary data based on 24hR from these households (22,173 participants). Household and 24hR estimates were standardized and harmonized for 33 dietary indicators, including 9 food groups, total energy, 8 macronutrients, and 15 micronutrients. Individual consumption was estimated from household data using two approaches, the Adult Male Equivalent (AME) and per capita (PC) approach. For each dietary indicator, differences in household vs. individual mean estimates were evaluated overall and by strata of individual characteristics, using Spearman's correlations and univariate and multivariate linear regression models. RESULTS Individualized household estimates overestimated individual intakes from 24hR for all dietary factors using either estimation method (P<0.001 for each), except for starchy vegetables (AME: P = 0.15; PC: P = 0.85). For foods, overestimation ranged from 4% for seafood to about 240% for fruits, and for nutrients from 11% for carbohydrates and poly-unsaturated fats to 55% for vitamin C, with similar overestimation for the AME and the PC method. By strata, overestimation was modestly higher in men vs. women, in children (0-10y) vs. adolescents (11-19y) and adults (20-44y, ≥45y), among adults of higher (≥6y) vs. lower (<6y) education, in Muslims vs. other religions (Christians, Hindus), and for the lowest vs. all other income groups. This overestimation was notably higher in young children (0-5y) vs. all other age groups and in the lowest vs. all other income groups. Underestimation was rarely observed, for example for milk intake (-56%) in young children (0-5y). The PC approach did not capture heterogeneity in validity of estimation of different dietary factors by age, mainly in children (0-5y, 6-10y). Spearman's correlations between individualized household estimates and 24hR data were higher for the AME (0.30-0.70) than PC (0.20-0.50) approach. Findings were similar with and without multivariate regression, with proportions of variance (R2) in 24hR intakes explained by the AME being generally greater than PC estimates, yet still low to modest. CONCLUSIONS In this national survey, established methods for estimating individual level intakes from household surveys produce overestimation of intakes of nearly all dietary indicators, with significant variation depending on the dietary factor and modest variation depending on individual characteristics. These findings suggest a need for new methods to estimate individual-level consumption from household survey estimates.
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21
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Chao HC, Chang YJ, Huang WL. Cut-off Serum Zinc Concentration Affecting the Appetite, Growth, and Nutrition Status of Undernourished Children Supplemented With Zinc. Nutr Clin Pract 2018; 33:701-710. [DOI: 10.1002/ncp.10079] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Hsun-Chin Chao
- Division of Pediatric Gastroenterology; Department of Pediatrics; Chang Gung Children's Medical Center; Chang Gung Memorial Hospital; Taoyuan City Taiwan
- Chang Gung University College of Medicine; 5 Fu-Hsing Street, Gueishan District Taoyuan City Taiwan
| | - Yi-Jung Chang
- Chang Gung University College of Medicine; 5 Fu-Hsing Street, Gueishan District Taoyuan City Taiwan
- Division of Pediatric General Medicine; Department of Pediatrics; Chang Gung Children's Medical Center; Chang Gung Memorial Hospital; Taoyuan City Taiwan
| | - Wan-Ling Huang
- Chang Gung University College of Medicine; 5 Fu-Hsing Street, Gueishan District Taoyuan City Taiwan
- Department of Nutritional Therapy; Chang Gung Memorial Hospital; Taoyuan City Taiwan
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22
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Liu E, Pimpin L, Shulkin M, Kranz S, Duggan CP, Mozaffarian D, Fawzi WW. Effect of Zinc Supplementation on Growth Outcomes in Children under 5 Years of Age. Nutrients 2018; 10:nu10030377. [PMID: 29558383 PMCID: PMC5872795 DOI: 10.3390/nu10030377] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 02/28/2018] [Accepted: 03/14/2018] [Indexed: 11/16/2022] Open
Abstract
(1) Background: The effects of zinc supplementation on child growth, and prior reviews of these studies, have shown mixed results. We aim to systematically review and meta-analyze randomized controlled trials evaluating effects of preventive zinc supplementation for 3 months or longer during pregnancy or in children up to age 5 years on pregnancy outcomes and child growth; (2) Methods: We searched PubMed, EMBASE, Cochrane Library, Web of Science, and trial registries for eligible trials up to October 10, 2017. Inclusion selection and data extractions were performed independently and in duplicate. Study quality was evaluated by the Cochrane Risk of Bias tool. Findings were pooled using random effects meta-analysis, with heterogeneity assessed by I² and τ² statistic, stratified analyses, and meta-regression, and publication bias by Egger's and Begg's tests; (3) Results: Seventy-eight trials with 34,352 unique participants were identified, including 24 during pregnancy and 54 in infancy/childhood. Maternal zinc supplementation did not significantly increase birth weight (weighted mean difference (WMD) = 0.08 kg, 95%CI: -0.05, 0.22) or decrease the risk of low birth weight (RR = 0.76, 95%CI: 0.52-1.11). Zinc supplementation after birth increased height (WMD = 0.23 cm, 95%CI: 0.09-0.38), weight (WMD = 0.14 kg, 95%CI: 0.07-0.21), and weight-for-age Z-score (WMD = 0.04, 95%CI: 0.001-0.087), but not height-for-age Z-score (WMD = 0.02, 95%CI: -0.01-0.06) or weight-for-height Z score (WMD = 0.02, 95%CI: -0.03-0.06). Child age at zinc supplementation appeared to modify the effects on height (P-interaction = 0.002) and HAZ (P-interaction = 0.06), with larger effects of supplementation starting at age ≥2 years (WMD for height = 1.37 cm, 95%CI: 0.50-2.25; WMD for HAZ = 0.12, 95%CI: 0.05-0.19). No significant effects of supplementation were found on the risk of stunting, underweight or wasting; (4) Conclusion: Although the possibility of publication bias and small study effect could not be excluded, the current meta-analysis indicates that zinc supplementation in infants and early childhood, but not pregnancy, increases specific growth outcomes, with evidence for a potentially stronger effect after 2 years of age. These findings inform recommendation and policy development for zinc supplementation to improve growth among young children.
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Affiliation(s)
- Enju Liu
- Institutional Centers of Clinical and Translational Research, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA.
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA.
| | - Laura Pimpin
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, USA.
| | - Masha Shulkin
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, USA.
| | - Sarah Kranz
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, USA.
| | - Christopher P Duggan
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, USA.
| | - Wafaie W Fawzi
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
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23
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Micha R, Coates J, Leclercq C, Charrondiere UR, Mozaffarian D. Global Dietary Surveillance: Data Gaps and Challenges. Food Nutr Bull 2018; 39:175-205. [PMID: 29478333 DOI: 10.1177/0379572117752986] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Detailed information on global individual-level consumption patterns is imperative for informed policy making. However, such data are dispersed and incomplete. OBJECTIVE To review and discuss the methodologies, observed data availability, challenges, and opportunities pertaining to global dietary surveillance. METHODS This investigation provides an extensive review of global dietary assessment methodologies and challenges, including at the survey level, the dietary collection and assessment level, and the dietary data processing and analysis level. The focus is on nationally representative individual-level data, and additional types of dietary data, such as dietary biomarkers, household assessment, and food availability, are reviewed as alternatives. Practical guidance is provided to inform key decisions when designing dietary surveys and collecting, analyzing, and using dietary data. This article further identifies and describes existing global and regional dietary initiatives/data sets. RESULTS Harmonized and standardized primary individual-level dietary data collection, processing, and analysis worldwide are currently not available. Evaluation and decision-making should be based on best available data, that is, secondary nonharmonized yet to the extent possible, standardized individual-level dietary data. Existing initiatives differ substantially in methodologies, including survey design/representativeness, coverage, diet assessment, and dietary metric standardization and processing. Data gaps have been identified that were more profound for certain countries, certain dietary indicators across countries, population subgroups, representativeness, or time periods. CONCLUSIONS Optimizing worldwide dietary habits to improve population health requires systematically identified and evaluated data on a continuing basis. Leveraging existing available dietary data and efforts is an indispensable prerequisite for informed priority setting targeting the intersections between diet and disease.
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Affiliation(s)
- Renata Micha
- 1 Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jennifer Coates
- 1 Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | | | | | - Dariush Mozaffarian
- 1 Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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24
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Abstract
The skin is the third most zinc (Zn)-abundant tissue in the body. The skin consists of the epidermis, dermis, and subcutaneous tissue, and each fraction is composed of various types of cells. Firstly, we review the physiological functions of Zn and Zn transporters in these cells. Several human disorders accompanied with skin manifestations are caused by mutations or dysregulation in Zn transporters; acrodermatitis enteropathica (Zrt-, Irt-like protein (ZIP)4 in the intestinal epithelium and possibly epidermal basal keratinocytes), the spondylocheiro dysplastic form of Ehlers-Danlos syndrome (ZIP13 in the dermal fibroblasts), transient neonatal Zn deficiency (Zn transporter (ZnT)2 in the secretory vesicles of mammary glands), and epidermodysplasia verruciformis (ZnT1 in the epidermal keratinocytes). Additionally, acquired Zn deficiency is deeply involved in the development of some diseases related to nutritional deficiencies (acquired acrodermatitis enteropathica, necrolytic migratory erythema, pellagra, and biotin deficiency), alopecia, and delayed wound healing. Therefore, it is important to associate the existence of mutations or dysregulation in Zn transporters and Zn deficiency with skin manifestations.
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25
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Lee D, Lee SH, Song J, Jee HJ, Cha SH, Chang GT. Effects of Astragalus Extract Mixture HT042 on Height Growth in Children with Mild Short Stature: A Multicenter Randomized Controlled Trial. Phytother Res 2017; 32:49-57. [PMID: 29130588 DOI: 10.1002/ptr.5886] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 07/10/2017] [Accepted: 07/16/2017] [Indexed: 11/09/2022]
Abstract
HT042 is a standardized functional food ingredient approved by Korean Food and Drug Administration with a claim 'HT042 can help height growth of children'. We aimed to evaluate the safety and efficacy of HT042 on height growth in children with mild short stature. A multicenter, randomized, double-blind, placebo-controlled parallel study was performed on children aged 6-8 years with height ranked below the 25th percentile. In 129 children, height gain was significantly higher in HT042 group than placebo group after 24 weeks (mean difference, 0.29 cm; 95% CI, 0.01 to 0.57 cm; p = 0.027). The difference was elevated when the efficacy analysis was restricted to children below the 10th percentile (mean difference, 0.45 cm; 95% CI, 0.04 to 0.87 cm; p = 0.031). Because bone age advancement was lower in HT042 group, height standard deviation score gain for bone age was higher in HT042 group and the difference was significant in children below the 10th percentile (mean difference, 0.20 score; 95% CI, 0.00 to 0.39 points; p = 0.045). Serum IGF-1 and IGFBP-3 levels were significantly increased compared with baseline within HT042 group, but group difference was not significant. HT042 supplementation helped to increase height growth in children without skeletal maturation and was more effective in much shorter children. The effects might be mediated by increases in serum IGF-1 and IGFBP-3 levels. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Donghun Lee
- Department of Herbal Pharmacology, Kyung Hee University College of Korean Medicine, Seoul, South Korea
| | - Sun Haeng Lee
- Department of Pediatrics, Kyung Hee University College of Korean Medicine, Seoul, South Korea
| | - Jungbin Song
- Department of Herbal Pharmacology, Kyung Hee University College of Korean Medicine, Seoul, South Korea
| | - Hee-Jung Jee
- Department of Biostatistics, Korea University College of Medicine, Seoul, South Korea
| | - Sung Ho Cha
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Gyu Tae Chang
- Pediatrics of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
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26
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Nutrition (Micronutrients) in Child Growth and Development: A Systematic Review on Current Evidence, Recommendations and Opportunities for Further Research. J Dev Behav Pediatr 2017; 38:665-679. [PMID: 28746059 DOI: 10.1097/dbp.0000000000000482] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE An important aspect of malnutrition is deficiency of different micronutrients during pregnancy or early childhood. We systematically reviewed the role of nutrition in child growth (weight or height gain) and development. METHODS A comprehensive literature search was done on PubMed/Cochrane Library browsing through 38,795 abstracts until December 31, 2016 to select systematic reviews/meta-analyses and individual randomized controlled trials (RCTs) of micronutrient supplementation. RESULTS Micronutrients studied included iron, iodine, folate, zinc, calcium, magnesium, selenium, vitamin D, vitamin A, vitamin B complex, and multiple micronutrients. We summarize evidence with details and results of RCTs, highlight strengths/weaknesses, and critically interpret findings. Effects of breastfeeding-promotion, food-supplementation (complementary and school feeding), conditional-cash-transfers, and integrated nutrition/psychosocial interventions are discussed. CONCLUSION Based on this evidence we make policy and programmatic recommendations for supplementation to mothers and children at high-risk of deficiency.
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27
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Roberts JL, Stein AD. The Impact of Nutritional Interventions beyond the First 2 Years of Life on Linear Growth: A Systematic Review and Meta-Analysis. Adv Nutr 2017; 8:323-336. [PMID: 28298275 PMCID: PMC5347103 DOI: 10.3945/an.116.013938] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A large body of evidence suggests that the first 1000 d from conception is a critical window in which interventions to address malnutrition will be most effective, but little is known about the impact on linear growth of nutritional interventions in children ≥2 y of age. The aim of this analysis was to evaluate the effectiveness of several nutrition-based interventions, specifically iron, zinc, calcium, iodine, vitamin A, multiple (≥2) micronutrients, protein, and food, at improving growth in children ≥2 y of age. A systematic search of MEDLINE and EMBASE retrieved 7794 articles. A total of 69 studies met prespecified inclusion criteria. Baseline height-for-age z score, age, nutrient dose, and study duration were examined as potential sources of heterogeneity. Zinc (mean effect size: 0.15; 95% CI: 0.06, 0.24), vitamin A (0.05; 95% CI: 0.01, 0.09), multiple micronutrients (0.26; 95% CI: 0.13, 0.39), and protein (0.68; 95% CI: 0.30, 1.05) had significant positive effects on linear growth, with baseline height-for-age z score as a significant inverse predictor of the effect size. Iron, calcium, iodine, and food-based interventions had no significant effect on growth. Age at baseline, study duration, and dose were not related to effect size for any nutrient examined. These findings suggest that zinc, vitamin A, multiple micronutrients, and protein interventions delivered after 24 mo of age can have a positive effect on linear growth, especially in populations that have experienced growth failure.
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Affiliation(s)
| | - Aryeh D Stein
- Nutrition and Health Sciences, Laney Graduate School, and .,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
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28
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Semba RD, Trehan I, Gonzalez-Freire M, Kraemer K, Moaddel R, Ordiz MI, Ferrucci L, Manary MJ. Perspective: The Potential Role of Essential Amino Acids and the Mechanistic Target of Rapamycin Complex 1 (mTORC1) Pathway in the Pathogenesis of Child Stunting. Adv Nutr 2016; 7:853-65. [PMID: 27633102 PMCID: PMC5015042 DOI: 10.3945/an.116.013276] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Stunting is the best summary measure of chronic malnutrition in children. Approximately one-quarter of children under age 5 worldwide are stunted. Lipid-based or micronutrient supplementation has little to no impact in reducing stunting, which suggests that other critical dietary nutrients are missing. A dietary pattern of poor-quality protein is associated with stunting. Stunted children have significantly lower circulating essential amino acids than do nonstunted children. Inadequate dietary intakes of essential amino acids could adversely affect growth, because amino acids are required for synthesis of proteins. The master growth regulation pathway, the mechanistic target of rapamycin complex 1 (mTORC1) pathway, is exquisitely sensitive to amino acid availability. mTORC1 integrates cues such as nutrients, growth factors, oxygen, and energy to regulate growth of bone, skeletal muscle, nervous system, gastrointestinal tract, hematopoietic cells, immune effector cells, organ size, and whole-body energy balance. mTORC1 represses protein and lipid synthesis and cell and organismal growth when amino acids are deficient. Over the past 4 decades, the main paradigm for child nutrition in developing countries has been micronutrient malnutrition, with relatively less attention paid to protein. In this Perspective, we present the view that essential amino acids and the mTORC1 pathway play a key role in child growth. The current assumption that total dietary protein intake is adequate for growth among most children in developing countries needs re-evaluation.
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Affiliation(s)
- Richard D Semba
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD;
| | - Indi Trehan
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO
| | | | - Klaus Kraemer
- Sight and Life, Basel, Switzerland; and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - M Isabel Ordiz
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO
| | | | - Mark J Manary
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO
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29
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Semba RD. The Rise and Fall of Protein Malnutrition in Global Health. ANNALS OF NUTRITION & METABOLISM 2016; 69:79-88. [PMID: 27576545 PMCID: PMC5114156 DOI: 10.1159/000449175] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 08/15/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND From the 1950s to the mid-1970s, United Nations (UN) agencies were focused on protein malnutrition as the major worldwide nutritional problem. The goal of this review is to examine this era of protein malnutrition, the reasons for its demise, and the aftermath. SUMMARY The UN Protein Advisory Group was established in 1955. International conferences were largely concerned about protein malnutrition in children. By the early 1970s, UN agencies were ringing the alarm about a 'protein gap'. In The Lancet in 1974, Donald McLaren branded these efforts as 'The Great Protein Fiasco', declaring that the 'protein gap' was a fallacy. The following year, John Waterlow, the scientist who led most of the efforts on protein malnutrition, admitted that a 'protein gap' did not exist and that young children in developing countries only needed sufficient energy intake. The emphasis on protein malnutrition waned. It is recently apparent that quality protein and essential amino acids are missing in the diet and may have adverse consequences for child growth and the reduction of child stunting. Key Messages: It may be time to re-include protein and return protein malnutrition in the global health agenda using a balanced approach that includes all protective nutrients.
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Affiliation(s)
- Richard D. Semba
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
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30
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Yazbeck N, Hanna-Wakim R, El Rafei R, Barhoumi A, Farra C, Daher RT, Majdalani M. Dietary Zinc Intake and Plasma Zinc Concentrations in Children with Short Stature and Failure to Thrive. ANNALS OF NUTRITION AND METABOLISM 2016; 69:9-14. [DOI: 10.1159/000447648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 06/09/2016] [Indexed: 11/19/2022]
Abstract
Background: The burden of zinc deficiency on children includes an increased incidence of diarrhea, failure to thrive (FTT) and short stature. The aim of this study was to assess whether children with FTT and/or short stature have lower dietary zinc intake and plasma zinc concentrations compared to controls. Methods: A case-control study conducted at the American University of Beirut Medical Center included 161 subjects from 1 to 10 years of age. Results: Cases had a statistically significant lower energy intake (960.9 vs. 1,135.2 kcal for controls, p = 0.010), lower level of fat (30.3 vs. 36.5 g/day, p = 0.0043) and iron intake (7.4 vs. 9.1 mg/day, p = 0.034). There was no difference in zinc, copper, carbohydrate and protein intake between the 2 groups. The plasma zinc concentration did not differ between the cases and controls (97.4 vs. 98.2 μg/dl, p = 0.882). More cases had mild-to-moderate zinc deficiency when compared to controls with 10.3 vs. 3.6%, p = 0.095. Conclusion: Our study did not show statistically significant difference in dietary zinc intake and plasma zinc concentrations between children with FTT and/or short stature compared to healthy controls. A prospective study is planned to assess the effect of zinc supplementation on growth parameters in FTT children.
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Impact of long-term use of oral nutritional supplement on nutritional adequacy, dietary diversity, food intake and growth of Filipino preschool children. J Nutr Sci 2016; 5:e20. [PMID: 27293557 PMCID: PMC4891560 DOI: 10.1017/jns.2016.6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 02/02/2016] [Accepted: 02/09/2016] [Indexed: 11/30/2022] Open
Abstract
Nutrient deficiencies during childhood have adverse effects on child growth and health. In a single-arm 48-week long-term intervention, we previously reported the efficacy of oral nutritional supplementation (ONS) and dietary counselling on catch-up growth and growth maintenance in nutritionally at-risk Filipino children. The present analysis was done to assess the contributing effects of ONS to nutritional adequacy, dietary diversity, food intake and longitudinal growth. ONS (450 ml) was consumed daily providing 450 kcal (1880 kJ) and at least 50 % of micronutrient requirements among 200 children aged 3–4 years with weight-for-height percentiles between 5th and 25th (WHO Growth Standards). Weight, height and dietary intakes using 24-h food recalls were measured at baseline, and at weeks 4, 8, 16, 24, 32, 40 and 48. Nutrient adequacy and dietary diversity score (DDS) were calculated. Generalised estimating equations were used to assess the effects of total nutrient intakes, DDS, ONS compliance and sociodemographic factors on longitudinal growth. The percentages of children with adequate intake of energy, protein, Fe, Ca and some vitamins at each post-baseline visit were improved from baseline, reaching 100 % for most nutrients. DDS was also increased from baseline and reached significance from week 16 onwards (P < 0·01). Male children, total energy intake and parental employment status were associated with weight-for-height percentile gain (P < 0·05), whereas higher parental education level and ONS compliance were significantly associated with height-for-age percentile gain over time (P < 0·05). Long-term ONS intervention did not interfere with normal food intake and helped promote nutritional adequacy and growth of Filipino children.
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Ogawa Y, Kawamura T, Shimada S. Zinc and skin biology. Arch Biochem Biophys 2016; 611:113-119. [PMID: 27288087 DOI: 10.1016/j.abb.2016.06.003] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 06/01/2016] [Accepted: 06/03/2016] [Indexed: 01/08/2023]
Abstract
Of all tissues, the skin has the third highest abundance of zinc in the body. In the skin, the zinc concentration is higher in the epidermis than in the dermis, owing to a zinc requirement for the active proliferation and differentiation of epidermal keratinocytes. Here we review the dynamics and functions of zinc in the skin as well as skin disorders associated with zinc deficiency, zinc finger domain-containing proteins, and zinc transporters. Among skin disorders associated with zinc deficiency, acrodermatitis enteropathica is a disorder caused by mutations in the ZIP4 transporter and subsequent zinc deficiency. The triad acrodermatitis enteropathica is characterized by alopecia, diarrhea, and skin lesions in acral, periorificial, and anogenital areas. We highlight the underlying mechanism of the development of acrodermatitis because of zinc deficiency by describing our new findings. We also discuss the accumulating evidence on zinc deficiency in alopecia and necrolytic migratory erythema, which is typically associated with glucagonomas.
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Affiliation(s)
- Youichi Ogawa
- Department of Dermatology, Faculty of Medicine, University of Yamanashi, Yamanashi, 409-3898, Japan.
| | - Tatsuyoshi Kawamura
- Department of Dermatology, Faculty of Medicine, University of Yamanashi, Yamanashi, 409-3898, Japan
| | - Shinji Shimada
- Department of Dermatology, Faculty of Medicine, University of Yamanashi, Yamanashi, 409-3898, Japan
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The effect of zinc supplementation on body composition and hormone levels related to adiposity among children: a systematic review. Public Health Nutr 2016; 19:2924-2939. [DOI: 10.1017/s1368980016001154] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AbstractObjectiveTo provide a comprehensive synthesis of the effects of Zn supplementation on childhood body composition and adiposity-related hormone levels.DesignFive electronic databases were searched for randomized controlled trials of Zn supplementation studies published before 28 February 2015. No statistical pooling of results was carried out due to diversity in study designs.SettingCommunity- or hospital-based, from fourteen developing and developed countries.SubjectsChildren and adolescents aged 0 to 10 years.ResultsSeven of the fourteen studies reported an overall or subgroup effect of Zn supplementation on at least one parameter of body composition, when determined by anthropometric measurements (increased mid upper-arm circumference, triceps skinfold, subscapular skinfold and mid upper-arm muscle area, and decreased BMI). Three out of the fourteen studies reported increased mean value of total body water estimated by bio-impedance analysis and increased fat-free mass estimated by dual energy X-ray absorptiometry and by total body water. Zn supplementation was associated with increased fat-free mass among stunted children. One study found supplementation decreased leptin and insulin concentrations.ConclusionsDue to the use of anthropometry when determining body composition, a majority of the studies could not accurately address whether alterations in the fat and/or fat-free mass components of the body were responsible for the observed changes in body composition. The effect of Zn supplementation on body composition is not consistent but may modify fat-free mass among children with pre-existing growth failure.
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Lee D, Kim YS, Song J, Kim HS, Lee HJ, Guo H, Kim H. Effects of Phlomis umbrosa Root on Longitudinal Bone Growth Rate in Adolescent Female Rats. Molecules 2016; 21:461. [PMID: 27070559 PMCID: PMC6273700 DOI: 10.3390/molecules21040461] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 03/26/2016] [Accepted: 03/31/2016] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the effects of Phlomis umbrosa root on bone growth and growth mediators in rats. Female adolescent rats were administered P. umbrosa extract, recombinant human growth hormone or vehicle for 10 days. Tetracycline was injected intraperitoneally to produce a glowing fluorescence band on the newly formed bone on day 8, and 5-bromo-2'-deoxyuridine was injected to label proliferating chondrocytes on days 8-10. To assess possible endocrine or autocrine/paracrine mechanisms, we evaluated insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3) or bone morphogenetic protein-2 (BMP-2) in response to P. umbrosa administration in either growth plate or serum. Oral administration of P. umbrosa significantly increased longitudinal bone growth rate, height of hypertrophic zone and chondrocyte proliferation of the proximal tibial growth plate. P. umbrosa also increased serum IGFBP-3 levels and upregulated the expressions of IGF-1 and BMP-2 in growth plate. In conclusion, P. umbrosa increases longitudinal bone growth rate by stimulating proliferation and hypertrophy of chondrocyte with the increment of circulating IGFBP-3. Regarding the immunohistochemical study, the effect of P. umbrosa may also be attributable to upregulation of local IGF-1 and BMP-2 expressions in the growth plate, which can be considered as a GH dependent autocrine/paracrine pathway.
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Affiliation(s)
- Donghun Lee
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 130-701, Korea.
| | - Young-Sik Kim
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 130-701, Korea.
| | - Jungbin Song
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 130-701, Korea.
| | - Hyun Soo Kim
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 130-701, Korea.
| | - Hyun Jung Lee
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 130-701, Korea.
| | - Hailing Guo
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 130-701, Korea.
| | - Hocheol Kim
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 130-701, Korea.
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Reifsnider E, Shin CN, Todd M, Jeong M, Gallagher M, Moramarco M. How Did They Grow: An Intervention to Reduce Stunted Growth in Low-Income Mexican-American Children. Res Nurs Health 2016; 39:105-20. [PMID: 26915468 DOI: 10.1002/nur.21714] [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] [Accepted: 02/01/2016] [Indexed: 11/10/2022]
Abstract
Growth stunting is a complex phenomenon related to undernutrition that can contribute to developmental delay, cognitive deficits, and small size and obesity in adulthood. Stunted growth, defined as height for age below the 5th percentile, is primarily caused by chronic malnutrition. In this study, a community-based intervention to reduce undernutrition was tested in a quasi-experimental design with 174 low-income, Mexican-American mothers and children recruited from a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic in a major southwestern city. The intervention was based on the public health nursing practice of collaborating with mothers of young children on appropriate nutrition and parenting, and was tailored by the author and community informants for mothers of children with stunted growth. Data were collected on child height and weight, dietary intake, maternal acculturation, maternal perceived stress as measured by the Perceived Stress Scale (PSS), home environment as measured by the home screening questionnaire (HSQ), and maternal-child interaction as measured by the Nursing Child Assessment Teaching Scale (NCATS). Intervention children had higher growth velocity than the children in the comparison group. These findings were especially prominent for children of women who were older and less acculturated. Results suggest that a nursing intervention delivered in collaboration with WIC can make a significant improvement in growth of low-income children with growth stunting.
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Affiliation(s)
- Elizabeth Reifsnider
- Nancy Melvin Professor, Associate Dean for Research, College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St., Phoenix, AZ, 85004
| | - Cha-Nam Shin
- Assistant Professor, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Michael Todd
- Associate Research Professor, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Mihyun Jeong
- Doctoral Student, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Martina Gallagher
- Assistant Professor, School of Nursing, University of Texas Houston Health Sciences Center, Houston, TX
| | - Michael Moramarco
- Project Coordinator, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
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Semba RD, Shardell M, Sakr Ashour FA, Moaddel R, Trehan I, Maleta KM, Ordiz MI, Kraemer K, Khadeer MA, Ferrucci L, Manary MJ. Child Stunting is Associated with Low Circulating Essential Amino Acids. EBioMedicine 2016; 6:246-252. [PMID: 27211567 PMCID: PMC4856740 DOI: 10.1016/j.ebiom.2016.02.030] [Citation(s) in RCA: 188] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 02/11/2016] [Accepted: 02/16/2016] [Indexed: 11/19/2022] Open
Abstract
Background Stunting affects about one-quarter of children under five worldwide. The pathogenesis of stunting is poorly understood. Nutritional interventions have had only modest effects in reducing stunting. We hypothesized that insufficiency in essential amino acids may be limiting the linear growth of children. Methods We used a targeted metabolomics approach to measure serum amino acids, glycerophospholipids, sphingolipids, and other metabolites using liquid chromatography-tandem mass spectrometry in 313 children, aged 12–59 months, from rural Malawi. Children underwent anthropometry. Findings Sixty-two percent of the children were stunted. Children with stunting had lower serum concentrations of all nine essential amino acids (tryptophan, isoleucine, leucine, valine, methionine, threonine, histidine, phenylalanine, lysine) compared with nonstunted children (p < 0.01). In addition, stunted children had significantly lower serum concentrations of conditionally essential amino acids (arginine, glycine, glutamine), non-essential amino acids (asparagine, glutamate, serine), and six different sphingolipids compared with nonstunted children. Stunting was also associated with alterations in serum glycerophospholipid concentrations. Interpretation Our findings support the idea that children with a high risk of stunting may not be receiving an adequate dietary intake of essential amino acids and choline, an essential nutrient for the synthesis of sphingolipids and glycerophospholipids. We used metabolomics and mass spectrometry to gain insight into nutrition of stunted children. Stunted children in rural Africa had low circulating levels of essential amino acids. Children at risk of stunting may not have an adequate dietary intake of essential amino acids.
Worldwide, one-quarter of children under five years are short for their age (stunted), indicative of chronic malnutrition. Lipid-based nutrient supplements containing micronutrients have little to no effect in reducing child stunting. We examined the relationship between circulating metabolites with stunting in young children in Africa. Stunted children had lower serum levels of all nine essential amino acids compared with non-stunted children. These results challenge the widespread assumption that protein intake is adequate among young children in developing countries. The findings support the idea that children at high risk of stunting are not receiving adequate dietary intake of essential amino acids.
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Affiliation(s)
- Richard D Semba
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Michelle Shardell
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Fayrouz A Sakr Ashour
- Department of Nutrition & Food Science, College of Agriculture and Natural Resources, University of Maryland, College Park, MD, USA
| | - Ruin Moaddel
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Indi Trehan
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA; School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi
| | - Kenneth M Maleta
- School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi
| | - M Isabel Ordiz
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA
| | - Klaus Kraemer
- Sight and Life, Basel, Switzerland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mohammed A Khadeer
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Mark J Manary
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA; School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi
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Zhao A, Gao H, Li B, Yu K, Win NN, Zhang Y, Wang P. Potential Contribution of Iron Deficiency and Multiple Factors to Anemia Among 6- to 72-Month-Old Children in the Kokang Area of Myanmar. Am J Trop Med Hyg 2015. [PMID: 26195457 DOI: 10.4269/ajtmh.15-0129] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The prevalence of anemia among children in Myanmar has been reported to be among the highest in the world. This study was conducted to determine 1) the prevalence of anemia in preschool children and 2) risk factors associated with anemia. A total of 138 children aged from 6 to 72 months were recruited through cluster sampling from six villages in Kokang. Hemoglobin (Hb) concentration, blood trace elements, and anthropometric indicators were measured. Feces samples were collected to examine for the presence of ascarid eggs. The overall prevalence of anemia in children was 61.6%, including 10.9% with severe anemia. Meanwhile, high prevalence of stunting (40.0%), underweight (22.4%), wasting (6.3%), and small head circumference (6.7%) was found. Children with anemia were more prone to stunting. Children with severe anemia and moderate anemia had significantly lower blood iron and zinc levels than children without anemia (P < 0.001 and P = 0.007). The prevalence of ascarid infection was 64.9%; however, it was not associated with anemia. Drinking spring water was positively associated with anemia (odds ratio [OR] = 6.368). This study demonstrated that anemia is an important public health problem among children from the Kokang area. Iron deficiency and drinking spring water may be the important causes of anemia among children.
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Affiliation(s)
- Ai Zhao
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China; School of Basic Medical Sciences, Capital Medical University, Beijing, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kunming, Yunnan, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kokang, Myanmar; Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China
| | - Hongchong Gao
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China; School of Basic Medical Sciences, Capital Medical University, Beijing, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kunming, Yunnan, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kokang, Myanmar; Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China
| | - Bo Li
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China; School of Basic Medical Sciences, Capital Medical University, Beijing, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kunming, Yunnan, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kokang, Myanmar; Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China
| | - Kai Yu
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China; School of Basic Medical Sciences, Capital Medical University, Beijing, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kunming, Yunnan, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kokang, Myanmar; Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China
| | - Naing Naing Win
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China; School of Basic Medical Sciences, Capital Medical University, Beijing, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kunming, Yunnan, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kokang, Myanmar; Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China
| | - Yumei Zhang
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China; School of Basic Medical Sciences, Capital Medical University, Beijing, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kunming, Yunnan, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kokang, Myanmar; Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China
| | - Peiyu Wang
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China; School of Basic Medical Sciences, Capital Medical University, Beijing, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kunming, Yunnan, People's Republic of China; Health Poverty Action Eastern Asia Program Office, Kokang, Myanmar; Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China
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Astiazarán-García H, Iñigo-Figueroa G, Quihui-Cota L, Anduro-Corona I. Crosstalk between Zinc Status and Giardia Infection: A New Approach. Nutrients 2015; 7:4438-52. [PMID: 26046395 PMCID: PMC4488794 DOI: 10.3390/nu7064438] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/06/2015] [Accepted: 05/12/2015] [Indexed: 12/27/2022] Open
Abstract
Zinc supplementation has been shown to reduce the incidence and prevalence of diarrhea; however, its anti-diarrheal effect remains only partially understood. There is now growing evidence that zinc can have pathogen-specific protective effects. Giardiasis is a common yet neglected cause of acute-chronic diarrheal illness worldwide which causes disturbances in zinc metabolism of infected children, representing a risk factor for zinc deficiency. How zinc metabolism is compromised by Giardia is not well understood; zinc status could be altered by intestinal malabsorption, organ redistribution or host-pathogen competition. The potential metal-binding properties of Giardia suggest unusual ways that the parasite may interact with its host. Zinc supplementation was recently found to reduce the rate of diarrhea caused by Giardia in children and to upregulate humoral immune response in Giardia-infected mice; in vitro and in vivo, zinc-salts enhanced the activity of bacitracin in a zinc-dose-dependent way, and this was not due to zinc toxicity. These findings reflect biological effect of zinc that may impact significantly public health in endemic areas of infection. In this paper, we shall explore one direction of this complex interaction, discussing recent information regarding zinc status and its possible contribution to the outcome of the encounter between the host and Giardia.
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Affiliation(s)
- Humberto Astiazarán-García
- Departamento de Nutrición y Metabolismo, Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera a La Victoria Km 0.6, Hermosillo, Sonora, CP 83304, Mexico.
| | - Gemma Iñigo-Figueroa
- Departamento de Nutrición y Metabolismo, Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera a La Victoria Km 0.6, Hermosillo, Sonora, CP 83304, Mexico.
| | - Luis Quihui-Cota
- Departamento de Nutrición Pública y Salud, Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera a La Victoria Km 0.6, Hermosillo, Sonora, C.P. 83304, Mexico.
| | - Iván Anduro-Corona
- Departamento de Nutrición y Metabolismo, Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera a La Victoria Km 0.6, Hermosillo, Sonora, CP 83304, Mexico.
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