Plasma and serum micronutrient concentrations in preschool children

Study on the Zinc Nutritional Status and Risk Factors of Chinese 6–18-Year-Old Children

Zinc is an essential micronutrient that is involved in several metabolic processes, especially children’s growth and development. Although many previous studies have evaluated the zinc nutritional status of children, there are very few reports on children aged 6–18 years old. Furthermore, there are few reports on children’s zinc nutrition status based on the Chinese population. According to WHO data, the prevalence of zinc deficiency in Asian countries is rather high and has resulted in high child mortality. In this study, we aimed to comprehensively assess zinc nutritional status and the prevalence of zinc deficiency among children aged 6–18 years in China based on nationally representative cross-sectional data. Subgroup comparisons were made under possible influencing factors. The potential risk factors of zinc deficiency were also discussed. A total of 64,850 children, equally male and female, were recruited from 150 monitoring sites in 31 provinces through stratified random sampling from China National Nutrition and Health Survey of Children and Lactating Mothers (CNNHS 2016–2017). Median and interquartile intervals were used to represent the overall zinc concentration levels and different subgroups. A Chi-square test was used to compare serum zinc levels and the prevalence of zinc deficiency in children under different group variables. In order to study the influencing factors of zinc deficiency, multiple logistic regression was utilized. It was found that the median concentration of serum Zn was 88.39 μg/dL and the prevalence of Zn deficiency was 9.62%. The possible influence factors for Zn deficiency were sex, anemia, nutritional status, city type and income. By conducting a subgroup analysis of the factors, it was found that males; those with anemia, stunting and low income; and children living in rural areas have a higher risk of Zn deficiency. This study offers a comprehensive analysis of Zn nutritional status among Chinese children, which provides reliable data for policy formulation to improve the zinc nutrition status of children.

Zinc deficiency in the pediatric age group is common but underevaluated

BACKGROUND

Subclinical micronutrient deficiencies have been gradually becoming more important as a public health problem and drawing attention of the health authorities. Today it has been known that detecting and treating people having deficiency symptoms alone is no longer sufficient. It is important to detect and prevent any deficiency before it displays clinical manifestations. Zinc deficiency is one of the most widespread micronutrient deficiencies. In this study, we aimed to evaluate the zinc status and the associated factors in healthy school-age children.

METHODS

The study was carried out in schools in Altindag, the district of Ankara. A total of 1063 healthy children, 585 girls and 478 boys, aged 5-16 years were included in the study. Serum zinc, high-sensitivity C-reactive protein levels and white blood cell count were measured. A serum zinc level <65 μg/dL was considered as subclinical zinc deficiency for children <10 years of age. For children ≥10 years of age the cutoffs for serum zinc concentration were set at 66 μg/dL for females and 70 μg/dL for males. A questionnaire was developed to collect socioeconomic and demographic information of the participants.

RESULTS

The prevalence of subclinical zinc deficiency in children attending the study was detected to be 27.8%. This high ratio showed zinc deficiency was an important health problem in the Altindag district of Ankara, Turkey.

CONCLUSIONS

Evaluating the indicators of zinc deficiency such as serum zinc concentration, dietary zinc intake and stunting prevalence, this study is the most comprehensive epidemiological study performed in children in Turkey. This study reveals the high prevalence of subclinical zinc deficiency and indicates that zinc deficiency is a public health concern for the study population.

Nutritional impacts of a fruit and vegetable subsidy programme for disadvantaged Australian Aboriginal children

Healthy food subsidy programmes have not been widely implemented in high-income countries apart from the USA and the UK. There is, however, interest being expressed in the potential of healthy food subsidies to complement nutrition promotion initiatives and reduce the social disparities in healthy eating. Herein, we describe the impact of a fruit and vegetable (F&V) subsidy programme on the nutritional status of a cohort of disadvantaged Aboriginal children living in rural Australia. A before-and-after study was used to assess the nutritional impact in 174 children whose families received weekly boxes of subsidised F&V organised through three Aboriginal medical services. The nutritional impact was assessed by comparing 24 h dietary recalls and plasma carotenoid and vitamin C levels at baseline and after 12 months. A general linear model was used to assess the changes in biomarker levels and dietary intake, controlled for age, sex, community and baseline levels. Baseline assessment in 149 children showed low F&V consumption. Significant increases (P< 0·05) in β-cryptoxanthin (28·9 nmol/l, 18 %), vitamin C (10·1 μmol/l, 21 %) and lutein–zeaxanthin (39·3 nmol/l, 11 %) levels were observed at the 12-month follow-up in 115 children, although the self-reported F&V intake was unchanged. The improvements in the levels of biomarkers of F&V intake demonstrated in the present study are consistent with increased F&V intake. Such dietary improvements, if sustained, could reduce non-communicable disease rates. A controlled study of healthy food subsidies, together with an economic analysis, would facilitate a thorough assessment of the costs and benefits of subsidising healthy foods for disadvantaged Aboriginal Australians.

Zinc intake and its dietary sources: results of the 2007 Australian National Children's Nutrition and Physical Activity Survey

The current Australian Nutrient Reference Values (NRV) use different Estimated Average Requirements (EAR) for zinc for adolescent boys and girls compared to the previous recommendations. The adequacy of zinc intakes of 2–16 years old children (n = 4834) was examined in the 2007 Australian National Children’s Nutrition and Physical Activity Survey. Zinc intakes were estimated from two 24-h recalls and compared with age- and gender-specific NRV. Food sources of zinc were assessed and compared with those of the 1995 National Nutrition Survey. The mean (SD) zinc intake was 10.2 (3.0) mg/day for all children. Nearly all children met the EAR for zinc except for 14–16 years old boys (29% did not meet EAR). Children (2–3 years) were at highest risk of excessive zinc intakes with 79% exceeding the Upper Level of Intake. Meat and poultry; milk products; and cereals and cereal products contributed 68% of total zinc intake. The contribution of cereals to total zinc intake has increased significantly since 1995, due to the greater market-availability of zinc-fortified breakfast cereals. We conclude that sub-groups of Australian children are at-risk of inadequate (boys 14–16 years) or excessive (children 2–3 years) zinc intakes, and monitoring of zinc status is required.

Distribution of serum concentrations of alpha-tocopherol and gamma-tocopherol in the US population

BACKGROUND

Although the population distribution of serum concentrations of alpha-tocopherol has been described in the United States, little is known about the distribution of gamma-tocopherol or the ratio of alpha-tocopherol to gamma-tocopherol.

OBJECTIVE

Our aim was to describe the distribution of serum concentrations of alpha-tocopherol and gamma-tocopherol in a nationally representative sample of US adults.

DESIGN

We reviewed data from 4087 adults aged >/=20 y who participated in the National Health and Nutrition Examination Survey (1999-2000). Concentrations of alpha-tocopherol and gamma-tocopherol were measured by using HPLC with ultraviolet-visible wavelength detection.

RESULTS

The arithmetic mean (+/-SEM) of serum concentrations of alpha-tocopherol was 30.09 +/- 0.45 micromol/L, the median was 25.94 micromol/L, and the geometric mean (+/-SEM) was 27.39 +/- 0.38 micromol/L. The arithmetic mean of serum concentrations of gamma-tocopherol was 5.74 +/- 0.22 micromol/L, the median was 5.25 micromol/L, and the geometric mean was 4.79 +/- 0.18 micromol/L. The median ratio of alpha-tocopherol to total cholesterol was 4.93 micromol/mmol, that of gamma-tocopherol to total cholesterol was 1.03 micromol/mmol, and that of alpha-tocopherol to gamma-tocopherol was 4.53 micromol/mmol. Concentrations of alpha-tocopherol increased significantly (P for trend < 0.001) with age and were significantly (P = 0.015) lower in men than in women. African Americans and Mexican Americans had significantly (P < 0.001) lower concentrations of alpha-tocopherol than did whites. The median concentrations of gamma-tocopherol showed a trend with respect to age, did not differ significantly between men and women, and were slightly but nonsignificantly lower in white participants than in African American or Mexican American participants.

CONCLUSION

Sociodemographic variations in serum concentrations of alpha-tocopherol and gamma-tocopherol exist among US adults.

HPLC method for simultaneous determination of retinol, alpha-tocopherol and coenzyme Q10 in human plasma

A simple HPLC method with UV detection is proposed for the simultaneous determination of three lipophilic vitamins: all-trans-retinol, alpha-tocopherol and coenzyme Q(10) (ubiquinone) in human plasma. The following chromatographic conditions were used: RP-18 column, a mobile phase consisted of methanol -n-hexane 72:28 (v/v) and UV detector set at 324, 292 and 276 nm for all-trans-retinol, alpha-tocopherol and coenzyme Q(10), respectively. The linearity range was 0.35-70 microM for all-trans-retinol, 0.23-44 microM for alpha-tocopherol and 0.12-23 microM for coenzyme Q(10). Deproteinised plasma samples were extracted with n-hexane prior to the analysis. The within-day and between day reproducibilities were 1.5 and 3.7% for all-trans-retinol, 4.0 and 5.8% for alpha-tocopherol and 2.3 and 3.1% for coenzyme Q(10), respectively. Using the proposed method the following recoveries were achieved: 91% for all-trans-retinol, 86% for alpha-tocopherol and 88% for coenzyme Q(10). The method was applied to the determination of the levels of retinol, tocopherol and coenzyme Q(10) in plasma of healthy children and children treated by elimination diet.

Influence of apolipoprotein E genotype on fat-soluble plasma antioxidants in Spanish children

BACKGROUND

Apolipoprotein (apo) E is a major determinant of plasma lipid concentrations, which in turn influence the plasma concentrations of various fat-soluble vitamins.

OBJECTIVE

We aimed to analyze the effect of APOE genotype on fat-soluble antioxidant concentrations in children.

DESIGN

A total of 926 healthy boys and girls aged 6-8 y were selected from 4 cities in Spain. APOE genotyping was carried out, and plasma concentrations of lipids, apolipoproteins, and lipid-soluble antioxidants were measured.

RESULTS

Plasma lipid concentrations were strongly influenced by APOE genotype. The mean plasma concentration of alpha-tocopherol was 21.3 micromol/L, which is one of the highest values ever reported for a population of children. Although plasma concentrations of alpha-tocopherol, gamma-tocopherol, lycopene, and alpha-carotene varied significantly between subjects with different APOE genotypes, most of these differences disappeared after adjustment for lipoprotein-related covariates. Nevertheless, tocopherol concentrations remained elevated in individuals with the E2/2 genotype. Multivariate regression analysis showed interactions of APOE genotype with triacylglycerol and apo B in determining alpha-tocopherol concentrations. When subjects were stratified according to major apo E groups, apo B appeared to be the most important predictor of alpha-tocopherol concentrations in all groups, whereas triacylglycerol was identified only in carriers of the E2 allele.

CONCLUSIONS

The association between APOE genotype and lipophilic antioxidant concentrations is dependent mainly on the effect of the polymorphism on lipoprotein concentrations. However, triacylglycerol plays a role in determining the variability of alpha-tocopherol concentrations in E2 carriers only. This suggests that the alpha-tocopherol content in each lipoprotein class varies according to APOE genotype.

Serum carotenoid concentrations in US children and adolescents

BACKGROUND

Carotenoids, a class of phytochemicals, may affect the risk of several chronic conditions.

OBJECTIVE

Our objective was to describe the distributions and correlates of serum carotenoid concentrations in US children and adolescents.

DESIGN

Using data from the third National Health and Nutrition Examination Survey (1988-1994), a cross-sectional study, we examined the distributions of serum concentrations of alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein and zeaxanthin, and lycopene among 4231 persons aged 6-16 y.

RESULTS

After adjustment for age, sex, race or ethnicity, poverty-income ratio, body mass index status, HDL- and non-HDL-cholesterol concentrations, C-reactive protein concentration, and cotinine concentration, only HDL-cholesterol (P < 0.001) and non-HDL-cholesterol (P < 0.001) concentrations were directly related to all carotenoid concentrations. Age (P < 0.001) and body mass index status (P < 0.001) were inversely related to all carotenoid concentrations except those of lycopene. Young males had slightly higher carotenoid concentrations than did young females, but the differences were significant only for lycopene concentrations (P = 0.029). African American children and adolescents had significantly higher beta-cryptoxanthin (P < 0.001), lutein and zeaxanthin (P < 0.001), and lycopene (P = 0.006) concentrations but lower alpha-carotene (P < 0.001) concentrations than did white children and adolescents. Mexican American children and adolescents had higher alpha-carotene (P < 0.001), beta-cryptoxanthin (P < 0.001), and lutein and zeaxanthin (P < 0.001) concentrations but lower lycopene (P = 0.001) concentrations than did white children and adolescents. C-reactive protein concentrations were inversely related to beta-carotene (P < 0.001), lutein and zeaxanthin (P < 0.001), and lycopene (P = 0.023) concentrations. Cotinine concentrations were inversely related to alpha-carotene (P = 0.002), beta-carotene (P < 0.001), and beta-cryptoxanthin (P < 0.001) concentrations.

CONCLUSION

These data show significant variations in serum carotenoid concentrations among US children and adolescents and may be valuable as reference ranges for this population.

Dietary intakes and nutrient status of vegetarian preschool children from a British national survey

BACKGROUND: Dietary intakes and nutrient status were compared in meat-eaters and non-meat-eaters from the National Diet and Nutrition Survey of children aged 1.5-4.5 years. METHODS: Children (n = 1351) were categorized as 'omnivores' or 'vegetarians', according to whether they consumed meat or meat products during a 4-day dietary record. Blood samples were also obtained for analysis of haematological and biochemical nutrient status. RESULTS: Three per cent of children were 'vegetarian'. They consumed higher proportions of milk and milk products, although this was significant only in older children (P = 0.007), owing to high consumption by the high proportion of Asian children. In vegetarians, energy intakes tended to be lower in both age groups. Percentage energy from protein and fat were lower, while that from carbohydrate was higher compared with omnivores. Cholesterol intakes were lower, significantly so for younger children (P < 0.001). Intakes of micronutrients were either higher (vitamins C and E, potassium) or lower (niacin and sodium) in younger vegetarians compared with omnivores. Energy-adjusted intakes of iron and zinc did not differ significantly from those of omnivores, although both intakes were low in many children (6-20% < LRNI), particularly in the younger group. Haematological and biochemical nutrient status indices showed few differences. Serum ferritin was lower in vegetarians, significantly so in younger children (P = 0.002). Antioxidant vitamin (A, C and E) status tended to be higher in vegetarians, while vitamin B12 intakes and status were more than adequate. Apart from poorer vitamin D intake and status in older Asian vegetarians, very few ethnic differences were observed. CONCLUSIONS: Nutrient intakes and status were generally adequate in preschool children who did not eat meat. Although serum ferritin levels were inferior (particularly in vegetarians under 3 years old), the lower intakes of fat, cholesterol and sodium, and higher antioxidant vitamin intakes and status indices were potentially beneficial. Given a balanced diet, adequate nutrient intakes and status can be maintained without consuming meat.