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Lepp HL, Amrein K, Dizdar OS, Casaer MP, Gundogan K, de Man AME, Rezzi S, van Zanten ARH, Shenkin A, Berger MM. LLL 44 - Module 3: Micronutrients in Chronic disease. Clin Nutr ESPEN 2024; 62:285-295. [PMID: 38875118 DOI: 10.1016/j.clnesp.2024.05.009] [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: 03/16/2024] [Revised: 04/26/2024] [Accepted: 05/15/2024] [Indexed: 06/16/2024]
Abstract
Micronutrients (MN), i.e. trace elements and vitamins, are essential organic molecules, which are required in the diet in relatively small amounts in any form of nutrition (oral, enteral, parenteral). The probability of MN depletion or deficiencies should be considered in all chronic illnesses, especially in those that can interfere with intake, digestion, or intestinal absorption. Low socio-economic status and food deprivation are recognized as the most prevalent reasons for MN deficiencies world-wide. Elderly multimorbid patients with multimodal therapy, as well as patients with long-lasting menu restrictions, are at high risk for both disease related malnutrition as well as multiple MN deficiencies, needing careful specific follow-up. The importance of monitoring MN blood levels along with CRP is essential for optimal care. Drug interactions are also highlighted. In patients with chronic conditions depending on medical nutrition therapy, the provision of adequate dietary reference intakes (DRI) of MN doses and monitoring of their adequacy belongs to standard of care.
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Affiliation(s)
- Hanna-Liis Lepp
- North Estonia Medical Centre Foundation, Department of Clinical Nutrition, Tallinn, Estonia.
| | - Karin Amrein
- Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Austria.
| | - Oguzhan S Dizdar
- Department of Internal Medicine and Clinical Nutrition Unit, University of Health Sciences Kayseri City Training and Research Hospital, Kayseri, Turkey.
| | - Michael P Casaer
- KU Leuven, Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, Leuven, Belgium.
| | - Kursat Gundogan
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey.
| | - Angélique M E de Man
- Amsterdam UMC, Location Vrije Universiteit, Department of Intensive Care, The Netherlands; Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.
| | - Serge Rezzi
- Swiss Nutrition and Health Foundation, Epalinges, Switzerland.
| | - Arthur R H van Zanten
- Amsterdam UMC, Location Vrije Universiteit, Department of Intensive Care, The Netherlands; Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.
| | - Alan Shenkin
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, UK.
| | - Mette M Berger
- Faculty of Biology & Medicine, Lausanne University, Lausanne, Switzerland.
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Seke M, Zivkovic M, Stankovic A. Versatile applications of fullerenol nanoparticles. Int J Pharm 2024; 660:124313. [PMID: 38857663 DOI: 10.1016/j.ijpharm.2024.124313] [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: 03/04/2024] [Revised: 05/25/2024] [Accepted: 06/04/2024] [Indexed: 06/12/2024]
Abstract
Nanomaterials have become increasingly important over time as research technology has enabled the progressively precise study of materials at the nanoscale. Developing an understanding of how nanomaterials are produced and tuned allows scientists to utilise their unique properties for a variety of applications, many of which are already incorporated into commercial products. Fullerenol nanoparticles C60(OH)n, 2 ≤ n ≤ 44 are fullerene derivatives and are produced synthetically. They have good biocompatibility, low toxicity and no immunological reactivity. In addition, their nanometre size, large surface area to volume ratio, ability to penetrate cell membranes, adaptable surface that can be easily modified with different functional groups, drug release, high physical stability in biological media, ability to remove free radicals, magnetic and optical properties make them desirable candidates for various applications. This review comprehensively summarises the various applications of fullerenol nanoparticles in different scientific fields such as nanobiomedicine, including antibacterial and antiviral agents, and provides an overview of their use in agriculture and biosensor technology. Recommendations are also made for future research that would further elucidate the mechanisms of fullerenols actions.
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Affiliation(s)
- Mariana Seke
- Laboratory for Radiobiology and Molecular Genetics, "Vinča" Institute of Nuclear Sciences -National Institute of The Republic of Serbia, University of Belgrade, Mike Petrovica Alasa 12-14, P.O.Box 522, 11 000 Belgrade, Serbia.
| | - Maja Zivkovic
- Laboratory for Radiobiology and Molecular Genetics, "Vinča" Institute of Nuclear Sciences -National Institute of The Republic of Serbia, University of Belgrade, Mike Petrovica Alasa 12-14, P.O.Box 522, 11 000 Belgrade, Serbia
| | - Aleksandra Stankovic
- Laboratory for Radiobiology and Molecular Genetics, "Vinča" Institute of Nuclear Sciences -National Institute of The Republic of Serbia, University of Belgrade, Mike Petrovica Alasa 12-14, P.O.Box 522, 11 000 Belgrade, Serbia
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Coates PM, Bailey RL, Blumberg JB, El-Sohemy A, Floyd ZE, Goldenberg JZ, Gould Shunney A, Holscher HD, Nkrumah-Elie Y, Rai D, Ritz BW, Weber WJ. The Evolution of Science and Regulation of Dietary Supplements: Past, Present, and Future. J Nutr 2024:S0022-3166(24)00356-0. [PMID: 38971530 DOI: 10.1016/j.tjnut.2024.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/19/2024] [Accepted: 06/26/2024] [Indexed: 07/08/2024] Open
Abstract
Dietary supplement use in the United States is widespread and increasing, especially among certain population groups, such as older Americans. The science surrounding dietary supplements has evolved substantially over the last few decades since their formal regulation in 1994. Much has been learned about the mechanisms of action of many dietary supplement ingredients, but the evidence on their health effects is still building. As is true of much nutrition research, there are many studies that point to health effects, but not all are at the level of scientific evidence (e.g., randomized controlled interventions), rigor, or quality needed for definitive statements of efficacy regarding clinical endpoints. New technologies and approaches are being applied to the science of dietary supplements, including nutrigenomics and microbiome analysis, data science, artificial intelligence, and machine learning - all of which can elevate the science behind dietary supplements. Products can contain an array of bioactive compounds derived from foods as well as from medicinal plants, which creates enormous challenges in data collection and management. Clinical applications, particularly those aimed at providing personalized nutrition options for patients, have become more sophisticated as dietary supplements are incorporated increasingly into clinical practice and self-care. The goals of this paper are to provide historical context for the regulation and science of dietary supplements, identify research resources, and suggest some future directions for science in this field.
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Affiliation(s)
- Paul M Coates
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA;.
| | - Regan L Bailey
- Institute for Advancing Health Through Agriculture, Texas A&M University System, College Station, TX, USA
| | - Jeffrey B Blumberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Ahmed El-Sohemy
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Z Elizabeth Floyd
- McIlhenny Botanical Research Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Joshua Z Goldenberg
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | | | - Hannah D Holscher
- Department of Food Science and Human Nutrition, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | | | - Deshanie Rai
- OmniActive Health Technologies, Morristown, NJ, USA
| | | | - Wendy J Weber
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA
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Adams KP, Vosti SA, Tarini A, Beye M, Pachón H, Kiselova S, Engle-Stone R. The potential contributions of bouillon fortification to meeting micronutrient requirements among women and preschool children in Senegal: A modeling study using household consumption and expenditure survey data. Ann N Y Acad Sci 2024; 1537:98-112. [PMID: 38973341 DOI: 10.1111/nyas.15156] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
To reduce micronutrient deficiencies, Senegal mandates the fortification of refined oil with vitamin A and wheat flour with iron and folic acid. Expanding Senegal's large-scale food fortification programs to include fortified bouillon could help fill the remaining gaps in dietary micronutrient requirements. Using 7-day household food consumption data collected between 2018 and 2019, we assessed the potential contributions of bouillon fortified with vitamin A (40-250 μg/g bouillon), folic acid (20-120 μg/g), vitamin B12 (0.2-2 μg/g), iron (0.6-5 mg/g), and zinc (0.6-5 mg/g) for meeting micronutrient requirements of women of reproductive age (WRA; 15-49 years old) and children (6-59 months old). Most households (90%) reported consuming bouillon, including poor and rural households. At modeled fortification levels, bouillon fortification reduced the national prevalence of inadequacy by up to ∼20 percentage points (pp) for vitamin A, 34 pp (WRA) and 20 pp (children) for folate, 20 pp for vitamin B12, 38 pp (WRA) and 30 pp (children) for zinc, and ∼8 pp for iron. Predicted reductions in inadequacy were generally larger among poor and rural populations, especially for vitamins A and B12. Our modeling suggests that bouillon fortification has the potential to substantially reduce dietary inadequacy of multiple micronutrients and could also help address inequities in dietary micronutrient inadequacies in Senegal.
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Affiliation(s)
- Katherine P Adams
- Institute for Global Nutrition, Department of Nutrition, University of California, Davis, Davis, California, USA
| | - Stephen A Vosti
- Institute for Global Nutrition, Department of Nutrition, University of California, Davis, Davis, California, USA
- Department of Agricultural and Resource Economics, University of California, Davis, Davis, California, USA
| | - Ann Tarini
- Independent Consultant, Laval, Quebec, Canada
| | | | - Helena Pachón
- Food Fortification Initiative, Atlanta, Georgia, USA
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Sophia Kiselova
- The Swiss Federal Institute of Technology in Lausanne (EPFL), Lausanne, Switzerland
| | - Reina Engle-Stone
- Institute for Global Nutrition, Department of Nutrition, University of California, Davis, Davis, California, USA
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González Maciel A, Rosas López LE, Romero-Velázquez RM, Ramos-Morales A, Ponce-Macotela M, Calderón-Guzmán D, Trujillo-Jiménez F, Alfaro-Rodríguez A, Reynoso-Robles R. Postnatal zinc deficiency due to giardiasis disrupts hippocampal and cerebellar development. PLoS Negl Trop Dis 2024; 18:e0012302. [PMID: 38950061 PMCID: PMC11244800 DOI: 10.1371/journal.pntd.0012302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 07/12/2024] [Accepted: 06/20/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Giardiasis and zinc deficiency have been identified as serious health problems worldwide. Although Zn depletion is known to occur in giardiasis, no work has investigated whether changes occur in brain structures. METHODS Three groups of gerbils were used: control (1), orogastrically inoculated on day 3 after birth with trophozoites of two isolates of Giardia intestinalis (HGINV/WB) group (2 and 3). Estimates were made at five ages covering: establishment of infection, Giardia population growth, natural parasite clearance and a post-infection age. QuantiChrome zinc assay kit, cresyl violet staining and TUNEL technique were used. RESULTS A significant decrease (p<0.01) in tissue zinc was observed and persisted after infection. Cytoarchitectural changes were observed in 75% of gerbils in the HGINV or WB groups. Ectopic pyramidal neurons were found in the cornus ammonis (CA1-CA3). At 60 and 90 days of age loss of lamination was clearly visible in CA1. In the dentate gyrus (DG), thinning of the dorsal lamina and abnormal thickening of the ventral lamina were observed from 30 days of age. In the cerebellum, we found an increase (p<0.01) in the thickness of the external granular layer (EGL) at 14 days of age that persisted until day 21 (C 3 ± 0.3 μm; HGINV 37 ± 5 μm; WB 28 ± 3 μm); Purkinje cell population estimation showed a significant decrease; a large number of apoptotic somas were observed scattered in the molecular layer; in 60 and 90 days old gerbils we found granular cell heterotopia and Purkinje cell ectopia. The pattern of apoptosis was different in the cerebellum and hippocampus of parasitized gerbils. CONCLUSION The morphological changes found suggest that neuronal migration is affected by zinc depletion caused by giardiasis in early postnatal life; for the first time, the link between giardiasis-zinc depletion and damaged brain structures is shown. This damage may explain the psychomotor/cognitive delay associated with giardiasis. These findings are alarming. Alterations in zinc metabolism and signalling are known to be involved in many brain disorders, including autism.
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Affiliation(s)
- Angélica González Maciel
- Laboratory of Cell and Tissue Morphology, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Laura Elizabeth Rosas López
- Laboratory of Cell and Tissue Morphology, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Rosa María Romero-Velázquez
- Laboratory of Cell and Tissue Morphology, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Andrea Ramos-Morales
- Laboratory of Cell and Tissue Morphology, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Martha Ponce-Macotela
- Laboratory of Experimental Parasitology, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - David Calderón-Guzmán
- Laboratory of Neuroscience, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | | | - Alfonso Alfaro-Rodríguez
- Division of Neurosciences, Instituto Nacional de Rehabilitación, "Luis Guillermo Ibarra Ibarra", Secretaría de Salud, Mexico City, Mexico
| | - Rafael Reynoso-Robles
- Laboratory of Cell and Tissue Morphology, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
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Nanga DC, Carboo JA, Chatenga H, Nienaber A, Conradie C, Lombard M, Dolman‐Macleod RC. Micronutrient supplementation practices in relation to the World Health Organisation 2013 guidelines on management of severe acute malnutrition. MATERNAL & CHILD NUTRITION 2024; 20:e13636. [PMID: 38456385 PMCID: PMC11168367 DOI: 10.1111/mcn.13636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/09/2024]
Abstract
In 2013, the World Health Organisation (WHO) updated the recommendations for micronutrient deficiency correction in hospitalised under-5 children with complicated severe acute malnutrition (SAM). This study aimed to describe the micronutrient deficiency correction practices in relation to WHO 2013 recommendations. Data from medical records of under-5 children admitted for SAM management at two hospitals in South Africa and three tertiary hospitals in Ghana were extracted. Micronutrient correction practices were compared to the WHO 2013 recommendations by considering the dosage, timing of micronutrient supplementation (vitamin A, iron and folic acid) and therapeutic feeds administered. In total, 723 medical records were included. Nearly half (48.3%) of the children received at least one of the studied micronutrients as a supplement. Vitamin A was supplemented in 27.4% of the children, while iron and folic acid were supplemented in 9.5% and 34.9%, respectively. Among the children who received vitamin A, 60.1% received the first dose on Day 1 of admission. Also, 46.4% of the iron-supplemented children received iron within the first week of admission. Vitamin A, iron and folic acid were administered within the dose range of 100,000-180,000 IU, 3.1-7.7 mg per kg per day, and 3-5 mg per day, respectively. Additionally, 71.7% of the children reportedly received therapeutic feeds that met WHO recommendations. The micronutrient deficiency correction practices regarding dose and timing differed from the 2013 WHO guidelines. Qualitative studies investigating the reasons for the disparities are recommended.
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Affiliation(s)
- Doris Cement Nanga
- Centre of Excellence for Nutrition (CEN), Faculty of Health ScienceNorth‐West UniversityPotchefstroomSouth Africa
- Department of Human Nutrition and Health, Faculty of Food and Human ScienceLilongwe University of Agriculture and Natural ResourcesLilongweMalawi
| | - Janet A. Carboo
- Centre of Excellence for Nutrition (CEN), Faculty of Health ScienceNorth‐West UniversityPotchefstroomSouth Africa
| | - Humphrey Chatenga
- Centre of Excellence for Nutrition (CEN), Faculty of Health ScienceNorth‐West UniversityPotchefstroomSouth Africa
- Department of Human Nutrition and Health, Faculty of Food and Human ScienceLilongwe University of Agriculture and Natural ResourcesLilongweMalawi
| | - Arista Nienaber
- Centre of Excellence for Nutrition (CEN), Faculty of Health ScienceNorth‐West UniversityPotchefstroomSouth Africa
| | - Cornelia Conradie
- Centre of Excellence for Nutrition (CEN), Faculty of Health ScienceNorth‐West UniversityPotchefstroomSouth Africa
| | - Martani Lombard
- Centre of Excellence for Nutrition (CEN), Faculty of Health ScienceNorth‐West UniversityPotchefstroomSouth Africa
| | - Robin Claire Dolman‐Macleod
- Centre of Excellence for Nutrition (CEN), Faculty of Health ScienceNorth‐West UniversityPotchefstroomSouth Africa
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Ayaz A, Zaman W, Radák Z, Gu Y. Green strength: The role of micronutrients in plant-based diets for athletic performance enhancement. Heliyon 2024; 10:e32803. [PMID: 38975163 PMCID: PMC11225853 DOI: 10.1016/j.heliyon.2024.e32803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/05/2024] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
This review examines the correlation between plant-based diets and athletic performance, with a specific emphasis on the vital aspect of optimizing micronutrients for athletes. In light of the increasing prevalence of plant-based nutrition among athletes due to its perceived advantages in terms of health, ethics, and the environment, this study investigates the ability of these diets to satisfy the demanding nutritional requirements essential for achieving optimal performance and facilitating recovery. The article emphasizes the significance of essential micronutrients such as iron, vitamin B12, calcium, vitamin D, zinc, and omega-3 fatty acids and also addressing the challenges with their absorption and bioavailability from plant sources. The review consolidates existing scientific knowledge to propose strategies for improving micronutrient consumption, comparing the effects of supplements against whole foods, and highlighting the significance of enhancing bioavailability. The proposal supports the implementation of personalized meal planning, with the assistance of sports nutritionists or dietitians, and is substantiated by case studies showcasing the success of plant-based athletes. Future research directions examine the long-term effects of plant-based diets on micronutrient status and athletic performance, as well as developing nutritional trends and technology. The review concludes that plant-based diets can meet athletes' nutritional demands and improve peak performance while aligning with personal and ethical values with strategic planning and professional guidance. This study intends to help athletes, coaches, and nutritionists understand plant-based nutrition for enhanced athletic performance.
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Affiliation(s)
- Asma Ayaz
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China
| | - Wajid Zaman
- Department of Life Sciences, Yeungnam University, Gyeongsan, 38541, Republic of Korea
| | - Zsolt Radák
- Research Institute of Sport Science, University of Physical Education, 1123, Budapest, Hungary
- Faculty of Sport Sciences, Waseda University, Tokorozawa, 359-1192, Japan
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China
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Adil N, Sibt-E-Hassan S, Siddiqui AJ, Jamil Z, Iqbal J, Ali SA, Musharraf SG. Toxic elements identified in breast milk of mothers residing in water contaminated region of Sindh and their impact on infants' growth patterns: A case-control study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 356:124368. [PMID: 38876378 DOI: 10.1016/j.envpol.2024.124368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 05/16/2024] [Accepted: 06/11/2024] [Indexed: 06/16/2024]
Abstract
Breast milk is a vital source of nutrition for breastfed infants, providing essential nutrients and elements but, in some cases, toxic ones. This is the first case-control study that investigated the elemental profile of breast milk samples collected from mothers residing in Matiari (Sindh), a region with insufficient industrial waste management, and its potential impact on infants' anthropometrics. Precisely, 62 milk samples, including 42 cases and 20 controls, were analyzed using the ICP-MS technique. Overall, six elements showed significance between the two groups, arsenic (As) was present at 0.68 μg/L in cases and absent in controls, while lead (Pb) exhibited elevated concentrations in the case group at 4.56 μg/L compared to 0.25 μg/L in controls, well-known for their toxicity. Barium (Ba) and manganese (Mn) levels were also higher in cases, associated with reported health effects on child well-being. Essential elements molybdenum (Mo) and selenium (Se) were higher in the controls. Furthermore, the association of these metals with the child growth standards as per WHO guidelines was calculated. Linear regression analysis revealed As negatively associated with WAZ and WHZ scores, while Mo was positively associated with WAZ, WHZ, and HAZ scores. These findings highlight serious health concerns in the region, where toxic elements pervade drinking water and food sources. Immediate actions are imperative to maintain the wellness of future generations.
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Affiliation(s)
- Nurmeen Adil
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Syed Sibt-E-Hassan
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Amna Jabbar Siddiqui
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Zehra Jamil
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan; Department of Community Health Science, Aga Khan University, Karachi, Pakistan
| | - Junaid Iqbal
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Syed Asad Ali
- Department of Community Health Science, Aga Khan University, Karachi, Pakistan
| | - Syed Ghulam Musharraf
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan; Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan.
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Ejara D, Ferede A, Shifa JE, Bekele F, Ahmed Hassen T. Compliance level and associated factors of iron folic acid supplementation among pregnant women in North Shoa Zone, Ethiopia. Sci Rep 2024; 14:13407. [PMID: 38862566 PMCID: PMC11166908 DOI: 10.1038/s41598-024-63111-x] [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: 03/28/2023] [Accepted: 05/24/2024] [Indexed: 06/13/2024] Open
Abstract
Iron deficiency is a widespread micronutrient deficiency, impacting over 30% of the global population. Iron Folic Acid supplement is recommended for pregnant women to counter iron deficiency anemia and neural tube anomalies. Although Iron Folic Acid supplementation is integral to Ethiopian antenatal care, one in four women in Ethiopia experiences anemia during pregnancy suggesting poor compliance. This study aimed to investigate compliance level and associated factors of Iron Folic Acid supplementation among pregnant women attending antenatal care in Wuchale Woreda of North Shoa Zone, Ethiopia. An institutional-based cross-sectional study was conducted among 302 pregnant women from March 20 to April 5, 2021, who were selected using a systematic random sampling technique. Data were collected through face-to-face interview, entered epi-data, and exported to Statistical Package for the Social Sciences for analysis. A multivariable logistic regression was used to identify factors associated with compliance level. All the results were presented with 95% confidence intervals. The compliance with Iron Folic Acid supplementation was 47.0%. Residing nearest to the health facility (AOR = 2.46; 95% CI 1.32, 4.57), initiating antenatal care at health center (AOR = 2.23; 95% CI 1.17, 4.51), having a family size of 4 and above (AOR = 4.99; 95% CI 2.43, 10.24), and receiving information from health extension workers (AOR = 5.52; 95% CI 1.30, 23.54) increased compliance with Iron Folic Acid supplementation. Less than half of the pregnant women were compliant with Iron Folic Acid utilization. There is a need to prioritize promoting the importance of Iron Folic Acid supplementation through health education particularly by targeting pregnant women with identified factors.
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Affiliation(s)
- Daba Ejara
- School of Nursing, Mada Walabu University, Shashamene Campus, Shashamene, Ethiopia.
| | - Amsal Ferede
- School of Nursing, Mada Walabu University, Shashamene Campus, Shashamene, Ethiopia
| | - Jemal Ebrahim Shifa
- School of Nursing, Mada Walabu University, Shashamene Campus, Shashamene, Ethiopia
| | - Fikadu Bekele
- Wuchale Woreda Health Office, North Shoa Zonal Health Department, Muke Turi, Ethiopia
| | - Tahir Ahmed Hassen
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
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Martins AC, Kraemer MVDS, Rodrigues VM, Hinnig PDF, Fernandes AC, Bernardo GL, Proença RPDC, Uggioni PL. Market-driven fortification of vitamins and minerals in packaged foods targeted at children in Brazil. NUTR BULL 2024; 49:209-219. [PMID: 38698740 DOI: 10.1111/nbu.12676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/20/2024] [Accepted: 04/08/2024] [Indexed: 05/05/2024]
Abstract
This study aimed to characterise the market-driven fortification of vitamins and minerals in packaged foods targeted at children in Brazil. We analysed 535 food labels using data collected in a census-type method (n = 5620) of food labels in a Brazilian supermarket in 2013. Micronutrients declared in nutrition claims and the ingredients list (synthetic compounds) were considered to be added for commercial purposes. Analysis of the ingredients list and nutrition claims showed that market-driven fortification of vitamins and minerals was present in 27.1% of foods. The main vitamins and minerals were vitamins A, B complex, C, D, calcium, iron and zinc. The food groups 'Milk and dairy products' and 'Sugars, sugary foods and snacks' had the highest frequencies of micronutrients declared in the ingredients list. Calcium, iron, phosphorus, zinc and all vitamins, except B7, were found to be added for commercial purposes. Micronutrients were found to be commonly added to packaged foods as a marketing strategy directed at parents and their children. Future studies should assess the amount of vitamins and minerals added to packaged foods targeted at children and whether intakes of vitamins and minerals in children are potentially excessive.
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Affiliation(s)
- Amanda Corrêa Martins
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Mariana Vieira Dos Santos Kraemer
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Vanessa Mello Rodrigues
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Patrícia de Fragas Hinnig
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Nutrition Department, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Ana Carolina Fernandes
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Nutrition Department, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Geyce Luci Bernardo
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Nutrition Department, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Rossana Pacheco da Costa Proença
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Paula Lazzarin Uggioni
- Nutrition Postgraduate Program, Nutrition and Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Nutrition Department, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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11
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Panzeri C, Pecoraro L, Dianin A, Sboarina A, Arnone OC, Piacentini G, Pietrobelli A. Potential Micronutrient Deficiencies in the First 1000 Days of Life: The Pediatrician on the Side of the Weakest. Curr Obes Rep 2024; 13:338-351. [PMID: 38512555 PMCID: PMC11150320 DOI: 10.1007/s13679-024-00554-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE OF REVIEW This study is to examine potential micronutrient deficiencies and any need for supplementation in children following specific diet plans in the first 1000 days of life. RECENT FINDINGS Optimal nutrition in the first 1000 days of life has a lifelong positive impact on child development. Specific intrauterine and perinatal factors, pathological conditions, and dietary restrictions can represent potential risk factors for micronutrient deficiencies in the first 1000 days of life, which can have negative systemic consequences. Preterm and low-birth-weight infants are intrinsically at risk because of immature body systems. Children affected by cystic fibrosis are prone to malnutrition because of intestinal malabsorption. The risk of micronutrient deficiency can increase in various situations, including but not limited to children following selective dietary regimens (vegetarian and vegan diets and children affected by specific neuropsychiatric conditions) or specific dietary therapies (children affected by food allergies or specific metabolic disorders and children following restricted diet as a part of therapeutic approach, i.e., ketogenic diet for epilepsy). In light of this situation, the micronutrient status in these categories of children should be investigated in order to tailor strategies specific to the individual's metabolic needs, with a particular focus on deficiencies which can impair or delay the physical and cognitive development of children, namely, vitamin B12, vitamin D and folic acid, as well as oligo-elements such as iron, zinc, calcium, sodium, magnesium, and phosphorus, and essential fatty acids such as omega-3. Identification of micronutrient deficiency in the first 1000 days of life and timely supplementation proves essential to prevent their long-term consequences.
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Affiliation(s)
- Carolà Panzeri
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, P.Le Stefani, 1 - 37126, Verona, Italy
| | - Luca Pecoraro
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, P.Le Stefani, 1 - 37126, Verona, Italy.
| | - Alice Dianin
- Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Pediatric Clinic, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Andrea Sboarina
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, P.Le Stefani, 1 - 37126, Verona, Italy
| | - Olivia C Arnone
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, P.Le Stefani, 1 - 37126, Verona, Italy
| | - Giorgio Piacentini
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, P.Le Stefani, 1 - 37126, Verona, Italy
| | - Angelo Pietrobelli
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, P.Le Stefani, 1 - 37126, Verona, Italy
- Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
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12
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Adams KP, Vosti SA, Somé JW, Tarini A, Becher E, Koudougou K, Engle-Stone R. Micronutrient-fortified bouillon as a strategy to improve the micronutrient adequacy of diets in Burkina Faso. Ann N Y Acad Sci 2024; 1536:135-150. [PMID: 38809659 DOI: 10.1111/nyas.15155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
Bouillon is a promising candidate for fortification to complement existing large-scale food fortification (LSFF) programs. We used household dietary data from Burkina Faso to model potential contributions of bouillon fortified with vitamin A (40-250 μg/g bouillon), folic acid (20-120 μg/g), vitamin B12 (0.2-2 μg/g), iron (0.6-5 mg/g), and zinc (0.6-5 mg/g) for meeting micronutrient requirements of women of reproductive age (15-49 years; WRA) and children (6-59 months). Most households (82%) reported bouillon consumption, with higher proportions of resource-constrained (84-88%) and rural households (88%) consuming bouillon. Accounting for the contributions of existing LSFF, household diets were inadequate to meet the micronutrient requirements of many WRA and children, exceeding 90% and 60% inadequacy for vitamins A and B12, respectively. Modeling results showed bouillon fortification could reduce inadequacy by up to ∼30 percentage points (pp) for vitamin A, ∼26 pp for folate among WRA (∼11 pp among children), ∼38 pp for vitamin B12, and 11-13 pp for zinc, with comparable reductions across socioeconomic strata and urban and rural residence. Predicted reductions in iron inadequacy were <3 pp. These results suggest dietary micronutrient inadequacies are a concern in Burkina Faso, and fortified bouillon can make substantial contributions to reducing micronutrient inadequacies, including among resource-constrained and rural populations.
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Affiliation(s)
- Katherine P Adams
- Institute for Global Nutrition, Department of Nutrition, University of California, Davis, Davis, California, USA
| | - Stephen A Vosti
- Institute for Global Nutrition, Department of Nutrition, University of California, Davis, Davis, California, USA
- Department of Agricultural and Resource Economics, University of California, Davis, Davis, California, USA
| | - Jérome W Somé
- Institut de Recherche en Sciences de la Santé, Centre National de Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso
| | | | - Emily Becher
- Institute for Global Nutrition, Department of Nutrition, University of California, Davis, Davis, California, USA
| | | | - Reina Engle-Stone
- Institute for Global Nutrition, Department of Nutrition, University of California, Davis, Davis, California, USA
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13
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Skowrońska M, Pawłowski M, Milewski R. Evaluating the Reliability of Health Portals' Nutrition and Supplementation Advice for Pregnant Women: A Comprehensive Review. Nutrients 2024; 16:1739. [PMID: 38892672 PMCID: PMC11175121 DOI: 10.3390/nu16111739] [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: 04/18/2024] [Revised: 05/27/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
This article evaluates the reliability and consistency of nutrition- and supplementation-related advice for pregnant women provided by ten selected health-related Internet portals. The portals were chosen based on their perceived reliability and prominence in Google searches, with representation from both English and Polish language sources. The evaluation criteria included the adherence of the presented information to official recommendations and its evidence-based character based on specific items representing dietary aspects important in pregnancy. While the overall reliability was deemed acceptable, significant variations existed both among the portals and specific evaluated items. Notably, HealthLine, Medline Plus, and NCEZ emerged as the most evidence-based, while WebMD and Medycyna Praktyczna were identified as less reliable. Despite a number of issues, the analysed portals remain valuable sources of nutritional information for pregnant women, offering user-friendly accessibility superior to alternatives such as social media on the one hand and scientific articles on the other. Improved consistency and attention to detail, especially in relation to vitamin intake and supplementation, would improve the overall quality of health portals.
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Affiliation(s)
| | - Michał Pawłowski
- Department of Biostatistics and Medical Informatics, Medical University of Białystok, 15-295 Białystok, Poland;
| | - Robert Milewski
- Department of Biostatistics and Medical Informatics, Medical University of Białystok, 15-295 Białystok, Poland;
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Kermansaravi M, Shahmiri SS, Kow L, Gawdat K, Abbas SI, Aly A, Bashir A, Bhandari M, Haddad A, ElFawal MH, Inam A, Kasama K, Kim SH, Kular KS, Lakdawala M, Layani LA, Lee WJ, Pazouki A, Prasad A, Safadi B, Wang C, Yang W, Adib R, Jazi AHD, Shabbir A. Technical Variations and Considerations around OAGB in IFSO-APC and IFSO-MENAC Chapters, an Expert Survey. Obes Surg 2024; 34:2054-2065. [PMID: 38662251 DOI: 10.1007/s11695-024-07239-9] [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: 03/06/2024] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE This study aimed to evaluate the technical variations of one-anastomosis gastric bypass (OAGB) among IFSO-APC and MENAC experts. BACKGROUND The multitude of technical variations and patient selection challenges among metabolic and bariatric surgeons worldwide necessitates a heightened awareness of these issues. Understanding different perspectives and viewpoints can empower surgeons performing OAGB to adapt their techniques, leading to improved outcomes and reduced complications. METHODS The scientific team of IFSO-APC, consisting of skilled bariatric and metabolic surgeons specializing in OAGB, conducted a confidential online survey. The survey aimed to assess technical variations and considerations related to OAGB within the IFSO-APC and IFSO-MENAC chapters. A total of 85 OAGB experts participated in the survey, providing their responses through a 35-question online format. The survey took place from January 1, 2024, to February 15, 2024. RESULTS Most experts do not perform OAGB for children and adolescents younger than 18 years. Most experts create the gastric pouch over a 36-40-F bougie and prefer to create a gastrojejunostomy, at the posterior wall of the gastric pouch. An anti-reflux suture during OAGB is performed in all patients by 51.8% of experts. Most experts set a common limb length of > 4 m in revisional and conversional OAGBs to prevent nutritional complications. CONCLUSION The ongoing debate among metabolic and bariatric surgeons regarding the technical variations and patient selection in OAGB remains a significant point of discussion. This survey demonstrated the variations in technical aspects and patient selection for OAGB among MBS surgeons in the IFSO-APC and IFSO-MENAC chapters. Standardizing the OAGB technique is crucial to ensure optimal safety and efficacy in this procedure.
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Affiliation(s)
- Mohammad Kermansaravi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Shahab Shahabi Shahmiri
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Lilian Kow
- Adelaide Bariatric Centre, Flinders University of South Australia, Adelaide, Australia
| | - Khaled Gawdat
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Ahmad Aly
- Austin and Repatriation Medical Centre, Heidelberg, Victoria, Australia
- University of Melbourne, Melbourne, Australia
| | - Ahmad Bashir
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC), Jordan Hospital, Amman, Jordan
| | | | - Ashraf Haddad
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC), Jordan Hospital, Amman, Jordan
| | | | - Atif Inam
- Metabolic, Thoracic & General Surgery Unit III, Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Kazunori Kasama
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Sang Hyun Kim
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | | | | | | | - Wei-Jei Lee
- Medical Weight Loss Center, China Medical University Hsinchu Hospital, Zhubei, Taiwan
| | - Abdolreza Pazouki
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Reza Adib
- The Wesley Hospital, Auchenflower, Queensland, Australia
| | - Amir Hossein Davarpanah Jazi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Asim Shabbir
- National University of Singapore, Singapore, Singapore
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15
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Kim JA, Lee JK, Lee SY. Serum trace elements during treatment in pancreatic cancer patients and their associations with cancer prognosis. Clin Nutr 2024; 43:1459-1472. [PMID: 38714150 DOI: 10.1016/j.clnu.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/27/2024] [Accepted: 04/09/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND & AIMS In this study, we assessed serum trace element concentrations in patients with pancreatic cancer and compared the results to those of healthy controls and patients with chronic pancreatitis. We evaluated the association between trace element concentrations during cancer treatment and the risk of cancer progression and mortality in pancreatic cancer patients. METHODS A retrospective cohort study was conducted at a tertiary center in Korea. Serum trace element concentrations of cobalt (Co), copper (Cu), selenium (Se), and zinc (Zn) were measured at diagnosis using an inductively coupled plasma-mass spectrometry in 124 patients with pancreatic cancer, 50 patients with chronic pancreatitis, and 120 healthy controls. Trace elements were measured after a median of 282.5 (95% confidence interval [CI], 224.0-326.5) days from treatment initiation to assess changes in trace element concentrations during treatment. RESULTS Serum Co concentrations were significantly higher in patients with chronic pancreatitis and pancreatic cancer compared to healthy controls, while serum Se concentrations were significantly lower. During treatment, serum concentrations of Cu, Se, and Zn significantly decreased in patients with pancreatic cancer. During the follow-up (median 152.5; 95% CI, 142.8-160.0 months), 85.5% of patients experienced progression or relapse, and 84.7% of patients died. Patients with decreased Se and Zn concentrations during treatment had a higher mortality (hazard ratio [HR], 2.10; 95% CI, 1.31-3.38; P = 0.0020 for Se; HR, 1.72; 95% CI, 1.06-2.79; P = 0.0269 for Zn) compared to those with unchanged or increased trace element concentrations during treatment. Patients with a greater reduction in Zn concentrations during treatment had a higher mortality than those with a smaller reduction (HR, 1.59; 95% CI, 1.01-2.52; P = 0.0483). Patients whose Zn status changed from normal to deficient during treatment had an increased mortality (HR, 1.76; 95% CI, 1.16-2.67, P = 0.0084). Patients with multiple (≥2) trace element deficiencies after treatment had poorer outcomes than those with no or single trace element deficiency. CONCLUSIONS This study revealed that decreases in Se and Zn concentrations during cancer treatment were associated with adverse outcomes in terms of cancer progression and mortality in patients with pancreatic cancer. Further prospective investigations are recommended.
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Affiliation(s)
- Jee Ah Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea; Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, South Korea
| | - Jong Kyun Lee
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea.
| | - Soo-Youn Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea.
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Tucci M, Martini D, Vinelli V, Biscotti P, Porrini M, Del Bo’ C, Riso P. The MED_EAT-IT approach: A modelling study to develop feasible, sustainable and nutritionally targeted dietary patterns based on the Planetary health diet. Curr Res Food Sci 2024; 8:100765. [PMID: 38779344 PMCID: PMC11109324 DOI: 10.1016/j.crfs.2024.100765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
In 2019, the EAT-Lancet Commission introduced the Planetary Health Diet (PHD), a guide for creating 2500 kcal/day country-specific sustainable diets that promote health while reducing the environmental impact associated with food systems. The PHD was previously adapted to the Italian food context, resulting in the EAT-IT dietary pattern. However, this adaptation revealed several challenges in terms of nutritional adequacy, feasibility, and environmental impact. This study reports on strategies to improve the previous pattern and align it more closely with the Mediterranean Diet, resulting in the MED_EAT-IT pattern. The study also explores feasible strategies for adapting this pattern to different energy targets, enhancing its scalability and promoting personalized approaches. For the optimization of this pattern, a specific calculation tool was developed to introduce variation to the pattern, considering realistic and feasible serving sizes and frequency of consumption. This tool integrates a defined food ontology, food composition data, and two environmental impact metrics (Carbon and Water Footprint). To optimize nutritional adequacy, several adaptations of the amount within the different food groups were made, for instance by increasing cereals and animal source by 25.5% kcal/day and 36.2% kcal/day respectively compared to EAT-IT. The resulting 2500 kcal/die pattern meets all nutritional requirements except for vitamin D and does not hamper the possibility to limit environmental impact (Carbon Footprint increased only by 12.2% but Water Footprint decreased by 6.3%). Lower energy targets were achieved by modulating amounts of the different food groups to ensure nutritional adequacy. The strategies and tools proposed here could aid in optimizing dietary plans, evaluating their potential for environmental impact reduction, and identifying issues that could hinder their adoption. Furthermore, the analyses carried out pave the way for the potential future development of new or improved foods that may contribute to the optimization of nutritional and environmental impact of diets.
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Affiliation(s)
- Massimiliano Tucci
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, via Celoria 2, 20133, Milano, Italy
| | - Daniela Martini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, via Celoria 2, 20133, Milano, Italy
| | - Valentina Vinelli
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, via Celoria 2, 20133, Milano, Italy
| | - Paola Biscotti
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, via Celoria 2, 20133, Milano, Italy
| | - Marisa Porrini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, via Celoria 2, 20133, Milano, Italy
| | - Cristian Del Bo’
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, via Celoria 2, 20133, Milano, Italy
| | - Patrizia Riso
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, via Celoria 2, 20133, Milano, Italy
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Jugha VT, Anchang JA, Sofeu-Feugaing DD, Taiwe GS, Kimbi HK, Anchang-Kimbi JK. Dietary micronutrients intake and its effect on haemoglobin levels of pregnant women for clinic visit in the Mount Cameroon health area: a cross-sectional study. Front Nutr 2024; 11:1341625. [PMID: 38774262 PMCID: PMC11106498 DOI: 10.3389/fnut.2024.1341625] [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: 11/20/2023] [Accepted: 04/10/2024] [Indexed: 05/24/2024] Open
Abstract
Background Nutritional deficiencies and its consequences such as anaemia are frequent among pregnant women residing in under resource settings. Hence, this study sought to investigate specific dietary micronutrient inadequacy and its effect on maternal haemoglobin levels. Methods This institution based cross-sectional survey enrolled 1,014 consenting pregnant women consecutively. Data on socio-demographic, economic and antenatal characteristics were recorded using a structured questionnaire. Minimum dietary diversity for women (MDD-W) was assessed using the 24-h recall method and haemoglobin (Hb) concentration (g/dL) determined using a portable Hb metre. Significant levels between associations was set at p < 0.05. Results Among those enrolled, 40.9% were anaemic while 89.6% had inadequate dietary nutrient intake. In addition, uptake of blood supplements, haem iron, plant and animal-based foods rich in vitamin A were 71.5, 86.2, 35.5 and 12.6%, respectively. Moreover, anaemia prevalence was significantly (p < 0.05) lower in women who took iron-folic acid along with food groups rich in haem iron (38.5%) or both plant and animal vitamin A (29.0%). Besides, mean maternal Hb levels was significantly (p < 0.001) higher in women who consumed haem iron (11.08 ± 1.35) and vitamin A food groups (11.34 ± 1.30) when compared with their counterparts who did not consume haem iron (10.54 ± 1.19) and vitamin A food groups (10.74 ± 1.31). Conclusion Dietary uptake of foods rich in haem-iron and vitamin A significantly improves Hb levels in Cameroonian pregnant women. Our findings underscore the importance of improving maternal nutritional awareness and counselling during antenatal period to reduce the anaemia burden.
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Affiliation(s)
- Vanessa Tita Jugha
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
| | - Juliana Adjem Anchang
- International Centre for Agricultural Research in the Dry Areas, ICARDA, Cairo, Egypt
| | | | | | - Helen Kuokuo Kimbi
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
- Department of Biomedical Sciences, University of Bamenda, Bamenda, Cameroon
- Department of Microbiology and Immunology, College of Medicine, Drexel University, Philadelphia, PA, United States
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Engle-Stone R, Wessells KR, Haskell MJ, Kumordzie SM, Arnold CD, Davis JN, Becher ER, Fuseini AD, Nyaaba KW, Tan X, Adams KP, Lietz G, Vosti SA, Adu-Afarwuah S. Effect of multiple micronutrient-fortified bouillon on micronutrient status among women and children in the Northern Region of Ghana: Protocol for the Condiment Micronutrient Innovation Trial (CoMIT), a community-based randomized controlled trial. PLoS One 2024; 19:e0302968. [PMID: 38709803 PMCID: PMC11073681 DOI: 10.1371/journal.pone.0302968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 04/08/2024] [Indexed: 05/08/2024] Open
Abstract
INTRODUCTION Micronutrient deficiencies are prevalent in West Africa, particularly among women of reproductive age (WRA) and young children. Bouillon is a promising food fortification vehicle due to its widespread consumption. This study aims to evaluate the impact of multiple micronutrient-fortified bouillon cubes, compared to control bouillon cubes (fortified with iodine only), on micronutrient status and hemoglobin concentrations among lactating and non-lactating WRA and young children in northern Ghana. METHODS This randomized, controlled doubly-masked trial will be conducted in the Kumbungu and Tolon districts in the Northern Region of Ghana, where prior data indicate multiple micronutrient deficiencies are common. Participants will be: 1) non-pregnant non-lactating WRA (15-49 y), 2) children 2-5 y, and 3) non-pregnant lactating women 4-18 months postpartum. Eligible participants will be randomly assigned to receive household rations of one of two types of bouillon cubes: 1) a multiple micronutrient-fortified bouillon cube containing vitamin A, folic acid, vitamin B12, iron, zinc, and iodine, or 2) a control cube containing iodine only. Each participant's household will receive a ration of bouillon cubes every 2 weeks, and households will be advised to prepare meals as usual, using the study-provided cubes. The trial duration will be 9 months for non-pregnant non-lactating WRA and children, and 3 months for lactating women. The primary outcomes will be changes in biomarkers of micronutrient status and hemoglobin among WRA and children and milk micronutrient concentrations among lactating women. Secondary outcomes will include change in prevalence of micronutrient deficiency and anemia; dietary intake of bouillon and micronutrients; inflammation, malaria, and morbidity symptoms; and child growth and development. DISCUSSION Evidence from this study will inform discussions about bouillon fortification in Ghana and West Africa. TRIAL REGISTRATION The trial was registered on ClinicalTrials.gov (NCT05178407) and the Pan-African Clinical Trial Registry (PACTR202206868437931). This manuscript reflects protocol version 4 (August 29, 2022).
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Affiliation(s)
- Reina Engle-Stone
- Department of Nutrition, University of California, Davis, California, United States of America
- Institute for Global Nutrition, University of California, Davis, California, United States of America
| | - K Ryan Wessells
- Department of Nutrition, University of California, Davis, California, United States of America
- Institute for Global Nutrition, University of California, Davis, California, United States of America
| | - Marjorie J. Haskell
- Department of Nutrition, University of California, Davis, California, United States of America
- Institute for Global Nutrition, University of California, Davis, California, United States of America
| | - Sika M. Kumordzie
- Institute for Global Nutrition, University of California, Davis, California, United States of America
| | - Charles D. Arnold
- Institute for Global Nutrition, University of California, Davis, California, United States of America
| | - Jennie N. Davis
- Institute for Global Nutrition, University of California, Davis, California, United States of America
| | - Emily R. Becher
- Institute for Global Nutrition, University of California, Davis, California, United States of America
| | - Ahmed D. Fuseini
- Department of Food Science and Nutrition, University of Ghana, Legon, Ghana
| | - Kania W. Nyaaba
- Department of Food Science and Nutrition, University of Ghana, Legon, Ghana
| | - Xiuping Tan
- Institute for Global Nutrition, University of California, Davis, California, United States of America
| | - Katherine P. Adams
- Department of Nutrition, University of California, Davis, California, United States of America
- Institute for Global Nutrition, University of California, Davis, California, United States of America
| | - Georg Lietz
- Institute of Cellular Medicine, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Stephen A. Vosti
- Institute for Global Nutrition, University of California, Davis, California, United States of America
- Department of Agricultural and Resource Economics, University of California, Davis, California, United States of America
| | - Seth Adu-Afarwuah
- Department of Food Science and Nutrition, University of Ghana, Legon, Ghana
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19
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Shi Z, Deng P, Zhou LA, Jin M, Fang F, Chen T, Liu G, Wen H, An Z, Liang H, Lu Y, Liu J, Liu Q. Wireless and battery-free wearable biosensing of riboflavin in sweat for precision nutrition. Biosens Bioelectron 2024; 251:116136. [PMID: 38377637 DOI: 10.1016/j.bios.2024.116136] [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: 12/27/2023] [Revised: 02/03/2024] [Accepted: 02/16/2024] [Indexed: 02/22/2024]
Abstract
Nutrition assessment is crucial for dietary guidance and prevention of malnutrition. Recent endeavors in wearable biochemical sensors have enabled real-time, in situ analysis of nutrients in sweat. However, the monitoring of riboflavin, an indispensable vitamin B involved in energy metabolism, remains challenging due to its trace level and variations in the sweat matrix. Herein, we report a wireless, battery-free, and flexible wearable biosensing system for the in situ monitoring of sweat riboflavin. Highly sensitive and selective electrochemical voltammetric detection is realized based on the synergistic effect of electrodeposited reduced graphene oxide (rGO) and platinum nanoparticles (PtNPs) with a low detection limit of 1.2 nM. The fully integrated system is capable of sweat sampling with the microfluidic patch, real-time riboflavin analysis and pH calibration with the flexible electrode array, as well as wirelessly simultaneous near field communication (NFC) energy harvesting and data transmission with the flexible circuit and a smartphone. On-body human sweat analysis demonstrates high accuracy cross-validated with gold-standard measurements, and reveals a strong correlation between sweat and urine riboflavin levels. The proposed wearable platform opens up attractive possibilities for noninvasive nutrient tracking, providing strong potential for personalized dietary guidance towards precision nutrition.
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Affiliation(s)
- Zhenghan Shi
- Biosensor National Special Laboratory, Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, 310027, PR China; Taizhou Key Laboratory of Medical Devices and Advanced Materials, Research Institute of Zhejiang University, Taizhou, 318000, PR China
| | - Peixue Deng
- Life Sciences Institute, Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Medical University, Nanning, Guangxi, 530021, PR China
| | - Li-Ang Zhou
- Biosensor National Special Laboratory, Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, 310027, PR China
| | - Meng Jin
- Biosensor National Special Laboratory, Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, 310027, PR China
| | - Feiyue Fang
- Biosensor National Special Laboratory, Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, 310027, PR China
| | - Tao Chen
- Biosensor National Special Laboratory, Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, 310027, PR China
| | - Guang Liu
- Biosensor National Special Laboratory, Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, 310027, PR China
| | - Hao Wen
- Biosensor National Special Laboratory, Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, 310027, PR China
| | - Zijian An
- Biosensor National Special Laboratory, Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, 310027, PR China
| | - Hao Liang
- Life Sciences Institute, Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Medical University, Nanning, Guangxi, 530021, PR China
| | - Yanli Lu
- Biosensor National Special Laboratory, Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, 310027, PR China
| | - Jun Liu
- Biosensor National Special Laboratory, Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, 310027, PR China; Taizhou Key Laboratory of Medical Devices and Advanced Materials, Research Institute of Zhejiang University, Taizhou, 318000, PR China
| | - Qingjun Liu
- Biosensor National Special Laboratory, Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, 310027, PR China; Taizhou Key Laboratory of Medical Devices and Advanced Materials, Research Institute of Zhejiang University, Taizhou, 318000, PR China.
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20
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Mouchati C, Durieux JC, Zisis SN, Tribout H, Scott S, Smith B, Labbato D, McComsey GA. Zinc Deficiency And sTNF-RII Are Associated With Worse COVID-19 Outcomes. J Nutr 2024; 154:1588-1595. [PMID: 38043624 DOI: 10.1016/j.tjnut.2023.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/07/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Zinc (Zn) is known for its substantial involvement in the immune response as an antioxidant and anti-inflammatory agent. Zn plasma levels' clinical significance in coronavirus disease (COVID) diagnosis is not yet fully established. OBJECTIVE We assessed the association between Zn deficiency, gut integrity, inflammation, and COVID-19 outcomes. METHODS A prospective observational cohort in which plasma Zn, soluble tumor necrosis factor alpha receptor II (sTNF-RII) intestinal fatty-acid binding protein (IFABP; marker of intestinal integrity), and zonulin levels (intestinal permeability) were collected from participants during the acute phase of a confirmed COVID-19 diagnosis. Zn was modeled as continuous and binary, categorized as Zn deficiency (Zn < 75 μg/dL) and Zn sufficiency (Zn ≥ 75 μg/dL). COVID-19 outcomes were classified according to the World Health Organization clinical progression scale. We used cumulative probit regression to assess if suboptimal Zn levels, gut, and inflammatory markers increase the likelihood of worse COVID-19 outcomes. RESULTS Zn deficiency was independently associated with 63% higher predicted odds of worse COVID outcomes. Increases in sTNF-RII {unadjusted odds ratio (uOR): 3.43 [95% confidence interval (CI): 2.02, 5.82]} and zonulin [uOR: 1.83 (95% CI: 1.21, 2.76)] levels were associated with greater odds of worse COVID outcomes. IFABP was not associated with worse COVID outcomes [uOR: 1.12 (95% CI: 0.82, 1.53)] or acute Zn deficiency [uOR: 1.35 (95% CI: 0.79, 2.35)]. The adjusted predicted odds of worse COVID outcomes are 3-fold higher (P = 0.04) for every one-unit decrease in Zn and is more than 2 times greater odds of COVID severity (P = 0.01) for every 1-unit increase in sTNF-RII. CONCLUSION Zn deficiency and inflammation were independently associated with greater odds of worse COVID outcomes.
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Affiliation(s)
- Christian Mouchati
- School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Jared C Durieux
- Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Sokratis N Zisis
- School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Heather Tribout
- Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Sarah Scott
- Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Beth Smith
- Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Danielle Labbato
- Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Grace A McComsey
- School of Medicine, Case Western Reserve University, Cleveland, OH, United States; Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.
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21
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de Jong MF, Nemeth E, Rawee P, Bramham K, Eisenga MF. Anemia in Pregnancy With CKD. Kidney Int Rep 2024; 9:1183-1197. [PMID: 38707831 PMCID: PMC11069017 DOI: 10.1016/j.ekir.2024.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 12/05/2023] [Accepted: 01/08/2024] [Indexed: 05/07/2024] Open
Abstract
Chronic kidney disease (CKD), anemia, and iron deficiency are global health issues affecting individuals in both high-income and low-income countries. In pregnancy, both CKD and iron deficiency anemia increase the risk of adverse maternal and neonatal outcomes, including increased maternal morbidity and mortality, stillbirth, perinatal death, preterm birth, and low birthweight. However, it is unknown to which extent iron deficiency anemia contributes to adverse outcomes in CKD pregnancy. Furthermore, little is known regarding the prevalence, pathophysiology, and treatment of iron deficiency and anemia in pregnant women with CKD. Therefore, there are many unanswered questions regarding optimal management with oral or i.v. iron and recombinant human erythropoietin (rhEPO) in these women. In this review, we present a short overview of the (patho)physiology of anemia in healthy pregnancy and in people living with CKD. We present an evaluation of the literature on iron deficiency, anemia, and nutritional deficits in pregnant women with CKD; and we evaluate current knowledge gaps. Finally, we propose research priorities regarding anemia in pregnant women with CKD.
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Affiliation(s)
- Margriet F.C. de Jong
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, The Netherlands
| | - Elizabeta Nemeth
- Department of Medicine, University of California, Los Angeles, California, USA
| | - Pien Rawee
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, The Netherlands
| | - Kate Bramham
- Department of Women and Children’s Health, King’s College London, London, UK
| | - Michele F. Eisenga
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, The Netherlands
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22
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Chai X, Chen X, Yan T, Zhao Q, Hu B, Jiang Z, Guo W, Zhang Y. Intestinal Barrier Impairment Induced by Gut Microbiome and Its Metabolites in School-Age Children with Zinc Deficiency. Nutrients 2024; 16:1289. [PMID: 38732540 PMCID: PMC11085614 DOI: 10.3390/nu16091289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/14/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Zinc deficiency affects the physical and intellectual development of school-age children, while studies on the effects on intestinal microbes and metabolites in school-age children have not been reported. School-age children were enrolled to conduct anthropometric measurements and serum zinc and serum inflammatory factors detection, and children were divided into a zinc deficiency group (ZD) and control group (CK) based on the results of serum zinc. Stool samples were collected to conduct metagenome, metabolome, and diversity analysis, and species composition analysis, functional annotation, and correlation analysis were conducted to further explore the function and composition of the gut flora and metabolites of children with zinc deficiency. Beta-diversity analysis revealed a significantly different gut microbial community composition between ZD and CK groups. For instance, the relative abundances of Phocaeicola vulgatus, Alistipes putredinis, Bacteroides uniformis, Phocaeicola sp000434735, and Coprococcus eutactus were more enriched in the ZD group, while probiotic bacteria Bifidobacterium kashiwanohense showed the reverse trend. The functional profile of intestinal flora was also under the influence of zinc deficiency, as reflected by higher levels of various glycoside hydrolases in the ZD group. In addition, saccharin, the pro-inflammatory metabolites, and taurocholic acid, the potential factor inducing intestinal leakage, were higher in the ZD group. In conclusion, zinc deficiency may disturb the gut microbiome community and metabolic function profile of school-age children, potentially affecting human health.
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Affiliation(s)
- Xiaoqi Chai
- School of Public Health, Lanzhou University, Lanzhou 730000, China; (X.C.); (X.C.); (T.Y.); (Q.Z.); (B.H.); (Z.J.)
| | - Xiaohui Chen
- School of Public Health, Lanzhou University, Lanzhou 730000, China; (X.C.); (X.C.); (T.Y.); (Q.Z.); (B.H.); (Z.J.)
| | - Tenglong Yan
- School of Public Health, Lanzhou University, Lanzhou 730000, China; (X.C.); (X.C.); (T.Y.); (Q.Z.); (B.H.); (Z.J.)
| | - Qian Zhao
- School of Public Health, Lanzhou University, Lanzhou 730000, China; (X.C.); (X.C.); (T.Y.); (Q.Z.); (B.H.); (Z.J.)
| | - Binshuo Hu
- School of Public Health, Lanzhou University, Lanzhou 730000, China; (X.C.); (X.C.); (T.Y.); (Q.Z.); (B.H.); (Z.J.)
| | - Zhongquan Jiang
- School of Public Health, Lanzhou University, Lanzhou 730000, China; (X.C.); (X.C.); (T.Y.); (Q.Z.); (B.H.); (Z.J.)
| | - Wei Guo
- Key Laboratory of Animal Genetics, Breeding and Reproduction in the Plateau Mountainous Region, Ministry of Education, Guizhou University, Guiyang 550000, China
| | - Ying Zhang
- School of Public Health, Lanzhou University, Lanzhou 730000, China; (X.C.); (X.C.); (T.Y.); (Q.Z.); (B.H.); (Z.J.)
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23
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Oumer A. Khat consumption and undernutrition among adult population in Ethiopia: A systematic review and meta-analysis. PLoS One 2024; 19:e0299538. [PMID: 38652725 PMCID: PMC11037525 DOI: 10.1371/journal.pone.0299538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/12/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND In Ethiopia, malnutrition is a public health threat causing a significant burden of morbidity, mortality, and economic crisis. Simultaneously, khat consumption is alarmingly increasing among adults, yet it might contribute to the existing burden of malnutrition, where the current evidence is inconclusive. Hence, this review was to estimate the association between khat consumption and undernutrition among adults in Ethiopia. METHODS A comprehensive search for Google, Google Scholar, and PubMed, coupled with a thorough manual search of the literature, was done up to date, October 18, 2023, using relevant search terms: "impact," "effects," "khat chewing," "khat consumption," "Ethiopia," "nutritional status," and "undernutrition." An updated PRISMA guideline was used to select relevant literature. The extracted data was summarized in narrative summaries, descriptions, and meta-analyses. The risk of bias was assessed. The results are presented in forest plots and funnel plots to assess publication bias. A pooled effect size (odds ratio) with a 95% certainty level was reported. RESULTS While a total of 17 articles (n = 45,679) were included in the narrative review, only 15 articles were included in the quantitative meta-analysis. The majority of studies had a low and moderate risk of bias (based on risk of bias assessment tool), mainly due to unclear exposure assessment and high study heterogeneity. A total of 11 studies were cross-sectional studies (71%), three were comparative studies (17.4%), and three were case control studies (17.4%). There is a higher risk of publication bias as evidenced by the funnel plot. Overall, five studies were from the Oromia region, and three studies were conducted at the national level. Overall, chewing had been shown to significantly increase the risk of undernutrition by 53% (pooled OR = 1.53; 95% CI: 1.09-2.16) under a random effect model. Under the fixed effect model, higher weight was given to national-level studies with higher samples, where chewing contributed to a 12% increased risk of undernutrition (AOR = 1.12; 95% CI: 1.01-2.23). Hence, khat chewing could raise the odds of undernutrition by 12-53%. CONCLUSION There is evidence of an association between khat chewing and an increased risk of undernutrition among adults in Ethiopia, which highlights the need for public health interventions to address the potential adverse effects of khat chewing on nutritional status.
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Affiliation(s)
- Abdu Oumer
- School of Public Health, College of Medicine and Health Sciences, Haramaya University, Harar, Ethiopia
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24
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Mao C, Shen Z, Long D, Liu M, Xu X, Gao X, Lin Y, Wang X. Epidemiological study of pediatric nutritional deficiencies: an analysis from the global burden of disease study 2019. Nutr J 2024; 23:44. [PMID: 38637763 PMCID: PMC11027389 DOI: 10.1186/s12937-024-00945-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 04/01/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Nutritional deficiencies (ND) continue to threaten the lives of millions of people around the world, with children being the worst hit. Nevertheless, no systematic study of the epidemiological features of child ND has been conducted so far. Therefore, we aimed to comprehensively assess the burden of pediatric ND. METHODS We analyzed data on pediatric ND between 1990 and 2019 from the Global Burden of Disease study (GBD) 2019 at the global, regional, and national levels. In addition, joinpoint regression models were used to assess temporal trends. RESULTS In 2019, the number of prevalent cases of childhood malnutrition increased to 435,071,628 globally. The global age-standardized incidence, prevalence, and DALY rates showed an increasing trend between 1990 and 2019. Meanwhile, the burden of child malnutrition was negatively correlated with sociodemographic index (SDI). Asia and Africa still carried the heaviest burden. The burden and trends of child malnutrition varied considerably across countries and regions. At the age level, we found that malnutrition was significantly more prevalent among children < 5 years of age. CONCLUSION Pediatric ND remains a major public health challenge, especially in areas with low SDI. Therefore, primary healthcare services in developing countries should be improved, and effective measures, such as enhanced pre-school education, strengthened nutritional support, and early and aggressive treatment, need to be developed.
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Affiliation(s)
- Chenhan Mao
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Zhuyang Shen
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Dan Long
- The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Min Liu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Xiaojin Xu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Xin Gao
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Yan Lin
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China.
| | - Xindong Wang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China.
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25
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Motadi SA, Mbhenyane XG, Zuma MK, Freeland Graves JH. Effects of Cucurbita Moschata squash (Butternut) seed paste in improving zinc and iron status in children attending Early Childhood Development centres in Limpopo province, South Africa. PLoS One 2024; 19:e0300845. [PMID: 38635826 PMCID: PMC11025940 DOI: 10.1371/journal.pone.0300845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 03/04/2024] [Indexed: 04/20/2024] Open
Abstract
Cucurbita moschata (Butternut squash) seeds are a rich source of nutrition containing nutrients including iron, zinc, copper, calcium, potassium, and phosphorus. The aim of this study was to determine if Cucurbita Moschata squash seed paste improves zinc and iron status, anthropometric status, and dietary intake in preschool children. A pretest-posttest control group trial using cluster randomisation was conducted over 6 months. Four preschools were randomly assigned to receive 100 g of intervention or 100 g of a placebo as the control to enhance iron and zinc status. A total of 276 preschool children were recruited from eight government registered Early Childhood Development centres in Limpopo province, South Africa. The control group consumed Cucurbita moschata flesh twice-weekly, while the intervention group consumed Cucurbita moschata seed paste twice-weekly during a six-month period. Iron (serum iron, transferrin, transferrin saturation, ferritin) and zinc (serum zinc) status and anthropometric indices such as weight, height and mid upper arm circumference for children were evaluated at baseline and the endpoint. Iron and zinc-rich food consumption was measured using a 24-hour dietary recall and food record during the study, and dietary intake was estimated using a food frequency questionnaire which was conducted at the beginning and endpoint. The intervention group significantly improved in the mean serum iron 0.23 μg/dL (95% CI: 0.11;0.33); ferritin 0.21μg/dL (95% CI: 0.13;0.39), transferrin saturation 0.33% (0.23;0.74) and zinc 0.16 μmol/dl (95% CI: 0.13;0.25) at the end of the study. In addition, the intervention group exhibited greater mean weight for age of 0.13 z-score (95% CI: 0.28; 0.34) and weight for height of 0.04 z-score (95% CI: 0.12,0.05), as well as the consumption of iron (p < 0,001), zinc (p < 0,001), and vitamin C (p < 0.001). At the end of the trial, fiber (p < 0.001), riboflavin (p = 0.001), vitamin B6 (p < 0.001), and vitamin B12 (p < 0.001) were significantly higher in the control group. Thus, the inclusion of intervention in the diet of children in an impoverished area of South Africa improved the iron and zinc status of these children. This supplement could be a cost effective and sustainable approach to improve nutrient status in rural South Africa. Trial registration: Pan African Clinical Trial Registry (PACTR202308740458863).
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Affiliation(s)
- Selekane Ananias Motadi
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Nutrition, Faculty of Health Sciences, University of Venda, Thohoyandou, South Africa
| | - Xikombiso Gertrude Mbhenyane
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Mthokozisi Kwazi Zuma
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Smallholder Agricultural Development, Agricultural Research Council, Pretoria, South Africa
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26
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Zhang A, Yin Y, Tian J, Wang X, Yue Z, Pei L, Liu L, Qin L, Jia M, Wang H, Ma Q, Gao WB, Cao LL. The close association of micronutrients with COVID-19. Heliyon 2024; 10:e28629. [PMID: 38590883 PMCID: PMC11000022 DOI: 10.1016/j.heliyon.2024.e28629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/12/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024] Open
Abstract
Objectives The present study was conducted to explore the performance of micronutrients in the prediction and prevention of coronavirus disease 2019 (COVID-19). Methods This is an observational case-control study. 149 normal controls (NCs) and 214 COVID-19 patients were included in this study. Fat-soluble and water-soluble vitamins were determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis, and inorganic elements were detected by inductively coupled plasma-mass spectrometry (ICP-MS) analysis. A logistic regression model based on six micronutrients were constructed using DxAI platform. Results Many micronutrients were dysregulated in COVID-19 compared to normal control (NC). 25-Hydroxyvitamin D3 [25(OH)D3], magnesium (Mg), copper (Cu), calcium (Ca) and vitamin B6 (pyridoxic acid, PA) were significantly independent risk factors for COVID-19. The logistic regression model consisted of 25(OH)D3, Mg, Cu, Ca, vitamin B5 (VB5) and PA was developed, and displayed a strong discriminative capability to differentiate COVID-19 patients from NC individuals [area under the receiver operating characteristic curve (AUROC) = 0.901]. In addition, the model had great predictive ability in discriminating mild/normal COVID-19 patients from NC individuals (AUROC = 0.883). Conclusions Our study showed that micronutrients were associated with COVID-19, and our logistic regression model based on six micronutrients has potential in clinical management of COVID-19, and will be useful for prediction of COVID-19 and screening of high-risk population.
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Affiliation(s)
- Aimin Zhang
- Department of Clinical Laboratory, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, China
| | - Yue Yin
- Department of Clinical Laboratory, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, China
| | - Jiashu Tian
- Department of Clinical Laboratory, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, China
| | - Xialin Wang
- Beckman Coulter Commercial Enterprise Co. Ltd., No.518 Fuquan North Road, Shanghai, China
| | - Zhihong Yue
- Department of Clinical Laboratory, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, China
| | - Lin Pei
- Department of Clinical Laboratory, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, China
| | - Li Liu
- Department of Clinical Laboratory, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, China
- Department of Clinical Laboratory, Beihua University Affiliated Hospital, No. 12 Jiefang Middle Road, Jilin, China
| | - Li Qin
- Department of Clinical Laboratory, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, China
| | - Mei Jia
- Department of Clinical Laboratory, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, China
| | - Hui Wang
- Department of Clinical Laboratory, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, China
| | - Qingwei Ma
- Bioyong Technologies Inc., Dewei Science Park, No.12 Kechuang 13th Street, Beijing, China
| | - Wei-bo Gao
- Department of Clinical Laboratory, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, China
| | - Lin-Lin Cao
- Department of Clinical Laboratory, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, China
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27
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Monir ZM, El-Din EMS, Kandeel WA, Sallam SF, Elsheikh E, Abushady MM, Allah FH, Tawfik S, Zeid DA. Evaluation of apparently healthy Egyptian infants and toddlers on the bayley-III scales according to age and sex. Ital J Pediatr 2024; 50:68. [PMID: 38616286 PMCID: PMC11017649 DOI: 10.1186/s13052-024-01635-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 03/23/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Child development is shaped throughout the first years of life through the interaction of genetics and the environment. Bayley-III is valuably used to determine early developmental delay (DD). The aim of this study was to detect the differences in performance of a sample of apparently healthy Egyptian infants and toddlers on the Bayley-III scales in relation to their age and gender. METHODS This was a cross-sectional study. Bayley scales were applied to 270 of the 300 recruited children following the inclusion criteria; to avoid potential risk factors affecting development. Assessment included cognitive, language and motor skills. Engaged children aged 18-42 months were divided into 4 age groups with six-month intervals. RESULTS Approximately 78.4%, 76.2%, and 72% of the participants had average and above average scores in the cognitive, motor, and language domains, respectively. The language domain was characteristically impacted. The oldest age group (36-42 months) scored the highest means composite scores, while the 2nd group aged 24 - <30 months, scored the lowest means in the three evaluated domains. In general, girls had non-significantly higher composite scores than boys, with a small effect size (d = 0.2-0.4). In the language domain, girls aged 30 to < 36 months scored significantly higher composite scores than boys (p < 0.05), with a medium effect size (d = 0.73). CONCLUSION The study indicates that the performance of apparently healthy Egyptian children on the Bayley III evaluation differs in relation to age and sex. The most vulnerable age group at potential risk of DD was children aged 24-30 months. Efforts must be directed to investigate the nutritional, physical, psychological and safety needs of this group. Attention must be paid to early childhood intervention programs that stimulate development, especially language development, and they must be tailored on the basis of age and gender. Gender-specific norms may be needed in the evaluation of language development.
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Affiliation(s)
- Zeinab M Monir
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Ebtissam M Salah El-Din
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Wafaa A Kandeel
- Biological Anthropology Department/Medical Research and Clinical Studies Institute, National Research Centre, 60014618, Cairo, Dokki, Egypt
| | - Sara F Sallam
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Eman Elsheikh
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Mones M Abushady
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Fawzia Hasseb Allah
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Sawsan Tawfik
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Dina Abu Zeid
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt.
- Child Health Department Medical Research and Clinical Studies Institute, National Research Centre, P.O.12622, Cairo, Egypt.
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Tan X, Tan PY, Gong YY, Moore JB. Overnutrition is a risk factor for iron, but not for zinc or vitamin A deficiency in children and young people: a systematic review and meta-analysis. BMJ Glob Health 2024; 9:e015135. [PMID: 38599666 PMCID: PMC11015307 DOI: 10.1136/bmjgh-2024-015135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/14/2024] [Indexed: 04/12/2024] Open
Abstract
INTRODUCTION Traditionally associated with undernutrition, increasing evidence suggests micronutrient deficiencies can coexist with overnutrition. Therefore, this work aimed to systematically review the associations between iron, zinc and vitamin A (VA) status and weight status (both underweight and overweight) in children and young people. METHODS Ovid Medline, Ovid Embase, Scopus and Cochrane databases were systematically searched for observational studies assessing micronutrient status (blood, serum or plasma levels of iron, zinc or VA biomarkers) and weight status (body mass index or other anthropometric measurement) in humans under 25 years of any ethnicity and gender. Risk of bias assessment was conducted using the American Dietetic Association Quality Criteria Checklist. Where possible, random effects restricted maximum likelihood meta-analyses were performed. RESULTS After screening, 83 observational studies involving 190 443 participants from 44 countries were identified, with many studies having reported on more than one micronutrient and/or weight status indicator. Iron was the most investigated micronutrient, with 46, 28 and 27 studies reporting data for iron, zinc and VA status, respectively. Synthesising 16 records of OR from seven eligible studies, overnutrition (overweight and obesity) increased odds of iron deficiency (ID) (OR (95% CI): 1.51 (1.20 to 1.82), p<0.0001, I2=40.7%). Odds appeared to be higher for children living with obesity (1.88 (1.33 to 2.43), p<0.0001, I2=20.6%) in comparison to those with overweight (1.31 (0.98 to 1.64), p<0.0001, I2=40.5%), although between group differences were not significant (p=0.08). CONCLUSIONS Overnutrition is associated with increased risk of ID, but not zinc or VA deficiencies, with an inverted U-shaped relationship observed between iron status and bodyweight. Our results highlight significant heterogeneity in the reporting of micronutrient biomarkers and how deficiencies were defined. Inflammation status was rarely adequately accounted for, and the burden of ID may well be under-recognised, particularly in children and young people living with overnutrition. PROSPERO REGISTRATION NUMBER CRD42020221523.
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Affiliation(s)
- Xiaomian Tan
- School of Food Science and Nutrition, University of Leeds, Leeds, West Yorkshire, UK
| | - Pui Yee Tan
- School of Food Science and Nutrition, University of Leeds, Leeds, West Yorkshire, UK
| | - Yun Yun Gong
- School of Food Science and Nutrition, University of Leeds, Leeds, West Yorkshire, UK
| | - J Bernadette Moore
- School of Food Science and Nutrition, University of Leeds, Leeds, West Yorkshire, UK
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Cao R, Su Y, Li J, Ao R, Xu X, Liang Y, Liu Z, Yu Q, Xie J. Exploring research hotspots and future directions in neural tube defects field by bibliometric and bioinformatics analysis. Front Neurosci 2024; 18:1293400. [PMID: 38650623 PMCID: PMC11033379 DOI: 10.3389/fnins.2024.1293400] [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: 09/13/2023] [Accepted: 03/11/2024] [Indexed: 04/25/2024] Open
Abstract
Background Neural tube defects (NTDs) is the most common birth defect of the central nervous system (CNS) which causes the death of almost 88,000 people every year around the world. Much efforts have been made to investigate the reasons that contribute to NTD and explore new ways to for prevention. We trawl the past decade (2013-2022) published records in order to get a worldwide view about NTDs research field. Methods 7,437 records about NTDs were retrieved from the Web of Science (WOS) database. Tools such as shell scripts, VOSviewer, SCImago Graphica, CiteSpace and PubTator were used for data analysis and visualization. Results Over the past decade, the number of publications has maintained an upward trend, except for 2022. The United States is the country with the highest number of publications and also with the closest collaboration with other countries. Baylor College of Medicine has the closest collaboration with other institutions worldwide and also was the most prolific institution. In the field of NTDs, research focuses on molecular mechanisms such as genes and signaling pathways related to folate metabolism, neurogenic diseases caused by neural tube closure disorders such as myelomeningocele and spina bifida, and prevention and treatment such as folate supplementation and surgical procedures. Most NTDs related genes are related to development, cell projection parts, and molecular binding. These genes are mainly concentrated in cancer, Wnt, MAPK, PI3K-Akt and other signaling pathways. The distribution of NTDs related SNPs on chromosomes 1, 3, 5, 11, 14, and 17 are relatively concentrated, which may be associated with high-risk of NTDs. Conclusion Bibliometric analysis of the literature on NTDs field provided the current status, hotspots and future directions to some extant. Further bioinformatics analysis expanded our understanding of NTDs-related genes function and revealed some important SNP clusters and loci. This study provided some guidance for further studies. More extensive cooperation and further research are needed to overcome the ongoing challenge in pathogenesis, prevention and treatment of NTDs.
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Affiliation(s)
- Rui Cao
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Key Laboratory of Coal Environmental Pathogenicity and Prevention of Ministry of Education, Shanxi Medical University, Taiyuan, China
- Translational Medicine Research Centre, Shanxi Medical University, Taiyuan, China
| | - Yanbing Su
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Jianting Li
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Key Laboratory of Coal Environmental Pathogenicity and Prevention of Ministry of Education, Shanxi Medical University, Taiyuan, China
| | - Ruifang Ao
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Key Laboratory of Coal Environmental Pathogenicity and Prevention of Ministry of Education, Shanxi Medical University, Taiyuan, China
| | - Xiangchao Xu
- Sci-Tech Information and Strategic Research Center of Shanxi Province, Taiyuan, China
| | - Yuxiang Liang
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Key Laboratory of Coal Environmental Pathogenicity and Prevention of Ministry of Education, Shanxi Medical University, Taiyuan, China
| | - Zhizhen Liu
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Key Laboratory of Coal Environmental Pathogenicity and Prevention of Ministry of Education, Shanxi Medical University, Taiyuan, China
| | - Qi Yu
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Key Laboratory of Coal Environmental Pathogenicity and Prevention of Ministry of Education, Shanxi Medical University, Taiyuan, China
| | - Jun Xie
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Key Laboratory of Coal Environmental Pathogenicity and Prevention of Ministry of Education, Shanxi Medical University, Taiyuan, China
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Bechensteen BT, Sithiravel C, Strøm-Roum EM, Ruud HK, Kravdal G, Winther JA, Valderhaug TG. Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study. BMC Pregnancy Childbirth 2024; 24:229. [PMID: 38566061 PMCID: PMC10985986 DOI: 10.1186/s12884-024-06407-0] [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: 10/19/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Maternal obesity is associated with adverse outcome for pregnancy and childbirths. While bariatric surgery may improve fertility and reduce the risk of certain pregnancy-related complications such as hypertension and gestational diabetes mellitus, there is a lack of evidence on the optimal nutritional monitoring and supplementation strategies in pregnancy following bariatric surgery. We aimed to assess the impact of bariatric surgery on micronutrients in post-bariatric pregnancy and possible differences between gastric bypass surgery and sleeve gastrectomy. METHODS In this prospective case control study, we recruited 204 pregnant women (bariatric surgery n = 59 [gastric bypass surgery n = 26, sleeve gastrectomy n = 31, missing n = 2] and controls n = 145) from Akershus university hospital in Norway. Women with previous bariatric surgery were consecutively invited to study participation at referral to the clinic for morbid obesity and the controls were recruited from the routine ultrasound screening in gestational week 17-20. A clinical questionnaire was completed and blood samples were drawn at mean gestational week 20.4 (SD 4.5). RESULTS The women with bariatric surgery had a higher pre-pregnant BMI than controls (30.8 [SD 6.0] vs. 25.2 [5.4] kg/m2, p < 0.001). There were no differences between groups regarding maternal weight gain (bariatric surgery 13.3 kg (9.6) vs. control 14.8 kg (6.5), p = 0.228) or development of gestational diabetes (n = 3 [5%] vs. n = 7 [5%], p = 1.000). Mean levels of vitamin K1 was lower after bariatric surgery compared with controls (0.29 [0.35] vs. 0.61 [0.65] ng/mL, p < 0.001). Multiadjusted regression analyses revealed an inverse relationship between bariatric surgery and vitamin K1 (B -0.26 ng/mL [95% CI -0.51, -0.04], p = 0.047) with a fivefold increased risk of vitamin K1 deficiency in post-bariatric pregnancies compared with controls (OR 5.69 [1.05, 30.77] p = 0.044). Compared with sleeve gastrectomy, having a previous gastric bypass surgery was associated with higher risk of vitamin K1 deficiency (OR 17.1 [1.31, 223.3], p = 0.030). CONCLUSION Post-bariatric pregnancy is negatively associated with vitamin K1 with a higher risk of vitamin K1 deficiency in pregnancies after gastric bypass surgery compared with after sleeve gastrectomy. Vitamin K1 deficiency in post-bariatric pregnancy have potential risk of hypocoaguble state in mother and child and should be explored in future studies.
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Affiliation(s)
- Brit Torunn Bechensteen
- Department of Endocrinology, Akershus University Hospital HF, Lørenskog, Norway
- Department of Clinical nutrition, Akershus University Hospital HF, Lørenskog, Norway
| | - Cindhya Sithiravel
- Multidisciplinary Laboratory Medicine and Medical Biochemistry, Akershus University Hospital HF, Lørenskog, Norway
| | | | - Heidi Kathrine Ruud
- Department of Clinical nutrition, Akershus University Hospital HF, Lørenskog, Norway
| | - Gunnhild Kravdal
- Multidisciplinary Laboratory Medicine and Medical Biochemistry, Akershus University Hospital HF, Lørenskog, Norway
| | - Jacob A Winther
- Department of Endocrinology, Akershus University Hospital HF, Lørenskog, Norway
| | - Tone G Valderhaug
- Department of Endocrinology, Akershus University Hospital HF, Lørenskog, Norway.
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Leonard UM, Leydon CL, Arranz E, Kiely ME. Impact of consuming an environmentally protective diet on micronutrients: a systematic literature review. Am J Clin Nutr 2024; 119:927-948. [PMID: 38569787 DOI: 10.1016/j.ajcnut.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND A global move toward consumption of diets from sustainable sources is required to protect planetary health. As this dietary transition will result in greater reliance on plant-based protein sources, the impact on micronutrient (MN) intakes and status is unknown. OBJECTIVE Evaluate the evidence of effects on intakes and status of selected MNs resulting from changes in dietary intakes to reduce environmental impact. Selected MNs of public health concern were vitamins A, D, and B12, folate, calcium, iron, iodine, and zinc. METHODS We systematically searched 7 databases from January 2011 to October 2022 and followed the PRISMA guidelines. Eligible studies had to report individual MN intake and/or status data collected in free-living individuals from the year 2000 onward and environmental outcomes. RESULTS From the 10,965 studies identified, 56 studies were included, mostly from high-income countries (n = 49). Iron (all 56) and iodine (n = 20) were the most and least reported MNs, respectively. There was one randomized controlled trial (RCT) that also provided the only biomarker data, 10 dietary intake studies, and 45 dietary modeling studies, including 29 diet optimization studies. Most studies sought to reduce greenhouse gas emissions or intake of animal-sourced foods. Most results suggested that intakes of zinc, calcium, iodine, and vitamins B12, A, and D would decrease, and total iron and folate would increase in a dietary transition to reduce environmental impacts. Risk of inadequate intakes of zinc, calcium, vitamins A, B12 and D were more likely to increase in the 10 studies that reported nutrient adequacy. Diet optimization (n = 29) demonstrated that meeting nutritional and environmental targets is technically feasible, although acceptability is not guaranteed. CONCLUSIONS Lower intakes and status of MNs of public health concern are a potential outcome of dietary changes to reduce environmental impacts. Adequate consideration of context and nutritional requirements is required to develop evidence-based recommendations. This study was registered prospectively with PROSPERO (CRD42021239713).
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Affiliation(s)
- Ursula M Leonard
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Clarissa L Leydon
- Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland; Department of Agrifood Business and Spatial Analysis, Teagasc Food Research Centre, Ashtown, Dublin, Ireland
| | - Elena Arranz
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland; Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.
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Renaud D, Höller A, Michel M. Potential Drug-Nutrient Interactions of 45 Vitamins, Minerals, Trace Elements, and Associated Dietary Compounds with Acetylsalicylic Acid and Warfarin-A Review of the Literature. Nutrients 2024; 16:950. [PMID: 38612984 PMCID: PMC11013948 DOI: 10.3390/nu16070950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
In cardiology, acetylsalicylic acid (ASA) and warfarin are among the most commonly used prophylactic therapies against thromboembolic events. Drug-drug interactions are generally well-known. Less known are the drug-nutrient interactions (DNIs), impeding drug absorption and altering micronutritional status. ASA and warfarin might influence the micronutritional status of patients through different mechanisms such as binding or modification of binding properties of ligands, absorption, transport, cellular use or concentration, or excretion. Our article reviews the drug-nutrient interactions that alter micronutritional status. Some of these mechanisms could be investigated with the aim to potentiate the drug effects. DNIs are seen occasionally in ASA and warfarin and could be managed through simple strategies such as risk stratification of DNIs on an individual patient basis; micronutritional status assessment as part of the medical history; extensive use of the drug-interaction probability scale to reference little-known interactions, and application of a personal, predictive, and preventive medical model using omics.
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Affiliation(s)
- David Renaud
- DIU MAPS, Fundamental and Biomedical Sciences, Paris-Cité University, 75006 Paris, France
- DIU MAPS, Health Sciences Faculty, Universidad Europea Miguel de Cervantes, 47012 Valladolid, Spain
- Fundacja Recover, 05-124 Skrzeszew, Poland
| | - Alexander Höller
- Department of Nutrition and Dietetics, University Hospital Innsbruck, 6020 Innsbruck, Austria
| | - Miriam Michel
- Department of Child and Adolescent Health, Division of Pediatrics III—Cardiology, Pulmonology, Allergology and Cystic Fibrosis, Medical University of Innsbruck, 6020 Innsbruck, Austria
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Van Wayenbergh E, Langenaeken NA, Verheijen J, Foubert I, Courtin CM. Mechanistic understanding of the stabilisation of vitamin A in oil by wheat bran: The interplay between vitamin A degradation, lipid oxidation, and lipase activity. Food Chem 2024; 436:137785. [PMID: 37866098 DOI: 10.1016/j.foodchem.2023.137785] [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: 07/13/2023] [Revised: 10/06/2023] [Accepted: 10/15/2023] [Indexed: 10/24/2023]
Abstract
Wheat bran stabilises vitamin A (retinyl palmitate, RP) in oil during storage, but the stabilisation mechanism remains unknown. We here studied the effect of the concentration of RP in oil (0.1-2%) and of RP-enriched oil in the system (5-50%) on the RP retention during accelerated storage of systems with native and toasted wheat bran. Generally, toasted bran showed better RP stabilisation than native bran. After four weeks of storage, up to 65% RP was retained in toasted bran systems, whereas the RP retention for native bran was below 10%. For native bran, a higher oil-to-bran ratio and, thus, a lower wheat lipase level resulted in better RP retention. For toasted bran, combined high oil and high RP concentrations resulted in the lowest RP retention. We, therefore, conclude that wheat bran protects RP and lipids from oxidation. This protection is reduced by the pro-oxidative effect of RP, lipid oxidation and lipase.
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Affiliation(s)
- Eline Van Wayenbergh
- KU Leuven, Department of Microbial and Molecular Systems (M(2)S), Laboratory of Food Chemistry and Biochemistry & Leuven Food Science and Nutrition Research Centre (LFoRCe), Kasteelpark Arenberg 20, B-3001 Leuven, Belgium
| | - Niels A Langenaeken
- KU Leuven, Department of Microbial and Molecular Systems (M(2)S), Laboratory of Food Chemistry and Biochemistry & Leuven Food Science and Nutrition Research Centre (LFoRCe), Kasteelpark Arenberg 20, B-3001 Leuven, Belgium
| | - Jolien Verheijen
- KU Leuven, Department of Microbial and Molecular Systems (M(2)S), Laboratory of Food Chemistry and Biochemistry & Leuven Food Science and Nutrition Research Centre (LFoRCe), Kasteelpark Arenberg 20, B-3001 Leuven, Belgium
| | - Imogen Foubert
- KU Leuven Kulak, Department of Microbial and Molecular Systems (M(2)S), Research Unit of Food and Lipids & Leuven Food Science and Nutrition Research Centre (LFoRCe), Etienne Sabbelaan 53, B-8500 Kortrijk, Belgium
| | - Christophe M Courtin
- KU Leuven, Department of Microbial and Molecular Systems (M(2)S), Laboratory of Food Chemistry and Biochemistry & Leuven Food Science and Nutrition Research Centre (LFoRCe), Kasteelpark Arenberg 20, B-3001 Leuven, Belgium.
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Islam MH, Nayan MM, Jubayer A, Amin MR. A review of the dietary diversity and micronutrient adequacy among the women of reproductive age in low- and middle-income countries. Food Sci Nutr 2024; 12:1367-1379. [PMID: 38455218 PMCID: PMC10916566 DOI: 10.1002/fsn3.3855] [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: 07/18/2023] [Revised: 10/31/2023] [Accepted: 11/08/2023] [Indexed: 03/09/2024] Open
Abstract
The dietary quality of women of reproductive age (WRA) is particularly important during preconception, conception, and pregnancy for themselves and their offspring. Poorly diversified diets resulting in inadequate micronutrient consumption may have adverse effects on their health. This narrative review summarizes the findings of studies reporting on dietary diversity and micronutrient intake by WRA in low- and middle-income countries (LMICs). Studies on WRA aged 15-49 years in LMICs, with a sample size of more than 150, report dietary diversity and multiple micronutrient intake based on 24-h dietary recall/food weighed record/food frequency questionnaire, and published between January 2011 and June 2021 were included. The results were compared to the Food and Agriculture Organization (FAO) recommended cut-off for dietary diversity and the Indian Council of Medical Research (ICMR) recommended age- and sex-specific estimated average requirements (EARs) for micronutrient intake. This review includes 35 articles, of which 21 focused on dietary diversity and 14 on micronutrient intake. The results showed that WRA in LMICs had inadequate dietary diversity, with mean food group consumption of only 3.0-4.84, and around 42.3%-90% of women consumed inadequately diversified diets (<5 food groups). Additionally, most studies found that WRA did not consume adequate amounts of essential micronutrients, particularly calcium, iron, zinc, vitamin A, thiamin, riboflavin, folate, and vitamin B12. However, the intake of vitamin C, niacin, and vitamin B6 was above the required levels. In conclusion, this review highlights the common inadequacy of dietary diversity and multiple micronutrient intake among WRA in most LMICs. Effective measures involving improving dietary diversity, food fortification with micronutrients, and supplementation programs could help improve the dietary quality and intake of optimal micronutrients by women in LMICs.
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Affiliation(s)
- Md. Hafizul Islam
- Institute of Nutrition and Food Science, University of DhakaDhakaBangladesh
| | - Md. Moniruzzaman Nayan
- Institute of Nutrition and Food Science, University of DhakaDhakaBangladesh
- Inspira Advisory and Consulting LimitedDhakaBangladesh
| | - Ahmed Jubayer
- Institute of Nutrition and Food Science, University of DhakaDhakaBangladesh
- Bangladesh Institute of Social Research (BISR) TrustDhakaBangladesh
| | - Md. Ruhul Amin
- Institute of Nutrition and Food Science, University of DhakaDhakaBangladesh
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Davis JN, Kumordzie SM, Arnold CD, Wessells KR, Nyaaba KW, Adams KP, Tan XJ, Becher E, Vosti SA, Adu-Afarwuah S, Engle-Stone R. Consumption of Discretionary Salt and Salt from Bouillon among Households, Women, and Young Children in Northern Region, Ghana: A Mixed-Methods Study with the Condiment Micronutrient Innovation Trial (CoMIT) Project. Curr Dev Nutr 2024; 8:102088. [PMID: 38419834 PMCID: PMC10897853 DOI: 10.1016/j.cdnut.2024.102088] [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: 09/21/2023] [Revised: 01/11/2024] [Accepted: 01/24/2024] [Indexed: 03/02/2024] Open
Abstract
Background Information on salt consumption patterns is needed to inform the need for and design of salt reduction strategies. Objectives In northern Ghana, this study aimed to estimate household consumption of salt, including salt from bouillon, and compare (estimated) women and children's salt intake to global recommendations; to estimate the proportion of salt consumed from bouillon; and to identify factors, including knowledge, attitudes, and practices, associated with household salt consumption. Methods Employing mixed-methods methodology, we conducted a pilot survey (n = 369 households enrolled) and focus group discussions (FGDs; n = 20) in Tolon and Kumbungu districts (14 urban, 14 rural clusters) (clinicaltrials.gov registry: NCT04632771). Households reported purchases of discretionary salt (DS, "table salt") and bouillon cubes. DS and total salt (TS; DS+salt from bouillon) consumption for women (15-49 y) and children (2-5 y) were estimated using the Adult Male Equivalent method and compared with global recommendations (<5 g/d women; <3.75 g/d children). Women's salt intake was also predicted from urinary sodium excretion (INTERSALT equation). Associations between DS and TS consumption, as well as household and women's characteristics, were tested with minimally adjusted and multivariable linear mixed-effects models. Qualitative FGD themes were generated using the Framework Method. Results From household purchase data, estimated TS consumption exceeded global recommendations for 44% of children [median: 2.9 (IQR: 1.9, 5.2) g/d] and 60% of women [6.0 (4.0, 10.2) g/d]; 35% of children and 50% of women exceeded recommendations from DS alone. Bouillon contributed <25% of households' TS consumption. Few characteristics were associated with DS or TS consumption. Salient qualitative themes that shaped salt consumption behaviors included salt's ubiquity as a seasoning, key household members' influence on food procurement and preparation, and perceptions about health. Conclusions Purchase data suggest salt consumption among women and children exceeds recommendations, even when excluding salt from bouillon; food prepared outside the home likely further contributes. Salt reduction interventions may be warranted in this context.
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Affiliation(s)
- Jennie N Davis
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - Sika M Kumordzie
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - Charles D Arnold
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - K Ryan Wessells
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - Kania W Nyaaba
- University of Ghana, Department of Nutrition and Food Science, Legon, Accra, Ghana
| | - Katherine P Adams
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - Xiuping Jenny Tan
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - Emily Becher
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - Stephen A Vosti
- University of California, Department of Agriculture and Resource Economics, Institute for Global Nutrition, Davis, CA, United States
| | - Seth Adu-Afarwuah
- University of Ghana, Department of Nutrition and Food Science, Legon, Accra, Ghana
| | - Reina Engle-Stone
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
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Shen Y, Jin H, Guo F, Zhang W, Fu H, Jin M, Chen G. Association of Magnesium, Iron, Copper, and Zinc Levels with the Prevalence of Behavior Problems in Children and Adolescents. Biol Trace Elem Res 2024:10.1007/s12011-024-04098-4. [PMID: 38388752 DOI: 10.1007/s12011-024-04098-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/07/2024] [Indexed: 02/24/2024]
Abstract
Magnesium (Mg), iron (Fe), copper (Cu), and zinc (Zn) are indispensable elements in children's growth and development. However, epidemiological evidence regarding essential elements and their mixed exposure to behavior problems remains in its infancy. The objective of the present study was to evaluate the association between essential elements and the manifestation of behavior problems, with an additional focus on the implications of their mixture. An electronic medical records review was performed among 4122 subjects aged 6-18 years who underwent examinations at Children's Hospital, Zhejiang University School of Medicine, between January 2019 and July 2022. The concentrations of essential elements were measured by atomic absorption spectrometry, and behavior problems were assessed by using the Conners' Parent Rating Scale (CPRS). A total of 895 (21.7%) children and adolescents were identified as having behavior problems. For single exposure, inversely linear dose-response relationships were identified between continuous Mg and Zn levels and the prevalence of behavior problems, and the prevalence ratios (PRs) in the categorical lowest tertile were 1.28 (95% confidence interval, CI: 1.07-1.54) for Mg and 1.31 (95% CI: 1.05-1.63) for Zn compared to the highest tertile. For mixture exposure, an inverse association between essential elements and behavior problems was also found, mainly contributed by Mg (posterior inclusion probability, PIP = 0.854). Whole blood levels of Mg and Zn were significantly inversely associated with behavior problems. The findings highlight the pivotal role of essential elements in behavior problems and emphasize the importance of maintaining adequate levels of essential elements during children's maturation.
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Affiliation(s)
- Ying Shen
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310005, China
| | - Huyi Jin
- Department of Public Health, and Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Fanjia Guo
- Department of Public Health, and Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Wanting Zhang
- Department of Public Health, and Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Jiaxing Center for Disease Control and Prevention, Jiaxing, 314000, China
| | - Hao Fu
- Department of Public Health, and Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Mingjuan Jin
- Department of Public Health, and Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| | - Guangdi Chen
- Department of Public Health, and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
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Schimansky S, Jasim H, Pope L, Hinds P, Fernandez D, Choleva P, Dev Borman A, Sharples PM, Smallbone T, Atan D. Nutritional blindness from avoidant-restrictive food intake disorder - recommendations for the early diagnosis and multidisciplinary management of children at risk from restrictive eating. Arch Dis Child 2024; 109:181-187. [PMID: 37414514 DOI: 10.1136/archdischild-2022-325189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 06/15/2023] [Indexed: 07/08/2023]
Abstract
Avoidant-restrictive food intake disorder (ARFID) is an eating disorder characterised by limited consumption or the avoidance of certain foods, leading to the persistent failure to meet the individual's nutritional and/or energy needs. The disordered eating is not explained by the lack of available food or cultural beliefs. ARFID is often associated with a heightened sensitivity to the sensory features of different types of food and may be more prevalent among children with autism spectrum disorder (ASD) for this reason. Sight loss from malnutrition is one of the most devastating and life-changing complications of ARFID, but difficult to diagnose in young children and those with ASD who have more difficulty with communicating their visual problems to carers and clinicians, leading to delayed treatment and greater probability of irreversible vision loss. In this article, we highlight the importance of diet and nutrition to vision and the diagnostic and therapeutic challenges that clinicians and families may face in looking after children with ARFID who are at risk of sight loss. We recommend a scaled multidisciplinary approach to the early identification, investigation, referral and management of children at risk of nutritional blindness from ARFID.
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Affiliation(s)
- Sarah Schimansky
- Bristol Eye Hospital, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
| | - Haneen Jasim
- Bristol Eye Hospital, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
| | - Lucy Pope
- Department of Paediatric Nutrition and Dietetics, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Philippa Hinds
- Community Child Health Partnership, Sirona Care and Health CIC, Bristol, UK
| | - Daphin Fernandez
- General Paediatrics, Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Paraskevi Choleva
- Bristol Eye Hospital, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
| | - Arundhati Dev Borman
- Bristol Eye Hospital, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
| | - Peta M Sharples
- Department of Paediatric Neurology, Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Todd Smallbone
- Department of Paediatric Neurology, Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Denize Atan
- Bristol Eye Hospital, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Gebreegziabher T, Sidibe S. Determinants of household-, maternal- and child-related factors associated with nutritional status among children under five in Mali: evidence from a Demographic and Health Survey, 2018. Public Health Nutr 2024; 27:e58. [PMID: 38311339 PMCID: PMC10882532 DOI: 10.1017/s1368980024000363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVE The current study aims to determine household-, maternal- and child-related factors influencing nutritional status among children under five in Mali. DESIGN Quantitative cross-sectional study using secondary data extracted from Mali DHS-VI 2018. SETTING Urban and rural areas of Mali. PARTICIPANTS A total of 8908 children participated, with 3999 in the younger age group (0-24 months) and 4909 in the older age group (25-59 months). RESULTS In the younger age group, the prevalence of stunting, wasting and underweight was 18·8 % (95 % CI%: 17·5, 20·0), 24·6 % (95 % CI: 23·2, 26·0) and 13·2 % (95 % CI: 12·1, 14·3), respectively, while in the older age group, it was 24·9 % (95 % CI: 23·7, 26·2), 22·7 % (95 % CI: 21·5, 24·0) and 5·7 % (95 % CI: 5·0, 6·5), respectively. Being average or large size at birth, having piped source of water, receiving Zn, deworming, high maternal BMI, receiving Fe during pregnancy, higher maternal education and being rich were associated with lower odds of one or more form of undernutrition in both groups. On the other hand, children who were anaemic, drank from a bottle, maternal anaemia, current pregnancy of mothers and living in rural areas were associated with higher odds of stunting, wasting or underweight. Interestingly, children who received Fe supplementation had a higher odds of wasting in the younger group but lower odds of all forms of undernutrition in the older group. CONCLUSIONS This study emphasised the potential risk factors associated with undernutrition in children. Children who consume non-potable water, have mothers with lower levels of education and BMI and reside in rural areas are more likely to experience undernutrition.
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Affiliation(s)
- Tafere Gebreegziabher
- Food Science and Nutrition, Department of Health Sciences, Central Washington University, 400 E University Way, Ellensburg, WA98926, USA
| | - Saran Sidibe
- Food Science and Nutrition, Department of Health Sciences, Central Washington University, 400 E University Way, Ellensburg, WA98926, USA
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Mishra E, Thakur MK. Vitamin B 12-folic acid supplementation improves memory by altering mitochondrial dynamics, dendritic arborization, and neurodegeneration in old and amnesic male mice. J Nutr Biochem 2024; 124:109536. [PMID: 37981108 DOI: 10.1016/j.jnutbio.2023.109536] [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: 06/25/2023] [Revised: 10/28/2023] [Accepted: 11/15/2023] [Indexed: 11/21/2023]
Abstract
Memory impairment during aging and amnesia is attributed to compromised mitochondrial dynamics and mitophagy and other mitochondrial quality control mechanisms. Mitochondrial dynamics involves the continuous process of fission and fusion of mitochondria within a cell and is a fundamental mechanism for regulating mitochondrial quality and function. An extensive range of potential nutritional supplements has been shown to improve mitochondrial health, synaptic plasticity, and cognitive functions. Previous findings revealed that supplementation of vitamin B12-folic acid reduces locomotor deficits and mitochondrial abnormalities but enhances mitochondrial and neuronal health. The present study aims to explore the impact of combined vitamin B12-folic acid supplementation on mitochondrial dynamics, neuronal health, and memory decline in old age and scopolamine-induced amnesia, which remains elusive. The results demonstrated that supplementation led to a noteworthy increase in recognition and spatial memory and expression of memory-related protein BDNF in old and amnesic mice. Moreover, the decrease in the fragmented mitochondrial number was validated by the downregulation of mitochondrial fission p-Drp1 (S616) protein and the increase in elongated mitochondria by the upregulation of mitochondrial fusion Mfn2 protein. The increased spine density and dendritic arborization in old and amnesic mice upon supplementation were confirmed by the enhanced expression level of PSD95 and synaptophysin. Furthermore, supplementation reduced ROS production, inhibited Caspase-3 activation, mitigated neurodegeneration, and enhanced mitochondrial membrane potential, ATP production, Vdac1 expression, myelination, in old and amnesic mice. Collectively, our findings imply that combined supplementation of vitamin B12-folic acid improves mitochondrial dynamics and neuronal health, and leads to recovery of memory during old age and amnesia.
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Affiliation(s)
- Ela Mishra
- Department of Zoology, Biochemistry and Molecular Biology Laboratory, Centre of Advanced Study, Institute of Science, Banaras Hindu University, Varanasi, India.
| | - Mahendra Kumar Thakur
- Department of Zoology, Biochemistry and Molecular Biology Laboratory, Centre of Advanced Study, Institute of Science, Banaras Hindu University, Varanasi, India.
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Levine DA, Mathew NE, Jung EH, Yan J, Newman NJ, Thulasi P, Yeh S, Ziegler TR, Wells J, Jain N. Characteristics of Vitamin A Deficiency Retinopathy at a Tertiary Referral Center in the United States. Ophthalmol Retina 2024; 8:126-136. [PMID: 37673395 DOI: 10.1016/j.oret.2023.08.021] [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: 03/31/2023] [Revised: 08/14/2023] [Accepted: 08/29/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE To explore the risk factors and fundus imaging features of vitamin A deficiency retinopathy (VADR) in an academic tertiary referral center in Atlanta, GA, United States, and to propose guidance regarding diagnostic workup and management of affected patients. DESIGN Single-center retrospective case series. SUBJECTS Nine patients seen between 2015 and 2021 at the Emory Eye Center diagnosed with VADR. METHODS Retrospective chart review. MAIN OUTCOME MEASURES Baseline serum retinol level, Snellen visual acuity, multimodal fundus imaging findings, and electroretinography findings. RESULTS Nine patients, 4 (44.4%) female, with a median (range) age of 68 (50-75) years were identified. The most common underlying etiologies for vitamin A deficiency included history of gastrointestinal surgery (55.6%), liver disease (44.4%), and nutritional depletion due to low-quality diet (44.4%). Only 1 (11.1%) patient had a history of bariatric surgery. Four (44.4%) patients were on some form of vitamin A supplementation before the diagnosis of VADR. Median (range) serum retinol level was 0.06 (< 0.06-0.19) mg/L. All patients had macular subretinal hyperreflective deposits resembling subretinal drusenoid deposits, although in some cases, these were scant and sparsely distributed. Six eyes of 3 patients with longstanding deficiency had defects in the external limiting membrane (ELM). Three of these eyes additionally had macular areas of complete retinal pigment epithelium and outer retinal atrophy (cRORA). Full-field electroretinography demonstrated severe rod dysfunction and mild to moderate cone system dysfunction. Many findings of VADR were reversible with vitamin A repletion. However, all eyes with ELM defects or cRORA had persistence or continued growth of these lesions. CONCLUSION Vitamin A deficiency retinopathy is uncommon in the developed world. However, given that early intervention can lead to dramatic visual improvement and avoid potentially permanent retinal damage, retina specialists should be familiar with its clinical presentation. The presence of nyctalopia and subretinal hyperreflective deposits in a patient with a history of gastrointestinal surgery, liver disease, and/or poor diet can be suggestive of this diagnosis, even in the presence of ongoing vitamin A supplementation. Vitamin A supplementation can vary in route and dosage and can be tailored to the individual with serial testing of serum retinol. FINANCIAL DISCLOSURE(S) The authors have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- David A Levine
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Namita E Mathew
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Emily H Jung
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jiong Yan
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Nancy J Newman
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia; Department of Neurology, Emory University School of Medicine, Atlanta, Georgia; Department of Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Praneetha Thulasi
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Steven Yeh
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Thomas R Ziegler
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jill Wells
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Nieraj Jain
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia.
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Holani R, Littlejohn PT, Edwards K, Petersen C, Moon KM, Stacey RG, Bozorgmehr T, Gerbec ZJ, Serapio-Palacios A, Krekhno Z, Donald K, Foster LJ, Turvey SE, Finlay BB. A Murine Model of Maternal Micronutrient Deficiencies and Gut Inflammatory Host-microbe Interactions in the Offspring. Cell Mol Gastroenterol Hepatol 2024; 17:827-852. [PMID: 38307490 PMCID: PMC10973814 DOI: 10.1016/j.jcmgh.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND & AIMS Micronutrient deficiency (MND) (ie, lack of vitamins and minerals) during pregnancy is a major public health concern. Historically, studies have considered micronutrients in isolation; however, MNDs rarely occur alone. The impact of co-occurring MNDs on public health, mainly in shaping mucosal colonization by pathobionts from the Enterobacteriaceae family, remains undetermined due to lack of relevant animal models. METHODS To establish a maternal murine model of multiple MND (MMND), we customized a diet deficient in vitamins (A, B12, and B9) and minerals (iron and zinc) that most commonly affect children and women of reproductive age. Thereafter, mucosal adherence by Enterobacteriaceae, the associated inflammatory markers, and proteomic profile of intestines were determined in the offspring of MMND mothers (hereafter, low micronutrient [LM] pups) via bacterial plating, flow cytometry, and mass spectrometry, respectively. For human validation, Enterobacteriaceae abundance, assessed via 16s sequencing of 3-month-old infant fecal samples (n = 100), was correlated with micronutrient metabolites using Spearman's correlation in meconium of children from the CHILD birth cohort. RESULTS We developed an MMND model and reported an increase in colonic abundance of Enterobacteriaceae in LM pups at weaning. Findings from CHILD cohort confirmed a negative correlation between Enterobacteriaceae and micronutrient availability. Furthermore, pro-inflammatory cytokines and increased infiltration of lymphocyte antigen 6 complex high monocytes and M1-like macrophages were evident in the colons of LM pups. Mechanistically, mitochondrial dysfunction marked by reduced expression of nicotinamide adenine dinucleotide (NAD)H dehydrogenase and increased expression of NAD phosphate oxidase (Nox) 1 contributed to the Enterobacteriaceae bloom. CONCLUSION This study establishes an early life MMND link to intestinal pathobiont colonization and mucosal inflammation via damaged mitochondria in the offspring.
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Affiliation(s)
- Ravi Holani
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada; Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paula T Littlejohn
- Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Karlie Edwards
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Charisse Petersen
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Kyung-Mee Moon
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada; Biochemistry and Molecular Biology Department, University of British Columbia, Vancouver, British Columbia, Canada
| | - Richard G Stacey
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tahereh Bozorgmehr
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada; Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Zachary J Gerbec
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada; Biochemistry and Molecular Biology Department, University of British Columbia, Vancouver, British Columbia, Canada; Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Antonio Serapio-Palacios
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada; Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Zakhar Krekhno
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada; Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katherine Donald
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada; Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leonard J Foster
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada; Biochemistry and Molecular Biology Department, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stuart E Turvey
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - B Brett Finlay
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada; Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada; Biochemistry and Molecular Biology Department, University of British Columbia, Vancouver, British Columbia, Canada.
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Bellad MB, Patted A, Derman RJ. Is It Time to Alter the Standard of Care for Iron Deficiency/Iron Deficiency Anemia in Reproductive-Age Women? Biomedicines 2024; 12:278. [PMID: 38397880 PMCID: PMC10886917 DOI: 10.3390/biomedicines12020278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
Two billion people worldwide suffer from anemia, with reproductive-age women being disproportionately affected. Iron plays a crucial role in cellular function and impacts cognition, physical function, and quality of life. Iron deficiency (ID) and iron deficiency anemia (IDA) are associated with adverse effects on pregnancy and fetal development. Oral iron supplementation has been the standard treatment for decades, often producing sub-optimal outcomes. Many babies are still being born with ID and suffer adverse sequelae due to inadequate iron levels in the mothers. Is it time to consider a broad scale-up of parenteral iron as a new standard of care?
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Affiliation(s)
- Mrutyunjaya B. Bellad
- Department of Obstetrics and Gynecology, KAHER’s Jawaharlal Nehru Medical College, Belagavi 590010, Karnataka, India;
| | - Anmol Patted
- Department of Global Affairs, Thomas Jefferson University, Philadelphia, PA 19107, USA;
| | - Richard J. Derman
- Department of Global Affairs, Thomas Jefferson University, Philadelphia, PA 19107, USA;
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Gelli A, Duchoslav J, Gladstone M, Gilligan D, Katundu M, Maleta K, Quisumbing A, Bliznashka L, Ahun M. Impact evaluation of a maternal and child cash transfer intervention, integrated with nutrition, early childhood development, and agriculture messaging (MAZIKO-IE): a study protocol for a cluster-randomised controlled trial. Trials 2024; 25:46. [PMID: 38218938 PMCID: PMC10790253 DOI: 10.1186/s13063-023-07782-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 11/06/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Children in Malawi face high rates of malnutrition and are at risk of not reaching their developmental potential. Community-based childcare centres (CBCCs) can be cost-effective platforms for scaling-up early childhood development (ECD) and nutrition social behaviour change (SBC) interventions. However, evidence also suggests potential synergies from coupling nutrition SBC with cash transfers (CT), given that rural households in Malawi face high levels of poverty and recurring extreme lean season food-security shocks. The Maziko trial is aimed at evaluating the effectiveness and cost-effectiveness of using CBCCs and parenting care groups as platforms to improve maternal diets and child nutrition and development by providing nutrition-sensitive SBC and CT intervention packages in communities already receiving a standard of care Government SBC program. METHODS We designed a 3-year cluster-randomised controlled trial in two districts of Malawi, including 156 communities randomised to one of four treatment arms: (1) standard of care (SoC) arm: receiving the standard Government SBC program; (2) SBC arm: receiving the SoC intervention with additional nutrition-sensitive SBC activities to improve nutritious food production, diets, and care practices for young children; (3) low CT arm: SoC plus SBC plus a maternal and child cash transfer ~ 17 USD per month; and (4) high CT arm: SoC plus SBC plus a maternal and child CT ~ 43 USD per month. The trial will enrol pregnant women and children < 2 years of age. The primary outcomes are maternal diet assessed using the mean probability of adequacy and child development assessed using the Malawi Developmental Assessment Tool. Intermediate outcomes along the programme impact pathways will also be measured, including maternal mental health, maternal empowerment, child feeding practices, and child nutritional status. DISCUSSION This is the first study to examine the impact and synergies of combining ECD SBC with nutrition-sensitive SBC and CTs on maternal and child outcomes during the first 1000 days. The findings from this evaluation will inform national ECD and nutrition programmes. TRIAL REGISTRATION ISRCTN ISRCTN53055824. Registered on 7 March 2022.
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Yang Y, Ke Y, Liu X, Zhang Z, Zhang R, Tian F, Zhi L, Zhao G, Lv B, Hua S, Wu H. Navigating the B vitamins: Dietary diversity, microbial synthesis, and human health. Cell Host Microbe 2024; 32:12-18. [PMID: 38211561 DOI: 10.1016/j.chom.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 01/13/2024]
Abstract
B vitamins are intricately involved in various physiological processes vital for health. Their significance is complicated by the heterogeneous landscape of B vitamin distribution in diets and the contributions of the gut microbiota. Here, we delve into the impact of these factors on B vitamins and introduce strategies, with a focus on microbiota-based therapeutic options, to enhance their availability for improved well-being. Additionally, we provide an ecological and evolutionary perspective on the importance of B vitamins to human-microbiota interactions. In the dynamic realms of nutrition and microbiome science, these essential micronutrients continue to play a fundamental role in our understanding of disease development.
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Affiliation(s)
- Yudie Yang
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China
| | - Yize Ke
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China
| | - Xinyan Liu
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China
| | - Zhidong Zhang
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China; College of Life Sciences, Inner Mongolia University, Hohhot 010070, China
| | - Rongji Zhang
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China; College of Life Sciences, Inner Mongolia University, Hohhot 010070, China
| | - Fang Tian
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Luqian Zhi
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China
| | - Guoping Zhao
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China
| | - Bomin Lv
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China.
| | - Sha Hua
- Department of Cardiovascular Medicine, Heart Failure Center, Ruijin Hospital Lu Wan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Hao Wu
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China; Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
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Fernández-Gaxiola AC, Neufeld LM, García-Guerra A. Considerations for Correction of Micronutrient Deficiencies Through Supplementation in Pregnant Women and Children Under-5 in Latin America. Food Nutr Bull 2024:3795721231219824. [PMID: 38186006 DOI: 10.1177/03795721231219824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
BACKGROUND Micronutrient deficiencies in Latin America are a public health concern, nonetheless, lack of information still exists in many countries, so that the true magnitude of the problem remains uncertain. OBJECTIVE To summarise experiences that can inform the development of policies and programs to address micronutrient deficiencies throung supplementation in pregnant women and chlidren under five years of age in Latin American. METHODS Review of the most evidence on the effects of micronutrients supplementation, focusing on pregnant women and children under five years of age. RESULTS Certain population groups, as women of reproductive age and children under 2 years of age, are at increased risk for deficiency due to their high micronutrient requirements. This is compounded by the limited access to micronutrient-rich foods for many people living in vulnerable situations. Micronutrient supplementation is an effective intervention to prevent and treat deficiency and to mitigate its adverse effects on health, nutrition, and pregnancy outcomes in micronutrient-deficient populations. The potential benefits of supplementation programs, however, are realized only when they reach those who have the potential to benefit, that is, with inadequate intakes of micronutrients from dietary sources, and when the quality of design and delivery of the programs aresufficient to reach that population timely, regularly, and effectively to enable and motivate consumption. CONCLUSIONS Several resources and experiences exist that can help favor the development of programs that can realize this biological and programmatic potential. There is need for continuous efforts to augment coverage and achieve results that can translate into economic benefits for individuals, families, and nations.
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Siddiqua TJ, Akhtar E, Haq MA, Shahab-Ferdows S, Hampel D, Islam S, Ahmed T, Allen LH, Raqib R. Effects of vitamin B12 supplementation on oxidative stress markers and pro-inflammatory cytokines during pregnancy and postpartum among Bangladeshi mother-child pairs. BMC Nutr 2024; 10:3. [PMID: 38172996 PMCID: PMC10765711 DOI: 10.1186/s40795-023-00785-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 10/30/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND There is limited research to determine whether vitamin B12 (B12) supplementation during pregnancy and lactation is protective against oxidative stress and pro-inflammatory cytokines and whether this effect is transferred to breastfed infants via milk. In addition, associations among maternal plasma/ milk and infant B12 status and immune function markers are poorly characterized. OBJECTIVES To evaluate effects of oral B12 supplementation during pregnancy and postpartum on maternal and infant 8-hydroxy-2'-deoxyguanosine (8-OH-dG, an oxidative stress marker) and proinflammatory cytokine levels, and examine associations between maternal plasma, breastmilk and infant B12 status as well as immune function markers. METHOD In a blinded, placebo-controlled trial, Bangladeshi women (n = 68, 18-35 years, hemoglobin < 11 g/dL, gestational weeks 11-14) received either 250 μg/day B12 or placebo throughout pregnancy up to 3-months postpartum. Samples were collected from mothers at baseline and 3-months postpartum and from infants at 3-months to measure B12 status indicators, 8-OH-dG and proinflammatory cytokines. RESULTS Maternal postpartum B12 was positively associated with infant plasma B12. Higher milk B12 concentrations were associated with increased infant B12 (beta (β) = 277, 95% confidence interval (CI) = (132, 423), p<0.001) and lower total homocysteine (β = -7.63, 95% CI = (-12.40, -2.86), p = 0.002) levels. Maternal B12 supplementation reduced plasma 8-OH-dG concentrations among postpartum mothers and infants compared to the placebo group. Supplementation increased plasma TNF-α and IL-6 levels among mothers and IL-10 and IFN-γ levels among infants. CONCLUSION Milk and maternal plasma B12 at 3 months were associated with infant B12. Maternal B12 supplementation modulates 8-OH-dG and several cytokines which may protect against immune response-induced oxidative stress. TRIAL REGISTRATION (clinicaltrials.gov: NCT01795131- 1st posted on 20/02/2013).
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Affiliation(s)
| | - Evana Akhtar
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Md Ahsanul Haq
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | | | - Daniela Hampel
- USDA ARS Western Human Nutrition Research Center, Davis, CA, USA
- Department of Nutrition, University of California, Davis, CA, USA
| | - Sharmin Islam
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Lindsay H Allen
- USDA ARS Western Human Nutrition Research Center, Davis, CA, USA
| | - Rubhana Raqib
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
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Verger EO, Eymard-Duvernay S, Bahya-Batinda D, Hanley-Cook GT, Argaw A, Becquey E, Diop L, Gelli A, Harris-Fry H, Kachwaha S, Kim SS, Nguyen PH, Saville NM, Tran LM, Zagré RR, Landais E, Savy M, Martin-Prevel Y, Lachat C. Defining a Dichotomous Indicator for Population-Level Assessment of Dietary Diversity Among Pregnant Adolescent Girls and Women: A Secondary Analysis of Quantitative 24-h Recalls from Rural Settings in Bangladesh, Burkina Faso, India, and Nepal. Curr Dev Nutr 2024; 8:102053. [PMID: 38187987 PMCID: PMC10767136 DOI: 10.1016/j.cdnut.2023.102053] [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: 09/19/2023] [Revised: 11/21/2023] [Accepted: 11/26/2023] [Indexed: 01/09/2024] Open
Abstract
Background The Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) indicator was validated as a proxy of micronutrient adequacy among nonpregnant women in low- and middle-income countries (LMICs). At that time, indeed, there was insufficient data to validate the indicator among pregnant women, who face higher micronutrient requirements. Objective This study aimed to validate a minimum food group consumption threshold, out of the 10 food groups used to construct MDD-W, to be used as a population-level indicator of higher micronutrient adequacy among pregnant women aged 15-49 y in LMICs. Methods We used secondary quantitative 24-h recall data from 6 surveys in 4 LMICs (Bangladesh, Burkina Faso, India, and Nepal, total n = 4909). We computed the 10-food group Women's Dietary Diversity Score (WDDS-10) and calculated the mean probability of adequacy (MPA) of 11 micronutrients. Linear regression models were fitted to assess the associations between WDDS-10 and MPA. Sensitivity, specificity, and proportion of individuals correctly classified were used to assess the performance of MDD-W in predicting an MPA of >0.60. Results In the pooled sample, median values (interquartile range) of WDDS-10 and MPA were 3 (1) and 0.20 (0.34), respectively, whereas the proportion of pregnant women with an MPA of >0.60 was 9.6%. The WDDS-10 was significantly positively associated with MPA in each survey. Although the acceptable food group consumption threshold varied between 4 and 6 food groups across surveys, the threshold of 5 showed the highest performance in the pooled sample with good sensitivity (62%), very good specificity (81%), and percentage of correctly classified individuals (79%). Conclusions The WDDS-10 is a good predictor of dietary micronutrient adequacy among pregnant women aged 15-49 y in LMICs. Moreover, the threshold of 5 or more food groups for the MDD-W indicator may be extended to all women of reproductive age, regardless of their physiologic status.
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Affiliation(s)
- Eric O Verger
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | | | - Dang Bahya-Batinda
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Giles T. Hanley-Cook
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Alemayehu Argaw
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Elodie Becquey
- International Food Policy Research Institute (IFPRI), Dakar, Senegal
| | - Loty Diop
- International Food Policy Research Institute (IFPRI), Dakar, Senegal
| | - Aulo Gelli
- International Food Policy Research Institute (IFPRI), Washington, DC, United States
| | - Helen Harris-Fry
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Sunny S Kim
- International Food Policy Research Institute (IFPRI), Washington, DC, United States
| | - Phuong Hong Nguyen
- International Food Policy Research Institute (IFPRI), Washington, DC, United States
| | | | | | - Rock R Zagré
- International Food Policy Research Institute (IFPRI), Dakar, Senegal
| | - Edwige Landais
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Mathilde Savy
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Yves Martin-Prevel
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
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Pastori G, Brouwer ID, Siemonsma M, Verhoef H, Huong LT, Le Xuan TT, Mai TT, Samuel FO, Shittu OF, Eyinla TE, Even B, Hernandez R, Lundy M, de Brauw A, Wertheim-Heck S, Ambler K, Meldrum G, De Filippo A, Talsma EF. Fruit and Vegetable Intake of Females Before, During, and After Introduction of 3 Bundled Food System Interventions in Urban Vietnam and Nigeria. Curr Dev Nutr 2024; 8:102050. [PMID: 38156343 PMCID: PMC10751831 DOI: 10.1016/j.cdnut.2023.102050] [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: 01/31/2023] [Revised: 10/31/2023] [Accepted: 11/23/2023] [Indexed: 12/30/2023] Open
Abstract
Background Low fruit and vegetable (FV) intake in low- and middle-income countries, which is associated with noncommunicable diseases and micronutrient deficiencies, requires food system interventions addressing FV accessibility, affordability, and acceptability. Periodic FV intake monitoring during interventions informs progress toward achieving increased intakes and contributes to understanding the effectiveness of these interventions. Objectives This study evaluates the trend in FV intake before, during, and after implementation of a set of nutrition-sensitive food system interventions addressing accessibility, affordability, and acceptability to increase FV consumption over a 1-y period in Vietnamese and Nigerian low-income urban and periurban females. Methods We used the Diet Quality Questionnaire to assess FV food group consumption among 600 Vietnamese (Hanoi) and 610 Nigerian (Ibadan) females before, during, and after the interventions (Vietnam: July 2020-September 2021; Nigeria: November 2020-December 2021). A FV score was compared between exposure groups with (mixed) count modeling. The trend in consumption of individual FV groups was analyzed with mixed logistic regression. Results The FV score was stable over time, and a small increase was observed after the intervention period especially in Nigeria and in urban Vietnam. A decrease in the total score was observed in periurban Vietnam. Fluctuations were detected in the probability of consumption of individual FV groups over time especially within the fruit groups, probably due to seasonal availability. The degree of exposure could not explain differences in FV intake. Conclusions We found a marginal increase in the proportion of females consuming FV during the interventions in both countries. The FV score appeared to be a simple, quick, and easy-to-use indicator for monitoring diversity, variety, and consumption.
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Affiliation(s)
- Giulia Pastori
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
| | - Inge D Brouwer
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
- International Food Policy Research Institute, United States
| | - Meike Siemonsma
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
| | - Hans Verhoef
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
| | - Le Thi Huong
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Vietnam
| | - Thi Thanh Le Xuan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Vietnam
| | | | - Folake O Samuel
- Department of Human Nutrition and Dietetics, University of Ibadan, Nigeria
| | - Oluyemisi F Shittu
- Department of Human Nutrition and Dietetics, University of Ibadan, Nigeria
| | | | - Brice Even
- The Alliance of Bioversity International and the International Center for Tropical Agriculture, Vietnam and Colombia
| | - Ricardo Hernandez
- The Alliance of Bioversity International and the International Center for Tropical Agriculture, Vietnam and Colombia
| | - Mark Lundy
- The Alliance of Bioversity International and the International Center for Tropical Agriculture, Vietnam and Colombia
| | - Alan de Brauw
- International Food Policy Research Institute, United States
| | - Sigrid Wertheim-Heck
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
| | - Kate Ambler
- International Food Policy Research Institute, United States
| | - Gennifer Meldrum
- The Alliance of Bioversity International and the International Center for Tropical Agriculture, Vietnam and Colombia
| | - Amanda De Filippo
- The Alliance of Bioversity International and the International Center for Tropical Agriculture, Vietnam and Colombia
| | - Elise F Talsma
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
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49
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Kramarz C, Murphy E, Reilly MM, Rossor AM. Nutritional peripheral neuropathies. J Neurol Neurosurg Psychiatry 2023; 95:61-72. [PMID: 37536924 DOI: 10.1136/jnnp-2022-329849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 06/30/2023] [Indexed: 08/05/2023]
Abstract
Nutritional peripheral neuropathies are a global problem, heavily influenced by geopolitical, cultural and socioeconomic factors. Peripheral neuropathy occurs most frequently secondary to B-vitamin deficiencies, which is suspected to increase in years to come due to the popularity of vegan and vegetarian diets and increased use of bariatric surgery.This review will focus on the common B-vitamins for which a causal link to peripheral neuropathy is more established (vitamins B1, B2, B6, B9 and B12). We will review the historical human and animal data on which much of the clinical descriptions of vitamin deficiencies are based and summarise current available tools for accurately diagnosing a nutritional deficiency. We will also review recently described genetic diseases due to pathogenic variants in genes involved in B-vitamin metabolism that have helped to inform the phenotypes and potential causality of certain B-vitamins in peripheral neuropathy (B2 and B9).Endemic outbreaks of peripheral neuropathy over the last two centuries have been linked to food shortages and nutritional deficiency. These include outbreaks in Jamaican sugar plantation workers in the nineteenth century (Strachan's syndrome), World War two prisoners of war, Cuban endemic neuropathy and also Tanzanian endemic optic neuropathy, which remains a significant public health burden today. An improved understanding of lack of which vitamins cause peripheral neuropathy and how to identify specific deficiencies may lead to prevention of significant and irreversible disability in vulnerable populations.
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Affiliation(s)
- Caroline Kramarz
- Department of Neuromuscular Diseases, Queen Square UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Elaine Murphy
- Charles Dent Metabolic Unit, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Mary M Reilly
- Department of Neuromuscular Diseases, Queen Square UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Alexander M Rossor
- Department of Neuromuscular Diseases, Queen Square UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
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50
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Lagoumintzis G, Patrinos GP. Triangulating nutrigenomics, metabolomics and microbiomics toward personalized nutrition and healthy living. Hum Genomics 2023; 17:109. [PMID: 38062537 PMCID: PMC10704648 DOI: 10.1186/s40246-023-00561-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
The unique physiological and genetic characteristics of individuals influence their reactions to different dietary constituents and nutrients. This notion is the foundation of personalized nutrition. The field of nutrigenetics has witnessed significant progress in understanding the impact of genetic variants on macronutrient and micronutrient levels and the individual's responsiveness to dietary intake. These variants hold significant value in facilitating the development of personalized nutritional interventions, thereby enabling the effective translation from conventional dietary guidelines to genome-guided nutrition. Nevertheless, certain obstacles could impede the extensive implementation of individualized nutrition, which is still in its infancy, such as the polygenic nature of nutrition-related pathologies. Consequently, many disorders are susceptible to the collective influence of multiple genes and environmental interplay, wherein each gene exerts a moderate to modest effect. Furthermore, it is widely accepted that diseases emerge because of the intricate interplay between genetic predisposition and external environmental influences. In the context of this specific paradigm, the utilization of advanced "omic" technologies, including epigenomics, transcriptomics, proteomics, metabolomics, and microbiome analysis, in conjunction with comprehensive phenotyping, has the potential to unveil hitherto undisclosed hereditary elements and interactions between genes and the environment. This review aims to provide up-to-date information regarding the fundamentals of personalized nutrition, specifically emphasizing the complex triangulation interplay among microbiota, dietary metabolites, and genes. Furthermore, it highlights the intestinal microbiota's unique makeup, its influence on nutrigenomics, and the tailoring of dietary suggestions. Finally, this article provides an overview of genotyping versus microbiomics, focusing on investigating the potential applications of this knowledge in the context of tailored dietary plans that aim to improve human well-being and overall health.
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Affiliation(s)
- George Lagoumintzis
- Division of Pharmacology and Biosciences, Department of Pharmacy, School of Health Sciences, University of Patras, 26504, Patras, Greece.
| | - George P Patrinos
- Division of Pharmacology and Biosciences, Department of Pharmacy, School of Health Sciences, University of Patras, 26504, Patras, Greece.
- Department of Genetics and Genomics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, Abu Dhabi, UAE.
- Zayed Center for Health Sciences, United Arab Emirates University, Al-Ain, Abu Dhabi, UAE.
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