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Cusack H, Hewlings S. The Impact of Iron Supplementation on Athletic Performance in Elite-Level Female Athletes–A Systematic Review. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Salam RA, Das JK, Irfan O, Ahmed W, Sheikh SS, Bhutta ZA. Effects of preventive nutrition interventions among adolescents on health and nutritional status in low- and middle-income countries: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1085. [PMID: 37131413 PMCID: PMC8356321 DOI: 10.1002/cl2.1085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background Malnutrition is one of the most common causes of morbidity and mortality among children and adolescents and is now considered to be one of the largest risk factors responsible for the global burden of diseases along with poor diet. Objectives The objective of this review was to assess the impact of preventive nutrition interventions (including nutrition education and counselling; micronutrient supplementation/fortification and macronutrient supplementation) to improve the health and nutritional status of adolescents aged 10-19 years in low- and middle-income countries (LMICs). The secondary objective of the review was to assess various contextual factors based on the World Health Organisation (WHO) health system building blocks framework that might potentially impact the effectiveness of these interventions for this age group. Search Methods The search was conducted on Cochrane Controlled Trials Register (CENTRAL), MEDLINE, EMBASE, CINAHL, PsycINFO, the WHO nutrition databases, CAB Global Health, Social Science Citation Index, Scopus, WHO Global Health Index, ADOLEC and EPPI until February 5, 2019. We searched Google Scholar along with key nutrition agencies database such as Nutrition International, the Global Alliance for Improved Nutrition, the World Food Programme and HarvestPlus to search for nonindexed, grey literature to locate relevant programme evaluations and any additional trials. All searches were performed without any restrictions on publication date, language or publication status. Selection Criteria We included randomised controlled trials, quasiexperimental studies, controlled before-after studies and interrupted time series evaluating the effectiveness of preventive nutrition interventions among adolescents between 10 and 19 years of age from LMICs. Data Collection and Analysis Two review authors independently assessed trials for inclusion, assessed risk of bias and extracted data from included studies. Meta-analysis was conducted separately for each outcome and intervention. For dichotomous data, we reported risk ratios (RR) with 95% confidence intervals (CI). For continuous data, we reported the mean difference (MD) or standard mean difference (SMD) with 95% CI. Main Results This review summarises findings from a total of 10 studies from 15 papers including 10,802 participants. All the studies included in this review assessed the impact of micronutrient supplementation/fortification on health and nutritional status among adolescents in LMIC. We did not find any study assessing the impact of nutrition education and counselling or on macronutrient supplementation among adolescents. Micronutrient supplementation/fortification interventions included calcium/vitamin D supplementation/fortification, iron supplementation with or without folic acid, zinc supplementation and multiple micronutrient (MMN) fortification. The majority of the studies (eight out of 10 studies) included adolescent girls aged between 10 and 19 years of age. We did not find any large scale preventive nutrition intervention programmes targeting adolescents in LMICs. We are uncertain of the effect of iron supplementation with or without folic acid on anaemia (daily supplementation; RR: 1.04, 95% CI 0.88, 1.24; one study; 1,160 participants; low quality evidence. Weekly supplementation; RR: 1.07, 95% CI: 0.91, 1.26; one study; 1,247 participants; low quality evidence). We are uncertain of the effect of various micronutrient supplementation/fortification on body mass index (calcium/vitamin D supplementation; (MD: -0.01 kg/m2; 95% CI: -1.20, 1.17; two studies; 730 participants; I 2 94%; very low quality evidence, iron supplementation with or without folic acid; MD: 0.29 kg/m2; 95% CI: -0.25, 0.83; two studies; 652 participants; I 2 69%; very low quality evidence, zinc supplementation; MD: 0.35 kg/m2; 95% CI: -0.15, 0.85; one study; 382 participants; very low quality evidence) and MMN fortification; MD: 0.23 kg/m2, 95% CI: -0.11, 0.57; two studies; 943 participants; I 2 22%; very low quality evidence). None of the included studies reported any other primary outcomes including morbidity or adverse effects. Iron supplementation with or without folic acid may improve haemoglobin concentrations (MD: 0.42 g/dL, 95% CI: 0.13, 0.71; four studies; 1,020 participants; I 2 89%; low quality evidence). Calcium/vitamin D supplementation may improve serum 25(OH) D levels (standardised mean difference [SMD]: 2.85, 95% CI: 0.89, 4.82; two studies; 395 participants; I 2 99%; low quality evidence). We are uncertain of the effect of calcium only supplementation (MD: 0.02 g/cm2, 95% CI: -0.00, 0.04; one study; 233 participants; low quality outcome) and calcium + vitamin D supplementation (MD: 0.02 g/cm2, 95% CI: -0.00, 0.04; one study; 235 participants; low quality evidence) on total bone mineral density (BMD). We are uncertain of the effect of MMN fortification on haemoglobin concentrations (MD: -0.10 g/dL, 95% CI: -0.88, 0.68; two studies; 1102 participants; I 2 100%; very low quality evidence); calcium supplementation on total body bone mineral content (BMC); (MD: 30.20 g, 95% CI: -40.56, 100.96; one study; 233 participants; low quality evidence), calcium + vitamin D supplementation on total body BMC (MD: 21.60 g, 95% CI: -45.32, 88.52; one study; 235 participants; low quality evidence) and zinc supplementation on serum zinc levels (SMD: 6.94, 95% CI: -4.84, 18.71; two studies; 494 participants; very low quality evidence). One study reported the impact of iron supplementation with or without folic acid on cognition of adolescent girls suggesting improved cognition in most of the tests with daily or twice weekly supplementation compared to once weekly or no supplementation. None of the other secondary outcomes were reported including any other development outcomes and all-cause mortality. These findings warrant caution while interpreting due to very few studies and high heterogeneity. Authors' Conclusions There is limited evidence of micronutrient supplementation/fortification among adolescents on health and nutritional status in LMICs, with lack of evidence on nutrition education and counselling and macronutrient supplementation. The findings are generaliseable for adolescent girls since all studies (except one) targeted female adolescents.
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Affiliation(s)
- Rehana A. Salam
- Division of Women and Child HealthAga Khan University HospitalKarachiPakistan
| | - Jai K. Das
- Division of Women and Child HealthAga Khan University HospitalKarachiPakistan
| | - Omar Irfan
- Division of Women and Child HealthAga Khan University HospitalKarachiPakistan
| | - Wardah Ahmed
- Department of PediatricsAga Khan UniversityKarachiPakistan
| | - Sana S. Sheikh
- Division of Women and Child HealthAga Khan University HospitalKarachiPakistan
| | - Zulfiqar A. Bhutta
- Centre for Global Child HealthThe Hospital for Sick ChildrenTorontoCanada
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Effects of Preventive Nutrition Interventions among Adolescents on Health and Nutritional Status in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Nutrients 2019; 12:nu12010049. [PMID: 31878019 PMCID: PMC7019616 DOI: 10.3390/nu12010049] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/12/2019] [Accepted: 12/17/2019] [Indexed: 12/30/2022] Open
Abstract
The objective of this review was to assess the impact of preventive nutrition interventions on health and nutritional status of adolescents aged 10–19 years in low- and middle-income countries (LMICs). We searched the databases until 5 February 2019 without any restrictions on publication, date, language, or publication status. A total of 10 studies (15 papers) including 10,802 participants assessing the impact of micronutrient supplementation/fortification were included in this review. We did not find any study assessing the impact of nutrition education and counseling or macronutrient supplementation among adolescents. Among primary outcomes, we are uncertain of the effect of iron supplementation with or without folic acid on anemia (daily supplementation; relative risk (RR): 1.04, 95% confidence interval (CI) 0.42, 2.57; one study; 1160 participants; low-quality evidence; weekly supplementation; RR: 1.07, 95% CI: 0.46, 2.52; one study; 1247 participants; low-quality evidence). We are also uncertain of the effect of various micronutrient supplementation/fortification on body mass index (BMI) (calcium/vitamin D supplementation; (MD: −0.01 kg/m2; 95% CI: −1.20, 1.17; two studies; 730 participants; I2 94%; very-low-quality evidence, iron supplementation with or without folic acid; MD: 0.47 kg/m2; 95% CI: −0.17, 1.11; two studies; 652 participants; I2 37%; very-low-quality evidence, zinc supplementation; MD: 0.35 kg/m2; 95% CI: −0.15, 0.85; one study; 382 participants; very-low-quality evidence) and multiple micronutrient (MMN) fortification; MD: 0.23 kg/m2, 95% CI: −0.11, 0.57; two studies; 943 participants; I2 22%; very-low-quality evidence). None of the included studies reported any other primary outcomes including morbidity or adverse effects. Among secondary outcomes, iron supplementation with or without folic acid may improve hemoglobin concentrations, and calcium/vitamin D supplementation may improve serum 25(OH)D levels, while calcium only supplementation and calcium and vitamin D supplementation may marginally improve total body bone mineral density (BMD). We are uncertain of the effect of MMN fortification on hemoglobin concentrations, calcium supplementation on total body bone mineral content (BMC), calcium + vitamin D supplementation on total body BMC, and zinc supplementation on zinc levels. There is limited evidence of micronutrient supplementation/fortification among adolescents, especially adolescent boys, on health and nutritional status in LMICs. These findings should be interpreted with caution due to the low quality and limited number of studies.
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Ghaseminasab Parizi M, Tangestani H, Rahmdel S, Aqaeinejad R SM, Abdollahzadeh SM, Mazloomi SM. Duplicate portion sampling gives the most accurate iron intake estimate: Implications for iron status of female students. INT J VITAM NUTR RES 2019; 88:190-198. [PMID: 30982441 DOI: 10.1024/0300-9831/a000510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Iron deficiency (ID) is one of the most common nutritional problems in the developing world, affecting primarily women of childbearing age. Poor dietary iron intake is a major reason of ID. Accurate measurement of iron intake is of crucial importance to combat the problem. The daily dietary iron intake of 67 female students aged between 20-30 years (a mean BMI of 21.8±3.4 kg/m2) was evaluated using three assessment methods: atomic absorption spectrometry of 3-day food duplicate samples, and food composition tables (FCTs) in combination with either food frequency questionnaire (FFQ) or dietary records. Iron status was examined using hematological and biochemical tests. The dietary iron intake determined by duplicate portion sampling (DPS; 4.12±1.84 mg/day) was significantly lower than the FCT-based estimates (P<0.001), and it was less than ¼ of the recommended dietary allowance of 18 mg/day. No significant correlation was found between DPS technique and FCT-based assessment methods. Fifty percent of the participants had small or depleted iron stores (serum ferritin< 30 ng/mL), but only 4.5% had ID anemia (serum ferritin< 12 ng/mL and hemoglobin<12 g/dL). Dietary iron intakes and FFQ-based intakes of vitamin C were not significantly correlated with all the investigated hematological parameters. In order to take some steps toward more practical approaches to combat this health problem, development of an accurate iron intake assessment seems to be the first priority. In this regard, improvement and validation of national FCTs would be a promising solution.
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Affiliation(s)
| | - Hadith Tangestani
- 1 School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samane Rahmdel
- 1 School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Seyed Mohammad Mazloomi
- 1 School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Lassi ZS, Moin A, Das JK, Salam RA, Bhutta ZA. Systematic review on evidence-based adolescent nutrition interventions. Ann N Y Acad Sci 2017; 1393:34-50. [PMID: 28436101 DOI: 10.1111/nyas.13335] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 02/20/2017] [Accepted: 02/21/2017] [Indexed: 01/08/2023]
Abstract
Adolescence is a critical stage in the life cycle, and adequate nutrition is necessary for the proper growth and development of individuals and their offspring. Here, we comprehensively review all published systematic reviews (through October 2016) on adolescents (10-19 years) and women of reproductive age, including pregnant women, which targeted interventions related to nutrition. For interventions where there was no existing systematic review on adolescents, we reviewed primary studies/trials. We included interventions on micronutrient supplementation (iron, folic acid, iron-folic acid (IFA), calcium, vitamin D, vitamin A, zinc, iodine, and multiple micronutrients), food/protein energy supplementation, nutrition education for pregnant adolescents, obesity prevention and management, and management of gestational diabetes. We identified a total of 35 systematic reviews, of which only five were conducted on adolescents, and 107 primary studies on adolescents. Our review suggests that iron alone, IFA, zinc, and multiple micronutrient supplementation in adolescents can significantly improve serum hemoglobin concentration. While zinc supplementation in pregnant adolescents showed improvements in preterm birth and low birth weight, we found a paucity of trials on calcium, vitamin D, vitamin A, and iodine supplementation. We found limited evidence on food/protein energy supplementation in adolescents. Interventions to prevent and manage obesity showed a nonsignificant impact on reducing body mass index. This review underscores the importance of adolescent nutrition interventions. It is imperative that countries design nutritional interventions, particularly for adolescents.
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Affiliation(s)
- Zohra S Lassi
- Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Anoosh Moin
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Jai K Das
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Rehana A Salam
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Zulfiqar A Bhutta
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.,Robert Harding Chair in Global Child Health & Policy, Centre for Global Child Health, the Hospital for Sick Children, Toronto, Canada.,Founding Director, Center of Excellence in Women and Child Health, the Aga Khan University, Karachi, Pakistan
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Khammarnia M, Amani Z, Hajmohammadi M, Ansari-Moghadam A, Eslahi M. A Survey of Iron Supplementation Consumption and its Related Factors in High School Students in Southeast Iran, 2015. Malays J Med Sci 2016; 23:57-64. [PMID: 27904426 DOI: 10.21315/mjms2016.23.5.8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 07/25/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND This study aimed to estimate the prevalence of iron supplement consumption and its associated factors among high school students in Iran. METHODS A mixed-methods (quantitative-qualitative) study was conducted in Zahedan, southeast Iran, in 2015. The sample comprised 400 high school students from different areas of Zahedan who were randomly selected. A standard questionnaire and semi-structured interview were used to collect data in the quantitative and qualitative phases, respectively. The data were analysed using SPSS software with one-way ANOVA and Pearson's chi square. Additionally, content analysis was used for the qualitative analysis. RESULTS In total, 38.2% of the students had not consumed iron supplements in the past 16 weeks, and students in third grade had the highest non-consumption rate (P=0.006). There was a significant positive relationship between iron tablet consumption and grade point average in the last year (P = 0.003). Digestive problems, influence of family and friends, students' reluctance, and poor environmental situations were the most important factors related to students' refusal to take tablets. CONCLUSIONS Most students did not take or irregularly consumed iron supplements. Based on the digestive problems of the students, improving the taste and quality of iron tablets is recommended.
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Affiliation(s)
- Mohammad Khammarnia
- Health Promotion Research Center, Zahedan University of Medical Sciences, Razi St, P.O. Box 98135, Zahedan, Iran
| | - Zahra Amani
- Health Promotion Research Center, Zahedan University of Medical Sciences, Razi St, P.O. Box 98135, Zahedan, Iran
| | - Mahsa Hajmohammadi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Razi St, P.O. Box 98135, Zahedan, Iran
| | - Alireza Ansari-Moghadam
- Health Promotion Research Center, Zahedan University of Medical Sciences, Razi St, P.O. Box 98135, Zahedan, Iran
| | - Marzieh Eslahi
- Student Research Committee, Shiraz University of Medical Sciences,, Zand St, P.O. Box 14336 - 71348, Shiraz, Iran
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Salam RA, Hooda M, Das JK, Arshad A, Lassi ZS, Middleton P, Bhutta ZA. Interventions to Improve Adolescent Nutrition: A Systematic Review and Meta-Analysis. J Adolesc Health 2016; 59:S29-S39. [PMID: 27664593 PMCID: PMC5026685 DOI: 10.1016/j.jadohealth.2016.06.022] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/14/2016] [Accepted: 06/24/2016] [Indexed: 01/08/2023]
Abstract
Adequate adolescent nutrition is an important step for optimal growth and development. In this article, we systematically reviewed published studies till December 2014 to ascertain the effectiveness of interventions to improve adolescent nutrition. We found one existing systematic review on interventions to prevent obesity which we updated and conducted de novo reviews for micronutrient supplementation and nutrition interventions for pregnant adolescents. Our review findings suggest that micronutrient supplementation among adolescents (predominantly females) can significantly decrease anemia prevalence (relative risk [RR]: .69; 95% confidence interval [CI]: .62-.76) while interventions to improve nutritional status among "pregnant adolescents" showed statistically significant improved birth weight (standard mean difference: .25; 95% CI: .08-.41), decreased low birth weight (RR: .70; 95% CI: .57-.84), and preterm birth (RR: .73; 95% CI: .57-.95). Interventions to promote nutrition and prevent obesity had a marginal impact on reducing body mass index (standard mean difference: -.08; 95% CI: -.17 to .01). However, these findings should be interpreted with caution due to significant statistical heterogeneity.
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Affiliation(s)
- Rehana A Salam
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Mehar Hooda
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Jai K Das
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Ahmed Arshad
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Zohra S Lassi
- Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Philippa Middleton
- South Australian Health and Medical Research Institute and The University of Adelaide, Adelaide, Australia
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada; Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan.
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Kaluza J, Madej D. Adverse effect after cessation of rats' unjustified iron or iron and zinc supplementation on hematological parameters but not ferritin concentration. Clin Nutr 2014; 34:44-8. [PMID: 24423746 DOI: 10.1016/j.clnu.2013.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 12/07/2013] [Accepted: 12/17/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND & AIMS Studies on the impact of supplementation cessation are lacking. We investigated the effect of iron and iron/zinc supplementation and cessation of this intervention on iron status parameters. METHODS The study was conducted on 6-week male Wistar rats, in 3 stages: 4-week adaptation to the diets: C--control (AIN-93M) and D--iron deficient (mineral mix without iron); 4-week supplementation: 10-times more iron (CSFe, DSFe) or iron/zinc (CSFeZn, DSFeZn) compared to C; 2-week post-supplementation period (the same diets as in the first stage). Red blood cell count, hemoglobin, hematocrit, transferrin saturation (TSAT) and ferritin concentration were determined. RESULTS After stage II D rats had statistically significantly (p-value ≤ 0.05) lower hemoglobin and TSAT in comparison to DSFe rats, but not DSFeZn, and significantly lower ferritin concentration in comparison to DSFe and DSFeZn rats. After stage III, CSFe and CSFeZn rats had a significantly lower level of all analyzed hematology parameters compared to C, in contrast rats fed DSFe and DSFeZn diets had higher hemoglobin concentration and hematocrit in comparison to D group. Moreover, in comparison to D rats those fed DSFe diet had higher TSAT and those fed DSFe and DSFeZn diets had significantly higher ferritin concentration. CONCLUSIONS After cessation of unjustified both iron and iron/zinc supplementation resulted in an adverse effect on hematological but not other iron status parameters. In the situation of iron deficiency in the diet, iron supplementation alone had a prolonged beneficial effect and was more effective than simultaneous iron/zinc supplementation in the improvement of the iron status.
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Affiliation(s)
- Joanna Kaluza
- Department of Human Nutrition, Warsaw University of Life Sciences - SGGW, 159C Nowoursynowska Str, 02-776 Warsaw, Poland.
| | - Dawid Madej
- Department of Human Nutrition, Warsaw University of Life Sciences - SGGW, 159C Nowoursynowska Str, 02-776 Warsaw, Poland
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Ploeger HE, Takken T, Wilk B, Issenman RM, Sears R, Suri S, Timmons BW. Exercise capacity in pediatric patients with inflammatory bowel disease. J Pediatr 2011; 158:814-9. [PMID: 21146188 DOI: 10.1016/j.jpeds.2010.10.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 08/31/2010] [Accepted: 10/15/2010] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To examine exercise capacity in youth with Crohn's disease (CD) and ulcerative colitis (UC). STUDY DESIGN Eleven males and eight females with CD and six males and four females with UC participated. Patients performed standard exercise tests to assess peak power (PP) and mean power (MP) and peak aerobic mechanical power (W(peak)) and peak oxygen uptake (VO(2peak)). Fitness variables were compared with reference data and also correlated with relevant clinical outcomes. RESULTS Pediatric patients with inflammatory bowel disease had lower PP (∼90% of predicted), MP (∼88% of predicted), W(peak) (∼91% of predicted), and VO(2peak) (∼75% of predicted) compared with reference values. When patients with CD or UC were compared separately to reference values, W(peak) was significantly lower only in the CD group. No statistically significant correlations were found between any exercise variables and disease duration (r = 0.01 to 0.14, P = .47 to .95) or disease activity (r = -0.19 to -0.31, P = .11 to .38), measured by pediatric CD activity index or pediatric ulcerative colitis activity index. After controlling for chronological age, recent hemoglobin levels were significantly correlated with PP (r = 0.45, P = .049), MP (r = 0.63, P = .003), VO(2peak) (r = 0.62, P = .004), and W(peak) (r = 0.70, P = .001). CONCLUSIONS Pediatric patients with inflammatory bowel disease exhibit impaired aerobic and anaerobic exercise capacity compared with reference values.
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Affiliation(s)
- Hilde E Ploeger
- Institute of Human Movement Sciences, University of Groningen, Groningen, The Netherlands
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Amani R, Soflaei M. Nutrition education alone improves dietary practices but not hematologic indices of adolescent girls in Iran. Food Nutr Bull 2007; 27:260-4. [PMID: 17542117 DOI: 10.1177/156482650602700309] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Iron-deficiency anemia is the most prevalent nutritional deficiency worldwide. Iron-deficiency anemia has particular negative consequences on women in their childbearing years, and its prevention is a high priority in most health systems. OBJECTIVE This interventional study assessed the effect of nutrition education on hematologic indices, iron status, nutritional knowledge, and nutritional practices of high-school girls in Iran. METHODS Sixty healthy 16- to 18-year-old girls were randomly selected from two high schools in the city of Ahvaz and divided into two equally matched groups, one that received nutrition education, and one that did not. The education group received instruction in face-to-face sessions, group discussions, and pamphlets for 2 months. The control group did not receive any information during the study. Hematologic tests, corpuscular indices, and serum ferritin levels were measured at baseline and after 2 months. Food-frequency questionnaires were administered and histories taken, clinical signs of nutritional deficiencies observed, anthropometric measurements taken, nutritional knowledge tested, practices determined, and lifestyle questionnaires administered to all subjects. RESULTS There were no statistically significant differences in any baseline characteristics between the two groups. Scores for nutritional knowledge and practices of the education group were significantly higher after two months compared with the baseline (31.4 +/- 6 vs. 24.3 +/- 5.9 points, p < .001, and 31.2 +/- 5 vs. 28.4 +/- 5.7 points, p < .05, respectively). The scores in the control group showed no significant changes from baseline to 2 months. Mean corpuscular volume values were elevated in the education group (p < .001) but not in the control group. However, in the control group, serum ferritin concentrations showed about a 17% drop at the end of the study (p < .004). There were no changes in other hematologic, lifestyle, clinical, or anthropometric data compared with baseline after completion of the study in both groups. CONCLUSION These findings indicate that nutritional education can improve knowledge of healthy nutrition and lifestyle choices. Focused nutritional education using available resources and correcting current dietary habits in a vulnerable group of young women may result in dietary changes that can ultimately improve iron intake.
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Affiliation(s)
- Reza Amani
- Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundi-Shapour University of Medical Sciences, Ahvaz, Iran.
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