Serum copper levels among a tribal population in Jharkhand State, India: a pilot survey

Status of Vitamin B12, Zinc, Copper, Selenium, Manganese, Molybdenum and Cobalt in Severe Acute Malnutrition

OBJECTIVES

To define the vitamin B12 levels and other micronutrients status in severe acute malnutrition (SAM) children.

METHODS

This was a prospective hospital based cross-sectional study.

INCLUSION CRITERIA

Children with severe acute malnutrition as per WHO criteria.

EXCLUSION CRITERIA

(i) Pernicious anemia (ii) Autoimmune gastritis (iii) SAM children on exclusive vitamin B12 supplementation. All enrolled children underwent a detailed clinical history, general physical examination with more emphasis on clinical features of vitamin B12 and other micronutrients deficiencies. Three ml of venous blood was collected to estimate vitamin B12 and other micronutrients. Primary outcome was percentage of deficiency of serum vitamin B12, zinc, copper, selenium, manganese, molybdenum and cobalt in SAM children.

RESULTS

Fifty children were included in the study. The mean age of children was 15.60±12.90 mo with male to female ratio 0.85:1. The common clinical presentation in order of frequency were upper respiratory infection (URI) symptoms 35 (70%), hepatomegaly 24 (48%), Hyperpigmentation 17 (34%), angular cheilitis 14 (28%), tremors 11 (22%), edema 07 (14%), and hypotonia 05 (10%). Anemia was found in 44 (88%) children. Prevalence of vitamin B12 deficiency was 34%. Other micronutrient deficiencies observed were cobalt 24 (100%), copper 05 (12%), zinc 04 (9.5%), and molybdenum 03 (12.5%). No statistical significance was found between clinical symptoms and levels of vitamin B12 with different age and sex.

CONCLUSIONS

Prevalence of low vitamin B12 and cobalt were more common than other micronutrients.

Association between Maternal Dietary Diversity and Low Birth Weight in Central India: A Case-Control Study

Low birth weight (LBW) is one of the major public health challenges in India. LBW etiology is multifactorial and linked to multiple determinants, including maternal undernutrition and sociodemographic characteristics. The objective of the present endeavor was to assess how maternal dietary diversity and other sociodemographic factors among marginalized populations are associated with the incidence of LBW. The study was a part of the community-based intervention that aimed to improve maternal and child health in the Morena district of Madhya Pradesh, a state in central India. In this case-control study, cases were defined as mothers with an LBW child (<2500 grams) and controls as mothers without an LBW child. A quantitative survey was done with women of reproductive age, having at least one child aged 0–24 months. We calculated the dietary diversity based on the number of food groups consumed during pregnancy by women on a daily basis. Stepwise logistic regression models were built to test for associations between sociodemographic and dietary diversity variables and LBW incidence. There were 157 mothers with and 214 without an LBW child. Women's diets mainly consisted of grains, such as wheat, rice, maize, and roots and tubers. Eggs and meat were consumed by less than 1% of the women. There were 20% lesser chances of an LBW child with increasing maternal dietary diversity scores (odds ratio: 0.79; 95% CI: 0.65, 0.96). The poor maternal diet quality during pregnancy may result in adverse birth outcomes with long-term consequences in a child.

Micronutrient status of Indian population

Micronutrients play an important role in the proper growth and development of the human body and its deficiency affects the health contributing to low productivity and vicious cycle of malnutrition, underdevelopment as well as poverty. Micronutrient deficiency is a public health problem affecting more than one-fourth of the global population. Several programmes have been launched over the years in India to improve nutrition and health status of the population; however, a large portion of the population is still affected by micronutrient deficiency. Anaemia, the most common form of micronutrient deficiency affects almost 50 to 60 per cent preschool children and women, while vitamin A deficiency and iodine-deficiency disorders (IDD) have improved over the years. This review focuses on the current scenario of micronutrient (anaemia, vitamin A, iodine, vitamin B12, folate, ferritin, zinc, copper and vitamin C) status in the country covering national surveys as well as recent studies carried out.

Bariatric Nutrition Guidelines for the Indian Population

BACKGROUND

Bariatric surgery numbers have seen a sharp rise in India in the last decade. A country known for its undernourished population has seen economic growth and with it, greater influence of western culture and foods. The obesity epidemic is on the rise here and India is one of the 10 most obese nations of the world being second only to China in the number of type 2 diabetes. Nutritionists in India often rely on recommendations and guidelines meant for the Caucasian population. Religious and cultural practices influence the dietary habits and patterns of the Indian population to a great extent; because of which the nutritional requirements are very different. This document was put together with an aim to provide nutritionists with recommendations on how to manage the Indian bariatric patient.

METHODS

A bariatric nutrition round table meeting was initiated by the Centre for Obesity and Digestive Surgery (CODS) to bring together experts in the field of bariatric nutrition to review current data on nutritional deficiencies in the morbid obese and existing post-operative deficiencies and to formulate nutritional recommendations for bariatric/metabolic surgery specific to patients from India.

RESULTS

Percentage of nutritional deficiencies and reasons for the same were identified among the Indian population and recommendations were made to suit this particular population.

CONCLUSION

It is recommended that all patients undergo compulsory pre-operative nutritional counseling and nutritional investigations and that nutritional follow-up be continued lifelong. In addition, long-term implications like hypoglycemia, dumping syndrome, sugar cravings, and weight regain, need to be picked up and managed efficiently. Most importantly, post-operative supplementation is a must irrespective of type of surgery.

Copper concentration in a healthy urban adult population of southern Iran

Nutritional deficiencies are important and widespread problems in most developing countries. Preventing and correcting micronutrient deficiencies are important because of the multiple negative consequences of these deficiencies. This study was designed to determine the prevalence of copper deficiency in an adult population in Shiraz, southern Iran. We also determined the association between copper status and other factors such as age, sex, and body mass index (BMI). In this cross-sectional study, 416 adults residing in Shiraz were selected by two-stage sampling. Serum copper was measured by flame-atomic absorption spectrometry. The data were analyzed with SPSS software. Mean age in our sample was 39.33 ± 15.06 years, and mean BMI was 26.17 ± 4.81 kg/m(2). Mean serum copper concentration was 118.15 ± 54.33 μg/dL in the whole sample, 109.74 ± 56.22 μg/dL in men, and 122.15 ± 53.04 μg/dL in women. The overall prevalence of copper deficiency was 24%. The prevalence of copper deficiency differed significantly between men and women but not between different age groups. Serum copper concentration correlated significantly with BMI (p < 0.05). This study is the first to evaluate serum copper status in a healthy population in southern Iran. We show that the mean copper concentrations were higher than those reported for Iranian populations in northern cities and were also higher compared with studies in most other countries. We suggested more detailed studies to identify the etiological determinants of this nutritional deficiency in Iran and elsewhere.