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Liu H, Wang Q, Dong Z, Yu S. Dietary zinc intake and migraine in adults: a cross-sectional analysis of the National Health and Nutrition Examination Survey 1999-2004. Headache 2023; 63:127-135. [PMID: 36588459 DOI: 10.1111/head.14431] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The study examined the relationship between dietary zinc intake and migraine. BACKGROUND Neuroinflammatory and oxidative stress are involved in the pathogenesis of migraine. Little is known about the effects of zinc, an anti-inflammatory and antioxidant trace element, on migraine. METHODS The US National Health and Nutrition Examination Survey data from 1999 to 2004 were analyzed for this cross-sectional study. Participants who had severe headache or migraine were classified as having migraine. Dietary zinc intake was evaluated using the 24 h dietary recall system. RESULTS A total of 11,088 participants were included, of whom, 20.2% (2236/11,088) reported having migraine disease. Compared to the lowest dietary zinc intake quintile (Q1, ≤5.9 mg/day), the adjusted odds ratios for migraine in Q2 (6.0-8.4 mg/day), Q3 (8.5-11.2 mg/day), Q4 (11.3-15.7 mg/day), and Q5 (≥15.8 mg/day) were 0.73 (95% confidence interval [CI]: 0.61-0.88, p = 0.004), 0.71 (95% CI: 0.56-0.91, p = 0.013), 0.71 (95% CI: 0.57-0.90, p = 0.008), and 0.70 (95% CI: 0.52-0.94, p = 0.029), respectively. Sensitivity analysis of zinc supplementation survey participants also showed an association between dietary zinc intake and migraine. Compared to the lowest total zinc intake quintile (Q1: 0.5-9.6 mg/day), the adjusted odds ratios for migraine in Q3 (19.3-24.3 mg/day) and Q4 (24.4-32.5 mg/day) were 0.62 (95% CI: 0.46-0.83, p = 0.019) and 0.67 (95% CI: 0.49-0.91, p = 0.045), respectively. CONCLUSIONS Our findings indicate an inverse association between dietary zinc intake and migraine in adult Americans.
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Affiliation(s)
- Huanxian Liu
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.,International Headache Center, Chinese PLA General Hospital, Beijing, China
| | - Qi Wang
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.,International Headache Center, Chinese PLA General Hospital, Beijing, China
| | - Zhao Dong
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.,International Headache Center, Chinese PLA General Hospital, Beijing, China
| | - Shengyuan Yu
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.,International Headache Center, Chinese PLA General Hospital, Beijing, China
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Consalez F, Ahern M, Andersen P, Kjellevold M. The Effect of the Meat Factor in Animal-Source Foods on Micronutrient Absorption: A Scoping Review. Adv Nutr 2022; 13:2305-2315. [PMID: 36055778 PMCID: PMC9776636 DOI: 10.1093/advances/nmac089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/21/2022] [Accepted: 08/18/2022] [Indexed: 01/29/2023] Open
Abstract
The EAT-Lancet Commission's planetary health guidelines suggest a reduction in the consumption of animal-source foods (ASFs) for better health and more sustainable food systems. ASFs are highly nutrient dense, therefore suited to address the widespread issue of micronutrient deficiencies, particularly in low-resource settings where diets are predominantly plant based. ASFs are also believed to contain the meat factor, a substance enhancing the absorption of micronutrients from plant-based foods. We conducted a scoping review with the objective of systematically mapping the available evidence on the meat factor. The MEDLINE/PubMed and Web of Science databases were searched for literature published up to September 2021. Articles eligible for inclusion were all studies assessing the effect of adding ASFs and/or ASF fractions on micronutrient absorption from a plant-based meal or the overall diet in animal models and human subjects. Screening and data extraction were performed, and results were charted into 12 categories. We identified 77 articles eligible for inclusion, 52 of which were conducted in human subjects, 24 in animal models, and 1 in both. The addition of muscle tissue and muscle tissue fractions to single plant-based meals steadily increased absorption of iron and zinc across studies. The efficacy of the meat factor in increasing iron and zinc absorption in the overall diet is less clear. No clear differences emerged between red meat, poultry, and fish in promoting the meat factor effect. No clear evidence indicates that milk and egg products contain the meat factor. Our review highlights the importance of muscle tissue for the potential of the meat factor to enhance absorption of micronutrients of concern. Although the literature supports including sustainable and economically accessible forms of these ASFs into the diet, we found limited studies in resource-poor countries and of diets with low meat intake.
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Affiliation(s)
- Fabio Consalez
- Fisheries and Aquaculture Division, Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
| | - Molly Ahern
- Fisheries and Aquaculture Division, Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
| | - Peter Andersen
- Department of Geography, University of Bergen, Bergen, Norway
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Sangeetha VJ, Dutta S, Moses JA, Anandharamakrishnan C. Zinc nutrition and human health: Overview and implications. EFOOD 2022. [DOI: 10.1002/efd2.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- V. J. Sangeetha
- Computational Modeling and Nanoscale Processing Unit National Institute of Food Technology, Entrepreneurship and Management – Thanjavur, Ministry of Food Processing Industries, Government of India Thanjavur India
| | - Sayantani Dutta
- Computational Modeling and Nanoscale Processing Unit National Institute of Food Technology, Entrepreneurship and Management – Thanjavur, Ministry of Food Processing Industries, Government of India Thanjavur India
| | - J. A. Moses
- Computational Modeling and Nanoscale Processing Unit National Institute of Food Technology, Entrepreneurship and Management – Thanjavur, Ministry of Food Processing Industries, Government of India Thanjavur India
| | - C. Anandharamakrishnan
- Computational Modeling and Nanoscale Processing Unit National Institute of Food Technology, Entrepreneurship and Management – Thanjavur, Ministry of Food Processing Industries, Government of India Thanjavur India
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Kumar SB, Arnipalli SR, Mehta P, Carrau S, Ziouzenkova O. Iron Deficiency Anemia: Efficacy and Limitations of Nutritional and Comprehensive Mitigation Strategies. Nutrients 2022; 14:nu14142976. [PMID: 35889932 PMCID: PMC9315959 DOI: 10.3390/nu14142976] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 12/16/2022] Open
Abstract
Iron deficiency anemia (IDA) has reached epidemic proportions in developing countries and has become a major global public health problem, affecting mainly 0–5-year-old children and young women of childbearing age, especially during pregnancy. Iron deficiency can lead to life-threatening loss of red blood cells, muscle function, and energy production. Therefore, the pathogenic features associated with IDA are weakness and impaired growth, motor, and cognitive performance. IDA affects the well-being of the young generation and the economic advancement of developing countries, such as India. The imbalance between iron intake/absorption/storage and iron utilization/loss culminates into IDA. However, numerous strategic programs aimed to increase iron intake have shown that improvement of iron intake alone has not been sufficient to mitigate IDA. Emerging critical risk factors for IDA include a composition of cultural diets, infections, genetics, inflammatory conditions, metabolic diseases, dysbiosis, and socioeconomic parameters. In this review, we discuss numerous IDA mitigation programs in India and their limitations. The new multifactorial mechanism of IDA pathogenesis opens perspectives for the improvement of mitigation programs and relief of IDA in India and worldwide.
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Haile D, Brown KH, McDonald CM, Luo H, Jarvis M, Teta I, Ndjebayi A, Martial GAJ, Vosti SA, Engle-Stone R. Applying Zinc Nutrient Reference Values as Proposed by Different Authorities Results in Large Differences in the Estimated Prevalence of Inadequate Zinc Intake by Young Children and Women and in Cameroon. Nutrients 2022; 14:nu14040883. [PMID: 35215534 PMCID: PMC8879783 DOI: 10.3390/nu14040883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 02/06/2023] Open
Abstract
Nutrient reference values (NRVs) for zinc set by several expert groups differ widely and may affect the predicted prevalence of inadequate zinc intake. We examined this possibility using NRVs published by four different authorities and nationally representative dietary intake data collected among children aged 12–59 months and women in Cameroon. Usual zinc intake was estimated from 24 h recall data using the National Cancer Institute method. Prevalences of total zinc intake below the dietary requirement and of “absorbable zinc intake” below the physiological requirement were estimated using NRVs published by the World Health Organization (WHO), US Institute of Medicine (IOM), International Zinc Nutrition Consultative Group (IZiNCG), and European Food Safety Authority (EFSA). The prevalence of inadequate zinc intake ranged from 10% (IZiNCG—physiological requirement, 95% CI 7–13%) to 81% (EFSA—physiological requirement, 95% CI 78–84%) among children and 9% (WHO—physiological requirement, 95% CI 8–11.0%) to 94% (IOM—physiological requirement, 95% CI 92–95%) among women These differences in the prevalence of inadequate intake translated into sizeable differences in the predicted benefit and cost-effectiveness of zinc fortification programs. Depending on the NRVs applied, assessments differ regarding the need for and design of zinc fortification programs. Efforts are needed to harmonize NRVs for zinc.
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Affiliation(s)
- Demewoz Haile
- Department of Nutrition, University of California, Davis, CA 95616, USA; (K.H.B.); (C.M.M.); (H.L.); (R.E.-S.)
- Institute for Global Nutrition, University of California, Davis, CA 95616, USA; (M.J.); (S.A.V.)
- Correspondence: ; Tel.: +1-530-601-3869
| | - Kenneth H. Brown
- Department of Nutrition, University of California, Davis, CA 95616, USA; (K.H.B.); (C.M.M.); (H.L.); (R.E.-S.)
- Institute for Global Nutrition, University of California, Davis, CA 95616, USA; (M.J.); (S.A.V.)
| | - Christine M. McDonald
- Department of Nutrition, University of California, Davis, CA 95616, USA; (K.H.B.); (C.M.M.); (H.L.); (R.E.-S.)
- Institute for Global Nutrition, University of California, Davis, CA 95616, USA; (M.J.); (S.A.V.)
- Departments of Pediatrics, and Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA 94143, USA
| | - Hanqi Luo
- Department of Nutrition, University of California, Davis, CA 95616, USA; (K.H.B.); (C.M.M.); (H.L.); (R.E.-S.)
- Institute for Global Nutrition, University of California, Davis, CA 95616, USA; (M.J.); (S.A.V.)
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Michael Jarvis
- Institute for Global Nutrition, University of California, Davis, CA 95616, USA; (M.J.); (S.A.V.)
| | - Ismael Teta
- Helen Keller International, Yaoundé 1771, Cameroon; (I.T.); (A.N.)
| | - Alex Ndjebayi
- Helen Keller International, Yaoundé 1771, Cameroon; (I.T.); (A.N.)
| | | | - Stephen A. Vosti
- Institute for Global Nutrition, University of California, Davis, CA 95616, USA; (M.J.); (S.A.V.)
- Department of Agricultural and Resource Economics, University of California, Davis, CA 95616, USA
| | - Reina Engle-Stone
- Department of Nutrition, University of California, Davis, CA 95616, USA; (K.H.B.); (C.M.M.); (H.L.); (R.E.-S.)
- Institute for Global Nutrition, University of California, Davis, CA 95616, USA; (M.J.); (S.A.V.)
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Zarei M, Rahimi K, Hassanzadeh K, Abdi M, Hosseini V, Fathi A, Kakaei K. From the environment to the cells: An overview on pivotal factors which affect spreading and infection in COVID-19 pandemic. ENVIRONMENTAL RESEARCH 2021; 201:111555. [PMID: 34197816 PMCID: PMC8236413 DOI: 10.1016/j.envres.2021.111555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/24/2021] [Accepted: 06/16/2021] [Indexed: 05/06/2023]
Abstract
Several factors ranging from environmental risks to the genetics of the virus and that of the hosts, affect the spread of COVID-19. The impact of physicochemical variables on virus vitality and spread should be taken into account in experimental and clinical studies. Another avenue to explore is the effect of diet and its interaction with the immune system on SARS-CoV-2 infection and mortality rate. Past year have witnessed extensive studies on virus and pathophysiology of the COVID-19 disease and the cellular mechanisms of virus spreading. However, our knowledge has not reached a level where we plan an efficient therapeutic approach to prevent the virus entry to the cells or decreasing the spreading and morbidity in severe cases of disease. The risk of infection directly correlates with the control of virus spreading via droplets and aerosol transmission, as well as patient immune system response. A key goal in virus restriction and transmission rate is to understand the physicochemical structure of aerosol and droplet formation, and the parameters that affect the droplet-borne and airborne in different environmental conditions. The lifetime of droplets on different surfaces is described based on the contact angle. Hereby, we recommend regular use of high-quality face masks in high temperature and low humidity conditions. However, in humid and cold weather conditions, wearing gloves and frequently hand washing, gain a higher priority. Additionally, social distancing rules should be respected in all aforementioned conditions. We will also discuss different routes of SARS-CoV-2 entry into the cells and how multiple genetic factors play a role in the spread of the virus. Given the role of environmental and nutritional factors, we discuss and recommend some strategies to prevent the disease and protect the population against COVID-19. Since an effective vaccine can prevent the transmission of communicable diseases and abolish pandemics, we added a brief review of candidate SARS-CoV-2 vaccines.
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Affiliation(s)
- Mohammad Zarei
- Department of Food Science and Technology, School of Industrial Technology, Faculty of Applied Sciences, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia
| | - Karim Rahimi
- Department of Molecular Biology and Genetics, Gene Expression and Gene Medicine, Aarhus University, Aarhus, Denmark
| | - Kambiz Hassanzadeh
- Laboratory of Neuronal Cell Signaling, EBRI Rita Levi-Montalcini Foundation, Rome, 00161, Italy; Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Mohammad Abdi
- Department of Clinical Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Vahedeh Hosseini
- Department of Molecular Medicine and Genetics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Fathi
- FUJIFILM Cellular Dynamics, Inc., Madison, WI, USA.
| | - Karim Kakaei
- Department of Chemistry, Faculty of Science, University of Maragheh, Maragheh, Iran.
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Multinutrient Biofortification of Maize ( Zea mays L.) in Africa: Current Status, Opportunities and Limitations. Nutrients 2021; 13:nu13031039. [PMID: 33807073 PMCID: PMC8004732 DOI: 10.3390/nu13031039] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/19/2021] [Accepted: 03/20/2021] [Indexed: 12/21/2022] Open
Abstract
Macro and micronutrient deficiencies pose serious health challenges globally, with the largest impact in developing regions such as subSaharan Africa (SSA), Latin America and South Asia. Maize is a good source of calories but contains low concentrations of essential nutrients. Major limiting nutrients in maize-based diets are essential amino acids such as lysine and tryptophan, and micronutrients such as vitamin A, zinc (Zn) and iron (Fe). Responding to these challenges, separate maize biofortification programs have been designed worldwide, resulting in several cultivars with high levels of provitamin A, lysine, tryptophan, Zn and Fe being commercialized. This strategy of developing single-nutrient biofortified cultivars does not address the nutrient deficiency challenges in SSA in an integrated manner. Hence, development of maize with multinutritional attributes can be a sustainable and cost-effective strategy for addressing the problem of nutrient deficiencies in SSA. This review provides a synopsis of the health challenges associated with Zn, provitamin A and tryptophan deficiencies and link these to vulnerable societies; a synthesis of past and present intervention measures for addressing nutrient deficiencies in SSA; and a discussion on the possibility of developing maize with multinutritional quality attributes, but also with adaptation to stress conditions in SSA.
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Anemia in preschool children from Angola: a review of the evidence. Porto Biomed J 2020; 5:e60. [PMID: 33299941 PMCID: PMC7722406 DOI: 10.1097/j.pbj.0000000000000060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 01/06/2020] [Indexed: 11/26/2022] Open
Abstract
Angola is one of the southern African countries with the highest prevalence of anemia, and despite the high geographic heterogeneity of its distribution across the country, it was reported to be indicative of a severe public health problem in some areas, mainly in children. Despite the relevance of this condition in the country there is still an important gap regarding scientific evidences and knowledge systematization in the indexed literature, that could be used to inform and optimize national public health policies willing to address it. Furthermore, the changes in anemia epidemiology among African preschool children and the late updates in nutrition-specific and nutrition-sensitive preventive strategies in the continent are of imperative relevance, as they could contribute to design context-specific national approaches to reduce anemia's morbidity and mortality. In this study we intent to perform a systematic review regarding the sparse evidence available on the country regarding the prevalence of anemia, its associated factors, the prevention, and/or control strategies with potential to reduce anemia that were implemented, and to discuss interventions targeting infections and/or nutrition conducted in other African countries.
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Moorthy D, Merrill R, Namaste S, Iannotti L. The Impact of Nutrition-Specific and Nutrition-Sensitive Interventions on Hemoglobin Concentrations and Anemia: A Meta-review of Systematic Reviews. Adv Nutr 2020; 11:1631-1645. [PMID: 32845972 PMCID: PMC7666908 DOI: 10.1093/advances/nmaa070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 02/12/2020] [Accepted: 05/21/2020] [Indexed: 11/14/2022] Open
Abstract
Anemia is a multifactorial condition arising from inadequate nutrition, infection, chronic disease, and genetic-related etiologies. Our aim was to assess the impact of nutrition-sensitive and nutrition-specific interventions on hemoglobin (Hb) concentrations and anemia to inform the prioritization and scale-up of interventions to address the multiple causes of anemia. We performed a meta-review synthesis of information by searching multiple databases for reviews published between 1990 and 2017 and used standard methods for conducting a meta-review of reviews, including double independent screening, extraction, and quality assessment. Quantitative pooling and narrative syntheses were used to summarize information. Hb concentration and anemia outcomes were pooled in specific population groups (children aged <5 y, school-age children, and pregnant women). Methodological quality of the systematic reviews was assessed using Assessing the Methodological Quality of Systematic Reviews (AMSTAR) criteria. Of the 15,444 records screened, we identified 118 systematic reviews that met inclusion criteria. Reviews focused on nutrition-specific interventions (96%). Daily and intermittent iron supplementation, micronutrient powders, malaria treatment, use of insecticide-treated nets (ITNs), and delayed cord clamping were associated with increased Hb concentration in children aged <5 y. Among children older than 5 y, daily and intermittent iron supplementation and deworming, and in pregnant women, daily iron-folic acid supplementation, use of ITNs, and delayed cord clamping, were associated with increased Hb concentration. Similar results were obtained for the reduced risk of anemia outcome. This meta-review suggests the importance of nutrition-specific interventions for anemia and highlights the lack of evidence to understand the influence of nutrition-sensitive and multifaceted interventions on the condition.
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Affiliation(s)
| | - Rebecca Merrill
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sorrel Namaste
- The Demographic and Health Survey Program, ICF, Rockville, MD, USA
| | - Lora Iannotti
- Brown School, Institute for Public Health, Washington University in St Louis, MO, USA
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Gupta S, Brazier AKM, Lowe NM. Zinc deficiency in low- and middle-income countries: prevalence and approaches for mitigation. J Hum Nutr Diet 2020; 33:624-643. [PMID: 32627912 DOI: 10.1111/jhn.12791] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/14/2020] [Accepted: 06/03/2020] [Indexed: 12/16/2022]
Abstract
This review addresses the prevalence of zinc deficiency in Low- and Middle-income Countries (LMICs) and assesses the available strategies for its alleviation. The paucity of national-level data on the zinc deficiency in LMICs is partially a result of the lack of a reliable biomarker. Zinc deficiency appears to be a public health problem in almost all the LMICs, irrespective of the recommended indicators (plasma zinc concentration, dietary zinc adequacy and stunting prevalence) used. Based on plasma/serum zinc concentration (PZC), which is the most appropriate indicator at present, the prevalence of zinc deficiency in LMICs is of concern. Among the 25 countries for which national PZC data were available, 23 had a zinc deficiency prevalence of >20% for at least one physiological group. Zinc supplementation is largely restricted as an adjunct therapy for diarrhoea management in children, and the best platform and the most effective way of preventive zinc supplementation delivery remains to be established. Impact assessment for current zinc fortification programmes in LMICs and the effectiveness of zinc supplementation as part of a multi-micronutrient powder is to be determined. Dietary diversification, though promising for LMICs, is in the nascent stages of development at present. Inclusion of meat and animal products can be an important way of improving zinc status. Programmatic experience with the promotion of home processing techniques to increase absorbable zinc in the diet is lacking. Conventional biofortification techniques are gaining recognition in LMICs; however, transgenic biofortification as a strategy remains controversial.
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Affiliation(s)
- S Gupta
- Lancashire Research Centre for Global Development, University of Central Lancashire, Preston, UK
| | - A K M Brazier
- Lancashire Research Centre for Global Development, University of Central Lancashire, Preston, UK
| | - N M Lowe
- Lancashire Research Centre for Global Development, University of Central Lancashire, Preston, UK
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Dietary intake and processes of behaviour change in a nutrition education intervention for pregnant women in rural Malawi: a cluster-randomised controlled trial. Public Health Nutr 2020; 23:2345-2354. [PMID: 32419688 PMCID: PMC7426887 DOI: 10.1017/s1368980020000294] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objective: To examine if increased intake of locally available nutrient-dense foods among pregnant women improved the quality of their dietary intake and if use of the Theory of Planned Behaviour could explain changes in their dietary behaviour. Design: We used data from a randomised controlled trial where the intervention group received nutrition education and dietary counselling. We promoted the use of recipes that utilised powders to enhance dietary diversity. We examined how the intervention achieved changes in dietary intakes and used mixed effects logistic regression models with random effects at village level to explore changes over time of the outcomes, adjusted for selected explanatory variables. Setting: The study was conducted in twenty villages in rural Malawi. Participants: Data from 257 pregnant women who were enrolled during late first trimester and followed until birth. Results: The intervention achieved improvements in the Dietary Diversity Score (DDS) and the Six Food Group Pyramid (SFG) score, especially in intakes of micronutrient-rich foods. A third of the women in the intervention group attained optimal DDS, whereas about 50 % attained optimal SFG. The theorised behaviour mediators (i.e. nutrition attitudes, nutrition behaviour control and subjective norm) that had improved were also significantly associated with high DDS. Conclusions: Improved dietary intakes were achieved through promoting the use of locally available nutrient-dense foods. Attainment of high DDS was a consequence of the women’s belief in the effectiveness of the proposed nutrition recommendations. We identified critical personal and environmental constraints related to dietary intakes during pregnancy in a low-resource setting.
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Dzomeku BM, Wald JP, Wünsche JN, Nohr D, Biesalski HK. Climate Change Enhanced Carotenoid Pro-Vitamin A Levels of Selected Plantain Cultivars. PLANTS 2020; 9:plants9040541. [PMID: 32331213 PMCID: PMC7238263 DOI: 10.3390/plants9040541] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 11/16/2022]
Abstract
Diet diversification and the exploitation of traditional, micronutrient-rich germplasm of staple crops are generally regarded as sustainable and low-cost approaches to increase the micronutrient intake of resource-poor people. Sun's UV index was collected daily throughout the year. The study assessed the seasonality of provitamin A carotenoids in three plantain cultivars in response to climatic condition. Fruits were harvested at three maturities and freeze-dried before analysis. The results showed that there were high levels of the sun's UV-B radiations throughout the year with the highest occurring from November to May when the area experienced clear skies with minimal cloud cover. These high levels of the sun's UV-B index occurred between 9.00 h GMT and 17.00 h GMT. The study also showed that α-carotene content increased with maturity in "Apantu" during the rainy seasons ranging from 95 to 172 μg/100 g of dry pulp. Similar trends were observed during the dry season with a range of 28 to 489 μg/100 g. The α-carotene contents were very high in the periods of high sun's UV-B radiations compared to the periods of low sun's UV-B radiations. The α-carotene levels in the giant French plantains showed similar trends. Intermediate French "Oniaba" and False Horn "Apantu" plantain cultivar showed the highest content of β-carotene during the dry season. The high provitamin A carotenoid levels in the cultivars coincided with the high levels of the sun's UV index.
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Affiliation(s)
- Beloved Mensah Dzomeku
- CSIR-Crops Research Institute, P.O. Box 3785, Kumasi AK000-AK911, Ghana
- Correspondence: ; Tel.: +233-24-4763722
| | - Julian P. Wald
- Institute of Nutrition Science (140a), University of Hohenheim, Garben strasse 30, D-70593 Stuttgart, Germany; (J.P.W.); (D.N.); (H.K.B.)
| | - Jens Norbert Wünsche
- Department of Crop Science, Crop Physiology of Specialty Crops (340f), University of Hohenheim, 70599 Stuttgart, Germany;
| | - Donatus Nohr
- Institute of Nutrition Science (140a), University of Hohenheim, Garben strasse 30, D-70593 Stuttgart, Germany; (J.P.W.); (D.N.); (H.K.B.)
| | - Hans K. Biesalski
- Institute of Nutrition Science (140a), University of Hohenheim, Garben strasse 30, D-70593 Stuttgart, Germany; (J.P.W.); (D.N.); (H.K.B.)
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Halenova T, Zlatskiy I, Syroeshkin A, Maximova T, Pleteneva T. Deuterium-Depleted Water as Adjuvant Therapeutic Agent for Treatment of Diet-Induced Obesity in Rats. Molecules 2019; 25:E23. [PMID: 31861678 PMCID: PMC6982901 DOI: 10.3390/molecules25010023] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/03/2019] [Accepted: 12/12/2019] [Indexed: 12/26/2022] Open
Abstract
In this study, we present the potential application of deuterium-depleted water (DDW) for the prevention and adjuvant treatment of obesity in rats. We tested the hypothesis that DDW can alleviate diet-induced obesity (DIO) and its associated metabolic impairments. Rats fed a high-fat diet had an increased body weight index (BWI), glucose concentration, and level of certain proinflammatory cytokines; decreased levels of insulin in the serum; decreased tryptophan and serotonin in the brain, and a decreased concentration of some heavy metals in the liver. Drinking DDW at a concentration of 10 ppm deuterium/protium (D/H) ad libitum for 3 weeks restored the BWI, glucose (serum), tryptophan (brain), and serotonin (brain) levels and concentration of Zn in the liver in the DIO animals to those of the controls. The levels of proinflammatory cytokines (IL-1β, IL-6, IFNγ) and anti-inflammatory TNFα were decreased in DIO rats, while anti-inflammatory cytokine (IL-4, IL-10) levels remained at the control levels, which is indicative of a pathophysiological syndrome. In contrast, in groups of rats treated with DDW, a significant increase in anti-inflammatory (IL-4, IL-10) and proinflammatory cytokines (IFNγ) was observed. This finding indicates a reduction in systemic inflammation in obese animals treated with DDW. Similarly, the high-fat diet caused an increased level of oxidative stress products, which was accompanied by decreased activity of both superoxide dismutase and catalase, whereas the administration of DDW decreased the level of oxidative stress and enhanced antioxidant enzyme activities.
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Affiliation(s)
- Tetiana Halenova
- Taras Shevchenko National University of Kyiv, ESC "Institute of Biology and Medicine", 64 Volodymyrska Str., 01601 Kyiv, Ukraine
| | - Igor Zlatskiy
- Peoples Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya St, Moscow 117198, Russia
- State Institute of Genetic and Regenerative Medicine NAMS of Ukraine, 67 Vyshgorodska Str., 04114 Kyiv, Ukraine
| | - Anton Syroeshkin
- Peoples Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya St, Moscow 117198, Russia
| | - Tatiana Maximova
- Peoples Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya St, Moscow 117198, Russia
| | - Tatiana Pleteneva
- Peoples Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya St, Moscow 117198, Russia
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Gibson RS, Raboy V, King JC. Implications of phytate in plant-based foods for iron and zinc bioavailability, setting dietary requirements, and formulating programs and policies. Nutr Rev 2019; 76:793-804. [PMID: 30010865 DOI: 10.1093/nutrit/nuy028] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Plant-based diets in low-income countries (LICs) have a high content of phytic acid (myo-inositol hexaphosphate [InsP6]) and associated magnesium, potassium, and calcium salts. Together, InsP6 acid and its salts are termed "phytate" and are potent inhibitors of iron and zinc absorption. Traditional food processing can reduce the InsP6 content through loss of water-soluble phytate or through phytase hydrolysis to lower myo-inositol phosphate forms that no longer inhibit iron and zinc absorption. Hence, some processing practices can reduce the need for high-dose iron fortificants in plant-based diets and alleviate safety concerns. Dietary phytate-to-iron and phytate-to-zinc molar ratios are used to estimate iron and zinc bioavailability and to identify dietary iron and zinc requirements according to diet type. The European Food Safety Authority has set adult dietary zinc requirements for 4 levels of phytate intake, highlighting the urgent need for phytate food composition data. Such data will improve the ability to estimate the prevalence of inadequate zinc intakes in vulnerable groups in LICs, which will facilitate implementation of targeted policies to alleviate zinc deficiency.
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Affiliation(s)
- Rosalind S Gibson
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Victor Raboy
- United States Department of Agriculture-Agricultural Research Service, Aberdeen, Idaho, USA
| | - Janet C King
- Children's Hospital Oakland Research Institute, Oakland, California, USA
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15
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The Role of Nanotechnology in the Fortification of Plant Nutrients and Improvement of Crop Production. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9030499] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nutrient deficiency in food crops is seriously affecting human health, especially those in the rural areas, and nanotechnology may become the most sustainable approach to alleviating this challenge. There are several ways of fortifying the nutrients in food such as dietary diversification, use of drugs and industrial fortification. However, the affordability and sustainability of these methods have not been completely achieved. Plants absorb nutrients from fertilizers, but most conventional fertilizers have low nutrient use and uptake efficiency. Nanofertilizers are, therefore, engineered to be target oriented and not easily lost. This review surveys the effects of the addition of macro- and nanonutrients to soil, the interaction, and the absorption capability of the plants, the environmental effect and food content of the nutrients. Most reports were obtained from recent works, and they show that plants nutrients could be enriched by applying nanoparticulate nutrients, which are easily absorbed by the plant. Although there are some toxicity issues associated with the use of nanoparticles in crop, biologically synthesized nanoparticles may be preferred for agricultural purposes. This would circumvent the concerns associated with toxicity, in addition to being pollution free. This report, therefore, offers more understanding on the application of nanotechnology in biofortification of plant nutrients and the future possibilities offered by this practice. It also highlights some of the ills associated with the introduction of nanomaterials into the soil for crop’s improvement.
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Fairweather-Tait SJ, de Sesmaisons A. Approaches used to estimate bioavailability when deriving dietary reference values for iron and zinc in adults. Proc Nutr Soc 2018; 78:1-7. [PMID: 30049292 DOI: 10.1017/s0029665118000484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This review aims to describe approaches used to estimate bioavailability when deriving dietary reference values (DRV) for iron and zinc using the factorial approach. Various values have been applied by different expert bodies to convert absorbed iron or zinc into dietary intakes, and these are summarised in this review. The European Food Safety Authority (EFSA) derived zinc requirements from a trivariate saturation response model describing the relationship between zinc absorption and dietary zinc and phytate. The average requirement for men and women was determined as the intercept of the total absorbed zinc needed to meet physiological requirements, calculated according to body weight, with phytate intake levels of 300, 600, 900 and 1200 mg/d, which are representative of mean/median intakes observed in European populations. For iron, the method employed by EFSA was to use whole body iron losses, determined from radioisotope dilution studies, to calculate the quantity of absorbed iron required to maintain null balance. Absorption from the diet was estimated from a probability model based on measures of iron intake and status and physiological requirements for absorbed iron. Average dietary requirements were derived for men and pre- and post-menopausal women. Taking into consideration the complexity of deriving DRV for iron and zinc, mainly due to the limited knowledge on dietary bioavailability, it appears that EFSA has made maximum use of the most relevant up-to-date data to develop novel and transparent DRV for these nutrients.
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Affiliation(s)
- Susan J Fairweather-Tait
- Norwich Medical School,Bob Champion Research and Educational Building,University of East Anglia,James Watson Road,Norwich NR4 7UQ,UK
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Prudhon C, Benelli P, Maclaine A, Harrigan P, Frize J. Informing infant and young child feeding programming in humanitarian emergencies: An evidence map of reviews including low and middle income countries. MATERNAL & CHILD NUTRITION 2018; 14:e12457. [PMID: 28670790 PMCID: PMC6865874 DOI: 10.1111/mcn.12457] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 03/07/2017] [Accepted: 03/19/2017] [Indexed: 01/08/2023]
Abstract
Around 200 million people were affected by conflict and natural disasters in 2015. Whereas those populations are at a particular high risk of death, optimal breastfeeding and complementary feeding practices could prevent almost 20% of deaths amongst children less than 5 years old. Yet, coverage of interventions for improving infant and young child feeding (IYCF) practices in emergencies is low, partly due to lack of evidence. Considering the paucity of data generated in emergencies to inform programming, we conducted an evidence map from reviews that included low- and middle-income countries and looked at several interventions: (a) social and behavioural change interpersonal and mass communication for promoting breastfeeding and adequate complementary feeding; (b) provision of donated complementary food; (c) home-based fortification with multiple micronutrient powder; (d) capacity building; (e) cash transfers; (f) agricultural or fresh food supply interventions; and (g) psychological support to caretakers. We looked for availability of evidence of these interventions to improve IYCF practices and nutritional status of infants and young children. We identified 1,376 records and included 28 reviews meeting the inclusion criteria. The highest number of reviews identified was for behavioural change interpersonal communication for promoting breastfeeding, whereas no review was identified for psychological support to caretakers. We conclude that any further research should focus on the mechanisms and delivery models through which effectiveness of interventions can be achieved and on the influence of contextual factors. Efforts should be renewed to generate evidence of effectiveness of IYCF interventions during humanitarian emergencies despite the challenges.
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Tang N, Skibsted LH. Zinc Bioavailability from Phytate-Rich Foods and Zinc Supplements. Modeling the Effects of Food Components with Oxygen, Nitrogen, and Sulfur Donor Ligands. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2017; 65:8727-8743. [PMID: 28905624 DOI: 10.1021/acs.jafc.7b02998] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Aqueous solubility of zinc phytate (Ksp = (2.6 ± 0.2) × 10-47 mol7/L7), essential for zinc bioavailability from plant foods, was found to decrease with increasing temperature corresponding to ΔHdis of -301 ± 22 kJ/mol and ΔSdis of -1901 ± 72 J/(mol K). Binding of zinc to phytate was found to be exothermic for the stronger binding site and endothermic for the weaker binding site. The solubility of the slightly soluble zinc citrate and insoluble zinc phytate was found to be considerably enhanced by the food components with oxygen donor, nitrogen donor, and sulfur donor ligands. The driving force for the enhanced solubility is mainly due to the complex formation between zinc and the investigated food components rather than ligand exchange and ternary complex formation as revealed by quantum mechanical calculations and isothermal titration calorimetry. Histidine and citrate are promising ligands for improving zinc absorption from phytate-rich foods.
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Affiliation(s)
- Ning Tang
- Department of Food Science, University of Copenhagen , Rolighedsvej 30, DK-1958 Frederiksberg C, Denmark
| | - Leif H Skibsted
- Department of Food Science, University of Copenhagen , Rolighedsvej 30, DK-1958 Frederiksberg C, Denmark
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Wang C, Lin X, Guo D, Ding L, Guo H, Xu G, Cui X, Wang X. Zinc Fractional Absorption from a Representative Diet in Young Chinese Men and Women of the Shandong Rural Region. Biol Trace Elem Res 2017; 177:16-24. [PMID: 27744602 DOI: 10.1007/s12011-016-0865-2] [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: 06/06/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
Abstract
The objective of this study was to investigate the zinc fractional absorption of young Chinese men and women from the Shandong rural region under the routine dietary pattern by stable isotope technique. Ten men and 10 women, aged 20 to 35 years, and with a representative diet during the experiment were recruited from the Shandong rural region. Stable 67Zn was used as a tracer to label ZnCl2, and Yb was used to monitor the excretion of 67Zn in urine and feces. All volunteers were given rice containing 4.0 mg 67Zn and 1.0 mg Yb on the fourth day. Then the food and fecal samples of all subjects were collected for 12 consecutive days. The total zinc and the stable zinc isotope ratio of all samples were determined by atomic absorption spectrophotometer and thermal ionization mass spectrometer, respectively. The determination of the other nutrients was performed based on the Chinese National Standard Methods. Among volunteers, the daily intake of zinc was 15.50 mg, 103.33 % of recommended nutrient intake (RNI, set by the Chinese Nutrition Society) in men and 15.43 mg, 134.17 % in women. The fractional absorption of Zn was 23.42 ± 2.23 % in men, and 22.49 ± 2.19 % in women. The protein candidates got from the typical diets was 93.96 % of RNI in women. Calcium and ascorbic acid intakes were 76.23 % of RNI and 27.91 % of RNI in men, respectively and 51.17 % of RNI and 34.23 % of RNI in women, respectively. Our results showed that a typical meal for someone in the Shandong rural region presented an adequate intake of zinc and a moderate Zn bioavailability. The shortage of protein and the inappropriate protein pattern may play important roles in reducing zinc bioavailability.
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Affiliation(s)
- Cuiping Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Xinying Lin
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China.
| | - Dongmei Guo
- Department of Chemistry and Bacteria Detection, School of Public Health, Shandong University, Jinan, China
| | - Lili Ding
- Nutrition Department, Beijing Hospital, Beijing, China
| | - Haifeng Guo
- China Nutrition and Health Food Association, Beijing, China
| | - Guifa Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Xi Cui
- Department of Chemistry and Bacteria Detection, School of Public Health, Shandong University, Jinan, China
| | - Xia Wang
- Department of Maternal and Child Health Care, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China.
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Melash AA, Mengistu DK, Aberra DA. Linking Agriculture with Health through Genetic and Agronomic Biofortification. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/as.2016.75029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Micronutrients Deficiency, a Hidden Hunger in Nepal: Prevalence, Causes, Consequences, and Solutions. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2015; 2015:276469. [PMID: 27347513 PMCID: PMC4897390 DOI: 10.1155/2015/276469] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 12/22/2014] [Indexed: 01/13/2023]
Abstract
Micronutrient deficiency is a global challenge to health as in Nepal. In Nepal, the targeted beneficiaries are less aware about importance of micronutrients (MNs), which has resulted in low intake of foods rich in MNs. Micronutrient deficiencies (MNDs) have huge impact on health of vulnerable population like women and children and have jeopardized the national economy and prosperity of developing countries including Nepal. However, less attention has been paid towards MNDs, which can be prevented. Therefore, this study aims to draw attention of the concerned authorities and researchers to combat against MNDs in Nepal. This study showed that different types of MNDs with higher prevalence exist in Nepal. The major causes of MNDs were poor diet, diseases and infestations, and poor health caring practices. The results of MNDs were unwanted child and maternal mortality, impairments of lives, and reduction in productivity and intellectual capacity. School health and nutrition education and supplementation and fortification of essential MNs proved to be effective while dietary diversification and economic growth and poverty eradication seemed promising. Control and prevention of MNDs can help to achieve Millennium Development Goals as well, so studies in this sector should be emphasized.
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Ahmed A, Ahmad A, Khalid N, David A, Sandhu MA, Randhawa MA, Suleria HAR. A question mark on iron deficiency in 185 million people of Pakistan: its outcomes and prevention. Crit Rev Food Sci Nutr 2014; 54:1617-35. [PMID: 24580562 DOI: 10.1080/10408398.2011.645087] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Micronutrient deficiency especially the iron deficiency is the bane of our lives, affecting all strata of society. Unfortunately, the women during pregnancy, adolescence, and children are under this curse particularly in developing countries like Pakistan. It is one of the biggest reasons of complications during pregnancy and malnourished children under five years of age. Maternal death, still-births, and underweight births are most common consequences of iron deficiency and these outbreaks as iron-deficiency anemia in Pakistan. Disastrous nature of iron deficiency requires an urgent call to eradicate it. Hence, the solution should not be frail comparing with the huge economic loss and other incompatibilities. Flour fortification, supplementation, dietary diversification, and especially maternal education are possible solutions for combating this micronutrient deficiency.
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Affiliation(s)
- Anwaar Ahmed
- a Department of Food Technology , PMAS Arid Agriculture University , Rawalpindi , 36400 , Pakistan
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Fink G, Heitner J. Evaluating the cost-effectiveness of preventive zinc supplementation. BMC Public Health 2014; 14:852. [PMID: 25128210 PMCID: PMC4143582 DOI: 10.1186/1471-2458-14-852] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 08/06/2014] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Even though the WHO currently recommends zinc for diarrhea management, no consensus has been reached with respect to routine distribution of zinc for preventive reasons. We reviewed the health impact of preventive zinc interventions, and evaluated the relative cost effectiveness of currently feasible interventions. METHODS Using the latest relative risk estimates reported in the literature, we parameterized a health impact model, and calculated the expected benefits of zinc supplementation in a representative low-income country. We then computed the cost and cost-effectiveness for three delivery mechanisms: the direct distribution of zinc supplements, the distribution of micronutrient biscuits including zinc, and the distribution of zinc through water filtration systems. RESULTS Combining all health outcomes and impact estimates, we find that systematic zinc supplementation among children of ages one to five would avert 1.423 DALYs per 100 households and year in least developed countries. The estimated cost per DALY is US$ 606 for pill supplementation, US$ 1211 for micronutrient biscuits, and US$ 879 per DALY saved for water filtration systems. CONCLUSIONS Preventive zinc supplementation to children of ages 1-5 appears to be a highly cost-effective intervention in typical developing country settings. More research will be needed to determine the most effective mechanism to deliver zinc to this target population.
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Affiliation(s)
- Günther Fink
- Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, 02115 Boston, MA USA
| | - Jesse Heitner
- Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, 02115 Boston, MA USA
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Khalid N, Ahmed A, Bhatti MS, Randhawa MA, Ahmad A, Rafaqat R. A Question Mark on Zinc Deficiency in 185 Million People in Pakistan—Possible Way Out. Crit Rev Food Sci Nutr 2014; 54:1222-40. [DOI: 10.1080/10408398.2011.630541] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Brown KH, Hess SY, Vosti SA, Baker SK. Comparison of the estimated cost-effectiveness of preventive and therapeutic zinc supplementation strategies for reducing child morbidity and mortality in sub-Saharan Africa. Food Nutr Bull 2013; 34:199-214. [PMID: 23964393 DOI: 10.1177/156482651303400209] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Zinc supplementation of young children in lower-income countries reduces morbidity from diarrhea and pneumonia and all-cause mortality, but the most cost-effective approach for distributing zinc supplements is unknown. OBJECTIVE To examine the potential impact of four possible strategies for delivering zinc supplements on disease prevention and deaths averted among children 6 to 59 months of age in sub-Saharan Africa. METHODS We analyzed different zinc supplementation strategies to assess their likely impact on morbidity and mortality of preschool children in sub-Saharan Africa and to estimate their possible costs. RESULTS Preventive zinc supplementation reduces diarrhea incidence by 27% among children 12 to 59 months of age, pneumonia incidence by 21% among children 6 to 59 months of age, and all-cause mortality by 18% among children 12 to 59 months of age. The likely average total program costs of zinc supplementation programs were estimated from the outlays of existing service delivery platforms, such as child health days, community-based nutrition programs, and clinic-based treatment of diarrhea, assuming different levels of coverage and target age ranges of children. CONCLUSIONS We found that the average total costs per life saved ranged from approximately US$462 to US$3,111, and the most cost-effective interventions were weekly or intermittent preventive zinc supplementation, because of the possibility of high coverage and fewer supplements required. Empirical data from zinc supplementation programs will be needed to confirm these estimates.
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Affiliation(s)
- Kenneth H Brown
- Department of Nutrition, Program in International and Community Nutrition, University of California, One Shields Avenue, Davis, CA 95616, USA.
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Amagloh FK, Hardacre A, Mutukumira AN, Weber JL, Brough L, Coad J. Sweet Potato-Based Complementary Food for Infants in Low-Income Countries. Food Nutr Bull 2012; 33:3-10. [DOI: 10.1177/156482651203300101] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pedraza DF, Rocha ACD, Queiroz EOD, Sousa CPDC. Estado nutricional relativo ao zinco de crianças que frequentam creches do estado da Paraíba. REV NUTR 2011. [DOI: 10.1590/s1415-52732011000400003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Avaliar o estado nutricional relativo ao zinco de crianças assistidas em creches do Estado da Paraíba. MÉTODOS: O estado nutricional relativo ao zinco de 235 crianças pré-escolares foi avaliado através de sua concentração no soro, da ingestão dietética de zinco e da estatura para idade, como recomendado pelo International Zinc Consultative Group. As concentrações séricas de zinco foram determinadas por espectrofotometria de absorção atômica de chama, considerando deficiência de zinco valores <65µmol/L. O consumo alimentar foi registrado mediante o recordatório de 24 horas, considerando a alimentação da criança no dia anterior e o consumo de alimentos na creche, e foi analisada a inadequação dietética de zinco de acordo com as necessidades médias estimadas de zinco segundo etapa da vida e tipo de dieta estabelecido pelo International Zinc Consultative Group. Adotou-se o Padrão de Crescimento Infantil da Organização Mundial da Saúde para o índice estatura para idade, considerando-se com deficit de estatura as crianças que apresentaram esse índice dois escores-Z abaixo do valor mediano da população de referência. Empregou-se o teste t ou análise de variância na análise estatística, programa Statistical Package for the Social Sciences-16.0. RESULTADOS: As prevalências de deficiência de zinco no soro, inadequação dietética de zinco e deficit de estatura foram de 16,2%, 16,6% e 7,7%, respectivamente. A média de zinco no soro foi estatisticamente menor nas crianças de mães com baixo peso em comparação com as crianças de mães com peso normal. CONCLUSÃO: As crianças estudadas apresentaram risco moderado de deficiência de zinco, pois são indicadas prevalências significativas de baixos níveis séricos de zinco, de consumo inadequado de zinco e de desnutrição crônica.
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Gibbs M, Bailey KB, Lander RD, Fahmida U, Perlas L, Hess SY, Loechl CU, Winichagoon P, Gibson RS. The adequacy of micronutrient concentrations in manufactured complementary foods from low-income countries. J Food Compost Anal 2011. [DOI: 10.1016/j.jfca.2010.07.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Wuehler SE, Hess SY, Brown KH. Accelerating improvements in nutritional and health status of young children in the Sahel region of Sub-Saharan Africa: review of international guidelines on infant and young child feeding and nutrition. MATERNAL AND CHILD NUTRITION 2011; 7 Suppl 1:6-34. [PMID: 21410888 DOI: 10.1111/j.1740-8709.2010.00306.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The United Nations Convention on the Rights of the Child holds governments responsible to ensure children's right to the highest attainable standard of health by providing breastfeeding support, and access to nutritious foods, appropriate health care, and clean drinking water. International experts have identified key child care practices and programmatic activities that are proven to be effective at reducing infant and young child undernutrition, morbidity, and mortality. Nevertheless, progress towards reducing the prevalence of undernutrition has been sporadic across countries of the Sahel sub-region of Sub-Saharan Africa. In view of this uneven progress, a working group of international agencies was convened to 'Reposition children's right to adequate nutrition in the Sahel.' The first step towards this goal was to organize a situational analysis of the legislative, research, and programmatic activities related to infant and young child nutrition (IYCN) in six countries of the sub-region: Burkina Faso, Chad, Mali, Mauritania, Niger, and Senegal. The purposes of this introductory paper are to review current information concerning the nutritional and health status of infants and young children in the Sahel and to summarize international guidelines on optimal IYCN practices. These guidelines were used in completing the above-mentioned situational analyses and encompass specific recommendations on: (i) breastfeeding (introduction within the first hour after birth, exclusivity to 6 months, continuation to at least 24 months); (ii) complementary feeding (introduction at 6 months, use of nutrient dense foods, adequate frequency and consistency, and responsive feeding); (iii) prevention and/or treatment of micronutrient deficiencies (vitamin A, zinc, iron and anaemia, and iodine); (iv) prevention and/or treatment of acute malnutrition; (v) feeding practices adapted to the maternal situation to reduce mother-to-child transmission of HIV; (vi) activities to ensure food security; and (vii) the promotion of hygienic practices concerning food preparation and storage and environmental sanitation. The following papers in this issue will present results of the situational analyses for the individual countries.
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Affiliation(s)
- Sara E Wuehler
- Helen Keller International, Africa Regional Office, Dakar-Yoff, Senegal.
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31
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Harrison GG. Public Health Interventions to Combat Micronutrient Deficiencies. Public Health Rev 2010. [DOI: 10.1007/bf03391601] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Brown KH, Baker SK. Galvanizing action: conclusions and next steps for mainstreaming zinc interventions in public health programs. Food Nutr Bull 2009; 30:S179-84. [PMID: 19472607 DOI: 10.1177/15648265090301s110] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper summarizes the results of the foregoing reviews of the impact of different intervention strategies designed to enhance zinc nutrition, including supplementation, fortification, and dietary diversification or modification. Current evidence indicates a beneficial impact of such interventions on zinc status and zinc-related functional outcomes. Preventive zinc supplementation reduces the incidence of diarrhea and acute lower respiratory tract infection among young children, decreases mortality of children over 12 months of age, and increases growth velocity. Therapeutic zinc supplementation during episodes of diarrhea reduces the duration and severity of illness. Zinc fortification increases zinc intake and total absorbed zinc, and recent studies are beginning to confirm a positive impact of zinc fortification on indicators of population zinc status. To assist with the development of zinc intervention programs, more information is needed on the prevalence of zinc deficiency in different countries, and rigorous evaluations of the effectiveness of large-scale zinc intervention programs should be planned. Recommended steps for scaling up zinc intervention programs, with or without other micronutrients, are described. In summary, there is now clear evidence of the benefit of selected interventions to reduce the risk of zinc deficiency, and a global commitment is urgently needed to conduct systematic assessments of population zinc status and to develop interventions to control zinc deficiency in the context of existing public health and nutrition programs.
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Affiliation(s)
- Kenneth H Brown
- Department of Nutrition, University of California, Davis, California 95616, USA.
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Hess SY, Lönnerdal B, Hotz C, Rivera JA, Brown KH. Recent advances in knowledge of zinc nutrition and human health. Food Nutr Bull 2009; 30:S5-11. [PMID: 19472599 DOI: 10.1177/15648265090301s102] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Zinc deficiency increases the risk and severity of a variety of infections, restricts physical growth, and affects specific outcomes of pregnancy. Global recognition of the importance of zinc nutrition in public health has expanded dramatically in recent years, and more experience has accumulated on the design and implementation of zinc intervention programs. Therefore, the Steering Committee of the International Zinc Nutrition Consultative Group (IZiNCG) completed a second IZiNCG technical document that reexamines the latest information on the intervention strategies that have been developed to enhance zinc nutrition and control zinc deficiency. In particular, the document reviews the current evidence regarding preventive zinc supplementation and the role of zinc as adjunctive therapy for selected infections, zinc fortification, and dietary diversification or modification strategies, including the promotion and protection of breastfeeding and biofortification. The purposes of this introductory paper are to summarize new guidelines on the assessment of population zinc status, as recommended by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the International Atomic Energy Agency (IAEA), and IZiNCG, and to provide an overview on several new advances in zinc metabolism. The following papers will then review the intervention strategies individually.
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Affiliation(s)
- Sonja Y Hess
- Department of Nutrition, University of California, Davis, California 95616, USA
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