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Weffort VRS, Lamounier JA. Hidden hunger - a narrative review. J Pediatr (Rio J) 2024; 100 Suppl 1:S10-S17. [PMID: 37918810 PMCID: PMC10960185 DOI: 10.1016/j.jped.2023.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE Malnutrition is characterized by situations of undernutrition and obesity resulting from the lack of micronutrients with the greatest impact on children. The objective of this review was to highlight inadequate food consumption, food security, and nutritional inadequacy leading to hidden hunger and the prevention and treatment of the main micronutrient deficiencies in Brazil. DATA SOURCE Literature review carried out through a bibliographic survey in PubMed (National Library of Medicine, United States), Lilacs (Latin American and Caribbean Literature in Health Sciences), and SciELO (Scientific Electronic Library Online) databases. The search used the terms Occult hunger, (hidden hunger), and Child, in articles published between 2013 and 2023 in Portuguese, English and Spanish. The search was performed on 06/25/2023. DATA SYNTHESIS The lack of micronutrients can occur insidiously and without clinical manifestations, being called hidden hunger. The prevention of nutritional deficiencies is part of the recommended actions in childcare, with healthy eating. Studies were cited related to macro and micronutrient intake deficiencies, both national and international, and strategies to improve micronutrient intake, including routine supplementation of iron, and vitamins D and A. The diagnosis, prevention, and treatment of the main deficiencies in Brazil (iron, vitamin A, vitamin D, zinc), currently adopted, concluded the topic. CONCLUSION Zero hunger and zero obesity must be part of the same policy, together with a nutritional education program.
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Lobo LMDC, Hadler MCCM. Vitamin E deficiency in childhood: a narrative review. Nutr Res Rev 2023; 36:392-405. [PMID: 35929460 DOI: 10.1017/s0954422422000142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Vitamin E is an important nutrient from the earliest stages of life. It plays key roles as an antioxidant and in the maintenance of the immune system, among others. Vitamin E deficiency (VED), which occurs more frequently in children, is rarely addressed in the literature. This narrative review aims to summarise the chemistry, biology, serum indicators and clinical trials that have evaluated the impact of fortification and other relevant aspects of vitamin E, in addition to the prevalence of its deficiency, in children worldwide. Vitamin E intake in recommended amounts is essential for this nutrient to perform its functions in the body. Serum α-tocopherol is the most widely used biochemical indicator to assess the prevalence of VED. VED has been associated with symptoms secondary to fat malabsorption and may lead to peripheral neuropathy and increased erythrocyte haemolysis. Reduced concentrations of α-tocopherol may be caused by the combination of diets with low amounts of vitamin E and inadequate consumption of fats, proteins and calories. The lowest prevalence of VED was found in Asia and the highest in North America and Brazil. High proportions of VED provide evidence that this nutritional deficiency is a public health problem in children and still little addressed in the international scientific literature. The planning, evaluation and implementation of health policies aimed at combatting VED in the paediatric population are extremely important.
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Affiliation(s)
| | - Maria Claret Costa Monteiro Hadler
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, Goiás, Brazil
- Graduate Program in Nutrition and Health, Faculty of Nutrition, Federal University of Goiás, Goiânia, Goiás, Brazil
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Padhani ZA, Das JK, Siddiqui FA, Salam RA, Lassi ZS, Khan DSA, Abbasi AMA, Keats EC, Soofi S, Black RE, Bhutta ZA. Optimal timing of introduction of complementary feeding: a systematic review and meta-analysis. Nutr Rev 2023; 81:1501-1524. [PMID: 37016953 DOI: 10.1093/nutrit/nuad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
CONTEXT The timing of introducing complementary feeding (CF) is crucial because premature or delayed CF can be associated with adverse health outcomes in childhood and adulthood. OBJECTIVE This systematic review aims to evaluate the impact of the timing of CF introduction on health, nutrition, and developmental outcomes among normal-term infants. DATA SOURCES Electronic databases and trial registries were searched, along with the reference lists of the included studies and relevant systematic reviews. DATA EXTRACTION Two investigators independently extracted data from the included studies on a standardized data-extraction form. DATA ANALYSIS Data were meta-analyzed separately for randomized controlled trials (RCTs) and observational studies on the basis of early introduction of CF (< 3 months, < 4 months, < 6 months of age) or late introduction of CF (> 6 months, > 8 months of age). Evidence was summarized according to GRADE criteria. In total, 268 documents were included in the review, of which 7 were RCTs (from 24 articles) and 217 were observational studies (from 244 articles). Evidence from RCTs did not suggest an impact of early introduction, while low-certainty evidence from observational studies suggested that early introduction of CF (< 6 months) might increase body mass index (BMI) z score and overweight/obesity. Early introduction at < 3 months might increase BMI and odds of lower respiratory tract infection (LRTI), and early introduction at < 4 months might increase height, LRTI, and systolic and diastolic blood pressure (BP). For late introduction of CF, there was a lack of evidence from RCTs, but low-certainty evidence from observational studies suggests that late introduction of CF (> 6 months) might decrease height, BMI, and systolic and diastolic BP and might increase odds of intestinal helminth infection, while late introduction of CF (> 8 months) might increase height-for-age z score. CONCLUSION Insufficient evidence does suggest increased adiposity with early introduction of CF. Hence, the current recommendation of introduction of CF should stand, though more robust studies, especially from low- and middle-income settings, are needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42020218517.
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Affiliation(s)
- Zahra A Padhani
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Jai K Das
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Faareha A Siddiqui
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Rehana A Salam
- Centre of Research Excellence, Melanoma Institute Australia, University of Sydney, Sydney, New South Wales, Australia
| | - Zohra S Lassi
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Ammaar M A Abbasi
- Division of Women and Child Health, Aga Khan University, Karachi, Sindh, Pakistan
| | - Emily C Keats
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sajid Soofi
- Division of Women and Child Health, Aga Khan University, Karachi, Sindh, Pakistan
| | - Robert E Black
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Zulfiqar A Bhutta
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
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Parâmetros hematológicos de crianças desnutridas após intervenção nutricional: ensaio clínico randomizado. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao0010345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Nogueira-de-Almeida CA, Ued FDV, Del Ciampo LA, Martinez EZ, Ferraz IS, Contini AA, Cruz FCSD, Silva RFB, Nogueira-de-Almeida ME, Lamounier JA. Prevalence of childhood anaemia in Brazil: still a serious health problem: a systematic review and meta-analysis. Public Health Nutr 2021; 24:6450-6465. [PMID: 34212834 PMCID: PMC11148596 DOI: 10.1017/s136898002100286x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To estimate the prevalence of anaemia in Brazilian children up to 83·9 months old. DESIGN Systematic review and meta-analysis, using databases PubMed, Scopus, SciELO, Lilacs, Google Scholar, Periódicos Capes, Arca, Biblioteca Virtual em Saúde, Microsoft Academic Search and Cochrane Library using search terms: anaemia, prevalence, child and Brazil. PROSPERO Registration number: CRD42020208818. SETTING Cross-sectional, cohort, case-control and intervention studies published between 2007 and 2020 were searched, excluding those who assessed children with an illness or chronic condition. The main outcome was anaemia prevalence. Random effects models based on the inverse variance method were used to estimate pooled prevalence measures. Sensitivity analyses removed studies with high contribution to overall heterogeneity. PARTICIPANTS From 6790 first screened, 134 eligible studies were included, totalling 46 978 children aged zero to 83·9 months analysed, with adequate regions representativeness. RESULTS Pooled prevalence of anaemia was 33 % (95 % CI 30, 35). Sensitivity analyses showed that withdrawal of studies that contributed to high heterogeneity did not influence national average prevalence. CONCLUSIONS Childhood anaemia is still a serious public health problem in Brazil, exposing 33 % of Brazilian children to the anaemia repercussions. The main limitation of the study is the estimation of national prevalence based on local surveys, but a large number of studies were included, with representation in all regions of the country, giving strength to the results. In Brazil, more public policies are needed to promote supplementation, fortification and access to healthy eating to reduce the high level of anaemia among children.
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Affiliation(s)
- Carlos Alberto Nogueira-de-Almeida
- Medical Department, Federal University of São Carlos, Brazil - DMED UFSCAR, Rod. Washington Luiz, km 235, São Carlos, SP13565-905, Brazil
| | - Fábio da Veiga Ued
- Nutrition School, University of São Paulo, Brazil - FMRP-USP, Ribeirao Preto, Brazil
| | | | | | - Ivan Savioli Ferraz
- Nutrition School, University of São Paulo, Brazil - FMRP-USP, Ribeirao Preto, Brazil
| | - Andrea Aparecida Contini
- Medical Department, Federal University of São Carlos, Brazil - DMED UFSCAR, Rod. Washington Luiz, km 235, São Carlos, SP13565-905, Brazil
| | | | | | | | - Joel Alves Lamounier
- Medical School, Federal University of Sao Joao Del Rei, Brazil - DMED UFSJ, Sao Joao Del Rei, Brazil
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Prevalence of iron-deficiency anaemia in Brazilian children under 5 years of age: a systematic review and meta-analysis. Br J Nutr 2020; 126:1257-1269. [PMID: 33371907 DOI: 10.1017/s000711452000522x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Fe-deficiency anaemia is considered an important public health problem both in wealthier countries and in those of medium and low income, especially in children under 5 years of age. The shortage of studies with national representativity in medium-income countries, such as Brazil, prevents the knowledge of the current situation and its associated factors. We conducted a systematic review and meta-analysis to estimate the pooled prevalence of Fe-deficiency anaemia in Brazilian children under 5 years of age and determined the factors involved in the variability of the estimates of prevalence. We collected fifty-seven studies from the databases MEDLINE, LILACS and Web of Science, along with the reference lists of included articles. We contacted authors for unpublished data. We did not restrict publication timespan and language. This systematic review and meta-analysis was reported according to the guidelines by PRISMA. The pooled prevalence of anaemia in Brazil was 40·2 (95 % CI 36·0, 44·8) %. The age range of the child and the period of data collection were associated with the anaemia prevalence. The pooled prevalence of anaemia was higher in children under 24 months of age (53·5 v. 30·7 %; P < 0·001) and in studies with data collected before 2004 (51·8 v. 32·6 %; P = 0·001). The efforts made by the Brazilian government were successful in the reduction of anaemia in children under 5 years of age in Brazil in the evaluated period. However, prevalence remains beyond acceptable levels for this population group.
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Costa JC, Maia MFS, Victora CG. Ciência & Saúde Coletiva - 25 years: contributions to pregnancy, delivery, and childhood studies. CIENCIA & SAUDE COLETIVA 2020; 25:4813-4830. [PMID: 33295503 DOI: 10.1590/1413-812320202512.21642020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/24/2020] [Indexed: 11/22/2022] Open
Abstract
We reviewed the scientific production on maternal health and the health of children under ten years of age, published in Journal Ciência & Saúde Coletiva during the last 25 years, focusing on quantitative studies. The authors' characteristics, populations under study, thematic areas, and methodology are described. A total of 170 publications were identified and grouped into 12 major themes. Pregnancy, delivery, and puerperium were the subject of 47 studies, followed by child anthropometric assessments (29), breastfeeding (24), and mortality (13). The selected publications represented 3.5% of the total original papers published by the Journal since its creation in 1996 and about 5% of the publications in the 2015-2020 period. The primary data sources were health service records, information systems, and population surveys. The cross-sectional design was used in 113 of the 170 articles, and 70% covered only one municipality. The Southeast and Northeast Regions of Brazil were the target of most studies, and the North Region was the least represented. The publications reflect the complexity of maternal and child health themes, with a particular focus on the importance of the Unified Health System and showing how open access data can contribute to public health research.
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Affiliation(s)
- Janaína Calu Costa
- Centro Internacional de Equidade em Saúde, Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Marechal Deodoro 1160, Centro. 96020-220 Pelotas RS Brasil.
| | - Maria Fatima Santos Maia
- Centro Internacional de Equidade em Saúde, Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Marechal Deodoro 1160, Centro. 96020-220 Pelotas RS Brasil.
| | - Cesar Gomes Victora
- Centro Internacional de Equidade em Saúde, Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Marechal Deodoro 1160, Centro. 96020-220 Pelotas RS Brasil.
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Visser M, Van Zyl T, Hanekom SM, Baumgartner J, van der Hoeven M, Taljaard-Krugell C, Smuts CM, Faber M. Nutrient patterns and their relation to anemia and iron status in 5- to 12-y-old children in South Africa. Nutrition 2019; 62:194-200. [PMID: 30925444 DOI: 10.1016/j.nut.2019.01.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/27/2018] [Accepted: 01/23/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The aim of this study was to assess nutrient patterns and their relation to anemia and iron status of school children using pooled data from three study populations in South Africa. METHODS Data from 5- to 12-y-old children (N = 578) from three independent studies conducted in two provinces in South Africa were pooled. Data used in the analysis were dietary intake, hemoglobin, and plasma ferritin concentrations. Nutrient patterns were determined using factor analysis. Logistic regression analysis was performed to determine relationships of nutrient patterns with anemia and iron deficiency. RESULTS In the pooled group, 13.8% of the children were anemic and 27.7% were iron deficient (ID). More than half of children did not meet the Estimated Average Requirement for various nutrients, including vitamins A, C, B12, folate, and zinc, although only 17.7% of children had an iron intake below the requirements. Median intakes for vitamins A and C were lower for anemic than non-anemic children (P = 0.03 and 0.02, respectively) and for ID versus non-ID children (P = 0.03 and 0.046, respectively). Four nutrient patterns were identified: plant protein, carbohydrate, iron, and B vitamins; animal protein and saturated fat; vitamins A and B12; and calcium and fiber. The vitamin A and B12 nutrient pattern was associated with lower odds of being anemic (odds ratio, 0.63; 95% confidence interval, 0.49-0.91; P = 0.035). CONCLUSION The present results highlighted the potential role of the combination of dietary vitamin A and B12 in the etiology of nutritional anemia in school-age children in South Africa. Nutrient pattern analysis may improve the understanding of the synergistic role of nutrients related to anemia and may assist in planning intervention strategies.
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Affiliation(s)
- Marina Visser
- Centre of Excellence for Nutrition, North-West University, South Africa.
| | - Tertia Van Zyl
- Centre of Excellence for Nutrition, North-West University, South Africa
| | - Susanna M Hanekom
- Centre of Excellence for Nutrition, North-West University, South Africa
| | | | - Marinka van der Hoeven
- Centre of Excellence for Nutrition, North-West University, South Africa; Infectious Disease and Public Health, Vrije University, The Netherlands
| | | | - Cornelius M Smuts
- Centre of Excellence for Nutrition, North-West University, South Africa
| | - Mieke Faber
- Centre of Excellence for Nutrition, North-West University, South Africa; Non-Communicable Diseases Research Unit, South African Medical Research Council, South Africa
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Taha Z, Garemo M, Nanda J. Patterns of breastfeeding practices among infants and young children in Abu Dhabi, United Arab Emirates. Int Breastfeed J 2018; 13:48. [PMID: 30479650 PMCID: PMC6240248 DOI: 10.1186/s13006-018-0192-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 11/05/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Despite the ongoing efforts to improve infant feeding practices, low rates of breastfeeding and early introduction of complementary feeding have been reported in many countries. Systematic documentation of breastfeeding practices in the United Arab Emirates (UAE) is needed in order to directing successful strategies. The aim of this study was to evaluate breastfeeding practices among mothers in Abu Dhabi, UAE, using the World Health Organization (WHO) infant and young child feeding indicators. METHODS In this cross-sectional study, mothers of children below the age of two were recruited from the community and health centers located in different areas in Abu Dhabi. Following informed consent, a structured questionnaire including WHO-indicators was used for in-person interviews on sociodemographics and breastfeeding. Exclusive breastfeeding (EBF) was calculated as the percentage of babies 0 - < 6 months of age who had been exclusively breastfed in the last 24 h. RESULTS A total of 1822 mothers participated in the study; 95.6% (1741/1822) of mothers initiated breastfeeding and 59.8% (1089/1822) initiated breastfeeding within the first hour. Exclusive breastfeeding among infants 0-6 months was 44.3% (362/818). Although the median duration of "any breastfeeding" was 12 months (95% CI 11.2, 12.7), the median duration of EBF was 3 months (95% CI 2.8, 3.3). Most of the children (894/1004, 89%) aged 6 months and above were receiving complementary feeding, but 21.7% (218/1004) of them had had an early introduction of complementary feeding, i.e. before 6 months of age. Using "the WHO infant and young child feeding indicators" as standard for comparative evaluation, breastfeeding initiation was rated "good", the proportion of children being exclusively breastfed until 6 months was rated "fair" and the duration of EBF was considered "poor". CONCLUSIONS According to the WHO infant feeding indicators the breastfeeding practices were suboptimal in several aspects with a low proportion of children being exclusively breastfed, short breastfeeding duration and early introduction of complementary feeding, despite high socioeconomic status. These findings suggest that there is a need to understand potential barriers towards breastfeeding in order to develop appropriate strategies to promote and support breastfeeding in Abu Dhabi.
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Affiliation(s)
- Zainab Taha
- Department of Health Sciences, Zayed University, PO Box 144534, Abu Dhabi, United Arab Emirates
| | - Malin Garemo
- Department of Health Sciences, Zayed University, PO Box 144534, Abu Dhabi, United Arab Emirates
| | - Joy Nanda
- The John Hopkins Medical Institutions, Baltimore, MD USA
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Souza NPD, Lira PICD, Fontbonne A, Pinto FCDL, Cesse EÂP. (Mal)nutrition and the new epidemiological trend in a context of development and inequalities. CIENCIA & SAUDE COLETIVA 2018; 22:2257-2266. [PMID: 28724007 DOI: 10.1590/1413-81232017227.03042017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 11/28/2016] [Indexed: 11/22/2022] Open
Abstract
The current context of intense social, economic and political transformations has contributed to changes in the health profile of the population and generated discussions about the impact of these changes on the reorganization of society. At the present moment, the increase in non-communicable illnesses and diseases raises major concerns about the paradox of malnutrition and obesity. Based on an in-depth reading and interpretation of texts, documents and databases, this article discusses issues related to nutrition, considering the dimensions of shortages and excesses, the evolution of nutrition over time, and the connection with the new epidemiological trend. We begin with a conceptual characterization, the historical background and the anthropological connections with the guiding theme of the article. We then describe the prevalence, distribution and secular trend of malnutrition and obesity, as well as the temporal relationship with the new epidemiological trend in Brazil within a context of development and inequalities. Finally, we reflect on the issue of (mal)nutrition in post-modernity, the new interests at stake in the health-disease process, as well as international experiences and strategies of partnerships designed to overcome these problems. We conclude by discussing some current advances and challenges in relation to the complexity and speed of contemporary changes.
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Affiliation(s)
- Nathália Paula de Souza
- Departamento de Saúde Coletiva, Centro de Pesquisas Aggeu Magalhães, Fiocruz. Av. Professor Moraes Rego s/n, Cidade Universitária. 50740-465 Recife PE Brasil.
| | | | - Annick Fontbonne
- UMR 204 Nutripass, IRD, SupAgro, Université Montpellier. Montpellier França
| | | | - Eduarda Ângela Pessoa Cesse
- Departamento de Saúde Coletiva, Centro de Pesquisas Aggeu Magalhães, Fiocruz. Av. Professor Moraes Rego s/n, Cidade Universitária. 50740-465 Recife PE Brasil.
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Vieira RCDS, do Livramento ARS, Calheiros MSC, Ferreira CMX, dos Santos TR, de Assunção ML, Ferreira HDS. Prevalence and temporal trend (2005-2015) of anaemia among children in Northeast Brazil. Public Health Nutr 2018; 21:868-876. [PMID: 29183408 PMCID: PMC10260909 DOI: 10.1017/s1368980017003238] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 09/19/2017] [Accepted: 10/03/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Anaemia is the main nutritional deficiency in Brazil, and a prevention and control programme (National Program for Iron Supplementation) has been developed since 2005. Studies on the temporal evolution of anaemia prevalence contribute to assessment of the effectiveness of the actions undertaken. The present study aimed to identify the prevalence and temporal trend of anaemia in children. DESIGN Study based on two cross-sectional household surveys carried out in 2005 and 2015. Anaemia was defined as Hb<11 g/dl (HemoCue®). Trend analysis was performed using the prevalence ratio (PR), calculated by Poisson regression with a robust adjustment of the variance. Differences were significant when P<0·05 in both crude analyses and those adjusted for possible confounding factors (e.g. socio-economic, demographic and health variables). SETTING Alagoas, Brazil. SUBJECTS In total, 666 and 782 children in the first and second Alagoas State Health and Nutrition Survey, respectively (probabilistic samples). RESULTS In 2005 and 2015, anaemia prevalence was 45·1 and 27·4 %, respectively (-39·1 %; PR=0·61; 95 % CI 0·52, 0·70). In both surveys, children aged ≤24 months were more affected (P24 months (67·2 v. 40·7 %; 27·0 v. 19·3 %, respectively). CONCLUSIONS The prevalence of anaemia reduced significantly in the evaluated period. Thus, it may no longer be a severe public health problem but can instead be considered a problem of moderate magnitude. It remains, however, above the level considered acceptable according to WHO criteria. These results justify the implementation of prevention and control actions.
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Affiliation(s)
- Regina Coeli da Silva Vieira
- Institute of Biological and Health Sciences, Federal University of Alagoas, Maceió, AL, Brazil
- Institute for Health and Biotechnology, Federal University of Amazonas, Manaus, AM, Brazil
- Faculty of Nutrition, Federal University of Alagoas, Campus A.C. Simões, BR 104 Norte, Km 96.7, Tabuleiro do Martins, CEP 57072-970, Maceió, AL, Brazil
| | | | | | | | | | - Monica Lopes de Assunção
- Faculty of Nutrition, Federal University of Alagoas, Campus A.C. Simões, BR 104 Norte, Km 96.7, Tabuleiro do Martins, CEP 57072-970, Maceió, AL, Brazil
| | - Haroldo da Silva Ferreira
- Faculty of Nutrition, Federal University of Alagoas, Campus A.C. Simões, BR 104 Norte, Km 96.7, Tabuleiro do Martins, CEP 57072-970, Maceió, AL, Brazil
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Fischer MDQ, Molz P, Hermes L, Santos CD, Limberger LB, Schlickmann DDS, Horta JA, Renner JDP, Prá D, Franke SIR. Neuropsychomotor development and genomic stability associated to folate and blood iron levels in preschool children. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2017. [DOI: 10.1590/1806-93042017000300006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to evaluate the neuropsychomotor development and the genomic stability associated to folate and blood iron levels in preschool children. Methods: a cross-sectional study in which evaluated the biochemical exams (complete hemogram, serum ferritin, iron and folate), neuropsychomotor development (Denver II Test) and genotoxicity (micronuclei cytome in buccal mucosa cells) of 55 children aging 36-59 months old. Student´s T test, Kruskal-Wallis and Pearson's or Spearman's correlation tests were applied with a significance level of p<0.05 for data analysis. Results: the prevalence of anemia was 1.8%. The Denver II test classified 32.7% of the children as normal and 67.3% were suspected of having a delay. The children suspected of having a delay presented a slight reduction on hemoglobin and hematocrit (p=0.05 and p=0.14), intermediate reduction on iron and folate (p=0.29 and p=0.23) and a notable reduction on ferritin (p=0.03). Folate and iron were significantly associated to the frequency of cells with DNA damages (p<0.05). The frequency of binucleated cells was positively associated to the Red Cell Distribution Width (RDW) (r=0.56; p=0.02) in children without a delay and negatively with folate (r=-0.334; p=0.047) in children with a delay. Conclusions: this study showed a low prevalence of anemia, but a high rate of children suspected of having a neuropsychomotor, possibly associated to low ferritin levels. Additionally, iron and folate were associated to DNA damage which may have contributed to the psychomotor development delay.
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Affiliation(s)
| | - Patrícia Molz
- Pontifícia Universidade Católica do Rio Grande do Sul, Brazil
| | | | | | | | | | | | | | - Daniel Prá
- Universidade de Santa Cruz do Sul, Brazil
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