Indicadores de insegurança alimentar e nutricional associados à anemia ferropriva em crianças brasileiras: uma revisão sistemática

Hospitalization of patients with nutritional anemia in the United States in 2020

Background

Nutritional anemia is highly prevalent and has triggered a globally recognized public health concern worldwide.

Objective

To better understand the prevalence of anemia and the state of nutritional health in developed countries to inform global nutritional health and better manage the disease.

Method

We employed the Healthcare Cost and Utilization Project (HCUP)-2020 National Inpatient Health Care Data (NIS), administered by The Agency for Healthcare Research and Quality. Nutritional anemia was diagnosed according to the International Classification of Diseases, 10th Revision (ICD-10). Matching analysis and multivariate regression were used to adjust for patient and hospital characteristics. Controls were obtained by stratifying and matching for age and sex.

Results

The 2020 HCUP-NIS database encompassed a survey over 6.4 million hospitalized patients, among which 1,745,350 patients diagnosed with anemia, representing approximately 26.97% of the hospitalized population, over 310,000 were diagnosed with nutritional anemia, and 13,150 patients were hospitalized for nutritional anemia as primary diagnosis. Hospitalization rate for nutritional anemia exhibited an increased age-dependent increase nationwide, especially among females, who displayed 1.87 times higher than males. Notably, in comparison to the control group, individuals of the Black race exhibit a higher prevalence of nutritional anemia (case group: 21.7%, control group: 13.0%, p < 0.001). In addition, hospitalization rates were higher among low-income populations, with lower rates of private insurance (case group: 18.7%, control group: 23.5%, p < 0.001) and higher rates of Medicaid insurance (case group: 15.4%, control group: 13.9%, p < 0.001). In areas characterized by larger urban centers and advanced economic conditions within the urban-rural distribution, there was an observed increase in the frequency of patient hospitalizations. Iron deficiency anemia emerged as the predominant subtype of nutritional anemia, accounting for 12,214 (92.88%). Secondary diagnosis among patients hospitalized for nutritional anemia revealed that a significant number faced concurrent major conditions like hypertension and renal failure.

Conclusion

In economically prosperous areas, greater attention should be given to the health of low-income individuals and the older adult. Our findings hold valuable insights for shaping targeted public health policies to effectively address the prevalence and consequences of nutritional anemia based on a overall population health.

Anaemia and iron deficiency associate with polymorphism TMPRSS6 rs855791 in Brazilian children attending day care centres

Fe-deficiency anaemia is a major public health concern in children under 5 years of age. TMPRSS6 gene, encoding matriptase-2 protein, is implicated in Fe homoeostasis and has been associated with anaemia and Fe status in various populations. The aim of this cross-sectional study was to investigate the associations between the single nucleotide polymorphism (SNP) TMPRSS6 rs855791 and biomarkers of anaemia and Fe deficiency in Brazilian children attending day care centres. A total of 163 children aged 6-42 months were evaluated. Socio-economic, demographic, biochemical, haematological, immunological and genotype data were collected. Multiple logistic and linear regressions with hierarchical selection were used to assess the effects of independent variables on categorised outcomes and blood marker concentrations. Minor allele (T) frequency of rs855791 was 0·399. Each copy of the T allele was associated with a 4·49-fold increased risk of developing anaemia (P = 0·005) and a 4·23-fold increased risk of Fe deficiency assessed by serum soluble transferrin receptor (sTfR) (P < 0·001). The dose of the T allele was associated with an increase of 0·18 mg/l in sTfR concentrations and reductions of 1·41 fl and 0·52 pg in mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH), respectively. In conclusion, the T allele of SNP TMPRSS6 rs855791 was significantly associated with anaemia and Fe deficiency assessed by sTfR in Brazilian children attending day care centres. The effect was dose dependent, with each copy of the T allele being associated with lower MCV and MCH and higher concentrations of sTfR.

Do Orofacial Clefts Impair Breastfeeding and Increase the Prevalence of Anemia?

OBJECTIVE

This study aimed to correlate the prevalence of iron deficiency anemia and breastfeeding with orofacial clefts in children.

DESIGN

Data on the participant profile, presence and type of the cleft lip and/or palate (CL/P), and records on anemia and breastfeeding were collected from patients' charts, and submitted to statistical analysis by χ² test (p < .05; software SPSS 23.0).

RESULTS

Two-hundred and ten files were divided according to: CL/P presence (cleft group;   n = 132) or absence (control group;   n = 78). Group CL/P was subdivided according to the type of cleft: CL/P-I (cleft lip;   n = 35); CL/P-II (cleft lip and palate;   n = 45); CL/P-III (cleft palate;   n = 43); and CL/P-IV (rare orofacial clefts;   n = 9). Group CL/P had significantly more records on anemia (p = .016) and fewer records on breastfeeding (P<.01) than controls. More records on anemia occurred in CL/P-II (p = .004) and CL/P-IV (p = .006) than the control group. The comparison among the orofacial cleft types regarding the anemia records showed no statistically significant differences (p = .123). Group CL/P-I had more records on breastfeeding than the other cleft types (p < .01).

CONCLUSIONS

Thus, it is suggested that the breastfeeding process is more complex, and the history of anemia is more frequent, in children with cleft lip and palate or rare orofacial clefts than in children without clefts.

Factors Associated with Anemia among Adults and the Elderly Family Farmers

The majority of studies on anemia are focused on children and women of reproductive age. Although the disease is a widespread public health problem, studies that include the rural population are scarce. This study determined the prevalence of anemia and associated factors in adults and the elderly living in the rural area of a municipality in Minas Gerais. Twelve rural communities were included. During home visits, hemoglobin levels were measured using a hemoglobinometer to check for the presence or absence of anemia. Additionally, anthropometric data and food insecurity data based on the Brazilian Food Insecurity Scale (EBIA) were collected. A questionnaire about socioeconomic, demographic, and housing conditions was applied. Analyses were performed using the Stata software version 13.0. Spearman correlation and regression analysis logistics were performed (p < 0.05) on 124 families (n = 297 farmers). The prevalence of anemia was 41.1%, being higher among women (55.7%). Additionally, 40.1% of the farmers were food insecure; 52.7% and 80.5% presented excess weight and cardiovascular risk, respectively. Poverty was a reality for 39.7% of individuals. A positive correlation between hemoglobin levels and per capita income was found as well as a negative correlation with EBIA scores and cardiovascular risk. Multivariate analysis showed that individuals experiencing food insecurity, the elderly, and those who do not own a property, were more likely to be anemic. Farmers with per capita income above 1/2 minimum wage were less likely to have anemia. The prevalence of anemia in the group studied was higher than previous studies. The disease is associated with factors that also predispose to food insecurity. The improvement of the determinants of insecurity can contribute to the fight against anemia.

Cluster Analysis and Classification Model of Nutritional Anemia Associated Risk Factors Among Palestinian Schoolchildren, 2014

Nutritional inadequacy has been a major health problem worldwide. One of the many health problems that result from it is anemia. Anemia is considered a health concern among all ages, particularly children, as it has been associated with cognitive and developmental delays. Researchers have investigated the association between nutritional deficiencies and anemia through various methods. As novel analytical methods are needed to ascertain the association and reveal indirect ones, we aimed to classify nutritional anemia using the cluster analysis approach. In this study, we included 4,762 students aged between 10 and 17 years attending public and UNRWA schools in the West Bank. Students' 24-h food recall and blood sample data were collected for nutrient intake and hemoglobin analysis. The K-means cluster analysis was used to cluster the hemoglobin levels into two groups. Vitamin B12, folate, and iron intakes were used as the indicators of nutrient intake associated with anemia and were classified as per the Recommended Dietary Allowance (RDA) values. We applied the Classification and Regression Tree (CRT) model for studying the association between hemoglobin clusters and vitamin B12, folate, and iron intakes, sociodemographic variables, and health-related risk factors, accounting for grade and age. Results indicated that 46.4% of the students were classified into the low hemoglobin cluster, and 60.7, 72.5, and 30.3% of vitamin B12, folate, and iron intakes, respectively, were below RDA. The CRT analysis indicated that vitamin B12, iron, and folate intakes are important factors related to anemia in girls associated with age, locality, food consumption patterns, and physical activity levels, while iron and folate intakes were significant factors related to anemia in boys associated with the place of residence and the educational level of their mothers. The deployment of clustering and classification techniques for identifying the association between anemia and nutritional factors might facilitate the development of nutritional anemia prevention and intervention programs that will improve the health and wellbeing of schoolchildren.

Prevalence of processed and ultra-processed food intake in Brazilian children (6-24 months) is associated with maternal consumption and breastfeeding practices

The aim of this study is to identify maternal consumption of processed and ultra-processed foods and to verify the factors associated with the supply of these foods to Brazilian children. This is a cross-sectional study with 231 mothers and children aged from 6 to 24 months. The mother's and children's food consumption was measured using three 24-hour recalls. The foods consumed were categorised according to the NOVA classification. The data were analysed by multinomial logistic regression. The supply of processed and ultra-processed foods to children was associated with the child's age (T2: OR = 1.17, p<.001; T3: OR = 1.23, p<.001), the absence of breast milk consumption (T3: OR = 3.82, p=.006) and the greater consumption of these foods by mothers (T2: OR = 3.15, p=.018; T3: OR = 4.59, p=.004). We conclude that mothers who consume processed and ultra-processed foods also include them in complementary feeding, and the consumption of these foods by the child increases with age, absence of breastfeeding, and with increased maternal consumption.

Food availability and food and nutrition (in)security of families providing for the National School Feeding Program

ABSTRACT Objective The natural probiotic kefir is fermented milk, and may have effects on satiety and voluntary energy intake. This randomized crossover trial aimed to determine whether kefir, consumed with low- or high-glycemic index meals, affects appetite and subsequent food intake. Methods This is a cross-sectional study with families of farmers who supplied Programa Nacional de Alimentação Escolar from 2011 to 2016 in the city of Viçosa, Minas Gerais, Brazil. To assess Food Insecurity, the Brazilian Food Insecurity Scale was applied to the person responsible for purchasing and producing meals in the family. The nutritional aspect was analyzed through the measurement of hemoglobin to check for anemia among family members and using the household food availability survey, where it was possible to analyze the amount of calories available for consumption, as well as the origin and kind of food. Results 27 families were evaluated, totalizing 91 individuals. With the Escala Brasileira de Insegurança Alimentar, it was found that 25.9% of the families were in light food insecurty situation. When caloric availability was assessed, 11.0% of families were considered insecure. In contrast, 59.0% of families had high calorie availability per capita (>3000 calories). Of the total households, 14.8% had more than 50.0% of the calories available for consumption coming from their own production. The foods most commonly produced for self-consumption were fresh vegetables, which are the most common ones supplied to Programa Nacional de Alimentação. In addition, the main source of kilocalories for the families were fresh and minimally processed foods. The presence of anemia in at least 1 resident was detected in 29.6% of households, with a negative correlation between the hemoglobin value (g/dL) and the Escala Brasileira de Insegurança Alimentar score. Conclusion It appears that the majority of the families of farmers supplying Programa Nacional de Alimentação Escolar are in a situation of Food and Nutritional Security, both by Escala Brasileira de Insegurança Alimentar and by the household availability of food. However, we cannot ignore the percentage of insecure families, since this situation can lead to other problems. Therefore, it is necessary to constantly assess the family situation of Fodd Insecurty and encourage production for self-consumption so that it contributes to food availability and quality. For this reason, the we highlight relevance of programs that strengthen the production and commercialization of food from family farming.