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Berti TL, de Castro IR, Pedrosa LF, Normando P, Farias DR, Lacerda EM, Oliveira N, Alves-Santos NH, Kac G. Serum Zinc Concentrations by Inflammation Status, Time of Day, and Fasting Status for Estimating Zinc Deficiency in 6-59-Mo-Old Children: Results from the Brazilian National Survey on Child Nutrition (ENANI-2019). J Nutr 2024; 154:994-1003. [PMID: 38218540 DOI: 10.1016/j.tjnut.2024.01.004] [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] [Received: 09/18/2023] [Revised: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Serum zinc concentration (SZC) is considered the best biomarker of zinc status in population-level evaluations. However, zinc deficiency (ZD) estimations can be biased if they do not consider blood collection timing, inflammation, and fasting status. OBJECTIVES The objectives of this study were to determine SZC without and with adjustment for inflammation, according to blood collection timing and fasting status, estimate ZD prevalence, and evaluate the associated factors with ZD in a representative sample of Brazilian children aged <5 y. METHODS Population-based study with 7597 children aged 6-59 mo surveyed by the Brazilian National Survey on Child Nutrition. SZC was adjusted for inflammation using the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia regression correction approach, with high-sensitive C-reactive protein, assessed according to blood collection timing (morning/afternoon) and fasting status (<8 and ≥8 h). SZC <65 μg/dL (morning collection) or SZC <57 μg/dL (afternoon collection) were classified as ZD. The analysis between associated factors and ZD used the adjusted prevalence ratio (PR). RESULTS After adjusting for inflammation, SZC was higher in all percentiles and varied according to collection timing and fasting status. Children who had blood collected in the morning without fasting or in the afternoon had lower SZC than those assessed in the morning with fasting. The differences in adjusted SZC according to the timing of collection and fasting status were greater in the higher percentiles of the distribution, with the greatest absolute difference observed when comparing the 95th percentile of morning fasting compared with nonfasting (20.3 μg/dL). The prevalence of ZD estimated without and with adjusting SZC for inflammation was 17.8% and 13.8%, respectively. The occurrence of diarrhea, fever, or respiratory symptoms in the 15 d before blood collection was associated with a higher prevalence of ZD (PR: 1.42; 95% confidence interval: 1.04, 1.94). CONCLUSIONS Adjusting SZC for inflammation and considering fasting status is important to avoid overestimating the prevalence of ZD.
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Affiliation(s)
- Talita L Berti
- Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Inês Rr de Castro
- Department of Social Nutrition, Nutrition Institute, State University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucia Fc Pedrosa
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Paula Normando
- Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Dayana R Farias
- Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elisa Ma Lacerda
- Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Natália Oliveira
- Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Gilberto Kac
- Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
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Hess SY, Wessells KR, Haile D, Rogers LM, Tan X, Barros JG, Bourassa MW, Gorstein J, Brown KH. Comparison of Published Estimates of the National Prevalence of Iron, Vitamin A, and Zinc Deficiency and Sources of Inconsistencies. Adv Nutr 2023; 14:1466-1478. [PMID: 37634853 PMCID: PMC10721533 DOI: 10.1016/j.advnut.2023.08.011] [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] [Received: 05/25/2023] [Revised: 07/21/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023] Open
Abstract
Micronutrient deficiencies result in a broad range of adverse health and functional consequences, but the true prevalence of specific deficiencies remains uncertain because limited information is available from nationally representative surveys using recommended biomarkers. The present review compares various reported national deficiency prevalence estimates for nutrients and years where the estimates overlap for individual countries that conducted nationally representative surveys and explores possible reasons for any discrepancies discovered. Nationally representative micronutrient status surveys that were conducted since 2000 among preschool-aged children or women of reproductive age and included assessment of iron, vitamin A, or zinc status based on recognized biomarkers were considered eligible for inclusion, along with any modeled deficiency prevalence estimates for these same countries and years. There was considerable variation across different published prevalence estimates, with larger inconsistencies when the prevalence estimate was based on proxies, such as hemoglobin for iron deficiency and dietary zinc availability for zinc deficiency. Numerous additional methodological issues affected the prevalence estimates, such as which biomarker and what cutoff was used to define deficiency, whether the biomarker was adjusted for inflammation, and what adjustment method was used. For some country-years, the various approaches resulted in fairly consistent prevalence estimates. For other country-years, however, the results differed markedly and changed the conclusions regarding the existence and severity of the micronutrient deficiency as a public health concern. In conclusion, to determine micronutrient status, we consider the assessment of one of the recommended biomarkers in a population representative survey as the best available information. If indicated, results should be adjusted for inflammation and generally acceptable cutoffs should be applied to facilitate comparisons, although individual countries may also apply nationally defined cutoffs to determine when and where to intervene. Global consensus is needed on best practices for presenting survey results and defining the prevalence of deficiency.
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Affiliation(s)
- Sonja Y Hess
- Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, CA, United States; Micronutrient Forum, Washington, DC, United States.
| | - K Ryan Wessells
- Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, CA, United States
| | - Demewoz Haile
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
| | | | - Xiuping Tan
- Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, CA, United States
| | - Jonathan G Barros
- Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, CA, United States
| | | | | | - Kenneth H Brown
- Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, CA, United States
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Mba CM, Jones KS, Forouhi NG, Imamura F, Assah F, Mbanya JC, Wareham NJ. The association between plasma zinc concentrations and markers of glucose metabolism in adults in Cameroon. Br J Nutr 2023; 130:1220-1227. [PMID: 36693633 PMCID: PMC7615052 DOI: 10.1017/s0007114523000223] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
An abnormal Zn status has been suggested to play a role in the pathogenesis of type 2 diabetes. However, epidemiological studies of the relationship between plasma Zn concentrations and diabetes are sparse and inconclusive. We aimed to investigate the association between plasma Zn concentrations and glycaemic markers (fasting glucose, 2-h glucose and homeostatic model assessment of insulin resistance) in rural and urban Cameroon. We studied 596 healthy adults (63·3 % women) aged 25-55 years in a population-based cross-sectional study. The mean plasma Zn concentration was 13·7 ± 2·7 µmol/L overall, with higher levels in men (14·4 ± 2·9 µmol/l) than in women (13·2 ± 2·6 µmol/l), P-value < 0·0001. There was an inverse relationship between tertiles of plasma Zn and 2-h glucose concentrations (P-value for linear trend = 0·002). The difference in 2-h glucose between those in the highest tertile of plasma Zn compared to the lowest was -0·63 (95 % CI - 1·02, -0·23) mmol/l. This remained significant after adjusting for age, sex, smoking status, alcohol intake, education level, area of residence, adiposity and objectively measured physical activity -0·43(-0·82, -0·04). Similar inverse associations were observed between plasma Zn concentrations and fasting glucose and homeostatic model assessment of insulin resistance when adjusted for socio-demographic and health-related behavioural characteristics. The current findings of an inverse association between plasma Zn concentrations and several markers of glucose homeostasis, together with growing evidence from intervention studies, suggest a role for Zn in glucose metabolism. If supported by further evidence, strategies to improve Zn status in populations may provide a cheap public health prevention approach for diabetes.
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Affiliation(s)
- Camille M. Mba
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Kerry S. Jones
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- National Institute for Health Research Biomedical Research Centre Nutritional Biomarker Laboratory, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Nita G. Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Felix Assah
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Jean Claude Mbanya
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
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Food-to-Food Fortification of a Traditional Pearl Millet Gruel with a Natural Source of β-Carotene (Sweet Potato) Improves the Bioaccessibility of Iron and Zinc. J FOOD QUALITY 2023. [DOI: 10.1155/2023/6413244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Iron and zinc deficiencies are still a major public health concern in the Far North Region of Cameroon where staple foods are mainly mineral rich cereals which equally contain inhibitors of their bioaccessibility. The effect of food-to-food fortification of a traditional pearl millet gruel with a natural source of β-carotene on the bioaccessibility of iron and zinc was assessed. A sensory evaluation of gruels fortified at 20, 30, and 40% with mashed sweet potato was carried out. The samples were analysed for carotenoids, phytates, polyphenols, iron, and zinc contents. Bioaccessible iron and zinc were evaluated using in vitro digestion method. The gruel fortified at 20% with mashed sweet potato had better scores (
< 0.05) of taste (3.93), colour (3.36), and overall acceptability (3.80) compared to the control. Carotenoid, polyphenol, and phytate contents were higher in fortified gruels (
< 0.05) compared to the control, while iron and zinc contents were lower. A significant increase (
< 0.05) in bioaccessibility of 8.08% and 26.96% for iron and 53.79% and 62.92% for zinc was observed at 20 and 30% incorporation level, respectively. However, at 40% incorporation level, the increase in bioaccessible iron was less important and bioaccessible zinc decreased. Mashed sweet potato can be used as a fortificant to improve the bioaccessibility of iron and zinc contents of local pearl millet gruel, if added moderately.
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Kotnis A, Bhatt GC, Joshi D, Shukla AK, Gupta P, Shah D, Choudhary B, Patil R, Dubey SK, Shukla M, Joshi A, Pakhare AP. Assessment of zinc inadequacy among tribal adolescent population of central India - A cross-sectional study. Indian J Med Res 2022; 156:339-347. [PMID: 36629194 PMCID: PMC10057370 DOI: 10.4103/ijmr.ijmr_3130_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background & objectives Zinc is a crucial micronutrient in adolescence, required for promoting growth and sexual maturation. Adolescents of some tribes may be at high risk of zinc deficiency due to dietary inadequacy and poor bioavailability of zinc from plant-based diets. This study aimed to evaluate the risk of zinc deficiency by estimating prevalence of inadequate zinc intake, prevalence of low serum zinc and stunting among tribal adolescents. Methods A cross-sectional community-based survey was conducted among adolescents (10-19 yr) in three purposively selected districts where Bhil, Korku and Gond tribes were in majority. Structured data collection instrument comprising information about sociodemographic characteristics and dietary recall data was used. Anthropometric assessment was conducted by standardized weighing scales and anthropometry tapes, and blood sample was collected from antecubital vein into trace element-free vacutainers. Serum zinc was estimated using an atomic absorption spectrophotometer. Results A total of 2310 households were approached for participation in the study, of which 2224 households having 5151 adolescents participated. Out of these enlisted adolescents, 4673 responded to dietary recall (90.7% response rate). Anthropometry of 2437 participants was carried out, and serum zinc was analyzed in 844 adolescents. The overall prevalence of dietary zinc inadequacy was 42.6 per cent [95% confidence interval (CI) 41.2 to 44.1] with reference to the estimated average requirement suggested by International Zinc Nutrition Consultative Group (IZiNCG) and 64.8 per cent (95% CI 63.4 to 66.2) with Indian Council of Medical Research-recommended requirements. Stunting was observed in 29 per cent (95% CI 27.2 to 30.8) participants. According to IZiNCG cut-offs, low serum zinc was detected in 57.5 per cent (95% CI 54.1 to 60.8) of adolescents, whereas it was 34.4 per cent (95% CI: 31.2-37.5) according to the national level cut-off. Interpretation & conclusions Risk of dietary zinc inadequacy and low serum zinc concentration amongst adolescents of the Gond, Bhil and Korku tribes is a public health concern.
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Affiliation(s)
- Ashwin Kotnis
- Department of Biochemistry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Girish C Bhatt
- Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Deepti Joshi
- Department of Pathology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Arvind K Shukla
- Department of Micronutrients, Indian Institute of Soil Sciences, Bhopal, Madhya Pradesh, India
| | - Palak Gupta
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Dishant Shah
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Bharat Choudhary
- Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh; Department of Trauma & Emergency Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Rajesh Patil
- Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Shiv Kumar Dubey
- Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Mukesh Shukla
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh; Department of Community Medicine, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India
| | - Ankur Joshi
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Abhijit P Pakhare
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Rakhmawati Y, Fatimah SN. The Role of Nutrients and MCV on Stunting: A Case Study on Indonesian Early Teenagers. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Many teenagers experience many nutritional problems, including anemia and stunting. The correlation between energy intake, protein, iron, and stunting with MCV levels in stunting adolescents in Jatinangor is not yet known.
AIM: This study aims to analyze the correlation of energy intake, protein, iron, and stunting and MCV levels in stunting adolescents in Jatinangor.
METHODS: This study was conducted with a cross-sectional design involving early adolescents aged 10-14 years in Jatinangor District as many as 41 people. Analysis of MCV levels was done by taking blood through veins. Stunting data were obtained based on WHO criteria with a value of z-score TB / U<- 2 SD and nutritional intake data including energy, protein, and iron obtained through 24-hour recall. To determine the intake of nutrients is done by interviewing with the method of 24 hours recall and FFQ. The data were analyzed with the Pearson Correlation Test.
RESULTS: The correlation between energy intake and MCV levels was p=0.022 (r=0.356). Furthermore, the correlation of protein intake and MCV levels was p=0.257, and iron intake with MCV levels was p=0.301. Eventually, the stunting correlation test to MCV levels was p=0.006 (r=0.419).
CONCLUSIONS: This study concludes that there is a correlation between energy intake and the value of the z-score TB / U index with MCV levels. There is no significant correlation between protein intake and iron intake with MCV levels in stunting adolescents in Jatinangor. There is a correlation between MCV and stunting levels, and there is no correlation between nutrient intake and stunting.
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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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Distribution and Determinants of Serum Zinc, Copper, and Selenium Levels among Children under Five Years from Popokabaka, Democratic Republic of Congo: A Cross-Sectional Study. Nutrients 2022; 14:nu14030683. [PMID: 35277041 PMCID: PMC8839910 DOI: 10.3390/nu14030683] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 01/27/2023] Open
Abstract
Information about essential trace elements among children in many African countries, including the Democratic Republic of Congo (DRC), is limited. We aimed to measure the distribution and determinants of serum zinc (Zn), copper (Cu), and selenium (Se) concentrations in a representative sample of children under five years old. We conducted a community-based cross-sectional study in Popokabaka, DRC. Blood samples were drawn from 412 children. The serum concentrations of minerals were measured using inductively coupled plasma−mass spectrometry. The median concentrations (P25−P75) of Zn, Cu, and Se were 61.9 µg/dL (52.8−70.2), 145.5 (120.0−167.0) µg/dL and 5.3 (4.3−6.3) µg/dL. The CRP-adjusted prevalence of serum Se deficiency was 84.1% (95% confidence interval [CI] 81.4−87.0) and of Zn deficiency was 64.6% (95% CI 59.8−69.1%). Only a few children were Cu deficient [1.5% (0.6−3.2)]. Evidence of inflammation (C-reactive protein, >5 mg/L) was associated with a lower Se concentration and higher Cu concentration. Furthermore, serum Se concentration was positively associated with linear growth. The average Cu/Zn molar ratio (2:1) was twice that recommended. Children in western Popokabaka had higher Zn and Se levels than their eastern neighbors. Zinc and selenium deficiencies are common among children in Popokabaka and require attention and prioritization.
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Monteiro JP, Fuzo CA, Ued FV, Kaput J. Dietary patterns related to zinc and polyunsaturated fatty acids intake are associated with serum linoleic/dihomo-γ-linolenic ratio in NHANES males and females. Sci Rep 2021; 11:12215. [PMID: 34108562 PMCID: PMC8190411 DOI: 10.1038/s41598-021-91611-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023] Open
Abstract
Identifying dietary patterns that contribute to zinc (Zn) and fatty acids intake and their biomarkers that may have an impact on health of males and females. The present study was designed to (a) extract dietary patterns with foods that explain the variation of Zn and PUFAs intake in adult men and women; and (b) evaluate the association between the extracted dietary patterns with circulating levels of serum dihomo-γ-linolenic fatty acid (DGLA) or serum linoleic/dihomo-γ-linolenic (LA/DGLA) ratio in males and females. We used reduced rank regression (RRR) to extract the dietary patterns separated by sex in the NHANES 2011-2012 data. A dietary pattern with foods rich in Zn (1st quintile = 8.67 mg/day; 5th quintile = 11.11 mg/day) and poor in PUFAs (5th quintile = 15.28 g/day; 1st quintile = 18.03 g/day) was found in females (S-FDP2) and the same pattern, with foods poor in PUFAs (5th quintile = 17.6 g/day; 1st quintile = 20.7 g/day) and rich in Zn (1st quintile = 10.4 mg/day; 5th quintile = 12.9 mg/day) (S-MDP2), was found in males. The dietary patterns with foods rich in Zn and poor in PUFAs were negatively associated with serum LA/DGLA ratio. This is the first study to associate the LA/DGLA ratio with Zn and PUFAs related dietary patterns in males and females.
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Affiliation(s)
- Jacqueline Pontes Monteiro
- Department of Pediatrics and Department of Health Sciences, Faculty of Medicine, Nutrition and Metabolism, University of São Paulo, Avenida Bandeirantes, Bairro Monte Alegre, Ribeirão Preto, SP, 3900, Brazil.
| | - Carlos A Fuzo
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutics Sciences, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Fábio V Ued
- Department of Pediatrics and Department of Health Sciences, Faculty of Medicine, Nutrition and Metabolism, University of São Paulo, Avenida Bandeirantes, Bairro Monte Alegre, Ribeirão Preto, SP, 3900, Brazil
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Feyisa BB, Tefera GM, Endris BS, Asayehu TT, Gebreyesus SH. Feeding practice, energy, and nutrient intake adequacy among children aged 6-23 months in Southern Ethiopia: a community based cross-sectional study. Food Sci Nutr 2020; 8:6680-6690. [PMID: 33312551 PMCID: PMC7723221 DOI: 10.1002/fsn3.1962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 01/09/2023] Open
Abstract
After 6 months, children require increased food and nutrient intake from complementary food for their growth and development. However, quantitative data on macro and micronutrient intakes from complementary food is limited. Thus, this study is designed to identify the adequacy of energy and micronutrient intake from complementary foods among children aged 6-23 months and to characterize current feeding practice in Southern Ethiopia. A community-based cross-sectional study was conducted from February to March 2016. Simple random sampling was used to recruit 190 mothers/primary caregivers of children aged 6-23 months. A repeated interactive multiple-pass 24-hr recall survey was used to assess' food and nutrient intake of children. Complementary food was low in animal sources, fruits, and vegetables. Most of the children (94.7%) consume grain, roots, and tubers. Vitamin A-rich fruits and vegetables are consumed by 71 (37.8%) children. Very few (1.6%) children consume iron-fortified food. Median protein intake exceeds the estimated requirement from complementary food. Except for vitamin B2 and B6, intake of energy and micronutrient were below world health organization (WHO) recommendations among children aged 9-23 months. In conclusion, infant and young child feeding practices in Butajira district did not conform to recommendations. Intake of energy and micronutrient from complementary food among children aged 6-23 months in Butajira district was inadequate. Consumption of a diverse diet by including animal source food (ASF) such as poultry, organ meat, chicken liver, beef, fruits, and vegetables is needed to fill the nutrient intake gap among the study participant.
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Affiliation(s)
- Beshadu Bedada Feyisa
- Department of Public HealthCollege of Medicine and Health ScienceAmbo UniversityAmboEthiopia
| | - Gosaye Mekonen Tefera
- Department of PharmacyCollege of Medicine and Health ScienceAmbo UniversityAmboEthiopia
| | - Bilal Shukur Endris
- School of Public HealthCollege of Health ScienceAddis Ababa UniversityAddis AbabaEthiopia
| | - Tamene Taye Asayehu
- Department of Food Science and Applied NutritionCollege of Applied SciencesAddis Ababa Science and Technology UniversityAddis AbabaEthiopia
| | - Seifu Hagos Gebreyesus
- School of Public HealthCollege of Health ScienceAddis Ababa UniversityAddis AbabaEthiopia
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11
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Bevis LEM, Hestrin R. Variation in crop zinc concentration influences estimates of dietary Zn inadequacy. PLoS One 2020; 15:e0234770. [PMID: 32645004 PMCID: PMC7347138 DOI: 10.1371/journal.pone.0234770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 06/02/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Zinc (Zn) deficiency is one of the most common micronutrient deficiencies worldwide. Accurate estimates of Zn intake would facilitate the design and implementation of effective nutritional interventions. OBJECTIVE We sought to improve estimates of dietary Zn intake by evaluating staple crop Zn content and dietary Zn consumption by children under the age of 5 in 9 rural districts of Uganda. METHODS We measured the Zn content of 581 crop samples from household farms and 167 crop samples from nearby markets, and administered food frequency questionnaires to the primary caretakers of 237 children. We estimated Zn consumption using 3 sources of crop Zn content: (i) the HarvestPlus food composition table (FCT) for Uganda, (ii) measurements from household crops, and (iii) measurements from market crops. RESULTS The Zn content of staple crops varied widely, resulting in significantly different estimates of dietary Zn intake. 41% of children appeared to be at risk when estimates were based on market-sampled crops, 23% appeared at risk when estimates were based on the HarvestPlus FCT, and 16% appeared at risk when estimates were based on samples from household farms. CONCLUSION The use of FCTs to calculate Zn intake overestimated the risk of dietary inadequacy for children who primarily consumed staple crops that were produced on household farms, but underestimated the risk for children who primarily consumed staple crops that were purchased at market. More information on the Zn content of staple crops in developing countries could lead to more accurate estimates of dietary intake and associated deficiencies.
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Affiliation(s)
- Leah E. M. Bevis
- Department of Agricultural, Environmental and Development Economics, The Ohio State University, Columbus, Ohio, United States of America
| | - Rachel Hestrin
- Soil and Crop Sciences, School of Integrative Plant Science, Cornell University, Ithaca, New York, United States of America
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12
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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: 93] [Impact Index Per Article: 23.3] [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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13
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Syam A, Sari NP, Thaha AR, Suriah, Jafar N, Salam A, Mallongi A. The effect of pumpkin seed flour (Cucurbita moschata Durch) on zinc serum levels in malnourished Wistar rats. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.10.095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Berhe K, Gebrearegay F, Gebremariam H. Prevalence and associated factors of zinc deficiency among pregnant women and children in Ethiopia: a systematic review and meta-analysis. BMC Public Health 2019; 19:1663. [PMID: 31829213 PMCID: PMC6907210 DOI: 10.1186/s12889-019-7979-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 11/20/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Pregnant women and children are the most vulnerable groups to zinc deficiency. Despite the presence of few primary studies, studies that could provide strong evidence that would help policymakers to develop appropriate interventional strategies in addressing zinc deficiency among pregnant women and children are limited in Ethiopia. Therefore, the aim of this systematic review and meta-analysis was to estimate the national pooled prevalence and associated factors of zinc deficiency among pregnant women and children. METHODS We searched Pub Med, Scopus, CINAHL, Google Scholar, and Google for studies reported on zinc deficiency and associated factors among pregnant women and children. Search terms were 'zinc deficiency', 'zinc status', 'associated factors', 'children', 'pregnant women', and 'Ethiopia' using the boolean operators 'OR' or 'AND'. Searches were using English language. A preferred reporting item for systematic reviews and meta-analysis (PRISMA) checklist was used. Two authors independently reviewed the studies. The effect sizes of the meta-analysis were the prevalence of zinc deficiency and adjusted odds ratio (AOR) of the associated factors. Finally, the Comprehensive Meta-Analysis (CMA) version 3.3.07 was used for statistical analysis by applying the random-effects model and publication bias was assessed using funnel plots and Egger's test. RESULTS Thirteen studies (7 among pregnant women having total participants of 2371 pregnant women and 6 among children with total participants of 5154 children) were included in this systematic review and meta-analysis. Using the random-effects model, the pooled prevalence of zinc deficiency was 59.9% (95%CI: 51.9, 67.7%) and 38.4% (95%CI: 28.6, 49.4) among pregnant women and children, respectively. The associated factors for zinc deficiency among pregnant women were coffee intake (adjusted odds ratio (AOR) =1.76), low intake of animal source foods (AOR = 2.57), and inadequate diet diversity (AOR = 2.12). CONCLUSION Overall, zinc deficiency among pregnant women and children is a significant public health concern in Ethiopia. Promoting dietary modification to enhance the bioavailability of zinc, improving diet diversity, and consuming animal source foods would help in alleviating and/or minimizing the problem among the target groups. Zinc supplementation could also be considered for pregnant women and children.
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Affiliation(s)
- Kidanemaryam Berhe
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray Ethiopia
| | - Freweini Gebrearegay
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray Ethiopia
| | - Hadush Gebremariam
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray Ethiopia
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Mark HE, Assiene JG, Luo H, Nankap M, Ndjebayi A, Ngnie-Teta I, Tarini A, Pattar A, Killilea DW, Brown KH, Engle-Stone R. Monitoring of the National Oil and Wheat Flour Fortification Program in Cameroon Using a Program Impact Pathway Approach. Curr Dev Nutr 2019; 3:nzz076. [PMID: 31367692 PMCID: PMC6660062 DOI: 10.1093/cdn/nzz076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/04/2019] [Accepted: 06/18/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Since 2011 Cameroon has mandated the fortification of refined vegetable oil with vitamin A and wheat flour with iron, zinc, folic acid, and vitamin B-12. In 2012, measured fortification levels for flour, and particularly oil, were below target. OBJECTIVES We assessed Cameroon's food fortification program using a program impact pathway (PIP) to identify barriers to optimal performance. METHODS We developed a PIP through literature review and key informant interviews. We conducted interviews at domestic factories for refined vegetable oil (n = 9) and wheat flour (n = 10). In 12 sentinel sites distributed nationally, we assessed availability and storage conditions of fortified foods in markets and frequency of consumption of fortified foods among women and children (n = 613 households). Food samples were collected from factories, markets, and households for measurement of micronutrient content. RESULTS Two-thirds of factories presented quality certificates for recent premix purchases. All factories had in-house capacity for micronutrient analysis, but most used qualitative methods. Industries cited premix import taxes and access to external laboratories as constraints. Mean vitamin A levels were 141% (95% CI: 116%, 167%), 75% (95% CI: 62%, 89%), and 75% (95% CI: 60%, 90%) of target in individual samples from factories, markets, and households, respectively. Most industry flour samples appeared to be fortified, but micronutrient levels were low. Among composite flour samples from markets and households, the mean iron and zinc content was 25 mg/kg and 43 mg/kg, respectively, ∼45% of target levels; folic acid (36%) and vitamin B-12 (29%) levels were also low. In the previous week, the majority of respondents had consumed "fortifiable" oil (63% women and 52% children) and wheat flour (82% women and 86% children). CONCLUSIONS In Cameroon, oil fortification program performance appears to have improved since 2012, but fortification levels remain below target, particularly for wheat flour. Consistent regulatory monitoring and program support, possibly through premix procurement and micronutrient analysis, are needed.
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Affiliation(s)
- Henry E Mark
- Department of Nutrition, University of California, Davis, Davis, CA, USA
| | | | - Hanqi Luo
- Department of Nutrition, University of California, Davis, Davis, CA, USA
| | | | | | | | | | - Amrita Pattar
- Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - David W Killilea
- Children's Hospital Oakland Research Institute, Oakland, CA, USA
| | - Kenneth H Brown
- Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - Reina Engle-Stone
- Department of Nutrition, University of California, Davis, Davis, CA, USA
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16
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Engle‐Stone R, Vosti SA, Luo H, Kagin J, Tarini A, Adams KP, French C, Brown KH. Weighing the risks of high intakes of selected micronutrients compared with the risks of deficiencies. Ann N Y Acad Sci 2019; 1446:81-101. [PMID: 31168822 PMCID: PMC6618252 DOI: 10.1111/nyas.14128] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/22/2019] [Accepted: 05/03/2019] [Indexed: 12/31/2022]
Abstract
Several intervention strategies are available to reduce micronutrient deficiencies, but uncoordinated implementation of multiple interventions may result in excessive intakes. We reviewed relevant data collection instruments and available information on excessive intakes for selected micronutrients and considered possible approaches for weighing competing risks of intake above tolerable upper intake levels (ULs) versus insufficient intakes at the population level. In general, population-based surveys in low- and middle-income countries suggest that dietary intakes greater than the UL are uncommon, but simulations indicate that fortification and supplementation programs could lead to high intakes under certain scenarios. The risk of excessive intakes can be reduced by considering baseline information on dietary intakes and voluntary supplement use and continuously monitoring program coverage. We describe a framework for comparing risks of micronutrient deficiency and excess, recognizing that critical information for judging these risks is often unavailable. We recommend (1) assessing total dietary intakes and nutritional status; (2) incorporating rapid screening tools for routine monitoring and surveillance; (3) addressing critical research needs, including evaluations of the current ULs, improving biomarkers of excess, and developing methods for predicting and comparing risks and benefits; and (4) ensuring that relevant information is used in decision-making processes.
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Affiliation(s)
| | - Stephen A. Vosti
- Department of Agricultural and Resource EconomicsUniversity of CaliforniaDavisCalifornia
| | - Hanqi Luo
- Department of NutritionUniversity of CaliforniaDavisCalifornia
| | | | | | | | - Caitlin French
- Department of NutritionUniversity of CaliforniaDavisCalifornia
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Tessema M, De Groote H, D Brouwer I, J M Feskens E, Belachew T, Zerfu D, Belay A, Demelash Y, S Gunaratna N. Soil Zinc Is Associated with Serum Zinc But Not with Linear Growth of Children in Ethiopia. Nutrients 2019; 11:nu11020221. [PMID: 30678175 PMCID: PMC6413067 DOI: 10.3390/nu11020221] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 12/26/2018] [Accepted: 01/14/2019] [Indexed: 01/20/2023] Open
Abstract
To our knowledge, the relationships among soil zinc, serum zinc and children's linear growth have not been studied geographically or at a national level in any country. We use data from the cross-sectional, nationally representative Ethiopian National Micronutrient Survey (ENMS) (n = 1776), which provided anthropometric and serum zinc (n = 1171) data on children aged 6⁻59 months. Soil zinc levels were extracted for each child from the digital soil map of Ethiopia, developed by the Africa Soil Information Service. Children's linear growth was computed using length/height and age converted into Z-scores for height-for-age. Multi-level mixed linear regression models were used for the analysis. Nationally, 28% of children aged 6⁻59 months were zinc deficient (24% when adjusted for inflammation) and 38% were stunted. Twenty percent of households in the ENMS were located on zinc-deficient soils. Soil zinc (in mg/kg) was positively associated with serum zinc (in µg/dL) (b = 0.9, p = 0.020) and weight-for-height-Z-score (b = 0.05, p = 0.045) but linear growth was not associated with soil zinc (p = 0.604) or serum zinc (p = 0.506) among Ethiopian preschool children. Intervention studies are needed to determine whether there are causal links between soil and human zinc status.
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Affiliation(s)
- Masresha Tessema
- Division of Human Nutrition and Health, Wageningen University, 6700 AA Wageningen, The Netherlands.
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Gulele Sub City, 1242 Addis Ababa, Ethiopia.
- Human Nutrition Unit, Jimma University, P.O. Box 378, Jimma, Ethiopia.
| | - Hugo De Groote
- International Maize and Wheat Improvement Centre (CIMMYT), 1041-00621 Nairobi, Kenya.
| | - Inge D Brouwer
- Division of Human Nutrition and Health, Wageningen University, 6700 AA Wageningen, The Netherlands.
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University, 6700 AA Wageningen, The Netherlands.
| | - Tefera Belachew
- Human Nutrition Unit, Jimma University, P.O. Box 378, Jimma, Ethiopia.
| | - Dilnesaw Zerfu
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Gulele Sub City, 1242 Addis Ababa, Ethiopia.
| | - Adamu Belay
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Gulele Sub City, 1242 Addis Ababa, Ethiopia.
| | - Yoseph Demelash
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Gulele Sub City, 1242 Addis Ababa, Ethiopia.
| | - Nilupa S Gunaratna
- Department of Nutrition Science and Public Health Graduate Program, Purdue University, West Lafayette, IN 47907, USA.
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18
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Ayana G, Moges T, Samuel A, Asefa T, Eshetu S, Kebede A. Dietary zinc intake and its determinants among Ethiopian children 6-35 months of age. BMC Nutr 2018; 4:30. [PMID: 32153891 PMCID: PMC7050893 DOI: 10.1186/s40795-018-0237-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/21/2018] [Indexed: 11/23/2022] Open
Abstract
Background Adequate zinc intake is essential for the growth and neurobehavioral development of young children. Zinc deficiency in children is recognized as risk factor for stunting. In Ethiopia, 38% of children under five years of age are stunted. This analysis was conducted to measure dietary zinc intake and to identify its determinants among children 6–35 months of age to design appropriate intervention. Methods Nationally and regionally representative data available from 6752 children 6–35 months of age from the Ethiopian national food consumption survey were analyzed. A multivariate model was used to identify determinants of dietary zinc intake. Results We found low dietary zinc intake among children 6–35 month age. National average dietary zinc intake was 1.74 mg/day. Socio-economic status, maternal education, and maternal age were positively associated with dietary zinc intake, while the number of children under 5 years-of-age in a household was negatively associated with dietary zinc intake (p < 0.0001). Children reportedly sick in the previous 2 weeks were most likely to have low dietary zinc intake (p < 0.0001). Conclusion The observed low dietary zinc intake in Ethiopian children has a significant association with health status of children, providing evidence for nutrition and health planners to emphasize on promoting consumption of zinc rich foods and preventing morbidity from common infections.
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Affiliation(s)
- Girmay Ayana
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tibebu Moges
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Aregash Samuel
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tsehai Asefa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Solomon Eshetu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Aweke Kebede
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Daniels L, Williams SM, Gibson RS, Taylor RW, Samman S, Heath ALM. Modifiable "Predictors" of Zinc Status in Toddlers. Nutrients 2018; 10:E306. [PMID: 29510562 PMCID: PMC5872724 DOI: 10.3390/nu10030306] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/23/2018] [Accepted: 03/02/2018] [Indexed: 01/29/2023] Open
Abstract
Suboptimal zinc status is common in very young children and likely associated with increased risk of infection and detrimental effects on growth. No studies have determined potentially modifiable "predictors" of zinc status in toddlers from high-income countries. This cross-sectional analysis of 115 toddlers from the Baby-Led Introduction to SolidS (BLISS) study used weighed diet records (three non-consecutive days) to assess dietary intake, and a venous blood sample (trace-element free techniques) to assess plasma zinc, at 12 months of age. "Predictors" of plasma zinc were determined by univariate analysis and multiple regression. Mean (SD) plasma zinc was 9.7 (1.5) μmol/L, 60% were below the IZiNCG reference limit of <9.9 μmol/L. Median (25th, 75th percentiles) intake of zinc was 4.4 (3.7, 5.4) mg/day. Red meat intake (p = 0.004), consumption of zinc-fortified infant formula (3-6 mg zinc/100 g) (p = 0.026), and food fussiness (p = 0.028) were statistically significant "predictors" of plasma zinc at 12 months. Although higher intakes of red meat, and consumption of infant formula, are potentially achievable, it is important to consider possible barriers, particularly impact on breastfeeding, cost, and the challenges of behavior modification. Of interest is the association with food fussiness-further research should investigate the direction of this association.
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Affiliation(s)
- Lisa Daniels
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand.
- Department of Medicine, University of Otago, Dunedin 9054, New Zealand.
| | - Sheila M Williams
- Department of Preventive and Social Medicine, University of Otago, Dunedin 9054, New Zealand.
| | - Rosalind S Gibson
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand.
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin 9054, New Zealand.
| | - Samir Samman
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand.
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW 2006, Australia.
| | - Anne-Louise M Heath
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand.
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Aceituno AM, Stanhope KK, Rebolledo PA, Burke RM, Revollo R, Iñiguez V, Suchdev PS, Leon JS. Using a monitoring and evaluation framework to improve study efficiency and quality during a prospective cohort study in infants receiving rotavirus vaccination in El Alto, Bolivia: the Infant Nutrition, Inflammation, and Diarrheal Illness (NIDI) study. BMC Public Health 2017; 17:911. [PMID: 29183280 PMCID: PMC5706310 DOI: 10.1186/s12889-017-4904-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 11/12/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Implementing rigorous epidemiologic studies in low-resource settings involves challenges in participant recruitment and follow-up (e.g., mobile populations, distrust), biological sample collection (e.g., cold-chain, laboratory equipment scarcity) and data collection (e.g., literacy, staff training, and infrastructure). This article describes the use of a monitoring and evaluation (M&E) framework to improve study efficiency and quality during participant engagement, and biological sample and data collection in a longitudinal cohort study of Bolivian infants. METHODS The study occurred between 2013 and 2015 in El Alto, Bolivia, a high-altitude, urban, low-resource community. The study's M&E framework included indicators for participant engagement (e.g., recruitment, retention, safety), biological sample (e.g., stool and blood), and data (e.g., anthropometry, questionnaires) collection and quality. Monitoring indicators were measured regularly throughout the study and used for course correction, communication, and staff retraining. RESULTS Participant engagement indicators suggested that enrollment objectives were met (461 infants), but 15% loss-to-follow-up resulted in only 364 infants completing the study. Over the course of the study, there were four study-related adverse events (minor swelling and bruising related to a blood draw) and five severe adverse events (infant deaths) not related to study participation. Biological sample indicators demonstrated two blood samples collected from 95% (333 of 350 required) infants and stool collected for 61% of reported infant diarrhea episodes. Anthropometry data quality indicators were extremely high (median SDs for weight-for-length, length-for-age and weight-for-age z-scores 1.01, 0.98, and 1.03, respectively), likely due to extensive training, standardization, and monitoring efforts. CONCLUSIONS Conducting human subjects research studies in low-resource settings often presents unique logistical difficulties, and collecting high-quality data is often a challenge. Investing in comprehensive M&E is important to improve participant recruitment, retention and safety, and sample and data quality. The M&E framework from this study can be applied to other longitudinal studies.
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Affiliation(s)
- Anna M. Aceituno
- RTI International, 3040 E. Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709 USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Kaitlyn K. Stanhope
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Paulina A. Rebolledo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
- Emory School of Medicine, Atlanta, GA USA
| | - Rachel M. Burke
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Rita Revollo
- Servicio Departamental de Salud, La Paz, Bolivia
| | - Volga Iñiguez
- Instituto de Biotecnología y Microbiología, Universidad Mayor de San Andrés, La Paz, Bolivia
| | - Parminder S. Suchdev
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
- Emory School of Medicine, Atlanta, GA USA
- Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Juan S. Leon
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
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Gibson RS, Charrondiere UR, Bell W. Measurement Errors in Dietary Assessment Using Self-Reported 24-Hour Recalls in Low-Income Countries and Strategies for Their Prevention. Adv Nutr 2017; 8:980-991. [PMID: 29141979 PMCID: PMC5683000 DOI: 10.3945/an.117.016980] [Citation(s) in RCA: 152] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Securing accurate measurements of dietary intake across populations is challenging. Of the methods, self-reported 24-h recalls are often used in low-income countries (LICs) because they are quick, culturally sensitive, do not require high cognitive ability, and provide quantitative data on both foods and nutrients. Measuring intakes via 24-h recalls involves 1) collecting data on food intakes, 2) the appropriate use of relevant food-composition data for calculating nutrient intakes, and 3) statistically converting observed intakes to "usual intakes" for evaluating nutrient adequacy or relations between foods and nutrients and health outcomes. Like all dietary methods, 24-h recalls are subject to random errors that lower the precision and systematic errors that can reduce accuracy at each stage of the measurement protocol. Research has identified the potential sources of measurement errors in 24-h recall protocols and emphasized that sources of random error can be reduced by incorporating standardized quality-control procedures and collecting more than one 24-h recall per person, with the number depending on the study objective. Careful design of the initial 24-h recall protocol can take into account potential sources of systematic error, such as day of the week, season, age, etc. Other sources of systematic error (e.g., energy underreporting) can best be detected by including a reference measure (e.g., doubly labeled water to measure energy expenditure). Alternatively, 24-h recall intakes of energy can be compared with same-day weighed intakes. Nevertheless, very few studies in LICs have assessed the validity of 24-h recalls in their study settings or adopted recommended standardized protocols to mitigate random errors. Hence, efforts should be made to improve the assessment, analysis, and interpretation of self-reported 24-h recall data for population studies in LICs. Accurate and precise dietary intake data at the national level can play an essential role in informing food, nutrition, and agricultural policies; food fortification planning; and compliance to food-based dietary guidelines.
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Affiliation(s)
- Rosalind S Gibson
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | | | - Winnie Bell
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
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Liu X, Piao J, Zhang Y, He Y, Li W, Yang L, Yang X. Assessment of Zinc Status in School-Age Children from Rural Areas in China Nutrition and Health Survey 2002 and 2012. Biol Trace Elem Res 2017; 178:194-200. [PMID: 28101714 DOI: 10.1007/s12011-016-0922-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 12/25/2016] [Indexed: 12/11/2022]
Abstract
Zinc is an essential trace element for growth and development in children, but zinc deficiency is a serious nutritional problem worldwide. Our study aimed to assess the zinc status of school-age children living in rural areas of China and to examine the change of zinc status based on the China Nutrition and Health Survey 2002 and 2012. We used the probability proportional to size sampling method for subject selection, and a total of 3407 school-age children were included in this study. Zinc status was assessed by three items of indicators recommended by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the International Atomic Energy Agency (IAEA), and the International Zinc Nutrition Consultative Group (IZiNCG). The concentration of serum zinc was 718.2 μg/L, and 44.4% of children being zinc deficiency in 2002, while 846.8 μg/L and 10.4% in 2012. Zinc intake was 7.8 mg/day with a 7.6% inadequate zinc intake in 2002, together with 6.9 mg/day and 38.2% in 2012. Height-for-age Z score was -1.06 and 19.1% of children being stunting in 2002, as well as -0.15 and 6.8% in 2012. In conclusion, the zinc status of school-age children living in rural areas of China has been significantly improved in addition to zinc intake over the past 10 years. However, the zinc deficiency still observed in poor rural areas of China in 2012. In addition, we suggested that the zinc bioavailability should be taken into account when assessing zinc status in population.
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Affiliation(s)
- Xiaobing Liu
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, West district, Beijing, 100050, China
| | - Jianhua Piao
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, West district, Beijing, 100050, China
| | - Yu Zhang
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, West district, Beijing, 100050, China
| | - Yuna He
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, West district, Beijing, 100050, China
| | - Weidong Li
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, West district, Beijing, 100050, China
| | - Lichen Yang
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, West district, Beijing, 100050, China
| | - Xiaoguang Yang
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, West district, Beijing, 100050, China.
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Engle-Stone R, Nankap M, Ndjebayi AO, Allen LH, Shahab-Ferdows S, Hampel D, Killilea DW, Gimou MM, Houghton LA, Friedman A, Tarini A, Stamm RA, Brown KH. Iron, Zinc, Folate, and Vitamin B-12 Status Increased among Women and Children in Yaoundé and Douala, Cameroon, 1 Year after Introducing Fortified Wheat Flour. J Nutr 2017; 147:1426-1436. [PMID: 28592513 PMCID: PMC5483962 DOI: 10.3945/jn.116.245076] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 01/31/2017] [Accepted: 05/03/2017] [Indexed: 01/21/2023] Open
Abstract
Background: Few data are available on the effectiveness of large-scale food fortification programs.Objective: We assessed the impact of mandatory wheat flour fortification on micronutrient status in Yaoundé and Douala, Cameroon.Methods: We conducted representative surveys 2 y before and 1 y after the introduction of fortified wheat flour. In each survey, 10 households were selected within each of the same 30 clusters (n = ∼300 households). Indicators of inflammation, malaria, anemia, and micronutrient status [plasma ferritin, soluble transferrin receptor (sTfR), zinc, folate, and vitamin B-12] were assessed among women aged 15-49 y and children 12-59 mo of age.Results: Wheat flour was consumed in the past 7 d by ≥90% of participants. Postfortification, mean total iron and zinc concentrations of flour samples were 46.2 and 73.6 mg/kg (target added amounts were 60 and 95 mg/kg, respectively). Maternal anemia prevalence was significantly lower postfortification (46.7% compared with 39.1%; adjusted P = 0.01), but mean hemoglobin concentrations and child anemia prevalence did not differ. For both women and children postfortification, mean plasma concentrations were greater for ferritin and lower for sTfR after adjustments for potential confounders. Mean plasma zinc concentrations were greater postfortification and the prevalence of low plasma zinc concentration in women after fortification (21%) was lower than before fortification (39%, P < 0.001); likewise in children, the prevalence postfortification (28%) was lower than prefortification (47%, P < 0.001). Mean plasma total folate concentrations were ∼250% greater postfortification among women (47 compared with 15 nmol/L) and children (56 compared with 20 nmol/L), and the prevalence of low plasma folate values was <1% after fortification in both population subgroups. In a nonrepresentative subset of plasma samples, folic acid was detected in 77% of women (73% of those fasting) and 93% of children. Mean plasma and breast-milk vitamin B-12 concentrations were >50% greater postfortification.Conclusion: Although the pre-post survey design limits causal inference, iron, zinc, folate, and vitamin B-12 status increased among women and children in urban Cameroon after mandatory wheat flour fortification.
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Affiliation(s)
- Reina Engle-Stone
- Department of Nutrition, University of California, Davis, Davis, CA;
| | | | | | - Lindsay H Allen
- Department of Nutrition, University of California, Davis, Davis, CA
- USDA, Agricultural Research Service Western Human Nutrition Research Center, Davis, CA
| | - Setareh Shahab-Ferdows
- Department of Nutrition, University of California, Davis, Davis, CA
- USDA, Agricultural Research Service Western Human Nutrition Research Center, Davis, CA
| | - Daniela Hampel
- Department of Nutrition, University of California, Davis, Davis, CA
- USDA, Agricultural Research Service Western Human Nutrition Research Center, Davis, CA
| | - David W Killilea
- Nutrition and Metabolism Center, Children's Hospital Oakland Research Institute, Oakland, CA
| | | | | | | | - Ann Tarini
- Helen Keller International, New York, NY
| | | | - Kenneth H Brown
- Department of Nutrition, University of California, Davis, Davis, CA
- Bill & Melinda Gates Foundation, Seattle, WA
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Killilea DW, Rohner F, Ghosh S, Otoo GE, Smith L, Siekmann JH, King JC. Identification of a Hemolysis Threshold That Increases Plasma and Serum Zinc Concentration. J Nutr 2017; 147:1218-1225. [PMID: 28490675 PMCID: PMC5443468 DOI: 10.3945/jn.116.247171] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 01/19/2017] [Accepted: 03/28/2017] [Indexed: 12/20/2022] Open
Abstract
Background: Plasma or serum zinc concentration (PZC or SZC) is the primary measure of zinc status, but accurate sampling requires controlling for hemolysis to prevent leakage of zinc from erythrocytes. It is not established how much hemolysis can occur without changing PZC/SZC concentrations.Objective: This study determines a guideline for the level of hemolysis that can significantly elevate PZC/SZC.Methods: The effect of hemolysis on PZC/SZC was estimated by using standard hematologic variables and mineral content. The calculated hemolysis threshold was then compared with results from an in vitro study and a population survey. Hemolysis was assessed by hemoglobin and iron concentrations, direct spectrophotometry, and visual assessment of the plasma or serum. Zinc and iron concentrations were determined by inductively coupled plasma spectrometry.Results: A 5% increase in PZC/SZC was calculated to result from the lysis of 1.15% of the erythrocytes in whole blood, corresponding to ∼1 g hemoglobin/L added into the plasma or serum. Similarly, the addition of simulated hemolysate to control plasma in vitro caused a 5% increase in PZC when hemoglobin concentrations reached 1.18 ± 0.10 g/L. In addition, serum samples from a population nutritional survey were scored for hemolysis and analyzed for changes in SZC; samples with hemolysis in the range of 1-2.5 g hemoglobin/L showed an estimated increase in SZC of 6% compared with nonhemolyzed samples. Each approach indicated that a 5% increase in PZC/SZC occurs at ∼1 g hemoglobin/L in plasma or serum. This concentration of hemoglobin can be readily identified directly by chemical hemoglobin assays or indirectly by direct spectrophotometry or matching to a color scale.Conclusions: A threshold of 1 g hemoglobin/L is recommended for PZC/SZC measurements to avoid increases in zinc caused by hemolysis. The use of this threshold may improve zinc assessment for monitoring zinc status and nutritional interventions.
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Affiliation(s)
| | | | - Shibani Ghosh
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA; and
| | - Gloria E Otoo
- Department of Nutrition and Food Sciences, University of Ghana, Accra, Ghana
| | - Lauren Smith
- Children's Hospital Oakland Research Institute, Oakland, CA
| | | | - Janet C King
- Children's Hospital Oakland Research Institute, Oakland, CA
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Ibeawuchi AN, Onyiriuka AN, Abiodun PO. High Prevalence of Zinc Deficiency in Rural Nigerian Preschool Children: A Community-Based Cross-Sectional Study. ROMANIAN JOURNAL OF DIABETES NUTRITION AND METABOLIC DISEASES 2017. [DOI: 10.1515/rjdnmd-2017-0004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background and Aims: In Nigeria, community-based epidemiological data related to the prevalence of zinc deficiency in preschool children are scarce. We assessed the prevalence of zinc deficiency and the associated socio-demographic variables in children aged between 6 and 60 months, living in a Nigerian rural community.
Materials and Methods: In this cross-sectional study, the serum zinc concentrations of 252 children aged between 6 and 60 months in a rural community in Nigeria were assessed, using atomic absorption spectrophotometry. The study population was selected by multistage random sampling and at least two children were selected from every household which had children in the study age group. The socio-demographic characteristics of the subjects were obtained, using an interviewer-administered questionnaire.
Results: A total of 252 children were studied, 134 (53.2%) males and 118 (46.8%) females. The mean age was 32.7±17.0 months, similar for both sexes. Overall, 220 (87.3%) had low serum zinc concentrations (less than 7.65µmol/L). According to age, the highest mean serum zinc concentration was 5.43±3.52µmol/L in children aged between 6 and 12 months. Correlation between serum zinc concentration and family size or socio-economic status (SES) showed that the smaller the family size and the higher the SES, the higher the serum zinc concentration.
Conclusions: The high prevalence of low serum zinc concentration indicates that zinc deficiency is a public health problem in our rural communities, requiring public health intervention.
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Affiliation(s)
| | - Alphonsus N. Onyiriuka
- Endocrine and Metabolic Unit, Department of Child Health, University of Benin Teaching Hospital, PMB 1111, Benin City, Nigeria
| | - Philip O. Abiodun
- Gastroenterology and Nutrition Unit, Department of Child Health, University of Benin Teaching Hospital, PMB 1111, Benin City, Nigeria
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26
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Abstract
BACKGROUND Information is needed on the national prevalence of zinc deficiency to guide program development and evaluation. OBJECTIVE To summarize results of national surveys that assessed plasma or serum zinc concentrations (PZC) and compare the prevalence of low PZC with other methods used to estimate countries' risk of zinc deficiency. METHODS National surveys that included PZC were identified through Internet searches and personal contacts. A survey was eligible if a nationally representative sampling scheme was used, PZC was analyzed, and the survey was implemented in a low- or middle-income country. Twenty surveys were eligible; 19 countries assessed PZC in young children and 14 in women of reproductive age. RESULTS In 13 of the 19 surveys, the prevalence of low PZC in children was >20%. Only Afghanistan, Azerbaijan, Nigeria, the Republic of Maldives, Sri Lanka, and China found a low prevalence of inadequate PZC among children. Some of these conclusions may be due to the lower than recommended cutoff that was used. Similarly, in 13 of 14 surveys, the prevalence of low PZC in women was >20%. Estimates of percentage population with inadequate dietary zinc intake based on food balance sheets underestimate the risk of zinc deficiency. The national stunting prevalence seems to be a useful proxy, as both indicators categorized countries similarly into high versus low risk of zinc deficiency, with some exceptions. CONCLUSIONS Results from 20 countries suggest that zinc deficiency is a public health concern in the majority of these countries and zinc intervention strategies should be considered.
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Affiliation(s)
- Sonja Y Hess
- 1 Program in International and Community Nutrition, University of California Davis, Davis, CA, USA
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27
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Hu YD, Pang W, He CC, Lu H, Liu W, Wang ZY, Liu YQ, Huang CY, Jiang YG. The cognitive impairment induced by zinc deficiency in rats aged 0∼2 months related to BDNF DNA methylation changes in the hippocampus. Nutr Neurosci 2016; 20:519-525. [PMID: 27329329 DOI: 10.1080/1028415x.2016.1194554] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study was carried out to understand the effects of zinc deficiency in rats aged 0∼2 months on learning and memory, and the brain-derived neurotrophic factor (BDNF) gene methylation status in the hippocampus. METHODS The lactating mother rats were randomly divided into three groups (n = 12): zinc-adequate group (ZA: zinc 30 mg/kg diet), zinc-deprived group (ZD: zinc 1 mg/kg diet), and a pair-fed group (PF: zinc 30 mg/kg diet), in which the rats were pair-fed to those in the ZD group. After weaning (on day 23), offspring were fed the same diets as their mothers. After 37 days, the zinc concentrations in the plasma and hippocampus were measured, and the behavioral function of the offspring rats was measured using the passive avoidance performance test. We then assessed the DNA methylation patterns of the exon IX of BDNF by methylation-specific quantitative real-time PCR and the mRNA expression of BDNF in the hippocampus by RT-PCR. RESULTS Compared with the ZA and PF groups, rats in the ZD group had shorter latency period, lower zinc concentrations in the plasma and hippocampus (P < 0.05). Interestingly, the DNA methylation of the BDNF exon IX was significantly increased in the ZD group, compared with the ZA and PF groups, whereas the expression of the BDNF mRNA was decreased. In addition, the DNMT1 mRNA expression was significantly upregulated and DNMT3A was downregulated in the ZD group, but not in the ZA and PF groups. CONCLUSION The learning and memory damage in offspring may be a result of the epigenetic changes of the BDNF genes in response to the zinc-deficient diet during 0∼2 month period. Furthermore, this work supports the speculative notion that altered DNA methylation of BDNF in the hippocampus is one of the main causes of cognitive impairment by zinc deficiency.
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Affiliation(s)
- Yan-Dan Hu
- a Department of Nutrition , Tianjin Institute of Health and Environmental Medicine , Tianjin 300050 , China.,b Department of Nutrition and Food Hygiene , West China School of Public Health, Sichuan University , Chengdu 610041 , China
| | - Wei Pang
- a Department of Nutrition , Tianjin Institute of Health and Environmental Medicine , Tianjin 300050 , China
| | - Cong-Cong He
- c College of Life Science, Nan Kai University , Tianjin 300000 , China
| | - Hao Lu
- b Department of Nutrition and Food Hygiene , West China School of Public Health, Sichuan University , Chengdu 610041 , China
| | - Wei Liu
- a Department of Nutrition , Tianjin Institute of Health and Environmental Medicine , Tianjin 300050 , China
| | - Zi-Yu Wang
- a Department of Nutrition , Tianjin Institute of Health and Environmental Medicine , Tianjin 300050 , China
| | - Yan-Qiang Liu
- c College of Life Science, Nan Kai University , Tianjin 300000 , China
| | - Cheng-Yu Huang
- b Department of Nutrition and Food Hygiene , West China School of Public Health, Sichuan University , Chengdu 610041 , China
| | - Yu-Gang Jiang
- a Department of Nutrition , Tianjin Institute of Health and Environmental Medicine , Tianjin 300050 , China
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28
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Martin-Prevel Y, Allemand P, Nikiema L, Ayassou KA, Ouedraogo HG, Moursi M, De Moura FF. Biological Status and Dietary Intakes of Iron, Zinc and Vitamin A among Women and Preschool Children in Rural Burkina Faso. PLoS One 2016; 11:e0146810. [PMID: 26991908 PMCID: PMC4798773 DOI: 10.1371/journal.pone.0146810] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 12/22/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Food-based approaches such as biofortification are meant to sustainably address micronutrient deficiencies in poor settings. Knowing more about micronutrient intakes and deficiencies is a prerequisite to designing and evaluating interventions. OBJECTIVE The objectives of the study were to assess biological status and dietary intakes of iron, zinc and vitamin A among women and children aged 36-59 months in rural Burkina Faso and to study relationships between intake and status to better inform future food-based interventions. DESIGN A cross-sectional survey was carried out in two rural provinces of Burkina Faso on a random cluster sample of 480 mother-child pairs. Dietary data was obtained by 24-hour recalls repeated on a random sub-selection of 37.5% of subjects to allow calculation of nutrient's probability of adequacy (PA). Biomarkers were measured on a sub-sample of 180 mother-child pairs. Blood samples were analyzed for hemoglobin, serum ferritin, soluble transferrin receptors (sTfR), C-reactive protein, alpha-1-glycoprotein, serum zinc concentration (SZnC) and retinol. For each micronutrient the relationship between biomarker and dietary intake was investigated by multiple linear regression models accounting for inflammatory biomarkers. RESULTS Mean PA for iron, zinc and vitamin A was 0.49, 0.87 and 0.21 among women and 0.61, 0.95 and 0.33 among children, respectively. Prevalence of anemia, corrected low serum ferritin and high sTfR was 37.6%, 4.0% and 77.5% among women and 72.1%, 1.5% and 87.6% among children, respectively. Prevalence of low SZnC and corrected low serum retinol was 39.4% and 12.0% among women and 63.7% and 24.8% among children, respectively. There was a tendency for a positive relationship between vitamin A intakes and serum retinol among women (β = 0.0003, P = 0.06). Otherwise, no link was found between micronutrients biomarkers and intakes. CONCLUSION Our study depicted different images of micronutrient deficiencies when based on dietary intakes or biomarkers results, thus highlighting the need for more suitable biomarkers and more precise measures of absorbable micronutrient intakes at the individual level. It thus points to challenges in the design and evaluation of future biofortification or other food-based interventions in rural areas of Burkina Faso.
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Affiliation(s)
- Yves Martin-Prevel
- Institut de Recherche pour le Développement, Research Unit 204 ‘Nutripass’, Montpellier, France
| | - Pauline Allemand
- Institut de Recherche pour le Développement, Research Unit 204 ‘Nutripass’, Montpellier, France
| | - Laetitia Nikiema
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Kossiwavi A. Ayassou
- Institut de Recherche pour le Développement, Research Unit 204 ‘Nutripass’, Montpellier, France
| | | | - Mourad Moursi
- HarvestPlus, International Food Policy Research Institute, Washington, DC, United States of America
| | - Fabiana F. De Moura
- HarvestPlus, International Food Policy Research Institute, Washington, DC, United States of America
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Elhadi A, Rayis DA, Abdullahi H, Elbashir LM, Ali NI, Adam I. Maternal and Umbilical Cord Blood Levels of Zinc and Copper in Active Labor Versus Elective Caesarean Delivery at Khartoum Hospital, Sudan. Biol Trace Elem Res 2016; 169:52-5. [PMID: 26089087 DOI: 10.1007/s12011-015-0411-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 06/11/2015] [Indexed: 02/03/2023]
Abstract
A case-control study was conducted in Khartoum Hospital Sudan to determine maternal and umbilical cord blood levels of zinc and copper in active labor versus elective cesarean delivery. Cases were women delivered vaginally and controls were women delivered by elective cesarean (before initiation of labor). Paired maternal and cord zinc and copper were measured using atomic absorption spectrophotometry. The two groups (52 paired maternal and cord in each arm) were well matched in their basic characteristics. In comparison with cesarean delivery, the median (interquartile range) of both maternal [87.0 (76.1-111.4) vs. 76.1 (65.2-88.3) μg/dL, P = 0.004] and cord zinc [97.8 (87.0-114.1) vs. 81.5(65.2-110.2) μg/dL P = 0.034] levels were significantly higher in the vaginal delivery. While there was no significant difference in the maternal copper [78.8 (48.1-106.1) vs. 92.4 (51.9-114.9) μg/dL, P = 0.759], the cord copper [43.5(29.9-76.1) vs. 32.2(21.7-49.6) μg/dL, P = 0.019] level was significantly higher in vaginal delivery. There was no significant correlation between zinc (both maternal and cord) and copper. While the cord zinc was significantly correlated with maternal zinc, there was no significant correlation between maternal and cord copper. The current study showed significantly higher levels of maternal and cord zinc and cord copper in women who delivered vaginally compared with caesarean delivery.
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Affiliation(s)
| | - Duria A Rayis
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
| | - Hala Abdullahi
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
| | | | - Naji I Ali
- Sudan Atomic Energy Commission, Khartoum, Sudan.
- College of Applied Medical Sciences, Almajmaah University, Almajmaah, Riyadh, KSA.
| | - Ishag Adam
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
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Galetti V, Mitchikpè CES, Kujinga P, Tossou F, Hounhouigan DJ, Zimmermann MB, Moretti D. Rural Beninese Children Are at Risk of Zinc Deficiency According to Stunting Prevalence and Plasma Zinc Concentration but Not Dietary Zinc Intakes. J Nutr 2016; 146:114-23. [PMID: 26609168 DOI: 10.3945/jn.115.216606] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 10/26/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Three commonly recommended indicators for risk assessment of population zinc deficiency are stunting rates among children aged <5 y, prevalence of inadequate dietary zinc intake, and prevalence of low plasma zinc (PZn). Data on zinc status in Benin are mainly drawn from stunting rates and data on PZn and dietary zinc intake are lacking. OBJECTIVES The aims of this study were 1) to assess the risk of zinc deficiency in preschool and school-age children from rural communities in northern Benin by means of the 3 indicators for population assessment, 2) to evaluate their level of agreement, and 3) to identify predictors of PZn and height-for-age z scores (HAZ). METHODS We analyzed preintervention data collected during 2 efficacy trials and cross-sectionally assessed the risk of zinc deficiency in preschool (1-5 y, n = 326) and school-age children (5-10 y, n = 272) by 1) conducting a 3-d weighed food record survey, coupled with direct zinc and phytic acid analysis of consumed foodstuffs, and calculating usual dietary zinc intakes in a subsample of school-age children (n = 36); 2) analyzing PZn in all children (n = 598); and 3) measuring anthropometry indexes for assessment of stunting (HAZ <-2 SD) in all children (n = 594) and in <5-y-old children only (n = 273). We derived predictors of PZn and HAZ by using multivariate regression with mixed-effect models. RESULTS Prevalence of inadequate intakes of zinc ranged from 11% to 80% depending on whether the estimated average requirements (EARs) by the International Zinc Nutrition Consultative Group or the EARs derived from the WHO's recommended nutrient intakes were used. Prevalence of low PZn adjusted for acute-phase protein status was 45.7%, with higher rates among preschoolers than school-age children (P = 0.002). The stunting rate in <5-y-old children was 51.3%. PZn was predicted by age, methodologic factors, and socioeconomic status, whereas HAZ was predicted by age, sex, hemoglobin, and socioeconomic status. CONCLUSIONS The prevalence of <5-y stunting and the prevalence of low PZn indicate that the risk of zinc deficiency is elevated in this population. Risk estimates based on the prevalence of inadequacy of zinc intakes varied depending on the EARs used, and a consensus would facilitate nutrition survey evaluations. These trials were registered at clinicaltrials.gov as NCT01472211 and NCT01790321.
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Affiliation(s)
- Valeria Galetti
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland;
| | - Comlan Evariste S Mitchikpè
- Laboratory of Human Nutrition, Faculty of Agricultural Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - Prosper Kujinga
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands; and
| | - Félicien Tossou
- Natitingou Health Zone, Ministry of Health, Natitingou, Benin
| | - D Joseph Hounhouigan
- Laboratory of Human Nutrition, Faculty of Agricultural Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Diego Moretti
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
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Kumera G, Awoke T, Melese T, Eshetie S, Mekuria G, Mekonnen F, Ewunetu T, Gedle D. Prevalence of zinc deficiency and its association with dietary, serum albumin and intestinal parasitic infection among pregnant women attending antenatal care at the University of Gondar Hospital, Gondar, Northwest Ethiopia. BMC Nutr 2015. [DOI: 10.1186/s40795-015-0026-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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32
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Shahab-Ferdows S, Engle-Stone R, Hampel D, Ndjebayi AO, Nankap M, Brown KH, Allen LH. Regional, Socioeconomic, and Dietary Risk Factors for Vitamin B-12 Deficiency Differ from Those for Folate Deficiency in Cameroonian Women and Children. J Nutr 2015; 145:2587-95. [PMID: 26446486 DOI: 10.3945/jn.115.210195] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 09/08/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Representative data on folate and vitamin B-12 dietary intake and status in low-income countries are rare, despite the widespread adoption of folic acid fortification. OBJECTIVE The purpose of this study was to evaluate folate and vitamin B-12 intake, status, and risk factors for deficiency before implementation of a national fortification program in Cameroon. METHODS A nationally representative cross-sectional cluster survey was conducted in 3 ecologic zones of Cameroon (South, North, and the 2 largest cities, Yaoundé/Douala), and information on dietary intake was collected from 10 households in each of 30 randomly selected clusters per zone. In a subset of women and their 12- to 59-mo-old children (n = 396 pairs), plasma folate and vitamin B-12, as well as breast milk vitamin B-12, were analyzed. RESULTS Vitamin B-12 and folate dietary intake patterns and plasma concentrations were similar for women and children. In the subsample, 18% and 29% of women and 8% and 30% of children were vitamin B-12 (≤ 221 pmol/L) and folate (< 10 nmol/L) deficient, respectively. Mean dietary folate ranged from 351 μg dietary folate equivalents/d in the North to 246 μg dietary folate equivalents/d in Yaoundé/Douala; plasma folate was negatively associated with socioeconomic status (P = 0.001). Plasma vitamin B-12 deficiency was similar in the South and North, 29% and 40%, respectively, but was only 11% in Yaoundé/Douala, and was positively associated with socioeconomic status. Mean breast milk vitamin B-12 was statistically significantly lower in the North (101 pmol/L) than in the South (296 pmol/L) or Yaoundé/Douala (349 pmol/L). CONCLUSIONS Folate intake and status are inadequate among women and young children in Yaoundé/Douala, whereas low vitamin B-12 intake and status are more common in poor and rural areas, especially in the North. Different strategies may be needed to control deficiency of these nutrients in different regions of Cameroon.
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Affiliation(s)
| | - Reina Engle-Stone
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA; and
| | - Daniela Hampel
- USDA, Agricultural Research Service Western Human Nutrition Research Center, Davis, CA
| | | | | | - Kenneth H Brown
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA; and
| | - Lindsay H Allen
- USDA, Agricultural Research Service Western Human Nutrition Research Center, Davis, CA; Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA; and
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Suthutvoravut U, Abiodun PO, Chomtho S, Chongviriyaphan N, Cruchet S, Davies PSW, Fuchs GJ, Gopalan S, van Goudoever JB, Nel EDLR, Scheimann A, Spolidoro JV, Tontisirin K, Wang W, Winichagoon P, Koletzko B. Composition of Follow-Up Formula for Young Children Aged 12-36 Months: Recommendations of an International Expert Group Coordinated by the Nutrition Association of Thailand and the Early Nutrition Academy. ANNALS OF NUTRITION AND METABOLISM 2015; 67:119-32. [PMID: 26360877 DOI: 10.1159/000438495] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 07/07/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND There are no internationally agreed recommendations on compositional requirements of follow-up formula for young children (FUF-YC) aged 1-3 years. AIM The aim of the study is to propose international compositional recommendations for FUF-YC. METHODS Compositional recommendations for FUF-YC were devised by expert consensus based on a detailed literature review of nutrient intakes and unmet needs in children aged 12-36 months. RESULTS AND CONCLUSIONS Problematic nutrients with often inadequate intakes are the vitamins A, D, B12, C and folate, calcium, iron, iodine and zinc. If used, FUF-YC should be fed along with an age-appropriate mixed diet, usually contributing 1-2 cups (200-400 ml) of FUF-YC daily (approximately 15% of total energy intake). Protein from cow's milk-based formula should provide 1.6-2.7 g/100 kcal. Fat content should be 4.4-6.0 g/100 kcal. Carbohydrate should contribute 9-14 g/100 kcal with >50% from lactose. If other sugars are added, they should not exceed 10% of total carbohydrates. Calcium should provide 200 mg/100 kcal. Other micronutrient contents/100 kcal should reach 15% of the World Health Organization/Food and Agriculture Organization recommended nutrient intake values. A guidance upper level that was 3-5 times of the minimum level was established. Countries may adapt compositional requirements, considering recommended nutrient intakes, habitual diets, nutritional status and existence of micronutrient programs to ensure adequacy while preventing excessive intakes.
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Affiliation(s)
- Umaporn Suthutvoravut
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Lim K, Booth A, Szymlek-Gay EA, Gibson RS, Bailey KB, Irving D, Nowson C, Riddell L. Associations between dietary iron and zinc intakes, and between biochemical iron and zinc status in women. Nutrients 2015; 7:2983-99. [PMID: 25903453 PMCID: PMC4425184 DOI: 10.3390/nu7042983] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 04/10/2015] [Accepted: 04/14/2015] [Indexed: 11/29/2022] Open
Abstract
Iron and zinc are found in similar foods and absorption of both may be affected by food compounds, thus biochemical iron and zinc status may be related. This cross-sectional study aimed to: (1) describe dietary intakes and biochemical status of iron and zinc; (2) investigate associations between dietary iron and zinc intakes; and (3) investigate associations between biochemical iron and zinc status in a sample of premenopausal women aged 18-50 years who were recruited in Melbourne and Sydney, Australia. Usual dietary intakes were assessed using a 154-item food frequency questionnaire (n = 379). Iron status was assessed using serum ferritin and hemoglobin, zinc status using serum zinc (standardized to 08:00 collection), and presence of infection/inflammation using C-reactive protein (n = 326). Associations were explored using multiple regression and logistic regression. Mean (SD) iron and zinc intakes were 10.5 (3.5) mg/day and 9.3 (3.8) mg/day, respectively. Median (interquartile range) serum ferritin was 22 (12-38) μg/L and mean serum zinc concentrations (SD) were 12.6 (1.7) μmol/L in fasting samples and 11.8 (2.0) μmol/L in nonfasting samples. For each 1 mg/day increase in dietary iron intake, zinc intake increased by 0.4 mg/day. Each 1 μmol/L increase in serum zinc corresponded to a 6% increase in serum ferritin, however women with low serum zinc concentration (AM fasting < 10.7 μmol/L; AM nonfasting < 10.1 μmol/L) were not at increased risk of depleted iron stores (serum ferritin <15 μg/L; p = 0.340). Positive associations were observed between dietary iron and zinc intakes, and between iron and zinc status, however interpreting serum ferritin concentrations was not a useful proxy for estimating the likelihood of low serum zinc concentrations and women with depleted iron stores were not at increased risk of impaired zinc status in this cohort.
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Affiliation(s)
- Karen Lim
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia; E-Mails: (K.L.); (A.B.); (E.A.S.-G.); (C.N.)
| | - Alison Booth
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia; E-Mails: (K.L.); (A.B.); (E.A.S.-G.); (C.N.)
| | - Ewa A. Szymlek-Gay
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia; E-Mails: (K.L.); (A.B.); (E.A.S.-G.); (C.N.)
| | - Rosalind S. Gibson
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054, New Zealand; E-Mails: (R.S.G.); (K.B.B.)
| | - Karl B. Bailey
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054, New Zealand; E-Mails: (R.S.G.); (K.B.B.)
| | - David Irving
- Australian Red Cross Blood Service, 17 O’Riordan Street, Alexandria, New South Wales 2015, Australia; E-Mail:
- University of Technology, Sydney 15 Broadway, Ultimo, New South Wales 2007, Australia
| | - Caryl Nowson
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia; E-Mails: (K.L.); (A.B.); (E.A.S.-G.); (C.N.)
| | - Lynn Riddell
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia; E-Mails: (K.L.); (A.B.); (E.A.S.-G.); (C.N.)
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35
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Improving nutrition security through agriculture: an analytical framework based on national food balance sheets to estimate nutritional adequacy of food supplies. Food Secur 2015. [DOI: 10.1007/s12571-015-0452-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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36
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Trace elements as predictors of preeclampsia in type 1 diabetic pregnancy. Nutr Res 2015; 35:421-30. [PMID: 25912764 DOI: 10.1016/j.nutres.2015.04.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/23/2015] [Accepted: 04/07/2015] [Indexed: 12/16/2022]
Abstract
Preeclampsia (PE) affects approximately 5% of all pregnancies, but is increased several-fold in women with pre-gestational type 1 diabetes mellitus (T1DM). Increased oxidative stress and altered maternal plasma trace elements that modulate the antioxidant system have been implicated in PE. In non-diabetic women, increased plasma copper and iron and decreased manganese, selenium, and zinc have been associated with PE in cross-sectional studies. In a longitudinal study, we hypothesized that plasma levels of trace elements differ between T1DM women with vs. without subsequent PE. Samples were collected during the first (gestation 12.2 ± 1.9 weeks, [mean ± SD]), second (21.6 ± 1.5 weeks), and third (31.5 ± 1.7 weeks) trimesters of pregnancy, all before the onset of PE. We compared 23 T1DM women who subsequently developed PE with 24 T1DM women who remained normotensive; and we included 19 non-diabetic (non-DM) normotensive pregnant women as reference controls. Trace elements were measured using inductively coupled plasma mass spectroscopy. In T1DM women with subsequent PE vs normotensive, only plasma zinc was significantly higher at the first trimester, while copper:zinc and copper:high-density lipoprotein cholesterol ratios were higher throughout gestation (all P < .05). These findings persisted after adjustment for covariates. Higher copper:zinc ratios may contribute to oxidative stress in T1DM women who develop PE. Ratios of pro- to anti-oxidant factors may predict risk for PE in diabetic pregnancies more effectively than individual trace element levels.
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37
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Han S, Mizoi M, Nakatani E, Adachi S, Miyakoshi Y, Yanagisawa H. Improvement of serum zinc levels in young Japanese women by provision of food information. Biol Trace Elem Res 2015; 164:169-77. [PMID: 25537076 DOI: 10.1007/s12011-014-0211-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/11/2014] [Indexed: 10/24/2022]
Abstract
We investigated whether or not an intervention of providing food information improves serum Zn levels in ninety-two 18-20-year-old Japanese women. The mean serum Zn level of the participants was 73.09 ± 10.56 (mean ± SD) μg/dL, where 79 % of the participants had lower than the reference Zn level (80 μg/dL) proposed by the Japan Society for Biomedical Research on Trace Elements. Participants were divided into food information (INF) group, supplement (SPL) group, and control (C) group, and their serum Zn levels were measured before and after 2 weeks of intervention. The results showed that changes in serum Zn levels were (expressed in μg/dL): 71.23 ± 8.42 to 76.83 ± 12.22 in INF group (NS; not significant), 72.72 ± 10.77 to 84.07 ± 12.03 in SPL group (P < 0.01), and 72.69 ± 9.46 to 74.52 ± 11.44 in C group (NS). Percentage of normal subjects in serum Zn level (>79 mg/dL) were significantly increased in INF group (16.7 to 40%, P < 0.05) and SPL group (17.2 to 69%, P < 0.001) by each intervention. Food information only entailed a table of food items with high Zn content (card-type) and Zn intake menu (recipes). The results suggested that providing food information is effective in improving latent low Zn in young Japanese women.
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Affiliation(s)
- Soonja Han
- Department of Public Health, Graduate School of Nutritional Sciences, Sagami Women's University, Sagamihara, Kanagawa, Japan
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38
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King JC, Brown KH, Gibson RS, Krebs NF, Lowe NM, Siekmann JH, Raiten DJ. Biomarkers of Nutrition for Development (BOND)-Zinc Review. J Nutr 2015; 146:858S-885S. [PMID: 26962190 PMCID: PMC4807640 DOI: 10.3945/jn.115.220079] [Citation(s) in RCA: 301] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 07/29/2015] [Accepted: 12/29/2015] [Indexed: 12/17/2022] Open
Abstract
Zinc is required for multiple metabolic processes as a structural, regulatory, or catalytic ion. Cellular, tissue, and whole-body zinc homeostasis is tightly controlled to sustain metabolic functions over a wide range of zinc intakes, making it difficult to assess zinc insufficiency or excess. The BOND (Biomarkers of Nutrition for Development) Zinc Expert Panel recommends 3 measurements for estimating zinc status: dietary zinc intake, plasma zinc concentration (PZC), and height-for-age of growing infants and children. The amount of dietary zinc potentially available for absorption, which requires an estimate of dietary zinc and phytate, can be used to identify individuals and populations at risk of zinc deficiency. PZCs respond to severe dietary zinc restriction and to zinc supplementation; they also change with shifts in whole-body zinc balance and clinical signs of zinc deficiency. PZC cutoffs are available to identify individuals and populations at risk of zinc deficiency. However, there are limitations in using the PZC to assess zinc status. PZCs respond less to additional zinc provided in food than to a supplement administered between meals, there is considerable interindividual variability in PZCs with changes in dietary zinc, and PZCs are influenced by recent meal consumption, the time of day, inflammation, and certain drugs and hormones. Insufficient data are available on hair, urinary, nail, and blood cell zinc responses to changes in dietary zinc to recommend these biomarkers for assessing zinc status. Of the potential functional indicators of zinc, growth is the only one that is recommended. Because pharmacologic zinc doses are unlikely to enhance growth, a growth response to supplemental zinc is interpreted as indicating pre-existing zinc deficiency. Other functional indicators reviewed but not recommended for assessing zinc nutrition in clinical or field settings because of insufficient information are the activity or amounts of zinc-dependent enzymes and proteins and biomarkers of oxidative stress, inflammation, or DNA damage.
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Affiliation(s)
- Janet C King
- Children’s Hospital Oakland Research Institute, Oakland, CA
- University of California, Davis, Davis, CA
| | - Kenneth H Brown
- University of California, Davis, Davis, CA
- Bill & Melinda Gates Foundation, Seattle, WA
| | | | - Nancy F Krebs
- University of Colorado School of Medicine, Aurora, CO
| | - Nicola M Lowe
- University of Central Lancashire, Preston, United Kingdom; and
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Prakash A, Bharti K, Majeed ABA. Zinc: indications in brain disorders. Fundam Clin Pharmacol 2015; 29:131-49. [PMID: 25659970 DOI: 10.1111/fcp.12110] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 07/08/2014] [Accepted: 12/24/2014] [Indexed: 12/14/2022]
Abstract
Zinc is the authoritative metal which is present in our body, and reactive zinc metal is crucial for neuronal signaling and is largely distributed within presynaptic vesicles. Zinc also plays an important role in synaptic function. At cellular level, zinc is a modulator of synaptic activity and neuronal plasticity in both development and adulthood. Different importers and transporters are involved in zinc homeostasis. ZnT-3 is a main transporter involved in zinc homeostasis in the brain. It has been found that alterations in brain zinc status have been implicated in a wide range of neurological disorders including impaired brain development and many neurodegenerative disorders such as Alzheimer's disease, and mood disorders including depression, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, and prion disease. Furthermore, zinc has also been implicated in neuronal damage associated with traumatic brain injury, stroke, and seizure. Understanding the mechanisms that control brain zinc homeostasis is thus critical to the development of preventive and treatment strategies for these and other neurological disorders.
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Affiliation(s)
- Atish Prakash
- Brain Degeneration and Therapeutics Group, Brain and Neuroscience Communities of Research, Universiti Teknologi MARA (UiTM), Shah Alam, 40450, Malaysia; Department of Pharmacology, ISF college of Pharmacy, Ghal kalan, Moga, 142-001, India; Brain Research Laboratory, Faculty of Pharmacy, Campus Puncak Alam, Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, 42300, Malaysia
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40
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Krebs NF, Miller LV, Hambidge KM. Zinc deficiency in infants and children: a review of its complex and synergistic interactions. Paediatr Int Child Health 2014; 34:279-88. [PMID: 25203844 DOI: 10.1179/2046905514y.0000000151] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Zinc deficiency is estimated to contribute to over half a million deaths per year in infants and children under 5 years of age. This paper reviews the features of mild-to-moderate zinc deficiency, which include growth faltering, deficits in immune function and altered integrity and function of the gastro-intestinal tract. Sub-clinical features include oxidative stress and a pro-inflammatory state. The homeostatic response to low dietary zinc intake by increasing absorption is limited, especially if the source of zinc is of poor bioavailability, and conservation of endogenous intestinal losses is a critical component of adaptation. Owing to low zinc intakes, older breastfed infants, especially those of low birthweight, are predictably at risk of zinc deficiency if complementary food choices are unfortified and/or low in zinc. Host factors such as young age, poor intra-uterine zinc accretion owing to poor maternal status and/or prematurity, and gastro-intestinal dysfunction also potently predispose to zinc deficiency. Environmental enteropathy, which is prevalent in low-resource settings, may substantially impair zinc absorption and/or increase endogenous losses, and thus lead to relatively high zinc requirements. Emerging evidence highlights common features between chronic inflammation and zinc deficiency, and each may exacerbate the other. More investigations of zinc homeostasis in populations in low-resource settings are needed to better quantify absorption capacity and losses. Effective preventive strategies must address potentially higher zinc requirements as well as the underlying context that perpetuates a vicious cycle of zinc deficiency and multiple adverse outcomes.
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