Vitamin D and iron deficiencies among Saudi children and adolescents: A persistent problem in the 21st century

Associations between Serum Iron Indices and Self-Assessed Multiple Intelligence Scores among Adolescents in Riyadh, Saudi Arabia

Micronutrient deficiencies, including iron deficiency, are linked to different cognitive impairments and sensory functions. However, whether circulating iron levels affect self-assessed multiple intelligence (MI) scores in adolescents remains uninvestigated. This study aimed to investigate associations between serum iron levels and self-assessed MI scores in adolescents in Riyadh, Saudi Arabia. Recruiting 434 Saudi adolescents (174 boys and 260 girls, aged 12-17), we administered the McKenzie questionnaire to assess MI across nine categories. Anthropometrics and fasting blood samples were collected to measure circulating iron and transferrin levels. Total iron-binding capacity (TIBC) and transferrin saturation (TSAT) levels were calculated. Notably, girls exhibited significantly higher MI scores in the interactive domain than boys (age and BMI-adjusted OR = 1.36, 95% confidence interval = 1.07-1.73, p = 0.01). No significant correlations were observed between serum iron and MI. However, normal TSAT levels (TSAT > 20%) corresponded with higher age and BMI-adjusted odds of MI scores in the musical (OR = 1.59, 95%CI = 1.1-2.2, p = 0.006), linguistic (1.57, 1.1-2.3, p = 0.016), kinesthetic (1.48, 1.1-2.1, p = 0.024), spatial (1.45, 1.1-2.1, p = 0.03), and existential (1.56, 1.1-2.1, p = 0.01) categories compared to ones with lower TSAT levels (TSAT ≤ 20%), only in boys. In conclusion, serum iron levels may not directly influence MI domains in adolescents in Riyadh, Saudi Arabia; however, lower TSAT levels, indicative of iron-deficiency anemia, may influence MI, only in boys, indicating a possible relationship between iron metabolism and cognitive functions.

Estimation of calories intake, iron, zinc, and selenium among children of the underprivileged area in Sindh, Pakistan

INTRODUCTION

Malnutrition is one of the most serious community health issues in developing countries. This study estimated total energy intake, Iron (Fe), Zinc (Zn), Selenium (Se), Calcium (Ca), and Phosphate (PO4) levels among school-going children (aged 13-17 years) of the underprivileged area in Sindh, Pakistan.

METHODS

Children from Mithi City, District Tharparkar, were selected for this cross-sectional investigation. Students from various schools from both genders who fulfilled the selection criteria were selected. A questionnaire was filled, and five ml blood samples were taken to analyze blood parameters. Each participant's estimated nutrient intake (ENI) per day was assessed and matched to the recommended daily allowance (RDA) to determine their micro and macronutrient intake.

RESULTS

A total of 300 school-going children [150(50%) boys (mean age 15± 0.8 years) and 150(50%) girls (mean age 14±1.3years)] were included in this study. Total calories (1449±949 Kcal vs. 1245±215 Kcal; p < .001), carbohydrates (138±27 gm vs. 126 ±25 gm; p < .001) protein (47±9.1 gm vs. 44±6 gm; p < .001) was significantly higher among boys compared to girls. In contrast, calcium (1094±105 mg vs. 1144±100; 0.004), phosphate 1050±125 vs. 1148±147; p<0.001), iron (9.2±1.7 mg vs. 10±1.3 mg; p<0.001), and Zinc (7.4±1.8 mg vs. 9.9±1.7 mg; p<0.001) intake was significantly higher among girls than boys. Gender-wise comparison of serum metals in school-going children showed that serum iron was significantly lower among girls than boys (100.86±25.65 μg/dl vs. 78.48±28.66 μg/dl; p<0.001), and no difference was found in serum Zn, Se, and Ca levels. Total proteins were also significantly lower among girls than boys (6.48±1.01g/dl vs. 4.87±1.4301g/dl; p<0.001). Serum iron, Ca, and total proteins were significantly lower among girls with normal ranges compared to boys with normal ranges. Total protein was significantly lower among girls below normal ranges than boys with normal ranges (p < .001). The correlation of carbohydrates, protein, and fat with some serum biochemical parameters in school-going children showed that serum Fe was significantly linked with proteins (r = 0.255; p < .0.05).

CONCLUSION

Our findings showed a concurrent shortage of macro and micronutrients. The current study also revealed that total energy intake was lower than the RDA and significant Fe, Zn, and Se deficiencies. The findings highlight the importance of measures aimed at improving children's nutritional status.

Status of vitamins and minerals in children with screening-identified celiac disease: A case-control study

OBJECTIVES

Micronutrient deficiencies characterize classical "late-diagnosed" celiac disease (CeD). This study aimed to identify the prevalence of micronutrient deficiencies among children with "early-diagnosed" screening-identified CeD to determine the clinical value of routine testing for deficiencies in those patients.

METHODS

A case-control study was conducted on screening-identified CeD patients diagnosed during a mass screening study (84 patients, mean age 11.3 ± 2.6 years). The controls (443 children, mean age 10.8 ± 2.5 years) were negative for celiac disease serological screening. Hemoglobin, serum levels of iron, ferritin, folate, vitamin B12, vitamin A, vitamin E, 25-OH vitamin D, zinc, and selenium were measured.

RESULTS

The mean serum levels of hemoglobin, iron, ferritin, vitamin D, zinc, copper, and selenium were significantly lower in CeD patients than in healthy controls (hemoglobin 12.56 vs. 13.02 g/dL [p = 0.04]; iron 10.61 vs. 17.6 µmol/L [p < 0.001], ferritin 25.7 vs. 48.3 µg/L [p < 0.001], vitamin D 29.1 vs. 37.5 nmol/L, zinc 11.9 vs. 21.7 µmol/L, copper 18.9 vs. 32.5 µmol/L, selenium 1.04 vs. 1.36 µmol/L; p < 0.001). Patients with celiac and severe intestinal damage (Marsh IIIb and IIIc) had significantly lower serum ferritin and vitamin A levels than patients with mild intestinal damage (Marsh II and IIIa) (ferritin 15 vs. 22 µg/L, p < 0.025; vitamin A 0.85 vs. 1.35 µmol/L, p = 0.007).

CONCLUSION

Micronutrient deficiencies are still detectable in "early-diagnosed" screening-identified CeD cases, a clinically relevant result that strongly supports efforts for screening and early diagnosis of CeD.

Micronutrients and Nutrition Status of School-Aged Children in Indonesia

Micronutrient deficiencies (MNDs) in school-aged children are still a major health problem in Indonesia. This study was designed to examine the status of micronutrients and their relationship to the nutritional status of children aged 5-12 years since an up-to-date database on the micronutrient status of children aged 5-12 years is needed. Data from the 2018 Indonesian Basic Health Research (Riskesdas) were used in this study, with 2456 subjects for analysis. Micronutrient analysis was carried out, including iron status (ferritin, C reactive protein (CRP)), levels of zinc, vitamin D, calcium, and vitamin A (retinol) in school-aged children (5-12 years). The ELISA measurement was applied to measure CRP, ferritin, and vitamin D. Zinc levels were analysed with atomic absorbance spectroscopy (AAS). Moreover, high-performance liquid chromatography (HPLC) was applied to calculate vitamin A. In addition, stunting and thinness data were also obtained from the Riskesdas study. The results showed that the prevalence of stunting and thinness in school-aged children was 11.4% and 9.2%, respectively, showing that the stunting prevalence in the city was lower than in the village (4.5% vs. 6.9%, P = 0.000, respectively). In addition, the prevalence of MNDs in Indonesian children was 13.4%, 19.7%, 4.2%, 3%, and 12.7% for ferritin, zinc, calcium, vitamin A, and vitamin D, respectively. The mean serum level of vitamin A and zinc was significantly lower in stunted children compared to normal school children (P = 0.010 and P = 0.014). The serum concentration of vitamin D was significantly lower in overweight children compared to thin and normal children (P = 0.000). Serum values of ferritin, zinc, and vitamin A were significantly higher in overweight children compared to thin and normal children (P = 0.000). A poor correlation was observed between the z-score of height-for-age (HAZ) and the levels of zinc (r = 0.089, P = 0.000), vitamin A (r = 0.105, P = 0.000), and vitamin D (-0.073, P = 0.000). In addition, very weak correlations between z-scores of body mass index-for-age (BAZ) and the serum concentrations of ferritin (0.091, P = 0.000), zinc (r = 0.115, P = 0.000), vitamin A (r = 0.137, P = 0.000), and vitamin D (r = -0.112, P = 0.000) were also seen. In conclusion, school-aged children in Indonesia experienced stunting, thinness, and micronutrient deficiency. Furthermore, stunting and thinness were also related to micronutrient deficiencies.