RESUMEN
INTRODUCTION: Fortification and supplementation are two strategies for micronutrient deficiency prevention. The objective of this study was to describe the source of iron and folic acid intake throughout the life cycle in the population of the Autonomous City of Buenos Aires. POULATION AND METHODS: Analysis of the information collected in the First Survey on Nutritional Food Intake of the Autonomous City of Buenos Aires (2011), which had a probability cluster sampling design. Consumption was assessed by means of a 24-hour recall. Iron and folic acid intake was estimated and categorized into natural content, enriched wheat flour, milk from the Maternal and Child Plan, fortified foods, and supplements. RESULTS: Out of the 5369 studied individuals, practically all got iron and folic acid from natural contents (58 % and 29 % of intake, respectively). More than 90 % consumed enriched wheat flour, which provided 28 % of iron and 54 % of folic acid. Fortified food consumption and intake varied greatly. Milk intake from the Maternal and Child Plan was small, even in specific groups. Intake from supplements was low, except in children < 2 years old (30 % consumed iron supplements, which accounted for 38 % of iron). CONCLUSION: In addition to natural intake from foods, enriched wheat flour accounted for a major source of folic acid and iron in this population; intake from fortified foods and supplements varied by age group.
Introducción. La fortificación y suplementación son estrategias para la prevención de carencias de micronutrientes. El objetivo fue describir la procedencia de la ingesta del hierro y ácido fólico a lo largo del ciclo vital de la población de la Ciudad Autónoma de Buenos Aires. Población y métodos. Análisis de la información de la Primera Encuesta Alimentaria y Nutricional de la Ciudad Autónoma de Buenos Aires 2011, que tomó una muestra probabilística por conglomerados. El consumo se recabó con recordatorio de 24 horas. Se calculó el aporte de hierro y ácido fólico, y se categorizó en contenido natural, harina de trigo enriquecida, leche del Plan Materno Infantil, alimentos fortificados y suplementos. Resultados. De los 5369 individuos evaluados, prácticamente, la totalidad obtenía hierro y ácido fólico de contenido natural (el 58 % y el 29 % del consumo, respectivamente). Más del 90 % consumía harina de trigo enriquecida, que aportaba el 28 % del hierro y el 54 % del ácido fólico. Los alimentos fortificados mostraron consumo y aporte muy variable. La leche del Plan Materno Infantil mostró muy baja participación, inclusive en grupos específicos. El aporte de suplementos fue bajo, excepto en < 2 años (el 30 % consumía suplementos de hierro, que aportaban el 38 % de este). Conclusión. Además del aporte natural de los alimentos, la harina de trigo enriquecida representó una importante contribución en el consumo de ácido fólico y hierro de esta población; los alimentos fortificados y los suplementos tuvieron una participación diferente según el grupo etario.
Asunto(s)
Enfermedades Carenciales/prevención & control , Dieta/estadística & datos numéricos , Suplementos Dietéticos/estadística & datos numéricos , Ácido Fólico/administración & dosificación , Alimentos Fortificados/estadística & datos numéricos , Hierro/administración & dosificación , Micronutrientes/administración & dosificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Argentina , Niño , Preescolar , Estudios Transversales , Encuestas sobre Dietas , Femenino , Ácido Fólico/uso terapéutico , Conductas Relacionadas con la Salud , Humanos , Lactante , Hierro/uso terapéutico , Masculino , Micronutrientes/uso terapéutico , Persona de Mediana Edad , Salud Urbana , Adulto JovenRESUMEN
PURPOSE: Most patients undergoing bariatric surgery (BS) are fertile women whose postoperative (post-op) hormonal balance and weight loss increases fertility, frequently leading to pregnancy. This study aims to analyze supplementation adherence of pregnant women after BS and perinatal outcomes. MATERIALS AND METHODS: This retrospective study analyzed records from women after BS who consulted nutritionists at least twice during pregnancy. Each patient received nutritional guidance about vitamin and mineral supplementation and protein intake. Demographic data, body mass index (BMI), percentage of weight loss (%WL) at conception, maximum post-op BMI and %WL, post-op time at conception, supplementation adherence, biochemical data, possible gestational complications, and infant's birth weight were collected. RESULTS: Data was obtained from 23 women (mean age 33 ± 4 years). On average, patients became pregnant 43 months after surgery. The mean preoperative BMI was 40.2 kg/m2, the maximum post-op %WL was 36.6%, and the mean %WL at conception was 32.0%. No gestational intercurrence was related to biochemical data. Supplementation adherence was 34.7% for one multivitamin and 34.7% for two multivitamins; 43.5% for iron, 43.5% for omega 3, 39.1% for folic acid, 17.4% for B complex, and 60.8% for calcium. Mean infant birth weight was 3.0 kg, and it was not associated with maximum %WL, % WL at conception, and time since BS at conception. CONCLUSION: Our data indicate satisfactory adherence to post-op micronutrient supplementation and few gestational complications following BS. Moreover, child's birth weight was not associated with maximum %WL, %WL at conception, or time since BS.
Asunto(s)
Cirugía Bariátrica , Enfermedades Carenciales/prevención & control , Suplementos Dietéticos , Obesidad Mórbida/dietoterapia , Obesidad Mórbida/cirugía , Cooperación del Paciente/estadística & datos numéricos , Complicaciones del Embarazo , Adulto , Cirugía Bariátrica/efectos adversos , Cirugía Bariátrica/rehabilitación , Enfermedades Carenciales/epidemiología , Ácidos Grasos Omega-3/administración & dosificación , Femenino , Ácido Fólico/administración & dosificación , Humanos , Hierro/administración & dosificación , Obesidad Mórbida/epidemiología , Periodo Posoperatorio , Embarazo , Complicaciones del Embarazo/epidemiología , Complicaciones del Embarazo/prevención & control , Estudios Retrospectivos , Resultado del Tratamiento , Vitaminas/administración & dosificaciónRESUMEN
Zinc is an important mineral for biological and physiological processes. Zinc deficiency (ZD) is one of the most common micronutrient deficiencies worldwide and a crucial determinant of pregnancy outcomes and childhood development. Zinc levels and the zinc supplementation rate among lactating women have not been assessed neither in Ecuador nor in the Andean region. We conducted a pilot study including 64 mothers of infants between eight days to seven months old from a primary care center located in Conocoto, a peri-urban community of Quito, Ecuador. The mothers were interviewed and a fasting blood sample was taken to determine plasma zinc levels. The prevalence of ZD was calculated and compared with the prevalence of ZD among Ecuadorian non-pregnant non-lactating women, and the sample was analysed considering zinc supplementation during pregnancy. The prevalence of ZD among the participants was 81.3% (95% CI: 71.7â»90.9), higher than the reported among non-pregnant non-lactating women (G² = 18.2; p < 0.05). Zinc supplementation rate was 31.2%. No significant differences were found comparing the groups considering zinc supplementation. The insights obtained from this study encourage extending studies to document zinc levels and its interactions among breastfeeding women in areas with a high prevalence of ZD in order to determine the need of zinc supplementation.
Asunto(s)
Enfermedades Carenciales/epidemiología , Enfermedades Carenciales/prevención & control , Suplementos Dietéticos , Lactancia , Salud Materna , Salud Urbana , Zinc/deficiencia , Zinc/uso terapéutico , Adolescente , Adulto , Enfermedades Carenciales/sangre , Ecuador/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Proyectos Piloto , Embarazo , Prevalencia , Adulto Joven , Zinc/sangreRESUMEN
Scientific research is an essential public health function, enabling recognition of problems that compromise health and facilitating solutions. Research is essential to formulate health policy at a national level. There has been significant but inconsistent overall progress, due to economic conditions in low- and middle-income countries. An example that illustrates this situation is the investigation of iodine deficiency (ID) in Peru, and the application of the results for development of a public health program. The research demonstrated persistent ID, which causes fetal brain damage and subsequent mental retardation. The use of iodinated oil to prevent and treat ID was shown to have an immediate and long-term effect, and confirmed that urinary concentration of iodine was the best indicator of iodine intake. These results were accepted by the Ministry of Health, and the National Program for the Control of Endemic Goiter and Cretinism was created in 1983, achieving virtual elimination of ID by 1995.
La investigación científica es una función esencial en salud pública; permite reconocer problemas y situaciones que comprometen la salud y la identificación de soluciones. La investigación es esencial para formulación de políticas desalud. Es imperativo para los países tener sistemas nacionales de investigación. Últimamente, ha habido un significativo avance global, pero el crecimiento no es uniforme, las condiciones son escasas en países con ingresos medianos y bajos. Una experiencia que ilustra esta situación ha sido la investigación de la deficiencia de yodo (DI) en Perú y la aplicación de resultados para la creación de un programa de salud pública. La investigación demostró persistente DI, que durante la gestación causa daño cerebral y retardo mental, que el uso de aceite yodado en la prevención y tratamiento tiene efecto inmediato y larga duración, y validó la concentración urinaria del yodo como el mejor indicador de nutrición de yodo. Estos resultados fueron tomados en cuenta por el Ministerio de Salud y en 1983 se creó el Programa Nacional de Control del Bocio y Cretinismo Endémicos, que ha logrado la eliminación virtual de la DI desde 1995.
Asunto(s)
Investigación Biomédica , Enfermedades Carenciales/prevención & control , Política de Salud , Yodo/deficiencia , Preescolar , Humanos , Lactante , Recién Nacido , PerúRESUMEN
BACKGROUND: Despite the well-documented importance of nutrition in optimizing performance and health, the dietary intake of soccer players has attracted little attention. AIM: We aimed to assess the pre-season dietary intake of professional soccer players and its adequacy in macro and micronutrients. METHODS: The pre-season dietary intake of 19 male athletes was assessed using a semi-structured 3-day food record. To determine dietary adequacy and excess, energy and macronutrient intake were compared with the Brazilian dietary reference values for athletes, and micronutrients were compared with the Estimated Average Requirement - EAR (minimum recommendation) and Tolerable Upper Intake Level - UL (maximum recommendation). RESULTS: Mean daily energy intake (40.74±12.81 kcal/kg) was adequate. However, there was a low carbohydrate intake (5.44±1.86 g/kg/day) and a high amount of protein and fat (1.91±0.75 and 1.27±0.50 g/kg/day, respectively). Sodium intake (3141.77±939.76 mg/day) was higher than UL (2300 mg/day), while the majority of players showed daily intake of vitamin A (74%), vitamin D (100%), folate (58%), calcium and magnesium (68%) below the EAR (625, 10 and 320 µg/day, 800 and 330 mg/day, respectively). CONCLUSION: The dietary intake of professional soccer players was adequate in energy, but inadequate in macro and micronutrients, which suggests the need to improve nutritional practices to sustain the physical demands of soccer during pre-season.
Asunto(s)
Atletas , Dieta Saludable , Cooperación del Paciente , Fenómenos Fisiológicos en la Nutrición Deportiva , Adolescente , Adulto , Brasil/epidemiología , Enfermedades Carenciales/epidemiología , Enfermedades Carenciales/etiología , Enfermedades Carenciales/fisiopatología , Enfermedades Carenciales/prevención & control , Registros de Dieta , Dieta Rica en Proteínas y Pobre en Hidratos de Carbono/efectos adversos , Ingestión de Energía , Humanos , Masculino , Prevalencia , Ingesta Diaria Recomendada , Riesgo , Estaciones del Año , Índice de Severidad de la Enfermedad , Fútbol , Adulto JovenRESUMEN
RESUMEN La investigación científica es una función esencial en salud pública; permite reconocer problemas y situaciones que comprometen la salud y la identificación de soluciones. La investigación es esencial para formulación de políticas desalud. Es imperativo para los países tener sistemas nacionales de investigación. Últimamente, ha habido un significativo avance global, pero el crecimiento no es uniforme, las condiciones son escasas en países con ingresos medianos y bajos. Una experiencia que ilustra esta situación ha sido la investigación de la deficiencia de yodo (DI) en Perú y la aplicación de resultados para la creación de un programa de salud pública. La investigación demostró persistente DI, que durante la gestación causa daño cerebral y retardo mental, que el uso de aceite yodado en la prevención y tratamiento tiene efecto inmediato y larga duración, y validó la concentración urinaria del yodo como el mejor indicador de nutrición de yodo. Estos resultados fueron tomados en cuenta por el Ministerio de Salud y en 1983 se creó el Programa Nacional de Control del Bocio y Cretinismo Endémicos, que ha logrado la eliminación virtual de la DI desde 1995.
ABSTRACT Scientific research is an essential public health function, enabling recognition of problems that compromise health and facilitating solutions. Research is essential to formulate health policy at a national level. There has been significant but inconsistent overall progress, due to economic conditions in low- and middle-income countries. An example that illustrates this situation is the investigation of iodine deficiency (ID) in Peru, and the application of the results for development of a public health program. The research demonstrated persistent ID, which causes fetal brain damage and subsequent mental retardation. The use of iodinated oil to prevent and treat ID was shown to have an immediate and long-term effect, and confirmed that urinary concentration of iodine was the best indicator of iodine intake. These results were accepted by the Ministry of Health, and the National Program for the Control of Endemic Goiter and Cretinism was created in 1983, achieving virtual elimination of ID by 1995.
Asunto(s)
Preescolar , Humanos , Lactante , Recién Nacido , Enfermedades Carenciales/prevención & control , Investigación Biomédica , Política de Salud , Yodo/deficiencia , PerúRESUMEN
Undernutrition and micronutrient deficiencies are still a public health problem in Latin America and the Caribbean (LAC), and overweight and obesity have reached epidemic proportions. To assess the nutrition landscape in LAC countries and guide future nutrition efforts and investments, the Pan American Health Organization and the Micronutrient Initiative joined efforts to 1) identify information gaps and describe the current nutritional situation in the region; 2) map existing policies to address malnutrition in Latin America; 3) describe the impact of conditional cash transfer programs (CCTs) on nutrition and health outcomes; and 4) identify the challenges and opportunities to address malnutrition in the region. This article summarizes the methods and key findings from that research and describes the current challenges and opportunities in addressing malnutrition in the LAC region. LAC countries have advanced in reducing undernutrition and micronutrient deficiencies, but important gaps in information are a major concern. These countries have policies to address undernutrition and micronutrient deficiencies, but comprehensive and intersectoral policies to tackle obesity are lacking. CCTs in Brazil, Colombia, and Mexico have been reported to have a positive impact on child nutrition and health outcomes, providing an opportunity to integrate nutrition actions in intersectoral platforms. The current epidemiological situation and policy options offer an opportunity for countries, technical agencies, donors, and other stakeholders to jointly scale up nutrition actions. This can support the development of comprehensive and intersectoral policies to tackle the double burden of malnutrition, strengthen national nutrition surveillance systems, incorporate monitoring and evaluation as systematic components of policies and programs, document and increase investments in nutrition, and assess the effectiveness of such policies to support political commitment and guarantee sustainability.
Asunto(s)
Enfermedades Carenciales/prevención & control , Política de Salud , Desnutrición/prevención & control , Brasil , Región del Caribe , Niño , Colombia , Humanos , América Latina , México , Obesidad Infantil/prevención & controlAsunto(s)
Enfermedades Carenciales/prevención & control , Suplementos Dietéticos , Metabolismo Energético , Inmunidad Innata , Selenio/uso terapéutico , Animales , Cardiomiopatías/etiología , Cardiomiopatías/prevención & control , Enfermedades Carenciales/inmunología , Enfermedades Carenciales/metabolismo , Enfermedades Carenciales/fisiopatología , Diabetes Mellitus Tipo 2/etiología , Diabetes Mellitus Tipo 2/prevención & control , Suplementos Dietéticos/envenenamiento , Infecciones por Enterovirus/etiología , Infecciones por Enterovirus/prevención & control , Humanos , Enfermedad de Kashin-Beck/etiología , Enfermedad de Kashin-Beck/prevención & control , Neoplasias/etiología , Neoplasias/prevención & control , Necesidades Nutricionales , Ingesta Diaria Recomendada , Selenio/deficiencia , Selenio/metabolismo , Selenio/envenenamientoRESUMEN
UNLABELLED: Iron deficiency causes anaemia and other adverse effects on the nutritional status and development of millions of children. Multi-micronutrient powders (MNP) have been shown to reduce anaemia in young children. In Peru, 50% of children 6-36 months are anaemic. Since 2009, the government has started distributing MNP. This qualitative study explored the acceptability of MNP by caregivers and the role of health personnel (HP) in three regions (Apurimac, Ayacucho and Cajamarca), piloting the MNP programme between 2009 and 2011. Data collection consisted of interviews (35) and observations (13) with caregivers and HP (11). In Cajamarca, 16 families were visited three times in their homes to understand caregivers' use and difficulties. Results showed the critical role HP has in influencing caregiver understanding and use of the MNP, as well as the need for training to avoid confusing messages and provide counselling techniques that consider cultural sensitivity to optimize HP interactions with caregivers and adapt the recommendations for MNP use to local family feeding routines. There was greater acceptance of MNP by caregivers giving semi-solid foods (e.g. purees) to their children than those who served dilute preparations (e.g. soups). Acceptance was similar across regions, but there were some differences between urban and rural settings. Home visits were shown to be a key in improving the use of MNP by caregivers as misunderstandings on preparation, required consistency and optimum practices were common. These findings can contribute to strategies to enhance acceptability and use. KEY MESSAGES: Acceptance and use of multi-micronutrient powders (MNP) by caregivers greatly depend upon how it is presented, promoted and counselled by health personnel. Counselling for MNP use needs to consider and adapt to the local cultural context and incorporate family and child feeding routines. MNP are presented as part of appropriate feeding practices, encouraging caregivers to find simple and acceptable ways of giving semi-solid or solid foods with which to mix it.
Asunto(s)
Cuidadores , Fenómenos Fisiológicos Nutricionales Infantiles , Enfermedades Carenciales/prevención & control , Suplementos Dietéticos , Promoción de la Salud , Micronutrientes/uso terapéutico , Aceptación de la Atención de Salud , Cuidadores/educación , Fenómenos Fisiológicos Nutricionales Infantiles/etnología , Preescolar , Asistencia Sanitaria Culturalmente Competente , Enfermedades Carenciales/etnología , Asistencia Alimentaria , Preferencias Alimentarias/etnología , Alimentos Fortificados , Conocimientos, Actitudes y Práctica en Salud/etnología , Personal de Salud , Humanos , Lactante , Alimentos Infantiles , Micronutrientes/administración & dosificación , Aceptación de la Atención de Salud/etnología , Educación del Paciente como Asunto , Perú/epidemiología , Proyectos Piloto , Rol Profesional , Relaciones Profesional-Familia , Investigación Cualitativa , Recursos HumanosAsunto(s)
Suplementos Dietéticos/efectos adversos , Compuestos de Selenio/efectos adversos , Selenio/efectos adversos , Oligoelementos/efectos adversos , Niño , Enfermedades Carenciales/prevención & control , Dieta , Humanos , Valores de Referencia , Riesgo , Selenio/uso terapéutico , Compuestos de Selenio/uso terapéutico , Oligoelementos/uso terapéuticoAsunto(s)
Anemia Ferropénica/prevención & control , Enfermedades Carenciales/prevención & control , Suplementos Dietéticos , Deficiencias de Hierro , Hierro/uso terapéutico , Oligoelementos/uso terapéutico , Anemia Ferropénica/diagnóstico , Anemia Ferropénica/epidemiología , Enfermedades Carenciales/diagnóstico , Enfermedades Carenciales/epidemiología , HumanosRESUMEN
BACKGROUND: Micronutrient deficiencies continue to afflict children rural populations around the world. A micronutrient delivery vehicle (MDV) was developed as a point-of-use technology for fortification of meals for school-age children beneficiaries of the Healthy Schools Program (HSP) in Honduras. RESULTS: MDV combines micronutrient powder through a traditional dough-making process, using staple flours (wheat and nixtamalized corn), oil and water as ingredients. After mixing the ingredients and kneading, dough is extruded through a specially designed hand press into noodles. After drying (overnight, 23°C), noodles are broken into small pieces, mixed (1:100 w/w) with rice and cooked as customary. Dispersion studies with NaFeEDTA showed adequate distribution (<10% RSD) and recovery (>90%) in white rice. Color changes in MDV due to addition of vitamin A and iron (NaFeEDTA) carried forward into cooked rice. In Honduras, children from two rural schools (N = 47, 6-12 years) were not able to differentiate (triangle test) between control and unfortified MDV mixed (1:100 w/w) with white rice. Children from four schools (N = 83, 7-12 years) accepted control and iron fortified rice (3 mg Fe per serving) based on color and flavor similarly. CONCLUSION: This is a feasible point-of-use fortification technology for improvement of meals provided by the HSP in Honduras.
Asunto(s)
Enfermedades Carenciales/prevención & control , Dieta , Alimentos Fortificados , Hierro/administración & dosificación , Micronutrientes/administración & dosificación , Oryza , Vitamina A/administración & dosificación , Niño , Color , Comportamiento del Consumidor , Femenino , Preferencias Alimentarias , Honduras , Humanos , Hierro/uso terapéutico , Deficiencias de Hierro , Masculino , Comidas , Micronutrientes/deficiencia , Micronutrientes/uso terapéutico , Polvos , Triticum , Vitamina A/uso terapéutico , Zea maysRESUMEN
A double-blind, randomized clinical trial was conducted to determine the effects of prevention of zinc deficiency on cognitive and sensorimotor development during infancy. At 6 mo of age, infants were randomly assigned to be administered a daily liquid supplement containing 10 mg/d of zinc (zinc sulfate), 10 mg/d of iron (ferrous sulfate), and 0.5 mg/d of copper (copper oxide), or an identical daily liquid supplement containing only 10 mg/d of iron and 0.5 mg/d of copper. Various controls were implemented to ensure adherence to the supplement protocol. A battery of developmental assessments was administered from 6 to 18 mo of age that included a visual habituation/recognition memory task augmented with heart rate at 6, 9, and 12 mo of age; the Bayley Scales of Infant Development, 2nd edition (BSID2) at 6, 12, and 18 mo; the A-not-B error task at 9 and 12 mo; and free-play attention tasks at 12 and 18 mo. Only infants supplemented with zinc had the normative decline in look duration from 6 to 12 mo during habituation and a normative decline in shifting between objects on free-play multiple-object attention tasks from 12 to 18 mo of age. The 2 groups did not differ on any of the psychophysiologic indices, the BSID2, or the A-not-B error task. The findings are consistent with zinc supplementation supporting a profile of normative information processing and active attentional profiles during the first 2 y of life. This trial was registered at clinicaltrials.gov as NCT00589264.
Asunto(s)
Desarrollo Infantil/efectos de los fármacos , Cognición/efectos de los fármacos , Suplementos Dietéticos , Desempeño Psicomotor/efectos de los fármacos , Zinc/administración & dosificación , Adulto , Cobre/administración & dosificación , Enfermedades Carenciales/prevención & control , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Compuestos Ferrosos/administración & dosificación , Estudios de Seguimiento , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Lactante , Masculino , Procesos Mentales/efectos de los fármacos , Neuronas/efectos de los fármacos , Neuronas/metabolismo , Perú , Factores Socioeconómicos , Adulto JovenRESUMEN
OBJECTIVES: To assess the effectiveness of the Sustainable Elimination of Iodine Deficiency Program through determination of urinary iodine and goiter prevalence. MATERIALS AND METHODS: A cross-sectional study was conducted in Cuban school children aged 6 to 11 years old in 2011-2012. A stratified multistage sample was used in which the levels of iodine excretion in urine (urinary iodine) and the presence of goiter were determined. RESULTS: The median urinary iodine was 176.3 µg/L; 7.6% of the students showed some deficiency of iodine, only 2.2% were below 50 µg/L (severe deficiency), and 15.3% had urinary iodine above 300 µg/L. The percentage of school children with optimal iodine nutrition was 43.5%, this category showed a significantly higher frequency (p=0.03) in the mountain areas (52.5%). Goiter prevalence was 17.6% which corresponds to a mild endemic. However, in the mountain area the prevalence was 32.6% (severe endemic). CONCLUSIONS: The comprehensive analysis of the impact of iodine deficiency control measures assessed by urinary iodine excretion and goiter prevalence reflects that it is no longer a population health problem in urban and rural areas of Cuba, attributable to a proper process of salt iodization. Nevertheless, high goiter prevalence is still observed in the mountain area of Cuba.
Asunto(s)
Enfermedades Carenciales/epidemiología , Enfermedades Carenciales/prevención & control , Bocio/epidemiología , Yodo/deficiencia , Niño , Estudios Transversales , Cuba/epidemiología , Femenino , Humanos , Yodo/orina , Masculino , Programas Nacionales de Salud , Prevalencia , Evaluación de Programas y Proyectos de Salud , Salud Rural , Salud UrbanaRESUMEN
Objetivos: Evaluar la efectividad del “Programa de Eliminación Sostenible de Deficiencia de Yodo” mediante determinación de yoduria y prevalencia de bocio. Materiales y métodos. Se realizó un estudio transversal en el cual se incluyó a la población escolar cubana de 6 a 11 años que cursaba estudios en el periodo 2011-2012. Se empleó un muestreo estratificado polietápico. En el cual se determinaron los niveles de excreción de yodo en la orina (yoduria) y la presencia de bocio. Resultados. La mediana de yoduria fue de 176,3 µg/L; el 7,6% de los escolares presentaron alguna deficiencia de yodo, solo el 2,2% estaba por debajo de 50 µg/L (deficiencia severa) y el 15,3% tenía yodurias por encima de 300 µg/L. El porcentaje de escolares con nutrición óptima de yodo fue de 43,5%, esta categoría presentó una frecuencia significativamente mayor ( p=0,03) en el estrato montaña (52,5%). La prevalencia de bocio encontrada fue de 17,6%, que corresponde a una endemia ligera. Sin embargo, en el estrato montaña se encontró una prevalencia de 32,6 % (endemia severa). Conclusiones. El análisis integral del impacto de las acciones de control de la deficiencia de yodo evaluado a través de la excreción urinaria de yodo y la prevalencia de bocio refleja que ha dejado de ser un problema de salud poblacional en los estratos urbano y rural de Cuba, atribuible a un adecuado proceso de yodación de la sal. Sin embargo, aún se observa una alta prevalencia de bocio en la zona de montaña de Cuba.
Objectives: To assess the effectiveness of the Sustainable Elimination of Iodine Deficiency Program through determination of urinary iodine and goiter prevalence. Materials and methods. A cross-sectional study was conducted in Cuban school children aged 6 to 11 years old in 2011-2012. A stratified multistage sample was used in which the levels of iodine excretion in urine (urinary iodine) and the presence of goiter were determined. Results. The median urinary iodine was 176.3 µg/L; 7.6% of the students showed some deficiency of iodine, only 2.2% were below 50 µg/L (severe deficiency), and 15.3% had urinary iodine above 300 µg/L. The percentage of school children with optimal iodine nutrition was 43.5%, this category showed a significantly higher frequency (p=0.03) in the mountain areas (52.5%). Goiter prevalence was 17.6% which corresponds to a mild endemic. However, in the mountain area the prevalence was 32.6% (severe endemic). Conclusions. The comprehensive analysis of the impact of iodine deficiency control measures assessed by urinary iodine excretion and goiter prevalence reflects that it is no longer a population health problem in urban and rural areas of Cuba, attributable to a proper process of salt iodization. Nevertheless, high goiter prevalence is still observed in the mountain area of Cuba.
Asunto(s)
Niño , Femenino , Humanos , Masculino , Enfermedades Carenciales/epidemiología , Enfermedades Carenciales/prevención & control , Bocio/epidemiología , Yodo/deficiencia , Estudios Transversales , Cuba/epidemiología , Yodo/orina , Programas Nacionales de Salud , Prevalencia , Evaluación de Programas y Proyectos de Salud , Salud Rural , Salud UrbanaRESUMEN
OBJECTIVE: To examine the micronutrient status of disadvantaged pre-schoolers from Northeast Brazil, following the introduction of pro-poor policies, by assessing the prevalence of anaemia and micronutrient deficiencies and the role of sociodemographic factors, genetic Hb disorders and parasitic infections. DESIGN: In a cross-sectional study, data on sociodemographic status, health, growth, genetic Hb disorders, parasites and nutrient supply from day-care meals were obtained. Fasting blood samples were collected and analysed for Hb, serum ferritin, transferrin receptor, folate, vitamin B12, retinol, Zn and Se. SETTING: Seven philanthropic day-care centres serving urban slums in Salvador, Northeast Brazil. SUBJECTS: Pre-schoolers aged 3-6 years from disadvantaged households. RESULTS: Of the 376 sampled children, 94 % were of black or mixed race; 33 % and 29 % had at least one genetic Hb disorder and intestinal parasite, respectively. Stunting and underweight were ≤5 %; 14 % were overweight. Day-care centres supplied micronutrient-dense meals and snacks each weekday. Less than 10 % of pre-schoolers had anaemia and micronutrient deficiencies. Predictors (P < 0·05) of Hb were α(3·7) thalassaemia, Se and retinol (but not ferritin). Micronutrient predictors (P < 0·05) were: elevated α1-glycoprotein for ferritin, Hb AS and BMI Z-score >1 for transferrin receptor, Zn and elevated α1-glycoprotein for retinol, sex and helminths for Se, helminths for vitamin B12, and Giardia intestinalis infection for serum folate. CONCLUSIONS: Impaired growth, anaemia and micronutrient deficiencies were uncommon among these disadvantaged pre-schoolers attending day care. A range of interventions including provision of micronutrient-dense, fortified day-care meals, deworming and vitamin A supplementation likely contributed to improved micronutrient status, suggesting expanded coverage of these programmes.
Asunto(s)
Anemia Ferropénica/prevención & control , Fenómenos Fisiológicos Nutricionales Infantiles , Enfermedades Carenciales/prevención & control , Asistencia Alimentaria , Alimentos Fortificados , Micronutrientes/uso terapéutico , Salud Urbana , Anemia Ferropénica/economía , Anemia Ferropénica/epidemiología , Anemia Ferropénica/etiología , Brasil/epidemiología , Niño , Guarderías Infantiles , Desarrollo Infantil , Preescolar , Estudios Transversales , Enfermedades Carenciales/economía , Enfermedades Carenciales/epidemiología , Enfermedades Carenciales/etiología , Dieta/efectos adversos , Dieta/economía , Femenino , Servicios de Alimentación/economía , Alimentos Fortificados/economía , Humanos , Masculino , Micronutrientes/administración & dosificación , Micronutrientes/deficiencia , Micronutrientes/economía , Estado Nutricional , Pobreza , Prevalencia , Factores Socioeconómicos , Salud Urbana/economíaRESUMEN
Objetivou-se com este trabalho quantificar a composição mineral das folhas de Oliveira a fim de diagnosticar o estado nutricional das plantas cultivadas em sistema convencional. O experimento foi conduzido com sete cultivares Arbequina, MGS Asc 315, MGS Mariense, MGS Grap 541, MGS Grap 561, Grappolo 575 e Leccino, em blocos casualizados com 4 repetições e parcelas com cinco plantas. Em maio de 2010 foram coletadas 60 folhas de cada cultivar (12 por planta) e submetidas a analise foliar. As cultivares apresentaram diferenças significativas entre si quanto aos teores foliares médios de nutrientes. Observou-se também que apesar da analise de solo apontar níveis elevados de Fe e Mn, a análise foliar acusou deficiência para esses elementos em todas as cultivares de Oliveira avaliadas. Os resultados alertam para os altos níveis de Cu, como consequência do uso abusivo de fungicidas a base de oxicloreto e calda bordalesa nos pomares. A concentração elevada desse elemento nas folhas pode causar fitotoxidez às plantas. Desta forma, sugere-se o uso racional de fertilizantes e de produtos fitossanitários no cultivo da oliveira a fim de evitar fitotoxidez ou deficiências nutricionais.
This study aimed to quantify the mineral composition of olive leaves to diagnose nutritional status of plants grown in conventional system. The experiment was conducted with seven cultivars: Arbequina, MGS Asc 315, MGS Mariense, MGS Grap 541, MGS Grap 561, Grappolo 575 and Leccino, in a randomized block design with four replications and five plants perplot. In May 2010, we collected 60 leaves for each cultivar (12 per plant),whichwere dried and subsequently analyzed. The results advert to the high levels of Cu, a consequence of the excessive use of fungicides based on copper oxychloride and Bordeaux mixture in the orchards. The high concentration of this element in the leaves can bephytotoxicity to plants and harmful to human health, since the leaves are used popularly as an aid in procedures for weight loss. Thus, we suggest the rational use of fertilizers and pesticides in the cultivation of olive trees to prevent nutritional deficiency or phytotoxicity and, if the research acknowledges the phytotherapic effect of leaves, the adoption of crops in the differentiated system of production, to obtain raw material with good quality and suitable for consumption in natura.