RESUMO
BACKGROUND: A large body of evidence shows that socioeconomic status (SES) is strongly associated to children's early development, health and nutrition. Few studies have looked at within sample differences across multiple measures of child nutrition and development. This paper examines SES gaps in child nutritional status and development in Bolivia using a representative sample of children 0-59 months old and a rich set of outcomes, including micronutrient deficiencies, anthropometic measures, and gross motor and communicative development. METHODS: We construct direct and proxy measures of living standards based on household expenditures and on ownership of assets combined with access to services and dwelling characteristics. The data for this study come from a nationally representative household survey in Bolivia that contains information on health, nutrition, and child development tests. We used a regression framework to assess the adjusted associations between child development outcomes and socioeconomic status, after controlling for other demographic factors that might affect child's development. The SES gap in child development was estimated by OLS. To explore when the development gaps between children in different socioeconomic groups start and how they change for children at different ages, we analyze the differences in outcomes between the poorest (Q1) and richest (Q5) quintiles by child's age by estimating kernel weighted local polynomial regressions of standardized scores for all child development indicators. RESULTS: There are large and statistically significant differences in all anthropometrics z-scores between children in Q5 and children in Q1: height for age (0.95 SD), weight for age (0.70 SD), and weight for height (0.21 SD). When we divide the sample into children at the bottom and top consumption quintiles the results show that 68.6% of children in the poorest quintile are anemic. While this percentage falls to 40.9% for children in the richest quintile, it remains high compared to other countries in the region. The prevalence of vitamin A deficiency is 29.9% for children in the richest quintile and almost 10 percentage points higher for those at the bottom quintile (39.0%); the prevalence of Iron deficiency for children in the top and bottom quintiles is 16.4% and 23.8%, respectively. Compared to the most deprived quintile, children in the wealthiest quintile are less likely to have iron deficiency, anemia, to be stunted, and to have a risk of delays in gross motor and communicative development. At age three, most of these gaps have increased substantially. Our findings are robust to the choice of socioeconomic measurement and highlight the need for targeted policies to reduce developmental gaps. CONCLUSION: These findings highlight the need for targeted public policies that invest in multiple dimensions of child development as early as possible, including health, nutrition and cognitive and verbal stimulation. From a policy perspective, the large socioeconomic gaps in nutrition outcomes documented here reinforce the need to strengthen efforts that tackle the multiple causes of malnutrition for the poorest.
Assuntos
Desenvolvimento Infantil , Deficiências Nutricionais/complicações , Micronutrientes/sangue , Estado Nutricional , Pobreza , Classe Social , Anemia/epidemiologia , Anemia/etiologia , Bolívia/epidemiologia , Pré-Escolar , Deficiências Nutricionais/sangue , Deficiências Nutricionais/epidemiologia , Feminino , Transtornos do Crescimento/etiologia , Humanos , Lactente , Recém-Nascido , Desenvolvimento da Linguagem , Masculino , Desnutrição/complicações , Destreza Motora , Prevalência , Fatores SocioeconômicosRESUMO
OBJECTIVES: Distinct diseases prevent endangered huemul deer (Hippocamelus bisulcus) recovery. Fundamental etiological factors include nutriments, a mayor component of habitat quality. Undernutrition affects growth, skeletal development, osteopathology, reproduction and immunocompetence: this paper amplifies data corroborating micro-nutrient deficiencies among huemul. RESULTS: In Argentina, 57% huemul cadavers exhibited osteopathology, with new cases reported here. Recently, 86% live huemul had osteopathology: cranial lesions involved antemortem tooth loss, reducing feeding efficiency and body condition, with starvation deaths. This population had tissues well deficient compared to other cervids, averaging 0.28 ppm selenium, 4.98 ppm copper, whereas for manganese 55% were deficient (2.52 ppm) and 45% adequate (42.79 ppm). Recently, lesions in one Chilean huemul were interpreted to stem from parapoxvirus. That population also has cases with cranial osteopathologies, high disease susceptibility (parapoxvirus, parasitism, foot lesions), crippled antlers, and low density, indicative of marginal habitat and primary etiological factors like undernutrition and immunosuppression. The reported atypical symptoms attributed to parapoxvirus may relate to probable diagnostic limitations, but does support presence of nutritional deficiencies. Patagonia has selenium deficient plants and livestock, including severe muscular dystrophy, and soil levels in extant huemul areas considered very deficient. Moreover, 73% of Chilean huemul were selenium deficient and 64% severely deficient with concomitant cranial osteopathology.
Assuntos
Doenças Ósseas/veterinária , Cervos , Deficiências Nutricionais/veterinária , Doenças do Sistema Imunitário/veterinária , Micronutrientes/deficiência , Infecções por Poxviridae/veterinária , Doenças Dentárias/veterinária , Animais , Argentina/epidemiologia , Autopsia , Doenças Ósseas/epidemiologia , Chile/epidemiologia , Deficiências Nutricionais/epidemiologia , Espécies em Perigo de Extinção , Doenças do Sistema Imunitário/epidemiologia , Masculino , Infecções por Poxviridae/epidemiologia , Doenças Dentárias/epidemiologiaRESUMO
BACKGROUND: Patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) are under risk of micronutrient deficiencies. We aimed to assess the preoperative and postoperative micronutrient deficiencies in a sample of patients with obesity who underwent LRYGB. METHODS: We evaluated 169 patients-satisfying the National Institute of Health criteria for bariatric surgery-who underwent a LRYGB from January 2014 to July 2017. Before surgery, we recorded a detailed medical history for every patient, and after surgery, we instructed them to return at 1, 6, 12, 24, 36, and 48 months after surgery. RESULTS: Preoperatively, anemia was present in 4.24% of patients, iron deficiency in 5.33%, vitamin B12 deficiency in 12.3%, and vitamin D deficiency in 74.35%. Postoperatively, the deficiency rates of calcium, magnesium, folate, and vitamins A, B1, and B6 were markedly low at 1, 2, and 3 years after surgery. In regard to anemia, iron, and vitamin B12, rates of deficiency were higher at 2 and 3 years postoperatively versus preoperatively, but only anemia (4% vs 14% and 4% vs 27%, at 2 and 3 years) and iron (5% vs 23% at 3 years) reached statistical significance. Compared with the preoperative assessment, the rates of vitamin D deficiency decreased over time (74% vs 50% at 1 year [p < 0.001], 74% vs 45% at 2 years [p < 0.002] and 74% vs 41% at 3 years [p < 0.04]). CONCLUSIONS: Vitamin D deficiency remains the most common preoperative deficiency. Anemia and deficiencies of iron and vitamin B12 are common before and after surgery. Deficiencies of calcium, magnesium, folate, and vitamins A, B1, and B6 are markedly low in the postoperative period.
Assuntos
Deficiências Nutricionais/epidemiologia , Derivação Gástrica/efeitos adversos , Micronutrientes/deficiência , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/epidemiologia , Adulto , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/etiologia , Deficiências Nutricionais/etiologia , Feminino , Seguimentos , Derivação Gástrica/métodos , Derivação Gástrica/estatística & dados numéricos , Humanos , Deficiências de Ferro , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Minerais/metabolismo , Obesidade Mórbida/epidemiologia , Resultado do Tratamento , Deficiência de Vitamina B 12/epidemiologia , Deficiência de Vitamina B 12/etiologia , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/etiologiaRESUMO
OBJECTIVE: To analyze the association between supplements and Liconsa milk intake, with anemia, zinc (ZD) and iron (ID) deficiencies, and morbidity in Mexican children resident of less than 100 000 habitants' localities. MATERIALS AND METHODS: A subsample of 1 516 children aged 1-4 participants of Ensanut 100k was analyzed, carried out in 2018. Anemia was considered if [Hb]<11 g/dL, ZD if [Zn]<65 µg/dL and ID if [ferritin]<12 µg/L. Supplements and Liconsa milk consumption were obtained from a semi-quantitative food frequency; morbidity by self-report of the mother. Multiple logistic regression models were used adjusted by confounders. RESULTS: Medium and high consumption of Liconsa milk was associated to lower odds of ID (OR=0.02, [95%CI 0.002,0.24] and OR=0.07, [95%CI 0.01,0.52]) and anemia (OR=0.13, [95%CI 0.04,0.37] and OR=0.17, [95%CI 0.03,0.87]). A high intake of Liconsa milk (OR=0.09, [95%CI 0.01,0.44]) and Vitaniño (OR=0.05 [95%CI 0.005, 0.46]) were both associated to lower diarrhea risk. CONCLUSIONS: To assure the continuity of the consumption of nutritional supplements is necessary for improving the health and the micronutrients status in vulnerable Mexican children.
OBJETIVO: Analizar la asociación entre el consumo de suplementos o leche Liconsa y anemia, deficiencias de zinc (DZ) y hierro (DH) y morbilidad en niños mexicanos residentes de localidades menores a 100 000 habitantes. MATERIAL Y MÉTODOS: Se analizó información de 1 516 niños de 1 a 4 años de la Encuesta Nacional de Salud y Nutrición en localidades con menos de 100 000 habitantes realizada en el año 2018. Se definió Anemia si [Hb]<11 g/dL, DZ: [Zn]<65 µg/dL y DH: [ferritina]<12 µg/L. El consumo de suplementos y de leche Liconsa se obtuvo del cuestionario de Frecuencia de Consumo de Alimentos y morbilidad por autorreporte de la madre. Se emplearon modelos de regresión logística múltiple para el análisis de las asociaciones, ajustados por confusores. RESULTADOS: El consumo medio y alto de leche Liconsa se asoció con menor momio de DH (RM=0.02 [IC95% 0.002,0.24] y RM=0.07 [IC95% 0.01,0.52]) y anemia (RM=0.13 [IC95% 0.04,0.37] y RM=0.17 [IC95% 0.03,0.87]). Un alto consumo de leche Liconsa (RM=0.09, [IC95% 0.01,0.44]) y de Vitaniño (RM=0.05 [IC95% 0.005, 0.46]) se asoció con menor momio de diarrea. CONCLUSIONES: Es necesario considerar la continuidad del consumo de suplementos nutricionales para mejorar la salud y el estado de micronutrimentos en población infantil mexicana vulnerable.
Assuntos
Anemia/epidemiologia , Deficiências Nutricionais/epidemiologia , Suplementos Nutricionais , Alimentos Fortificados , Deficiências de Ferro , Leite , Morbidade , Zinco/deficiência , Animais , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , México/epidemiologia , Inquéritos Nutricionais , Densidade DemográficaRESUMO
Resumen: Objetivo: Analizar la asociación entre el consumo de suplementos o leche Liconsa y anemia, deficiencias de zinc (DZ) y hierro (DH) y morbilidad en niños mexicanos residentes de localidades menores a 100 000 habitantes. Material y métodos: Se analizó información de 1 516 niños de 1 a 4 años de la Encuesta Nacional de Salud y Nutrición en localidades con menos de 100 000 habitantes realizada en el año 2018. Se definió Anemia si [Hb]<11 g/dL, DZ: [Zn]<65 µg/dL y DH: [ferritina]<12 µg/L. El consumo de suplementos y de leche Liconsa se obtuvo del cuestionario de Frecuencia de Consumo de Alimentos y morbilidad por autorreporte de la madre. Se emplearon modelos de regresión logística múltiple para el análisis de las asociaciones, ajustados por confusores. Resultados: El consumo medio y alto de leche Liconsa se asoció con menor momio de DH (RM=0.02 [IC95% 0.002,0.24] y RM=0.07 [IC95% 0.01,0.52]) y anemia (RM=0.13 [IC95% 0.04,0.37] y RM=0.17 [IC95% 0.03,0.87]). Un alto consumo de leche Liconsa (RM=0.09, [IC95% 0.01,0.44]) y de Vitaniño (RM=0.05 [IC95% 0.005, 0.46]) se asoció con menor momio de diarrea. Conclusiones: Es necesario considerar la continuidad del consumo de suplementos nutricionales para mejorar la salud y el estado de micronutrimentos en población infantil mexicana vulnerable.
Abstract: Objective: To analyze the association between supplements and Liconsa milk intake, with anemia, zinc (ZD) and iron (ID) deficiencies, and morbidity in Mexican children resident of less than 100 000 habitants' localities. Materials and methods: A subsample of 1 516 children aged 1-4 participants of Ensanut 100k was analyzed, carried out in 2018. Anemia was considered if [Hb]<11 g/dL, ZD if [Zn]<65 µg/dL and ID if [ferritin]<12 µg/L. Supplements and Liconsa milk consumption were obtained from a semi-quantitative food frequency; morbidity by self-report of the mother. Multiple logistic regression models were used adjusted by confounders. Results: Medium and high consumption of Liconsa milk was associated to lower odds of ID (OR=0.02, [95%CI 0.002,0.24] and OR=0.07, [95%CI 0.01,0.52]) and anemia (OR=0.13, [95%CI 0.04,0.37] and OR=0.17, [95%CI 0.03,0.87]). A high intake of Liconsa milk (OR=0.09, [95%CI 0.01,0.44]) and Vitaniño (OR=0.05 [95%CI 0.005, 0.46]) were both associated to lower diarrhea risk. Conclusions: To assure the continuity of the consumption of nutritional supplements is necessary for improving the health and the micronutrients status in vulnerable Mexican children.
Assuntos
Humanos , Animais , Masculino , Feminino , Lactente , Pré-Escolar , Alimentos Fortificados , Morbidade , Suplementos Nutricionais , Deficiências Nutricionais/epidemiologia , Leite , Anemia/epidemiologia , Zinco/deficiência , Inquéritos Nutricionais , Estudos Transversais , Densidade Demográfica , México/epidemiologiaRESUMO
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.
Assuntos
Cirurgia Bariátrica , Deficiências Nutricionais/prevenção & controle , Suplementos Nutricionais , Obesidade Mórbida/dietoterapia , Obesidade Mórbida/cirurgia , Cooperação do Paciente/estatística & dados numéricos , Complicações na Gravidez , Adulto , Cirurgia Bariátrica/efeitos adversos , Cirurgia Bariátrica/reabilitação , Deficiências Nutricionais/epidemiologia , Ácidos Graxos Ômega-3/administração & dosagem , Feminino , Ácido Fólico/administração & dosagem , Humanos , Ferro/administração & dosagem , Obesidade Mórbida/epidemiologia , Período Pós-Operatório , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/prevenção & controle , Estudos Retrospectivos , Resultado do Tratamento , Vitaminas/administração & dosagemRESUMO
BACKGROUND: Obesity and its complications are prevalent in women and increase with age. Polyneuropathy (PNP) is a complication of obesity and bariatric surgery (BS). In subjects with severe (grades II and III) obesity and without DM who are candidates for BS, the prevalence of PNP and associated conditions are not well characterized. The aim of this study was to evaluate the prevalence of PNP in severely obese (SO) women without DM or common nutritional deficiencies in order to determine factors associated with the presence of PNP. METHODS: A cross-sectional study was performed on 450 SO women. They were evaluated with the Michigan Neuropathy Screening Instrument, a Sleep Apnea Questionnaire, and the short form of the International Physical Activity Questionnaire. Data on blood pressure, body mass index, waist circumference, serum glucose, glycated hemoglobin, LDL and HDL cholesterol, triglycerides, vitamin B12, and postmenopausal (PM) status were also collected. Patients with DM and other common causes of PNP were excluded. To evaluate which variables were independently associated with PNP (dependent variable), Poisson regression models were used. RESULTS: The prevalence of PNP was 11.6%. In univariate analysis, PNP was associated with age, PM status, and diagnosis of systemic arterial hypertension (p < 0.001, p < 0.001, and p = 0.016, respectively), and there was a trend toward an association with sleep apnea risk (p = 0.101). In multivariate analysis, PM status (PR = 2.836, 95% CI 1.735-4.636, p = 0.001) and age (PR = 1.0511, 95% CI 1.031-1.071, p = 0.001) were independently associated with PNP diagnosis in two different models. CONCLUSION: Even prior to BS, PNP is highly prevalent and is associated with PM status and age in SO women without diabetes.
Assuntos
Deficiências Nutricionais/epidemiologia , Obesidade Mórbida/epidemiologia , Polineuropatias/epidemiologia , Adulto , Estudos Transversais , Deficiências Nutricionais/complicações , Diabetes Mellitus , Feminino , Humanos , Michigan/epidemiologia , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Polineuropatias/etiologia , Prevalência , Fatores de RiscoRESUMO
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.
Assuntos
Deficiências Nutricionais/epidemiologia , Deficiências Nutricionais/prevenção & controle , Suplementos Nutricionais , Lactação , Saúde Materna , Saúde da População Urbana , Zinco/deficiência , Zinco/uso terapêutico , Adolescente , Adulto , Deficiências Nutricionais/sangue , Equador/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Projetos Piloto , Gravidez , Prevalência , Adulto Jovem , Zinco/sangueRESUMO
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.
Assuntos
Atletas , Dieta Saudável , Cooperação do Paciente , Fenômenos Fisiológicos da Nutrição Esportiva , Adolescente , Adulto , Brasil/epidemiologia , Deficiências Nutricionais/epidemiologia , Deficiências Nutricionais/etiologia , Deficiências Nutricionais/fisiopatologia , Deficiências Nutricionais/prevenção & controle , Registros de Dieta , Dieta Rica em Proteínas e Pobre em Carboidratos/efeitos adversos , Ingestão de Energia , Humanos , Masculino , Prevalência , Recomendações Nutricionais , Risco , Estações do Ano , Índice de Gravidade de Doença , Futebol , Adulto JovemRESUMO
BACKGROUND: Micronutrient deficiencies are still highly prevalent in countries undergoing the nutrition transition, but nationally representative data documenting their burden in children are exceedingly rare. OBJECTIVE: To examine the distribution and recent trends in micronutrient status biomarkers of Colombian children. METHODS: We compared the distributions of plasma ferritin, serum zinc, and vitamin A in Colombian children between 2005 and 2010 using 2 cross-sectional, nationally representative surveys overall and by categories of sociodemographic variables. Analysis for ferritin included boys and nonpregnant girls aged 1 to 17 years. Analyses for zinc and vitamin A included children aged 1 to 4 years. RESULTS: The mean 2010 to 2005 differences in ferritin, zinc, and vitamin A were 2.5 µg/L (95% confidence interval [CI]: 1.3 to 3.7), -34.9 µg/dL (95% CI: -39.6 to -30.2), and -11.5 µg/dL (95% CI: -12.3 to -10.7), respectively, after adjusting for sociodemographic characteristics. These differences varied significantly by region of residence. In 2010, region of residence was a significant correlate for all 3 micronutrients. Other important correlates included age and maternal education for ferritin and body mass index-for-age Z score, maternal education, wealth index, food insecurity, and urbanicity for vitamin A. CONCLUSIONS: Plasma ferritin was slightly higher in 2010 than in 2005, whereas serum zinc and vitamin A were substantially lower in 2010. In the absence of obvious causal explanations, it is uncertain whether this decline represents a worsening of micronutrient status in Colombian children or an artifact due to systematic laboratory or data management errors incurred in the surveys.
Assuntos
Anemia Ferropriva/sangue , Fenômenos Fisiológicos da Nutrição Infantil , Deficiências Nutricionais/sangue , Transição Epidemiológica , Estado Nutricional , Deficiência de Vitamina A/sangue , Zinco/deficiência , Adolescente , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/etnologia , Biomarcadores/sangue , Criança , Fenômenos Fisiológicos da Nutrição Infantil/etnologia , Pré-Escolar , Colômbia/epidemiologia , Estudos Transversais , Deficiências Nutricionais/epidemiologia , Deficiências Nutricionais/etnologia , Feminino , Ferritinas/sangue , Humanos , Lactente , Masculino , Inquéritos Nutricionais , Estado Nutricional/etnologia , Prevalência , Análise Espaço-Temporal , Vitamina A/sangue , Deficiência de Vitamina A/epidemiologia , Deficiência de Vitamina A/etnologia , Zinco/sangueRESUMO
Context: Iodine deficiency is the leading cause of preventable neurodevelopmental delay in children worldwide and a possible public health concern in Haiti. Objective: To determine the prevalence of iodine deficiency in Haitian young children and its influence by environmental factors. Design: Cross-sectional study, March through June 2015. Setting: Community churches in 3 geographical regions in Haiti. Participants: 299 healthy Haitian children aged 9 months to 6 years; one-third each enrolled in a coastal, mountainous, and urban region. Main Outcome Measures: Urinary iodide, serum thyrotropin (TSH), goiter assessment, and urinary perchlorate and thiocyanate. Results: Mean age was 3.3±1.6 years, with 51% female, median family income USD 30/week, and 16% malnutrition. Median urinary iodide levels were normal in coastal (145 µg/L, interquartile range [IQR] 97 to 241) and urban regions (187 µg/L, IQR 92 to 316), but revealed mild iodine deficiency in a mountainous region (89 µg/L, IQR 56 to 129), P < 0.0001. Grade 1 goiters were palpated in 2 children, but TSH values were normal. Urinary thiocyanate and perchlorate concentrations were not elevated. Predictors of higher urinary iodide included higher urinary thiocyanate and perchlorate, breastfeeding, and not living in a mountainous region. Conclusions: Areas of mild iodine deficiency persist in Haiti's mountainous regions. Exposure to two well-understood environmental thyroid function disruptors is limited.
Assuntos
Deficiências Nutricionais/epidemiologia , Disruptores Endócrinos/urina , Poluentes Ambientais/urina , Iodo/urina , Percloratos/urina , Tiocianatos/urina , Tireotropina/sangue , Criança , Pré-Escolar , Estudos Transversais , Deficiências Nutricionais/sangue , Deficiências Nutricionais/urina , Feminino , Bócio/diagnóstico , Bócio/epidemiologia , Haiti/epidemiologia , Humanos , Lactente , Iodo/deficiência , MasculinoRESUMO
INTRODUCTION: National programs of salt iodization were implemented in Brazil to combat iodine deficiency (ID) in children of school age. Currently, there are limited data in Brazil on those still vulnerable to this deficiency and the state of nutritional iodine status in the northeast region of Brazil, where children are vulnerable to malnutrition. OBJECTIVE: The aim of this study was to analyze the iodine nutritional status, household food insecurity, socioeconomic and demographic characteristics among schoolchildren from the public school system living in state the state of Bahia, Brazil. METHODS: A cross-sectional study was conducted on 1419 schoolchildren in Bahia between the ages of 6 and 14 years old. Anthropometric parameters, urinary iodine concentrations (UIC), and thyrotropin (TSH) measurements were evaluated from blood spots on filter paper. RESULTS: The mean UIC was 206.4 ± 80.5 µg/L, with a median of 221.6 µg/L, indicating sufficient iodine intake in the region. Low urinary iodide concentration (<100 µg/L) was detected in 12.3% of the schoolchildren (n = 174), with 6.2% with mild (<100 µg/L), 3.0% with moderate (20-49 µg/L), and 3.1% with severe ID (<20 µg/L). Moreover, 9.4% (n = 134) had a urinary iodide concentration of >300 µg/L, indicating the coexistence of excessive iodine intake (EII). The mean TSH was 1.0 ± 0.6 mIU/L. The body mass index category "overweight/obesity" was a protective factor against EII (odds ratio [OR] = 0.64 [confidence interval (CI) 0.4-1.0]; p = 0.07). Urban areas (73%) had a mean UIC of 213.1 ± 80 µg/L compared with 176.8 ± 76.1 µg/L in rural areas. The risk for EII increased in children living in a house with more than six people (OR = 1.62 [CI 0.9-2.6]; p < 0.05) and water consumption from shallow wells (OR = 1.70 [CI 0.9-3.1]; p = 0.09). The risk of ID was increased by 70% in schoolchildren who had moderate or severe food insecurity (OR = 1.70 [CI 0.9-3.0]; p > 0.05). CONCLUSION: A significant proportion of schoolchildren still have ID or EII in the northeast region of Brazil, emphasizing the importance of committed public policies to address this problem. Socioeconomic factors and the lack of education about nutritional importance of iodine were important influencing factors in the presence of ID in schoolchildren.
Assuntos
Deficiências Nutricionais/epidemiologia , Abastecimento de Alimentos/estatística & dados numéricos , Iodo/urina , Fatores Socioeconômicos , Tireotropina/sangue , Adolescente , Índice de Massa Corporal , Brasil/epidemiologia , Criança , Estudos Transversais , Deficiências Nutricionais/sangue , Deficiências Nutricionais/urina , Água Potável , Feminino , Humanos , Masculino , Estado Nutricional , Sobrepeso/epidemiologia , Obesidade Infantil/epidemiologia , Fatores de Proteção , Características de Residência , Fatores de Risco , População Rural , Instituições Acadêmicas , População UrbanaRESUMO
Appropriate feeding behaviours are important for child growth and development. In societies undergoing nutrition transition, new food items are introduced that may be unfavourable for child health. Set in rural Nicaragua, the aim of this study was to describe the infant and young child feeding (IYCF) practices as well as the consumption of highly processed snack foods (HP snacks) and sugar-sweetened beverages (SSBs). All households with at least one child 0- to 35-month-old (n = 1371) were visited to collect information on current IYCF practices in the youngest child as well as consumption of SSBs and HP snacks. Breastfeeding was dominant (98%) among 0- to 1-month-olds and continued to be prevalent (60%) in the second year, while only 34% of the 0- to 5-month-olds were exclusively breastfed. Complementary feeding practices were deemed acceptable for only 59% of the 6- to 11-month-old infants, with low dietary diversity reported for 50% and inadequate meal frequency reported for 30%. Consumption of HP snacks and SSBs was frequent and started early; among 6- to 8-month-olds, 42% and 32% had consumed HP snacks and SSBs, respectively. The difference between the observed IYCF behaviours and World Health Organization recommendations raises concern of increased risk of infections and insufficient intake of micronutrients that may impair linear growth. The concurrent high consumption of SSBs and HP snacks may increase the risk of displacing the recommended feeding behaviours. To promote immediate and long-term health, growth and development, there is a need to both promote recommended IYCF practices as well as discourage unfavourable feeding behaviours.
Assuntos
Bebidas/efeitos adversos , Fenômenos Fisiológicos da Nutrição Infantil , Sacarose Alimentar/efeitos adversos , Fast Foods/efeitos adversos , Métodos de Alimentação/efeitos adversos , Saúde da População Rural , Lanches , Desenvolvimento Infantil , Fenômenos Fisiológicos da Nutrição Infantil/etnologia , Pré-Escolar , Estudos Transversais , Deficiências Nutricionais/epidemiologia , Deficiências Nutricionais/etnologia , Deficiências Nutricionais/etiologia , Características da Família/etnologia , Preferências Alimentares/etnologia , Humanos , Lactente , Recém-Nascido , Nicarágua/epidemiologia , Inquéritos Nutricionais , Hipernutrição/epidemiologia , Hipernutrição/etnologia , Hipernutrição/etiologia , Fatores de Risco , Saúde da População Rural/etnologiaRESUMO
BACKGROUND: Although morbid obesity is related to excess of energy and macronutrient intake, it does not rule out the presence of micronutrient deficiencies. The aim of this study was to evaluate food intake and the prevalence of micronutrient deficiencies in a group of morbidly obese women seeking bariatric surgery. METHODS: A total of 103 morbidly obese women were studied prior to bariatric surgery. Anthropometry and body composition (dual-energy X-ray absorptiometry, DEXA) were performed on all subjects. Energy and nutrient intake was determined by food frequency questionnaire. Blood tests to assess micronutrients status, including plasma iron, ferritin, transferrin, zinc, copper, calcium, phosphorus, hemoglobin, hematocrit, mean corpuscular volume (MCV), and hair zinc, were performed. Folic acid, vitamin B12, vitamin D, and parathyroid hormone (PTH) were also assessed in 66 subjects. RESULTS: Mean energy intake was 2801 ± 970 kcal/day. Carbohydrate, protein, and lipid intake represented 55 ± 9.1, 13.9 ± 3.3, and 32.5 ± 8.2% of total energy intake, respectively. Iron, calcium, and vitamin D intake was below the recommended dietary allowance. The prevalence of nutritional deficiencies were as follows: plasma iron 12.6%, ferritin 8.7%, transferrin 14.6%, plasma zinc 2.9%, calcium 3.3%, phosphorus 2.3%, hemoglobin 7.7%, hematocrit 13.6%, MCV 6.8%, and hair zinc 15.7%. In the subsample, 10.6% had a vitamin B12 deficiency, 71.7% showed low concentrations of vitamin D, and 66% had high PTH levels. No folic acid or copper deficiencies were detected. CONCLUSIONS: Despite high daily energy intake and adequate macronutrient distribution, morbidly obese Chilean women seeking bariatric surgery present with deficient intake of some micronutrients and a high prevalence of micronutrient deficiencies.
Assuntos
Deficiências Nutricionais/epidemiologia , Micronutrientes/deficiência , Obesidade Mórbida/cirurgia , Adulto , Anemia Ferropriva/epidemiologia , Cirurgia Bariátrica , Chile/epidemiologia , Comorbidade , Registros de Dieta , Ingestão de Alimentos , Ingestão de Energia , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade Mórbida/epidemiologia , Período Pré-Operatório , PrevalênciaAssuntos
Anemia Ferropriva/prevenção & controle , Deficiências Nutricionais/prevenção & controle , Suplementos Nutricionais , Deficiências de Ferro , Ferro/uso terapêutico , Oligoelementos/uso terapêutico , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/epidemiologia , Deficiências Nutricionais/diagnóstico , Deficiências Nutricionais/epidemiologia , HumanosRESUMO
OBJECTIVE: We examined associations between the frequency of fruit and vegetable (F&V) consumption and nutritional deficiencies among Brazilian schoolchildren. DESIGN: A cross-sectional, population-based study was performed. A short FFQ was used to assess consumption of fruits and vegetables (F&V) over the past month. The prevalence ratios (PR) and 95 % confidence intervals for stunting, obesity, anaemia, vitamin A and folate deficiencies, vitamin E and vitamin D insufficiencies were estimated for low F&V consumption frequency (vegetables ≤ 3 times/month and fruits ≤ 3 times/week) and compared with children with usual F&V consumption frequency (vegetables ≥ 1 time/week and fruits ≥ 4 times/week). SETTING: Acrelândia, Western Brazilian Amazon. SUBJECTS: A total of 702 children aged 4-10 years. RESULTS: Only 5 % of children consumed F&V ≥ 5 times/d. Prevalence of deficiency was 31 %, 15 %, 9 % and 2 % for vitamins D, A, E and folate, respectively. Overall, 6.3% of children were anaemic, 3.3% were stunted, 2.7% were obese and 33 % had multiple nutritional deficiencies. Low frequency of F&V consumption was associated with lower plasma concentrations of carotenoids and vitamin E. Nutritional deficiencies were higher among non-consumers of F&V when compared with usual consumers: anaemia (PR=1.9; 95 % CI 1.0, 3.7), vitamin E insufficiency (PR=2.5; 95% CI 1.5, 4.2), vitamin D insufficiency (PR=1.5; 95% CI 1.1, 1.9) and stunting (PR=2.6; 95% CI 1.1, 6.1). CONCLUSIONS: In our study, the occurrence of nutritional deficiencies in children with low F&V consumption was twice as high as in children with usual F&V consumption, reinforcing the importance of effective actions to promote the consumption of F&V.
Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Deficiências Nutricionais/etiologia , Dieta/efeitos adversos , Frutas , Política Nutricional , Cooperação do Paciente , Verduras , Anemia Ferropriva/sangue , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/etnologia , Anemia Ferropriva/etiologia , Brasil/epidemiologia , Criança , Fenômenos Fisiológicos da Nutrição Infantil/etnologia , Pré-Escolar , Estudos Transversais , Deficiências Nutricionais/sangue , Deficiências Nutricionais/epidemiologia , Deficiências Nutricionais/etnologia , Dieta/etnologia , Feminino , Humanos , Masculino , Cooperação do Paciente/etnologia , Prevalência , Fatores de Risco , Inquéritos e Questionários , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/etnologia , Deficiência de Vitamina D/etiologia , Deficiência de Vitamina E/sangue , Deficiência de Vitamina E/epidemiologia , Deficiência de Vitamina E/etnologia , Deficiência de Vitamina E/etiologiaRESUMO
OBJECTIVES: To determine prevalence and socio-demographic factors associated with ferritin deficiency in a representative sample of children in Colombia. MATERIALS AND METHODS: Cross sectional secondary data analysis of the National Survey on the Nutritional Situation (ENSIN) conducted in 2010 in Colombia in 3542 children between 12 and 59 months. Plasma ferritin levels were determined by chemiluminescence and values <12 ug/L were considered as deficit ferritin. Sociodemographic factors (sex, age, ethnicity, socioeconomic status, and geographical region) were collected using a structured questionnaire. All analyses were performed taking into account the complex nature of the sample. RESULTS: It was found that the average value of ferritin was 32.1 g/L, (CI 95%: 30.7-35.6).10.6% (CI 95%: 9.3-12.0) of the children had ferritin levels less than 12.0 ug/L. The multivariate logistic regression shows that children aged 12 to 23 (OR 5.1, CI 95%: 3.3-8.0) and 24 to 35 months (OR 2.4, CI 95%: 1.5-3.7), belonging to the indigenous ethnic group (OR 1.8, CI 95%: 1.1-2.8), living in the Atlantic region (OR 2.0, CI 95%: 1.1 -3.6), or Pacific area (OR 2.0, CI 95%: 1.1-3.6) were associated with a higher probability of ferritin deficiencies. CONCLUSIONS: A significant prevalence of anemia caused by ferritin deficiency was found as well as various sociodemographic factors that contributed to the likelihood of increasing this problem. Comprehensive interventions are recommended in which nutritional and educational components are involved.
Assuntos
Ferritinas/deficiência , Pré-Escolar , Colômbia/epidemiologia , Estudos Transversais , Deficiências Nutricionais/epidemiologia , Feminino , Humanos , Lactente , Masculino , PrevalênciaRESUMO
Objetivos. Determinar la prevalencia y los factores sociodemográficos asociados a la deficiencia de ferritina en una muestra representativa de niños de Colombia. Materiales y métodos. Análisis secundario transversal de la Encuesta Nacional de la Situación Nutricional (ENSIN) realizada en Colombia el año 2010 en 3542 infantes entre 12 y 59 meses de edad. Los niveles plasmáticos de ferritina se determinaron por quimioluminiscencia y se consideraron como déficit de ferritina los valores < 12 µg/L, los factores sociodemográficos (sexo, edad, etnia, nivel socioeconómico, región y área geográfica) se recogieron mediante una encuesta estructurada. Todos los análisis se realizaron teniendo en cuenta la naturaleza compleja de la muestra. Resultados. Se encontró que el valor promedio de ferritina fue de 32,1 µg/L, (IC 95%: 30,7-35,6). El 10,6% (IC 95%: 9,3-12,0) de los niños presentaron niveles de ferritina menores a 12,0 µg/L. La regresión logística multivariable muestra que los niños de 12 a 23 (OR 5,1; IC 95%: 3,3-8,0) y 24 a 35 meses de edad (OR 2,4; IC 95%: 1,5-3,7), pertenecer al grupo étnico indígena (OR 1,8; IC 95%: 1,1-2,8), residir en la zona atlántico (OR 2,0; IC 95%: 1,1-3,6), o zona pacifica (OR 2,0; IC 95%: 1,1-3,6) se asociaron a una mayor probabilidad de presentar deficiencias de ferritina. Conclusiones. Se encontró una importante prevalencia de anemia por deficiencia de ferritina y diversos factores sociodemográficos contribuyeron con la probabilidad de incrementar este problema. Se recomienda intervenciones integrales donde estén involucrados los componentes nutricional y educativo.
Objectives. To determine prevalence and socio-demographic factors associated with ferritin deficiency in a representative sample of children in Colombia. Materials and methods. Cross sectional secondary data analysis of the National Survey on the Nutritional Situation (ENSIN) conducted in 2010 in Colombia in 3542 children between 12 and 59 months. Plasma ferritin levels were determined by chemiluminescence and values <12 ug/L were considered as deficit ferritin. Sociodemographic factors (sex, age, ethnicity, socioeconomic status, and geographical region) were collected using a structured questionnaire. All analyses were performed taking into account the complex nature of the sample. Results. It was found that the average value of ferritin was 32.1 g/L, (CI 95%: 30.7-35.6).10.6% (CI 95%: 9.3-12.0) of the children had ferritin levels less than 12.0 ug/L. The multivariate logistic regression shows that children aged 12 to 23 (OR 5.1, CI 95%: 3.3-8.0) and 24 to 35 months (OR 2.4, CI 95%: 1.5-3.7), belonging to the indigenous ethnic group (OR 1.8, CI 95%: 1.1-2.8), living in the Atlantic region (OR 2.0, CI 95%: 1.1 -3.6), or Pacific area (OR 2.0, CI 95%: 1.1-3.6) were associated with a higher probability of ferritin deficiencies. Conclusions. A significant prevalence of anemia caused by ferritin deficiency was found as well as various sociodemographic factors that contributed to the likelihood of increasing this problem. Comprehensive interventions are recommended in which nutritional and educational components are involved.