bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Iron-Fortified Ultra Rice in Improving the Iron Status of Women in Mexico
Authors: Hotz Christine , Porcayo Maribel , Onofre Germán , García-Guerra Armando , Elliott Terry , Jankowski Shirley , Greiner Ted 
Published: November 2015

Background Universal fortification of staple foods with iron has been widely promoted as a cost-effective strategy to reduce iron deficiency in developing-country populations. Nonetheless, relatively few efficacy trials have been reported to date to demonstrate impact on iron status. The Ultra Rice technology provides a means of delivering fortificant iron via rice. Objective The objective of this study was to test the efficacy of rice fortified with microencapsulated, micronized iron pyrophosphate to improve the iron status of women in Mexico in a randomized, controlled intervention trial. Methods Nonpregnant, nonlactating women 18 to 49 years of age were recruited from six factories. The women received a daily portion of cooked rice 5 days per week for a period of 6 months, before and after which iron status indicators were determined in venous blood samples. Results The average intake of iron from the fortificant was 13 mg/day. Mean plasma ferritin concentration and estimated body iron stores were significantly higher, and transferrin receptors were lower, in the iron-fortified rice group following the intervention. Mean hemoglobin concentration also increased in the treatment group, but the increase was significant only when the analysis was restricted to those with baseline hemoglobin < 12.8 g/dL. The absolute reduction in anemia and iron deficiency was 10.3 and 15.1 percentage points, respectively. Total iron intake from fortificant was a significant covariate of change in body iron stores. The overall prevalence of anemia was reduced by 80%. Conclusions Fortification of rice with iron using this technology is an efficacious strategy for preventing iron deficiency.
Discussion: Effects of Folate and Vitamin B12 Deficiencies During Pregnancy on Fetal, Infant, and Child Development
Authors: Villalpando Salvador 
Published: November 2015

The essentiality of folate and vitamin B12 for the synthesis of DNA may interfere with a successful pregnancy outcome when the mother is deficient in these micronutrients. The objective of this paper is to assess the effects of folate and vitamin B12 deficiencies on pregnancy outcomes, other than neural tube defects (NTD), and the effects of these deficiencies on infant and child development. Supplementation studies identified by two Cochran Reviews were selected to assess the impact of folate deficiency on pregnancy outcomes, and a systematic review of the literature was used to assess their effects on infant and child developments. Folate supplementation consistently resulted in improvement of hematological and folate status indicators. Seven supplemental studies consistently found no differences in the risk of total fetal loss, early or late miscarriage, stillbirth, preeclampsia, perinatal death, neonatal death, preterm birth, small-for-gestational age, or infant death in supplemented women compared with their controls. Two of those studies found greater placental weights (difference 96 g; 95% CI, 30.7 to 161.2 g), birthweights (difference 312 g; 95% CI, 108.5 to 515.4 g), and a lower risk for newborns weighing < 2,500 g in supplemented women (RR = 0.94; 95% CI, 0.90 to 0.99). Abnormal vitamin B12 and homocysteine serum concentrations were more readily associated with poor pregnancy outcomes. The very few studies addressing the effects of folate and vitamin B12 deficiencies on infant and child development were inconclusive. Early supplementation with folate to pregnant women improves hematological and folate status indicators, but has little or no effect on pregnancy outcomes, other than on NTD. Vitamin B12 deficiencies and low homocysteine are more readily associated with poor pregnancy outcomes.
Decreasing Stunting, Anemia, and Vitamin A Deficiency in Peru: Results of the Good Start in Life Program
Authors: Lechtig Aarón , Cornale Guido , Ugaz María Elena , Arias Lena 
Published: November 2015

Background The rates of stunting, iron-deficiency anemia, and vitamin A deficiency in Peru are among the highest in South America. There is little scaled-up experience on how to solve these problems countrywide. Objective To evaluate the Good Start in Life Program during the period from 2000 to 2004. Methods Data on weight, height, hemoglobin, serum retinol, urinary iodine, and age were obtained from children under 3 years of age during two transverse surveys in 2000 and 2004. Results In 2004, the program covered 75,000 children, 35,000 mothers, and 1 million inhabitants from 223 poor communities. The rate of stunting decreased from 54.1% to 36.9%, the rate of iron-deficiency anemia decreased from 76.0% to 52.3%, and the rate of vitamin A deficiency decreased from 30.4% to 5.3% ( p < .01). The annual cost per child was US$116.50. Conclusions Adaptations of this participative program could contribute to decreased stunting, iron-deficiency anemia, and vitamin A deficiency at the national scale in Peru and many other countries.
Undernutrition in the Kora Mudi Tribal Population, West Bengal, India: A Comparison of Body Mass Index and Mid-Upper-Arm Circumference
Authors: Bisai Samiran , Bose Kaushik 
Published: November 2015

Background Undernutrition among adult tribal women is a major health problem in India. Objectives To compare the utility of two different anthropometric indicators of chronic energy deficiency (CED) among tribal Kora Mudi women and to determine which of these two is a better indicator of undernutrition. Methods A cross-sectional study of 123 individuals was conducted. The body mass index (BMI) and mid-upper-arm circumference (MUAC) were used to evaluate CED. Results The prevalence of CED based on BMI less than 18.5 was 55.3%, and the prevalence of CED based on MUAC less than 22.0 cm was 51.2%. Both of these prevalence rates are classified in the very high-prevalence category (≥ 40%) and indicate a critical situation according to World Health Organization recommendations. Mean BMI increased significantly with higher quartile of MUAC. There was a significant difference in the prevalence of CED between the MUAC quartiles. The risk ratio for CED for women in the lowest quartile of MUAC was 9.33 compared with those in the highest quartile. There was a significant positive association between MUAC and BMI. Regression analysis demonstrated that MUAC had a significant positive impact on BMI; the percentage of the variation in BMI explained by MUAC was 52%. Logistic regression analysis demonstrated that overall, 82.11% of cases of CED were correctly classified with the use of MUAC. The use of MUAC correctly diagnosed 82.35% of cases of CED and 81.82% of women with normal nutritional status. Conclusions This population was facing severe nutritional stress. With limited resources and in the absence of skilled manpower, it may be more appropriate to use MUAC for human population surveys, particularly among tribal populations of developing countries.
Are Vitamin A and Iron Deficiencies Re-Emerging in Urban Latin America? A Survey of Schoolchildren in Bogota, Colombia
Authors: Maslova Ekaterina , Mora-Plazas Mercedes , Forero Yibby , López-Arana Sandra , Baylin Ana , Villamor Eduardo 
Published: November 2015

Background In Latin America, the burden of vitamin A and iron deficiencies has been documented primarily in preschool-age children. There are few recent reports on the vitamin A and iron status of school-age children. Objective We aimed to determine the prevalence and predictors of vitamin A and iron deficiencies in Colombian schoolchildren. Methods We examined plasma retinol and ferritin concentrations in relation to socioeconomic and anthropometric factors in a representative sample of 2,811 low- and middle-income children 5 to 12 years of age in Bogotá, Colombia. Results The prevalence rates of deficiencies of vitamin A (plasma retinol < 0.70 μmol/L) and iron (plasma ferritin < 15 μg/L) were 14% and 3%, respectively. In multivariate analysis, plasma retinol concentrations were positively associated with child's age and household's socioeconomic stratum, whereas ferritin concentrations were positively related to child's age, number of home assets, and having a nonsingle mother. Ferritin concentrations were much lower among girls than boys in the 11- and 12-year-old age group, whereas there were only small positive differences between girls and boys in younger children (p for interaction < .0001) . Both vitamin A and iron deficiencies were independently associated with lower z-scores for body-mass-index-for-age, after adjustment for sociodemographic factors and C-reactive protein concentrations. Neither vitamin A nor iron status was related to height-for-age. Conclusions The prevalence rates of vitamin A and iron deficiencies among schoolchildren from Bogotá, Colombia, are not negligible. Both vitamin A and iron status are positively associated with socioeconomic status and anthropometric indices. The effect of improving vitamin A and iron status on physical growth and other functional outcomes needs to be further examined in this age group.
Relationship of Household Food Insecurity to Neonatal, Infant, and Under-Five Child Mortality among Families in Rural Indonesia
Authors: Campbell Ashley A. , de Pee Saskia , Sun Kai , Kraemer Klaus , Thorne-Lyman Andrew , Moench-Pfanner Regina , Sari Mayang , Akhter Nasima , Bloem Martin W. , Semba Richard D. 
Published: November 2015

Background Food insecurity is common in developing countries and is related to the physical well-being of families. Household food insecurity is intended to reflect a household's access, availability, and utilization of food, but its relationship with child mortality has not been well characterized. Objective To examine the relationship of a modified household food insecurity score with a history of neonatal, infant, and under-five child mortality. Methods In a cross-sectional study of 26,339 rural households in the Indonesian Nutrition Surveillance System, 2000–03, household food insecurity was measured with the use of a modified nine-item food security questionnaire. A simple food insecurity score of 0 to 9 was calculated based on responses and related to mortality history in the family. Results The proportion of households with neonatal, infant, and under-five child mortality was 4.6%, 8.8%, and 10.6%, respectively. In households with and without neonatal, infant, and under-five child mortality, the mean (± SD) food insecurity scores were 2.19 ± 1.89 vs. 1.72 ± 1.65, 2.29 ± 1.94 vs. 1.69 ± 1.63, and 2.29 ± 1.93 vs. 1.68 ± 1.62 (all p < .0001), respectively. The food insecurity score was related to mortality among neonates (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02 to 1.09; p = .003), infants (OR, 1.06; 95% CI, 1.03 to 1.09; p < .0001), and children under five (OR, 1.07; 95% CI, 1.04 to 1.10; p < .0001) after adjustment for potential confounders. Conclusions Higher household food insecurity score is associated with greater neonatal, infant, and under-five child mortality among rural families in Indonesia. Greater household food insecurity may signify a higher risk of infant and young child mortality.
Iodine Stability and Sensory Quality of Fermented Fish and Fish Sauce Produced with the Use of Iodated Salt
Authors: Chanthilath Boualapha , Chavasit Visith , Chareonkiatkul Somsri , Judprasong Kunchit 
Published: November 2015

Background Universal salt iodization promotes the use of iodated salt for producing industrial food products, although it might affect product quality and iodine stability. Objective To assess iodine loss during fermentation of fermented fish and fish sauces produced by using iodated salt and the effect on product sensory quality. Methods Fermented fish and fish sauces were produced with iodated rock and grain sea salts (approximately 30 ppm iodine). Fermented fish was prepared from freshwater fish mixed with salt and rice bran and fermented for 6 months at room temperature. Fish sauces were prepared by mixing anchovy with salt and fermenting either exposed to sunlight or in the shade for 12 months. Residual iodine was determined with a spectrophotometer at day 0 and months 1, 3, and 6 for fermented fish and day 0 and months 3, 6, and 12 for fish sauces. After fermentation, the products were tested for sensory acceptability by Laotian and Thai panelists (approximately 50 in each panel) after they were cooked and served in the traditional manner. Results After fermentation, the level of residual iodine was 7.61 ppm (16% loss) in fermented fish, 5.57 ppm (55% loss) in fish sauce prepared with exposure to sunlight, and 9.52 ppm (13% loss) in fish sauce prepared in the shade. Sensory qualities of the products that were produced from fortified and unfortified salts as well as dishes prepared from these products were not significantly different (p > 0.05). Conclusions It is feasible to produce fermented fish and fish sauces with iodated salt and maintain acceptable iodine levels.
Efficacy of Fortification of School Meals with Ferrous Glycine Phosphate and Riboflavin against Anemia and Angular Stomatitis in Schoolchildren
Authors: Vinodkumar Malavika , Rajagopalan Srinivasa 
Published: November 2015

Objective Multiple micronutrient deficiencies exist in many developing countries. We conducted a study to test the efficacy of ferrous glycine phosphate in reducing anemia and of riboflavin in reducing angular stomatitis when these micronutrients were added to the noon meal for schoolchildren. Methods A pre- and post-test design was used to study children 5 to 9 years of age, with an experimental and a control group. Two schools in the same locality in Chennai were chosen for the study. The experimental school had 65 children and the control school had 71 children, all of whom consumed a noon meal at the school daily. The children in the experimental school received a powder containing ferrous glycine phosphate and riboflavin, which was added to the meal during cooking every day for 6 months. The dosage was 28 mg of elemental iron and 1 mg of riboflavin per child per day. The children attended school for 5 days each week from Monday to Friday, except for holidays; they received the fortificants on 100 days during the 6-month period. There was no intervention in the control school. Children in the experimental and control groups were matched by socioeconomic status, age, and eating habits at baseline. All the children in the experimental and control schools were dewormed at baseline and at endline after 6 months. Hemoglobin was measured by the cynamethemoglobin method at baseline and endline. Results Binary logistic regression showed a significant (p < .001) time x group interaction for anemia. The prevalence of anemia in the experimental school was 69.0% at baseline and 32.8% after 100 days of intervention over 6 months, a statistically significant change ( p < .001). The prevalence of anemia in the control school was 91.5% at baseline and increased to 97.2% at endline; the increase was not statistically significant. The prevalence of angular stomatitis was reduced from 21% at baseline to 0% at endline in the experimental school, whereas it was 23% at baseline and 20% at endline in the control school. Conclusions The added fortificants reduced the prevalence of the micronutrient deficiencies.
Nutritional Quality of Diets fed to Young Children in Urban Slums can be Improved by Intensive Nutrition Education
Authors: Palwala Misba , Sharma Shweta , Udipi Shobha A. , Ghugre Padmini S. , Kothari Gopa , Sawardekar Pradeep 
Published: November 2015

Background Almost half of India's children under 3 years of age are undernourished and at risk for illness and death. Poor complementary feeding practices contribute substantially to the problem. Promoting appropriate feeding practices is critical for ensuring child survival, health, and nutrition. Nutrition education is a feasible intervention and has the potential to help achieve the Millennium Goals, provided it is implemented appropriately. However, in existing programs, education is too generalized and based on information transfer. Objective To develop and implement a need-based, situation-specific education program for mothers to bring about changes in complementary feeding practices, with emphasis on the quantity and nutritional quality of complementary feeds. Methods Four hundred fourteen mothers or caregivers from five slums in Mumbai participated in a 3-month intervention study. Gaps in complementary feeding practices were identified at baseline. Education was given by trained fieldworkers, first to groups of 8 to 10 mothers or caregivers using innovative modules and demonstrations, followed by weekly monitoring and reinforcement. A simple checklist was used at each follow-up to assess impact, identify practices not adopted, and provide further inputs. Data collected at three follow-ups were compared with baseline and analyzed by SPSS using the chi-square test, the t-test, and ANOVA to assess whether feeding practices of the mothers or caregivers were altered favorably. Conclusions The intervention process used in this study, the modules used, and the use of the checklist as complementary feeding practices. Incorporation of these in existing Growth Monitoring and Promotion programs would help to improve child nutrient intakes and thus reduce the prevalence of undernutrition.
Effects of Maternal Zinc Supplementation on Pregnancy and Lactation Outcomes
Authors: Hess Sonja Y. , King Janet C. 
Published: November 2015

Observational studies in human populations suggest that maternal zinc deficiency during pregnancy may cause adverse pregnancy outcomes for the mother and fetus. Therefore, we reviewed the current evidence from studies of zinc supplementation, with or without other micronutrients, during pregnancy and lactation to assess its impact on maternal, fetal, and infant health. A meta-analysis of supplementation trials indicates a 14% reduction in premature delivery among zinc-supplemented women. Most studies found no significant impact of maternal zinc supplementation on infant birthweight, but a subset of studies conducted in underweight or zinc-deficient women suggests that there may be a positive effect of zinc supplementation in such women. However, the number of relevant studies is limited, and more information is needed to confirm these observations. The results for other pregnancy outcomes are inconsistent, and the number of available studies is small. Likewise, the impact of maternal zinc supplementation during pregnancy on infant postnatal growth and risk of infection is variable, and few studies are available. Thus, more research will be needed to allow definitive conclusions to be drawn, especially for the second half of infancy and later childhood. Studies found no adverse effects of maternal zinc supplementation on iron status during pregnancy. More information is required on other potential adverse effects, particularly with regard to a possible modifying effect of preexisting maternal zinc status. In view of the possible benefits of zinc supplementation for reducing the risk of premature delivery, the possible positive impact of zinc supplementation on infant birthweight among undernourished women, and the lack of reported adverse effects, zinc should be included in maternal supplements given during pregnancy in populations at risk for zinc deficiency.
Adherence and Costs of Micronutrient Supplementation in Pregnancy in a Double-Blind, Randomized, Controlled Trial in Rural Western China
Authors: Zeng Lingxia , Yan Hong , Cheng Yue , Dang Shaonong , Dibley Michael J. 
Published: November 2015

Background Efforts to determine the impact of prenatal multivitamin supplementation on birth outcome have been carried out in several developing countries. A review of factors that would impact the effectiveness of prenatal supplementation under normal field conditions is currently lacking and will be required for expanded supplementation programs. An efficacy trial of a multiple micronutrient supplement for pregnant women was conducted in rural western China, and additional information on side effects, rates of adherence, program inputs, and cost was also gathered. Objectives To examine reports of side effects and rates of adherence to prenatal multiple micronutrient supplementation in comparison with supplementation with folic acid and with iron–folic acid, and to describe inputs and costs associated with prenatal supplementation in China. Methods A cluster-randomized, double-blind, controlled trial was conducted in two rural counties in northwest China. All pregnant women in villages were randomly assigned to take daily supplements of folic acid, iron–folic acid, or a recommended daily allowance of 15 vitamins and minerals from enrollment until delivery. Information was collected from the women on side effects and adherence. Program inputs and costs of supplementation were tracked. Descriptive statistics were used for the analysis. The biological effectiveness of prenatal multiple micronutrient supplements is reported elsewhere. Results Less than 4% of women withdrew from the study because of side effects. Adherence to supplementation was high: the supplements were consumed on more than 90% of the days on which they were available for consumption. The mean number of supplements consumed was high at 165 capsules, and about 40% consumed the recommended 180 supplements during pregnancy. Conclusions High adherence to a prenatal supplement schedule can be achieved when mothers have frequent contact with trained health workers and a reliable supply of supplements.
Impact of Multiple Micronutrient versus Iron–Folic Acid Supplements on Maternal Anemia and Micronutrient Status in Pregnancy
Authors: Allen Lindsay H. , Peerson Janet M. 
Published: November 2015

Background Multiple micronutrient supplements could increase hemoglobin and improve micronutrient status of pregnant women more than iron supplements alone or iron with folic acid. Objective To compare the effects of multiple micronutrients with those of iron supplements alone or iron with folic acid, on hemoglobin and micronutrient status of pregnant women. Methods Studies were identified in which pregnant women were randomized to treatment with multiple micronutrients, or with iron with or without folic acid. A pooled analysis was conducted to compare the effects of these supplements on maternal hemoglobin, anemia, and micronutrient status. Effect size was calculated for individual and combined studies, based on mean change from baseline to final measure in the group receiving iron, with or without folic acid, minus the mean change in the group, divided by the pooled standard deviation of the two groups. The effect on the relative risk of anemia or iron deficiency was calculated as the probability of anemia or iron deficiency in the group receiving multiple micronutrients divided by the probability in the group receiving iron, with or without folic acid. Results Multiple micronutrient supplements had the same impact on hemoglobin and iron status indicators as iron with or without folic acid. There was no overall effect on serum retinol or zinc. In the only study in which status of other micronutrients was analyzed, a high prevalence of multiple deficiencies persisted in the group receiving multiple micronutrients provided with daily recommended intakes of each nutrient. Conclusions Multiple micronutrient supplements increased hemoglobin synthesis to the same extent as supplementation with iron with or without folic acid, although often they contained lower amounts of iron. The amount of supplemental iron and other nutrients that can enable pregnant women with micronutrient deficiencies to achieve adequate status remains to be determined.