Maternal micronutrient status as a risk factor for perinatal mortality in a Tanzanian randomized controlled trial

The objective of this study was to determine if maternal micronutrient status (specifically iron) during pregnancy is a risk factor for perinatal mortality among women in Tanzania. Secondary analysis of data from a randomized, double-blind, placebo-controlled vitamin A supplementation trial conducted between August 2010-March 2013 was used to assess iron intake among women who experienced a stillbirth or early neonatal death. The mean dietary iron intake (measured using a quantitative Food Frequency Questionnaire) for this population was 12.64 mg/day (SD = 6.32). There were 206 cases of perinatal mortality. Three classifications of dietary iron intake were devised and risk ratios were calculated using the Log Binomial Regression Model: <18 mg/day (RR: 2.13), 18-27 mg/day (RR: 2.63), & >27 mg/day (the reference group to which the first two classification groups were compared).There was neither a significant relationship found among women who consumed iron levels <18 mg/day or between 18-27 mg/day of iron compared to women who consumed more than 27 mg/day of iron, but on average there was twice the risk for perinatalmortality. The current study is consistent with previous literature findings and supports the need for more efficacious nutrition strategies. (Afr J Reprod Health 2022; 26[7]: 38-48).

Prevalence and factors associated with undernutrition among exclusively breastfeeding women in Arba Minch Zuria District, Southern Ethiopia: a cross-sectional community-based study

BACKGROUND: In developing countries, women are generally vulnerable to undernutrition especially during lactation because of inadequate nutrient intake. The purpose of this study was to assess the prevalence of underweight, associated factors and mean dietary intake of selected nutrients among lactating women in Arba Minch Zuriya districts, Gamo Gofa, Ethiopia. METHODS: Multistage cluster sampling technique was used to select 478 exclusively breastfeeding women. Data was collected by using structured questionnaire, and weight and height measurements. Mean intake of calories, calcium, iron, zinc and vitamin A was assessed by using 24-hour recall method on subsample of 73 subjects and compared against the Ethiopian and African food composition tables. Logistic regression analysis was used to evaluate the association between various independent variables and maternal underweight. RESULTS: The prevalence of underweight was 17.4%. Maternal underweight significantly associated with short birth to pregnancy interval, high workload burden, household food insecurity, less access to nutrition information and low level of women educational status. CONCLUSIONS: A significant proportion of women suffered from undernutrition and the mean intake of calories, calcium and zinc were below the recommended level for lactating women. Hence, to improve nutritional status of lactating women, strategies should focus on nutrition counseling, improvement in women's access to labour saving technologies and effective household food security interventions

Evolution des pratiques alimentaires au Maroc

Le Maroc connaît une transition alimentaire qui touche le milieu urbain et rural. L'urbanisation, le développement économique et la mondialisation sont à l'origine de modifications des habitudes alimentaires. Le régime alimentaire marocain, de type méditerranéen, est basé sur une large consommation de céréales et de fruits et légumes. L'alimentation se diversifie progressivement, surtout pour les ménages urbains et les classes plus aisées. Elle comprend davantage d'aliments riches en micronutriments, mais la consommation de produits d'origine animale reste très limitée alors que les ressources du pays, en poisson notamment, sont très importantes. Les aliments prêts à consommer et la restauration hors domicile deviennent plus courants en milieu urbain favorisant la consommation d'aliments riches en sucre et en graisse. Cette évolution témoigne de la transition nutritionnelle en cours en milieu rural aussi bien qu'urbain. Couplées à une réduction de l'activité physique, ces modifications sont à l'origine de la progression du surpoids et de l'obésité dans la population adulte

Overview on main nutrition-related diseases in three countries from North Africa

The aim of this review article is to give a holistic overview on the magnitude of nutrition-related diseases in the North African region and to outline major factors associated with the prevalence of these complications. A literature analysis was performed on PubMed and Google Scholar for data relating to nutrition-related diseases published between January 2007 and March 2017. The employed keywords were; "Algeria AND Morocco AND Tunisia AND Nutrition-Related diseases". We focused firstly on the nutrition-related diseases associated to inadequate intake of nutrients and unhealthy dietary habits such as low birth weight, anaemia and micronutrient deficiencies, thereafter, diseases associated with changes in lifestyle such as obesity, diabetes and cardiovascular disease are highlighted. Factors contributing to nutritional problems vary from country to another. Low socioeconomic status, low educational levels, unhealthy eating habits, poverty and ignorance are mainly responsible for both under and over nutrition problems. Despite their alarming rates, national strategies to combat these nutritional diseases do not exist or are ineffective in North African countries. Efforts are focused on therapeutic actions, however, the scarcity or the complete lack of preventive health care services, epidemiological surveys, nutritional surveillance and lack of nutritional assessment need to be considered. Continuous and accurate analyses of the evolving situation will allow setting up a good tools, strategies and health intervention programs in North African countries. ​

Food fortification knowledge in women of child-bearing age at Nkowankowa township in Mopani District, Limpopo Province, South Africa

Background: Globally, there is evidence that three micronutrients deficiencies are of public health concern among children. They are vitamin A; iodine and iron deficiencies. Communities particularly affected are those in situations where poverty, unemployment, civil unrest, war and exploitation remain endemic. Malnutrition is an impediment to productivity; economic growth and poverty eradication. It is estimated that 32% of the global burden would be removed by eliminating malnutrition; including micronutrients deficiencies. Setting: The study was carried out in NkowaNkowa township of Mopani District, Limpopo Province, South Africa.Aim: The main objective was to determine the women's knowledge on food fortification. Methods: The study design was descriptive. The snowballing method was used to identify women of child-bearing age. Data were collected from 120 participants using a questionnaire. The questionnaire consisted of socio-demographic; general questions on women's knowledge on food fortification. The questionnaire was administered by the researcher using the local language Xitsonga. Results: The findings of the study revealed that a majority of 204 (57.0%) of the participants were able to define food fortification correctly while 257 (72.0%) of the participants knew which foods are fortified as well as the benefits of a food fortification programme. The majority (252 [70.0%]) of the participants knew that maize meal is one of the food vehicle used for fortification in South Africa. Conclusion: Most of the questions were answered correctly by more than 50.0% of the participants. The researcher deduced that the study participants are knowledgeable about food fortification based on the response given in relation to the programme

Plasma Micronutrients (magnesium, zinc, selenium) Status and Lipid Profile in Type II Diabetes Mellitus Patients in Sagamu, Southwestern Nigeria

Background: Diabetes mellitus (DM) is a group of metabolic disorders characterised by hyperglycemia with secondary derangements in micronutrient status. Various studies had given conflicting reports of increased or decreased levels of micronutrients in Type II DM.Objective: To measure the plasma micronutrient levels and lipid profile in adults with Type II DM.Method: Plasma magnesium, zinc and selenium levels were measured among 100 subjects comprising 50 people with DM (age range 36-70 years) and 50 control subjects without DM (age range 29-70 years). The anthropometric parameters were measured; fasting blood glucose, plasma cholesterol, triglycerides, and high-density lipoprotein cholesterol, micronutrients (magnesium, zinc and selenium) levels were also measured using standard methods.Result: There were statistically significant (p < 0.05) higher plasma glucose, blood pressure (systolic and diastolic), LDLC, and lower levels of plasma magnesium, zinc, selenium, HDLC levels among the patients with DM (cases) compared with the normal control subjects. No significant difference was observed in the plasma total cholesterol and triglyceride between the two groups. A significant negative correlation was found between the plasma levels of the trace metals (magnesium, zinc and selenium) and triglycerides (r = - 0.36, r = - 0.43, r = - 0.51 respectively).Conclusion: Plasma levels of magnesium, zinc and selenium are reduced in Type II DM with associated hyperglycaemia-driven dyslipidaemia

Low Levels of some Nutritional Parameters of Pregnant Women in a Rural Community of South East Nigeria: Implications for the Attainment of the Millennium Developmental Goal

In developing countries; under nutrition is common; and this plays a crucial role in the pathogenesis of malaria and anemia. Indeed it has been associated with adverse pregnancy outcomes. Unfortunately; published evidence concerning the situation is lacking. Objectives: To evaluate some nutritional function indices of pregnant women in a rural Nigerian community. Subjects and Methods: This is a cross sectional study involving of 171 pregnant women from a rural area in South-eastern Nigeria. They included 72 and 99 women in their second and third trimesters respectively. The control group was of 60 women; matched in age; parity and socioeconomic conditions; non-pregnant; non-menstruating and non lactating apparently healthy women. The parameters measured by standard methods included serum iron; total proteins; albumin; globulin; packed cell volume and hemoglobin. Results: The results obtained from control group; second and third trimesters; recorded as Mean (SEM) were 134.60(3.12) ?g/L; 101.20(4.48) ?g/L and 91.87(3.42) ?g/L respectively for iron; 69.12(0.80) g/L; 63.60(0.71) g/L and 57.74(0.75) g/L for total proteins; 42.95(0.92) g/L; 35.74(1.00) g/L and 35.26(0.64) g/L for albumin; 26.77(1.00) g/L; 27.78(1.07) g/L and 22.93(0.88) g/L for globulin; 32.80(0.36); 27.92(0.37) and 27.73(0.34) for packed cell volume; and 11.25(0.11) g/L; 9.59(0.13) g/L and 9.57(0.14) g/L for hemoglobin respectively. These results showed that all the parameters decreased significantly in pregnancy (P0.001) except globulin that did not show immediate; significant decrease. Conclusion: There is a general decrease in the nutrition parameters studied among the pregnant women from our study area; indicating under-nutrition. Urgent measures should be taken to improve the nutritional status of rural dwellers especially the antioxidant micronutrients

Nutrition Education to Improve Dietary Intake and Micronutrient Nutriture among Children in Less-Resourced Areas: A Randomised Controlled Intervention in Kabarole District; Western Uganda

Objective: To determine whether nutrition education targeting the child-feeding practices of low-income rural caregivers will reduce anaemia and improve vitamin A nutriture of the young children in their care.Design: A controlled intervention trial; based on experiential learning theory. Forty-six women completed a nine-session nutrition education programme; while controls (n = 43) concurrently engaged in sewing classes. Setting: Two rural farming communities in the Kabarole district; western Uganda. Subjects: Less literate; low-income rural female caregivers and the children in their care (6-48 months). Outcome measures: Caregivers' child-feeding practices and the children's nutritional status were assessed at baseline; one month after intervention (Follow-up 1) and one year from baseline (Follow-up 2). Results: Caregivers in the intervention group reported improved child snacking patterns; food-selection practices; meal adequacy; and food variety. Children in the intervention group recorded lower haemoglobin levels at baseline (9.86 vs. 10.70 g/dl) and caught up with controls at Follow-up 1 (10.06 vs. 10.78 g/dl). However; changes were not sustained. Mean retinol-binding protein improved from 0.68 ?mol/l (95CI: 0.57-0.78) to 0.91 ?mol/l (95CI: 0.78-1.03) among intervention children; but remained approximately the same in controls. Vitamin A nutriture was influenced by infections. Conclusion: Nutrition education significantly improved feeding practices and children's nutritional status. The effectiveness and sustainability of this programme can be enhanced if nutrition education is integrated into other food-production and public health programmes

Nutrition Education to Improve Dietary Intake and Micronutrient Nutriture among Children in Less-Resourced Areas: A Randomised Controlled Intervention in Kabarole District; Western Uganda

Objective:To determine whether nutrition education targeting the child-feeding practices of low-income rural caregivers will reduce anaemia and improve vitamin A nutriture of the young children in their care.Design: A controlled intervention trial; based on experiential learning theory. Forty-six women completed a nine-session nutrition education programme; while controls (n = 43) concurrently engaged in sewing classes. Setting: Two rural farming communities in the Kabarole district; western Uganda. Subjects: Less literate; low-income rural female caregivers and the children in their care (6-48 months). Outcome measures: Caregivers' child-feeding practices and the children's nutritional status were assessed at baseline; one month after intervention (Follow-up 1) and one year from baseline (Follow-up 2). Results: Caregivers in the intervention group reported improved child snacking patterns; food-selection practices; meal adequacy; and food variety. Children in the intervention group recorded lower haemoglobin levels at baseline (9.86 vs. 10.70 g/dl) and caught up with controls at Follow-up 1 (10.06 vs. 10.78 g/dl). However; changes were not sustained. Mean retinol-binding protein improved from 0.68 ?mol/l (95CI: 0.57-0.78) to 0.91 ?mol/l (95CI: 0.78-1.03) among intervention children; but remained approximately the same in controls. Vitamin A nutriture was influenced by infections. Conclusion: Nutrition education significantly improved feeding practices and children's nutritional status. The effectiveness and sustainability of this programme can be enhanced if nutrition education is integrated into other food-production and public health programmes

Trace mineral status and glycaemic control in Nigerians with type 2 diabetes

Diabetes has been shown to be associated with abnormalities in the metabolism of micronutrients, especially chromium, zinc, copper, magnesium, and manganese. People with type 2 diabetes attending the Diabetes Clinic of the University of Benin Teaching Hospital, were recruited to examine the relationship between trace mineral status and glycaemic control. A total of 120 persons were studied, mean (±SD) age was 54±7 years and mean duration of diabetes 4±4 years. Serum chromium level correlated inversely with fasting blood glucose (FBG) and HbA1c, unlike the serum concentration of zinc which had no significant correlation with either FBG or HbA1c. People with diabetes should be encouraged to eat local specific foods rich in chromium

Effects of maternal micronutrient supplementation on fetal loss and under-2-years child mortality: long-term follow-up of a randomised controlled trial from Guinea-Bissau

A number of trials on maternal multi-micronutrient supplementation (MMS) have found a benefical effect on birth weight, but few have demonstrated a beneficial effect on infant survival. We examined the effect of two different preparations of antenatal MMS on fetal loss and under-2-years child mortality, as compared with iron-folic acid supplementation among 2,100 pregnant women in Guinea-Bissau. Women receiving a 1xRDA MMS preparation (consisting of 14 vitamins and minerals) had a marginally reduced risk of fetal loss (Relative risk (RR) 0.65, 95% CI 0.40; 1.05), and women receiving a 2xRDA MMS preparation had a similar effect (RR 0.67, 95% CI 0.42; 1.08), the pooled effect being 0.66 (95% CI 0.44; 0.99). None of the supplements reduced under-2-years mortality or the combination of fetal loss and under-2-years mortality. There was a marginally negative effect of both the 1xRDA (RR 2.10, 95% CI 0.99; 4.46) and the 2xRDA (RR 2.02, 95% CI 0.95; 4.32) MMS preparation on mortality specifically between 92­365 days of age. (Afr. J. Reprod. Health 2010; 14[2]:17-26)

Nutrition and Oral Health

There is an interdependent relationship between nutrition and health of oral tissues. The well-being of the oral tissues; the quantity and quality of saliva and the dimension of taste depend on the intake of nutrients. Oral health determines the type of food consumed and ultimately the nutritional level. A review of literature was to outline this interdependent relationship

Micronutrient Intake of HIV-Infected Women in Mangaung; Free State

Background. Poor nutritional status in HIV/AIDS patients can affect immune function profoundly; leading to faster disease progression and earlier death.Objective. To determine the micronutrient intake of HIV-infected women in Mangaung.Design and setting. A cross-sectional study was undertaken in Mangaung; Bloemfontein; Free State.Subjects and methods. A representative group of 500 pre-menopausal women (25 - 44 years) was randomlyselected to participate in the study. Micronutrient intake was determined using a Quantitative Food FrequencyQuestionnaire (QFFQ). Median micronutrient intakes were compared with the Recommended Dietary Allowance(RDA) or Adequate Intake (AI) values. The prevalence of women with intakes 67of the RDA or AI was calculated. Median micronutrient intakes were compared between HIV-infected and uninfected women using non-parametric 95confidence intervals (CIs) and the Mann-Whitney test.Results. Sixty-one per cent of women in the younger age group (25 - 34 years) and 38of older women (35 - 44 years) were HIV-infected. Between 46.6and 70.7of all women consumed 67of the RDA or AI for calcium;total iron; selenium; folate and vitamin C. At least 25of HIV-infected women did not meet either the RDA or the AI for vitamins A; D and E. Younger HIV-infected women had significantly higher intakes of calcium (p = 0.046);phosphorus (p = 0.04); potassium (p = 0.04); vitamin B12 (p = 0.01); vitamin D (p = 0.03) and vitamin E (p = 0.04)than their HIV-uninfected counterparts. Older HIV-infected women had significantly lower intakes of haem iron (p = 0.03); non-haem iron (p = 0.04) and selenium (p = 0.04) than their HIV-uninfected counterparts.Conclusions. Insufficient micronutrient intakes are common in both HIV-infected and uninfected women. A well-balanced diet and micronutrient supplementation seem warranted to ensure optimal health and survival; particularly in HIV-infected women

Estrategia nacional na area de micronutrientes

A estrategia sobre Micronutrientes desenhada para Mocambique teve em conta a realidade nacional; tendo como base as seguintes suposicoes: que o principal problama no pais e a desnutricao energetico proteico; que as deficiencias em micronutrientes no pais raramente aparecem isoladas; em geral estao intimamente associadas a problemas de desnutricao energetico proteico. Em populacoes onde as percetagens de carencias em micronutrientes sao elevadas estao geralmente associadas a problemas de desnutricao energetico proteico; doencas infecciosas e parasitarias provavelmente vivem em situacoes de inseguranca alimentar. As deficiencias devidas aos micronutrientes constituem um grande problema de saude publica no pais; reflectindo-se na situacao social e economica da populacao. Para o sucesso na implementacao da estrategia a nivel do pais; necessitar-se-a de envolver as diferentes instituicoes e organizacoes que representam e trabalham nas areas de Seguranca Alimentar e Nutricao. Concretamente se podera dizer que para alem do Ministerio da Saude dever-se-a incluir o Ministerio da Agricultura e Pescas; Ministerio do Comercio Industria e Turismo; Ministerio de Plano e Financas; Ministerio de Educacao; Organizacoes Internacionais e nao Governamentais; Representantes do Sector privado; todos deverao ser vistos como parceiros na implementacao de estrategia sendo crucial a coordenacao das actividades. Neste contexto a estrategia de micronutrientes e um componente integrante da Estrategia Nacional de Seguranca Alimentar e Nutricao tendo tambem sido integrada no Plano de Accao Inter-sectorial de Alimentacao e Nutricao