ABSTRACT
Background: The negative effects of iron deficiency anemia (IDA) on cognition are well documented in previous studies; however, distinct mechanisms of these effects are still a matter of debate. Brain derived neurotrophic factor (BDNF) has an important role in brain functions specially memory and learning and was reported to be low in IDA in animal studies. Objective: This study was thus designed to estimate BDNF serum level in patients suffering from IDA and correlate its level to their cognitive function. Study Design: Cross sectional case-control study. Place and Duration of the Study: The Outpatient Clinic in the Children`s Hospital, Ain Shams University, between May, 2009 and March, 2010. Methods: The study was conducted on 27 child suffering from IDA (hemoglobin <11gm/dl and serum ferritin<12ng/ml) with a mean age of 7.96±3.06 years. Full history taking and thorough clinical examination were done. Complete blood count, serum ferritin and BDNF were measured. Cognitive assessment using Wechsler intelligence test was performed for enrolled children. Fifty healthy age and sex matched children were enrolled as controls. Results: Wechsler intelligence test showed significantly lower verbal, performance and total IQ values among IDA patients compared to controls. Total IQ score showed significant positive correlation with hemoglobin level and significant negative correlation with red cell width (RDW). Although BDNF level was not significantly lower in IDA patients, it showed a significant positive correlation with object assembly. Multiple regression analysis using total IQ as a dependent variable showed that RDW was the most determinant factor that affected IQ scores. Conclusion: Wechsler IQ test results were adversely affected in IDA patients. BDNF level was not significantly lower in IDA children but it showed a significant positive correlation with one of Wechsler IQ test items in such patients. Larger scale studies are recommended to further investigate BDNF as a possible mediator that disturb cognitive functions in IDA and explore other mediators.
ABSTRACT
Aims: The study was designed to assess the changes in knowledge, attitude and practice (KAP) of preschool teachers before and after 3 months of attending a nutrition education intervention program. Study Design: Place and duration of the study: Nine governmental and 13 private schools from 2 urban districts in Cairo, Egypt between September 2011 and March 2012. Methodology: We included 150 preschool teachers (149 female and 1 male) from 9 governmental and 13 private schools. The teachers filled a questionnaire regarding their KAP towards children nutrition. Re-evaluation was done using the same questionnaire 3 months after attending a nutrition education program. Results: Initially private school teachers had significantly higher nutrition knowledge and attitude than governmental teachers (P=.012 and <.001 respectively). This difference was eliminated post intervention regarding knowledge (P=.06) but private school teachers still had significantly higher attitude by then (P=.001). Although no significant difference was initially detected in practice (P=.53), that of private school teachers was significantly better post intervention (P=.007). Finally all enrolled teachers showed significant increase in KAP scores after attending the nutrition education sessions (P<.001 for all the KAPs). Conclusion: Nutrition KAPs are essential for preschool teachers and should thus be assessed and cyclically reinforced by educational programs.
ABSTRACT
Objective: To study the effect of heavy consumption of sugar sweetened beverages on serum 25-hydroxy vitamin D (25OHD) level and bone mineral density (BMD) in preadolescents. Study Design: Case-control. Place and Duration of Study: Outpatient clinic in Children`s hospital, Ain Shams University, between September, 2009 and July, 2010. Methods: A questionnaire to define the frequency of beverage consumption was filled by one thousand children within the age range of 8-12 years. Fifty children were selected from the heavy sugar sweetened beverages consumers and were compared to 50 clinically healthy age and sex matched children who gave no history of more than average sugar sweetened beverages intake. Each enrolled case filled a questionnaire that assesses duration of beverage intake, frequency and type as well as milk consumption. Questions concerning symptoms of pain, limitation of movement and fractures were also included. Anthropometric measurements were taken. Serum calcium and phosphorus were measured as well as the circulating 25OHD and dual-emission xray absorptiometry scan assessed their BMD Z-score. Results: Children who heavily consumed the sugar sweetened beverages had significantly lower 25 (OH) vitamin D, and BMD Z-score as compared to the controls (t= 4.05, P<0.001 and t= 3.73, P<0.001, respectively). There was significant negative correlations between duration of beverage intake and both BMD Z-score and 25OHD among heavy sugar sweetened beverage consumers(r=0.38, P=0.01 and r=0.4, P<0.001, respectively). A significant negative correlation was detected between duration of beverage intake and serum calcium among heavy sugar sweetened beverage consumers (r = -0.46 and P<0.001) and significant positive correlation between BMD Zscore and 25OHD among them (r = 0.69 and P<0.001). Conclusion: Sugar sweetened beverages intake is associated with a decrease in 25OHD which contributes to low bone mineralization in preadolescents and the duration of intake is the most determinant factor for this association. Consumption of carbonated beverages had more hazardous effect on 25OHD and BMD than packed fruit juice while milk intake showed an opposite effect. We recommend more awareness programs for preadolescents and their parents whether at school or as a part of national campaigns to boost healthy trends in beverage consumption.