Prevalence of iodine deficiency disorders among school children in Saudi Arabia: results of a national iodine nutrition study

This study aimed at establishing updated data on iodine nutrition among schoolchildren in Saudi Arabia. A cross-sectional cluster survey among schoolchildren aged 8-10 years was conducted during February-April 2012. Children were clinically examined for goitre, urine and household salt samples were collected to estimate urinary iodine concenteration [UIC] and iodine content in salt. The overall goitre prevalence at the national level among 4 016 children was 4.2%. The prevalence was < 5% in all regions of the country except southern region with a prevalence of 12.7%. The median UIC of 2224 samples was 133 microg/L, with 74.3% of the surveyed children with UIC>/=100 microg/L. Analysis of salt samples [n = 4242] revealed that 69.8% of households were consuming adequately iodized salt. The findings suggest iodine sufficiency at the national level, however southern region still has a goitre prevalence of mild degree severity and the proportion of households consuming adequately iodized salt is still below recommendations

Eficacia del hierro aminoquelado en comparación con el sulfato ferroso como fortificante de un complemento alimentario en preescolares con deficiencia de hierro, Medellín, 2011 / Effectiveness of iron amino acid chelate versus ferrous sulfate as part of a food complement in preschool children with iron deficiency, Medellín, 2011

Introducción. La disminución de los depósitos de hierro constituye el primer eslabón de la cadena conducente a la deficiencia de hierro, la carencia nutricional más prevalente y principal causa de anemia en todo el mundo, situación que puede prevenirse mediante la fortificación de alimentos. Objetivo. Comparar la eficacia del hierro aminoquelado con el sulfato ferroso como fortificante de un complemento alimentario en preescolares con deficiencia de hierro. Materiales y métodos. Se llevó a cabo un ensayo clínico triple ciego con distribución aleatoria de grupos. Se analizaron 56 preescolares con deficiencia de hierro (ferritina menor de 24 ng/ml) a los que se les dio diariamente 13 g de leche con 12,5 mg de hierro,. Después de dos meses se midieron los niveles de hemoglobina, hematocrito y ferritina sérica. Resultados. En el grupo con sulfato ferroso la concentración de ferritina sérica aumentó de 18,8 a 24,1 ng/ml, mientras que dicha variación fue de 18,4 a 29,7 ng/ml con el hierro aminoquelado, en ambos casos con diferencias significativas. El nivel de ferritina final difirió según el grupo de estudio, siendo mayor en el grupo con hierro aminoquelado (p=0,022). La hemoglobina y el hematocrito no variaron después de la intervención. Las reacciones adversas en el grupo con sulfato ferroso fueron de 35,7 %, en contraste con el 42,9 % en el grupo con hierro aminoquelado; cinco niños presentaron infección de las vías respiratorias, sin diferencias estadísticas. Conclusiones. Los dos compuestos aumentan los niveles de ferritina, siendo mayor el aumento entre quienes toman leche con hierro aminoquelado. No fue diferente la incidencia de reacciones adversas o de infecciones entre los grupos.

Introduction: Iron depleted deposits are the first link in the chain of events leading to iron deficiency which is the most prevalent nutritional shortage and main cause of anemia worldwide. This situation can be prevented through food fortification. Objective: To compare the efficacy of amino acid chelate iron with ferrous sulfate as fortifier of a dietary complement in preschoolers with iron deficiency. Materials and methods: This study was a blinded clinical trial with randomized groups. We analyzed 56 preschoolers with iron deficiency (ferritin < 24 ng/ml) that received 13 g of milk with 12.5 mg of iron, either amino acid chelate or in the ferrous sulfate form. After two months, hemoglobin, hematocrit and serum ferritin concentrations were measured. Results: In the ferrous sulfate group, ferritin concentration increased from 18.8 ng/ml to 24.1 ng/ml, while the variation was of 18.4 ng/ml to 29.7 ng/ml in the amino acid chelate group, with statistically differences in both cases. Serum ferritin was different between groups, being higher in iron amino acid chelate group (p=0.022). Hemoglobin and hematocrit levels did not change after the intervention. Adverse reactions in the ferrous sulfate group were 35.7%, compared with 42.9% in the iron amino acid chelate group; 5 children had respiratory tract infection, without statistical differences. Conclusions: Both compounds increased serum ferritin concentration, with a higher increase in those who were given milk with iron amino acid chelate. There were no differences in the adverse reactions and infections incidences between the groups.

Relação entre níveis de hemoglobina, concentração de retinol sérico e estado nutricional em crianças de 6 a 59 meses do Estado da Paraíba / Relationship among hemoglobin levels, serum retinol level and nutritional status in children aged 6 to 59 months from the state of Paraíba, Brazil

OBJETIVO: Analisar a relação entre os níveis de hemoglobina, concentração de retinol sérico e estado nutricional em crianças de 6 a 59 meses de idade do estado da Paraíba. MÉTODOS: Corte transversal, de base populacional, envolvendo 1.108 crianças de 6 a 59 meses de idade, de ambos os sexos, do Estado da Paraíba. As concentrações de hemoglobina foram analisadas em sangue venoso por meio decontador automático, e as de retinol sérico por cromatografia líquida de alta resolução. Para a avaliação do estado nutricional energético-proteico, foram utilizados peso e estatura pelos índices: peso/idade, estatura/idade e peso/estatura em escores-Z. As proporções foram comparadas pelo teste do Qui-quadrado de Pearson e teste exato de Fisher, e a associação entre as concentrações de hemoglobina e de retinolemia e o estado nutricional, pelo modelo de regressão de Poisson. RESULTADOS: Observou-se prevalência de 36,5% (IC95%=33,7-39,3) de anemia (Hb<11,0 g/dL), 21,4% (IC95%=17,3-22,2) de hipovitaminose A (<0,70µmol/L), 7,3% (IC95%=5,8-8,8)) de desnutrição crônica (estatura/idade<-2), 1,3% (IC95%=0,6-2,0) de desnutrição global (peso/idade<-2), e 2,3% (IC95%=1,4-3,2) de desnutrição aguda (estatura/idade<-2). Na análise multivariada, observou-se associação direta entre anemia e retinolemia inadequada, assim como entre anemia e desnutrição crônica. CONCLUSÃO: A elevada prevalência da anemia e da hipovitaminose A impõe a adoção de medidas efetivas de prevenção e controle. A associação entre as carências nutricionais demonstrou que uma melhoria na retinolemia bem como no estado nutricional tende a reduzir a anemia no contexto estudado.

OBJECTIVE: This study investigated the relationship among hemoglobin level, serum retinol level and nutritional status in children aged 6 to 59 months from the state of Paraíba, Brazil. METHODS: This was a cross-sectional, population-based study with 1,108 children of both genders aged 06 to 59 months from the state of Paraíba. Hemoglobin (Hb) level in venous blood was determined by an automatic counter and serum retinol level by high-performance liquid chromatography. Protein-energy nutritional status was assessed by calculating the children’s weight-for-age, height-for-age and weight-for-height Z-scores. Proportions were compared by the Pearson’s chi-square and Fisher’s exact tests and the association of hemoglobin level with retinol level and nutritional status by Poisson regression. RESULTS: The prevalences of anemia (Hb<11.0g/dL) and vitamin A deficiency (<0.70 µmol/L) were 36.5% (CI95% 33.7-39.3) and 21.4% (CI95% 17.3-22.2), respectively. The prevalences of chronic malnutrition (HAZ<-2), global malnutrition (weight-for-age<-2) and acute malnutrition (weight-for-height<-2) were 7.3% (CI95% 5.8-8.8), 1.3% (CI95% 0.6-2.0) and 2.3% (CI95% 1.4-3.2), respectively. Multivariate analysis showed that anemia was directly associated with low serum retinol level and chronic malnutrition. CONCLUSION: The high prevalences of anemia and vitamin A deficiency require the implementation of effective prevention and control measures. The association between these nutritional deficiencies demonstrated that an improvement in serum retinol levels and nutritional status tends to reduce anemia in the study context.

La dieta: un principio básico en el tratamiento de la disglucemia / Diet: a basic principle in the treatment of dysglycemia

Se revisó la bibliografía médica relacionada con la dietoterapia en los estados de disglucemia: desequilibrio metabólico de los carbohidratos que comienza a producirse desde la fase prediabética hasta la diabetes mellitus como tal, de cuyo análisis se extrajeron y resumieron aspectos básicos concernientes a características de la alteración, principios nutricionales, cálculo de la dieta según peso ideal e índice de masa corporal, así como importancia del tratamiento no farmacológico para prevenir la diabetes sacarina u otras complicaciones de esta enfermedad a largo plazo.

The medical literature related to the dietotherapy in the dysglycemia states was reviewed: metabolic imbalance of carbohydrates which begins to take place from the prediabetic phase to the diabetes mellitus as such. From its analysis, basic aspects concerning the characteristics of the change, nutritional principles, calculation of the diet according to the ideal weight and body mass index were collected and summarized, as well as the importance of the non pharmacological treatment to prevent the diabetes mellitus or other complications of this long term disease.

Comparison of ready-to-use therapeutic food with cereal legume-based khichri among malnourished children.

Objective: To compare the acceptability and energy intake of Ready-to-Use Therapeutic Food (RUTF) with cereal legume based khichri among malnourished children. Design: An acceptability trial with cross-over design. Setting: Urban low to middle socioeconomic neighbor-hoods in Delhi. Subjects: 31 children aged ³6 to £36 months with malnutrition, defined as Weight for height (WHZ) <–2 to ³–3 SD, with no clinical signs of infection or edema. Intervention: Children were offered weighed amounts of RUTF and khichri in unlimited amounts for 2 days, one meal of each on both days. Water was fed on demand. Caregivers’ interviews and observations were conducted on the second day. Outcome Measures: Acceptability of RUTF compared to khichri based on direct observation and energy intake for test and control meals. Results: The proportion of children who accepted RUTF eagerly was 58% as against 77% for khichri. 42% children on RUTF and 23% on khichri accepted the meal but not eagerly. The median (IQR) energy intake over the two day period in children aged 6 to 36 months from RUTF was 305 (153, 534) kcal, and from khichri was 242 (150, 320) kcal (P=0.02). Conclusion: RUTF and khichri were both well accepted by study children. The energy intake from RUTF was higher due to its extra energy density.

Rapid reversal of manifestations of acquired zinc deficiency in alcoholic cirrhosis with diet therapy.

Features of acquired zinc deficiency syndrome occurred in an alcoholic cirrhotic during hospital stay while he was on parenteral nutrition. Rapid reversal of symptoms occurred with resumption of normal diet without additional zinc supplementation.