Anemia, deficiencias de zinc y hierro, consumo de suplementos y morbilidad en niños mexicanos de 1 a 4 años: resultados de la Ensanut 100k / Anemia, iron and zinc deficiencies, supplements consumption and morbidity in Mexican children aged 1 to 4: analysis of Ensanut 100k

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.

Prevalencia y factores sociodemográficos asociados a la deficiencia de ferritina en niños de Colombia, 2010 / Prevalence and demographic factors associated with ferritin deficiency in Colombian children, 2010

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.

Impacto de las acciones para la eliminación sostenible de la deficiencia de yodo en Cuba / Impact of the actions for the sustainable elimination of iodine deficiency in Cuba

Objetivos: Evaluar la efectividad del “Programa de Eliminación Sostenible de Deficiencia de Yodo” mediante determinación de yoduria y prevalencia de bocio. Materiales y métodos. Se realizó un estudio transversal en el cual se incluyó a la población escolar cubana de 6 a 11 años que cursaba estudios en el periodo 2011-2012. Se empleó un muestreo estratificado polietápico. En el cual se determinaron los niveles de excreción de yodo en la orina (yoduria) y la presencia de bocio. Resultados. La mediana de yoduria fue de 176,3 µg/L; el 7,6% de los escolares presentaron alguna deficiencia de yodo, solo el 2,2% estaba por debajo de 50 µg/L (deficiencia severa) y el 15,3% tenía yodurias por encima de 300 µg/L. El porcentaje de escolares con nutrición óptima de yodo fue de 43,5%, esta categoría presentó una frecuencia significativamente mayor ( p=0,03) en el estrato montaña (52,5%). La prevalencia de bocio encontrada fue de 17,6%, que corresponde a una endemia ligera. Sin embargo, en el estrato montaña se encontró una prevalencia de 32,6 % (endemia severa). Conclusiones. El análisis integral del impacto de las acciones de control de la deficiencia de yodo evaluado a través de la excreción urinaria de yodo y la prevalencia de bocio refleja que ha dejado de ser un problema de salud poblacional en los estratos urbano y rural de Cuba, atribuible a un adecuado proceso de yodación de la sal. Sin embargo, aún se observa una alta prevalencia de bocio en la zona de montaña de Cuba.

Objectives: To assess the effectiveness of the Sustainable Elimination of Iodine Deficiency Program through determination of urinary iodine and goiter prevalence. Materials and methods. A cross-sectional study was conducted in Cuban school children aged 6 to 11 years old in 2011-2012. A stratified multistage sample was used in which the levels of iodine excretion in urine (urinary iodine) and the presence of goiter were determined. Results. The median urinary iodine was 176.3 µg/L; 7.6% of the students showed some deficiency of iodine, only 2.2% were below 50 µg/L (severe deficiency), and 15.3% had urinary iodine above 300 µg/L. The percentage of school children with optimal iodine nutrition was 43.5%, this category showed a significantly higher frequency (p=0.03) in the mountain areas (52.5%). Goiter prevalence was 17.6% which corresponds to a mild endemic. However, in the mountain area the prevalence was 32.6% (severe endemic). Conclusions. The comprehensive analysis of the impact of iodine deficiency control measures assessed by urinary iodine excretion and goiter prevalence reflects that it is no longer a population health problem in urban and rural areas of Cuba, attributable to a proper process of salt iodization. Nevertheless, high goiter prevalence is still observed in the mountain area of Cuba.

Seguridad alimentaria, crecimiento y niveles de vitamina A, hemoglobina y zinc en ninos preescolares del nordeste de Brasil / Food security, growth and vitamin A, hemoglobin and zinc levels of preschool children in the northeast of Brazil

El presente estudio buscó analizar la asociación entre la (in)seguridad alimentaria y el estado nutricional de niños preescolares asistidos en jardines infantiles. La seguridad alimentaria fue evaluada a través de la Escala Brasileña de Inseguridad Alimentaria (EBIA). El estado nutricional se evaluó a través del peso/edad, talla/edad, hemoglobina, retinol sérico y zinc sérico. Fueron encontradas prevalencias de déficit de estatura (6,2%), déficit de peso/edad (2,1%), deficiencia de vitamina A (24,4%), anemia (15,5%) y deficiencia de zinc (15,0%). La inseguridad alimentaria familiar fue caracterizada en 64,2% de las familias predominando la forma leve (32,6%). El estudio concluye que la inseguridad alimentaria estimada por la EBIA no se asoció a los Escore-z de crecimiento ni a las concentraciones de retinol sérico, hemoglobina y zinc sérico.

This study sought to examine the association between the food (in)security and nutritional status of preschool children attended in daycare centers. Food security was assessed using the Brazilian Food Insecurity Scale. The nutritional status was evaluated using the weight/height, weight/age, height/age, hemoglobin, serum retinol and serum zinc status. The prevalence of stunting (6.2%), overweight (3.1%), underweight (2.1%), vitamin A deficiency (24.4%), anemia (15.5%), and zinc deficiency (15%) was established. Food insecurity was found in 64.4% of the families, predominantly in its mild form (32.6%). This study concludes that food insecurity as measured by the EBIA was not associated with Z-score growth or with vitamin A, hemoglobin and zinc biochemical concentrations.

Iron, zinc, copper and magnesium deficiencies in Mexican adults from the National Health and Nutrition Survey 2006 / Deficiencias de hierro, zinc, cobre y magnesio en adultos mexicanos. Encuesta Nacional de Salud y Nutrición 2006

OBJECTIVE: To describe the prevalence of serum iron and zinc deficiencies and low serum concentrations (LSC) of copper and magnesium in Mexican adults. MATERIALS AND METHODS: Blood samples from subjects (>20 years, both genders) participating in the 2006 National Health and Nutrition Survey were used to measure the serum concentrations of s-ferritin, soluble- transferrin-receptor (s-TfR), zinc, copper, and magnesium. RESULTS: The prevalence of s-ferritin<12ug/L was 18.1 and 3.6% while s-TfR>6mg/L was 9.5 and 4.4%, for females and males, respectively. The prevalence of zinc deficiency was 33.8% females and 42.6% males; LSC of copper were 16.8 and 18.2%, and 36.3 and 31.0% for magnesium, for females and males, respectively. CONCLUSIONS: The prevalence of deficiencies in iron (in females), and zinc are still high in the adult population. LSC of copper and magnesium are published for the first time and show significant prevalence of deficiencies. Corrective actions are necessary in order to diminish these nutritional deficits in the Mexican population.

OBJETIVO: Describir la prevalencia de deficiencias de hierro y zinc y valores bajos (VB) de cobre y magnesio en adultos mexicanos. MATERIAL Y MÉTODOS: Se utilizaron muestras de sangre de individuos (>20 años, ambos sexos) de la Encuesta Nacional de Salud y Nutrición 2006 para medir concentraciones séricas de s-ferritina, receptor soluble de transferrina (s-TfR), zinc, cobre y magnesio. RESULTADOS: La prevalencia de s-ferritina<12ug/L fue de 18.1 y 3.6%, s-TfR>6mg/L de 9.5 y 4.4% para mujeres y hombres, respectivamente. Para zinc fue de 33.8% mujeres y 42.6% hombres. Para VB de cobre fue 16.8 y 18.2%; y magnesio 36.3 y 31.0% en mujeres y hombres, respectivamente. CONCLUSIONES: Las prevalencias de deficiencia de hierro (mujeres) y zinc aún son altas en la población adulta. VB de cobre y magnesio se publican por primera vez en una muestra representativa de adultos y muestran prevalencias importantes. Son necesarias medidas correctivas para combatir estos problemas en la población mexicana.

Estado nutricional y carencias de micronutrientes en la dieta de adolescentes escolarizados de la Zona Metropolitana de Guadalajara, Jalisco

Las deficiencias de micronutrientes son una parte importante, del más amplio y serio problema de la malnutrición. La adolescencia constituye una etapa de gran riesgo nutricional debido al aumento de necesidades, cambios de hábitos alimentarios y posibles situaciones de riesgo. Existe evidencia documentada de deficiencia de micro nutrimentos entre la población de México. El objetivo del trabajo fue determinar el estado nutricional del adolescente escolarizado y la ingestión de micronutrientes en su dieta. La muestra estuvo conformada por 307 adolescentes. Se analizó la composición corporal a través de indicadores antropométricos. Para determinar la ingestión de micro nutrimentos se utilizó el recordatorio de 24 horas y el software Mexfoods. Los porcentajes que indican una ingestión adecuada se clasificaron según los siguientes puntos de corte: debajo de los requerimientos mínimos, cuando la ingesta fue <50%; cubren requerimientos mínimos ≥50% y <75%; y exceden requerimientos mínimos cuando fue ≥75%. El IMC indicó que el 21.8 % de estudiantes de ambos sexos presentaron desnutrición mientras que la prevalencia de sobrepeso y obesidad fue del 27.9%. Los resultados de la ingestión de micro nutrimentos indicaron deficiencias significativas en hierro (p = 0.002), zinc (p= 0.000) y calcio (p = 0.002). Las vitaminas del complejo B fueron las que presentaron menores porcentajes de insuficiencias. Se identificó que la dieta de los adolescentes presenta carencias significativas de micro nutrimentos y siendo las mujeres las que resultaron con mayores deficiencias. Urge establecer estrategias destinadas a reducir los problemas derivados del déficit en la alimentación de los adolescentes.

Nutritional state and shortcoming of micronutrients on schooled youth's diet on the metropolitan zone of Guadalajara Jalisco. The adolescence is a stage of high nutritional risk due to the increased requirements, changes in eating habits and potential risk. There are documented evidence of micronutrient deficiency among the population of Mexico.To evaluate the nutritional status and micronutrient deficiencies in the diet of adolescents. The sample consisted of 307 adolescents. We analyzed the body composition by using anthropometric indicators. To determine the intake of micronutrients, the 24 hours reminder and software Mexfoods were used. The percentages that indicate adequate intake were classified according to the following breakpoints: Below minimum requirements, when intake was <50%; minimum requirements covered ≥ 50% and <75%; and exceed minimum requirements when it was ≥ 75 %. The BMI indicated that 21.8% of students of both sexes showed malnutrition and the prevalence of overweight and obesity was 27.9%. The micronutrient intake results indicated significant deficiencies in iron (p = 0.002), zinc (p = 0.000) and calcium (p = 0.002). The B-complex vitamins were those that had lower failure rates. We identified that the diet of adolescents has significant micronutrient deficiencies and that adolescent girls resulted with the major deficiencies. It is urgent to develop strategies, to reduce the problems of food deficit in adolescents.

Iron, zinc, copper and magnesium nutritional status in Mexican children aged 1 to 11 years / Estado nutricio de hierro, zinc, cobre y magnesio en niños mexicanos de 1 a 11 años de edad

OBJECTIVE: To describe the micronutrient nutritional status of a national sample of 1-11 year old Mexican children surveyed in 2006 in National Health and Nutrition Survey (ENSANUT 2006) and their association with dietary and sociodemographic factors. MATERIALS AND METHODS: Serum samples were used (n=5 060) to measure the concentrations of ferritin, transferrin receptor, zinc, copper and magnesium. RESULTS: Prevalence of deficiencies in 1-4 and 5-11y old children were for iron (using low ferritin) 26.0 and 13.0%; zinc, 28.1 and 25.8%, respectively; and copper, ≈30% in both age groups. Magnesium low serum concentrations (MLSC), were found in 12.0% and 28.4% of the children, respectively. Being beneficiary of Liconsa (OR=0.32; C.I.95%, 0.17-0.61) or belonging to higher socioeconomic status (OR=0.63; C.I.95%, 0.41-0.97) were protective against iron deficiency. Increasing age (OR=0.59; C.I.95%, 1.19-1.32) and living in the Central Region (OR=0.59; C.I.95%, 0.36-0.97) were protective against MLSC. CONCLUSIONS: Deficiencies of iron and zinc are serious public health problems in Mexican children.

OBJETIVO: Describir el estado nutricio de micronutrimentos en niños de 1-11 años de edad de la Encuesta Nacional de Salud y Nutrición 2006 y su asociación con factores dietéticos y sociodemográficos. MATERIAL Y MÉTODOS: Se usaron muestras séricas (n=5060) para medir las concentraciones de ferritina, receptor de transferrina, zinc, cobre y magnesio. RESULTADOS: La prevalencias de deficiencias en niños de 1-4 y de 5 a 11 años fueron para ferritina, 26.0 y 13%; zinc, 28.1 y 25.8% respectivamente y cobre ≈30% en ambos grupos. Las concentraciones bajas de magnesio (CBM) fueron 12.0 y 28.4%, respectivamente. Ser beneficiario de Liconsa (RM=0.32; IC 95%: 0.17-0.61) y pertenecer al nivel socioeconómico alto (RM=0.63; IC, 95%: 0.41-0.97) fueron protectores para deficiencia de hierro. La edad (RM=1.26; IC, 95%: 1.19-1.32) y vivir en la región Centro (RM=0.59; IC, 95%: 0.36-0.97) fueron protectores para CBM. CONCLUSIONES: Las deficiencias de hierro y zinc son serios problemas de salud pública en niños mexicanos.

Anemia and iron, zinc, copper and magnesium deficiency in Mexican adolescents: National Health and Nutrition Survey 2006 / Anemia y deficiencia de hierro, zinc, cobre y magnesio en adolescentes mexicanos: resultados de la ENSANUT 2006

OBJETIVE: To describe the frequency of anemia and iron, zinc, copper and magnesium deficiencies among Mexican adolescents in the probabilistic survey ENSANUT 2006. MATERIALS AND METHODS: The sample included 2447 adolescents aged 12 to 19 y. Capillary hemoglobin and venous blood samples were collected to measure the concentrations of ferritin, sTFR, CRP, zinc, iron, copper and magnesium. Logistic regression models were constructed to assess the risk for mineral deficiencies. RESULTS: The overall prevalence of anemia was 11.8 and 4.6%, body iron deficiency 18.2 and 7.9% for females and males, respectively. Overall prevalence of tissue iron deficiency was 6.9%, low serum copper were14.4 and 12.25%; zinc 28.4 and 24.5%, magnesium 40 and 35.3%; for females and males, respectively. CONCLUSIONS: There is a high prevalence of mineral deficiency in Mexican adolescents; females were more prone to have more mineral deficiencies. Nutritional interventions are necessaries in order to reduce and control them.

OBJETIVO: Describir la prevalencia de anemia y deficiencia de hierro, zinc, cobre y magnesio en adolescentes mexicanos en la encuesta probabilística ENSANUT 2006. MATERIAL Y MÉTODOS: La muestra incluyó 2447 adolescentes de 12 a 19 años de edad. Se tomó hemoglobina capilar y muestras de sangre venosa para medir las concentraciones séricas de ferritina, sTFR, CRP, zinc, hierro, cobre y magnesio. Se construyeron modelos de regresión logística para evaluar el riesgo de deficiencia de minerales. RESULTADOS: La prevalencia de anemia fue de 11.8% en mujeres y 4.6% en hombres. Las deficiencias de hierro fueron de 18.2 y 7.9% La deficiencia tisular de hierro fue 6.9%; la baja concentración de cobre fue de 14.4 y 12.25% la de zinc de 28.4 y 24.5%, la de magnesio fue 40 y 35.3% en mujeres y hombres, respectivamente. CONCLUSIONES: Existe una alta prevalencia de deficiencia de minerales en los adolescentes; las mujeres tuvieron mayor riesgo. Son necesarias intervenciones nutricionales para reducir o controlar estas deficiencias.

Overview of the nutritional status of selected micronutrients in Mexican children in 2006 / Estado nutricional de algunos micronutrientes en niños mexicanos en 2006

OBJETIVE: To present an overview of micronutrient status of Mexican children in 2006. MATERIALS AND METHODS: Data on iron, zinc, folate and vitamin B12 deficiencies and low serum copper and magnesium were gathered and critically analyzed from the 2006 National Health and Nutrition Survey. RESULTS: Iron deficiency is still the main nutritional deficiency in children (13%-26%). Zinc deficiency was high in all age groups (≈25%) but reduced 5.6 PP in children <5 y from 1999 to 2006. Folate deficiency was 3.2% and vitamin B12 deficiency 7.7% in children. Low serum magnesium and copper were high (22.6% and 30.6%, respectively). CONCLUSIONS: The prevalence of iron deficiency seems to be lowering, and zinc deficiency has reduced in Mexican children. A high prevalence of copper and magnesium deficiencies warrants further research on their public health implications.

OBJETIVO: Presentar un panorama del estado de micronutrimentos de niños mexicanos en 2006. MATERIAL Y MÉTODOS: Los datos sobre deficiencias de hierro, zinc, folatos, vitamina B12 y concentraciones bajas de cobre y magnesio se analizaron a partir de la Encuesta Nacional de Salud y Nutrición 2006. RESULTADOS: La deficiencia de hierro fue la más importante en niños (13-26%). La deficiencia de zinc fue alta en todos los grupos de edad (≈25%) y disminuyó entre 1999 y 2006 5.6 pp en niños. La deficiencia de folatos fue de 3.2% y la de vitamina B12 de 7.7%. Las concentraciones bajas de magnesio y cobre fueron altas (22.6 y 30.6%, respectivamente). CONCLUSIONES: La deficiencia de hierro pareció disminuir y la de zinc se redujo en niños mexicanos. La alta prevalencia de deficiencias de cobre y magnesio merecen más investigación para entender sus implicaciones en salud pública.

Estado de ferro e retinol sérico entre crianças e adolescentes atendidos por equipe da Estratégia de Saúde da Família de Itajaí, Santa Catarina / Iron status and serum retinol levels among children and adolescents attended by a Family Health Strategy team in Itajaí, Santa Catarina State

Este trabalho visa determinar prevalências de deficiência de ferro e vitamina A em crianças e adolescentes atendidos por equipe de Saúde da Família de Itajaí (SC) e avaliar relações entre o estado de ferro e o retinol sérico. Realizou-se um censo nutricional das famílias cadastradas. Coletaram-se dados socioeconômicos e demográficos. Avaliou-se a concentração de hemoglobina, hematócrito, ferro e retinol séricos. Participaram do estudo 31 das 156 famílias cadastradas. Apenas 39,1 por cento das crianças e 62,0 por cento dos adolescentes coletaram amostras sanguíneas. A renda média per capita foi 1,68±1,00 salários mínimos. Nenhum dos pais ou mães era analfabeto. Residiam em domicílio próprio 80,6 por cento das famílias. Todos os domicílios apresentavam esgoto e abastecimento de água por rede pública e 87,1 por cento eram de alvenaria. Diagnosticou-se deficiência de ferro em 16,7 por cento das crianças e 19,3 por cento dos adolescentes, e deficiência de vitamina A em apenas uma criança. Observaram-se correlações significativas para o ferro e retinol séricos entre crianças e entre adolescentes para a concentração de hemoglobina, hematócrito e retinol sérico. Encontraram-se prevalências leves de deficiência de ferro e vitamina A, possivelmente devido às características socioeconômicas e demográficas.

The objective of this article is to determine prevalence of iron and vitamin A deficiencies among children and adolescents attended by a Family Health Strategy team in Itajaí, Santa Catarina State, and to assess relations between iron status and serum retinol. A nutritional census of the families was carried out. Socioeconomic and demographic data were collected. Hemoglobin concentration, hematocrite, serum iron and retinal were determined. Thirty-one out of the 156 enrolled families participated in the study. Only 39.1 percent of the children and 62.0 percent of the adolescents had their blood samples collected. Mean per capita income was 1.68±1.00 minimum wages. None of the parents was illiterate and most families (80.6 percent) owned their homes. All homes had public sewage and water supply, and 87.1 percent were made of brickwork. Iron deficiency was diagnosed in 16.7 percent of the children and 19.3 percent of the adolescents. Only one child had vitamin A deficiency. Significant correlations were found between serum iron and retinol among children, and among adolescents between serum retinol and hemoglobin concentration and hematocrite. We found mild prevalences of iron and vitamin A deficiencies, possibly due to the socioeconomic and demographic characteristics.

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.

Tracking progress towards sustainable elimination of iodine deficiency disorders in Bihar.

OBJECTIVES: To assess the status of the iodine deficiency in the population of Bihar and track progress of the elimination efforts. METHODS: A community based field survey was conducted. Using quantitative and qualitative research methods, data was collected by following internationally recommended protocol and methodology. Thirty clusters were selected using population proportionate to size technique. School age children (6 to 12 years) were the target group studied. Urinary iodine in target children and iodine content of salt at households were the indicators used. RESULTS: Total of 1169 children were studied. The median urinary iodine concentration was found to be 85.6 microg/L. Urinary iodine concentration was less than 50 microg/L in 31.5% of the subjects. Only 40.1% of the household salt samples were found to be adequately iodised as determined by titration method (> or =15 ppm iodine). CONCLUSIONS: Study results show existence of iodine deficiency in the state. There is need to accelerate our efforts to achieve iodine sufficiency and this should be done on a war-footing.

Iodine deficiency disorders among the pregnant women in a rural hospital of West Bengal.

BACKGROUND & OBJECTIVES: Iodine deficiency disorder (IDD) is a major nutritional problem in India. The pregnant women and their neonates have been important target groups for study of the prevalence of IDD in a community. No such study was available to assess the prevalence of IDD among the pregnant women and neonates in the state of West Bengal. The present study was undertaken to assess the status of IDD in the pregnant women and its effect on the neonatal thyroid function in Burdwan district of West Bengal. METHODS: The present study was a hospital-based, cross-sectional, non-interventional study among 267 full term pregnant mothers, and the neonates born to them. One hundred non pregnant healthy women were selected as controls. The overall iodine status of the pregnant and non pregnant women was estimated by measuring the urinary iodine excretion (UIE) and the serum thyroid stimulating hormone (TSH) levels. The neonatal thyroid function was estimated by measuring the TSH levels in their cord blood. RESULTS: A total of 78.4 per cent pregnant women showed UIE > 10 mug/dl with 7 per cent having a UIE < 5 mug/dl. The median UIE and the serum TSH values in the pregnant women were found to be 14.4 mug/dl and 4.1 mIU/l, respectively. No statistically significant difference was found when compared with the control values. Only 2.9 per cent of the neonates showed a cord blood TSH value > 5 mIU/l which is just below the recommended criteria for mild endemicity for IDD in the study population. INTERPRETATION & CONCLUSION: Pregnant women of the study area were iodine repleted. The neonatal thyroid function was also within normal range. The findings of the present study indicates that the iodine supplementation of the salt should be maintained in the area with periodical surveillance.

Status of iodine deficiency amongst school children in twenty four districts in southern India.

The central legislation banning sale of non-iodized salt for edible purposes in the entire country was withdrawn by the Government in the year 2000. The present study was conducted in the year 2001 immediately after lifting the central ban to establish the baseline urinary iodine excretion levels in twenty four districts of Southern India. In each district all the senior secondary schools were enlisted and one school was selected by random sampling. About 120 children in the age group of 11 to 18 years were selected using the random number tables. The urinary iodine excretion levels were analysed using the wet digestion method. It was found that districts Rangareddy, Kolar, Yanam and Perambalour had median UIE levels less than 100 microg/l, indicating iodine deficiency. The findings of the present study highlights the success of Universal salt iodisation programme. The Government of India should reinitiate the process of central ban on sale of non iodised salt in the country to prevent the iodine deficiency disorders.

Moléstias associadas à carência crônica de iodo / Disorders associated to chronic iodine deficiency

Fundamentalmente, a glândula tiróide, face à carência de iodo, se adapta por incremento da captação deste halogênio, aumenta a sua massa glandular (bócio), induz secreção preferencial de T3 e eleva a síntese e liberação de TSH. Os exames laboratoriais e de imagem permitem a comprovação dos mecanismos adaptativos. A iodúria permite avaliação quantitativa do grau de carência iódica. Em algumas populações, coexiste a influência de bocígenos naturais presentes nos alimentos consumidos localmente. O cretinismo endêmico é síndrome neurológica e endócrina que conduz o indivíduo a quadro severo de rebaixamento mental e surdo-mudez. No Brasil, as moléstias associadas à carência de iodo foram sempre avaliadas por inquéritos nacionais em escolares. A correção da deficiência de iodo se faz pela adição de iodato de potássio ao sal de consumo humano. Várias leis e decretos foram elaborados tentando aperfeiçoar o sistema universal de iodação do sal, que, mais recentemente, foi aprimorado e tornou-se mais eficiente em propiciar iodo a toda população brasileira.