Micronutrient Deficiencies in Pre-school Age Children and Women of Reproductive Age in Jordan.

Objectives: Jordan's 2010 National Micronutrient Survey assessed the prevalence and severity of anemia and micronutrient deficiencies in Jordanian women and children. Methods: A stratified multistage cluster sampling was used to establish a nationally representative household-based sample of Jordanian children (12 - 59 months) and non-pregnant women of reproductive age (15-49 years). Weighted descriptive statistics were used to calculate national prevalence and multivariate analyses were undertaken for the determination of risk factors of vitamin D deficiency Results: Anemia in children (hemoglobin < 110g/L) and women (hemoglobin < 120g/L) was a mild (17.0%) and moderate (30.6%) public health problem, respectively. Vitamin A deficiency (serum retinol < 0.70 umol/L) was prevalent in 18.3% of children and 4.8% of women. Vitamin D deficiency (25(OH)D3 < 11.0 ng/mL and < 12.0 ng/mL in children and women, respectively) was prevalent in 19.8% of children and 60.3% of women. Vitamin D deficiency was significantly more likely in women who routinely cover themselves with a scarf compared to those women who do not cover. In urban areas, children whose mothers were vitamin D deficient were more likely to be vitamin D deficient than children whose mothers were not deficient. Conclusions: With the exception of vitamin A, a higher burden of micronutrient deficiencies is seen in Jordanian women than children. Vitamin D deficiency in women is the most prevalent micronutrient deficiency in Jordan with approximately 3 out of 5 women being deficient.

Review of the National Wheat Flour Fortification Program in Egypt - Assessing Compliance of Mills Fortifying Flour/Baladi Bread with Folate and Iron and Estimating Consumption of Fortified Flour in Women of Reproductive Age with HIECS Data.

Objectives: To evaluate outcomes of the Government of Egypt national wheat flour fortification program, including fortification level of flour at mills and the estimation of fortified flour/baladi bread intake using Egypt Household Income, Expenditure, and Consumption Survey (HIECS) data to determine the contribution of fortification to dietary intake of iron and folic acid (FA) among women of reproductive age (WRA). Methods: Flour samples were collected from 53 mills and analyzed for iron content using atomic absorption spectrometry. HIECS 2010/2011 data was used to estimate average consumption of fortified flour and iron and folic acid intake of WRA using the FAO adjustment factors for calculating adult equivalent consumption units. Results: 95% of the flour samples collected at the mills during the audit were fortified at optimal levels or above. In the region with highest prevalence of deficiency, Lower Egypt, women's estimated daily intake of fortified flour was lower as compared with other regions, but still provided over 24% and 48% of RDA of iron and FA, respectively. In Upper Egypt, consumption of fortified flour and intake of iron and FA was highest providing over 33% and 60% of RDA, respectively. Conclusions: The fortified flour is reaching those in need and is significantly increasing dietary intake of iron and FA among WRA. Together with the monitoring of the fortification levels at the mills this data allows tracking of the coverage and consumption of fortified foods in Egypt. An adaptation of the HIECS data collection tool could further improve the estimate of fortified food intake.

Formative Work to Design the Packaging of a Lipid-based Nutrient Supplement for a Home Fortification Program in the Democratic Republic of Congo (DRC) .

Objectives: To determine a culturally appropriate product name and package design that would communicate important usage instructions for a lipid-based nutrient supplement (LNS) for a target population with diverse languages and low literacy. Methods: Formative work was conducted in two locations in Katanga region, DRC: Mabaya, a rural village and Kipushi, a peri-urban area. In each site, focus group discussions with parents of children aged 0-24 months (3 with mothers, and 1 with fathers) were conducted. Additionally, two key informant interviews with mothers and health workers were conducted in each location. Two sets of 7 images, one for each LNS sachet in the strip, were tested to assess perceptions of use. Different color options and product names were tested to identify culturally appropriate packaging. Results: The majority of participants read the different images on the multi sachet strip as a story line. Participants retained the main messages that the strip should convey: Optimal child feeding and care, product use, target group and potential product benefits. All participants recognized the mother and children in the images as "Congolese". Green and brown were identified as suitable colors for the packaging and were associated with qualities such as growth, and healthy development. The names Kulazuri (eating well) and Afiabora (good health) were preferred. A combination of the first two name proposals "Kulabora" (eating better) was decided upon. Conclusions: The results from this formative assessment were used to finalize the design of the LNS product, which is currently being distributed in Kasenga health zone.

Voluntary lifestyle changes and knowledge about healthy lifestyles of chilean primary health care workers

Se evaluaron los cambios en los estilos de vida y conocimientos en alimentación saludable y actividad física en profesionales de atención primaria de salud. Se aplicó una encuesta a 194 profesionales (médicos, enfermeras, nutricionistas, matronas y asistentes sociales), de los cuales el 86 por ciento eran mujeres. Se observó que durante el último año, la mayoría de los profesionales modificó sus hábitos hacia estilos de vida mas saludables. Alrededor del 80 por ciento señalaron que consumen menos grasas y consumen mas verduras, dos tercios indicaron consumir menos azúcar, alrededor de la mitad menos alcohol y un 45 por ciento hacen más actividad física. La gente mas joven es la que ha hecho las mayores modificaciones, a pesar que aumentaron el consumo de bebidas gaseosas, alcohol y tabaco. Un 80 por ciento de los profesionales respondió correctamente las preguntas relacionadas con alimentación y actividad física. Se encontró diferencias estadísticamente significativas entre los diferentes grupos de profesionales. Se concluye que muchos profesionales han efectuado cambios hacia estilos de vida mas saludable, tienen un buen conocimiento de hábitos alimentarios y actividad física. Estos resultados indican la importancia del trabajo en equipo para contribuir a la prevención de las enfermedades crónicas no transmisibles