Relating Iron Intake to Iron Status and Cognitive Functioning, Results from a 6-month Efficacy Trial Involving Biofortified Pearl Millet in India.

Objectives: Iron plays a key role in neurophysiology and iron deficiency, a highly prevalent issue worldwide, has been related to impaired cognitive functioning (CF). The current work explores the potential of iron intervention, via pearl millet (PM), to improve the iron status and CF of Indian adolescents. Methods: A subset of subjects (n=127; 12-16y; 55 F, 54% iron-deficient at baseline) performed tests of CF before and after 6 months of PM consumption. Three speeded tests were administered: 1) Simple Reaction Time (SRT), a test of perceptual processing speed, 2) Go/No-Go (GNG), a test of inhibitory control and 3) Attentional Network Task (ANT), a test of three critical functions of attention. Relations between iron intake after 3 or 6 months and changes in hemoglobin, ferritin, and body iron as well as changes in CF were explored using mediation models, where appropriate. Results: Iron intake after 3 months was positively related to change in hemoglobin (p<0.001) and body iron (p=0.05) and in performance on GNG and ANT subcomponents (p<0.05). Hemoglobin change after 3 months was positively related to change in SRT and ANT performance (p=0.03). Change in hemoglobin mediated the relation between iron intake and ANT performance. An improvement in body iron after 6 months was related to improvement in performance on all CF tasks (p<0.05). Conclusions: Our findings support iron intervention via PM as an effective strategy to improve iron status and CF, and expand the understanding of the role iron plays in CF during adolescence.

Vitamin D Deficiency Increases the Risk of Stunting and Other Adverse Pregnancy Outcomes: Results from a Perinatal Cohort Study in Kenya.

Objectives: Vitamin D may protect against adverse pregnancy outcomes. The prevalence of vitamin D deficiency in pregnant women in sub-Saharan Africa has not been extensively studied and no studies have examined vitamin D status at multiple time points during pregnancy and their association with birth outcomes. Methods: We examined the prevalence of vitamin D deficiency (<50 nmol/L) and insufficiency (<75 nmol/L) in women during pregnancy, and their associations with adverse perinatal outcomes in Kenya. Serum 25-hydroxyvitamin D (25(OH)D) was measured at enrollment and at three additional time points during pregnancy, at delivery, and in cord blood. Binomial and linear regression was used to examine associations between maternal vitamin D status and adverse pregnancy outcomes. Results: A total of 21% of women had vitamin D deficiency and 51% had insufficiency at enrollment. Vitamin D status improved during pregnancy; only 11% had vitamin D deficiency and 32% had insufficiency at delivery. However, 30% and 74% of the cord blood samples had vitamin D deficiency and insufficiency, respectively. Maternal vitamin D concentrations were also associated with significantly higher weight-for-age and weight-for-length Z-scores in the newborns with mean increases of 0.1 and 0.2 per 10 nmol/L serum 25-hydroxyvitamin D, respectively. Further, maternal vitamin D deficiency was associated with a 4-fold increase in the risk of stunting among the neonates (p=0.018). Conclusions: Vitamin D insufficiency is common in pregnant women in Kenya and predicts neonatal birth size. Further research is needed on methods of improving vitamin D status during pregnancy in sub-Saharan Africa.

Multidimensional health status of HIV-infected outpatients at a tertiary care center in north India.

Background : Quality of life (QOL) scores inform researchers acquainted with such tools about patients' perception of various domains of their health. The scores provide a useful denominator for clinical trials, especially in chronic diseases with therapeutic side effects, such as HIV. However, in clinical settings, there is a felt need of description of problems commonly perceived by patients. Aim : This study describes the multidimensional health-related issues of HIV-positive patients. Settings and Design : Cross-sectional design with convenient sampling was used to recruit 138 HIV-positive patients at the outpatient section of the Department of Medicine of a tertiary care hospital in north India. Materials and Methods : A structured questionnaire was used to collect information about health-related problems. Identified problems were assessed using a Likert scale for severity. Results : Out of the 20 assessed problems, the patients reported positive for an average of 12.01 +/- 3.78 problems. The most prevalent problems were those related to emotions (98.6%), lack of energy (96.4%), and health perception (92.0%). The most distressing problems were 'feeling that health was not good' (77.5%) and 'health was bad' (75.4%). The number of problems reported was significantly related to weight loss ( P = 0.006) and clinical category ( P = 0.023). A significant correlation was observed between weight loss and problems in social activities ( P P P P = 0.002).Conclusion : Many patients have significant problems in dimensions other than physical. A physician's awareness about these problems is important for a holistic patient management.