Effect of the Brazilian iron fortification of wheat and corn flour on the nutritional iron status in adolescents, 6 years after its implementation

BACKGROUND: As it is difficult to know the content of iron added in the Brazilian iron fortification of wheat and corn flour, and if the compound has good or poor bioavailability, the objective was to assess the effect of the Brazilian iron fortification program, as it was carried out, on iron nutritional status of adolescents, 6 years after its implementation. METHODS: A cross-sectional retrospective study was conducted with adolescents aged 10 to 17 years, both sexes, treated at a primary health care center. Data were collected from medical records of patients and compared with those of a previous survey conducted at the same center in 2004. Anthropometry, iron biochemical indicators, food intake, pubertal stage, and transferrin saturation were assessed, with pubertal stage and transferrin saturation being the last two variables compared between 2004 and 2010. Mann-Whitney and chi-square tests were also used. RESULTS: In 2010, mean hemoglobin values and serum ferritin levels were within normal ranges for both sexes, and adolescents who consumed diets with low iron bioavailability constituted more than half of the sample (52.7%). In2004, a 10.3 and 18.6% prevalence of iron deficiency was observed, based on low transferrin saturation, in females and males, respectively. It was noted that during the 6-year period, this prevalence decreased significantly, 4 and10.4%. CONCLUSIONS: Anemia and iron deficiency are not prevalent in this population, probably due to the implementation of flour fortification with iron; it is not possible, however, to attribute such a result only to the implementation of this strategy.

Folic acid intake by pregnant women from Vale do Jequitinhonha, Brazil, and the contribution of fortified foods / Consumo de ácido fólico por gestantes do Vale do Jequitinhonha, Brasil, e a contribuição dos alimentos fortificados

The folate deficiency can result in irreversible health damage, such as the neural tube defects. The aim of this article is to determine the folate intake of pregnant women in Vale do Jequitinhonha, Minas Gerais state, Brazil, one of the poorest regions in the world. A descriptive, cross-sectional study was done in 2013 with 492 pregnant women attending the basic health units run by the public health service (Sistema Único de Saúde, SUS) in 15 municipalities. A standard questionnaire was used to gather the data, which included socioeconomic indicators and a food frequency questionnaire. The data were analyzed and compared statistically based on prevalence ratios and 95% confidence intervals. The prevalence of inadequate folate intake was associated with some socioeconomic factors: it was higher amongst the low income and less educated women, in younger women and those who had fewer meals per day. The prevalence of inadequate folate intake in the diet was 94.7% when the contribution of food fortification was not considered, 49.2% taking into account fortified foods, and 17.1% considering food folate, fortified foods, and supplementation with folic acid. We conclude that fortifying foods with folic acid at the current levels reduces the inadequacy of folate intake in the diet, but not enough to assure safe levels and to meet the nutritional requirements of pregnant women in Brazil.

A deficiência de folato pode acarretar prejuízos irreversíveis como os defeitos do tubo neural. O objetivo deste artigo é determinar o padrão de consumo de folato por gestantes no Vale do Jequitinhonha, Minas Gerais, Brasil, uma das regiões mais pobres do mundo. A pesquisa descritiva do tipo transversal foi realizada com 492 gestantes atendidas em Unidades Básicas de Saúde do SUS em 15 municípios do Vale do Jequitinhonha no ano de 2013. Para a coleta de dados foi utilizado um questionário padronizado, que inclui um questionário socioeconômico e inquérito de frequência alimentar. Os dados foram analisados e comparados estatisticamente através de razão de prevalências e intervalo de confiança de 95%. A prevalência de consumo insuficiente de folato mostrou-se associada com alguns fatores socioeconômicos: foi maior em gestantes com baixa renda, de baixa escolaridade e em gestantes mais jovens e que realizavam menos refeições por dia. Observou-se que a prevalência de consumo insuficiente de folato na dieta foi de 94,7% desconsiderando a inclusão de alimentos fortificados, 49,2% considerando a dieta com alimentos fortificados e 17,1% considerando a dieta, a fortificação e a suplementação medicamentosa com ácido fólico. Conclui-se que a fortificação de alimentos com ácido fólico nos níveis atuais reduz a inadequação do consumo na dieta, mas não é suficiente para suprir as necessidade e garantir os níveis seguros da oferta deste nutriente entre gestantes brasileiras.

Ingestão de folato nos períodos pré e pós-fortificação mandatória: estudo de base populacional em São Paulo, Brasil / Folic acid intake before and after mandatory fortification: a population-based study in São Paulo, Brazil / Ingesta de folatos en la prefortificación o posfortificación: estudio de base poblacional en São Paulo, Brasil

Analisou-se a ingestão de folato nos períodos pré e pós-fortificação. Os dados dietéticos foram coletados por recordatório de 24 horas (R24h) no Inquérito de Saúde de São Paulo (ISA-Capital) em 2003 e 2007/2008, estratificando-se a população segundo fase da vida e sexo. Utilizaram-se os valores de recomendação: necessidade média estimada (EAR) e nível máximo de ingestão tolerada (UL) e o método "EAR como ponto de corte" para estimar a inadequação da ingestão. Houve redução na prevalência de inadequação da ingestão de folato em todos os estratos, com destaque para os adolescentes e adultos do sexo masculino, de 72% para < 1% e de 76% para 6%, mas nas mulheres adultas a inadequação permaneceu elevada (38%). Antes da fortificação, o feijão foi o alimento que mais contribuiu para a ingestão de folato; após, o maior contribuinte passou a ser o pão, porém o feijão permaneceu importante. A fortificação foi bem-sucedida (aumentou a ingestão dentro de níveis seguros), porém, gera preocupação a elevada proporção no grupo alvo, mulheres adultas, que não atingem a recomendação para ingestão de folato.

This study analyzed folic acid intake before and since mandatory fortification. Dietary data were collected by 24-hour recall in a health survey in São Paulo (ISA-Capital) in 2003 and 2007-2008, stratifying the population according to life stage and gender. Estimated average requirement (EAR) and tolerable upper intake level (UL) were used to assess intake. Prevalence of inadequate folic acid intake decreased in all groups, especially adolescents and adult males (72% to < 1% and 76% to 6%, respectively) but remained high in adult women (38%). Beans were the main source of folic acid before fortification. With fortification, bread became the main source, but beans remained important. Fortification was successful (increased intake within safe levels), but it raised concerns about the high proportion in the target group (adult women) who still fail to meet the recommended intake.

Se analizó la ingesta de folato en los periodos de pre- y posfortificación. Los datos dietéticos se recogieron mediante un recordatorio de 24 horas en la Encuesta de Salud de São Paulo (ISA-Capital) en 2003 y 2007/2008, estratificando la población según etapa de la vida y sexo. Se utilizaron los valores de recomendación: necesidad media estimada (EAR) y la ingesta máxima tolerable (UL) y el método "EAR como punto de corte" para estimar la ingesta inadecuada. Se observó una reducción en la prevalencia de ingesta inadecuada de folato en todos los grupos, especialmente en los adolescentes y adultos varones, de un 72% a < 1% y de un 76% a un 6%, no obstante, en las mujeres adultas, la inadecuación seguía siendo alta (38%). Antes de la fortificación, los frijoles son el alimento que más contribuye a la ingesta de folato, después es el pan el que también constituye una fuente de folato, pese a que los frijoles siguen siendo los más importantes. La fortificación fue exitosa (aumento de la ingesta dentro de niveles seguros), sin embargo, se plantea una preocupación por el alto porcentaje del grupo objetivo: mujeres adultas que no cumplen con la recomendación para la ingesta de ácido fólico.

Avaliação da biodisponibilidade de ferro ingerido por crianças em idade pré-escolar / Evaluation of iron bioavailability in preschool children

The study aimed to evaluate the bioavailability of iron ingested by children under six years old. The data were obtained from a population-based crosssectionalstudy aimed to evaluate the effect of flour fortification with ironon anemia in preschool children. The feeding data were obtained from 24-hour recalls. The bioavailability of iron intake was calculated by us ingthe algorithm proposed by Monsen et al. which takes into account the iron stock body, total iron intake, heme iron, nonheme iron, vitamin C and the amount of meat per meal. Among the 4032 of meals studied, 72% had alow iron bioavailability. None of the 774 children studied showed a daily diet with intermediate or high iron bioavailability, which may be partially explained by the deficient consumption of iron and/or by the consumption of food items which facilitate its absorption.

El foco del trabajo fue la evaluación de labio disponibilidad del hierro ingerido por niños menores de seis años de edad. Los datos fueron obtenidos de un estudio transversal de base poblacional que enfocaba valorar el efecto que la fortificación de harinas con hierro ejercía sobrela anemia de niños en edad preescolar. Los datos de la alimentación fueron obtenidos por mediode recordatorios registrados a cada 24 horas con las madres o responsables por los niños. La biodisponibilidad del hierro ingerido fue calculada por medio del algoritmo propuesto por Monsen et al., que considera el estoque corporal de hierro, la ingestión de hierro total; el hierro hemínico (Fe-hem); el hierro no hemínico (Feno-hem), la vitamina C y la cantidad de carne por comida. De las 4032 comidas estudiadas, un 72% presentaron baja disponibilidad de hierro. Ninguno de los 774 niños que fueron estudiados presentó una alimentación diaria con biodisponibilidad de hierro media o alta, lo que puede ser parcialmente explicado por deficiencia en el consumo de hierro y/o de alimentos que son facilitadores de la absorción del mineral.

O trabalho objetivou avaliar a biodisponibilidade do ferro ingerido por crianças menores de seis anos de idade. Os dados foram obtidos de estudo transversal de base populacional que avaliou o efeito da fortificação das farinhas com ferro sobre a anemia em pré-escolares. Foram aplicados recordatórios de 24 horas às mães ou responsáveis pelas crianças. A biodisponibilidade do ferro ingerido foi calculada através do algoritmo proposto por Monsen et al. que leva em consideração o estoque corporal de ferro, a ingestão de ferro total; ferro heme; ferro não heme; vitamina C e a quantidade de carne, por refeição. Das 4032 refeições estudadas, 72% apresentaram baixa biodisponibilidade de ferro. Nenhuma das 774 crianças estudadas apresentou alimentação diária com média ou alta biodisponibilidade de ferro, o que pode ser parcialmente explicado pelo consumo deficitáriode ferro e/ou de alimentos facilitadores de sua absorção.

Immunohistochemical study on the effect of soft diet and omega 3-fortified soft diet on neurogenesis in the rat dentate gyrus and the subventricular zone

Adult brain neurogenesis persists in the subventricular zone [SVZ] and in the subgranular zone [SGZ] of the dentate gyrus. Modulation of neurogenesis by diet is a mechanism by which nutrition affects memory, learning, and mood. To study the effect of the soft diet with or without omega 3 fatty acids on neurogenesis. Thirty weaned male albino rats [3 weeks] were divided into three groups. Group 1 [control group] were fed on hard diets, group 2 were fed on soft diets, and group 3 were fed on soft diets plus omega 3 fatty acids for 3 months. Nerve cell proliferation in the SVZ and the SGZ was detected immunohistochemically using thymidine analog bromodeoxyuridine [BrdU]. The results were statistically analyzed. In the dentate gyrus, there was a significant increase in the number of BrdU-positive cells in groups 1 and 3 compared with group 2. Meanwhile in the SVZ, there was a significant increase in the number of BrdU-positive cells in group 3 compared with group 1. In group 1, the newly formed cells in the SGZ reached the granular cell layer of the dentate gyrus. The newly formed cells in the SVZ reached the olfactory bulb [OB] after 2 weeks but failed to survive for 4 weeks in the OB. In group 2, few newly formed cells reached the granular cell layer of the dentate gyrus, but they failed to reach the OB. In group 3, the newly formed cells reached their destination in the granular cell layer of the dentate gyrus and the OB. In the OB, the cells succeeded to survive for 4 weeks and were incorporated among the granular cells of OB. Hard diet and omega 3-fortified soft diet had a stimulatory effect on the process of neurogenesis in the dentate gyrus. Meanwhile in the SVZ, fortified soft diet had more stimulatory effect on proliferation and improvement of the survival rate of the newly formed cells than the hard diet

Anemia em pré-escolares atendidos em creches de Sâo Paulo (SP): perspectivas decorrentes da fortificação das farinhas de trigo e de milho / Anemia in pre-school children attending day care centers of São Paulo: perspectives of the wheat and maize flour fortification

Pre-school children are one of the most vulnerable groups to iron-defi ciencyanemia. The objective of this study was to measure the hemoglobin concentration and to diagnose the prevalence of anemia in children from 24 to 60 months old attending child day care centers. The diagnosis of anemiain 465 pre-school children from six child day care centers in Butantã,S.Paulo/Brasil, was carried out with peripheral hemoglobin measurementsand analysed by HemoCue employing 11,0g/dL as the cut-off for anemia.The nutritional status was calculated through weight/age, height/age, weight/height with cut-off values of -2.0 and +2.0 for malnutrition and obesity, respectively. The pre-school children had presented 20.9% anemia, 2.4% of the children were shown to be stunting, 0.9% wasting and 5.1% obesity. The childrenïs anthropometric features, as well as socio-economic and family conditions, were not associated with anemia. The prevalence of anemia,signifi cantly lower than the described in the totality of studies developedamong preschool children before the publication of Resolution 344/2002,that it determined the fortifi cation of wheat and maize fl ours with iron,allows to suggest that the supplemental iron, propagated through fortifi edfoods, positively played the role it was assigned to strategy of intervention forthe control of the iron defi ciency.

Los niños en edad preescolar son uno delos grupos más vulnerables a la anemiaferropriva. El objetivo del estudio fue medir la concentración de hemoglobina y diagnosticar la prevalencia de anemia en niños de 24 meses a 60 meses que frecuentan Jardines Infantiles.El diagnostico de anemia en 465 preescolares de seis unidades del barrio Butantã, municipio de São Paulo, Brasil, fue realizado por medio de la determinación de la concentración dehemoglobina periférica, utilizando punto de corte de 11,0g/dl. El estado nutricional fue calculado utilizando el puntajeûZ para peso/ edad, estatura/edad y peso/estaturacon niveles de corte -2,0 + 2,0 para desnutrición y obesidad, respectivamente. Fue diagnosticada anemia en 20,9% de los preescolares, desnutrición anterior en 2,4%, desnutrición actual en 0,9% y obesidad en 5,1%. No se encontró relación entre la anemia y las características antropométricas de los niños ni con las variables socio-económicas y domiciliares de las familias. La prevalencia de anemia encontrada es signifi cativamente menor que la descrita en estudios realizados en las mismas poblaciones de preescolares anteriormente a la publicación de la resolución 344/2002, eso que determinó el fortificación de las harinas de trigo y maíz con hierro. Esto permite sugerir que el suplemento de hierro, aportado por medio de los alimentos fortificados ejerció positivamente el papel que le fue conferido en el estratégia de la intervención para controlar su deficiencia.

A criança em idade pré-escolar é um dos grupos mais vulneráveis à anemia ferropriva. O objetivo do estudo foi medir a concentração de hemoglobinae diagnosticar a prevalência de anemia em crianças com 24 meses a 60 meses de idade que frequentam Centros de Educação Infantil. O diagnóstico de anemia de 465 pré-escolaresde seis unidades da regional do Butantã,município de São Paulo, foi realizado com determinação da concentração de hemoglobina periférica utilizando ponto de corte de 11,0g/dL. O estado nutricional foi calculado utilizando os escores-Z de peso/idade, estatura/idade e peso/estatura com níveis de corte -2,0 e +2,0para desnutrição e obesidade, respectivamente. Os pré-escolares apresentaram 20,9% deanemia; 2,4% de crianças foram diagnosticadas como tendo desnutrição pregressa, 0,9% desnutrição atual e 5,1% obesidade. Não houveassociação da anemia com as características antropométricas das crianças e com as variáveissocioeconômicas e domiciliares das famílias. A prevalência de anemia, significativamente menor do que a descrita na totalidade deestudos desenvolvidos entre pré-escolares antes da publicação da Resolução 344/2002, quedeterminou a fortifi cação das farinhas de trigo e de milho com ferro, permite sugerir que o ferro suplementar, veiculado pelos alimentosfortificados, exerceu positivamente o papel que lhe foi conferido na estratégia de intervenção para o controle da deficiência de ferro.

Bakery fortification and biological evalation of bottle gourd seeds [lagenaria siceraria]

This study was conducted to investigate the potential use of roasted bottle gourd seeds [BGS] as a source of protein, oil and fiber in some bakery products [white pan bread and cup cake] and determine their hypocholesterolemic effects in rats. The roasted whole BGS were subjected to different chemical determinations [Trypsin inhibitor activity and proximal composition]. White pan bread and cup cake were fortified with roasted whole BGS and their kernel flours at different percentages [10, 15 and 20%]. All the fortified samples were subjected to both objective and organoleptic evaluation. The fortified products which maintained better characteristics were subjected to nutritive value determination. The biological study included 20 male albino rats of Sprague Dawley strain, weighing [120 +/- 10 g] and lasted for 4 weeks. The rats were divided into four main groups [n = 5 rats] as follows group 1 [control] fed on a basal diet, group 2 hypocholesterolemic [HC] rats fed on a high fat and high cholesterol diet, group 3 rats fed on hypocholesterolemic diet containing [10%] raw BGS flour and group 4 rats fed on hypocholesterolemic diet containing [10%] roasted BGS flour. Food intake, body weight gain, feed efficiency ratio [FER], relative organ weights. hematocrit level, serum calcium, iron and lipid profiles were determined. Results showed that the chemical composition of fortified white pan bread and cup cake improved significantly [p<0.05] as compared to the control. The biological study showed that rats fed on raw BGS had significant [p<0.05] decrease in food intake, body weight gain, FER, hematocrit level and high density lipoprotein cholesterol concentration, while it induced significant [p<0.05] increase in low density lipoprotein cholesterol concentrations as compared to the control group. Meanwhile, roasted BGS caused significant [p<0.05] increase in body weight gain and ameliorate the lipid profile parameters. Feeding tested rats on raw and roasted BGS each individually resulted in non-significant [p<0.05] decrease in calcium level and non-significant increase in iron level comparing with HC group. It can be concluded that under the study condition, roasted BGS had good impact on nutritional values of bakery products and showed hypocholesterolemic effectl on experimental animals

Intensive nutrition education with or without supplementary feeding improves the nutritional status of moderately-malnourished children in Bangladesh.

This prospective randomized trial was carried out to test the efficacy of a specific intervention for reducing the extent of their malnutrition and to change behaviour of mothers relating to child-feeding practices, care-giving, and health-seeking practices under the Bangladesh Integrated Nutrition Project (BINP). The study was conducted in rural Bangladesh among 282 moderately-malnourished (weight-for-age between 61% and 75% of median of the National Center for Health Statistics standard) children aged 6-24 months. Mothers of the first intervention group received intensive nutrition education (INE group) twice a week for three months. The second intervention group received the same nutrition education, and their children received additional supplementary feeding (INE+SF group). The comparison group received nutrition education from the community nutrition promoters twice a month according to the standard routine service of BINP. The children were observed for a further six months. After three months of interventions, a significantly higher proportion of children in the INE and INE+SF groups improved (37% and 47% respectively) from moderate to mild or normal nutrition compared to the comparison group (18%) (p < 0.001). At the end of six months of observation, the nutritional status of children in the intervention groups improved further from moderate to mild or normal nutrition compared to the comparison group (59% and 86% vs 30%, p < 0.0001). As the intensive nutrition education and supplementation given were highly effective, more children improved from moderate malnutrition to mild or normal nutritional status despite a higher incidence of morbidity. The frequency of child feeding and home-based complementary feeding improved significantly (p < 0.001) in both the intervention groups after three months of interventions and six months of observation. Body-weight gain was positively associated with age, length-for-age, weight-for-length, frequency of feeding of khichuri, egg, and potato (p < 0.05). Ability of mothers to identify malnutrition improved from 15% to 99% in the INE group and from 15% to 100% in the INE+SF group, but reduced from 24% to 21% in the comparison group. Use of separate feed pots, frequency of feeding, and cooking of additional complementary feeds improved significantly in the INE and INE+SF groups compared to the comparison group after three months of interventions and six months of observation. It can be concluded from the findings of the study that intensive nutrition education significantly improves the status of moderately-malnourished children with or without supplementary feeding.

Iron deficiency anemia in children: prevalence and prevention studies in Ribeirao Preto, Brazil / Anemia en niños por deficiencia de hierro: prevalencia y estudios preventivo en Ribeirao Preto, Brasil

Brazil. Iron deficiency and ferropenic anemia are, certainly, the most prevalent and specific nutritional problems in Brazil. The Ribeirao Preto region is no exception to it. A large prevalence of iron deficiency/anemia is found, mainly in the age group 6-24 months. In spite of the fact that several aspects of its physiopathology are known is a very difficult problem to be solved. Many approaches and alternatives for thheir prevention have been tried but we are far from controlling the situation. Several studies carried out at the Medical School of Ribeirao Preto, University of Sao Paulo, Brazil have shown this high incidence of iron deficiency and iron anemia among infants and preshool children. The importance of iron supplementation to preterm, premature and normal infants was pointed out. The possibility of use of iron complexes to prevent iron deficiency, besides the usual ferrous sulfate, was shown. Several community studies proved the feasibility of distribution and intake of iron as supplements or carriers as alternatives to prevent iron deficiency

Micronutrients and urban life-style: lessons from Guatemala / Micronutrientes y estilo de vida urbana: lección de Guatemala

Guatemala is a nation of 10 million persons, at the northern point of the chain of five Republics derived from Spanish colonies on the Ishmus of Central America. The country is diverse in its ethnicities, its climate and terrain, and its agricultural pursuits. The majority of its population is poor, illiterate, and under-employed. It has had aunique and turbulent political history, and only recently has emerged. The traditional basis of the diet, dating to Mayan times, is maize and beans. Guatemala City, with its population in excess of 2 million inhabitants, having doubled since the Earthquake of 1976, is the only major metropolis. The pattern of dietary selection and the format of eating meals is changing in relationship to the size, congestion, economic evolution, and modernization of the capital city. A wider selection of foods is consumed in the city, but preparation follows the traditions of the cuisine. Street vendors play an ever larger role in the feeding of the urban poor. Quantitative data are only available for vitamin A and zinc, and only in certain subsegment of the population. The vitamin A in fortified foods, notably table sugar which is fortified with retinyl palmitate by legal mandate, makes up over one-third of the intake. The maize tortilla is an important sources of calcium, iron, zinc and copper. Average zinc intakes are appropriate, but the biological availability of the metal is low. The intake of iodine is totally dependent upon table salt which is inconsistently fortified. Data on micronutrient status exists for vitamin A, iron, iodine, riboflavin and zinc. With respect to rural areas, no major advantages or disadvantages in the adequacy of micronutrient nutriture can be calimed for the urban population. IT is probable that, in the metropolitan area, vitamin A nutriture is slightly better and riboflavin status somewhat poorer than in the countryside. The prospects for tuture directions in urban lifestyle, in micronutrient status and in their interaction are uncertain. The pressures of growth are straining the ability of the municipal infrastructure and the industrial base to respond with provision of services and employment

Micronutrient deficiency in urban Indonesia / Deficiencia de micronutrientes en area urbana de Indonesia

The economic situation of characterized by a large increase in the gross national product which has been on average 7 por ciento annually during the last ten years. This was accompanied by rapid urbanization. With the economic improvement, "First World" health and nutrition problems are coexisting in Indonesia. In 1992, the most common of death cause was cardiovascular disease whereas tuberculosis was the second ranking. About 40 por ciento of the preschool children are stunted. The main stable food and source is rice, although the urban population has a more diverse food pattern than the rural population. In Jakarta, many children receive too late colostrum feeding and mothers are not aware about the importance of correct breastfeeding practices after delivery. Three studies had shown that about one fidth of preschool children and one fourth of elderly take micronutriens. Nevertheless are prevalent in Jakarta. About one third of women suffer from moderate vitamin A deficiency (plasma retino <0.70 mmol/L) and 50 por ciento of pregnant women are anemic. More information is necessary on other micronutrient deficiencies. For example, a small study revealed that nearly two thirds of non-institutionalized alderly living in Jakarta experience thiamine deficiency. Appropriate interventions to reduce micronutrient deficienies should sensitiza the urban population to the fact that the government should restrict itself no use its resources to assist only the poorest individuals and groups, whereas it must be expected from the middle class to spend more to solve their own problemas

Formulación de una Estrategia Alternativa para Superar el "Non-Compliance" en la Suplementación con HIerro en Mujeres Anémicas durante el Puerperio, Santo Domingo-Ecuador 1994 / Formulation of an Alternative Strategy to Overcome the \"Non-Compliance\" in the Suplementary with Iron in Anemic Women during the Puerperium, Sacred Domingo-Ecuador 1994

Se realizó un estudio de mercadeo social para diseñar una estrategia de suplementación con hierro en mujeres anémicas durante el puerperio en el Hospital de Santo Domingo de los Colorados. Se identificó, definió, y caracterizó a los públicos inmersos en el proceso: madres en puerperio, personal de salud asistencial, autoridades de los niveles local y central, farmacias y centros naturistas de la localidad,organismos internacionales de apoyo técnico y finaciero en el área de la salud y nutrición.Se aplicaron técnicas de investigación cualitativa y cuantitativa: observación participante, entrevistas a profundidad a informantes claves, grupos focales y un ensayo clínico. El anállisi se orientó a establecer factores asociados al "non-compliance". preferencias, necesidades y deseos de los públlicos para sustentar

Cuándo y cómo intervenir en el anciano malnutrido / When and who to intervene in the malnutrition aged

Los ancianos se encuentran en una situación de riesgo de sufrir malnutrición por diversos factores, entre los que se encuentran los cambios fisiológicos que se producen con el proceso de envejecimiento, enfermedades sistémicas con la enfermedad de Parkinson, la diabetes, las infecciones, la depresión y otros trastornos psiquiátricos, alteraciones bioquímicas y los efectos de diversas medicaciones. Muchos de estos factores son reversibles si se reconocen y se modifican de forma precoz. Los niveles de colesterol y de albúmina pueden ayudar a confirmar el diagnóstico de malnutrición. Entre las intervenciones encaminadas a mejorar el estado nutricional se encuentran: el realizar más ejercicio, aumentar la ingesta de nitrógeno y de agua, evitar el estreñimiento, recomendar una revisión rutinaria de la dentadura y prescribir suplementos nutricionales cuando sea necesario

Suplementación con hierro en escolares anémicos

Se estudiaron 60 niños, con un promedio de edad de 6 años a 7 meses en una localidad subtropical del Ecuador. Se obtuvieron valores de hemoglobina (Hb) antes del tratamiento y luego de 30 días de administración de hierro oral 3 mg/kg/día. el cumplimiento de las indicaciones terapéuticas se evaluó siguiendo la metodología vigente en unidades de salud y por profesinales médicos. Se analizó el patrón de rendimiento escolar por calificaciones globales y se obtuvo datos antropométricos (edad, peso, talla). Se encontró una prevalencia de anemia de 33.3 por ciento, más acentuada en hombre y en el grupo de niños nutricionalmnente normales (36.3 por ciento). La prevalencia de desnutrición global, crónica y aguda fue de 42.5 por ciento, 38.3 por ciento y 20.07 por ciento respectivamente. Llama la atención este último dato, el cual es mayor que las cifras de referencia. El cumplimiento del tratamiento fue del 80 por ciento y la corrección de anemia fue únicamente del 18 por ciento. No se encontró cambios en el rendimiento escolar luego de la suplementación con hierro...

El consumo alimentario de las familias y niños beneficiarios del Programa Nacional de Alimentación Complementaria en Chile / Food consumption of the families and children assisted by the national program of complementary feeding in Chile

El objetivo del trabajo fue conocer el consumo alimentario de niños beneficiarios del Sistema Nacional de Servicio de Salud, para evaluar el impacto de los alimentos entregados por el Programa Nacional de Alimentación Complementaria. Se realizó una encuesta alimentaria en 600 hogares, a todos los miembros de la familia. La distribución intrafamiliar de la leche-cereal fue baja: en todos los quintiles de ingresos, más del 87 por ciento de los niños menores de 6 años consumían el alimento. El aporte energético de la leche-cereal fue de un 18,4 por ciento en un consumo calórico de los niños que consumieron leche-cereal fue de 1749 Kcal

Desarrollo y evaluación de un panqué enriquecido con harina de algodón / Development and evaluation of an enriched cake with cottonsedd meal

En Venezuela, los problemas nutricionales, específicamente la desnutrición caloricoproteica, se ha acentuado en los últimos años. Una posible solución lo constituye el enriquecimiento de alimentos con fuentes de proteínas, como las que contiene el residuo o torta de la extracción del aceite de las semillas de algodón. En este trabajo se caracterizaron las harinas de algodón obtenidas industrialmente y se utilizó hasta en un 15 por ciento en un panqué enriquecido, susceptible a ser utilizado en la merienda escolar. Se seleccionó el panqué de vainilla con 45 por ciento de harina de algodón debido a que la aceptabilidad a nivel de laboratorio fue de 97 por ciento. Se probó en una escuela con 1.009 niños de distintas edades, la aceptabilidad fue de 97 por ciento. Se concluyó que este producto, que suministra 395 Kcal y 13 g de proteínapor cada 100 g, podría ser utilizado para mejorar el aporte calóricoproteico de la merienda escolar