Compliance with home-based fortification strategies for delivery of iron and zinc: its effect on haematological and growth markers among 6-24 months old children in north India.

Compliance is a key component in successful implementation of the delivery of micronutrients among children. The present study evaluates the compliance with two home-based food fortification strategies (fortified complementary food or sprinkle) for providing iron and zinc among children aged 6-24 months. A total of 292 children were randomly allocated to receive either rice-based fortified complementary food and nutrition education (Cf = 101), sprinkle and nutrition education (Mp = 97), or nutrition education alone as control (Ed = 94). All the enrolled children were breastfed at the beginning of the study and were advised to continue breastfeeding. Biweekly information on compliance and anthropometry was collected. Complete haemogram estimation was conducted at baseline and end of the study. Compliance with the fortified complementary food was higher compared to sprinkle (Cf = 81%, Mp = 64% child-days). Consumption of the fortified complementary food for 6 months resulted in a significant increase in mean haemoglobin in the intervention group compared to control group (Cf 1.29 +/- 1.6 g/dL; Ed 0.23 +/- 1.3 g/dL; p < 0.001). Our results showed that fortified complementary food had higher compliance than sprinkle and is a suitable delivery mechanism for iron and zinc in preschool children.

Food safety security: a new concept for enhancing food safety measures.

The food safety security (FSS) concept is perceived as an early warning system for minimizing food safety (FS) breaches, and it functions in conjunction with existing FS measures. Essentially, the function of FS and FSS measures can be visualized in two parts: (i) the FS preventive measures as actions taken at the stem level, and (ii) the FSS interventions as actions taken at the root level, to enhance the impact of the implemented safety steps. In practice, along with FS, FSS also draws its support from (i) legislative directives and regulatory measures for enforcing verifiable, timely, and effective compliance; (ii) measurement systems in place for sustained quality assurance; and (iii) shared responsibility to ensure cohesion among all the stakeholders namely, policy makers, regulators, food producers, processors and distributors, and consumers. However, the functional framework of FSS differs from that of FS by way of: (i) retooling the vulnerable segments of the preventive features of existing FS measures; (ii) fine-tuning response systems to efficiently preempt the FS breaches; (iii) building a long-term nutrient and toxicant surveillance network based on validated measurement systems functioning in real time; (iv) focusing on crisp, clear, and correct communication that resonates among all the stakeholders; and (v) developing inter-disciplinary human resources to meet ever-increasing FS challenges. Important determinants of FSS include: (i) strengthening international dialogue for refining regulatory reforms and addressing emerging risks; (ii) developing innovative and strategic action points for intervention {in addition to Hazard Analysis and Critical Control Points (HACCP) procedures]; and (iii) introducing additional science-based tools such as metrology-based measurement systems.

Metrology in physics, chemistry, and biology: differing perceptions.

The association of physics and chemistry with metrology (the science of measurements) is well documented. For practical purposes, basic metrological measurements in physics are governed by two components, namely, the measure (i.e., the unit of measurement) and the measurand (i.e., the entity measured), which fully account for the integrity of a measurement process. In simple words, in the case of measuring the length of a room (the measurand), the SI unit meter (the measure) provides a direct answer sustained by metrological concepts. Metrology in chemistry, as observed through physical chemistry (measures used to express molar relationships, volume, pressure, temperature, surface tension, among others) follows the same principles of metrology as in physics. The same basis percolates to classical analytical chemistry (gravimetry for preparing high-purity standards, related definitive analytical techniques, among others). However, certain transition takes place in extending the metrological principles to chemical measurements in complex chemical matrices (e.g., food samples), as it adds a third component, namely, indirect measurements (e.g., AAS determination of Zn in foods). This is a practice frequently used in field assays, and calls for additional steps to account for traceability of such chemical measurements for safeguarding reliability concerns. Hence, the assessment that chemical metrology is still evolving.

Nuclear and isotopic techniques applied to supporting nutritional studies in East Asia and Pacific Countries: IAEA's contributions over 20 years.

The world's scientific community has recognized that isotopic techniques play a vital role in monitoring the effectiveness of nutrition intervention by providing precise data on absorption, bioavailablity and interaction of various micronutrients in a cost effective manner. The International Atomic Energy Agency (IAEA) has been supporting many such health related studies in Member States from developing countries using nuclear and isotopic methods for over 20 years. This report documents the Agency's support for a variety of projects in East Asia and Pacific countries to assess body composition, total energy expenditure, nutrient intake, osteoporosis, infection, vitamin and mineral bioavailability as well as food composition. The IAEA spent a total of 10,302,356 US dollars through Coordinated Research Projects (CRP) and Technical Cooperation Projects (TCP) over the past 20 years. Out of this only 2,732,802, US dollars or 26.5% was used by the East Asia and Pacific countries. While the participation of East Asia and Pacific countries was strong in CRPs and moderate in regional TCPs, they did not participate in national TCPs at all. The non-participation under national TCPs is a serious deficiency when compared with Latin American and African regions and therefore, more participation from the East Asia and Pacific countries in national TCPs is strongly encouraged in the future.

Iron deficiency: causes, consequences, and strategies to overcome this nutritional problem.

Iron deficiency and anemia affect a substantial portion of the world's population, provoking severe health problems to the people suffering these conditions, as well as important economic losses to the regions in which this nutritional deficiency is significant. In this work, the principal causes and consequences produced by this deficiency are discussed, as well as the different strategies that can be applied in order to prevent and solve this nutritional problem.

Analytical methods: improvements, advancements and new horizons.

The workshop and exhibits dealing with analytical methods were selected to highlight the current state of the art in elemental analysis. The presentations in the first part of the workshop described approaches and advances important to the analysis of trace minerals. These presentations included: 1) two approaches to mass spectrometry, inductively coupled plasma and accelerator mass spectrometry; 2) use of nuclear magnetic resonance in studies of mineral function; and 3) the use and limitations of fluorescent probes in studies of metal uptake and regulation. In the second part of the workshop, the International Atomic Energy's contributions to nutritional "metrology" were described. Advances in instrumentation over the past decade have led to extraordinary improvements in the precision and sensitivity of mineral analyses. The ability to address isotopic speciation at such low levels sets the stage for numerous novel approaches in the assessment of trace mineral function.

Nuclear techniques in nutrition and health: importance and applications in developing regions.

Nuclear and isotope methods in one form or another are regarded as essential tools for carrying out nutrition research besides enhancing sensitivity of nutrition monitoring techniques. They have been used extensively in industrialized countries to analyse human energy requirements, body composition including bone mineral density, and the metabolism of important nutrients such as protein, fat, vitamins and minerals. The information acquired has led to many improvements in nutrition and health. Currently, several strategic applications of isotopic techniques are being introduced in developing countries where they can benefit millions through monitoring improvement in nutritional status, and serve as specific indicators of broader social and economic advances.

Isotopic tools for strengthening health and nutritional monitoring and their current applications in developing regions of the world.

Nuclear and isotope methods in one form or another are regarded as essential tools for carrying out nutrition research besides enhancing sensitivity of nutrition monitoring techniques. They have been used extensively in industrialized countries to analyze human energy requirements, body composition including bone mineral density, to determine food composition, and to study metabolism of important nutrients such as protein, fat, vitamins, and minerals. The information acquired has led to many improvements in nutrition and health. Importantly, the developmental needs of countries in economic transition are being increasingly identified and resolved through field applications of isotopic tools, thus strengthening health and nutrition monitoring. Currently, several strategic applications of isotopic techniques are being introduced in developing countries where they can benefit millions through monitoring improvement in nutritional status, and serve as specific indicators of broader social and economic advances. These examples are highlighted in this report.

Application of stable isotopic techniques in the prevention of degenerative diseases like obesity and NIDDM in developing societies.

Economic development in developing societies characterized by industrialization, urbanization, and globalization has seen the emergence of an epidemic of diet- and life-style-related chronic degenerative diseases. A research project was initiated under the aegis of the International Atomic Energy Agency (IAEA), Vienna, Austria under its Coordinated Research Programme (CRP) to promote the use of stable isotopic techniques to document the extent of the problem and to understand the determinants of this epidemic. The principal objectives of this CRP involving countries both in the North and the South are to define the magnitude of the problem of obesity and non-insulin dependent diabetes mellitus (NIDDM) in developing countries, to identify the vulnerable groups at increased risk, and to attempt to describe the metabolic and physiological mechanisms underlying this phenomenon. These comparative international studies of obesity and NIDDM are looking at the effects of childhood malnutrition (Brazil) and socioeconomic differentials (Mexico) on adult risk factors; the composition of the daily diet on obesity (Chile); levels of patterns of physical activity of older adults (China) as well as their influence on weight gain and obesity (Cuba, Nigeria); the impact of body composition and energy expenditure on the evolution frank diabetes from impaired glucose tolerance (Jamaica), and of body compositional changes and the role of inflammatory cytokines on impaired glucose tolerance (India). The last study conducted in New Zealand was aimed at comparing the energy expenditures of Maori (Pacific Island) with New Zealanders of European descent.

Stable isotope techniques in human nutrition research: concerted action is needed.

Use of stable isotopes in applied nutrition has been a developing field for over 60 years. The past 20 years has seen improvements in computer and mass-spectrometer technology that has opened up even greater possibilities in the understanding of human metabolism. While improvements in technology can bring great opportunities, it can also cause problems if there is no consensus among the stable isotope user-community on standardization of new techniques and methods. Users of stable isotopes have traditionally been split into two groups; those who work with heavy isotopes (e.g., 58Fe, 70Zn) and those who work with light isotopes (e.g., 2H218O). Standardization issues have been addressed by the light isotope users and awareness of this type of problem is starting to emerge within the heavy isotope community.

Nuclear and isotopic techniques for addressing nutritional problems, with special reference to current applications in developing countries.

Nuclear and isotopic techniques are valuable tools in human nutritional research studies. Isotopes, both radioactive and nonradioactive, enable detailed evaluations of nutrient intake, body composition, energy expenditure, status of micronutrients, and nutrient bioavailability. In recent times, isotopic methods have been widely used in a number of coordinated research projects and technical cooperation projects of the International Atomic Energy Agency's Nutrition Programme. The doubly labeled water technique combines the use of the stable isotopes oxygen-18 and hydrogen-2 (deuterium) to measure total energy expenditure in free-living human subjects, and to investigate the magnitude and causes of both undernutrition and the emergence of obesity in developing countries. The deuterium dilution technique is a reliable tool to measure breastmilk intake and thereby infant growth and development. In collaboration with the World Health Organization's Growth Monitoring Program, this technique is being used to generate new data on growth standards for children in developing countries. This technique is also used in the measurement of body composition by the estimation of lean body mass and fat mass in individuals. Stable isotopes of iron and zinc have been successfully used to assess the nutritional impact of several nationwide food supplementation-programs conducted on pregnant and lactating women and children in both industrialized and developing countries. Isotopic techniques are especially suitable for monitoring changes in body composition, energy metabolism, and mineral status (with particular reference to osteoporosis) in the elderly. Nuclear methods have also served to develop models for a physiological reference man in Asia in support of radiological health and safety issues, for establishing elemental composition of foods, and for measurement of pollutants in the environment.