ABSTRACT
Diets of infants across the world are commonly deficient in multiple micronutrients during the period of growth faltering and dietary transition from milk to solid foods. A randomized placebo controlled trial was carried out in Indonesia, Peru, South Africa, and Vietnam, using a common protocol to investigate whether improving status for multiple micronutrients prevented growth faltering and anemia during infancy. The results of the pooled data analysis of the 4 countries for growth, anemia, and micronutrient status are reported. A total of 1134 infants were randomized to 4 treatment groups, with 283 receiving a daily placebo (P), 283 receiving a weekly multiple micronutrient supplement (WMM), 280 received a daily multiple micronutrient (DMM) supplement, and 288 received daily iron (DI) supplements. The DMM group had a significantly greater weight gain, growing at an average rate of 207 g/mo compared with 192 g/mo for the WMM group, and 186 g/mo for the DI and P groups. There were no differences in height gain. DMM was also the most effective treatment for controlling anemia and iron deficiency, besides improving zinc, retinol, tocopherol, and riboflavin status. DI supplementation alone increased zinc deficiency. The prevalence of multiple micronutrient deficiencies at baseline was high, with anemia affecting the majority, and was not fully controlled even after 6 mo of supplementation. These positive results indicate the need for larger effectiveness trials to examine how to deliver supplements at the program scale and to estimate cost benefits. Consideration should also be given to increasing the dosages of micronutrients being delivered in the foodlets.
Subject(s)
Anemia/prevention & control , Developing Countries , Diet , Dietary Supplements , Growth Disorders/prevention & control , Micronutrients , Geography , Humans , Indonesia , Infant , Peru , Randomized Controlled Trials as Topic , South Africa , VietnamABSTRACT
Anemia, micronutrient deficiencies, and growth faltering are still common in Peru. The study objective was to determine the efficacy of different micronutrient supplements in preventing growth failure, anemia, and micronutrient deficiencies in Peruvian infants. Three hundred and thirteen infants aged 6 to 12 mo participated in a double-blind, masked, controlled trial in which they were randomly assigned to receive either a daily dose of iron (DI), a daily dose of multiple micronutrients (DMM), a weekly dose of multiple micronutrients, or a placebo (P) for 6 mo. None of the supplements tested prevented growth faltering or the morbidities common during infancy. Anemia and plasma homocysteine concentrations fell significantly in all groups during the study, but the mean change of plasma homocysteine during the trial period was significantly smaller in the DI group than in other groups, and the increase in hemoglobin concentrations was smaller in the P group than the micronutrient treatment groups. Plasma ferritin concentrations decreased least in the groups taking daily micronutrient supplements containing iron (DI and DMM). There were no significant differences among groups in mean final values or changes in plasma zinc, retinol, tocopherol, or riboflavin. Although the DMM intervention was the most efficacious for preventing anemia, iron, and zinc deficiencies, 15%, 20%, and 50% of this group still remained anemic, zinc deficient, and iron deficient, respectively, at the end of the study. Further research thus should investigate whether higher doses of iron and zinc, together with infection control measures, are more efficacious.
Subject(s)
Anemia/prevention & control , Dietary Supplements , Growth Disorders/prevention & control , Infant Food , Micronutrients , Adult , Body Height , Deficiency Diseases/epidemiology , Female , Growth , Humans , Infant , Iron Deficiencies , Male , Morbidity , Peru , Weight GainABSTRACT
Infants in developing countries are at risk of concurrent micronutrient deficiencies, because the same causative factors may lead to deficiencies of different micronutrients. Inadequate dietary intake is considered one of the major causes of micronutrient deficiencies, especially among poor and underprivileged children in developing countries. Operational strategies and distribution systems are often duplicated when supplementation programs for single micronutrients are implemented at the same time. The International Research on Infant Supplementation (IRIS) trial was conducted in four distinct populations on three continents: Africa, Latin America, and Asia. The participating countries were South Africa, Peru, Vietnam, and Indonesia. The study had a randomized, doubleblind, placebo-controlled design. Each country aimed to enroll at least 70 infants per intervention group (65 + 5 anticipated dropouts). The micronutrient vehicle was in the form of a "foodlet" (food-like tablet) manufactured as chewable tablets, which were easy to break and dissolve, and which had the same taste, color, and flavor for all countries. Children were randomly assigned to one of four 6-month intervention groups: group 1 received a daily foodlet containing multiple micronutrients; group 2 received a daily placebo foodlet containing no micronutrients; group 3 received a weekly foodlet that contained multiple micronutrients (twice the dose of the daily foodlet) and placebo foodlets on the other days of the week; group 4 received a daily foodlet containing only 10 mg of elemental iron. The IRIS Trial aimed to examine the prevalence of multi-micronutrient deficiencies in 6- to 12-month-old infants from rural populations, and to examine the efficacy of multi-micronutrient supplementation in infants from the different countries included in the study. This paper describes the general methodology of the IRIS trial and the operational differences among the country sites.
Subject(s)
Deficiency Diseases/prevention & control , Dietary Supplements , Growth , Micronutrients/administration & dosage , Biomarkers/blood , Cross-Cultural Comparison , Deficiency Diseases/blood , Deficiency Diseases/epidemiology , Double-Blind Method , Female , Humans , Indonesia/epidemiology , Infant , Infant Nutrition Disorders/blood , Infant Nutrition Disorders/epidemiology , Infant Nutrition Disorders/prevention & control , Infant Nutritional Physiological Phenomena , Male , Peru/epidemiology , Rural Health , South Africa/epidemiology , Treatment Outcome , Vietnam/epidemiologyABSTRACT
There is an urgent need for the development of a high-energy, micronutrient-dense food, such as a spread, for clinical and emergency nutrition. The spread to be used in the International Research on Infant Supplementation (IRIS) III trial will contain carotene-rich palm oil as a source of vitamin A and energy, and heme iron from slaughterhouse blood as an iron source. All other micronutrients shall come from a pre-mix. The product shall be designed for young children, in particular, but can be consumed by adults, as well. An efficacy study will be conducted for six months in children 6 to 12 months old.
Subject(s)
Carotenoids/administration & dosage , Food, Fortified , Iron Deficiencies , Iron, Dietary/administration & dosage , Micronutrients/administration & dosage , Vitamin A Deficiency/diet therapy , Carotenoids/blood , Double-Blind Method , Female , Humans , Infant , Iron, Dietary/blood , Male , Multicenter Studies as Topic , Palm Oil , Plant Oils/chemistry , Randomized Controlled Trials as Topic , Treatment Outcome , Vitamin AABSTRACT
Describe los programas de suplementacion alimentaria que se estan realiazando en el Perú, para combatir la malnutrición
Subject(s)
Humans , Child , Infant Nutritional Physiological Phenomena , Nutritional Sciences , Nutrition DisordersABSTRACT
Resúmenes de los artículos publicados por el Instituto de Investigación Nutricional entre los años 1963 y 1990.
Subject(s)
Humans , Health , Nutritional Sciences , Infant Nutrition , Peru , ResearchABSTRACT
Contiene: La situación nutricional en el Perú; El proyecto "Manejo dietético de la diarrea"; Prácticas de alimentación infantil; Desarrollo de una receta infantil: El Sanquito; ¿Cómo alimentar al niño con diarrea?; Taller Diseño de dietas infantiles
Subject(s)
Humans , Child, Preschool , Diarrhea, Infantile/diet therapy , Infant NutritionABSTRACT
La presente guía que está dirigida a todas las personas que deberán asumir la capacitación de promotores en programas de educación nutricional y control de crecimiento y desarrollo de niños. Recopila técnicas participativas para nutricionistas, asistentas sociales, enfermeras, educadores y trabajadores de Salud Pública.
Subject(s)
Humans , Food and Nutrition Education , Health , Health Promotion , Infant NutritionABSTRACT
Para implementar un programa orientado a mejorar la alimentación de los niños durante y después de diarrea aguda, se obtiene información de las creencias culturales y prácticas alimenticias de la población. Se realizaron dos encuestas: Callejón de Huaylas y comunidades urbano-marginales de Lima. Se realizaron estudios antropológicos y un estudio longitudinal
Subject(s)
Diarrhea, Infantile , Feeding Behavior , Infant Nutrition , Nutrition Surveys , Peru , Pilot ProjectsABSTRACT
Este manual pretende transferir en forma práctica las pautas generales para organizar y desarrollar cursos de entrenamiento a promotores de la comunidad en aspectos de salud y nutrición; desarrollar los contenidos educativos con métodos y técnicas que motiven su participación y los incentive a transferir esos conocimientos a la comunidad
Subject(s)
Infant , Child, Preschool , Child , Humans , Male , Female , Child Development , Child Health Services , Growth , Health Education , Health Promotion , Infant Nutrition , PeruABSTRACT
El programa tiene como objetivo mejorar el manejo dietético durante la diarrea y el período de convalescencia; esta encuesta sirve para conocer las prácticas alimenticias y las creencias culturales que la población tiene. Contiene: Antecedentes, Metodología, Resultados, Prácticas de alimentación, Factores que influyen en la alimentación de los niños, Creencias y prácticas sobre la diarrea, Alimentación durante la diarrea, y Utilización de medios de comunicación en la zona de estudio
