Food Nutr Bull
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparative evaluation of multiple micronutrient and iron-folic acid supplementation during pregnancy in Pakistan: impact on pregnancy outcomes.
Maternal micronutrient deficiencies are widespread in Pakistan and are potentially associated with maternal undernutrition and intrauterine growth retardation. Intervention strategies largely consist of administration of iron-folic acid supplements during pregnancy. ⋯ These data suggest that multiple micronutrient supplements are well tolerated during pregnancy, but the effect on birthweight is modest. The observed effect on early neonatal mortality suggests the need for further studies and careful assessment of the intervention in health system settings.
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Iodine is necessary for the synthesis of thyroid hormones, which play a decisive role in the development of the brain during fetal and early postnatal life. ⋯ Pregnant women in the urban area of Tuzla had adequate iodine status except for those with restricted salt intake, which presents an increased risk to the mother as well to as the unborn child. Women in the rural area of Tuzla were found to be iodine-deficient, regardless of whether they had restricted their salt intake or not. However, for those pregnant women who have been advised to restrict their salt intake and who thus face the risk of iodine deficiency, the use of salt with higher concentrations of iodine could be advised.
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The Baby-Friendly Hospital Initiative (BFHI) was launched in the 1990s by the World Health Organization (WHO) and UNICEF as a global effort with hospitals, health services, and parents to ensure babies are breastfed for the best start in life. It is one of the Operational Targets of the Global Strategy for Infant and Young Child Feeding endorsed in 2002 by the Fifty-Fifth World Health Assembly and the UNICEF Executive Board. After about 18 years, great progress has been made, and most countries have breastfeeding authorities or BFHI coordinating groups. ⋯ Based on this progress, the Initiative was streamlined according to the experience of the countries and materials were revised. The new package consolidated all WHO and UNICEF materials into one package, reflected new research and experience, revisited the criteria used for the BFHI in light of HIV/ AIDS, reinforced the International Code of Marketing of Breast-Milk Substitutes, provided modules for mother-friendly care, and gave more guidance for monitoring and reassessment. WHO and partners will continue to give support to BFHI implementation as one essential effort contributing to achievement of the Millennium Development Goals.
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The term "pediatric metabolic syndrome" includes a cluster of cardiovascular risk factors such as insulin resistance, dyslipidemia (including increased triglycerides and decreased HDL cholesterol), hypertension, and obesity in children. No studies have been performed on this syndrome in a pediatric population in Costa Rica. ⋯ This study reported a prevalence of 5.6% of metabolic syndrome among a sample of Costa Rican overweight and obese prepuberal children. Lifestyle interventions focusing on weight reduction and increasing physical activities should be promoted by education and health authorities in order to avoid the early development and onset of type 2 diabetes and atherosclerosis in childhood.
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The importance of folate in reproduction can be appreciated by considering that the existence of the vitamin was first suspected from efforts to explain a potentially fatal megaloblastic anemia in young pregnant women in India. Today, low maternal folate status during pregnancy and lactation remains a significant cause of maternal morbidity in some communities. The folate status of the neonate tends to be protected at the expense of maternal stores; nevertheless, there is mounting evidence that inadequate maternal folate status during pregnancy may lead to low infant birthweight, thereby conferring risk of developmental and long-term adverse health outcomes. ⋯ Starting pregnancy with an inadequate vitamin B12 status may increase risk of birth defects such as NTD, and may contribute to preterm delivery, although this needs further evaluation. Furthermore, inadequate vitamin B12 status in the mother may lead to frank deficiency in the infant if sufficient fetal stores of vitamin B12 are not laid down during pregnancy or are not available in breastmilk. However, the implications of starting pregnancy and lactation with low vitamin B12 status have not been sufficiently researched.