Food Nutr Bull
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Anemia affects almost two-thirds of pregnant women in developing countries and contributes to maternal morbidity and mortality and to low birthweight. ⋯ A high percentage of women at 20 to 26 weeks of pregnancy had mild to moderate anemia. Pica, tea consumption, and low intake of eggs and red meat were associated with anemia. Women of childbearing age should be provided nutritional education regarding food sources of iron, especially prior to becoming pregnant, and taught how food choices can either enhance or interfere with iron absorption.
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Worldwide obesity has become an unprecedented public health challenge. In addition, a notable increase in the risk of insulin resistance and type 2 diabetes mellitus has emerged. In Costa Rica, there are no epidemiological data to establish the prevalence of type 2 diabetes in the pediatric population. However, information from the Endocrinology Department of the Children's National Hospital indicates an increased number of cases in the last 2 to 3 years. ⋯ The prevalence of impaired glucose tolerance and insulin resistance in obese children indicates a worrisome trend in the incidence of type 2 diabetes in Costa Rica. Strategies for weight reduction, obesity prevention, and promotion of healthy lifestyles are necessary to prevent the onset of type 2 diabetes during childhood and adolescence.
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Diarrhea and malnutrition remain major health problems among children of developing countries. During diarrhea, the patient's dietary intake and absorption of nutrients are reduced while nutritional requirements are increased. ⋯ Food intake was reduced in the hospitalized children because of severe illness. Patients with lower energy intake as a percentage of RDA had delayed clinical recovery and higher stool output.
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High iron needs and low-iron diets combine to make early childhood one of the highest risk periods for iron deficiency. Recommendations for iron supplementation for this age group have been based on positive effects on anemia and child development. In contrast, the evidence regarding growth and morbidity outcomes has been equivocal, with some evidence of risk. ⋯ Cost-effectiveness analysis suggests that targeting supplements to iron-deficient children in Zanzibar may not increase costs (relative to universal supplementation) and would increase benefit. Operations research is needed to test this. We conclude with three options for maximizing the benefits and minimizing the risks of iron supplements.
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Randomized Controlled Trial
Prenatal multiple micronutrient supplementation has greater impact on birthweight than supplementation with iron and folic acid: a cluster-randomized, double-blind, controlled programmatic study in rural Niger.
Micronutrient deficiencies during pregnancy are associated with adverse pregnancy outcomes, including reduced birthweight. Low birthweight is associated with increased risk of infant mortality and growth failure. ⋯ Prenatal supplementation with multiple micronutrients had a greater positive impact on birthweight than supplementation with iron/folic acid. Our data suggest that prenatal supplementation with multiple micronutrients as part of a prenatal care package in addition to interventions to promote improved maternal prepregnancy nutrition status is an important strategy to increase birthweight and reduce the incidence of low birthweight.