Food and Nutrition Bulletin最新文献

{"title":"Perspective on Emerging Micronutrient Deficiencies in Latin America and the Caribbean.","authors":"Noel W Solomons","doi":"10.1177/03795721241257008","DOIUrl":"10.1177/03795721241257008","url":null,"abstract":"<p><p>The moral imperative of public health systems is to maximize the health and welfare of the population to the extent possible. Constraints often include a lack of resources, political will, popular acceptance, or an acceptable safety margin. Major agencies have established iron, iodine, and vitamin A as the principal elements for micronutrients, with folate and zinc on the second plane. As the armamentarium of interventions to favor micronutrient nutrition, for example, preventive health measures, dietary improvement, forms of fortification, and nutrient supplements, is offered in public health policy. The utility of their merger with other nutrients, emergent nutrients, has been considered. The Latin America and Caribbean Region has unique characteristics. The scientific and epidemiology considerations for action in the Region's health concern on 4 emergent nutrient deficiencies of public health-vitamins D and E, essential fatty acids, and choline-are reviewed.</p>","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":" ","pages":"S39-S46"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations for Correction of Micronutrient Deficiencies Through Supplementation in Pregnant Women and Children Under-5 in Latin America.","authors":"Ana C Fernández-Gaxiola, Lynnette M Neufeld, Armando García-Guerra","doi":"10.1177/03795721231219824","DOIUrl":"10.1177/03795721231219824","url":null,"abstract":"<p><strong>Background: </strong>Micronutrient deficiencies in Latin America are a public health concern, nonetheless, lack of information still exists in many countries, so that the true magnitude of the problem remains uncertain.</p><p><strong>Objective: </strong>To summarise experiences that can inform the development of policies and programs to address micronutrient deficiencies throung supplementation in pregnant women and chlidren under five years of age in Latin American.</p><p><strong>Methods: </strong>Review of the most evidence on the effects of micronutrients supplementation, focusing on pregnant women and children under five years of age.</p><p><strong>Results: </strong>Certain population groups, as women of reproductive age and children under 2 years of age, are at increased risk for deficiency due to their high micronutrient requirements. This is compounded by the limited access to micronutrient-rich foods for many people living in vulnerable situations. Micronutrient supplementation is an effective intervention to prevent and treat deficiency and to mitigate its adverse effects on health, nutrition, and pregnancy outcomes in micronutrient-deficient populations. The potential benefits of supplementation programs, however, are realized only when they reach those who have the potential to benefit, that is, with inadequate intakes of micronutrients from dietary sources, and when the quality of design and delivery of the programs aresufficient to reach that population timely, regularly, and effectively to enable and motivate consumption.</p><p><strong>Conclusions: </strong>Several resources and experiences exist that can help favor the development of programs that can realize this biological and programmatic potential. There is need for continuous efforts to augment coverage and achieve results that can translate into economic benefits for individuals, families, and nations.</p>","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":" ","pages":"S47-S54"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139377442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent Challenges of Micronutrient Deficiencies in Latin America Need Action.","authors":"A C Fernández-Gaxiola, A García-Guerra, L M Neufeld","doi":"10.1177/03795721241262136","DOIUrl":"10.1177/03795721241262136","url":null,"abstract":"<p><p>Micronutrient deficiencies affect growth and development and are critical for maintaining health at all ages. Their critical role in exacerbating complications of infections and chronic diseases continues to impact morbidity, mortality, and quality of life for many. Raising awareness and advocating for micronutrient deficiencies in Latin America is urgent to reduce this preventable burden. Globally, an estimated 372 million preschool-aged children and 1.2 billion non-pregnant women of reproductive age suffer deficiency from 1 or more micronutrient. Data is limited and often old, and the true burden of problem in the region remains unclear. There are also limited data on dietary intake and on the double burden of malnutrition. Latin America has been a leader in the design and implementation of innovative and effective actions to reduce excess energy intake and curb the consumption of unhealthy Actions to address deficiency have been implemented in many countries in the region over the years, but current evidence suggests that micronutrient deficiencies have fallen off the public health agenda in Latin America. Effective programming can be developed / appropriately adapted only with knowledge of the current burden. Such data can also help guide and predict future areas of risk and priorities to missing upcoming nutrition issues in the population. Renewed commitment to quantify and monitor micronutrient deficiencies in the region is essential. Abundant evidence and guidance exist to inform effective program selection, design and implementation to address this public health problem.</p>","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":" ","pages":"S7-S10"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Landscape of Micronutrient Dietary Intake by 15- to 65-Years-Old Urban Population in 8 Latin American Countries: Results From the Latin American Study of Health and Nutrition.","authors":"Rafael Monge-Rojas, Rulamán Vargas-Quesada, Agatha Nogueira Previdelli, Irina Kovalskys, Marianella Herrera-Cuenca, Lilia Yadira Cortés, Martha Cecilia Yépez García, Reyna Liria-Domínguez, Attilio Rigotti, Regina Mara Fisberg, Gerson Ferrari, Mauro Fisberg, Georgina Gómez","doi":"10.1177/03795721231215267","DOIUrl":"10.1177/03795721231215267","url":null,"abstract":"<p><strong>Background: </strong>Latin American countries have shifted from traditional diets rich in micronutrients to a Westernized diet rich in high energy-dense foods and low in micronutrients.</p><p><strong>Objective: </strong>This study aimed to determine the prevalence of adequate micronutrient intakes in urban populations of 8 Latin American countries.</p><p><strong>Method: </strong>Micronutrient dietary intake data were collected from September 2014 to August 2015 from 9216 men and women aged 15.0 to 65.0 years living in urban populations of 8 Latin American countries. Dietary intake was collected using two 24-hour recalls on nonconsecutive days. Micronutrient adequacy of intake was calculated using the Estimated Average Requirement cut-off method.</p><p><strong>Results: </strong>In general terms, the prevalence of inadequate intake of thiamine, riboflavin, niacin, folate, cobalamin, iron, phosphorus, copper, and selenium ranged from 0.4% to 9.9%. In contrast, the prevalence of inadequacy of pyridoxine, zinc, vitamin C, and vitamin A ranged from 15.7% to 51.5%. The nutrients with a critical prevalence of inadequacy were magnesium (80.5%), calcium (85.7%), and vitamin D (98.2%). The highest prevalence of inadequate intakes was observed in the low educational level, participants with overweight/obesity, in men, and varies according to socioeconomic status.</p><p><strong>Conclusions: </strong>There is an urgent need to define direct regional actions and strategies in Latin America aimed at improving micronutrient adequacy, either through staple food fortification programs, agronomic biofortification, or food policies that facilitate economic access to micronutrient-rich foods.</p>","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":" ","pages":"S11-S25"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138797408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micronutrient Deficiencies in Older Adults in Latin America: A Narrative Review.","authors":"Vanessa De la Cruz-Góngora, Rosa Palazuelos-González, Omar Domínguez-Flores","doi":"10.1177/03795721231214587","DOIUrl":"10.1177/03795721231214587","url":null,"abstract":"<p><strong>Background: </strong>The population in Latin America and Caribbean (LAC) has experienced a major demographic transition with increased numbers of older adults (OA). This change brings opportunities in the public health sector to implement health prevention interventions and delay the onset of geriatric syndromes. Micronutrients play an important role in the maintenance of biological function which contributes to longevity. Micronutrient deficiencies (MD) in OA increase the risk for onset of chronic comorbidities and geriatric syndromes.</p><p><strong>Aim: </strong>To review and summarize the existing data on micronutrient status in OA in the LAC region and discuss the gaps and challenges in public health approaches to address deficiencies.</p><p><strong>Methods: </strong>Literature review in Medline for records describing nutritional biomarkers in older adults (≥ 60y) from community dwelling and population-based studies in LAC.</p><p><strong>Results: </strong>Few countries (including Chile, Ecuador, Costa Rica, Brazil, and Mexico) have documented one or more nutritional deficiencies for OA in national health surveys, however across the entire region, evidence of micronutrient levels is scarce. Some surveys have documented a high prevalence and large heterogeneity in the prevalence of vitamin D followed by B12 deficiency, being the 2 MDs most studied due their effects on cognition, frailty, and bone mineral density in the OA population. Other MD including C, E, A, copper, zinc, iron, and selenium have also been reported.</p><p><strong>Conclusion: </strong>Information on the micronutrient status in OA from LAC is poorly documented. Research and capacity building initiatives in the region are crucial to develop tailored strategies that address the specific nutritional needs and challenges faced by the ageing population in Latin America.</p>","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":" ","pages":"S26-S38"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139037571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Memoriam: Dr. Noel W. Solomons (1940–2024)","authors":"Manuel Ruz","doi":"10.1177/03795721241261216","DOIUrl":"https://doi.org/10.1177/03795721241261216","url":null,"abstract":"","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":"21 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141886790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Brief Overview of the Diagnosis and Treatment of Cobalamin (B12) Deficiency.","authors":"Bruce H R Wolffenbuttel, Andrew McCaddon, Kourosh R Ahmadi, Ralph Green","doi":"10.1177/03795721241229500","DOIUrl":"https://doi.org/10.1177/03795721241229500","url":null,"abstract":"<p><strong>Background: </strong>An increasing number of adult individuals are at risk of vitamin B12 deficiency, either from reduced nutritional intake or impaired gastrointestinal B12 absorption.</p><p><strong>Objective: </strong>This study aims to review the current best practices for the diagnosis and treatment of individuals with vitamin B12 deficiency.</p><p><strong>Methods: </strong>A narrative literature review of the diagnosis and treatment of vitamin B12 deficiency.</p><p><strong>Results: </strong>Prevention and early treatment of B12 deficiency is essential to avoid irreversible neurological consequences. Diagnosis is often difficult due to diverse symptoms, marked differences in diagnostic assays' performance and the unreliability of second-line biomarkers, including holo-transcobalamin, methylmalonic acid and total homocysteine. Reduced dietary intake of B12 requires oral supplementation. In B12 malabsorption, oral supplementation is likely insufficient, and parenteral (i.e. intramuscular) supplementation is preferred. There is no consensus on the optimal long-term management of B12 deficiency with intramuscular therapy. According to the British National Formulary guidelines, many individuals with B12 deficiency due to malabsorption can be managed with 1000 µg intramuscular hydroxocobalamin once every two months after the initial loading. Long-term B12 supplementation is effective and safe, but responses to treatment may vary considerably. Clinical and patient experience strongly suggests that up to 50% of individuals require individualized injection regimens with more frequent administration, ranging from daily or twice weekly to every 2-4 weeks, to remain symptom-free and maintain a normal quality of life. 'Titration' of injection frequency based on measuring biomarkers such as serum B12 or MMA should not be practiced. There is currently no evidence to support that oral/sublingual supplementation can safely and effectively replace injections.</p><p><strong>Conclusions: </strong>This study highlights the interindividual differences in symptomatology and treatment of people with B12 deficiency. Treatment follows an individualized approach, based on the cause of the deficiency, and tailored to help someone to become and remain symptom-free.</p>","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":"45 1_suppl","pages":"S40-S49"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin B12 Deficiency-Induced Neuropathy and Cognitive and Motor Impairment in the Elderly: A Case Study.","authors":"Marieke J H J Dekker, Gonneke C Heerdink, Clara H M Plattel","doi":"10.1177/03795721241226886","DOIUrl":"10.1177/03795721241226886","url":null,"abstract":"<p><p>Vitamin B12 deficiency can present with a variety of neurological and cognitive symptoms. Especially in elderly patients, vitamin B12 deficiency can be easily overlooked because symptoms may be attributed to comorbid conditions or solely to the aging process. In this case study, we present two patients, a 71-year-old man and a 74-year-old female, with vitamin B12 deficiency. The male patient had a history of (partial) resection of the ileum/jejunum/colon because of intestinal ischemia. The female patient had a history of hypothyroidism, type 2 diabetes with complications (including peripheral neuropathy), mitochondrial myopathy, and chronic lymphocytic leukemia. Both patients presented with severe fatigue, cognitive impairment, and impaired walking. Next to this, the male patient suffered from depressive symptoms and mild disorientation, and the female patient experienced neuropathic pain. She also mentioned a positive family history for B12 deficiency. The first patient had normal to high B12 levels because he was already on B12 injections (once every three weeks) because of an earlier diagnosed B12 deficiency. The female patient had B12 levels within normal range (holotranscobalamin 54 pmol/L) and her diagnosis was confirmed by elevated homocysteine and methylmalonic acid levels. Treatment with frequent hydroxocobalamin injections and other supplements significantly improved their cognitive, emotional, and motor functions. These cases underscore the need for a high level of clinical suspicion in elderly patients, also in cases of normal B12 levels but with clinical signs of deficiency and a positive risk factor, such as stomach or small bowel surgery or positive family history.</p>","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":"45 1_suppl","pages":"S53-S57"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excess Folic Acid and Vitamin B12 Deficiency: Clinical Implications?","authors":"Joshua W Miller, Andre Smith, Aron M Troen, Joel B Mason, Paul F Jacques, Jacob Selhub","doi":"10.1177/03795721241229503","DOIUrl":"10.1177/03795721241229503","url":null,"abstract":"<p><strong>Background: </strong>In the 1940s to 1950s, high-dose folic acid supplements (>5 mg/d) were used clinically to reverse the megaloblastic anemia of vitamin B12 deficiency caused by pernicious anemia. However, this treatment strategy masked the underlying B12 deficiency and possibly exacerbated its neuropathological progression. The issue of masking and exacerbating B12 deficiency has recently been rekindled with the institution of folic acid fortification and the wide-spread use of folic acid supplements.</p><p><strong>Objectives: </strong>The objectives of this review are to describe clinical and epidemiological evidence that excess folic acid exacerbates B12 deficiency, to summarize a hypothesis to explain this phenomenon, and to provide guidance for clinicians.</p><p><strong>Results: </strong>Cognitive function test scores are lower and blood homocysteine and methylmalonic acid concentrations are higher in people with low B12 and elevated folate than in those with low B12 and nonelevated folate. High-dose folic acid supplementation in patients with pernicious anemia or epilepsy cause significant reductions in serum B12. It is hypothesized that high-dose folic acid supplements cause depletion of serum holotranscobalamin and thus exacerbate B12 deficiency.</p><p><strong>Conclusion: </strong>The evidence for excess folic acid exacerbating B12 deficiency is primarily correlative or from uncontrolled clinical observations, and the hypothesis to explain the phenomenon has not yet been tested. Nonetheless, the evidence is sufficiently compelling to warrant increased vigilance for identifying B12 deficiency in at risk individuals, including older adults and others with low B12 intake or conditions that are associated with B12 malabsorption, who also ingest excessive folic acid or are prescribed folic acid in high doses.</p>","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":"45 1_suppl","pages":"S67-S72"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Vitamin B12 Deficiency Patient-Reported Outcome Measure for Clinical Practice and Research.","authors":"Kim I M Suijker, Clara H M Plattel, Catherine H Seage, Nicola Ward, Delyth H James, Jolande Y Vis","doi":"10.1177/03795721241236284","DOIUrl":"https://doi.org/10.1177/03795721241236284","url":null,"abstract":"<p><strong>Background: </strong>It is difficult to recognize vitamin B12 deficiency and to evaluate the effect of B12 treatment due to a broad range of variable clinical symptoms overlapping with other diseases and diagnostic biomarkers that quickly normalize during treatment. This poses a risk of delay in diagnosis and a challenge to uniformly monitor the effect of B12 treatment. There is a need for a new clinical outcome measure suitable for clinical practice and clinical evaluation studies.</p><p><strong>Objective: </strong>To develop a Patient-Reported Outcome Measure (PROM) which measures the severity of vitamin B12 deficiency symptoms.</p><p><strong>Methods: </strong>The B12 PROM was developed by (1) gathering input from experts and literature review to define a construct and develop a conceptual model, (2) processing input from health care providers, scientists, and patients to develop items and response options, and (3) improving items based on the feedback from laypersons, test interviews, semi-structured cognitive interviews with patients, and forward and backward translation (ENG-NL).</p><p><strong>Results: </strong>The B12 PROM includes 62 items grouped into 8 categories of symptoms related to vitamin B12 deficiency (General, Senses, Thinking, In limbs and/or face, Movement, Emotions, Mouth & Abdomen, Urinary tract & Reproductive organs). Cognitive interviews demonstrated good comprehensibility and comprehensiveness.</p><p><strong>Conclusions: </strong>This study is the first step in the development of a disease-specific PROM for vitamin B12 deficiency to measure the burden of symptoms. Further validation and reliability testing are necessary before the PROM can be applied in clinical practice and research.</p>","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":"45 1_suppl","pages":"S73-S79"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}