evidence-based blog of Filippo Dibari

Posts Tagged ‘micronutrients’

Associations of dietary diversity scores and micronutrient status in adolescent Mozambican girls

In Under-nutrition on March 17, 2017 at 3:08 pm

Korkalo, L., Erkkola, M., Heinonen, A.E. et al. Eur J Nutr (2017) 56: 1179.

(download for free)




In low-income settings, dietary diversity scores (DDSs) often predict the micronutrient adequacy of diets, but little is known about whether they predict levels of biochemical indicators of micronutrient status.


In 2010, we studied two samples of non-pregnant 14- to 19-year-old girls in central Mozambique, the first in January–February (‘hunger season’; n = 227) and the second in May–June (harvest season; n = 223). In this paper, we examined whether a low Women’s Dietary Diversity Score (WDDS) predicts a low concentration of haemoglobin, serum ferritin, zinc, and folate, and plasma retinol in adolescent Mozambican girls. We constructed three scores: WDDS based on 24-h recalls, WDDS15g based on 24-h recall and employing a 15 g limit, and 7dWDDS based on 7-day food frequency questionnaires. Logistic regression models, stratified by season, were used to estimate the odds of having a low concentration of a status indicator (≤25th percentile of the season-specific distribution or cut-off from the literature) in those with a low score compared to those with a higher score.


In January–February, after adjusting for confounders, a low (≤3) WDDS and a low (≤5) 7dWDDS were each associated with higher odds of having low serum zinc compared to having a higher score, regardless of which of the two types of cut-offs for serum zinc was used. These associations were not present in May–June.


Our data from Mozambique suggest that dietary diversity is associated with serum zinc, but this association seems to be limited to the hunger season.

AfroPop Music Video on Healthy Eating–through Beans!

In Under-nutrition on April 2, 2015 at 6:29 am

by Harvest Plus

Rwanda’s top musicians promote beans, a nutritious food that improves children’s and women’s health! The artistes (King James, Miss Jojo, Riderman,Tom Close, and Urban Boyz) have donated their talent for a healthier Rwanda.

Help Rwanda say goodbye to malnutrition by shring this great song!

Swahili version: click here. Download song free (mp3) here.

Iron bioavailability from a lipid-based complementary food fortificant mixed with millet porridge can be optimized by adding phytase and ascorbic acid but not by using a mixture of ferrous sulfate and sodium iron EDTA

In Under-nutrition on March 22, 2014 at 9:14 am

by Cercamondi CI, Egli IM, Mitchikpe E, Tossou F, Hessou J, Zeder C, Hounhouigan JD, Hurrell RF

J Nutr. 2013 Aug;143(8):1233-9


Home fortification with lipid-based nutrient supplements (LNSs) is a promising approach to improve bioavailable iron and energy intake of young children in developing countries.

To optimize iron bioavailability from an LNS named complementary food fortificant (CFF), 3 stable isotope studies were conducted in 52 young Beninese children. Test meals consisted of millet porridge mixed with CFF and ascorbic acid (AA).

Study 1 compared iron absorption from FeSO4-fortifed meals with meals fortified with a mixture of FeSO4 and NaFeEDTA. Study 2 compared iron absorption from FeSO4-fortifed meals without or with extra AA. Study 3 compared iron absorption from FeSO4-fortified meals with meals containing phytase added prior to consumption, once without or once with extra AA. Iron absorption was measured as erythrocyte incorporation of stable isotopes.

In study 1, iron absorption from FeSO4 (8.4%) was higher than that from the mixture of NaFeEDTA and FeSO4 (5.9%; P < 0.05). In study 2, the extra AA increased absorption (11.6%) compared with the standard AA concentration (7.3%; P < 0.001). In study 3, absorption from meals containing phytase without or with extra AA (15.8 and 19.9%, respectively) increased compared with meals without phytase (8.0%; P < 0.001). The addition of extra AA to meals containing phytase increased absorption compared with the test meals containing phytase without extra AA (P < 0.05).

These findings suggest that phytase and AA, and especially a combination of the two, but not a mixture of FeSO4 and NaFeEDTA would be useful strategies to increase iron bioavailability from a CFF mixed with cereal porridge.

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Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age (Review)

In Under-nutrition on June 2, 2013 at 1:12 pm

by De-Regil LM, Suchdev PS, Vist GE, Walleser S, Peña-Rosas JP

Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.



Use of a powder mix of vitamins and minerals to fortify complementary foods immediately before consumption and improve health and nutrition in children under two years of age.

Deficiencies of vitamins and minerals, particularly of iron, vitamin A and zinc, affect approximately half of the infants and young children under two years of age worldwide. Exclusive breastfeeding until six months of age and continued breastfeeding for at least two years are recommended to maintain children’s adequate health and nutrition. After six months of age, infants start receiving semi-solid foods but the amount of vitamins and minerals can be insufficient to fulfil all the requirements of the growing baby.

Micronutrient powders (MNP) are single-dose packets of powder containing iron, vitamin A, zinc and other vitamins and minerals that can be sprinkled onto any semi-solid food at home or at any other point of use to increase the content of essential nutrients in the infant’s diet during this period. This is done without changing the usual baby diet.

This review includes eight good quality trials that involved 3748 infants and young children from low income countries in Asia, Africa and the Caribbean. We found that a variety of MNP formulations containing between five and 15 vitamins and minerals have been given for between two and 12 months to infants and young children aged six to 23 months of age.

The use of MNP containing at least iron, zinc and vitamin A for home fortification of foods was associated with a reduced risk of anaemia and iron deficiency in children under two. The studies did not find any effects on growth. Although the acceptability of this innovative intervention was high, there is no additional benefit to usually recommended iron drops or syrups, however few studies compared these different interventions. No deaths were reported in the trials and information on side effects and morbidity, including malaria, was scarce.

The use of MNP was beneficial for male and female infants and young children six to 23 months of age, independent of whether they lived in settings with different anaemia and malaria backgrounds or whether the intervention was provided for two, six or 12 months. The most appropriate arrangements for use (daily or intermittently), the appropriate vitamin and mineral composition of the mix of powders and the way to deliver this intervention effectively in public health programmes to address multiple micronutrient deficiencies remain unclear.


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Nutrition for a Better Tomorrow: Scaling Up Delivery of Micronutrient Powders for Infants and Young Children

In Under-nutrition on April 19, 2013 at 10:55 am

Results for Development Institute

By Kanika Bahl, Emilia Toro, Claire Qureshi, and Pooja Shaw

Click to download the summary or the entire document.



Maize porridge enriched with a micronutrient powder containing low-dose iron as NaFeEDTA, but not amaranth grain flour, reduces anemia and iron deficiency in Kenyan preschool children.

In Under-nutrition on October 6, 2012 at 6:06 am

Macharia-Mutie CW, Moretti D, Van den Briel N, Omusundi AM, Mwangi AM, Kok FJ, Zimmermann MB, Brouwer ID

J Nutrition 142: 1756-1763, 2012


Few studies have evaluated the impact of fortification with iron-rich foods such as amaranth grain and multi-micronutrient powder (MNP) containing low doses of highly bioavailable iron to control iron deficiency anemia (IDA) in children.

We assessed the efficacy of maize porridge enriched with amaranth grain or MNP to reduce IDA in Kenyan preschool children. In a 16-wk intervention trial, children (n = 279; 12-59 mo) were randomly assigned to: unrefined maize porridge (control; 4.1 mg of iron/meal; phytate:iron molar ratio 5:1); unrefined maize (30%) and amaranth grain (70%) porridge (amaranth group; 23 mg of iron/meal; phytate:iron molar ratio 3:1); or unrefined maize porridge with MNP (MNP group; 6.6 mg iron/meal; phytate:iron molar ratio 2.6:1; 2.5 mg iron as NaFeEDTA).

Primary outcomes were anemia and iron status with treatment effects estimated relative to control. At baseline, 38% were anemic and 30% iron deficient.

Consumption of MNP reduced the prevalence of anemia [-46% (95% CI: -67, -12)], iron deficiency [-70% (95% CI: -89, -16)], and IDA [-75% (95% CI: -92, -20)]. The soluble transferrin receptor [-10% (95% CI: -16, -4)] concentration was lower, whereas the hemoglobin (Hb) [2.7 g/L (95% CI: 0.4, 5.1)] and plasma ferritin [40% (95% CI: 10, 95)] concentrations increased in the MNP group. There was no significant change in Hb or iron status in the amaranth group.

Consumption of maize porridge fortified with low-dose, highly bioavailable iron MNP can reduce the prevalence of IDA in preschool children. In contrast, fortification with amaranth grain did not improve iron status despite a large increase in iron intake, likely due to high ratio of phytic acid:iron in the meal.

(Chinese trial:) β-Carotene in Golden Rice is as good as β-carotene in oil at providing vitamin A to children

In Under-nutrition on September 20, 2012 at 8:46 am

Guangwen TangYuming HuShi-an YinYin WangGerard E DallalMichael A Grusak, and Robert M Russell

Am J Clin Nutr September 2012 



Background: Golden Rice (GR) has been genetically engineered to be rich in β-carotene for use as a source of vitamin A.

Objective: The objective was to compare the vitamin A value of β-carotene in GR and in spinach with that of pure β-carotene in oil when consumed by children.

Design: Children (n = 68; age 6–8 y) were randomly assigned to consume GR or spinach (both grown in a nutrient solution containing 23 atom% 2H2O) or [2H8]β-carotene in an oil capsule. The GR and spinach β-carotene were enriched with deuterium (2H) with the highest abundance molecular mass (M) at Mβ-C+2H10. [13C10]Retinyl acetate in an oil capsule was administered as a reference dose. Serum samples collected from subjects were analyzed by using gas chromatography electron-capture negative chemical ionization mass spectrometry for the enrichments of labeled retinol: Mretinol+4 (from [2H8]β-carotene in oil), Mretinol+5 (from GR or spinach [2H10]β-carotene), and Mretinol+10 (from [13C10]retinyl acetate).

Results: Using the response to the dose of [13C10]retinyl acetate (0.5 mg) as a reference, our results (with the use of AUC of molar enrichment at days 1, 3, 7, 14, and 21 after the labeled doses) showed that the conversions of pure β-carotene (0.5 mg), GR β-carotene (0.6 mg), and spinach β-carotene (1.4 mg) to retinol were 2.0, 2.3, and 7.5 to 1 by weight, respectively.

Conclusions: The β-carotene in GR is as effective as pure β-carotene in oil and better than that in spinach at providing vitamin A to children. A bowl of ∼100 to 150 g cooked GR (50 g dry weight) can provide ∼60% of the Chinese Recommended Nutrient Intake of vitamin A for 6–8-y-old children. This trial was registered at http://www.clinicaltrials.gov as NCT00680212.

Feel free to suggest web sites which debate the results from this study. Thanks. fil

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