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Transcript of Micronutrient Deficiencies
Deficiencies Shannon Demko
Sabari Veeravalli “Vitamin & nutrient deficiencies rarely occur alone, rarely have a single cause, and always occur in a wider ecological, social, and political environment. Poor quality diets low in micronutrients are invariably a consequence of poverty, itself of a consequence of local, national, and global inequities.”
-- Semba, et. al., p. 417 Vitamin A Dietary Sources Fish and Liver Oils Dairy Products Egg Yolks Dark Green, Yellow and Orange Vegetables Vitamin A 300-600ug/day infants & children;
600-900ug/day for adults;
750-1300ug/day for pregnant & lactating women DEFICIENCY ASSOCIATIONS:
- Visual issues such as night blindness, Bitot’s Spots, corneal xerosis, ulceration
- Vulnerability to infections
- Growth stunting, malnutrition
According to WHO, about 250 million pre-school aged children around he world are vitamin A deficient
TREATMENT: Intake of high potency vitamin A
Night blindness improves in 24-48 hours
Bitot’s spots respond in 2-5 days
Breast-feeding – protects against xerophthalmia up to age 4
Increased intake of vitamin A rich foods from diverse sources
Fortification & supplementation Zinc Dietary Sources:
red meat RDAs: 2-5 mg/day for infants & children;
8-11 mg/day for adults;
11-13 mg/day for pregnant & lactating women
- Stunted growth
- Vulnerability to infections, especially respiratory & diarrheal
- Skin lesions
- Alopecia 1/3 of the World's population is affected by a Zinc dificiency TREATMENT & PREVENTION
- Multiple micronutrient supplementation, especially along with iron, especially for pregnant & lactating women
- Increased intake of animal products & other zinc rich foods, if available Iron DIETARY SOURCES: red meats, fish and poultry; lentils and beans; leafy greens; whole grains and nuts; human breast milk 8-11 mg/day for infants & children,
8-15 mg/day for adults,
10-30 mg/day for pregnant & lactating women
- Anemia: develops over time due to a low dietary intake; results in low blood hemoglobin levels
- Signs of iron deficiency are exhaustion, poor cognitive development, weakened immune systems PREVALENCE
WHO approximates that 4-5 billion people are iron deficient globally
Young children and women of childbearing ages are at the most risk
Improved nutrition education on bioavailability of iron sources
Iron fortification of easily accessible foods such as milk, wheat flour, curry powders, salt
Iodine Leafy Greens Fruits Grains Dairy 90-120 mcg/day for infants & children
150 mcg/day for adults
250 mcg/day for pregnant & lactating women DEFICIENCY ASSOCIATIONS
Poor cognitive development, mental retardation, inadequate thyroid hormone production resulting in goiter;
Iodized salt remains the primary strategy; oral iodized oil is provided to populations where salt is difficult to obtain PREVENTION
World Health Assembly set intake goals to ensure normal brain development
Steps taken on governmental and community-wide levels to improve education and access to iodized salt and iodine oils Multiple
Micronutrient Deficiencies Elevated Risk
Populations - Children
- Pregnant Women
- Refugees Common combined deficiencies:
- Iron & Vitamin A
- Iron & Zinc
- Vitamin A & Zinc
Causes include lack of bioavailability and poor dietary intake of micronutrient rich foods
Implications for child health:
- Poor neurological development
- Increased risk for underweight & growth retardation
- Delayed motor & cognitive development Implications for maternal health:
- Low birth weight
- Increased risk of neural tube defects
- Impaired lactation Case Study:
Micronutrient Initiative http://www.micronutrient.org
“The Micronutrient Initiative (MI) is the leading organization working exclusively to eliminate vitamin and mineral deficiencies in the world´s most vulnerable populations.”
MI partners with WFP in supplementation & fortification programs in Afghanistan:
1. Besides the Afghanistan examples cited in the video, briefly (1-3 sentences) summarize another of the Micronutrient Initiative’s programs or strategies.
2. Given that multiple micronutrient deficiencies are thought to be more common than isolated micronutrient deficiencies, why do you think there is less data available on them?
3. Micronutrient deficiencies are especially acute in the aftermath of disasters & during emergencies. Find and discuss an example of a related response to a recent global event (natural disasters, political crises, etc.)
•Bothwell TH, Charlton RW, Cook JD, Finch CA. 1979. Iron Metabolism in Man. St. Louis: Oxford: Blackwell Scientific.
•Dallman PR. 1986. Biochemical basis for the manifestations of iron deficiency. Annual Review Nutrition 6:13-40.
•DRI Reports, Initials. (2011). Dietary reference intakes (dris): recommended dietary allowances and adequate intakes, vitamins. Manuscript submitted for publication, Food and Nutrition, The National Academies Press, Washington, DC. Retrieved from http://iom.edu/Activities/Nutrition/SummaryDRIs/~/media/Files/Activity%20Files/Nutrition/DRIs/RDA%20and%20AIs_Vitamin%20and%20Elements.pdf
•Institute of Medicine. Food and Nutrition Board. 2001. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium and Zinc. Washington, DC: National Academy Press.
•Patrick L. Iodine: deficiency and therapeutic considerations. Altern Med Rev. 2008 Jun;13(2):116-127.
•The World Health Organization, . (2010). Childhood and maternal undernutrition. Retrieved from http://www.who.int/whr/2002/chapter4/en/index3.html
•The World Health Organization, Initials. (2010). Micronutrient deficiencies. Retrieved from http://www.who.int/nutrition/topics/vad/en/index.html Dietary Sources