An Ex-Ante Analysis of the Impact of Biofortified Zinc Rice on Dietary Zinc Inadequacy: Evidence from Bangladesh, Indonesia, and the Philippines.

BACKGROUND: South, East, and Southeast Asia are among the regions of the world with the highest estimated prevalence of inadequate zinc intake. Because populations in those regions eat rice as their main staple, zinc biofortification of rice can potentially improve zinc intake, especially among the most vulnerable. OBJECTIVES: We modeled the impact of the consumption of zinc-biofortified rice on zinc intake and inadequacy among women of childbearing age and young children nationally in Indonesia, the Philippines, and at a subnational level in Bangladesh. METHODS: We conducted an ex-ante analysis by applying increments of zinc content in rice, from a baseline level of 16 parts per million (ppm) to 100 ppm, and based on rice consumption data to substitute levels of conventional rice with zinc-biofortified rice varying between 10% and 70%. RESULTS: Among all datasets evaluated from these 3 countries, the prevalence of dietary zinc inadequacy at baseline was 94%-99% among women of childbearing age, 77%-100% among children 4-5 y old, and 27%-78% among children 1-3 y old. At the current breeding target of 28 ppm, zinc-biofortified rice has the potential to decrease zinc inadequacy by ≤50% among women and children in rural Bangladesh and among children in the Philippines where consumption of rice is higher compared with Indonesia. CONCLUSIONS: Our analysis shows that increasing zinc content in rice ≤45 ppm reduces the burden of zinc inadequacy substantially, after which we encourage programs to increase coverage to reach the highest number of beneficiaries.

Preventing and Controlling Zinc Deficiency Across the Life Course: A Call to Action.

Through diverse roles, zinc determines a greater number of critical life functions than any other single micronutrient. Beyond the well-recognized importance of zinc for child growth and resistance to infections, zinc has numerous specific roles covering the regulation of glucose metabolism, and growing evidence links zinc deficiency with increased risk of diabetes and cardiometabolic disorders. Zinc nutriture is, thus, vitally important to health across the life course. Zinc deficiency is also one of the most common forms of micronutrient malnutrition globally. A clearer estimate of the burden of health disparity attributable to zinc deficiency in adulthood and later life emerges when accounting for its contribution to global elevated fasting blood glucose and related noncommunicable diseases (NCDs). Yet progress attenuating its prevalence has been limited due, in part, to the lack of sensitive and specific methods to assess human zinc status. This narrative review covers recent developments in our understanding of zinc's role in health, the impact of the changing climate and global context on zinc intake, novel functional biomarkers showing promise for monitoring population-level interventions, and solutions for improving population zinc intake. It aims to spur on implementation of evidence-based interventions for preventing and controlling zinc deficiency across the life course. Increasing zinc intake and combating global zinc deficiency requires context-specific strategies and a combination of complementary, evidence-based interventions, including supplementation, food fortification, and food and agricultural solutions such as biofortification, alongside efforts to improve zinc bioavailability. Enhancing dietary zinc content and bioavailability through zinc biofortification is an inclusive nutrition solution that can benefit the most vulnerable individuals and populations affected by inadequate diets to the greatest extent.

Estimación de emisiones de gases de efecto invernadero en la dieta de mujeres adolescentes en áreas rurales de oriente de Guatemala / Estimation of greenhouse of gas emissions in the diet of adolescent women in rural areas of eastern Guatemala

Introducción. La producción de alimentos es una de las principales causas de Emisiones de Gases de Efecto Invernadero (GEI). Estimar las emisiones GEI de la dieta es el punto de partida para definir dietas saludables y sostenibles con el ambiente. Objetivo. Estimar el total GEI de la dieta de mujeres adolescentes del oriente de Guatemala, así como la contribución de grupos de alimentos a este valor. Materiales y métodos. En el contexto de un estudio de agricultura y nutrición en el oriente de Guatemala, se realizó un análisis secundario de los datos dietéticos (Recordatorio de 24 horas) de 2082 mujeres adolescentes. Los alimentos reportados fueron enlazados con la base de datos SHARP, que contiene estimaciones de GEI para 944 alimentos. La variable de enlace fue un código único armonizado con el sistema de clasificación FoodEx2. Resultados. La dieta es poco diversa, principalmente a base de grupos de alimentos de origen vegetal, con poca presencia de alimentos de origen animal. El GEI de la dieta fue de 2,3 Kg CO2 eq/ per cápita/día, con la mayor contribución de comidas preparadas (26,7%) y panes, tortillas y similares (12,8%). Conclusiones. La dieta de las mujeres adolescentes de áreas rurales de Guatemala tiene un GEI inferior al reportado en otros países de la región para estratos socioeconómicos con mayor consumo de alimentos de origen animal. Este estudio es el punto de partida para sistematizar la metodología para continuar con las estimaciones de GEI en Guatemala(AU)

Introduction. Food production is one of the main causes of Greenhouse Gas Emissions (GHGE). Estimating GHG emissions from the diet is the starting point for defining healthy and environmentally sustainable diets. Objective. Estimate the total GHGE in the diet of adolescent women from eastern Guatemala, as well as the contribution of food groups to this value. Materials and methods. In the context of an agriculture and nutrition study in eastern Guatemala, a secondary analysis of dietary data (24-hour recall) of 2082 adolescent women was performed. The reported foods were linked to the SHARP database, which contains GHGE estimates for 944 foods. The linking variable was a unique code harmonized with the FoodEx2 classification system. Results. The diet is not diverse, mainly based on food groups of plant origin, with little presence of foods of animal origin. The GHG of the diet was 2.3 Kg CO2 eq/per capita/day, with the greatest contribution from prepared foods (26.7%) and breads, tortillas and similar products (12.8%). Conclusions. The diet of adolescent women in rural areas of Guatemala has a lower GHG than that reported in other countries in the region for socioeconomic strata with greater consumption of foods of animal origin. This study is the starting point to systematize the methodology to continue with GHG estimates in Guatemala(AU)

Estandarización de personal en diagnóstico clínico de bocio: ¿Cómo evaluar la concordancia entre examinadores de la tiroides? / Personnel standarization in clinical diagnosis of goiter: ¿How to evaluate concordance between thyroid examiners?

El uso de las pruebas t de Student y Cochran para evaluar medidas de tendencia central, así como la prueba de F para evaluar la variabilidad, y el análisis de correlación, han sido usados en forma equivocada para evaluar concordancia entre examinadores del tiroides. En el presente artículo se presenta la prueba de Kappa intraclase (Bloch y Kraemer, 1989), así como la experiencia de su uso en Centroamérica para estandarizar a los examinadores del tiroides que participaron en las encuestas nacionales para determinar prevalencia de bocio en 1990

Anemia in Latin America and the Caribbean, 2009. Situation analysis, trends, and implications for public health programming / Anemia en América Latina y el Caribe, 2009. Análisis de la situación, tendencias, e implicancias para la programación en salud pública

[Executive summary] This report presents aggregated results on the prevalence of anemia and iron deficiency in countries of Latin America and Caribbean during the period 1981–2009. It provides the most recent data available on the prevalence of anemia at the national, subregional, and regional levels; trends; and estimated numbers of affected children and affected women of childbearing age. It summarizes the current situation of policies and programs to prevent and treat anemia and iron deficiency, and discusses their strengths and weaknesses. A joint initiative of the Micronutrient Initiative (MI) of Canada and the Pan American Health Organization (PAHO), the information in this report will be useful for governments, public health authorities, national policy makers, and other stakeholders interested in preventing anemia and iron deficiency.

Impacto socioeconómico de la epidemia del VIH/SIDA en Guatemala

En marzo de 1995 se realizó en Guatemala una evaluación del impacto socioeconómico que tendría la epidemia causada por el Virus de la Inmunodeficiencia Humana (VIH). El estudio fue el resultado del esfuerzo conjunto entre el Ministerio de Salud Pública de Guatemala, Organizaciones no Gubernamentales guatemaltecas, la Agencia de los Estados Unidos para el Desarrollo (USAID/Guatemala) y el proyecto de Control y Prevención del SIDA (AIDSCAP) de Family Health International (FHI), y la Organización Panamericana de la Salud (OPS). Dos componentes se incluyeron en la metodología de este estudio, uno epidemiológico y el otro económico. Para el componente epidemiológico se consideraron los casos del Síndrome de Inmunodeficiencia Adquirida (SIDA) notificados a la Organización Panamericana de Salud (OPS) en Guatemala. Estos datos mostraron que el patrón de contagio en Guatemala es básicamente sexual. Además, se utilizaron estudios aislados de prevalencia de infectados por el VIH como representativos de dos escenarios epidemiológicos conservadores dentro de los cuales puede encontrarse la prevalencia real de VIH en la población general; uno de mujeres embarazadas en el cual se estimó una prevalencia del 0.4 por ciento y el otro en el grupo de donadores de sangre con prevalencia del 0.2 por ciento. Utilizando datos de prevalencia de infeccion por VIH de 1994 como base y los escenarios mencionados, se realizaron proyecciones hacia el año 2000 para describir el comportamiento de la epidemia en términos de nuevas infecciones y número de casos de SIDA esperados en Guatemala...