A new family home approach to controlling iron deficiency anemia in all ages in less-developed and developing countries using iron-fortified water.

Nutritional iron deficiency anemia is considered the main public health problem of poor less-developed and developing countries. The World Health Organization has estimated that 1.5-2.0 billion persons are anemic. It has been said that close to 1 million deaths are linked to iron deficiency anemia. The groups most vulnerable to this form of anemia are said to be small children and women of reproductive age. Our goal is to show that iron fortification in the water, will control anemia. The method used was a literature review. Methods have been identified to control anemia, but the fortification of water is a more efficient, low cost, reaches the entire population, prevents and treats deficiency anemia. We concluded that the iron fortification of drinking water at home is a simple, effective, and low-priced approach for the prevention of iron deficiency anemia prevalent in poor and developing countries.

Iron absorption from beans with different contents of iron, evaluated by stable isotopes.

BACKGROUND: The introduction of biofortified foods such as beans with higher iron content may be a useful tool in preventing iron deficiency. The biofortification aims to reach the root of the problem of malnutrition, targets the neediest population, uses embedded distribution mechanisms, is scientifically feasible and effective in terms of cost, and complements other ongoing interventions to control micronutrient deficiency. However, to ensure effectiveness, measurement of the absorption of minerals is essential. OBJECTIVE: The objective of this study was to evaluate the iron bioavailability of common bean BRS Pontal (PO), targeted for biofortification, compared with common bean BRS Estilo in man through reliable techniques that have not been previously used in Brazil. METHODS: The study included 29 young adult volunteers divided into 2 groups: Group CB (13 subjects) received 100 g of common beans (BRS-Estilo) cooked labeled with iron-58 (58Fe) and Group TBB (16 patients) received 100 g common bean target for iron biofortification (BRS-Pontal), cooked and labeled with iron58 (58Fe). The next day they received the reference dose of ferrous sulfate enriched iron-57 (57Fe). Isotopic evaluation of iron for measurement of iron incorporation into erythrocytes was performed 14 days after consumption. The beans used, were produced, through conventional breeding program, by EMBRAPA/Rice and Beans. RESULTS: The iron absorption was evaluated by assessing the isotopic enrichment of the stable isotope. Mean iron absorption from the meal with common beans was 0.409% (±0.040%) and mean iron incorporation from the meal with target beans for biofortification 0.407% (±0.038%) and did not differ between the groups. CONCLUSIONS: This study tested the iron absorption from a single bean meal in healthy volunteers or non anemics, In the present study the iron absorption ratio from common bean Pontal (PO), targeted for biofortification and compared with common bean BRS Estilo was not significantly different. The iron concentration of the TBB, probably was not sufficient to improve higher bioavailability. It is recommended to evaluate the not only the absorption of iron in cultivars that present a higher difference in iron concentration but also in association with other components of the Brazilian diet, such as rice and beans.

Fortification of drinking water to control iron-deficiency anemia in preschool children.

BACKGROUND: Iron-deficiency anemia is the most common type of micronutrient malnutrition in the world. Its etiology and control are well understood, but the problem persists and is increasing in some developing countries. Iron fortification of mass-consumption foods is considered one of the most viable approaches to deliver bioavailable iron to the population. OBJECTIVE: To review and analyze the use of drinking water as an iron vehicle to reduce ferropenic anemia in developing countries. METHODS: Drinking water with added iron compounds was offered to preschool children at day-care centers in Brazil. Iron solutions were prepared with 10 mg to 20 mg iron/L. Clinical and anthropometric measurements and blood hemoglobin concentrations were obtained at the beginning of each study and 4 to 8 months later. RESULTS: No problems with acceptability or side effects were observed. Daily water intake by children was around 500 mL. Iron-deficiency anemia was found in all studies. Control children not receiving iron supplementation mantained their initial hemoglobin level. Anemia was reduced in the groups receiving iron-fortified drinking water. CONCLUSIONS: Based on physical properties, tests in rats, and studies on preschool children at Brazilian day-care centers, we have shown that drinking water locally fortified with iron compounds should be considered and used as a worldwide available vehicle to control iron-deficiency anemia. Drinking water, besides being universally available, is a locally available vehicle, easily fortified, can be a vehicle for hydrosoluble iron, and reduces iron-deficiency anemia in preschool children.

Effect of fortification of drinking water with iron plus ascorbic acid or with ascorbic acid alone on hemoglobin values and anthropometric indicators in preschool children in day-care centers in Southeast Brazil.

BACKGROUND: Iron-deficiency anemia currently is the most frequently occurring nutritional disorder world-wide. Previous Brazilian studies have demonstrated that drinking water fortified with iron and ascorbic acid is an adequate vehicle for improving the iron supply for children frequenting day-care centers. OBJECTIVE: The objective of this study was to clarify the role of ascorbic acid as a vehicle for improving iron intake in children in day-care centers in Brazil. METHODS: A six-month study was conducted on 150 children frequenting six day-care centers divided into two groups of three day-care centers by drawing lots: the iron-C group (3 day-care centers, n = 74), which used water fortified with 10 mg elemental iron and 100 mg ascorbic acid per liter, and the comparison group (3 day-care centers, n = 76), which used water containing only 100 mg ascorbic acid per liter. Anthropometric measurements and determinations of capillary hemoglobin were performed at the beginning of the study and after six months of intervention. The food offered at the day-care centers was also analyzed. RESULTS: The food offered at the day-care center was found to be deficient in ascorbic acid, poor in heme iron, and adequate in non-heme iron. Supplementation with fortified drinking water resulted in a decrease in the prevalence of anemia and an increase in mean hemoglobin levels associated with height gain in both groups. CONCLUSIONS: Fortification of drinking water with iron has previously demonstrated effectiveness in increasing iron supplies. This simple strategy was confirmed in the present study. The present study also demonstrated that for populations receiving an abundant supply of non-heme iron, it is possible to control anemia in a simple, safe, and inexpensive manner by adding ascorbic acid to drinking water.

Effect of a rice bran fiber diet on serum glucose levels of diabetic patients in Brazil.

Eleven diabetic patients: 5, type 1 and 6, type 2 received a low-fiber diet (I) during 1 week and during the next 7 days the same diet, enriched with 40 g of fiber (30.6% insoluble and 11.7% soluble components) from rice bran (II) per day. Results showed that mean fasting and postprandial serum glucose levels were reduced, but values of high fiber diet were significantly lower (p < 0.001) than that of the lower fiber diet. For all patients, the high-fiber diet increased fecal weight. This increase was due to the fiber excreted, rather than water retained. There was no relationship between the increase in fiber intake and its fecal excretion. Sucrose and raffinose were found in the bran, but not in the feces. Lactose was present in the stools of the patients receiving enriched diet.

Domestic drinking water--an effective way to prevent anemia among low socioeconomic families in Brazil.

Iron deficiency and iron-deficiency anemia are common in the developing world. We evaluated the feasibility of iron fortification of domestic drinking water to prevent and control iron deficiency and iron-deficiency anemia. Twenty-one families representing 88 persons, including children, were selected to participate in this study. Twelve families added an iron solution plus ascorbic acid to their domestic drinking water over a four months period and nine families added a placebo. Blood samples were collected, before and after the four months, for hemoglobin and serum ferritin measurements. Iron-fortified drinking water increased hemoglobin (children 10.9 +/- 1.1 g/dl to 11.7 +/- 1.1 g/dl p < .01, adults 12.9 +/- 1.7 g/dl to 13.7 +/- 1.7 g/dl p < .01) and ferritin (children 27.6 +/- 21.6 ng/dl to 33.8 +/- 22.1 ng/dl, adults 74.8 +/- 41.3 ng/dl to 106.2 +/- 93.9 ng/dl p < .05). No significant changes in hemoglobin and ferritin were found in the placebo group after 4 months. Preparation, distribution, and consumption of the solutions were successful. Iron fortification of household drinking water can be a simple and effective alternative to deal with iron deficiency and iron-deficiency anemia in less developed areas.

Bioavailability of iron measurement in two nutrients multiple solutions by in vitro and in vivo;a comparative methodology between methods.

OBJECTIVES: The bioavailability of dietary iron present in a nutritional formulation may be evaluated by in vitro and in vivo methods since they provide for a cohesive line study and provided in the literature. The aim of this study was to evaluate the bioavailability of iron targeting a comparative analysis of two nutritional supplement formulations (A and B). METHODS: For this study were using in vitro and in vivo methods, both described in the literature for availability of iron in an enteral feeding after ingestion supplement nutrition with much nutrients. RESULTS: The results obtained by in vitro simulation of the human gastrointestinal tract were 0.70 ± 0.02 and 0.80 ± 0.01 % iron availability by formulations A and B. In vivo studies, as measured by the curves of serum iron in humans after ingestion of formulations allowed the calculation of coefficient of variation Δ < 0, indicating that there was a low absorption of iron. The bioavailability of iron as two multi-nutrients solutions obtained by in vitro and in vivo showed that there were comparisons of those methodologies used in this study.

Objetivos: La biodisponibilidad de hierro presente en una formulación nutricional puede ser evaluada por in vitro y in vivo, ya que proporcionan para un estudio de línea cohesiva y proporcionado en la literatura. El objetivo de estudio fue evaluar la biodisponibilidad de hierro con in vitro y in vivo, dirigida a un análisis comparativo de dos formulaciones de suplementos nutricionales (A y B). Métodos: Fueron utilizados dos métodos descritos en la literatura que para evaluar la biodiponibilidad de hierro. Uno que es la simulación de digestión humana y otro por los niveles de hierro sérico después de la ingestión de la formulación en los seres humanos. Resultados: Los resultados obtenidos por la simulación in vitro de la digestión del tracto gastrointestinal humano fueron 0,70 ± 0,02 y 0,80 dialisibilidad 0,01% de hierro, respectivamente, para las formulaciones A y B. Los estudios in vivo, segú n se mide por las curvas de hierro en suero en seres humanos después de la ingestión de las formulaciones mostró coeficiente de variación Δ < 0, lo que indica que había una baja absorción de hierro. La biodisponibilidad de hierro a los dos multi-nutrientes soluciones fueron obtenidos por in vitro y in vivo mostraron que había una comparación de las metodologías utilizadas en soluciones acuosas de muchos nutrientes.

Iron (FeSo4) bioavailability in obese subjects submitted to bariatric surgery.

BACKGROUND: Iron bioavailability in obese subjects after the ingestion of a nutritional supplement was the aim of this work. METHODS: Fourteen persons were studied before and after bariatric surgery after the ingestion of a nutritional formulation containing 25 mg iron, 25 g fiber and 800 mg calcium. RESULTS: The following ferremia values (median and minimum--maximum) were obtained before and after bariatric surgery, respectively: Fasting, 105 (70 - 364) µg/dL and 198 (38 - 617) µg/dL; 1 hour, 103 (63 - 305) µg/dL and 160 (11 - 207) µg/dL; 2 hours, 103 (62 - 150) µg/dL and 141 (10 - 412) µg/dL; 3 hours. 97 (63 - 190) µg/dL and 153 (6 - 270) µg/dL; 4 hours, 91 (58 - 163) µg/dL and 156 (40 - 251) µg/dL (p>0.05), with no association of serum iron levels with time. There was a difference in total triglycerides (95 ± 29 mg/dL and 60 ± 10 mg/dL) which were correlated with a decrease in serum ferritin levels (r = 0,926, p = 0.008), UIBC (r = 0.910, p = 0.01), total cholesterol (r = 0,918, p = 0.01) and LDL-c fraction (r = 0.830, p = 0.04), with an increase in HDL-c fraction (r = 0,807, p = 0.05). CONCLUSION: Iron bioavailability in obese subjects was affected by the ingestion of the nutritional formulation containing calcium and fiber, a fact that may cause these patients to develop iron deficiency.

Objetivo: Obesos sometidos a cirugía bariátrica muestran la utilización de deterioro de hierro. Evaluar la biodisponibilidad del hierro en los obesos por el consumo de suplemento nutricional que contiene múltiples nutrientes antes y después de seis meses de la cirugía bariátrica. Material y Métodos: El estudio incluyó a 14 voluntarios antes y después de la cirugía bariátrica que recibieron formulaciones que contienen múltiples nutrientes y medir las concentraciones séricas de hierro en ayunas y cada 1 hora después de la ingestión de formulaciones, con un total de cuatro horas. Resultados: Ferremia por el consumo de entre dos formulaciones de pre-y post-operatorios fueron: El ayuno 104.50 (70,00-363,00) mg / dl y 198.00 (38.00 a 617.00) mg / dl, 103.00 horas (63,00 a 305,00) mg / dl y 160.00 (11,00- 206,90) mg / dL, 2 horas 102.50 (62.00 a 150.00) mg / dL y 141.30 (10.00 a 412.20) mg / dl, 3 horas 97.00 (63.00 a 190.00) mg mg / dl y 153,00 (6,00 hasta 269,60) / dl , 4 horas 91,00 (58,00 a 163,00) mg / dl y 156.10 (40.00 a 250.50) mg / dl y no hubo asociación estadísticamente significativa entre los dos períodos para los niveles de hierro suero. Los valores de la zona de las curvas en el suero fueron 453,50 ± 202,80 mg / dl / hora, p = 0,000 y 579,00 ± 380,30 mg / dl / hora, p = 0,007 y fue estadísticamente diferente entre los dos períodos. La biodisponibilidad del hierro en soluciones que contienen múltiples nutrientes se vio afectada antes y después de seis meses de la cirugía bariátrica. Conclusión: Se encontró que los niveles se redujeron ferremia con la cirugía, que puede poner en peligro estos pacientes presentaron deficiencia de hierro.

A new family home approach to controlling iron deficiency anemia in all ages in less-developed and developing countries using iron-fortified water

Nutritional iron deficiency anemia is considered the main public health problem of poor less-developed and developing countries. The World Health Organization has estimated that 1.5-2.0 billion persons are anemic. It has been said that close to 1 million deaths are linked to iron deficiency anemia. The groups most vulnerable to this form of anemia are said to be small children and women of reproductive age. Our goal is to show that iron fortification in the water, will control anemia. The method used was a literature review. Methods have been identified to control anemia, but the fortification of water is a more efficient, low cost, reaches the entire population, prevents and treats deficiency anemia. We concluded that the iron fortification of drinking water at home is a simple, effective, and low-priced approach for the prevention of iron deficiency anemia prevalent in poor and developing countries(AU)

A anemia por deficiência nutricional de ferro é considerada o principal problema de saúde pública dos países menos-desenvolvidos e em desenvolvimento. A Organização Mundial de Saúde estimou que 1,5-2,0 milhões de pessoas são anêmicas. Aproximadamente 1 milhão de mortes estão ligadas a anemia por deficiência de ferro. Os grupos mais vulneráveis a anemia são crianças e mulheres em idade reprodutiva. Nosso objetivo é mostrar que fortificação de ferro na água, irá controlar anemia. O método utilizado foi revisão da literatura. Diversos métodos têm sido identificados para controle da anemia, mas a fortificação da água é uma forma mais eficiente e de baixo custo, atingindo toda a população, previnindo e tratando a anemia por deficiência. Concluímos que a fortificação de ferro na água potável em casa é uma abordagem simples, eficaz e de baixo custo para a prevenção da anemia ferropriva prevalente nos países pobres e em desenvolvimento(AU)

Ingestion of ferrous sulfate increases ferremia in patients with short bowel syndrome.

OBJECTIVE: Because short bowel syndrome is associated with iron deficiency, the objective of the present study was to monitor ferremia after the ingestion of different iron compounds and doses in enterectomized patients. METHODS: This was a randomized, double-blind, cross-over study conducted in 13 patients of both sexes in the metabolic unit of Hospital das Clínicas de Faculdade de Medicina de Ribeirão Preto-Universídade de São Paulo and was divided into two stages. Three different iron compounds, ferrous sulfate (FS), sodium iron ethylenediaminetetra-acetic acid (EDTA), and dehydrated cell fraction (DCF), were studied. The patients were randomly assigned to one of four groups receiving high-dose DCF (120mg) and low-dose DCF (5mg) and the two iron compounds. The subjects (n=7) receiving high-dose DCF participated in 2 test days. All patients receiving the physiologic dose (low-dose DCF, n=6) participated in 3 test days with a 1-mo interval between compounds. After an 8-h fast, blood samples were collected at 0.25, 0.5, 1, and 2h. Serum iron curve and the sum of the area under the curve were calculated and adjusted according to a mixed-effect linear model (P<0.05). RESULTS: Serum FS levels were higher in the 120-mg group compared with the others (P<0.005). The mean areas under the curve for FS and EDTA at the doses of 120 and 5mg of elemental iron were 238, 224, 177, and 153 microg/dL, respectively. The mean area under the curve for DCF was 165 microg/dL, with no significant difference between groups. CONCLUSION: Regardless of dose, FS was the compound that resulted in higher ferremia compared with the other doses and compounds.

Aspectos relacionados ao diagnóstico laboratorial da deficiência de ferro em crianças / Aspects related to the laboratory diagnosis of child iron deficiency

Objetivo: investigar parâmetros laboratoriais utilizados no diagnóstico do estado nutricional de ferro em uma população de crianças pré-escolares com elevada prevalência de anemia, visando avaliar o modelo explicativo vigente. Métodos: foram avaliadas 119 crianças de 12 a 72 meses nas duas únicas creches públicas da cidade de Pontal-SP, dosando-se hemoglobina, ferro sérico, capacidade total de ligação do ferro, ferritina sérica, receptor de transferrina e realizando-se teste de falcização. Resultados: 81 crianças foram diagnosticadas como anêmicas com prevalência de 68,1%, sendo que 61 delas (75,3%) apresentaram pelo menos um indicador de deficiência de ferro. No subgrupo de 20 crianças com anemia e sem sinais de deficiência de ferro, 19 apresentaram normocitose, tornando improvável a presença de doença talassêmica. Nesse grupo foram encontradas quatro crianças com possibilidade de processo inflamatório, sendo uma com ferritina acima de 120 ng/mL e três com CTLF inferior a 200 microg/dL. Além disso, uma única criança apresentou microcitose com valores de CTLF e ferritina dentro da normalidade. Nas demais 15 crianças o diagnóstico preciso da anemia não pôde ser determinado pelos exames realizados. Conclusões: os dados apresentados remetem para a necessidade de aprimoramento nas técnicas diagnósticas de anemia e deficiência de ferro em crianças. A utilização do modelo diagnóstico atual inclui significativo número de crianças anêmicas sem diagnóstico causal preciso, o que é altamente relevante do ponto de vista clínico e de saúde pública...

Objetivo: investigar parâmetros laboratoriais utilizados no diagnóstico do estado nutricional de ferro em uma população de crianças pré-escolares com elevada prevalência de anemia, visando avaliar o modelo explicativo vigente. Métodos: foram avaliadas 119 crianças de 12 a 72 meses nas duas únicas creches públicas da cidade de Pontal-SP, dosando-se hemoglobina, ferro sérico, capacidade total de ligação do ferro, ferritina sérica, receptor de transferrina e realizando-se teste de falcização. Resultados: 81 crianças foram diagnosticadas como anêmicas com prevalência de 68,1%, sendo que 61 delas (75,3%) apresentaram pelo menos um indicador de deficiência de ferro. No subgrupo de 20 crianças com anemia e sem sinais de deficiência de ferro, 19 apresentaram normocitose, tornando improvável a presença de doença talassêmica. Nesse grupo foram encontradas quatro crianças com possibilidade de processo inflamatório, sendo uma com ferritina acima de 120 ng/mL e três com CTLF inferior a 200 microg/dL. Além disso, uma única criança apresentou microcitose com valores de CTLF e ferritina dentro da normalidade. Nas demais 15 crianças o diagnóstico preciso da anemia não pôde ser determinado pelos exames realizados. Conclusões: os dados apresentados remetem para a necessidade de aprimoramento nas técnicas diagnósticas de anemia e deficiência de ferro em crianças. A utilização do modelo diagnóstico atual inclui significativo número de crianças anêmicas sem diagnóstico causal preciso, o que é altamente relevante do ponto de vista clínico e de saúde pública...

Jardinópolis sem anemia, primeira fase: avaliação antropométrica e do estado nutricional de ferro / Jardinópolis without anemia, first stage: anthropometric and iron nutrition status evaluation

OBJETIVOS: Com a finalidade de preparar um programa municipal de fortificação da água de beber com ferro, foi realizado levantamento antropométrico e do estado nutricional de ferro das crianças institucionalizadas nas cinco creches de período integral da cidade de Jardinópolis, São Paulo. MÉTODOS: Em estudo transversal, foram avaliadas 184 crianças com idades entre 12 e 59,9 meses, no período entre 1º e 31 de agosto de 2006. De cada criança, foram obtidos dados pessoais, peso, estatura e colhida amostra de sangue para dosagem de hemoglobina, volume corpuscular médio (VCM), índice de saturação da transferrina (IST) e o red cell distribution width (RDW). RESULTADOS: A prevalência global de anemia foi de 29,3 por cento e a média de hemoglobina de 11,5g/dL. Deficiência de ferro foi observada em 75 por cento das crianças. As prevalências de deficit (escore Z <-2) para os indicadores peso para idade, estatura para idade e peso para estatura foram de respectivamente 1,6 por cento, 0,5 por cento e 4,3 por cento. A prevalência de obesidade (escore Z de peso para estatura >2) foi de 2,2 por cento. CONCLUSÕES: Apesar de inferior a outros estudos brasileiros, a prevalência de anemia mostrou-se elevada. A antropometria mostrou que a oferta de macronutrientes está bastante próxima do ideal, mas a elevada prevalência de crianças deficientes em ferro indica a necessidade da adoção de medidas para aprimorar a oferta de ferro.

OBJECTIVE: The aim of this study was to get basic information about the nutritional status of institutionalized preschool children who attend full time day-care centers in the city of Jardinópolis, São Paulo, Brazil, with the purpose of preparing a fortification trial. METHODS: This cross-sectional study enrolled 184 children, aged 12 to 59.9 months, between August 1st to 31st, 2006. Personal data on each child along with weight, height, hemoglobin, mean corpuscular volume (MCV), transferrin saturation and the red cell distribution width (RDW) were obtained. RESULTS: Anemia was present in 29.3 percent of the children and the mean hemoglobin value for the whole group was 11.5g/dL. Iron deficiency was observed in 75 percent of all children. Deficit prevalence (Z score <-2) of weight to age, height to age and weight for height was found to be 1.6 percent, 0.5 percent and 4.3 percent respectively. The presence of obesity (Z score of weight for height >2) was 2.2 percent. CONCLUSIONS: Although less than noted in other Brazilian studies, the prevalence of anemia was high. The anthropometry showed that macronutrients offer is next to the ideal, but the high prevalence of iron deficient children indicates the need to adopt strategies to improve iron supply.

Growth and hematological studies on Brazilian children of low socioeconomic level

Anemia and undernutrition are common all over the world, especially in less developed countries. The relationship between low weight, short stature and iron deficiency should be better understood so that appropriate measures might be taken to prevent these problems. A total of 115 institutionalized children aged 12 to 72 months were studied in day-care institutions in the town of Pontal, Southeastern Brazil, during the second semester of 1999. Personal data, weight, height and hematological profile were obtained from all subjects. Food intake was evaluated in 20 children by a direct food-weighing method. The prevalence of low weight for age (2.6), low weight for height (1.7) and low height for age (4.3) was considered low. Anemia was observed in 68.7 of the children. Diet was found to be adequate in terms of the major nutrients evaluated, but food iron supply was of low bioavailability. In conclusion, the population studied revealed a peculiar behavior i.e., the coexistence of fairly good anthropometric nutritional status along with iron-deficiency anemia. The prevention of this kind of malnutrition cannot be limited to an adequate calorie/protein supply but should also be based on the correction of the severe iron deficiency present in this low socioeconomic level preschool children in Brazil.

Em busca de novas propostas para o ensino médico: contribuiçöes das ciências sociais / Searching new proposals for medical teaching (social sciences contributions)

Pesquisa recente da CINAEM (Comissäo Interinstitucional de Avaliaçäo do Ensino Médico) aponta falhas na formaçäo dos médicos brasileiros: deficiente formaçäo ética e humanística; especializaçäo precoce; preparo inadequado para o trabalho com a comunidade e para o atendimento às demandas da populaçäo. A formaçäo de profissionais que atendam às exigências de um mercado extremamente competitivo e, ao mesmo tempo, engajados na realidade onde deveräo atuar, é tarefa que se impöe a todos aqueles que pretendem colaborar na formaçäo das novas geraçöes, nesta época marcada por profundas mudanças sociais.

Avaliaçäo do estado nutricional de ferro na criança / Evaluation by nutritional status of iron in child

Considerando-se a importância da anemia ferropiva e da deficiência de ferro como grave problema de saúde pública, especialmente para as crianças, o presente trabalho busca revisar e atualizar os conhecimentos existentes nessa área, apresentando e discutindo especialmente os métodos clássicos e recentes de disgnóstico do estado nutricional de ferro

Monte Alto sem anemia, primeira fase: avaliação nutricional das crianças pré-escolares / The city of Monte Alto: nutritional status in preschool children

Objetivos: Com a finalidade de preparar um programa municipal de intervenção nutricional, foi realizado levantamento das condições nutricionais das crianças intitucionalizadas nas 9 creches da cidade de Monte Alto, SP. Métodos: Em estudo transversal, foram avaliadas 503 crianças com idades entre 12 e 83,9 meses, no período entre 1º e 31 de agosto de 2002. De cada criança foram obtidos dados pessoais, peso, estatura e colhida amostra de sangue para dosagem de hemoglobina capilar. Resultados: A prevalência global de anemia foi de 14,5 por cento e a média de hemoglobina de 11,8 g/dl. As prevalências de déficit (escore z < -2) para os indicadores peso para idade, estatura para idade e peso para estatura foram de respectivamente 2,6 por cento, 1,6 por cento e 4 por cento. A prevalência de obesidade (escore z de peso para estatura > 2) foi de 4,2 por cento. Conclusões: Observaram-se prevalências relativamente baixas entre os distúrbios nutricionais estudados, sendo que a anemia se evidenciou o mais relevante. A obesidade mostrou-se discretamente mais prevalente que a subnutrição, indicando o provável início de um processo de transição nutricional.

Enrichment of the diet with synthetic and natural sources of provitamin A

O uso de alimentos localmente disponíveis, ricos em pró-vitamina A e retinol, bem como a fortificaçao de alimentos, apresenta resultados conhecidos na melhora do estado nutricional em relaçao a esse nutriente. No Brasil, diversos alimentos regionais sao conhecidos como boas fontes de pró-vitamina A tais como o buriti, azeite de dendê, manga o outros. O aumento do consumo desses alimentos poderia suprir as necessidades de vitamina A da populaçao vulnerável. Ao mesmo tempo, a fortificaçao de alimentos industrializados com forma sintética ou natural de próvitamina A poderia contribuir para uma adequaçao mais rápida da quantidade de vitamina A ingerida em muitas partes de nosso país. O enriquecimento de alimentos tem sido considerado por muitos como método mais efetivo para prevenir a deficiência de micronutrientes em países en desenvolvimento. Nossos estudos prévios sobre esse assunto têm mostrado que o óleo vegetal, especialmente o de soja, é um bom veículo alternativo para a fortificaçao com vitamina A. Mais tarde, nós tambén enriquecemos o óleo de soja com B-caroteno. Nossos estudos mostraram que o B-caroteno é bastante estável quando aquecido a temperatura de cozimento e fritura (retençao de 92,4ñ6,7 e 65,4ñ8,6 por ciento respectivamente). O cozimento de alimentos preparados com óleo enriquecido nao alterou significativamente a biodisponibilidade do B-caroteno sintético em ratos nem sua absorçao em humanos. O enriquecimento do óleo de soja com óleos de palma naturalmente ricos em pró-vitamina A pode ser uma alternativa para o Brasil. Oleos de palma sao utilizados no preparo de pratos regionais em algumas partes do país, e isso poderia facilitar a aceitaçao pela populaçao. O emriquecimento de alimentos, como óleo de soja, usualmente consumidos no Brasil, con B-caroteno sintético ou através da mistura de fontes naturais de pró-vitamina A pode ser uma boa alternativa para aumentar a ingestao de vitamina A pela nossa populacao

Curso de especializaçäo em nutriçäo: uma experiência interprofissional e multidisciplinar / Nutrition specialization course: inter-professional and multidisciplinary experience

Este trabalho apresenta uma revisäo do Curso de Especializaçäo em Nutriçäo da Faculdade de Medicina de Ribeiräo Preto-USP. Os dados foram obtidos nos arquivos da Biblioteca Especializada em Nutriçäo "Prof. Dutra de Oliveira", da Faculdade de Ciências Farmacêuticas da UNESP, campus de Araraquara. Os resultados mostram que cerca de 200 alunos, vindos das mais diferentes áreas profissionais, freqüentaram este curso desde sua implantaçäo, em 1968 até 1994. Aspectos históricos do curso, sua filosofia de ensino, as atividades propostas e as opiniöes de seus alunos säo apresentados. O curso tem contribuído para a caracterizaçäo da nutriçäo como uma área interprofissional e multidisciplinar. Seus ex-alunos estäo atuando hoje em diversas áreas da nutriçäo, sendo que muitos deles säo professores universitários.

Nutriçäo clínica na Faculdade de Medicina de Ribeiräo Preto - USP / Clinical nutrition in the Faculty of Medicine of Ribeiräo Preto - University of Säo Paulo

Os autores apresentam uma revisäo a cerca do ensino de Nutriçäo, em Escolas Médicas, discutem questöes filosóficas desse empreendimento médico, sua importância na formaçäo do médico geral e suas perspectivas para o futuro, no Brasil e em todo o mundo. Apresentam as principais características do Curso de Nutrologia da Faculdade de Medicina de Ribeirao Preto - USP, enfatizam os objetivos, descrevem as atividades das quais participam os alunos do quarto ano médico, as aulas teóricas, práticas de enfermaria e ambulatório, específicas da Divisäo de Nutrologia do Departamento de Clínica Médica. Discutem a demanda dos serviços de atendimento no Hospital das Clínicas da FMRP-USP, relacionando-os aos da divisäo da Nutrologia.