Vitamin E deficiency in childhood: a narrative review.

Vitamin E is an important nutrient from the earliest stages of life. It plays key roles as an antioxidant and in the maintenance of the immune system, among others. Vitamin E deficiency (VED), which occurs more frequently in children, is rarely addressed in the literature. This narrative review aims to summarise the chemistry, biology, serum indicators and clinical trials that have evaluated the impact of fortification and other relevant aspects of vitamin E, in addition to the prevalence of its deficiency, in children worldwide. Vitamin E intake in recommended amounts is essential for this nutrient to perform its functions in the body. Serum α-tocopherol is the most widely used biochemical indicator to assess the prevalence of VED. VED has been associated with symptoms secondary to fat malabsorption and may lead to peripheral neuropathy and increased erythrocyte haemolysis. Reduced concentrations of α-tocopherol may be caused by the combination of diets with low amounts of vitamin E and inadequate consumption of fats, proteins and calories. The lowest prevalence of VED was found in Asia and the highest in North America and Brazil. High proportions of VED provide evidence that this nutritional deficiency is a public health problem in children and still little addressed in the international scientific literature. The planning, evaluation and implementation of health policies aimed at combatting VED in the paediatric population are extremely important.

Evaluation of dietary folate in children assisted in Family Health Strategy units: A cross-sectional study.

BACKGROUND AND AIMS: Folate is an indispensable nutrient in human food and its deficiency may affect growth and development, and influence the risk of infant morbidity and mortality. The objective was to analyze the consumption of folic acid and its association with socioeconomic, environmental, maternal and anthropometric data of children aged 12-14 months assisted in Family Health Strategy units in a Brazilian capital. METHODS: This is a cross-sectional study included in a pragmatic clinical trial conducted with 101 children. Food intake was analyzed by means of a 24-h recall, a simple and multiple linear regression analysis was performed in a hierarchical model, and the outcome variable Dietary Folate Equivalents (DFE) was calculated. A hierarchical model was used at three levels (distal: sociodemographic; medial processes: maternal characteristics; proximal: individual processes of the child) in the adjustment of the model, in which the variables presenting p < 0.20 in the crude analysis were inserted in the adjusted analysis, from distal to proximal block, in the increasing order of magnitude of association with the outcome. RESULTS: Regarding folic acid consumption, 10.9% (n = 11) of children presented deficiency according to the calculated DFE considering the evaluation by Estimated Average Requirement (EAR), and 42.6% (n = 43) had excessive intake according to the calculated DFE considering the evaluation by the Tolerable Upper Intake Levels (UL). After multiple linear regression analysis flour intake was associated with an increase in DFE intake by 2.05 µg (95% CI: 1.72-2.45) and the presence of at least one more child under 5 years of age with an increase in DFE intake by 0.77 µg (95% CI: 0.67-0.89), while receiving the Bolsa Família Program is associated with an increase in DFE intake by 1.39 µg (95% CI: 1.07-1.65) in the model adjusted for birthweight and maternal age, regardless of the child's age. CONCLUSION: Data from this study showed low prevalence of deficient consumption and high percentage of excessive consumption of folic acid in the children. In addition, receiving the Bolsa Família Program, consuming flour and the number of children under 5 years of age were positively associated with the calculated DFE.