Impact of flour fortification with calcium on calcium intake: a simulation study in seven countries.

Calcium intake is low in many countries, especially in low-income countries. Our objective was to perform a simulation exercise on the impact, effectiveness, and safety of a flour fortification strategy using the Intake Modelling, Assessment, and Planning Program. Modeling of calcium fortification scenarios was performed with available dietary intake databases from Argentina, Bangladesh, Italy, the Lao People's Democratic Republic (Lao PDR), Uganda, Zambia, and the United States. This theoretical exercise showed that simulating a fortification with 156 mg of calcium per 100 g of flour would decrease the prevalence of low calcium intake, and less than 2% of the individuals would exceed the recommended calcium upper limit (UL) in Argentina, Italy, Uganda, and Zambia. Bangladesh and the Lao PDR showed little impact, as flour intake is uncommon. By contrast, in the United States, this strategy would lead to some population groups exceeding the UL. This exercise should be replicated and adapted to each country, taking into account the updated prevalence of calcium inadequacy, flour consumption, and technical compatibility between calcium and the flour-type candidate for fortification. A fortification plan should consider the impact on all age groups to avoid the risk of exceeding the upper levels of calcium intake.

Multiple micronutrient supplements in pregnancy: Implementation considerations for integration as part of quality services in routine antenatal care. Objectives, results, and conclusions of the meeting.

Health promotion, screening, diagnosis, and disease prevention are essential services of quality routine antenatal care for pregnant adult and adolescent women. Supplementation programmes in pregnancy, generally implemented in the context of antenatal care services, have had less than optimal results in many countries, generally attributed to limited access, low coverage, and reduced adherence to the recommended regimens and counselling. The World Health Organization Department of Nutrition for Health and Development, in collaboration with the United Nations Children's Fund and Nutrition International, convened the technical consultation "Multiple micronutrient supplements in pregnancy: Implementation considerations for successful incorporation into existing programmes." The objectives of the technical consultation were to (a) examine implementation experiences of micronutrient supplementation interventions in pregnant women, lessons learnt, and best practices; (b) discuss programmatic and technical considerations of interventions on multiple micronutrient supplementation in pregnant women in low-, middle-, and high-income countries; and (c) identify implementation considerations that can be useful to scaling up efforts by national policymaker and their advisors considering multiple micronutrient supplementation in pregnant women as part of existing antenatal care programmes as well as other delivery platforms. The consultation was based on presentations of background papers, case studies, and plenary discussions. Country representatives were asked to discuss the context of micronutrient supplementation for their countries and share implementation challenges they faced. This paper provides the background and rationale of the technical consultation, synopsises the presentations, and provides a summary of the main considerations and conclusions reached during plenary discussions.

Dieta e inflamación / Diet and inflammation

La inflamación puede definirse como una respuesta local al daño celular, que se caracteriza por aumento del flujo sanguíneo, vasodilatación capilar, infiltración de leucocitos y la producción local de mediadores de inflamación por parte del huésped. La inflamación es parte de la respuesta y es necesario el retorno a la homeostasis luego de daño producido por un agente infeccioso, daño físico o estrés metabólico. Cuando persiste el estímulo que dispara el proceso, la inflamación puede hacerse crónica y contribuir a la patogénesis de enfermedades como la diabetes mellitus tipo 2 y la hipertensión. En estas enfermedades, ácidos grasos saturados, lipoproteínas y agregados proteicos disparan la respuesta inmunitaria y producen inflamación, que al no poder ser fácilmente eliminados, perpetúan la respuesta y contribuyen con la persistencia de la enfermedad. Los patrones de consumo saludable se han asociado con bajas concentraciones de marcadores de inflamación. Entre los componentes de una dieta saludable el consumo de cereales integrales, pescado, frutas y verduras se asocian con menor inflamación. La vitamina C, E y los carotenoides disminuyen la concentración de marcadores de inflamación, mientras otros nutrientes como los lípidos, tienen efectos opuestos: los ácidos grasos saturados y los transmonosaturados son pro-inflamatorios, mientras que los ácidos grasos poliinsaturados, especialmente los de cadena larga, son antiinflamatorios. También se revisan los productos de glicosilación avanzada y su papel en la producción de inflamación de bajo grado(AU)

Inflammation could be defined as a local response to cell damage, characterized by increased blood flow, capillary vasodilation, leukocyte infiltration and local production of inflammation mediators by the host. Inflammation is part of the response and the return to homeostasis after an insult by a pathogen, physical damage or metabolic stress is also required. When the stimulus that triggers the response is not eliminated, inflammation could become chronic and contribute to the pathogenesis of diseases such as diabetes and hypertension. In these diseases saturated fatty acids, lipoproteins and protein aggregates trigger the immune response and produce inflammation. If they are not properly eliminated, the response is maintained and the disease continues. Healthy consumption patterns have been associated with low levels of inflammation markers. Some of the components identified as part of a healthy diet include whole grains, fish, fruits and vegetables. Vitamins C and E, as well as carotenoids, diminish the concentration of markers of inflammation, while other nutrients have opposite effects: saturated, as well as trans-monosaturated fatty acids are pro-inflammatory whereas polyunsaturated fatty acid, especially long chain, are anti-inflammatory. Advanced glycation end products and their role in inflammation are also reviewed(AU)

Valores de referencia de ácido fólico para la población venezolana / Reference values of folic acid for the Venezuelan population

En esta revisión de las recomendaciones de ácido fólico para Venezuela, se presentan las definiciones adoptadas a nivel mundial conocidas como Ingestas Dietéticas de Referencia (DRIs por Dietary Reference Intakes) que incluyen: Ingesta Dietética Recomendada (RDA), Requerimiento Promedio Estimado (EAR), Ingesta Adecuada (AI) y Niveles de Ingesta Máximos Tolerables (UL). En contraste con la situación en algunos países, donde se comienza a considerar un ajuste en las políticas de fortificación de alimentos con ácido fólico para evitar su exceso, en Venezuela varios estudios muestran una elevada prevalencia de deficiencia de este nutriente. Los datos nacionales no son suficientes para establecer los requerimientos, por lo tanto, al igual que en la revisión del año 2000, las recomendaciones actuales se basan en las definidas para la población de Estados Unidos. Las Ingestas Dietéticas Recomendadas (RDA) para Venezuela son: menores de 1 año 65-80 μg/día, niños 150- 300 μg/día, adolescentes y adultos 400 μg/día, embarazadas 600 μg/día y lactancia 500 μg/día. El Requerimiento Promedio Estimado (EAR) es: niños 120-250 μg/día, adolescentes 330 μg/ día y adultos 320 μg/día, embarazadas 520 μg/día y lactancia 450 μg/día. Los Niveles de Ingesta Máximos Tolerables (UL) son: niños 300-600 μg/día, adolescentes 800 μg/día y adultos 1000 μg/día, embarazadas y madres entre 14 y 18 años 800 μg/ día y para embarazadas y lactantes mayores 1000 μg /día. Es importante seguir evaluando la situación de este nutriente, con la finalidad de diseñar políticas adecuadas y eficientes que puedan controlar en ciertos grupos de la población tanto la deficiencia como el exceso.

The review on folic acid requirements for Venezuela comprise the definitions adopted worldwide known as Dietary Reference Intakes (DRIs) that include Recommended Dietary Allowance (RDA), Estimated Average Requirement (EAR), Adequate Intake (AI) and Tolerable Upper Intake Levels (UL). In contrast with the situation in some countries, that required adjustments in fortification policies in order to avoid excessive folic acid consumption, in Venezuela several studies show an elevated prevalence of deficiency. National evidence at this point is insufficient to establish the recommendation, and as in the 2000 review of the Venezuelan RDAs, the actual recommendations are based on the reported for the United States population. The Recommended Dietary Allowances for Venezuela are 65-80 μg/day for infants less than 1 year old, 150-300 μg/day for children and 400 μg/day for adolescents and adults, increasing to 600 μg/day during pregnancy and to 500 μg/day during lactation. The estimated average requirement is 120-250 μg/day for children, 330 μg/day for adolescents, 320 μg/day for adults, 520 μg/day for pregnancy and 450 μg/day during lactation. The tolerable upper intake levels for folic acid are 300-600 μg/day for children, 800 μg/day for adolescents and 1000 μg/day for adults. During pregnancy and lactation the UL is 800 μg/day for pregnant and lactating women between 14 and 18 years of age, and 1000 μg /day for older pregnant and lactating women. The continuous evaluation of folic acid status is important to design adequate and efficient policies to control both, the deficiency and the excess of folic acid consumption.

Valores de referencia de vitamina A para la población venezolana / Reference values of vitamin A for the Venezuelan population

La deficiencia de vitamina A es uno de los problemas de salud pública mas prevalentes a nivel mundial, principalmente a los países menos desarrollados, afectando especialmente a mujeres y niños. La causa más común de deficiencia de vitamina A es la ingesta inadecuada, sobre todo en presencia de infección. Las consecuencias de la deficiencia son xeroftalmia, ceguera nocturna, anemia, mayor susceptibilidad a infecciones y el aun controversial aumento de la mortalidad neonatal. Los datos nacionales no son suficientes para establecer los requerimientos, por esto, igual que en la revisión del año 2000, las recomendaciones actuales se basan en las definidas para la población de Estados Unidos. La Ingesta Dietética Recomendada (RDA) para Venezuela es: menores de 1 año 400-500 ER/día, niños 300-400 ER/día, adolescentes 600 ER/día y para adultos 900 ER/día para hombres y 700 ER/día para mujeres, aumentando a 750 ER/día por embarazo y a 1200-1300 ER/día por lactancia, dependiendo de la edad. El Requerimiento Promedio Estimado (EAR) es 210 a 275 ER/día para niños, 445 ER/día para adolescentes varones, 420 ER/día para adolescentes hembras, 630 ER/día para hombres y 485 ER/día para mujeres, aumentando a 530-550 ER/día por el embarazo y a 885-900 ER/día durante la lactancia, dependiendo de la edad. Los Niveles de Ingesta Máximos Tolerables (UL) para vitamina A son 600 ER/día para niños, 1700 a 2800 ER/día para adolescentes y 3000 ER/día para adultos, hombres y mujeres.

Vitamin A deficiency is one of the most prevalent nutritional deficiencies worldwide, mainly affecting children and women. The cause of vitamin A deficiency is insufficient intake, especially in presence of infection and the consequences of the deficiency are xerophthalmia, night blindness, anemia, increased susceptibility to infections and the still controversial increase in infant mortality. National evidence at this point is insufficient to establish the recommendation, and as in the 2000 review of the Venezuelan RDAs, the actual recommendations are based on the reported for the United States population. The Recommended Dietary Allowances (RDA) for Venezuela are 400-500 RE/day for infants, 300-400 RE/day for children 600 RE/day for adolescents, 900 RE/day for men and 700 RE/day for women, increasing to 750 RE/day for pregnancy and to 1200-1300 RE/day during lactation, depending on the age. The estimated average requirement (EAR) is between 210 and 275 RE/day for children, 445 RE/day for male adolescents, 420 RE/day for female adolescents, 630 RE/day for men and 485 RE/day for women, increasing to 530-550 and 885-900 RE/ day during pregnancy and lactation, respectively. The tolerable upper intake levels (UL) for vitamin A are 600 RE/day for children, 1700 a 2800 RE/day for adolescents and 3000 RE/day for adults, males and females.

Valores de referencia de niacina para la población venezolana / Reference values of niacin for the Venezuelan population

La niacina es una vitamina hidrosoluble, conocida también como ácido nicotínico o vitamina B3. La nicotinamida es un derivado de la niacina (amida del ácido nicotínico), y es utilizada por el cuerpo para producir las coenzimas nicotinamida adenina dinucleótido (NAD) y nicotinamida adenina dinucleótido fosfato (NADP). En esta revisión de los requerimientos de niacina para Venezuela, encontramos que los datos nacionales no son suficientes para establecer las recomendaciones de consumo de este nutriente, por lo tanto, al igual que en la revisión del año 2000, las recomendaciones actuales se basan en las definidas para la población de Estados Unidos. Las Ingestas Dietéticas Recomendadas (RDAs) para Venezuela son: menores de 1 año (2-4 mg/día), niños entre 1 y 8 años (6-8 mg/día), niños entre 9 y 13 años (12 mg/día), adolescentes y adultos del sexo femenino (14 mg/día), adolescentes y adultos del sexo masculino (16 mg/día), embarazadas (18 mg/día) y lactancia (17 mg/ día). En cuanto al Requerimiento Promedio Estimado (EAR): 5-9 mg/día para niños, 11 mg/día para adolescentes y adultos del sexo femenino y 12 mg/día para adolescentes y adultos del sexo masculino, aumentado a 14 mg/día para embarazadas y a 13 mg/ día durante la lactancia. Los Niveles de Ingesta Máximos Tolerables (UL) son: niños entre 1 y 3 años (10 mg/día), niños entre 4 y 8 años (15 mg/día), niños entre 9 y 13 años (20 mg/día), adolescentes (30 mg/día) y adultos (35 mg/día). Es necesario realizar estudios donde se evalúe el estado nutricional de esta vitamina en diferentes grupos de la población, que incluya no solo la estimación del consumo, sino la utilización de indicadores bioquímicos, como la medición de los niveles de las coenzimas NAD y NADP en eritrocitos o sangre completa y la determinación de los principales metabolitos urinarios de la vitamina.

Niacin is a water soluble vitamin, also known as nicotinic acid or Vitamin B3. Nicotinamide is a derivative of niacin (amide of nicotinic acid), and is used by the body to produce the coenzyme nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP). In preparing this review about the niacin requirements for Venezuela, it was found that there is not enough national data to establish recommendations, therefore, as in the 2000 review of the Venezuelan Recommended Dietary Allowances (RDAs), the actual recommendations for intake of niacin, are based on those reported for the United States population. The RDAs for Venezuela are: 2-4 mg/day for infants less than 1 year old, 6-8 mg/ day for children between 1 and 8 years, 12 mg/day for children between 9 and 13 years, 14 mg/day for adolescents and female adults, 16 mg/day for adolescents and adult males, 18 mg/day during pregnancy and 17 mg/day during lactation. The estimated average requirement (EAR) is: 6-9 mg/day for children, 11 mg/ day for adolescents and female adults and 12 mg/day for adolescents and adult males, increasing to 14 mg/day during pregnancy and to 13 mg/day during lactation. The niacin Tolerable Upper Intake Levels (UL) are: 10 mg/day for children between 1 and 3 years, 15 mg/day for children between 4 and 8 years, 20 mg/day for children between 9 and 13 years, 30 mg/day for adolescents and 35 mg/day for adults. It is necessary to perform studies where the nutritional status of this vitamin is evaluated for different population groups, including not only the estimation of consumption, but the use of biochemical indicators, such as measuring the levels of the coenzymes NAD and NADP in erythrocytes or whole blood and determination of the major urinary metabolites of the vitamin.

Valores de referencia de hierro, yodo, zinc, selenio, cobre, molibdeno, vitamina C, vitamina E, vitamina K, carotenoides y polifenoles para la población venezolana / Reference values of iron, iodine, zinc, selenium, copper, molybdenum, vitamin C, vitamin E, vitamin K, carotenoids and polyphenols for the Venezuelan population

Esta revisión de las recomendaciones de energía y nutrientes para la población Venezolana presenta los valores de hierro, yodo, zinc, selenio, cobre, molibdeno, vitamina C, vitamina E, vitamina K, carotenoides y polifenoles. Se adoptan definiciones internacionales de Ingestas Dietéticas de Referencia (DRIs por Dietary Reference Intakes) que incluyen: Ingesta Dietética Recomendada (RDA), Requerimiento Promedio Estimado (EAR), Ingesta Adecuada (AI) y Niveles de Ingesta Máximos Tolerables (UL). Las RDA para hierro: 11 mg/día para < 1 año, 7-10 mg/día niños, 8-11 mg/día para hombres, 8-18 mg/día para mujeres y 27 mg/día para embarazadas. RDA Yodo: 110-130 mg/ día recién nacidos, 90-120 mg/día niños y adolescentes y 150 mg/ día adultos, 220 mg/día embarazo y 290 mg/día lactancia. RDA Zinc: 2-3 mg/día < 1 año, 3-5 mg/día niños, 8-11 mg/día adolescentes y hombres, 8-9 mg/día adolescentes y mujeres, 12 mg/ día para embarazadas y 13 mg/día durante la lactancia. RDA Vitamina C: 40-50 mg/día recién nacidos, 15-45 mg/día niños, 75 mg/día adolescentes masculinos, 65 mg/día adolescentes femeninas, 90 mg/día hombres y 75 mg/día mujeres, 80-85 mg/día embarazadas y lactancia 115-120 mg/día. También se presentan valores de cobre, selenio, molibdeno, vitaminas E, K, carotenoides y polifenoles. Estas recomendaciones contribuirán al diseño de políticas adecuadas y eficientes que puedan ayudar a evitar o a tratar las consecuencias derivadas de la deficiencia o el exceso de estos nutrientes.

The review on iron, iodine, zinc, selenium, copper, molybdenum, vitamin C, vitamin E, vitamin K, carotenoids and polyphenols recommendations for Venezuela comprise the definitions adopted worldwide known as Dietary Reference Intakes (DRIs) that include Recommended Dietary Allowance (RDA), Estimated Average Requirement (EAR), Adequate Intake (AI) and Tolerable Upper Intake Levels (UL). The RDA for iron: 11 mg/day for infants < 1 year of age, 7 - 10 mg/day for children, 8-11 mg/day for males, 8-18 mg/day for females and 27 mg/day during pregnancy. RDA for iodine: 110-130 mg/day for infants, 90-120 mg/ day for children and adolescents, 150 mg/day for adults, 220 mg/ day for pregnancy and 290 mg/day during lactation. RDA Zinc: 2-3 mg/day for infants, 3-5 mg/day for children, 8-11 mg/day for male adolescents and adults, 8-9 mg/day for female adolescents and adults, 12 mg/day during pregnancy and 13 mg/day for lactation. RDA Vitamin C: 40-50 mg/day for infants, 15-45 mg/ day for children, 75 mg/day for male adolescents, 65 mg/day for female adolescents, 90 mg/day for adult males, 75 mg/day for adult females, 80-85 mg/day during pregnancy and 115-120 mg/ day during lactation. Recommendations for copper, selenium, molybdenum, vitamins E, K, carotenoids and polyphenols are also presented. These recommendations will help to design adequate and efficient policies that could help to avoid or to treat the consequences derived from the deficiency or the excess of these nutrients.

[Reference values of vitamin A for the Venezuelan population]. / Valores de referencia de vitamina A para la población venezolana.

Vitamin A deficiency is one of the most prevalent nutritional deficiencies worldwide, mainly affecting children and women. The cause of vitamin A deficiency is insufficient intake, especially in presence of infection and the consequences of the deficiency are xerophthalmia, night blindness, anemia, increased susceptibility to infections and the still controversial increase in infant mortality. National evidence at this point is insufficient to establish the recommendation, and as in the 2000 review of the Venezuelan RDAs, the actual recommendations are based on the reported for the United States population. The Recommended Dietary Allowances (RDA) for Venezuela are 400-500 RE/day for infants, 300-400 RE/day for children 600 RE/day for adolescents, 900 RE/day for men and 700 RE/day for women, increasing to 750 RE/day for pregnancy and to 1200-1300 RE/day during lactation, depending on the age. The estimated average requirement (EAR) is between 210 and 275 RE/day for children, 445 RE/day for male adolescents, 420 RE/day for female adolescents, 630 RE/day for men and 485 RE/day for women, increasing to 530-550 and 885-900 RE/ day during pregnancy and lactation, respectively. The tolerable upper intake levels (UL) for vitamin A are 600 RE/day for children, 1700 a 2800 RE/day for adolescents and 3000 RE/day for adults, males and females.

[Reference values of folic acid for the Venezuelan population]. / Valores de referencia de ácido fólico para la población venezolana.

The review on folic acid requirements for Venezuela comprise the definitions adopted worldwide known as Dietary Reference Intakes (DRIs) that include Recommended Dietary Allowance (RDA), Estimated Average Requirement (EAR), Adequate Intake (AI) and Tolerable Upper Intake Levels (UL). In contrast with the situation in some countries, that required adjustments in fortification policies in order to avoid excessive folic acid consumption, in Venezuela several studies show an elevated prevalence of deficiency. National evidence at this point is insufficient to establish the recommendation, and as in the 2000 review of the Venezuelan RDAs, the actual recommendations are based on the reported for the United States population. The Recommended Dietary Allowances for Venezuela are 65-80 microg/day for infants less than 1 year old, 150-300 microg/day for children and 400 microg/day for adolescents and adults, increasing to 600 microg/day during pregnancy and to 500 microg/day during lactation. The estimated average requirement is 120-250 microg/day for children, 330 microg/day for adolescents, 320 microg/day for adults, 520 microg/day for pregnancy and 450 microg/day during lactation. The tolerable upper intake levels for folic acid are 300-600 microg/day for children, 800 microg/day for adolescents and 1000 microg/day for adults. During pregnancy and lactation the UL is 800 microg/day for pregnant and lactating women between 14 and 18 years of age, and 1000 microg/day for older pregnant and lactating women. The continuous evaluation of folic acid status is important to design adequate and efficient policies to control both, the deficiency and the excess of folic acid consumption.

[Reference values of niacin for the Venezuelan population]. / Valores de referencia de niacina para la población venezolana.

Niacin is a water soluble vitamin, also known as nicotinic acid or Vitamin B3. Nicotinamide is a derivative of niacin (amide of nicotinic acid), and is used by the body to produce the coenzyme nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP), In preparing this review about the niacin requirements for Venezuela, it was found that there is not enough national data to establish recommendations, therefore, as in the 2000 review of the Venezuelan Recommended Dietary Allowances (RDAs), the actual recommendations for intake of niacin, are based on those reported for the United States population. The RDAs for Venezuela are: 2-4 mg/day for infants less than 1 year old, 6-8 mg/day for children between 1 and 8 years, 12 mg/day for children between 9 and 13 years, 14 mg/day for adolescents and female adults, 16 mg/day for adolescents and adult males, 18 mg/day during pregnancy and 17 mg/day during lactation. The estimated average requirement (EAR) is: 6-9 mg/day for children, 11 mg/ day for adolescents and female adults and 12 mg/day for adolescents and adult males, increasing to 14 mg/day during pregnancy and to 13 mg/day during lactation. The niacin Tolerable Upper Intake Levels (UL) are: 10 mg/day for children between 1 and 3 years, 15 mg/day for children between 4 and 8 years, 20 mg/day for children between 9 and 13 years, 30 mg/day for adolescents and 35 mg/day for adults. It is necessary to perform studies where the nutritional status of this vitamin is evaluated for different population groups, including not only the estimation of consumption, but the use of biochemical indicators, such as measuring the levels of the coenzymes NAD and NADP in erythrocytes or whole blood and determination of the major urinary metabolites of the vitamin.

[Reference values of iron, iodine, zinc, selenium, copper, molybdenum, vitamin C, vitamin E, vitamin K, carotenoids and polyphenols for the Venezuelan population]. / Valores de referencia de hierro, yodo, zinc, selenio, cobre, molibdeno, vitamina C, vitamina E, vitamina K, carotenoides y polifenoles para la población venezolana.

The review on iron, iodine, zinc, selenium, copper, molybdenum, vitamin C, vitamin E, vitamin K, carotenoids and polyphenols recommendations for Venezuela comprise the definitions adopted worldwide known as Dietary Reference Intakes (DRIs) that include Recommended Dietary Allowance (RDA), Estimated Average Requirement (EAR), Adequate Intake (AI) and Tolerable Upper Intake Levels (UL). The RDA for iron: 11 mg/day for infants < 1 year of age, 7-10 mg/day for children, 8-11 mg/day for males, 8-18 mg/day for females and 27 mg/day during pregnancy. RDA for iodine: 110-130 microg/day for infants, 90-120 microg/ day for children and adolescents, 150 microg/day for adults, 220 microg/ day for pregnancy and 290 microg/day during lactation. RDA Zinc: 2-3 mg/day for infants, 3-5 mg/day for children, 8-11 mg/day for male adolescents and adults, 8-9 mg/day for female adolescents and adults, 12 mg/day during pregnancy and 13 mg/day for lactation. RDA Vitamin C: 40-50 mg/day for infants, 15-45 mg/ day for children, 75 mg/day for male adolescents, 65 mg/day for female adolescents, 90 mg/day for adult males, 75 mg/day for adult females, 80-85 mg/day during pregnancy and 115-120 mg/day during lactation. Recommendations for copper, selenium, molybdenum, vitamins E, K, carotenoids and polyphenols are also presented. These recommendations will help to design adequate and efficient policies that could help to avoid or to treat the consequences derived from the deficiency or the excess of these nutrients.

Evaluación y correlación de variables bioquímicas, antropométricas y de consumo de riboflavina, hierro y vitamina A en escolares venezolanos / Evaluation and correlation of biochemical, anthropometrical and consumption variables of riboflavin, iron and vitamin a in scholars from venezuela

El objetivo fue evaluar el estado de riboflavina, hierro y vitamina A de un grupo de escolares de Caracas, correlacionando variables bioquímicas, de composición corporal y de consumo de energía y nutrientes. Se estudiaron 69 niños con edades comprendidas entre 6 y 8 años a los que se les determinó estrato socioeconómico, consumo de alimentos, adecuación de consumo y fórmula dietética. Se tomaron medidas antropométricas y una muestra de sangre para la determinación de hemoglobina y hematocrito, así como concentraciones plasmáticas de riboflavina por método enzimático, retinol por HPLC, hierro por colorimetría y ferritina por ELISA. Los escolares tuvieron una dieta monótona en la que los cuatro alimentos más consumidos fueron cereales. La dieta resultó inadecuada en vitamina A (48%), hierro (39%), riboflavina (6%) y vitamina B6 (80%). Las determinaciones antropométricas mostraron un importante porcentaje de desnutrición actual (19%), aunque la mayoría presentó estado nutricional antropométrico y composición corporal normales. Las determinaciones hematológicas mostraron deficiencias de riboflavina (16%), retinol (57%), hierro (67%) y anemia (14%). En conclusión, la dieta fue poco variada, deficitaria en calorías, vitamina B6, vitamina A, proteínas y hierro y excesiva en riboflavina, con un estado nutricional antropométrico y composición corporal normales. Los datos de consumo y adecuación de la dieta se correlacionaron con las deficiencias encontradas en pruebas hematológicas, mientras que los datos antropométricos no fueron marcadamente afectados, aunque hubo correlación entre las variables área muscular y área grasa, y el consumo de energía, proteínas, grasa, hierro y riboflavina(AU)

The objective was to evaluate the status of riboflavin, iron and vitamin A in a group of school children from Caracas, correlating biochemical, body composition and consumption data. The sample included 69 scholars aged 6 to 8 years whose socio economic status, food consumption patterns and adequacy as well as dietetic formulae were determined. Anthropometric measures were recorded and a blood sample was taken to determine hemoglobin, hematocrit and plasmatic concentrations of riboflavin by an enzymatic method, retinol by HPLC, iron by a colorimetric method and ferritin by ELISA. The scholars had a monotonous diet and the 4 most consumed food items were cereals. The diet resulted inadequate in vitamin A (48%), iron (39%), riboflavin (6%) and vitamin B6 (80%). Anthropometric evaluation showed an important percentage of recent undernutrition (19%), although most of the individuals had a nutritional anthropometric state and a body composition within normal ranges. Hematological determinations showed deficiencies of riboflavin (16%), retinol (57%), iron (67%) and anemia (14%). In conclusion, the diet was monotonous, deficient in calories, vitamin B6, vitamin A, proteins and iron and excessive in riboflavin, with inadequate anthropometric and body composition status. Data on consumption and diet adequacy correlated with results from hematological tests, while anthropometric data was not markedly affected, although there was a linear correlation between muscular and fat areas with energy, protein, fat, iron and riboflavin consumption(AU)

A program of nutritional education in schools reduced the prevalence of iron deficiency in students.

The objective was to determine the prevalence of iron, folates and retinol deficiencies in school children and to evaluate the changes after an intervention of nutritional education. The project was developed in 17 schools. The sample included 1,301 children (678 males and 623 females). A subsample of 480 individuals, was randomly selected for drawing blood for biochemical determinations before and after the intervention of nutritional education, which included in each school: written pre and post-intervention tests, 6 workshops, 2 participative talks, 5 game activities, 1 cooking course and 1 recipe contest. Anthropometrical and biochemical determinations included weight, height, body-mass index, nutritional status, hematocrit, serum ferritin, retinol and folate concentrations. There was high prevalence of iron (25%), folates (75%) and vitamin A (43%) deficiencies in school children, with a low consumption of fruit and vegetables, high consumption of soft drinks and snacks and almost no physical activity. The nutritional education intervention produced a significant reduction in iron deficiency prevalence (25 to 14%), and showed no effect on vitamin A and folates deficiencies. There was a slight improvement in nutritional status. This study shows, through biochemical determinations, that nutritional education initiatives and programs have an impact improving nutritional health in school children.

Perfil de alimentación y nutrición de mujeres en edad fértil de un municipio del centroccidente de venezuela / Feeding and nutrition profile of fertile age women from a west-center township in venezuela

Con el objetivo de identificar el estado nutricional y alimentación de las mujeres de 12 a 45 años del Municipio Jiménez, Estado Lara, Venezuela, se realizó un estudio de prevalencia entre septiembre 2007 y abril 2008. La muestra consistió de 243 mujeres seleccionadas a través de una muestra aleatoria estratificada según sectores rural- urbano, por conglomerados. Cada participante respondió un cuestionario con datos personales y socioeconómicos, se le tomó peso, talla, circunferencia media del brazo, pliegues tricipital y subescapular y se calculó el índice de masa corporal y los indicadores de composición corporal, utilizando referencias internacionales y nacionales. La evaluación dietética consistió en una encuesta de frecuencia de consumo y 2 recordatorios de 24 horas. 46,6% presentaron exceso de peso, más frecuente en mujeres adultas, mientras que el déficit de peso fue de 8,3%, más frecuente en adolescentes (p=0,000) y 44,1% presentó exceso de grasa corporal. Se observó deficiencia importante en la adecuación de consumo de calcio (34,7%), zinc (20,9%), cobre (13,3%), folatos (41,5%), vitaminas B6 (19,8%), vitamina C (62,6%), proteínas (72,0%) y calorías (58,1%). Más del 90% de la muestra consumían diariamente cereales y grasas visibles, con menor frecuencia lácteos (61,7%), carnes y huevos (76,5%), leguminosas (17%), frutas (40,0%), vegetales (14,0%). En la población estudiada coexiste una importante prevalencia de déficit y exceso de peso, así como hábitos alimenticios inadecuados, lo cual amerita programas de intervención para disminuir los riesgos de enfermedades crónicas y mortalidad(AU)

The objective was to study the nutritional status and food habits of women of childbearing age (12 to 45 years) from Municipio Jimenez, Lara State, Venezuela. The sample consisted in 243 women, randomly selected from rural and urban conglomerates of the Municipio. Each woman was requested to fill a questionnaire, with personal and socioeconomic information, between September 2007 and April 2008. Weight, height, mid arm circumferences and skinfolds were obtained. The body mass index and composition indicators were calculated. The nutritional status of the group was classified according to national and international standards. Dietetic evaluation consisted in one food frequency and two food recall questionnaires. Overweight was present in 46.6% of women, being higher in adult women, low weight affected 8.3% being significantly more frequent in adolescents (p=0,000). There were important deficiencies in consumption adequacy of calcium (34.7%), zinc (20.9%), copper (13.3%), folates (41.5%), vitamins B6 (19.8%), C (62.6%), proteins (72.0%) and calories (58.1%). Cereals and edible fats were consumed daily by more than 90% of the sample. Intake of dairy products (61.7%), meats and eggs (76.5%), grains (17.0%), fruits (40.0%), and vegetables (14.0%), was less frequent. In conclusion, the population studied showed the simultaneous co-existence of excess and deficit of weight as well as inadequate food habits, that justify the implementation of intervention programs to diminish mortality and the risk of non-transmissible chronic diseases(AU)

Folatos y hierro en mujeres en edad fértil de una comunidad en Venezuela afectada por la incidencia de defectos del tubo neural / Folate and iron in fertile age women from a Venezuelan community affected by incidence of neural tube defects

El objetivo de este estudio transversal fue identificar el estado nutricional de folatos y hierro en mujeres en edad fértil del Municipio Jiménez, Estado Lara, Venezuela. El muestreo fue probabilístico por conglomerados del área urbana y rural, seleccionándose 15 conglomerados donde se estudiaron a las mujeres entre 12 y 45 años (269 mujeres). Previa firma del consentimiento informado, se les practicó: Encuesta con datos personales, antecedentes y variables relacionadas con folatos y hierro; datos socioeconómicos (Encuesta Graffar-Méndez Castellano y Necesidades Básicas Insatisfechas); en muestra de sangre se determinó Hemoglobina y Folato Eritrocitario (FE); en suero se determinó Ferritina, y Folato Sérico (FS). 53,53% de la muestra presentó valores bajos de FS, y el 10,78% valores deficientes. 80,7% presentó deficiencia severa según FE y 5,9% deficiencia moderada. En ambas pruebas, la media fue mayor en mujeres tratadas con Acido Fólico ó embarazadas (p=0,000) y la media del FE también resultó mayor en adultas que adolescentes (p=0,001) y en mujeres no pobres (p=0,011); no hubo diferencias significativas según ingesta de café, alcohol, anticonceptivos, procedencia, estrato social. La anemia se determinó en 11,2%, más frecuente en adultas (p=0,029) y en las del medio urbano (p=0,042). Ferritina baja se encontró en 37.3% de la muestra, las diferencias según variables no fueron significativas. En conclusión, la prevalencia de deficiencia de hierro y folatos en mujeres en edad fértil del Municipio Jiménez es alta, ésta podría constituir un factor condicionante de defectos del tubo neural, por lo cual deben ejecutarse estrategias para superar este déficit.

The objective of this transversal study was to determine folate and iron nutritional status of women in fertile age from Municipio Jiménez, Lara State, Venezuela. The sampling was probabilistic by conglomerates from the urban and rural areas, selecting 15 conglomerates from which women between 12 and 45 years (269), were studied. After signing informed consent, participating were interviewed for personal data, antecedents related to folate and iron, socioeconomic data (Graffar-Mendez Castellano method and unsatisfied basic needs). In blood sample was determined Hemoglobin, and Erythrocytic Folate (FE). Serum was obtained to determine Ferritin and Serum Folate (FS). 53,53% of the sample presented low FS levels, 10.78% were FS deficient. Severe FE deficiency was present in 80.7% of the cases, moderate deficiency affected 5,9%. For both tests, median was higher for women in treatment with Acido Fólico or pregnant (p=0,000), median for FE was higher for adults (p=0.001) and in non poor women (p=0.011). There were no significant differences for coffee, alcohol, anticonceptive consumption, urban or rural resident or socioeconomic strata. The prevalence of anemia was 11,2% being significantly more frequent in adults than in adolescents (p= 0,029) and in urban women (p=0,042). Low ferritin were found in 37,3% of the sample, the effect of different variables was not statistically significant. In conclusion, there is a high prevalence of iron and folate deficiencies in women of fertile age from Municipio Jiménez, which could constitute a conditioning factor for the appearance of neural tube defects.

Prevalence of anemia and deficiencies of iron, folic acid and vitamin B12 in an indigenous community from the Venezuelan Amazon with a high incidence of malaria.

The objective of this work was to determine the prevalence of anemia and deficiencies of iron, folic acid and vitamin B12 in Betania del Topocho, a Piaroa community from Estado Amazonas, Venezuela, a zone with a high incidence of malaria. The group studied included 184 subjects of all ages that assisted to the local health center for malaria diagnosis. Analysis performed included hematology by coulter counter, ferritin quantification by ELISA with monoclonal antibodies and folic acid and vitamin B12 determinations by an immunoradiometric assay. It was found that the prevalence of anemia was 89.6% and deficiencies of iron, folic acid and vitamin B12 affected 37.1,70.3 and 12.4% of the population studied, respectively. Plasmodium infection was detected by molecular diagnosis in 53.2% of the cases, and 86% of them were anemic. The highest incidence of anemia was found in children, with a prevalence of 100% in infants of both sexes. The high prevalence of anemia, iron and folic acid deficiencies found, indicates an important health and nutrition problem that should be immediately and properly addressed. The number of cases of anemia due to iron deficiency could be underestimated, since ferritin concentration increased as a acute phase protein, although prevalence data was also analyzed with a cutoff point of 30 microg/L for ferritin concentration.

Prevalence of anemia and deficiencies of iron, folic acid and vitamin B12 in an indigenous community from the Venezuelan Amazon with a high incidence of malaria

El objetivo de este trabajo fue estudiar la prevalencia de anemia y de las deficiencias de hierro, ácido fólico y vitamina B12 en Betania del Topocho, población indígena de la etnia Piaroa, del Estado Amazonas, Venezuela, una zona con alta incidencia de malaria. Se estudiaron 184 sujetos de todas las edades que asistieron al Centro de salud para despistaje de malaria. Se realizó hematología completa por Coulter counter, la cuantificación de ferritina por ELISA con anticuerpos monoclonales, y la determinación de ácido fólico y vitamina B12 séricas por un ensayo inmunoradiométrico. La prevalencia de anemia fue de 89.6 por ciento y las deficiencias de hierro, ácido fólico y vitamina B12 afectaron 37.1, 70.3 y 12.4 por ciento de la población estudiada, respectivamente. La infección con Plasmodium fue detectada por diagnóstico molecular en el 53.2 por ciento de los casos, y 86 por ciento de ellos eran anémicos. La mayor incidencia de anemia fue encontrada en niños, con una prevalencia de 100 por ciento en lactantes de ambos sexos. La alta prevalencia de anemia y deficiencias de hierro y ácido fólico indican un problema de salud y de nutrición importante en esta comunidad que debe ser tratada de forma adecuada y urgente. Los casos de anemia debidos a deficiencia de hierro, podrían estar siendo subestimados, ya que la ferritina sérica es también una proteína de fase aguda que aumenta en caso de infección, aunque los datos de prevalencia fueron también analizados con un punto de corte de 30 µg/L para la concentración de ferritina.

La alimentación del futuro: nuevas tecnologías y su importancia en la nutrición de la población / The alimentation of the future: new technologies and their importance for the nutrition of populations

En esta revisión se enfocan de manera general la situación actual de disponibilidad de alimentos y las posibles soluciones al muy evidente riesgo de insuficiencia alimentaria para los próximos años. En algunos países la producción de alimentos ya es insuficiente y el hambre y la desnutrición son problemas graves. El objetivo de este trabajo fue ofrecer una visión general de la situación actual y el futuro inmediato de la alimentación en el planeta, abordando conceptos como los alimentos funcionales y transgénicos, la nutrigenómica, y las nanotecnologías aplicadas a la producción y comercialización de alimentos. Gracias a las nuevas técnicas experimentales, ha ocurrido un importante avance en el conocimiento sobre el potencial de los alimentos para conservar o mejorar la salud. Las posibilidades de usar alimentos de acuerdo a nuestra composición genética o de modificarlos para obtener solo ciertos nutrientes o de que en nuestro organismo se liberen solo ciertos principios activos, es hoy una realidad. Sin embargo es importante resaltar, que frente a los gigantescos avances en tecnología alimentaria y al interesante y prometedor panorama que se nos ofrece en términos de alimentación, salud, calidad y expectativa de vida con los llamados nuevos alimentos y tecnologías, tenemos una abrumadora realidad de hambre y desnutrición en el mundo.