Nutritional and Hematological Status of Sudanese Women of Childbearing Age with Steady-state Sickle Cell Anemia.

OBJECTIVES: We sought to investigate the nutritional and hematological status of Sudanese women of childbearing age with sickle cell anemia (SCA). Anthropometry and hematology were used to assess nutritional status and health and disease conditions, respectively. METHODS: Women with steady-state (HbSS, n = 39; age = 19.0±2.7) and without (HbAA, n = 36; age, 19.8±2.7) SCA were recruited during a routine visit to the Hematology Clinic, Ibn-Auf Teaching Hospital, Khartoum, Sudan. RESULTS: The two groups of women lived in similar environmental conditions and ate similar diets three times a day. However, despite taking regular meals, the women with sickle anemia were thinner and lighter (p < 0.001) and shorter (p = 0.002) compared with those who do not have the disease. Also, they had higher levels of mean corpuscular hemoglobin (Hb) concentration and white cell count (p < 0.001), mean corpuscular volume (p = 0.003), and platelet (p = 0.002) and lower packed cell volume and Hb (p < 0.001). There was no difference in levels of anthropometric and hematological variables between the hydroxyurea treated and untreated SCA patients (p > 0.050). CONCLUSIONS: The low anthropometric (height, weight, and body mass index) and abnormal hematological values in the women with SCA in steady-state reflect sustained nutritional insults inflected by the disease and poverty. Tailored nutritional counseling/advice must be an integral part of managing patients with SCA. Such advice is particularly vital for women of childbearing age because of the adverse effects of prepregnancy nutritional deficiency on outcomes.

Randomized open-label trial of docosahexaenoic acid-enriched fish oil and fish meal on cognitive and behavioral functioning in Omani children.

OBJECTIVE: This study aimed to examine the effect of docosahexaenoic acid (DHA)-enriched fish oil supplement and meal of grilled fish on cognitive and behavioral functioning manifested as attention-deficit/hyperactivity disorder in primary school students 9 to 10 y of age in Muscat, Oman. METHODS: This randomized open-label trial involved two types of interventions: fish oil supplement or one serving (100 g) of grilled fish per day (Sunday through Friday) for 12 weeks. Red cell total lipid DHA levels were assessed. The Verbal Fluency Test, Buschke Selective Reminding Test, and Trail Making Test were used to measure cognitive functioning. Behavioral functioning was assessed using a standardized Arabic version of the National Initiative for Children's Health Quality Vanderbilt Assessment Scales. All measurements were carried out before and after intervention. RESULTS: DHA levels increased by 72% and 64% in the fish oil (mean, 3.6%-6.2%) and fish-meal (mean, 3.4%-5.6%) groups, respectively (P = 0.000). The Trail Making Test was the only cognitive test that demonstrated marked differences between groups: Median interquartile range difference between pre- and postintervention in the Trail Making Part B score was 61.5 (SE, 19.3, 103.2) in the fish oil versus fish-meal group, 24.5 (SE, -15.2, 74.7, P = 0.005). The Vanderbilt Assessment Scales also showed significant differences between groups (P < 0.001). CONCLUSION: This study contributed to available evidence on the cognitive and behavioral benefits of DHA in healthy school children. Expanding the food fortification program with DHA-enriched fish oil should be considered as part of broader policy to improve child health.

Attention Deficit Hyperactivity Disorder and Parental Factors in School Children Aged Nine to Ten Years in Muscat, Oman.

OBJECTIVES: The objectives of this study were to determine the prevalence of attention deficit hyperactivity disorder (ADHD) and specific parental risk factors that may contribute to the development of ADHD in children. METHODS: The study was conducted in Oman among fourth-grade students (aged nine to 10 years). A standardized Arabic version of the National Initiative for Children's Health Quality Vanderbilt Assessment Scale (Teachers questionnaire) was used to determine the presence of ADHD. Parental factors such as socioeconomic status, education, and occupation were documented. RESULTS: The prevalence rate of ADHD was 8.8%. Poor maternal education status, low familial socioeconomic status, and paternal occupation were significantly associated with an increased risk of ADHD. CONCLUSIONS: This was the first study that examined familial and parental characteristics of children with ADHD as potential risk factors for the condition. Such psychosocial factors could be employed to further the development of more proficient preventative measures and remedial services.

Lipid-soluble nutrient status of healthy Omani school children before and after intervention with oily fish meal or re-esterified triacylglycerol fish oil.

OBJECTIVES: Over the past two decades, the Omani diet has changed considerably to resemble a high calorie and a low nutrient density Western diet. We investigated the fat soluble nutrient status of children before and after intervention with fish diet or fish oil. METHODS: Children ages 9 and 10 y (n = 314) were recruited from three randomly selected schools. The schools were assigned to a fish, fish oil, or control group and the children were given a lightly grilled oily fish, a re-esterified triacylglycerol fish oil capsule, or no fish for 12 wk. RESULTS: Plasma vitamin A, beta carotene, vitamin E concentrations, and vitamin E/total lipid ratio at baseline were 2.7 ± 0.85 µmol/L, 0.68 ± 0.48 µmol/L, 21.1 ± 4.8 µmol/L, and 5.0 ± 0.81 µmol/mmol, respectively, and none of the children were deficient. They were severely deficient (<27.5 nmol/L; 10.5% boys and 28.5% girls), deficient (27.5-44.9 nmol/L; 47.6% boys and 49.4% girls) or insufficient (50-74.9 nmol/L; 34.6% boys and 21.5% girls) in vitamin D; only 7.3% boys and 0.6% girls had optimal status (≥75 nmol/L). Parathyroid hormone (5.0 ± 1.7 versus 5.8 ± 2.1 pmol/L; P < 0.0001) and alkaline phosphatase (225.2 ± 66.6 versus 247.8 ± 73.7 U/L; P < 0.01) levels were lower in boys. Postintervention, the fish oil (54.1 ± 17.5 nmol/L; P < 0.001) and fish (49.2 ± 17.4 nmol/L; P < 0.05) groups had elevated levels of vitamin D compared with the controls (42.3 ± 17.5 nmol/L). CONCLUSIONS: Vitamin D deficiency is prevalent in Omani school children, but it can be mitigated with omega-3 fatty acid supplementation. Vitamin D plays a crucial role in skeletal and extraskeletal systems. Hence, there is a need for a child-focused program of food fortification and outdoor activities to alleviate the problem.

Iodine status and fish intake of Sudanese schoolchildren living in the Red Sea and White Nile regions.

OBJECTIVE: To investigate iodine status and fish consumption of schoolchildren living in the Red Sea and White Nile regions of Sudan. DESIGN: Cross-sectional study to determine urinary iodine concentration, visible goitre rate, iodine content of salt and fish consumption. SETTING: Port Sudan (Red Sea) and Jabal Awliya (White Nile), Sudan. SUBJECTS: Two hundred eighty (n 280) children aged 6-12 years (142 boys, 138 girls). RESULTS: The median urinary iodine concentration in children from Port Sudan and Jabal Awliya was 553 and 160 µg/l, respectively. Goitre was detected in 17.1 % of children from Port Sudan but only in 1.4 % from Jabal Awliya, The salt samples from Port Sudan contained 150-360 mg iodine (KOI3)/kg salt, whereas those from Jabal Awliya had levels below the detection limit. Despite consuming salt devoid of iodine, children from Jabal Awliya had optimal iodine status. It is plausible that consumption of Nile fish from Jabal Awliya Reservoir, which is a good source of iodine and favoured by the locals, might have provided sufficient iodine. In contrast, children from Port Sudan were at higher risk of iodine-induced hyperthyroidism resulting from consumption of excessively iodised salt. CONCLUSIONS: The findings of the study clearly demonstrated that (i) Sudan still has a problem with iodine nutrition and quality control and monitoring of salt iodisation and (ii) including fish in the diet could provide a sufficient amount of iodine for schoolchildren.

The Supercourse of fisheries: importance of sharing educational materials and implications for cancer and chronic disease research.

Epidemiologic research has demonstrated that fish is an important component of human nutrition. Existing information for the public about the benefits vs dangers of fish consumption is often contradictory and unclear. Education in the field of human nutrition, especially in the area of fish consumption could be markedly enhanced if there were better mechanisms for the development of customized high quality, low cost educational lectures Researchers from the Department of Epidemiology, University of Pittsburgh, in collaboration with the members of the Global Health Network Supercourse project are developing a library of lectures on nutrition, environmental health, and fisheries, for the use and share among the scientists of the world. With the growing demand for environmental health/nutrition awareness, there is an escalating demand for easily accessible and inexpensive teaching materials on nutritional information, including fish and fisheries. The Supercourse has a network of 45,000 faculty members from 171 countries who have contributed more than 3400 public health lectures, providing forum for sharing the latest research developments in the areas of nutrition. This article outlines the importance of creating easily accessible educational modules on the issues of nutrition, environmental health challenges, and fisheries.