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1.
Cochrane Database Syst Rev ; 5: CD011817, 2021 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-34028001

RESUMO

BACKGROUND: Reference standard indices of iron deficiency and iron overload are generally invasive, expensive, and can be unpleasant or occasionally risky. Ferritin is an iron storage protein and its concentration in the plasma or serum reflects iron stores; low ferritin indicates iron deficiency, while elevated ferritin reflects risk of iron overload. However, ferritin is also an acute-phase protein and its levels are elevated in inflammation and infection. The use of ferritin as a diagnostic test of iron deficiency and overload is a common clinical practice. OBJECTIVES: To determine the diagnostic accuracy of ferritin concentrations (serum or plasma) for detecting iron deficiency and risk of iron overload in primary and secondary iron-loading syndromes. SEARCH METHODS: We searched the following databases (10 June 2020): DARE (Cochrane Library) Issue 2 of 4 2015, HTA (Cochrane Library) Issue 4 of 4 2016, CENTRAL (Cochrane Library) Issue 6 of 12 2020, MEDLINE (OVID) 1946 to 9 June 2020, Embase (OVID) 1947 to week 23 2020, CINAHL (Ebsco) 1982 to June 2020, Web of Science (ISI) SCI, SSCI, CPCI-exp & CPCI-SSH to June 2020, POPLINE 16/8/18, Open Grey (10/6/20), TRoPHI (10/6/20), Bibliomap (10/6/20), IBECS (10/6/20), SCIELO (10/6/20), Global Index Medicus (10/6/20) AIM, IMSEAR, WPRIM, IMEMR, LILACS (10/6/20), PAHO (10/6/20), WHOLIS 10/6/20, IndMED (16/8/18) and Native Health Research Database (10/6/20). We also searched two trials registers and contacted relevant organisations for unpublished studies. SELECTION CRITERIA: We included all study designs seeking to evaluate serum or plasma ferritin concentrations measured by any current or previously available quantitative assay as an index of iron status in individuals of any age, sex, clinical and physiological status from any country. DATA COLLECTION AND ANALYSIS: We followed standard Cochrane methods. We designed the data extraction form to record results for ferritin concentration as the index test, and bone marrow iron content for iron deficiency and liver iron content for iron overload as the reference standards. Two other authors further extracted and validated the number of true positive, true negative, false positive, false negative cases, and extracted or derived the sensitivity, specificity, positive and negative predictive values for each threshold presented for iron deficiency and iron overload in included studies. We assessed risk of bias and applicability using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool. We used GRADE assessment to enable the quality of evidence and hence strength of evidence for our conclusions. MAIN RESULTS: Our search was conducted initially in 2014 and updated in 2017, 2018 and 2020 (10 June). We identified 21,217 records and screened 14,244 records after duplicates were removed. We assessed 316 records in full text. We excluded 190 studies (193 records) with reasons and included 108 studies (111 records) in the qualitative and quantitative analysis. There were 11 studies (12 records) that we screened from the last search update and appeared eligible for a future analysis. We decided to enter these as awaiting classification. We stratified the analysis first by participant clinical status: apparently healthy and non-healthy populations. We then stratified by age and pregnancy status as: infants and children, adolescents, pregnant women, and adults. Iron deficiency We included 72 studies (75 records) involving 6059 participants. Apparently healthy populations Five studies screened for iron deficiency in people without apparent illness. In the general adult population, three studies reported sensitivities of 63% to 100% at the optimum cutoff for ferritin, with corresponding specificities of 92% to 98%, but the ferritin cutoffs varied between studies. One study in healthy children reported a sensitivity of 74% and a specificity of 77%. One study in pregnant women reported a sensitivity of 88% and a specificity of 100%. Overall confidence in these estimates was very low because of potential bias, indirectness, and sparse and heterogenous evidence. No studies screened for iron overload in apparently healthy people. People presenting for medical care There were 63 studies among adults presenting for medical care (5042 participants). For a sample of 1000 subjects with a 35% prevalence of iron deficiency (of the included studies in this category) and supposing a 85% specificity, there would be 315 iron-deficient subjects correctly classified as having iron deficiency and 35 iron-deficient subjects incorrectly classified as not having iron deficiency, leading to a 90% sensitivity. Thresholds proposed by the authors of the included studies ranged between 12 to 200 µg/L. The estimated diagnostic odds ratio was 50. Among non-healthy adults using a fixed threshold of 30 µg/L (nine studies, 512 participants, low-certainty evidence), the pooled estimate for sensitivity was 79% with a 95% confidence interval of (58%, 91%) and specificity of 98%, with a 95% confidence interval of (91%, 100%). The estimated diagnostic odds ratio was 140, a relatively highly informative test. Iron overload We included 36 studies (36 records) involving 1927 participants. All studies concerned non-healthy populations. There were no studies targeting either infants, children, or pregnant women. Among all populations (one threshold for males and females; 36 studies, 1927 participants, very low-certainty evidence): for a sample of 1000 subjects with a 42% prevalence of iron overload (of the included studies in this category) and supposing a 65% specificity, there would be 332 iron-overloaded subjects correctly classified as having iron overload and 85 iron-overloaded subjects incorrectly classified as not having iron overload, leading to a 80% sensitivity. The estimated diagnostic odds ratio was 8. AUTHORS' CONCLUSIONS: At a threshold of 30 micrograms/L, there is low-certainty evidence that blood ferritin concentration is reasonably sensitive and a very specific test for iron deficiency in people presenting for medical care. There is very low certainty that high concentrations of ferritin provide a sensitive test for iron overload in people where this condition is suspected. There is insufficient evidence to know whether ferritin concentration performs similarly when screening asymptomatic people for iron deficiency or overload.


Assuntos
Anemia Ferropriva/sangue , Ferritinas/sangue , Sobrecarga de Ferro/sangue , Adolescente , Adulto , Idoso , Anemia Ferropriva/diagnóstico , Viés , Biomarcadores/sangue , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Sobrecarga de Ferro/diagnóstico , Masculino , Pessoa de Meia-Idade , Gravidez , Gestantes , Sensibilidade e Especificidade , Adulto Jovem
2.
Ann N Y Acad Sci ; 1493(1): 59-74, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33432622

RESUMO

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.


Assuntos
Cálcio na Dieta/administração & dosagem , Farinha , Alimentos Fortificados , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Simulação por Computador , Bases de Dados Factuais , Países em Desenvolvimento , Registros de Dieta , Ingestão de Alimentos , Feminino , Farinha/análise , Alimentos Fortificados/análise , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pobreza , Gravidez , Recomendações Nutricionais , Adulto Jovem
3.
Viruses ; 13(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33477428

RESUMO

We systematically searched regional and international databases and screened 1658 non-duplicate records describing women with suspected or confirmed ZIKV infection, intending to breastfeed or give breast milk to an infant to examine the potential of mother-to-child transmission of Zika virus (ZIKV) through breast milk or breastfeeding-related practices. Fourteen studies met our inclusion criteria and inform this analysis. These studies reported on 97 mother-children pairs who provided breast milk for ZIKV assessment. Seventeen breast milk samples from different women were found positive for ZIKV via RT-PCR, and ZIKV replication was found in cell cultures from five out of seven breast milk samples from different women. Only three out of six infants who had ZIKV infection were breastfed, no evidence of clinical complications was found to be associated with ZIKV RNA in breast milk. This review updates our previous report by including 12 new articles, in which we found no evidence of ZIKV mother-to-child transmission through breast milk intake or breastfeeding. As the certainty of the present evidence is low, additional studies are still warranted to determine if ZIKV can be transmitted through breastfeeding.


Assuntos
Aleitamento Materno , Transmissão Vertical de Doenças Infecciosas , Leite Humano/virologia , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/transmissão , Zika virus , Aleitamento Materno/efeitos adversos , Humanos , Avaliação de Resultados em Cuidados de Saúde , Vigilância em Saúde Pública , Ensaios Clínicos Controlados Aleatórios como Assunto , Infecção por Zika virus/virologia
4.
Ann N Y Acad Sci ; 1484(1): 55-73, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32949062

RESUMO

Low dietary calcium is very common in many populations, contributing to nutritional rickets/osteomalacia in children/adults and increasing the risk of several health problems. Calcium is a nutrient of concern as the recommended nutrient requirements are difficult to meet in the absence of dairy products. The provision of culturally acceptable calcium-fortified foods may improve calcium intake when it is a feasible and cost-effective strategy in a particular setting. This landscape review was conducted in 2019 and describes current calcium fortification efforts and lessons learned from these experiences. Worldwide, the United Kingdom is the only country where calcium fortification of wheat flour is mandatory. It is estimated that this fortified staple ingredient contributes to 13-14% of calcium intake of the British population. Other items voluntary fortified with calcium include maize flour, rice, and water. Current calcium fortification programs may lack qualified personnel/training, clear guidelines on implementation, regulation, monitoring/evaluation, and functional indicators. Also, the cost of calcium premix is high and the target groups may be hard to reach. There is a lack of rigorous evaluation, particularly in settings with multiple micronutrient programs implemented simultaneously, with low quality of the evidence. Further research is needed to assess the impact of calcium fortification programs.


Assuntos
Cálcio na Dieta , Cálcio/metabolismo , Alimentos Fortificados/normas , Necessidades Nutricionais , Cálcio/química , Análise Custo-Benefício , Farinha/normas , Humanos , Oryza/química , Triticum/química , Reino Unido/epidemiologia , Água/química , Zea mays/química
5.
Ann N Y Acad Sci ; 1485(1): 3-21, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32986887

RESUMO

Low calcium intake is common worldwide and can result in nutritional rickets in children and osteomalacia in adults. Calcium-fortified foods could improve calcium intake. However, there is limited calcium fortification experience, with technical and practical issues that may hamper its adoption. The objective of this landscape review is to summarize these issues to help policymakers guide the planning and design of calcium fortification as a public health strategy. One challenge is the low bioavailability of calcium salts (∼20-40%); thus, large amounts need to be added to food to have a meaningful impact. Solubility is important when fortifying liquids and acidic foods. Calcium salts could change the flavor, color, and appearance of the food and may account for 70-90% of the total fortification cost. Safety is key to avoid exceeding the recommended intake; so the amount of added calcium should be based on the target calcium intake and the gap between inadequate and adequate levels. Monitoring includes the quality of the fortified food and population calcium intake using dietary assessment methods. Calcium fortification should follow regulations, implemented in an intersectorial way, and be informed by the right to health and equity. This information may help guide and plan this public health strategy.


Assuntos
Cálcio , Alimentos Fortificados , Política Nutricional , Saúde Pública , Dieta , Humanos , Necessidades Nutricionais
6.
Ann N Y Acad Sci ; 1484(1): 32-54, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32860259

RESUMO

The pandemic of coronavirus disease 2019 (COVID-19) is caused by infection with a novel coronavirus strain, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At present, there is limited information on potential transmission of the infection from mother to child, particularly through breast milk and breastfeeding. Here, we provide a living systematic review to capture information that might necessitate changes in the guidance on breast milk and breastfeeding given the uncertainty in this area. Our search retrieved 19,414 total records; 605 were considered for full-text eligibility and no ongoing trials were identified. Our review includes 340 records, 37 with breast milk samples and 303 without. The 37 articles with analyzed breast milk samples reported on 77 mothers who were breastfeeding their children; among them, 19 of 77 children were confirmed COVID-19 cases based on RT-PCR assays, including 14 neonates and five older infants. Nine of the 68 analyzed breast milk samples from mothers with COVID-19 were positive for SARS-CoV-2 RNA; of the exposed infants, four were positive and two were negative for COVID-19. Currently, there is no evidence of SARS-CoV-2 transmission through breast milk. Studies are needed with longer follow-up periods that collect data on infant feeding practices and on viral presence in breast milk.


Assuntos
Aleitamento Materno , COVID-19 , Transmissão Vertical de Doenças Infecciosas , Leite Humano/virologia , SARS-CoV-2/metabolismo , COVID-19/epidemiologia , COVID-19/metabolismo , COVID-19/transmissão , Criança , Feminino , Humanos , Lactente , Recém-Nascido
7.
Ann N Y Acad Sci ; 1450(1): 5-14, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31006883

RESUMO

Anemia is an important public health problem that negatively affects health of individuals and economic potential of populations. An accurate case definition is critical for understanding burden and epidemiology of anemia, for planning public health interventions, and for clinical investigation and treatment of patients. The current threshold hemoglobin concentrations for diagnosis of anemia were proposed in 1968 and based on studies predominantly of Caucasian adult populations in Europe and North America. The World Health Organization is undertaking a project to review global guidelines for anemia. We describe the process of obtaining input from technical experts, researchers, blood bank experts, policy makers, and program implementers to identify key information or knowledge gaps for anemia diagnosis. From this scoping exercise, six priority areas were identified on diverse topics related to the use and interpretation of hemoglobin concentrations to diagnose anemia in individuals and populations. A call for authors was conducted to produce background, review, and research papers across priority topics. This paper summarizes the first technical meeting, which included commissioned papers as well as case studies, describes key data gaps identified, and describes the next steps in the guideline development process to assess available evidence and define knowledge gaps to improve anemia characterization.


Assuntos
Anemia/diagnóstico , Hemoglobinas/análise , Anemia/sangue , Saúde Global , Humanos , Organização Mundial da Saúde
8.
Ann N Y Acad Sci ; 1446(1): 5-20, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30291627

RESUMO

The excessive consumption of certain vitamins and minerals could have deleterious consequences on health and development of individuals and populations. Simultaneous micronutrient-delivery interventions could be challenging in terms of safety as the target populations may overlap, posing a risk of excessive intake of certain micronutrients. The Evidence and Programme Guidance Unit of the Department of Nutrition for Health and Development of the World Health Organization convened a technical consultation on the risk of excessive intake of vitamins and minerals delivered through public health interventions in October 2017. The technical consultation's working groups identified important and emerging technical issues, lessons learned, and research priorities related to (1) planning, implementing, monitoring, and evaluating nutrition programs for the detection and control of the risk of excessive intakes; (2) safety, quality control, and assurance considerations; (3) coordination between public health nutrition interventions and other interventions and sectors; and (4) the legislative framework and policy coherence needed for simultaneous nutrition interventions. This paper provides the background and rationale of the technical consultation, synopsizes the presentations, and provides a summary of the main considerations proposed by the working groups.


Assuntos
Minerais/administração & dosagem , Prática de Saúde Pública , Vitaminas/administração & dosagem , Humanos , Fatores de Risco
9.
Arch Med Res ; 49(6): 405-417, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30573199

RESUMO

BACKGROUND: Serum or plasma ferritin concentration is recommended by WHO as a biomarker to assess iron status in individuals and populations. METHODS: A systematic review was undertaken to summarise the evidence for ferritin reflecting iron status and to assess the cut-off points in different populations. Electronic databases were searched for studies evaluating ferritin concentrations compared against bone marrow aspirates for iron deficiency and to liver biopsies for risk of iron overload. RESULTS: From 18822 records, 298 studies were assessed in full-text, including 72 studies on iron deficiency and 36 on iron overload in the quantitative analysis. All studies were observational. For iron deficiency, the mean ferritin concentration in healthy individuals was 15.1 µg/L (9 studies, 390 participants) when bone marrow iron content was 0, and 70.4 µg/L (3 studies, 151 participants) when bone marrow iron was 1+ or higher. In non-healthy populations, mean ferritin concentrations were 82.43 µg/L for iron depletion (38 studies, 1023 participants) and 381.61 µg/L for iron sufficiency (38 studies, 1549 participants) with wide variations depending on the pathology. For iron overload the results point out to a cut-off close to 500 µg/L although the data was very limited. CONCLUSION: Ferritin concentration is low in iron deficient individuals and high in iron-loaded individuals, regardless of confounding clinical conditions. Current WHO thresholds for healthy populations appear valid but the data is limited for different age groups or physiological conditions. For iron overload, ferritin concentration would only help in the presumptive diagnosis and guide the need for further assessment.


Assuntos
Anemia Ferropriva/diagnóstico , Ferritinas/sangue , Sobrecarga de Ferro/diagnóstico , Ferro/sangue , Adulto , Anemia Ferropriva/sangue , Biomarcadores/sangue , Feminino , Humanos , Sobrecarga de Ferro/sangue , Masculino , Estudos Observacionais como Assunto , Padrões de Referência
10.
Matern Child Nutr ; 14 Suppl 5: e12704, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30585705

RESUMO

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.


Assuntos
Suplementos Nutricionais , Micronutrientes , Cuidado Pré-Natal , África ao Sul do Saara , Ásia , Feminino , Humanos , Nicarágua , Gravidez , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/normas , Qualidade da Assistência à Saúde
11.
Curr Geriatr Rep ; 7(2): 103-113, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29721404

RESUMO

Purpose of Review: This review broadly discusses the consequences of inadequate consumption, by deficit or excess, of selected micronutrients on the quality of life and morbidity during aging, specifically considering increases in life expectancy and the costs of care in the older persons. Recent Findings: A literature review of the periods 2012 to 2018, focusing on vitamins A, B12, and D, calcium, iron and folate, was completed as these micronutrients are found to significantly affect the aging process. Causation and application of these micronutrients to disorders related to aging are controversial and mixed. This review highlights research needs and controversial points on the role of these micronutrients. Summary: Micronutrient deficiencies are a common and avoidable contributor to decreased quality of life and healthcare costs in the older persons. Further research is needed to determine adequate intakes and innovative uses, including appropriate thresholds for improved health outcomes for this population.

13.
Ann N Y Acad Sci ; 1390(1): 3-13, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27936288

RESUMO

Biofortification of staple crops has been proposed as a strategy to address micronutrient malnutrition, particularly with respect to insufficient intake of vitamin A, iron, zinc, and folate. The World Health Organization, in collaboration with the Food and Agriculture Organization of the United Nations and the Sackler Institute for Nutrition Science at the New York Academy of Sciences, convened a technical consultation entitled "Staple Crops Biofortified with Vitamins and Minerals: Considerations for a Public Health Strategy" in April 2016. Participants of the consultation reviewed the definition of biofortification of staple crops, patterns of crops production, processing, consumption, seed varieties, and micronutrient stability and bioavailability, as well as farmers' adoption and acceptability of the modified crops. Also discussed were economic, environmental, safety, and equity aspects of biofortified crops, as well as legal, policy, regulatory, and ethical issues for the implementation of biofortification strategies in agriculture and nutrition. Consultation working groups identified important and emerging technical issues, lessons learned, and research priorities to better support the evidence of improved nutrition and unintended adverse effects of biofortification. This paper provides the background and rationale of the technical consultation, synopsizes the presentations, and provides a summary of the main considerations proposed by the working groups.


Assuntos
Produtos Agrícolas/química , Alimentos Fortificados , Micronutrientes , Saúde Pública , Agricultura , Disponibilidade Biológica , Inocuidade dos Alimentos , Humanos , Nigéria , Uganda , Nações Unidas , Vitaminas , Populações Vulneráveis , Organização Mundial da Saúde , Zâmbia
14.
Ann N Y Acad Sci ; 1379(1): 38-47, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27508517

RESUMO

Fortification of condiments or seasonings may be useful for delivering micronutrients if they are consumed consistently by most of the population, as occurs in many countries. The World Health Organization, in collaboration with the Micronutrient Initiative and the Sackler Institute for Nutrition Science at the New York Academy of Sciences, convened a technical consultation on "Fortification of Condiments and Seasonings with Vitamins and Minerals in Public Health: from Proof of Concept to Scaling Up" to review the role of condiments and seasonings in improving micronutrient status, as constituents of regular diets and patterns of production and consumption worldwide. The consultation covered aspects related to implementation, monitoring, evaluation, and legal frameworks of fortification programs, as well as food safety and policy coherence for condiment fortification in the context of other public health strategies. This paper introduces the background and rationale of the technical consultation, synopsizes the presentations, and provides a summary of the main considerations proposed by the working groups.


Assuntos
Condimentos , Alimentos Fortificados , Micronutrientes , Política Nutricional , Saúde Pública/métodos , Inocuidade dos Alimentos/métodos , Humanos , Micronutrientes/administração & dosagem , Política Nutricional/tendências , Saúde Pública/tendências
15.
Ann N Y Acad Sci ; 1379(1): 3-16, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27153401

RESUMO

Spices and condiments are an important part of human history and nutrition, and have played an important role in the development of most cultures around the world. According to the Codex Alimentarius, the category of salts, spices, soups, sauces, salads, and protein products includes substances added to foods to enhance aroma and taste. Spices have been reported to have health benefits as antioxidant, antibiotic, antiviral, anticoagulant, anticarcinogenic, and anti-inflammatory agents. Health claims about the benefits of condiments for disease prevention or health improvement need to be science based and extensively supported by evidence; data on their preventive or protective potential in humans are currently limited. The condiments market has been growing continuously over the last few years, with the quantity of products sold under the category of sauces, dressings, and condiments during the period 2008-2013 increasing from 31,749,000 to 35,795,000 metric tons. About 50 of the 86 spices produced in the world are grown in India. From 2008 to 2013, the United States was the largest importer of spices, followed by Australia, the United Kingdom, Canada, and Russia. The main buyers of fish sauce are Vietnam and Thailand, with purchases of 333,000 and 284,000 metric tons in 2013, respectively. The sauces and condiments category is dynamic, with large differences in consumption in habits and practices among countries. This paper aims to establish definitions and discuss potential health benefits, consumption patterns, and global markets for sauces, spices, and condiments.


Assuntos
Condimentos , Ingestão de Alimentos , Internacionalidade , Marketing/tendências , Alimentos de Soja , Especiarias , Antioxidantes/administração & dosagem , Antioxidantes/economia , Condimentos/economia , Alimentos Fortificados/economia , Humanos , Marketing/economia , Alimentos de Soja/economia , Especiarias/economia
16.
Rev. esp. nutr. comunitaria ; 21(2): 30-33, abr.-jun. 2015.
Artigo em Espanhol | IBECS | ID: ibc-163585

RESUMO

Las intervenciones nutricionales a nivel poblacional están justificadas cuando en una población existen deficiencias de nutrientes. Los métodos más confiables y preferidos son aquellos que proporcionan resultados individuales que al ser sumados pueden revelar la situación general de la población. Los métodos de evaluación de la dieta más comúnmente utilizados en programas de nutrición incluyen las Hojas de Balance de Alimentos (FBS), el Recordatorio de veinticuatro Horas (24 HR), los Cuestionarios de Frecuencia de Consumo alimentario (FFQ), la Herramienta de Evaluación Rápida de Fortificación (FRAT) y las Encuestas de Consumo y Gasto en los Hogares (HCES). Cada método de evaluación de la dieta tiene fortalezas y debilidades que varían según el contexto y la finalidad. La selección del método debe basarse en las necesidades de datos del programa, la disponibilidad de los métodos, el costo y una clara comprensión de las ventajas y desventajas involucradas (AU)


Nutritional interventions at the population level are justified when there are nutrient deficiencies in the population. The most trusted and preferred methods are those that provide individual results that can be added to reveal the overall situation of the population. The methods of dietary assessment most commonly used in nutrition programs include the Food Balance Sheets (FBS), the twenty-four Hours Recall (24 HR), Food Frequency Questionnaires (FFQ), Fortification Rapid Assessment Tool (FRAT) and Household Consumption and Expenditure Surveys (HCES). Each method of dietary assessment has strengths and weaknesses that vary according to context and purpose. The choice of method should be based on the data needs of the program, the availability of methods, cost and a clear understanding of the advantages and disadvantages involved (AU)


Assuntos
Humanos , 24457 , Programas de Nutrição/organização & administração , Nutrientes/métodos , Biomarcadores , Inquéritos e Questionários , Inquéritos Nutricionais/economia , Inquéritos Nutricionais/métodos , Doença Crônica/prevenção & controle
18.
An. venez. nutr ; 27(1): 47-56, jun. 2014.
Artigo em Espanhol | LILACS, LIVECS | ID: lil-748418

RESUMO

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)


Assuntos
Humanos , Masculino , Feminino , Tecido Adiposo , Síndrome Metabólica , Diabetes Mellitus , Dieta/efeitos adversos , Hipersensibilidade Alimentar , Inflamação/etiologia , Intestinos/anatomia & histologia , Doenças Cardiovasculares , Alimentos, Dieta e Nutrição , Sistema Imunitário , Doenças Metabólicas
19.
Ann N Y Acad Sci ; 1312: 1-7, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24730734

RESUMO

Fortification is the purposeful addition of vitamins and minerals to foods during their industrial processing, as a way to improve the nutrition and health of populations who consume these foods. Twelve countries have mandatory maize (Zea mays subsp. Mays) flour or meal fortification. The World Health Organization (WHO) is updating evidence-informed guidelines for the fortification of staple foods in public health, including the fortification of maize flour and corn meal with iron and other micronutrients. Although there is limited experience with fortification of maize, mass fortification of maize flour with at least iron has been practiced for many years in several countries in the Americas and Africa: Brazil, Costa Rica, El Salvador, Kenya, Mexico, Nigeria, Rwanda, South Africa, Tanzania, Uganda, the United States, and Venezuela. The WHO, in collaboration with the Sackler Institute for Nutrition Science and the Flour Fortification Initiative (FFI), convened a consultation on technical considerations for fortification of maize flour and corn meal in public health in New York, New York on April 8-9, 2013 to provide input into the guideline-development process and to discuss technical considerations of the fortification processes for maize flour and corn meal.


Assuntos
Farinha/normas , Alimentos Fortificados/normas , Saúde Pública/normas , Zea mays/normas , Humanos , Cidade de Nova Iorque , Saúde Pública/métodos
20.
Ann N Y Acad Sci ; 1312: 105-12, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24650320

RESUMO

Maize (Zea mays), also called corn, is believed to have originated in central Mexico 7000 years ago from a wild grass, and Native Americans transformed maize into a better source of food. Maize contains approximately 72% starch, 10% protein, and 4% fat, supplying an energy density of 365 Kcal/100 g and is grown throughout the world, with the United States, China, and Brazil being the top three maize-producing countries in the world, producing approximately 563 of the 717 million metric tons/year. Maize can be processed into a variety of food and industrial products, including starch, sweeteners, oil, beverages, glue, industrial alcohol, and fuel ethanol. In the last 10 years, the use of maize for fuel production significantly increased, accounting for approximately 40% of the maize production in the United States. As the ethanol industry absorbs a larger share of the maize crop, higher prices for maize will intensify demand competition and could affect maize prices for animal and human consumption. Low production costs, along with the high consumption of maize flour and cornmeal, especially where micronutrient deficiencies are common public health problems, make this food staple an ideal food vehicle for fortification.


Assuntos
Ingestão de Alimentos , Manipulação de Alimentos/métodos , Alimentos Fortificados/estatística & dados numéricos , Micronutrientes , Zea mays , Manipulação de Alimentos/economia , Alimentos Fortificados/economia , Humanos , Micronutrientes/administração & dosagem , Micronutrientes/economia , Organização Mundial da Saúde , Zea mays/economia
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