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1.
Medicine (Baltimore) ; 98(49): e18314, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31804379

RESUMO

The aim of this study was to investigate possible associations of nutrient intake on glaucoma in subjects of Japanese descent living in Los Angeles, CA.In this cross-sectional study, 581 Japanese American participants in Los Angeles underwent an interview, fundus photography, comprehensive physical, and blood examinations, along with determining the body mass index status and any confounding factors. CDSketch was used to measure the cup-disc ratio and rim width of each fundus in the retinal photographs. A multivariate logistic regression test with adjustment for confounding factors was used to assess the association between glaucoma and nutrient intake.A total of 61 of 581 participants were diagnosed with glaucoma in this study. Multivariate logistic regression analysis showed that a high intake of iron (odds ratio [OR]: 1.303, P = .004), low intake of vitamin A (OR: 0.365, P = .019), and vegetable fat (OR: 0.957, P = .004) were associated with an increased risk of glaucoma.Current findings showed that high iron intake and low vitamin A and vegetable fat intake appeared to be associated with an increased risk of glaucoma in subjects of Japanese descent living in the Los Angeles populations.


Assuntos
Americanos Asiáticos , Glaucoma/etnologia , Glaucoma/epidemiologia , Estado Nutricional , Estudos Transversais , Ingestão de Energia , Feminino , Humanos , Ferro na Dieta/administração & dosagem , Japão/etnologia , Los Angeles/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Verduras , Deficiência de Vitamina A/epidemiologia
2.
Medicine (Baltimore) ; 98(43): e17613, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651873

RESUMO

The aim was to test the association between dietary iron intake and the prevalence of nonalcoholic fatty liver disease (NAFLD) in a large sample of middle-aged and elderly Chinese population.The data included in this analysis were collected from a population-based cross-sectional study, that is, the Xiangya Hospital Health Management Center Study. Dietary iron intake was assessed using a validated semiquantitative food frequency questionnaire. The relationship between dietary iron intake and the prevalence of NAFLD was examined using logistic and spline regressions.A cross-sectional study including 5445 subjects was conducted. The prevalence of NAFLD was 36.9%. Compared with the lowest quintile, the energy-adjusted odds ratios (ORs) of NAFLD were 1.33 (95% confidence interval [CI]: 1.07-1.64), 1.80 (95% CI: 1.41-2.29) and 2.11 (95% CI: 1.60-2.80) in the 3rd, 4th, and 5th quintile of iron intake, respectively (P-value for trend <.001). In addition, dietary iron intake was positively associated with the OR of NAFLD in a dose-response relationship manner (test for trend P < .001). However, after stratifying the data by gender, such association only remained in the male, but not in the female population. With adjustment of additional potential confounders, the results did not change materially.Subjects with higher dietary iron intake were subject to a higher prevalence of NAFLD in a dose-response relationship manner. However, such association probably only exists in males, but not in females.


Assuntos
Ferro na Dieta/administração & dosagem , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários
3.
J Trace Elem Med Biol ; 56: 198-206, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31525623

RESUMO

BACKGROUND: Neurodegenerative diseases such as Alzheimer's and Parkinson's disease are characterized by the progressive deterioration of the structure and function of the nervous system. A number of environmental risk factors including potentially toxic elements such as iron, lead to negative effects on many metabolic reactions as well as neuroprotection. The aim of this study is to reveal whether long-term iron overload is one of the underlying factors in the pathogenesis of Alzheimer's disease (AD). METHODS: 15 young-adult male rats were randomly divided into 5 groups treated with iron through drinking water for 4 months. Following feeding, the iron content, reduced glutathione (GSH), and hydrogen peroxide (H2O2) levels of cortex tissues were measured. Specific enzyme activities were determined spectrophotometrically. mRNA expression profiles were measured using real-time PCR (qPCR). RESULTS: Iron levels were elevated in case of non-toxic (0.87 and 3 µg/mL) iron administration. However, no changes were observed in toxic (30 and 300 µg/mL) iron administration. GSH and H2O2 levels altered with long-term iron overload. Glutathione peroxidase (GPx) enzyme activities significantly increased in all groups, while glutathione S-transferase (GST) activity increased only in case of 0.87 and 30 µg/mL iron administration. Expression levels of neuroprotective and AD-related genes were altered by 3 µg/mL iron overload in a dose-dependent manner. The expression and activity of acetylcholinesterase (AChE) were elevated at 3 µg/mL iron concentration. CONCLUSION: The findings of the present study allow us to conclude that long-term dietary iron intake, especially at a dose of 3 µg/mL demonstrates negative effects on the rat cortex by provoking antioxidant metabolism and AD pathology in a dose-dependently.


Assuntos
Doença de Alzheimer/patologia , Córtex Cerebral/patologia , Ferro na Dieta/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Acetilcolinesterase/metabolismo , Doença de Alzheimer/genética , Animais , Córtex Cerebral/efeitos dos fármacos , Glutationa/metabolismo , Glutationa Peroxidase/metabolismo , Glutationa Transferase/metabolismo , Peróxido de Hidrogênio/metabolismo , Ferro/metabolismo , Sobrecarga de Ferro/metabolismo , Ferro na Dieta/administração & dosagem , Peroxidação de Lipídeos , Masculino , Malondialdeído/metabolismo , Oxirredução , Ratos Sprague-Dawley
4.
Nutrients ; 11(9)2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31510077

RESUMO

High tissue iron levels are a risk factor for multiple chronic diseases including type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). To investigate causal relationships and underlying mechanisms, we used an established NAFLD model-mice fed a high fat diet with supplemental fructose in the water ("fast food", FF). Iron did not affect excess hepatic triglyceride accumulation in the mice on FF, and FF did not affect iron accumulation compared to normal chow. Mice on low iron are protected from worsening of markers for non-alcoholic steatohepatitis (NASH), including serum transaminases and fibrotic gene transcript levels. These occurred prior to the onset of significant insulin resistance or changes in adipokines. Transcriptome sequencing revealed the major effects of iron to be on signaling by the transforming growth factor beta (TGF-ß) pathway, a known mechanistic factor in NASH. High iron increased fibrotic gene expression in vitro, demonstrating that the effect of dietary iron on NASH is direct. Conclusion: A lower tissue iron level prevents accelerated progression of NAFLD to NASH, suggesting a possible therapeutic strategy in humans with the disease.


Assuntos
Ferro na Dieta/administração & dosagem , Ferro/deficiência , Cirrose Hepática/prevenção & controle , Fígado/metabolismo , Hepatopatia Gordurosa não Alcoólica/prevenção & controle , Ração Animal , Animais , Dieta Hiperlipídica , Modelos Animais de Doenças , Progressão da Doença , Frutose , Regulação da Expressão Gênica , Células Hep G2 , Humanos , Ferro/sangue , Ferro na Dieta/sangue , Fígado/patologia , Cirrose Hepática/sangue , Cirrose Hepática/genética , Cirrose Hepática/patologia , Masculino , Camundongos Endogâmicos C57BL , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/genética , Hepatopatia Gordurosa não Alcoólica/patologia , Transdução de Sinais
5.
J Sci Med Sport ; 22(11): 1266-1271, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31272913

RESUMO

OBJECTIVES: In 2016 the Australian football league introduced the first women's league, integrating part-time female athletes into the professional sporting environment. This study aims to assess the dietary intakes of professional Australian football league women's (AFLW) athletes to highlight key focus areas for nutrition and additionally provide nutrition recommendations for dietitians working with these athletes. DESIGN: Cross-sectional study. METHODS: Dietary intake data was collected from 23 players from the same club competing in the Australian football league women's, during a preseason week. Dietary intakes were assessed using three day estimated food records. RESULTS: Majority of athletes did not meet recommendations for carbohydrate (96%, n=22), iron (87%, n=20) and calcium (61%, n=14). In comparison, majority of athletes met protein (74%, n=17) and fat (78%, n=18) recommendations. No significant difference was found in energy intake on main training, light training and recovery days (p>0.05). Energy and carbohydrate intakes reported by AFLW athletes (1884±457kcalday-1 and 2.7±0.7gkg-1day-1) were consistent with values reported in previous studies that included professional female athletes. CONCLUSIONS: This research highlights that further exploration of the factors that influence dietary intake is required to support athletes to meet energy and carbohydrate recommendations required for desired training and performance outcomes.


Assuntos
Dieta , Futebol Americano , Fenômenos Fisiológicos da Nutrição Esportiva , Adulto , Atletas , Austrália , Cálcio na Dieta/administração & dosagem , Estudos Transversais , Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Ingestão de Energia , Feminino , Humanos , Ferro na Dieta/administração & dosagem , Adulto Jovem
6.
BMC Public Health ; 19(1): 889, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277638

RESUMO

BACKGROUND: Many low- and middle-income countries recommend micronutrient supplements for pregnant women to improve their nutritional status, prevent possible deficiencies and avoid fetal healgth consequences. This study evaluated the influence of socioeconomic status on the use of folic acid, iron salts and other vitamins and minerals among pregnant women in the 2015 Pelotas Birth Cohort. METHODS: This population-based birth cohort study was carried out with 4270 women. Participants were interviewed during pregnancy and at the maternity hospital about the antenatal period; including the use of iron salts, vitamins and other minerals. Descriptive analyses were performed to characterize the sample. The analyses were adjusted according to socioeconomic variables (maternal education, ethnicity, household income). RESULTS: The overall prevalence of the use of folic acid, iron salts or other vitamins and minerals was 91.0% (95% CI: 90.1-91.8). Specifically, 70.9% (95% CI: 69.5-72.3) used folic acid, 72.9% (95% CI: 71.5-74.3) used iron compounds, and 31.8% (95% CI: 30.3-33.2) used other vitamins or minerals. In the adjusted analysis, the use of iron salts was associated with nonwhite mothers, with ≤4 years of education and whose family income was less than or equal to the monthly minimum wage. The use of folic acid and other vitamins and minerals was associated with white mothers who were more highly educated and had a higher family income. CONCLUSION: Although folic acid and other vitamins and minerals were more frequently used in white, richer and more educated mothers, which indicates inequality, iron supplements were more frequently used in the poorer, less educated nonwhite mothers, suggesting the opposite association for this supplement.


Assuntos
Ácido Fólico/administração & dosagem , Ferro na Dieta/administração & dosagem , Gestantes , Vitaminas/administração & dosagem , Adolescente , Adulto , Brasil , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Fatores Socioeconômicos , Adulto Jovem
7.
Pak J Pharm Sci ; 32(3): 1091-1095, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31278724

RESUMO

Iron deficiency anemia (IDA) is one of the foremost health issues among women of reproductive age. The study highlights to assess the level of awareness about the causes, symptoms, prevention and treatment of IDA among women of reproductive age in district Bahawalpur, province Punjab, Pakistan. A randomized study was conducted by using a self-designed standardized questionnaire disseminated to the hostels of female residents and homes in the immediate vicinity of Islamia University Bahawalpur. Females aged 18-45 years without any previous history of medical or gynecological problems were enlisted. A total number of 200 women were surveyed for awareness of iron deficiency anemia. Seventy three percent (73%) of women (n=146) were aware of the term IDA with the highest proportion of women falling in the age bracket 20-35 years. Most (66.9%) of the women were aware of the fact that their diet contains iron and its importance in health. It is concluded that, in reproductive age women the IDA can be prevented and treated through proper guidance and awareness through education.


Assuntos
Anemia Ferropriva , Conhecimentos, Atitudes e Prática em Saúde , Ferro na Dieta/administração & dosagem , Adolescente , Adulto , Anemia Ferropriva/etiologia , Anemia Ferropriva/prevenção & controle , Anemia Ferropriva/terapia , Dieta , Suplementos Nutricionais , Escolaridade , Feminino , Humanos , Pessoa de Meia-Idade , Paquistão , Gravidez , Inquéritos e Questionários , Adulto Jovem
8.
Nutrients ; 11(5)2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31083351

RESUMO

Although hereditary hemochromatosis is associated with the mutation of genes involved in iron transport and metabolism, secondary hemochromatosis is due to external factors, such as intended or unintended iron overload, hemolysis-linked iron exposure or other stress-impaired iron metabolism. The present review addresses diet-linked etiologies of hemochromatosis and their pathogenesis in the network of genes and nutrients. Although the mechanistic association to diet-linked etiologies can be complicated, the stress sentinels are pivotally involved in the pathological processes of secondary hemochromatosis in response to iron excess and other external stresses. Moreover, the mutations in these sentineling pathway-linked genes increase susceptibility to secondary hemochromatosis. Thus, the crosstalk between nutrients and genes would verify the complex procedures in the clinical outcomes of secondary hemochromatosis and chronic complications, such as malignancy. All of this evidence provides crucial insights into comprehensive clinical or nutritional interventions for hemochromatosis.


Assuntos
Hemocromatose/etiologia , Ferro na Dieta/efeitos adversos , Ferro/metabolismo , Regulação da Expressão Gênica , Hemocromatose/genética , Humanos , Ferro na Dieta/administração & dosagem , Proteínas Reguladoras do Ferro/genética , Proteínas Reguladoras do Ferro/metabolismo , Mutação
9.
Nutrients ; 11(5)2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31083370

RESUMO

Iron intake and heme/non-heme iron proportions are crucial for iron deficiency anemia prevention. Women of childbearing age are indicated by World Health Organization as the primary target group, but maintaining iron balance is particularly challenging for adolescents. The aim of the presented study was to analyze heme and non-heme iron intake and dietary sources in adolescent menstruating females in a national Polish sample. The study was conducted in a representative sample of adolescents (aged 15-20) who were recruited from all regions of Poland based on secondary school sampling (random quota sampling), with 1385 female adolescents being included in the sample. The iron intake was assessed using the previously validated IRONIC-FFQ (IRON Intake Calculation-Food Frequency Questionnaire). The intakes of iron, heme iron, non-heme iron, and iron from food product groups were assessed and compared with those of male adolescents (n = 1025) who were recruited from the same schools, as well as between sub-groups stratified by age, body mass index, anemia history, following vegetarian diet, applying iron supplementation and school type. Compared with male individuals, females were characterized by a lower intake of all forms of iron. It was stated that non-heme iron intake was highest in younger ones, overweight ones, vegetarian ones, and comprehensive school students. Female adolescents with anemia history were characterized by similar iron intake as others. For the target group, there is inadequate nutritional education and a necessity to broaden the knowledge about specific sources of iron.


Assuntos
Ferro na Dieta/administração & dosagem , Ferro/deficiência , Menstruação , Adolescente , Registros de Dieta , Feminino , Humanos , Estado Nutricional , Polônia , Adulto Jovem
10.
Food Nutr Bull ; 40(2): 241-253, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31064219

RESUMO

BACKGROUND: Undernutrition among schoolchildren is a prevalent public health problem which may be due to inadequate energy and nutrient intakes associated with low dietary diversity. OBJECTIVE: This study assessed dietary diversity scores (DDS), energy and nutrient intakes of schoolchildren (6-15 years), and risks factors of DDS and determined if energy and nutrient intakes were dependent on dietary diversity. METHODS: The study involved a 2-stage random sampling of 90 schoolchildren. Dietary diversity and nutrient intake data were obtained through a 3-day weighed food intake. Analysis of variance, t test, and χ2 with Cochran-Mantel-Haenszel test were used to determine relationships among and between variables; P < .05 was reported as significant. RESULTS: Few (22.2%) had high DDS with no significant difference (P > .05) between age groups and sex. Children from male headed households were more likely to have medium DDS (odds ratio [OR] = 3.231; 95% confidence interval [CI] = 1.037-10.070) than those from female headed households (P < .05). Low nutrient intakes were observed among 85.6% for niacin, 76.7% for calcium, 72.2% for riboflavin, 54.4% for protein, 32.2% for thiamine, and 15.6% for vitamin C. Among boys, prevalence of inadequate riboflavin intake was significantly (P < .05) higher among 6- to 9-year-olds. Among girls, prevalence of inadequate vitamin A intake was significantly (P < .01) higher among 10 to 15-year-olds. Children with adequate intakes of iron (OR = 0.744, 95% CI = 0.653-0.847) and thiamine (OR = 5.651, 95% CI = 1.214-26.310) were more likely to have high DDS. CONCLUSION: The schoolchildren had low energy and nutrient intakes. Iron and thiamine, intakes were dependent on DDS.


Assuntos
Dieta , Ingestão de Energia , Nutrientes/administração & dosagem , Adolescente , Ácido Ascórbico/administração & dosagem , Cálcio na Dieta/administração & dosagem , Criança , Estudos Transversais , Feminino , Humanos , Ferro na Dieta/administração & dosagem , Masculino , Nigéria , Riboflavina/administração & dosagem , População Rural , Tiamina/administração & dosagem , Vitamina A/administração & dosagem
11.
Ital J Pediatr ; 45(1): 48, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975170

RESUMO

BACKGROUND: Low birth weight is defined as infant born with weight of less than 2500 g. It is one of the major public health problems worldwide. In Ethiopia, there are limited evidences on factors contributing to low birthweight. OBJECTIVE: To assess factors associated with low birth weight babies in Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia from March to April, 2018. METHODS AND MATERIALS: An unmatched case control study was conducted at Hawassa University Comprehensive Specialized Hospital. All low birth weight newborns and two unmatched controls for each case were included in the study from March to April, 2018. Data were collected through face to face interview using a structured and pre-tested questionnaire. The collected data were managed with Epi-data version 3.1 software and exported to the Statistical Package for Social Science (SPSS) version 22. Bivariate and multivariate binary logistic regression were used to identify factors associated with low birth weight at p-value < 0.05 with their respective odds ratios and 95% confidence interval. Hosmer-Lemeshow test was used to assess goodness-of-fit. RESULTS: In this study 330 mother-newborn pairs (110 cases and 220 controls) were participated making 100% response rate. Among the participants 325(98.48%) were married, 164 (49.7%) were Protestant, 296 (89.7%) had ANC follow up and 212 (64.24%) were multipara. Mothers' mid-upper arm circumference less than 220 mm [(AOR) =2.89, 95% CI: 1.58, 5.29)], lack of nutritional counseling [AOR = 2.37, 95%CI: 1.3, 4.34], presence of complications during pregnancy [AOR = 2.96, 95%CI: 1.55, 5.64)] and lack of iron supplementations during pregnancy [AOR = 2.89, 95%CI: 1.58, 5.29)] were significantly associated with Low birth weight. CONCLUSIONS: Mothers' mid-upper arm circumference less than 220 mm, lack of nutritional counseling, presence of complications and lack of iron supplementations during current pregnancy were significantly associated with low birth weight. Counseling on nutrition during prenatal care needs attention of service providers.


Assuntos
Recém-Nascido de Baixo Peso , Adulto , Braço/anatomia & histologia , Estudos de Casos e Controles , Aconselhamento , Serviços de Dietética , Etiópia , Feminino , Hospitais Universitários , Humanos , Recém-Nascido , Ferro na Dieta/administração & dosagem , Avaliação Nutricional , Gravidez , Complicações na Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Adulto Jovem
12.
BMC Public Health ; 19(1): 397, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975203

RESUMO

BACKGROUND: Iron deficiency is the most prevalent nutrient deficiency and the most common cause of anaemia worldwide. Because of the increased iron requirements during pregnancy, iron deficiency can lead to maternal anaemia and reduced newborn iron stores. We examined the proportion and risk factors of iron deficiency among pregnant women in a developed Asian country. METHODS: Within a prospective cohort in Singapore, 985 Asian women were assessed for iron status at 26-28 weeks' gestation, with plasma ferritin and soluble transferrin receptor (sTfR) measurements. Iron status was determined according to plasma ferritin concentrations at ≥30 µg/L (iron sufficiency), 15 to < 30 µg/L (modest iron depletion) and < 15 µg/L (severe iron depletion). Multivariable ordinal logistic regression was used to analyze risk factors for modest and severe iron depletion. RESULTS: The median (25-75th percentile) plasma ferritin concentration was 24.2 (19.9-30.6) µg/L. Overall, 660 (67.0%) and 67 (6.8%) women had modest and severe iron depletion, respectively. Higher plasma sTfR was observed in women with severe iron depletion than among those with iron sufficiency (median 17.6 versus 15.5 nmol/L; p < 0.001). Age < 25 years (odds ratio 2.36; 95% confidence interval 1.15-4.84), Malay (2.05; 1.30-3.24) and Indian (1.98; 1.14-3.44) ethnicities (versus Chinese), university qualification (1.64; 1.13-2.38), multiparity (1.73; 1.23-2.44) and lack of iron-containing supplementation (3.37; 1.25-8.53) were associated with increased odds of modest and severe iron depletion. CONCLUSIONS: Nearly three-quarters of Singaporean women were iron deficient in the early third trimester of pregnancy. These results suggest universal screening and supplementation of at-risk pregnancies may be evaluated as a preventive strategy. TRIAL REGISTRATION: NCT01174875 . Registered 1 July 2010 (retrospectively registered).


Assuntos
Anemia Ferropriva/epidemiologia , Ferritinas/sangue , Ferro na Dieta/administração & dosagem , Complicações Hematológicas na Gravidez/epidemiologia , Adulto , Anemia Ferropriva/sangue , Anemia Ferropriva/diagnóstico , Biomarcadores/sangue , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Ferro/sangue , Gravidez , Complicações Hematológicas na Gravidez/sangue , Complicações Hematológicas na Gravidez/diagnóstico , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Receptores da Transferrina/sangue , Fatores de Risco , Singapura , Adulto Jovem
13.
Cochrane Database Syst Rev ; 3: CD004905, 2019 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-30873598

RESUMO

BACKGROUND: Multiple-micronutrient (MMN) deficiencies often coexist among women of reproductive age in low- and middle-income countries. They are exacerbated in pregnancy due to the increased demands of the developing fetus, leading to potentially adverse effects on the mother and baby. A consensus is yet to be reached regarding the replacement of iron and folic acid supplementation with MMNs. Since the last update of this Cochrane Review in 2017, evidence from several trials has become available. The findings of this review will be critical to inform policy on micronutrient supplementation in pregnancy. OBJECTIVES: To evaluate the benefits of oral multiple-micronutrient supplementation during pregnancy on maternal, fetal and infant health outcomes. SEARCH METHODS: For this 2018 update, on 23 February 2018 we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP), and reference lists of retrieved studies. We also contacted experts in the field for additional and ongoing trials. SELECTION CRITERIA: All prospective randomised controlled trials evaluating MMN supplementation with iron and folic acid during pregnancy and its effects on pregnancy outcomes were eligible, irrespective of language or the publication status of the trials. We included cluster-randomised trials, but excluded quasi-randomised trials. Trial reports that were published as abstracts were eligible. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS: We identified 21 trials (involving 142,496 women) as eligible for inclusion in this review, but only 20 trials (involving 141,849 women) contributed data. Of these 20 trials, 19 were conducted in low- and middle-income countries and compared MMN supplements with iron and folic acid to iron, with or without folic acid. One trial conducted in the UK compared MMN supplementation with placebo. In total, eight trials were cluster-randomised.MMN with iron and folic acid versus iron, with or without folic acid (19 trials)MMN supplementation probably led to a slight reduction in preterm births (average risk ratio (RR) 0.95, 95% confidence interval (CI) 0.90 to 1.01; 18 trials, 91,425 participants; moderate-quality evidence), and babies considered small-for-gestational age (SGA) (average RR 0.92, 95% CI 0.88 to 0.97; 17 trials; 57,348 participants; moderate-quality evidence), though the CI for the pooled effect for preterm births just crossed the line of no effect. MMN reduced the number of newborn infants identified as low birthweight (LBW) (average RR 0.88, 95% CI 0.85 to 0.91; 18 trials, 68,801 participants; high-quality evidence). We did not observe any differences between groups for perinatal mortality (average RR 1.00, 95% CI 0.90 to 1.11; 15 trials, 63,922 participants; high-quality evidence). MMN supplementation led to slightly fewer stillbirths (average RR 0.95, 95% CI 0.86 to 1.04; 17 trials, 97,927 participants; high-quality evidence) but, again, the CI for the pooled effect just crossed the line of no effect. MMN supplementation did not have an important effect on neonatal mortality (average RR 1.00, 95% CI 0.89 to 1.12; 14 trials, 80,964 participants; high-quality evidence). We observed little or no difference between groups for the other maternal and pregnancy outcomes: maternal anaemia in the third trimester (average RR 1.04, 95% CI 0.94 to 1.15; 9 trials, 5912 participants), maternal mortality (average RR 1.06, 95% CI 0.72 to 1.54; 6 trials, 106,275 participants), miscarriage (average RR 0.99, 95% CI 0.94 to 1.04; 12 trials, 100,565 participants), delivery via a caesarean section (average RR 1.13, 95% CI 0.99 to 1.29; 5 trials, 12,836 participants), and congenital anomalies (average RR 1.34, 95% CI 0.25 to 7.12; 2 trials, 1958 participants). However, MMN supplementation probably led to a reduction in very preterm births (average RR 0.81, 95% CI 0.71 to 0.93; 4 trials, 37,701 participants). We were unable to assess a number of prespecified, clinically important outcomes due to insufficient or non-available data.When we assessed primary outcomes according to GRADE criteria, the quality of evidence for the review overall was moderate to high. We graded the following outcomes as high quality: LBW, perinatal mortality, stillbirth, and neonatal mortality. The outcomes of preterm birth and SGA we graded as moderate quality; both were downgraded for funnel plot asymmetry, indicating possible publication bias.We carried out sensitivity analyses excluding trials with high levels of sample attrition (> 20%). We found that results were consistent with the main analyses for all outcomes. We explored heterogeneity through subgroup analyses by maternal height, maternal body mass index (BMI), timing of supplementation, dose of iron, and MMN supplement formulation (UNIMMAP versus non-UNIMMAP). There was a greater reduction in preterm births for women with low BMI and among those who took non-UNIMMAP supplements. We also observed subgroup differences for maternal BMI and maternal height for SGA, indicating greater impact among women with greater BMI and height. Though we found that MMN supplementation made little or no difference to perinatal mortality, the analysis demonstrated substantial statistical heterogeneity. We explored this heterogeneity using subgroup analysis and found differences for timing of supplementation, whereby higher impact was observed with later initiation of supplementation. For all other subgroup analyses, the findings were inconclusive.MMN versus placebo (1 trial)A single trial in the UK found little or no important effect of MMN supplementation on preterm births, SGA, or LBW but did find a reduction in maternal anaemia in the third trimester (RR 0.66, 95% CI 0.51 to 0.85), when compared to placebo. This trial did not measure our other outcomes. AUTHORS' CONCLUSIONS: Our findings suggest a positive impact of MMN supplementation with iron and folic acid on several birth outcomes. MMN supplementation in pregnancy led to a reduction in babies considered LBW, and probably led to a reduction in babies considered SGA. In addition, MMN probably reduced preterm births. No important benefits or harms of MMN supplementation were found for mortality outcomes (stillbirths, perinatal and neonatal mortality). These findings may provide some basis to guide the replacement of iron and folic acid supplements with MMN supplements for pregnant women residing in low- and middle-income countries.


Assuntos
Suplementos Nutricionais , Ácido Fólico/administração & dosagem , Ferro na Dieta/administração & dosagem , Micronutrientes/administração & dosagem , Complicações na Gravidez/terapia , Interações de Medicamentos , Feminino , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Micronutrientes/efeitos adversos , Micronutrientes/deficiência , Mortalidade Perinatal , Gravidez , Resultado da Gravidez , Nascimento Prematuro/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
PLoS One ; 14(3): e0213982, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30897129

RESUMO

BACKGROUND: Anemia during pregnancy is a major public health problem globally with multiple causes including inadequate dietary intakes. The aim of the study was to assess the effect of nutrition education on nutritional knowledge, hemoglobin level and dietary intake of anemic pregnant women. MATERIALS AND METHODS: A quasi-experimental study was conducted among 115 mild to moderately anemic pregnant women attending ante natal clinics. Pregnant women were consecutively enrolled and assigned to receive nutrition education and diet plan in intervention group (n = 58) and general education only in control group (n = 57). The nutrition education was given to pregnant women on individual basis at the time of enrollment and follow-ups were done through biweekly phone calls and every 4 weeks during ANC visits. Baseline data were collected using semi-structure questionnaire for interview and hemoglobin level was also measured. Data were collected after 10 weeks of nutrition education intervention. Independent sample t-test was used to compare differences between the two groups. RESULTS: Out of 115 pregnant women enrolled, 107 completed the study (Intervention: 53; Control: 54). At the end of the nutrition education intervention and iron rich food based diet plan, the change in hemoglobin level was significantly high in the intervention over control group [0.56±0.40gm/dl vs. 0.16±0.82gm/dl, p = 0.002]. The change in the maternal nutritional knowledge score on anemia and iron rich foods was significantly high in the intervention over control group [8.26±4.57 vs. 1.05±6.59, p<0.001].Consumption of iron rich food was significantly high in the intervention group (P<0.05). CONCLUSION: Provision of nutrition education and iron rich food based diet plan was significantly associated with improved hemoglobin levels, improved dietary intake and nutritional knowledge on anemia and iron rich foods.


Assuntos
Anemia/sangue , Anemia/complicações , Hemoglobinas/metabolismo , Complicações na Gravidez/sangue , Fenômenos Fisiológicos da Nutrição Pré-Natal , Adolescente , Adulto , Anemia/dietoterapia , Dieta , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Ferro na Dieta/administração & dosagem , Nepal , Terapia Nutricional , Estado Nutricional , Gravidez , Complicações na Gravidez/dietoterapia , Adulto Jovem
15.
Nutrients ; 11(3)2019 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-30813509

RESUMO

Improving infant and young child feeding is an effective intervention to improve child growth. A cross-sectional study followed by observation of selected households was used to establish the most popular foods given to children 12⁻59 months old in Bukoba and Kiboga districts of Tanzania and Uganda, respectively. Six meals were identified: maize-based porridge, steamed-mashed banana served with beans, banana cooked with beans, banana cooked with groundnut sauce, stiff porridge (Ugali) served with beans and sardines, and cassava cooked with beans. Raw ingredients were transported to Universität für Bodenkultur, Austria, within 48 h and meals prepared following community validated procedures within 24 h by project team members that involved graduate students from East Africa and Europe. High-performance liquid chromatography (HPLC) analysis and microwave digestion followed by flame atomic absorption spectroscopy were used in establishing provitamin A carotenoids and iron content, respectively. Findings indicated no trace of vitamin A or iron in the maize-based porridge, whereas 2.28 mg/100 g ep (edible portion) and 1.18 mg/100 g ep of iron were recorded in stiff-porridge served with beans and sardines and banana cooked with beans, respectively. Banana-based foods had 23 to 43 vitamin A RAE (retinal activity equivalent) µg/100 g ep. With estimated average requirements of iron and vitamin A for children 1⁻3 years being 5 mg/day and 275 RAE µg/day, respectively, these foods are poor sources of these nutrients in their current form. Thus, there is a need to explore opportunities for modifying preparation methods and incorporating nutritious and diverse ingredients into the foods prepared for infants and young children in Eastern African countries.


Assuntos
Alimentos Infantis , Fenômenos Fisiológicos da Nutrição do Lactente , Ferro na Dieta/administração & dosagem , Valor Nutritivo , Vitamina A/administração & dosagem , Estudos Transversais , Dieta , Feminino , Análise de Alimentos , Humanos , Lactente , Masculino , Tanzânia , Uganda
16.
J Nutr ; 149(3): 366-371, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30753562

RESUMO

Anemia in Indian women continues to be highly prevalent, and is thought to be due to low dietary iron content. The high risk of dietary iron deficiency is based on the Indian Council of Medical Research recommendation of 21 mg/d, but there is a need for a secure and transparent determination of the Estimated Average Requirement (EAR) of iron in this population. In nonpregnant, nonlactating women of reproductive age (WRA), the EAR of iron was determined to be 15 mg/d. Applying this value to daily iron intakes among WRA in nationally representative Indian state-based data showed that the median risk of dietary iron deficiency was lower than previously thought (65%; IQR: 48-78%), with considerable heterogeneity between states (range: 25-93%). However, in a validation, this risk matched the risk of iron deficiency as defined by blood biomarkers in a recently completed survey. When the risk of dietary iron deficiency was modelled for an increase in iron intake through food fortification of a single dietary staple, that provided 10 mg/d, the median risk reduced substantially (from 65% to 20%), and it virtually disappeared when supplementary iron intakes through the national iron supplementation program were considered. The risk of exceeding the tolerable upper level (TUL) of intake of iron remains low in the population when receiving fortification of 10 mg/d, but is much higher if they consume greater amounts of iron through supplements (range: 0-54%). This newly and transparently defined Indian EAR of iron should be used to evaluate, with precision, the benefits and risks of iron fortification and supplementation policies.


Assuntos
Anemia Ferropriva/epidemiologia , Anemia Ferropriva/prevenção & controle , Alimentos Fortificados , Ferro na Dieta/administração & dosagem , Necessidades Nutricionais , Adulto , Anemia Ferropriva/etiologia , Suplementos Nutricionais , Feminino , Humanos , Índia/epidemiologia , Estado Nutricional , Fatores de Risco
17.
Eur J Clin Microbiol Infect Dis ; 38(4): 689-693, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30685806

RESUMO

An unabsorbed dietary iron supplementation can modify the colonic microbiota equilibrium and favor the growth of pathogenic strains over barrier strains. Nevertheless, the impact of oral iron supplements (OIS) use on the clinical outcomes of patients with gram-negative bacteremia (GNB) has not been evaluated. To explore the impact of OIS on the outcomes of patients with GNB. A retrospective study conducted in a tertiary hospital including patients with GNB during 2011-2016. The entire cohort was divided into chronic OIS users (study group) and nonusers (control group). The two groups were compared for the study outcomes, septic shock at presentation, length of hospital stay (LOS), and short-term mortality. The study cohort included 232 patients; 44 patients in the study group and 188 in the control one. There was no any significant difference in demographic and comorbidities characteristics between the two groups. Escherichia coli comprised the majority of bacteria (69%), while the urinary tract was the main source of the bacteremia. OIS alone and after adjustment was significantly associated with septic shock at presentation (OR = 2, CI95% [1.03-5], p = 0.04 and OR = 5, CI95% [1.4-15], p = 0.01, respectively). By multivariate analysis, OIS was significantly associated with 30-day mortality (OR = 3, CI95% [1.05-7], p = 0.04), but had no impact on LOS (16 + 23 vs. 12 + 15, p = 0.9). There is a significant association between chronic OIS exposure and increased adverse outcomes in patients with GNB. These findings might have important clinical implications.


Assuntos
Bacteriemia/patologia , Suplementos Nutricionais/efeitos adversos , Infecções por Bactérias Gram-Negativas/patologia , Ferro na Dieta/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Bacteriemia/complicações , Estudos de Casos e Controles , Escherichia coli , Infecções por Escherichia coli/etiologia , Feminino , Infecções por Bactérias Gram-Negativas/complicações , Mortalidade Hospitalar , Humanos , Ferro na Dieta/administração & dosagem , Masculino , Registros Médicos , Pessoa de Meia-Idade , Estudos Retrospectivos , Choque Séptico/etiologia , Choque Séptico/mortalidade , Centros de Atenção Terciária/estatística & dados numéricos , Infecções Urinárias/complicações , Infecções Urinárias/microbiologia
18.
Nutrients ; 11(1)2019 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-30654514

RESUMO

Anemia affects 1.62 billion people worldwide. Latin America and the Caribbean (LAC) comprise several developing countries where children are a population at risk. This systematic review and meta-analysis aimed to estimate the prevalence of anemia in this population. Electronic databases, reference lists, and websites of health ministries were searched until December 2018. Stratified analyses were performed using RevMan5.3 to estimate the overall prevalence of anemia in preschool and school-age children. The effectiveness of nutritional interventions was also evaluated. We included 61 studies from the 917 reviewed, which included 128,311 preschool- and 38,028 school-age children from 21 LAC countries. The number of anemic children was 32.93% and 17.49%, respectively, demonstrating a significant difference according to age (p < 0.01). No difference was observed by gender and only school-age children from low/very low socioeconomic status (SES) (25.75%) were more prone to anemia than those from middle SES (7.90%). It was not a concern in the Southern Cone but constituted a serious public health problem in the Latin Caribbean. Nutritional interventions reduced the prevalence from 45% to 25% (p < 0.01). Anemia is still a public health problem for children in LAC countries. National surveys should include school-age children. Further nutritional interventions are required to control anemia.


Assuntos
Anemia/epidemiologia , Anemia/terapia , Suplementos Nutricionais , Ferro na Dieta/administração & dosagem , Região do Caribe/epidemiologia , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Humanos , América Latina/epidemiologia , Masculino , Estado Nutricional , Prevalência , Saúde Pública
19.
Am J Clin Nutr ; 109(1): 109-116, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30649164

RESUMO

Background: High body iron status has been shown to be associated with adverse health outcomes. However, the relation between high body iron status, body mass index (BMI), and cognition is still understudied. Objective: This study aimed to examine the association between iron intake and cognitive function in Chinese adults and tested the interaction effect of iron intake and BMI on cognition. Design: Longitudinal study data from a nationwide sample (n = 4852; age ≥55 y) from the China Health and Nutrition Survey during 1991-2006 were used. Of the participants, 3302 had completed cognitive screening tests in ≥2 surveys. Cognitive function was assessed in 1997, 2000, 2004, and 2006. Dietary iron intake was obtained from a 3-d food record during home visits in 1991, 1993, 1997, 2000, 2004, and 2006. Multivariable mixed linear regression and logistic regression were used. Results: The cumulative mean ± SD iron intake in 1997 of tested subjects was 23.7 ± 11.3 mg/d (25.4 mg/d in men and 22.2 mg/d in women). High iron intake was associated with poor cognition. In fully adjusted models, across the quartiles of iron intake the regression coefficients (95% CIs) were 0, -0.39 (-0.77, -0.01), -0.55 (-0.95, -0.15), and -0.90 (-1.33, -0.47), respectively. Comparing extreme quartiles of iron intake (high), the OR (95% CI) for poor cognitive function was 1.30 (1.04, 1.64). There was a significant interaction between iron intake and BMI. The association between high iron intake and poor cognition was stronger among those with a high BMI than those with a low BMI. Among those with a BMI (kg/m2) >24, across quartiles of iron intake the ORs (95% CIs) for poor cognitive function were 1.00, 1.27 (0.91, 1.78), 1.41 (0.97, 2.04), and 2.04 (1.38, 3.01), respectively. Conclusion: Higher iron intake is associated with poor cognition in Chinese adults, especially among those with a high BMI.


Assuntos
Peso Corporal/fisiologia , Cognição/efeitos dos fármacos , Ferro na Dieta/administração & dosagem , Idoso , Animais , Grupo com Ancestrais do Continente Asiático , Índice de Massa Corporal , China/epidemiologia , Demência/epidemiologia , Dieta , Feminino , Humanos , Ferro na Dieta/efeitos adversos , Estudos Longitudinais , Masculino , Carne , Pessoa de Meia-Idade , Inquéritos Nutricionais
20.
Biochim Biophys Acta Gen Subj ; 1863(4): 703-713, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30677469

RESUMO

BACKGROUND: Up to 50% of patients with chronic heart failure (HF) have systemic iron deficiency, which contributes to symptoms and poor prognosis. Myocardial iron deficiency (MID) in HF patients has been recently documented, but its causes and consequences are unknown. The goal of our study was to address these questions in a well-defined rat HF model induced by volume overload due to aorto-caval fistula. METHODS: Modulation of dietary iron content in a rat model of HF has been used to address how iron status affects cardiac iron levels, heart structure and function, and how the presence of HF affects cardiac expression of hepcidin and other iron-related genes. RESULTS: MID developed in the rat model of heart failure. Iron supplementation did not normalize the myocardial iron content; however, it improved survival of HF animals compared to animals fed diet with normal iron content. We observed marked upregulation of hepcidin mRNA expression in HF animals, which was not associated with systemic or cardiac iron levels but strongly correlated with markers and parameters of heart injury. Identical iron-independent pattern was observed for expression of several iron-related genes. CONCLUSIONS: MID is not caused by defective iron absorption or decreased systemic iron levels, but rather by intrinsic myocardial iron deregulation. Altered cardiac expression of hepcidin and other iron-related genes is driven by iron-independent stimuli in the failing heart. GENERAL SIGNIFICANCE: Understanding of the causes and consequences of MID is critical for finding strategies how to improve cardiac iron stores and in HF patients.


Assuntos
Modelos Animais de Doenças , Insuficiência Cardíaca/metabolismo , Hepcidinas/metabolismo , Ferro na Dieta/administração & dosagem , Ferro/metabolismo , Miocárdio/metabolismo , Administração Oral , Animais , Homeostase , Ferro/deficiência , Masculino , Miocárdio/química , Ratos , Ratos Sprague-Dawley
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