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Introduction: According to current knowledge, at birth, the pineal gland and melatonin receptors are already present and the suprachiasmatic nucleus is largely functional, and noradrenaline, the key pineal transmitter, can be detected in the early foetal period. It is still unclear why the pineal gland is not able to start its own pulsatile synthesis and secretion of melatonin in the first months of life, and as a result, infants during this time are dependent on an external supply of melatonin. Method: The causes and consequences of this physiological melatonin deficiency in human infancy are examined in a systematic review of the literature, in which 40 of 115 initially selected publications were evaluated in detail. The references of these studies were checked for relevant studies on this topic. References from previous reviews by the author were taken into account. Results: The development and differentiation of the pineal gland, the pinealocytes, as the site of melatonin synthesis, and the development and synaptic coupling of the associated predominantly noradrenergic neural pathways and vessels and the associated Lhx4 homebox only occurs during the first year of life. Discussion: The resulting physiological melatonin deficiency is associated with sleep disorders, infant colic, and increased crying in babies. Intervention studies indicate that this deficiency should be compensated for through breastfeeding, the administration of nonpooled donor milk, or through industrially produced chrononutrition made from nonpooled cow's milk with melatonin-poor day milk and melatonin-rich night milk. [ABSTRACT FROM AUTHOR]

Adequate micronutrient intake and status are global public health goals. Vitamin and mineral deficiencies are widespread and known to impair health and survival across the life stages. However, knowledge of molecular effects, metabolic pathways, biological responses to variation in micronutrient nutriture, and abilities to assess populations for micronutrient deficiencies and their pathology remain lacking. Rapidly evolving methodological capabilities in genomics, epigenomics, proteomics, and metabolomics offer unparalleled opportunities for the nutrition research community to link micronutrient exposure to cellular health; discover new, arguably essential micronutrients of microbial origin; and integrate methods of molecular biology, epidemiology, and intervention trials to develop novel approaches to assess and prevent micronutrient deficiencies in populations. In this review article, we offer new terminology to specify nutritional application of multiomic approaches and encourage collaboration across the basic to public health sciences to advance micronutrient deficiency prevention. [ABSTRACT FROM AUTHOR]

Bariatric surgery is an important weight loss tool in individuals with severe obesity. It is currently the most effective long-term weight loss treatment that lowers obesity-related comorbidities. It also has significant physiological and nutritional consequences that can result in gastrointestinal complications and micronutrient deficiencies. After gastric bypass, clinical events that negatively affect nutritional status include malabsorption, dumping syndrome, kidney stones, altered intestinal bile acid availability, bowel obstruction, ulcers, gastroesophageal reflux, and bacterial overgrowth. Risk factors for poor nutritional status and excessive loss of lean body mass and bone include reduced dietary quality and inadequate intake, altered nutrient absorption, and poor patient compliance with nutrient supplementation. There are unique concerns in adolescents, older individuals, and individuals who become pregnant postoperatively. With careful management, health-care professionals can assist with long-term weight loss success and minimize the risk of acute and long-term nutrition complications after bariatric surgery. [ABSTRACT FROM AUTHOR]

Intracellular levels of glutathione, the major mammalian antioxidant, are reported to decline with age in several species. To understand whether ageing affects circulating glutathione levels in cats, blood was sampled from two age groups, < 3 years and > 9 years. Further, to determine whether dietary supplementation with glutathione precursor glycine (GLY) affects glutathione concentrations in senior cats (> 8 years), a series of free GLY inclusion level dry diets were fed. Subsequently, a 16-week GLY feeding study was conducted in senior cats (> 7 years), measuring glutathione, and markers of oxidative stress. Whole blood and erythrocyte total, oxidised and reduced glutathione levels were significantly decreased in senior cats, compared with their younger counterparts (P ≤ 0·02). The inclusion level study identified 1·5 % free GLY for the subsequent dry diet feeding study. Significant increases in erythrocyte total and reduced glutathione were observed between senior cats fed supplemented and control diets at 4 weeks (P ≤ 0·03; maximum difference of 1·23 µM). Oxidative stress markers were also significantly different between groups at 8 (P = 0·004; difference of 0·68 nG/ml in 8-hydroxy-2'-deoxyguanosine) and 12 weeks (P ≤ 0·049; maximum difference of 0·62 nG/mG Cr in F2-isoprostane PGF2 α ). Senior cats have lower circulating glutathione levels compared with younger cats. Feeding senior cats a complete and balanced dry diet supplemented with 1·5 % free GLY for 12 weeks elevated initial erythrocyte glutathione and altered markers of oxidative stress. Dietary supplementation with free GLY provides a potential opportunity to restore age-associated reduction in glutathione in cats. [ABSTRACT FROM AUTHOR]

Although relatively abundant in nature, zinc deficiency is one of the most prevalent mineral micronutrient deficiencies, particularly in sub-Saharan Africa (SSA). However, there are limited data on zinc nutriture for children in the SSA region. A study was undertaken to review the available literature that reported the prevalence of zinc deficiency assessed using the three population-level indicators (plasma/serum zinc, dietary zinc intake and stunting) among children 0–59 months of age in SSA. A search combination of words was performed on PUBMED, Google Scholar, AGORA, ScienceDirect and SpringerLink databases. The following search terms were entered; "stunting OR low height for age AND serum zinc OR plasma zinc, AND dietary zinc intake AND under five AND Sub-Saharan Africa". We identified 25 studies. Two were randomised controlled trials and the rest were cross-sectional studies of which eight were national surveys. Nineteen studies from nine countries have assessed plasma or serum zinc. A total of 10 studies from 6 countries assessed dietary zinc intake. The prevalence of risk of zinc deficiency ranged from 20–83% using PZn/SZn, and 31–99% using inadequate dietary Zn intake, with the exception of one study that reported 8%. The risk of zinc deficiency among children aged between 0 and 59 months appears to be high and of public health concern. Stunting was the most commonly reported proxy indicator of zinc deficiency. When planning interventions, stakeholders should consider collecting appropriate biomarker data and design context-specific interventions. [ABSTRACT FROM AUTHOR]

Gene therapy promises to possess a good prospect in bridging the gap between dental applications and medicine. The dynamic therapeutic modalities of gene therapy have been advancing rapidly. Conventional approaches are being revamped to be more comprehensive and pre-emptive, which could do away with the need for surgery and medicine altogether. The complementary base sequences known as genes convey the instructions required to manufacture proteins. The oral cavity is one of the most accessible locations for the therapeutic intervention of gene therapy for several oral tissues. In 1990, the first significant trial of gene therapy was overseen to alleviate adenosine deaminase deficiency. The notion of genetic engineering has become increasingly appealing as a reflection of its benefits over conventional treatment modalities. An example of how this technology may alter dentistry is the implementation of gene therapy for dental and oral ailments. The objective of this article is to examine the effects of gene therapy on the field of dentistry, periodontology and implantology. Furthermore, the therapeutic factors of disease therapy, minimal invasion, and appropriate outcome have indeed been taken into consideration. [ABSTRACT FROM AUTHOR]

As dietary guidance for populations shifts from preventing deficiency disorders to chronic disease risk reduction, the biology supporting such guidance becomes more complex due to the multifactorial risk profile of disease and inherent population heterogeneity in the diet–disease relationship. Diet is a primary driver of chronic disease risk, and population-based guidance should account for individual responses. Cascading effects on evidentiary standards for population-based guidance are not straightforward. Precision remains a consideration for dietary guidance to prevent deficiency through the identification of population subgroups with unique nutritional needs. Reducing chronic disease through diet requires greater precision in (a) establishing essential nutrient needs throughout the life cycle in both health and disease; (b) considering effects of nutrients and other food substances on metabolic, immunological, inflammatory, and other physiological responses supporting healthy aging; and (c) considering healthy eating behaviors. Herein we provide a template for guiding population-based eating recommendations for reducing chronic diseases in heterogenous populations. [ABSTRACT FROM AUTHOR]

Objective: To determine the significance of zinc supplementation for zinc deficiency during chemotherapy for gynecologic malignancies. Methods: Twenty‐eight patients suspected of zinc deficiency before chemotherapy were prospectively evaluated. Gustatory test, serum zinc, blood count, and biochemical examinations were made pre‐chemotherapy at 3‐ and 6‐week intervals. Patients with serum zinc levels <70 μg were prescribed oral zinc acetate hydrate (167.8 mg/day) for 3 weeks. The primary outcome was efficacy of zinc supplementation, the secondary outcomes were zinc deficiency rates and adverse effects of the zinc supplement. Results: Fifteen (mean serum zinc level: 67.4 ± 6.2 μg/dL) out of 28 patients were administered zinc supplementation pre‐chemotherapy, and subsequent serum zinc levels reached 83.2 ± 15.3 μg/dL in 3 weeks. Factors associated with chemotherapy (vs. chemoradiation, p = 0.041) and taxane + platinum (p = 0.048) were significant risk factors for decreasing zinc levels following chemotherapy. Although patients that required zinc supplementation showed decreased serum zinc levels after chemotherapy and tended to experience taste alteration (sour: p = 0.041), zinc supplementation for zinc deficiency during chemotherapy did not alter taste perception. Conclusion: Zinc supplementation promptly increased serum levels without major complications and may prevent an alteration in taste perception. [ABSTRACT FROM AUTHOR]

Beriberi was first described by Chinese physicians around 300 AD long before thiamine was discovered and long before medicine had advanced to the understanding of how nutrients in food were important to disease prevention. The connection between the loss in nutrient value due to the processing of specific foods had yet to be realized. As with many of our discoveries in nutrition, it took man centuries to identify the nutrient that when deficient caused beriberi. Once the initial link was made, then discoveries of how thiamine functions and how much humans need came together in rapid order. [ABSTRACT FROM AUTHOR]

Minerals play a fundamental role in optimising health and managing chronic disease. Some of their roles include mineralisation of bone, antioxidant activity, carbohydrate metabolism, and neurotransmission. This snapshot aims to introduce the clinical utility of the minerals calcium, chromium, magnesium, selenium, and zinc, including the functions, deficiency signs and symptoms, and uses of the minerals. Part 2 will discuss the clinical utility of copper, iodine, iron, manganese, molybdenum, and silica. [ABSTRACT FROM AUTHOR]

Background: Zinc deficiency impairs immune function and is common among children in South-East Asia.Objectives: The effect of zinc supplementation on immune function in young Laotian children was investigated.Methods: Children (n = 512) aged 6-23 mo received daily preventive zinc tablets (PZ; 7 mg Zn/d), daily multiple micronutrient powder (MNP; 10 mg Zn/d, 6 mg Fe/d, plus 13 other micronutrients), therapeutic dispersible zinc tablets only in association with diarrhea episodes (TZ; 20 mg Zn/d for 10 d after an episode), or daily placebo powder (control). These interventions continued for 9 mo. Cytokine production from whole blood cultures, the concentrations of T-cell populations, and a complete blood count with differential leukocyte count were measured at baseline and endline. Endline means were compared via ANCOVA, controlling for the baseline value of the outcome, child age and sex, district, month of enrollment, and baseline zinc status (below, or above or equal to, the median plasma zinc concentration).Results: T-cell cytokines (IL-2, IFN-γ, IL-13, IL-17), LPS-stimulated cytokines (IL-1β, IL-6, TNF-α, and IL-10), and T-cell concentrations at endline did not differ between intervention groups, nor was there an interaction with baseline zinc status. However, mean ± SE endline lymphocyte concentrations were significantly lower in the PZ than in the control group (5018 ± 158 compared with 5640 ± 160 cells/μL, P = 0.032). Interactions with baseline zinc status were seen for eosinophils (Pixn = 0.0036), basophils (Pixn = 0.023), and monocytes (P = 0.086) but a significant subgroup difference was seen only for eosinophils, where concentrations were significantly lower in the PZ than in the control group among children with baseline plasma zinc concentrations below the overall median (524 ± 44 compared with 600 ± 41 cells/μL, P = 0.012).Conclusions: Zinc supplementation of rural Laotian children had no effect on cytokines or T-cell concentrations, although zinc supplementation affected lymphocyte and eosinophil concentrations. These cell subsets may be useful as indicators of response to zinc supplementation.This trial was registered at clinicaltrials.gov as NCT02428647. [ABSTRACT FROM AUTHOR]

Iron deficiency is the most common micronutrient deficiency worldwide. Iron is essential for the development of multiple organ systems, most especially the developing brain. Iron deficiency, particularly during sensitive periods of brain development, such as in early childhood, is associated with long‐lasting adverse consequences for cognition, motor function and behaviour. Little consideration has been given to iron deficiency in newborn infants and its potential health consequences. Fetal iron accretion is compromised by pregnancy complications such as pre‐term birth and gestational diabetes mellitus, and our work has identified an increased risk of low iron stores at birth from maternal lifestyle factors such as smoking and obesity. Early‐life events, including Caesarean section delivery, further add to the cumulative risk of neonatal iron deficiency, which can persist throughout infancy into early childhood. While investigations into the long‐term neurological consequences of neonatal iron deficiency are limited, there is evidence of poorer memory, motor function and language ability in children born iron deficient. Recently, we also identified significant behavioural consequences of neonatal deficiency persisting from 2 to 5 years of age, with effects particularly apparent in 'high‐risk' children born to obese or smoking mothers or delivered by Caesarean section. Interventions targeting the fetal/neonatal period could therefore represent a key opportunity for the prevention of iron deficiency and its associated long‐term health consequences. A dual approach is required, comprising public health strategies targeting prevention, to improve health in women of reproductive age, and the development of screening strategies for the early detection of iron deficiency in newborn infants. [ABSTRACT FROM AUTHOR]

Zinc deficiency is a global public health problem, affecting ~17% of the world's population, with the greatest burden in low‐ and middle‐income countries. An increasing body of evidence suggests that biofortification may be a cost‐effective and sustainable approach to reducing zinc and other micronutrient deficiencies. Biofortification enhances the nutritional quality of food crops through conventional plant breeding techniques and agronomic practices. This paper presents ongoing research on biofortification in Pakistan, where over 40% of women are zinc deficient. The Biofortified Zinc Flour to Eliminate Deficiency (BiZiFED) project aims to investigate the impact of biofortification as a strategy to alleviate zinc deficiency in Pakistan. The project is supported by the Biotechnology and Biological Sciences Research Council (BBSRC) Global Challenges Research Fund from May 2017 to April 2019. This paper outlines the four objectives and work packages within the BiZiFED project: (1) a double‐blind, randomised controlled trial to examine the effect of consuming flour made from a high zinc variety of biofortified wheat (Zincol‐2016/NR‐421) on dietary zinc intake and status; (2) a cost‐effectiveness study to assess the health and economic impact of agronomic biofortification of wheat; (3) a mixed methods study to explore the cultural acceptability and sustainability of biofortification in Pakistan; (4) capacity building and development of long‐term research partnerships in Pakistan. The findings will contribute to the evidence base for the potential impact of biofortification to alleviate zinc deficiency among the poorest communities. [ABSTRACT FROM AUTHOR]

Abstract Boron (B) has many beneficial functions in biological, metabolic and physiological processes for plants and animals. It plays a vital role in maintaining animal health and preventing nutritional disorders. Boron deficiency has been correlated with low immune function and high incidence of osteoporosis which increases mortality risk. Extraordinary boron level causes cell damage and toxicity in human and different animal species. In the past few years, attention has been paid to clear the pleiotropic effects of boron including activating of immune response, antioxidant detoxification activities, affecting bone metabolism, enhancing animal performance and modulating various body systems. Furthermore, the role of boron as anti-heat stress agent has been identified in plants and suggested in animals. Liver metabolism also shows significant alterations in dairy cows in response to the dietary supplementation of boron. Likewise, adding boron to animal feed enhances bone density, wound healing and embryonic development. Additionally, boron has a potential impact on the metabolism of numerous minerals and enzymes. In view of the information about boron benefits, high or low level boron merits the concern. As well, researches are required to do more in-depth investigations on boron influences, and to adjust its requirements in different animal species. [ABSTRACT FROM AUTHOR]

Aim: Biotinidase deficiency is an autosomal recessive disease, also known as late-onset biotin-sensitive multiple carboxylase deficiency caused by pathogenic mutations in the biotinidase (BTD) gene responsible for the production of biotinidase. In this study, we aimed to present the clinical findings and BTD gene molecular analysis results in the light of the literature. Material and Methods: Nine patients who were positive in heel blood screening and cases compatible with neurological, sensory, metabolic, respiration and skin findings of biotinidase deficiency were included in the study. For the isolation of genomic DNA from the participants included in the study, 2 cc of peripheral blood was taken into Ethylene Diamine Tetra Acetic Acid (EDTA) tubes and their genomic DNA was isolated and sequence analysis of the BTD gene was performed. Results: According to the all exon sequence analysis results of the BTD gene, homozygous c.1368A>C/p.Gln456His mutation was detected in 1 patient; heterozygous c.1368A>C/p.Gln456His mutation was detected in 1 patient; combined heterozygous c.1330G>C/p.Asp444His and c.511G>A/p.Ala171Thr mutations were detected in 1 patient, combined heterozygous c.1336G>C/p.Asp446His and c.511G>A/p.Ala171Thr were detected in 1 patient, and c.557G>A/p.Cys186Tyr mutation was detected in 1 patient. No mutation was detected in 4 patients. Conclusion: Early diagnosis and treatment are very important for eliminating the problems experienced by patients with BTD disorder and for preventing complications that may occur in case of delay. It is important that informing the patient and family members about the prenatal diagnosis or preimplantation genetic diagnosis method for autosomal recessive inherited disease by giving genetic counseling. [ABSTRACT FROM AUTHOR]

Background: Dietary iodine requirements are high during pregnancy, lactation, and infancy, making women and infants vulnerable to iodine deficiency. Universal salt iodization (USI) has been remarkably successful for preventing iodine deficiency in the general population, but it is uncertain if USI provides adequate iodine intakes during the first 1000 d.Objective: We set out to assess if USI provides sufficient dietary iodine to meet the iodine requirements and achieve adequate iodine nutrition in all vulnerable population groups.Methods: We conducted an international, cross-sectional, multicenter study in 3 study sites with mandatory USI legislation. We enrolled 5860 participants from 6 population groups (school-age children, nonpregnant nonlactating women of reproductive age, pregnant women, lactating women, 0-6-mo-old infants, and 7-24-mo-old infants) and assessed iodine status [urinary iodine concentration (UIC)] and thyroid function in Linfen, China (n = 2408), Tuguegarao, the Philippines (n = 2512), and Zagreb, Croatia (n = 940). We analyzed the iodine concentration in household salt, breast milk, drinking water, and cow's milk.Results: The salt iodine concentration was low (<15 mg/kg) in 2.7%, 33.6%, and 3.1%, adequate (15-40 mg/kg) in 96.3%, 48.4%, and 96.4%, and high (>40 mg/kg) in 1.0%, 18.0%, and 0.5% of household salt samples in Linfen (n = 402), Tuguegarao (n = 1003), and Zagreb (n = 195), respectively. The median UIC showed adequate iodine nutrition in all population groups, except for excessive iodine intake in school-age children in the Philippines and borderline low intake in pregnant women in Croatia.Conclusions: Salt iodization at ∼25 mg/kg that covers a high proportion of the total amount of salt consumed supplies sufficient dietary iodine to ensure adequate iodine nutrition in all population groups, although intakes may be borderline low during pregnancy. Large variations in salt iodine concentrations increase the risk for both low and high iodine intakes. Strict monitoring of the national salt iodization program is therefore essential for optimal iodine nutrition. This trial was registered at clinicaltrials.gov as NCT02196337. [ABSTRACT FROM AUTHOR]

Introduction: The consumption of saturated fats is considered a risk factor for cardiovascular diseases. Objective: Review published papers on the role of macro-nutrient intake in cardiovascular risk. Results: Recent reports from the PURE study and several previous metaanalyses, show that the consumption of total saturated and unsaturated fat is not associated with risk of acute myocardial infarction or mortality due to cardiovascular disease. High carbohydrate intake was associated with the highest risk of total and cardiovascular mortality, while total fat consumption or of its different types was associated with a lower risk of mortality. A high consumption of fruits, vegetables and legumes was associated with lower risk of total mortality and non-cardiovascular mortality. The consumption of 100 g of legumes, two or three times a week, ameliorated deficiencies of the nutrients contained in these foods and was associated with a reduction in the risk of developing chronic noncommunicable diseases. Conclusion: A healthy diet should be balanced and varied, be composed of a proportion of complex carbohydrates rich in fibber between 50-55% of the daily energy consumed, of saturated and unsaturated fat (25-30%), animal and vegetable protein (including legumes) between 15-25%, vitamins, minerals and water. These nutrients are abundantly present in fruits, vegetables, cereals, legumes, milk and its derivatives, eggs and meats, so public policies should promote the availability and access to these nutrients within primary prevention programs to reduce the growing prevalence of cardio-metabolic diseases. [ABSTRACT FROM AUTHOR]

Background Vegetarians are likely to have lower intakes of preformed docosahexaenoic acid ( DHA) than omnivorous populations who consume fish and animal products. As such, vegetarian populations have omega-3 indices up to 60% lower than those who consume marine products. Algae, the primary producer of DHA in the marine food chain, offer an alternative source of DHA for those who do not consume marine or animal products. This systematic review aims to examine the evidence for the relationship between supplementation with algal forms of DHA and increased DHA concentrations in vegetarian populations. Methods The SCOPUS, Science Direct and Web of Science scientific databases were searched to identify relevant studies assessing the effect of algal DHA consumption by vegetarian (including vegan) populations. Results Four randomised controlled trials and two prospective cohort studies met the inclusion criteria. All included studies reported algal sources of DHA significantly improve DHA concentrations (including plasma, serum, platelet and red blood cell fractions), as well as omega-3 indices, in vegetarian populations. An evident time or dose response was not apparent given the small number of studies to date. Conclusions Future studies should address long chain n-3 polyunsaturated fatty acid deficiencies in vegetarian populations using algal DHA and explore the potential physiological and health improvements in these individuals. [ABSTRACT FROM AUTHOR]

Background: Industrial food fortification is a major strategy to improve dietary micronutrient intakes and prevent deficiencies. Zambia introduced mandatory sugar fortification with vitamin A, at a target of 10 mg/kg, in 1998. Representative surveys conducted since that time do not support marked improvement in vitamin A status.Objective: To describe vitamin A concentrations in retail sugar, as well as vendor practices, perceptions of fortified foods, and sugar use practices.Methods: We conducted a census of sugar vendors in one Zambian community, capturing information on vendors, available brands and packaging options, and storage conditions. We purchased all brands and package types of sugar available at each vendor. In a 15% subsample, we conducted semi-structured interviews with vendor-consumer pairs. We tested 50% of sugar samples at random for vitamin A using an iCheck portable fluorimeter.Results: The distribution of vitamin A in sugar in market samples was highly skewed, with a median of 3.1 mg/kg (25th-75th percentiles: 1.8-5.5) and a range from 0.2 to 29.9 mg/kg. Only 11.3% of samples met the 10 mg/kg statutory requirement. Sugar was primarily repackaged and sold in small quantities, with rapid turnover of stocks. Perceptions of fortification by vendors and consumers were generally positive.Conclusions: Vitamin A in fortified sugar fell well below statutory requirements. Our data point to challenges at regional depot and/or poor adherence to fortification standards at the factory level. A renewed commitment to monitoring and enforcement will be required for Zambia to benefit from a food fortification strategy. [ABSTRACT FROM AUTHOR]

Objective: Fortification of food-grade (edible) salt with iodine is recommended as a safe, cost-effective and sustainable strategy for the prevention of iodine-deficiency disorders. The present paper examines the legislative framework for salt iodization in Asian countries.Design: We reviewed salt iodization legislation in thirty-six countries in Asia and the Pacific. We obtained copies of existing and draft legislation for salt iodization from UNICEF country offices and the WHO's Global Database of Implementation of Nutrition Actions. We compiled legislation details by country and report on commonalities and gaps using a standardized form. The association between type of legislation and availability of iodized salt in households was assessed.Results: We identified twenty-one countries with existing salt iodization legislation, of which eighteen were mandatory. A further nine countries have draft legislation. The majority of countries with draft and existing legislation used a mandatory standard or technical regulation for iodized salt under their Food Act/Law. The remainder have developed a 'stand-alone' Law/Act. Available national surveys indicate that the proportion of households consuming adequately iodized salt was lowest in countries with no, draft or voluntary legislation, and highest in those where the legislation was based on mandatory regulations under Food Acts/Laws.Conclusions: Legislation for salt iodization, particularly mandatory legislation under the national food law, facilitates universal salt iodization. However, additional important factors for implementation of salt iodization and maintenance of achievements include the salt industry's structure and capacity to adequately fortify, and official commitment and capacity to enforce national legislation. [ABSTRACT FROM AUTHOR]

Background: Zinc deficiency is an important problem in children, especially in developing countries. Zinc supplements have beneficial effects on multiple factors, including treatment of growth retardation and hypogonadism, and they can be used as therapeutic and prophylactic agents against infection in children. Objective: To determine the prevalence of zinc deficiency in 6-month to 12-year-old children in Bandar Abbas. Methods: This study was done in Bandar Abbas in 2013. In this cross-sectional study, 583 children were evaluated after obtaining a written informed consent from their parents. Zinc levels < 6 μg/dl were defined as zinc deficiency, zinc levels of 80-66 μg/dl were defined as insufficient, and zinc levels of 80-115 μg/dl were defined as sufficient levels. SPSS software, version 20, descriptive statistics, the chi-squared test, and the t-test were used to analyze the data. Results: Five hundred and eighty-three children with a mean age of 42.82±30.68 months participated in this study. Among the participants, 263 (45.1%) were females, and 320 (54.9%) were males. The prevalence of zinc deficiency was 17.5% in this study. Zinc deficiencies were reported in 67 males (20.94%) males and in 35 females (13.30%). Zinc deficiencies were more common in boys, and this difference was statistically significant (p=0.01). Conclusion: The results of this study indicated that the prevalence of zinc deficiencies is high in Bandar Abbas and that it is more prevalent in males than in females. The children in this area should be screened for zinc deficiency. Future studies should focus on then treatment of zinc deficiency and its role in different aspects of children’s health. [ABSTRACT FROM AUTHOR]

Dietary guidelines in many countries include a recommendation to consume oily fish, mainly on the basis of evidence from prospective cohort studies that fish consumption is cardioprotective. However, average intakes are very low in a large proportion of the UK population. Some groups, such as vegans and vegetarians, purposely omit fish (along with meat) from their diet resulting in zero or trace intakes of long chain (LC) n-3 PUFA. Although the efficacy of dietary fish oil supplementation in the prevention of CVD has been questioned in recent years, the balance of evidence indicates that LC n-3 PUFA exert systemic pleiotropic effects through their influence on gene expression, cell signalling, membrane fluidity and by conversion to specialised proresolving mediators; autacoid lipid mediators that resolve inflammatory events. The long-term impact of reduced tissue LC n-3 PUFA content on cardiovascular health is surprisingly poorly understood, particularly with regard to how low proportions of LC n-3 PUFA in cell membranes may affect cardiac electrophysiology and chronic inflammation. Randomised controlled trials investigating effects of supplementation on prevention of CHD in populations with low basal LC n-3 PUFA tissue status are lacking, and so the clinical benefits of supplementing non-fish-eating groups with vegetarian sources of LC n-3 PUFA remain to be determined. Refocusing dietary LC n-3 PUFA intervention studies towards those individuals with a low LC n-3 PUFA tissue status may go some way towards reconciling results from randomised controlled trials with the epidemiological evidence. [ABSTRACT FROM AUTHOR]

The need for evidence to inform nutrition program design and implementation has long been recognized, yet the generation and use of evidence for program decision making has lagged. The results of the coverage surveys reported in this supplement highlight some of the strengths and areas for improvement of current population-based (i.e., staple foods and condiments) and targeted (e.g., foods for infants and young children) fortification programs. Among other topics, the results identify a few striking successful fortification programs whereby the majority of the food vehicle used is fortifiable and fortified, and coverage is equitable among those classified as vulnerable and not. Other programs have great potential based on very high use of a fortifiable food vehicle, including in most cases among the vulnerable, but that potential is not currently reached because of low compliance with fortification requirements. Programs were also identified whereby the food vehicle has limited potential to make public health contributions to micronutrient intake, given the low proportions of the population who consume the food vehicle in general or who consume the fortifiable food vehicle. Four key lessons were learned: 1) the potential for impact of food fortification depends on the appropriate choice of food fortification vehicle but also on the proportion of the food vehicle consumed that is fortifiable; 2) the design of fortification programs should be informed by the magnitude and distribution of inadequate intake and deficiency and consumption of fortifiable foods, and part of micronutrient deficiency control strategies to ensure coordination with other programs; 3) effective quality control of fortification levels in foods urgently needs strengthening, including the many governance and other policy factors that influence the capacity, resources, and commitment to do this; 4) periodic review of the assumptions related to dietary patterns that underpin food fortification is needed to ensure continual safe and impactful programs. [ABSTRACT FROM AUTHOR]

In light of evidence that high-dose iron supplements lead to a range of adverse events in low-income settings, the safety and efficacy of lower doses of iron provided through biological or industrial fortification of foodstuffs is reviewed. First, strategies for point-of-manufacture chemical fortification are compared with biofortification achieved through plant breeding. Recent insights into the mechanisms of human iron absorption and regulation, the mechanisms by which iron can promote malaria and bacterial infections, and the role of iron in modifying the gut microbiota are summarized. There is strong evidence that supplemental iron given in nonphysiological amounts can increase the risk of bacterial and protozoal infections (especially malaria), but the use of lower quantities of iron provided within a food matrix, ie, fortified food, should be safer in most cases and represents a more logical strategy for a sustained reduction of the risk of deficiency by providing the best balance of risk and benefits. Further research into iron compounds that would minimize the availability of unabsorbed iron to the gut microbiota is warranted. [ABSTRACT FROM AUTHOR]

Identifying the role of the diet at the start of many diseases and evaluating the nutritional status of an individual, family and community is significant for public health. The main objective of this paper is to geographically evaluate the nutritional status and deficiency disease in the development blocks of Varanasi district, India. Primary data are collected from 800 respondents of 16 selected villages (2 villages from each development block) in the rural part of Varanasi district and their results are analyzed with the help of SPSS statistical software. The study involved geographical survey based interviews using a questionnaire, measurement of nutrient intake and assessment of their general knowledge and awareness about nutrition and deficiency diseases on the basis of their occupational structure, house type and income status. The findings of this paper also show that the socio-economic status of the respondents is closely related with nutritional status of people living in the rural areas of Varanasi district. It is interesting to note that about 15% of household's intake is still less than 1500 calories per capita per day, which leads to malnutrition and deficiency diseases. More than half of the respondents of the study area are found to be suffering from nutritional deficiency diseases. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency is the most common nutritional deficiency worldwide, however uncertainty persists regarding the benefits of vitamin D supplementation. Vitamin D is essential for calcium homeostasis, and has been linked to falls and fractures in older people. There are numerous risk factors for vitamin D deficiency, chief among them old age. Studies of vitamin D supplementation have given mixed signals, but over all there is evidence of benefit for those with risk factors for deficiency. International guidelines recommend vitamin D target levels of >25 to >80 nmol/l, best achieved by a daily dose of 800–1000 IU. Large bolus doses should be avoided. There are still unanswered questions regarding vitamin D supplementation and target levels. There is need for well designed and powered trials to achieve consensus. [ABSTRACT FROM AUTHOR]

Magnesium deficiency is prevalent in women of childbearing age in both developing and developed countries. The need for magnesium increases during pregnancy, and the majority of pregnant women likely do not meet this increased need. Magnesium deficiency or insufficiency during pregnancy may pose a health risk for both the mother and the newborn, with implications that may extend into adulthood of the offspring. The measurement of serum magnesium is the most widely used method for determining magnesium levels, but it has significant limitations that have both hindered the assessment of deficiency and affected the reliability of studies in pregnant women. Thus far, limited studies have suggested links between magnesium inadequacy and certain conditions in pregnancy associated with high mortality and morbidity, such as gestational diabetes, preterm labor, preeclampsia, and small for gestational age or intrauterine growth restriction. This review provides recommendations for further study and improved testing using measurement of red cell magnesium. Pregnant women should be counseled to increase their intake of magnesium-rich foods such as nuts, seeds, beans, and leafy greens and/or to supplement with magnesium at a safe level. [ABSTRACT FROM AUTHOR]

Food fortification is a cost-effective approach to prevent and control of micronutrient deficiencies in India. A cross-sectional survey of children 0–35 months of age residing in the catchment areas of anganwadi centers in the state of Telangana was conducted to assess the coverage of adequately iodized salt and the potential for rice fortification. Salt samples were collected and tested for iodine concentration using iodometric titration. Information on demographics, household rice consumption, and Telangana’s rice sector was collected and interpreted. In households of selected children, 79% of salt samples were found to be adequately iodized. Salt brand and district were significant predictors of inadequately iodized salt. Daily rice consumption among children and women averaged 122 grams and 321 grams per day, respectively. Approximately 28% of households reported consuming rice produced themselves or purchased from a local farmer, 65% purchased rice from a market or shop, 6% got rice from a public distribution system site, and 2% obtained it from a rice mill. In the catchment areas of Telangana’s anganwadi centers, there is significant variation in the coverage of adequately iodized salt by district. Future surveys in Telangana should measure the coverage of salt iodization in the general population using quantitative methods. Nonetheless, increasing the adequacy of iodization of smaller salt manufacturers would help achieve universal salt iodization in Telangana. Despite high consumption of rice, our findings suggest that large-scale market-based rice fortification is not feasible in Telangana due to a large proportion of households producing their own rice and highly fragmented rice distribution. Distributing fortified rice via Telangana’s public distribution system may be a viable approach to target low-income households, but would only reach a small proportion of the population in Telangana. [ABSTRACT FROM AUTHOR]

Selenium, a “dual-surface” element, maintains a very thin line between a level of necessity and harmfulness. Because of this, a deficiency or excess of this element in an organism is dangerous and causes health-related problems, both physically and mentally. The main source of selenium is a balanced diet, with a proper selection of meat and plant products. Meanwhile, the proper assimilation of selenium into these products depends on their bioavailability, bioaccessibility, and/or bioactivity of a given selenium compound. From the time when it was discovered that selenium and its compounds have a significant influence on metabolic processes and in many countries throughout the world, a low quantity of selenium was found in different parts of the environment, pressure was put upon an effective and fast method of supplementing the environment with the help of selenium. This work describes supplementation methods applied with the use of selenium, as well as new ideas for increasing the level of this element in various organisms. Based on the fact that selenium appears in the environment at trace levels, the determination of total amount of selenium or selenium speciation in a given sample demands the selection of appropriate measurement methods. These methods are most often comprised of a sample preparation technique and/or a separation technique as well as a detection system. The work presents information on the subject of analytical methods used for determining selenium and its compounds as well as examples in literature of their application. [ABSTRACT FROM PUBLISHER]

Background: A current priority in aquaculture is the replacement of fish meal with alternative feedstuffs to ensure the industry's sustainability. However, most alternative protein sources are deficient in at least 1 indispensable amino acid (IAA). Therefore, there is a critical need to establish refined estimates of IAA requirements of fish.Objectives: The objectives of this study were to determine the total aromatic amino acid (TAAA) requirement (Phe + Tyr) and the Tyr replacement value for Phe in juvenile red drum Sciaenops ocellatus.Methods: The TAAA requirement was obtained by feeding juvenile red drum diets that contained incremental amounts of Phe (0.54, 0.84, 1.14, 1.44, 1.74, and 2.04 g/100 g dry diet) and a fixed concentration of Tyr. Because of the TAAA requirement obtained, a second feeding trial was conducted to determine the maximum Tyr replacement value for Phe when a control diet was prepared with an 80%:20% Phe-to-Tyr ratio (Phe:Tyr; 1.60 g Phe/100 g dry diet and 0.41 g Tyr/100 g), and 5 experimental diets were prepared by decreasing the inclusion of Phe and increasing the inclusion of Tyr (Phe:Tyr of 70%:30%, 60%:40%, 50%:50%, 40%:60%, and 30%:70%).Results: Weight gain, the feed efficiency ratio, and the protein efficiency ratio increased 354%, 133%, and 134%, respectively, relative to that of fish fed the basal diet as the Phe concentration increased to 1.44 g/100 g of dry diet; at higher concentrations of Phe, no significant differences were found between treatments. Analysis of the weight gain data with a broken-line model estimated the TAAA requirement of red drum to be 2.10 g/100 g dry diet (1.69 g Phe + 0.41 g Tyr). The maximum Tyr replacement value for Phe was estimated at 40%:60% Phe:Tyr, because only fish fed the diet with a 30%:70% Phe:Tyr ratio had a significant reduction (42%) in growth performance.Conclusion: The TAAA requirement for maximum growth of juvenile red drum was estimated to be 2.10 ± 0.08 g/100 g dry diet. Moreover, Tyr can account for up to 60% of the TAAA requirement of juvenile red drum. [ABSTRACT FROM AUTHOR]

Previous studies on rats and human subjects have established that the linoleic acid (LA) requirement is 2 % of the total energy intake (en%), but is obtained in the absence of α-linolenic acid (ALA) and consequently appear to be overestimated. This raises questions since a recent study including ALA has suggested to divide the historical value by four. However, this recent study has remained inconclusive because the animals used were not totally LA-deficient animals. For the first time, the present study was especially designed using physiological and biochemical markers and performed in two steps: (1) to achieve a specific n-6 fatty acid deficiency model using growing male rats fed either a 0 en% from LA/0 en% from ALA (0LA/0ALA), 0LA/0·5ALA or 2LA/0·5ALA diet, born from female rats fed a 0LA/0·5ALA diet; and (2) to refine the required level of LA in the presence of ALA using rats fed either a 0LA/0ALA, 0·5LA/0·5ALA, 1LA/0·5ALA, 1·5LA/0·5ALA diet, born from female rats fed a 0LA/0·5ALA diet. The first step shows that the best LA deficiency model was obtained using rats fed the 0LA/0ALA diet, born from female rats fed the 0LA/0·5ALA diet. The second step demonstrates that in growing rats, LA deficiency was corrected with an intake of 1–1·5 en% from LA and 0·5 en% from ALA. These data suggest that the requirements in humans should be revisited, considering the presence of ALA to set up the recommendation for LA. [ABSTRACT FROM PUBLISHER]

Hypovitaminosis D is a common syndrome with well established risk factors. Only recently, however, are the expansive implications of vitamin D deficiency becoming recognized, including cardiovascular complications, cancer, and dementia. The increased attention to the role of vitamin D has made its assessment more crucial in comprehensive patient management. [ABSTRACT FROM AUTHOR]

Zinc deficiency has far-reaching consequences on maternal, infant, and child health, resulting in impairments in growth, immune competence, reproductive function, and neurobehavioral development. A major determinant of zinc deficiency in low-income populations is inadequate intakes of dietary zinc, induced by low zinc intakes, and poor bioavailability. Several food-based strategies can be used to enhance zinc intake including those designed to increase the consumption of cellular animal foods (ie, meat, poultry, fish), rich in absorbable zinc; national and targeted zinc fortification programs; and biofortification. Improvements in the bioavailability of zinc can be achieved by reducing the phytate content of unrefined cereals and legumes via soaking, fermentation, or germination at the household level, adding phytase enzyme to zinc fortificants, or producing low-phytate cereal varieties through biofortification involving plant breeding or genetic engineering. Many of these food-based strategies have the potential to improve zinc nutriture in low-income countries, especially in resource-poor households and across generations, with the aim of enhancing growth and pregnancy outcome and reducing child morbidity and mortality. To be effective, such strategies must be integrated with ongoing national agriculture, food, nutrition, and health education programs and implemented using a participatory approach to ensure their acceptability, adoption, and sustainability. [ABSTRACT FROM AUTHOR]

The period of complementary feeding represents a major portion of the 1000-day critical window and thus impacts a period of substantial and dynamic infant development. This review highlights and synthesizes findings of several recent studies conducted to evaluate food-based strategies on outcomes related to micronutrient status, growth, and neurocognitive development. Particular emphasis is placed on interventions using meat or fortified products to impact iron and zinc intakes, because of the dependence of breast-fed infants on complementary food choices to meet requirements for these 2 critical micronutrients. Regular consumption of modest amounts of meat or fortified cereals provides adequate absorbed zinc to meet estimated physiologic requirements, whereas homeostatic adaptation to lower zinc intake from unfortified cereal/plant staples is inadequate to meet requirements. Iron fortification of cereals may be somewhat more effective than meat to improve iron status, but neither prevents iron deficiency in breastfed infants, even in westernized settings. Improvements in the quality of complementary foods have had very modest effects on linear growth in settings where stunting is prevalent. Maternal education is strongly associated with both linear growth and with child neurodevelopment. The determinants of early growth faltering are more complex and intractable than "simple" dietary deficiencies. Solutions to growth faltering in young children most likely need to be multidimensional and almost certainly will need to start earlier than the complementary feeding period. [ABSTRACT FROM AUTHOR]

Well-planned vegetarian diets are considered adequate for all stages of the life cycle, despite limited data on the zinc status of vegetarians during early childhood. The bioavailability of iron and zinc in vegetarian diets is poor because of their higher content of absorption inhibitors such as phytate and polyphenols and the absence of flesh foods. Consequently, children as well as adult vegetarians often have lower serum ferritin concentrations than omnivores, which is indicative of reduced iron stores, despite comparable intakes of total iron; hemoglobin differences are small and rarely associated with anemia. However, data on serum zinc concentrations, the recommended biomarker for identifying population groups at elevated risk of zinc deficiency, are sparse and difficult to interpret because recommended collection and analytic procedures have not always been followed. Existing data indicate no differences in serum zinc or growth between young vegetarian and omnivorous children, although there is some evidence of low serum zinc concentrations in vegetarian adolescents. Some vegetarian immigrants from underprivileged households may be predisposed to iron and zinc deficiency because of nondietary factors such as chronic inflammation, parasitic infections, overweight, and genetic hemoglobin disorders. To reduce the risk of deficiency, the content and bioavailability of iron and zinc should be enhanced in vegetarian diets by consumption of fortified cereals and milk, by consumption of leavened whole grains, by soaking dried legumes before cooking and discarding the soaking water, and by replacing tea and coffee at meals with vitamin C-rich drinks, fruit, or vegetables. Additional recommended practices include using fermented soy foods and sprouting at least some of the legumes consumed. Fortified foods can reduce iron deficiency, but whether they can also reduce zinc deficiency is less certain. Supplements may be necessary for vegetarian children following very restricted vegan diets. [ABSTRACT FROM AUTHOR]

Genetically Modified crops were first grown commercially in 1996. This paper explores what genetic modification is, what crops are GM and which traits these crops have. It also shows how GM crops are tested, regulated and monitored in the US and Australia. It details some of the scientific controversy about GM. It clarifies how GM food is labelled in Australia. [ABSTRACT FROM AUTHOR]

The dietary reference intakes ( DRIs) are a set of reference intake levels for nutrients that can be used for planning diets and assessing nutrient inadequacies of individuals and groups. Since the publication of the DRI reports 1997-2004, the reference intake levels have been used for various purposes. While DRIs have been used appropriately for planning and assessing diets for many different situations, there have been instances in which specific DRI categories have not been applied as intended. In this review, cases are described in which DRIs were applied correctly, as well as cases from the growing number of examples in which the wrong DRI was used or DRIs were used incorrectly. [ABSTRACT FROM AUTHOR]

Background/objectives:Vitamin B6 is suggested to have a protective role against depression. However, the association between vitamin B6 intake and depression remains inconclusive, and few studies have examined the relationship between circulating vitamin B6 concentrations and depressive symptoms. Here, we investigated the cross-sectional and prospective associations between serum pyridoxal concentrations and depressive symptoms among Japanese workers. Subjects/methods: Participants were 422 municipal employees (aged 21-67 years) who participated in a baseline survey in 2006 for cross-sectional analysis, and 210 subjects without depressive symptoms at baseline (2006) who completed both baseline and follow-up (2009) surveys for prospective analysis. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Logistic regression analysis was used to estimate the odds ratio of depressive symptoms (CES-D scale of ≥19) according to tertile of serum pyridoxal with adjustment for potential confounding variables. Results:In the cross-sectional analysis, serum pyridoxal concentrations were significantly associated with a decreased prevalence of depressive symptoms (P for trend=0.03); the multivariable-adjusted odds ratio of depressive symptoms for the highest tertile of pyridoxal was 0.54 (95% confidence interval 0.30-0.96) compared with the lowest tertile. In longitudinal analyses, higher serum pyridoxal concentrations at baseline were associated with a trend toward reduced depressive symptoms after 3 years; the multivariable-adjusted odds ratio of depressive symptoms for the highest versus the lowest tertile of pyridoxal concentration was 0.55 (95% confidence interval 0.13-2.32).Conclusions:A higher vitamin B6 status may be associated with a decreased risk of depressive symptoms in Japanese. [ABSTRACT FROM AUTHOR]

Infection is a major cause of neonatal death in developing countries. This review investigates whether host iron status affects the risk of maternal and/or neonatal infection, potentially contributing to neonatal death, and summarizes the iron acquisition mechanisms described for pathogens causing stillbirth, preterm birth, and congenital infection. In vitro evidence shows that iron availability influences the severity and chronicity of infections that cause these negative outcomes of pregnancy. In vivo evidence is lacking, as relevant studies of maternal iron supplementation have not assessed the effect of iron status on the risk of maternal and/or neonatal infection. Reducing iron-deficiency anemia among women is beneficial and should improve the iron stores of babies; moreover, there is evidence that iron status in young children predicts the risk of malaria and, possibly, the risk of invasive bacterial diseases. Caution with maternal iron supplementation is indicated in iron-replete women who may be at high risk of exposure to infection, although distinguishing between iron-replete and iron-deficient women is currently difficult in developing countries, where a point-of-care test is needed. Further research is indicated to investigate the risk of infection relative to iron status in mothers and babies in order to avoid iron intervention strategies that may result in detrimental birth outcomes in some groups of women. [ABSTRACT FROM AUTHOR]

Background: Iron deficiency (ID) is a major cause of anemia, along with other nutritional, parasitic, and genetic factors. Accurate biomarkers are needed to estimate the relative contribution of ID to anemia. Soluble transferrin receptor (sTfR) is thought to be unaffected by inflammation. Objectives: The objectives were to determine the difference in sTfR and plasma ferritin (PF) concentrations among infants (6-23 mo of age), school-age children (6-8 y of age), and women (15-25 y of age) with and without inflammation and with and without Plasmodium falciparum infection and to assess the effect of adjusting sTfR and PF for inflammation or for P. falciparum infection on the estimated prevalence of ID. Design: The data were derived from a 14-mo prospective longitudinal survey on anemia, which was conducted in the Taabo area, south-central Côte d'Ivoire. Results: At baseline, sTfR concentration was significantly higher in infants and school-age children with either inflammation or P. falciparum infection than in control individuals without inflammation or without P. falciparum infection. Individuals with inflammation had significantly higher PF concentrations than did subjects without inflammation. Adjustments in sTfR concentrations for inflammation or P. falciparum infection in infants and school-age children resulted in significantly lower ID prevalence. Adjustment of PF for inflammation and Plasmodium infection resulted in a higher ID prevalence in infants and women. Conclusions: In Ivorian infants and school-age children, ID prevalence was considerably lower after adjustment of sTfR for inflammation. However, as the prevalence estimates for ID differed widely if based on sTfR or PF, caution is still needed when estimating ID prevalence in areas with a high prevalence of inflammation or malaria. This trial was registered at controlled-trials.com as ISRCTN02181959. [ABSTRACT FROM AUTHOR]

Since its first discovery in an Iranian male in 1961, zinc deficiency in humans is now known to be an important malnutrition problem world‑wide. It is more prevalent in areas of high cereal and low animal food consumption. The diet may not necessarily be low in zinc, but its bio‑availability plays a major role in its absorption. Phytic acid is the main known inhibitor of zinc. Compared to adults, infants, children, adolescents, pregnant, and lactating women have increased requirements for zinc and thus, are at increased risk of zinc depletion. Zinc deficiency during growth periods results in growth failure. Epidermal, gastrointestinal, central nervous, immune, skeletal, and reproductive systems are the organs most affected clinically by zinc deficiency. Clinical diagnosis of marginal Zn deficiency in humans remains problematic. So far, blood plasma/serum zinc concentration, dietary intake, and stunting prevalence are the best known indicators of zinc deficiency. Four main intervention strategies for combating zinc deficiency include dietary modification/diversification, supplementation, fortification, and bio‑fortification. The choice of each method depends on the availability of resources, technical feasibility, target group, and social acceptance. In this paper, we provide a review on zinc biochemical and physiological functions, metabolism including, absorption, excretion, and homeostasis, zinc bio‑availability (inhibitors and enhancers), human requirement, groups at high‑risk, consequences and causes of zinc deficiency, evaluation of zinc status, and prevention strategies of zinc deficiency. [ABSTRACT FROM AUTHOR]

The relationship between nutrition and health-economic outcomes is important at both the individual and the societal level. While personal nutritional choices affect an individual's health condition, thus influencing productivity and economic contribution to society, nutrition interventions carried out by the state also have the potential to affect economic output in significant ways. This review summarizes studies of nutrition interventions in which health-related economic implications of the intervention have been addressed. Results of the search strategy have been categorized into three areas: economic studies of micronutrient deficiencies and malnutrition; economic studies of dietary improvements; and economic studies of functional foods. The findings show that a significant number of studies have calculated the health-economic impacts of nutrition interventions, but approaches and methodologies are sometimes ad hoc in nature and vary widely in quality. Development of an encompassing economic framework to evaluate costs and benefits from such interventions is a potentially fruitful area for future research. [ABSTRACT FROM AUTHOR]

Nutrient intake recommendations, unlike hormone replacement standards, are based empirically, rather than physiologically, i.e., they lack an a priori normal referent. Randomized controlled trials do not provide the needed referent and are unlikely to distinguish between fully normal and various suboptimal nutritional states. Several alternative approaches, each providing an a priori normal, are described and briefly discussed. [ABSTRACT FROM AUTHOR]

Bariatric surgery is fast becoming an efficient and safe method of weight reduction, especially for patients in whom conservative measures have failed. As the obese population of the world increases, so will the number of patients requesting or requiring surgical weight loss methods. Bariatric patients however have numerous co-morbidities that make their operative course more difficult, and therefore is important to have a good understanding of the important issues surrounding their pre, peri and post operative management. This article aims to educate the reader about optimal management of the bariatric surgical patient. [ABSTRACT FROM AUTHOR]

Anemia and iron deficiency affect billions of people worldwide, especially women of reproductive age, pregnant women, and young children. Many countries have iron and folic acid supplementation programs for pregnant women. However, the impact of these programs is uncertain. Multiple-micronutrient supplementation during pregnancy has been advocated; however, it is unclear whether this has additional advantages. Overall, programs have shown only modest impact on increasing birth weight. This review discusses the present state of knowledge on interventions to improve iron status during pregnancy and reproductive health, and investigates other possibilities such as supplementation prior to conception to improve maternal and child health. [ABSTRACT FROM AUTHOR]