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Micronutrient deficiencies affect growth and development and are critical for maintaining health at all ages. Their critical role in exacerbating complications of infections and chronic diseases continues to impact morbidity, mortality, and quality of life for many. Raising awareness and advocating for micronutrient deficiencies in Latin America is urgent to reduce this preventable burden. Globally, an estimated 372 million preschool-aged children and 1.2 billion non-pregnant women of reproductive age suffer deficiency from 1 or more micronutrient. Data is limited and often old, and the true burden of problem in the region remains unclear. There are also limited data on dietary intake and on the double burden of malnutrition. Latin America has been a leader in the design and implementation of innovative and effective actions to reduce excess energy intake and curb the consumption of unhealthy Actions to address deficiency have been implemented in many countries in the region over the years, but current evidence suggests that micronutrient deficiencies have fallen off the public health agenda in Latin America. Effective programming can be developed / appropriately adapted only with knowledge of the current burden. Such data can also help guide and predict future areas of risk and priorities to missing upcoming nutrition issues in the population. Renewed commitment to quantify and monitor micronutrient deficiencies in the region is essential. Abundant evidence and guidance exist to inform effective program selection, design and implementation to address this public health problem. [ABSTRACT FROM AUTHOR]

Objective: Standard approaches have found that rapid growth during the first 2 years of life is a risk factor for overweight in later childhood. Our objective was to test whether growth velocity, independent of concurrent size, was associated with overweight using a nonlinear random-effects model that allows for enhanced specifications and estimations.Methods: Longitudinal data from a birth cohort in Mexico (n=586) were used to estimate growth trajectories over 0–24 months for body mass index (BMI), length and weight using the SuperImposition by Translation and Rotation (SITAR) models. The SITAR models use a nonlinear random-effects model to estimate an average growth curve for BMI, length and weight and each participant’s deviation from this curve on three dimensions—size, velocity and timing of peak velocity. We used logistic regression to estimate the association between overweight status at 7–9 years and size, velocity and timing of BMI, length and weight trajectories during 0–24 months. We tested whether any association between velocity and overweight varied by relative size during 0–24 months or birth weight.Results: SITAR models explained the majority of the variance in BMI (73%), height (86%) and weight (85%) between 0–24 months. When analyzed individually, relative BMI/length/weight (size) and BMI/length/weight velocity during 0–24 months were each associated with increased odds of overweight in late childhood. Associations for timing of peak velocity varied by anthropometric measure. However, in the mutually adjusted models, only relative BMI/length/weight (size) remained statistically significant. We found no evidence that any association between velocity and overweight varied by size during 0–24 months or birth weight.Conclusions: After mutual adjustment, size during 0–24 months of life (as opposed to birth size), but not velocity or timing of peak velocity, was most consistently associated with overweight in later childhood.

The article offers perspective on the fortification of staple foods by the addition of vitamins/or minerals at processing. It considers food fortification as a cost-effective public health intervention and emphasizes the need to strengthen monitoring of compliance and enforcement of regulations, as well as the importance of identifying dietary nutrient gaps. Initiatives for the generation and use of evidence for program decision-making in nutrition and food fortification are discussed.

We examined the relative importance of different variables for predicting iron status at 6 mo of age in a sample of term infants (n = 476) randomized to receive early or delayed umbilical cord clamping and followed through 6 mo of age in Mexico City. At 0, 2, 4 and 6 mo of age we collected data on infant growth, diet and morbidity; at 6 mo, we collected an infant venous blood sample. Outcome variables were infant hemoglobin (Hgb), hematocrit (Hct), mean cell volume (MCV), and plasma ferritin and transferrin receptor (TfR). At 6 mo of age, 17% of males and 10% of females were anemic, but iron deficiency (6-7%) and iron deficiency anemia (1-3%) were uncommon. Using multiple linear regression analysis, Hgb and Hct were associated positively with maternal height and prenatal iron supplementation and negatively with breastfeeding at 6 mo of age. Iron status was associated positively with delayed cord clamping (MCV, ferritin, TfR), maternal or placental iron status (MCV, ferritin), use of iron-fortified infant formula (ferritin, TfR) and birth weight (ferritin), and negatively with male sex (MCV, ferritin, TfR), weight gain since birth (MCV, ferritin, TfR), recent illness (TfR) and breastfeeding at 6 mo (MCV). Factors that operate before and during pregnancy and at the time of delivery are important determinants of infant hematological and iron status at 6 mo of age. [ABSTRACT FROM AUTHOR]

Stunting and wasting provide indicators of different nutritional deficiency problems, the causes of which are well established. Underweight based on weight-for-age cannot distinguish between these two and is therefore not useful to target programs and has limited value for tracking progress. Stunting reduces later school attainment and income as adults and increases the risk of obesity and noncommunicable diseases in later life. Globally, the estimated number of stunted children is decreasing, but is not on track to meet the goal of 100 million by 2025 (165 million), and there has been little change in the number of children suffering from wasting since 2004. Stunting and wasting provide excellent indicators of inequity. For example, from 1990 to 2010, the number of stunted children in Asia declined from 188.7 to 98.4 million, while in sub-Saharan Africa there was essentially no change in prevalence, and the number of stunted children increased from 45.7 to 55.8 million. Recent global development movements are recognizing the need for robust measures of trends in nutritional status of children, particularly during the critical first years of life. Such measures are needed to track progress and improve accountability, and should be aspirational to mobilize sufficient investment in nutrition., (© 2014 Nestec Ltd., Vevey/S. Karger AG, Basel.)

Objectives: To describe the fetal growth pattern of a population from rural Guatemala and determine when during gestation growth faltering becomes evident., Methods: Ultrasound examinations were conducted for 319 women. Femur length (FL), biparietal diameter (BPD), abdominal (AC) and head circumference (HC) were compared with reference values., Results: FL and AC were similar to reference values throughout gestation. BPD and HC were below the 50th percentile by 30 weeks' gestation and below the 10th percentile later in gestation. We expected all four dimensions to show marked growth restriction during gestation. Measurement differences may explain the results but would call into question the value of cross-study comparisons. Infants born small for gestational age were small in all measures as early as 15 weeks., Conclusions: Fetal growth faltering begins in early gestation among infants who were born small. The lack of deviation from reference data for FL and AC requires further clarification.