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Copyright of Recent Contributions to Physics is the property of Al-Farabi Kazakh National University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To quantify and compare concurrent within-person trends in lifestyle risks, nutrition status, and drivers of food choice among urban migrants in Central Asia., Design: We collected panel data on household structure, drivers of food choice, nutrition knowledge, and diverse measures of nutrition status and lifestyle risk from urban migrants at 0, 3, 6, and 9 months using harmonized methodology in two cities. Trends were analyzed using mixed-effects models and qualitatively compared within and between cities., Setting: Ulaanbaatar, Mongolia and Almaty, Kazakhstan., Participants: 200 adults (22-55 years) who migrated to these cities within the past 2 years., Results: Adjusting for age and sex, each month since migration was positively associated with fasting triglycerides in Almaty (0.55 mg/dL; 95%CI: 0.13-0.94) and BMI (0.04 kg/m 2 ; 95%CI: 0.01-0.07), body-fat (0.14%; 95%CI: 0.01-0.26), and fasting glucose (0.04 mmol/L; 95%CI: 0.02-0.05) and lipids in Ulaanbaatar ( p <0.05). In Almaty, nutrition knowledge (measured using an objective 20-point scale) declined despite improvements in diet quality (measured by Prime Diet Quality Score). Influence of food availability, price, and taste on food choice increased in Almaty ( p <0.05). Upon multivariable-adjustment, nutrition knowledge was positively associated with diet quality in Almaty and adherence to "Acculturated" diet patterns in both cities ( p <0.05). Different trends in smoking, sleep quality, and generalized anxiety were observed between cities., Conclusions: Findings indicate heterogenous shifts in nutrition, lifestyles, and drivers of food choice among urban migrants in Central Asia and provide an evidence base for focused research and advocacy to promote healthy diets and enable nutrition-sensitive food environments.

Purpose: There is strong scientific evidence for reducing sodium and increasing potassium intake to the recommended levels to lower blood pressure and cardiovascular risk, but consumption levels in Kazakhstan are unknown. This study sought to estimate mean sodium and potassium intake using 24-h urine samples and describe dietary knowledge and behavior among adults in Kazakhstan., Methods: In two cross-sectional surveys, the same multi-stage cluster sampling method was used to randomly select participants aged 25-64 years from Almaty City in 2015 and Kyzylorda in 2016. Complete 24-h urine samples were available for 478 participants; 294 in Almaty City and 184 in Kyzylorda (response rates 86% and 54%, respectively) and were weighted for the age and sex distribution of the two regions., Results: Weighted mean 24-h urinary sodium excretion was 6782 mg/day (17.2 g salt) (95% CI 6507-7058) in both regions combined, and not significantly different between the regions (P = 0.660). 99% of adults in the two regions combined consumed above the World Health Organization's (WHO) recommended sodium maximum of 2000 mg/day; however, only 15% of adults perceived that they consumed excess sodium. Weighted mean 24-h urinary potassium excretion was 2271 mg/day (95% CI 2151-2391) for the regions combined., Conclusion: Mean sodium consumption in Kazakhstan was more than triple the WHO's recommended maximum, and mean potassium consumption was below the recommended minimum. National efforts to lower sodium intake and increase potassium intake are needed and would likely prevent ample premature deaths and disease burden.

Objective: This study aimed to assess the knowledge, attitudes, and practices (KAPs) regarding iodine deficiency among the population of Kyrgyzstan, with a focus on pregnant women, and to correlate these factors with the urinary iodine concentration (UIC). Methods: A cross-sectional study was conducted using structured questionnaires and urine sample analysis to evaluate iodine status. A multistage stratified sampling method ensured a representative sample from both urban and rural areas. Descriptive statistics were used to summarize demographic characteristics and KAP variables, whereas chi-square tests and multivariate logistic regression analysis were used to identify predictors of KAP outcomes. Results: The study included 690 participants, with balanced representation from both urban and rural areas. The mean knowledge score was moderate, with significant gaps in the understanding of iodine deficiency. The participants generally had positive attitudes toward iodine intake but exhibited suboptimal practices, especially in rural areas. Pregnant women demonstrated greater knowledge, but fewer practical behaviors related to iodine intake. Compared with rural participants, urban participants had higher UIC levels, indicating better iodine nutrition. Multivariate regression analysis revealed that residence, knowledge, attitudes, and practices significantly influenced UIC levels. Conclusion: Despite existing iodization programs, significant gaps remain in the knowledge and practices related to iodine intake, particularly in rural areas. This study highlights the need for targeted public health interventions to improve iodine nutrition and reduce the burden of iodine deficiency disorders in Kyrgyzstan. Enhancing public health education, improving the accessibility and affordability of iodized salt, and regularly monitoring the iodine status are essential strategies for addressing these issues. [ABSTRACT FROM AUTHOR]

Background: A project for universal salt iodation with potassium iodate and wheat flour fortification with a vitamin-mineral premix was implemented in Azerbaijan, Kazakhstan, Kyrgyzstan, Mongolia, Tajikistan, and Uzbekistan between 2002 and 2007., Objective: To determine the potential effectiveness of the food fortification programs in improving the micronutrient status of selected families in a sentinel population in each country., Methods: An area was selected in each country in a sentinel population expected to have early access to iodated salt and fortified wheat flour. Within this area, an average of 40 families with a woman of reproductive age and two children between 2 and 15 years old were sampled at baseline. All the rounds of the study were carried out in women and children in the same households. Hemoglobin, serum ferritin, folic acid, and urinary iodine excretion were analyzed at baseline, one year, and three years later., Results: In the third round in 2007 significant increases were observed in the average levels of blood hemoglobin, serum ferritin and folic acid, and urinary iodine. Corresponding decreases in the prevalence of anemia and increases in serum ferritin levels, folic acid, and iodine were found., Conclusions: Salt and wheat flour fortification resulted in a significant improvement in the micronutrient status of children and women living in sentinel households in the countries participating in the Asian Development Bank project. Sentinel studies were a cost-effective way of determining potential national effectiveness.

Background: Overconsumption of sodium has been identified as a key driving factor for diet-related cardiovascular diseases (CVDs). China, being a country bearing a hefty burden of CVD, has a large population with diverse cultural traditions and ethnic beliefs, which complicates the patterns of dietary sodium intake, necessitating a systematic investigation into the profile of the high sodium intake (HSI)-related burden of CVD within its subregions. This study aims to estimate the evolving patterns of HSI-induced CVD burden across China from 1990 to 2019. Methods: The methodology used in the Global Burden of Disease Study was followed to assess deaths and disability-adjusted life years (DALYs) by age, sex, region, and socio-demographic index (SDI). The estimated annual percentage change (EAPC) was calculated to quantify the secular changes in the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR). Results: In 2019, 0.79 million deaths and 1.93 million DALYs of CVD were attributed to HSI, an increase of 53.91% and 39.39% since 1990, respectively. Nevertheless, a downward trend in ASMR (EAPC: −1.45, 95% CI: −1.55, −1.35) and ASDR (EAPC: −1.61, 95% CI: −1.68, −1.53) was detected over time. ASMR and ASDR were higher for males, individuals aged ≥60 years, and regions with low-middle SDI. A markedly negative association between the EAPC in both ASMR and ASDR and the SDI was found in 2019 (ρ = −0.659, p < 0.001 and ρ = −0.558, p < 0.001, respectively). Conclusions: The HSI-induced CVD burden is gender-, age-, and socioeconomic-dependent. Integrated and targeted strategies for CVD prevention are anticipated in the future throughout China. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The World Health Organization (WHO) recommends that adults consume less than 5 grams of salt per day to reduce the risk of cardiovascular disease. This study aims to examine the average population daily salt intake in the 53 Member States of the WHO European Region.Design: A systematic review was conducted to examine the most up-to-date salt intake data for adults published between 2000 and 2022. Data were obtained from peer-reviewed and grey literature, WHO surveys and studies, as well as from national and global experts.Setting: The 53 Member States of the WHO European Region.Participants: People aged 12 years or more.Results: We identified 50 studies published between 2010-2021. Most countries in the WHO European Region (n = 52, 98%) reported salt intake above WHO recommended maximum levels. In almost all countries (n = 52, 98%), men consume more salt than women, ranging between 5.39 - 18.51g for men and 4.27 - 16.14g for women. Generally, Western and Northern European countries have the lowest average salt intake, whilst Eastern European and Central Asian countries have the highest average. 42% of the fifty-three countries (n = 22) measured salt intake using 24h urinary collections, considered the gold standard method.Conclusions: This study found that salt intakes in the WHO European Region are significantly above WHO recommended levels. Most Member States of the Region have conducted some form of population salt intake. However, methodologies to estimate salt intake are highly disparate and underestimations are very likely. [ABSTRACT FROM AUTHOR]

Background. Due to the global rise in diabetes patients, nurses of all specialties and positions are increasingly caring for these individuals on a daily basis. The purpose of this study was to examine the latest recommendations and individual studies on diabetes management and to determine the place of nurses in a multidisciplinary team. Materials and methods. The article used descriptive methods and methods of comparative analysis to determine the characteristics of nursing practice in the management of patients with diabetes. Results. From the information studied, it became clear that nurses should be prepared to receive quality education associated with ongoing support and care in the community, primary health care institutions or in hospitals for such patients. Education in self-management and psychosocial problem solving are key elements of diabetes care and nursing. The Diabetes Self-Management Education and Support program is a crucial tool for patient-nurse communication, involving ongoing psychological support through educational techniques to address questions and concerns from individuals with diabetes and their families. Conclusions. Trained nurses can also perform screening for mental disorders and diabetes complications in order to timely diagnose or prevent their development. Regardless of new technologies or treatments, nurses must never lose their role as advocates for patients’ rights. [ABSTRACT FROM AUTHOR]

The World Health Organization has set clear global targets in reducing non-communicable disease mortality by 2030 in its sustainable development goals. This study models the number of deaths that could be averted if Eurasian Economic Union (EEU) member states met the target of reducing their population's current mean salt intake by 30% to achieve mortality reduction targets. Using the WHO Preventable Risk Integrated ModEl (PRIME), we modelled the mortality impact of reducing salt consumption by 30%, as well as according to WHO recommended levels (5 g/person/day), for the five member states of the EEU. PRIME models the number of averted deaths from reducing salt intake by applying established risk ratios to a given population. The baseline demographic and mortality data that are required to generate these estimates were obtained from the relevant government statistical bodies, and salt intake data were referenced from surveillance studies. Uncertainty intervals were generated using Monte Carlo simulation. If salt consumption was reduced by 30%, we estimate that there would have been 94,150 (95%UI: 47,329 to 137,131) fewer deaths due to cardiovascular disease in the EEU in the baseline year, with males and the elderly being more affected. If the WHO-recommended maximum salt intake of 5 g/day was achieved, a total of 193,155 (95%UI: 98,548 to 272,536) deaths would have been prevented. These findings underline the importance of incorporating effective policy changes to meet targets in reducing NCD mortality by one-third by 2030. [ABSTRACT FROM AUTHOR]

Higher salt (sodium) intake has been associated with higher blood pressure (BP). The degree of association may be influenced by factors such as age, origin, and dietary components. This study aimed to evaluate the 24 h urinary sodium (Na) and potassium (K) excretion in normotensive and hypertensive Dominican adults and estimate their salt intake. 163 volunteers (18–80 years old) participated in a cross-sectional study. The 24 h Na and K urinary excretion were measured using an ion-selective electrode technique. Na and K urinary excretion (99.4 ± 46.5 and 35.0 ± 17.5 mmol/24 h) did not correlate with BP, except in the normotensive group, in which K correlated with SBP (0.249, p = 0.019). Na and K excretion were similar in normotensive and hypertensive subjects. When considering two age groups (18–45, 46–80 years), the Na-to-K molar ratio (3.1 ± 1.3) was higher in younger subjects (p = 0.040). Na-to-K ratio was associated with DBP in the total group (r = 0.153, p = 0.052), in the hypertensive group (r = 0.395, p < 0.001), and in the older group with SBP (0.350, p = 0.002) and DBP (0.373, p < 0.001). In the older group, Na-to-K ratio and DBP correlated after controlling for subjects with hypertension controlled by treatment (r = 0.236, p = 0.041). The Na-to-K ratio correlated, when salt intake was over 5 g/day (52.2%), with SBP (rho = 0.219, p = 0.044) and DBP (rho = 0.259, p = 0.017). Determinants of BP in the total sample were age (SBP, beta: 0.6 ± 0.1, p < 0.001; DBP, beta: 0.2 ± 0.1, p < 0.002), sex (SBP, beta: 11.2 ± 3.5, p = 0.001), body mass index (BMI) (SBP, beta: 1.0 ± 0.3, p < 0.001; DBP, beta: 0.4 ± 0.2, p = 0.01), and Na-to-K ratio (SBP, beta: 3.0 ± 1.1, p = 0.008; DBP, beta: −12.3 ± 4.0, p = 0.002). Sex and BMI were determinants in the younger group. Na-to-K molar ratio was determinant in the older group (SBP, beta: 6.7 ± 2.4, p = 0.005; DBP, beta: 3.8 ± 1.1, p < 0.001). The mean Na and salt intakes (2.3 and 5.8 g/day) were slightly higher and the K intake lower (1.4 g/day) than WHO recommendations. [ABSTRACT FROM AUTHOR]

The accumulation of sediments in reservoir is always a problem. Over time, these accumulations occupy the volume meant for water management, dramatically reducing the reservoir's effectiveness. The environment of the river basin below the reservoir undergoes significant changes. In this regard, assessing changes in volumetric W-H characteristics, particularly in reservoirs built on high turbidity rivers, is critical. The Mataghis Reservoir on Tartar River was chosen as the object of study. The quantity of accumulated sediments was established by original measurements and was calculated in three hydrologic ways at distinct stages of operation. The actual graphs showing the reservoir's W-H volumetric characteristics were made two decades after commissioning and are still in use. According to the findings, over 70 per cent of the reservoir volume has been filled with sediments over the course of the reservoir's thirty-year operation. A theoretical model of the sediment buildup process in basins has been created. Separate parameters have been created for the deposition of bottom sediments entering the reservoir and suspended particles in the flow. Based on them, the patterns of distribution of accumulated sediments according to the length and height of the reservoir were drawn out. The vertical pulsation velocity and the results of studies for determining the minimum rate of soil particle flow were used. To solve sedimentation problems in operating and newly constructed reservoirs, a methodology for evaluating changes in the amount of collected water and changes in the volume of water control, as well as a theoretical method for projecting their future behavior, can be applied. [ABSTRACT FROM AUTHOR]

Hypertension is a leading risk factor for cardiovascular events and death. A reduction in salt intake is among the most cost-effective strategies to reduce blood pressure and the risk of cardiovascular diseases. Increasing potassium lowers blood pressure and is associated with lower cardiovascular risk. Adequate iodine intake is important to prevent iodine deficiency disorders. Salt iodization is a key strategy to prevent such deficiency. In Lithuania, no surveys have been performed to directly assess sodium, potassium and iodine consumption. The aim of the present study was to measure sodium, potassium and iodine intake in a randomly selected adult Lithuanian adult population using 24 h urine collections, and to assess knowledge, attitudes and behavior towards salt consumption. Salt and potassium intakes were estimated in 888 randomly selected participants by 24 h urine sodium and potassium excretion and 679 individuals provided suitable 24 h urine samples for the analysis of iodine excretion. Average salt intake was 10.0 (SD 5.3) g/24 h and average potassium intake was 3.3 (SD 1.3) g/24 h. Only 12.5% of participants consumed less than 5 g/24 h of salt. The median value of urinary iodine concentration (UIC) was 95.5 μg/L. Our study showed that average salt intake is twice as high as the maximum level recommended by the World Health Organization while potassium and iodine intakes in Lithuania are below the recommended levels. [ABSTRACT FROM AUTHOR]

Aim. This study aims to examine which factors influence the distance traveled by patients for inpatient care in Kenya. Methods. We used data from the fourth round of the Kenya Household Health Expenditure and Utilization survey. Our dependent variable was the self-reported distance traveled by patients to access inpatient care at public health facilities. As the clustered data were correlated, we used the generalized estimating equations approach with an exchangeable correlation under a Tweedie distribution. To select the best-fit covariates for predicting distance, we adopted a variable selection technique using the Q I C u and R 2 criteria, wherein the lowest (highest) value for the former (latter) is preferred. Results. Using data for 451 participants from 47 counties, we found that three-fifths were admitted between 1 and 5 days, two-thirds resided in rural areas, and 90% were satisfied with the facilities' service. Wealth quintiles were evenly distributed across respondents. Most admissions (81%) comprised < 15, > 65, and 25–54 years. Many households were of medium size (4–6 members) and had low education level (48%), and nine-tenths had no access to insurance. While two-thirds reported employment-based income, the same number reported not having cash to pay for inpatient services; 6 out of 10 paid over 3000 KES. Thus, differences in employment, ability to pay, and household size influence the distance traveled to access government healthcare facilities in Kenya. Interpretation. Low-income individuals more likely have large households and live in rural areas and, thus, are forced to travel farther to access inpatient care. Unlike the unemployed, the employed may have better socioeconomic status and possibly live near inpatient healthcare facilities, thereby explaining their short distances to access these services. Policymakers must support equal access to inpatient services, prioritize rural areas, open job opportunities, and encourage smaller families. [ABSTRACT FROM AUTHOR]

Objective: To understand the factors influencing the implementation of salt reduction interventions in low- and middle-income countries (LMIC).Design: Retrospective policy analysis based on desk reviews of existing reports and semi-structured stakeholder interviews in four countries, using Walt and Gilson's 'Health Policy Triangle' to assess the role of context, content, process and actors on the implementation of salt policy.Setting: Argentina, Mongolia, South Africa and Vietnam.Participants: Representatives from government, non-government, health, research and food industry organisations with the potential to influence salt reduction programmes.Results: Global targets and regional consultations were viewed as important drivers of salt reduction interventions in Mongolia and Vietnam in contrast to local research and advocacy, and support from international experts, in Argentina and South Africa. All countries had population-level targets and written strategies with multiple interventions to reduce salt consumption. Engaging industry to reduce salt in foods was a priority in all countries: Mongolia and Vietnam were establishing voluntary programs, while Argentina and South Africa opted for legislation on salt levels in foods. Ministries of Health, the WHO and researchers were identified as critical players in all countries. Lack of funding and technical capacity/support, absence of reliable local data and changes in leadership were identified as barriers to effective implementation. No country had a comprehensive approach to surveillance or regulation for labelling, and mixed views were expressed about the potential benefits of low sodium salts.Conclusions: Effective scale-up of salt reduction programs in LMIC requires: (1) reliable local data about the main sources of salt; (2) collaborative multi-sectoral implementation; (3) stronger government leadership and regulatory processes and (4) adequate resources for implementation and monitoring. [ABSTRACT FROM AUTHOR]

Objective: Assess the effectiveness of iron-fortified flour on iron status.Design: Systematic review and meta-analysis.Setting: Argentina, Australia, Azerbaijan, Bangladesh, Brazil, Cameroon, Chile, China, Costa Rica, Côte d'Ivoire, Denmark, India, Iran, Jordan, Kazakhstan, Kenya, Kuwait, Mongolia, Morocco, Norway, South Africa, Sri Lanka, Tajikistan, Thailand, UK, USA, Uzbekistan, Venezuela, Vietnam, and Zambia.Participants: Fifty-two articles (ninety-four trials) were examined. The main target groups were women, children, and infants/toddlers. The effects of different types of iron-fortified flour (wheat, maize, rice, soy, and beans) on iron status were examined.Results: A random effects analysis of before-after studies showed that iron-fortified flour led to significant increases of mean haemoglobin level (3·360 g/l; 95 % CI: 0·980, 5·730) and mean serum ferritin level (4·518 µg/l; 95 % CI: 2·367, 6·669); significant decreases of anaemia (-6·7 %; 95 % CI: -9·8 %, -3·6 %) and iron deficiency (ID) (-10·4 %; 95 % CI: -14·3 %, -6·5 %); but had no significant effect on iron deficiency anaemia (IDA). A random effects analysis of controlled trials indicated that iron-fortified flour led to significant increases of mean haemoglobin level (2·630 g/l; 95 % CI: 1·310, 3·950) and mean ferritin level (8·544 µg/l; 95 % CI: 6·767, 10·320); and significant decreases of anaemia (-8·1 %; 95 % CI: -11·7 %, -4·4 %), ID (-12·0 %; 95 % CI: -18·9 %, -5·1 %), and IDA (-20·9 %; 95 % CI: -38·4 %, -3·4 %).Conclusions: Flour fortification with iron is an effective public health strategy that improves iron status of populations worldwide. [ABSTRACT FROM AUTHOR]

Mandatory fortification of edible oil (soybean and palm) with vitamin A was decreed in Bangladesh in 2013. Yet, there is a dearth of data on the availability and consumption of vitamin A fortifiable oil at household level across population sub-groups. To fill this gap, our study used a nationally representative survey in Bangladesh to assess the purchase of fortifiable edible oil among households and project potential vitamin A intake across population sub-groups. Data is presented by strata, age range and poverty–the factors that potentially influence oil coverage. Across 1,512 households, purchase of commercially produced fortifiable edible oil was high (87.5%). Urban households were more likely to purchase fortifiable oil (94.0%) than households in rural low performing (79.7%) and rural other strata (88.1%) (p value: 0.01). Households in poverty were less likely to purchase fortifiable oil (82.1%) than households not in poverty (91.4%) (p <0.001). Projected estimates suggested that vitamin A fortified edible oil would at least partially meet daily vitamin A estimated average requirement (EAR) for the majority of the population. However, certain population sub-groups may still have vitamin A intake below the EAR and alternative strategies may be applied to address the vitamin A needs of these vulnerable sub-groups. This study concludes that a high percentage of Bangladeshi population across different sub-groups have access to fortifiable edible oil and further provides evidence to support mandatory edible oil fortification with vitamin A in Bangladesh. [ABSTRACT FROM AUTHOR]

Industrial fortification of wheat flour is a potentially effective strategy for addressing micronutrient deficiencies in Mongolia, given its ubiquitous consumption and centralized production. However, Mongolia has not mandated fortification of any foods except for salt with iodine. This study modeled the effectiveness and safety of mandatory industrial fortification of wheat flour alone and in combination with edible oil and milk in reducing the prevalence of multiple micronutrient intake deficiencies among healthy non-pregnant adults in Mongolia. Six days of diet records (3 summer, 3 winter) were collected from 320 urban and rural adults across the country and analyzed for food and nutrient consumption using a purpose-built food composition table, and the Intake Monitoring and Planning Program (IMAPP) was used to project the effects of fortification on summer and winter bioavailable micronutrient intake and intake deficiency under different fortification guidelines within population subgroups defined by urban or rural locality and sex. Projections showed that flour fortification would be effective in reducing intake deficiencies of thiamin and folate, while marginal benefits of fortification with iron and riboflavin would be smaller given these nutrients’ higher baseline consumption, and fortification with zinc, niacin, and vitamin B12 may be unnecessary. Fortification of flour, oil, and milk with vitamins A, D, and E at levels suggested by international guidelines would substantially reduce vitamin A intake deficiency and would increase vitamin D intake considerably, with the greatest benefits elicited by flour fortification and smaller benefits by additionally fortifying oil and milk. These results support mandatory industrial fortification of wheat flour, edible oil, and milk with iron, thiamin, riboflavin, folate, and vitamins A, D, and E in Mongolia. Considerations will be necessary to ensure the fortification of these nutrients is also effective for children, for whom the potential benefit of zinc, niacin, and vitamin B12 fortification should be assessed. [ABSTRACT FROM AUTHOR]

Risk factors in Aral Sea region include toxic metals that competitively interact with essential elements influencing their metabolism, affecting metabolic and cognitive functions. According to epidemiological data, cerebrovascular disease and thyroid function abnormality are the leading disorders. Cognitive and metabolic disorders are considered as risk factors in cerebrovascular diseases. Thus, the objective of current work was to determine the metabolic and cognitive state of people in Aralsk, associated with an imbalance of essential trace elements and find correlation between toxic metals load and psychoemotional status. 275 people between the ages of 21 and 45 years were involved. In evaluating cognitive state, a decrease in short-term memory for numbers and an increase in depression among subjects was found. An inverse correlation between the copper level in blood and short-term memory for numbers, between depression and iodine level in blood, between the zinc level in blood and the "attentional capacity" was also found. The results showed a significant metabolic stress among subjects during adaptation to a high chemical load. Data represent a cross-sectional age-dependent review of metabolic and cognitive processes and microelement metabolism among population, living in the Aral Sea region for a long time. [ABSTRACT FROM AUTHOR]

Many factors put Mongolians at risk of vitamin D deficiency. Despite low levels observed in Mongolian children and pregnant women, there are few data published on the vitamin D status of non-pregnant adults. Between summer 2011 and winter 2013, paired summer and winter blood samples were collected from 320 healthy men and women (20-58 years) living in eight Mongolian provinces. Mean serum 25(OH)D concentrations were 22.5 ng/mL (95% CI: 14.5, 32.5) in summer and 7.7 ng/mL (95% CI: 4.6, 10.8) in winter, with a distribution (<10/10-20/20-30/≥30 ng/mL) of 3.1%/39.3%/39.6%/17.9% in summer and 80.1%/19.5%/0.3%/0.0% in winter. Residents of the capital, Ulaanbaatar, had lower levels in both seasons than any other region, whereas residents of the Gobi desert had the highest. In summer, indoor workers had significantly lower levels than outdoor workers (-2.3 ng/mL; 95%CI; -4.1, -5.7) while levels in males exceeded those in females (4.0 ng/mL; 95% CI: 2.3, 5.7). Effects of region, occupation, and sex were also significant in multivariable regression. In conclusion, Mongolian adults had extremely low serum 25(OH)D, particularly in winter, when 80.1% had concentrations below 10 ng/mL. These results indicate a need for effective vitamin D interventions for the Mongolian adult population, particularly among women and residents of Ulaanbaatar. [ABSTRACT FROM AUTHOR]

Around 65% of pregnant women in South Asia suffer from IDA & in Indian sub-continent alone, the rate of developing IDA during pregnancy is 88%. Moreover anemic pregnant patients are more likely to give birth to low birth weight babies which itself is another factor adding to socio-economic burden on the whole family. The food has not been fortified for Iron, Zinc & Vitamin D & hence the prevention of anemia has not yet been achieved Objectives: To study Awareness of women about food fortification & prevention of IDA Vs cost for treating anemia. Period: August 2015-Dec 2015. Study Design: Observational Study. Settings: At Bhatti International Hospital, Kasur Results: Among the selected anemic women, almost half (55%) had mild anemia, while rest had moderate to severe anemia indicting that the prevalence is very common. The treatment offered was oral &/or IV Iron with blood transfusions. The cost of iv Iron therapy & blood transfusions estimates in thousands with added risks of Transfusion Reactions, allergic reactions& transmission of blood-borne diseases like HCV,HBV,HIV(AIDS)&others. The awareness level was found to be poor among these women .Only 8/60 i.e 13% had some idea about iron deficiency anemia & almost none knew about food fortifications. The insight about their own disease of IDA was also 35% (21/60) indicating that most of the women in community live with IDA without any understanding of a preventable condition. Conclusion: The cost & time spend to treat IDA can be minimizes creating awareness about food fortification & supplementation. [ABSTRACT FROM AUTHOR]

Background: Iron deficiency Anemia (IDA) in children is a recognized public health problem that impacts adversely on child morbidity, mortality and impairs cognitive development. In Pakistan information on the true prevalence and predictors of IDA is limited. This study sought to investigate IDA in children under five years of age using data from a nationally representative stratified cross-sectional survey. Methods: Secondary analysis was performed on the National Nutrition Survey in Pakistan 2011–2012. We used a pre-structured instrument to collect socio demographic and nutritional data on mothers and children. We also collected Anthropometric measurements and blood samples for micronutrient deficiencies. IDA was defined as having both haemoglobin levels of <110 g/L and ferritin levels of < 12 μg/L. Data analysis was performed by applying univariate and multivariate techniques using logistic regression through SPSS. Findings: A total of 7138 children aged between 6–59 months were included in the analysis. The prevalence of IDA was 33.2%. In multivariate regression analysis adjusted odds ratios (AOR) were calculated. Age < 24 months (AOR 1.40, 95% CI 1.18–1.55 p <0.05), stunting (AOR 1.42 CI 1.23–1.63 p<0.05), presence of clinical anemia (AOR 5.69 CI 4.93–6.56 p<0.05), having a mother with IDA (AOR 1.72 CI 1.47–2.01 p<0.05) and household food insecurity (AOR 1.20 CI 1.10–1.40 P<0.05) were associated with IDA. Living in a rural area (AOR 0.77 CI 0.65–0.90 p<0.05) and being a female child (AOR 0.87 CI 0.76–0.98 p<0.05) were associated with reduced odds of IDA. Conclusion: The prevalence of IDA amongst Pakistani children represents a moderate burden that disproportionately affects the youngest, growth retarded children, affected children are more likely to have mothers with IDA and live in areas where food security is lacking. National efforts to alleviate the burden of IDA should involve both short term vertical programs such as iron supplementation and long term horizontal programs including wheat flour fortification. [ABSTRACT FROM AUTHOR]

The effectiveness of flour fortification in reducing anaemia prevalence is equivocal. The goal was to utilise the existing national-level data to assess whether anaemia in non-pregnant women was reduced after countries began fortifying wheat flour, alone or in combination with maize flour, with at least Fe, folic acid, vitamin A or vitamin B12. Nationally representative anaemia data were identified through Demographic and Health Survey reports, the WHO Vitamin and Mineral Nutrition Information System database and other national-level nutrition surveys. Countries with at least two anaemia surveys were considered for inclusion. Within countries, surveys were excluded if altitude was not consistently adjusted for, or if the blood-draw site (e.g. capillary or venous) or Hb quantification method (e.g. HemoCue or Cyanmethaemoglobin) differed. Anaemia prevalence was modelled for countries that had pre- and post-fortification data (n 12) and for countries that never fortified flour (n 20) using logistic regression models that controlled for time effects, human development index (HDI) and endemic malaria. After adjusting for HDI and malaria, each year of fortification was associated with a 2·4 % reduction in the odds of anaemia prevalence (PR 0·976, 95 % CI 0·975, 0·978). Among countries that never fortified, no reduction in the odds of anaemia prevalence over time was observed (PR 0·999, 95 % CI 0·997, 1·002). Among both fortification and non-fortification countries, HDI and malaria were significantly associated with anaemia (P< 0·001). Although this type of evidence precludes a definitive conclusion, results suggest that after controlling for time effects, HDI and endemic malaria, anaemia prevalence has decreased significantly in countries that fortify flour with micronutrients, while remaining unchanged in countries that do not. [ABSTRACT FROM AUTHOR]

Background: Approximately 2.2 billion (2200 million) of the world population are living in the area with Iodine deficiency (ID), most of them in the developing countries. In IRAN about 2 million are exposed to Iodine deficiency. Most of the complications of ID are not curable, especially brain damage. On the other hand, adding iodine to daily salt is a suitable program for decreasing iodine deficiency. This has been the main aim of IDD National committee since 1986. This study is a before after preventive trial, and was conducted to determine the effect of iodized salt in preventing the disorders of Iodine deficiency. Methods: This study was a preventive field trial in 2 stages before and after prevention. Since 1995, Iodized salt has been distributed in Tabas in Yazd province. Sample of 2,150 students aged 6 18 years were chosen by stratified cluster random sampling method from 24 schools, 12 schools from rural and 12 from urban areas. Goiter frequency and educational status were determined using WHO criteria and mean scored, respectively. Results: Prevalence of goiter has decreased from 34 to 25 percent after 10 years (P < 0.001). The prevalence in urban areas has decreased from 35.8 to 23.5 percent and in rural from 35.6 to 28.5 percent (P = 0.02). Prevalence of Goiter has changed from 32.8 to 20 percent and from 39.5 to 31.5 in boys and girls, respectively (P < 0.001). There was a statistically significant relation between educational status and goiter frequency before and after prevention (P = 0.01). There was also a statistically significant relation between educational status in 2 stages, before and after intervention (P < 0.001). Conclusions: Although, there are some confounding variables, such as: educational resources development, improved educational methods, and enhanced family emphasis on extracurricular education, increased frequency of students in higher education after intervention shows the iodine effects on mental function. [ABSTRACT FROM AUTHOR]

Background: Iodine deficiency affects nearly 1.9 billion people worldwide, but it can be prevented by salt iodization. This cross-sectional survey assessed current iodine status, iodized salt coverage and risk factors for goitre among schoolchildren in South Tajikistan. Methods: Ten primary schools in four districts in South Tajikistan were randomly selected. In schoolchildren aged 7 to 11 years, a spot urine sample was collected for measurement of urinary iodine, dried blood spots were collected for measurement of thyroglobulin, and goitre was assessed by palpation. Iodine content of salt samples and local selling points was determined by coloration using rapid test kits and titration method. Results: Of 623 schoolchildren enrolled, complete data was obtained from 589. The overall median urinary iodine concentration (UIC) was 51.2 μg/L indicating mild-to-moderate iodine deficiency. Among all children, 46.6% (95% Confidence Interval (CI) = 42.4%-50.6%) of children were found to be goitrous (grade 1 goitre: 30.6%, 95% CI = 26.9%-34.5%; grade 2 goitre: 16.0%, 95% CI = 13.1%-19.2%). The risk factor for goitre remaining significant in the multivariable logistic regression model was ‘buying salt once a month’ (OR = 2.89, 95% CI = 1.01-8.22) and ‘buying salt once every six months’ (OR = 2.26, 95% CI = 1.01-5.04) compared to ‘buying salt every one or two weeks’. The overall median thyroglobulin concentration was elevated at 13.9 μg/L. Of the salt samples from households and selling points, one third were adequately iodised, one third insufficiently and one third were not iodised. Conclusion: Iodine deficiency remains a serious health issue among children in southern Tajikistan. There is a persisting high prevalence of goitre, elevated thyroglobulin and low UIC despite interventions implemented by Tajikistan and international partners. Quality control of salt iodine content needs to be improved. Continued efforts to raise awareness of the health effects of iodine deficiency are needed to increase consumer demand for iodised salt. [ABSTRACT FROM AUTHOR]

Designing and implementing effective monitoring and evaluation (M&E) is an integral element of wheat flour fortification programs. This review provides practical guidance for designing a M&E system for a flour fortification program. The Centers for Disease Control and Prevention's Framework for Program Evaluation in Public Health has been adapted to identify key issues in the development of an integrated M&E system. A clear understanding of 1) the stakeholders in flour fortification and their needs, 2) the description and context of the fortification program, 3) the country's wheat flour and flour products market, and 4) the resources available for the M&E component are critical and should be considered early in a program's design. [ABSTRACT FROM AUTHOR]

Fortification of wheat flour with iron and folic acid became mandatory in Ivory Coast in 2007. The purpose of this study was to determine the time trend relation between mandatory double fortification of wheat flour with iron and folic acid and markers and prevalence of anemia by comparing the data between pre- and post-fortification periods in Ivory Coast children. Data were derived from the pediatric unit of the University Hospital of Treichville, Abidjan, Ivory Coast. Medical records of 467 children from 5 to 14 years old were analyzed from the years 2004 through 2010. Periods from 1 January 2004 to 31 December 2006 and 1 January 2008 to 31 December 2010 were considered as pre- and post-fortification periods, respectively. Data on hemoglobin, hematocrit, red blood cell count (RBC), mean corpuscular volume (MCV), and anemia between pre- and post-fortification periods were compared. There were no significant differences in hemoglobin, hematocrit, RBC, and prevalence of anemia between pre- and post-fortification periods. However, MCV in post-fortification period was significantly higher compared to pre-fortification period in all subjects (77.6 fL vs. 76.8 fL; p = 0.02) and in young girls (79.1 fL vs. 75.2 fL; p = 0.01). Lack of significant differences in anemia and in markers of anemia between pre- and post-fortification periods need further investigation in children of Ivory Coast. [ABSTRACT FROM AUTHOR]

Background: In Ethiopian, the prevalence of anemia among preschool aged children widely varied across regions. Since anemia adversely affects the cognitive and physical development of the children, it is important to determine its burden for implementing appropriate measurements. Therefore, this study was aimed at determining the anemia prevalence and associated factors among preschool aged children.Method: A community based cross-sectional study was conducted on a total of 432 preschool children in Menz Gera Midir district from January to May, 2017. A multi stage sampling procedure was applied to select the target groups. Hemocue analyzer for Haemoglobin determination; anthropometric measurements for assessment nutritional status, structured questionnaires for socio-demographic and economic variables were used for data collection. The morphological appearance of red blood cell was assessed microscopically to determine type of anemia. Descriptive statistics were employed to summarize the data and binary logistic regression was used for inferential statistics. A p value less than 0.05 was considered as statistically significant.Result: The overall prevalence of anemia was 123 (28.5%); of which 38 (30.9%) and 85 (69.1%) were moderate and mild, respectively. Morphologically about 50.4, 37.4 and 12.2% were microcytic hypochromic, normocytic normochromic and macrocytic anemias, respectively. Child age 6-11 months (COR: 5.67, 95% CI: 2.2, 14.86), child age 12-23 months (COR: 5.8, 95% CI: 2.3, 14.7), wasting (COR: 3.5, 95% CI: 1.2, 9.8), stunting (COR: 3.8, 95% CI: 1.92, 7.77), underweight (COR: 2.12, 95% CI: 1.07, 4.38), MUAC measurement below 13 cm (COR: 5.6, 95% CI: 2.83, 11.15), household headed by female (COR: 3.24, 95% CI: 1.1, 9.63), maternal anemia (COR: 4, 95% CI: 2.2, 7.23) and household food insecurity (COR: 2.12, 95% CI: 1.09, 4.12) were significantly associated with anemia.Conclusion: The prevalence of anemia among the children was found to be high and associated with child age group, child nutritional status, house hold headed by female, maternal anemia and household food insecurity. Further studies on nutritional anemia, community based nutritional education, iron supplementation to children at risk should be promoted. [ABSTRACT FROM AUTHOR]

This study assessed awareness and attitudes regarding industrial food fortification among adults in urban and rural Mongolia, and the city of Harbin, China. Between 2014 and 2017, surveys were collected from healthy men and women aged ≥18 years (182 Harbin residents and 129 urban and rural Mongolians participating in a nationwide nutrition survey in Mongolia). Survey reproducibility was assessed among 69 Mongolian participants to whom it was administered twice (summer and winter). Findings revealed that only 19% of rural and 30% of urban Mongolians, and 48% of Harbin residents were aware that industrial fortification is practiced in their countries. For most food groups evaluated, at least half of Mongolians and less than half of Harbin residents thought fortification was government-mandated (only the addition of iodine with salt is actually mandated in both countries). Fifty-five percent of rural and urban Mongolians favored mandatory fortification of foods, 14% disapproved of it, and 31% were uncertain (compared with 25%, 38%, and 37% respectively in Harbin). Upon learning that the primary purpose of adding vitamin D to milk is to prevent rickets, 75% of Mongolians but only 18% of Harbin residents favored mandatory fortification, while 42% of Harbin residents favored voluntary fortification (compared with <10% of Mongolians). In conclusion, in Mongolia and Harbin, awareness and understanding of food fortification is low, as is receptivity toward mandatory fortification. Health promotion and social marketing should be designed to create an enabling environment for increasing supply and demand of fortified foods, in support of upcoming program implementation in Mongolia and potential future legislation in northeern China. [ABSTRACT FROM AUTHOR]