Micronutrient fortification of food and its impact on woman and child health: A systematic review

Background: Vitamins and minerals are essential for growth and metabolism. The World Health Organization estimates that more than 2 billion people are deficient in key vitamins and minerals. Groups most vulnerable to these micronutrient deficiencies are pregnant and lactating women and young children, given their increased demands. Food fortification is one of the strategies that has been used safely and effectively to prevent vitamin and mineral deficiencies.Methods: A comprehensive search was done to identify all available evidence for the impact of fortification interventions. Studies were included if food was fortified with a single, dual or multiple micronutrients and impact of fortification was analyzed on the health outcomes and relevant biochemical indicators of women and children. We performed a meta-analysis of outcomes using Review Manager Software version 5.1.Results: Our systematic review identified 201 studies that we reviewed for outcomes of relevance. Fortification for children showed significant impacts on increasing serum micronutrient concentrations. Hematologic markers also improved, including hemoglobin concentrations, which showed a significant rise when food was fortified with vitamin A, iron and multiple micronutrients. Fortification with zinc had no significant adverse impact on hemoglobin levels. Multiple micronutrient fortification showed non-significant impacts on height for age, weight for age and weight for height Z-scores, although they showed positive trends. The results for fortification in women showed that calcium and vitamin D fortification had significant impacts in the post-menopausal age group. Iron fortification led to a significant increase in serum ferritin and hemoglobin levels in women of reproductive age and pregnant women. Folate fortification significantly reduced the incidence of congenital abnormalities like neural tube defects without increasing the incidence of twinning. The number of studies pooled for zinc and multiple micronutrients for women were few, though the evidence suggested benefit. There was a dearth of evidence for the impact of fortification strategies on morbidity and mortality outcomes in women and children.Conclusion: Fortification is potentially an effective strategy but evidence from the developing world is scarce. Programs need to assess the direct impact of fortification on morbidity and mortality

Students’ perception of classroom inter-professional learning activity among pharmacy, dietetics and medical students in IMU

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Prevalência de diagnóstico auto-referido de osteoporose, Brasil, 2006 Prevalencia de diagnóstico auto-referido de osteoporosis, Brasil, 2006 Prevalence of self-reported diagnosis of osteoporosis in Brazil, 2006

OBJETIVO: Estimar a prevalência de osteoporose auto-referida (com diagnóstico médico prévio) e de fatores de risco e proteção associados. MÉTODOS: Estudo transversal baseado em dados do sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL). Foram entrevistados 54.369 indivíduos com idade >18 anos residentes em domicílios servidos por pelo menos uma linha telefônica fixa nas capitais brasileiras e Distrito Federal em 2006. Estimativas de osteoporose segundo fatores socioeconômicos, comportamentais e índice de massa corporal foram estratificadas por sexo. Foram calculados riscos de ocorrência de osteoporose para cada variável individualmente, e em modelo multivariado, considerando-se odds ratio como proxy da razão de prevalência. RESULTADOS: A prevalência de osteoporose referida foi de 4,4%, predominantemente entre mulheres (7,0%), com idade >45 anos, estado civil não solteiro e ex-fumante. Entre homens, ter mais de 65 anos, ser casado ou viúvo e sedentário associaram-se positivamente ao desfecho. CONCLUSÕES: Dentre os fatores associados à osteoporose, destacam-se aspectos modificáveis relacionados com a prevenção da doença, como a atividade física e tabagismo.<br>OBJETIVO: Estimar la prevalencia de osteoporosis auto-referida (con diagnóstico médico previo) y de factores de riesgo y protección asociados. MÉTODOS: Estudio transversal basado en datos del Sistema de Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas por Pesquisa Telefónica (VIGITEL). Fueron entrevistados 54.369 individuos con edad >18 años residentes en domicilios servidos por al menos una línea telefónica fija en las capitales brasileras y Distrito Federal en 2006. Estimaciones de osteoporosis según factores socioeconómicos, de comportamiento e índice de masa corporal fueron estratificados por sexo. Fueron calculados riesgos de ocurrencia de osteoporosis para cada variable individualmente, y en modelo multivariado, considerándose odds ratio como proxy de la razón de prevalencia. RESULTADOS: La prevalencia de osteoporosis referida fue de 4,4%, predominantemente entre mujeres (7,0%), con edad >45 años, estado civil no soltero y ex-fumador. Entre hombres, tener más de 65 años, ser casado o viudo y sedentario se asociaron positivamente a osteoporosis. CONCLUSIONES: Entre los factores asociados a la osteoporosis, se destacan aspectos modificables relacionados con la prevención de la enfermedad, como la actividad física y tabaquismo.<br>OBJECTIVE: To estimate the prevalence of self-reported osteoporosis (with previous medical diagnosis) and the associated risk and protection factors. METHODS: A cross-sectional study was carried out, based on data from the system Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL - telephone-based surveillance of risk and protective factors for chronic diseases). A total of 54,369 individuals aged >18 years living in homes served by at least one fixed telephone line in Brazilian state capitals and the Federal District in 2006 were interviewed. Estimates of osteoporosis in relation to socioeconomic and behavioral factors and the body mass index were stratified according to sex. The risk of occurrence of osteoporosis was calculated for each variable separately and through a multivariate model, taking the odds ratio to be a proxy for the prevalence ratio. RESULTS: The reported prevalence of osteoporosis was 4.4%, predominantly among women (7.0%) >45 years of age whose marital status was not single and who were former smokers. Among men, age > 65 years, married or widowed status and sedentarism were positively associated with this outcome. CONCLUSIONS: Among the factors associated with osteoporosis, modifiable characteristics relating to disease prevention were highlighted, such as physical activity and smoking habits