Micronutrient fortified condiments and noodles to reduce anemia in children and adults : a literature review and meta-analysis

Micronutrient deficiencies impose a considerable burden of disease on many middle and low income countries. Several strategies have been shown to be effective in improving micronutrient deficiencies. However, the impact of fortified condiments as well as fortified noodles is less well documented. We aimed to investigate existing evidence on the impact of micronutrient fortified condiments and noodles on hemoglobin, anemia, and functional outcomes in children and adults (age: 5 to 50 years). We conducted a literature review in electronic databases. In addition, we screened the homepages of relevant organizations and journals. We included randomized controlled trials (RCT). Of 1046 retrieved studies, 14 RCT provided data for the meta-analysis. Micronutrient fortification of condiments and noodles increased hemoglobin concentrations by 0.74 g/dL (95%-confidence intervals (95%-CI): 0.56 to 0.93; 12 studies) and 0.3 g/dL (95%-CI: 0.12 to 0.48; 1 study), respectively. Micronutrient fortification also led to a reduced risk of having anemia (risk ratio 0.59 (95%-CI 0.44 to 0.80)). Ferritin concentrations increased with fortified condiments. Functional outcomes were rarely assessed and showed mixed results. The use of micronutrient fortified condiments can be a strategy to reduce anemia in children and adults due to micronutrient deficiencies. The effect of fortified noodles seems to be smaller

Expression of βE and γ-globin genes in infants heterozygous for hemoglobin E and double heterozygous for hemoglobin E and α-thalassemia

This study described the expression of βE-globin in newborns heterozygous for HbE. Despite the lower level of HbE, the pattern of βE-globin gene expression was similar to βA-globin because the increase in HbE and HbA reached the peak level at the same time. A delayed decline of HbF was observed

Assessing the healthfulness of pre-packaged beverages and investigating sugar thresholds for revising front-of-pack labels: a case study in Thailand

Thailand's implementation of the “Healthier Choice” logo (THCL) as a front-of-pack nutritional labeling (FOPNL) scheme aims to promote healthier consumer food choices. In response, the beverage industry has increasingly replaced nutritive sweeteners (NS) with non-nutritive sweeteners (NNS) in their products. This study evaluates the energy and sugar content, sweetener usage, and overall healthfulness of pre-packaged beverages in Thai supermarkets, while also assessing their compliance with WHO “free sugar” consumption guidelines and exploring appropriate sugar thresholds for revising the THCL criteria. A cross-sectional audit was conducted in a major Bangkok supermarket between March and April 2022, collecting data on 881 pre-packaged beverages. To ensure a comprehensive evaluation, these beverages were further categorized based on product ingredients, THCL status, and sweetener type. Healthfulness was assessed using three validated nutrient profiling systems (NPS), and sugar threshold scenarios were evaluated using receiver operating characteristic analysis and area under the curve metrics. The median energy and sugar content per 100 ml were 37.9 kcal (21.9–52.2) and 5.00 g (2.0–7.8), respectively. Overall, pre-packaged beverages in Thai supermarkets were predominantly classified as “less healthy,” with 40.1% containing at least one NNS. Products carrying the THCL logo (27.7%) had lower energy and sugar content, indicating a “healthier” profile. However, these beverages also exhibited a higher prevalence of NNS compared to unlabeled products. Regardless of beverage type, consuming a typical bottle containing NS or a combination of NS and NNS in a single sitting often exceeded the WHO's recommended daily limit of 5% of total energy intake from free sugars. Thus, the study also proposes a phased approach to sugar reduction, initially lowering the sugar threshold to 5.0 g/100 ml, followed by a further reduction to 4.0 g/100 ml. In conclusion, the study underscores the widespread use of NNS in Thai pre-packaged beverages and identifies an overall “less healthy” nutritional profile across product categories. Reducing sugar content and implementing incremental sugar benchmarks in the THCL scheme are essential steps toward improving the healthfulness of pre-packaged beverages in Thailand and aligning these products more closely with WHO guidelines on sugar consumption

A comparison of food and nutrient intake between instant noodle consumers and non-instant noodle consumers in Korean adults

Instant noodles are widely consumed in Asian countries. The Korean population consumed the largest quantity of instant noodles in the world in 2008. However, few studies have investigated the relationship between instant noodles and nutritional status in Koreans. The objective of this study was to examine the association between instant noodle consumption and food and nutrient intake in Korean adults. We used dietary data of 6,440 subjects aged 20 years and older who participated in the Korean National Health and Nutrition Examination Survey III. The average age of the instant noodle consumers (INC) was 36.2 and that of the non-instant noodle consumers (non-INC) was 44.9; men consumed more instant noodles than women (P < 0.001). With the exception of cereals and grain products, legumes, seaweeds, eggs, and milk and dairy products, INC consumed significantly fewer potatoes and starches, sugars, seeds and nuts, vegetables, mushrooms, fruits, seasonings, beverages, meats, fishes, and oils and fats compared with those in the non-INC group. The INC group showed significantly higher nutrient intake of energy, fat, sodium, thiamine, and riboflavin; however, the INC group showed a significantly lower intake of protein, calcium, phosphorus, iron, potassium, vitamin A, niacin, and vitamin C compared with those in the non-INC group. This study revealed that consuming instant noodles may lead to excessive intake of energy, fats, and sodium but may also cause increased intake of thiamine and riboflavin. Therefore, nutritional education helping adults to choose a balanced meal while consuming instant noodles should be implemented. Additionally, instant noodle manufacturers should consider nutritional aspects when developing new products

Why do adult women in Vietnam take iron tablets?

BACKGROUND: Conducting iron supplementation programs has been a major strategy to reduce iron deficiency anemia in pregnancy. However, only a few countries have reported improvements in the anemia rate at a national level. The strategies used for control of nutrition problems need regular review to maintain and improve their effectiveness. The objective of this study was to analyze the factors in compliance with taking iron tablets, where daily doses of iron (60 mg) and folic acid (400 μg) were distributed in rural Vietnamese communes. METHODS: A cross sectional survey was conducted in Nghe An province, Vietnam in January, 2003. The study population was adult women aged less than 35 years who delivered babies between August 1(st )2001 and December 1(st )2002 (n = 205), of which 159 took part in the study. Data for the study were collected from a series of workshops with community leaders, focus group discussions with community members and a questionnaire survey. RESULTS: Improvements in the rate of anemia was not given a high priority as one of the commune's needs, but the participants still made efforts to continue taking iron tablets. Two major factors motivated the participants to continue taking iron tablets; their experience of fewer spells of dizziness (50%), and their concern for the health of their newborn baby (54%). When examining the reasons for taking iron tablets for at least 5–9 months, the most important factor was identified as 'a frequent supply of iron tablets' (OR = 11.93, 95% CI: 4.33–32.85). CONCLUSION: The study found that multiple poor environmental risk factors discouraged women from taking iron tablets continuously. The availability (frequent supply) of iron tablets was the most effective way to help adult women to continue taking iron tablets

Evaluation of the health status of preschool children stratified based on the weight-length index (WLI)

This study was conducted to prepare basic materials and offer advice regarding dietary habits to prevent and cure childhood obesity by comparing and analyzing dietary habit, nutritional status, blood factors, and mineral contents of hair. All subjects were stratified by their weight-length index (WLI). According to the standard WLI values, 64.9% of children were within the normal value, 13.5% of children were underweight, and 21.6% of children were overweight and obese (WLI ≥ 110%). Overall, the score assessed dietary habit for all children was 21.32 ± 2.55 point (921 subjects), with 5.1% of children having excellent dietary habits and 3.1% having poor dietary habits. Additionally, 37.9% of underweight children, 37.6% of normal weight children, and 43.2% of overweight and obese children consumed higher amounts of protein than underweight children did (meat, fish, eggs, and soy products) (P < 0.05). Overweight and obese children consumed more fried foods than underweight or normal weight children (P < 0.05). Moreover, 38.0% of the children had hemoglobin levels of 12 g/dl, while 7.6% were anemic (11.1 g/dl). When a hematocrit level of 33% was taken as the standard, 11.0% of children were anemic. The plasma transferrin content was 263.76 ± 54.52 mg/dl in overweight and obese children. The mean values of Fe, Cu, Ca, Cr, Mn, Se, Na, K, Li, V, Co, and Mo were within the reference values, but the Zn concentrations of underweight, normal weight, and overweight and obese children were 67.97 ± 28.51 ppm, 70.09 ± 30.81 ppm, and 73.99 ± 30.36 ppm, respectively. The Zn concentration of overweight and obese children (73.99 ± 30.36 ppm) was lower than that of the standard value (180~220 ppm). Therefore, a nutritional education program and new guidance for dietary pattern should be developed to reduce the number of underweight and overweight and obese children