week 5 (async)- micronutrient malnutrition

Question 1

symptoms of iron deficiency

Answer 1

fatigue, headache, fast heartbeat, frequent infections, weakness, chest pain, brittle nails, pale skin, cold hands and feet, SOB, lightheadedness

Question 2

prevalence of iron deficiency

Answer 2

• affects 2 billion people worldwide
• severe iron deficiency results in death of 50,000 women per year in pregnancy and childbirth
• iron deficiency lowers productivity of workforces (2% loss in GDP)

Question 3

assessing iron deficiency

Answer 3

a) biochemical: blood test
- hemoglobin
- serum ferritin (storage form of iron)
- low levels of both hemoglobin and ferritin indicate iron-deficiency anemia
b) clinical: pallor
- pale conjunctiva or skin can indicate iron-deficiency anemia

Question 4

consequences of IDA (children)

Answer 4

• premature birth, LBW, increased risk of infections, death, impaired physical growth
• impaired cognitive development, negative impact on learning

Question 5

consequences of IDA (adults)

Answer 5

• reduced productivity (2% decrease in GDP)
• increased likelihood of death during childbirth (contributes to 20% of maternal deaths)

Question 6

causes of IDA

Answer 6

• low dietary intake
• poor absorption (low bioavailability, diarrhea)
• increased needs (growth, pregnancy, lactation
• infections (malaria, hookworm, Tb)

Question 7

sources of iron

Answer 7

liver, beef, pork, dried beans/fruits, fortified foods, spinach

Question 8

iron requirements

Answer 8

males = 8mg, females = 18 mg
vegetarian intake should be 1.8 x higher;
males = 14 mg, females = 32 mg

Question 9

on average, how much iron do people consume?

Answer 9

1000kcal of a mixed diet provides 6mg of iron

take men 1300kcal and women 3000kcal to reach their goal

Question 10

how do cast iron pots and iron fish alleviate IDA?

Answer 10

both cast iron cookware and iron fish release iron into the food so that it can be absorbed

Question 11

how to treat IDA?

Answer 11

a) change diet
- dietary diversification, increase enhancers and decrease inhibitors
b) consume more heme iron
- animal tissue is 40% heme and 60% nonheme
c) consume fortified foods
- industrial (wheat flour) or household (micronutrient powder)
d) control hookworm by wearing shoes
- lesions lead to GI bleeds (blood loss)

Question 12

heme vs nonheme iron

Answer 12

a) heme iron
- part of hemoglobin and myoglobin
- only present in blood and muscle
- higher bioavailability than nonheme iron
b) nonheme iron
- found in both plants and animals
- lower bioavailability

Question 13

iron enhancers

Answer 13

vitamin C, MFP factor

Question 14

iron inhibitors

Answer 14

phytates, oxalates, polyphenols, fibre, calcium, zinc, antacids, EDTA

Question 15

benefits of industrial iron fortification

Answer 15

very low cost (2$ per person per lifetime) and high economic benefits form increased productivity (15,000$ per person per lifetime)

Question 16

benefits of household iron fortification

Answer 16

easy, highly accepted by kids, can be added to any soft foods, encapsulated in lipid to prevent tast from transferring

Question 17

zinc deficiency

Answer 17

• contributes to growth failure and weakened immunity in kids
• contributes to 800,000 child deaths per year (from diarrhea, malaria, pneumonia)

Question 18

treating zinc deficiency related illnesses

Answer 18

• zinc supplements can help treat diarrhea and reduce mortlity by 50%
• 10-14 day zinc supplementation + oral rehydration salts for acute diarrhea episode

Question 18

kit yamoyo

Answer 18

• piggybacked on coca cola supply chain to get zinc supplements into rural areas
• they found that after one year, 45% of children with diarrhea were treated with their ORS/zinc
• 93% of kits were used properly and only 4% of kits were transported in coke crates
• success resulted from creating an effective value chain

Question 19

iodine deficiency

Answer 19

• major preventable cause of intellectual disability worldwide
• iodine deficiency in pregnancy leads to approximately 20 million infants per year born with cog/growth impairements
• public health response was fortifying salt

Question 19

cretinism

Answer 19

severely stunted physical and mental grwoth usually due to maternal hypothyroidism

Question 20

goiter

Answer 20

swelling of thyroid gland (90% caused by iodine deficiency)

Question 20

sources of iodine

Answer 20

seafood, cereals grown in iodine-rich soils, milk, fortified foods

Question 21

iodine deficiency in UK pregnant women

Answer 21

• 2 of 3 are iodine deficient
• iodine requirements are higher during pregnancy and the UK doesn’t regulate iodization of salt (availability is low)
• they have to rely on other dietary sources which are quite low in iodine

Question 22

iodine requirements

Answer 22

adults: 150mcg pregnancy: 220mcg 1 tsp of iodized salt: 380mcg

Question 23

supplementation

Answer 23

use of concentrated micronutrients in oil,, powder or liquid form

Question 24

fortification

Answer 24

addition of micronutrients to common food products used by the general public such as cereals, wheat flour and rice

Question 25

biofortification

Answer 25

when agronomic and plant breeding approaches in agriculture are used to increase the concentration of particular micronutrients in staple food crops

Question 26

hidden hunger index

Answer 26

calculated as the average of three nutritional indicators in preschool children; prevalence of stunting, anemia and vitamin A deficiency