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Public Health Interventions to Combat Micronutrient Deficiencies

Abstract

Micronutrient deficiency conditions are global in scope, with developing countries suffering most from such “silent epidemics”. There are several different approaches to combating micronutrient malnutrition at the level of populations and vulnerable groups. We review these briefly with attention to successes, advantages and disadvantages. We recommend active governmental leadership and policy review on a continuing basis to address these fundamental public health problems.

References

  1. 1.

    Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL, editors. Global burden of disease and risk factors. Washington (DC): World Bank Publications; 2006.

  2. 2.

    Jamison DT, Mosley WH, Measham AR, Bobadilla JL, editors. Disease control priorities in developing countries. Oxford: Oxford University Press; 1993.

  3. 3.

    TH Tulchinsky. Micronutrient deficiency conditions: global health issues. Public Health Reviews 2010;32:243–255.

  4. 4.

    Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, et al. for the Maternal and Child Undernutrition Study Group. What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008;371:417–40.

  5. 5.

    Contento I, Balch GI, Bronner YL et al. The effectiveness of nutrition education and implications for nutrition education policy, programs and research: a review of research. J Nutr Educ. 1995;27:279–83.

  6. 6.

    Szymlek-Gay EA, Ferguson EL, Heath AL, Gray AR, Gibson RS. Food-based strategies improve iron status in toddlers: a randomized controlled trial 12. Am J Clin Nutr. 2009;90:1541–51.

  7. 7.

    Gibson RS, Anderson VP. A review of interventions based on dietary diversification or modification strategies with the potential to enhance intakes of total and absorbable zinc. Food Nutr Bull. 2009;30 (1Suppl):S108–43.

  8. 8.

    Centers for Disease Control and Prevention. Achievements in public health, 1900–1999: Safer and healthier foods. MMWR Morb Mort Wkly Rep. 1999;48(40):905–913.

  9. 9.

    Food and Agriculture Organization of the United Nations. Hunger. Available from URL: http://www.fao.org/hunger/en (Accessed 28 December, 2009).

  10. 10.

    Alderman H, Linnemayr S. Anemia in low-income countries is unlikely to be addressed by economic development without additional programs. Food Nutr Bull. 2009;30:265–9.

  11. 11.

    Shankar AV, Asrilla Z, Kadha JK, Sebayang S, Apriatni M, Sulastri A, et al. on behalf of the SUMMIT Study Group. Programmatic effects of a large-scale multiple-micronutrient supplementation trial in Indonesia: Using community facilitators as intermediaries for behavior change. Food Nutr Bull. 2009;30: S207–14.

  12. 12.

    Rivera JA, Shamah T, Villalpando S, Monterrubio E. Effectiveness of a largescale iron-fortified milk distribution program on anemia and iron deficiency in low-income young children in Mexico. Am J Clin Nutr. 2010;91:431–8.

  13. 13.

    Oakley GP. Folic acid and vitamin B12 fortification of flour: a global basic food security requirement. Public Health Reviews 2010;32:284–295.

  14. 14.

    Allen L, de Benoist B, Dary O, Hurrell R (editors). Guidelines on food fortification with micronutrients. Geneva: World Health Organization and Food and Agricultural Organization of the United Nations; 2006. Available from URL: http://www.who.int/nutrition/publications/guide_food_fortification_micronutrients.pdf (Accessed 7 April, 2010).

  15. 15.

    Adu-Afarwuah S, Lartey A, Brown KH, Zlotkin S, Briend A, Dewey KG. Randomized comparison of 3 types of micronutrient supplements for home fortification of complementary foods in Ghana: effects on growth and motor development. Am J Clin Nutr. 2007:86:412–20.

  16. 16.

    Vinodkumar M, Rajagopalan S. Efficacy of fortification of school meals with ferrous glycine phosphate and riboflavin against anemia and angular stomatitis in schoolchildren. Food Nutr Bull. 2009;30:260–4.

  17. 17.

    Ten Year Strategy to Reduce Vitamin and Mineral Deficiencies, Maternal, Infant and Young Child Nutrition Working Group: Formulation Subgroup. Formulations for fortified complementary foods and supplements: Review of successful products for improving the nutritional status of infants and young children. Food Nutr Bull. 2009;30:S239–55.

  18. 18.

    Zehner ER. Integrating maternal, infant and young child nutrition: Report on the Ten Year Strategy Infant and young Child Nutrition (IYCN) Working Group October 2008 workshop. Food Nutr Bull. 2009;30:S190–6.

  19. 19.

    Institute of Medicine. WIC Food Packages: Time for a Change. Washington (DC): National Academies Press; 2005. Available from URL: http://www.iom.edu/~/media/Files/Report%20Files/2005/WIC-Food-Packages-Timefor- a-Change/wic8pagerwithtables.ashx (Accessed 6 April, 2010).

  20. 20.

    Owen AL, Owen GM. Twenty years of WIC: a review of some effects of the program. J Am Diet Assoc. 1997;97:777–82.

  21. 21.

    Black MM, Cutts DB, Frank DA, Geppert J, Skalicky A, Levenson S, et al. for Children’s Sentinel Nutritional Assessment Program Study Group. Special supplemental nutrition program for women, infants and children participation and infants’ growth and health: a multisite surveillance study. Pediatrics. 2004;114:169–76.

  22. 22.

    Buescher PA, Horton SJ, Devaney BL, Roholt SJ, Lenihan AJ, Whitmire JT, et al. Child participation in WIC: Medicaid costs and use of health care services. Am J Public Health. 2003;93:145–50.

  23. 23.

    Jones G, Steketee RW, Black RE, Buttha ZA, Morris SS. How many child deaths can we prevent this year? Lancet. 2003;362:65–71.

  24. 24.

    Guyon AB, Quinn VJ, Hainsworth M, Ravonimanantsoa P, Ravelojoana V, Rambeloson Z, et al. Implementing an integrated nutrition package at large scale in Madagascar: The Essential Nutrition Actions framework. Food Nutr Bull. 2009;30:233–44.

  25. 25.

    Lagarde M, Haines A, Palmer N. The impact of conditional cash transfers on health outcomes and use of health services in low and middle income countries. Cochrane Database Syst Rev. 2009(4) CD008137. Available from URL: http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD008137/pdf_abstract_fs.html (Accessed 7 April, 2010).

  26. 26.

    Rivera CB, Currais Nunes L, Rungo P. The impact of conditional cash transfers on health status: the Brazilian Bolsa Familia Programme. Rev Esp Salud Publica. 2009;83:85–97. (article in Spanish).

  27. 27.

    Rivera JA. Improving nutrition in Mexico: The use of research for decision making. Nutr Rev. 2009:67:S62–5.

  28. 28.

    Rivera JA, Sotres-Alvarez D, Habicht JP, Shamah T, Villalpando S. Impact of the Mexican program for education, health and nutrition (Progresa) on rates of growth and anemia in infants and young children: a randomized effectiveness study. JAMA. 2004;291:2563–70.

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Correspondence to Gail G. Harrison PhD.

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Key Words

  • micronutrients
  • malnutrition
  • Public Health
  • interventions
  • fortification
  • supplementation
  • nutrition monitoring