Search Results (11)

Background: Children with Autism Spectrum Disorder (ASD) frequently exhibit severe food selectivity and micronutrient deficiencies, impacting growth and nutritional status. Evidence on integrated nutritional interventions in resource-constrained settings remains limited. Objective: To assess the feasibility and preliminary pre–post changes associated with a 12-week multicomponent nutritional intervention among Vietnamese children with ASD. Methods: In this exploratory single-arm pilot study, 56 children with ASD (mean age 59.0 ± 22.3 months; 80.4% male) were recruited from five community centers in Nghe An Province, Vietnam. The intervention comprised caregiver nutrition education, individualized dietary counseling, and daily multi-micronutrient supplementation. Anthropometric indicators, biochemical markers, feeding behaviors, and dietary intake were assessed at baseline and after 12 weeks. Pre–post changes were evaluated using paired statistical tests, and multivariable linear regression examined factors associated with growth response. Results: The study achieved a 100% completion rate, with all 56 recruited participants finishing the 12-week intervention and all scheduled follow-up assessments. Among children < 60 months, mean Weight-for-Age Z-score (WAZ) increased from −0.66 to −0.28 and mean Height-for-Age Z-score (HAZ) from −1.18 to −0.97 (p < 0.001). For children older than 60 months, mean HAZ increased from −0.87 to −0.58 (p < 0.001) and Body Mass Index-for-Age Z-score (BAZ) from −0.20 to 0.06 (p = 0.006). Significant increases occurred in serum zinc (10.29 to 11.72 µmol/L; p = 0.001), ferritin (31.74 to 34.79 ng/mL; p = 0.001), and hemoglobin (122.73 to 124.77 g/L; p = 0.002), while albumin remained unchanged. Concurrent improvements were observed in feeding behaviors and nutrient-dense food intake. Regression analysis indicated that lower baseline anthropometric status was significantly associated with greater gains in WAZ and HAZ. Conclusions: This community-based multicomponent intervention was feasible and associated with short-term improvements in feeding behaviors, dietary intake, selected biomarkers, and growth measures in children with ASD, supporting further evaluation in randomized controlled trials. Full article

Background: Micronutrient deficiencies (MD) are highly prevalent among candidates for bariatric surgery (BS) and are associated with adverse perioperative and postoperative outcomes. Although guidelines recommend systematic preoperative screening and correction, conventional targeted supplementation (CTS) often requires multiple products, potentially limiting adherence and delaying surgical readiness. Bariatric-specific multivitamins (BSM) may simplify nutritional management, but their real-world effectiveness for preoperative correction of multiple MD remains insufficiently investigated. Objective: To compare the effectiveness, efficiency, and adherence of a BSM versus CTS for preoperative correction of multiple MD in BS candidates. Methods: This retrospective multicenter cohort study included 1560 adults with obesity evaluated for BS between 2020 and 2024 across three Italian bariatric centers. The primary efficacy analysis was restricted to patients presenting with ≥3 laboratory-confirmed MD at baseline. Patients treated between 2020 and 2022 received individualized CTS using multiple products, whereas those treated between 2023 and 2024 received a single BSM. Biochemical follow-up was scheduled at 4 and 8 weeks. The primary outcome was the achievement of complete biochemical correction of all baseline deficiencies at the predefined 4-week follow-up assessment (composite endpoint). Secondary outcomes included supplementation burden and self-reported adherence. Early correction rates were compared using absolute risk differences and risk ratios; adjusted associations were evaluated using multivariable regression models including center and baseline deficiency burden. As a supplementary analysis, the patient-level proportion of baseline deficiencies corrected at 4 weeks was also evaluated. Results: Among patients with ≥3 baseline deficiencies (n = 216), complete biochemical correction at 4 weeks was achieved in 55/134 patients (41.0%) in the BSM group and in 13/82 patients (15.9%) in the CTS group, corresponding to an absolute risk difference of 25.2 percentage points (95% CI 7.8–40.0) and a risk ratio of 2.59 (95% CI 1.51–4.44). In adjusted analyses accounting for center and baseline deficiency pattern, BSM use remained independently associated with early complete correction (adjusted absolute risk difference 26.3 percentage points; adjusted risk ratio 2.69). Sensitivity analyses restricting follow-up timing and excluding early calendar periods yielded consistent results. The mean proportion of baseline deficiencies corrected per patient at 4 weeks was higher in the BSM group compared with CTS (0.74 ± 0.25 vs. 0.54 ± 0.30). Compared with CTS, BSM was associated with lower supplementation burden (1 vs. 3.5 supplements on average) and higher adherence (92% vs. 70%). Conclusions: In a real-world multicenter cohort of BS candidates with ≥3 baseline MD, a simplified preoperative supplementation strategy based on a BSM was associated with a significantly higher probability of complete biochemical correction at 4 weeks, lower supplementation burden, and higher reported adherence compared with CTS. Although complete correction was not universal at 4 weeks, BSM significantly increased the likelihood of achieving early multi-deficiency normalization. Given the non-concurrent observational design, these findings should be interpreted as hypothesis-generating and warrant confirmation in prospective studies with concurrent cohorts. Full article

Background: Iodine deficiency remains a significant public health concern worldwide and may contribute to metabolic disorders beyond thyroid dysfunction. Emerging evidence suggests that nutritional factors, such as vitamin A, may influence the health effects of iodine deficiency, yet population-based evidence remains limited. This study aimed to investigate the associations between iodine deficiency and cardiometabolic risk factors (blood pressure, glucose, and lipids) and to explore whether these associations are different between adults with different vitamin A levels. Methods: A total of 4723 adults (1895 males and 2828 females) were included in this cross-sectional study. Participants were categorized based on iodine status and serum vitamin A levels. Demographic, anthropometric, and biochemical indicators were assessed through standardized examinations. Multivariable linear and logistic regression models were used to evaluate the associations between iodine deficiency and continuous (systolic blood pressure [SBP], diastolic blood pressure [DBP], fasting blood glucose [FBG], total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], triglycerides [TGs]) and binary outcomes (hypertension, hyperglycemia, and dyslipidemia), with stratified analyses by gender, age, and vitamin A status. Results: Iodine deficiency was significantly associated with higher SBP (β = 2.89, 95% confidence interval [CI]: 2.00–3.77), DBP (β = 1.08, 0.55–1.60), FBG (β = 0.06, 0.01–0.12) and TC (β = 0.05, 0.00–0.10). The odds of hypertension (odds ratio [OR] = 1.41, 1.23–1.63) and hyperglycemia (OR = 1.39, 1.17–1.65) were also increased. Stratified analyses indicated that these associations were more pronounced among participants with vitamin A deficiency than those with sufficient vitamin A. In this subgroup, iodine deficiency was positively associated with FBG (β = 0.14, 0.03–0.25), TC (β = 0.08, 0.00–0.15), and hyperglycemia (OR = 1.35, 1.04–1.76). Conclusions: The findings suggest that the association of iodine deficiency with adverse cardiometabolic risk factors may be stronger in individuals with concurrent vitamin A deficiency. This highlights the potential value of integrated nutritional assessments and supports the need for longitudinal studies to confirm these interactions and assess the effects of combined micronutrient supplementation. Full article

Colorectal cancer (CRC) is a major global health concern with high morbidity and mortality, particularly complicated by postoperative complications. This narrative review explores the interplay between cancer-related malnutrition (CRM) and oxidative stress (OS) as key modifiable risk factors influencing surgical outcomes in CRC patients. Drawing on the recent literature, the article analyzes the multifactorial pathophysiology of CRM, including systemic inflammation, micronutrient deficiency, and metabolic derangements, and its role in weakening antioxidant defenses. Concurrently, oxidative stress, marked by elevated reactive oxygen species and impaired redox homeostasis, is linked to impaired wound healing, infection susceptibility, and anastomotic complications. The review highlights that CRM and OS are interdependent, synergistically exacerbating postoperative morbidity. It also emphasizes the diagnostic and therapeutic implications of integrating nutritional screening tools with oxidative biomarkers to optimize perioperative care. Current evidence suggests that early immunonutrition- and redox-modulating strategies may improve surgical resilience, though standardization of biomarkers and intervention protocols remains a challenge. This article underscores the need for individualized, integrated approaches to perioperative management and proposes CRM–OS interaction as a potential predictive model for surgical risk in CRC. The findings advocate for future clinical trials targeting both nutrition and oxidative status to enhance recovery and long-term prognosis. Full article

The double burden of malnutrition (DBM)—the coexistence of overweight/obesity and micronutrient deficiency—is an emerging public health concern among school-aged children. Using data from 6063 participants in Colombia’s 2015 National Survey of Nutritional Status (ENSIN), this study estimated DBM prevalence and identified factors associated with its occurrence among children aged 5–12 years. DBM was defined as concurrent overweight/obesity (BMI-for-age z-score > 1) and vitamin D deficiency, applying thresholds of <30, <37.5, and <50 nmol/L. The prevalence of DBM ranged from 0.7% to 6.9%. Firth’s penalized logistic regression models were conducted separately for (1) overweight/obese combined, (2) overweight-only, and (3) obesity-only groups. For DBM1, insufficient physical activity was linked to higher odds across all three models. For DBM2, smaller household size and higher maternal education were associated with greater odds in the combined model. Living in large urban areas was related to lower odds compared with major metropolitan areas, a pattern also observed in the overweight-only model. For DBM3, children from the second wealth quartile (Q2) showed higher odds than those from the poorest (Q1), with a similar pattern in the overweight-only analysis. Stricter DBM definitions tended to capture behavioral and household characteristics, whereas broader thresholds reflected structural and contextual conditions. Despite its relatively low prevalence, DBM remains a relevant public health issue among Colombian schoolchildren. Full article

Pregnant women and children are vulnerable to vitamin A deficiency (VAD), which is often compounded by concurrent deficiencies in other micronutrients, particularly iron and zinc, in developing countries. The study investigated the effects of early-life VAD on motor and cognitive development and trace mineral status in a mouse model. C57BL/6J dams were fed either a vitamin A-adequate (VR) or -deficient (VD) diet across two consecutive gestations and lactations. Offspring from both gestations (G1 and G2) continued the same diets until 6 or 9 weeks of age. Behavioral assays were conducted to evaluate motor coordination, grip strength, spatial cognition, and anxiety. Hepatic trace minerals were analyzed. A VD diet depleted hepatic retinoids and reduced plasma retinol across all ages and gestations. Retracted rear legs and abnormal gait were the most common clinical manifestations observed in VD offspring from both gestations at 9 weeks. Poor performance on the Rotarod test further confirmed their motor dysfunction. VAD didn’t affect hemoglobin levels and had no consistent effect on hepatic trace mineral concentrations. These findings highlight the critical role of vitamin A in motor development. There was no clear evidence that VAD alters the risk of iron deficiency anemia or trace minerals. Full article

Under iron (Fe)-limited conditions, plants have developed strategies for acquiring this essential micronutrient. Several Fe sources have been studied as potential fertilizers, with Fe synthetic chelates being the most used to prevent and correct Fe chlorosis in crops. The determination of the activity of the Fe chelate reductase (FCR) enzyme has long been described in the literature to understand the efficiency of Strategy I plants in acquiring Fe from fertilizers under deficient conditions. Other experiments have focused on the translocation of Fe to the plant to define the effectiveness of Fe fertilizers. Yet, both assays are relevant in knowing the capacity of a novel Fe source and other compounds alleviating Fe chlorosis in Strategy I plants. This work reviews the methodologies that are used in FCR assays to evaluate novel Fe fertilizers, including the factors modulating the results obtained for FCR assay activity, such as the Fe substrate, the Fe level during the growing period and during the FCR assay, the pH, the choice of an in vivo or in vitro method, and the plant species. A discussion of the benefits of the concurrence of FCR and Fe uptake assays is then presented alongside a proposed methodology for assessing the effectiveness of Fe fertilizers, emphasizing the importance of understanding chemical and physiological plant interactions. This methodology unifies key factors that modify FCR activity and combines these with the use of the ⁵⁷Fe tracer to enhance our comprehension of the efficacy of Fe-based fertilizers’ effectiveness in alleviating Fe chlorosis. This comprehensive approach not only contributes to the fundamental understanding of Fe-deficient Strategy I plants but also establishes a robust method for determining the efficiency of novel sources for correcting Fe deficiency in plants. Full article

Although phosphorus (P) fertilizer application is widely used to improve production, irrational P application has a negative impact on the zinc (Zn) nutrition of cereal crops. Previous researchers observed and confirmed that P application decreases grain Zn concentrations and bioavailability in cereal crops. However, it remains unclear whether different P fertilizer types can alleviate the antagonism of P and Zn in the soil and grain and, thus, enhance the Zn nutritional level of cereal crops while maintaining production. Thus, a completely randomized pot experiment was conducted on winter wheat grown in two calcareous soils (lime concretion black soil and fluvo-aquic soil). Five P fertilizer types (single superphosphate, diammonium phosphate, fused calcium–magnesium phosphate, triple superphosphate, and ammonium polyphosphate, abbreviated, respectively, as SSP, DAP, FMP, TSP, and APP) were applied to each soil compared to no P fertilizer (CK). Plant and topsoil samples were collected during the flowering and maturity stages of winter wheat, and biomass, Zn concentrations in each organ, and grain phytic acid concentrations were analyzed. Grain yield was not affected by the application of different P fertilizer types to lime concretion black soil, while it was significantly increased by the application of TSP and APP to fluvo-aquic soil. The application of DAP and APP effectively promoted soil available Zn concentrations in both calcareous soils. In lime concretion black soil, the application of FMP significantly increased Zn remobilization to grains, while the application of DAP increased post-anthesis Zn uptake, thereby increasing grain Zn concentrations and its bioavailability. In fluvo-aquic soil, post-anthesis Zn remobilization and uptake were significantly increased by the application of TSP and APP, finally achieving higher grain Zn concentrations and Zn harvest index and effectively promoting grain Zn bioavailability. In conclusion, the rational application of DAP to wheat grown in lime concretion black soil and of TSP or APP to fluvo-aquic soil can achieve superior grain Zn nutrition quality while concurrently retaining high production and high P use efficiency, reducing micronutrient deficiency and further contributing to green agricultural development and human health. Full article

The pandemics of obesity, undernutrition, and climate change represent severe threats to child health. They co-occur; interact with each other to produce sequelae at biological, psychological, or social levels; and share common underlying drivers. In this paper, we review the key issues concerning child diet and nutritional status, focusing on the interactions with climate and food systems. Inadequate infant and young child feeding practices, food insecurity, poverty, and limited access to health services are the leading causes of malnutrition across generations. Food system industrialization and globalization lead to a double burden of malnutrition, whereby undernutrition (i.e., stunting, wasting, and deficiencies in micronutrients) coexists with overweight and obesity, as well as to harmful effects on climate. Climate change and the COVID-19 pandemic are worsening child malnutrition, impacting the main underlying causes (i.e., household food security, dietary diversity, nutrient quality, and access to maternal and child health), as well as the social, economic, and political factors determining food security and nutrition (livelihoods, income, infrastructure resources, and political context). Existing interventions have the potential to be further scaled-up to concurrently address undernutrition, overnutrition, and climate change by cross-cutting education, agriculture, food systems, and social safety nets. Several stakeholders must work co-operatively to improve global sustainable nutrition. Full article

Micronutrients include vitamins, minerals and, trace elements that are required in minute quantities but play a vital role in normal human growth, development and physiological functioning. Micronutrient deficiencies, also known as hidden hunger, are a global issue, with particularly high prevalence rates in developing countries. Currently, Sri Lanka is experiencing the double burden of over- and undernutrition. This review describes the micronutrient status of Sri Lanka based on results of national surveys and related articles published from 2000. The available data suggest a higher prevalence of iron, zinc, calcium, folate, and vitamin A deficiencies. The prevalence of iodine deficiency has declined gradually following the implementation of a universal salt iodization program. Iron deficiency is the most common cause of anemia and low red blood cell indices. Females are more vulnerable to micronutrient deficiencies than males. The coexistence of multiple micronutrient deficiencies and concurrent macro- and micronutrient deficiencies is common. Studies have shown an association between micronutrient deficiencies and different demographic, socioeconomic, and dietary factors. Therefore, there is a need for comprehensive studies, nutritional policies, and nationwide intervention programs in Sri Lanka to improve the micronutrient status of the population. Full article

Certain population sub-groups in the United States are vulnerable to micronutrient malnutrition. Nationally representative data from the National Health and Nutrition Examination Survey (NHANES) describing the biochemical status of vitamins A, B6, B12, C, D, E, folate, and anemia, were aggregated to determine the overall risk of multiple concurrent deficiencies in U.S. children and adults (n = 15,030) aged >9 years. The prevalence of deficiency risk according to socio-demographic, life-stage, dietary supplement use, and dietary adequacy categories was investigated. Thirty-one percent of the U.S. population was at risk of at least one vitamin deficiency or anemia, with 23%, 6.3%, and 1.7% of the U.S. population at risk of deficiency in 1, 2, or 3–5 vitamins or anemia, respectively. A significantly higher deficiency risk was seen in women (37%), non-Hispanic blacks (55%), individuals from low income households (40%), or without a high school diploma (42%), and underweight (42%) or obese individuals (39%). A deficiency risk was most common in women 19–50 years (41%), and pregnant or breastfeeding women (47%). Dietary supplement non-users had the highest risk of any deficiency (40%), compared to users of full-spectrum multivitamin-multimineral supplements (14%) and other dietary supplement users (28%). Individuals consuming an adequate diet based on the Estimated Average Requirement had a lower risk of any deficiency (16%) than those with an inadequate diet (57%). Nearly one-third of the U.S. population is at risk of deficiency in at least one vitamin, or has anemia. Full article