Nutrition:Micronutrient deficiency/nutritionalproblemsin nja

• Control infection:

  • Immunization and control programmes for parasitic infections like malaria, hookworm, schistosomiasis
• Improve nutritional status by preventing and controlling other nutritional deficiencies such as Vitamin B12, folate, vitamin A, and using Ascorbic acid or Vitamin C to increase the absorption of Iron
• Iodine Deficiency Diseases (IDD):

  • A major threat worldwide, particularly among preschool children and pregnant women in Low-Income Countries (LICs)
  • Most prevalent cause of preventable brain damage in the foetus and infant
  • Important cause of retarded cognitive development in young children
  • A population is considered at risk if the total goiter rate is >5%
  • The number of countries where iodine deficiency is a public health problem has halved over the past decade
  • On the verge of being eliminated globally
• Iodine functions:

  • Production of thyroid hormones
  • Regulation of tissue growth & development, especially the brain
  • Sources: Seafoods (e.g. crayfish, shrimps, crab), vegetables grown in iodine-rich soils
  • Food content depends on soil level
  • Minimum daily requirement is ≈5mcg
• Causes of IDD:

  • Deficiency in the diet (Commonest)
  • Physiological malfunction of Iodine in the thyroid gland
  • Interference with thyroid hormone synthesis by goitrogens (e.g. in cassava, cabbage)
• Effects of IDD:

  • During pregnancy: Stillbirths, spontaneous abortion, congenital abnormalities such as cretinism, impaired cognitive development in children
  • Mental impairment that reduces intellectual capacity at home, in school, and at work
• Prevention and control of IDD:

  • Food fortification through Universal Salt Iodization (USI)
  • Main intervention strategy for IDD control
  • Cost-effective
  • Adopted in 1993
  • Alliances with UNICEF, ICCIDD, international and bilateral agencies, and the salt industry have helped countries set up permanent national salt iodization programmes
• In Nigeria:

  • In the 80's, Iodine Deficiency was a significant Public Health concern with a total goiter rate as high as 67%
  • The Federal Government of Nigeria, with UNICEF support, launched the USI programme in Nigeria in 1993
  • The goiter rate has now reduced to 6%
  • 98% of households have access to adequately iodized salt
  • 100% iodized salt is being produced at the factory level
• Vitamin A Deficiency (VAD):

  • A public health problem in more than half of all countries, especially in Africa and South-East Asia
  • Young children and pregnant women are usually affected
  • The leading cause of preventable blindness in children
  • Increases the risk of disease and death from severe infections
• Vitamin A functions:

  • Retinol is essential for the normal functioning of the visual system, growth & development
  • Maintenance of the integrity of the epithelium, immune function, and reproduction
  • Sources: Pre-formed vitamin (retinol) found in animal food, β-carotene in dark green leafy vegetables, carrots, fresh tomatoes, yellow fruits, red palm oil
• Causes of VAD:

  • Economic factors
  • Socio-cultural factors
  • Serum level of retinol < 20mcg/dl indicates deficiency
• Effects of VAD:

  • In children: Severe visual impairment and blindness, significantly increases the risk of severe illness and death from common childhood infections
  • In pregnant women: Night blindness, poor pregnancy, and lactation outcomes
• Prevention and control of VAD:

  • Supplementation through routine immunization, boost coverage through National Immunization Days (NIDs)
  • Food fortification with sugar, vegetable oil, wheat, and maize flour
  • Biofortification with Vitamin A orange sweet potato, maize, cassava
  • Dietary diversification by producing and consuming Vitamin A rich foods
  • Treatment for high-risk children like those with diarrhoea, measles, Protein Energy Malnutrition
• Essential components to tackle HH at the community level:

  • Awareness to improve women’s, infants’, and young children’s utilization of health services, portable water, good sanitation, and hygiene to prevent diseases that interfere with nutrient absorption
  • Messages promoting best practices such as early initiation of breastfeeding, exclusive breastfeeding for up to 6 months, and breastfeeding for up to 24 months with adequate and sufficient complementary food
• Conclusion:

  • Micronutrient deficiency refers to a lack of essential vitamins and minerals crucial for maintaining good health and preventing various diseases
  • Public health nutrition focuses on addressing and preventing micronutrient deficiencies at the population level
• Strategies for the prevention and control of micronutrient deficiency diseases:

  • Food supplementation
  • Food fortification
  • Dietary diversification
  • Nutrition education
• Assignment:

  • List 3 micronutrients and the diseases that result from their deficiency
  • List and write short notes on at least three strategies for the control of micronutrient deficiency diseases
  • How would you prevent micronutrient deficiency in your locality?
  • What are trace elements? Give 5 examples
  • List 5 states within the goitre endemic zone in Nigeria
• Macronutrients are essential nutrients required by the body in relatively large amounts to support various physiological functions and maintain overall health
• Micronutrients are chemical substances in human nutrition required throughout life in small quantities to orchestrate a range of physiologic functions
• The deficiency of micronutrients has dire effects on humans, both individuals and populations
• There are six basic classes of nutrients:

  • Protein
  • Carbohydrates
  • Fats
  • Vitamins
  • Minerals
  • Water
• Carbohydrates are the body's main source of energy, supplying energy to the brain, muscles, and nervous system
• Proteins are formed from amino acids and serve as body builders, a source of energy, and enzymes involved in many chemical reactions in the body
• Proteins also function as hormones, regulators of fluid balance, transporters, and antibodies in the body
• Fats are a macronutrient and energy source, with saturated and unsaturated fatty acids, important for structural integrity of cells, and involved in the synthesis of essential compounds
• Fats are linked with heart diseases, cancer, obesity, and high cholesterol, and deficiency can lead to growth retardation and other health issues
• Vitamins are organic compounds with independent functions, categorized as fat-soluble (A, D, E, K) and water-soluble (C, B vitamins)
• Minerals help regulate body functions, divided into trace minerals (iron, zinc, copper, etc.) and major minerals (calcium, magnesium, potassium, etc.)
• Water helps regulate body temperature, remove waste products, and allows chemical reactions to take place
• Micronutrient deficiency, also known as 'hidden hunger,' occurs when the quality of food people eat does not meet their nutritional requirements
• Globally, more than 2 billion people suffer from mineral and vitamin deficiency, with a higher burden in developing countries
• Iron deficiency is the most common and widespread nutritional disorder globally, leading to anaemia
• Iron deficiency anaemia affects over 30% of the world's population, with causes including inadequate dietary intake, parasitic infections, and other diseases
• Effects of iron deficiency include impaired development in infants, increased risk of maternal and fetal morbidity in pregnant women, and reduced work capacity in adults
• Prevention and control of iron deficiency anaemia should be multi-factorial and multi-sectorial, with comprehensive public health measures implemented in high-risk countries
• Anemia package is implemented in countries with high levels of iron deficiency anemia, malaria, helminth infections, and schistosomiasis
• Prevention and control of anemia:

  • Increase iron intake through supplementation, fortification, bio-fortification (e.g. iron beans, millet)
  • Dietary diversification
  • Enhancement of iron absorption
• Control infection:

  • Immunization and control programs for parasitic infections like malaria, hookworm, schistosomiasis
• Improve nutritional status by preventing and controlling other nutritional deficiencies such as Vitamin B12, folate, vitamin A, and using ascorbic acid or Vitamin C to increase the absorption of iron
• Iodine Deficiency Diseases (IDD):

  • Major threat worldwide, especially among preschool children and pregnant women in Low-Income Countries (LICs)
  • Most prevalent cause of preventable brain damage in the fetus and infant
  • Important cause of retarded cognitive development in young children
  • A population is considered at risk if the total goiter rate is >5%
  • The number of countries where iodine deficiency is a public health problem has halved over the past decade
  • On the verge of being eliminated globally