This study was conducted to evaluate the impact of a food aid program (Plan Más Vida, PMV) on the micronutrient nutritional condition of lactating mothers 1 year after its implementation. The food program provided supplementary diets (wheat- and maize-fortified flour, rice or sugar, and fortified soup) to low-income families from the province of Buenos Aires, Argentina. A prospective, non-experimental study was carried out to evaluate the micronutrient nutritional status of lactating mothers (n = 178 at baseline and n = 151 after 1 year). Biochemical tests (hemoglobin, ferritin, zinc, vitamin A, and folic acid), anthropometric assessments (weight and height) and dietary surveys (24-h recall) were performed. We found no significant changes in anthropometric values 1 year after the intervention. The risk for vitamin A (retinol 20-30 μg/dl) and folate deficiency significantly decreased 1 year after PMV implementation (56.3 vs. 29.9 and 50.3 vs. 3.4 %, respectively; p < 0.001). Anemia was seen in 25.8 % of lactating mothers at baseline, without statistically significant differences 1 year after (p = 0.439). The nutritional data obtained after assessing the early impact of PMV actions may be useful to provincial health authorities to perform periodic evaluations in the future.
Arch Argent Pediatr 2012;110(2):120-125 / 120 RESUMEN Introducción. La anemia es un problema de salud pública que afecta particularmente a los menores de 2 años, con graves consecuencias en el desarrollo psicomotor e intelectual de los niños y en las capacidades productivas en la adultez. Objetivo. Estudiar la prevalencia de anemia, sus variaciones y los posibles factores asociados en niños menores de 6 meses. Población y métodos. Se realizó un estudio descriptivo de corte transversal, revisando los registros de controles de salud de 363 niños con edades comprendidas entre 4 y 5 meses de edad completos, asistidos durante 2007-2010. Se analizó la asociación entre anemia (hemoglobina <10,3 g/ dl) y alimentación (amamantamiento exclusivo o alimentación complementaria), tipo de parto y sexo. Se compararon las medias de peso al nacer y la puntuación z de peso para edad, talla para edad y peso para talla, en niños anémicos contra no anémicos. Resultados. El 28,9% (105/363) de los niños presentaron anemia y la prevalencia fue significativamente mayor en los varones (38,3% contra 20,9%; p= 0,000). No hubo diferencias significativas según el tipo de alimentación y la forma de terminación del parto. La media de peso al nacer y de puntuación z de peso para edad, talla para edad y peso para talla fue significativamente menor en los anémicos contra los no anémicos. Se encontró una disminución significativa de la anemia (de 37,8% en 2007 a 20,3% en 2010 en el período estudiado, p= 0,012). Conclusión. La prevalencia de anemia fue de 28,9% y descendió significativamente entre el 2007 y 2010. Fue mayor en varones, en niños nacidos con menor peso y con menores índices antropométricos. Nuestros resultados, aun cuando tienen carácter local, reflejan el alto riesgo nutricional de la población menor de 6 meses. Palabras clave: anemia, lactantes, bajos recursos, Argentina. ABSTRACT Introduction.Anemia is a public healthcare problem that particularly affects children under the age of 2 years, with consequences that greatly affect psychomotor and intellectual growth during childhood and productive capacities in adulthood.Objective. To study the prevalence of anemia, its variations and possibly associated factors in children under 6 months of age. Material and methods. Cross-sectional descriptive study analyzing health records of 363 children aged 4-5 months assisted in the period 2007-2010. We determined the association of anemia (hemoglobin <10,3 g/dl) with feeding (exclusive breastfeeding and mixed feeding), type of birth and sex. Birth weight means and z-scores for weight-for-age, height-for-age, and weight-for-height were compared in anemic versus non-anemic children. Results. Anemia was present in 28.9% (105/363) of children, being its prevalence significantly higher in boys (38.3% versus 20.9%; p= 0.000). There were no significant differences in type of birth or feeding. Mean birth weight and mean z-score for weight-for-age, height-for-age and weight-for-height was significantly lower in anemic vs. non-anemic children. We found a ...
We studied the impact of a food supplementation program (Plan Más Vida (PMV)) on the micronutrient nutritional condition of pregnant women from low-income families 1 year after its implementation. The food program provided supplementary diet (wheat and maize--fortified flour, rice or sugar, and fortified soup). We performed a prospective, nonexperimental, cross-sectional study in the province of Buenos Aires, Argentina, evaluating pregnant women at baseline (n = 164) and 1 year after PMV implementation (n = 108). Biochemical tests (hemogram, ferritin, vitamin A, zinc, and folic acid), anthropometric assessments (weight and height), and dietary surveys (24 h recall) were performed at the two study points. One year after PMV implementation, no significant changes in anthropometric values were observed. Folic acid deficiency and the risk of vitamin A deficiency (retinol, 20-30 μg/dl) decreased significantly (35.8 to 6.1 % and 64 to 41 %, respectively; p < 0.000). Anemia and prevalence of iron and zinc deficiency values did not change. Diet survey results showed that although nutrient intake increased significantly, it was still below recommendations. Implementation of the PMV and of the government nutritional strategies had a high impact on the prevalence of folic acid deficiency. We also observed a decrease in the risk of vitamin A deficiency, and no impact on iron and zinc nutritional status. Adherence to the specific fortified food (soup) was not good and intra-family dilution and distribution of food was high.
Docosahexaenoic acid (DHA) is among the main components of synaptosomal membranes and myelin sheaths. Because DHA is essential for child neurodevelopment, breast milk DHA levels should be improved by optimizing maternal nutrition. We determined DHA percentage levels in breast milk of low-income mothers receiving care at the public healthcare sector. We performed a descriptive, cross-sectional study in breast milk samples from 39 exclusively breast-feeding adult mothers with normal fetal and neonatal history. Samples were collected 90 ± 7 days after delivery. Breast milk fatty acid composition was determined by gas chromatography. The cut-off value of DHA was 0.3% of total fatty acids in milk according to recommendations. Median DHA in milk was 0.14% (0.12–0.21). Breast milk DHA levels were lower than the minimum recommended in 92% of samples. The analysis of breast milk samples from low-income exclusively breast-feeding mothers showed that they did not reach the minimum recommended DHA percentage.
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