How to improve iron status among infants and young children is of continued concern in low- to middle-income countries, including Brazil. In a double blind, 5-mo, home-based, randomized trial in Brazil, we gave one group of mildly anemic 6- to 24-mo-old children (n = 175) rice fortified with micronized ferric pyrophosphate using the Ultra Rice technology and a placebo solution (URG) and another group identical nonfortified rice and iron drops. We instructed parents on the correct dosage of iron drops and to feed their children rice as they normally would. We measured serum ferritin (SF) and hemoglobin (Hb) concentrations at baseline and at 5 mo. At baseline, the prevalences of iron deficiency and anemia in the total sample were 73.1 and 100%, respectively. At 5 mo, SF and Hb increased in both groups, although the change in the URG was larger (P < 0.01). Adult participants were unable to distinguish cooked fortified rice from unfortified rice in terms of smell, color, or taste. As rice is normally consumed at home, MPF-fortified rice increased iron stores and reduced anemia in a group of mildly anemic children 6-24 mo old. In populations where young children are routinely fed approximately 100 g of cooked rice daily, fortifying it with iron may improve iron status at least as well as providing free iron drops.

Daily consumption of iron-fortified drinking water in daycare facilities is an effective, simple and inexpensive means of reducing and controlling for moderate and severe anemia in pre-school children.

Iron-deficiency-anemia affects 30% of the world population. Women of reproductive age and children are the most affected. Iron supplementation in the form of tablets and syrups has not been successful in developing countries, and iron deficiency is still the most important deficiency related to malnutrition. Iron-deficiency anemia affects physical and cognitive development at an early age in children, often resulting in irreversible outcomes. Studies from the last two decades have shown that the prevalence of iron-deficiency anemia can be reduced given adequate investments and political will directed at iron fortification of foods and liquids. A successful low-cost iron-fortification program incorporates implementation and strategic use of communication for program inception where education is in the forefront. A review of the available reports from experience in Brazil with iron fortification of foods and liquids is presented.

Background Due to the social isolation measures adopted in an attempt to mitigate the risk of transmission of SARS-CoV-2, there has been a reduction in vaccination coverage of children and adolescents in several countries and regions of the world. Objective Analyze the number of doses of vaccine against Measles-Mumps-Rubella (MMR) applied before and after the beginning of mitigation measures due to COVID-19 pandemic in Brazil. Methods The data collected refer to the number of doses of the MMR vaccine applied monthly to the target population residing in Brazil: cahildren, aged 12 months (first dose) and children, aged 9 years (second dose), from April 2019 to December 2020. Differences in MMR vaccine doses from April 2019 to March 2020 (before the start of mitigation measures) and April 2020 to September 2020 (after the start of the mitigation measures) were evaluated. Spatial analysis identified clusters with a high percentage of reduction in the median of applied doses no Brazil. Results There was a reduction in the median of doses applied in the Regions North (− 33.03%), Northeast (− 43.49%) and South (− 39.01%) e nos Estados Acre (− 48.46%), Amazonas (− 28.96%), Roraima (− 61.91%), Paraíba (− 41.58%), Sergipe (− 47.52%), Rio de Janeiro (-59.31%) and Santa Catarina (− 49.32) (p < 0.05). High-high type spatial clusters (reduction between 34.00 and 90.00%) were formed in the five regions of Brazil (Moran’s I = 0.055; p = 0.01). Conclusion A reduction in the number of MMR vaccine doses was evidenced as a possible effect by the restrictive actions of COVID-19 in Brazil.

Rice is a common food staple consumed by diverse societies and represents the basis of diet for more than half of the world's population. Brazil is one of the major producers of cereal grains and the largest in South American. It produced approximately 10 million tons. in 2003 (FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS, 2004). According to research on Family Incomes carried out by the Brazilian Institute of Statistics and Geography (INSTITUTO BRASILEIRO DE GEOGRAFIA E ESTATÍSTICA, 2004), the average amount of household rice consumption was approximately 25 kg/person/year. The easy cultivation of rice, its conservation and transportation, high yield, low cost, high nutritional value, and countless forms of utilization are just some of the many characteristics that make rice so popular and appreciated by different cultures (PHILIPPI, 2003). According to Philippi (2003), rice constitutes an excellent source of carbohydrates and energy in addition to vitamins such as thiamin, riboflavin, and niacin; however, iron is not a significant component of the white rice popularly consumed in this country (UNIVERSIDADE ESTADUAL DE CAMPINAS, 2006). The fortification of foods with nutrients is an accepted practice which has been employed by food industries since the second half of the 20 th century (REILLY, 1996) aiming at increasing the nutritional value and prevent or correct one or more nutrient deficiencies (BRASIL, 1998). Today, with the advance of technology, rice can be an efficient option as a vehicle for fortification of iron as a way to minimize the prevalence of iron deficiency anemia, which represents, worldwide , a hegemonic nutritional problem in public health terms affecting, principally, children and reproductive aged women (WORLD HEALTH ORGANIZATION, 2001). In Brazil, iron deficiency anemia has shown the tendency to assume epidemic proportions over the last decades (OLIVEIRA et al., 2002; MONTEIRO; SZARFARC; MONDINI, 2000). Resumo O objetivo deste trabalho foi verificar diferenças sensoriais entre o arroz convencional e o arroz fortificado com ferro e determinar a aceitação deste pelo consumidor. As diferenças entre os dois tipos de arroz foram analisadas por meio do teste Duo-Trio, com 37 julgadores não treinados. O Teste de Aceitação avaliou aparência geral, cor, aroma e sabor do arroz fortificado com 43 julgadores não treinados, utilizando escala hedônica de sete pontos, com extremos "desgostei muitíssimo" e "gostei muitíssimo". Não houve diferenças significativas entre as amostras analisadas pelo Teste Duo-Trio. Os valores médios obtidos no Teste de Aceitação para os atributos avaliados (aparência geral, cor, aroma e sabor) foram entre 5,6 e 5,9; correspondentes a "gostei" e "gostei muito" de acordo com a escala hedônica. O ferro não causou alterações às características sensoriais do produto final, e o arroz fortificado foi bem aceito.

Plasma zinc and hair zinc levels, anthropometric status and food intake of children in a rural area of Brazil A B S T R A C T ObjectiveThe objective of this study was to investigate the levels of plasma zinc, hair zinc, growth and food consumption in children aged 6 to 24 months in a rural area of Diamantina (MG), Brazil. MethodsPlasma and hair zinc concentrations were analyzed using flame atomic absorption spectrometry and neutron activation analysis, respectively. Weight-for-age, weight-for-height and height-for-age, expressed as Z-scores, were measured according to the World Health Organization reference curves. Dietary zinc intake was determined by a 3-day dietary recall filled out by the mother or guardian. ResultsZinc deficiency was found in 11.2% and 16.8% of the children according to plasma zinc e hair zinc levels, respectively. Mean plasma zinc and hair zinc for children ≤11 (49) and >11 (127)

A cross-sectional study was conducted with 139 family caregivers in two community health center areas in the city of Belo Horizonte, located in the southeastern state of Minas Gerais, Brazil. The purpose of the study was to analyze the relationship between level of care dependency and quality of life (QOL) of family caregivers. A socio-demographic questionnaire, the Barthel Index for assessing patients’ care dependency level, and the World Health Organization’s Quality of Life–BREF (WHOQOL-BREF) for evaluating family caregivers’ QOL were used. Patients’ care dependency level was not significantly associated with family caregivers’ QOL. However, the QOL decreased when family caregivers had chronic disease and were dependent on public health care services, and increased when they received caregiver education and practiced a leisure activity. These factors are modifiable or controllable; therefore, family health nurses have an important role in formulating strategies to support family caregivers, especially those related to health education aimed at health care, health promotion, control, and prevention of diseases.

Estudo transversal realizado em 2016, cujo objetivo foi descrever a prevalência estimada e os fatores associados à hipertensão arterial sistêmica entre adultos e idosos Krenak, em Terra Indígena localizada na beira do rio Doce, na região leste de Minas Gerais, Brasil. Foram aferidos peso, estatura, perímetro da cintura, pressão arterial sistólica, pressão arterial diastólica e glicemia capilar. Informações sociodemográficas e de estilo de vida foram obtidas via aplicação de questionário face a face. Modelos de regressão de Poisson foram construídos para estimar a associação independente entre as variáveis de interesse e a hipertensão arterial sistêmica. A prevalência da hipertensão arterial sistêmica foi de 31,2% (IC95%: 24,4-37,9) entre os indígenas Krenak. Houve associação independente no modelo final para o aumento da idade, obesidade abdominal e hiperglicemia. Destaca-se a necessidade de ações eficazes de prevenção, de diagnóstico e acompanhamento frente aos fatores modificáveis da hipertensão arterial sistêmica, uma vez que foi observada elevada prevalência dessa condição na comunidade indígena Krenak.