Prevention of micronutrient deficiencies : tools for policymakers and public health workers / Committee on Micronutrient Deficiencies, Board on International Health [and] Food, and Nutrition Board, Institute of Medicine ; Christopher P. Howson, Eileen T. Kennedy, and Abraham Horwitz, editors.

Format:

Book

Conference/Event

Contributor:

Howson, Christopher Paul.

Kennedy, Eileen T., 1947-

Horwitz, A.

Institute of Medicine (U.S.). Committee on Micronutrient Deficiencies.

Institute of Medicine (U.S.). Food and Nutrition Board.

Conference Name:

Workshop on Micronutrient Deficiencies (1996 : National Academy of Sciences)

Language:

English

Subjects (All):

Trace element deficiency diseases--Prevention--Government policy.

Trace element deficiency diseases.

Physical Description:

xii, 207 p. : ill.

Edition:

1st ed.

Place of Publication:

Washington, D.C. : National Academy Press, 1998.

Language Note:

English

Summary:

Micronutrient malnutrition affects approximately 2 billion people worldwide. The adverse effects of micronutrient deficiencies are profound and include premature death, poor health, blindness, growth stunting, mental retardation, learning disabilities, and low work capacity. Preventing Micronutrient Deficiencies provides a conceptual framework based on past experience that will allow funders to tailor programs to existing regional/country capabilities and to incorporate within these programs the capacity to address multiple strategies (i.e., supplementation/fortification/food-based approaches/public health measures) and multiple micronutrient deficiencies. The book does not offer recommendations on how to alleviate specific micronutrient deficiencies--such recommendations are already available through the publications of diverse organizations, including the U.S. Agency for International Development, the Micronutrient Initiative, World Bank, United Nations Childrens' Fund, and the World Health Organization. Instead, this volume examines key elements in the design and implementation of micronutrient interventions, including such issues as: The importance of iron, vitamin A, and iodine to health. Populations at risk for micronutrient deficiency. Options for successful interventions and their cost. The feasibility of involving societal sectors in the planning and implementation of interventions. Characteristics of successful interventions. The book also contains three in-depth background papers that address the prevention of deficiencies of iron, vitamin A, and iodine.

Contents:

Prevention of Micronutrient Deficiencies

Copyright

Acknowledgments

Contents

Prevention of Micronutrient Deficiencies Tools for Policymakers and Public Health Workers

1 Summary

PROJECT CHARGE

ORGANIZATION OF THE REPORT

FINDINGS AND RECOMMENDATIONS

Findings

Recommendations

2 Key Elements in the Design and Implementation of Micronutrient Interventions

THE IMPORTANCE OF IRON, VITAMIN A, AND IODINE TO HEALTH

Iron

Vitamin A

Iodine

THE CONTINUUM OF POPULATION RISK

OPTIONS FOR SUCCESSFUL INTERVENTIONS

Supplementation

Fortification

Food-Based Approaches

Other Public Health Control Measures

COSTS OF INTERVENTIONS

FEASIBILITY OF INVOLVING KEY SOCIETAL SECTORS IN THE PLANNING AND IMPLEMENTATION OF MICRONUTRIENT IN ...

ELEMENTS OF SUCCESSFUL INTERVENTIONS ACROSS THE CONTINUUM OF POPULATION RISK

Interventions for Level IV Populations

Interventions for Level III Populations

Interventions for Level II Populations

INTERVENTIONS FOR LEVEL I POPULATIONS

Balancing Approaches to Country-Specific Circumstances

Coordinating Interventions Across Micronutrients

COMMON ELEMENTS OF SUCCESSFUL MICRONUTRIENT INTERVENTIONS

Political Will/Stability

Strategic and Program Planning

Community Involvement, Participation, and Consumer Demand

Physical and Administrative Infrastructure

Communications Strategies

Use of Appropriate Vehicle

Sustainability

Information Systems, Monitoring, and Evaluation

Biological Indicators

Background Papers

3 Prevention of Iron Deficiency

DIAGNOSIS OF IRON DEFICIENCY AND ANEMIA

CAUSES OF IRON DEFICIENCY

IRON EXCESS

PREVENTION OF IRON DEFICIENCY IN AT-RISK GROUPS

Infancy

Preschool Children (3 to &lt

7 Years of Age)

School-Age Children and Adolescents

Women of Childbearing Age

Pregnant Women.

SUSTAINABLE APPROACHES TO THE ELIMINATION OF IRON DEFICIENCY

Dietary Improvement

Improving the Supply and Intake of Food Iron

Improving the Bioavailability of Food Iron

Food Fortification

Fortification Compounds

Fortification Strategies

Effectiveness of Iron Fortification

Iron Supplementation

During Pregnancy

Prepregnancy Supplementation

BENEFITS AND COSTS OF PREVENTING IRON DEFICIENCY

Prevention of Iron Loss Due to Parasites

SUGGESTED NATIONAL GOALS

Short-Term

Long-Term

APPENDIX

Five Studies in Developing Countries Addressing the Effectiveness of Iron Fortification

The Thai Study

The India Study

The South Africa Study

The Guatemala Study

The Venezuelan Study

REFERENCES

4 Prevention of Vitamin A Deficiency

MAJOR HEALTH CONSEQUENCES

Xerophthalmia and Nutritional Blindness

Childhood Morbidity and Mortality

Other Health Consequences

MAGNITUDE AND EPIDEMIOLOGY OF THE PROBLEM

Defining Vitamin A Status

Extent of the Problem

Risk Factors

Age

Gender

Quality of Diet

Disease Occurrence

Seasonality

Cultural Factors

Clustering

ECONOMIC COSTS OF VAD

INDICATORS OF VAD

Identification of Groups and Populations

Monitoring Intervention Impact and Outcome

CRITICAL ELEMENTS FOR SUCCESSFUL NUTRITION INTERVENTION PROGRAMS

APPROACHES TO THE PREVENTION OR CORRECTION OF VAD

Dietary Modification: Where Food Sources of Vitamin A Are Available but Underutilized

Thailand's Experience in Applying a Social Marketing Methodology to Increase the Utilization of Locally Available Vitamin...

Context

Design of the Intervention

Implementation and Evaluation

Results

OTHER COUNTRIES' EXPERIENCES

Other Social Marketing Experiences.

Lessons Learned in Behavior Modification Where Vitamin A-Rich Foods Are Available

Dietary Modification: Home and Community Provisioning to Increase Availability of Vitamin A-Rich Foods

Experiences in Bangladesh with Promotion of Home Gardens

West Bengal, India: Experience with Horticultural Interventions in a Drought-Prone and Poverty-Stricken Rural Area

Vietnam Gardening Project to Increase Production and Consumption of Vitamin A-Rich Foods*

Lessons Learned from Successful Gardening Projects

Small Animal Husbandry and Fish Production to Increase Household and Community Availability of Preformed Vitamin A Sources

Multi-Mix Complementary and Weaning Foods

Genetic Selection and Engineering to Improve Vitamin A Activity of Vegetables and Staple Crops

Can Vitamin A Nutriture Be Improved by Feeding Plant Sources of Provitamin A?

Vitamin A-Fortified Sugar in Guatemala: A Successful National Experience

Indonesian Experience with Fortified Monosodium Glutamate: A National Failure

The Philippines Experience with Fortified Margarine: A Promising Government and Private-Sector Partnership

Other Fortification Efforts

Food-to-Food Fortification

Lessons Learned from Fortification Experiences

Emergency and Food-Aid Programs

National Delivery Systems

The Experience of Northeast Brazil with Community-Supported Supplement Distribution

The Experience of Bangladesh with an Immunization-Linked, Prophylactic Supplementation Program for Infants

Possibilities for Low-Dose, Community Supplementation

Lessons Learned from Supplementation Programs

Public Health Interventions

Lessons Learned from Public Health Interventions for Disease Control

COMPLEMENTARITY OF INTERVENTIONS

Phasing in Vitamin A Interventions

Vitamin A with Other Micronutrient Initiatives.

COSTS AND BENEFITS

BALANCING APPROACHES TO COUNTRY-SPECIFIC CIRCUMSTANCES

Two National Case Studies

Indonesia

Tanzanian Experience

SUMMARY

5 Prevention of Iodine Deficiency

REQUIREMENTS FOR IODINE

CONSEQUENCES OF IODINE DEFICIENCY AND ITS CORRECTION

Goiter

Mental and Neuromotor Retardation

Reproductive Impairment

Impaired Agricultural Productivity

Economic Stagnation

Physical Growth

CONSEQUENCES OF THE CORRECTION OF IODINE DEFICIENCY

INTERACTION WITH OTHER MICRONUTRIENTS

EXTENT OF IODINE DEFICIENCY

Assessment Techniques*

Goiter Rates

Urinary Iodine

Measurements of TSH

Thyroglobulin

Iodine in Food and Water

Extent and Distribution of Iodine Deficiency

Economic Costs of Iodine Deficiency

INDICATORS OF IODINE DEFICIENCY AND IMPACT OF PREVENTION

Identifying Target Populations

Monitoring Intervention Programs and Their Impact

PREVENTION AND CORRECTION

Salt*

Iodinated Bread

Iodinated Water

Drops and Tablets of Iodine

Iodinated Oil

Summary Statement on Fortification and Supplementation

NATIONAL PROGRAMS: SOME EXAMPLES OF SUCCESS AND FAILURE

Ecuador

Nigeria

Bolivia

Guatemala

United States

Bhutan

Zimbabwe

STRUCTURE OF PREVENTIVE PROGRAMS

Assessment

Salt Industry

Education

Legal Approaches

IMPEDIMENTS TO IDD CONTROL

In the Domain of Policy

Inadequate Political and Popular Support

Inadequate Involvement of the Salt Industry in Achieving Local or Universal Iodization of Salt

Insufficient Education

Insufficient Monitoring

Complacency

In the Domain of Programs

In the Domain of Research.

In the Domain of Financial Support

Conditions

Costs and Benefits

ACTION PLANS FOR THE INTERNATIONAL AGENCIES

Independent Evaluation

Strengthening Monitoring

Strengthening the Role of Regional and Country Program Directors

Enhancing Cooperative Efforts among Agencies

Pursuing Relevant Research

Extension of a Micronutrient Database

Extending and Expanding Communications

Extending Advocacy

Closing Gaps in Knowledge of the Extent of ID and IDDs

Conferences and Workshops at the Country, Regional, and International Levels

Resource Development

Dedicated Team Approach

APPENDIX: ICCIDD GUIDELINES FOR ASSESSMENT OF PROGRESS TOWARD IDD ELIMINATION

Appendix: Workshop Agenda.

Notes:

Edited papers from the Workshop on Micronutrient Deficiencies, held at the National Academy of Sciences, Washington, D.C., Dec. 5-7, 1996.

Includes bibliographical references.

ISBN:

9786610186884

9780309174374

0309174376

9781280186882

1280186887

9780309591621

0309591627

9780585023335

0585023336

OCLC:

923263712