Multiple Micronutrient Deficiency Among Adolescent Girls with Normal Nutritional Status - Need for Fortified Nutritional Support in Rural Settings of South Tamil Nadu, India

Authors

  • Sunitha K Thoothukudi Medical College, Thoothukudi, India
  • Muthu G Model Rural Health Research Unit, Pondicherry, India
  • Jesuraj Arockiasamy National Institute of Epidemiology, Indian Council of Medical Research, Chennai, India
  • Maryam Jamila S Model Rural Health Research Unit, Kallur, Tirunelveli, India
  • Yuvaraj J SRM University, Trich, India
  • Shantaraman K Directorate of Medical Education, Chennai, India

DOI:

https://doi.org/10.55489/njcm.150220242830

Keywords:

Adolescent Girls, Nutritional Status, Anaemia, Micronutrient’s deficiency

Abstract

Introduction: Adolescents contribute to one fifth of the world's population and is a high priority lifecycle stage for nutrition needs and intervention. Nutritional deficiency, including micronutrients, hinders their normal growth and development. Improving adolescent girls’ nutrition has reproduction-related benefits and serves as a unique opportunity to break the vicious cycle of intergenerational structural problems. The objective is to estimate the prevalence of anaemia, micronutrient deficiency and nutritional status among adolescent girls in rural India.

Methods: A community-based cross-sectional study was conducted among 241 adolescent girls in rural Tirunelveli, India with 220 blood samples.

Results: The mean age of 241 adolescent girls was 13.8±1.4 years and nutritional status was normal, overweight, obese, thin and stunted in 81.7%, 14.5%, 3.3%,0.4% and 4.6% respectively. The prevalence of anaemia, iron deficiency and iron-deficiency anaemia were 37.2%, 34.5% and 12.3%. Except for selenium, the estimated micronutrient deficiency levels were Vitamin B12 - 40.9%, Copper-30.9%, Zinc-13.6% and Iodine- 11%. Only 19.1% girls had adequate levels of all micronutrients. Vitamin B12 deficiency was more in girls who were overweight (p<0.05).

Conclusion: Multiple micronutrient deficiency with normal nutritional status is high among adolescent girls with Vitamin B12 deficiency higher than Iron. Multipronged strategies, including introducing micronutrient fortified healthy snacks in schools, might bring greater acceptance and improvement in nutritional health among these girls.

References

Global strategy for women's, children's and adolescent's health 2016-2030. World Health Organization 2015.

World Population Prospects 2019: Highlights. United Na-tions. Department of Economic and Social Affairs, Population Division 2019.

Adolescent nutrition: a review of the situation in selected South-East Asian Countries. WHO Regional Office for South East Asia 2006: 8-15.

The implications for training of embracing: a life course ap-proach to health. WHO 2000, https://apps.who.int/iris/ han-dle/10665/69400

4th report on the world nutrition situation: nutrition throughout the life cycle. United Nations, Subcommittee on Nutrition; International Food Policy Research Institute 2000.

Twig G, Yaniv G, Levine H, et al. Body-mass index in 2.3 mil-lion adolescents and cardiovascular death in adulthood. N Engl J Med 2016; 374: 2430-2440. Doi: https://doi.org/10.1056/NEJMoa1503840 PMid:27074389

Worldwide trends in body-mass index, underweight, over-weight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet. 2017; 390: 2627-2642.

Daniels SR, Arnett DK, Eckel RH, et al. Overweight in Children and Adolescents. Pathophysiology, Consequences, Preven-tion, and Treatment. Circulation 2005; 111: 1999-2012. Doi: https://doi.org/10.1161/01.CIR.0000161369.71722.10 PMid:15837955

Grebmer KV, Saltzman A, Birol E, et al. Global Hunger Index: The Challenge of Hidden Hunger 2014.

The State of Food and Agriculture, FAO 2013, http://www. fao.org/3/i3300e/i3300e.pdf

World Health Organization. Global accelerated action for the health of adolescents (AA-HA!). 2017.

Weekly Iron Folic Acid Supplementation (WIFS). National Health Mission. Ministry of Health and Family Welfare, Gov-ernment of India. https://nhm.gov.in/

Sheet IF. NFHS-5 (National Family Health Survey-5). Interna-tional Institute for Population Studies. 2019-2021

Serum ferritin concentrations for the assessment of iron sta-tus and iron deficiency in populations. Vitamin and Mineral Nutrition Information System 2011, https://www.who.int/vmnis/ indicators/serum_ferritin.pdf

Allen, L. H. How common is vitamin B-12 deficiency? Am. J. Clin. Nutr 2009; 89: 693S-696S. Doi: https://doi.org/10.3945/ajcn.2008.26947A PMid:19116323

Zimmermann MB, Jooste PL and Pandav CS. Iodine-deficiency disorders. Lancet 2008; 372: 1251-62. Doi: https://doi.org/10.1016/S0140-6736(08)61005-3 PMid:18676011

The Micronutrient Initiative. Investing in the Future: A United Call to Action on Vitamin and Mineral Deficiencies. Global Report. 2009, https://www.who.int/vmnis/ pub-lications/investing_in_the_future.pdf.

Revised Policy Guidelines on National Iodine Deficiency Disorders Control Programme. National Rural Health Mission IDD and Nutrition Cell. Directorate General of Health Services Ministry of Health and Family Welfare, Government of India. New Delhi 2006.

Olivares M, Uauy R. Copper as an essential nutrient. Am J Clin Nutr 1996; 63: 791-6. Doi: https://doi.org/10.1093/ajcn/63.5.791 PMid:8615366

Harris ED. The iron-copper connection: The link to cerulo-plasmin grows stronger. Nutr Rev 1995; 53: 170-3. Doi: https://doi.org/10.1111/j.1753-4887.1995.tb01545.x PMid:7478312

Nishi Y. Zinc and growth. J Am Coll Nutr 1996; 15: 340-4. Doi: https://doi.org/10.1080/07315724.1996.10718608 PMid:8829089

Hegazy, Manal M Zaher, Manal A Abd el-hafez, et al. Relation between anemia and blood levels of lead, copper, zinc and iron among children Amal A. BMC Research Notes 2010; 3:133. Doi: https://doi.org/10.1186/1756-0500-3-133 PMid:20459857 PMCid:PMC2887903

Kucharzewski M, Braziewicz J, Majewska U, et al. Concentra-tion of selenium in the whole blood and the thyroid tissue of patients with various thyroid diseases. Biol Trace Elem Res 2002; 88: 25-30. Doi: https://doi.org/10.1385/BTER:88:1:25 PMid:12117262

Johnson C.C, Fordyce F.M and Rayman M.P. Factors control-ling the distribution of selenium in the environment and their impact on health and nutrition. Proc Nutr Soc 2010; 69: 119-32. Doi: https://doi.org/10.1017/S0029665109991807 PMid:19968907

Sheet IF. NFHS-4 (National Family Health Survey-4). Interna-tional Institute for Population Studies. 2017.

WHO. AnthroPlus for Personal Computers Manual: Software for Assessing Growth of the World's Children and Adoles-cents; 2009.

WHO- BMI for age. Available from https://www.who.int/ toolkits/growth-reference-data-for-5to19-years/indicators/ bmi-for-age [Cited 2023 Apr 19]

Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition In-formation System. World Health Organization, 2011.

De Benoist B. Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. Food Nutr Bull 2008; 29: S238-44. Doi: https://doi.org/10.1177/15648265080292S129 PMid:18709899

Kenneth H Brown, Juan A Rivera, Zulfiqar Bhutta, et al. Inter-national Zinc Nutrition Consultative Group (IZiNCG) tech-nical document #1. Assessment of the risk of zinc deficiency in populations and options for its control. Food Nutr Bull 2004; 25: S99-203.

Alan H.B.Wu. Tietz Clinical Guide to Laboratory Tests (4th edition). Elsevier, 2006.

Vitamin and Mineral Nutrition Information System. World Health Organization. Geneva. Switzerland 2013, http://www. who.int/nuUrinary iodine concentrations for determining iodine status deficiency in populations.Nutrition/vmnis/ in-dicators/urinary iodine

Khairnar MR, Wadgave U and Shimpi PV. Updated BG Prasad socioeconomic classification for 2016. J Indian Assoc Public Health Dent 2016; 14: 469-70. Doi: https://doi.org/10.4103/2319-5932.195832

Government of India. Census of India; 2011, http://census in-dia.gov.in/2011-prov-results/prov_results_paper1_india.html.

Popkin BM, Richards MK and Montiero CA. Stunting is associ-ated with overweight in children of four nations that are un-dergoing the nutrition transition. J Nutr 1996; 126: 3009-16. Doi: https://doi.org/10.1093/jn/126.12.3009 PMid:9001368

Bedwal RS, Bahuguna A. Zinc, copper and selenium in repro-duction. Experientia 1994; 50: 626-40. Doi: https://doi.org/10.1007/BF01952862 PMid:8033970

Zimmermann MB, Köhrle J. The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid 2002; 12: 867-78. Doi: https://doi.org/10.1089/105072502761016494 PMid:12487769

Downloads

Published

2024-02-01

How to Cite

1.
K S, Muthu G, Arockiasamy J, Maryam Jamila S, Yuvaraj J, Shantaraman K. Multiple Micronutrient Deficiency Among Adolescent Girls with Normal Nutritional Status - Need for Fortified Nutritional Support in Rural Settings of South Tamil Nadu, India. Natl J Community Med [Internet]. 2024 Feb. 1 [cited 2024 Jul. 21];15(02):105-11. Available from: https://njcmindia.com/index.php/file/article/view/2830

Issue

Section

Original Research Articles