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      Micronutrient gaps during the complementary feeding period in 6 countries in Eastern and Southern Africa: a Comprehensive Nutrient Gap Assessment

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          Abstract

          Insufficient quantity and inadequate quality of foods in early life are key causes of all forms of malnutrition. Identification of nutrient and dietary gaps in the diets of infants and young children is essential to inform policies and programs designed to improve child diets. A Comprehensive Nutrient Gap Assessment was used to assess the public health significance of nutrient gaps during the complementary feeding period and to identify evidence gaps in 6 countries in Eastern and Southern Africa. Important gaps were identified in iron, vitamin A, zinc, and calcium and, to a lesser extent, vitamin B 12 and folate. The best whole-food sources of these micronutrients available in part or all of the countries studied include beef liver, chicken liver, small dried fish, beef, and eggs. Investment is needed in many countries to collect data on micronutrient biomarkers and dietary intake. Strategic actions to improve child diets will require engagement and intervention across relevant systems to accelerate progress on improving the diets of infants and young children.

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          Most cited references28

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          Maternal and child undernutrition and overweight in low-income and middle-income countries

          The Lancet, 382(9890), 427-451
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            Iron deficiency: global prevalence and consequences.

            Iron deficiency is considered to be one of most prevalent forms of malnutrition, yet there has been a lack of consensus about the nature and magnitude of the health consequences of iron deficiency in populations. This paper presents new estimates of the public health importance of iron-deficiency anemia (IDA), which were made as part of the Global Burden of Disease (GBD) 2000 project. Iron deficiency is considered to contribute to death and disability as a risk factor for maternal and perinatal mortality, and also through its direct contributions to cognitive impairment, decreased work productivity, and death from severe anemia. Based on meta-analysis of observational studies, mortality risk estimates for maternal and perinatal mortality are calculated as the decreased risk in mortality for each 1 g/dl increase in mean pregnancy hemoglobin concentration. On average, globally, 50% of the anemia is assumed to be attributable to iron deficiency. Globally, iron deficiency ranks number 9 among 26 risk factors included in the GBD 2000, and accounts for 841,000 deaths and 35,057,000 disability-adjusted life years lost. Africa and parts of Asia bear 71% of the global mortality burden and 65% of the disability-adjusted life years lost, whereas North America bears 1.4% of the global burden. There is an urgent need to develop effective and sustainable interventions to control iron-deficiency anemia. This will likely not be achieved without substantial involvement of the private sector.
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              Trends and mortality effects of vitamin A deficiency in children in 138 low-income and middle-income countries between 1991 and 2013: a pooled analysis of population-based surveys.

              Vitamin A deficiency is a risk factor for blindness and for mortality from measles and diarrhoea in children aged 6-59 months. We aimed to estimate trends in the prevalence of vitamin A deficiency between 1991 and 2013 and its mortality burden in low-income and middle-income countries.
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                Author and article information

                Journal
                Nutr Rev
                Nutr Rev
                nutritionreviews
                Nutrition Reviews
                Oxford University Press
                0029-6643
                1753-4887
                April 2021
                08 March 2021
                08 March 2021
                : 79
                : Suppl 1 , Assessing Nutrient Gaps and Affordability of Complementary Foods: New Methods and their Application in Different Settings
                : 16-25
                Affiliations
                [1 ] United Nations Children's Fund (UNICEF) , New York, New York, USA
                [2 ] Global Alliance for Improved Nutrition , Washington, DC, USA
                [3 ] Department of Environmental Science and Policy, University of California , Davis, Davis, California, USA
                [4 ] Institute for Global Nutrition, University of California , Davis, Davis, California, USA
                [5 ] Intake, Center for Dietary Assessment, FHI Solutions , Washington, DC, USA
                [6 ] Department of Population Medicine and Diagnostic Sciences, Cornell University , Ithaca, New York, USA
                [7 ] Helen Keller International, New York , New York, USA
                [8 ] UNICEF, Regional Office for Eastern and Southern Africa , Nairobi, Kenya
                Author notes
                T. Beal, Global Alliance for Improved Nutrition, 1701 Rhode Island Ave NW, Washington, DC 20036, USA. E-mail: tbeal@ 123456gainhealth.org .
                Author information
                http://orcid.org/0000-0002-2375-0328
                http://orcid.org/0000-0002-0398-9825
                https://orcid.org/0000-0002-9580-0320
                https://orcid.org/0000-0002-5373-6754
                https://orcid.org/0000-0001-8079-9702
                http://orcid.org/0000-0001-9387-8530
                Article
                nuaa142
                10.1093/nutrit/nuaa142
                7947982
                33693910
                d3529812-0229-4466-b254-09180f7d3186
                © The Author(s) 2021. Published by Oxford University Press on behalf of the International Life Sciences Institute.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Pages: 10
                Funding
                Funded by: Ministry of the Foreign Affairs of the Netherlands;
                Award ID: MINBUZA-2019.334151
                Funded by: Bill & Melinda Gates Foundation, DOI 10.13039/100000865;
                Funded by: Regional Initiatives for Sustained Improvements in Nutrition and Growth;
                Award ID: OPP1179059
                Funded by: Bill & Melinda Gates Foundation, DOI 10.13039/100000865;
                Categories
                Articles
                AcademicSubjects/MED00060

                Nutrition & Dietetics
                adequacy,assessment,dietary intake,micronutrient deficiencies,nutrient gap
                Nutrition & Dietetics
                adequacy, assessment, dietary intake, micronutrient deficiencies, nutrient gap

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