 | 4th Report on the World Nutrition Situation - Nutrition throughout the Life Cycle (ACC/SCN, 2000, 138 p.) |
 |  | (introduction...) |
| | ADMINISTRATIVE COMMITTEE ON COORDINATION/SUB-COMMITTEE ON NUTRITION - (ACC/SCN) THE UN SYSTEM’S FORUM FOR NUTRITION |
| | INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE |
| | FOREWORD |
| | HIGHLIGHTS |
| | CONTRIBUTORS |
| | ACKNOWLEDGEMENTS |
| | LIST OF ABBREVIATIONS |
| | PREFACE |
|  | CHAPTER 1: NUTRITION THROUGHOUT THE LIFE CYCLE |
| | (introduction...) |
| | 1.1 Intrauterine Growth Retardation (IUGR) |
| | 1.2 Undernutrition in Preschool Children |
| | 1.3 The Growth of School-Age Children |
| | 1.4 Adolescent Nutrition |
| | 1.5 Adult Malnutrition |
| | 1.6 Nutrition of Older People in Developing Countries |
| | Summary |
| | CHAPTER 2: MICRONUTRIENT UPDATE |
| | (introduction...) |
| | 2.1 Iron Deficiency Update |
| | 2.2 Iodine Deficiency Disorders Update |
| | 2.3 Vitamin A Deficiency Update |
| | 2.4 Multiple Micronutrient Deficiencies |
| | Summary |
| | CHAPTER 3: BREASTFEEDING AND COMPLEMENTARY FEEDING |
| | (introduction...) |
| | 3.1 Evidence Linking Breastfeeding to Improved Outcomes |
| | 3.2 Evidence Linking Complementary Feeding to Improved Outcomes |
| | 3.3 Conceptualizing Infant Feeding Behaviours |
| | 3.4 HIV and Infant Feeding |
| | 3.5 Breastfeeding and Complementary Feeding Patterns and Trends |
| | 3.6 Role of National and International Initiatives in Support of Optimal Infant Feeding |
| | 3.7 Looking Forward: The Importance of Exclusive Breastfeeding |
| | CHAPTER 4: NUTRITION AND HUMAN DEVELOPMENT |
| | (introduction...) |
| | 4.1 The Relevance of Nutrition for Development |
| | 4.2 The Implications of Some Global Phenomena for Nutrition |
| | 4.3 The Ascent of Human Rights in Development |
| | Summary |
| | CHAPTER 5: NUTRITION OF REFUGEES AND DISPLACED POPULATIONS |
| | (introduction...) |
| | 5.1 Trends in Numbers of People Affected |
| | 5.2 Overview of the Humanitarian Response to Emergencies |
| | 5.3 Trends in Assessment Methodologies |
| | 5.4 Trends in Food and Nutrition Response Programmes |
| | 5.5 Trends in Information Sharing and Learning |
| | 5.6 Case Studies: The Scale and Severity of Nutritional Problems among Refugees and Displaced Populations |
| | 5.7 Future Directions |
| | Summary |
| | APPENDICES |
| | Appendix 1: Conceptualizing Nutrition Problems in Society |
| | Appendix 2: Countries in the UN Regions and Sub-Regions |
| | Appendix 3: Methods to Estimate Trends in Undernutrition Prevalence: A Review |
| | Appendix 4: Statistical Notes for Sections 1.1, 1.2, and 1.3 |
| | Appendix 5: Latest National Prevalence of Stunting and Underweight in Preschool Children |
| | Appendix 6: Explaining Trends in Child Underweight in the Developing World |
| | Appendix 7: Data Employed for Analysis of Child Underweight Rates in Sub-Saharan Africa |
| | Appendix 8: Prevalence and Numbers of Overweight Preschool Children in 1995 |
| | Appendix 9: Countries Classified by WHO Regions |
| | Appendix 10: National Implementation of the International Code of Marketing of Breastmilk Substitutes |
| | Appendix 11: Summary of Five Studies of the Social Impacts of the Indonesian Crisis |
| | Appendix 12: Some Food and Nutrition Information and Data Resources on the Internet |
| | REFERENCES |
| | BACK COVER |
2.4 Multiple Micronutrient Deficiencies
Many population groups in the developing world suffer from multiple nutrient deficiencies. The clustering of iron and vitamin A deficiencies has already been mentioned, but there are many more significant overlaps.
Moreover, deficiencies often interact. Vitamin A supplementation at appropriate levels has been found to improve not only vitamin A status but also iron metabolism in pregnant women and preschool and school-age children.28 It should be considered where iron deficiency is common. A combined iron and vitamin A supplement has been found to be more than 40% more effective in reducing anaemia than an iron supplement alone. Such findings are not specific to supplementation. A vitamin A sugar fortification programme in Guatemala resulted in improved iron status of the population,29 while a trial with vitamin A - fortified MSG in Indonesia increased haemoglobin levels among children.30
Given such frequent overlaps and given the fact that at certain stages of the life cycle - most notably during pregnancy - it may be difficult for dietary needs to be met through diet alone, multiple micro-nutrient supplementation holds clear potential to address multiple nutrient deficiencies in a cost-effective manner. Recent advances have been made in this area since 1998. One publication has addressed key issues concerning the design and implementation of such programmes.31 Also, a joint UNICEF/WHO/UNU workshop was convened in 1999 to consider the composition of a multi-micronutrient supplement to be used in forthcoming trials among pregnant women in developing countries.
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