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portance of Women and Child Nut Nutrition and Health Issues Why Hime Tomo? March 2017

The Importance of Women and Children`s Nutrition

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The Importance of Women and Child Nutrition

・ Nutrition and Health Issues・Why Hime Tomo?

March 2017

Introduction:

<Reference>1.) Blössner, Monika, de Onis, Mercedes. Malnutrition: quantifying the health impact at national and local levels. Geneva, World Health Organization, 2005. (WHOEnvironmental Burden of Disease Series, No. 12).

Iron and folic acid are essential nutrients to ensure both mother and baby`s health.

Iron and folic acid are highly recommended for all women who are planning to get pregnant and expecting mothers to prevent anemia that cause preterm and low-birth weight and folate deficiency that may cause neural-tube defects in offspring.

Women`s reproductive biology (menstrual cycle, pregnancy and birth) is one of the factors making all women more vulnerable in iron and folate deficiency than men. In women with high risk of anemia intermittent supplementation is also recommended in non-pregnant women.

The nutritional status of women and children is particularly important, because it is through women and their off-spring that the pernicious effects of malnutrition are propagated to future generations.[1]

Percent of women of reproductive age with anemia

29.4%

Percent of women of Pregnant women with

anemia

38.2 %

Anemia

The Southeast Asian Region has the highest prevalence of Anemia in the world next to Africa. Accounting 65% in children, 48.2% in pregnant women and 35.7% in non-pregnant women of Asia.

Importance of Iron+Folate Supplementation:Southeast Asia

<Reference> 1.) WHO. Worldwide prevalence on anaemia 1993-2005. http://www.who.int/vmnis/anaemia/prevalence/summary/anaemia_status_summary/en/.Accessed on March 17, 2017.2.) WHO. World Malaria Report 2012. http://www.searo.who.int/entity/malaria/data/sear12.pdf?ua=1.Accessed on March 17 2017.

Malaria

In Southeast Asian Region it is reportedly that approximately 70% of the population is at risk for malaria.[2]

Pregnancy reduces woman`s immunity making them more vulnerable to illness, anemia, malaria infection, severe disease and even death.

Malaria Area Map

Congenital Disorders

Evidence suggests that congenital and genetic disorders are major proportion of perinatal and neonatal morbidity and mortality in Arab Countries.

Genetic disorders and congenital disorders occur in about 2%-5% live birth, 30% paediatric hospitalization and 50% of childhood death.[1]

What are common birth defects in the Arab World?1. Down Syndrome2. Thalassamias3. Sickle-cell anemia4. Glucose-6-phosphate dehydrogenase(G6PD)5. Autosomal recessive disorders (congenital malformations, mental and physical handicap)

Importance of Iron+Folate Supplementation:Arab World

<Reference>1.) Lihadh Al-Gazali, Hanan Hamamy, Shaikha Al-Arrayad, Genetic disorders in the Arab world, BMJ. 2006 Oct 21; 333(7573): 831–834.2.) Akl C. Fahed, 1 Abdul-Karim M. El-Hage-Sleiman, Theresa I. Farhat, 2Georges M. Nemer. Diet, Genetics, and Disease: A Focus on the Middle East and North Africa Region, Journal of Nutrition and Metabolism Volume 2012 (2012)3.) WHO EMRO, Genetic disorders and congenital abnormalities: strategies for reducing the burden in the Region, EMHJ 1997:3(1)

・ Anemia

Iron and Folic acid plays an important role in production and maintenance of red blood cell.Lack of iron and folic acid in the body causes anemia

Women of reproductive age lose iron by blood loss during menstruation, pregnancy and child birth. Folic acid in the other hand being a water soluble vitamin cannot be stored by our body and easily destroyed by cooking. In addition, it is naturally excreted by leaving the body through urine.Therefore, we need to consume folic acid every day to ensure that we have enough in our system.

According to WHO anemia is accounted for 29.4% in women of reproductive age and 38.2% in pregnant women.[1]

Folic acid and iron supplementation is recommended not only to expecting mothers but also to menstruating women as well .

Common Micronutrient Deficiencies in Asia

<Reference>1.) WHO. The global prevalence of anemia in 2011. http://www.who.int/nutrition/publications/micronutrients/global_prevalence_anaemia_2011/en/.Accessed February 3,2017.

・ Vitamin D (VDD)

Vitamin D is produced by human body from exposure to sunlight, consumption of foods rich in Vitamin D and Vitamin D supplements. Vitamin D requirements are probably greater in pregnancy.Vitamin D plays an important role in immune function, healthy cell division and bone health. Vitamin D deficiency is associated with several chronic diseases including cardiovascular, autoimmune disease and cancer.[1]

During pregnancy vitamin D insufficiency may develop and adverse health outcomes such as preeclampsia, gestational diabetes mellitus and Caesarean section.There are also health consequences in new-borns such as low birth weight, neonatal rickets neonatal hypocalcaemia, asthma and type 1 diabetes.

In South Asia, Vitamin D deficiency (VDD) seemed to affect 84% of pregnant women in India, 70% of healthy volunteers in Pakistan, 26% of male children in Sri Lanka and 8% of children in Bangladesh[1]

<Reference>1.) Saeed Akhtar et al.Micronutrient deficiencies in South Asia – Current status and strategies.Trends Food Sci Technol;31(1):55–62.

・ Vitamin A Deficiency (VAD)

Vitamin A are essential for eye health, immunity and cell growth.Vitamin A deficiency is the leading cause of preventable blindness, disease and death from severe infections in children and cause night blindness and increases risk of death in pregnant women. Vitamin A deficiency is a public health problem in half of all countries especially in low-income and middle income countries.

・ Zinc Deficiency

Zinc is also an essential nutrient. Zinc Deficiency cause severe infections.Worldwide, zinc deficiency is responsible for approximately 16% of lower respiratory tract infections, 18% of malaria and 10% of diarrhoeal disease.

・ Iodine Deficiency

Iodine deficiency may result mental retardation and goiter.Iodine deficiency has also been associated with lower mean birth weight and increased infant mortality, hearing impairment, impaired motor skills, and neurological dysfunction.

<Reference>1.) WHO. The world health report. http://www.who.int/whr/2002/chapter4/en/index3.html.Accessed on March 16, 2017

More than 30% of women of reproductive age are anemic. This is because women of reproductive age lose blood through menstruation and are particularly vulnerable to iron deficiency. Intermittent supplementation is recommended.Additionally, intermittent supplementation also reduce oxidative stress. [1]

Intermittent supplementation of folic acid and iron in menstruating women are recommended by WHO as public intervention.

Intermittent Supplementation in Menstruating Women:

<Reference>1.) WHO. Guideline: Intermittent iron and folic acid supplementation in menstruating women. Geneva, World Health Organization, 2011.

Supplement composition Iron: 60 mg of elemental ironFolic acid: 2800 μg (2.8mg)

Frequency One supplement per week

Duration and time interval between periods of supplementation

3 months of supplementation followed by 3 months of no supplementation after which the provision of supplements should restart.

Target group

All menstruating adolescent girls and adult women

Settings

Populations where the prevalence of anemia among non-pregnant women of reproductive age is 20% or higher

Folic acid and iron requirements increase during pregnancy. Folate is required for the growth and development of the fetus. Folate deficiency has been associated with abnormalities in both mothers (anemia, peripheral neuropathy) and fetuses (congenital abnormalities).[1]

While Iron is required because when maternal anemia is diagnosed before midpregnancy, it has been associated with an increased risk of preterm delivery and infant low birth weight. [2]

In addition to Folic acid and Iron, supplements may be formulated to include other vitamin and minerals according to United Nation Multiple Micronutrient Preparation to defeat malnutrition during pregnancy.[3]

Daily Supplementation in Pregnant Women:

<Reference>1.) James A Greenberg, MD, Stacey J Bell, DSc, RD, Yong Guan, MD, and Yan-hong Yu, MD, PhD. Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention. Rev Obstet Gynecol. 2011 Summer; 4(2): 52–59.2.) Scholl TO1, Reilly T. Anemia, iron and pregnancy outcome. J Nutr. 2000 Feb;130(2S Suppl):443S-447S.3.) UNICEF, WHO, UNU. Composition of a multi-micronutrient supplement to be used in pilot programs among pregnant women in developing countries: report of a United Nations Children’s Fund (UNICEF), World Health Organization (WHO), United Nations University (UNU) workshop held at UNICEF Headquarters, New York, July 9, 1999, New York, United Nations Children’s Fund, 2000 (http://apps.who.int/iris/handle/10665/75358,accessed 1 December 2012).

Supplement composition

Iron: 30-60 mg of elemental ironFolic acid: 400 μg(0.4mg)

Frequency One supplement daily

DurationThroughout pregnancy. Iron and folic acid supplementation should begin as early as possible

Target group All pregnant adolescents and adult women

Settings All settings

What is Hime Tomo?

“Hime” is the Japanese word for "princess", or more literally "demoiselle", i.e. a (usually young) lady of higher birth.

Since the dietary supplement contains important nutrition such as folic acid and iron etc., we wish Hime Tomo become Women’s good “Tomo”.

Ingredients That Makes Hime Tomo UniqueFolic acid is widely used as a pre-natal supplement to prevent neural tube defects (NTD), congenital malformations and folate deficiency. Folate is required for the growth and development of the fetus. Daily intake of Folic acid 1 month before and during pregnancy is recommended by WHO.

Iron is an essential mineral that helps make red blood cells that carry oxygen throughout the body. Iron supplementation reduced risk of low birth weight, preterm birth, maternal severe anaemia, and infections during pregnancy. Iron daily supplementation for pre-natal care is also recommended by WHO.

*Nutrition Facts, raw materials and their health benefits.

Other Benefits:• Folic acid also concluded to be cure hot flashes

in menopause women.• In malaria endemic areas folic acid and iron

supplementation is highly recommended to prevent and treat malaria infections.

*Nutrition Facts, raw materials and their health benefits.

Ingredients That Makes Hime Tomo Unique

Vitamin D also known as “Sunshine Vitamin” has many functions in the body including bone integrity and calcium metabolism. Vitamin D reduce the risk of pre-eclampsia, low birth weight pre-term birth and Vitamin D deficiency. Vitamin D deficiency is associated with other chronic diseases such as insulin resistance, gestational diabetes mellitus, bacterial vaginosis and increase of Caesarean section delivery.

Young Green Barely Leaves Loaded with essential nutrients and active enzymes that supply nutrition. Also offers antioxidant, protection against free radical damage, antidepressant-like effect, overall detoxification and supports cellular metabolism reducing premature aging.

What Makes Hime Tomo Different?

“Barley young leaves" makes HimeTomo stands out among many of the folic acid supplement in the market. In Japan, young barely leaf green juice “Aojiru” is known as “Super Food” and is widely used as health supplement.

Young barely leaves has many health benefits and famous for its loads of nutritional components such as Vit A, Zinc, Iodine, Amino acids and Fatty acids etc.[1], micronutrients that is lacking asian diet.

In addition, barley young leaves are reported to help for stress relief in anxiety, depression, pregnancy. [2] [3] [4]

<Reference>1.) National Nutrient Database for Standard Reference Release 28 slightly revised May, 2016 2.) Pharmacogn Mag. 2015 May; 11(Suppl 1): S86–S92.3.) Curr Opin Psychiatry. 2012 Mar; 25(2): 141–148.4.) National Academies Press (US); 1990.

Folic acid 400 mcg

Barley Young leaf 50.00 mg  

Ferric Pyrophosphate 25.40 mg

Vitamin D3 4.00 mg

Total 500 mg

Supplement fact of HimeTomo2 tablets of a day

Other ingredients: Maltitol

Per 2 tablets

Healthy Women and ChildrenTowards the Better Future