The State of the World's Children 1998: Fact Sheets

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Micronutrients

  • Iodine
  • Vitamin A
  • Iron
  • Zinc
  • Folate

Micronutrients, so called because they are needed by the body only in minute amounts, play leading roles in the production of enzymes, hormones and other substances, helping to regulate growth, activity, development and the functioning of the immune and reproductive systems. Adequate intake is especially crucial during early childhood and other periods of rapid growth, pregnancy and breastfeeding.

The 1990 World Summit for Children singled out deficiencies of three micronutrients — iron, iodine and vitamin A — as being particularly common and of great concern for women and children in developing countries. The Summit set goals for the virtual elimination of iodine and vitamin A deficiencies and the reduction of iron deficiency anaemia in women by one third by the year 2000. Since then, knowledge of the prevalence and importance of deficiencies of zinc and folate have also been recognized. And more is being learned every day about the importance of micronutrients for both the physical and cognitive development of children.

Iodine

  • Iodine deficiency is the single most important cause of preventable brain damage and mental retardation. In pregnant women it significantly raises the risk of stillbirth and miscarriage. There is also evidence that severe iodine deficiency increases women's risk of pregnancy-related death.
  • An estimated 43 million people worldwide suffer from varying degrees of brain damage and physical impairment due to iodine deficiency, including 11 million who are cretins, afflicted with profound mental retardation. Some 760 million people have goitres, the swelling of the thyroid gland in the neck that is the most common and visible sign of iodine deficiency.
  • Less severe iodine deficiencies in children and adults can mean a loss of 10 intelligence quotient (IQ) points and can impair physical coordination.
  • The successful global campaign to iodize all edible salt is reducing the risk of iodine deficiency, which threatened 1.6 billion people as recently as 1992. About 12 million infants born in 1996 were spared that risk thanks to iodized salt, and the number of babies born cretins is estimated to have dropped by more than half, from 120,000 in 1990 to under 55,000 worldwide.

Vitamin A

  • Over 100 million young children suffer from vitamin A deficiency. It is a contributing factor in the 2.2 million deaths each year from diarrhoea among children under five and the nearly 1 million deaths from measles. Severe deficiency can also cause irreversible corneal damage, leading to partial or total blindness.
  • Results of a dozen field trials in Brazil, Ghana, India, Indonesia, Nepal and elsewhere indicate that supplementing the diets of children at risk of vitamin A deficiency can reduce deaths from diarrhoea. Four studies showed deaths were reduced by 35-50 per cent. The vitamin can also reduce by half the number of deaths due to measles.
  • Vitamin A capsules cost roughly 2 cents each. Supplementation reduces the risk of death of a child deficient in vitamin A by 23 per cent. In 1997 alone, the lives of at least 300,000 young children were saved by vitamin A supplementation programmes in developing countries.
  • Supplements of both vitamin A and zinc may boost children's resistance to malaria, which kills 600,000 young children each year, according to early evidence from a study in Papua New Guinea. One third of children receiving vitamin A had lower fevers due to mild to moderately high levels of malaria parasites.
  • Low-dose vitamin A supplements have been found to reduce pregnancy-related deaths by an average of 44 per cent among women in areas where deficiency is widespread, according to a large-scale study in Nepal. The global toll of maternal deaths is nearly 600,000 each year, the vast majority of which are women in developing countries who die from largely preventable causes. Yet scientists emphasize that high-dose vitamin A supplements should never be taken by women of childbearing age because of the potential risk of harm to a developing foetus.
  • A 1994 study of HIV-infected women in Malawi concluded that vitamin A-deficient women were four and a half times more likely to pass on the virus to their children.

Iron

  • Iron deficiency anaemia, the most common nutritional disorder in the world, lowers resistance to disease and weakens a child's learning ability and physical stamina. It is a significant cause of maternal mortality, increasing the risk of haemorrhage and infection during childbirth.
  • Nearly 2 billion people are estimated to be anaemic and millions more are iron deficient, the vast majority of them women. A range of factors cause iron deficiency anaemia, including inadequate diet, blood loss associated with menstruation and parasitic infections such as hookworm.
  • A single dose of antiworm medicine costs as little of 3 cents and can eliminate or significantly reduce intestinal worm infections, an important cause of anaemia.
  • Fortifying foods with iron and providing iron supplements are two approaches to addressing iron deficiency. Fortification of wheat flour and flour products is being promoted, particularly in Latin America and the Middle East, where these foods are widely consumed. UNICEF is a major supplier of iron/folate tablets, providing a total of 2.7 billion for pregnant women in 122 countries from 1993 to 1996.

Zinc

  • Zinc promotes normal growth and development and is an element in enzymes that work with red blood cells which move carbon dioxide from tissues to lungs. It also helps maintain an effective immune system. Zinc deficiency in malnourished children contributes to growth failure and susceptibility to infections, and is also thought to be associated with complications of childbirth. There are, however, no data on the prevalence of zinc deficiency. This deficiency usually occurs where malnutrition is prevalent and is now recognized as a public health problem in many countries.
  • Trials in Bangladesh, India and Indonesia have shown reductions of about one third in the duration and severity of diarrhoea in children receiving zinc supplements and a median 12 per cent decline in the incidence of pneumonia.
  • Zinc supplements helped blunt the most severe malaria cases in children under age five, reducing by over a third the number of such cases seen at health centres, according to a study on zinc and vitamin A supplementation. Overall clinic visits by those receiving zinc decreased by a third, and signs of other infections were reduced by 20-50 per cent.
  • The cost of a year's supply of zinc supplements for a child is only $1.
  • Zinc deficiency, increasingly recognized as widespread among women in developing countries, is associated with long labour, which increases the risk of maternal and infant death. A number of studies have found that zinc supplementation reduces complications of pregnancy.

Folate

  • Folate is a B vitamin that helps in the formation of red blood cells. Folate also regulates the nerve cells at the embryonic and foetal stages of development, helping to prevent serious neural-tube defects of the spinal cord and brain.
  • Folate deficiency causes birth defects in the developing foetus during the earliest weeks of pregnancy — before most women are aware that they are pregnant. It is also associated with a high risk of pre-term delivery and low birthweight. Folate deficiency also contributes to anaemia, especially in pregnant and lactating women, and may be associated with increased risk of maternal death and illness.
  • UNICEF is a major supplier of iron/folate tablets for pregnant women in developing countries, helping to reduce the risks of folate deficiency for both mothers and infants.

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