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Nutrient excesses

It is perhaps unnecessary to emphasize that dietary deficiencies should not and cannot be corrected by excessive nutrient intakes. Too much vitamin A produces some of the same symptoms as its deficiency and can be fatal [167]. China has a tremendous problem of foetal damage due to iodine deficiency during pregnancy, and at the same time there are local areas in which an excess of iodine elicits somewhat similar symptoms [145, 168]. A large excess of iron can overburden the liver and cause serious disease. In severely malnourished individuals a sudden large parenteral or oral dose of iron can lead to overwhelming infection [169-171]. This is because iron is made available for the replication of the infectious agent at a time when the immune system of the individual is severely compromised.

While the subject is beyond the scope of this paper, it should that the dietary excesses of affluent societies also have their health costs [172]. Coronary heart disease is rare in populations with dietary fat intakes below 25% of total calories and increases progressively as the percentage of fat calories rises. This is particularly the case when these come increasingly from foods of animal origin, in which most of the fat is saturated and cholesterol is relatively high. The diseases exacerbated by such dietary excesses include not only hypertension, coronary heart disease, and type-two diabetes but also some forms of cancer, particularly those of the colon, prostate, and breast [173]. Smoking, lack of exercise, overweight, and frank obesity increase the health risk.

It is, therefore, no longer enough for countries to have policies and programmes to eliminate hidden hunger. They must also design their nutrition education and other food and nutrition activities to avoid replacing the problems of undernutrition with the diseases exacerbated by food excess. However, this must not weaken the focus on eliminating hidden hunger.

Our obligation to the human future

This paper has focused on freedom from hunger, both hidden and overt, as the most fundamental of human rights. There are also the very real problems of environmental pollution and destruction, global warming, loss of germ plasm, and a rate of human reproduction that exacerbates all of these. Conquering hunger will release human potential for creating better societies. However, achieving the other rights of shelter, education, and hope for the future will not follow automatically unless governments implement appropriate polices.

While the reduction in child mortality that follows the alleviation of hunger is a prerequisite to fertility reduction, successful fertility reduction also requires education, economic opportunity, and a potential advantage to having fewer children. Success in lowering, and eventually stabilizing, population growth is essential to the permanent solution of all of the other problems, including environmental deterioration, food supplies for the poor in developing countries, global warming, civil disturbances, and wars.

There is now evidence from a number of countries that the conquest of hunger is possible even before poverty can be eliminated. This is all the more reason to recognize that solving all of the physical and biological problems will still have little meaning if the social problems of poverty, misery, and lack of hope persist for any substantial proportion of the world's population. When we work for adequate feeding of the world's population, we must recognize that the sustained conquest of hunger will also require overcoming exponential population growth, the avoidance of global warming and environmental destruction, the cessation of war, and maintenance of societies that give their citizens dignity and hope.

The physical, biological, and social problems humankind is facing are caused by human activity, and they can be solved by human actions if we avoid further delay. All those concerned with the human food chain from production to consumption whose collective efforts are recognized by the World Food Prize have their own formidable tasks. In addition, they must also be effective partners in the efforts of other disciplines to assure the future of human society in a sustainable environment in which it can flourish.

Finally, in the words of Gabriel Mistral:

Many things we need can wait.
The child cannot.
Right now is the time his bones are being formed,
his blood is being made and
his senses are being developed.
To him we cannot answer—"Tomorrow."
His name is today.

References

  1. Sen A. Poverty and famine: an essay on entitlement and deprivation. Oxford: Clarendon, 1981.
  2. Scrimshaw NS, Young VR. Adaptation to low protein and energy intakes. Hum Org 1989;40(1):20-30.
  3. Viteri FE, Torun B. Ingestién calórica y trabajo físico de obreros agrícolas en Guatemala. Bol Ofic Sanit Panam 1975;78:58-74.
  4. Viteri FE, Torun B. Nutrition, physical activity and growth. In: Ritzen M, Aperia A, Hall K, Larsson A, Zetterberg A, Zetterström R. eds. The biology of normal growth. New York: Raven Press, 1981:265-73.
  5. De Guzman MP, Florentino RF, Cabrera IP, Yuchingtat GP, Solanzo FG. Nutritional status and energy expenditure levels of some undernourished members of the rural household. Manila, Philippines: Food and Nutrition Research Institute, 1985.
  6. Prentice AM. Adaptations to long-term low energy intake. In: Pollitt ED, Amante P. eds. Energy intake and activity. New York: Alan Liss, 1984:3-31.
  7. Woldgemuth JC, Latham MC, Hall A, Chester A, Crompton DWT. Worker productivity and the nutritional status of Kenyan road construction laborers. Am J Clin Nutr 1982;36:68-78.
  8. Kraut HA, Muller EA. Calorie intake and industrial output. Science 1946;104:495-97.
  9. Viteri FE. Considerations on the effect of nutrition on the body composition and physical working capacity of young Guatemalan adults. In: Scrimshaw NS, Altschul A, eds. Amino acid fortification of protein foods. Cambridge, Mass, USA: MIT Press, 1971:35075.
  10. Davies CT, Brotherhood JR, Collins KJ et al. Energy expenditure and physiological performance of Sudanese cane cutters. Br J Indust Med 1976;33:181-86.
  11. Maksud MG, Spurr GB, Barac-Nieto M. The aerobic power of several groups of laborers in Colombia and the United States. Eur J Appl Physiol 1976;35: 173-82.
  12. Ferro-Luzzi A, Franklin M, James WPT. A simplified approach to assessing adult chronic energy deficiency. Eur J Clin Nutr 1992;46(3):173-86.
  13. James WPT, Ferro-Luzzi A, Waterlow JC. Definition of chronic energy deficiency in adults. Report of a working party of the International Dietary Energy Consultative Group. Eur J Clin Nutr 1988;42:969-81.
  14. James WPT. Research relating to energy adaptation in man. In: Schurch B. Scrimshaw NS, eds. Chronic energy deficiency: consequences and related issues. Lausanne, Switzerland: Nestlé Foundation, 1987:7-36.
  15. National Institute of Nutrition. Annual report. Hyderabad, India: Indian Council of Medical Research, 1989-90.
  16. Immink MDC, Viteri FE, Flores R. Torun B. Microeconomic consequences of energy deficiency in rural populations in developing countries. In: Pollitt E, Amante P. eds. Energy intake and activity. New York: Liss, 1984:355-76.
  17. Prentice MA, Watkinson M, Whitehead RG, Lamb WH, Cole TJ. Prenatal dietary supplementation of African women and birth weight. Lancet 1983;1:489-92.
  18. Spencer T. Heywood P. Seasonality subsistence agriculture and nutrition in a lowland community of Papua New Guinea. Ecol Food Nutr 1983;13:221-29.
  19. Loutan L, Lamotte JM. Seasonal variations in nutrition among a group of nomadic pastoralists in Niger. Lancet 1984;2:945-47.
  20. Benefice E, Chevassus-Agnes S. Barral H. Nutritional situation and seasonal variations for pastoralist populations of the Sahel (Senegalese Ferlo). Ecol Food Nutr 1984;14:229-47.
  21. Ferro-Luzzi A, Pastore G. Sette S. Seasonality in energy metabolism. In: Schurch B. Scrimshaw NS, eds. Chronic energy deficiency: consequences and related issues. Lausanne, Switzerland: Nestlé Foundation, 1987:37-58.
  22. Keys A, Henschel A, Michelson O. Taylor HL. The biology of human starvation. Minneapolis, Minn, USA: University of Minnesota, 1950.
  23. Torun B. Short and long term effects of low or restricted energy intakes on the activity of infants and children. In: Schurch B. Scrimshaw NS, eds. Activity, energy expenditure and energy requirements of infants and children. Lausanne, Switzerland: Nestlé Foundation, 1990:335-59.
  24. Cravioto J. DeLicardie E, Birch HG. Nutrition, growth, and neurointegrative development: an experimental and ecologic study. Pediatr 1968;38(suppl): 319-72.
  25. Cravioto J. DeLicardie E. Environmental correlates of severe clinical malnutrition and language development in survivors from kwashiorkor or malnutrition. In: Nutrition, the nervous system, and behavior. Washington, DC: Pan American Health Organization, 1972;251:73-94.
  26. Spurr GB, Maksud MG, Barac-Nieto M. Energy expenditure, productivity and physical work capacity of sugar cane loaders. Am I Clin Nutr 1977;30: 1740-46.
  27. Desai I, Waddell C, Dutra S et al. Marginal malnutrition and reduced physical work capacity of migrant adolescent boys in southern Brazil. Am J Clin Nutr 1984;40: 135-45.
  28. Areskog NH, Selinus R. Vahiquist B. Physical work capacity and nutritional status in Ethiopian male children and young adults. Am J Clin Nutr 1969;22:471-79.
  29. Martorell R. Rivera J. Kaplowitz H. Consequences of stunting in early childhood for adult body size in rural Guatemala. Annales Nestlé 1990;48:85-92.
  30. Satyanarayana K, Naidu NA, Narasinga Rao BS. Nutritional deprivation in childhood and the body size, activity, and physical work capacity of young boys. Am J Clin Nutr 1979;32:1769-75.
  31. Satyanarayana K, Nadamuni Naidu A, Chatterjee B. Narasinga Rao BS. Body size and work output. Am J Clin Nutr 1977;30:322-25.
  32. Martorell R. Child growth retardation: a discussion of its causes and its relationship to health. In: Blaxter K, Waterlow JC, eds. Nutritional adaptation in man. London: John Libbey, 1985: 13-30.
  33. Scrimshaw NS, Taylor CE, Gordon JE. Interactions of nutrition and infection. Geneva: World Health Organization, 1968.
  34. Mönckeberg F. Effect of early marasmic malnutrition on subsequent physical and psychological development. In: Scrimshaw NS, Gordon JE, eds. Malnutrition, learning, and behavior. Cambridge, Mass, USA: MIT Press, 1968:269-78.
  35. McKay H, Sinesterra L, McKay A, Gomez H, Lloreda P. Improving cognitive ability in chronically deprived children. Science 1978;200:270-78.
  36. Herrera MG, Mora JO, Christiansen N et al. Effects of nutritional supplementation and early education on physical and cognitive development. In: Turner RR, Reese HW, eds. Life-span developmental psychology: intervention. New York: Academic Press, 1980:149-84.
  37. Grantham-McGregor S. Chronic undernutrition and cognitive abilities. Hum Nutr 1984;38:83-94.
  38. Klein RE, Yarbrough C, Lasky RE, Habicht JP. Correlations of mild to moderate protein-calorie malnutrition among rural Guatemalan infants and preschool children. In: Cravioto J, Hambraeus L, Vahiquist B, eds. Early malnutrition and mental development. Uppsala, Sweden: Almqvist & Wiksell, 1974:168-81.
  39. Klein RE. Malnutrition and human behavior: a backward glance at an ongoing longitudinal study. In: Levitsky DA, ed. Malnutrition, environment, and behavior. Ithaca, NY' USA: Cornell University Press, 1979:219-37.
  40. Chavez A. Martinez C, Yaschine T. Nutrition. behavioral development and mother-child interaction in young, rural children. Fed Proc 1975;34:1574-82.
  41. Chavez A, Martinez C. Growing up in a developing community. Guatemala City. Guatemala: Institute of Nutrition of Central America and Panama, 1982.
  42. Martorell R. Overview of long-term nutrition intervention studies in Guatemala, 19681989. Food Nutr Bull 1992;14(3):270-77.
  43. Pollitt E. Gorman K, Engle P. Martorell R. Rivera J. Early supplementary feeding and cognition: effect over two decades. Chicago, Ill, USA: Society for Research in Child Development (in press).
  44. Gopalan C. Small is healthy? For the poor, not the rich. Bull Nutr Found India 1983;4(3): 1-3.
  45. Gopalan C. The nutrition policy of brinkmanship. Bull Nutr Found India 1982:3: 1-3.
  46. Reutlinger S. Alderman H. The prevalence of calorie deficient diets in developing countries. World Dev 1980;8:239-411.
  47. FAO. The fifth world survey. Rome: Food and Agriculture Organization, 1987.
  48. Joint FAO/WHO/UNU Expert Consultation. Energy and protein requirements. WHO Technical Report Series, no. 724. Geneva: World Health Organization, 1985.
  49. Sukhatme PV, Margen S. Auto-regulatory homeostatic nature of energy balance. In: Sukhatme PV' ed. Newer concepts in nutrition and their implications for policy. Pune. India: Maharashtra Association for the Cultivation of Science Research Institute, 1982: 101- 14.
  50. Rand WM, Scrimshaw NS. Protein and energy requirements: insight from long-term studies. Bull Nutr Found India 1984;5(4): 1 -3.
  51. ACC/SCN. First report on the world nutrition situation: a report complied from information available to the United Nations agencies of the ACC/SCN. Geneva: UN Subcommittee on Nutrition, 1987.
  52. ACC/SCN. Update on the nutrition situation: recent trends in nutrition in 33 countries. Geneva: UN Subcommittee on Nutrition. 1989.
  53. Carlson BA, Wardlaw TM. A global, regional and country assessment of child malnutrition. Staff Working Paper no. 7. New York: UNICEF. 1990.
  54. Joint FAO/WHO Ad Hoc Expert Committee. Energy and protein requirements. WHO Technical Report Series, no. 522. Rome: Food and Agriculture Organization, 1973.
  55. Rand WM, Uauy R. Scrimshaw NS, eds. Protein-energy-requirement studies in developing countries: results of international research. Tokyo: United Nations University Press, 1984.
  56. Torún B. Young VR, Rand WM, eds. Protein-energy requirements of developing countries: evaluation of new data. Tokyo: United Nations University Press. 1981.
  57. Young VR, Bier DM, Pellett PL. A theoretical basis for increasing current estimates of the amino acid requirements in adult man, with experimental support. Am J Clin Nutr 1989;50:80-92.
  58. Young VR, Pellett PL. Current concepts concerning indispensable amino acid needs in adults and their implications for international nutrition planning. Food Nutr Bull 1990;12(4):289-300.
  59. Mertz ET. Quality protein maize. St. Paul, Minn, USA: American Association of Cereal Chemists. 1992.
  60. Keusch GT, Scrimshaw NS. Control of infection to reduce the prevalence of infantile and child malnutrition. Rev Infect Dis 1986;8:237-87.
  61. Scrimshaw NS. Effect of infection on nutrient requirements (Rhoades lecture). Parent Ent Nutr 1991: 15(6):589-600.
  62. UNU. Protein-energy requirements under conditions prevailing in developing countries: current knowledge and research needs. Tokyo: United Nations University Press, 1979.
  63. Behar M, Scrimshaw NS. Epidemiology of protein malnutrition. In: Human nutrition: historic and scientific. New York Academy of Medicine Monograph no. 3. New York: International Universities Press, 1960:257-73.
  64. Berry-Koch A. Moench R. Hakewill P. Dualeh M. Alleviation of nutritional deficiency diseases in refugees. Food Nutr Bull 1990;12(2): 106-12.
  65. Toole MJ. Micronutrient deficiencies in refugees: a conference hosted by the Centers for Disease Control (CDC), Atlanta, Ga. Lancet 1992;339:1214-16.
  66. Scrimshaw NS. Functional significance of iron deficiency: an overview. In: Enwonwu CO, ed. Functional significance of iron deficiency. Nashville, Tenn, USA: Meharry Medical College, 1990:1-13.
  67. Ending hidden hanger: a policy conference on micronutrient malnutrition, October 1012, 1991, Montreal. Atlanta, Ga, USA: Task Force for Child Survival and Development, 1992.
  68. WHO. Global nutrition status update, 1989. Geneva: World Health Organization, 1989.
  69. National Institute of Nutrition. Annual report. Hyderabad, India: Indian Council of Medical Research, 1986-87.
  70. Pilch SM, Senti FR, eds. Assessment of the iron nutrition status of the US population based on data collected in the second national health and nutrition examination survey, 19761980. Bethesda, Md, USA: Federation of American Societies for Experimental Biology, Life Sciences Research Office, 1984.
  71. Oski FA, Honig AS. The effects of therapy on the developmental score of iron-deficient infants. J Pediatr 1978;92(1):21-25.
  72. Pollitt E. Effects of a diet deficient in iron on the growth and development of preschool and school-age children. Food Nutr Bull 1991;13(2):110-18.
  73. Webb T. Oski F. Iron deficiency anemia and scholastic achievement in young adolescents. J Pediatr 1973; 82(5):827-30.
  74. Walter T. Kovalsys J. Stekel A. Effect of mild iron deficiency on infant mental development scores. J Pediatr 1983;102(4):519-22.
  75. Lozoff B. Methodologic issues in studying behavioral effects of infant iron-deficiency anemia. Am J Clin Nutr 1989;50:641-54.
  76. Lozoff B. Brittenham G. Viteri FE, Urrutia JJ.Behavioral abnormalities with iron deficiency. In: Pollitt E, Leibel RL, eds. Iron deficiency: brain biochemistry and behavior. New York: Raven Press, 1982:183-94.
  77. Pollitt E, Soemangri AG, Yunis F. Scrimshaw NS. Cognitive effects of iron deficiency anemia (letter to the editor). Lancet 1985;1 :158.
  78. Lozoff B. Jimenez E, Wolf AW. Long term developmental outcome of infants with iron deficiency. New Eng IJ Med 1991;325(10):687-95.
  79. Seshadri S. Gopaldas T. Impact of iron supplementation on cognitive functions in preschool and schoolaged children: the Indian experience. Am J Clin Nutr 1989;50(3):67586.
  80. Soemantri AG. Preliminary findings on iron supplementation and learning achievement of rural Indonesian children. Am J Clin Nutr 1989;50(3):698-702.
  81. Soemantri AG, Pollitt E, Kim I. Iron deficiency anemia and educational achievement. Am J Clin Nutr 1985;42:1221-28.
  82. Pollitt E, Hathirat P. Kotchabhakdi NJ, Missell B. Valyasevi A. Iron deficiency and educational achievement in Thailand. Am J Clin Nutr 1989;50(3):687-97.
  83. Yehuda S. Youdim MBH. Brain iron: a lesson from animal models. Am J Clin Nutr 1989;50(3):618-29.
  84. Youdim MBH, Yehuda S. Ben-Shachar D, Ashkenazi R. Behavioral and brain biochemical changes in iron-deficient rats: the involvement of iron in dopamine receptor function. In: Pollitt E, Leibel RL, eds. Iron deficiency: brain biochemistry and behavior. New York: Raven Press, 1982:39-56.
  85. Youdim MBH, Ben-Shachar D, Yehuda S. Putative biological mechanisms of the effect of iron deficiency on brain biochemistry and behavior. Am J Clin Nutr 1989;50(3):607-17.
  86. Hershko C, Karsai A, Eylon L, Izak G. The effect of chronic iron deficiency on some biochemical functions of the human hematopoeietic tissue. Blood 1970; 36:321-29.
  87. Higashi O. Sato Y. Takamatsu H. Oyama M. Mean cellular peroxidase (MCP) of leukocytes in iron deficiency anemia. Tokoku J Exp Med 1967;93:105-13.
  88. Sagone AL, Balcerzak SP. Activity of iron containing enzymes in erythrocytes and granulocytes in thalasemia and iron deficiency. Am J Med Sci 1970; 259:350-57.
  89. Walter T. Arrendon S. Stekel AM. Effect of iron therapy on phagocytosis and bactericidal activity in neutrophils of iron deficient infants. Am J Clin Nutr 1986;44:87782.
  90. Srikantia SG, Bhaskaram C, Prasad JS, Krishnanchari KAVR. Anaemia and immune response. Lancet 1976; 1:1307-09.
  91. Stinnert JD. Nutrition and the immune response. Boca Raton, Fla, USA: CRC Press, 1983.
  92. Chandra RK. Reduced bactericidal capacity of polymorphs in iron deficiency. Arch Dis Child 1973;48: 864-66.
  93. Chandra RK, Newberne PM. Nutrition, immunity and infection: mechanisms of interactions. New York: Plenum Press, 1977.
  94. Bhaskaram C, Reddy V. Cell-mediated immunity in iron and vitamin-deficient children. Br Med J 1975 ;3:522.
  95. Chandra RK, Saraya AK. Impaired immunocompetence associated with iron deficiency. J Pediatr 1975; 86:899-902.
  96. Joynson DHM, Walker DM, Jacobs A, Dolby AE. Defect of cell mediated immunity in patients with iron deficiency anaemia. Lancet 1972;2: 1058-59.
  97. Keusch GT. Nutrition as a determinant of host response to infection and the metabolic sequelae of infectious disease. In: Seminars in infectious disease. Vol. 2. New York: Medical Bock Corp, 1979:256-303.
  98. Brown CV, Brown GW, Bonehill B. Iron deficiency and its functional consequences. Alaska Med 1967; 9:93.
  99. Fortuine R. Acute puralent meningitis in Alaskan natives: epidemiology, diagnosis and prognosis. Can Med Assoc J 1966;94(1):19-22.
  100. Basta S. Soekirman, Karyadi D, Scrimshaw NS. Iron deficiency anemia and the productivity of adult males in Indonesia. Am J Clin Nutr 1979;32:916-25.
  101. Hussein MA, Hassein HA, Abdel-Ghaffar AA, Salem S. Effect of iron supplements on the occurence of diarrhoea among children in rural Egypt. Food Nutr Bull 1988;10(2):3539.
  102. Hussaini MA, Karyadi HD, Gunadi H. Evaluation of nutritional anaemia intervention among anemic female workers on a tea plantation. In: Hallberg L, Scrimshaw NS, eds. Iron deficiency and work performance. Washington, DC: Nutrition Foundation. 1981 :72-85.
  103. Viteri FE, Torun B. Anaemia and physical work capacity. Clin Haemat 1974;3:609-26.
  104. Edgerton VR, Ohira Y. Hettiarachi J. Senewiratne B. Gardner GW, Barnard RJ. Elevation of hemoglobin and work performance in iron-deficient subjects. J Nutr Sci 1981;27:77-86.
  105. Edgerton VR, Ohira Y, Gardner GW, Senewiratne B. Effects of iron deficiency anemia on voluntary activities in rats and humans. In: Pollitt E, Leibel RL, eds. Iron deficiency: brain biochemistry and behavior. New York: Raven Press, 1982: 141-60.
  106. Gardner GW, Edgerton VR, Senewiratne B, Barnard RJ, Ohira Y. Physical work capacity and metabolic stress in subjects with iron deficiency anemia. Am J Clin Nutr 1977;30:910-17.
  107. Davies CT, Chukweumeka AC, Van Haaren JP. Iron deficiency anemia: its effect on maximum aerobic power and responses to exercise in African males aged 17-40 years. Clin Sci 1973;44:555-62.
  108. Davies CT, Van Haaren JP. Effect of treatment on physiological responses to exercise in east African industrial workers with iron deficiency anemia. Brit J Indust Med 1973;30:335-40.
  109. Spurr GB, Barac M, Maksud MG. Childhood undernutrition: implications for adult work capacity and productivity. In: Folinsbee LJ, Wagner JA, Borgia JF, Drinkwater BL, Gliner JA, Bedi IF, eds. Environmental stress: individual human adaptations. New York: Academic Press, 1978:165-81.
  110. Powers C, Bates CJ, Downe R, Brubacher D, Sutcliffe V, Thurnhill A. Running performance in Gambian children: effects of water-soluble vitamins or iron. Eur J Clin Nutr 1988;42(11):895-902.
  111. Hussaini MA, Djojosoebagio S. Karyadi D. Socioeconomic and dietary correlates of iron deficiency on an Indonesian tea plantation. In: Proceedings of the eighth annual INACG meeting. Bali, Indonesia: INACG, 1984.
  112. Vijayalakshmi P. Kupputhai U. Maheswari VU. Anaemia and work output of farm women. Ind J Nutr Diet 1987;24:253-59.
  113. Macgregor MW. Maternal anemia as a factor in prematurity and perinatal mortality. Scot Med J 1963; 8:134.
  114. Worthington-Roberts B. Maternal iron deficiency and pregnancy outcome. In: Enwonwu CO, ed. Functional significance of iron deficiency. Nashville, Tenn, USA: Meharry Medical College, 1990:45-70.
  115. Bothwell TH, Charlton RW, eds. Iron deficiency in women. Washington, DC: Nutrition Foundation, 1981.
  116. Llewellyn-Jones D. Severe anaemia in pregnancy. Austr NZ J Obstet Gynaec 1965;5:191.
  117. Beischer NA, Holsman M, and Kitchen WH. Relation of various forms of anemia to placental weight. Am J Obstet Gynec 1968;101:801-09.
  118. Soewondo S. Husaini M, Pollitt E. Effects of iron deficiency on attention and learning processes in preschool children: Bandung. Indonesia. Am J Clin Nutr 1989,51):667-74.
  119. Latham MC, Stephenson LS, Kinoti SN, Zaman MS, Kurz KM. Improvements in growth following iron supplementation in young Kenyan school children. Nutrition 1990;6(2):15965.
  120. Briend A, Hoque BA, Aziz KMA. Iron in tube well water and linear growth in rural Bangladesh. Arch Dis Child 1990;65:224-25.
  121. Aukett MA, Parks YA, Scott PH. Treatment with iron increases weight gain and psychomotor development. Arch Dis Child 1986;61:849-54.
  122. Judisch JM, Naiman JL, Soski FA. The fallacy of the fat iron deficient child. Pediatr 1986;37:987-92.
  123. Beard JL. Iron deficiency, thyroid function, and thermoregulation. In: Enwonwu CO, ed. Functional significance of iron deficiency. Annual Nutrition Workshop Series, vol. 3. Nashville, Tenn, USA: Meharry Medical College 1989:71-80.
  124. Dillman E, Cale C, Green W. Johnson DG, Mackler B. Finch CA. Hypothermia in iron deficiency due to altered triiodothyronine metabolism. Am J Physiol 1980;239: R377-81.
  125. Dillman E, Mackler B. Johnson D et al. Effect of iron deficiency on catecholamine metabolism and body temperature regulation. In: Pollitt E, Leibel RL, eds. Iron deficiency: brain biochemistry and behavior. New York: Raven Press, 1982:57-62.
  126. Martinez-Torres C, Cubeddu L, Dillman E et al. Effect of exposure to low temperature on normal and iron deficient subjects. Am J Physiol 1984;246:R380-83.
  127. Beard JL, Borel M. Thermogenesis and iron deficiency anemia. Nutr Today 1988;23:41-45.
  128. Editorial. Vitamin A and malnutrition/infection complex in developing countries. Lancet 1990;336:1349-51.
  129. West KP Jr, Pokhrel RP, Katz J et al. Efficacy of vitamin A in reducing preschool child mortality in Nepal. Lancet 1991;338:67-71.
  130. Sommer A, Tarwotjo I, Loeden AA, Djunaedi E, West KP, and Tilden R. Impact of vitamin A supplementation on childhood mortality: a randomized controlled community trial. Lancet 1986;1:1169-73.
  131. Muhilal, Murdiana A, Azis I, Saidin S. Jahari AB, Karyadi D. Vitamin A-fortified monosodium glutamate and vitamin A status: a controlled field trial. Am J Clin Nutr 1988;48:1265-70.
  132. Rahmathulla L, Underwood BA, Thulasiraj RD. Reduced mortality among children in southern India receiving a small weekly dose of vitamin A. N Engl J Med 1990;323:929-35.
  133. Vijayaraghavan K, Radhaiah G. Prakasam BS, Sarma KVR, Vihodini R. Effect of massive dose vitamin A on morbidity and mortality in Indian children. Lancet 1990;336: 1342-45.
  134. Herrera MG, Nestel P. El Amin A, Fawzi WW, Mohammed KA, Weld L. Vitamin A supplementation and child survival. Lancet 1992;340:267-71.
  135. Chandra RK, Vyas D. Vitamin A, immunocompetence and infection. Food Nutr Bull 1989;11(3):12-19.
  136. Barclay AJG, Foster A, Sommer A. Vitamin A supplements and mortality related to measles: randomised clinical trial. Br Med J 1987;294:294-96.
  137. Coutsoudis A, Broughton M, Coovbadia HM. Vitamin A supplementation reduces measles morbidity in young African children: a randomized, placebo-controlled, double-blind trial. Am J Clin Nutr 1991: 54:890-95.
  138. Hussey GD, Klein MA. A randomized, controlled trial of vitamin A in children with severe measles. New Engl J Med 1989;323: 160-64.
  139. World Health Organization. Joint WHO/UNICEF statement: vitamin A for measles. Week Epidem Record 1987;62:133-34.
  140. Sommer A, Katz J, Tarwotjo I. Increased risk of respiratory disease and diarrhea in children with preexisting mild vitamin A deficiency. Am J Clin Nutr 1984;40: 1090-95.
  141. Milton RC, Reddy V, Naidu AN. Mild vitamin A deficiency and childhood morbidity: an Indian experience. Am J Clin Nutr 1987;46:827-29.
  142. Bloem MW, Wedel M, Egger RJ. Mild vitamin A deficiency and risk of respiratory tract disease and diarrhoea in preschool and school children in northeastern Thailand. Am J Epidem 1990;131:332-39.
  143. Green LK, ed. Malnutrition, behavior, and social organization. New York: Academic Press, 1977.
  144. Green LK. Physical growth and development, neurological maturation and behavioral functioning in two Ecuadorian Andean communities in which goiter is endemic. Am J Phys Anthro 1973;38: 119-34.
  145. Ma T, Lu T, Tan Y, Chen B, Zhu X. The present status of endemic goitre and endemic cretinism in China. Food Nutr Bull 1982 ;4(4): 13- 19.
  146. Stanbury JB. The iodine deficiency disorders (IDD): current status. Food Nutr Bull 1991;13(4):285-86.
  147. Upadhyay SK, Agarwal KN, Rani A. Cherian S. Tripathi AM. Agarwal DK. Developmental lag in preschool children of goitrous mothers. Ind Pediatr 1983 ;20:259-63.
  148. Hetzel BS. An overview of the prevention and control of iodine deficiency. In: Hetzel BS, Dunn JT, Stanbury JB, eds. The prevention and control of iodine deficiency disorders. New York: Elsevier, 1987.
  149. Hetzel BS. The prevention and control of iodine deficiency disorders. ACC/SCN Nutrition Policy Discussion Paper no. 3. Geneva: UN Subcommitte on Nutrition, 1988.
  150. Scrimshaw NS. The geographic pathology of thyroid disease. In: The thyroid. International Academy of Pathology Monograph no. 5. Baltimore, Md, USA: Williams & Wilkins, 1964: 100-122.
  151. Pebley AR, Delgado H. Brinemann E. Fertility desires and child mortality experience among Guatemalan women. Stud Fam Plan 1979;10:129-36.
  152. Schultz TP. Interrelationships between mortality and fertility. In: Ridker RG, ed. Population and development: the search for selective interventions. Baltimore, Md, USA: Johns Hopkins University Press. 1976:239-89.
  153. Taylor CE, Newman IS, Kelly NU. The child survival hypothesis. Pop Stud 1976;30:263-71
  154. Zeitlin ME, Wray DJ, Stanbury JB, Schlossman NP, Meurer MJ, Weinthal PJ. Nutrition and population growth: the delicate balance. Cambridge, Mass, USA: Oelgeschlager, Gunn & Hain, 1982.
  155. UNICEF. The state of the world's children, 1991. New York: UNICEF, 1991.
  156. UNICEF. World declaration on the survival, protection, and development of children, and plan of action for implementation of the world declaration on survival, protection, and development of children in the 1990s. New York: UNICEF. 1990.
  157. Gongora J. Mejia CF. Dos años de tratamiento del bocio simple con sal yodada en el departamento de Caldas. Rev Clin 1952;16:357-71.
  158. Arroyave G. Aguilar JR, Flores M, Guzman MA. Evaluation of sugar fortification with vitamin A at the national level. Washington, DC: Pan American Health Organization, 1979.
  159. Dunn JT, Van der Haar F. A practical guide to the correction of iodine deficiency. Wageningen, Netherlands: International Council for Control of Iodine Deficiency Disorders (ICCIDD), 1990:1-62.
  160. Clements FW. Goiter prophylaxis by addition of potassium iodate to bread. Lancet 1970;1:489-92.
  161. Darton-Hill I, Sibanda IF, Mitra M et al. Distribution of vitamin-A capsules for the prevention and control of vitamin-A deficiency in Bangladesh. Food Nutr Bull 1988;10(3):60-70.
  162. Layrisse M, Martinez-Torres C, Méndez-Castellano H et al. Requerimientos de nutrientes que participan en la eritropayesis. In: Bengoa JM, Torún B. Behar M, Scrimshaw NS, eds. Metas nutricionales y guias de alimentación para América Latina: bases para su desarrollo. Caracas: UNU/Fundación Cavendes, 1988:25074.
  163. National Institute of Nutrition. Annual report. Hyderabad, India: Indian Council of Medical Research, 1990-91: 10-12.
  164. Narasinga Rao BS. Fortification of salt with iron and iodine to control anaemia and goitre: development of a new formula with good stability and bioavailability of iron and iodine. Food Nutr Bull 1994;15(1):32-39.
  165. World Health Organization. Report of a conference on primary health care, Alma Ata, USSR. Geneva: WHO, 1978.
  166. Cash R. Keusch GT, Lamstein J. Child health and survival: UNICEF GOBI-FFF Programme. London: Croom Helm, 1987.
  167. Stimson WH. Vitamin A intoxication in adults: report of a case with summary of the literature. New Engl J Med 1961;265:369.
  168. Li M, Liu DR, Qu CY et al. Endemic goiter in central China caused by excessive iodine intake. Lancet 1987;2:257-58.
  169. McFarlane HS, Reddy S. Adcock KJ, Adeshina H. Cooke AR, Akene J. Immunity, transferrin and survival in kwashiorkor. Br Med J 1970;4:268-70.
  170. Murray MJ, Murray AB, Murray BA, Murray MB. Diet and cerebral malaria: the effect of famine and refeeding. Am J Clin Nutr 1978;31 :57-61.
  171. Murray MJ, Murray AB, Murray MB, Murray CJ. The adverse effect of iron repletion on the course of certain infections. Br Med J 1978;2:1113-15.
  172. National Research Council. Diet and health: implications for reducing chronic disease risk. Washington, DC: National Academy of Sciences, 1989.
  173. Committee on Diet, Nutrition, and Cancer, Assembly of Life Sciences, National Research Council. Diet, nutrition, and cancer. Washington, DC: National Academy Press, 1982.

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