Recomendaciones de micronutrientes para grupos vulnerables en contexto de desnutrición, durante la pandemia de COVID-19 en Latinoamérica
Palabras clave:
COVID-19, Grupos de Riesgo, Mujeres Embarazadas, Lactancia Materna, Niñas y Niños, Adultos Mayores, Desnutrición, Micronutrientes, Suplementación, Risk Groups, Pregnant Women, Breastfeeding, Children, Older Adults Undernutrition, MicronutrientsResumen
La crisis por COVID-19 (SARS-CoV-2) puede convertirse en una catástrofe alimentaria para Latinoamérica, aumentando las personas que padecen hambre de 135 a 265 millones, especialmente en Venezuela, Guatemala, Honduras, Haití y El Salvador, que ya enfrentaban crisis económicas y sanitarias. Este manuscrito presenta la posición de un grupo de expertos latinoamericanos sobre las recomendaciones de consumo y/o suplementación con vitamina A, C, D, zinc, hierro, folatos y micronutrientes múltiples, en contextos de desnutrición, para grupos vulnerables: mujeres embarazadas y lactantes, niñas y niños menores de 5 años y adultos mayores. Las recomendaciones buscan disminuir el impacto potencial que tendrá COVID-19 en el estado nutricional, durante la pandemia. La posición surge de la discusión de dichos expertos con base a la revisión de evidencia científica actual para estos grupos vulnerables. Está dirigida a tomadores de decisiones, encargados de políticas públicas, personal de salud y organismos de la sociedad civil. Después de la lactancia materna y una dieta suficiente en cantidad y calidad, la suplementación con los micronutrientes presentados, puede contribuir a prevenir y tratar enfermedades virales, reforzar el sistema inmune y reducir complicaciones. La lactancia materna con medidas de higiene respiratoria, el suministro de múltiples micronutrientes en polvo para niños desde los 6 meses hasta los 5 años y el aporte de hierro y folatos o micronutrientes múltiples para la embarazada, son estrategias comprobadas y eficaces que deben seguirse implementando en tiempos de COVID-19. Para los adultos mayores la suplementación con vitamina C, D y zinc puede estar indicada.
The COVID-19 crisis (SARS-CoV-2) might transform into a food catastrophe in Latin America and would increase the number of people suffering from hunger from 135 to 265 million, particularly in Venezuela, Guatemala, Honduras, Haiti and El Salvador, already facing economic and health crises. This manuscript presents the position of a group of Latin American experts in nutrition for establishing the recommendations for consumption and / or supplementation with vitamin A, C, D, zinc, iron, folates and multiple micronutrients, in undernutrition contexts, for vulnerable population of pregnant and lactating women, children under 5 years and the elderly. The recommendations seek to decrease the potential impact that COVID-19 will have on nutritional status during the pandemic. The position arises from the discussion of the experts based on the review of current scientific evidence for these vulnerable groups. It aims to reach stakeholders, public policy makers, health personnel and civil society organizations. Only after breastfeeding and a sufficient diet in terms of quantity and quality, a supplementation with the micronutrients mentioned above can help prevent and treat viral diseases, strengthen the immune system and even reduce complications. Breastfeeding with respiratory hygiene measures, the provision of multiple micronutrients powders for children from 6 moths to 5 years of age and the supply of iron and folates or multiple micronutrients tablets for pregnant women are proven and effective strategies that must continue to be implemented during COVID-19 pandemic. For older adults, supplementation with vitamin C, D and zinc might be indicated.
Descargas
Citas
REFERENCIAS
Food Security Information Network. Global report on food crises: Joint analysis for better decisions. Rome, Italy and Washington, DC: Food and Agriculture Organization (FAO); World Food Programme (WFP); and International Food Policy Research Institute (IFPRI).FAO, IFPRI y WFP; 2020.
Organización de las Naciones Unidas para la Alimentación y la Agricultura, Organización Panamericana de la Salud, World Food Program, Fondo de las Naciones Unidas para la Infancia. Panorama de la seguridad alimentaria y nutricional en América Latina y el Caribe 2019. Santiago; 2019. Licencia: CC BY-NC-SA 3.0 IGO.
Pee S, Flores-Ayala R, Hees J, Jefferds M, Irizarry L, Kraemer K, et al. Home fortification with micronutrient powders (MNP). EJNFS. 2014;4(1):10-1.
Vilar-Compte M, Sandoval-Olascoaga S, Bernal-Stuart A, Shimoga S, Vargas-Bustamante A. The impact of the 2008 financial crisis on food security and food expenditures in Mexico: A disproportionate effect on the vulnerable. Public Health Nutr. 2015;18(16):2934-42.
Organización de las Naciones Unidas para la Alimentación y la Agricultura, Organización Panamericana de la Salud, World Food Program, Fondo de las Naciones Unidas para la Infancia. Panorama de la seguridad alimentaria y nutricional en América Latina y el Caribe 2018. Santiago; 2018. Licencia: CC BY-NC-SA 3.0 IGO.
Calder PC, Carr AC, Gombart AF, Eggersdorfer M. Optimal nutritional status for a well-functioning immune system is an important factor to protect against viral infections. Nutrients. 2020;12(4):1181.
Gombart AF, Pierre A, Maggini S. A review of micronutrients and the immune system–working in harmony to reduce the risk of infection. Nutrients. 2020;12(1):236.
Linus Pauling Institute. Immunity in depth 2010. Oregon; 2015. [Accesado el: 18 de mayo de 2020]. Disponible a través de: https://lpi.oregonstate.edu/mic/health-disease/immunity#authors-reviewers.
Naciones Unidas. Directrices relativas a la COVID-19. Nacionas Unidas. Derechos Humanos. Oficina del Alto Comisionado; 2020. [Accesado el 1 de mayo de 2020]. Disponible a través de: https://www.ohchr.org/Documents/Events/COVID-19_Guidance_SP.pdf
Ghosh I. Hunger pandemic: The COVID-19 effect on global food insecurity. 8 de mayo de 2020. [Accesado el 18 de mayo de 2020]. Disponible a través de: https://www.visualcapitalist.com/covid-19-global-food-insecurity/.
Mehta S. Nutritional status and COVID-19: An opportunity for lasting change? Clin Med (Lond). 2020; clinmed.2020-0187.
Puerto E. La nutrición, su relación con la respuesta inmunitaria y el estrés oxidativo. Rev haban cienc méd. 2008;7:1-12.
Arias ME, Villegas J. Avances en inmunidad gestacional. Int. J. Morphol. 2010;28:713-8.
Centers for Disease Control and Prevention. If you are pregnant, breastfeeding, or caring for young children. Atlanta, GA: CDC, 2020. [Accesado el 18 de mayo de 2020]. Disponible a través de: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html
Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol. 2004;191(1):292-7.
Lam CM, Wong SF, Leung TN, Chow KM, Yu WC, Wong TY, et al. A case-controlled study comparing clinical course and outcomes of pregnant and non-pregnant women with severe acute respiratory syndrome. BJOG. 2004;111(8):771-4.
Gillman MW, Ludwig DS. How early should obesity prevention start? N Engl J Med. 2013;369(23):2173-5.
Elshafeey F, Magdi R, Hindi N, Elshebiny M, Farrag N, Mahdy S, et al. A systematic scoping review of COVID-19 during pregnancy and childbirth. Int J Gynaecol Obstet. 2020;150(1):47-52.
Qiancheng X, Jian S, Lingling P, Lei H, Xiaogan J, Weihua L, et al. Coronavirus disease 2019 in pregnancy. Int J Infect Dis. 2020;95:376-83.
World Health Organization. Pregnancy, childbirth, breastfeeding and covid-19. Geneva: WHO, 2020. [Accesado el 15 de mayo de 2020]. Disponible a través de: https://www.who.int/reproductivehealth/publications/emergencies/COVID-19-pregnancy-ipc-breastfeeding-infographics/en/#.
De Rose DU, Piersigilli F, Ronchetti MP, Santisi A, Bersani I, Dotta A, et al. Novel coronavirus disease (covid-19) in newborns and infants: What we know so far. Ital J Pediatr. 2020;46:1-8.
Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics. [Preprint] 2020.
Newburg DS, Walker WA. Protection of the neonate by the innate immune system of developing gut and of human milk. Pediatr Res. 2007;61(1):2-8.
Cacho NT, Lawrence RM. Innate immunity and breast milk. Front Immunol. 2017;8:584.
Groß R, Conzelmann C, Müller JA, Stenger S, Steinhart K, Kirchhoff F, et al. Detection of SARS-CoV-2 in human breastmilk. Lancet. 2020.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and ct features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 2020;55(5):1169-74.
Liu J, Liao X, Qian S, Yuan J, Wang F, Liu Y, et al. Community transmission of severe acute respiratory syndrome coronavirus 2, shenzhen, China, 2020. Emerg Infect Dis. 2020;26(6).
Shen K, Yang Y, Wang T, Zhao D, Jiang Y, Jin R, et al. Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: Experts’ consensus statement. World J Pediatr. 2020:1-9.
Ruel MT, Alderman H, Maternal, Group CNS. Nutrition-sensitive interventions and programmes: How can they help to accelerate progress in improving maternal and child nutrition? Lancet. 2013;382(9891):536-51.
Derbyshire E, Delange J. Covid-19: Is there a role for immunonutrition, particularly in the over 65s? BMJ Nutrition, Prevention & Health. 2020;0:1–6.
Verity R, Okell LC, Dorigatti I, Winskill P, Whittaker C, Imai N, et al. Estimates of the severity of coronavirus disease 2019: A model-based analysis. Lancet Infect Dis 2020;20: 669–77.
Centers for Disease Control and Prevention. Older adults. Atlanta, G: CDC, 2020. [Accesado el 1 de mayo de 2020] Disponible a través de: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html.
World Health Organization. Statement Older people are at highest risk from COVID-19, but all must act to prevent community spread. 2 abril 2020. Copenhague: WHO, 2020. [Accesado el 1 de mayo de 2020]. Disponible a través de: http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/statements/statement-older-people-are-at-highest-risk-from-covid-19,-but-all-must-act-to-prevent-community-spread.
Gobierno de México. Covid-19 México. 2020. [Accesado el 7 de mayo de 2020]. Disponible a través de: https://coronavirus.gob.mx/datos/.
World Health Organization. Supplemental nutrition with dietary advice for older people affected by undernutrition. 2019. [Accesado el 1 de mayo de 2020]. Disponible a través de: https://www.who.int/elena/titles/nutrition-older-people/en/
Incalzi RA, Scichilone N, Fusco S, Corsonello A. Nutritional status in aging and lung disease. In Molecular Basis of Nutrition and Aging: A Volume in the Molecular Nutrition Series. Elsevier Inc. 2016. p. 411-421.
Alwarawrah Y, Kiernan K, MacIver NJ. Changes in nutritional status impact immune cell metabolism and function. Front Immunol. 2018;9:1055.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020.
Niu S, Tian S, Lou J, Kang X, Zhang L, Lian H, et al. Clinical characteristics of older patients infected with COVID-19: A descriptive study. Arch Gerontol Geriatr. 2020:104058.
Li T, Zhang Y, Gong C, Wang J, Liu B, Shi L, et al. Prevalence of malnutrition and analysis of related factors in elderly patients with covid-19 in Wuhan, China. Eur J Clin Nutr. 2020:1-5.
Mayo Clinic. Senior health: How to prevent and detect malnutrition. Mayo Clinic, 2019. [Accesado el 4 de mayo de 2020]. Disponible a través de: https://www.mayoclinic.org/es-es/healthy-lifestyle/caregivers/in-depth/senior-health/art-20044699
Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, et al. Evidence that vitamin d supplementation could reduce risk of influenza and COVID-19 infections and deaths. Nutrients. 2020;12(4):988.
World Health Organization. Mental health and covid-19. Copenhague: WHO Regional Office for Europe, 2020. [Accesado el 13 de mayo de 2020]. Disponible a través de: http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/novel-coronavirus-2019-ncov-technical-guidance-OLD/coronavirus-disease-covid-19-outbreak-technical-guidance-europe-OLD/mental-health-and-covid-19.
Organización Mundial de la Salud. Directriz: Administración de suplementos de vitamina A a lactantes y niños 6–59 meses de edad. Ginebra: Organización Mundial de la Salud; 2011.
Tam E, Keats EC, Rind F, Das JK. Micronutrient supplementation and fortification interventions on health and development outcomes among children under-five in low-and middle-income countries: A systematic review and meta-analysis. Nutrients. 2020;12(2):289.
Chen H, Zhuo Q, Yuan W, Wang J, Wu T. Vitamin a for preventing acute lower respiratory tract infections in children up to seven years of age. Cochrane Database Syst Rev. 2008(1).
Imdad A, Mayo-Wilson E, Herzer K, Bhutta ZA. Vitamin a supplementation for preventing morbidity and mortality in children from six months to five years of age. Cochrane Database Syst Rev. 2017(3).
Rodríguez A, Hamer DH, Rivera J, Acosta M, Salgado G, Gordillo M, et al. Effects of moderate doses of vitamin A as an adjunct to the treatment of pneumonia in underweight and normal-weight children: A randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2005 Nov;82(5):1090-6.
Mayo-Wilson E, Imdad A, Herzer K, Yakoob MY, Bhutta ZA. Vitamin a supplements for preventing mortality, illness, and blindness in children aged under 5: Systematic review and meta-analysis. BMJ. 2011;343:d5094.
World Health Organization. Essential nutrition actions: Mainstreaming nutrition through the life-course. Geneva; 2019. Licence: CC BY-NC-SA 3.0 IGO.
The Global Alliance for Vitamin A. Universal vitamin A supplementation for preschool-aged children in the context of COVID-19: Gava consensus statement. Global Alliance for Vitamin A (GAVA); 2020. [Accesado el 22 de mayo de 2020]. Disponible a través de: http://www.gava.org/content/user_files/2020/04/GAVA-Consensus-Statement-VAS-in-the-context-of-COVID-19-v.20200407.pdf
Institute of Medicine. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington DC: Institute of Medicine, National Academies Press, 2001. https://doi.org/10.17226/10026.
The Global Alliance for Vitamin A. Post-partum vitamin a supplementation (VAS). Global Alliance for Vitamin A (GAVA); 2019. [Accesado el 22 de mayo de 2020]. Disponible a través de: http://www.gava.org/content/user_files/2019/05/GAVA-Brief-Post-partum-VAS-EN-May-1.pdf
Linus Pauling Institute. Older adults. Micronutrients for older adults. Oregon; 2019 [Accesado el 7 de mayo de 2020]. Disponible a través de: https://lpi.oregonstate.edu/mic/life-stages/older-adults.
Ran L, Zhao W, Wang J, Wang H, Zhao Y, Tseng Y, et al. Extra dose of vitamin C based on a daily supplementation shortens the common cold: A meta-analysis of 9 randomized controlled trials. Biomed Res Int. 2018;2018:1837634.
Carr AC, Maggini S. Vitamin C and immune function. Nutrients. 2017;9(11):1211.
Hemilä H. Vitamin C and infections. Nutrients. 2017;9(4):339.
Das JK, Bilal H, Salam RA, Bhutta ZA. Vitamin C supplementation for prevention and treatment of pneumonia. Cochrane Database Syst Rev. 2018 Sep; 2018(9): CD013134.
Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD000980.
Hemilä H, Chalker E. Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: A meta-regression analysis. J Intensive Care. 2020;8:15.
Wang Y, Lin H, Lin B-w, Lin J-d. Effects of different ascorbic acid doses on the mortality of critically ill patients: A meta-analysis. Ann Intensive Care. 2019;9(1):58.
Institute of Medicine. Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. Washington DC: Institute of Medicine, National Academy Press, 2000. https://doi.org/10.17226/9810.
National Institutes of Health. Vitamina C: National Institutes of Health Office of Dietary Supplements; 2019. [Accesado el 8 de mayo de 2020]. Disponible a través de: https://ods.od.nih.gov/factsheets/VitaminC-DatosEnEspanol/.
Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, et al. Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583.
Charan J, Goyal JP, Saxena D, Yadav P. Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis. J Pharmacol Pharmacother. 2012;3(4):300.
Arihiro S, Nakashima A, Matsuoka M, Suto S, Uchiyama K, Kato T, et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza and upper respiratory infection in patients with inflammatory bowel disease. Inflamm Bowel Dis. 2019;25(6):1088-95.
Loeb M, Dang AD, Thiem VD, Thanabalan V, Wang B, Nguyen NB, et al. Effect of vitamin D supplementation to reduce respiratory infections in children and adolescents in vietnam: A randomized controlled trial. Influenza Other Respir Viruses. 2019;13(2):176-183.
Xiao L, Xing C, Yang Z, Xu S, Wang M, Du H, et al. Vitamin D supplementation for the prevention of childhood acute respiratory infections: A systematic review of randomised controlled trials. Br J Nutr. 2015;114(7):1026-34.
Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the institute of medicine: What clinicians need to know. J Clin Endocrinol Metab. 2011;96(1):53-58.
Mithal A, Kalra S. Vitamin D supplementation in pregnancy. Indian J Endocrinol Metab. 2014;18(5):593-6.
Hollis BW, Johnson D, Hulsey TC, Ebeling M, Wagner CL. Vitamin D supplementation during pregnancy: Double-blind, randomized clinical trial of safety and effectiveness. J Bone Miner Res. 2011;26(10):2341-57.
Armas LA, Hollis BW, Heaney RP. Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab. 2004;89(11):5387-91.
National Institute on Aging. Vitamins and minerals: National Institute of Aging; 2019 [Accesado el 7 de mayo de 2020]. Disponible a través de: https://www.nia.nih.gov/health/vitamins-and-minerals.
Alberta Health Services. Nutrition guideline seniors health review. Canada: Alberta Health Services. Nutrition services; 2019. [Accesado el 8 de mayo de 2020]. Disponible a través de: https://www.albertahealthservices.ca/nutrition/Page2929.aspx
Institute of Medicine. Dietary reference intakes for calcium and vitamin D Washington DC: Institute of Medicine, National Academies Press, 2010. https://doi.org/10.17226/13050.
te Velthuis AJ, van den Worm SH, Sims AC, Baric RS, Snijder EJ, van Hemert MJ. Zn(2+) inhibits coronavirus and arterivirus rna polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture. PLoS Pathog. 2010;6(11):e1001176.
Razzaque M. Covid-19 pandemic: Can maintaining optimal zinc balance enhance host resistance? [Preprint] 2020. doi: 10.20944/preprints202004.0006.v1
Das RR, Singh M. Oral zinc for the common cold. JAMA. 2014;311(14):1440-1.
Hemilä H. Zinc lozenges and the common cold: A meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage. JRSM open. 2017;8(5).
International Zinc Nutrition Consultative Group. Determining the risk of zinc deficiency: Assessment of dietary zinc intake. International Zinc Nutrition Consultative Group; 2019 04/03. Contract No.: 3.
Lonnerdal B. Dietary factors influencing zinc absorption. J Nutr. 2000;130(5S Suppl):1378S-83S.
World Health Organization. Diet, nutrition, and the prevention of chronic diseasess: Report of a joint who/fao expert consultation. WHO Technical Report Series. Rome: World Health Organization; 2003 23/04/2003. Report No.: 916 Contract No.: TRS 916.
World Health Organization. Who guideline: Use of multiple micronutrient powders for point-of-use fortification of foods consumed by infants and young children aged 6–23 months and children aged 2–12 years. Geneva, Switzerland: World Health Organization; 2016.
UNICEF GNC, GTAM, WFP. Protecting maternal diets and nutrition services and practices in the context of COVID-19. Official. 2020 22/04/2020. Contract No.: Brief. No. 4.
Haider BA, Bhutta ZA. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database Syst Rev. 2017;4(4):Cd004905.
Smith ER, Shankar AH, Wu LS, Aboud S, Adu-Afarwuah S, Ali H, et al. Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: A meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries. Lancet Glob Health. 2017;5(11):e1090-e100.
Black RE, Dewey KG. Benefits of supplementation with multiple micronutrients in pregnancy. Ann N Y Acad Sci. 2019;1444(1):3-5.
Home Fortification Technical Advisory Group. Programmatic guidance brief on use of micronutrient powders (MNP) for home fortification. Home Fortification Technical Advisory Group; 2011.
Panel NS-o-tS. National institutes of health state-of-the-science conference statement: Multivitamin/mineral supplements and chronic disease prevention. Am J Clin Nutr. 2007;85(1):257S-264S.
National Institutes of Health. Iron: National Institutes of Public Heatlh. Office of Dietary Supplements; 2020. [Accesado el 5 de mayo de 2020]. Disponible a través de: https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/.
Irwin LG, Siddiqi A, Hertzman C. Desarrollo de la primera infancia: Un potente ecualizador. Comisión sobre los Determinantes Sociales de la Salud de la Organización Mundial de la Salud; 2007. [Accesado el 7 de mayo de 2020]. Disponible a través de: https://www.who.int/social_determinants/publications/early_child_dev_ecdkn_es.pdf?ua=1
World Health Organization. Iron deficiency anaemia: Assesment, prevention and control: A guide for programme managers: World Health Organization; 2001. [Accesado el 8 de mayo de 2020]. Disponible a través de: https://www.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/WHO_NHD_01.3/en/
World Health Organization. Daily iron supplementation in infants and children. Guideline. World Health Organization; 2016. [Accesado el 7 de mayo de 2020]. Disponible a través de: https://www.who.int/nutrition/publications/micronutrients/guidelines/daily_iron_supp_childrens/en/.
Contreras-Manzano A, de la Cruz V, Villalpando S, Rebollar R, Shamah-Levy T. Anemia y deficiencia de hierro en adultos mayores mexicanos. Resultados de la ENSANUT 2012. Salud Publica Mex [Internet]. 2015; 57(5):394-402.
Busti F, Campostrini N, Martinelli N, Girelli D. Iron deficiency in the elderly population, revisited in the hepcidin era. Front Pharmacol. 2014;5:83.
Stauder R, Valent P, Theurl I. Anemia at older age: Etiologies, clinical implications, and management. Blood. 2018;131(5):505-514.
World Health Organization. Periconceptional folic acid supplementation to prevent neural tube defects. World Health Organization; 2019. [Accesado el 18 de mayo de 2020]. Disponible a través de: https://www.who.int/elena/titles/folate_periconceptional/en/
Smith AD, Kim Y-I, Refsum H. Is folic acid good for everyone? Am J Clin Nutr. 2008;87(3):517-533.
Greenberg JA, Bell SJ, Guan Y, Yu YH. Folic acid supplementation and pregnancy: More than just neural tube defect prevention. Rev Obstet Gynecol. 2011;4(2):52-9.
Czeizel AE, Dudás I, Vereczkey A, Bánhidy F. Folate deficiency and folic acid supplementation: The prevention of neural-tube defects and congenital heart defects. Nutrients. 2013;5(11):4760-75.
National Institutes of Health. Folate: National Institutes of Public Health. Office of Dietary Supplements; 2020. [Accesado el 18 de mayo de 2020]. Disponible a través de: https://ods.od.nih.gov/factsheets/Folate-Consumer/.
Taneja S, Strand TA, Kumar T, Mahesh M, Mohan S, Manger MS, et al. Folic acid and vitamin B-12 supplementation and common infections in 6-30-mo-old children in India: A randomized placebo-controlled trial. Am J Clin Nutr. 2013;98(3):731-737.
Bhandari N, Taneja, S., Mazumder, S., Bahl, R., Fontaine, O., Bhan, M. K., & Zinc Study Group. Adding zinc to supplemental iron and folic acid does not affect mortality and severe morbidity in young children. J Nutr. 2007;137(1):112-117.
Bunout D, Barrera G, Hirsch S, Gattas V, de la Maza MP, Haschke F, et al. Effects of a nutritional supplement on the immune response and cytokine production in free-living chilean elderly. JPEN J Parenter Enteral Nutr. 2004;28(5):348-354.
Asociación Esfera. Manual esfera: Carta humanitaria y normas mínimas para la respuesta humanitaria. Manual. Ginebra, Suiza: Asociación Esfera; 2018.
Descargas
Cómo citar
Número
Sección
Licencia
Usted es libre de:
Compartir — copiar y redistribuir el material en cualquier medio o formato
Adaptar — remezclar, transformar y construir a partir del material
La licenciante no puede revocar estas libertades en tanto usted siga los términos de la licencia
Bajo los siguientes términos:
Atribución — Usted debe dar crédito de manera adecuada, brindar un enlace a la licencia, e indicar si se han realizado cambios. Puede hacerlo en cualquier forma razonable, pero no de forma tal que sugiera que usted o su uso tienen el apoyo de la licenciante.
NoComercial — Usted no puede hacer uso del material con propósitos comerciales.
No hay restricciones adicionales — No puede aplicar términos legales ni medidas tecnológicas que restrinjan legalmente a otras a hacer cualquier uso permitido por la licencia.
