Sprinkles Fortified Supplement

packages_sprinklesBy: Nikki Nies

Nearly 300 million children are impacted anemia, with parents finding their children listless and prone to illness.   With damage in the first 1000 days of life to a badly malnourished child is irreversible. In the late 1990s, UNICEF introduced Sprinkles, which were created by Dr. Stanley Zlotkin. Dr. Zlotkin is a professor of pediatrics, nutritional sciences and public health.  Sprinkles is an innovative treatment for the treatment of anemia in children under the age of five, formed of zinc.

Prior to the creation of Sprinkles, the normal treatment was the unpleasant, unflavorful iron supplements via pill or syrup.  Sprinkles is a specially coated, powdered supplement in the form of rice or corn porridge without the untasty flavor.

Regulation of iron absorption is two fold: dietary and store regulator.  There is a short term increase in dietary iron that’s not avidly absorbed and while iron stores increase in liver, hepicidin is released.  Hepcidin is a hepatic peptide that diminishes intestinal mucosal iron ferroportin release.  As body iron stores fall, hepcidin decreases and intestinal mucosa’s signaled to release absorbed iron into circulation.  Dietary citrate and ascorbate from citrus foods can also impact absorption, by forming complexes with iron that increase abruption while tannins found in tea decrease absorption.

The supplements are provided through UNICEF and the Centers for Disease Control and Prevention. The Sprinkles fortified food supplement is provided to those between the ages of six months to two years old and to all pregnant and lactating women.  Those younger than six months are encouraged t be exclusively breast fed in accordance with WHO guidelines for breast feeding. In the past, Sprinkles was delivered in the form of drops, but due to complains of stain to teeth and inability for many parents to “know” how many drops to use due to illiteracy, these supplements are provided in the form of a pap for infant and in drink form for women This is supplement is designed to treat and prevent anemia.  In addition, the amount of vitamin D in Sprinkles is meant to meet the RDI for vitamin D, which in turn is able to prevent rickets.

Additionally, stool color in infants that use Sprinkles are known to change to a dark or black color as iron itself is dark in color.  Sometimes some quantities are left unabsorbed and the iron is excreted in the stool, causing the change in color.

Therefore, due to the positive impact of the Sprinkles implementation into children’s nutrition profile, iron is my favorite micronutrient as it can mean the difference between life or death.  Iron’s mainly absorbed in the duodenum and upper jejunum, with divalent metal transporter 1 (DMT1) facilitating the transfer of iron across epithelial cells.  With the help of ferroportin in the bloodstream, this is released within the enterocyte and is bound in bloodstream by transferrin, a transport glycoprotein.  There is an equal balance of storage and use of iron, with half of absorbed iron put into storage pool in cells, while other half is recycled into erythropoiesis.

Photo Credit: SGHI

1. Worldwide programs. Sprinkles Global Health Initiiative Web site. http://www.sghi.org/worldwide_program/mexico_pg1.html. Accessed 10/24/14, 2014

2. Loewenberg S. Easier than taking vitamins. NYTimes Web site. http://opinionator.blogs.nytimes.com/2012/09/05/easier-than-taking-vitamins/?_php=true&_type=blogs&_r=0. Published 9/5/12. Updated 2012. Accessed 10/21, 2014

3. O’Brien TX. Iron metabolism, anemia, and heart failure. J Am Coll Cardiol. 2011;58(12):1252-1253.

4. Rambousková J, Krsková A, Slavíková M, et al. Trace elements in the blood of institutionalized elderly in the czech republic. Arch Gerontol Geriatr. 2013;56(2):389-394.

The Financial Toll of Excess Weight


By: Nikki Nies

I was recently at a neighbor’s house, perusing her Money magazine that was laying on her coffee table.  I’m always up to hear the latest tips on money, yet I wasn’t expecting to read an article on obesity in money magazine.  Yet, there it was, in Money magazine, there was an article called The Economics of Fat to Thin.  With more than 2/3 of Americans overweight or obese, of course, I had to read it.

Some scary statistics, such as:

  • According to the U.S. Center for Disease and Control and Prevention, being obese elevates the risk of coronary heart disease, diabetes, stroke and cancer
  • Annually costs the government an additional $450 billion
  • An overweight person tend to consume more calories, with added costs of an additional $90 billion a year
  • Employers and employees pay a higher life insurance premium; pay out more for  those who are overweight or obese for workers’ compensation
  • The obese spend 42% more on medical care article-2531797-1A5C3A8800000578-940_634x366
  • 77% more on medications than those with healthy weights
  • May spend 48% more on hospital stays
  • The severely obese will have an additional $3000-$10000 in medical costs
  • Obese earn up to 6% less than their thinner counterparts
  • The obese are 1.7 times more likely than leaner peers to take 7 or more sick days
  • “Plus size” and “big and tall” clothes are often more expensive since they require more fabric
  • May need to pay for an additional plane ticket for 2 seats
  • Excess weight can result in decreased fuel efficiency, every 100 lbs could lessen miles per gallon by up to 2% stated by US Energy Department
  • The morbidly obese may deduct 8-10 years from their life span
  • Those with BMI above 30 have 50-100% increased risk of premature death compared to those with healthy weigh

I liked this article because I wasn’t expecting it from  Money magazine.  Their in depth evaluation and impact of excess weight on one’s wallet is eye opening and provides an eye opening additional angle on the problems people can avoid by living a healthier life.

Sources: http://www.nytimes.com/2011/09/13/health/13brodybox.html?_r=0





The Weight of the Nation


By: Nikki Nies

The Weight of the Nation is a documentary created and produced by HBO.  This 4 part miniseries brings together health professionals, policy makers, researchers and partners that advocates of obesity strategies and solutions.
Although long, this documentary gives a good explanation of how we’ve gotten where we are now–with 2/3 of adults overweight.  The scary part, more and more children, America’s future, are overweight.

Sources: http://theweightofthenation.hbo.com/films



“Porky” American Men


By: Nikki Nies

With alarming statistics constantly being thrown around in the news about the obesity epidemic, the numbers can become overwhelming.  A Pittsburgh artist, Nickolay Lamm, has created a 3D visual with the help of the CDC to put into perspective the male body composition.  Above are four men representing four well known countries.  Can you guess which one is the American man? 8C9394027-131015-average-maile-body-439p.blocks_desktop_small

If you guessed the second one, you would be right! From left to right, the 3D avatars represent a man from the Netherlands, America, France and Japan.  Not only does the American avatar represent the largest beer belly, but the amount of extra “bum.” The American avatar has been described as “porkier” than his internationa friends, representing 69% of men over the age of 20 that have been classified as overweight or obese.

Lamm sees the body shape project as a “reality check” for American men. “We have the biggest cars, the biggest houses. But I’m sure we don’t want to have the biggest waistlines.”

According to the CDC, the average BMI for an American man is 28.3, which is borderline obese (BMI of >30 is considered obese).  The average Japanese man’s BMI is 23.7, from the Netherlands 25.2 and from France 25.5. A BMI from 18.5-24.5 is considered a normal weight.

Lamm has received criticism that his avatars do not represent the “average” American man as the American population has become more diverse in the last couple decades.  In actuality, the skin tone is considered “pink” and overpowers all boundaries of ethnicities.

This visual representation of the body composition of not only American men, but in relation to other world leader’s population hopefully is not passed up like so many statistics are.



Physical Activity Objectives of 2020



In 2008, the Physical Activity Guidelines for Americans (PAG) were created, which emphasizes the goal to “improve health, fitness and quality of life through daily physical activity.”  This is a team effort by the Center of Disease Control (CDC) and the President’s Council on Fitness, Sports and Nutrition.
Physical activity covers an array of activities, everything from moderate and vigorous physical activity and muscle strengthening activities.  More than 80% of adolescents and adults do not meet the exercise guidelines. It is hoped with these updated objectives, that the information will be disseminated through all public agencies–schools, communities, organizations and businesses.
The Physical Activity Objectives:
  • Monitor physician counseling about exercise
  • Provide structural environments, such as the availability of sidewalks, bike lanes, trails, and parks
  • Legislative policies that improve access to facilities that support physical activity
  • Physical activity in childcare settings
  • Limit TV viewing and electronic usage
  • Recess and physical education in public and private schools
It may sound menial to list the benefits of physical activity, but why aren’t more people engaging in physical activity if the benefits outweigh the cost?  What’s stopping you?
Family on bikes outdoors smiling
The Healthy People Objectives of 2020 want to provide all the accessibility, ability and confidence to engage in physical activity regularly.  For the future, they recognize the multidisciplinary approach that is required to meet their goals.  Collaboration with education and health care, transportation, urban planning, recreation and environmental health are essential for the future.
  • Prevent early chronic diseases
  • Prevent depression
  • Decreases level of body fat
  • Reduces high blood pressure
  • Improves bone health
  • Decreases stress levels
  • Improves cardiorespiratory and muscular fitness
  • Associated with a higher income
  • Enjoyable scenery
  • Social support from family and friends
  • Belief in one’s self–self efficacy