Micronutrient malnutrition affects approximately 2 billion people worldwide. The adverse effects of micronutrient deficiencies are profound and include premature death, poor health, blindness, growth stunting, mental retardation, learning disabilities, and low work capacity. Preventing Micronutrient Deficiencies provides a conceptual framework based on past experience that will allow funders to tailor programs to existing regional/country capabilities and to incorporate within these programs the capacity to address multiple strategies (i.e., supplementation/fortification/food-based approaches/public health measures) and multiple micronutrient deficiencies. The book does not offer recommendations on how to alleviate specific micronutrient deficienciesâ€"such recommendations are already available through the publications of diverse organizations, including the U.S. Agency for International Development, the Micronutrient Initiative, World Bank, United Nations Childrens' Fund, and the World Health Organization. Instead, this volume examines key elements in the design and implementation of micronutrient interventions, including such issues as: The importance of iron, vitamin A, and iodine to health. Populations at risk for micronutrient deficiency. Options for successful interventions and their cost. The feasibility of involving societal sectors in the planning and implementation of interventions. Characteristics of successful interventions. The book also contains three in-depth background papers that address the prevention of deficiencies of iron, vitamin A, and iodine.

Combating Nutritional Blindness in Children: A Case Study of Technical Assistance in Indonesia focuses on the processes in technical assistance (TA) as applied to the Nutritional Blindness Research Project, a case study on nutritional blindness among children in Indonesia. The manuscript first offers information on the Nutritional Blindness Research Project, as well as the processes and reactions to TA, xerophthalmia, and Helen Keller International. The text then tackles the development of a research project, including proposal, initial organization, and staffing, as well as periodic observation of children at home. The book examines the treatment of children in the hospitals, and particularly notes the planning phase, study and treatment of the disease, and socioeconomic data of patients and their families. The text also underscores the participation of the World Health Organization and USAID in the project and funding of the project. The manuscript is a dependable reference for students of economic and social development administration and international technical assistance.

The ability to see deeply affects how human beings perceive and interpret the world around them. For most people, eyesight is part of everyday communication, social activities, educational and professional pursuits, the care of others, and the maintenance of personal health, independence, and mobility. Functioning eyes and vision system can reduce an adult's risk of chronic health conditions, death, falls and injuries, social isolation, depression, and other psychological problems. In children, properly maintained eye and vision health contributes to a child's social development, academic achievement, and better health across the lifespan. The public generally recognizes its reliance on sight and fears its loss, but emphasis on eye and vision health, in general, has not been integrated into daily life to the same extent as other health promotion activities, such as teeth brushing; hand washing; physical and mental exercise; and various injury prevention behaviors. A larger population health approach is needed to engage a wide range of stakeholders in coordinated efforts that can sustain the scope of behavior change. The shaping of socioeconomic environments can eventually lead to new social norms that promote eye and vision health. Making Eye Health a Population Health Imperative: Vision for Tomorrow proposes a new population-centered framework to guide action and coordination among various, and sometimes competing, stakeholders in pursuit of improved eye and vision health and health equity in the United States. Building on the momentum of previous public health efforts, this report also introduces a model for action that highlights different levels of prevention activities across a range of stakeholders and provides specific examples of how population health strategies can be translated into cohesive areas for action at federal, state, and local levels.

This volume is the newest release in the authoritative series issued by the National Academy of Sciences on dietary reference intakes (DRIs). This series provides recommended intakes, such as Recommended Dietary Allowances (RDAs), for use in planning nutritionally adequate diets for individuals based on age and gender. In addition, a new reference intake, the Tolerable Upper Intake Level (UL), has also been established to assist an individual in knowing how much is "too much" of a nutrient. Based on the Institute of Medicine's review of the scientific literature regarding dietary micronutrients, recommendations have been formulated regarding vitamins A and K, iron, iodine, chromium, copper, manganese, molybdenum, zinc, and other potentially beneficial trace elements such as boron to determine the roles, if any, they play in health. The book also: Reviews selected components of food that may influence the bioavailability of these compounds. Develops estimates of dietary intake of these compounds that are compatible with good nutrition throughout the life span and that may decrease risk of chronic disease where data indicate they play a role. Determines Tolerable Upper Intake levels for each nutrient reviewed where adequate scientific data are available in specific population subgroups. Identifies research needed to improve knowledge of the role of these micronutrients in human health. This book will be important to professionals in nutrition research and education.

Rev. ed. of: Field guide to the detection and control of xerophthalmia. 2nd ed. 1982.

Every aspect of immune function and host defense is dependent upon a proper supply and balance of nutrients. Severe malnutrition can cause significant alteration in immune response, but even subclinical deficits may be associated with an impaired immune response, and an increased risk of infection. Infectious diseases have accounted for more off-duty days during major wars than combat wounds or nonbattle injuries. Combined stressors may reduce the normal ability of soldiers to resist pathogens, increase their susceptibility to biological warfare agents, and reduce the effectiveness of vaccines intended to protect them. There is also a concern with the inappropriate use of dietary supplements. This book, one of a series, examines the impact of various types of stressors and the role of specific dietary nutrients in maintaining immune function of military personnel in the field. It reviews the impact of compromised nutrition status on immune function; the interaction of health, exercise, and stress (both physical and psychological) in immune function; and the role of nutritional supplements and newer biotechnology methods reported to enhance immune function. The first part of the book contains the committee's workshop summary and evaluation of ongoing research by Army scientists on immune status in special forces troops, responses to the Army's questions, conclusions, and recommendations. The rest of the book contains papers contributed by workshop speakers, grouped under such broad topics as an introduction to what is known about immune function, the assessment of immune function, the effect of nutrition, and the relation between the many and varied stresses encountered by military personnel and their effect on health.

This book is a comprehensive source of authoritative information on the clinical features,diagnosis, differential diagnosis, and management of medical and surgical retinal diseases. The Manual has 122 chapters, organized in 18 sections covering medical and surgical aspects of retinal diseases such as trauma, AMD, Uveitis, infections, endophthalmitis, pediatric diseases, dystrophies, and tumors. Easy-to-read chapters convey the fundamental concepts with the aid of clinical photographs, imaging studies (including fluorescein and indocyanine angiograms, ultrasonograms, CT scans, and MRI scans) and tables. The manual is of value to a wide range of practitioners and trainees, including students,residents, fellows and ophthalmologists who treat retinal diseases.

This book shows how vitamin A deficiency – before the vitamin was known to scientists – affected millions of people throughout history. It is a story of sailors and soldiers, penniless mothers, orphaned infants, and young children left susceptible to blindness and fatal infections. We also glimpse the fortunate ones who, with ample vitamin A-rich food, escaped this elusive stalker. Why were people going blind and dying? To unravel this puzzle, scientists around the world competed over the course of a century. Their persistent efforts led to the identification of vitamin A and its essential role in health. As a primary focus of today’s international public health efforts, vitamin A has saved hundreds of thousands of lives. But, we discover, they could save many more were it not for obstacles erected by political and ideological zealots who lack a historical perspective of the problem. Although exhaustively researched and documented, this book is written for intellectually curious lay readers as well as for specialists. Public health professionals, nutritionists, and historians of science and medicine have much to learn from this book about the cultural and scientific origins of their disciplines. Likewise, readers interested in military and cultural history will learn about the interaction of health, society, science, and politics. The author’s presentation of vitamin A deficiency is likely to become a classic case study of health disparities in the past as well as the present.

Many studies over the past decade and a half have indicated that vitamin A status is an important determinant of health. The World Bank now estimates that vitamin A intervention programs are some of the most cost-effective health strategies globally. This new book, written by leading investigators in the field, is the first to synthesize the many important studies to date. The authors identify and quantify the biological, clinical and public health impact of vitamin A deficiency on childhood growth, mortality and morbidity, including anemia and blindness. They deal with the epidemiologic and biological basis of these findings, and with the prevention and treatment of these disorders, particularly of measles, diarrhea and xeorophthalmia. Alternative approaches to identifying individuals and populations in need of intervention, alternative strategies for improving vitamin A and carotenoids, and the relationship between vitamin A and immunity are discussed. This comprehensive volume on a critically important and widespread nutritional deficiency will serve as a unique resource for nutritionists, physicians, public health workers and policy makers, and will be especially relevant to clinicians and researchers in international health.