Is There an Issue with Micronutrient Intakes Among Kids in the Arab Gulf?

Is There an Issue with Micronutrient Intakes Among Kids in the Arab Gulf?

Eating a nutritionally adequate diet during childhood and adolescence is important for optimal growth and development and for future health. Achieving this can be challenging, due to food preferences, varying requirements for growth, limited knowledge of nutrition, societal changes to food purchasing habits and increased eating away from home.1 Dietary surveys in the region are limited, however those that have been carried out suggest that large numbers of children have intakes of vitamins and/or minerals which are marginal or in some cases deficient.2,3,4

Key points:

Many children in the Arab Gulf are not meeting their recommended nutrient intakes
 
Low Vitamin D intakes are universal and of serious concern
 
Choosing nutrient dense foods such as fruit, vegetables and fortified breakfast cereals can effectively improve vitamin and mineral intakes.
 
All Kellogg’s children’s breakfast cereals* are fortified with 6 B vitamins, vitamin D and iron
 
Breakfast is a key opportunity to boost micronutrient intake

*Kellogg’s family and kids ranges include Corn Flakes, Coco Pops, Frosties, Rice Krispies and Miel Pops.

Current Micronutrient Status in Children

Evidence suggests that children living in the Arab Gulf are facing a paradox of nutrition. Overweight and obesity are increasingly common due to overconsumption of some macronutrients, in combination with sedentary lifestyles.1 In contrast the number of children consuming low intakes of vitamins and minerals is high.2,3

Of particular concern are low intakes of vitamin A and folic acid, combined with almost universally poor intakes of vitamin D and calcium across every age group.2,3 Intake data are summarised in Table 1 and these suggest a trend towards a worsening in nutritional status in all countries as adolescence progresses. This may be explained, at least in part, by increasing independence, and more frequent eating outside of the family home.5,6

Table 1: Vitamins and Minerals at risk in Children’s diets

Nutrients where more than half the population are below the EAR* are highlighted in red

*The EAR is the amount of a nutrient that meets the nutritional needs of half the population - half will need more than this and half will need less. Where large numbers have intakes below the EAR this suggests a widespread issue with intake which should be addressed.

Poor Vitamin D status – a region wide concern

Of particular concern is Vitamin D, which has become one of the most common vitamin deficiencies seen globally. Dietary surveys indicate widespread low dietary intake of this important vitamin (see Table 1 above). Vitamin D can be manufactured in the skin from sunlight. However despite an abundance of sunshine, a recent systematic review has shown that between 30-75% of children living in the Arab Gulf have poor vitamin D status.7 This is likely to be due to a combination of factors including poor dietary intakes, hot climate limiting time spent outdoors, and use of sunscreen lotions (which also block vitamin D production in the skin).8

There are few natural dietary sources of vitamin D, and the most significant source is limited largely to fatty types of fish. Some commonly consumed foods are fortified with vitamin D, such as cereals (including some breakfast cereals – check labels) and dairy products. Dietary guidelines for Arab Gulf Countries encourage the consumption of nutrient fortified grain-based foods such as cornflakes and other breakfast cereals, bread, and some types of biscuit to help boost intake of iron, folic acid, calcium, and vitamin D.9,10

Kellogg’s has been fortifying its products with vitamins and minerals, in response to public dietary needs for over 70 years. A most recent update to Kellogg’s fortification portfolio is the addition of vitamin D to all children’s breakfast cereals such that they now provide 25% of the Reference Intake (RI) in every portion. Where present this is clearly highlighted on front of pack.

Fortified Breakfast Cereals could help to meet dietary shortfalls

Fortified breakfast cereals are generally considered to be nutrient dense (i.e. they have high levels of nutrients, vitamins and minerals in relation to energy content). When regularly consumed these have been shown to make a valuable contribution to the diets of children and adolescents.11,12

For children (and adults) in the Arab Gulf, fortified breakfast cereals are a great source of nutrients such as thiamine (B1), riboflavin (B2), niacin (B3), B6, folic acid (B9), B12, vitamin D and iron.4 In addition, breakfast cereals are almost universally consumed with milk or yoghurt, adding an additional boost to intakes of both protein and calcium.

Health promotions efforts are needed to support parents, families and schools to encourage consumption of a nutrient dense healthy diet, as part of an active lifestyle.2 This includes encouraging consumption of more fruits and vegetables, lean meats, low fat dairy and fish, and fortified foods, to help boost vitamin and mineral intake among children and adolescents of all ages.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References:

  1. Musaiger AO (2011) The Paradox of Nutrition-Related Diseases in the Arab Countries: The Need for Action. Int. J. Environ. Res. Public Health 8: 3637-3671.
  2. Habiba IA et al (2013) High proportion of 6 to 18-year-old children and adolescents in the United Arab Emirates are not meeting dietary recommendations. Nutr Res 33: 447-456.
  3. Al-Daghri NM et al (2012) Assessment of selected nutrient intake and adipocytokine profile among Saudi children and adults. Endocrine Journal 59: 1057-1063. 
  4. Zaghloul S et al (2012) Evidence for nutrition transition in Kuwait: over-consumption of macronutrients and obesity. Pub Health Nutr 16: 596–607.
  5. Musaiger AO (2011) Dietary and lifestyle habits amongst adolescents in Bahrain. Food & Nut Res 55: 7122
  6. Washi SA et al (2010) Poor diet quality and food habits are related to impaired nutritional status in 13- to 18-year-old adolescents in Jeddah. Nutr Res 30: 527-534
  7. Bassil D et al (2013) Hypovitaminosis D in the Middle East and North Africa Prevalence, risk factors and impact on outcomes. Dermato-Endocrinology 5: 274–298.
  8. Alshishtawy MM (2012) Vitamin D Deficiency This clandestine endemic disease is veiled no more. SQU Med J 12: 140-152.
  9. Musaiger AO et al (2012) Food-Based Dietary Guidelines for the Arab Gulf Countries. J Nutr Metab 2012:1-10.
  10. Ministry of Health (2012) Dietary Guidelines for Saudis The healthy Food Palm. General Directorate of Nutrition 2012 M - 1433 H.
  11. Hennessey A et al (2015) Impact of voluntary food fortification practices in Ireland: trends in nutrient intakes in Irish adults between 1997–9 and 2008–10. Brit J Nut 113: 310–320.
  12. Berner LA et al (2014) Fortified Foods Are Major Contributors to Nutrient Intakes in Diets of US Children and Adolescents. J Acad Nutr Diet. 114: 1009-1022.