Menu ENN Search

Letter on micronutrient deficiency management, by Donald McLaren

Dear Editor

I was amazed, and greatly disappointed, to read the report of the workshop on Community Based Approaches to Managing Severe Malnutrition, and the piece on this subject in Field Exchange, March 2004, pp 16-19. Why was there no mention, whatsoever, about any of the micronutrient deficiencies? These almost invariably accompany severe proteinenergy malnutrition, and therefore constitute a very important part of "severe malnutrition". All those concerned should surely know that deficiency of vitamin A, iron, iodine, and zinc, and possibly others, are responsible in large part for the very high rates of mortality and morbidity among young children and pregnant and lactating women, and others, in developing countries. I find it ironic that on the very next pages you have printed an excellent article by Dr Andre Briend, which rightly draws attention to the scandal, and reflects an area in which I was actively involved in over several decades, in trying to combat the criminal micronutrient inadequacy of many refugee rations. The most startling feature of Table 1 in Dr Briend's article is the absence of both vitamins A and C. Even to this day, there are constantly recurring reports of frank scurvy and non-blinding and blinding xerophthalmia.

Yours faithfully

Donald S. McLaren, MD, PhD, FRCP

The ENN would like to point out that the report referred to in the letter above was the proceedings of a meeting summarised by the ENN, and included with issue 21 of Field Exchange. While micronutrient deficiencies were discussed at the meeting, the main focus of discussions was around the 'new' strategy of addressing severe malnutrition through community based care. It should also be noted that all diets used in projects described in the Dublin report used foods that were highly fortified with all micronutrients (along the WHO recommendations for F100 rehabilitation diets). Nonetheless, Dr. McLaren's letter, and the article by Andre Briend to which he refers, do highlight how we can never be complacent about micronutrient deficiencies. Sadly, the steady flow of articles about micronutrient deficiency outbreaks in humanitarian crises received by the ENN and often published in Field Exchange bear testimony to this.

More like this

FEX: Series of emergency meetings

'The Management of Childhood Malnutrition: nutritional rehabilitation in poverty, famine and war' This meeting was organised by the International Child Health Group on the 7th...

FEX: Treatment of Severe Malnutrition with a Therapeutic Spread

On going Research Milk based diets are used in the treatment of severely malnourished children. However, these diets need to be given under supervision particularly as there...

en-net: Plumpy nut Vis-à-vis Supplementary plumpy

Based on the nutritional information of the two products, there is no difference in nutritional composion (energy,protein, Fat, and micronutritient) except plumy nut has animal...

en-net: Your opinion sought on draft guidance to regulate marketing of Ready to Use Supplemental Foods

Ready to use supplemental foods (RUSFs) are receiving increasing attention by agencies working to alleviate problems of malnutrition. In late 2010, members of the NGO/Civil...

FEX: References for Special Supplement 2

Livelihood activities in South Sudan 1. World Health Organisation (WHO), Management of Severe Malnutrition: A manual for physicians and other senior health workers. Geneva:...

en-net: Upto what extend iron flour fortification can increase the Hb level of anemic adolescent women if iron fortified wheat flour is feed to these anemic adolescent women for 3 months?

i am doing my Mphil research on iron wheat flour fortification for anemic adolescent women. can any one have any information or relevant site or paper that how much it will...

FEX: en-net update

By Tamsin Walters, en-net moderator Over the past three months (Nov 2016 to Jan 2017), 47 questions have been posted on en-net, generating 81 responses. The forum areas for...

en-net: Target weight setting for MAM HIV positive in OTC

Dear ENN collegues, Please share your experiences on attainment of 20% target weight gain among MAM HIV positive children enrolled in Outpatient therapeutic care when admitted...

FEX: Issue 31 Editorial

A mother attending a MSF programme in Niger One of the longest raging debates in nutrition continues in the letters section of this issue of Field Exchange. Put simply, does...

FEX: Issue 05 Editorial

Dear Readers, This edition of Field Exchange focuses on micronutrients. Andre Briend from ISERM gives us an overview of some of the key emergency related micronutrient...

FEX: Issue 28 Editorial

This issue of Field Exchange features four field articles about community based therapeutic care of the severely malnourished, a type of programming that is increasingly being...

en-net: Protein type for children U2 and Pregnant and Lactating women- Specific guidance?

Are there any specific guidelines on what should be the protein sources and distribution between animal and plant protein for adequate nutrition in children U2 and for PLW?...

FEX: Series of letters on ENN conflict of interest, by Noreen Prenderville, Mark Myatt, Steve Collins and Mark Manary

A word from ENN In Issue 23 of Field Exchange, a letter by Mary Lunga'ho, Lida Lhotska and Rebecca Norton was published highlighting concerns they had regarding potential ENN...

ENN Latest

Read an article about comparison of treatment of severe acute malnutrition with ready-to-use therapeutic food and ready-to-use-supplementary food: Research plans in Pakistan...

en-net: ChroSAM study - how can we better support malnourished children to Thrive as well as Survive?

Dear colleagues,

Any thoughts and reflections on the implications of our new paper just out today in Lancet Global Health very welcome: ChroSAM study (Chronic Disease...

FEX: Towards the Overdue Elimination of Deficiency Disease Epidemics

By André Briend Andre Briend is a medical doctor, working for the Institut de Recherche pour le Développement (IRD), a French public research institution with a mandate to...

en-net: Treatment of Preg/Lact women with F100/RUTF?

Could I please have some advice on the recommended treatment for severely malnourished P/L women. I am currently working with our Zimbabwe team and have read in the national...

en-net: Lactose Intolerance

What are the messages on IYCF regarding the feeding guidance for Lactose intolerance baby? How should they select and prepare food from natural sources?

Dear...

FEX: Assessing micronutrient deficiencies in emergencies

Summary of review1 Field haemoglobin testing using a hemacue machine Micronutrient deficiencies have been reported for years in emergency settings, especially in refugee...

FEX: A Review of the advances and challenges in nutrition in conflicts and crises over the last 20 years

Abbreviated version of unpublished paper Food distribution at the ICRC kitchen in Tonj. By Frances Mason and Anna Taylor This paper is a shortened version of the complete...

Close

Reference this page

Donald S. McLaren (2004). Letter on micronutrient deficiency management, by Donald McLaren. Field Exchange 22, July 2004. p18. www.ennonline.net/fex/22/lettersdonald