Micronutrientes no crescimento e desenvolvimento infantil

Autores

  • Dixis Figueroa Pedraza
  • Daiane de Queiroz

DOI:

https://doi.org/10.7322/jhgd.20005

Palavras-chave:

micronutrientes, crescimento, desenvolvimento infantil, desenvolvimento cognitivo, zinco, ferro, vitamina A

Resumo

OBJETIVO: abordar a importância dos micronutrientes zinco, ferro e vitamina A no crescimento linear e desenvolvimento infantil. MÉTODO: foram consultadas as bases de dados Medline e LILACS utilizando duas estratégias de busca: i) growth AND zinc AND iron AND vitamin A AND child, preschool OR infant, para o tema micronutrientes e crescimento; e ii) child development AND zinc AND iron AND vitamin A, para o tema micronutrientes e desenvolvimento. Os artigos foram classificados quanto ao tipo de manuscrito e principais resultados. RESULTADOS: foram incluídos 19 artigos referentes ao crescimento e 5 artigos referentes ao desenvolvimento. DISCUSSÃO: considerando as prevalências, sugere-se que as deficiências de ferro e zinco devem contribuir, concurrentemente, com o déficit de estatura. O papel do zinco no sistema hormonal primário justifica ser o nutriente de maior importância no crescimento, afetando a estatura das crianças tanto em estados de deficiência leve como moderada. Evidências fisiológicas e experimentais colocam a importância dos micronutrientes ferro e zinco no desenvolvimento e déficit cognitivo nos primeiros anos da vida. Apesar disso, os resultados ainda não são conclusivos. Pensa-se que o zinco pode limitar processos neuropsicológicos específicos, já o ferro é essencial para o funcionamento do sistema neuro-transmissor. Estudar o efeito das deficiências de micronutrientes no desenvolvimento apresenta vários problemas metodológicos e analíticos. O crescimento e desenvolvimento representam um processo com determinação comum no qual a deficiência de zinco pode representar a forma mais comum em que o crescimento linear poderia ser utilizado como um bom preditor de desenvolvimento cognitivo.

Referências

Ministério da Saúde do Brasil. Saúde da criança. Acompanhamento do crescimento e desenvolvimento infantil. Brasília (DF):MS; 2002.

Organización Panamericana de la Salud. Manual de crecimiento y desarrollo delniño. Washington (DC): OPS; 1994. (Serie PALTEX para ejecutores de programas desalud; 33).

Vasconcelos FAG. Avaliação nutricional de coletividades. 4ª ed. Florianópolis: Editorada UFSC; 2008.

Uauy R, Kain J, Mericq V, Rojas J, Corvalán C. Nutrition, child growth, and chronic disease prevention. Ann Med2008; 40(1): 11-20.

United Nations, Administrative Committee on Coordination Sub-Committee on Nutrition. 4th Report on the World Nutrition Situation: Nutrition throughout the life cycle. Ginebra: ACC/SCN; 2000.

Sucupira ACSL, Werner J Jr, Resegue R. Desenvolvimento. In: Sucupira ACSL, Bricks LF, Kobinger MEBA, Saito MI, Zuccoltto SMC, coord. Pediatria em consultório. 4.ª ed. São Paulo: Sarvier; 2000. p. 22-39.

Organização Pan-Americana da Saúde. Manual para vigilância do desenvolvimento infantil no contexto da AIDPI. Washington (DC): OPAS; 2005. (Serie OPS/FCH/CA/05.16.P).

Singh M. Role of micronutrients for physical growth and mental development. Indian J Pediatr 2004; 71(1): 59-62.

Allen LH, Gillespie SR. What works? Areview of the efficacy and effectiveness of nutrition interventions. Manila, Philippines: ADB; 2001.

Allen LH, Peerson JM, Olney DK. Provision of multiple rather than two or fewer micronutrients more effectively improves growth and other outcomes in micronutrient-deficient children and adults. J Nutr. 2009;139(5):1022-30.

Ramakrishnan U, Neufeld LM, Flores R, Rivera J, Martorell R. Multiple micronutrient supplementation during early childhood increases child size at 2 y of age only among high compliers. Am J Clin Nutr 2009; 89(4): 1125-31.

Ramakrishnan U, Nguyen P, Martorell R. Effects of micronutrients on growth of children under 5 y of age: meta-analysesof single and multiple nutrient interventions. Am J Clin Nutr 2009; 89:191-203.

Bhutta ZA, Ahmed T, Black RE, CousensS, Dewey K, Giugliani E, Haider BA, Kirkwood B, Morris SS, Sachdev HP, Shekar M; What works? Interventions for maternal and child under nutrition and survival. Lancet. 2008; 371(9610):417-40.

Chen K, Li TY, Chen L, Qu P, Liu YX. Effects of vitamin A, vitamin A plus iron and multiple micronutrient-fortified seasoning powder on preschool children in a suburb of Chongqing, China. J NutrSci Vitaminol 2008; 54(6): 440-7.

Lutter CK, Rodríguez A, Fuenmayor G, Avila L, Sempertegui F, Escobar J. Growth and micronutrient status in children receiving a fortified complementary food. J Nutr 2008; 138(2): 379-88.

Uauy R, Kain J, Mericq V, Rojas J, Corvalán C. Nutrition, child growth, and chronic disease prevention. Ann Med. 2008; 40(1): 11-20.

Elizabeth KE, Krishnan V, Zachariah P. Auxologic, biochemical and clinical (ABC) profile of low birth weight babies-a 2-year prospective study. J Trop Pediatr2007; 53(6): 374-82.

Fahmida U, Rumawas JS, Utomo B, Patmonodewo S, Schultink W. Zinc-iron, but not zinc-alone supplementation, increased linear growth of stunted infants with low haemoglobin. Asia Pac J Clin Nutr 2007; 16(2): 301-9.

Katz J, Christian P, Dominici F, Zeger SL. Treatment effects of maternal micronutrient supplementation vary by percentiles of the birth weight distribution in rural Nepal. J Nutr 2006; 136(5): 1389-94.

Hop le T, Berger J. Multiple micronutrient supplementation improves anemia, micronutrient nutrient status, and growth of Vietnamese infants: double-blind, randomized, placebo-controlled trial. J Nutr 2005; 135(3):660S-665S.

Smuts CM, Dhansay MA, Faber M, VanStuijvenberg ME, Swanevelder S, Gross R, Benadé AJ. Efficacy of multiple micronutrient supplementation for improving anemia, micronutrient status, and growth in South African infants. J Nutr2005; 135(3): 653S-659S.

Untoro J, Karyadi E, Wibowo L, Erhardt MW, Gross R. Multiple micronutrient supplements improve micronutrient status and anemia but not growth and morbidity of Indonesian infants: a randomized, double-blind, placebo-controlled trial. J Nutr 2005; 135(3):639S-645S.

Christian P, Khatry SK, Katz J, Pradhan EK, LeClerq SC, Shrestha SR, Adhikari RK, Sommer A, West KP Jr. Effects of alternative maternal micronutrient supplements on low birth weight in rural Nepal: double blind randomized community trial. BMJ 2003; 326(7389): 571.

Oelofse A, Van Raaij JM, Benade AJ, Dhansay MA, Tolboom JJ, Hautvast JG.The effect of a micronutrient-fortified complementary food on micronutrient status, growth and development of 6- to12-month-old disadvantaged urban South African infants. Int J Food Sci Nutr. 2003;54(5): 399-407.

Rivera Dommarco J, Hotz C, Gonzalez de Cossío T, Neufeld L, Garcia Guerra A. The effect of micronutrient deficiencies on child growth: a review of results from community-based supplementation trials. J Nut. 2003; 133(11 Suppl 2): 4010S-20.

Bhandari N, Bahl R, Taneja S. Effect of micronutrient supplementation on line argrowth of children. Brit J Nut 2001; 85Suppl 2: S131-37.

Dijkhuizen MA, Wieringa FT, West CE, Muherdiy antiningsih M. Concurrent micronutrient deficiencies in lactating mothers and their infants in Indonesia. Am J Clin Nutr 2001; 73(4): 786-91.

Wehby GL, Murray JC. The effects of prenatal use of folic acid and other dietary supplements on early child development. Matern Child Health J2008; 12(2): 180-7.

Silva LSV, Thiapó AP, Souza GGS, Saunders C, Ramalho A. Micronutrientes na gestação e lactação. Rev Bras Saúde Matern Infant. 2007; 7(3): 237-44.

Silva SLV, Thiapó AP, Souza GG de, Saunders C, Ramalho A. Micronutrientes na gestação e lactação. Rev Bras Saúde Matern Infant. 2007; 7(3): 237-44.

Ministério da Saúde. Carências de micronutrientes. Brasília (DF): MS; 2007.

Pinero DJ, Connor JR. Iron in the brain: An important contributor in normal and diseased states. Neuroscientist .2000; 6(6):435-53.

Oppenheimer SJ. Iron and its relation to immunity and infectious disease. J Nutr.2001; 131(2 Supl 2): 616S-35.

Mafra D, Cozzolino SMF. Importância do zinco na nutrição humana. Rev Nutr 2004;17(1): 79-87.

International Zinc Nutrition Consultative Group. Assessment of the risk of zinc deficiency in populations and options for its control. Hotz C and Brown KH, eds. Food Nutr Bull 2004; 25(1 Suppl 2): S91-204.

Black RE. Micronutrients in pregnancy. Br J Nutr 2001; 85 Suppl 2: S193-7.

Llanos A, Uauy R, González de Cossío T, Barros A, para el Proyecto Challenges for Childhood Health and Nutrition Research in Latin America: addressing the 90/10gap. Bajo Peso al Nacer. Bangladesh:Child Health and Nutrition ResearchInitiative; 2003.

Neufeld L, Hotz C, para el Proyecto Challenges for Childhood Health and Nutrition Research in Latin America: addressing the 90/10 gap. Restricción e nel crecimiento y deficiencia demicronutrientes. Bangladesh: Child Health and Nutrition Research Initiative; 2003.

Ramakrishnan U, Martorell R. The role of vitamin A in reducing child mortality and morbidity and improving growth. Salud Publica Mex 1998; 40: 189–98.

Christa L, Walker F, Black RE. Functional indicators for assessing zinc deficiency. Food Nutr Bull 2007; 28(3 Suppl): S454-79.

Chhagan M K, Broeck J V, Luabeya K-KA, Mpontshane N, Tomkins A, Bennish ML. Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24months. BMC Public Health 2010;10(145). Disponível em: http://www.biomedcentral.com/1471-2458/10/145. Acesso em: 5 de julho de 2010.

Bee H. A criança em desenvolvimento. 9ªed. Porto Alegre: Artmed; 2003.

Fernandes A. Nutrição e Desenvolvimento. In: Silva AC, Gomes-Pedro J, editors. Nutrição Pediátrica: Princípios Básicos. Lisboa: ACSM; 2005.p. 225-33.

Sachdev HPS, Gera T, Nestel P. Effect of iron supplementation on mental and motor development in children: systematic review of randomized controlled trials. Public Health Nutrition. 2004; 8(2): 117–32.

Guardiola A, Egewarth C, Rotta NT. Avaliação do desenvolvimento neuropsicomotor em escolares de primeira série e sua relação com o estado nutricional. J Pediatr 2001; 77(3): 189-96.

Santos-Monteiro J, Guedes RCA, Castro RM, Filho JEC. Psychosocial stimulation and brain plasticity in malnourished individuals. Rev Bras Saude Matern Infant. 2002; 2(1): 15-22.

Fernandes A. Nutrição e desenvolvimento. Nutrição Pediátrica: Princípios Básicos. Lisboa: ACSM; 2005.

Lozoff B. Iron deficiency and child development. Food Nutr Bull 2007; 28 (4Suppl): S560-71.

Black MM. Micronutrient Deficiencies and Cognitive Functioning. J. Nutr 2003;133 Suppl: 3927S–31.

Grantham-McGregor S, Ani CC. The role of micronutrients in psychomotor and cognitive development. British Medical Bulletin 1999; 55(3): 511-27.

Humphrey JH, Agoestina T, Juliana A, Septiana S, Widjaja H, Cerreto MC, WuLee SF, Ichord RN, Katz J, and West KP. Neonatal vitamin A supplementation: effect on development and growth at 3 yof age. Am J Clin Nutr 1998; 68: 109–17.

Sandstead HH, Penland JG, Alcock NW,Dayal HH, Xue CCh, Jui SL, Faji Z, Jia JY. Effects of repletion with zinc and other micronutrients on neuropsychologic performance and growth of Chinese children. Am J Clin Nutr 2007; 86: 412–20.

Rosado JL. Deficiencia de zinc y sus implicaciones funcionales. Salud Pública Mex 1998; 40(2): 181-8.

Black MM. Zinc deficiency and child development. Am J Clin Nutr 1998; 68Suppl: 464S-9.

Salgueiro MJ, Weill R, Hernándezb-TrianaM, Zubillaga M, Lysionek A, Caro R. Deficiência de zinc em relación com el desarrollo intelectual y sexual. Rev Cubana Salud Pública 2004; 30(2).Disponível em: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-4662004000200007&lng=es. Acesso em:5 de julho de 2010.

Gardner JMM, Powell CA, Baker-Henningham H, Walker SP, Cole TJ. Zinc supplementation and psychosocial stimulation: effects on the development of undernourished Jamaican children. Am JClin Nutr 2005; 82: 399–405.

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2011-04-01

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