الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The first 2 years in life are considered to be the most vulnerable period in the whole life span of an individual. The very rapid rate of growth and the rapid physiological changes occurring in an infant’s body require proper nutrition aiming at fulfilling his nutritional needs in this critical period. The irreversible effects on an infant’s body that can occur in case of chronic severe malnutrition adds even more to the vulnerability of this period. Exclusive breast feeding in the first 6 months of an infant’s life is able to supply him with all the nutrients needed, but after these 6 months breast milk alone is not sufficient to meet his nutritional needs and complementary feeding should be introduced.
Unmet nutritional requirements can lead to a wide spectrum of malnutrition disorders. Malnutrition can be divided broadly into macronutrient malnutrition (deficient dietary carbohydrates, fats and proteins) and micronutrient malnutrition (deficiency of vitamins and minerals). Macronutrient malnutrition leads to protein energy malnutrition which varies in severity leading to marasmus or kwashiorkor in severe cases. On the other hand, micronutrient deficiency has a wide variation of clinical presentations according to the micronutrient accused and whether its deficiency is alone or combined with other micronutrient deficiencies. The increasing global burden of this problem especially in developing countries together with the lack of recent data-to our knowledge- documenting the magnitude of inadequate micronutrients intake in Egypt arose the need of such a study.
This study aimed to determine the prevalence of inadequate intake of seven micronutrients namely: calcium, iron, zinc, vitamin A, vitamin C, thiamin and riboflavin. The other aim was measuring the anthropometric measurements of the studied sample to determine the overall body status of the sample. A questionnaire was used for data collection from 400 infants selected at random from 8 MCH centers from Alexandria governorate. Food frequency questionnaire was used for the collection of dietary data. Data were analyzed using SPSS version’ 21’ and ‘WHO anthro’ application version’ 3.2.2’ was used for calculating and graphing anthropometric indices.
After data collection and its statistical analysis the following parameters were obtained:
1- The Sociodemographic characteristics, medical history, breast feeding and formula feeding practices.
2- Anthropometric measures and anthropometric indices.
3- Prevalence of inadequate intake of each one of the seven micronutrients and factors affecting inadequacy.
The results of the study can be summarized as follows:
• Inadequate calcium intake from complementary food was found among 18% of children below 12 months of age and among 60.4 % of children above 12 months.
• Inadequate iron intake from complementary food was found among 69.1 % of children below 12 months and among 39.6 % of children above 12 months.
• Inadequate zinc intake from complementary food was found among 24.7% of children below 12 months and among 45.9% of children above 12 months.
• Inadequate vitamin A intake from complementary food was found among 42.1% of children below 12 months and among 32.7% of children above 12 months.
• Inadequate vitamin C intake from complementary food was found among 66.9% of children below 12 months and among 23% of children above 12 months.
• Inadequate thiamine intake from complementary foods was found among 27% of children below 12 months and among 73% of children above 12 months.
• Inadequate riboflavin intake from complementary food was found among 18.5% of children below 12 months and among 42.3% of children above 12 months.
• Wasting was found among 15.1% of children below 12 months and among 10.5% of children above 12 months.
• Low weight for age was found among 22.5% of children below 12 months and among 10.9% of children above 12 months.
• Stunting was found among 51.1% of children below 12 months and among 22.8% of children above 12 months.
• According to BMI for age, underweight, overweight and obesity was found among 36.6%, 6.1%, 4.9% respectively among children below 12 months, and 10.2%, 11.2% and 20.4 of children above 12 months of age.
• Most children of the studied sample had fair breast feeding practices.
• Less than 7% of children were bottle fed, about 20% were bottle fed in addition to breast feeding and the rest of children within the sample were exclusively breast fed before the introduction of weaning food.
• The most commonly consumed foods as complementary foods were: rice, macroni, baladi bread, eggs, processed cheese, cow milk, squash, carrots, bananas and apples.
• Regarding sources of children’s diet; children depended mostly on dairy products followed by cereals and bakery, and to a lesser extent on fruits and vegetables followed by animal protein.
The problem of inadequate micronutrient intake or in other words “hidden hunger” cannot be approached on a single level. Co-operation between mothers at home, primary health care centers (PHCs) and national health authorities.
1- Mothers at home:
Mothers at home should be educated about how to prepare a safe and balanced diet for their infants and about the proper complementary feeding guidelines that can ensure optimum supply form all the essential micronutrients. This can be done through the media, PHCs or by door-to-door health educators.
2- Primary health care centers:
Primary health care centers can carry out health education programmes in addition to taking opportunities of compulsory vaccination as a chance to increase mother’s awareness about the health and nutrition of their children.
3- Local health authorities:
On the national levels, local health authorities are advised to do detailed research about the problematic nutrients and investigate for the signs of actual deficiency. Measures for infant food fortification and providing supplements to be available for low income families can be done as a trial to overcome the lack of available healthy and balanced diet and the relatively low availability of animal source foods.