Rice flour was proposed as a vehicle for iron and zinc fortification in Sri Lanka. Although widely consumed, rice flour has not been evaluated as a fortified food, and the absorption of minerals including iron and zinc from this flour is unknown. Determination of the bioavailability of these nutrients is a critical step before commencing a fortification program. We randomly divided 53 Sri Lankan schoolchildren ages 6-10 y into 4 groups that consumed a local dish prepared with 25 g of fortified rice flour labeled with one of the following: 1) (58)FeSO(4) 2) (58)FeSO(4) + Na(2)EDTA 3) (58)FeSO(4) + (67)ZnO or, 4) (58)FeSO(4) + Na(2)EDTA + (67)ZnO. The levels of iron and zinc were 60 mg/kg; the rice flour also contained folate at 2 mg/kg in each group. Na(2)EDTA was added at a Fe:Na(2)EDTA, 1:1 molar ratio. A total of 48 children completed the trial. Absorption of (58)Fe from a meal was significantly greater (P < 0.01) in the groups administered FeSO(4) + Na(2)EDTA (4.7 +/- 3.6%) than in those administered FeSO(4) without Na(2)EDTA (2.2 +/- 1.3%). Fractional absorption of zinc was 13.5 +/- 6.0% in the FeSO(4) + Na(2)EDTA group and 8.8 +/- 2.0% in the FeSO(4) group (P = 0.037). Although zinc absorption was low, our results demonstrated a benefit in using Na(2)EDTA to improve both iron and zinc absorption. We conclude that the fortification of rice flour is feasible, although additional strategies such as dephytinization or an increase in the level of iron and zinc fortification should be considered to obtain a higher proportion of the daily requirement of total absorbed iron and zinc.

Objective: To determine the effectiveness of combined iron and zinc over the iron or zinc-only supplementation in correcting deficiency and possible interactive effects in a group of adolescent school children. Subjects and methods: Schoolchildren (n ¼ 821) of 12-16 years of age were randomized into four groups and supplemented with iron (50 mg/day), zinc (14 mg/day), iron þ zinc or placebo capsules 5 days per week for 24 weeks. Anthropometry, and haemoglobin (Hb), serum zinc (SZn) and serum ferritin (SF) concentrations were determined before and after the intervention. Results: There were no significant effects between-groups in their weight, height and Hb concentrations with the intervention when compared with the placebo group. Iron-only and combination-supplemented groups had reached mean SF concentrations of 55.1 mg/l with no difference between them (P ¼ 0.99). The zinc-only group had a mean change of 4.3 mmol//l whereas the combine-supplemented group had a mean change of 4.0 mmol/l (P ¼ 0.82). The prevalence of anaemia was found to be 70.3% in the iron group at baseline; this was reduced to 14.5% after the supplementation. In the combinesupplemented group anaemia, prevalence was reduced from 64.8 to 19.3%. Conclusions: Zinc alone or in combination with iron has not shown a significant improvement in growth in adolescence. Severe and moderate forms of anaemia were successfully treated in children who received iron supplementation. Initial high prevalence of low SZn and iron stores was significantly improved with micronutrient supplementation.

Assessing micronutrient status in children may also have the benefit of addressing the problems of various micronutrient deficiencies with a unified programmatic approach on a public health scale. A cross-sectional survey in the Galle district of the micronutrient and anthropometric status of 248 children of ages 3-5 years was performed to determine the prevalence of micronutrient deficiencies [iron, zinc (Zn), folate, calcium, caeruloplasmin, iodine, vitamin A and vitamin D] and the extent to which multiple micronutrient deficiencies coexist. The prevalence of anaemia [haemogbolin (Hb) < 110.0 g L⁻¹] was 34.0% in males and 33.0% in females (overall 33.5%, gender difference, P = 0.92). In anaemic children, 7.0% of males and 15.0% of females were iron deficient (serum ferritin < 15.0 µg L⁻¹). Folate deficiency (<3.00 ng mL⁻¹) was found in 41.0% and 33.0% of male and female, respectively, whereas Zn deficiency (<9.95 µmol L⁻¹) occurred in 57.0% and 50.0% of male and female, respectively. Serum vitamin D deficiency (<35.0 nmol L⁻¹) was found in 26% and 25% of male and female, respectively. Anaemic males had a 3.0-fold (95% confidence interval (CI) 1.1-8.3) and 2.3-fold (95% CI 0.8-6.6) greater risk of being underweight and thin, whereas the risk among anaemic females was 0.7-fold (95% CI 0.3-1.8) and 0.9-fold (95% CI 0.3-2.6) for being underweight and thin. Only 7.3% of the subjects did not have any micronutrient deficiency, 38.3% were deficient in two micronutrients, 17.7% had three micronutrient deficiencies and 6.0% had four or more micronutrient deficiencies. Multiple micronutrient deficiencies are prevalent in Sri Lankan pre-school children and established baseline data for future studies.

Aims:To evaluate the effects of zinc with or without other antioxidants on blood glucose, lipid profile, and serum creatinine in adult diabetics on long-term follow-up.Materials and methods:Patients (n = 96) were randomly allocated to three groups: group A (n = 29) was supplemented with oral zinc sulfate (22 mg/day) and multivitamin/mineral (zinc+MVM) preparation; group B (n = 31) was given the same preparation without zinc (MVM); and group C (n = 36) was given a matching placebo for a period of 4 months in a single-blinded study. Blood samples were taken at baseline and after 4 months of supplementation to assess blood glucose (fasting and postprandial) and glycosylated hemoglobin (HbA1C%) and serum levels of zinc, creatinine, and lipids.Results:The zinc+MVM group had a mean change of fasting blood sugar −0.33 mmol/L (standard error of the mean 0.21 mmol/L) and was significant (P = 0.05) when compared with the other two groups (mean change in the MVM group +0.19 (0.31) mmol/L and +0.43 (0.23) mmol/L in the control group, respectively). The HbA1C% level reduced significantly, irrespective of the baseline level, in zinc+MVM-supplemented individuals. In the other two groups, the change of HbA1C% level was not significant. Serum lipid levels reduced significantly in the zinc+MVM and MVM groups.Conclusions:Zinc+MVM supplementation showed beneficial effects in the metabolic control of adult diabetics in addition to elevating their serum zinc level. Zinc supplementation improved glycemic control measured by HbA1C% and fasting and postprandial glucose. Furthermore, zinc supplementation lowered serum cholesterol and cholesterol/high-density lipoprotein ratio.

Background The upsurge of COVID-19 has caused numerous psycho-social challenges for healthcare professionals because of its ability to spread rapidly in the community and high mortality rate. The seriousness of the disease has led many healthcare professionals plagued by stigma as well as discrimination. In this study, depressive symptomatology, levels of anxiety, and related psychosocial and occupational factors experienced by healthcare professionals in Sri Lanka during COVID -19 were investigated. Methods A total of 512 healthcare professionals were surveyed using an online survey. The Generalized Anxiety Disorder 7-item scale, the Center for Epidemiologic Studies Depression Scale-Revised-10, and psychosocial and occupational factors predictive of depression and anxiety were included in the survey questionnaire. Logistic regression determined the factors associated with the presence of depressive symptoms and anxiety. Results Results showed that elevated depressive symptoms and anxiety were experienced by 53.3% and 51.3%, respectively, of the participants. No differences in the prevalence of elevated depressive symptoms and anxiety were found between those who were exposed and non-exposed to COVID-19 confirmed or suspected patients. Having a fear of being infected with COVID-19 and spreading it among family members were associated with increased risk of depression. Among those exposed to COVID-19 confirmed or suspected patients, poor occupational safety (OR = 2.06, 95% CI 1.25–3.39), stigmatization (OR = 2.19, 95% CI 1.29–3.72), and heavy workload (OR = 2.45, 95% CI 1.53–3.92) were associated with increased risk of elevated depressive symptoms, whilst poor self-confidence (OR = 2.53, 95% CI 1.56–4.09) and heavy workload (OR = 1.94. 95% CI 1.22–3.12) were associated with increased risk of anxiety. Conclusions Fear of being infected and distress caused by fear of spreading it among family members, stigmatization, poor self-confidence, poor occupational safety and heavy workload are vital risk factors that need to be considered in future psychological support services designed for the healthcare professionals in unprecedented outbreaks like COVID-19.