MICRONUTRIENTS - WHO

1 MICRONUTRIENTS2010 - 2011 Department of Nutrition for Health and DevelopmentWHO/NMH/NHD/ 2010-2011, major efforts of WHO headquarters, in collaboration with WHO regions, were focused on establishing a process for developing and updating evidenceinformed guidelines for micronutrient interventions and biomarkers as well as upgrading and expand-ing the Vitamin and Mineral Nutrition Information System (VMNIS). Sixteen evidence-informed guidelines for micronutrient interventions were published during this biennium and new tools and resources were developed to support Member States and their partners in successfully implementing effective micronutrient interventions.

2 Furthermore, research studies were initiated with collaborating institutions on the biological and biochemical pathways underlying neonatal vitamin A supplementation and on the development of models to assess the burden of vitamin and mineral has now published the VMNIS website and over 100 documents related to MICRONUTRIENTS in 6 WHO official languages. This allows WHO to more effectively guide public health practices, reach out international audiences who need it, and achieve better health outcomes worldwide. In this way, multilingual communication is an essential tool for improving global continues its commitment to coordinate the universal call to scale up nutrition actions by increasing multilateral work on technical and policy agendas at the global, regional and country level with the core group of United Nations agencies and interna-tional partners dealing with micronutrient interventions in public 2010-2011 Department of Nutrition for Health and Development2 DRAFT1.

3 EVIDENCE-INFORMED GUIDELINE DEVELOPMENT 3 SupplementationPoint-of-use fortification of foodsOthers2. SCIENTIFIC PUBLICATIONS AND REPORTS 4 Technical ReportsWHO MICRONUTRIENTS mailing list3. MULTILINGUALISM 74. WHO VITAMIN AND MINERAL NUTRITION INFORMATION SYSTEM 85. OUR TEAM 106. RESEARCH 127. OUR PARTNERS 138. FINANCIAL SUPPORT 169. WHO MEETINGS 18 TABLE OF CONTENTSM icronutrients 2010-2011 Department of Nutrition for Health and Development3 DRAFT1. EVIDENCE-INFORMED GUIDELINE DEVELOPMENTA WHO guideline is any document containing WHO recommendations about health interventions, whether they are clinical, public health or policy interventions.

4 A recommendation provides information about what policy-makers, health-care providers or patients should do. It implies a choice between different interventions that have an impact on health and that have ramifications for the use of resources. As of 2009, all publications containing WHO recommendations are approved by the WHO Guidelines Review Committee. WHO has developed the evidence-informed recommendations for MICRONUTRIENTS interventions in public health using the procedures outlined in the WHO Handbook for guideline development. The steps in this process include: (i) identification of priority questions and outcomes; (ii) evidence retrieval; (iii) assessment and synthesis of the evidence; (iv) formulation of recommendations, including research priorities; and (v) planning for dissemination, implementation, impact evaluation and updating.

5 Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, evidence profiles related to preselected topics are prepared based on up-to-date systematic reviews. During 2010-2011, WHO Headquarters updated or developed the following guidelines on micronutrient : Neonatal vitamin A supplementation Guideline: Vitamin A supplementation for infants 1 5 months of age Guideline: Vitamin A supplementation for infants and children 6-59 months of age Guideline: Vitamin A supplementation in pregnant women Guideline: Vitamin A supplementation in postpartum women Guideline: Vitamin A supplementation during pregnancy for reducing the risk of mother-to-child transmission of HIV Guideline.

6 Intermittent iron supplementation in preschool and school-age children Guideline: Intermittent iron and folic acid supplementation in menstruating women Guideline: Daily iron and folic acid supplementation in pregnant women (in press)Guideline: Intermittent iron and folic acid supplementation in non-anaemic pregnant women (in press)Guideline: Calcium supplementation in pregnant women (in press)Guideline: Vitamin D supplementation in pregnant women (in press)POINT-OF-USE FORTIFICATION OF FOODSG uideline: Use of multiple micronutrient powders for home fortification of foods consumed by infants and children 6 23 months of age Guideline: Use of multiple micronutrient powders for home fortification of foods consumed by pregnant womenOTHERSWHO recommendations for prevention and treatment of pre-eclampsia and eclampsiaGuideline: Iron interventions in areas where malaria transmission occurs (in press)These guidelines are available on the WHO website and the eLibrary of Evidence for Nutrition Actions ( ).

7 1 Guideline: Vitamin A supplementation in infants 1 5 months of age Guideline: Vitamin A supplementation in pregnancy for reducing the risk of mother-to-child transmission of HIV Guideline: Vitamin A supplementation in postpartum women Guideline: Vitamin A supplementation in infants and children 6 59 months of age MICRONUTRIENTS 2010-2011 Department of Nutrition for Health and Development4 DRAFT1. SCIENTIFIC PUBLICATIONS AND REPORTSPeer review and publication in scientific journals help ensure that sound methods are appropriately utilized in the development of guidelines.

8 They serve as a means of quality control, a term which also includes the transparency and repeatability of research for independent verification, the validity of the conclusions and interpretations drawn from the reported data, the overall importance for advancement within the field of nutrition and public health, novelty, as well as applicability. The WHO guideline development process calls for a systematic review of the evidence related to a particular intervention undergoing evaluation. For micronutrient interventions, technical staff from NHD have prepared many of these systematic reviews, while WHO has commissioned the Cochrane Collaboration to complete other reviews.

9 Other publications referred to vitamin and mineral nutrition surveillance and research area related to micronutrient interventions in public health. As part of the Cochrane pre-publication editorial process, protocols and reviews are commented on by external peers (an editor and two referees external to the editorial team) and the group s statistical adviser before publication The Cochrane handbook for systematic reviews of interventions describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.

10 Disclaimer: The authors in bold are staff members of the World Health Organization. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the decisions or policies of the World Health M, de Benoist B, Rogers L. Epidemiology of iodine deficiency: Salt iodisation and iodine status. Best Practice & Research. Clinical Endocrinology & Metabolism. 2010 Feb; 24(1):1-11. Palacios C, Pe a-Rosas JP. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems: RHL commentary (last revised: 1 February 2010).