title: Integration to Implementation and the Micronutrient Forum: A Coordinated Approach for Global Nutrition. Case Study Application: Safety and Effectiveness of Iron Interventions.
abstract: Paramount among the challenges to our ability to address the role of food and nutrition in health promotion and disease prevention is how to design and implement context-specific interventions and guidance. The Integration to Effective Implementation (I-to-I) concept is intended to address the complexities of the global health context through engagement of the continuum of stakeholders involved in the food and nutrition enterprise. The 2014 Micronutrient Forum (MNF) Global Conference held in Addis Ababa, Ethiopia, in June 2014 offered the opportunity to apply the I-to-I approach with the use of current concerns about the safety and effectiveness of interventions to prevent and treat iron deficiency (ID) as a case study. ID is associated with a range of adverse outcomes, especially in pregnant and nonpregnant women, infants, and primary school-age children. Strategies to combat ID include iron supplementation, multiple micronutrient powders, and food-based interventions to enhance dietary iron intake. Recent reports indicate potential increased adverse risks when iron is provided in areas with high infection burdens (e.g., malaria). This paradox has weakened iron intervention programs. Furthermore, the selection and interpretation of available biomarkers for assessing iron nutrition have been found to be compromised by the inflammatory process. These issues highlight the need for a comprehensive approach that considers basic biology, assessment, interventions, and how these can be translated into appropriate programs and policies. The application of the I-to-I with the use of the MNF offered an opportunity to explore how that might be achieved.
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD; raitend@mail.nih.gov.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Raiten
authors.affiliation: Global Alliance for Improved Nutrition, Geneva, Switzerland;
authors.forename: Lynnette M
authors.initials: LM
authors.lastname: Neufeld
authors.affiliation: Micronutrient Initiative, Ottawa, Canada;
authors.forename: Luz-Maria
authors.initials: LM
authors.lastname: De-Regil
authors.affiliation: MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom;
authors.forename: Sant-Rayn
authors.initials: SR
authors.lastname: Pasricha
authors.affiliation: The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, University of Sydney, Sydney, Australia;
authors.forename: Ian
authors.initials: I
authors.lastname: Darnton-Hill
authors.affiliation: Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology, Zurich, Switzerland;
authors.forename: Richard
authors.initials: R
authors.lastname: Hurrell
authors.affiliation: Nutritional Sciences, Penn State University, State College, PA;
authors.forename: Laura E
authors.initials: LE
authors.lastname: Murray-Kolb
authors.affiliation: Department of Biophysics, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India;
authors.forename: K Madhavan
authors.initials: KM
authors.lastname: Nair
authors.affiliation: Division of Nutrition, Ministry of Health, Nairobi, Kenya;
authors.forename: Terry
authors.initials: T
authors.lastname: Wefwafwa
authors.affiliation: UNICEF, New York, NY; and.
authors.forename: Roland
authors.initials: R
authors.lastname: Kupka
authors.affiliation: National Nutrition Agency, Banjul, Gambia.
authors.forename: Modou Cheyassin
authors.initials: MC
authors.lastname: Phall
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD;
authors.forename: Fayrouz A
authors.initials: FA
authors.lastname: Sakr Ashour
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000517:prevention & control*; D005260:Female; D014943:Global Health; D006304:Health Status; D006801:Humans; D007239:Infections / Q000150:complications; D007249:Inflammation / Q000150:complications; D007501:Iron / Q000009:adverse effects / Q000627:therapeutic use*; D019266:Iron, Dietary / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D014131:Trace Elements / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D019266:Iron, Dietary; D014131:Trace Elements; D007501:Iron
keywords: anemias; international nutrition; interventions; iron; public health