Key Definitions

The following Key Definitions represent Vitamin Angels’ interpretation of the terms and are intended to clarify our application of the terms to our work.


  • Albendazole - an anthelminthic treatment that kills intestinal worms. According to WHO recommendations, Vitamin Angels provides albendazole twice a year to eligible children 12-59 months in countries with moderate and severe levels of VAD.-[ii]

  • At-risk populations – Any population susceptible to an undesirable condition. Vitamin Angels’ use of the term typically refers to children 6-59 months of age and/or pregnant and breastfeeding women who are susceptible to micronutrient deficiency.

  • Children’s Multivitamins – vitamin and mineral supplements intended to be taken daily. When referring to children’s multivitamins Vitamin Angels is typically referring to multiple micronutrient supplements intended for children 6-59 months of age. Our chewable multivitamins are manufactured to our formulation and specifications, which are in accordance with those recommended by the WHO and UNICEF.[iii]

  • Deworming – ridding the body of intestinal worms using an anthelminthic drug such as albendazole.[iv]

  • Dietary supplements (micronutrient) – Provision of micronutrients (vitamins and minerals) via a tablet, capsule, syrup or powder.[v]  No single food contains all of the vitamins and minerals; therefore, a balanced and varied diet is necessary for good nutrition.[vi] When eating a balanced and varied diet is not possible, dietary supplements are one recommendation.
     
  • Essential nutrients – a nutrient required for normal human body function that either cannot be produced by the body at all, or cannot be produced in amounts adequate for good health and thus must be obtained from a dietary source. Examples include iodine, zinc, folate and vitamin A.
     
  • Exclusive breastfeeding – An infant receives only breast milk and no other liquids or solids, not even water, with the exception of oral rehydration salts (ORS) or drops or syrups consisting of vitamins, mineral supplements, or medicines when recommended by a healthcare professional. UNICEF recommends exclusive breastfeeding for infants aged 0-6 months.[vii]
     
  • Field Partners – organizations that receive a micronutrient grant from Vitamin Angels to serve at-risk women and children under five years through their existing programs. While we sometimes refer to field partners as grantees, NGOs, or nonprofit organizations, our field partner network may also include faith-based groups, preschools, food banks, free clinics, pregnancy resource centers, among others.
     
  • Hidden Hunger – a form of chronic undernutrition that occurs when intake and absorption of essential vitamins and minerals (micronutrients) are too low to sustain good health and development. Examples of essential vitamins and minerals are vitamin A, zinc, iodine, folate, calcium and iron, as well as others. An estimated 2 billion people suffer from hidden hunger.[viii]
     
  • Infant mortality rate – Probability of dying between birth and exactly one year of age expressed per 1,000 live births.[ix] Commonly referred to as IMR.
     
  • Macronutrients - nutrients that provide calories or energy. Nutrients are substances needed for growth, metabolism, and for other body functions. Since “macro” means large, macronutrients are nutrients needed in large amounts. There are three macronutrients:
    • Proteins—needed for growth and muscle development
      • Sources: animal products, dairy, and legumes
    • Carbohydrates—provide energy
      • Sources: grains, fruits and vegetables
    • Fats—help the body absorb nutrients needed for brain and nervous system development, and also provide energy
      • Sources: animal products, dairy, and vegetable oils
         
  • Malnutrition – means poor nutrition. This includes excess consumption of nutrients (overnutrition) or inadequate consumption or absorption of one or more nutrients (undernutrition).[x] Vitamin Angels generally applies the term “malnutrition” to mean undernutrition, as this is more commonly used by the general public.
     
  • Maternal Mortality or “maternal death” – the death of a woman while pregnant, during childbirth or within 42 days after childbirth or until the pregnancy is complete. Complications during pregnancy and childbirth are a leading cause of death and disability among women of reproductive age in developing countries.[xi]
     
  • Micronutrients - Micronutrients are nutrients needed in very small amounts, for example a vitamin or mineral, and are essential for normal growth and development. 
     
  • Micronutrient Deficiency – An insufficient intake and/or inadequate absorption of energy, protein or micronutrients that in turn leads to nutritional deficiency. Essential micronutrients include vitamin A, zinc, iodine, folate, calcium and iron, as well as others. Micronutrient deficiencies are caused by a long-term lack of nutritious food, or by childhood infectious diseases such as diarrhea, measles, pneumonia or worms.[xiii]-[xiv] [See “undernutrition”]
     
  • Minerals – Inorganic nutrients that also play a key role in ensuring health and well‐ being. They include the trace elements copper, iodine, iron, manganese, selenium, and zinc together with the macro elements calcium, magnesium, potassium, and sodium. As with vitamins, minerals are found in small quantities within the body and are obtained from a wide variety of foods.[xv]
     
  • Morbidity – refers to any illness, disease, or poor health.
     
  • Nutrition – the intake of food, considered in relation to the body’s dietary needs. Good nutrition – an adequate, well-balanced diet – is a cornerstone of good health. Poor nutrition can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity.[xvi]
     
  • Prenatals or Pre/Postnatal Multivitamins – vitamin and mineral supplements intended to be taken daily during pregnancy and while a woman is breastfeeding. The formulation of pre/postnatal multivitamins includes folate, vitamin A, calcium, iron, iodine and others for a total of 15 different vitamins and minerals that are needed to meet daily nutritional requirements. Vitamin Angels’ prenatals are manufactured to our formulation and specifications, which are in accordance with those recommended by the WHO and UNICEF.[xvii] Vitamin Angels refers to multiple micronutrient supplements for pregnant and lactating (breastfeeding) women as “prenatals”. While our supplements are intended to be taken before and after birth, we use the term prenatal as it is both concise and recognizable by the general public.
     
  • STH – soil transmitted helminths (STH), also known as intestinal worms are one of the most common infections worldwide and affect the poorest and most deprived communities. STH are transmitted by eggs present in human feces, which in turn contaminate soil in areas where sanitation is poor. Intestinal worms produce a wide range of symptoms including diarrhea, abdominal pain, general fatigue, anemia, and weakness.[xviii] STH is a global public-health problem – about 266 million preschool-age children ages 12-59 months are at-risk for intestinal worms globally.[xix]
     
  • Stunting – when a child is too short for his or her age as measured by the height-for-age nutritional index. This is caused by inadequate nutrition over a long period of time and/or frequent infections.[xx] Stunting mostly occurs before age 2, and the effects – including delayed motor development, impaired cognitive function and poor school performance – are largely irreversible. Stunting prevalence is slowly decreasing globally, but affected approximately 165 million or 26 percent of all children younger than 5 years in 2011.[xxi]-[xxii] [See Chronic Undernutrition]
     
  • Under-five mortality rate – Probability of dying between birth and exactly five years of age expressed per 1,000 live births.[xxiii] Commonly referred to as child mortality or U5MR.
     
  • Undernutrition – inadequate consumption or absorption of one or more nutrients, either micro- or macronutrients, that in turn leads to nutritional deficiency. Individuals suffering from undernutrition may experience chronic undernutrition and/or acute undernutrition.[xxiv] Individuals suffering from undernutrition may exhibit few, if any, visible symptoms, especially when caused by a lack of micronutrients. This is why undernutrition is sometimes called “hidden hunger”.
     
  • Chronic undernutrition (or "stunting") – inadequate nutrition over long periods of time (including poor maternal, infant, and young child nutrition) and/or repeated infections that result in a failure to grow. This is measured by the height-for-age nutritional index.[xxv] [See Stunting]
     
  • Acute Undernutrition (or “wasting”) – characterized by a rapid deterioration in nutritional status over a short period of time. In children, it can be measured using the weight-for-height nutritional index or mid-upper arm circumference. There are different levels of severity of acute undernutrition (malnutrition): moderate acute malnutrition (MAM) and severe acute malnutrition (SAM).[xxvi] [See Wasting]
     
  • Underserved – to receive inadequate service, typically refers to individuals who have limited or no access to national health services.  
     
  • Underweight – Wasting or stunting or a combination of both, measured through the weight-for-age nutritional index.[xxvii] Worldwide approximately 16 percent or 100 million children younger than 5 years are underweight.[xxviii]
     
  • Vitamins – Essential organic nutrients, most of which are not made in the body, or only in insufficient amounts, and are mainly obtained through food. When their intake is inadequate, vitamin deficiency disorders can be the consequence. Each of the 13 vitamins known today have specific functions in the body: vitamin A, provitamin A (beta‐carotene), vitamin B1, vitamin B2, vitamin B6, vitamin B12, biotin, vitamin C, vitamin D, vitamin E, folic acid, vitamin K, niacin and pantothenic acid. [xxix]
     
  • Vitamin A – Vitamin A is a fat-soluble vitamin that is naturally present in many foods. Vitamin A is not produced by the body, so it must be consumed in food or supplement form. Vitamin A is important for normal vision, the immune system and reproduction. Vitamin A also helps the heart, lungs, kidneys, and other organs work properly.[xxx]-[xxxi] Foods high in vitamin A include breast milk, sweet potatoes, carrots, dark leafy greens, orange squash, apricots, cantaloupe, bell peppers, fish, eggs, and liver.
     
  • Vitamin A Deficiency (VAD) – insufficient consumption of vitamin A to meet the body’s needs. VAD is caused by a poor intake of vitamin A rich foods. VAD may lead to night blindness (xerophthalmia), complete blindness, and childhood illnesses such as diarrhea and other infections. VAD is a global public-health problem – about 190 million children under 5 years-old – mostly in Africa and South-East Asia are affected.[xxxii]
     
  • Vitamin A Supplementation (VAS) – provision of vitamin A in supplement form. Vitamin Angels’ use of the term references supplementation of populations at-risk of or suffering from vitamin A deficiency (VAD). The WHO recommends universal VAS every 4-6 months for all eligible children ages 6-59 months in countries with moderate or severe VAD. VAS is a preventive approach to alleviate VAD and can reduce mortality in young children. The WHO recommends that children 6-11 months of age receive one annual vitamin A dose of 100,000 IU and children 12-59 months of age receive two annual vitamin A doses of 200,000 IU.[xxxiii]
     
  • Wasting – when a child’s weight is too low for his or her height as measured by the weight-for-height nutritional index or mid-upper arm circumference. Wasting is a strong predictor of mortality among children under 5 years. It is usually caused by severe food shortage or disease. As of 2011, wasting affected approximately 52 million or 8 percent of children younger than 5 years.[xxxiv]-[xxxv] [See Acute Undernutrition]
 
Citations:
World Health Organization. How to add deworming to vitamin A distribution. 2004. p. 7.
[ii] World Health Organization. Preventive chemotherapy in human helminthiasis. Coordinated use of anthelminthic drugs in control interventions: a manual for health professionals and programme managers, 2006.
[iii] Joint statement by the World Health Organization, the World Food Programme and the United Nations Children’s Fund: Preventing and controlling micronutrient deficiencies in populations affected by an emergency. WHO. UNICEF. WFP. 2006
[iv] World Health Organization. Preventive chemotherapy in human helminthiasis. Coordinated use of anthelminthic drugs in control interventions: a manual for health professionals and programme managers, 2006.
[v] Nutrition Glossary: A resource for communicators. UNICEF. April 2012. http://www.unicef.org/lac/Nutrition_Glossary_(3).pdf
[vi] What are micronutrients? DSM. https://www.dsm.com/content/dam/dsm/cworld/en_US/documents/what-are-micronutrients.pdf
[vii] Nutrition Glossary: A resource for communicators. UNICEF. April 2012. http://www.unicef.org/lac/Nutrition_Glossary_(3).pdf
[viii] Chapter 3: Addressing the Challenges of Hidden Hunger. International Food Policy Research Institute. https://www.ifpri.org/sites/default/files/ghi/2014/feature_1818.htm
[ix] Basic Indicators. UNICEF. 2003. http://www.unicef.org/infobycountry/stats_popup1.html
[x] Nutrition Glossary: A resource for communicators. UNICEF. April 2012. http://www.unicef.org/lac/Nutrition_Glossary_(3).pdf
[xi] Health statistics and information systems. World Health Organization. 2000. http://www.who.int/healthinfo/statistics/indmaternalmortality/en/
[xii] What are micronutrients? DSM. https://www.dsm.com/content/dam/dsm/cworld/en_US/documents/what-are-micronutrients.pdf
[xiii] Nutrition Glossary: A resource for communicators. UNICEF. April 2012. http://www.unicef.org/lac/Nutrition_Glossary_(3).pdf
[xiv] Black R, Victora CG, Walker SP, Bhutta ZA, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet. 2013.
[xv] What are micronutrients? DSM. https://www.dsm.com/content/dam/dsm/cworld/en_US/documents/what-are-micronutrients.pdf
[xvi] Nutrition. World Health Organization - http://www.who.int/topics/nutrition/en/
[xvii] Joint statement by the World Health Organization, the World Food Programme and the United Nations Children’s Fund: Preventing and controlling micronutrient deficiencies in populations affected by an emergency. WHO. UNICEF. WFP. 2006.
[xviii] Intestinal worms. World Health Organization. Retrieved 23 Nov. 2015 form http://www.who.int/intestinal_worms/more/en/
[xix] World Health Organization. Weekly epidemiological record. World Health Organization. 6 March 2015, No. 10, 2015, 90: 89-96.
[xx] Nutrition Glossary: A resource for communicators. UNICEF. April 2012. http://www.unicef.org/lac/Nutrition_Glossary_(3).pdf
[xxi] Black R, Victora CG, Walker SP, Bhutta ZA, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet. 2013
[xxii] UNICEF State of the World’s Children, 2015.  http://sowc2015.unicef.org/
[xxiii] Basic Indicators. UNICEF. 2003. http://www.unicef.org/infobycountry/stats_popup1.html
[xxiv] Nutrition Glossary: A resource for communicators. UNICEF. April 2012. http://www.unicef.org/lac/Nutrition_Glossary_(3).pdf
[xxv] Nutrition Glossary: A resource for communicators. UNICEF. April 2012. http://www.unicef.org/lac/Nutrition_Glossary_(3).pdf
[xxvi] Nutrition Glossary: A resource for communicators. UNICEF. April 2012. http://www.unicef.org/lac/Nutrition_Glossary_(3).pdf
[xxvii] Nutrition Glossary: A resource for communicators. UNICEF. April 2012. http://www.unicef.org/lac/Nutrition_Glossary_(3).pdf
[xxviii] Black R, Victora CG, Walker SP, Bhutta ZA, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet. 2013.
[xxix] What are micronutrients? DSM. https://www.dsm.com/content/dam/dsm/cworld/en_US/documents/what-are-micronutrients.pdf
[xxx] WHO/UNICEF/IVACG Task Force. Vitamin A supplements: A guide to their use in the treatment and prevention of vitamin A deficiency and xerophthalmia, 2nd editions, 1997:3.
[xxxi] Sommer A, West KP Jr. Vitamin A deficiency: Health, survival and vision. New York: Oxford University Press, 1996.
[xxxii] World Health Organization. Global prevalence of vitamin A deficiency in populations at rick 1995-2005. Geneva: WHO Press, 2009.
[xxxiii] Stevens GA, Bennett JE, Hennocq Q, Lu Y, et al. Trends and mortality effects of vitamin A deficiency in children in 138 low-income and middle-income countries between 1991 and 2013: a pooled analysis of population-based surveys. Lancet Glob Health 2015;3: e528–36
[xxxiv] Black R, Victora CG, Walker SP, Bhutta ZA, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet. 2013
[xxxv] UNICEF State of the World’s Children, 2015.  http://sowc2015.unicef.org/
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