NLiS Country Profile: Afghanistan

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The recommended level of dietary energy intake for a population group is the mean energy requirement of the healthy, well-nourished individuals who constitute that group. Mean corpuscular hemoglobin concentration MCHC Measures average concentration of hemoglobin in red blood cells. It does not include deductions for depreciation of physical capital or depletion and degradation of natural resources. National implementation of the international code. This indicator is the percentage of the population whose food intake falls below the minimum level of dietary energy requirements, and who therefore are undernourished or food-deprived. Gigantism, acromegaly, uncontrolled diabetes, diabetes, fasting, anorexia nervosa, exercise. Hyperthyroidism, T3 toxicosis, thyroid medication use, heroin use, estrogen use, pregnancy, iodine deficiency goiter.

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Too much of it floating around the blood is associated with cardiovascular disease CVD. Low density lipoprotein LDL This compound carries cholesterol to body cells from the liver. Overeating and most folks overeat processed fats, sugars, and refined grains , hypothyroidism, nephrotic syndrome, multiple myeloma, hepatic obstruction, anorexia nervosa, diabetes, renal failure, porphyria, pregnancy, androgen use. Apo A is the main component of HDL. Apo B is the main component of LDL.

Diabetes, renal failure, diets very high in polyunsaturated fat, smoking, some drugs, genetic diseases. Malnutrition, plant-based diets, high polyunsaturated fat diets, some drugs, genetic diseases. Lipoprotein a Lp a This is another sub-fraction of cholesterol. High levels of this are associated with premature heart disease. Not significant — levels might be slightly lower with niacin use. High density lipoprotein HDL This compound carries cholesterol from cells back to the liver.

The ratio of total cholesterol to HDL is considered a better predictor of heart disease than total cholesterol or LDL. The goal is to have a ratio of 5: An optimum ratio is 3. Lots of exercise for many years, estrogen use, low levels of alcohol consumption. Diabetes, cholestasis, renal failure, obesity, sedentary behavior, certain drugs, insulin resistance.

When triglycerides are under , the LDL calculation is usually inflated. The triglyceride to HDL ratio might be the single best predictor of heart disease risk. A ratio above 4: The goal is a ratio of 2: CVD, liver disease, alcoholism, renal disease, hypothyroidism, pregnancy, birth control medications, smoking, obesity, diabetes, gout, anorexia nervosa, a recent meal with fat.

Malnutrition, hyperthyroidism, some lung diseases, strenuous exercise, a lean body. C-reactive protein CRP A marker for low grade inflammation. Useful in predicting CVD.

Pain, fever, infection, inflammatory bowel disease, arthritis, autoimmune disease. Not significant — can be an indication that inflammation is decreasing. Homocysteine An amino acid found in small amounts in the blood resulting from the synthesis of cysteine from methionine. Only cleared from the body with adequate blood levels of vitamin B12, B6 and folate.

Elevations of homocysteine are associated with CVD. Folic acid deficiency, vitamin B12 deficiency, vitamin B6 deficiency, heredity, older age, kidney disease, male gender, certain medications.

Liver function tests Test What it is Higher with Lower with Alkaline phosphatase If the bile duct is blocked cholestasis , this enzyme gets backed up and spills into the bloodstream. Values can help to evaluate bone health since elevated levels show active bone growth or inflammation due to damaged or healing bones.

If elevated in conjunction with GGT, we have a liver issue. GGT A cholestatic liver enzyme. If the bile duct is blocked cholestasis , this enzyme gets backed up and spills into the blood stream. Evaluates liver and gallbladder function, but is also found in kidneys. Helpful when alkaline phosphatase levels are elevated. High alcohol intake, various liver disorders, stress, excess body fat, exercise, some drugs.

Liver damage, heart damage, muscle damage, high body fat, diabetes, mononucleosis, pregnancy, hypothyroidism, shock, some drugs. Azotemia, dialysis, vitamin B6 deficiency. Damage to the liver from alcohol, inflammation, increased body fat, mononucleosis, some drugs, heart attack, aspirin, strenuous exercise. Bilirubin This is a normal, yellow fluid metabolic by-product of red blood cell breakdown that must be cleared by the liver.

Bile flow impairment, carcinoma, liver disease, high levels of red blood cell breakdown, prolonged fasting, anorexia nervosa, niacin supplementation, some forms of anemia.

Exposing a blood sample to 1 hour of sunlight can decrease bilirubin. Rare and not significant. Foods with lots of orange color carrots, yams can increase the yellow hue in serum and falsely increase bilirubin levels if tested with a spectrophotometer.

Ammonia The end product of protein metabolism. The liver normally removes ammonia via portal vein circulation with conversion to urea.

Kidney function tests Test What it is Higher with Lower with Creatinine This is a metabolic by-product of muscle metabolism that must be filtered by the kidneys. Since muscle creatine breaks down into creatinine, someone with more muscle will have abundant creatine and potentially higher creatinine levels.

When there is disordered kidney function, the ability to excrete creatinine diminishes. Impaired kidney function along with high BUN , obstruction of the urinary tract, muscle disease, shock, heart failure, dehydration, rhabdomyolysis, high meat diet, hyperthyroidism. Decreased muscle mass, inadequate protein intake, pregnancy. BUN blood urea nitrogen Urea is a waste product of protein metabolism eliminated from the body through urine, feces, and perspiration.

Various kidney diseases, heart failure, urinary tract obstruction, gut hemorrhage, diabetes with ketoacidosis, steroid use, circulatory disorders, high animal protein intake, intense exercise, salt or water depletion from sweating, diarrhea, vomiting.

Pregnancy, liver failure, acromegaly, Celiac disease, syndrome of inappropriate antidiuretic hormone SIADH , malnutrition.

Increased ratio with normal creatinine occurs in: Salt depletion, dehydration, heart failure, catabolic states, gut hemorrhage, high animal protein intake. Increased ratio with elevated creatinine occurs in: Obstruction of the urinary tract, ketoacidosis, prerenal azotemia.

Decreased ratio with decreased BUN occurs in: Decreased ratio with elevated creatinine occurs in: Some drug use, rhabdomyolysis, muscular folks who are developing kidney failure. TSH is secreted by the pituitary gland and stimulates thyroid gland function, leading to the release of T3 and T4.

TSH secretion is regulated by T3 and T4 feedback inhibition and is stimulated by thyrotropin-releasing hormone released from the hypothalamus. This test is the most sensitive for primary hypothyroidism. An under-active thyroid, advanced age, amphetamine abuse. An overactive thyroid, corticosteroid use, too much thyroid replacement medication. TSH tends to go down later in the day. Free T3 triiodothyronine The fraction of T3 that exists unbound in the blood. Hyperthyroidism, high altitude, T3 toxicosis.

Hypothyroidism, late stage pregnancy. Total T3 triiodothyronine T3 has three iodine atoms attached and more metabolic action than T4, but the effect is short lived. This test is helpful for diagnosing T3 toxicosis and hyperthyroidism. Not useful for diagnosing hypothyroidism. Hyperthyroidism, T3 toxicosis, thyroid medication use, heroin use, estrogen use, pregnancy, iodine deficiency goiter.

Hypothyroidism, anabolic steroid use, aspirin, niacin use, fasting, malnutrition. Free T4 thyroxine This only makes up a small fraction of total T4. Free T4 is unbound and available to tissues. Hyperthyroidism, heparin use, hypothyroidism treated with T4. Hypothyroidism, chronic illness, pregnancy. Total T4 thyroxine T4 has four atoms of iodine attached. This test shows the total amount of T4, consisting of T4 bound to carrier proteins and unbound T4 available to cells.

Bound T4 is inactive. Hyperthyroidism, high estrogen levels from pregnancy, birth control use, estrogen replacement, hepatitis, lymphoma, heroin use, excessive iodine intake. Steroid use, liver disease, hypothyroidism, aspirin, nephritic syndrome.

T3 and rT3 have an inverse relationship, when there is more of one, there is less of the other. Reproductive function tests Test What it is Higher with Lower with Testosterone Responsible for the development of male secondary sex characteristics and sex drive in both men and women. Secreted by testes, ovaries and adrenal glands.

Exists in serum as both unbound free and bound. Unbound is active testosterone. Levels are subject to diurnal variation with a peak in the early morning. Anabolic steroid use, cancer of the testes. Hyperthyroidism, adrenal tumors, androgen resistance, ovarian tumors, hirsutism, polycystic ovaries, some drugs, virilization, hilar cell tumors. IGF-1 A growth factor produced by the liver and muscles directly in response to growth hormone.

IGF-1 can help evaluate pituitary function and diagnose situations related to growth hormone production. Increased growth hormone production, puberty, pregnancy, pituitary tumors, obesity. Deficiency or insensitivity to growth hormone, decreased pituitary function, advancing age, anorexia nervosa, malnutrition, diabetes, kidney disease, liver disease, high dose estrogen. Growth hormone GH A hormone secreted by the pituitary gland in response to exercise, deep sleep, hypoglycemia, glucagon, insulin and vasopressin.

GH is essential to the growth process and metabolism. Gigantism, acromegaly, uncontrolled diabetes, diabetes, fasting, anorexia nervosa, exercise.

Released mainly by the adrenal glands — it can also be released by the testes and ovaries. Controlled by ACTH from the pituitary gland. Adrenal tumors, PCOS, puberty. Adrenal dysfunction, pituitary dysfunction. Estradiol An important estrogen involved with sexual development.

Produced mainly in the ovaries, but also in the adrenal glands and testes. Levels vary in menstruating women. Useful for diagnosing the reason behind amenorrhea. Puberty, gynecomastia, ovarian tumor. Turner syndrome, ovarian failure, rapid weight loss, low body fat, anorexia nervosa, malnutrition. PSA for men A screening recommended for males 40 years or older. PSA is produced by the prostate gland.

Prostate cancer, prostate enlargement. Carbohydrate tolerance tests Test What it is Higher with Lower with Fasted insulin Insulin is a hormone secreted by the pancreas in response to increases in blood sugar, usually following a meal. Type 1 diabetes, hypopituitarism, diabetes medications. Fasted glucose Blood sugar. Beyond that, a true high fasted blood sugar indicates insulin resistance. Protein status tests Test What it is Higher with Lower with Albumin and globulin These are proteins made in the liver and released into the blood.

They are useful for evaluating overall health and nutrition status. Severe liver disease, infectious disease, blood disease, autoimmune disease, tuberculosis, multiple myelomas.

The half-life is 15 days. This lab can help indicate bone defects. Low levels are associated with immune disorders, CVD and some cancers. Excessive supplementation or consumption from food. Vitamin B Also known as anti-pernicious anemia factor. Necessary for red blood cell production, tissue repair, DNA synthesis, nervous system development. Leukemia, renal failure, liver disease, polycythemia vera, heart failure, diabetes, obesity, COPD, high supplemental intake.

Pernicious anemia, inflammatory bowel disease, tapeworm, hypothyroidism, Zollinger-Ellison syndrome, bacterial overgrowth, dietary insufficiency, malabsorption, increased losses, aging, smoking, alcohol use, pregnancy, birth control medications, high supplemental doses of vitamins A and C. Folic acid Needed for normal cell function. It is formed by bacteria in the intestines and is stored in the liver. Folic acid levels in the blood can increase with vitamin B12 deficiency. Bacterial overgrowth, dietary excess, vitamin B12 deficiency.

Dietary insufficiency, malabsorption, pregnancy, hypothyroidism, megaloblastic anemia, liver disease, celiac disease, vitamin B6 deficiency, carcinomas, inflammatory bowel diseases, anticonvulsant Rx, antimalarial Rx, antacid Rx, birth control Rx.

Calcium and phosphorus Two elements tightly regulated in the body by the parathyroid gland, kidney and vitamin D. Measures can be abnormal with blood and bone disease, kidney disease, hormonal imbalances, intestinal disorders, excessive intake of vitamin C. Sodium An electrolyte necessary for fluid balance and cellular activity.

Regulated by kidneys and adrenal glands. Vomiting, diarrhea, sweating, fluid overload disorders. Potassium Electrolyte important for muscles. Very low and very high levels are associated with heart rhythm abnormalities.

Fluid loss from medications diuretics , diarrhea, vomiting. Chloride Electrolyte regulated by the kidneys and adrenal glands. A high or low level usually corresponds to a high or low level of sodium or potassium.

Iron This mineral is necessary for red blood cells and is the basis of hemoglobin. Iron can be lost through the intestinal and urinary tract, and through the menstrual cycle. Lost iron must be replaced in the diet.

Iron losses in men and post-menopausal women are very low. All iron blood test results can be altered by alcohol consumption, estrogens, birth control, antibiotics, aspirin, and testosterone. Levels also change with the time of day. Hemolytic anemia, iron poisoning, iron overload syndromes, hemochromatosis, transfusions, excessive supplementations, liver damage, vitamin B6 deficiency, lead poisoning, leukemia, nephritis.

Iron deficiency anemia, blood loss, infections, pregnancy, progesterone birth control pills, pernicious anemia remission, inadequate iron absorption, menstruation, dietary insufficiency, chronic inflammatory diseases. Transferrin A transport protein largely synthesized by the liver that regulates iron absorption. Iron deficiency anemia, pregnancy, estrogen therapy.

Microcytic anemia, protein deficiency, infection, liver disease, renal disease, iron overload. WHO and UNICEF today issued new step guidance to increase support for breastfeeding in health facilities that provide maternity and newborn services. This document should be useful to academic and research institutes, and groups and individuals who work on these indicators.

This document is available in English, French, Spanish, and Russian. The Chinese and Arabic version of the report will also be available soon. Skip to main content. The state of food security and nutrition in the world News release Read more about the report Watch the launch webcast. News release Capture the moment - Early initiation of breastfeeding: Marketing of breast-milk substitutes: National implementation of the international code.

WHO plan to eliminate industrially-produced trans -fatty acids from global food supply. Saturated fatty acid and trans-fatty intake for adults and children Guidelines: Read for more information. Guidance to promote breastfeeding in health facilities. Global nutrition monitoring framework: Operational guidance for tracking progress in meeting targets for Read more about the operational guidance.

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