The use of NaFeEDTA-fortified fish sauce is an effective tool for controlling iron deficiency in women of childbearing age in rural Vietnam

One cost-effective strategy for controlling iron deficiency is the fortification of staple foods or condiments with iron. We evaluated the effectiveness of fortifying fish sauce with NaFeEDTA for improving iron status in women of childbearing age in Vietnam in a double-blind intervention with randomization by village. All families in the selected villages were supplied with fish sauce that was either unfortified (Group C, 10 villages) or fortified with NaFeEDTA [9 mmol (500 mg) Fe/L, Group F, 11 villages] for 18 mo. The effect of fortification was assessed in the 576 women (n = 288/group) by measuring hemoglobin and serum ferritin (SF) at 6, 12, and 18 mo. Analysis of the group x time interaction using a repeated-measures test for each response demonstrated a significant effect of fortification on hemoglobin (P = 0.039) and log SF (P < 0.0001) in Group F with no significant changes in Group C. The prevalence of iron deficiency (SF < 12 microg/L) decreased from 22.3 to 4.0% and the prevalence of anemia (hemoglobin < 120 g/L) from 24.7 to 8.5% in Group F with no significant changes in Group C. NaFeEDTA fortification of fish sauce is an effective method for reducing the prevalence of iron deficiency in women in Vietnam.     

Effects of wheat flour fortified with different iron fortificants on iron status and anemia prevalence in iron deficient anemic students in Northern China

OBJECTIVES: To compare the effects of wheat flours fortified with NaFeEDTA, FeSO4 and elemental iron (electrolytic iron), in improving iron status in anemic students. METHODS: Four hundreds anemic students (11 to 18 years old) were divided into four groups and given wheat flour fortified with different iron fortificants at different concentrations: control group (no added iron); NaFeEDTA group (20 mg Fe/kg); FeSO4 group (30 mg Fe/kg); and elemental iron group (60 mg Fe/kg). The trial lasted for 6 months and the following parameters were examined every 2 months: whole blood hemoglobin, free erythrocyte protoporphyrin, serum ferritin, serum iron, total iron binding capacity and transferrin receptor. RESULTS: The flour consumption in the 4 groups was 300-400 g/person/day, accounted for 70% of total cereal consumption in the diets. There were no significant differences in flour consumption among the 4 groups. Blood hemoglobin level increased in all the 3 intervened groups, but the increment in the NaFeEDTA group was significantly higher and earlier than the other 2 groups; and only 1% of the subjected remained anemic at the end of the trial in the NaFeEDTA group, while 40% and 60% of the subjects in the FeSO4 and electrolytic iron group remained anemic, respectively. The order of improvements in free erythrocyte protoporphyrin, serum ferritin and transferring receptor levels were: NaFeEDTA > FeSO4 > electrolytic iron. No significant changes were found in the control group on all the tested parameters during the trial. CONCLUSIONS: The results indicated that even NaFeEDTA was added at a lower level, it has better effects than FeSO4 and elemental iron on controlling iron deficiency anemia and improving iron status in anemic children; while elemental iron was the least effective.     

贫血孕妇铁与维生素A营养状况分析

目的 了解妊娠妇女铁、维生素A、核黄素等营养素的摄入及贫血的患病情况，为开展营养干预提供科学依据。方法随机抽取山东省莘县430名贫血孕妇和292名非贫血孕妇，采用24h回顾法比较2组孕妇主要营养素摄入情况，分析孕妇维生素A、核黄素及铁的营养水平。结果2组孕妇膳食均以粮谷类等植物性食物为主，铁的摄入量接近膳食推荐摄入量（RNIs）；血清检验结果显示，贫血组的铁营养水平明显低于非贫血组；85．2％贫血孕妇血浆铁蛋白〈14μg／L，转铁蛋白受体平均为31．42nmol／L；贫血组缺乏维生素A和核黄素的比例分别为62．9％和63．1％，明显高于相应的非贫血组（P〈0．01）。结论贫血不仅与铁的吸收利用率有关，而且与维生素A、核黄素摄入不足或缺乏有密切关系。     

A micronutrient-fortified beverage prevents iron deficiency,reduces anemia and improves the hemoglobin concentration of pregnant Tanzanian women

Maternal malnutrition continues to be a major contributor to adverse reproductive outcomes in developing countries, despite longstanding efforts to fortify foods or to distribute medicinal supplements to pregnant women. The objective of this study was to test the effect of a micronutrient-fortified beverage containing 11 micronutrients (iron, iodine, zinc, vitamin A, vitamin C, niacin, riboflavin, folate, vitamin B-12, vitamin B-6 and vitamin E) on the hemoglobin, iron and vitamin A status of pregnant women in Tanzania. A group of 259 pregnant women with gestational ages of 8 to 34 wk were enrolled in a randomized double-blind controlled trial in which study women received 8 wk of supplementation. Hemoglobin, ferritin and dried blood spot retinol were measured at baseline and at the end of the supplementation period. The supplement resulted in a 4.16 g/L increase in hemoglobin concentration and a 3 micro g/L increase in ferritin and reduced the risk of anemia and iron deficiency anemia by 51 and 56%, respectively. The risk of iron deficiency was reduced by 70% among those who had iron deficiency at baseline and by 92% among those who had adequate stores. The micronutrient-fortified beverage may be a useful and convenient preventative measure, one that could help improve the nutritional status of women both before and during pregnancy and thereby help avoid some of the potential maternal and fetal consequences of micronutrient deficiencies.     

社会动员与社会营销在成年女性中推广铁强化酱油的有效性

目的评价社会动员与社会营销在铁缺乏成年女性中推广NaFeEDTA强化酱油上的有效性。方法研究设计为无对照组的、社区基础的、自身对照的前后比较研究,研究地点为河北省石家庄市的3个县(区),研究干预为社会动员和社会营销策略,研究对象为20岁以上的成年女性,研究结局为与缺铁性贫血有关的知识、态度与行为。通过横断面抽样选择样本,分别在基线和1年后对研究对象进行结局评价。结果成年女性知识、态度发生了积极改变,购买过铁强化酱油的百分比从8.9%显著增加到36.6%(P<0.001)。结论社会动员与社会营销显著改善了铁缺乏人群中成年女性的KAP。     

Brazilian nut consumption improves selenium status and glutathione peroxidase activity and reduces atherogenic risk in obese women

Studies have shown that there are inverse relationships between nut consumption and the reduction of cardiovascular risk. This study tested the hypothesis that daily consumption of Brazilian nuts would have a positive effect upon selenium (Se) status, erythrocyte glutathione peroxidase activity, lipid profile, and atherogenic risk in severely obese women. Thirty-seven severely obese women each consumed 1 Brazilian nut a day (290 μg of Se a day) for 8 weeks. Blood Se concentrations, total erythrocyte glutathione peroxidase activity, lipid profile, and Castelli I and II indexes were evaluated before and after the nuts consumption. All the patients were Se deficient at baseline; this deficiency was remedied by the consumption of the Brazilian nut (P < .0001). The intake of Brazilian nuts promoted a significant increase in high-density lipoprotein cholesterol concentrations (P < .00001), which then resulted in a significant improvement of the Castelli I (P < .0002) and II (P < .0004) indexes. This study shows that obese people who implement daily consumption of Brazilian nuts can improve both Se status and lipid profile, especially high-density lipoprotein cholesterol levels, thereby reducing cardiovascular risks.     

2004—2013年铁强化酱油对我国贫血预防控制作用的评估

目的分析2004—2013年铁强化酱油(铁酱油,IFSS)项目对中国人群贫血发生率持续下降的作用,了解铁酱油项目对贫血的预防和控制作用。方法通过对已报道的铁酱油随机双盲对照干预试验进行Meta分析,确定铁酱油对贫血的作用。根据铁酱油产量及消费人群数据并结合2002年全国营养调查和2015年中国居民营养与慢病状况数据进行分析。通过确定铁酱油消费人群贫血率变化,来推断铁酱油对贫血发生率下降的归因。结果 Meta分析结果显示,食用IFSS人群的贫血率约为不食用IFSS人群贫血率的27%。铁酱油10年间达到有效覆盖时间的覆盖人数为1.86亿,其中2849万人贫血通过铁酱油得到改善。采用铁酱油每改善一名贫血患者的成本为0.12元。结论铁酱油项目对居民贫血发生率持续下降有一定作用,归因占到23.2%,但仍存在不确定因素,可导致分析结果的偏差。     

Multi-micronutrient-fortified biscuits decreased the prevalence of anaemia and improved iron status, whereas weekly iron supplementation only improved iron status in Vietnamese school children

In Vietnam, nutrition interventions do not target school children despite a high prevalence of micronutrient deficiencies. The present randomised, placebo-controlled study evaluated the impact of providing school children (n 403) with daily multiple micronutrient-fortified biscuits (FB) or a weekly Fe supplement (SUP) on anaemia and Fe deficiency. Micronutrient status was assessed by concentrations of Hb, and plasma ferritin (PF), transferrin receptor (TfR), Zn and retinol. After 6 months of intervention, children receiving FB or SUP had a significantly better Fe status when compared with the control children (C), indicated by higher PF (FB: geometric mean 36·9 (95?% CI 28·0, 55·4) μg/l; SUP: geometric mean 46·0 (95?% CI 33·0, 71·7) μg/l; C: geometric mean 34·4 (95?% CI 15·2, 51·2) μg/l; P?相似文献   

Supplemental vitamin A improves anemia and growth in anemic school children in Tanzania

We conducted a randomized controlled trial of the effects of dietary supplements on anemia, weight and height in 136 anemic school children from a low socioeconomic background in Bagamoyo District schools in Tanzania. The aim of the current study was to investigate the impact of dietary supplements on anemia and anthropometric indices of anemic school children. The supplements were vitamin A alone, iron and vitamin A, iron alone or placebo, administered in a double-blinded design for 3 mo. All supplements were provided with local corn meals. Hemoglobin concentration, body weight and height were measured at baseline and at follow-up after supplementation. Vitamin A supplementation increased the mean hemoglobin concentration by 13.5 g/L compared with 3.5 g/L for placebo [P < 0.0001, 95% confidence interval (CI) 6.19-13.57), the mean body weight by 0.6 kg compared with 0.2 kg for placebo (P < 0.0001, 95% CI 0.19-0.65) and the mean height by 0.4 cm compared with 0.1 cm for placebo (P = 0.0009, 95% CI 0.08-0.42). However, the group of children who received combined vitamin A and iron supplementation had the greatest improvements in all indicators compared with placebo (18.5 g/L, P < 0.0001, 95% CI 14.81-22.23; 0.7 kg, P < 0. 0001, 95% CI 0.43-0.88 and 0.4 cm, P < 0.0001, 95% CI 0.22-0.56 for hemoglobin, weight and height, respectively). It is likely that vitamin A supplementation may have a useful role in combating the problems of vitamin A deficiency and anemia, as well as in improving children's growth, in developing countries.     

1139例妊娠期妇女缺铁性贫血的调查分析

目的调查了解武汉市中心城区孕妇缺铁性贫血概况及其相关因素,提出干预措施,提高围产保健质量。方法对在武汉市江岸区妇幼保健院围产保健门诊进行产前检查的1139例孕妇进行膳食问卷调查,并统一由检验科进行采血样检验。结果妊娠期妇女缺铁性贫血总发生率为9．4％,其中,轻度贫血占贫血总数的96．3％,中度贫血占3．7％,无重度贫血患者。随着孕期的增加,贫血患病率增高,孕晚期发病率最高（14．9％）,各孕期孕妇贫血患病率比较差异有统计学意义∥值分别为9．180、4．038、24．281,P〈0．01或〈0．05。孕妇贫血还与年龄、文化程度密切相关,随着孕妇年龄的增大、文化程度的降低,贫血的发生率逐渐升高。结论妊娠期妇女缺铁性贫血发病率较高,且多发生在中、晚孕期。因此,应加强孕期保健宣传工作,制定干预措施,并从孕早期开始补充铁剂,降低孕妇贫血发生率,从而减少贫血对孕妇和胎儿的不良影响。     

Influence of fish on the bioavailability of plant iron in the anemic rat

The effect of fish protein and fish oil on the utilization of endogenous iron in wheat bran, spinach and soy protein isolate was investigated by using the anemic rat as an animal model. Marine products were substituted for casein and corn oil in the diets of these animals. Hemoglobin regeneration was one criteria used to measure iron uptake. Relative biological values (RBV) were computed from a regression equation obtained from control animals receiving graded levels of FeSO4 X 7H2O. The RBV of iron from plant sources provided in diets containing casein-corn oil versus fish-fish oil were: wheat bran, 123 vs. 111%; spinach, 53 vs. 49%; and soybean isolate, 84 vs. 67%; RBV FeSO4 = 100%. These changes were not significant. The decreases in iron absorption from diets containing marine products was attributed to the fish oil. Absorption of exogenous iron (59Fe) was measured in the same animals after the 14-day repletion period. Assimilation of the 59Fe was highly correlated (r2 = 0.958) with hemoglobin level at time of dosing. Diet composition did not appear to have the same effect on the percentage of 59Fe retained after 110 hours by the rat as compared to levels of hemoglobin regeneration (i.e., RBV). A "meat factor" effect was not shown by substituting fish for casein the diets containing plant iron sources fed anemic rats.     

Low dose daily iron supplementation improves iron status and appetite but not anemia, whereas quarterly anthelminthic treatment improves growth, appetite and anemia in Zanzibari preschool children

Iron deficiency and helminth infections are two common conditions of children in developing countries. The consequences of helminth infection in young children are not well described, and the efficacy of low dose iron supplementation is not well documented in malaria-endemic settings. A 12-mo randomized, placebo controlled, double-blind trial of 10 mg daily iron and/or mebendazole (500 mg) every 3 mo was conducted in a community-based sample of 459 Zanzibari children age 6-71 mo with hemoglobin > 70 g/L at baseline. The trial was designed to examine treatment effects on growth, anemia and appetite in two age subgroups. Iron did not affect growth retardation, hemoglobin concentration or mild or moderate anemia (hemoglobin < 110 g/L or < 90 g/L, respectively), but iron significantly improved serum ferritin and erythrocyte protoporphyrin. Mebendazole significantly reduced wasting malnutrition. but only in children <30 mo old. The adjusted odds ratios (AORs) for mebendazole in this age group were 0.38 (95% CI: 0.16, 0.90) for weight-for-height less than -1 Z-score and 0.29 (0.09, 0.91) for small arm circumference. In children <24 mo old, mebendazole also reduced moderate anemia (AOR: 0.41, 0.18, 0.94). Both iron and mebendazole improved children's appetite, according to mothers' report. In this study, iron's effect on anemia was limited, likely constrained by infection, inflammation and perhaps other nutrient deficiencies. Mebendazole treatment caused unexpected and significant reductions in wasting malnutrition and anemia in very young children with light infections. We hypothesize that incident helminth infections may stimulate inflammatory immune responses in young children, with deleterious effects on protein metabolism and erythropoiesis.     

452例孕妇缺铁性贫血分析

目的调查了解孕妇缺铁性贫血与孕周关系及影响贫血发生的因素,提出预防措施。方法对850例孕妇进行血红蛋白(Hb)、血清铁(Fe)测定。结果妊娠缺铁性贫血的发生率为53%,随着孕周的进展贫血发生率增高,孕28周后贫血发生率上升显著,孕28周~36周时贫血发生率最高达53%。结论建议对孕妇的补铁可从孕12周~16周后开始。     

晚期孕妇铁、锌、铜营养状况与贫血的关系

目的：了解晚期孕妇血清铁、锌、铜营养状况和缺铁性贫血的关系。方法：对在1999年12月-2000年2月期间来福建省福清市医院和妇幼保健院门诊检查的242名晚期孕妇采取空腹静脉血10ml，测定血红蛋白（Hb）、红细胞压积（Hct）和血清铁（Fe）、锌（Zn）、铜（Cu）、铁蛋白（SF）、可溶性转铁蛋白受体（s-TfR）的含量，同时测量身高、体重等指标。结果：贫血孕妇的血清Fe、Cu、SF含量显低于非贫血孕妇，而血清锌、s-TfR含量两组差异无显性。结论：孕妇贫血不仅与缺铁有关，同时伴有铜等微量元素的缺乏。     

口服铁剂改善妊娠缺铁性贫血效果及铁储备状态的研究

目的:探讨口服铁剂改善孕期贫血及铁储备状态的作用。方法:选择144例妊娠贫血孕妇(贫血组,口服多糖铁复合物胶囊150 mg/次,2次/天)、100例正常孕妇(预防组,口服多糖铁复合物胶囊150 mg/次,1次/天)和50例正常孕妇(对照组,膳食补铁),测定血红蛋白(Hb)、红细胞计数(RBC)、血清铁蛋白(SF)、血清铁(SI)。结果:贫血组和预防组Hb和RBC呈现早-中期下降(P<0.05)、中-晚期上升(P<0.05)的变化,对照组各孕周Hb、RBC呈逐渐下降趋势(P<0.05)。整个孕周3组孕妇SF均呈进行性下降(P<0.01)。3组孕妇SI早-中期下降较为明显(P<0.01)。结论:单纯膳食补铁不能满足孕期对铁的需求。孕期铁储备处于持续消耗状态。需重视孕早期及孕中期铁剂补充。     

贫血孕妇营养状况及免疫水平的调查分析

目的检测贫血孕妇体内维生素A(VitA)、核黄素(VitB2)和铁(Fe)的水平,为在人群中科学合理地实施对VitA、VitB2和Fe的联合干预提供理论依据。方法随机抽取340名贫血孕妇和150名非贫血孕妇,采用24h回顾法进行膳食调查,并检测受试者体内VitA、VitB2和Fe的水平。结果贫血组孕妇膳食中VitA、VitB2的摄入量分别仅达到推荐量的52.08%和55.88%,明显低于非贫血组孕妇(P<0.01)。贫血组血清VitA、VitB2及Fe的营养状况、免疫指标均明显低于非贫血组(P<0.001)。而同时缺乏3种营养素的孕妇免疫球蛋白水平和淋巴细胞增殖活性明显低于缺乏某一种营养素的孕妇。结论贫血孕妇体内VitA、VitB2和Fe水平较低,由此可影响机体的细胞免疫和体液免疫功能,而3种营养素同时缺乏时影响更明显。     

A comparative intervention trial on fish sauce fortified with NaFe-EDTA and FeSO4+citrate in iron deficiency anemic school children in Kampot, Cambodia

BACKGROUND: Inhabitants of agrarian villages of rural Cambodia suffer from high prevalences of iron deficiency and anemia in the context of a monotonous diet. OBJECTIVE: To compare the efficacy and safety of placebo Khmer fish sauce to that of 10 mL of fish sauce containing 10 mg of iron, added to daily school meals either as NaFe-EDTA or as FeSO4+ citrate. METHODS: 140 students aged 6-21 years were enrolled in a double-blinded, placebo-controlled intervention trial. They were randomly allocated to one of three treatment groups, and followed for 21 weeks during which 114 school meals seasoned with 10 mL of fish sauce were consumed by each participant. Changes in the concentrations of hemoglobin (hb), serum ferritin (SF), and C-reactive protein (CRP) and in body weight and standing height were determined. Prevalences of vomiting, diarrhea, and acute respiratory infections were monitored weekly. RESULTS: Both iron-fortified fish sauces increased hb and SF concentrations significantly as compared to placebo. No significant differences were observed between FeSO4+citrate and NaFe-EDTA fortification, regarding mitigation of iron-deficiency anemia (IDA) or regarding CRP, growth, infections, or side-effects. CONCLUSIONS: Iron-fortified Khmer fish sauce added to Khmer food is a suitable vehicle for iron fortification in children and adolescents. FeSO4+citrate and NaFe-EDTA show equivalent efficacy and safety.     

Retinol and riboflavin supplementation decreases the prevalence of anemia in Chinese pregnant women taking iron and folic Acid supplements

In rural China, many pregnant women in their third trimester suffer from anemia (48%) and iron deficiency (ID; 42%), often with coexisting deficiencies of retinol and riboflavin. We investigated the effect of retinol and riboflavin supplementation in addition to iron plus folic acid on anemia and subjective well-being in pregnant women. The study was a 2-mo, double-blind, randomized trial. Subjects (n = 366) with anemia [hemoglobin (Hb) 相似文献   

乙二胺四乙酸铁钠强化酱油对学生贫血状况的改善

将 30 0名缺铁性贫血学生分为对照组 (未强化铁的酱油 )、低Fe剂量组 (5mg d)、高Fe剂量组(2 0mg d) ,观察乙二胺四乙酸铁钠 (NaFeEDTA)强化酱油对缺铁性贫血的干预效果。试验为期三个月 ,开始和结束时分别测定血红蛋白、血清铁、血清铁蛋白、原卟啉、总铁结合力、转铁蛋白 ,并每月测定血红蛋白一次。结果表明 ,对照组各项检验指标干预前后差异无显著性。低剂量组和高剂量组呈现出较为一致的变化 ,表现为血红蛋白、血清铁、血清铁蛋白、转铁蛋白含量的显著性增加和原卟啉、总铁结合力的显著性下降。低剂量组和高剂量组在干预前后未见明显差异。试验结果提示 ,采用乙二胺四乙酸铁钠强化酱油进行营养干预对缺铁性贫血学生的铁营养状况有改善。