Concurrent micronutrient deficiencies in lactating mothers and their infants in Indonesia

BACKGROUND: Deficiencies of vitamin A, iron, and zinc are prevalent worldwide, affecting vulnerable groups such as lactating women and infants. However, the existence of concurrent deficiencies has received little attention. OBJECTIVE: The aim was to investigate the extent to which deficiencies of vitamin A, iron, and zinc coexist and the nutritional relation between lactating mothers and their infants. DESIGN: In a cross-sectional survey in rural West Java, Indonesia, 155 lactating mothers and their healthy infants were assessed anthropometrically and blood, urine, and breast-milk samples were obtained. RESULTS: Marginal vitamin A deficiency was found in 54% of the infants and 18% of the mothers. More than 50% of the mothers and infants were anemic and 17% of the infants and 25% of the mothers were zinc deficient. There was a strong interrelation between the micronutrient status of the mothers and infants and the concentrations of retinol and beta-carotene in breast milk. Vitamin A deficiency in infants led to an increased risk of anemia and zinc deficiency (odds ratios: 2.5 and 2.9, respectively), whereas in mothers the risk of anemia and iron deficiency (odds ratios: 3.8 and 4.8, respectively) increased. In infants, concentrations of insulin-like growth factor I were related to concentrations of plasma retinol and beta-carotene but not to zinc. CONCLUSIONS: Micronutrient deficiencies were prevalent in West Java. The micronutrient status of lactating mothers and that of their infants were closely related; breast milk was a key connecting factor for vitamin A status. Furthermore, concurrent micronutrient deficiencies appeared to be the norm.     

母亲KAP模式干预对婴幼儿缺铁性贫血的影响研究

摘要:目的　了解母亲KAP（知识、态度、行为）对缺铁性贫血婴幼儿的影响,为防治婴幼儿缺铁性贫血提供理论依据。方法　对2013年3月-2014年8月武汉市儿保门诊首次进行规范化健康体检的1858例6月龄至36月龄婴幼儿抽取血红蛋白检测并对其母亲进行问卷调查,了解母亲KAP水平,予以教育指导及知识、态度、行为干预后再次进行KAP问卷调查。结果　婴幼儿缺铁性贫血发生率31.3％。母亲中普遍存在缺铁性贫血知识欠缺,对铁缺乏及其引起的疾病等知识贫乏,喂养行为不科学,尤其在母乳喂养、合理添加辅食、系统学习科学育儿知识等方面掌握明显不足,造成婴幼儿缺铁性贫血的发生。而对母亲进行喂养方式、食物提供及健康教育指导后,婴幼儿缺铁性贫血情况明显改善,婴幼儿缺铁性贫血发生率17.5％。结论　应开展多层面的婴幼儿缺铁性贫血知识专项宣传,提高母亲对贫血的认知水平,从饮食理念、饮食行为、饮食态度等方面改善母亲的喂养习惯,并要求其长期保持,以此逐步地养成其良好的饮食习惯,降低婴幼儿缺铁性贫血发生率。     

Effect of maternal and neonatal vitamin A supplementation and other postnatal factors on anemia in Zimbabwean infants: a prospective, randomized study

BACKGROUND: Anemia is prevalent in infants in developing countries. Its etiology is multifactorial and includes vitamin A deficiency. OBJECTIVE: Our primary aim was to measure the effect of maternal or neonatal vitamin A supplementation (or both) on hemoglobin and anemia in Zimbabwean infants. Our secondary aim was to identify the underlying causes of postnatal anemia. DESIGN: A randomized, placebo-controlled trial was conducted in 14 110 mothers and their infants; 2854 infants were randomly selected for the anemia substudy, of whom 1592 were successfully observed for 8-14 mo and formed the study sample. Infants were randomly assigned within 96 h of delivery to 1 of 4 treatment groups: mothers and infants received vitamin A; mothers received vitamin A and infants received placebo; mothers received placebo and infants received vitamin A; and mothers and infants received placebo. The vitamin A doses were 400,000 and 50,000 IU in the mothers and infants, respectively. RESULTS: Vitamin A supplementation had no effect on hemoglobin or anemia (hemoglobin <105 g/L) in unadjusted or adjusted analyses. Infant HIV infection independently increased anemia risk >6-fold. Additional predictors of anemia in HIV-negative and -positive infants were male sex and lower total body iron at birth. In addition, in HIV-positive infants, the risk of anemia increased with early infection, low maternal CD4+ lymphocyte count at recruitment, and frequent morbidity. Six-month plasma ferritin concentrations <12 microg/L were a risk factor in HIV-negative but not in HIV-positive infants. Maternal HIV infection alone did not cause anemia. CONCLUSION: Prevention of infantile anemia should include efforts to increase the birth endowment of iron and prevent HIV infection.     

Prevalence and risk factors of iron deficiency in young mothers

Quality of life and achievements are impaired by unrecognised iron deficiency. The iron requirement of women during their child-bearing age is high and increases in pregnancy. The aim of this study was to determine the prevalence and risk factors for iron deficiency in young mothers under contemporary German life conditions. Between September 1997 and August 1998 the iron status of 507 mothers of one-year old children was assessed. The data was derived from venous blood and questionnaires. Besides conventional methods, the concentration of soluble transferrin receptor was used as leading indicator of iron status. 9.5% had cellular iron deficiency and 2.2% of all mothers had iron deficiency anemia. In addition to absence of school education non-German nationality, a high number of children and vegetarian food are risk factors for iron deficiency. In contrast, high alcohol intake and cigarette smoking are associated with a better iron status. Children of mothers with insufficient iron supply are also at higher risk of iron deficiency.     

Hookworms, malaria and vitamin A deficiency contribute to anemia and iron deficiency among pregnant women in the plains of Nepal

Anemia and iron deficiency during pregnancy are prevalent in developing countries, but their causes are not always known. We assessed the prevalence and severity of anemia and iron deficiency and their association with helminths, malaria and vitamin A deficiency in a community-based sample of 336 pregnant women in the plains of Nepal. Hemoglobin, erythrocyte protoporphyrin (EP) and serum ferritin were assessed in venous blood samples. Overall, 72.6% of women were anemic (hemoglobin < 110 g/L), 19.9% had moderate to severe anemia (hemoglobin < 90 g/L) and 80.6% had iron deficiency (EP > 70 micromol/mol heme or serum ferritin < 10 microg/L). Eighty-eight percent of cases of anemia were associated with iron deficiency. More than half of the women (54.2%) had a low serum retinol concentration (<1.05 micromol/L), 74.2% were infected with hookworms and 19.8% had Plasmodium vivax malaria parasitemia. Hemoglobin, EP and serum ferritin concentrations were significantly worse and the prevalence of anemia, elevated EP and low serum ferritin was increased with increasing intensity of hookworm infection. Hookworm infection intensity was the strongest predictor of iron status, especially of depleted iron stores. Low serum retinol was most strongly associated with mild anemia, whereas P. vivax malaria and hookworm infection intensity were stronger predictors of moderate to severe anemia. These findings reinforce the need for programs to consider reducing the prevalence of hookworm, malaria infection and vitamin A deficiency where indicated, in addition to providing iron supplements to effectively control anemia.     

Concomitant supplemental vitamin A enhances the response to weekly supplemental iron and folic acid in anemic teenagers in urban Bangladesh.

BACKGROUND: Iron deficiency is the most common micronutrient deficiency and affects >2 billion persons worldwide, leading to anemia in >40% of women of reproductive age in the developing world. OBJECTIVE: The objective was to determine whether weekly supplementation with iron and folate would reduce the frequency of anemia in teenage women in urban Bangladesh before they became pregnant. DESIGN: Participants with a hemoglobin concentration of 80-120 g/L were entered into a randomized, double-blind, placebo-controlled trial and received supplements of placebo, vitamin A, iron + folic acid, or iron + folic acid + vitamin A weekly for 12 wk. The supplements contained 2.42 mg vitamin A (retinol) as retinyl palmitate, 120 mg elemental Fe as ferrous sulfate, and 3.5 mg folic acid. RESULTS: Hemoglobin concentrations increased significantly more after supplementation with iron + folic acid or iron + folic acid + vitamin A than after either the placebo or vitamin A alone. There was a significantly greater increase in hemoglobin after iron + folic acid + vitamin A than after iron + folic acid, but the additional effect disappeared after adjustment for baseline hemoglobin, serum vitamin A, and ferritin and the number of supplements taken. Those with the lowest baseline hemoglobin had the greatest increase in hemoglobin. Compared with the placebo, iron + folic acid + vitamin A reduced anemia by 92%, iron deficiency by 90%, and vitamin A deficiency by 76%. CONCLUSION: There may be significant health benefits from a program that enhances the nutritional status of iron, folate, and vitamin A in poor urban young women before they become pregnant.     

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.     

北京市孕妇缺铁性贫血的研究

作者对北京市宣武区妇幼保健院645名产前健康检查孕妇进行了缺铁性贫血的调查研究。对其中44名用24小时回顾法进行了膳食调查,发现铁摄取量超过供给标准。从645名各期孕妇血红蛋白含量、红细胞数及血球压积测定结果,发现孕妇贫血患病率随妊娠而有明显增加,末期最高。膳食中铁吸收利用不良可能是缺铁的主要原因。33例贫血孕妇每天补充元素铁平均12.4mg,维生素C66mg,1个月后血红蛋白水平明显升高,说明这些孕妇贫血原因主要是铁的不足所引起。对贫血孕妇补充铁剂是必要的,作者认为在摄入适当的维生素C时,每日给贫血孕妇补充元素铁10mg左右是适宜的。     

Prevalence and causal factors of anemia in children in Tunisia

Anemia continue to be prevalent among children under five years despite the improvement of socioeconomic and sanitary indicators. The purpose of the present cross-sectorial study is to assess the etiologic factors responsible for anemia. Knowledge of the relative importance of the different causes should form a basis for intervention strategies to prevent and control anemia. The survey covered 955 children under the age of five years, native of two regions with the highest prevalent of anemia, the Southwest and the District of Tunis. The results showed that 29% of children suffered from anemia. About 70% of them were iron deficient. The fractions of the deficiency in vitamin B12 and in folates were insignificant. Only 3% of children had chronic inflammation associated with (and possibly responsible for) their anemia A little fraction of anemia (approximately 5%) was due to thalassemia or drepanocytosis. Picawasan important causal factor of iron deficiency anemia. The parasites identified instool could not cause anemia.     

Relationship of vitamin A deficiency, iron deficiency, and inflammation to anemia among preschool children in the Republic of the Marshall Islands

INTRODUCTION: Although vitamin A deficiency, iron deficiency, and inflammation may contribute to anemia, their relative contribution to anemia has not been well characterized in preschool children in developing countries. OBJECTIVE: To characterize the contributions of vitamin A and iron deficiencies and inflammation to anemia among preschool children in the Republic of the Marshall Islands. SUBJECTS AND METHODS: A community-based survey, the Republic of the Marshall Islands Vitamin A Deficiency Study, was conducted among 919 preschool children. The relationship of vitamin A and iron status and markers of inflammation, tumor necrosis factor-alpha, alpha1-acid glycoprotein, and interleukin-10, to anemia were studied in a subsample of 367 children. RESULTS: Among the 367 children, the prevalence of anemia was 42.5%. The prevalence of severe vitamin A deficiency (serum vitamin A < 0.35 micromol/l) and iron deficiency (serum ferritin < 12 microg/dl) were 10.9 and 51.7%, respectively. The respective prevalence of iron deficiency anemia (hemoglobin < 110 g/l and iron deficiency), anemia with inflammation (anemia with TNF-alpha > 2 pg/ml and/or AGP > 1000 mg/l), and severe vitamin A deficiency combined with anemia was 26.7, 35.6, and 7.6%. In multivariate linear regression models that adjusted for age, sex, and inflammation, both iron deficiency (odds ratio (OR) 1.74, 95% confidence interval (CI) 1.08-2.83, P = 0.023) and severe vitamin A deficiency (OR 4.85, 95% CI 2.14-10.9, P < 0.0001) were significantly associated with anemia. CONCLUSIONS: Both iron and vitamin A deficiencies were independent risk factors for anemia, but inflammation was not a significant risk factor for anemia among these preschool children.     

Vitamin A deficiency,iron deficiency,and anemia among preschool children in the Republic of the Marshall Islands

OBJECTIVE: We investigated the co-occurrence of vitamin A deficiency, iron deficiency, and anemia among young children in the Republic of the Marshall Islands. METHODS: Hemoglobin, serum retinol, and serum ferritin were assessed in the Republic of the Marshall Islands Vitamin A Deficiency Study, a community-based survey that involved 919 children ages 1 to 5 y. RESULTS: The proportion of children with vitamin A deficiency (serum retinol concentrations < 0.70 microM/L) was 59.9%. The prevalences of anemia (hemoglobin < 110 g/L), iron deficiency (serum ferritin < 12 microg/L), and iron deficiency anemia (iron deficiency and anemia) were 36.4%, 53.5%, and 23.8%, respectively. The proportion of children who had co-occurrence of vitamin A and iron deficiencies was 33.2%. The mean ages of children with and without vitamin A deficiency were 3.2 +/- 1.4 and 2.9 +/- 1.5 y, respectively (P = 0.01), and the mean ages of those with and without iron deficiency were 2.7 +/- 1.3 and 3.5 +/- 1.4 y, respectively (P < 0.0001).CONCLUSIONS: Children in the Republic of the Marshall Islands, ages 1 to 5 y, are at high risk of anemia, vitamin A deficiency, and iron deficiency, and one-third of these children had the co-occurrence of vitamin A and iron deficiencies. Further investigation is needed to identify risk factors and evaluate interventions to address vitamin A and iron deficiencies among children.     

Prevalence of anemia in elderly subjects living at home: role of micronutrient deficiency and inflammation

OBJECTIVE: Aging is associated with increased risk of developing anemia and micronutrient deficiencies. Wheat-based staple foods are iron fortified in Chile. We aimed to establish the prevalence and etiology of anemia in apparently healthy free-living elderly subjects. DESIGN AND SETTING: A cross-sectional study was performed in an outpatient clinic of Santiago, Chile. SUBJECTS AND METHODS: A group of 274 subjects (93 men, 181 women)>/=60 y old living at home and apparently healthy was studied. Clinical and anthropometric evaluations and dietary survey were performed. Complete blood count, and status of iron, copper, folate, vitamins B12 and A and C-reactive protein, and erythrocyte sedimentation rate were measured. RESULTS: Prevalence of anemia was 5.4% for men and 4.4% for women. Subjects with inflammatory process had a higher prevalence of anemia (22.2% men, 31.6% women). Abnormal serum retinol (<0.35 micromol/l) was found in 13.7% of men and 15.9% of women. Prevalence of folate deficiency (<7 nmol/l) was 50.5% in men and 33.1% in women. Low serum vitamin B12 (<148 pmol/l) was present in 51.1% of men and 30. 9% of women. Iron and copper deficiencies were infrequent. CONCLUSIONS: Anemia is not prevalent in free-living elderly subjects when iron intake is adequate. Inflammatory process is the main etiology of anemia in this age group. Vitamin A, folate and vitamin B12 deficiencies were found in a significant proportion of the study group. SPONSORSHIP: Sandoz Foundation for Gerontological Research.     

Anemia and deficiencies of folate and vitamin B-6 are common and vary with season in Chinese women of childbearing age

Little is known about the micronutrient status of Chinese women of childbearing age. We assessed nonfasting plasma concentrations of folic acid, vitamin B-12, vitamin B-6 (as pyridoxal-5'-phosphate), hemoglobin (Hb), ferritin and transferrin receptor (TfR) in 563 nonpregnant textile workers aged 21-34 y from Anqing, China. All women had obtained permission to become pregnant and were participating in a prospective study of pregnancy outcomes. Mean (SD) plasma concentrations were 9.7 (4.1) nmol/L folic acid, 367 (128) pmol/L vitamin B-12, 40.2 (15.8) nmol/L vitamin B-6, 108 (12. 9) g/L Hb, 42.6 (34.2) microgram/L ferritin and 5.2 (2.7) mg/L TfR. Twenty-three percent of women had biochemical evidence of folic acid deficiency, 26% were deficient in vitamin B-6 and 10% had low vitamin B-12. Overall, 44% of women were deficient in at least one B vitamin. Although anemia (Hb < 120 g/L) was detected in 80% of women, only 17% had depleted iron stores (ferritin < 12 microgram/L); 11% had elevated TfR concentrations. Distinct seasonal trends were observed in the prevalence of moderate anemia (Hb < 100 g/L) and deficiencies of folic acid and vitamin B-6, with significantly lower concentrations of folate and Hb occurring in summer and lower concentrations of vitamin B-6 occurring in winter and spring than in other seasons. We conclude that deficiencies of folic acid, vitamin B-6 and iron were relatively common in this sample of Chinese women of childbearing age and were contributing to the high prevalence of anemia. Without appropriate supplementation, these deficiencies could jeopardize the women's health and increase their risk of adverse pregnancy outcomes.     

Nutritional anemia and its epidemiological correlates among women of reproductive age in an urban slum of Bhubaneswar, Orissa

The present cross-sectional study involving 240 women of reproductive age as the study population was carried out in the beneficiary slum area, the field practice area of Community Medicine department to find out the burden of nutritional anemia and study its epidemiological correlates. The prevalence of anemia was found to be 60.8%, of which 39.6, 20.0 and 1.2% women had mild, moderate and severe anemia, respectively. Almost 63, 21.2 and 15.7% of the study subjects had microcytic hypochromic picture, indicative of iron deficiency anemia, normocytic hypochromic picture suggestive of early stage of iron deficiency anemia and dimorphic/ macrocytic hypochromic anemia implying iron deficiency anemia and or folate/vitamin B12 deficiency respectively. Statistical analyses have shown that epidemiological factors like age, education of respondents, socioeconomic status, history of excessive menstrual bleeding and inadequate intake of green leafy vegetables and pulses were found to be significantly associated with anemia.     

Zinc plus beta-carotene supplementation of pregnant women is superior to beta-carotene supplementation alone in improving vitamin A status in both mothers and infants

BACKGROUND: Deficiencies of vitamin A, iron, and zinc are prevalent in women and infants in developing countries. Supplementation during pregnancy can benefit mother and infant. OBJECTIVE: We examined whether supplementation during pregnancy with iron and folic acid plus beta-carotene or zinc or both improves the micronutrient status of mothers and infants postpartum. DESIGN: Pregnant women (n = 170) were supplemented daily only during pregnancy with beta-carotene (4.5 mg), zinc (30 mg), or both or placebo plus iron (30 mg) and folic acid (0.4 mg) in a randomized, double-blind, placebo-controlled trial. Micronutrient status was assessed 1 and 6 mo postpartum. RESULTS: Six months postpartum, plasma retinol concentrations were higher in the women who received zinc during pregnancy than in women who did not. Infants born to mothers supplemented with beta-carotene + zinc had higher plasma retinol concentrations, with the frequency of vitamin A deficiency reduced by >30% compared with the other 3 groups. Breast-milk beta-carotene concentrations were higher in all women supplemented with beta-carotene, but breast-milk retinol concentrations were higher only in women who received beta-carotene + zinc. Zinc concentrations did not differ among groups in mothers and infants. CONCLUSIONS: Zinc supplementation during pregnancy improved the vitamin A status of mothers and infants postpartum, which indicates a specific role of zinc in vitamin A metabolism. Addition of both beta-carotene and zinc to iron supplements during pregnancy could be effective in improving the vitamin A status of mothers and infants.     

Cross-sectional study on the iron and vitamin A status of pregnant women in West Java, Indonesia.

A cross-sectional study of the prevalence of iron and vitamin A deficiency in normal pregnant women in West Java, Indonesia, was carried out. Of the 318 women studied, 49.4% were anemic and, according to multiple criteria, 43.5% had iron-deficiency anemia, 22.3% had iron-deficient erythropoiesis, and 6.6% had iron depletion. Serum retinol values revealed that 2.5% of the pregnant women were vitamin A deficient and 31% had marginal vitamin A status. The relative dose-response test carried out on 45 women showed that 4 (8.9%) had deficient vitamin A liver stores. After gestational stage, parity, and subdistrict were adjusted for, serum retinol concentrations were significantly positively associated (P < 0.01) with hemoglobin concentrations, hematocrit, and serum iron concentrations. The suboptimal vitamin A status associated with nutritional-deficiency anemia suggests that pregnant women in the area should be supplemented not only with iron but also with vitamin A. This proposal should be tested in an intervention study.     

汶川大地震一年后灾区农村60月龄以下儿童的营养状况

目的 了解汶川大地震对受灾地区儿童营养和生长发育状况的影响,以及灾后1年灾区儿童的维生素A、D缺乏及营养性贫血的流行状况及原因.方法 于2009年4月中旬调查了466名灾区农村60月龄以下儿童(其中0～月龄儿童162名,24～59月龄儿童304名)的生长发育状况、贫血发生率,以及24～59月龄儿童的铁缺乏发生率、维生素A、D、B12和叶酸的营养状况,并与2002年中国居民营养与健康状况调查中农村相应年龄儿童的结果进行比较.结果 灾区6月龄以下婴儿的基本纯母乳喂养率仅为58.8%(30/51).在0～23月龄儿童中,1 h内开奶率仅为10.7%(16/150),有92.0%(149/162)的儿童从未使用过营养素补充剂.灾区24～59月龄儿童的谷薯类平均摄入量为(267.2±154.3)g/d,高于2002年全国农村儿童水平(178.75 g/d;u=9.995,P＜0.01);蔬菜、水产和禽肉类的摄入量分别为(63.6±56.7)、(2.6±7.9)和(19.4±24.0)g/d,低于2002年全国农村儿童水平(135.05、8.82和32.23 g/d;u值分别为21.971、13.728和9.321,P值均＜0.01);水果、乳制品和豆类食品的摄入量分别为(102.2±110.8)、(65.2±123.8)和(20.5±29.0)g/d,高于2002年的调查结果(分别为32.81、2.87和6.50 g/d;u值分别为10.919、8.778和8.417,P值均＜0.01).维生素A缺乏和边缘缺乏率分别为15.4%(29/188)和30.3%(57/188),维生素D缺乏和不足合计为92.0%(183/199),0～月龄儿童和24～59月龄儿童的贫血发生率分别为47.5%(77/162)和21.5%(60/279),24～59月龄儿童铁缺乏率为45.7%(86/188),锌缺乏率为65.5%(129/197).儿童的身高发育迟缓,24～59月龄儿童的生长迟缓率为13.6%(38/279).结论 地震影响地区儿童的膳食结构不合理,供热食物和供蛋白质(植物来源)食物的摄入量基本能满足要求,但是存在肉、豆、奶、水产和蔬菜类食物摄入不足.维生素A、D、铁、锌缺乏较为普遍.     

汶川大地震一年后灾区育龄妇女的营养状况

目的 了解汶川大地震对受灾地区育龄妇女营养状况的影响,以及地震1年后灾区育龄妇女的维生素A、D缺乏及营养性贫血的流行状况及原因.方法 于2009年4月中旬调查了灾区3个县,每县2个乡镇,共计孕妇58名、乳母66名、15～44岁育龄非孕非哺乳妇女242名的营养和膳食状况,并将本次调查结果与2002年中国居民营养与健康状况调查中相似人群的结果进行了比较.结果 灾区孕妇、乳母和非孕非哺乳妇女的谷薯类食物的摄入量分别为(426.8±271.8)、(568.0±306.1)和(483.0±277.7)g/d,与2002年中国居民营养与健康状况调查中全国农村水平(分别为486.8、509.3和495.1 g/d)相近;油脂类食物的摄入量则分别为(41.9±51.6)、(55.5±69.2)和(66.9±125.7)g/d,亦与2002年调查结果(分别为45.2、43.9和41.4 g/d)一致.但是禽肉类、水产品和蛋类食品的摄入量仅为(58.1±67.7)、(76.3±218.7)和(23.9±29.6)g/d;这些优质蛋白的食物摄入量仍远低于中国营养学会妇幼分会膳食指南的推荐量.微量营养素缺乏较为普遍,维生素A缺乏和边缘缺乏率分别为6.9%(24/347)和18.2%(63/347),维生素D缺乏和不足合计达93.9%(323/344),贫血发生率为32.6%(112/344),铁缺乏率为51.0%(171/335),锌缺乏率为61.6%(210/347).结论 受地震影响,灾区育龄妇女的膳食结构受到明显的影响,由于动物性食物的摄入量明显不足,导致优质蛋白的摄入量不足、维生素A、D、铁、锌的缺乏较为普遍.     

Trends of under- and overweight among rural and urban poor women indicate the double burden of malnutrition in Bangladesh

BACKGROUND: Although undernutrition and communicable diseases dominate the current disease burden in resource-poor countries, the prevalence of diet related chronic diseases is increasing. This paper explores current trends of under- and overweight in Bangladeshi women. METHOD: Nationally representative data on reproductive age women from rural Bangladesh (n = 242,433) and selected urban poor areas (n = 39,749) collected by the Nutritional Surveillance Project during 2000-2004 were analyzed. RESULTS: While the prevalence of chronic energy deficiency [CED, body mass index (BMI) < 18.5 kg/m(2)] continues to be major nutritional problem among Bangladeshi women (38.8% rural, 29.7% urban poor; P < 0.001), between 2000-2004, 9.1% of urban poor and 4.1% of rural women were overweight (BMI > or = 25 kg/m(2), P < 0.001). In addition, 9.8% of urban poor and 5.5% of rural women were found to be 'at risk of overweight' (BMI 23.0-<25 kg/m(2)). From 2000 to 2004, prevalence of CED decreased (urban poor: 33.8-29.3%; rural: 42.6-36.6%), while prevalence of overweight increased (urban poor: 6.8-9.1%; rural: 2.8-5.5%). The risk of being overweight was higher among women who were older and of higher socioeconomic status. Rural women with at least 14 years of education had a 8.1-fold increased risk of being overweight compared with non-educated women [95% confidence intervals (CI): 6.6-8.7]. Women living in houses of at least 1000 sq ft (93 m(2)) were 3.7 times more likely to be overweight compared with women living in <250 sq ft (23 m(2)) houses (95% CI: 3.2-4.3). CONCLUSION: The recent increase in overweight prevalence among both urban poor and rural women, along with high prevalence of CED, indicates the emergence of a double burden of malnutrition in Bangladesh.     

海南黎族孕妇α-地中海贫血及机体铁蛋白、维生素B_(12)和叶酸水平分析

目的:调查海南黎族孕妇α-地中海贫血基因携带率、基因类型以及机体铁蛋白、维生素B12和叶酸水平。方法:收集海南保亭、琼中、五指山、陵水4个地区黎族孕妇EDTA-K2抗凝全血及血清标本共239例,全自动血细胞分析仪检测红细胞相关参数,化学发光免疫分析仪检测血清铁蛋白、维生素B12和叶酸含量,同时用GAP-PCR法检测α-地贫3种常见基因缺失型。结果:海南黎族孕妇α-地贫基因携带率为63.18%,保亭、琼中、五指山和陵水地区分别为63.26%、46.97%、61.36%和77.50%,以静止型和标准型为主;铁蛋白缺乏率为54.81%,保亭、琼中、五指山和陵水地区分别为46.94%、54.55%、54.55%和60.00%,其中合并α-地贫和缺铁占35.56%;维生素B12缺乏者占0.84%,叶酸缺乏者占0.42%,合并维生素B12和叶酸缺乏占0.42%。黎族孕妇贫血发生率32.22%,所有标本中小细胞低色素性贫血104例占43.51%,其中单纯α-地贫31例占29.80%;单纯铁缺乏14例占13.46%,同时合并地贫和缺铁51例占49.04%,其他8例占7.69%。血象正常者中的α-地贫95.65%为静止型。结论:海南黎族孕妇α-地中海贫血和缺铁情况较严重,而叶酸和维生素B12无明显缺乏。需要加强黎族孕妇α-地中海贫血和缺铁防治,血象检查可作为有效的筛查手段。