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肯尼亚学童存在多种微量营养素缺乏的情况,但血浆维生素B-12水平升高是补充肉类或牛奶后唯一可检测到的微量营养素反应。

Kenyan school children have multiple micronutrient deficiencies, but increased plasma vitamin B-12 is the only detectable micronutrient response to meat or milk supplementation.

作者信息

Siekmann Jonathan H, Allen Lindsay H, Bwibo Nimrod O, Demment Montague W, Murphy Suzanne P, Neumann Charlotte G

机构信息

Program in International Nutrition, University of California, Davis, CA 95616, USA.

出版信息

J Nutr. 2003 Nov;133(11 Suppl 2):3972S-3980S. doi: 10.1093/jn/133.11.3972S.

DOI:10.1093/jn/133.11.3972S
PMID:14672298
Abstract

Animal source foods (ASF) can provide micronutrients in greater amounts and more bioavailable forms compared to plant source foods, but their intake is low in many poor populations. However, the impact of ASF on micronutrient status of undernourished populations has not been assessed. Supplemental meat (60-85 g/d), milk (200-250 mL/d) or energy (isocaloric with the meat and milk, 240-300 kcal/d) were randomly assigned to 555 undernourished school children aged 5-14 y in a rural malaria-endemic area of Kenya, at one school meal daily for one school year. Blood and stool samples were collected at baseline and after 1 y to assess stool parasites, malaria, hemoglobin, serum or plasma C-reactive protein, ferritin, iron, zinc, copper, vitamin B-12, folate and retinol, and erythrocyte riboflavin. At baseline, there was a high prevalence of micronutrient deficiencies (iron, zinc, vitamins A and B-12 and riboflavin), yet plasma ferritin was low in few children, and none had low serum copper. At the end of the year of supplementation, plasma vitamin B-12 concentrations were significantly increased in children fed the Meat or Milk meal; prevalence of severe plus moderate deficiency fell from 80.7% at baseline to 64.1% in the Meat group and from 71.6 to 45.1% in the Milk group, respectively. No significant improvement was observed in the status of other micronutrients compared to the Energy and Control groups, although malaria and other infections may have obscured effects. Supplementation with small amounts of meat or milk reduced the high prevalence of vitamin B-12 deficiency in these children.

摘要

与植物源食物相比,动物源食物(ASF)能以更大量且生物利用率更高的形式提供微量营养素,但在许多贫困人群中其摄入量较低。然而,ASF对营养不良人群微量营养素状况的影响尚未得到评估。在肯尼亚一个疟疾流行的农村地区,555名5至14岁的营养不良学童被随机分配,每天在一顿学校餐中补充肉类(60 - 85克/天)、牛奶(200 - 250毫升/天)或能量(与肉类和牛奶热量相等,240 - 300千卡/天),持续一学年。在基线期和1年后采集血液和粪便样本,以评估粪便寄生虫、疟疾、血红蛋白、血清或血浆C反应蛋白、铁蛋白、铁、锌、铜、维生素B - 12、叶酸、视黄醇以及红细胞核黄素。在基线期时,微量营养素缺乏(铁、锌、维生素A、B - 12和核黄素)的患病率很高,但血浆铁蛋白水平低的儿童很少见,且没有儿童血清铜水平低。在补充的这一年结束时,食用肉类餐或牛奶餐的儿童血浆维生素B - 12浓度显著升高;重度加中度缺乏症的患病率分别从基线期肉类组的80.7%降至64.1%以及牛奶组从71.6%降至45.1%。与能量组和对照组相比,其他微量营养素状况未观察到显著改善,尽管疟疾和其他感染可能掩盖了这种影响。补充少量肉类或牛奶降低了这些儿童中维生素B - 12缺乏症的高患病率。

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