Department of Human Nutrition, University of Otago, Dunedin, New Zealand Department of Statistics, Iowa State University, Ames, Iowa, USA Food and Nutrition Research Institute, Department of Science and Technology, Bicutan, Taguig, Metro Manila, Philippines.
Matern Child Nutr. 2014 Jan;10(1):112-25. doi: 10.1111/j.1740-8709.2012.00405.x. Epub 2012 Apr 20.
We used the World Health Organization's recommended procedures to establish desirable fortificant levels for three problem micronutrients in children's diets, based on dietary data collected earlier from Filipino (n = 1374; 6-36 months), Mongolian (n = 179; 12-36 months) and Cambodian (n = 177; 12-36 months) children. Prevalence of inadequate and excessive intakes of calcium and zinc (via cut-point method) and iron (via full-probability approach) was assessed after adjusting usual intake distributions with pc-side using internal or external within-person variances from Filipino (calcium and iron) and US National Health And Nutrition Examination Survey III (zinc) national surveys. Fortificant levels were determined by repositioning usual intake distributions so that the 2.5th percentile of the targeted populations equalled the estimated average requirement (calcium, zinc) or so that full-probability prevalence was no larger than 2.5% (iron). Prevalence of inadequate intakes was ≥70% for calcium and iron, except Filipino infants (30% for Ca) and Cambodian toddlers (41% for Fe); but <1% for zinc for toddlers in Mongolia and 20% in Cambodia. Prevalence of excessive intakes was <1% for zinc, calcium and iron, except for Mongolian toddlers (11% for Zn). Desirable fortificant levels, although apparently negligible for zinc, were 530-783 mg for calcium and 10.8-22.8 mg for iron (per 100 g). Fortificant levels can be estimated from 24-h recalls, preferably by applying internal within-person variances. Fortification with calcium and iron was necessary, but seemingly not for zinc, despite a high prevalence of low serum zinc, suggesting the need for better defined cut-offs for population risk of zinc deficiency based on dietary zinc intake and/or serum zinc.
我们使用世界卫生组织推荐的程序，根据早些时候从菲律宾（n=1374；6-36 个月）、蒙古（n=179；12-36 个月）和柬埔寨（n=177；12-36 个月）儿童收集的饮食数据，为儿童饮食中的三种问题微量营养素确定了理想的强化水平。在调整通常的摄入量分布后，使用 pc 端根据内部或外部的个体内方差，使用菲律宾（钙和铁）和美国国家健康和营养检查调查 III（锌）全国调查的数据，通过切点法评估钙和锌（铁通过全概率方法）摄入不足和过量的发生率。通过重新定位通常的摄入分布来确定强化水平，使目标人群的第 2.5 个百分位数等于估计的平均需求量（钙、锌），或者使全概率的流行率不超过 2.5%（铁）。除了菲律宾婴儿（30%的 Ca）和柬埔寨幼儿（41%的 Fe）外，钙和铁的摄入不足发生率均≥70%；但蒙古幼儿的锌摄入不足发生率<1%，柬埔寨为 20%。锌、钙和铁的摄入过量发生率均<1%，但蒙古幼儿（11%的 Zn）除外。尽管锌的强化水平显然微不足道，但理想的强化水平为 530-783mg 钙和 10.8-22.8mg 铁（每 100g）。可以通过应用个体内方差，从 24 小时回忆中估计强化水平。需要强化钙和铁，但锌似乎不需要，尽管血清锌水平较低的发生率很高，这表明需要根据膳食锌摄入量和/或血清锌更好地定义人群缺锌风险的切点。
