Lander Rebecca L, Bailey Karl B, Lander Alastair G, Alsaleh Abdulmonem A, Costa-Ribeiro Hugo C, Mattos Angela P, Barreto Danile L, Houghton Lisa A, Morison Ian M, Williams Sheila M, Gibson Rosalind S
1Department of Human Nutrition,University of Otago,PO Box 56,Dunedin,New Zealand.
2Department of Pathology,University of Otago,Dunedin,New Zealand.
Public Health Nutr. 2014 Sep;17(9):1984-92. doi: 10.1017/S1368980013002310. Epub 2013 Sep 5.
To examine the micronutrient status of disadvantaged pre-schoolers from Northeast Brazil, following the introduction of pro-poor policies, by assessing the prevalence of anaemia and micronutrient deficiencies and the role of sociodemographic factors, genetic Hb disorders and parasitic infections.
In a cross-sectional study, data on sociodemographic status, health, growth, genetic Hb disorders, parasites and nutrient supply from day-care meals were obtained. Fasting blood samples were collected and analysed for Hb, serum ferritin, transferrin receptor, folate, vitamin B₁₂, retinol, Zn and Se.
Seven philanthropic day-care centres serving urban slums in Salvador, Northeast Brazil.
Pre-schoolers aged 3-6 years from disadvantaged households.
Of the 376 sampled children, 94 % were of black or mixed race; 33 % and 29 % had at least one genetic Hb disorder and intestinal parasite, respectively. Stunting and underweight were ≤5 %; 14 % were overweight. Day-care centres supplied micronutrient-dense meals and snacks each weekday. Less than 10 % of pre-schoolers had anaemia and micronutrient deficiencies. Predictors (P < 0·05) of Hb were α(3·7) thalassaemia, Se and retinol (but not ferritin). Micronutrient predictors (P < 0·05) were: elevated α₁-glycoprotein for ferritin, Hb AS and BMI Z-score >1 for transferrin receptor, Zn and elevated α₁-glycoprotein for retinol, sex and helminths for Se, helminths for vitamin B₁₂, and Giardia intestinalis infection for serum folate.
Impaired growth, anaemia and micronutrient deficiencies were uncommon among these disadvantaged pre-schoolers attending day care. A range of interventions including provision of micronutrient-dense, fortified day-care meals, deworming and vitamin A supplementation likely contributed to improved micronutrient status, suggesting expanded coverage of these programmes.
通过评估贫血和微量营养素缺乏的患病率以及社会人口学因素、遗传性血红蛋白疾病和寄生虫感染的作用，来研究巴西东北部贫困学龄前儿童在扶贫政策实施后的微量营养素状况。
在一项横断面研究中，获取了关于社会人口学状况、健康、生长、遗传性血红蛋白疾病、寄生虫以及日托膳食营养供应的数据。采集空腹血样并分析血红蛋白、血清铁蛋白、转铁蛋白受体、叶酸、维生素B₁₂、视黄醇、锌和硒。
巴西东北部萨尔瓦多市为城市贫民窟服务的七家慈善日托中心。
来自贫困家庭的3至6岁学龄前儿童。
在376名抽样儿童中，94%为黑人或混血儿；分别有33%和29%的儿童至少患有一种遗传性血红蛋白疾病和肠道寄生虫感染。发育迟缓率和体重不足率均≤5%；超重率为14%。日托中心每个工作日都提供富含微量营养素的膳食和零食。学龄前儿童贫血和微量营养素缺乏的比例不到10%。血红蛋白的预测因素（P<0.05）为α(3·7)地中海贫血、硒和视黄醇（而非铁蛋白）。微量营养素的预测因素（P<0.05）为：铁蛋白的α₁-糖蛋白升高、转铁蛋白受体的血红蛋白AS和BMI Z评分>1、锌和视黄醇的α₁-糖蛋白升高、硒的性别和蠕虫感染、维生素B₁₂的蠕虫感染以及血清叶酸的贾第鞭毛虫感染。
在这些接受日托的贫困学龄前儿童中，生长发育受损、贫血和微量营养素缺乏并不常见。一系列干预措施，包括提供富含微量营养素的强化日托膳食、驱虫和补充维生素A，可能有助于改善微量营养素状况，这表明应扩大这些项目的覆盖范围。
