Naem Noha E, El-Sayed Nawal M, Nossier Samia A, Abu Zeid Azza A
aMinistry of Health (MOH) bDepartments of Nutrition cFamily Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
J Egypt Public Health Assoc. 2014 Apr;89(1):35-41. doi: 10.1097/01.EPX.0000443987.44261.9b.
Deficiencies of protein, energy, and micronutrients are highly prevalent in developing countries and have major effects on pregnancy outcome. Low dietary intake is the most common reason for zinc deficiency. The present research is part of a larger double-blind randomized-controlled trial to evaluate the effect of zinc supplementation on the pregnancy outcome. The aim of the present study was to assess the zinc status and dietary intake of zinc and other macronutrients and micronutrients among pregnant women in Alexandria, Egypt.
Participants were pregnant women attending two antenatal care centers that serve low-income and middle-income pregnant populations. A total of 1055 healthy pregnant women aged 20-45 years were assessed for eligibility. Of these, only 675 had serum zinc level below the median for the gestational age. They were assigned randomly to one of three parallel groups. Zinc supplements were provided from 16 weeks until delivery. A subsample of 100 women was assessed for their dietary intake. A questionnaire interview was used to collect basic socioeconomic and data on current pregnancy and labor. Dietary data were collected using the 24-h recall method and a food frequency questionnaire. The nutritive value of the daily diet was computed using the Egyptian food composition tables. The blood hemoglobin level, serum zinc level, and fasting blood sugar were determined.
Zinc deficiency was detected among 53.5% of the sample. Dietary intake of zinc was low, representing 59.4, 59.4, and 62% of the recommended dietary allowance (RDA) for the zinc group, zinc plus multivitamins, and the placebo group, respectively. The iron intake was below 50% of the RDA. Protein intake was less than 70% of the RDA. The mean intakes of fat were 191.97, 211.8, and 196.3 g/day for the three groups. The mean energy intake represented 51.1, 53.5, and 49.8% of the RDA.
Except for carbohydrate intake, the dietary intake of all macronutrients and micronutrients was low. The lowest intake was of iron (below 50% of the RDA). Zinc and protein intake represented less than 70% of the RDA. The overall energy intake was around 50% of the RDA. Nutritional health education should be used as a preventive approach to allow the large sector of the low-income population to maximize the use of the limited resources in the best way. In women at high risk of zinc deficiency, zinc supplementation should be added to the routine supplements.
蛋白质、能量及微量营养素缺乏在发展中国家极为普遍，且对妊娠结局有重大影响。膳食摄入量低是锌缺乏最常见的原因。本研究是一项规模更大的双盲随机对照试验的一部分，旨在评估补锌对妊娠结局的影响。本研究的目的是评估埃及亚历山大港孕妇的锌状况以及锌和其他常量营养素及微量营养素的膳食摄入量。
参与者为在两个为低收入和中等收入孕妇群体提供服务的产前护理中心就诊的孕妇。共评估了1055名年龄在20 - 45岁的健康孕妇是否符合条件。其中，只有675人的血清锌水平低于相应孕周的中位数。她们被随机分配到三个平行组之一。从孕16周开始直至分娩提供锌补充剂。对100名妇女的子样本进行膳食摄入量评估。通过问卷调查收集基本社会经济状况以及当前妊娠和分娩的数据。膳食数据采用24小时回顾法和食物频率问卷收集。使用埃及食物成分表计算每日饮食的营养价值。测定血红蛋白水平、血清锌水平和空腹血糖。
样本中53.5%的人检测出锌缺乏。锌的膳食摄入量较低，锌组、锌加多种维生素组和安慰剂组分别占推荐膳食摄入量（RDA）的59.4%、59.4%和62%。铁摄入量低于RDA的50%。蛋白质摄入量不足RDA的70%。三组的脂肪平均摄入量分别为191.97克/天、211.8克/天和196.3克/天。平均能量摄入量占RDA的51.1%、53.5%和49.8%。
除碳水化合物摄入量外，所有常量营养素和微量营养素的膳食摄入量均较低。摄入量最低的是铁（低于RDA的50%）。锌和蛋白质摄入量不足RDA的70%。总体能量摄入量约为RDA的50%。应采用营养健康教育作为预防措施，使广大低收入人群能够以最佳方式最大限度地利用有限资源。对于锌缺乏高危女性，应在常规补充剂中添加锌补充剂。
