Bromage Sabri, Ahmed Tahmeed, Fawzi Wafaie W
Departments of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh.
Food Nutr Bull. 2016 Dec;37(4):475-493. doi: 10.1177/0379572116652748. Epub 2016 Jun 15.
Bangladesh incurs among the highest prevalence of stunting and micronutrient deficiencies in the world, despite efforts against diarrheal disease, respiratory infections, and protein-energy malnutrition which have led to substantial and continuous reductions in child mortality over the past 35 years. Although programs have generally paid more attention to other micronutrients, the local importance of calcium to health has been less recognized.
To synthesize available information on calcium deficiency in Bangladesh in order to inform the design of an effective national calcium program.
We searched 3 online databases and a multitude of survey reports to conduct a narrative review of calcium epidemiology in Bangladesh, including population intake, determinants and consequences of deficiency, and tested interventions, with particular reference to young children and women of childbearing age. This was supplemented with secondary analysis of a national household survey in order to map the relative extent of calcium adequacy among different demographics.
Intake of calcium is low in the general population of Bangladesh, with potentially serious and persistent effects on public health. These effects are especially pertinent to young children and reproductive-age women, by virtue of increased physiologic needs, disproportionately poor access to dietary calcium sources, and a confluence of other local determinants of calcium status in these groups.
A tablet supplementation program for pregnant women is an appealing approach for the reduction in preeclampsia and preterm birth. Further research is warranted to address the comparative benefit of different promising approaches in children for the prevention of rickets.
尽管在过去35年里，针对腹泻病、呼吸道感染和蛋白质能量营养不良所采取的措施已使儿童死亡率大幅持续下降，但孟加拉国仍是世界上发育迟缓及微量营养素缺乏患病率最高的国家之一。尽管各项计划通常更关注其他微量营养素，但钙对健康的重要性在当地却较少得到认可。
综合孟加拉国钙缺乏的现有信息，为制定有效的国家钙计划提供依据。
我们检索了3个在线数据库及大量调查报告，对孟加拉国的钙流行病学进行叙述性综述，内容包括人群摄入量、缺乏的决定因素和后果以及经测试的干预措施，特别提及幼儿和育龄妇女。此外，还对一项全国家庭调查进行了二次分析，以描绘不同人口群体中钙充足的相对程度。
孟加拉国普通人群的钙摄入量较低，对公众健康可能产生严重且持续的影响。鉴于生理需求增加、获取膳食钙源的机会严重不均以及这些群体中其他影响钙状况的当地决定因素相互交织，这些影响对幼儿和育龄妇女尤为相关。
为孕妇补充片剂是降低先兆子痫和早产发生率的一种有吸引力的方法。有必要进一步开展研究，以探讨不同有前景的方法对预防儿童佝偻病的相对益处。
