Susheela Andezhath K, Gupta Rashmi, Mondal Nisith K
Fluorosis Foundation of India, B-1, Saransh Apartment, 34 I.P. Extension, New Delhi 110092, India.
Natl Med J India. 2016 Jul-Aug;29(4):200-204.
Though a major public health problem of nutritional anaemia in schoolchildren is being addressed by iron supplementation and/or fortified food, they continue to be anaemic. We aimed to study the effect of fluoride consumption on haemoglobin levels and whether elimination of fluoride from the diet would correct anaemia in children.
Two hundred and fifty adolescent girls, 10-17 years of age, from a government senior secondary girls school in East Delhi, participated in the programme. Only those girls who were dewormed in the school health programme and not on any medication particularly for malaria, were included. The investigations done were (i) haemoglobin level; (ii) fluoride content in urine; and (iii) fluoride content in drinking water both at home and in school. The anaemic students consuming safe drinking water with fluoride level <1.0 mg/L and with urine fluoride >1.0 mg/L were introduced to interventions, viz. diet editing and diet counselling when parents came for the monthly parent-teacher meeting. Besides the parents, their wards and class teachers also attended the counselling session. The students were monitored by re-testing haemoglobin and urine fluoride levels at 1, 3 and 6 months after the start of the intervention.
There was an inverse relationship in the levels of urine fluoride and haemoglobin. Reduction in the level of urine fluoride led to a rise in the haemoglobin level. Following interventions, the haemoglobin level revealed significant improvement from the anaemic (<12.0 g/dl) to the non- anaemic range (12.0-14.4 g/dl). At 6 months of follow-up, of the 244 girls studied, those with severe anaemia decreased from 3% to 1%, with moderate anaemia from 97% to58% and the non-anaemic girls increased from 0% to 41%.
Non-toxic nutritive food and safe water with fluoride level < 1.0 mg/L are useful in improving haemoglobin levels in a high percentage of anaemic schoolchildren. A haemoglobin level of > 12.0-14.4 g/dL is an achievable target in children without iron supplementation.
尽管通过补充铁剂和/或食用强化食品来解决学龄儿童营养性贫血这一主要公共卫生问题，但他们仍然贫血。我们旨在研究氟摄入对血红蛋白水平的影响，以及从饮食中去除氟是否能纠正儿童贫血。
来自东德里一所政府高中女子学校的250名10至17岁的青春期女孩参与了该项目。仅纳入那些在学校健康项目中已驱虫且未服用任何特别是用于治疗疟疾药物的女孩。所进行的调查包括：（i）血红蛋白水平；（ii）尿氟含量；（iii）家中和学校饮用水中的氟含量。对于饮用氟含量<1.0毫克/升且尿氟>1.0毫克/升的贫血学生，在家长参加每月家长会时，对其进行饮食调整和饮食咨询等干预措施。除了家长，他们的孩子和班主任也参加了咨询会议。在干预开始后的1、3和6个月，通过重新检测血红蛋白和尿氟水平对学生进行监测。
尿氟水平与血红蛋白水平呈负相关。尿氟水平降低导致血红蛋白水平升高。经过干预后，血红蛋白水平从贫血水平（<12.0克/分升）显著改善至非贫血范围（12.0 - 14.4克/分升）。在6个月的随访中，在研究的244名女孩中，重度贫血者从3%降至1%，中度贫血者从97%降至58%，非贫血女孩从0%增至41%。
氟含量<1.0毫克/升的无毒营养食品和安全饮用水有助于提高高比例贫血学龄儿童的血红蛋白水平。在不补充铁剂的情况下，血红蛋白水平>12.0 - 14.4克/分升是儿童可以实现的目标。
