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印度南部某区城乡结合部学龄儿童饮食微量营养素摄入不足:主食强化和营养素补充的潜力。

High dietary micronutrient inadequacy in peri-urban school children from a district in South India: Potential for staple food fortification and nutrient supplementation.

机构信息

Department of Dietetics, ICMR-National Institute of Nutrition, Hyderabad, India.

Biochemistry Division, ICMR-National Institute of Nutrition, Hyderabad, India.

出版信息

Matern Child Nutr. 2020 Dec;16 Suppl 3(Suppl 3):e13065. doi: 10.1111/mcn.13065.

Abstract

Multiple micronutrient deficiencies (MNDs) co-exist, often because of poor intakes and adversely impact health. Habitual diets were assessed in 300 school children (6-17 years old) recruited from two government schools by simple random sampling. Probability of adequacy (PA) for 11 micronutrients and mean probability of adequacy (MPA) was calculated. Haemoglobin, plasma ferritin, folic acid, vitamin B and C-reactive protein were estimated. Descriptive statistics and regression analysis were used to estimate magnitude and factors associated with MNDs. The contribution of fortified foods and/or supplements in addressing inadequacies and excessive intakes was modelled. The PA ranged from 0.04 for folate to 0.70 for zinc, and the MPA was 0.27. Prevalence of anaemia (53%), iron deficiency (57%; ID), iron deficiency anaemia (38%; IDA), folate deficiency (24%) and B deficiency (43%) was high. Dietary inadequacy of iron, zinc and a low MPA was associated with anaemia and IDA. Inclusion of double fortified salt (DFS), fortified rice (FR) or iron folic acid (IFA) supplements individually in habitual diet reduced probability of iron inadequacy significantly from 82% to ≤13%. Inclusion of DFS and FR simultaneously led to disappearance of iron inadequacy, but risk of excessive intake increased to 16%. Inclusion of DFS, FR and IFA together increased risk of excess iron intake to 40%. Nevertheless, intakes of folate and B remained inadequate even with FR and/or IFA. These results indicate a high risk of dietary MNDs in children and suggest need for more systematic intake measurements in representative sample and adjustment of iron dosages to avoid excessive intakes.

摘要

多种微量营养素缺乏症(MNDs)同时存在,通常是由于摄入不足,对健康造成不良影响。通过简单随机抽样,从两所政府学校招募了 300 名 6-17 岁的学童来评估习惯性饮食。计算了 11 种微量营养素的充足概率(PA)和平均充足概率(MPA)。估计了血红蛋白、血浆铁蛋白、叶酸、维生素 B 和 C 反应蛋白。采用描述性统计和回归分析来估计 MNDs 的严重程度和相关因素。还对强化食品和/或补充剂在解决不足和过量摄入方面的作用进行了建模。PA 范围从叶酸的 0.04 到锌的 0.70,MPA 为 0.27。贫血(53%)、缺铁(57%;ID)、缺铁性贫血(38%;IDA)、叶酸缺乏(24%)和 B 缺乏(43%)的患病率较高。铁、锌和低 MPA 的膳食不足与贫血和 IDA 相关。在习惯性饮食中单独纳入双重强化盐(DFS)、强化大米(FR)或铁叶酸(IFA)补充剂可使铁不足的概率从 82%显著降低至≤13%。同时纳入 DFS 和 FR 可使铁不足的风险消失,但过量摄入的风险增加至 16%。同时纳入 DFS、FR 和 IFA 会使过量摄入铁的风险增加到 40%。尽管如此,即使摄入了 FR 和/或 IFA,叶酸和 B 的摄入量仍不足。这些结果表明儿童存在膳食 MNDs 的高风险,建议在代表性样本中进行更系统的摄入量测量,并调整铁剂量以避免过量摄入。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f01/7752122/6242c4e2dfb2/MCN-16-e13065-g001.jpg

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