Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública (INSP), Universidad N-655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, Cuernavaca 62100, Mexico.
Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública (INSP), Universidad N-655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, Cuernavaca 62100, Mexico.
Nutrients. 2022 Jul 22;14(15):3003. doi: 10.3390/nu14153003.
Supplementation in malnourished pregnant women should not displace natural healthy foods. Objective: To estimate the differential effects of three nutritional supplements on macro- and micronutrient intake of pregnant women beneficiaries of the conditional cash transfer program Prospera (CCT-POP). Methods: Prospective cluster randomized trial. Communities were randomly assigned to receive a fortified beverage (Beverage), micronutrient tablets (Tablets), or micronutrient powder (MNP). Pregnant women (at <25 weeks) were recruited. The food frequency questionnaire was applied at 25 and 37 weeks of pregnancy and at one and three months postpartum (mpp). Differential effects of the three supplements on the median change in nutrient intake from baseline to each follow-up stage were estimated. Results: Median change in protein intake from dietary and supplement sources were significantly lower for MNP and Tablets than for Beverages (baseline to 37 w: −7.80 ± 2.90 and −11.54 ± 3.00, respectively; baseline to 1 mpp: −7.34 ± 2.90 for MNP, p < 0.001). Compared to Beverages, median increases were higher for the MNP for vitamins C (31.2 ± 11.7, p < 0.01), E (1.67 ± 0.81, p < 0.05), and B12 (0.83 ± 0.27, p < 0.01) from baseline to 37 wk; from baseline to 1 mpp, there was a higher median increase in B12 (0.55 ± 0.25, p < 0.05) and folate (63.4 ± 24.3, p < 0.01); and from baseline to 3 mpp, a higher median increase in iron (2.38 ± 1.06, p < 0.05) and folate (94.4 ± 38.1, p < 0.05). Conclusions: Intake of micronutrients was higher for MNP and Tablets, likely due to food displacement among Beverage consumers. Although iron bioavailability and absorption inhibitors were not considered for the present analyses, the distribution of Tablets or MNP had several advantages in this context where micronutrient deficiency remains high among pregnant women, but macronutrient intake is generally adequate or even high.
在营养不良的孕妇中进行补充不应取代天然健康食品。目的：估计三种营养补充剂对有条件现金转移计划（CCT-POP）Prospera 受益孕妇的宏量和微量营养素摄入的差异影响。方法：前瞻性集群随机试验。社区被随机分配接受强化饮料（饮料）、微量营养素片剂（片剂）或微量营养素粉末（MNP）。招募了孕妇（<25 周）。在妊娠 25 周和 37 周以及产后 1 个月和 3 个月（mpp）应用食物频率问卷。估计了三种补充剂对从基线到每个随访阶段的营养素摄入中位数变化的差异影响。结果：从饮食和补充来源的蛋白质摄入中位数变化，MNP 和片剂组明显低于饮料组（从基线到 37 周：-7.80 ± 2.90 和-11.54 ± 3.00；从基线到 1 mpp：-7.34 ± 2.90，MNP，p < 0.001）。与饮料相比，MNP 组维生素 C（31.2 ± 11.7，p < 0.01）、E（1.67 ± 0.81，p < 0.05）和 B12（0.83 ± 0.27，p < 0.01）的中位数增加更高，从基线到 37 周；从基线到 1 mpp，B12（0.55 ± 0.25，p < 0.05）和叶酸（63.4 ± 24.3，p < 0.01）的中位数增加更高；从基线到 3 mpp，铁（2.38 ± 1.06，p < 0.05）和叶酸（94.4 ± 38.1，p < 0.05）的中位数增加更高。结论：MNP 和片剂的微量营养素摄入更高，可能是由于饮料消费者的食物替代。尽管目前的分析未考虑铁生物利用度和吸收抑制剂，但在这种情况下，当孕妇的微量营养素缺乏仍然很高，但宏量营养素摄入通常足够甚至较高时，片剂或 MNP 的分配具有几个优势。
