Biomedical subjects

Rosalind S Gibson

Publications and source records attributed to Rosalind S Gibson.

At least 19 recordsLinked to original sources

PubMed2007

Does zinc deficiency play a role in stunting among primary school children in NE Thailand?

Stunting in school-age years may result in a decrease in adult size, and thus reduced work capacity and adverse reproductive outcomes. We have compared the mean intakes of energy, protein and selected growth-limiting nutrients in fifty-eight stunted children and 172 non-stunted controls drawn from 567 children aged 6-13 years attending ten rural schools in NE Thailand. Control children were selected randomly after stratifying children by age in each school. Dietary data were calculated from 24-h recalls using nutrient values from Thai food composition data and chemical analysis. Inter-relationships between stunting and sociodemographic, anthropometric and biochemical variables were also examined. Biochemical variables investigated were serum albumin, zinc, ferritin, transferrin receptor and retinol, and iodine in casual urine samples. Significantly more males than females were stunted (males, n 38, 65.5% v. females, n 20. 34.5%: P=0.025). Stunted males had lower mean intakes of energy, protein, calcium, phosphorus and zinc, and a lower mean (95% CI) serum zinc (9.19 (8.53, 9.84) v. 9.70 (8.53, 9.29) micromol/1) than non-stunted males; no other biochemical differences were noted. Stunted males also had a lower mean arm muscle area (P= 0.015), after adjusting for age, than non-stunted males. In conclusion, the lower dietary intakes of the stunted males compared to their non-stunted counterparts may be associated with anorexia and hypogeusia induced by zinc deficiency. Hence, zinc deficiency may be a factor limiting linear growth, especially among boys in NE Thailand, but more research is needed to establish whether other factors also play a role.

Adolescent↗

PubMed2006

Zinc: the missing link in combating micronutrient malnutrition in developing countries.

The first cases of human Zn deficiency were described in the 1960s in the Middle East. Nevertheless, it was not until 2002 that Zn deficiency was included as a major risk factor in the global burden of disease, and only in 2004 did WHO/UNICEF include Zn supplements in the treatment of acute diarrhoea. Despite this recognition Zn is still not included in the UN micronutrient priority list, an omission that will continue to hinder efforts to reduce child and maternal mortality, combat HIV/AIDS, malaria and other diseases and achieve the UN Millennium Development Goals for improved nutrition in developing countries. Reasons for this omission include a lack of awareness of the importance of Zn in human nutrition, paucity of Zn and phytate food composition values and difficulties in identifying Zn deficiency. Major factors associated with the aetiology of Zn deficiency include dietary inadequacies, disease states inducing excessive losses or impairing utilization and physiological states increasing Zn requirements. To categorize countries according to likely risk of Zn deficiency the International Zinc Nutrition Consultative Group has developed indirect indicators based on the adequacy of Zn in the national food supplies and/or prevalence of childhood growth stunting. For countries identified as at risk confirmation is required through direct measurements of dietary Zn intake and/or serum Zn in a representative sample. Finally, in at risk countries either national or targeted Zn interventions such as supplementation, fortification, dietary diversification or modification, or biofortification should be implemented, where appropriate, by incorporating them into pre-existing micronutrient intervention programmes.

Developing Countries↗

PubMed2006

Improving the bioavailability of nutrients in plant foods at the household level.

Plant foods are the major staples of diets in developing countries, in which the consumption of animal-source foods is often low because of economic and/or religious concerns. However, such plant-based diets are often associated with micronutrient deficits, exacerbated in part by poor micronutrient bioavailability. Diet-related factors in plant foods that affect bioavailability include: the chemical form of the nutrient in food and/or nature of the food matrix; interactions between nutrients and other organic components (e.g. phytate, polyphenols, dietary fibre, oxalic acid, protein, fat, ascorbic acid); pretreatment of food as a result of processing and/or preparation practices. Consequently, household strategies that reduce the content or counteract the inhibiting effects of these factors on micronutrient bioavailability are urgently needed in developing-country settings. Examples of such strategies include: germination, microbial fermentation or soaking to reduce the phytate and polyphenol content of unrefined cereal porridges used for young child feeding; addition of ascorbic acid-containing fruits to enhance non-haem-Fe absorption; heating to destroy heat-labile anti-nutritional factors (e.g. goitrogens, thiaminases) or disrupt carotenoid-protein complexes. Such strategies have been employed in both experimental isotope-absorption and community-based studies. Increases in Fe, Zn and Ca absorption have been reported in adults fed dephytinized cereals compared with cereals containing their native phytate. In community-based studies in rural Malawi improvements in dietary quality and arm-muscle area and reductions in the incidence of anaemia and common infections in young children have been observed.

Biological Availability↗

PubMed2006

Major variables of zinc homeostasis in Chinese toddlers.

BACKGROUND: Measurement of the major variables of zinc homeostasis is an essential prerequisite for estimating human zinc requirements, which currently require a factorial approach. The data required for this approach have not been available for toddlers, whose requirements have been estimated by extrapolation from other age groups. OBJECTIVE: The objective of the study was to measure key variables of zinc homeostasis in rural and small-town Chinese toddlers. DESIGN: Zinc stable-isotope tracers were administered intravenously and orally with all meals for 1 d to 43 toddlers. Subsequent metabolic collections in the homes included duplicate diets, quantitative fecal collections, and spot urine sampling. Fractional absorption of zinc (FAZ) was measured by a dual-isotope tracer ratio technique, and endogenous fecal zinc (EFZ) was measured by an isotope dilution technique. RESULTS: No group or sex differences were found. Therefore, results were combined for 43 toddlers aged 19-25 mo whose major food staple was white rice. Selected results (x+/- SD) were 1.86 +/- 0.55 mg total dietary Zn/d; 0.35 +/- 0.12 FAZ; 0.63 +/- 0.24 mg total absorbed Zn/d; 0.67 +/- 0.23 mg EFZ/d; and 65.0 +/- 8.3 microg plasma Zn/dL. The molar ratio of dietary phytate to zinc was 2.7:1. CONCLUSIONS: The mean intake and absorption of zinc in this population are low in comparison with estimated average dietary and physiologic requirements for zinc, and plasma zinc values are consistent with zinc deficiency. Intestinal losses of endogenous zinc exceed previous estimates for toddlers, and only modest evidence exists of conservation in response to low zinc intake and absorption.

Child, Preschool↗

PubMed2006

Zinc absorption during late pregnancy in rural southern Ethiopia.

BACKGROUND: Little is yet known about zinc absorption in late pregnancy, and no information on absorption from the total diet is available. OBJECTIVE: The objective was to measure the fractional absorption of zinc (FAZ) and to estimate the total quantity of absorbed zinc (TAZ) each day during the third trimester of pregnancy in poor rural southern Ethiopian women. DESIGN: The participants (n = 17) were a convenience sample from a larger study population. The third stage of pregnancy was estimated from fundal height by the Bushulo Health Center prenatal outreach program. FAZ was determined with a dual-isotope tracer ratio technique that uses measurements of urine enrichment with zinc stable isotopes administered intravenously and orally, as an extrinsic label, with all meals in 1 d. Total dietary zinc (TDZ) was calculated from weighed diet records and Ethiopian food-composition tables supported by zinc and phytate analyses of major food items for individual meals. Plasma zinc and exchangeable zinc pool size were also estimated. RESULTS: Mean (+/-SD) FAZ was 0.35 +/- 0.11, TDZ was 6.0 +/- 3.2 mg/d, TAZ was 2.1 +/- 1.0 mg/d, phytate intake was 1033 +/- 843 mg/d, plasma zinc was 44.1 +/- 6.0 microg/dL, and the exchangeable zinc pool size was 142 +/- 39 mg. The molar ratio of phytate to zinc was 17:1. CONCLUSIONS: Women from a poor rural population who were dependent on a moderately high-phytate diet had low TDZ and low plasma zinc concentrations in the third trimester of pregnancy. TAZ was modestly higher than that predicted but did not meet physiologic requirements.

Administration, Oral↗

PubMed2006

A multimicronutrient-fortified seasoning powder enhances the hemoglobin, zinc, and iodine status of primary school children in North East Thailand: a randomized controlled trial of efficacy.

Anemia and co-existing deficiencies of zinc, iron, iodine, and vitamin A occur among children in many developing countries including NE Thailand, probably contributing to impairments in growth, immune competence, and cognition. Sustainable strategies are urgently required to combat these deficiencies. We assessed the efficacy of a micronutrient-fortified seasoning powder served with a school lunch on reducing anemia and improving the micronutrient status of rural NE Thai children. Children (n = 569) aged 5.5-13.4y from 10 schools were randomly assigned to receive a seasoning powder either unfortified or fortified with zinc (5 mg), iron (5 mg), vitamin A (270 microg), and iodine (50 microg) (per serving) and incorporated into a school lunch prepared centrally and delivered 5 d/wk for 31 wk. Teachers monitored school lunch consumption. Baseline and final micronutrient status, hemoglobinopathies, and infection or inflammation were assessed from blood and urine samples. For the primary outcome, anemia (based on hemoglobin), no intervention effect was apparent (odds ratio: 1.02 95% CI: 0.69, 1.51) after adjustment for design strata. The odds of zinc (based on serum zinc) and urinary iodine deficiency in the fortified group were 0.63 (0.42, 0.94) and 0.52 (0.38, 0.71) times those in the unfortified group, respectively. Fortification had no effect on serum retinol (0.61: 0.25,1.51), ferritin (1.12: 0.43, 2.96), or mean red cell volume (1.16: 0.82, 1.64). Therefore, a micronutrient-fortified seasoning powder is a promising vehicle for improving zinc, iodine, and hemoglobin status, and its potential for incorporation into lunch programs in day care centers and schools in NE Thailand warrants investigation.

Adolescent↗

PubMed2006

Primary school children from northeast Thailand are not at risk of selenium deficiency.

Selenium has important roles as an antioxidant, in thyroid hormone metabolism, redox reactions, reproduction and immune function, but information on the selenium status of Thai children is limited. We have assessed the selenium status of 515 northeast Thai children (259 males; 256 females) aged 6 to 13 years from 10 rural schools in Ubon Ratchthani province. Serum selenium (n=515) was analyzed by Graphite Furnace Atomic Absorption Spectrophotometry and dietary selenium intake by Hydride Generation Absorption Spectrophotometry from one-day duplicate diet composites, from 80 (40 females; 40 males) randomly selected children. Inter-relationships between serum selenium and selenium intakes, and other biochemical micronutrient indices were also examined. Mean (SD) serum selenium was 1.46 (0.24) micro mol/L. Concentrations were not affected by infection or haemoglobinopathies, but were dependent on school (P< 0.001), sex (P=0.038), and age group (P=0.003), with serum zinc as a significant covariate. None of the children had serum selenium concentrations indicative of clinical selenium deficiency (i.e. <0.1 micro mol/L). Significant correlations existed between serum selenium and serum zinc (r= 0.216; P < 0.001), serum retinol (r = 0.273; P < 0.001), urinary iodine (r = -0.110; P = 0.014), haemoglobin (r = 0.298; P <0.001), and haematocrit (r = 0.303; P< 0.001). Mean (SD) dietary selenium intake was 46 (22) micro g/d. Children with low serum selenium concentrations had a lower mean selenium intake than those with high serum selenium concentrations (38 +/- 17 vs.51 +/- 24 micro g/d; P< 0.010). In conclusion, there appears to be no risk of selenium deficiency among these northeast Thai children.

Adolescent↗

PubMed2005

Are breast-fed infants and toddlers in New Zealand at risk of iodine deficiency?

OBJECTIVE: This study assessed the iodine status of New Zealand infants and toddlers and explored factors that might influence their iodine status. METHODS: A community-based, cross-sectional survey of 6- to 24-mo-old children was conducted in three cities in the South Island of New Zealand. Iodine status was determined by a casual urine sample. Breast-feeding mothers were asked to provide a breast milk sample for iodine determination. Caregivers collected a 3-d weighed diet record from their children to investigate associations between dietary patterns and urinary iodine excretion. RESULTS: The median urinary iodine concentration for the group (n = 230) was 67 microg/L (interquartile range 37-115) with 37% (95% confidence interval 30.5-43.4) of children having a urinary iodine concentration lower than 50 microg/L. When children were classified by current feeding method, those children who were currently formula-fed had a significantly higher median urinary iodine concentration (99 microg/L) than did children who were currently breast-fed (44 microg/L; P < 0.000). The mean iodine concentration in breast milk was 22 microg/L (n = 39). After multivariate analysis using estimates from 3-d diet records, only percentage of energy from infant formula was significantly associated with urinary iodine concentration (P = 0.005). CONCLUSIONS: This study found mild iodine deficiency in a group of New Zealand infants and toddlers. Children who consumed infant formula, which is fortified with iodine, had better iodine status than did children who were currently breast-fed because breast milk contained low levels of iodine.

Breast Feeding↗

PubMed2005

Efficacy of a community-based dietary intervention to enhance micronutrient adequacy of high-phytate maize-based diets of rural Malawian children.

OBJECTIVE: To evaluate the efficacy of a community-based dietary intervention to reduce risk of micronutrient inadequacies in high-phytate maize-based Malawian diets. DESIGN: Quasi-experimental post-test design with a non-equivalent control group. SETTING: Four villages in Mangochi District, Southern Malawi. PARTICIPANTS: Households with children aged 3-7 years in two intervention (n = 200) and two control (n = 81) villages participated in a 6-month intervention employing dietary diversification, changes in food selection patterns, and modifications to food processing to reduce the phytate content of maize-based diets. Baseline comparability between the groups was confirmed via assessment of sociodemographic characteristics, anthropometry, knowledge and practices, morbidity, haemoglobin and hair zinc. After 12 months, knowledge and practices and dietary intakes were assessed by interactive 24-hour recalls, one during the food plenty and a second during the food shortage season. Nutrient adequacy for the two groups was compared via dietary quality indicators and predicted prevalence of inadequate intakes using the probability approach. RESULTS: Intervention children had diets that were significantly more diverse and of a higher quality than those of controls. Median daily intakes of protein, calcium, zinc (total and available), haem iron, vitamin B12 and animal foods (grams; % of total energy) were higher (P < 0.05) whereas phytate intakes, phytate/zinc and phytate/iron molar ratios were lower (P < 0.01) in the intervention group; some spread of knowledge and practices to controls occurred. CONCLUSIONS: Our community-based dietary strategies reduced the predicted prevalence of inadequate intakes of protein, calcium, zinc and vitamin B12, but not iron, in children from Malawian households with very limited resources.

Child↗

PubMed2005

Only a small proportion of anemia in northeast Thai schoolchildren is associated with iron deficiency.

BACKGROUND: Iron deficiency is assumed to be the major cause of anemia in northeast Thailand, but other factors may be involved. OBJECTIVE: We determined the prevalence of anemia among schoolchildren in northeast Thailand and the role of hemoglobinopathies, selected micronutrient deficiencies, and other factors in hemoglobin status. DESIGN: Blood samples were collected from 567 children aged 6-12.9 y attending 10 primary schools for the determination of a complete blood count and hemoglobin type [Hb AA (normal hemoglobin), Hb AE (heterozygous for Hb type E), and Hb EE (homozygous for Hb type E)] and the measurement of serum ferritin, transferrin receptor, retinol, vitamin B-12, and plasma and erythrocyte folate concentrations. Children with a C-reactive protein concentration > or = 10 mg/L (n = 12), which indicated infection, were excluded. RESULTS: The prevalence of anemia was 31%. Age, hemoglobin type, and serum retinol were the major predictors of hemoglobin concentration. Hb AA and Hb AE children with anemia had lower (P < 0.01) hematocrit, mean cell volume, and serum retinol values than did their nonanemic counterparts; no significant differences in serum ferritin were found by hemoglobin type. Only 16% (n = 22) of the anemic Hb AA and Hb AE children were iron deficient. Hb AA and Hb AE children with a serum retinol concentration <0.70 micromol/L (n = 14) had a significantly higher geometric mean serum ferritin concentration than did those with a retinol concentration > or = 0.70 micromol/L (P = 0.009); no significant difference in transferrin receptor concentrations was found between these 2 groups. CONCLUSIONS: Hemoglobinopathies, suboptimal vitamin A status, and age were the major predictors of hemoglobin concentration. The contribution of iron deficiency to anemia was low, and its detection was complicated by coexisting suboptimal vitamin A status.

Anemia, Iron-Deficiency↗

PubMed2005

Household dietary strategies to enhance the content and bioavailability of iron, zinc and calcium of selected rice- and maize-based Philippine complementary foods.

Philippine complementary foods are predominantly plant-based, with a low content of readily available iron, zinc, and calcium, and a relatively high amount of phytate, a potent inhibitor of mineral absorption. Some of the phytate is water soluble, and hence can be removed by soaking. In this study we have compared the iron, zinc, and calcium content, and estimated iron and zinc bioavailability of rice- and maize-based Filipino complementary foods prepared with and without soaking and/or enrichment with chicken liver, egg yolk, small soft-boned fish, and mung bean grits. Analysis of iron, zinc, and calcium were performed by atomic absorption spectrometry, and phytate (based on hexa-(IP6) and penta-inositol phosphate (IP5) by HPLC; corresponding [Phy]/[Fe] and [Phy]/[Zn] molar ratios were calculated as predictors of iron and zinc bioavailability. Addition of chicken liver, followed by egg yolk, resulted in the greatest increases in iron and zinc content for both the rice- and maize-based complementary foods, whereas addition of small dried fish with bones had the greatest effect on calcium. The IP5 + IP6 content and [Phy]/[Zn] molar ratios were higher in the maize- than rice-based complementary foods, and were reduced by soaking, although only the maize plus mung bean grits, with and without soaking, had [Phy]/[Zn] molar ratios above 15. Enrichment with animal protein or soaking has the potential to enhance the content of absorbable iron, zinc, and probably calcium to varying degrees in rice- and maize-based Philippine complementary foods.

Biological Availability↗

PubMed2004

Macronutrient and selected vitamin intakes from complementary foods of infants and toddlers from Cebu, Philippines.

Intakes of macronutrients (energy, protein, fat, and carbohydrate) and vitamins (vitamin A, thiamin, riboflavin, niacin, and vitamin C) (per day and per 100 kcal) from complementary foods by a cohort of Filipino breast-fed infants and toddlers (n=1794) were studied at 10, 16, and 22 months of age using a single 24-h recall. With the exception of protein, intakes of energy and vitamins for all age groups were below the World Health Organization estimated needs and desired nutrient densities from complementary foods regardless of breast-feeding frequency. Nutrient deficits were greater for rural children compared with urban children, and were attributed to low intakes of energy, as well as cellular animal protein, fruits and vegetables.

Breast Feeding↗

PubMed2003

Effect of folic acid supplementation on plasma zinc concentrations of young women.

OBJECTIVE: Women of reproductive age are advised to consume supplements or fortified foods containing at least 400 microg/d folic acid for the prevention of neural tubes defects. Concerns exist about the adverse effects of folic acid on zinc status. METHODS: Seventy-eight women (18 to 49 y) were assigned for 12-wk to receive either a placebo or a 400 microg/d folic acid supplement. RESULTS: At 12-wk mean (95% CI) red cell folate increased by 431 (350-511) nmol/L in the supplemented group relative to placebo (P < 0.001) but there was no change in plasma zinc in either group (P = 0.213). CONCLUSIONS: Folic acid supplementation does not reduce plasma zinc concentrations in women of childbearing age.

Adolescent↗

PubMed2003

Efficacy and tolerability of low-dose iron supplements during pregnancy: a randomized controlled trial.

BACKGROUND: Iron deficiency anemia (IDA) is common in pregnant women, but previous trials aimed at preventing IDA used high-dose iron supplements that are known to cause gastrointestinal side effects. OBJECTIVE: The objective was to assess the effect on maternal IDA and iron deficiency (ID, without anemia) of supplementing pregnant women with a low dosage (20 mg/d) of iron. Effects on iron status were assessed at the time of delivery and at 6 mo postpartum. Gastrointestinal side effects were assessed at 24 and 36 wk of gestation. DESIGN: This was a randomized, double-blind, placebo-controlled trial of a 20-mg daily iron supplement (ferrous sulfate) given from 20 wk of gestation until delivery. RESULTS: A total of 430 women were enrolled, and 386 (89.7%) completed the follow-up to 6 mo postpartum. At delivery, fewer women from the iron-supplemented group than from the placebo group had IDA [6/198, or 3%, compared with 20/185, or 11%; relative risk (RR): 0.28; 95% CI: 0.12, 0.68; P < 0.005], and fewer women from the iron-supplemented group had ID (65/186, or 35%, compared with 102/176, or 58%; RR: 0.60; 95% CI: 0.48, 0.76; P < 0.001). There was no significant difference in gastrointestinal side effects between groups. At 6 mo postpartum, fewer women from the iron-supplemented group had ID (31/190, or 16%, compared with 51/177, or 29%; RR: 0.57; 95% CI: 0.38, 0.84; P < 0.005). The rate of IDA between the groups did not differ significantly at 6 mo postpartum. CONCLUSION: Supplementing the diet of women with 20 mg Fe/d from week 20 of pregnancy until delivery is an effective strategy for preventing IDA and ID without side effects.

Adult↗

PubMed2003

Experiences of a community-based dietary intervention to enhance micronutrient adequacy of diets low in animal source foods and high in phytate: a case study in rural Malawian children.

A community-based dietary diversification/modification intervention, employing a quasiexperimental design with a nonequivalent control group, was conducted in two intervention and two control villages in rural Southern Malawi. The aim was to enhance the content and bioavailability of micronutrients in maize-based diets of stunted children ages 30-90 mo. Efficacy was evaluated through a comparison of the changes in knowledge and practices, anthropometry, malaria screening, hemoglobin and hair zinc after 12 mo, common infections monthly postintervention and nutrient adequacy postintervention via 24-h recalls. Intervention diets were more diverse and of higher quality than the control diets, supplying significantly more animal source foods, especially soft-boned fish, but less phytic acid (p < 0.01). Median intakes of energy, protein, calcium, available zinc, heme iron and vitamin B-12 were greater (p < 0.05) in intervention compared to the control groups; some spread of knowledge and practices to the control groups occurred. Intervention enhanced Z-scores for mid-upper-arm circumference and arm muscle area (p < 0.001), but had no impact on weight or height gain. After controlling for baseline variables, mean hemoglobin was higher (107 vs. 102 g/L; p < 0.01) postintervention, whereas incidence of anemia and common infections were lower in the intervention groups compared to the control groups, with no change in malaria or hair zinc status. Dietary strategies reduced the prevalence of inadequate intakes of protein, calcium, zinc and vitamin B-12, but not iron, because fish was the major source of animal food consumed. More efforts to raise small animals and promote their consumption are needed to enhance dietary quality and ensure optimal growth, health and cognitive development in young Malawian children.

Animals↗

PubMed2003

Design and quality control issues related to dietary assessment, randomized clinical trials and meta-analysis of field-based studies in developing countries.

The essential design and quality control aspects of dietary assessment, randomized controlled trials (RCT) in developing countries and their subsequent meta-analysis are reviewed. Dietary assessment protocols consist of three stages: measurement of food intakes using a method appropriate for the study objectives, calculation of nutrient intakes and finally an evaluation of their nutrient adequacy. The latter may involve: 1) assessment of dietary diversity (average number of different foods consumed per day) and selected indices of dietary quality such as intakes of animal source foods (g/d); 2) percentage of energy from protein, fat and animal protein; 3) selected nutrient densities; and 4) dietary phytate:zinc molar ratio, as well as the prevalence of inadequate nutrient intakes calculated using a probability approach. To establish causality between the nutrient inadequacies identified and adverse health outcomes, RCT must be undertaken. A prerequisite of RCT is double-blind randomization, a procedure designed to eliminate biases arising from baseline confounding variables, unintended interventions and ascertainment bias. Results from existing RCT can be summarized via meta-analysis to gain a better understanding of the population relationship. Meta-analysis is a statistical technique involving linear models or generalized linear models, which can be performed after locating the individual studies, and selecting and abstracting all the necessary data.

Developing Countries↗

PubMed2003

Vitamin B12 and folate status of older New Zealand women.

The primary aim of this study was to assess the biochemical vitamin B12 and folate status of a representative group of elderly women (70-80 y) living in Dunedin, New Zealand. A second aim was to determine the prevalence of hyperhomocysteinaemia and to explore the determinants of homocysteine (hcy) concentration in this population. A cross-sectional study was carried out between June and August of 2000. Two hundred and fifty women were randomly selected from the 1998 electoral roll. Fasting blood samples were analysed for folate, vitamin B12, total hcy, creatinine, and haematological parameters. Of the women selected, 87 did not respond, 37 were not traceable, 23 were not eligible or had died, and 103 agreed to participate. The overall response rate was 46%. Based on a cut-off of 150 pmol/L for serum B12, 13% of participants would be classified as having sub-optimal vitamin B12 status. Of the women, 3 and 5%, respectively, had low serum (< 6.6 nmol/L) and erythrocyte folate (< 317 nmol/L) concentrations. No participant had megaloblastic anaemia. The prevalence of hyperhomocysteinaemia (> 15 mumol/L) in this population was 18%. Hyperhomocysteinaemia in this group may be partly explained by renal insufficiency because there was a significant association between serum creatinine and plasma hcy (P < 0.001). Blood folate levels but not serum B12 were significantly inversely associated with hcy. In conclusion, there was a moderately high prevalence of hyperhomocysteinaemia and suboptimal plasma vitamin B12 concentrations but not low blood folate concentrations in this elderly female population.

Aged↗

PubMed2002

Zinc and iron status during pregnancy of Filipino women.

Low birthweight is associated with maternal anaemia and, in some circumstances, with low iron and zinc status, but this relationship has not been investigated in the Philippines. In this study, we assessed the prevalence of anaemia and suboptimal iron and zinc status in pregnant women from three geographical regions (mountain, coast, city) of Zamboanga del Sur province at 24 weeks (n = 305). and again at 36 weeks (n = 127), gestation. At 24 weeks, 34% were anaemic (i.e., haemoglobin < 105 g/L) from all causes, of whom only 14% had concomitant low serum ferritin values (i.e., < 12 microg/L). The presence of infection was low, based on both elevated white blood cell count (> 11 x 10(9)/L; 19%) and serum C-reactive protein (> 15 mg/L; 3%). Of the women surveyed, 20% were iron depleted but not anaemic, and 15% were zinc deficient (i.e., serum zinc < 7.1 Micromol/L). The mean (+/- SD) birthweight of the infants (n = 250) was 3074 g +/- 408 g, of whom 5% were of low birthweight (< 2500 g). No differences existed for biochemical indices or birthweight among the three regions, or between women consuming maize or rice-based diets. Women with low haemoglobin (P = 0.05) and low serum zinc (P = 0.14) values at 24 weeks gestation had infants with lower birthweights than those with values > or = 105 g/L and > or = 7.1 micromol/L, respectively. However, in the multivariate model, the contribution of maternal haemoglobin to the variance in birthweight at 24 weeks gestation was non-significant, although modest for serum zinc. Anaemia and/or suboptimal zinc status during pregnancy may be related to low birthweight in the Philippines, and their aetiology deserves further study.

Adolescent↗