Vitamin D Defciency in Mongolian Children / Эрүүл мэндийн лаборатори

Background: The prevalence of rickets is high among Mongolian children. The disease can be prevented by sufficient intake of vitamin D. Vitamin D is a fat-soluble vitamin that is naturally present in very few foods, and is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Serum concentration of 25(OH)D is the best indicator of vitamin D status. The aim of this study was to determine the concentrations of 25(OH)D in serum samples of small children and evaluate their vitamin D status. Materials and Methods: The concentrations of 25(OH)D were determined in serum samples of 98 children (54 male and 44 female) 6-36 months of age using a 2-step radioimmuno assay procedure. Vitamin D defciency was defned as 25(OH)D < 25nmol/L. Results: The mean serum 25(OH)D concentration was 29.00 nmol/L with no statistically signifcant differences between boys and girls, age groups and children from rural and urban areas. The vitamin D defciency among the surveyed children was 61.2%. The defciency was higher among children from Ulaanbaatar city (65.7% vs 51.9% in rural areas) and in boys (66.7% vs 55.8% in girls). Conclusion: The high level of vitamin D deficiency indicates that there is a need to promote the expansion of the coverage of vitamin D supplements among young children.

Vitamin D Defciency in Mongolian Children / Эрүүл мэндийн лаборатори

Background:The prevalence of rickets is high among Mongolian children. The disease can be prevented by sufficient intake of vitamin D. Vitamin D is a fat-soluble vitamin that is naturally present in very few foods, and is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Serum concentration of 25(OH)D is the best indicator of vitamin D status. The aim of this study was to determine the concentrations of 25(OH)D in serum samples of small children and evaluate their vitamin D status.Materials and Methods:The concentrations of 25(OH)D were determined in serum samples of 98 children (54 male and 44 female) 6-36 months of age using a 2-step radioimmuno assay procedure. Vitamin D defciency was defned as 25(OH)D < 25nmol/L.Results:The mean serum 25(OH)D concentration was 29.00 nmol/L with no statistically signifcant differences between boys and girls, age groups and children from rural and urban areas. The vitamin D defciency among the surveyed children was 61.2%. The defciency was higher among children from Ulaanbaatar city (65.7% vs 51.9% in rural areas) and in boys (66.7% vs 55.8% in girls).Conclusion:The high level of vitamin D deficiency indicates that there is a need to promote the expansion of the coverage of vitamin D supplements among young children.

Poor dietary quality of complementary foods is associated with multiple micronutrient deficiencies during early childhood in Mongolia.

OBJECTIVE: To assess whether persistent micronutrient deficiencies in Mongolian children identified in our earlier biochemical study are associated with inadequacies in quantity and/or quality in their complementary diets. DESIGN: A cross-sectional study of breast-fed children aged 6-23 months, randomly selected from four districts in Ulaanbaatar and four provincial capitals. SUBJECTS: Weight and length were measured, and sociodemographic status, feeding practices and nutrient adequacy of complementary foods for children aged 6-8 months (n 26), 9-11 months (n 29) and 12-23 months (n 73) were assessed via questionnaire and in-home interactive 24 h recalls. RESULTS: No geographic differences existed so data were combined. Adherence to WHO infant and young child feeding practices was poor: few children were exclusively breast-fed up to 6 months of age or received the recommended number of feedings containing the recommended number of food groups. Nevertheless, energy intakes from complementary diets, primarily from cereals and non-nutritious snacks, were above WHO-estimated needs; <1 % of energy was from meat and eggs or fruits and vegetables. Median intakes and densities of most nutrients (except protein, thiamin and riboflavin) failed to meet WHO recommendations for at least two age groups, assuming average breast milk intake; greatest density deficits were for Fe > vitamin C > vitamin A > Zn > Ca. CONCLUSIONS: Complementary feeding in Mongolia is compromised by deficits in several micronutrients but not energy, in part because of frequent consumption of non-nutritious snacks. The latter may interfere with breast-feeding and should be avoided. Instead, wheat-based complementary foods should be enriched with affordable cellular animal foods and fruits rich in vitamin C to combat existing micronutrient deficits.

Multiple Micronutrient Defficiencies During Early Childhood / Монголын Анагаах Ухаан

Introduction. The high rate of malnutrition in young Mongolian children is a serious issue. Anemia, stunting and rickets have all been identified as significant problems. Low levels of serum folate have been reported among some young children in two previous surveys. Zinc is a growth-limiting micronutrient that may contribute to the persistent stunting in young Mongolian children. The traditional rice and wheat-based complementary foods used for young child feeding are likely to be inadequate in zinc. Certainly, the overall prevalence of stunting in Mongolia (i.e., 20%) is suggestive of substantial risk of zinc deficiency. It is possible that co-existing low selenium status may exacerbate zinc deficiency, because selenium compounds regulate the delivery of zinc from metallothioneine to zinc enzymes. To date, however, there have been no studies on the selenium and zinc status of the Mongolian population. Study objective. The objective of this study was to assess the biochemical indicators of micronutrient deficiency among 6-36 months old children. Subjects and methods. This cross-sectional study was conducted in four districts of Ulaanbaatar city and in centers of Bulgan, Bayanhongor, Dornod and Khovd aimags and included 243 (122 male and 121 female) apparently healthy children aged 6 to 36 months. Hemoglobin analysis was performed using a hemoglobinometer Hemocue AB, serum ferritin was analyzed by enzyme immunoassay technology, serum retinol by high-pressure liquid chromatography, serum zinc and selenium were analyzed by atomic absorption spectrophotometry and serum 25(OH)D analysis was performed using radioimmuno assay procedure. Results. Mean hemoglobin, serum ferritin, folate, 25(OH)D, retinol, zinc and selenium concentrations in children from Ulaanbaatar city and aimag centers were determined. Age-group differences for the means were significant for hemoglobin, serum ferritin, serum folate (p=0.001)and serum zinc(p=0.01). The differences between Ulaanbaatar and the aimag centers were also significant for hemoglobin, serum ferritin, serum zinc (p=0.05) and serum folate (p=0.001). 24.3% of the children were anemic. The prevalence of anemia was greater among the children in the aimag centers than in Ulaanbaatar city and in younger children than in the oldest age group. The prevalence of iron deficiency anemia was 15.3% and was independent of setting but was lowest in the oldest children aged 24 to 36 months. Of all the surveyed children, only 3.7% had low level of serum folate. The overall prevalence of low serum retinol levels indicative of vitamin A deficiency was 33.7%, with no differences by setting or age group. 74.7% of the children had low serum zinc concentrations. There was no significant difference in the prevalence between children living in Ulaanbaatar city and the aimag centers, or among the three age groups of children in either setting. The overall prevalence of low serum selenium concentrations was 57.7%, with no differences in the prevalence by setting or age-group. The prevalence of low serum levels of 25(OH)D was 61% and was highest among the children aged 6 to 12 months of Ulaanbaatar city. Conclusion: 1. Zinc deficiency had the highest prevalence (74.7%) among the surveyed children, followed by low serum selenium levels (57.7%). 2. 36% of the children were at risk of two and 64% of more than two coexisting micronutrient deficiencies. 3. There is a need for multi-micronutrient programs that take into account the potential interactions of micronutrients instead of the present single micronutrient based interventions on-going in Mongolia.