Effect of vitamin D, calcium and multiple micronutrients supplementation on lipid profile in pre-menopausal Bangladeshi garment factory workers with hypovitaminosis D.

Elevated total cholesterol and low-density lipoprotein cholesterol in sera are both well-known risk factors of coronary heart disease. Adequate vitamin D status is important for optimal function of many organs and tissues of our body. There is continuing controversy about the effect of adequate vitamin D consumption on serum lipids and lipoproteins. The present study assessed the effect of vitamin D, calcium and multiple micronutrients supplementation on the lipid profile in Bangladeshi young female garment factory workers who have hypovitaminosis D. This placebo-controlled intervention trial conducted over a period of one year randomly assigned a total of 200 apparently healthy subjects aged 16-36 years to 4 groups. The subjects received daily supplements of 400 IU of vitamin D (VD group) or 400 IU of vitamin D+600 mg of calcium lactate (VD-Ca group), or multiple micronutrients with 400 IU of vitamin-D+600 mg of calcium lactate (MMN-VD-Ca group), or the group consuming placebo (PL group). Serum concentrations of lipid and lipoprotein, 25-hydroxyvitamin D (25OHD) and intact parathyroid hormone (iPTH) were measured at baseline and after one year of follow-up. No significant changes in the serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), LDL-C/HDL-C ratio were observed in the supplemented groups compared to the placebo group. Supplementation had a positive effect (p<0.05) on very low-density-lipoprotein cholesterol (VLDL-C) and triacylglycerol (TAG). A negative correlation between changes in serum iPTH and HDL-C was observed, which indicated that subjects with the greatest decline in S-iPTH had the greatest increase in HDL-C. The results suggest that consumption of adequate vitamin D with calcium or MMN for one-year may have no impact on serum lipid profile in the subjects studied. Longer-term clinical trials with different doses of supplemental vitamin D are warranted in evaluating the effect of intervention.

Effect of long-term intermittent supplementation with multiple micronutrients compared with iron-and-folic acid supplementation on Hb and micronutrient status of non-anaemic adolescent schoolgirls in rural Bangladesh.

The present study examined whether long-term supplementation with once- and twice-weekly multiple micronutrients (MMN-1 and MMN-2) can improve Hb and micronutrient status more than twice-weekly Fe-folic acid (IFA-2) supplementation in non-anaemic adolescent girls in Bangladesh. An equal number of 324 rural schoolgirls aged 11-17 years were given MMN-1 or MMN-2 or IFA-2 supplements for 52 weeks in a randomised, double-blind trial. Blood samples were collected at baseline, and at 26 and 52 weeks of supplementation. The girls receiving IFA-2 supplements were more likely to be anaemic than the girls receiving MMN-2 supplements for 26 weeks (OR 5·1, 95% CI 1·3, 19·5; P = 0·018). All three supplements reduced Fe deficiency effectively. Both the MMN-1 and MMN-2 groups showed significantly greater improvements in vitamins A, B(2) and C status than the girls in the IFA-2 group, as might be expected. Receiving a MMN-1 supplement was found to be less effective than MMN-2 supplement in improving Fe, vitamins A, B(2) and folic acid status. Receiving micronutrient supplements beyond 26 weeks showed little additional benefit in improving micronutrient status. In conclusion, given twice-weekly for 26 weeks, MMN supplements can improve micronutrient status effectively with no significant increase in Hb concentration compared with IFA supplements in non-anaemic Bangladeshi adolescent girls. However, it significantly reduces the risk of anaemia. Before any recommendations can be made, further research, including into cost-effectiveness, is needed to see whether MMN supplementation has any additional longer-term health benefits over that of IFA supplementation in this population.

Optimizing the Rheological and Textural Properties of Chapatti Enriched with House Crickets (Acheta domesticus) Flour Using Hydrocolloids by an I-Optimal Design.

The fortification of food with edible insect flour can improve its nutrition profile, but also affect its techno-functional characteristics. In this study, an I-optimal design was applied to improve the rheological and textural properties of wheat flour chapatti containing 10% cricket (Acheta domesticus) flour. More specifically, the impact and optimal addition of hydrocolloids (carboxymethyl cellulose, hydroxypropyl methylcellulose, guar gum and xanthan gum) and water content were studied. For all the responses, the model and model terms were highly significant and showed the different impact of the hydrocolloids on the rheological properties. To evaluate the predictive power of the models, two sets of optimal process settings were chosen: one based on dough properties, and another on baked chapatti. For both sets, the actual responses were in the range of predicted responses for almost all properties. In addition, it was shown that using the settings based on dough properties, the actual responses were not significantly different from the control chapatti, whereas for the settings based on baked chapatti, there were differences in terms of the extensibility of both dough and chapatti. Thus, the I-optimal design is suitable to optimize the dough properties and the baked chapatti when enriching chapatti with cricket flour.

Profiling of minerals, water soluble vitamins and carotenoid in selected unconventional leafy and non-leafy vegetables of Bangladesh.

The present study was aimed at evaluating mineral contents, B-vitamins (B1, B2, B3, B6), vitamin C, total carotenoids content and carotene composition of unconventional vegetables, comprising 7 leafy and 4 non-leafy, growing in Bangladesh. Investigated unconventional vegetables were found to have varied amount of minerals (0.04 ± 0.01 to 786.41 ± 6.37 mg/100 g), B-vitamins (0.06 ± 0.01 to 1.05 ± 0.13 mg/100 g) and vitamin C (5.23 ± 0.81 to 59.01 ± 2.23 mg/100 g). The study findings also revealed that the selected plant samples exhibited diverse amount of ß-carotene ranging from 106.26 ± 5.32 µg/100 g EP in Orhor dal to 994.81 ± 21.01 µg/100 g EP in Orhor Pata whereas lutein content ranged from 7.76 ± 1.02 µg/100 g EP in Pahari Kolar Thor to 566.33 ± 20.63 µg/100 g EP in Kachuripana. It can be suggested that regular intake of these vegetables may contribute to daily minerals and vitamins requirement and can combat micronutrient deficiency.

Rheological Characterization of Chapatti (Roti) Enriched with Flour or Paste of House Crickets (Acheta domesticus).

Addition of edible insects to food products may improve the nutritional status but can also influence their techno-functional properties. This study investigates the impact of supplementing wheat flour by cricket flour or paste at different levels (5-15%) on the rheological and textural properties of flour, dough, and baked chapatti. Addition of freeze-dried cricket flour resulted in the highest water absorption. The storage modulus increased at higher level (10-15%) of supplementation to wheat flour indicating an increased dough consistency. Similarly, biaxial extension of the dough showed an increased resistance to extension and decreased extensibility at higher level of supplementation due to a reduced strength of the gluten network. Uniaxial extension of baked chapatti showed less extensible and harder chapatti with the addition of a higher amount of cricket flour or paste. At lower level (5%), incorporation of cricket flour resulted in chapatti with textural properties comparable to the reference. Oven dried cricket powder is suggested as the best option for incorporating in chapatti dough to improve food security in Asian Countries.

Long-term intermittent multiple micronutrient supplementation enhances hemoglobin and micronutrient status more than iron + folic acid supplementation in Bangladeshi rural adolescent girls with nutritional anemia.

Previous short-term supplementation studies showed no additional hematologic benefit of multiple micronutrients (MMN) compared with iron + folic acid (IFA) in adolescent girls. This study examines whether long-term once- or twice-weekly supplementation of MMN can improve hemoglobin (Hb) and micronutrient status more than twice-weekly IFA supplementation in anemic adolescent girls in Bangladesh. Anemic girls (n = 324) aged 11-17 y attending rural schools were given once- or twice-weekly MMN or twice-weekly IFA, containing 60 mg iron/dose in both supplements, for 52 wk in a randomized double-blind trial. Blood samples were collected at baseline and 26 and 52 wk. Intent to treat analysis showed no significant difference in the Hb concentration between treatments at either 26 or 52 wk. However, after excluding girls with hemoglobinopathy and adjustment for baseline Hb, a greater increase in Hb was observed with twice-weekly MMN at 26 wk (P = 0.045). Although all 3 treatments effectively reduced iron deficiency, once-weekly MMN produced significantly lower serum ferritin concentrations than the other treatments at both 26 and 52 wk. Both once- and twice-weekly MMN significantly improved riboflavin, vitamin A, and vitamin C status compared with IFA. Overall, once-weekly MMN was less efficacious than twice-weekly MMN in improving iron, riboflavin, RBC folic acid, and vitamin A levels. Micronutrient supplementation beyond 26 wk was likely important in sustaining improved micronutrient status. These findings highlight the potential usefulness of MMN intervention in this population and have implications for programming.

Effect of vitamin D, calcium and multiple micronutrient supplementation on vitamin D and bone status in Bangladeshi premenopausal garment factory workers with hypovitaminosis D: a double-blinded, randomised, placebo-controlled 1-year intervention.

Due to little outdoor activity and low dietary intake of vitamin D (VD), Bangladeshi low-income women are at risk for osteoporosis at an early age. The present study assessed the effect of VD, Ca and multiple micronutrient supplementation on VD and bone status in Bangladeshi young female garment factory workers. This placebo-controlled 1-year intervention randomly assigned 200 apparently healthy subjects (aged 16-36 years) to four groups: VD group, daily 10 microg VD; VD and Ca (VD-Ca) group, daily 10 microg VD+600 mg Ca; multiple micronutrient and Ca (MMN-Ca) group, 10 microg VD and other micronutrients+600 mg Ca; a placebo group. Serum 25-hydroxyvitamin D (S-25OHD), intact parathyroid hormone (S-iPTH), Ca, phosphate and alkaline phosphatase were measured. Bone mineral density and bone mineral content were measured by dual-energy X-ray absorptiometry. All measurements were made at baseline and at 12 months. Significantly (P < 0.001) higher S-25OHD concentrations were observed in the supplemented groups than in the placebo group after the intervention. Supplementation had an effect (P < 0.001) on S-iPTH in the VD-Ca and MMN-Ca groups compared with the placebo group. Bone mineral augmentation increased at the femur in the supplemented groups. Supplementation with VD-Ca should be recommended as a strategic option to reduce the risk of osteomalacia and osteoporosis in these subjects. MMN-Ca may have analogous positive health implications with additional non-skeletal benefits.

Comparative assessment of nutritional composition, polyphenol profile, antidiabetic and antioxidative properties of selected edible wild plant species of Bangladesh.

Wild edible plants are recently recognized as an important source of acquiring macro and micro nutrients beneficial for human health. Hence, the present study was undertaken to assess the antidiabetic and antioxidant potentials, polyphenolic profile, - as well as the ascorbic acid, proximate and mineral compositions of five selected Bangladeshi wild plants. The studied samples were rich in ash, fiber, protein, vitamin C and low in fat. The undertaken plant samples were found to have good amounts of total phenolic, total flavonoid, and antioxidant capacities, documented by DPPH, FRAP, and TEAC assays. They also exhibited varying spectrum of polyphenols estimated by HPLC. Significant inhibition of α-amylase activity by plant extracts was also observed. Evaluation by principal component analysis revealed clear separation among the wild plant varieties. The study findings would enrich the food composition table of Bangladesh and allow the population to consume more wild plants and increase their production.

Nutritional Composition, Total Phenolic Content, Antioxidant and α-Amylase Inhibitory Activities of Different Fractions of Selected Wild Edible Plants.

Wild plants are considered the richest source of essential nutrients and other beneficial phytochemicals. Hence, the objective of this study was to evaluate the nutritional composition, antioxidant- and α-amylase inhibition activities of leaves and roots of selected Bangladeshi wild plants. These wild plants were found to have high fiber (13.78-22.26 g/100 g), protein (7.08-21.56 g/100 g) and ash (8.21-21.43 g/100 g) contents. The total phenolic and total flavonoid contents were significantly higher in the leaves than the roots. Additionally, antioxidant activity was evaluated using ferric-reducing antioxidant power, 2, 2-diphenyl-1-picrylhydrazyl radical (DPPH) and trolox equivalent antioxidant capacity assays and was strongly correlated with phenolic compounds. The leaf extracts of the selected plants also exhibited potent α-amylase inhibition (~71%) and were significantly higher than their root counterparts. Thus, the study findings concluded that the investigated plants were good sources of fiber, protein, mineral, natural antioxidant compounds and α-amylase inhibitors, and their increased intake could provide health benefits. The principal component analysis (PCA) of analyzed variables divided the samples into three clear groups, and the first two principal components accounted for 86.05% of the total data set variance.

Vitamin D deficiency and low bone status in adult female garment factory workers in Bangladesh.

The manufacture of garments is the main industry in Bangladesh and employs 1.6 million female workers. Due to the indoor lifestyle and low dietary intake of calcium, we hypothesised that they are at risk of low vitamin D and bone mineral status. Two hundred female garment workers (aged 18-36 years) were randomly selected. Serum 25-hydroxyvitamin D (S-25OHD), serum intact parathyroid hormone (S-iPTH), serum calcium (S-Ca), serum phosphate (S-P) concentration and serum alkaline phosphatase activity (S-ALP) were measured from fasting samples. Bone indexes of hip and spine were measured by dual-energy X-ray absorptiometry. The mean S-25OHD (36.7 nmol/l) was low compared to that recommended for vitamin D sufficiency. About 16% of the subjects were found to be vitamin D-deficient (S-25OHD 21 ng/l) was associated with progressive reduction in bone mineral density at the femoral neck and lumbar spine. According to the WHO criteria, the mean T-score of the femoral neck and lumbar spine of the subjects were within osteopenic range. We observed that subjects with a bone mineral density T-score < -2.5 had a trend of lower values of BMI, waist-hip circumference, mid-upper-arm circumference, S-25OHD and higher S-iPTH and S-ALP. The high prevalence of hypovitaminosis D and low bone mineral density among these subjects are indicative of higher risk for osteomalacia or osteoporosis and fracture.

Efficacy of twice-weekly multiple micronutrient supplementation for improving the hemoglobin and micronutrient status of anemic adolescent schoolgirls in Bangladesh.

BACKGROUND: Although iron deficiency is a major cause of anemia, other micronutrient deficiencies may also play a role. OBJECTIVE: We examined whether multiple micronutrient supplementation is more efficacious than is supplementation with iron and folic acid alone for improving the hemoglobin and iron status of anemic adolescent girls in Bangladesh. DESIGN: Anemic (hemoglobin < 12.0 g/dL) girls (n = 197) aged 14-18 y from rural schools in Dhaka District were entered into a randomized double-blind trial and received twice-weekly supplements of iron and folic acid (IFA group) or multiple micronutrients (15 micronutrients, including iron and folic acid; MMN group) for 12 wk. RESULTS: At recruitment, the characteristics of the girls in the 2 groups were not significantly different, except for family size and body mass index. At the end of the study, although both groups benefited significantly from supplementation, mean changes in hemoglobin and serum ferritin concentrations were not significantly different between groups. Compared with the IFA group, girls in the MMN group had significantly greater increases in mean serum vitamin A, plasma vitamin C, red blood cell folic acid, and riboflavin concentrations (assessed as erythrocyte glutathione reductase activation coefficient). After 12 wk of supplementation, only the prevalence of vitamins A and C and riboflavin deficiencies decreased more significantly in the MMN group than in the IFA group. CONCLUSIONS: Twice-weekly MMN supplementation for 12 wk significantly improved the status of the micronutrients assessed but was not more efficacious than was supplementation with iron and folic acid alone in improving the hematologic status of anemic adolescent girls. More frequent doses may be needed to achieve full benefit.

Anaemia and vitamin A status among adolescent schoolboys in Dhaka City, Bangladesh.

OBJECTIVES: To investigate the prevalence of anaemia and subclinical vitamin A deficiency among adolescent schoolboys in Dhaka City, Bangladesh, and to identify factors related to anaemia and vitamin A status. DESIGN: A cross-sectional study. SETTING: Government high schools in Dhaka City, Bangladesh. SUBJECTS AND METHODS: A total of 381 boys, aged 11-16 years, from 10 schools in Dhaka City participated in the study. Socio-economic, anthropometric and dietary data were collected. Haemoglobin and serum retinol (vitamin A) concentrations were determined. RESULTS: Seven per cent of the boys were anaemic and 22% had serum vitamin A levels below the adequate level of 1.05 micromol l(-1), with only 1.5% having subclinical vitamin A deficiency (<0.70 micromol l(-1)). Food frequency data revealed poor dietary habits. Multiple regression analysis showed that age, body mass index (BMI), parents' occupation, serum vitamin A level and frequency of intakes of meat and fruit were significantly independently related to haemoglobin level. The overall F-ratio (13.1) was highly significant (P<0.000) and the adjusted R(2) was 0.192. For serum vitamin A, BMI, father's education, per capita expenditure on food, haemoglobin concentration and frequency of intake of vitamin A-rich fruit were found to be significantly independently related. The overall F-ratio (14.5) was highly significant (P<0.000) and the adjusted R(2) was 0.186. CONCLUSION: The data show that adolescent schoolboys in Dhaka City have anaemia and inadequate vitamin A status, although the extent of the problems is lower than in other population groups in the country. Sociodemographic and dietary factors appear to have important relationships with anaemia and vitamin A status of these boys.

Vitamin A deficiency in poor, urban, lactating women in Bangladesh: factors influencing vitamin A status.

AIMS: To investigate the prevalence of vitamin A deficiency among lactating women in a poor urban population of Bangladesh, and to examine the relationship between various factors and vitamin A status. DESIGN: Cross-sectional study. SETTING: Maternal and child health clinic in Dhaka City, Bangladesh. SUBJECTS AND METHODS: A total of 120 lactating women aged 17-37 years were randomly selected from women who attended a local maternal and child health clinic in Dhaka City for immunisation of their children. Various socio-economic, personal characteristics, dietary intakes of vitamin A and anthropometric data were collected. Serum retinol (vitamin A) concentration was determined as a measure of vitamin A status. RESULTS: Of the subjects, 37% had low serum vitamin A levels (<30 microg x dl-1), with 13.3% having sub-clinical vitamin A deficiency (<20 microg x dl-1). Eighty-seven per cent had vitamin A intakes below the recommended dietary allowance. The lactating women who were either illiterate or received only informal education had significantly lower serum vitamin A levels compared with those who received formal education. The women whose husbands received formal education had significantly higher serum vitamin A levels than those whose husbands were either illiterate or received only informal education. The serum vitamin A levels of women in households with poor sanitation/latrine practice were significantly lower than those of women in households with good sanitation/latrine practice. The women with one child had significantly lower serum vitamin A levels than those with two or more children. Women with a lactation period of 6 months or more had significantly lower serum vitamin A levels than women with a lactation period of less than 6 months. The women who consumed less than the median vitamin A intake (274.8 microg day-1) had significantly lower serum vitamin A levels than those who consumed more than the median vitamin A intake. By multiple regression analysis, education level of the women, number of living children, duration of lactation and dietary intake of vitamin A were found to have significant independent relationships with serum vitamin A. The overall F-ratio (6.8) was highly significant the adjusted R2 was 0.16 (multiple ). CONCLUSION: A significant proportion of poor, urban, lactating women in Bangladesh have vitamin A deficiency. Among the various factors, education level of the women, number of living children, duration of lactation and dietary intake of vitamin A appear to be important in influencing the vitamin A status of these women.