Micronutrient status of populations and preventive nutrition interventions in South East Asia.

Objectives Since the 1990s, programs for the control of micronutrient deficiencies became a public health priority for many governments, including the countries partnering the project "Sustainable Micronutrient Interventions to Control Deficiencies and Improve Nutritional Status and General Health in Asia" (SMILING): Cambodia, Indonesia, Laos-PDR, Thailand and Vietnam. The aim of this study was to map which micronutrient deficiencies have been addressed and which interventions were in place in the SMILING countries. Methods The mapping covered the period up to 2012. Updated information from relevant surveys after 2012 is included in this paper after the completion of the SMILING project. The mapping of micronutrient status was limited to either national or at least large-scale surveys. Information on nutrition interventions obtained through a systematic mapping of national programs combined with a snowball collection from various sources. Results Among the five SMILING countries, Thailand differed historically by an early implementation of a nationwide community-based nutrition program, contributing to reductions in undernutrition and micronutrient deficiencies. For Cambodia, Indonesia, Laos PDR, and Vietnam, some national programs addressing micronutrients have been implemented following adjusted international recommendations. National surveys on micronutrient status were scattered and inconsistent across the countries in design and frequency. Conclusion for practice In conclusion, some micronutrient deficiencies were addressed in national interventions but the evidence of effects was generally lacking because of limited nationally representative data collected. Improvement of intervention programs to efficiently reduce or eliminate micronutrient deficiencies requires more systematic monitoring and evaluation of effects of interventions in order to identify best practices.

Quantitative responses of serum folate to increasing intakes of folic acid in healthy women.

OBJECTIVES: Health authorities are advising people to increase folate intake and more foods are being fortified with folic acid. Estimation of dietary folate is difficult because nutrient data bases lack this nutrient in many countries and bioavailability is variable. To see if serum folate can be used to reflect effective folate intake, we have measured serum folate after healthy women had taken different doses of pure folic acid supplements in the nutritional range. METHODS: A total of 20 volunteer subjects took part in one or more of three experiments, six of them took part in all three. In each experiment subjects took two different doses of folic acid, each for three weeks. Experiment (1) 100 micrograms then 1000 micrograms/d; experiment (2) 500 micrograms then 1500 micrograms/d; experiment (3) 1000 then 2000 micrograms/d. Serum folate was measured after overnight fast with a homogenous enzyme binding assay kit. In experiment (3) red cell folates were also measured. RESULTS: It took three weeks' of the same supplement for serum folate to reach its full higher value. Mean serum folates of small groups of subjects were significantly higher with each higher dose of supplement. The biggest increase was for the first 100 micrograms that is in the range of intake from unfortified foods. The curve of serum folate against folic acid supplement intake shows that serum folate of groups of people, properly standardized, can provide a practical method for assessing adequacy or change of people's folate intake. Red cell folates were less responsive.