RESUMEN
Documentation of micronutrient intake inadequacies among developing country populations is important for planning interventions to control micronutrient deficiencies. The objective of this study was to quantify micronutrient intakes by young children and their primary female caregivers in rural Bangladesh. We measured 24-h dietary intakes on 2 nonconsecutive days in a representative sample of 480 children (ages 24-48 mo) and women in 2 subdistricts of northern Bangladesh by using 12-h weighed food records and subsequent 12-h recall in homes. We calculated the probability of adequacy (PA) of usual intakes of 11 micronutrients and an overall mean PA, and evaluated dietary diversity by counting the total number of 9 food groups consumed. The overall adequacy of micronutrient intakes was compared to dietary diversity scores using correlation and multivariate regression analyses. The overall mean prevalence of adequacy of micronutrient intakes for children was 43% and for women was 26%. For children, the prevalence of adequate intakes for each of the 11 micronutrients ranged from a mean of 0 for calcium to 95% for vitamin B-6 and was <50% for iron, calcium, riboflavin, folate, and vitamin B-12. For women, mean or median adequacy was <50% for all nutrients except vitamin B-6 and niacin and was <1% for calcium, vitamin A, riboflavin, folate, and vitamin B-12. The mean PA (MPA) was correlated with energy intake and dietary diversity, and multivariate models including these variables explained 71-76% of the variance in MPA. The degree of micronutrient inadequacy among young children and women in rural Bangladesh is alarming and is primarily explained by diets low in energy and little diversity of foods.
Asunto(s)
Dieta/efectos adversos , Abastecimiento de Alimentos , Micronutrientes/administración & dosificación , Salud Rural , Adulto , Bangladesh/epidemiología , Cuidadores , Preescolar , Estudios Transversales , Países en Desarrollo , Dieta/economía , Dieta/etnología , Registros de Dieta , Femenino , Abastecimiento de Alimentos/economía , Humanos , Masculino , Micronutrientes/deficiencia , Micronutrientes/economía , Niacina/administración & dosificación , Niacina/deficiencia , Niacina/economía , Encuestas Nutricionales , Prevalencia , Salud Rural/economía , Salud Rural/etnología , Deficiencia de Vitamina B 6/economía , Deficiencia de Vitamina B 6/epidemiología , Deficiencia de Vitamina B 6/etnología , Deficiencia de Vitamina B 6/etiología , Adulto JovenRESUMEN
OBJECTIVE: The aim of the study was to assess the adequacy of polyunsaturated fatty acid intake by rural Bangladeshi children 24 to 48 months old in relation to their breast-feeding status. MATERIALS AND METHODS: Multistage sampling was used to select a representative sample of children 24 to 48 months of age from 2 rural districts in Bangladesh (n = 479). Two nonconsecutive 24-hour periods of dietary data were collected via 12-hour daytime in-home observations and recall. Breast milk intake was estimated using test weighing. The National Cancer Institute (NCI) method for episodically consumed foods was used to estimate distributions of usual food and nutrient intakes. RESULTS: Based on the estimated intake distributions, >95% of the children had usual fat intakes <30% of total energy. Among 24- to 35-month-old (younger) and 36- to 48-month-old (older) children, respectively, 4% and 16% of breast-feeding children and 31% and 41% of non-breast-feeding children were estimated to consume <10% of total energy from fat. An estimated 80% of all of the children consumed <4% of total energy as linoleic acid, and 99% consumed <1% of energy as α-linolenic acid. Younger breast-feeding children had higher estimated average docosahexaenoic acid (DHA) intakes (0.04 g DHA/day) than their non-breast-feeding counterparts (0.01 g DHA/day; P = 0.0005). Both breast-feeding and non-breast-feeding older children had estimated mean DHA intakes of 0.02 g/day (P = 0.74). CONCLUSIONS: Rural Bangladeshi children 24 to 48 months old, and especially those who have discontinued breast-feeding, may benefit from increased fat consumption.
Asunto(s)
Lactancia Materna , Grasas de la Dieta/administración & dosificación , Ingestión de Energía , Ácidos Grasos Insaturados/administración & dosificación , Bangladesh , Fenómenos Fisiológicos Nutricionales Infantiles , Preescolar , Femenino , Humanos , Masculino , Población RuralRESUMEN
Maternal fat intake and adipose reserves are major sources of PUFA during lactation. The present study examined the cross-sectional relationship between prolonged breast-feeding and maternal BMI, assessed adequacy of fat intake among lactating and non-lactating mothers of children 24-48 months of age and determined breast-milk fatty acid composition. Multi-stage sampling was used to select a representative sample of mothers from two rural districts in Bangladesh (n 474). Dietary data were collected during two non-consecutive 24 h periods via 12 h in-home daytime observations and recall. The National Cancer Institute method for episodically consumed foods was used to estimate usual intake distributions. Breast milk samples were collected from ninety-eight women, and breast-milk fatty acid methyl esters were quantified using GC. Approximately 42 % of lactating v. 26 % of non-lactating mothers were underweight (BMI < 18·5 kg/m2; P = 0·0003). The maternal diet was low in total fat (approximately 8 % of mean total energy) and food sources of PUFA, including oil and animal source foods, resulting in a low estimated mean total consumption of PUFA (5·1 g/d). Almost all women were estimated to consume less than the recommended intake levels for total fat, total PUFA, α-linolenic acid (ALA) and DHA. Median breast-milk linoleic acid (8·5 % weight) and ALA (0·2 %) concentrations were among the lowest reported in the literature, in contrast with arachidonic acid (0·5 %) and DHA (0·3 %) concentrations, which were mid-range. Bangladeshi women in general, and especially those who practise prolonged breast-feeding, may benefit from increased consumption of food sources of PUFA.
Asunto(s)
Dieta , Grasas de la Dieta/análisis , Ácidos Grasos Esenciales/administración & dosificación , Ácidos Grasos Esenciales/análisis , Leche Humana/química , Adolescente , Adulto , Bangladesh , Preescolar , Estudios Transversales , Ingestión de Energía , Femenino , Análisis de los Alimentos , Humanos , Lactancia/fisiología , Persona de Mediana Edad , Áreas de Pobreza , Población Rural , Adulto JovenRESUMEN
Rural Bangladeshi populations have a high risk of zinc deficiency due to their consumption of a predominantly rice-based diet with few animal-source foods. Breeding rice for higher zinc content would offer a sustainable approach to increase the population's zinc intakes. The objectives of the study were to quantify usual rice and zinc intakes in young children and their adult female primary caregivers and to simulate the potential impact of zinc-biofortified rice on their zinc intakes. We measured dietary intake in a representative sample of 480 children (ages 24-48 mo) and their female caregivers residing in 2 rural districts of northern Bangladesh. Dietary intakes were estimated by 12-h weighed records and 12-h recall in homes on 2 nonconsecutive days. Serum zinc concentrations were determined in a subsample of children. The median (25th, 75th percentile) rice intakes of children and female caregivers were 134 (99, 172) and 420 (365, 476) g raw weight/d, respectively. The median zinc intakes were 2.5 (2.1, 2.9) and 5.4 (4.8, 6.1) mg/d in children and women, respectively. Twenty-four percent of children had low serum zinc concentrations ( < 9.9 micromol/L) after adjusting for elevated acute phase proteins. Rice was the main source of zinc intake, providing 49 and 69% of dietary zinc to children and women, respectively. The prevalence of inadequate zinc intakes was high in both the children (22%) and women (73-100%). Simulated increases in rice zinc content to levels currently achievable through selective breeding decreased the estimated prevalence of inadequacy to 9% in children and 20-85% in women, depending on the assumptions used to estimate absorption. Rural Bangladeshi children and women have inadequate intakes of zinc. Zinc biofortification of rice has the potential to markedly improve the zinc adequacy of their diets.