Prospective study on the effect of blood donation in the iron status

Introduction: blood donation can generate iron metabolism imbalance and deficiency of this micronutrient, mainly in frequent donors. Objective: to evaluate the effect of blood donation in the iron status in repeat donors of a blood bank in Medellín. Methods: prospective study with 70 repeat donors randomly selected. Ferritin, erythrogram, reticulocytary haemoglobin, coprological, physical activity, and iron ingestion tests were carried out; previous blood donations was collected of the blood bank database. Summary measures, frequencies, results of Friedman test, McNemars test, Student's t-test for paired samples, and the Spearman correlation were calculated on the SPSS 25.0® software. Results: the physical activity frequency, the prevalence of intestinal parasites, the parameter of leuko-plateletgram, and the iron ingestion in the diet did not show statistically significant differences between the two moments of the study, unlike the MCV (Mean Corpuscular Volume), MCHC (Mean Corpuscular Hemoglobin Concentration) and ferritin. In the second stage, ferritin (which decreases as the amount of donations increases) decreased 10% in women and 15% in men. Conclusion: blood donation decreases storage iron and the plundering of the reserves becomes more serious as the amount of donations increases, and also as the period of time between donations decreases. It is necessary to implement strategies to reduce the prevalence of iron deficiency, which include nutritional education, pre-donation iron deficiency determining, and medical guidance on the ingestion of dietary iron supplements.

Sociodemographic factors associated with low intake of bioavailable iron in preschoolers: National Health and Nutrition Survey 2012, Mexico.

BACKGROUND: Children < 5 years of age are at risk of developing an iron deficiency due to a low intake of bioavailable iron (FeBio). Few studies have estimated dietary FeBio in children at a national level in relation to sociodemographic characteristics. This study aimed to estimate FeBio intake and its association with sociodemographic factors among Mexican children aged 12-59 months. METHODS: A cross-sectional study was carried out. Information on serum ferritin and diet was obtained from a national survey and representative sample of 1012 Mexican children aged 12-59 months. We used a 24-h recall to estimate total iron, heme and non-heme iron, vitamin C, phytates, calcium, and meat intake. We calculated FeBio intake using an algorithm. Differences in FeBio intake were analyzed by area of residence (rural/urban), country region (north, center, south), and socioeconomic status (SES), using linear regression models by age subgroups (12-23 and 24-59 months) and total population, while adjusting for study design. RESULTS: Total iron intake was 9.2 ± 6.7 mg/d. The estimated average of total FeBio fluctuated between 0.74-0.81 mg/d, with a bioavailability of 9.15-12.03% of total iron. Children aged 12-23 months residing in rural areas consumed less FeBio than those in urban areas (ß = - 0.276) (p < 0.05). Children aged 24-59 months with high SES consumed more FeBio (ß = 0.158 mg/d) than those of a low SES (p < 0.05). CONCLUSIONS: FeBio is low in Mexican preschoolers. Being from a rural area and having low SES were negatively associated with FeBio intake. These results can benefit interventions seeking to improve iron status.

Dietary Iron Intakes in Men in Europe Are Distinctly Above the Recommendations: A Review of 39 National Studies From 20 Countries in the Period 1995 - 2016.

The objective of this review was to assess whether dietary iron intake in men in Europe is in symphony with the dietary recommendations. A literature search of national dietary surveys reporting the intake of iron using PubMed, Google Scholar, National Nutrient Databases and previous literature on dietary reviews was performed. The subjects were men aged 18 - 70 years. A total of 39 national dietary surveys in 20 European countries in the period 1995 - 2016 were included. There were considerable differences between median/mean iron dietary intake in the 20 countries. Seven countries/regions, UK-Northern Ireland, UK-Wales, Sweden, Belgium, UK-Scotland, UK-England and Serbia reported median/mean iron intake ranging from 10.5 to 11.6 mg/day. Ten countries, Norway, Finland, Lithuania, Italy, Hungary, Portugal, The Netherlands, Denmark, Iceland and Austria reported iron intake from 12.0 to 13.5 mg/day. France, Germany, Ireland and Spain reported iron intake from 14.8 to 16.0 mg/day, while Poland and Slovakia reported the highest intake of 17.2 and 22.7 mg/day. In surveys from France and The Netherlands, intake of heme iron constituted 11% of total dietary iron intake. Nutrient density for iron, reported in five countries, varied from median 11.6 mg iron/10 MJ in Denmark to 16.0 in France. In all countries, the majority of men had a dietary iron intake markedly above a recommended intake of 9 mg/day. In Europe, 75-87% of men have a dietary iron intake above 9 mg/day. A high iron intake together with relatively high intakes of meat and alcohol contributes to a high iron status and a high frequency of body iron overload in many men. We need consensus on common European standardized dietary methods, uniform dietary reference values and uniform statistical methods to perform inter-country comparisons.

Análise hierarquizada dos fatores associados à anemia em lactentes / Hierarchical analysis of the factors associated with anemia in infants

RESUMO Objetivo: Avaliar a prevalência e os fatores associados à anemia em lactentes assistidos por Unidades de Saúde de Vitória da Conquista, Bahia. Métodos: Estudo transversal com uma amostra representativa de 366 crianças de 6 a 23 meses. Realizou-se aplicação de questionário ao cuidador, avaliação antropométrica e dosagem de hemoglobina das crianças. As associações foram identificadas por meio da regressão de Poisson com variâncias robustas com seleção hierárquica das variáveis independentes. Resultados: A prevalência de anemia foi de 26,8%, e os fatores associados foram: renda familiar igual ou inferior a um salário mínimo (RP: 1,50; IC95% 1,03-2,18), número de moradores no domicílio superior a cinco (RP: 1,50; IC95% 1,07-2,11), utilização de água não filtrada (RP: 1,68; IC95% 1,11 -2,56), número de filhos maior que três (RP: 1,64; IC95% 1,01-2,68), consumo de carne e/ou vísceras menor que uma vez por semana (RP: 1,78; IC95% 1,24-2,58) e idade de 6 a 11 meses (RP: 1,75; IC95% 1,20-2,55). Conclusões: A anemia nos lactentes avaliados é um moderado problema de saúde pública, a qual está associada a fatores socioeconômicos, demográficos e dietéticos. Dessa forma, medidas são necessárias para sua prevenção.

ABSTRACT Objective: To evaluate the prevalence of anemia and the associated factors in infants assisted in health units of Vitória da Conquista, Bahia, Northeast Brazil. Methods: Cross-sectional study with a representative sample of 366 children aged 6 to 23 months. A questionnaire was applied to the caregiver, and the children's anthropometric measurements and hemoglobin levels were collected. The associations were identified by Poisson regression with robust variances based on a hierarchical analysis model. Results: The prevalence of anemia was 26.8%, and the associated factors were: family income equal to or lower than one minimum wage (PR: 1.50; 95%CI 1.03-2.18), number of household members higher than five (PR: 1.50; 95%CI 1.07-2.11), use of unfiltered water (PR: 1.68; 95%CI 1.11-2.56), number of offspring higher than three (PR: 1.64; 95%CI 1.01-2.68), consumption of meat and/or viscera less than once/week (PR: 1.78; 95%CI 1.24-2.58) and age 6-11 months (PR: 1.75; 95%CI 1.20-2.55). Conclusions: Anemia in the infants assessed is a moderate public health problem, which is associated with socioeconomic, demographic, and dietary factors; thus, measures are necessary for its prevention.

Níveis de Hemoglobina e Consumo de Alimentos Fontes de Ferro em Estudantes do Ensino Médio / Hemoglobin Levels and Iron-rich Food Intake Among High-school Students

Introdução: Estudos mostram um aumento progressivo na prevalência de anemia por deficiência de Ferro. Objetivo: Consistiu em avaliar os níveis de hemoglobina e o consumo de alimentos fontes de Ferro em estudantes do ensino médio da rede pública estadual de Lagarto, Sergipe. Métodos: Realizou- se uma pesquisa com abordagem descritiva e analítica do tipo transversal, durante o período de outubro de 2016 a fevereiro de 2017. Foram investigados 300 estudantes por meio de amostragem de conveniência. Aplicaram-se formulários de extração de dados para avaliação dos fatores associados à anemia, comportamento alimentar e consumo de alimentos fontes de Ferro. Resultados: Os níveis de hemoglobina foram avaliados com o auxílio de um hemoglobinômetro portátil e apresentaram um valor médio igual a 13,31±1,4 g/dL (mínimo=8,0; máximo=17,3), sendo 17,3% (n=52) considerado abaixo do nível normal. A prevalência de anemia no sexo feminino foi maior (88,5%; n=46; p=0,001). Quanto à preferência alimentar, os alimentos fontes de ferro mais consumidos diariamente foram as leguminosas (85,6%; n=256) e as oleaginosas (75,3%; n=226). A carne vermelha (62,3%; n=187) e o ovo (62,3%; n=187) não estão incluídos no cardápio diário, porém são consumidos pela maioria dos estudantes todas as semanas. Conclusão: Uma vez que os adolescentes se encontram em risco para deficiência de Ferro é fundamental a sensibilização quanto à alimentação adequada e saudável e, desta forma, promover qualidade de vida e diminuir os impactos da anemia como redução da capacidade de aprendizagem e produtividade. (AU)

Introduction: Studies have shown a progressive increase in the prevalence of iron-deficiency anemia. Objective: This study aimed to evaluate hemoglobin levels and the consumption of iron-rich foods among high-school students from the city of Lagarto, Sergipe state, Brazil. Material and Methods: This was a cross-sectional study with a descriptive and analytical approach carried out from October 2016 to February 2017. In total, 300 students were analyzed by convenience sampling. Data extraction forms were administered to evaluate factors associated with anemia, eating behavior, and consumption of iron-rich foods. Hemoglobin levels were measured using a portable hemoglobinometer. Results: The mean hemoglobin level was 13.31 ± 1.4 g/dL (minimum, 8.0 g/dL; maximum, 17.3 g/dL), with 17.3% of the students (n = 52) having hemoglobin levels below the normal level. The prevalence of anemia in females was higher (88.5%; n = 46; p = 0.001) than that in males. Regarding food preference, the most commonly consumed iron-rich foods in everyday meals were leguminous (85.6%; n = 256) and oilseeds (75.3%; n = 226). Red meat (62.3%; n = 187) and eggs (62.3%; n = 187) are not part of the students' daily meals, but most students eat them at least once a week. Conclusions: Because adolescents are generally at a risk of iron deficiency, it is fundamentally important to raise their awareness about consuming adequate and healthy foods, thereby improving their quality of life and reducing the consequences of anemia, such as impaired learning and productivity. (AU)

Anemia in pregnant adolescents: impact of treatment on perinatal outcomes.

OBJECTIVE: This study sought to evaluate the anemia prevalence and effect of anemia treatment in pregnant adolescents. METHODS: A cross-sectional study. Data from perinatal outcomes, serum hemoglobin level and iron supplementation were collected. Samples were divided into three groups: pregnant adolescents without anemia, with treated anemia and with untreated anemia. Frequencies, means, standard deviations and Chi-squared values were calculated. The significance level was 5%, and the software used was Epi-info 7. RESULTS: The study included 458 pregnant adolescents. The mean age was 16 years old, and the prevalence of anemia was 41.27% (189). Mild, moderate or severe anemia were presented in 65.60%, 33.86% and 0.52%, respectively, of study participants. Among pregnant adolescents with anemia, 87.24% received treatment with iron supplementation. Preterm labor (p = 0.003), gestational age at birth <37 weeks (p = 0.036) and stillbirth (p = 0.004) showed an association with nontreated anemia. Positive HIV was more prevalent in adolescents with nontreated anemia (p = 0.018). The cesarean rate was 36.90%, with no difference between groups. CONCLUSION: Anemia is a public health problem among pregnant adolescents, and iron supplementation reduces negative neonatal outcomes. Treatment adherence by a multidisciplinary and qualified prenatal care team can be key in reducing adverse neonatal outcomes associated with pregnancy during adolescence.

Reflexões sobre a suplementação de ferro na população infantil / Reflections on iron supplementation in children

Este estudo tem como objetivo aprimorar conhecimentos e melhorar a prática diária na assistência à saúde da criança. Buscou-se utilizar referências a partir do ano de 1987,conseguidas em bibliotecas virtuais e acervo pessoal de Pediatria. Os textos foram submetidosà leitura exploratória, interpretativa e seletiva. Este estudo busca reflexão sobre a consciência e o comportamento de pais e cuidadores, tentando compreender os problemas advindos da não suplementação ou da suplementação inadequada de ferro, com o intuito de orientar sobre a importância da suplementação de ferro na primeira infância.Também adverte sobre a necessidade de mais estudos sobre os benefícios e malefícios pouco discutidos e difundidos advindos da suplementação de ferro na dieta na infância.

This study aims to improve the knowledge and daily practice in child health care. We attempted to use references starting in 1987, achieved in virtual libraries and personal collections in Pediatrics. The texts were submitted to an exploratory, interpretive, and selective reading. This study aims to reflect on the consciousness and behavior of parents and caregivers, trying to understand the problems resulting from no supplementation orinadequate iron supplementation in order to advise on the importance of iron supplementation in early childhood. In addition, it warns about the need for more studies on the benefits and harms arising from iron supplementation in the childhood diet, which are little discussed and disseminated.

Iron intake and its association with iron-deficiency anemia in agricultural workers' families from the Zona da Mata of Pernambuco, Brazil / Consumo de ferro e sua associação com a anemia ferropriva nas famílias de trabalhadores rurais da Zona da Mata de Pernambuco, Brasil

OBJECTIVE: To verify the association between dietary iron intake and the occurrence of iron-deficiency anemia in agricultural workers' families from the municipality of Gameleira in the state of Pernambuco, Brazil. METHODS: The study population consisted of 46 harvesters' families, consisting of 225 individuals. The food intake of each individual was recorded on three different days by directly weighing the foods consumed. Hemoglobin was determined by fingerstick (HemoCue). This research used the probability of adequacy method to assess iron intake and the paired t test for comparing groups. The Spearman Mann-Whitney test estimated associations between the dietary variables and anemia. RESULTS: The prevalence of anemia was high in all ages groups and highest (67.6%) in children aged <5 years with a mean hemoglobin of 10.37 g/dL (±1.30 g/dL). Children aged <5 years had low percentage of iron intake adequacy (53.1%). Most of them consumed diets with low iron bioavailability (47.5%). Associations between the occurrence of anemia and dietary variables were significant for total iron (heme and nonheme), its bioavailabilities, and general meat intake. CONCLUSION: Inadequate dietary iron intake and inadequate intake of factors that facilitate iron absorption can be considered decisive for the occurrence of iron-deficiency anemia. Food insecurity occurs between family members, with some members being favored over others with regard to the intake of good dietary iron sources. .

OBJETIVO: Verificar a associação entre o consumo de ferro dietético e a ocorrência da anemia ferropriva em famílias de trabalhadores rurais do município de Gameleira, Pernambuco. MÉTODOS: A população foi composta por 46 famílias de trabalhadores de cana-de-açúcar, totalizando 225 indivíduos. Para cada indivíduo, foram realizados três inquéritos alimentares pelo método de registro alimentar por pesagem direta dos alimentos e dosagem de hemoglobina por meio do equipamento Hemocue. Utilizou-se o método da adequação aparente para avaliar a ingestão de ferro, e o teste t pareado na comparação entre grupos de indivíduos. Para estimar associações entre variáveis dietéticas e anemia, foi utilizado o teste de Mann-Whitney. RESULTADOS: A prevalência de anemia foi elevada em todas as faixas etárias, sendo maior (67,6%) no grupo de crianças com menos de 5 anos de idade, com média de hemoglobina de 10,37 g/dL (±1,30 g/dL). Na análise da adequação aparente, as crianças menores de 5 anos apresentaram baixo percentual de adequação (53,1%). A maioria delas apresentou um percentual elevado de dieta com baixa biodisponibilidade de ferro (47,5%). As associações entre a ocorrência de anemia e as variáveis dietéticas mostraram-se estatisticamente significantes para ferro total (heme e não heme), suas biodisponibilidades e consumo de carnes em geral. CONCLUSÃO: A inadequação do consumo de ferro dietético e dos fatores facilitadores da sua absorção pode ser considerada determinante para a ocorrência da anemia ferropriva. As famílias vivenciam insegurança alimentar intrafamiliar, com discriminação do consumo de alimentos fontes de ferro entre seus membros. .

Elementos traço e complicações obstétricas na gestação na adolescência / Trace elements and obstetric complications in teenage pregnancy

Minerais estão relacionados com todas as etapas de crescimento e diferenciação celular. Quando a gestação coincide com a adolescência a demanda nutricional necessária para ótimo desenvolvimento e crescimento materno e fetal aumenta consideravelmente. Apesar de existirem muitos estudos sobre as funções destes micronutrientes, pouco se sabe sobre suas atuações no resultado da gestação. Este trabalho objetivou revisar na literatura o papel do cobre, ferro, e zinco no resultado da gestação, em especial de gestantes adolescentes, focando intercorrências como baixo peso ao nascer, partos pré-termo, pré-eclampsia, abortos, dentre outras complicações associadas à gestação na adolescência. Os estudos já realizados são limitados, há a necessidade de promovê-los em países em desenvolvimento, onde a deficiência de micronutrientes e intercorrências possuem altos índices. Os benefícios da suplementação de minerais na redução da prevalência de déficits e na melhora dos estoques maternos têm sido demonstrados, mas dados sobre os benefícios potenciais para o feto são pouco conclusivos.

Minerals are associated with all stages of growth and cellular differentiation. When gestation coincides with adolescence, the nutritional requirements for optimal development of the mother and fetus increase significantly. Although there are many studies on the function of micronutrients, little is known about their influence on pregnancy outcome. This work aimed to review studies that investigated the influence of copper, iron and zinc on pregnancy outcome, especially in teenagers, focusing on intercurrences such as low birth weight, preterm births, pre-eclampsia, miscarriages and other complications associated with teenage pregnancy. There are only a few studies on this topic and a need to promote them in developing countries, where high rates of micronutrient deficiencies and intercurrences are common. The efficacy of mineral supplementation in reducing deficiency rates and improving maternal reserves has been demonstrated but data on potential benefits for the fetus are not very conclusive.

Efetividade superior do esquema diário de suplementação de ferro em lactentes / Greater effectiveness of daily iron supplementation scheme in infants

Objetivo: Avaliar a efetividade de esquemas, diário e semanal, de suplementação profilática de ferro medicamentoso na prevenção da anemia ferropriva em lactentes não anêmicos. Métodos: Estudo populacional, prospectivo, de abordagem quantitativa com intervenção profilática, realizado no município de Viçosa, MG, em 2007/8. Foram selecionadas 103 crianças não anêmicas, entre seis e 18 meses de idade, correspondendo a 20,2 por cento das crianças cadastradas e atendidas pelas Equipes de Saúde da Família. As crianças foram divididas em dois grupos de suplementação: dosagem diária recomendada pela Sociedade Brasileira de Pediatria (grupo 1, n=34) e dosagem semanal preconizada pelo Ministério da Saúde (grupo 2, n=69). As avaliações ocorreram no início do estudo e após seis meses, sendo realizadas dosagem de hemoglobina (ß-hemoglobinômetro portátil), avaliação antropométrica e dietética, e aplicação de questionário socioeconômico. Os indicadores de impacto utilizados foram a prevalência de anemia, variação de hemoglobina, adesão e efeitos adversos aos suplementos. Resultados: Os grupos se mostraram homogêneos quanto às variáveis socioeconômicas, biológicas e de saúde anteriores à intervenção. Após seis meses de suplementação, observaram-se maiores médias de hemoglobina no grupo 1 em relação ao grupo 2, (11,66; DP=1,25 e 10,95; DP=1,41, respectivamente, p=0,015); além de menores prevalências de anemia (20,6 por cento e 43,5 por cento, respectivamente, p=0,04). Apenas o tempo de suplementação influenciou na anemia grave (p=0,009). Não foram encontradas diferenças estatisticamente significantes para as variáveis adesão ao suplemento e efeitos adversos. Conclusões: A dosagem diária recomendada pela Sociedade Brasileira de Pediatria mostrou-se mais efetiva na prevenção da anemia em lactentes, quando comparada à dosagem utilizada pelo Ministério da Saúde. A dosagem semanal recomendada pelo programa do governo brasileiro precisa ser reavaliada para aumentar...

Adequação do consumo de ferro por gestantes e mulheres em idadefértil atendidas em um serviço de pré-natal / Adequacy of iron consumption in pregnant and fertile women assisted by a prenatal service / Adecuación del consumo de hierro por mujeres embarazadas y fértiles asistidaspor un servicio prenatal

Anemia por carência alimentar de ferro é o problema nutricional mais prevalente em nível de saúde coletiva e afeta crianças e mulheresem idade reprodutiva, em especial as gestantes. Este estudo avaliou o consumo de alimentos fontes de ferro, naturais e fortificados, e a adequaçãode energia e nutrientes de mulheres em idade reprodutiva, gestantes ou não. Desenvolveu-se um estudo transversal em maternidade social dacidade de São Paulo com 30 gestantes com 20 ou mais semanas de gestação e 30 mulheres em idade fértil. Recordatório de 24h e questionário de frequência de consumo alimentar foram usados para avaliar a prática alimentar. A maioria das mulheres tinha consumo diário de feijão efrequente (2-4 vezes/semana) de folhas verdes, carnes vermelhas e aves, fontes naturais de ferro. Entre os alimentos fortificados, destacou-se oconsumo diário de pães e frequente de biscoitos. O consumo diário de frutas cítricas, que favorece a absorção do ferro, foi referido apenas porcerca de um quarto das não-gestantes e metade das gestantes. Elevado percentual de mulheres referiu consumo diário de inibidores da absorção de ferro.Adequação do consumo de cálcio foi baixa para os dois grupos, porém as gestantes também apresentaram baixo percentual de adequação deferro e folato. Os resultados evidenciam a importância da orientação nutricional nos programas de saúde da mulher, em especial às gestantes.

Iron-deficiency anemia is the most prevalent collective nutritional problem and affects children and fertile women and especiallypregnant women. This study evaluated food consumption of iron sources, natural and fortified, and the adequacy of energy and nutrients forfertile women, pregnant or not. We did a transversal study of social maternity of the city of São Paulo with 30 pregnant women with 20 or moregestation weeks and 30 fertile women. A 24h note form and a questionnaire for food consumption frequency were used to evaluate alimentarypractices. Most women reported daily beans’ consumption and frequent consumption of green leaves (2-4 times per week), red meats and poultry,natural sources of iron. Regarding fortified foods, frequent daily bread and cookie consumption was observed. Daily consumption of citric fruits,which favors the absorption of iron, was reported only by about a quarter of non-pregnant women and half the pregnant women. A high percentile ofwomen reported daily consumption of iron absorption inhibitors. Adequacy of calcium consumption was low for the two groups, but pregnantwomen also presented a low percentage of iron and folate. Results show the importance of nutritional instruction in women health programs,especial concerning pregnant women.

La anemia por deficiencia de hierro es el problema alimenticio colectivo más frecuente que afecta a niños y a mujeres fértiles y especialmentea mujeres embarazadas. Este estudio evaluó el consumo de alimentos de las fuentes de hierro, natural y fortificado, y la adecuaciónde la energía y de los nutrientes para las mujeres fértiles, embarazadas o no. Hicimos un estudio transversal de maternidad social en la ciudad deSão Paulo con 30 mujeres embarazadas con 20 o más semanas de gestación y 30 mujeres fértiles. Un formulario de registro 24h y un cuestionarioacerca de la frecuencia de consumo de alimentos fueron utilizados para evaluar prácticas alimenticias. La mayoría de las mujeres consumíadiariamente habas e frecuentemente hortalizas (2-4 veces por semana), carnes rojas y las aves de corral, fuentes naturales de hierro. Respectoa los alimentos fortificados, es frecuente el pan y el consumo de galletas. El consumo diario de frutas cítricas, que favorecen la absorción delhierro, fue relatado solamente por alrededor un cuarto de mujeres no embarazadas y la mitad de las mujeres embarazadas. Un alto porcentaje de mujeresrelató el consumo diario de inhibidores de la absorción del hierro. La adecuación del consumo del calcio es baja para los dos grupos, pero lasmujeres embarazadas también presentan un porcentaje bajo del hierro y del folato. Los resultados demuestran la importancia de la instrucciónalimenticia en programas de salud de las mujeres, especial referente a mujeres embarazadas.

Nutritional assessment of lactating women in Shiraz in relation to recommended dietary allowances

Tables of food frequency and nutrient intake were created for a r and om sample of 266 lactating women from different areas of Shiraz city, Islamic Republic of Iran. Women were interviewed at home in 1998 and nutrient intake was calculated from a food frequency questionnaire and 24-hour dietary recall. On average, daily consumption was 2 servings of dairy foods, 4 of bread/rice, 2 of vegetables and 3 of fruits; weekly consumption was 5 servings of meat and 3 of legumes. Estimated average daily energy intake was 2250 kcal. Protein and vitamin C intake were significantly higher than United States recommended dietary allowances [RDA], while iron and calcium intake were significantly lower. Protein intake was insufficient among 9.0% of women, calcium in 35.7%, iron in 18.8% and vitamin C in 15.0%

Iron deficiency anaemia-an old enemy

Anaemia has remained a widespread public health problem in countries of the Eastern Mediterranean Region. Prevalence figures vary from a low of 17% to a high of over 70% among preschool children; from 14% to 42% among adolescents and from 11% to over 40% among women of childbearing age. Although the prevalence of anaemia has often been used as a proxy indicator for iron deficiency anaemia, this approach is not valid in settings where the etiology of anaemia is complex or unknown or where other micronutrient deficiencies of folate, vitamin B12 and vitamin A can co-exist. An integrated, multifactorial and multisectoral approach has to be adopted comprising targeted interventions to provide iron supplements to especially vulnerable segments of the population, in particular pregnant women; food-based approaches to increase iron intake through food fortification and dietary diversification; and other measures combined with iron interventions where other causes of anaemia are prevalent

Validation of the integration of health belief model and planned behavior theory / 北京大学学报(医学版)

Objective:To establish and validate a new model of health belief model(HBM) combined with theory of planned behavior(TPB).Methods:Path analysis was applied to set up a new model predicting iron-fortified soy sauce consumption behavior using baseline survey data among women in rural and urban areas in Beijing,and the model was validated in follow-up survey.Results:It was proved that health values had powerful direct effect on behavior identity and had relatively strong direct effect on attitudes towards behavior;behavior identity had strong effect on behavior barriers,mostly in a direct way,and on behavior intention in a direct or indirect way;control belief was an important external factor influencing behavior intention;behavior intention was the most direct and most important one of factors influencing actual behavior;and convenience to buy was an important external factor influencing actual beha-vior.Conclusion:The integrated model of TPB and HBM explains behavior better and may be attempted in other similar researches.