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Using data from the national micronutrients survey 2011–2012, the present study explored the status of subclinical vitamin A nutrition and the underlying determinants in the Bangladeshi population.
A nationwide cross-sectional study.
The survey covered 150 clusters; fifty in each of rural, urban and slum strata.
Three population groups: (i) pre-school age children (6–59 months; PSAC); (ii) school age children (6–14 years; SAC); and (iii) non-pregnant non-lactating women (15–49 years; NPNLW).
National prevalence of subclinical vitamin A deficiency was 20·5, 20·8 and 5·3 % in PSAC, SAC and NPNLW, respectively. Slum populations had higher prevalence compared with urban (PSAC: 38·1 v. 21·2 %, P<0·001; SAC: 27·1 v. 22·1 %, P=0·004; NPNLW: 6·8 v. 4·7 %, P=0·01). Dietary vitamin A met up to 27·1–46·0 % of daily needs; plant-source vitamin A constituted 73–87 % of the intakes. Multivariable regression analyses showed that higher consumption of animal foods was associated with higher retinol status in PSAC (β=0·27; P<0·001); and living in urban area was related to higher retinol status in NPNLW (β=0·08, P=0·004) and PSAC (β=0·11, P=0·04). Increased intake of leafy vegetables was associated with lower retinol status in SAC (β=−0·08, P=0·02). Vitamin A supplementation in PSAC did not significantly influence serum retinol within one year post-supplementation (P>0·05 for differences in β between <3 months v. 3–6 months, 6–9 months and 9–12 months).
Prevalence of subclinical vitamin A deficiency was high in children in Bangladesh. Intakes of animal-source foods and leafy vegetables were associated with higher and lower retinol status, respectively. Increased food diversity through animal-source foods is required.
Using data from the national micronutrients survey 2011–2012, the present study explored the determinants of Fe status and Hb levels in Bangladesh with a particular focus on groundwater Fe.
Cross-sectional study conducted at the nationwide scale.
The survey was conducted in 150 clusters, fifty in each of the three strata of rural, urban and slum.
Three population groups: pre-school age children (6–59 months; PSAC), school age children (6–14 years; SAC) and non-pregnant non-lactating women (15–49 years; NPNLW).
National prevalence of Fe deficiency was 10·7 %, 7·1 % and 3·9–9·5 % in PSAC, NPNLW and SAC, respectively. Prevalence of anaemia was 33·1 % (PSAC), 26·0 % (NPNLW) and 17·1–19·1 % (SAC). Multivariate regression analyses showed that the area with ‘predominantly high groundwater Fe’ was a determinant of higher serum ferritin levels in NPNLW (standardized β=0·19; P=0·03), SAC (standardized β=0·22; P=0·01) and PSAC (standardized β=0·20; P=0·03). This area also determined higher levels of Hb in PSAC (standardized β=0·14; P=0·01).
National prevalence of Fe deficiency in Bangladesh is low, contrary to the widely held assumption. High Fe level in groundwater is associated with higher Fe status (all populations) and higher Hb level (PSAC).
We quantified the prevalence of vitamin D status in 6–24-month-old underweight and normal-weight children and identified the socio-economic and dietary predictors for status.
Cross-sectional, baseline data from a nutritional intervention study were analysed. Multinomial logistic regression was used to estimate the odds of being vitamin D deficient or insufficient with the reference being vitamin D sufficient.
Urban slum area of Mirpur field site, Dhaka, Bangladesh.
Underweight (weight-for-age Z-score <−2·00) and normal-weight (weight-for-age Z-score ≥−1·00) children aged 6–24 months.
Among 468 underweight children, 23·1 % were sufficient, 42·3 % insufficient, 31·2 % deficient and 3·4 % severely vitamin D deficient. Among 445 normal-weight children, 14·8 % were sufficient, 39·6 % insufficient and 40·0 % deficient and 5·6 % severely deficient. With adjusted multinominal regression analysis, risk factors (OR (95 % CI)) for vitamin D deficiency in underweight children were: older age group (18–24 months old; 2·9 (1·5–5·7)); measurement of vitamin D status during winter (3·0 (1·4–6·4)) and spring (6·9 (3·0–16·1)); and maternal education (≥6 years of institutional education; 2·2 (1·0–4·9)). In normal-weight children, older age group (3·6 (1·2–10·6)) and living in the richest quintile (3·7 (1·1–12·5)) were found to be significantly associated with vitamin D insufficiency.
The study demonstrates a significant burden of vitamin D insufficiency and deficiency in both underweight and normal-weight children <2 years of age from an urban slum of Bangladesh. Identification of risk factors may help in mitigating the important burden in such children.
To investigate the prevalence of vitamin A deficiency (VAD) among pregnant women in rural Bangladesh, and examine the relationship between various factors and vitamin A status.
Community Nutrition Promoter (CNP) centres in Kapasia sub-district of Gazipur district, Bangladesh.
A cross-sectional study.
Subjects and methods
Two hundred women, aged 18–39 years, in their second or third trimester of pregnancy were selected from seventeen CNP centres in four unions of Kapasia sub-district where they usually visit for antenatal care. Various socio-economic, personal and pregnancy-related information, dietary intake of vitamin A and mid-upper arm circumference (MUAC) data were collected. Serum retinol (vitamin A) concentration was determined.
More than half (51 %) of the pregnant women had low vitamin A status (serum retinol <1·05 μmol/l) with 18·5 % having VAD (serum retinol <0·70 μmol/l). Fifty-three per cent of the women’s vitamin A intake was less than the recommended dietary allowance. By multiple regression analysis, MUAC, per-capita expenditure on food and wealth index were found to have significant independent positive relationship with serum retinol concentration, while gestational age of the pregnant women had a negative relationship. The overall F-ratio (10·3) was highly significant (P = 0·0001), the adjusted R2 was 0·18 (multiple R = 0·45).
VAD is highly prevalent among rural pregnant women in Bangladesh. Gestational age, nutritional status, per-capita expenditure on food and wealth index appear to be important in influencing the vitamin A status of these women. An appropriate intervention is warranted in order to improve the vitamin A status.
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