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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).
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