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The effects of daily versus weekly folic acid supplementation on biochemical and functional status of reproductive age women in rural Guatemala.

机译:每天和每周补充叶酸对危地马拉农村地区育龄妇女的生化和功能状态的影响。

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Folic acid (FA) and other micronutrient deficiencies are significant public health problems in Guatemala, particularly in women of reproductive age. These deficiencies have several adverse effects on women and also have potential long-term consequences for their children if deficiencies occur during pregnancy. Wheat flour fortification has been implemented in Guatemala for many years, but it has little impact on rural and indigenous populations where the staple is corn rather than wheat. In that context, weekly FA plus other micronutrient supplementation is an attractive idea for reaching women in poor rural areas and in indigenous regions. There is, however, uncertainty about the efficacy of this regimen in comparison to daily supplementation. This randomized controlled trial (RCT) was conducted to (1) investigate the efficacy of weekly versus daily FA plus other micronutrients supplementation on micronutrient status and depressive symptoms in women of childbearing age and (2) examine the possible interaction of iron with zinc. The RCT involved random assignment of 459 women to 4 groups that received weekly (5000 or 2800mug) or daily (400 or 200mug) FA plus iron, zinc and vitamin B12 for 12 weeks. Generalized linear regression models were used to assess treatment effects. Our findings showed that weekly FA plus other micronutrients are as efficacious as daily supplementation in improving folate metabolic status and depressive symptoms. However, daily is more efficacious than weekly supplementation in improving serum ferritin and vitamin B12. No differences were found among the four groups in hemoglobin (Hb) or serum zinc after the intervention, but Hb improved significantly for anemic women. The addition of zinc did not affect the efficacy of supplements on iron status, but had no impact on zinc status. Findings from our study suggest that weekly FA plus other micronutrient supplementation should be considered as a possible intervention for improving the nutritional status and mental health of women not reached by food fortification interventions. However, other approaches need to be considered to alleviate zinc deficiency.
机译:叶酸(FA)和其他微量营养素缺乏症是危地马拉的重要公共卫生问题,尤其是在育龄妇女中。这些缺陷对妇女有若干不利影响,如果在怀孕期间发生缺陷,也会对她们的孩子造成长期的潜在后果。危地马拉已经实施了小麦粉强化,但对以玉米而不是小麦为主食的农村和土著人口影响不大。在这种情况下,每周一次的脂肪酸和其他微量营养素补充是吸引贫困农村地区和土著地区妇女的诱人想法。但是,与每日补充相比,该方案的疗效尚不确定。进行这项随机对照试验(RCT),以(1)研究每周FA和每日FA以及其他微量营养素补充剂对育龄妇女微量营养素状态和抑郁症状的功效,以及(2)检查铁与锌之间可能的相互作用。 RCT涉及将459名妇女随机分配到4个小组,每周(5000或2800马克)或每天(400或200马克)FA加铁,锌和维生素B12连续12周。广义线性回归模型用于评估治疗效果。我们的研究结果表明,每周FA和其他微量营养素在改善叶酸代谢状态和抑郁症状方面与每日补充一样有效。但是,每天服用比每周补充在改善血清铁蛋白和维生素B12方面更为有效。干预后,四组的血红蛋白(Hb)或血清锌无差异,但贫血女性的Hb明显改善。锌的添加不影响补铁对铁状态的功效,但对锌状态没有影响。我们的研究结果表明,每周FA和其他微量营养素补充应被视为改善食品强化干预措施无法达到的妇女营养状况和心理健康的一项可能干预措施。但是,需要考虑其他方法来缓解锌缺乏症。

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