Risk factors for anemia and micronutrient deficiencies among women of reproductive age—the impact of the wheat flour fortification program in Uzbekistan

Nutrients

Volumn 12, Issue 3, 2020, Pages

  Petry, Nicolai ^a   Nizamov, Fakhriddin ^b   Woodruff, Bradley A ^a   Ishmakova, Regina ^c   Komilov, Jasur ^d   Wegmüller, Rita ^a   Wirth, James P ^a   Arifdjanova, Diyora ^b   Guo, Sufang ^b   Rohner, Fabian ^a  

^a Ground Work   (Switzerland)

^b UNICEF   (United States)

^c Vitamed Clinic LLC   (Uzbekistan)

^d MedStandart LLC ^*  (Uzbekistan)

Author keywords

Anemia; Folate deficiency; Folic acid; Iron; Iron deficiency; Uzbekistan; Vitamin A insufficiency; Wheat flour fortification; Women of reproductive age

Indexed keywords

C REACTIVE PROTEIN; CYANOCOBALAMIN; FERRITIN; FOLIC ACID; HEMOGLOBIN; IRON; OROSOMUCOID; RETINOL; TRACE ELEMENT;

ADOLESCENT; ADULT; ANEMIA; ARTICLE; BIOFORTIFICATION; BODY MASS; BREAST FEEDING; FEMALE; FOLIC ACID DEFICIENCY; FOOD INTAKE; HEMOGLOBIN BLOOD LEVEL; HUMAN; IRON DEFICIENCY; IRON INTAKE; MAJOR CLINICAL STUDY; NUTRITIONAL DEFICIENCY; QUANTITATIVE ANALYSIS; RETINOL DEFICIENCY; RISK FACTOR; RISK REDUCTION; UNDERWEIGHT; UZBEKISTAN; WHEAT FLOUR; EATING; FLOUR; FORTIFIED FOOD; IRON DEFICIENCY ANEMIA; MIDDLE AGED; NUTRITION; NUTRITIONAL STATUS; REPRODUCTION; RISK; YOUNG ADULT;

ADOLESCENT; ADULT; ANEMIA; ANEMIA, IRON-DEFICIENCY; EATING; FEMALE; FLOUR; FOLIC ACID DEFICIENCY; FOOD, FORTIFIED; HUMANS; MICRONUTRIENTS; MIDDLE AGED; NUTRITIONAL PHYSIOLOGICAL PHENOMENA; NUTRITIONAL STATUS; REPRODUCTION; RISK; UZBEKISTAN; VITAMIN A DEFICIENCY; YOUNG ADULT;

EID: 85081198476     PISSN: None     EISSN: 20726643     Source Type: Journal    
DOI: 10.3390/nu12030714     Document Type: Article

References (35)

1. Global Burden of Disease Study Collaborators 2013; Vos, T.; Allen, C.; Arora, M.; Barber, R.M.; Bhutta, Z.A.; Brown, A.; Liang, X.; Kawashima, T.; Coggeshall, M.; et al. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015, 386, 743–800. [CrossRef]
2. Rogers, L.M.; Cordero, A.M.; Pfeiffer, C.M.; Hausman, D.B.; Tsang, B.L.; De-Regil, L.M.; Rosenthal, J.; Razzaghi, H.; Wong, E.C.; Bailey, L.B.; et al. Global folate status in women of reproductive age: A systematic review with emphasis on methodological issues. Ann. N. Y. Acad. Sci. 2018. [CrossRef] [PubMed]
3. De-Regil, L.M.; Peña-Rosas, J.P.; Fernández-Gaxiola, A.C.; Rayco-Solon, P. Effects and safety of periconceptional oral folate supplementation for preventing birth defects. Cochrane Database Syst. Rev. 2015. [CrossRef] [PubMed]
4. Keats, E.; Haider, B.; Tam, E.; Bhutta, Z. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database Syst. Rev. 2019. [CrossRef] [PubMed]
5. Van der Spoel, E.; Rozing, M.P.; Houwing-Duistermaat, J.J.; Slagboom, P.E.; Beekman, M.; de Craen, A.J.; Westendorp, R.; van Heemst, D. Optimal Serum and Red Blood Cell Folate Conentration in Women of Reproductive Age for Prevention of Neural Tube Defects; World Health Organization: Geneva, Switzerland, 2015. [CrossRef]
6. Wald, N.J.; Morris, J.K.; Blakemore, C. Public health failure in the prevention of neural tube defects: Time to abandon the tolerable upper intake level of folate. Public Health Rev. 2018. [CrossRef] [PubMed]
7. Keats, E.C.; Neufeld, L.M.; Garrett, G.S.; Mbuya, M.N.N.; Bhutta, Z.A. Improved micronutrient status and health outcomes in low-and middle-income countries following large-scale fortification: Evidence from a systematic review and meta-Analysis. Am. J. Clin. Nutr. 2019. [CrossRef] [PubMed]
8. Kancherla, V.; Wagh, K.; Johnson, Q.; Oakley, G.P. A 2017 global update on folic acid-preventable spina bifida and anencephaly. Birth Defects Res. 2018. [CrossRef] [PubMed]
9. Hurrell, R.; Ranum, P.; de Pee, S.; Biebinger, R.; Hulthen, L.; Johnson, Q.; Lynch, S. Revised recommendations for iron fortification of wheat flour and an evaluation of the expected impact of current national wheat flour fortification programs. Food Nutr. Bull. 2010, 31, S7–S21. [CrossRef] [PubMed]
10. Hurrell, R.; Bothwell, T.; Cook, J.D.; Dary, O.; Davidsson, L.; Fairweather-Tait, S.; Hallberg, L.; Lynch, S.; Rosado, J.; Whittaker, P.; et al. The usefulness of elemental iron for cereal flour fortification: A SUSTAIN Task Force report. Sharing United States Technology to Aid in the Improvement of Nutrition. Nutr. Rev. 2002, 60, 391–406. [CrossRef] [PubMed]
11. Wang, C.Y.; Babitt, J.L. Hepcidin regulation in the anemia of inflammation. Curr. Opin. Hematol. 2016. [CrossRef] [PubMed]
12. Ministry of Health Uzbekistan, UNICEF, GroundWork. Uzbekistan Nutrition Survey 2017. 2019. Available online: http://groundworkhealth.org/wp-content/uploads/2019/11/Uzbekistan_Nutrition_Survey_en_web. pdf (accessed on 10 January 2020).
13. Hund, L.; Northrop-Clewes, C.A.; Nazario, R.; Suleymanova, D.; Mirzoyan, L.; Irisova, M.; Pagano, M.; Valadez, J.J. A novel approach to evaluating the iron and folate status of women of reproductive age in Uzbekistan after 3 years of flour fortification with micronutrients. PLoS ONE 2013. [CrossRef] [PubMed]
14. Vitamin-Mineral Mixture for the Enrichment of Wheat Flour for Baking—O’z DST 1098:2005; State Standard of the Republic of Uzbekistan: Tashkent, Uzbekistan, 2005.
15. Vitamin-Mineral Mixture for the Enrichment of Wheat Flour Baking—O’z DSt 3221:2017; State Standard of the Republic of Uzbekistan: Tashkent, Uzbekistan, 2017.
16. World Health Organization. WHO STEPS Surveillance Manual: The WHO STEPwise Approach to Non-Communicable Disease Risk Factor Surveillance; World Health Organization: Geneva, Switzerland, 2017.
17. World Health Organization. Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Vitamin and Mineral Nutrition Information System (WHO/NMH/NHD/MNM/11.1); World Health Organization: Geneva, Switzerland, 2011.
18. Namaste, S.M.; Rohner, F.; Huang, J.; Bhushan, N.L.; Flores-Ayala, R.; Kupka, R.; Northrop-Clewes, C.A.; Mei, Z.; Rawat, R.; Raiten, D.J.; et al. Approaches to understand and adjust ferritin concentrations in the presence of inflammation in preschool-aged children and women of reproductive age: A multi-country analysis. Am. J. Clin. Nutr. 2017, 106, 359S–371S. [PubMed]
19. World Health Organization/Centers for Disease Control and Prevention. Assessing the Iron Status of a Population, 2nd ed.; World Health Organization: Geneva, Switzerland, 2007.
20. World Health Organization. Serum Retinol Concentrations for Determining the Prevalence of Vitamin A Deficiency in populations. In Vitamin and Mineral Nutrition Information System; World Health Organization: Geneva, Switzerland, 2011.
21. Tanumihardjo, S.A. Biomarkers of vitamin A status: What do they mean? World Health Organization: Report. Priorities in Assessment of Vitamin A and Iron Status in Populations. Biomarkers 2012, 2, 2.
22. Larson, L.M.; Namaste, S.M.; Williams, A.M.; Engle-Stone, R.; Addo, O.Y.; Suchdev, P.S.; Wirth, J.P.; Temple, V.; Serdula, M.; Northrop-Clewes, C.A. Adjusting retinol-binding protein concentrations for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Am. J. Clin. Nutr. 2017, 106, 390S–401S. [CrossRef] [PubMed]
23. Allen, L.; DeBenoist, B.; Dary, O.; Hurrell, R. Guidelines on Food Fortification with Micronutrients; World Health Organization: Geneva, Switzerland, 2006.
24. Thurnham, D.I.; McCabe, G.P.; Northrop-Clewes, C.A.; Nestel, P. Effects of subclinical infection on plasma retinol concentrations and assessment of prevalence of vitamin a deficiency: Meta-analysis. Lancet 2003. [CrossRef]
25. Shetty, P.S.; James, W.P.T. Body Mass Index: A Measure of Chronic Energy Deficiency in Adults; Food and Agriculture Organization: Rome, Italy, 1994.
26. Filmer, D.; Pritchett, L.H. Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India. Demography 2001, 38, 115–132. [PubMed]
27. Vyas, S.; Kumaranayake, L. Constructing socio-economic status indices: How to use principal components analysis. Health Policy Plan. 2006. [CrossRef]
28. Food and Agriculture Organization. Human Energy Requirements: Report of a Joint FAO/WHO/UNU Expert Consultation; Food and Agriculture Organization: Rome, Italy, 2001.
29. Weisell, R.; Dop, M. The Adult Male Equivalent concept and its application to Household Consumption and Expenditures Surveys (HCES). Food Nutr. Bull. 2012. [CrossRef] [PubMed]
30. Food and Agriculture Organization; World Health Organization. Vitamin and Mineral Requirements in Human Nutrition, 2nd ed.; World Health Organization: Geneva, Switzerland, 2004; pp. 1–20.
31. World Health Organization/UNICEF Joint Monitoring Programme for Water Supply Sanitation and Hygiene (JMP). In JMP Methodology—2017 Update & SDG Baselines; World Health Organization: Geneva, Switzerland, 2017.
32. Food and Agriculture Organization; U.S. Agency for International Development-Food and Nutrition Technical Assistance. Minimum Dietary Diversity for Women—A Guide to Measurement; Food and Agriculture Organization: Rome, Italy, 2018.
33. Chen, M.Y.; Rose, C.E.; Qi, Y.P.; Williams, J.L.; Yeung, L.F.; Berry, R.J.; Hao, L.; Cannon, M.J.; Crider, K.S. Defining the plasma folate concentration associated with the red blood cell folate concentration threshold for optimal neural tube defects prevention: A population-based, randomized trial of folic acid supplementation. Am. J. Clin. Nutr. 2019. [CrossRef] [PubMed]
34. World Health Organization. Serum and Red Blood Cell Folate Concentrations for Assessing Folate Status in Populations; World Health Organization: Geneva, Switzerland, 2015; Available online: https://apps. who.int/iris/bitstream/handle/10665/75584/WHO_NMH_NHD_EPG_12.1_eng.pdf;sequence=1 (accessed on 10 January 2020).
35. Kassebaum, N.J.; Jasrasaria, R.; Naghavi, M.; Wulf, S.K.; Johns, N.; Lozano, R.; Regan, M.; Chou, D.P.; Pullan, R.L.; Flaxman, S.R.; et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood 2014. [CrossRef]