Anemia in relation to body mass index and waist circumference among Chinese women

Extent: 3 p.BACKGROUND: This study aimed to investigate the relationship of anemia and body mass index among adult women in Jiangsu Province, China. Data were collected in a sub-national cross-sectional survey, and 1,537 women aged 20 years and above were included in the analyses. Subjects were classified by body mass index (BMI) categories as underweight, normal weight, overweight and obese according to the Chinese standard. Central obesity was defined as a waist circumference ≥ 80 cm. Anemia was defined as hemoglobin concentration < 12 g/dl. Prevalence ratios (PRs) of the relationship between anemia and BMI or waist circumference were calculated using Poisson regression. FINDINGS: Overall, 31.1% of the Chinese women were anemic. The prevalence of overweight, obesity and central obesity was 34.2%, 5.8% and 36.2%, respectively. The obese group had the highest concentrations of haemoglobin compared with other BMI groups. After adjustment for confounders, overweight and obese women had a lower PR for anemia (PR: 0.72, 95% CI: 0.62-0.89; PR: 0.59, 95% CI: 0.43-0.79). Central obesity was inversely associated with anemia. CONCLUSION: In this Chinese population, women with overweight/obesity or central obesity were less likely to be anemic as compared to normal weight women. No measures are required currently to target anemia specifically for overweight and obese people in China.Yu Qin, Alida Melse-Boonstra, Xiaoqun Pan, Baojun Yuan, Yue Dai, Jinkou Zhao, Michael B. Zimmermann, Frans J. Kok, Minghao Zhou and Zumin Sh

WITHIN-YEAR CHANGES IN HOUSEHOLDS’ ACCESS TO FOOD IN A UNIMODAL CLIMATE RURAL AREA OF BENIN REPUBLIC

Food insecurity is a concern in Benin not only because of seasonal variations in food availability but also the limited access to food experienced by some households. This study analysed the effect of seasonality on household access to food in a rural area of Benin characterised by a unimodal climate. One hundred and seventy volunteer households were recruited in the study area and monitored during the increased, intermediate and decreased (or lean) food availability periods (FAPs) from September 2018 to July 2019. Socio-demographic data were collected during individual interviews with household heads and used to describe the sample. Data on households’ access to food were collected on a bimonthly basis using a food consumption score (FCS) questionnaire. Food consumption scores were used to divide the households into three food consumption groups (FCGs): poor (FCS ≤ 21), borderline (21.5 ≤ FCS ≤ 35) and acceptable (FCS > 35). Generalized estimate equation (GEE) was used to compare FCGs among the repeated measures. The principal occupation of household heads was agriculture (72.9%) and the mean household size was 6.8±3.6 persons. The FCS ranged from 59.7±15.5 to 69.4±15.9. The lowest FCS was recorded in September (intermediate FAP) whereas the highest was obtained in May (lean FAP). All the households (100%) had acceptable food consumption during the increased FAP (November to January). The proportion of households with acceptable food consumption was 91% in September and decreased from 99% in March to 90% in July, that is, during the lean FAP. On the other hand, the proportion of households with borderline and poor food consumption was 9% in September and increased from 1% in March to 10% in July. The proportions of FCGs obtained in November, January, March and May significantly differed from that of July (p<0.05) whereas there was no significant difference between September and July. Households had frequent (5 to 7 days/week) and regular (all months) intakes of starchy staples, vegetables, meats and fish. In contrast, the frequency of pulses and fruits consumption varied between months. In conclusion, the lean FAP (May to July) and the following intermediate FAP (September) are characterised by a deterioration in households’ access to food. The variation of pulses and fruits consumption throughout the year is the result of food insecurity and constitutes a major risk factor for micronutrient malnutrition for household members

WITHIN-YEAR CHANGES IN HOUSEHOLDS’ ACCESS TO FOOD IN A UNIMODAL CLIMATE RURAL AREA OF BENIN REPUBLIC

Food insecurity is a concern in Benin not only because of seasonal variations in food availability but also the limited access to food experienced by some households. This study analysed the effect of seasonality on household access to food in a rural area of Benin characterised by a unimodal climate. One hundred and seventy volunteer households were recruited in the study area and monitored during the increased, intermediate and decreased (or lean) food availability periods (FAPs) from September 2018 to July 2019. Socio-demographic data were collected during individual interviews with household heads and used to describe the sample. Data on households’ access to food were collected on a bimonthly basis using a food consumption score (FCS) questionnaire. Food consumption scores were used to divide the households into three food consumption groups (FCGs): poor (FCS ≤ 21), borderline (21.5 ≤ FCS ≤ 35) and acceptable (FCS > 35). Generalized estimate equation (GEE) was used to compare FCGs among the repeated measures. The principal occupation of household heads was agriculture (72.9%) and the mean household size was 6.8±3.6 persons. The FCS ranged from 59.7±15.5 to 69.4±15.9. The lowest FCS was recorded in September (intermediate FAP) whereas the highest was obtained in May (lean FAP). All the households (100%) had acceptable food consumption during the increased FAP (November to January). The proportion of households with acceptable food consumption was 91% in September and decreased from 99% in March to 90% in July, that is, during the lean FAP. On the other hand, the proportion of households with borderline and poor food consumption was 9% in September and increased from 1% in March to 10% in July. The proportions of FCGs obtained in November, January, March and May significantly differed from that of July (p<0.05) whereas there was no significant difference between September and July. Households had frequent (5 to 7 days/week) and regular (all months) intakes of starchy staples, vegetables, meats and fish. In contrast, the frequency of pulses and fruits consumption varied between months. In conclusion, the lean FAP (May to July) and the following intermediate FAP (September) are characterised by a deterioration in households’ access to food. The variation of pulses and fruits consumption throughout the year is the result of food insecurity and constitutes a major risk factor for micronutrient malnutrition for household members

Clin Infect Dis

Background: In sub-Saharan Africa, malaria in the first half of pregnancy is harmful for both the mother and her foetus. However, malaria in the 1st trimester of pregnancy, when women are usually not protected against malaria, has been little investigated. For the first time, we assessed the effects of malaria in the 1st trimester on maternal and birth outcomes using a preconceptional study design. Methods: From June 2014 to March 2017, 1214 women of reproductive age were recruited and followed monthly until 411 became pregnant. Pregnant women were then followed from 5-6 weeks of gestation until delivery. Path analysis was used to assess the direct effect (i.e., not mediated by malaria in the 2nd or 3rd trimester) of malaria in the 1st trimester on maternal anaemia and poor birth outcomes. The cumulative effect of infections during pregnancy on the same outcomes was also evaluated. Results: The prevalence of malaria infection in the 1st trimester was 21.8%. Malaria in the 1st trimester was significantly associated with maternal anaemia in the 3rd trimester (adjusted odds ratio [aOR]: 2.25, 95% CI 1.11, 4.55). While we did not evidence any direct effect of 1st trimester malaria infections on birth outcomes, their association with infections later in pregnancy tended to increase the risk of low birthweight. Conclusions : alaria infections in the 1st trimester were highly prevalent and have deleterious effects on maternal anaemia. They highlight the need for additional preventive measures starting in early pregnancy, or even before conception

Changes in women's dietary diversity before and during pregnancy in Southern Benin

International audienceDietary diversity before and during pregnancy is crucial to ensure optimal foetal health and development. We carried out a cohort study of women of reproductive age living in the Sô‐Ava and Abomey‐Calavi districts (Southern Benin) to investigate women's changes in dietary diversity and identify their determinants both before and during pregnancy. Nonpregnant women were enrolled (n = 1214) and followed up monthly until they became pregnant (n = 316), then every 3 months during pregnancy. One 24‐hr dietary recall was administered before conception and during each trimester of pregnancy. Women's dietary diversity scores (WDDS) were computed, defined as the number of food groups out of a list of 10 consumed by the women during the past 24 hr. The analysis included 234 women who had complete data. Mixed‐effects linear regression models were used to examine changes in the WDDS over the entire follow‐up, while controlling for the season, subdistrict, socio‐demographic, and economic factors. At preconception, the mean WDDS was low (4.3 ± 1.1 food groups), and the diet was mainly composed of cereals, oils, vegetables, and fish. The mean WDDS did not change during pregnancy and was equally low at all trimesters. Parity and household wealth index were positively associated with the WDDS before and during pregnancy in the multivariate analysis. Additional research is needed to better understand perceptions of food consumption among populations, and more importantly, efforts must be made to encourage women and communities in Benin to improve the diversity of their diets before and during pregnancy

Simple food group diversity indicators predict micronutrient adequacy of women's diets in 5 diverse, resource-poor settings

Women of reproductive age living in resource-poor settings are at high risk of inadequate micronutrient intakes when diets lack diversity and are dominated by staple foods. Yet comparative information on diet quality is scarce and quantitative data on nutrient intakes is expensive and difficult to gather. We assessed the potential of simple indicators of dietary diversity, such as could be generated from large household surveys, to serve as proxy indicators of micronutrient adequacy for population-level assessment. We used 5 existing data sets (from Burkina Faso, Mali, Mozambique, Bangladesh, and the Philippines) with repeat 24-h recalls to construct 8 candidate food group diversity indicators (FGI) and to calculate the mean probability of adequacy (MPA) for 11 micronutrients. FGI varied in food group disaggregation and in minimum consumption required for a food group to count. There were large gaps between intakes and requirements across a range of micronutrients in each site. All 8 FGI were correlated with MPA in all sites; regression analysis confirmed that associations remained when controlling for energy intake. Assessment of dichotomous indicators through receiver-operating characteristic analysis showed moderate predictive strength for the best choice indicators, which varied by site. Simple FGI hold promise as proxy indicators of micronutrient adequacy. J. Nutr. 140: 2059S-2069S, 2010