Folate deficiency in women of reproductive age in nine administrative regions of Ethiopia: an emerging public health problem

Objective: To investigate the country-wide extent of folate deficiency and risk factors in Ethiopian women. Design: Cross-sectional study. Methods: Multistage cluster sampling and systematic sampling were used to select 970 women aged 15 to 49 years from nine accessible regions of Ethiopia. Demographic and health information was collected via questionnaire. Biological samples were collected by medical technologists. Outcome measures: demographic and health variables, food frequency, haemoglobin status, ferritin status and folate status. Results: Mean ± SD plasma folate was 5.57 ± 3.84 ng/mL. Forty-six per cent of women had severe folate deficiency (= 4 ng/mL) and 21.2% had marginal folate deficiency (> 4–6.6 ng/mL) with unequal prevalence across the country. Severe folate deficiency was higher in women who were unmarried (p = 0.002), had parity of 4–6 (p = 0.001), used oral contraceptives (p = 0.01), had no illnesses (p = 0.001), had intestinal parasites (0.001), followed lower plant food diets (0.001), followed lower animal product diets (0.001), had no anaemia (0.001) and had no iron deficiency (0.001). In logistic regression analysis, only low plant food diets (p = 0.001) and iron deficiency (p < 0.001) retained their significance with regard to folate deficiency. The odds for developing folate deficiency was 0.9 times less likely among those with higher plant food intake (AOR-0.9;95%CI – 0.72–1.2) and 0.2 times less likely among those with adequate iron (AOR-0.2;95%CI – 0.17–0.34). Conclusions: Folate deficiency is widespread in Ethiopian women, emphasising the need for sustainable folate intake through dietary diversification and appropriate public health measures.Keywords: folate deficiency; Ethiopia; women; iron deficienc

Cardiovascular risk factors among Chamorros

BACKGROUND: Little is known regarding the cardiovascular disease risk factors among Chamorros residing in the United States. METHODS: The Chamorro Directory International and the CDC's Behavioral Risk Factor Surveillance System Questionnaire (BRFSS) were used to assess the health related practices and needs of a random sample of 228 Chamorros. RESULTS: Inactivity, hypertension, elevated cholesterol and diabetes mellitus were more prevalent in this Chamorro sample compared to the US average. Participants who were 50-and-older or unemployed were more likely to report hypertension, diabetes and inactivity, but they were also more likely to consume more fruits and vegetables than their younger and employed counterparts. Women were more likely to report hypertension and diabetes, whereas men were more likely to have elevated BMI and to have never had their blood cholesterol checked. CONCLUSION: The study provides data that will help healthcare providers, public health workers and community leaders identify where to focus their health improvement efforts for Chamorros and create culturally competent programs to promote health in this community

Nutrient intakes and nutritional biomarkers in pregnant adolescents: a systematic review of studies in developed countries

Background: Babies born to adolescent mothers have been shown to have poorer outcomes compared to those born to adults. Nutritional status may have an important role to play in improving the health of pregnant adolescents; however there is a lack of evidence regarding the adequacy of adolescent diets during pregnancy. This systematic review aims to examine what is known about the nutritional status of adolescent pregnant women. Methods: A systematic search of the literature identified 21 studies which met the inclusion criteria for the review. Primary research papers using any methods were included where they were published in English between January 1995 and May 2015 and included measurements of nutrient intakes or biological markers of nutritional status in pregnant women aged 11-19 years. Individual study data was first summarised narratively before study means were pooled to give an estimate of nutritional status in the population. Results: The results show that individual studies reported intakes of energy, fibre and a number of key micronutrients which were below recommended levels. Biological markers of iron and selenium status also showed cause for concern. Pooled analysis of individual means as a percentage of UK Dietary Reference Intakes showed intakes of vitamin D (34.8 % CI 0-83.1) to be significantly below recommendations (p=0.05). Serum selenium levels were also found to be low (61.8 μg/L, CI 39-84). Conclusions: This review has identified a number of areas where the nutritional status of pregnant adolescents is sub-optimal, which may have implications for the health of adolescent mothers and their babies. It was not however possible to examine the impact of supplement use or socio-demographic characteristics which limits the interpretation these results. Further work is needed to establish the characteristics of those most at risk within this population, how this differs from adult pregnant women and the role of supplementation in achieving adequate nutrition