Aetiological factors and perception of anaemia in Tunisian women of reproductive age

OBJECTIVES: To identify aetiological factors in anaemia and to explore knowledge, perceptions and attitudes towards anaemia. DESIGN: Two cross-sectional surveys and sixteen focus group discussions. SETTING: The two regions with the highest prevalence of anaemia in Tunisia, Greater Tunis (GT) and the South West (SW). SUBJECTS: Two representative samples of 687 (GT) and 729 (SW) women of reproductive age; 108 women were included in focus group discussions. RESULTS: Among anaemic women, 63.4% in the GT region and 80.2% in the SW displayed iron deficiency (ID). Genetic haemoglobinopathies accounted for 10.0% and 3.6% of the cases of anaemia in the two regions, respectively. After adjustment for confounders, the major factors for iron-deficiency anaemia were low dietary Fe intake (OR = 5.0, 95% CI 3.0, 8.4), drinking tea after eating (OR = 3.4, 95% CI 2.0, 5.7) and pica (OR = 2.1, 95% CI 1.1, 3.9). Most of the women related anaemia to the following causes: malnutrition, lack of hygiene, and their heavy workload and responsibilities in the household. Many women connected anaemia with hypotension. Few established a relationship between ID and anaemia. They had confidence in their doctor for treatment, but many complained they were not given sufficient information. Low dietary Fe intake, inappropriate food practices and inadequate perceptions contribute to the aetiology of anaemia in women. CONCLUSIONS: These results point out to the need for a strategy combining food fortification, Fe supplementation for pregnant women, nutritional education for the general public and at-risk specific target groups, and training of health professionals.     

Awareness and consumption of folate-fortified foods by women of childbearing age in Western Australia

OBJECTIVES: The introduction of voluntary fortification of some foods with folic acid in Australia has been implemented since evidence of the prevention of neural tube defects with periconceptional folic acid was published. Our objectives were to determine how many women were aware of folate and when they became aware, what was the awareness of labels on foods that mentioned folate, and how much folate-fortified food women ate. METHODS: To address these objectives we collected data by self-administered questionnaire from a random sample of 578 recently pregnant women in Western Australia between September 1997 and March 2000. RESULTS: Overall, 89% of women had heard, seen or read anything about the link between folate and birth defects such as spina bifida, 62% first became aware of the folate message before their recent pregnancy and 42% of women noticed any labels on foods that mention folate before or during their recent pregnancy. Overall, 53% of women were aware of foods that have folate added to them and 33% usually or always read the labels on food packaging. The folate-fortified foods most often consumed by women were cereals (69%), breads (34%) and milk (15%). Of the women who consumed folate-fortified foods (78%), the earlier they became aware of the folate message and noticed labels on food, the more fortified foods they consumed. CONCLUSIONS: These results indicate that staple foods fortified with folate are consumed by almost 80% of women in the population. Therefore, mandatory fortification of staple foods may reach most women, providing improved opportunity for the prevention of neural tube defects in Australia.     

Anthropometry of women of childbearing age in Morocco: body composition and prevalence of overweight and obesity

OBJECTIVE: To determine the prevalence of obesity and body fat distribution of Moroccan women of childbearing age, using a panel of anthropometric measurements. DESIGN AND SETTING: A cross-sectional survey conducted in 1995 in an agricultural community, El Jadida province of Morocco. Weight, height, waist and hip circumferences and triceps, biceps, subscapular and supra-iliac skinfold thicknesses were measured. Body mass index (BMI), waist/hip ratio (WHR), sum of all and sum of trunk skinfold thicknesses were determined. SUBJECTS: In total, 1269 women aged 15-49 years from urban and rural areas were surveyed. RESULTS: The means of all anthropometric measurements including body fat were higher in urban than in rural women and increased with age. Trunk fat contributed 50% of total fat. Globally, 4.7% of women were underweight (BMI<18.5 kg m(-2)), 35.2% were overweight or obese (BMI> or =25 kg m(-2)), 10.1% were obese (BMI> or =30 kg m(-2)) and 16.8% had central obesity (WHR>0.85). The prevalence of overweight and obesity was higher in the urban than in the rural area. Underweight prevalence decreased with age, whereas that of overweight and obesity increased. All anthropometric parameters adjusted for age increased with the increase of BMI and WHR. CONCLUSIONS: Although undernutrition is still prevalent, there is an alarming prevalence of overweight and obesity in Moroccan women of childbearing age. The results indicate a shift in this country from the problem of dietary deficiency to the problem of dietary excess, and alert one to the necessity of establishing an intervention to prevent obesity-related diseases. It is necessary to address which of the anthropometric variables studied here is the best predictor of obesity-related diseases in this population.     

Physiological changes associated with potassium deficiency in cotton

Potassium (K) fertility recommendations based on cotton petiole diagnostic analysis results have been inconsistent in the past, partly because the lowest acceptable petiole K concentration is unknown. Therefore, cotton was grown in sand filled 8‐L pots under two K treatments in a growth chamber at the Altheimer Laboratory in Fayetteville, AR to determine the petiole K concentration that will impact leaf physiology. Chamber‐grown plants were watered every second day with nutrient solution and with deionized water on alternate days. At 14 days after planting two treatments were established consisting of (1) continued complete nutrient solution, and (2) nutrient solution containing no K. Measurements were taken 13, 19, and 26 days after treatment establishment (DATE). Organ K concentrations, leaf chlorophyll, photosynthesis, adenosine triphosphate (ATP), and nonstructural carbohydrate concentrations were monitored as plant K deficiencies developed. All organ K concentrations were much lower in the no‐K treatment on each analysis date. Visual K deficiencies were first observed at 19 DATE along with reductions reductions in leaf chlorophyll concentration. Leaf photosynthesis was greatly reduced in the no‐K treatment beginning at 19 DATE. However, leaf ATP and nonstructural carbohydrate concentrations were higher at 19 and 26 DATE in the no‐K treatment, which may have been the result of reduced utilization and translocation of these metabolites. Our studies show that reductions in leaf physiological processes and plant growth did not occur until the petiole K concentration fell below 0.88% on a dry weight basis. Therefore, reductions in lint yield and quality should not develop until this critical petiole level is attained.     

Maize meal fortification is associated with improved vitamin A and iron status in adolescents and reduced childhood anaemia in a food aid-dependent refugee population

OBJECTIVE: To assess changes in the Fe and vitamin A status of the population of Nangweshi refugee camp associated with the introduction of maize meal fortification. DESIGN: Pre- and post-intervention study using a longitudinal cohort. SETTING: Nangweshi refugee camp, Zambia. SUBJECTS: Two hundred and twelve adolescents (10-19 years), 157 children (6-59 months) and 118 women (20-49 years) were selected at random by household survey in July 2003 and followed up after 12 months. RESULTS: Maize grain was milled and fortified in two custom-designed mills installed at a central location in the camp and a daily ration of 400 g per person was distributed twice monthly to households as part of the routine food aid ration. During the intervention period mean Hb increased in children (0.87 g/dl; P < 0.001) and adolescents (0.24 g/dl; P = 0.043) but did not increase in women. Anaemia decreased in children by 23.4% (P < 0.001) but there was no significant change in adolescents or women. Serum transferrin receptor (log10-transformed) decreased by -0.082 microg/ml (P = 0.036) indicating an improvement in the Fe status of adolescents but there was no significant decrease in the prevalence of deficiency (-8.5%; P = 0.079). In adolescents, serum retinol increased by 0.16 micromol/l (P < 0.001) and vitamin A deficiency decreased by 26.1% (P < 0.001). CONCLUSIONS: The introduction of fortified maize meal led to a decrease in anaemia in children and a decrease in vitamin A deficiency in adolescents. Centralised, camp-level milling and fortification of maize meal is a feasible and pertinent intervention in food aid operations.     

Risk factors for iron-deficiency anaemia among pregnant women living in rural Vietnam

OBJECTIVE: To assess the prevalence of anaemia in rural Vietnam and to determine its risk factors. DESIGN: A cross-sectional survey. SETTING: Vietnam, Nghe An Province. STUDY POPULATION: The total number of participants was 439. Of these participants, one was excluded from the study due to a mental disorder. Forty-seven did not participate in the test for parasites and 68 did not complete at least one of the questions. RESULTS: The prevalence of anaemia (haemoglobin (Hb) <11.0 g dl(-1)) was 43.2% and of severe anaemia (Hb <8.0 g dl(-1)) was 0.5%. Taking iron tablets, the consumption of eggs and the preference for Western medicine significantly and positively correlated with Hb concentration in the pregnant women in a multiple regression analysis. Pregnancy duration and hookworm infestation significantly and negatively correlated with Hb concentration in the pregnant women. CONCLUSION: The prevalence of anaemia in rural Vietnam has remained as high as that found in the national anaemia survey in 2000. The results of the present study could aid in the development of an iron-deficiency anaemia programme among pregnant women in rural Vietnam that emphasises iron supplementation, parasite control and improved diet, including the consumption of eggs. The programme's focus should be on women who prefer traditional medicine to Western medicine.     

Trends in the prevalence of anaemia in Japanese adult women, 1989-2003

OBJECTIVE: There is an increasing concern of anaemia in Japanese women, but no national trend data has existed to date. We analysed long-term national trends of anaemia in adult women. DESIGN: Secondary analyses of 15 consecutive cross-sectional nationwide surveys conducted during the period 1989-2003. Analyses were based on 5-year intervals (1989-1993, 1994-1998, 1999-2003). SETTING: Japan. SUBJECTS: The subjects included the National Health and Nutrition Survey of Japan (NHNS-J) population. Analyses were based on 50 967 non-pregnant/non-lactating women aged 20 years and over, with complete data sets. We stratified subjects into six age groups (20-29 years, 30-39 years, 40-49 years, 50-59 years, 60-69 years and 70+ years), and three age groups (20-49 years, 50-69 years, 70+ years) for analyses on residential areas (metropolitan, cities and towns). RESULTS: Decreases in trends of mean haemoglobin values (intravenous) were significant in all age groups. Changes in the prevalence of anaemia were significant only in women aged 30-39 and 40-49 years. Anaemia (haemoglobin < 12.0 g dl-1) increased from 16.8% to 20.6% in women aged 30-39 years, and from 20.2% to 26.9% in women aged 40-49 years, respectively. Prevalence was highest in women aged 70 years and older in all times, but no significant change was observed. CONCLUSIONS: Haemoglobin values have declined significantly in all ages in the last 15 years. Anaemia was especially significant in women aged 30-39 years and 40-49 years. Our findings suggest that a large number of young women in Japan are at risk of anaemia, so continuous monitoring and controlling efforts of this trend are needed.     

Effects of humic acid on remediation of the nutritional deficiency of gerbera in hydroponic culture

Information is scant on the effect of humic acid (HA) on physiological, antioxidant and photosynthesis attributes of gerbera plants undergoing nutrient deficiency in culture solution. Gerbera plants cv. Malibu were grown in a factorial experiment based on a completely randomized design with 3 replications, using 3 different nutrient solutions [complete nutrient solution (NSc), 25% NSc (NS1), and 50% NSc (NS2)] treated with 2 levels of humic acid [0 (HA0) and 500 mg/l (HA1)].The interaction effect of HA and NS showed that HA improved the flower number in NSc, the transpiration in NS1+HA1, photosynthesis rate in NSc+HA1, stomatal conductance (gs) in NS2, mesophyll conductance of leaves in all NS levels and photosynthetic water use efficiency in NSc+HA1. The interaction effect of nutrient solution and HA on antioxidant activity was inconclusive, malondialdehyde content was the highest in NS2 and the lowest in NS1+HA1. The peroxidase activity increased in complete nutrient solution with and without HA and there were no differences among other treatments. Superoxide dismutase activity increased in NS1 and complete nutrient solution with HA and reached the highest in NSc. Humic acid was more effective in nutrient uptake, i.e., nitrogen, phosphorus, potassium, calcium, zinc, and iron (N, P, K, Ca, Zn, and Fe) in complete nutrient solution compared to NS1 and NS2. Conclusively, humic acid can compensate the nutrient deficiency stress of the culture solution in regards to protein synthesis, photosynthesis attributes regardless of the nutrient uptake of gerbera.     

Soil fertility is associated with fungal and bacterial richness,whereas pH is associated with community composition in polar soil microbial communities

Microbial activities in Arctic and Antarctic soils are of particular interest due to uncertainty surrounding the fate of the enormous polar soil organic matter (SOM) pools and the potential to lose unique and vulnerable micro-organisms from these ecosystems. We quantified richness, evenness and taxonomic composition of both fungi and bacteria in 223 Arctic and Antarctic soil samples across 8 locations to test the global applicability of hypotheses concerning edaphic drivers of soil microbial communities that have been primarily developed from studies of bacteria in temperate and tropical systems. We externally validated our model's conclusions with an independent dataset comprising 33 Arctic heath samples. We also explored if our system was responding to large scale climatic or biogeographical processes that we had not measured by evaluating model stability for one location, Mitchell Pennisula, that had been extensively sampled. Soil Fertility (defined as organic matter, nitrogen and chloride content) was the most important edaphic property associated with measures of α-diversity such as microbial richness and evenness (especially for fungi), whereas pH was primarily associated with measures of β-diversity such as phylogenetic structure and diversity (especially for bacteria). Surprisingly, phosphorus emerged as consistently the second most important driver of all facets of microbial community structure for both fungi and bacteria. Despite the clear importance of edaphic factors in controlling microbial communities, our analyses also indicated that fungal/bacterial interactions play a major, but causally unclear, role in structuring the soil microbial communities of which they are a part.     

Studies of various elements of nutritional and toxicological interest associated with different molecular weight fractions in Brazil nuts

On-line hyphenation of size exclusion chromatography (SEC), UV, and inductively coupled plasma mass spectrometry (ICP-MS) was used to study the molecular weight distribution patterns of several elements in Brazil nuts (Bertholletia excelsa). This technique was used for the elemental speciation of different elements of nutritional and toxicological interests such as Mg, Fe, Co, Mo, Ag, Hg, and Pb. Elemental fractionation in Brazil nuts was studied using a Superdex peptide column with resolving capacity in the range of 14 to 0.18 kDa. Three different mobile phases, Tris buffer solution (pH 8.0), phosphate buffer (pH 7.5), and CAPS buffer solution (pH 10.0), were tried for the SEC fractionation. Size exclusion fractionation of all the extracted solutions was performed using a 50 mmol L(-)(1) Tris buffer (pH 8) as the mobile phase at a flow rate of 0.6 mL min(-)(1). Three different extractions, 0.05 mol L(-)(1) NaOH, 0.05 mol L(-)(1) HCl, and hot water at 60 degrees C, were performed, and the association of elements with various molecular weight fractions was evaluated. Total elemental concentrations in the extracted samples were determined and compared with the values obtained after total digestion to calculate the recovery values. Generally, high extraction efficiency was obtained with the NaOH solution as compared with HCl and hot water except in the case of magnesium, for which HCl was found to be a good extractant. Chromatographic elution profiles for these extractions were quite distinct from each other in most cases. Most of the elemental species were found to be associated with high molecular weight fractions. To study the differences obtained during the sample-processing step, the results obtained for nuts with shell were treated differently from those obtained for nuts purchased without shell and were compared.