RESUMEN
OBJECTIVE: The aim of this study was to develop and validate a food frequency questionnaire (FFQ) for pregnant women to identify those who are at risk for possible deficiencies in the key nutrients for pregnancy. METHODS: Pregnant women 18 to 39 y of age who availed themselves of perinatal services in community health centers in Makati City, Philippines were screened for the study. Five hundred eligible participants were asked to complete three 24-h food recalls for the development of the FFQ. A different set of participants with a total number of 100 were recruited for the validation of the questionnaire, which involved the use of the 3-d food record as the reference tool. The validity of the nutrient intakes obtained from the FFQ were measured against the values from the 3-d food record using Pearson's correlation coefficients and Bland-Altman plots. RESULTS: Significant correlations at P ≤ 0.05 were seen for energy, fat, riboflavin, cobalamin, and calcium. Pearson's correlation coefficients ranged from 0.016 to 0.32 for energy and nutrients. CONCLUSIONS: Acceptable agreements were seen for most of the nutrients. Possible deficiencies for key nutrients during pregnancy can be detected by the developed FFQ for Filipino pregnant women living in low-income urban communities with similar profiles.
RESUMEN
BACKGROUND: Until 1998, iodine deficiency was a public health problem in the Philippines. A law entitled "An Act Promoting Salt Iodization Nationwide" (ASIN) has been passed and implemented by the government to eliminate iodine deficiency. The contribution of salt iodization, as well as dietary, health, and environmental factors, to improving the intellectual performance of Filipino schoolchildren remains to be determined. OBJECTIVE: The objectives of the study were to determine the relationship between iodine status and levels of psychomotor and cognitive performance in first-grade children aged 6 to 10 years, and to examine the extent to which dietary, biochemical, health, and environmental factors contribute to children's mental performance. METHODS: Two hundred ninety children in six classroom sections from a public school in Manila were examined by measurement of urinary iodine excretion (UIE) and thyroid palpation. The median UIE level for each section was determined. Sixty-five children classified as iodine deficient (UIE < 90 microg/L with grade 1 goiter, n = 34) and non-iodine deficient (UIE > 100 microg/L without goiter, n = 31) were given psychomotor and cognitive function tests (Bender-Gestalt and Raven's Colored Progressive Matrices). Scores from the two tests were used to determine each child's general ability percentile rank. Other variables examined were dietary intake (% RDA of nutrients ingested based on two nonconsecutive 24-hour recalls); deficiencies in iron, vitamin A, and selenium; parasitic infection; coliform contamination of drinking water; household use of iodized salt; illness in the past 2 weeks; and wasting and stunting. RESULTS: Children whose general ability scores were at or above the 50th percentile had higher UIE levels, but the relationship was not significant. Children from sections with higher median UIE levels had higher percentile ranks for general ability (p = .002). Backward logistic regression showed that the variance in deficient and adequate mental performance was explained by dietary intakes that met > or = 80% of the RDA for energy, protein, thiamin, and riboflavin; the use of iodized salt; child's iodine status; and stunting (R2 = .520, p = .0016). Higher class median UIE was associated with better psychomotor and cognitive performance in children who were tested. Factors that contributed to better performance include higher intakes of energy, protein, thiamin, and riboflavin; household use of iodized salt; normal iodine status; and absence of stunting or chronic malnutrition. CONCLUSIONS: Salt iodization, accompanied by adequate intakes of energy, protein, and foods rich in thiamin and riboflavin, can contribute to improved mental performance in Filipino schoolchildren. Longer-term factors that can contribute to improved performance are achievement of normal iodine status and elimination of protein-energy malnutrition.