RESUMO
BACKGROUND/OBJECTIVES: In Guatemala, population-wide vitamin A fortification of table sugar has been operating for two decades. The objective of this study was to estimate the adequacy of vitamin A intakes in pregnant and lactating women from low-income, urban and rural communities. SUBJECTS/METHODS: One or two previous-day dietary recalls were collected in a convenience sample of 234 pregnant and lactating women in the Western Highlands of Guatemala. Estimated daily intakes and main sources of total vitamin A, provitamin A and preformed vitamin A were calculated. Total intakes, adjusted for day-to-day variation, were examined in relation to estimated average requirements (EAR). RESULTS: Median estimated 1-day total vitamin A intake was 1177 µg retinol activity equivalents (RAE) (interquartile range (IQR) 832-1782) in the urban site and 567 µg RAE (IQR 441-737) in the rural site. Women not meeting their status-specific vitamin A requirement were 3.5 times more common in the rural communities (31%) than in the urban confines (9%). In the urban area, 26 women (21%) had preformed vitamin A intakes above 1500 µg on the day of data collection. Preformed vitamin A accounted for a median of 83.9% and 60.9% of the daily total vitamin A intake in the urban and rural sites, respectively. Sugar was the principal source of vitamin A, contributing 512 µg RAE (IQR 343-749) in the urban site and 256 µg RAE (IQR 189-363 µg) in the rural area. CONCLUSIONS: The vitamin A contribution from fortified sugar can be a determinant of reaching adequacy; nevertheless, a significant proportion of pregnant and lactating women do not meet the EAR, especially in the rural setting.
Assuntos
Sacarose Alimentar/análise , Ingestão de Alimentos , Alimentos Fortificados/estatística & dados numéricos , Deficiência de Vitamina A/epidemiologia , Vitamina A/análise , Adolescente , Adulto , Registros de Dieta , Sacarose Alimentar/química , Feminino , Alimentos Fortificados/análise , Guatemala/epidemiologia , Humanos , Lactação , Gravidez , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Deficiência de Vitamina A/etiologia , Adulto JovemRESUMO
OBJECTIVE: To compare methods for estimating discretionary salt intake, that is, salt added during food preparation and consumption in the home. SETTING: The study was carried out in a rural Guatemalan village. SUBJECTS: Subjects were selected non-randomly, based on their willingness to cooperate. Nine mother-son dyads participated; the sons were aged 6-9 y. INTERVENTIONS: Three approaches for estimating the discretionary salt consumption were used: 24 h recall; collection of duplicate portions of salt; and urinary excretion of lithium during consumption of lithium-labelled household salt. Total salt intake was assessed from the excretion of chloride over 24 h. RESULTS: The mean discretionary salt consumption based on lithium excretion for mothers was 3.9+/-2.0 g/d (mean +/- s.d.) and for children 1.3+/-0.6 g/d. Estimates from the 24 h recalls and from the duplicate portion method were approximately twice and three times those measured with the lithium-marker technique respectively. The salt intake estimated from the recall method was associated with the lithium-marker technique for both mothers and children (Spearman correlation coefficient, 0.76 and 0.70 respectively). The mean daily coefficient of variation in consumption of discretionary salt measured by the three methods, for mothers and boys respectively, were: lithium marker, 51.7 and 43.7%; 24 h recall, 65.8 and 50.7%; and duplicate portion, 51.0 and 62.6%. CONCLUSIONS: We conclude that an interview method for estimating discretionary salt intake may be a reasonable approach for determining the relative rank-order in a population, especially among female food preparers themselves, but may grossly overestimate the actual intake of salt added during food preparation and consumption.
Assuntos
Cloreto de Sódio na Dieta/administração & dosagem , Adulto , Criança , Cloretos/urina , Feminino , Guatemala , Humanos , Entrevistas como Assunto , Lítio/urina , Masculino , Rememoração Mental , Pessoa de Meia-Idade , Cloreto de Sódio na Dieta/metabolismo , Cloreto de Sódio na Dieta/urina , Espectrofotometria AtômicaRESUMO
The use of discretionary salt, which is salt added during cooking and at the table, as a suitable vehicle for iodine intake was assessed by measuring salt consumption using the lithium-marker technique in rural areas of Guatemala and Benin. In both countries, we studied boys aged 6-12 y and their mothers. Subjects used lithium-labeled salt after all unlabeled salt was removed from their households. In Guatemala, 24-h urine samples for 9 mother-son pairs were collected at baseline and on days 7, 8, and 9 during the use of lithium-labeled salt. Total maternal salt intake averaged 5.2 +/- 1.7 g/d (mean +/- SD), of which 77 +/- 24% came from discretionary sources, whereas Guatemalan boys consumed 1.8 +/- 0.6 g salt/d, of which 72 +/- 12% came from discretionary sources. In Benin, urine collection from 13 mother-son pairs took place at baseline and on days 5 and 7. Beninese mothers had a total salt intake of 9.0 +/- 2.9 g/d and their sons had an intake of 5.7 +/- 2.8 g/d; discretionary salt contributed 52 +/- 14% and 50 +/- 13%, respectively, of total salt consumed. Therefore, fortification of household salt appears to be an appropriate method of controlling iodine deficiency in both countries, although fortification of other salt sources could be considered in Benin.