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ORIGINAL RESEARCH COMMUNICATIONS |
1 From the Division of Human Nutrition and Epidemiology, Wageningen University, Netherlands; the Nutrition Research and Development Centre, Bogor, Indonesia; and the Division of Gastroenterology, University Medical Centre Nijmegen, Nijmegen, Netherlands.
Background: Deficiencies of vitamin A, iron, and zinc are prevalent worldwide, affecting vulnerable groups such as lactating women and infants. However, the existence of concurrent deficiencies has received little attention.
Objective: The aim was to investigate the extent to which deficiencies of vitamin A, iron, and zinc coexist and the nutritional relation between lactating mothers and their infants.
Design: In a cross-sectional survey in rural West Java, Indonesia, 155 lactating mothers and their healthy infants were assessed anthropometrically and blood, urine, and breast-milk samples were obtained.
Results: Marginal vitamin A deficiency was found in 54% of the infants and 18% of the mothers. More than 50% of the mothers and infants were anemic and 17% of the infants and 25% of the mothers were zinc deficient. There was a strong interrelation between the micronutrient status of the mothers and infants and the concentrations of retinol and ß-carotene in breast milk. Vitamin A deficiency in infants led to an increased risk of anemia and zinc deficiency (odds ratios: 2.5 and 2.9, respectively), whereas in mothers the risk of anemia and iron deficiency (odds ratios: 3.8 and 4.8, respectively) increased. In infants, concentrations of insulin-like growth factor I were related to concentrations of plasma retinol and ß-carotene but not to zinc.
Conclusions: Micronutrient deficiencies were prevalent in West Java. The micronutrient status of lactating mothers and that of their infants were closely related; breast milk was a key connecting factor for vitamin A status. Furthermore, concurrent micronutrient deficiencies appeared to be the norm.
Key Words: Vitamin A • iron • zinc • deficiency • infants • lactating mothers • anthropometry • plasma • human milk • retinol • ß-carotene • retinol binding protein • ferritin • hemoglobin • insulin-like growth factor I • Indonesia
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