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Nutrients 2016, 8(2), 66; doi:10.3390/nu8020066

Impact of Food Rations and Supplements on Micronutrient Status by Trimester of Pregnancy: Cross-Sectional Studies in the Maela Refugee Camp in Thailand

1
Institute of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart 70599, Germany
2
Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot 63110, Thailand
3
Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK
4
Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
5
German Institute of Human Nutrition, Potsdam-Rehbruecke, 14558 Nuthetal, Germany
*
Author to whom correspondence should be addressed.
Received: 4 December 2015 / Revised: 30 December 2015 / Accepted: 12 January 2016 / Published: 26 January 2016
(This article belongs to the Special Issue Premenopausal Nutrition and Fertility)
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Abstract

Micronutrient fortified flour (MFF), supplementary food rations and micronutrient (MN) supplements may prevent deficiencies among pregnant women. Objectives of cross-sectional surveys in 2004 (n = 533) and 2006 (n = 515) were to assess the impact of new food rations (flour, oil) and supplements on MN status by trimester of pregnancy in the Maela refugee camp. Hemoglobin, iron status, zinc, retinol, β-carotene and tryptophan decreased, while α-/γ-tocopherol and 5-methyltetrahydrofolate (5-MTHF) increased from first to third trimester. In 2006, mean zinc and α-tocopherol for each trimester was significantly higher than in 2004. The weeks of supplemented thiamine and folic acid were positively correlated with thiamine diphosphate (TDP) and 5-MTHF, but not for ferrous sulfate as iron deficiency was observed in 38.5% of third-trimester women. Frequent consumption of fish paste and owning a garden or animal were associated with significantly higher iron status, retinol, β-carotene, and 5-MTHF. In conclusion, MFF and supplementary oil were most likely to explain improved zinc and α-tocopherol status, while thiamine and folate supplements ensured high TDP and 5-MTHF in late pregnancy. MN supplements, MN-rich staple food, small gardens, and programs to improve iron compliance are promising strategies to prevent MN deficiencies during pregnancy in vulnerable populations. View Full-Text
Keywords: micronutrients; pregnancy; refugee; iron status; zinc; tocopherol; folic acid; thiamine; retinol; β-carotene micronutrients; pregnancy; refugee; iron status; zinc; tocopherol; folic acid; thiamine; retinol; β-carotene
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Stuetz, W.; Carrara, V.I.; Mc Gready, R.; Lee, S.J.; Sriprawat, K.; Po, B.; Hanboonkunupakarn, B.; Grune, T.; Biesalski, H.K.; Nosten, F.H. Impact of Food Rations and Supplements on Micronutrient Status by Trimester of Pregnancy: Cross-Sectional Studies in the Maela Refugee Camp in Thailand. Nutrients 2016, 8, 66.

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