Objective: The study was designed to evaluate the vitamin D status in women of different physiological status of two socioeconomic groups in Bangladesh. Design: A cross-sectional study, using serum 25-hydroxyvitamin D (25-OHD), calcium, phosphorus and alkaline phosphatase activity. Setting: Two regions of Bangladesh. The Dhaka city area and west region of Nandail (Betagair Union), Mymensingh. Subjects: Representative subjects of two groups (low socio-economic group ¼ group L, n ¼ 99; and high socio-economic group ¼ group H, n ¼ 90) of Bangladeshi women aged 16 -40 y. About 87% of the subjects were housewives and the rest, 13%, were distributed among other different professions. Each group comprised of three sub-groups (non-pregnant nonlactating ¼ 1, pregnant ¼ 2, and lactating ¼ 3). Results: The influence of socio-economic status and physiological status on serum 25-OHD concentration (P ¼ 0.038, P ¼ 0.015, respectively), serum calcium concentration (P < 0.001, P < 0.001, respectively) and alkaline phosphatase activity (P < 0.001, P < 0.001, respectively) were observed. The distribution of serum 25-OHD concentration in both groups was shifted overall toward the lower limit of the normal range. Seventeen percent of women in group L and 12% of women in group H had serum 25-OHD concentration < 25 nmol=l. Hypovitaminosis D (serum 25-OHD concentration 37.5 nmol=l) was observed in 50% of subjects in group L and 38% of subjects in group H, respectively. The prevalence of hypovitaminosis was higher in lactating subjects of the groups L and H (63 and 46%, respectively) than in the other sub-groups in the same group. Conclusions: The results of the study suggested that women in Bangladesh were at risk of hypovitaminosis D and lactation was an additional risk factor in low income groups. The situation may increase the risk of bone loss.

Objectives: To compare thyroid-stimulating hormone (TSH) levels in neonatal cord blood between study sites in Bangladesh, Guatemala and the United States. Also, to compare neonatal TSH results with indicators of iodine deficiency in school children. Design: Consecutive births and, in school children, cross-sectional surveys. Setting: Savar, Bangladesh; San Pedro Sacatepequez, Guatemala; and Atlanta, United States. Subjects: In each study site, cord blood was spotted on to filter paper and TSH levels determined using a sensitive monoclonal assay. In the USA, heel stick blood specimens from newborns spotted on to filter paper were also obtained as well as exposure to iodine-containing antiseptics during the birthing process. Urine specimens were collected from mothers of newborns and tested for iodine concentration. School children in the same areas were surveyed for thyroid size by palpation and ultrasonography, and urine specimens collected for iodine concentration. Results: Between 141 and 243 cord blood specimens were collected from each study site. The prevalence of elevated cord blood TSH levels (. 5 mU l 21

Effects of 0.03% polychlorinated biphenyls (PCB) in the diet and various dietary fibers [konjac mannan (KM), pectin, sodium carboxymethyl cellulose (CMC) and cellulose] at a 5% level in the diet on serum and liver lipid metabolism and urinary ascorbic acid were studied. A comparison between dietary PCB and 1% cholesterol in the diet was also made. Serum albumin, protein, total and high density lipoprotein (HDL)-cholesterol, triglyceride, urinary and liver ascorbic acid, liver cholesterol and total lipids were increased in rats fed PCB. Pectin or KM depressed the elevation in serum protein, total and HDL-cholesterol, triglyceride and liver lipids due to PCB intake. Cellulose or CMC had no significant effect on these indices. Urinary ascorbic acid was not decreased by these dietary changes. Serum total cholesterol and low density lipoprotein (LDL) plus very low density lipoprotein (VLDL)-cholesterol, and liver total lipids, and cholesterol were significantly higher, and serum HDL-cholesterol and triglyceride were significantly lower in the cholesterol-fed group as compared to PCB-fed rats. Addition of KM to a cholesterol diet significantly depressed serum total cholesterol and LDL plus VLDL-cholesterol, liver cholesterol and total lipids. It seems likely that cholesterol metabolism is quite different during dietary PCB and cholesterol feeding.

The study was supported by the Academy of Finland, University of Helsinki and NorFa, Norway.

An extensive iodine deficiency disorders survey was conducted in Bangladesh in 1993 to assess the latest iodine nutriture status of the country. The clinical variables of the survey were goitre and cretinism, and the biochemical variable was urinary iodine. The "EPI-30 cluster" sampling methodology was followed for selecting the survey sites. In each survey site, the study population consisted of boys and girls, aged 5-11 years, and men and women, aged 15-44 years, in about equal populations. The total number of survey sites was 78 and the total number of respondents was 30,072. The total number of urine samples was 4512 (15% sub-sample). The current total goitre rate (grade 1 + grade 2) in Bangladesh is 47.1% (hilly, 44.4%; flood-prone, 50.7%; and plains, 45.6%). The prevalence of cretinism in the country is 0.5% (hilly, 0.8%; flood-prone, 0.5%; and plains, 0.3%). Nearly 69% of Bangladeshi population have biochemical iodine deficiency (urinary iodine excretion [UIE] < 10 mg/dl) (hilly, 84.4; flood-prone, 67.1%; and plains 60.4%). Women and children are more affected that men, in terms of both goitre prevalence and UIE. The widespread severe iodine deficiency in all ecological zones indicates that the country as a whole is an iodine-deficient region. Important recommendations of global interest are made from the experience of the survey.