Seasonal Epidemiology of Serum 25-Hydroxyvitamin D Concentrations among Healthy Adults Living in Rural and Urban Areas in Mongolia

Bromage, Sabri; Rich‐Edwards, Janet W.; Tselmen, Daria; Baylin, Ana; Houghton, Lisa A; Baasanjav, N; Ganmaa, Davaasambuu

doi:10.3390/nu8100592

Cited by 18 publications

(27 citation statements)

References 19 publications

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“…Prior research by our group and others has demonstrated extremely low levels of consumption and biochemical status of vitamin D among Mongolians of different ages across the country, a high prevalence of rickets nationwide, and that vitamin D fortification of milk consumed by school children was effective in ameliorating biochemical vitamin D deficiency [ 4 , 5 , 16 ]. We have also observed beneficial effects of vitamin D supplementation on child growth, risk of respiratory infections, and risk of atopic dermatitis in Mongolia [ 41 – 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although wheat flour has become much more important in recent centuries, the modern Mongolian diet still consists largely of dairy products and red meat, and little fruits, non-tuberous vegetables, legumes, nuts and seeds, and seafood [ 2 , 3 ]. Despite steady and impressive progress in curbing wasting, stunting, and low birth weight, a persisting lack of diversity in the Mongolian diet underlies a high prevalence of multiple biochemical micronutrient deficiencies among women and children, including those of iron, vitamin A, and vitamin D [ 4 , 5 ]. Micronutrient deficiencies in women of reproductive age pose a threat to their health, as well as the health of their offspring during pregnancy and nursing, and may lead to severe and permanent physical and cognitive deficits [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Projected effectiveness of mandatory industrial fortification of wheat flour, milk, and edible oil with multiple micronutrients among Mongolian adults

et al. 2018

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Industrial fortification of wheat flour is a potentially effective strategy for addressing micronutrient deficiencies in Mongolia, given its ubiquitous consumption and centralized production. However, Mongolia has not mandated fortification of any foods except for salt with iodine. This study modeled the effectiveness and safety of mandatory industrial fortification of wheat flour alone and in combination with edible oil and milk in reducing the prevalence of multiple micronutrient intake deficiencies among healthy non-pregnant adults in Mongolia. Six days of diet records (3 summer, 3 winter) were collected from 320 urban and rural adults across the country and analyzed for food and nutrient consumption using a purpose-built food composition table, and the Intake Monitoring and Planning Program (IMAPP) was used to project the effects of fortification on summer and winter bioavailable micronutrient intake and intake deficiency under different fortification guidelines within population subgroups defined by urban or rural locality and sex. Projections showed that flour fortification would be effective in reducing intake deficiencies of thiamin and folate, while marginal benefits of fortification with iron and riboflavin would be smaller given these nutrients’ higher baseline consumption, and fortification with zinc, niacin, and vitamin B12 may be unnecessary. Fortification of flour, oil, and milk with vitamins A, D, and E at levels suggested by international guidelines would substantially reduce vitamin A intake deficiency and would increase vitamin D intake considerably, with the greatest benefits elicited by flour fortification and smaller benefits by additionally fortifying oil and milk. These results support mandatory industrial fortification of wheat flour, edible oil, and milk with iron, thiamin, riboflavin, folate, and vitamins A, D, and E in Mongolia. Considerations will be necessary to ensure the fortification of these nutrients is also effective for children, for whom the potential benefit of zinc, niacin, and vitamin B12 fortification should be assessed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Projected effectiveness of mandatory industrial fortification of wheat flour, milk, and edible oil with multiple micronutrients among Mongolian adults

et al. 2018

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“…As fasting is not required for accurate measurement of the biomarkers of interest, serum was collected at random times during the day in order to avoid systematic error in dietary measurements that could occur from interrupting all subjects at the same time (e.g., before breakfast). Details of the dietary assessment, blood collection, and anthropometry have been described earlier [9,17].…”

Section: Study Population and Data Collectionmentioning

confidence: 99%

“…While childhood stunting and vitamin A deficiency have decreased over the past two decades, this period has also seen a sharp rise in the prevalence of adolescent and adult overweight and type 2 diabetes [7,8]. Currently, almost one third of pregnant women are anemic, less than two thirds of infants are reportedly exclusively breastfed up to six months of age, and vitamin D deficiency is endemic [7,9].…”

Section: Introductionmentioning

confidence: 99%

Diet and Nutrition Status of Mongolian Adults

Bromage

Tselmen²,

Lander

et al. 2020

Nutrients

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(1) Background: Aspects of the Mongolian food supply, including high availability of animal-source foods and few plant foods, are plausibly associated with disease in the population. Data on Mongolian diets are lacking, and these risks are poorly quantified. The purpose of this study was to provide a multifaceted nutritional analysis of the modern Mongolian diet. (2) Methods: The study population consisted of 167 male and 167 female healthy non-pregnant urban and nomadic adults (22–55 years) randomly selected from lists of residents in 8 regions. From 2011–2016, 3-day weighed diet records and serum were collected twice from each participant in summer and winter; anthropometry was collected once from each participant. Serum was analyzed for biomarkers, and nutrient intake computed using purpose-built food composition data and adjusted for within-person variation. Exploratory dietary patterns were derived and analyzed for associations with diet and nutrition measurements. (3) Results: We collected 1838 of an expected 1986 diet records (92.5%), 610/658 serum samples (92.7%), and 315/334 height and weight measurements (94.3%). Sixty-one percent of men and 51% of women were overweight or obese. Consumption of red meat, refined grains, and whole-fat dairy was high, while that of fruits, non-tuberous vegetables, eggs, nuts and seeds, fish and poultry, and whole grains was low. Dairy and red meat were more consumed in summer and winter, respectively. Dietary inadequacy of 10 of 21 assessed nutrients, including fiber, folate, and vitamin D were >50% prevalent, while protein, zinc, and vitamin B12 inadequacy were low. Biochemical evidence of iron and vitamin A deficiency was also low. Three dietary patterns (Urban, Transitional, Nomadic) explained 41% of variation in food consumption. The Urban pattern was positively associated with BMI in multivariate analysis. (4) Conclusions: Results indicate a high prevalence of key dietary inadequacies and overweight among Mongolian adults. Prior studies by our group have suggested that expanded supplementation and food fortification would be effective in addressing micronutrient inadequacies; these strategies should be coupled with measures to mitigate the growing burden of chronic disease.

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“…In spring, summer and autumn season, the urbanization degree differences on vitamin D status was concerned [11,26]. These differences mainly be attributed to the particularities of the physical environment which could be more supportive of increased outdoor physical activity levels and consequently greater sun exposure in rural area [27].…”

Section: Discussionmentioning

confidence: 99%

Variation Trend of Vitamin D Status in Wintertime Among Infants: A Cross-sectional Study

Li¹,

Dai²,

Qiu³

et al. 2019

JGO

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Background The requirement of vitamin D in different stage may be diverse, but research on the variation trend of vitamin D status during infancy is scarce. Objective This study aimed to explore the variation trend of vitamin D status and influencing factors of vitamin D deficiency and insufficiency during wintertime among infants. Methods A cross-sectional study was conducted. A total of 500 infants were included in our study during January to March 2017. The serum 25(OH)D was performed by chemiluminescent assay. Multivariate Logistic regression was conducted to evaluate the influencing factors of vitamin D deficiency and vitamin D insufficiency. Results The older infants had a higher concentration of vitamin D than younger infants (r=0.62, P<0.0001). And the overall prevalence of vitamin D deficiency and insufficiency were 33.80% and 18.00%, respectively. With the increase of month age, the risk of vitamin D deficiency (OR=0.63, 95%CI: 0.57-0.70) and insufficiency (OR=0.69, 95%CI: 0.62-0.77) were both declined. In addition, the infant with low birthweight, breastfed, living in rural area were correlated with a higher risk of vitamin D deficiency and insufficiency (P<0.05). Conclusion Vitamin D deficiency and insufficiency prevalence changed with month age, routine monitoring of vitamin D levels is necessary for infant.

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Seasonal Epidemiology of Serum 25-Hydroxyvitamin D Concentrations among Healthy Adults Living in Rural and Urban Areas in Mongolia

Cited by 18 publications

References 19 publications

Projected effectiveness of mandatory industrial fortification of wheat flour, milk, and edible oil with multiple micronutrients among Mongolian adults

Projected effectiveness of mandatory industrial fortification of wheat flour, milk, and edible oil with multiple micronutrients among Mongolian adults

Diet and Nutrition Status of Mongolian Adults

Variation Trend of Vitamin D Status in Wintertime Among Infants: A Cross-sectional Study

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