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Background@#Breastfeeding is the ideal food source for all newborns globally. Proper feeding of infants and young children promotes optimal growth and development, especially in the critical window from birth to 2 years of age. Exclusive breastfeeding for 6 months and continued breastfeeding for the first 2 years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe.@*Objective@#To assess the indicators of infant feeding practices among 0- 23 months old children.@*Materials and Methods@#The NNS V was implemented in 21 aimags (provinces) in 4 economic regions (Central, Eastern, Khangai, Western) and the capital city of Ulaanbaatar. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design [1]. The infant and young child feeding indicators assessed in the NNS V were based on the mother’s or caretaker’s report of breastfeeding and consumption of foods and fluids by the child during the day or night prior to being interviewed.@*Results@#83.7% of children under 2 years started breastfeeding within 1 hour of birth and though almost all children were ever breastfed (97.9%), a slightly higher percentage of girls were ever breastfed overall and within 1 hour of birth. Children 0-5 months were categorized according to whether they were exclusively breastfed or predominantly breastfed, with the former only allowing vitamins, mineral supplements, and medicine and the latter also including plain water and non-milk liquids. Among children 0-5 months of age, 58.3% were exclusively breastfed and 65.3% were predominantly breastfed, having received other liquids or foods in addition to breast milk. The prevalence of exclusive breastfeeding was lowest in the 4th wealth index quintile (46.5%) and wealthiest quintile (54.0%) households.@*Conclusions@#Exclusive breastfeeding and early initiation of breastfeeding practices are unacceptably low in Mongolia; 20% of newborns are not breastfed within 1 hour of birth and more than 40% of infants under 6 months of age are not exclusively breastfed and therefore, not receiving optimum nutritional and immunity benefits from breast milk. Strengthening IYCF counselling in all regions and wealth quintiles to support women to practice optimal breastfeeding, along with counselling and awareness of timely and adequate complementary feeding for children under 2 years of age, should be a top priority for public health and as it is a key strategy to reduce malnutrition in children.
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Background @#Overweight and obesity are conditions of over nutrition resulting from consumption of more calories than the body requires leading to excess body fat accumulation. The prevalence of both overweight and obesity is increasing globally in all age groups in high, middle, and low-income countries and is largely attributed to the “nutrition transition” with a shift from traditional diets to readily available and inexpensive, low-nutrient unhealthy foods high in energy [1]. </br> The move away from traditional to “junk” foods often occurs at the same time as the move of populations away from daily physical activity and increase in sedentary activities such as time spent in front of a phone, computer, or television, furthering increasing the risk of becoming overweight. People who are overweight or obese are at higher risk for serious health problems including hypertension, heart disease, stroke, diabetes, some cancers, and osteoarthritis. The increase in overweight and obesity is accompanied by a dramatic increase in prevalence of above mentioned chronic conditions in the worldwide. While the long-term repercussions of overweight and obesity are severe, they are largely preventable and treatable through healthy diets and healthy lifestyle behaviors [2].@*Materials and Methods@#The fifth National nutrition survey (NNSV) was implemented in 21 provinces (aimags) in 4 socio-economic regions (Central, Eastern, Khangai, and Western) and the capital city of Ulaanbaatar. Given the regional differences in dietary patterns and nutrition status, target populations were stratified into 5 strata based on 4 regions and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design. In total, 1750 school children data on demographic and dietary information collected by interview methods and anthropometric measurement results were used in this study. @*Ethical considerations@#The survey protocol was discussed at the Scientific Committee of the Public Health Institute (recently named by National Center for Public Health) and granted by order of director of Scientific committee of PHI on 28th June, 2016. Ethical approval for conducting the NNS V was obtained from the Medical Ethics Committee under the Ministry of Health of Mongolia on July 7, 2016. Participation in the survey was voluntary, oral and written informed consent were obtained from adult caregivers of each children. @*Results@#Consumption of unhealthy or junk (high-calorie, low-nutrient) foods in the past week was nearly universal (99.0%) among school children 6-11 years of age. Over half of children (51.4%) consumed junk foods at least once per week and 45.7% consumed junk foods a few times a week. Consumption of sugar-sweetened beverages was high with 80.9% of children consuming these at least once in the past week. Overall consumption of fried foods was lower than consumption of junk foods or sugar-sweetened beverages with 22.7% of children not consuming any fried foods in the past week and only 8.5% of children consuming fried foods a few times per week. Consumption of sweet foods was high with nearly all children having consumed sweet foods in the past week, 45.9% of children 6-11 years having consumed sweet foods a few times per week. </br> The prevalence of overweight (BMI > +1 SD) was 22.2% and prevalence of obesity (BMI > +2 SD) was 6.4%. Overweight prevalence was higher in boys (26.6%) compared to girls (17.8%) and in urban (23.9%) compared to rural (17.6%) areas with the highest prevalence in Ulaanbaatar (25.6%) compared to other regions. Children 6 years old (26.1%) and 7 years old (25.6%) had a higher prevalence of overweight than older children.@*Conclusion@#</br> 1. Consumption of unhealthy foods and drinks is common to 6-11 year olds group, with almost all children (99.2%) consuming any type of unhealthy foods and drinks at least once per week, in particular, 8 out of 10 children were found consuming sugary drinks and/or deep fried food. </br>2. The consumption of unhealthy foods was not differing by child’s sex, there were revealed significant differences between living area and regions. Proportion of the school children 6-11 years of age was relatively higher in Ulaanbaatar city and urban settings. </br>3. The prevalence of overweight and obesity in school children aged 6-11years sharply increased from 2010 NNS IV level and reached 22.2% and 6.4%, respectively. Among children with obesity consumption of any unhealthy foods and sugary drinks were 1.4–1.9 times higher than nonobese children, respectively.
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Background@#Iron is an essential mineral needed for physical and cognitive development with iron needs greatest during pregnancy, infancy, childhood, and adolescence. Iron is vital throughout the lifespan as it is a component of haemoglobin, the protein responsible for transporting oxygen from the lungs to body cells for energy production. Iron deficiency results from a depletion of body iron stores due to increased iron needs, inadequate dietary iron intake, reduced iron absorption, or loss of iron from infections caused by malaria, hookworms, and other intestinal parasites. In advanced stages, iron deficiency leads to iron deficiency anaemia, a condition of low red blood cells and reduced oxygen-carrying capacity.@*Goal@#This study aimed to determine body iron stores in Mongolian children aged 6-59 months, and estimate prevalence of iron deficiency among of studied children. @*Materials and Methods@#In this study were used materials that collected during the fifth national nutrition survey conducted in 21 provinces of 4 economic regions and 8 districts of Ulaanbaatar city of Mongolia. The fifth national nutrition survey was household based survey; therefore sampling unit was household with 5 year-old child. We had used demographic information collected by interview methods and laboratory examination results on ferritin, soluble transferrin (sTfR), C reactive protein (CRP) and α1-acid glycoprotein (AFP) in serum samples collected from 6 to 59 months old children, pregnant women and 15–49 year-old men living in child’s households. Serum Ferritin and soluble transferrin (sTfR) were used as a biomarker for iron store and iron deficiency and C reactive protein (CRP) and AFG were used as indicators for acute and chronic infection. The determination of iron status is challenging when concomitant infection and inflammation are present because of confounding effects of the acute-phase response on the interpretation of most iron indicators. Effects of C reactive protein (CRP) and AGP concentrations on estimates of ID according to serum ferritin (SF) and soluble transferrin receptor (sTfR) were considered in the study. @*Ethical considerations @#The survey protocol was discussed at the scientific committee of the Public health institute and approved by director of scientific committee of PHI on June 28, 2016. Ethical approval for conducting the survey, including obtaining biological samples was obtained from the Medical ethics committee under the Ministry of Health of Mongolia on July 7, 2016. Participation in the survey was voluntary, oral and written informed consent was obtained from each participants and adult caregivers of under 5 year-old children. @*Results@#Biomarkers of iron status were adjusted with inflammation indicators and estimated iron deficiency (ID) and total body iron store in 1732 children 6-59 month-olds. The study findings showed that adjusted mean concentration of serum ferritin and soluble transferrin receptor was 33.7 µg/l and 8.8 mg/l in children age of 6-59 months, respectively. The calculated total body iron store by using adjusted SF and soluble transferrin receptor was 2.8 mg/kg among surveyed children. Iron deficiency was estimated by using 2 different biomarkers among selected population group. The prevalence of iron deficiency estimated by using SF was 20.7% in children 6-59 months. Iron deficiency in children defined by using serum soluble transferrin receptor was 27.7%.@*Conclusions@#</br> 1. The average serum ferritin and soluble transferrin receptor concentrations was 33.7 µg/l and 8.8 mg/l in children age of 6-59 months, respectively. Total body iron store estimated by using SF and soluble transferrin was 2.8 mg/kg among surveyed children. </br>2. The prevalence of iron deficiency estimated by using SF and sTfR was 20.7% and 27.7% in children 6-59 months, respectively. According to the WHO recommendation, prevalence of iron deficiency among Mongolian children aged 6-59 months is classified as “prevalent”. </br>3. Overall proportion of children with low body iron store was 22.4%. The prevalence of iron depletion is relatively common in boys, young children aged 6–23 months, and rural children aged 6-59 months.
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Background@#Weight at birth is a good indicator of the mother’s health and nutrition status during gestation and a child’s chances for survival, growth, long-term health, and psychosocial development. Low birth weight (defined as less than 2500 grams) poses a range of serious health risks for children. @*Objective@#To assess the prevalence of low birth weights (LBW).@*Materials and Methods@#The NNS V was implemented in 21 provinces (aimags) in 4 economic regions (Central, Eastern, Khangai, Western) and the capital city of Ulaanbaatar. A total of 2250 children aged 0-59 months. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design. For the selection of households in urban areas, the process involved first selecting 30 khoroos (clusters), then khesegs, and then households with a child 0-59 months of age.@*Ethical considerations @#The survey methodology was discussed at the Scientific Committee of the Public Health Institute (recently named by National Center for Public Health) and granted the PHI Directors Order on 28th June, 2016. Ethics approval for conducting the NNS V, was obtained from the Medical Ethics Committee under the Mongolian Ministry of Health. @*Results@#Almost all (99.5%) children in the sample were weighed at birth with 5.0% weighing less than 2500 grams at birth and 12.6% weighing over 4000 grams at birth. The prevalence of low birth weight was slightly higher among girls than boys, however high birth weight was much more common in boys (15.9%) compared to girls (9.5%). Prevalence of low birth weight was highest in Western region (9.6%) and the poorest households (7.8%) while the prevalence of high birth weight was highest in Ulaanbaatar (13.8%) and wealthiest households1 (16.4%). High birth weight was more than double among children of overweight (17.5%) and obese (17.3%) mothers compared to children of normal weight (8.4%) or underweight (7.0%) mothers. Among singleton births, women <29 years of age had higher LBW rates than did those 30-39 years of age in both years, irrespective of birth order. LBW rate was more than double among mothers in kazak ethnic groups (13.8%).@*Conclusions@#The younger age of the mother was more likely to develop low birth weight, and it was twice as high among mothers in Kazak ethnic groups. Therefore, adolescents and women of reproductive age needed to improve the health education and to identify the causes and risk factors of low birth weight among mothers in Kazak ethnic groups.
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Background@#In order to study and evaluate the nutrition situation of the Mongolian people. The 2016-2017 NNS V includes 5 different age groups from Mongolian’s four economic development regions and Ulaanbaatar. The NNS V survey quantifies the prevalence of the nutrition conditions that are of greatest concern to the population, particularly young children and pregnant women.@*Goal@#To establish the prevalence of micronutrients deficiency and estimate micronutrient intake in pregnant women@*Materials and Methods@#Totally 2220 pregnant women included in cross-sectional study from urban and rural area. Survey procedures consisted of interview, anthropometric measurements, clinical examinations, and the collection of biological (blood and urine) samples for pregnant women. Micronutrient deficiencies were assessed by tests for hemoglobin, serum, ferritin, soluble transferrin receptor (sTfR), retinol-binding protein (RBP), 25-hydroxyvitamin D {25(ОН)D}, spot urine samples for determination of urinary iodine concentration.@*Result@#The prevalence of anemia, as measured by hemoglobin, was 21.4% and the iron deficiency anemia (IDA) was 10.5%, as measured by adjusted serum ferritin or soluble transferrin receptor (sTfR) was 29.6%. </br> Prevalence of iron deficiency as measured by serum ferritin was also highest in Western 35.1% and lowest in Eastern region 21.5% (P<0.01). The prevalence of vitamin D in pregnant women was high with 75.4% and 4.4% of all pregnant women had sufficient vitamin D status. An additional 20.2% of pregnant women having insufficient levels. The median concentration of 120.5µg/l indicates inadequate iodine status in pregnant women, as the desired range for adequate iodine nutrition in pregnancy 150-249 µg/l.@*Conclusion@#</br>1. One in every 5 pregnant women (21.4%) is anemic. </br>2. Vitamin D intake among pregnant women (7.3%) is very low, with 75.4% having vitamin D deficiency and vitamin D insufficiency –by 20.2%. </br>3. Median urinary iodine concentration of pregnant women is 120.2mg/l, considerably lower than WHO recommended reference range, indicating pregnant women are at risk of iodine deficiency. </br>4. Despite visible growth in vitamin and mineral supplements intake by pregnant women, compared to 2010, the infrequency of intake and failure to consume recommended number of supplements as instructed in the relevant guides persist.
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Background@#Overweight and obesity are conditions of over nutrition resulting from consumption of more calories than the body requires leading to excess body fat accumulation. The prevalence of both overweight and obesity is increasing globally in all age groups in high, middle, and low-income countries and is largely attributed to the “nutrition transition” with a shift from traditional diets to readily available and inexpensive high-energy and low-nutrient foods [1]. </br> The move away from traditional to “Junk” foods often occurs at the same time as the move of populations away from daily physical activity and increase in sedentary activities such as time spent in front of a phone, computer, or television, furthering increasing the risk of becoming overweight. People who are overweight or obese are at higher risk for serious health problems including hypertension, heart disease, stroke, diabetes, some cancers, and osteoarthritis. The increase in overweight and obesity is accompanied by a dramatic increase in prevalence of these chronic diseases at the global level. While the long-term repercussions of overweight and obesity are severe, they are largely preventable and treatable through healthy diets and healthy lifestyle behaviors [2].@*Materials and Methods@#The NNS V was implemented in 21 provinces (aimags) in 4 economic regions (Central, Eastern, Khangai, and Western) and the capital city of Ulaanbaatar. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design [3]. Total participated 1944 mothers’ years of age who had a child aged 0-59 months. @*Ethical considerations @#The survey methodology was discussed at the Scientific Committee of the Public Health Institute (recently named by National Center for Public Health) and granted the PHI Directors Order on 28th June, 2016. Ethics approval for conducting the NNS V, including obtaining biological (blood and urine) samples, was obtained from the Medical Ethics Committee under Ministry of Health, Mongolia on 7th July, 2016 with granted approval to conduct the survey and send blood serum samples to the VitMin laboratory in Germany. Participation in the survey was voluntary and oral and written informed consent was obtained from all individuals selected for the survey. Participant confidentiality was maintained during data collection, data entry, data analysis, and in the dissemination of survey findings. @*Results@#Nearly half of mothers (46.2%) were overweight with 16.5% of mothers obese and 4.1% underweight. The prevalence of overweight in mothers was highest in rural areas (50.1%), married status (49.3%), and lowest in Ulaanbaatar (42.3%) compared to other regions (48.6% to 52.6%). The overall prevalence of anaemia among mothers was 16.2% with highest prevalence amongst Kazakh (31.9%) and other ethnic minority mothers (25.1%), mothers with secondary education (20.3%) and unemployed mothers (19.9%). Minimum dietary diversity is a proxy indicator for the nutrient content of a diet based on consumption of at least 5 of 10 food groups.<sup>1</sup> People who consume food items from at least 5 food groups are likely to consume at least 1 animal-source food and items from 2 or more of the fruit and vegetable food groups. In the NNS V, 70.2% of mothers met the minimum dietary diversity requirement with a higher prevalence in urban areas (74.8%) and Ulaanbaatar (77.5%).@*Conclusion@#The prevalence of overweight and obesity in mothers of reproductive age is 46.2%, with the highest percentage of mothers with overweight and obesity being in rural areas (50.1%), which is 5.8 percentage points higher than that of urban mothers. 16.2% of mothers are anemic. Prevalence of Minimum dietary diversity among mothers is 70.2%. Food consumption is inadequate in mothers with the primary and secondary education, and in mothers in rural areas, and in poorest mothers or in mothers with the second and third wealth index. @*@#<sup>1</sup><i>FAO and FHI 360. 2016. Minimum Dietary Diversity for Women: A Guide for Measurement. Rome: FAO.</i>
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Introduction. Population life expectancy and health status are directly related to adolescent health,as many chronic disease conditions are affi liated with adolescence. The Mongolia GSHS, 2010 wasstudied dietary behavior and some risk factors belong to non communicable diseases of secondaryschoolchildren among surveyed children. Overall, 5.5% of students have eating habits that are healthybased on the WHO recommendations developed form the Mongolian Ministry of Health. One in sixstudents (15.9%) ate fruits and vegetable fi ve or more times per day. 27.3% of students consumeddairy products valuable for childhood growth two or more times per day. More than one in four students(27.6%) drank carbonated beverages and soft drinks one or more times per day.Findings of this survey show that attention is needed into adolescence and period of young children toprevent and decrease NCD and thus this was a background of our study.Goal. Determine schoolchildren’s food consumption and dietary behavior.Material and Methods. The 2013 Mongolia GSHS employed a two-stage cluster sample designto produce is preventative sample of students in grades 7-12. In total, 60 schools (25 schools fromUlaanbaatar city and 35 rural, respectively) and 203 classes were selected to participate in the MongolianGSHS.School level: The fi rst-stage sampling frame consisted of all schools (urban, rural, public, or private)containing any grades 7-12. Schools were selected systematically with probability proportional to schoolenrollment size.Class level: The second-stage sampling frame consisted of randomly selecting intact classrooms(using a random start) from each school to participate. All relevant classes in each selected school wereincluded in the sampling frame. All students in the sampled classrooms were eligible to participate in theGSHS (2013).“Nationwide health survey based on schools in Mongolia 2013” covered 5393 schoolchildren (age 12-18) from 59 public and private schools. Coverage rate was 89% and total response rate was 88%.Result. According to the WHO recommendations, 18.6 percent (95%CI 17.2-20.1) of students consumedfruits and vegetables fi ve or more times per day. Additionally, consumption of fruits and vegetablesdecreases as age and grade increase.Totally, 31.3 percent (95%CI 29.3-33.3) of students consumed dairy products such as milk, yogurt andcheese two or more times per day in the past month. In addition, 33.0% (95%CI 30.5-35.5) of malestudents eat dairy products compared to 29.5% of female students; that is males consume 3.5% morefruits and vegetables; however there is no statistical difference. On the other hand, 43.4 percent ofchildren aged 12 years or younger consumed dairy products, 32.9 percent of children aged 13 to 15years old and 24.8 percent of children aged 16 years old or older consume dairy products; thus, showinga decreasing trend with age.One of three (33.6%) of students drank carbonated beverages one or more times per day during the pastmonth. Consumption of carbonated beverages differed between males and females (37.6% vs. 29.7%)and increased by age. By age group, high consumption of carbonated and soft drinks was observedamong students aged 16 years old or older (34.4-35.2 percent), while 33.8 percent of children aged13-15 years old, and 29.4 percent of students 12 years old or younger consumed carbonated and softdrinks.Amongst all students, 55.3 percent (95%CI 52.0-69.3) ate breakfast “usually or always”, 26.1 percentate breakfast “sometimes”, and 13.7 percent ate breakfast “rarely or never”. About 1.9% of studentswent hungry to school “usually or always” during the past one month because of insuffi cient food in theirhome.Among participated school children, 26.4 percent (95%CI 21.5-31.9) of students ate fast food three ormore times within the last seven days at restaurants such as Max Burger, Mondonald and their schoolcafeteria. Percentage of students that ate regularly at fast food restaurants or school canteens wasincreased by 8% than the indicator of the previous survey result.Conclusion1. Fruits and Vegetables: One in fi ve students consumed fruits and vegetables in accordance withthe dietary guidelines for healthy eating and this indicator are increased by 2.7% compared to theprevious study.2. Dairy products: Consumption of dairy products is increased by 4% compared to the previous study;however, it is decreased with age.3. Carbonated Beverages: Consumption of carbonated beverages by students was at similar level inboth, urban and rural areas, and it is increased by 6 points from the previous study level, especiallyhigher consumption was observed among male students.4. Fast Food: Percentage of students that ate regularly at fast food restaurants or school canteens wasincreased by 8% than the indicator of the previous survey result.
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Background: Disorders in the human body due to selenium defi ciency are associated with geographiclocation or environment, especially selenium concentrations in water and in soil. Selenium concentrationsin the blood of populations around the world, varies greatly. To date, no research has been conducted onaverage serum selenium level of adult Mongolians.Goal. To conduct a comparative study on the average serum selenium level of adult Mongolians bygeographic regions.Materials and Methods. In this study were participated 2339 healthy subjects randomly selectedfrom sampling units based on 4 geographical regions of Mongolia. For the study were used thequestionnaire and biochemical methods. Blood samples were collected from all subjects and serumselenium concentration was measured by the thermo fi sher scientifi c analyzer using atomic absorptionspectrophotometer method.Result: The mean serum selenium level in adult Mongolians was 0.78 μmol/l. A comparative analysisshowed a statistically signifi cant difference (ð<0.0001) in the mean serum selenium level of adultMongolians living in different geographic regions. In particular, the mean serum selenium level ofadult Mongolians was 0.85 μmol/l in the Altai Mountain, 0.57 μmol/l in Khangai mountain, 1.0 μmol/l inGobi, 0.71 μmol/l in Dornod steppe regions and thus indicator was 0.75 μmol/l among adult citizens ofUlaanbaatar. Majority of residents living in Khangai mountain and Dornod steppe regions were at a riskof selenium defi ciency.Conclusions:1. Comparative analysis of the average serum selenium level of adult Mongolians by region showedthat the Gobi region has highest (1.0 μìîë/ë) and Khangai region has the lowest (0.57 μìîë/ë).2. Study fi ndings showed that 7 – 8 individuals out of 10 residents of Dornod steppe and Khangairegions were at the risk of selenium defi ciency.
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Selenium was discovered by the Swedish chemist Jo¨ns Jacob Berzelius in 1817 and has been recognized as an essential trace element for many life forms including man since 1957. As an essential trace element, the importance of selenium (Se) in humans is well established, and its deficiency has caused serious health effects in humans, such as Keshan disease. Foods are major natural source of Se, and its levels generally depend on soil Se levels. Since its discovery as an important component of antioxidant enzymes, such as glutathione peroxidase (GPx), thioredoxin reductase (TrxR) and iodothyronine deiodinases (IDD), there has been an increased interest in the study of other Se-containing proteins (selenoproteins) or enzymes (selenoenzymes)].Selenocysteine is recognised as the 21st amino acid, and it forms a predominant residue of selenoproteins and selenoenzymes in biological tissues. The molecular structure of selenocystiene is an analogue of cysteine where a sulphur atom is replaced by Se. Selenium can be measured in whole blood, blood fractions (plasma, serum, red blood cells), hair, nails, and urine. Plasma selenium levels below 0.6mM (40–50 ng/ml) are considered deficient, and risk of toxicity occurs at levels higher than 2mM (160 ng/ml), with reports of toxic effects at concentrations higher than 3mM (250 ng/ml)The increased production of ROS (reactive oxygen species) can exert oxidative stress in the physiological system, and if excess ROS are not properly regulated they can cause damage to cellular lipids, proteins and DNA. The damage caused by ROS has been linked to various human diseases, including heart diseases. The presence of ROS can also cause the oxidation of lowdensity lipoprotein (LDL),and it has been reported to be associated with initiation of atherogenesis in heart diseases. One hypothesis is that the presence of high Se as antioxidant selenoenzymes and selenoproteins may help to reduce the production of oxidised LDL and, therefore, would reduce the incidence of heart diseases.Thioredoxin reductase plays a significant role in preventing the development of atherosclerosis by reducing oxidative stress and increasing NO bioavailability
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IntroductionThe trace elements selenium is a constituent of the antioxidant enzyme glutathione peroxidase. Becauseit boosts the body’s antioxidant capacity, selenium is thought to have some ability to control cell damagethat may lead to cancer. Selenium low status has been linked to increased risk of various diseases, suchas cancer and heart disease.GoalInvestigate serum selenium level of adult mongolians and conduct age and gender coparartive analysisof the serum selenium content.Materials and MethodsCross sectional study was performed among the 2339 apparently healthy Mongolians of both gendersaged ≥18 years. In the study were used questionnaire and biochemical methods. Blood samples werecollected from all subjects and serum selenium concentration was measured by atomic absorptionspectrophotometry method using thermo fisher scientific analyzer.ResultsThe mean and confidence interval of serum selenium level in adult Mongolians was 0.78 μmol/l (95%CI0.77-0.79) and there was no significant difference between genders. Thus the mean was 0.77 μmol/l(95%CI 0.76-0.80) among women and in men it was 0.78 μmol/l (95%CI 0.76-0.80). Data analysisrevealed that older age group individuals were at risk of lowered serum selenium level. In particular,the oldest age group of over 60 years (females: 0.74 μmol/l, 95%CI 0.70-0.77; males: 0.68 μmol/l,95%CI 0.64-0.71). The difference in selenium status between age groups was statistically significant inboth sexes. The overall prevalence of serum selenium concentrations indicative risk of deficiency was59.7%, with no significant differences in the prevalence by genders. Survey findings revealed that riskof selenium deficiency had statistically significant difference between age groups among the surveyedmen.Conclusion: The mean value of serum selenium in adult Mongolians was 0.78 μmol/l and there was nosignificant difference between genders.
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IntroductionAfter discovering an important biological function of selenium, selenium content and its deficiency arestarted to be extensively studied in numerous epidemiological studies that have been conducted inmany countries in the world. In Mongolia, as a country geographically located in unstable climate zone,there are no studies conducted on selenium so far since the last century, except one study determiningselenium deficiency signs in livestock.GoalTo determine selenium (Se) content in Mongolian wheat and livestock meatMaterials and MethodsIn total 30 samples of wheat planted in Dornod, Uvs, Tuv and Selenge aimags of Mongolia and 142samples of Mongolian beef and beef imported to Russia from China, respectively were underwent inlaboratory analysis. Wheat was hold at room temperature to reach the regular weight, and muscletissue of meat was dried in a lofildryer. Dried wheat and meat were then powdered into homogenousconsistency and were kept in air proof polyethylene container at room temperature until being analyzed.Selenium content was determined by fluorometric method [2].ResultsOut of wheat sorts grown in Mongolia, selenium was detected in extremely low level in wheat of Khalkhingol sort of Dornod aimag (7±1 mkg/kg) and Selenge sort of Selenge aimag (8±1 mkg/kg), and in wheatsold in retail outlets of Baruunturuun soum of Uvs aimag (7±1 mkg/kg) and Khongor soum of Darkhan-Uul aimag (8±1 mkg/kg). However, selenium content was relatively higher in wheat samples of Darkhan34 sort of Baruunturuun soum of Uvs aimag (31±5 mkg/kg) and of Altaiskaya sort of Jargalant (29±3mkg/kg) and Bornuur (32±1 mkg/kg) soums of Tuv aimag, and in sample of retail wheat of Sagil soum(29±1 mkg/kg) of Uvs aimag.When determined the selenium content in Mongolian livestock meat, in average, the selenium contentwere 109-296 mg/kg in beef, 94-200 mg/kg in lamb, 120-225 mg/kg in horse meat and 124-197 mg/kg ingoat, and the differences were not statistically significant (p>0.5). The highest selenium content of 400mg/kg was detected in horse meat of Govi-Altai aimag.Conclusion: The selenium content in wheat and livestock meat which are the mean stable food forMongolians is considerably low.
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INTRODUCTION:The Government of Mongolia pays significant attention to reduce noncommunicable diseases and theirrisk factors. WHO Global strategy to reduce salt intake recommended to Member States to assessknowledge, attitude and practice (KAP) of the population on salt intake.GOAL:To determine KAP on salt intake was explored in relation to geographical location and its challenges.MATERIALS AND METHODS:This is a cross-sectional study that included 1,040 people with age range 25 - 64 years. The participantswere randomly selected from the four economic regions - western, khangai, central and eastern regions,and Ulaanbaatar city of Mongolia. The ethical aspect of the study was reviewed and approved at ameeting of the Ethics Review Committee in the medical sector at the Ministry of health, Mongolia onJuly 8, 2012 by Resolution number 14.RESULTS:The population with no knowledge of high salt content foods was 23.5% in the western region, 18.9%was in the khangai region, 16.2% was in the central region, 22.0% was in the eastern region, and15.0% was in Ulaanbaatar (ð<0.000). The participants that think a high salt diet and foods do not causehealth problems were higher in the western region 15.8%, and participants who do not know whether itcauses health problems were higher in the eastern region 11.2% compared to other regions (p<0.001).The study population from the central region and males from eastern region did not aware the negativeconsequences of salty meal/foods towards developing stomach cancer (p<0.001).Percentage of population who drink salty tea was 84.4% in the western region, 90.7% were in thekhangai region, 23.4% were in the central region, and 11.0% were in the eastern region, and 44.8%were in Ulaanbaatar (p<0.000).CONCLUSION:Salt reduction intervention especially interventions on changing attitude should be conducted aftertaking account the specific differences of the local areas.
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IntroductionOne key target of the United Nations Millennium Development goals is to reduce the prevalence of underweight among children younger than 5 years by half between 1990 and 2015. Child malnutrition is internationally recognized as an important public health indicator for monitoring nutritional status and health in populations. World Health Organization estimated the malnutrition was associated with 54% of child deaths in developing countries. The devastating effects of malnutrition on human performance, health, and survival are well-established and a recent global analysis demonstrated that child malnutrition is the leading cause of the global burden of disease. The importance of assessing population nutritional status every 5 years is widely recognized, and three rounds of National Nutrition Survey were carried out in Mongolia since 1992 with support from UNICEF. The most recent Third National Nutrition Survey was carried out with the purpose of assessing nutritional status of Mongolian children and women six years ago in 2004.ObjectiveTo describe the national prevalence of underweight in children under five.Materials and MethodsThe current cross-sectional survey was conducted in 21 provinces of 4 economic regions of the country and capital Ulaanbaatar city. Household was randomly selected based on local administrative and soum/family hospital registry and enrolled a total of 706 children aged 0-59 months were selected from sampled households. Interviews, anthropometric measurements and clinical examinations were used in the survey. Child growth was assessed based on z-scores calculated using the WHO Child Growth Standard. Low weight-for-age (underweight) can result from either long-term or short-term nutritional deficit.Results4.7% of the surveyed children were underweight. According to the WHO criteria the prevalence of underweight in Mongolian children less than 5 years of age was include “low prevalence rate”. The prevalence of the underweight among children less than 5 years was significantly higher in Rural area than the Urban.Conclusions:1. The national prevalence of underweight remains at “low” level according to WHO classification. 2. Child malnutrition reduction is needed to successfully meet the Millennium Development Goals.3. In rural area the prevalence of underweight among in 0-59 months old children was highest than urban area’s children.4. The prevalence of nutrition deficiencies varies between different regions calling for implementation of interventions specific for local conditions and needs.
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IntroductionIn Mongolia, cardiovascular diseases (CVDs) and stroke have consistently been the number one cause of population mortality since 1990s. Hypertension is an independent risk factor for CVDs and stroke. There is a conclusive evidence that high salt intake is the strongest dietary factor for hypertension. However, in Mongolia, evidence on actual salt intake of the population, its potential sources and relations to high blood pressure has been in lack so far.GoalThe survey was aimed to determine actual daily salt intake and related behavior patterns in the population residing in Eastern and Khangai regions and in the city and to identify the directions of further activities to decrease the amount of salt consumed per day by the target population.Materials and MethodsThe survey recruited a total of 475 adults from Khentii, Bulgan aimags and Bayanzurkh district of Ulaanbaatar. Questionnaires, physical measurements and laboratory analyses were applied to collect and process the data on population demographics, behavior patterns and salt related KAP, blood pressure and sodium and potassium values in 24 hour urine samples to estimate daily salt intake. A survey database was developed using EPI INFO and the data was entered in twice. SPSS 18 software was used for the data analysis, mean and standard deviations were estimated using t and F statistics on continuous variables with normal distribution, and chi square test was applied to differences in proportions.ResultsMean age of the survey population was 44.5 years; the survey population was not differing in their age, gender and region. Average daily consumption of salt was 9.5 grams in the survey population; it was not differing in terms of region. Men consumed on average 10.1 grams of salt which is twice much higher than the WHO recommended amount. Salt consumption was higher among those aged 45-54 years and rural persons, particularly men. For men and people aged 45-54 years old, the salt consumption was directly related to their salt tea drinking habit (r= 0.14; p=0.04). Those who drink alcoholic drinks frequently have higher body mass index and/or less educational attainment were more likely to drink tea with salt. In the Eastern Region, regardless of a habit of drinking tea without salt, the high salt consumption seems to be caused by insufficient knowledge of salt containing meals and food products (r=.27; p=0.001), lack of awareness of health impacts of salt, as well as lack of attitude towards their control of daily salt intake (r= ; p= ). In the Khangai Region and the urban city, salt added to meals and food preparation (Partial r =.22; p=0.05), salt containing food products and salt tea are the main factors of high salt consumption. The survey population in these areas lacks attitude and practice to decrease and control their daily salt intake.ConclusionSalt consumption is generally high among the adults of the Eastern and Khangai Regions and in UB city; males and rural people are lacking in knowledge and attitude related with salt content of food, food choice and with the potential health impacts of excessive sodium intake.
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BackgroundAn estimated 522 066 students are studying in secondary school of Mongolia and it was 19% of total population. Population life expectancy and health status is directly related to adolescents’ health, as many chronic disease conditions are affiliated with adolescence. Many premature deaths among adults result from behavior initiated during adolescence. According to the NRC survey, one in thirteen schoolchildren (7.3%) was underweight, 16.3% was stunting, and 13.8% were iodine deficiency. It has taken 52.8% of total daily energy among 11-14 years schoolchildren and 50.5% were between 15 and 17 ages. In addition, research in Mongolia in 2005 indicate serious problems in healthy eating behavior; 8% of adolescents consumed milk products on daily basis, 71.7% had breakfast only sometimes, and 83.2% had a meal one time per day. Micronutrient deficiency such as anemia, A, D vitamins among them is cause of low consumption of vegetable and fruits. There is a need to study schoolchildren’s dietary recall.ObjectiveTo study and evaluate schoolchildren’s nutritional statusMaterials and MethodsThe descriptive and cross sectional study was carried out in 4 districts of Ulaanbaatar city (750 schoolchildren from each district) and 2 aimags (889 schoolchildren from Uvurkhangai and 925 from Dornod) of Mongolia. Also determined current nutrition situation of surveyed schoolchildren by using 24 hours recall method and assessed.ResultA total of 4760 (46.6% boys and 53.4% girls) school children surveyed and 46.6% were boys and 53.4% were girls. 71.7 percent of total respondents have breakfast sometimes, 83.2 of them have a lunch only one time per day, and 38.3 percent of total daily energy takes from dinner and have not any difference between age groups. Adolescent aged 7-10 years takes 92.7 percent of total calorie, 90.1 percent of protein, 93.9 percent of carbohydrate and 92.3 percent of fat compared to RDI of Mongolia and thus animale fat is the 1.6 times more than the norm. Consumption of vitamins and minerials such as vitamin A, and iron8 calcium were insufficient among schoolchildren. Specially, it was lower among male student than female. For instance vitamin C intake was 48.0- 58.6 percent among female students aged above 11 years and it was 47.3- 51.8 percent for male students. About 30 percent of total calcium is consumed per day among overal respondents. Conclusions:1. Daily intake of basic nutrients and energy is lower by 10-30 percent than RDI of Mongolia among schoolchildren.2. High consumption of in diet among male adolescents of age 15 years and above causes disbalance of adequate ratio of main nutrients as protein8 fat and carbohydrates.3. There is not enough suffecient consumption of vitamins and minerials specially calcium.
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Introduction. More than 3.5 million mothers and children under five die unnecessarily each year due to the underlying cause of under nutrition, and millions more are permanently disabled by the physical and mental effects of a poor dietary intake in the earliest months of life. Malnutrition has a negative impact on the physical and intellectual development which can further affect health, living potentials and the quality of life. It has been established that to reduce child mortality and to prevent illnesses related to malnutrition the most effective actions are to breastfeed, feed with proper complementary foods, enrich child’s diet with vitamin A, zinc and other necessary vitamins and mineral supplements, and to treat chronic malnutrition. This can be achieved by implementing internationally reputed projects and programs. Goal. To assess the knowledge, attitude and practice of mothers in the project areas towards, infant and young child feeding.Materials and Methods. This survey conducted in each of 5 soums of Gobi-Altai, Sukhbaatar, Dundgobi, Tuv, and Arkhangai aimags and each of 5 khoroos of Chingeltei and Songinokhairkhan districts of Ulaanbaatar city. Survey recruited a total of 1077 mothers and caregivers of children aged 0-35 months.Results. 7 in 10 mothers participating in the study have “insufficient” level of knowledge of feeding young children and this is related to the mother’s education level. 2. 21.8% of mothers and caregivers were aware of the recommendations of breastfeeding the child within an hour after birth and 38.6% were not aware of exclusive breastfeeding until 6 months of age. 1 in 4 mothers participating in the survey (25.2%) had the wrong understanding of feeding a child 1-2 times a day while complementary feeding: 43.6% of mothers in Sukhbaatar aimag, and 33.8% in Gobi-Altai aimag had this insufficient knowledge of frequency of breast feeding while giving complementary food to the baby. Half (50.3%) of mothers and caregivers did not know the correct amount of food to be given at one time to feed a child and this knowledge was insufficient across all aimags and districts. Knowledge of illnesses caused by nutrition and their preventions was insufficient among mothers in all aimags and districts.Conclusions:1. 65, 7% of mothers exclusively breastfed their children until the age of 6 months. The percentage of exclusively breastfeeding in districts is similar to the national average; however, in rural aimags it is twice higher.2. Only 41, 5% of children up to 3 years of age were fed with complementary food at right time, while 42, 8% - too early and 15%- too late.3. Only 8, 7% of mothers and caretakers have correct practice of feeding children of 12-23 months old more than 5 times per day, which is not sufficient indicator.
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Introduction. Malnutrition has a negative impact on the physical and intellectual development which can further affect health, living potentials and the quality of life. A lack of a sustained decrease in low birth weight and young child malnutrition is associated with the failure to provide nutritious food in adequate quantities to pregnant and breastfeeding women and children up to two years of age. The most recent estimate from the 2005 MICS survey of the prevalence of wasting is 2.8 percent, stunting is 26.8 percent, and underweight is 7.4 percent among children aged 0-59 months in Mongolia.Goal. To assess the current nutritional status of 0-59 months old children of Mongolia, and identify next steps to improve child nutrition.Materials and Methods. This cross-sectional survey was conducted in 21 aimags of 4 economic regions of the country and in the city Ulaanbaatar. A total of 706 children aged 0-59 months were selected from sampled households. Interviews, anthropometric measurements and clinical examinations were used in the survey.Results. The distribution of length/height-for-age Z-scores of the surveyed children was shifted to the left compared to the WHO Child Growth Standard. The weighted average z-score and its standard deviation was 0.78±1.5, which is characteristic of high proportion of "short" children in Mongolia. Of the surveyed children, 15.6% (95%CI 12.7¬18.9) were stunted about one-third of stunted children had severe stunting. The prevalence of stunting was highest in the Western Region, the differences between this region and all other regions were statistically significant. Rural children had statistically significantly prevalence rates of overall stunting, moderate stunting, and severe stunting compared to their urban counterparts. Underweight and stunting were much more prevalent in children who had a low birth weight. Of those with a low birth weight, 35.5% (95%C118.4- 57.3) were underweight and 54.1% (95%CI 35.3-71.8) stunted, but there were no wasted children.Conclusions:1. In rural area the prevalence of stunting among in 0-59 months old children was highest than urban area's children.2. The prevalence of stunting was highest in the Western Region and remains at "high" level according to WHO classification.3. Underweight and stunting were much more prevalent in children who had a low birth weight4. The high rate of stunting among under five year olds is likely related to dietary behavior, and requires further study and intervention efforts.
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Goal: To determine schoolchildren’s growth and nutrition situationMaterials and MethodsThe descriptive and cross sectional study was carried out in 4 districts of Ulaanbaatar city (750 schoolchildren from each district) and 2 aimags (889 schoolchildren from Uvurkhangai and 925 from Dornod) of Mongolia. The study was conducted in two steps, Step 1 or beginning of school year covered totally 4760 schoolchildren and in end of school year totally 4108 schoolchildren. Data for the survey was collected by using questionnaire and clinical examintions and antropometric measurements. Weight of schoolchildren was used UNISCALE electrical scales with precision to 100g and height was used standard measurement with precision to 1mm. Schoolchildren’s growth was assessed by method “Sigma” and compared to the survey “Growth means of schoolchildren up to 16 years of Mongolia” (PHI, 2006). The nutritional status of schoolchildren were taken in accordance with the Z score calculated with relation to WHO average population anthropometric reference (WHO, 1995). Also determined current nutrition situation of surveyed schoolchildren by using 24 hours recall method and assessed. Nutrition assessment was used the standard indicators of Technical Committee, WHO [3, 7, 8].ResultsA total of 4760 (46.6% boys and 53.4% girls) school children were present beginning of the school year and 4108 (46.0% boys and 54% girls) of their were end of school year during the visit. Almost 60 of the total school children were from districts of UB beginning and end of school year. Beginning of the school year, 5.1 percent of total surveyed schoolchildren were assessed underweight and 14.1 percent is stunting, 1.7 percent is wasting and end of school year it was 4.7 percent underweight, 13.9 percent stunting and 1.2 percent wasting.71.7 percent of total respondents have breakfast sometimes, 83.2 of them have a lunch only one time per day, and 38.3 percent of total daily energy takes from dinner and have not any difference between age groups. Consumption of food products such as green vegetables, beef liver which are rich with vitamin A is inadequate. Example; among 7-10 years old 184.9 mcg, 11-14 years 247.2 mcg, above 15 years old was 241.6 mcg. Amount minerals such as calcium and phosphorium per day was among 7-10 years old 398.2mg and 756.1мг, 11-14 насанд кальци 277.8-301.5мг, фосфор 688.6-899.5мг, above 15 years old was calcium 366.4-378.3mg, phosphorium 875.3-978.8mg. Dairy consumption was analyzed by urban and rural areas among schoolchildren and it was among urban schoolchildren is more by 16.6-21.4 percent from rural areas.Conclusion:1. The progress made improving gradually the nutritional status of schoolchildren from previous study. The prevalence of underweight, stunting and wasting is “low” level among schoolchildren by WHO. There is statistically significant lower nutritional status among schoolchildren in rural area than in urban.2. Micronutrient deficiency is main reason of undernutrition among schoolchildren. In other words, the vitamins (C, A, D), and minerals (Ca, Fe) which are essential for schoolchildren growth and fiber is insufficient in their food. The consumption of diary is inadequate among schoolchildren of rural area compared to urban.3. Consumption of fruits and vegetables and diary products is inadeguate among total surveyed schoolchildren especially in rural area.
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Introduction. The high rate of malnutrition in young Mongolian children is a serious issue. Anemia, stunting and rickets have all been identified as significant problems. Low levels of serum folate have been reported among some young children in two previous surveys. Zinc is a growth-limiting micronutrient that may contribute to the persistent stunting in young Mongolian children. The traditional rice and wheat-based complementary foods used for young child feeding are likely to be inadequate in zinc. Certainly, the overall prevalence of stunting in Mongolia (i.e., 20%) is suggestive of substantial risk of zinc deficiency. It is possible that co-existing low selenium status may exacerbate zinc deficiency, because selenium compounds regulate the delivery of zinc from metallothioneine to zinc enzymes. To date, however, there have been no studies on the selenium and zinc status of the Mongolian population. Study objective. The objective of this study was to assess the biochemical indicators of micronutrient deficiency among 6-36 months old children. Subjects and methods. This cross-sectional study was conducted in four districts of Ulaanbaatar city and in centers of Bulgan, Bayanhongor, Dornod and Khovd aimags and included 243 (122 male and 121 female) apparently healthy children aged 6 to 36 months. Hemoglobin analysis was performed using a hemoglobinometer Hemocue AB, serum ferritin was analyzed by enzyme immunoassay technology, serum retinol by high-pressure liquid chromatography, serum zinc and selenium were analyzed by atomic absorption spectrophotometry and serum 25(OH)D analysis was performed using radioimmuno assay procedure. Results. Mean hemoglobin, serum ferritin, folate, 25(OH)D, retinol, zinc and selenium concentrations in children from Ulaanbaatar city and aimag centers were determined. Age-group differences for the means were significant for hemoglobin, serum ferritin, serum folate (p=0.001)and serum zinc(p=0.01). The differences between Ulaanbaatar and the aimag centers were also significant for hemoglobin, serum ferritin, serum zinc (p=0.05) and serum folate (p=0.001). 24.3% of the children were anemic. The prevalence of anemia was greater among the children in the aimag centers than in Ulaanbaatar city and in younger children than in the oldest age group. The prevalence of iron deficiency anemia was 15.3% and was independent of setting but was lowest in the oldest children aged 24 to 36 months. Of all the surveyed children, only 3.7% had low level of serum folate. The overall prevalence of low serum retinol levels indicative of vitamin A deficiency was 33.7%, with no differences by setting or age group. 74.7% of the children had low serum zinc concentrations. There was no significant difference in the prevalence between children living in Ulaanbaatar city and the aimag centers, or among the three age groups of children in either setting. The overall prevalence of low serum selenium concentrations was 57.7%, with no differences in the prevalence by setting or age-group. The prevalence of low serum levels of 25(OH)D was 61% and was highest among the children aged 6 to 12 months of Ulaanbaatar city. Conclusion: 1. Zinc deficiency had the highest prevalence (74.7%) among the surveyed children, followed by low serum selenium levels (57.7%). 2. 36% of the children were at risk of two and 64% of more than two coexisting micronutrient deficiencies. 3. There is a need for multi-micronutrient programs that take into account the potential interactions of micronutrients instead of the present single micronutrient based interventions on-going in Mongolia.