Vitamin A status of Filipino preschool children given a massive oral dose.

The protection period of a 200,000 IU of vitamin A on Filipino children was determined. Subjects were 105 children aged 1-5 years given a single massive dose during the "Araw ng Sangkap Pinoy" (ASAP) in March 1995. Serum retinol was measured by HPLC at baseline, one, two, four and six months after the administration of the dose. Results showed that baseline serum retinol levels were significantly lower than all follow-up values. Serum retinol values were maintained at levels higher than pre-supplementation values although the values decreased on the second month after supplementation. The proportions of deficient and low (< 20 microg/dl) levels were significantly lower one and six months after supplementation. All follow-up serum retinol levels of children with deficient and low values at baseline were significantly lower (p < 0.001) than those with normal values. The WHO recommendation of 200,000 IU was effective in increasing serum retinol concentrations and maintaining it above pre-supplementation levels up to 6 months after administration of the dose. It also replenished organic vitamin A reserves as shown by the dose response (S30DR) approach. Incidence of infection also decreased among the children. Supplementation with vitamin A has likewise resulted in an increase in hemoglobin values and a decrease in the proportion of anemics (Hb < 11.0 g/dl) among the children.

Iron status of Filipino infants and preschoolers using plasma ferritin and transferrin receptor levels.

Iron status of 1,861 Filipino infants and preschoolers was evaluated by measurements of plasma ferritin (PF), transferrin receptor (TR) and hemoglobin (Hb). One group of subjects (Group I) consisted of all anemic subjects together with a systematic subsample from the Fourth National Nutrition Survey-Biochemical Phase. Results showed that depleted iron stores based on PF (< 12.0 ng/ml) was present in 70.0% of infants and 60.5% of preschoolers. Tissue iron deficiency based on TR (> 8.5 mg/l) was present in higher proportion (80.0% and 73.7% for infants and preschoolers) which was comparable to the proportion of anemia (80.3%). In a subgroup of subjects from the Country Program for Children IV (Group 2) elevated TR was present in 61.4% of infants and 46.5% of preschoolers. A lower proportion of depleted iron stores of 22.7% in infants and 15.2% in preschoolers was observed. Correlation test showed that there was a closer relationship between Hb and TR (r = -0.42) than Hb and PF (r = 0.20) even if PF was expected to give a higher proportion of values below normal. The occurrence of anemia in the presence of elevated TR without any decrease in PF values suggest that the diagnostic ability of PF could be limited in the presence of infection. Therefore, future studies should include biochemical tests such as C-reactive proteins (CRP) to determine the extent of association between anemia and infection.

Menstrual blood loss and iron nutrition in Filipino women.

Menstrual blood loss was measured in 80 apparently healthy women aged 15-44 years. The study showed a median menstrual blood loss of 37.1 ml per period and the range was from 5.4-169.0 ml. With an average menstrual cycle of 29 days and a mean hemoglobin content of 12.8 g/dl the average iron loss was estimated to be about 0.55 mg/day. The simultaneous effects of menstrual iron loss and dietary iron intake on the iron status of menstruating women were examined using multiple regression analysis. The parameters used to measure iron status were serum iron, transferrin saturation index (TSI), hemoglobin and mean corpuscular hemoglobin concentration (MCHC). Among these parameters, TSI was found to be the most sensitive indicator of changes in factors affecting iron balance moreover, it was found that with greater menstrual loss and decreasing iron intake, there was a marked fall in TSI. However, the decline of TSI did not reach a level at which deficiency of iron transport would have occurred. These results suggest that iron intake was enough to replenish the iron lost in menstruation. Results of statistical analysis showed that the upper limit of menstrual blood loss should be about 80 ml per period. Any loss above this level for continuously long period of time may lead to anemia. This condition is further aggravated by insufficient iron intake. The data from this study are useful in estimating the recommended dietary allowance (RDA) for iron for menstruating Filipino women. They will also serve as a basis of management of patients in medical practice in terms of evaluating risk of and treatment of iron-deficiency anemia.