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Ara G, Little DC, Mamun AA, de Roos B, Grieve E, Khanam M, Hasan SMT, Ireen S, Ali SD, Boitchi AB, Dijkhuizen MA, Ahmed T, Roos N. Factors affecting the micronutrient status of adolescent girls living in complex agro-aquatic ecological zones of Bangladesh. Sci Rep 2023; 13:6631. [PMID: 37095307 PMCID: PMC10126111 DOI: 10.1038/s41598-023-33636-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/16/2023] [Indexed: 04/26/2023] Open
Abstract
Inadequate intake of both macro and micronutrients is the major determinant of micronutrient deficiencies in adolescent girls. This study assessed multiple micronutrient status including vitamin D, iron, vitamin A, and urinary iodine concentration among adolescent girls through two seasonal cross-sectional surveys conducted during dry and wet seasons. Mixed-effects linear and logistic regression analysis were conducted to assess associations between micronutrient status, salinity and seasonality. The mean age of the girls was 14 years. Vitamin (OH)D insufficiency was significantly higher in freshwater areas in wet season compared to dry season (wet season: 58% and dry season: 30%, P < 0.001). In wet season, risk of vitamin (OH)D insufficiency was three times higher compared to dry season (AOR: 3.03, 95% CI 1.71, 5.37, P < 0.001). The odds of vitamin (OH)D insufficiency was 11 times higher in fresh water areas compared to high saline areas (AOR: 11.51, 95% CI 3.40, 38.93, P < 0.001). The girls had higher risk of iron deficiency in wet season. Despite the environment being enriched with micronutrient-contained aquatic food, adolescent girls in coastal areas experience different micronutrient deficiencies. The high prevalence of vitamin (OH)D insufficiency in freshwater locations and seasonal iron deficiency in high saline areas needs attention.
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Affiliation(s)
- Gulshan Ara
- Nutrition and Clinical Services Division, icddr, b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark.
| | - David C Little
- Institute of Aquaculture, University of Stirling, Stirling, UK
| | - Abdullah-Al Mamun
- Department of Fisheries and Marine Science, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Baukje de Roos
- The Rowett Institute, University of Aberdeen, Aberdeen, UK
| | | | - Mansura Khanam
- Nutrition and Clinical Services Division, icddr, b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - S M Tafsir Hasan
- Nutrition and Clinical Services Division, icddr, b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | | | - Samira Dilruba Ali
- Nutrition and Clinical Services Division, icddr, b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Anika Bushra Boitchi
- Nutrition and Clinical Services Division, icddr, b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Marjoleine A Dijkhuizen
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, icddr, b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Nanna Roos
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
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Grieve E, Mamun AA, de Roos B, Barman BK, Ara G, Roos N, Pounds A, Sneddon AA, Murray F, Ahmed T, Little DC. Adolescent girls in aquaculture ecozones at risk of nutrient deficiency in Bangladesh development and validation of an integrated metric. BMC Public Health 2023; 23:405. [PMID: 36855076 PMCID: PMC9972605 DOI: 10.1186/s12889-023-15175-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 01/31/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND This study developed and validated an integrated metric that enhances understanding of linkages between agro-ecological and socio-economic factors that are important for explaining nutritional wellbeing in relation to fish consumption; especially among adolescent girls who are at risk of nutritional deficiency in Bangladesh. Currently, there is no metric that takes account of environmental, cultural and economic contexts when considering fish consumption and dietary health from a policy perspective. METHODS The study was designed as a bi-seasonal survey, repeated in the same population of adolescent girls recruited during the dry and wet seasons. Sampling was stratified by five settings (four aqua-agroecological zones and one processing plant community), with 60 girls recruited in each. Associations between candidate predictors (salinity, diet diversity, religion, socio-economic status and women's autonomy score) and dependent variables representing nutritional outcomes (anthropometry, omega-3 index and micronutrient levels) were explored in multivariable regressions. The fitted model with its predictors was validated, and a risk score derived from responses to a few short questions on religion, salinity zone, female autonomy, diet diversity and tilapia consumption. RESULTS The omega-3 index showed the clearest distinction between seasons, by salinity and religion. Higher female autonomy, religion (being Hindu rather than Muslim), geographical location (living in a high or mid-saline area), and a higher dietary diversity were the strongest predictors of whole blood omega-3 index. The c-index for the prognostic model was 0.83 and 0.76 in the wet and dry season respectively, indicating good predictive accuracy. There appeared to be a clear trend in risk scores differentiating between those 'chronically at risk' and those 'never at risk'. CONCLUSIONS Observational data on different aquaculture-ecozones defined by salinity enabled us to establish linkages between seasonal fish intake, religion, diet diversity, female autonomy and nutritional wellbeing. The purpose of the metric is to reveal these specific linkages in practice. This tool should improve targeting of timely, preventative and cost-effective nutritional interventions to adolescent girls most at-risk from low omega-3 levels in communities where seafood is produced.
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Affiliation(s)
- Eleanor Grieve
- 1 Lilybank Gardens, Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ UK
| | - Abdullah-Al Mamun
- Department of Fisheries and Marine Science, Noakhali Science and Technology University, University Road, Noakhali, 3814 Bangladesh
| | - Baukje de Roos
- The Rowett Institute, University of Aberdeen, Ashgrove Road W, Aberdeen, AB25 2ZD UK
| | - Benoy K. Barman
- WorldFish, Bangladesh and South Asia, House 355/A Rd 114, Dhaka, 1212 Bangladesh
| | - Gulshan Ara
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, GPO Box 128, Dhaka, 1000 Bangladesh
| | - Nanna Roos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Allé 51, 2200 Copenhagen, Denmark
| | - Alexandra Pounds
- Institute of Aquaculture, University of Stirling, Stirling, FK9 4LA UK
| | - Alan A. Sneddon
- The Rowett Institute, University of Aberdeen, Ashgrove Road W, Aberdeen, AB25 2ZD UK
| | - Francis Murray
- Institute of Aquaculture, University of Stirling, Stirling, FK9 4LA UK
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, GPO Box 128, Dhaka, 1000 Bangladesh
| | - David C. Little
- Institute of Aquaculture, University of Stirling, Stirling, FK9 4LA UK
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