Original Article

European Journal of Clinical Nutrition (2006) 60, 623–632. doi:10.1038/sj.ejcn.1602361; published online 14 December 2005

Risk of zinc, iodine and other micronutrient deficiencies among school children in North East Thailand

Guarantor: RS Gibson.

Contributors: RAT and RSG wrote the manuscript, with input from other authors. PW and RSG developed the study hypothesis and secured the funding and TP was the project field co-ordinator. RAT, TP, MSM, SG, AB, PW and RSG participated in the collection, analyses, and/or interpretation of the data. KBB carried out the biochemical analyses undertaken in New Zealand, EW supervised the analysis and interpretation of the serum retinol values in Thailand.

R A Thurlow2, P Winichagoon1, T Pongcharoen1, S Gowachirapant1, A Boonpraderm1, M S Manger2, K B Bailey2, E Wasantwisut1 and R S Gibson2

  1. 1Institute of Nutrition, Mahidol University, Salaya, Thailand
  2. 2Department of Human Nutrition, University of Otago, New Zealand

Correspondence: Dr RS Gibson, Department of Human Nutrition, University of Otago, PO Box 56, Union Street, Dunedin, New Zealand. E-mail: rosalind.gibson@stonebow.otago.ac.nz

Received 25 April 2005; Revised 11 October 2005; Accepted 20 October 2005; Published online 14 December 2005.

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Abstract

Introduction:

 

Micronutrient deficiencies during childhood can contribute to impairments in growth, immune competence, and mental and physical development, and the coexistence of several such deficiencies can adversely affect the efficacy of single micronutrient interventions.

Objective:

 

To assess the prevalence of zinc and iodine deficiency and their interrelationships with vitamin A deficiency and anemia and associations with socio-economic status, hemoglobin type, and anthropometry in a cross-sectional study.

Setting:

 

A total of 10 primary schools in North East Thailand.

Methods:

 

Non-fasting venipuncture blood samples and casual urine samples were collected from 567 children aged 6–13 years. Anthropometric measures and serum zinc, albumin, C-reactive protein and urinary iodine, are reported here and integrated with published data on vitamin A, anemia, and socio-economic status.

Results:

 

Of the children, 57% had low serum zinc and 83% had urinary iodine levels below the 100 mug/l cutoff. Suboptimal serum zinc and urinary iodine concentrations may result from low intakes of zinc and iodized salt. Significant risk factors for low serum zinc were serum retinol <1.05 mumol/l and being male. Those for urinary iodine <100 mug/l were height-for-age score>median and being female. For serum retinol <1.05 mumol/l, risk factors were low hemoglobin, low serum zinc, and <9 years, and for low hemoglobin indicative of anemia risk factors were <9 years, AE hemoglobinopathy, and serum retinol <1.05 mumol/l. Of the children, 60% were at risk of two or more coexisting micronutrient deficiencies, most commonly suboptimal urinary iodine and low serum zinc.

Conclusion:

 

The findings emphasize the need for multimicronutrient interventions in North East Thailand.

Keywords:

zinc, iodine, vitamin A, anemia, children, Thailand

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