title: Impact of Food Rations and Supplements on Micronutrient Status by Trimester of Pregnancy: Cross-Sectional Studies in the Maela Refugee Camp in Thailand.
abstract: Micronutrient fortified flour (MFF), supplementary food rations and micronutrient (MN) supplements may prevent deficiencies among pregnant women. Objectives of cross-sectional surveys in 2004 (n = 533) and 2006 (n = 515) were to assess the impact of new food rations (flour, oil) and supplements on MN status by trimester of pregnancy in the Maela refugee camp. Hemoglobin, iron status, zinc, retinol, β-carotene and tryptophan decreased, while α-/γ-tocopherol and 5-methyltetrahydrofolate (5-MTHF) increased from first to third trimester. In 2006, mean zinc and α-tocopherol for each trimester was significantly higher than in 2004. The weeks of supplemented thiamine and folic acid were positively correlated with thiamine diphosphate (TDP) and 5-MTHF, but not for ferrous sulfate as iron deficiency was observed in 38.5% of third-trimester women. Frequent consumption of fish paste and owning a garden or animal were associated with significantly higher iron status, retinol, β-carotene, and 5-MTHF. In conclusion, MFF and supplementary oil were most likely to explain improved zinc and α-tocopherol status, while thiamine and folate supplements ensured high TDP and 5-MTHF in late pregnancy. MN supplements, MN-rich staple food, small gardens, and programs to improve iron compliance are promising strategies to prevent MN deficiencies during pregnancy in vulnerable populations.
authors.affiliation: Institute of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart 70599, Germany. wolfgang.stuetz@uni-hohenheim.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stuetz
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot 63110, Thailand. verena@shoklo-unit.com.
authors.forename: Verena I
authors.initials: VI
authors.lastname: Carrara
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot 63110, Thailand. rose@shoklo-unit.com.|Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK. rose@shoklo-unit.com.
authors.forename: Rose
authors.initials: R
authors.lastname: Mc Gready
authors.affiliation: Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK. sue@tropmedres.ac.|Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand. sue@tropmedres.ac.
authors.forename: Sue J
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot 63110, Thailand. poo@shoklo-unit.com.
authors.forename: Kanlaya
authors.initials: K
authors.lastname: Sriprawat
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot 63110, Thailand. smru@tropmedres.ac.
authors.forename: Basi
authors.initials: B
authors.lastname: Po
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand. Borimas@tropmedres.ac.
authors.forename: Borimas
authors.initials: B
authors.lastname: Hanboonkunupakarn
authors.affiliation: German Institute of Human Nutrition, Potsdam-Rehbruecke, 14558 Nuthetal, Germany. scientific.director@dife.de.
authors.forename: Tilman
authors.initials: T
authors.lastname: Grune
authors.affiliation: Institute of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart 70599, Germany. biesal@uni-hohenheim.de.
authors.forename: Hans K
authors.initials: HK
authors.lastname: Biesalski
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot 63110, Thailand. francois@tropmedres.ac.|Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK. francois@tropmedres.ac.
authors.forename: François H
authors.initials: FH
authors.lastname: Nosten
mesh_terms: D000328:Adult; D003677:Deficiency Diseases / Q000517:prevention & control*; D004032:Diet; D019587:Dietary Supplements; D005247:Feeding Behavior; D005260:Female; D005502:Food; D063105:Food Assistance; D051639:Gardening; D006801:Humans; D018977:Micronutrients / Q000097:blood / Q000172:deficiency / Q000627:therapeutic use*; D009752:Nutritional Status; D011247:Pregnancy; D011264:Pregnancy Trimesters; D012036:Refugees; D013785:Thailand; D035862:Vulnerable Populations; D055815:Young Adult
chemical_list: D018977:Micronutrients
keywords: folic acid; iron status; micronutrients; pregnancy; refugee; retinol; thiamine; tocopherol; zinc; β-carotene
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