Mw. D.H.S. Dillon : Nutritional Health of Indonesian Adolescent Girls in Indonesia

  News
  Newsroom
  Archive
  Calendar
  2012
  2011
  2010
  2009
  2008
  2007
  2006
  2005
  2004
  2003
  2002
  2001
  2000
  1999
  News
  RSS
  Calendar
  Open days
  Courses
  Congresses and symposia
  PhD-graduations and speeches

5 Apr 2005 16:00
Unit: Wageningen University
Location: Aula (gebouw 362), Gen. Foulkesweg 1, Wageningen
Promotor: prof.dr. J.G.A.J. Hautvast (emeritus) (Nutrition and Health)prof.dr. C.E. West † (Nutrition in relation to health and diseases, KUN)
Co Promotor: dr.ir. H. Verhoef

 In developing countries, adolescent girls often have anemia and micronutrient deficiencies. The objective of this thesis was to investigate the role of riboflavin or vitamin A as determinant of anemia and iron deficiency in Indonesian adolescent girls. Several cross-sectional studies, involving a total of 856 adolescent schoolgirls, were carried out in Jakarta and Tangerang. Most studies, except for the one in East Jakarta, failed to show any relationship between riboflavin and hemoglobin or plasma ferritin concentration. A clear relationship between vitamin A status and hemoglobin concentration was observed only when all survey results were combined, whilst a relationship between vitamin A status and plasma ferritin concentration was observed in Central Jakarta and all survey results combined.
Anemia in the majority of the girls was related to iron deficiency. This was substantiated by our findings that iron supplementation for 16 weeks resulted in a reduction of anemia prevalence as compared to placebo group and conversely, that the prevalence of anemia increased at 16 weeks after cessation of iron supplementation. In a randomized controlled trial involving 258 anemic adolescent schoolgirls, daily supplementation with riboflavin or vitamin A in addition to iron for eight weeks failed to improve or only marginally improved concentration of hemoglobin or plasma ferritin beyond that achieved by supplementation with iron alone. However, addition of riboflavin may have improved the iron status of girls with more severe anemia, and vitamin A supplementation resulted in a 19% (95% CI: 1% to 39%) increase of plasma ferritin concentration. Despite the marginal treatment effects, supplementation with riboflavin or vitamin A markedly improved biochemical indicators of riboflavin and vitamin A status, respectively. The prevalence of anemia (9-57%) in our studies indicates that anemia is a problem of public health significance. Dietary intakes of riboflavin, vitamin A and iron were poor. The prevalence range of riboflavin, vitamin A and iron deficiency was 21-96%, 7-25% and 20-58%, respectively. The prevalence of girls with iron status below a minimal target (as indicated by serum ferritin concentration < 30 µg/L) and with inadequate vitamin A stores (as indicated by serum retinol concentration <1.05 µmol/L) ranged 50-82% and 40-73%, respectively. The high prevalence of vitamin A and riboflavin deficiencies are a cause of public health concern; however, our findings alone provide insufficient ground to justify supplementation with riboflavin and vitamin A for intervention programs aimed at alleviating anemia. Further studies are needed to determine the functional consequences of low riboflavin and vitamin A status on the health of adolescent girls. In addition, prospective studies on the efficacy of micronutrient intervention in adolescent girls on the pregnancy performance and outcome are proposed.
Print this activity