The effect of daily rather than weekly iron supplementation was compared in women who were 8-24 wk pregnant. One group (n = 68) received 60 mg Fe/d, the second group (n = 71) received 120 mg Fe/wk, given at once. Supplementation lasted 11.3 wk on average, depending on gestational date at entry, and was not supervised. Hemoglobin increased in both groups (P < 0.001); serum ferritin did not change significantly. There was no significant difference between groups for changes in hemoglobin and serum ferritin. In a subgroup of women with a hemoglobin concentration < 110 g/L at baseline (n = 45 daily; n = 54 weekly) no significant within-group changes occurred in serum ferritin, but the change in the daily group was 4.1 micrograms/L higher than in the weekly group (P = 0.049). Compliance, as indicated by two positive stool tests, was approximately equal to 54.3% in the daily group and 62.2% in the weekly group. We conclude that for the complete sample of subjects, the treatment effect of daily compared with weekly supplementation was similar under conditions resembling a normal antenatal care program.

Background: Micronutrient deficiencies remain common in preschool children in developing countries. Interventions focus on single micronutrients and often lack effectiveness. Weekly instead of daily supplementation may improve effectiveness. Objective: The efficacy of weekly and daily supplementation in reducing anemia prevalence and in improving the zinc, vitamin A, and growth status of 6-24-mo-old Vietnamese children was investigated. Design: In this double-blind, placebo-controlled trial, the daily group (n = 55) received 8 mg elemental Fe (as iron sulfate), 5 mg elemental Zn (as zinc sulfate), 333 g retinol, and 20 mg vitamin C 5 d/wk for 3 mo. The weekly group (n = 54) received 20 mg Fe, 17 mg Zn, 1700 g retinol, and 20 mg vitamin C once a week. A third group (n = 54) received a placebo only. Venous blood samples were collected at the start and end of the supplementation period and anthropometric measurements were taken at the start and 3 mo after the end of supplementation. Results: At baseline, 45.6% of subjects had hemoglobin concentrations < 110 g/L, 36.3% had zinc concentrations < 10.71 mol/L, and 45.6% had retinol concentrations < 0.70 mol/L. Hemoglobin, retinol, and zinc concentrations of both the weekly and daily groups increased similarly compared with the placebo group (P < 0.001). There was no significant difference in growth between the supplemented groups and the placebo group. However, the height-for-age of subjects stunted at baseline increased with z scores of 0.48 (P < 0.001) and 0.37 (P < 0.001) for the daily and weekly groups, respectively. Conclusions: Weekly and daily supplementation improved hemoglobin, zinc, and retinol concentrations similarly. Neither intervention affected growth of the overall population, but growth of children stunted at baseline was improved through both types of supplementation.Am J Clin Nutr 1999;69:80-6.

The study was designed to determine whether population-specific hemoglobin cut-off values for detection of iron deficiency are needed for Indonesia by comparing the hemoglobin distribution of healthy young Indonesians with that of an American population. This was a cross-sectional study in 203 males and 170 females recruited through a convenience sampling procedure. Hemoglobin, iron biochemistry tests and key infection indicators that can influence iron metabolism were analyzed. The hemoglobin distributions, based on individuals without evidence of clear iron deficiency and infectious process, were compared with the National Health and Nutrition Survey (NHANES) II population of the United States. Twenty percent of the Indonesian females had iron deficiency, but no male subjects were iron deficient. The mean hemoglobin of Indonesian males was similar to the American reference population at 152 g/L with comparable hemoglobin distribution. The mean hemoglobin of the Indonesian females was 2 g/L lower than that of the American reference population, which may be the result of incomplete exclusion of subjects with milder form of iron deficiency. When the WHO cutoff (Hb < 120 g/L) was applied to female subjects, the sensitivity of 34.2% and specificity of 89.4% were more comparable to the test performance for white American women, in contrast to those of the lower cut-off. On the basis of the finding of hemoglobin distribution of men and the test performance of anemia (Hb < 120 g/L) for detecting iron deficiency for women, it is concluded that there is no need to develop different cut-off points for anemia as a tool for iron-deficiency screening in this population.

To investigate the efficacy of two different iron supplements administered either on a weekly basis or during menstruation, a 16-week community experimental study was carried out among postmenarcheal female adolescent students in Kupang, East Nusa Tenggara, Indonesia. Forty eight students received a placebo tablet weekly, 48 other students got an iron tablet weekly and 41 students took an iron tablet for four consecutive days during their menstruation cycle. All subjects were given deworming tablets before supplementation. Haemoglobin, serum ferritin, height, weight, mid-upper arm circumference and dietary intake were assessed before and after intervention. The supplementation contributed to a significant improvement in the iron status of the intervention groups compared to the placebo group (P < 0.05). In the menstruation group, the haemoglobin concentrations of the anaemic subjects improved significantly (P < 0.05) while for the non-anaemic subjects, serum ferritin concentrations also increased significantly (P < 0.05). In the weekly group for anaemic and nonanaemic subjects, there was a significant increase in both haemoglobin and serum ferritin concentrations (P < 0.05). This study revealed that weekly supplementation of iron tablets continued for 16 weeks contributed a higher improvement to haemoglobin concentration, compared with supplementing iron tablets for four consecutive days during menstruation for four menstrual cycles. This suggests that weekly iron supplementation is preferable.

No abstract

These findings suggest that fat intake might be an important determinant of breast cancer among populations with a low fat diet in Indonesia.

Anaemia was relatively common in patients attending for routine outpatient diabetes clinic review. The high prevalence of anaemia supports the routine screening for anaemia in the diabetes out-patient clinic, including in those without overt nephropathy.

To empower local authorities to plan and evaluate adequate interventions, appropriate iodine deficiency disorders (IDD) indicators need to be identified. The aim of this study was to describe the magnitude and severity of IDD with different outcome indicators and associate them with functional indicators. Schoolchildren (n = 544) aged 8-10 y were assessed in 11 villages within five subdistricts of Malang District, East Java, Indonesia. Outcome indicators of IDD were goiter size as measured by palpation and ultrasonography (USG), urinary iodine excretion (UIE) and serum thyroid stimulating hormone (TSH) concentration in blood as well as functional indicators such as intellectual performance (IQ: Catell's Culture Fair Intelligence Test) and anthropometric indices. The total goiter rate (TGR) measured by palpation and USG were 35.7 and 54.4%, respectively. Based on UIE and TSH, the prevalence of iodine deficiency was 63.7 and 3.4%, respectively. In individuals, goiter, thyroid volume and UIE were associated significantly (r = -0.35; P < 0.001 and r = -0.30; P = 0.02 respectively). Among villages, TGR measured by palpation was significantly correlated with thyroid volume (r = 0.61; P = 0.045) and UIE (r = 0.68; P = 0.021), whereas TSH was not significantly associated with any of the observed indicators in individuals or groups. Multiple regression analysis showed that USG (beta = -0.67; P < 0.001) and UIE (beta = 4.39; P = 0.008) related significantly with cognitive performance (IQ). The associations between IDD indicators and cognitive performance and height-for-age Z scores suggest that socioeconomically advantaged children had better iodine status. We suggest that UIE is the best indicator for local authorities to assess iodine deficiency.