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Stability of selected water-soluble vitamins in model systemsPacquette, Connie L. January 1998 (has links)
The potential for regulated additions of L-ascorbic acid, thiamine, and riboflavin to assist in maintaining vitamin stability when each formed part of a multivitamin system was investigated in aqueous solutions. Screening studies were performed to identify major factors that accelerated vitamin loss during aerobic storage at ambient temperature. These showed L-ascorbic acid to be destabilised by cupric ion. Light (at 339 lux) was further shown to affect the influence of cupric ion on Lascorbic acid, whereby the catalytic activity of cupric ion at trace levels (0.5 ppm) appeared to be concealed by the effect of light. Riboflavin degradation, by contrast, resulted directly from the presence of light. Neither cupric ion nor light affected the stability of thiamine. However, a change in pH from acidity (pH 3-6) to neutrality (pH 7) caused a marked decline in thiamine stability. L-Ascorbic acid was more prone to degradation at pH close to its primary pKa value. However, there was no apparent relationship between riboflavin degradation and pH. Investigations of between-vitamin influences showed riboflavin to accelerate Lascorbic acid loss. This effect was apparent whether or not light was present. However, L-ascorbic acid destabilised riboflavin only in the absence of cupric ion and light. To optimise multivitamin stability, study was made under acid conditions in various types of citrate systems with cupric ion and light absent and under reduced levels of oxygen. Input variables included the levels of vitamin additions and pH. Using response-surface methodology, quadratic equations could be fitted adequately to stability data obtained for L-ascorbic acid in citrate-phosphate, citrate-sucrose, and citrate systems and for both thiamine and riboflavin in citrate-phosphate and citrate systems. L-Ascorbic acid and thiamine stability responses (as % residue) were lowered by an increase in pH over the pH 2.6 to 3.0 range in both citrate-phosphate and citrate systems. The stability of riboflavin with pH was maintained solely in the citrate-phosphate system. Within the same system, increased additions of both thiamine and riboflavin improved L-ascorbic acid stability. In citrate, thiamine stability benefited from riboflavin additions only when L-ascorbic acid additions were low. High levels of addition of L-ascorbic acid were also directly responsible for thiamine instability. An improvement in riboflavin stability with L-ascorbic acid additions was observed only with thiamine added at high levels. In citrate-sucrose, L-ascorbic acid was more prone to degradation with an increase in thiamine added level at low pH. Levels of vitamin additions and pH that yield maximum responses in L-ascorbic acid, thiamine, and riboflavin stability have been predicted using the set of conditions given by the quadratic models.
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Μελέτη της αποτελεσματικότητας των διαφημίσεων πολυβιταμινούχων σκευασμάτων / Study of the result of the advertisement multivitamin productsΚοκκώνη, Ελευθερία 22 July 2008 (has links)
Στη παρούσα εργασία μελετήσαμε την αποτελεσματικότητα των διαφημίσεων έξι πολυβιταμινούχων σκευασμάτων που διατίθενται από τα φαρμακεία. Στόχος ήταν να μελετήσουμε τη στάση των καταναλωτών απένατι στα σκευάσματα αυτά και κατά πόσο επηρέαζονται ύστερα από την επαφή τους με τα διαφημιστικά έντυπα. / In that survey we studied the result of the advertisement of six multivitamin products that are offered at pharmacies. Our aim was to study people attitude towards tmem and whether they are influenced after their contact with the advertisements.
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High Vitamin Intakes during Pregnancy and Characteristics of Metabolic Syndrome in Wistar Rat Dams and their OffspringReza López, Sandra Alicia 19 January 2012 (has links)
High vitamin (HV), AIN-93G diet with ten-fold the regular amount of vitamins (RV), consumed by pregnant Wistar rats increases characteristics of metabolic syndrome (MetS) in their first litters. Therefore, the effects of the maternal HV-diet on tissue mechanisms regulating insulin resistance in offspring (Part 1) and on characteristics of MetS in the dams and their second litter (L2) offspring (Part 2) were examined. Part 1 (studies 1 and 2) hypothesis was that the maternal HV-diet alters tissue fatty acid (FA) concentrations, expression of peroxisome-proliferator-activated receptors (PPARs) genes, and their regulation of metabolism in the offspring, favoring insulin resistance. Part 2 (studies 3 and 4) hypothesis was that high-vitamin intakes during the first pregnancy increase weight gain, food intake and markers of MetS in both the dams and their litters. In all experiments, dams were fed the RV or HV-diet. In study 4, a high-folic-acid-diet (HFol, RV+10-fold folic acid) was added. In studies 1 and 2, the offspring were weaned to an obesogenic diet. The HV-diet affected tissue FA concentrations (study 1), increased muscle PPAR-ɑ mRNA levels and uncoupled relationships between hepatic PPAR-γ mRNA levels and insulin resistance (study 2) in male offspring. In study 3, dams fed the HV-diet during the first pregnancy were maintained on the RV-diet and then mated again after 12wk. Their litters were fed the RV-diet. The HV-diet increased weight gain and food intake of both dams and L2, and insulin resistance in their offspring. In study 4, both HV and HFol-diets increased post-weaning weight gain, but differed in their effects on biomarkers of food intake regulation. In conclusion, feeding the HV-diet during the first pregnancy increases post-weaning body weight and food intake in Wistar rat dams, uncouples tissue regulation of glucose metabolism and promotes characteristics of MetS in their litters. Folic acid is not the only vitamin involved.
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High Vitamin Intakes during Pregnancy and Characteristics of Metabolic Syndrome in Wistar Rat Dams and their OffspringReza López, Sandra Alicia 19 January 2012 (has links)
High vitamin (HV), AIN-93G diet with ten-fold the regular amount of vitamins (RV), consumed by pregnant Wistar rats increases characteristics of metabolic syndrome (MetS) in their first litters. Therefore, the effects of the maternal HV-diet on tissue mechanisms regulating insulin resistance in offspring (Part 1) and on characteristics of MetS in the dams and their second litter (L2) offspring (Part 2) were examined. Part 1 (studies 1 and 2) hypothesis was that the maternal HV-diet alters tissue fatty acid (FA) concentrations, expression of peroxisome-proliferator-activated receptors (PPARs) genes, and their regulation of metabolism in the offspring, favoring insulin resistance. Part 2 (studies 3 and 4) hypothesis was that high-vitamin intakes during the first pregnancy increase weight gain, food intake and markers of MetS in both the dams and their litters. In all experiments, dams were fed the RV or HV-diet. In study 4, a high-folic-acid-diet (HFol, RV+10-fold folic acid) was added. In studies 1 and 2, the offspring were weaned to an obesogenic diet. The HV-diet affected tissue FA concentrations (study 1), increased muscle PPAR-ɑ mRNA levels and uncoupled relationships between hepatic PPAR-γ mRNA levels and insulin resistance (study 2) in male offspring. In study 3, dams fed the HV-diet during the first pregnancy were maintained on the RV-diet and then mated again after 12wk. Their litters were fed the RV-diet. The HV-diet increased weight gain and food intake of both dams and L2, and insulin resistance in their offspring. In study 4, both HV and HFol-diets increased post-weaning weight gain, but differed in their effects on biomarkers of food intake regulation. In conclusion, feeding the HV-diet during the first pregnancy increases post-weaning body weight and food intake in Wistar rat dams, uncouples tissue regulation of glucose metabolism and promotes characteristics of MetS in their litters. Folic acid is not the only vitamin involved.
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Estudo sobre a composição elementar de suplementos dietéticos pelo método de análise por ativação com nêutrons / A study of the elemental composition of dietary supplements by the method of neutron activation analysisSouza, Vitor Ito 22 November 2017 (has links)
O consumo de suplementos dietéticos tem crescido para complementar a deficiência da ingestão de nutrientes essenciais, para melhorar o desempenho das atividades físicas nos atletas, prevenir doenças e para retardar os efeitos do envelhecimento. Além disso, estes produtos são facilmente acessíveis e de custo relativamente barato. Consequentemente, a avaliação da composição elementar dos suplementos dietéticos é de grande interesse para o controle da qualidade destes produtos e também para avaliar riscos à saúde humana com o seu consumo. O objetivo deste trabalho foi a avaliação da composição elementar de suplementos dietéticos multivitamínicos e proteicos, adquiridos na cidade de São Paulo. As concentrações de As, Br, Ca, Co, Cr, Cs, Fe, K, La, Na, Rb, Sb, Sc, Se e Zn foram determinadas nestes suplementos utilizando o procedimento do método de análise por ativação com nêutrons (NAA). O procedimento experimental consistiu em irradiar alíquotas dos suplementos e os padrões sintéticos dos elementos no reator IEA-R1, seguida de espectrometria de raios gama. O controle da qualidade analítica dos resultados foi realizado pela análise de materiais de referência certificados. A comparação entre os resultados obtidos nos suplementos com os valores declarados nos rótulos, indicou que os suplementos multivitamínicos contêm quantidades de elementos concordantes com os valores dos rótulos, ao contrário dos suplementos proteicos, que apresentaram quantidades para alguns elementos que não concordaram com os valores apresentados nos rótulos. Comparando a quantidade de elemento por dose do suplemento dietético com o percentil de valor diário de ingestão recomendado, foi possível verificar que todos os elementos estão abaixo de 100%, exceto para os elementos Cr em dois suplementos e Se em um suplemento. Os resultados da ingestão dos elementos calculada para a porção diária recomendada pelo fabricante, mostrou que para os suplementos analisados, nenhum elemento ultrapassou o limite superior tolerável. Nos suplementos analisados, os elementos tóxicos Cd e Hg não foram detectados e foram calculados os limites de detecção. Os resultados obtidos neste estudo demonstraram a viabilidade de aplicar NAA na avaliação da composição dos suplementos para diversos elementos. / Dietary supplement consumption has grown to complement deficiency of essential nutrient intake, to improve physical activity performance in athletes, to prevent diseases and to delay the effects of age. These products are readily accessible and relatively cheap. Consequently, the evaluation of the elemental composition of these supplements are of great interest for its quality control and to assess risks to human health. This study evaluated elemental composition of multivitamin and protein dietary supplements, acquired in São Paulo city. Concentrations of As, Br, Ca, Co, Cr, Cs, Fe, K, La, Na, Rb, Sb, Sc, Se and Zn were determined in these dietary supplements, using neutron activation analysis (NAA). The NAA procedure consisted of irradiating aliquots of supplement samples and synthetic element standards at the IEA-R1 nuclear research reactor, followed by gamma ray spectrometry. Analytical quality control of the results was evaluated by analyzing certified reference materials. Comparison between the results obtained in these dietary supplements and the values declared on their labels indicated that the multivitamin supplements contain element amounts according to the label values. On the other hand, protein supplements presented amounts of some elements that disagreed with those values presented on the labels. Comparing the element amount per dose of the dietary supplement with the recommended daily intake percentile, it was possible to verify that all elements are below 100%, except for Cr in two supplements and element Se in one supplement. Element intakes per daily portion calculated according to the supplement intake recommendations, showed element quantities do not exceed the tolerable upper intake levels. In the analyzed supplement samples, toxic elements such as Cd and Hg were not detected, and their detection limits were calculated. To assess the risks of dietary supplement intake, the elemental doses calculated were compared with the daily recommended and the upper limit intake values. The results obtained in this study demonstrated the feasibility of applying NAA to evaluate composition of dietary supplements for several elements.
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Estudo sobre a composição elementar de suplementos dietéticos pelo método de análise por ativação com nêutrons / A study of the elemental composition of dietary supplements by the method of neutron activation analysisVitor Ito Souza 22 November 2017 (has links)
O consumo de suplementos dietéticos tem crescido para complementar a deficiência da ingestão de nutrientes essenciais, para melhorar o desempenho das atividades físicas nos atletas, prevenir doenças e para retardar os efeitos do envelhecimento. Além disso, estes produtos são facilmente acessíveis e de custo relativamente barato. Consequentemente, a avaliação da composição elementar dos suplementos dietéticos é de grande interesse para o controle da qualidade destes produtos e também para avaliar riscos à saúde humana com o seu consumo. O objetivo deste trabalho foi a avaliação da composição elementar de suplementos dietéticos multivitamínicos e proteicos, adquiridos na cidade de São Paulo. As concentrações de As, Br, Ca, Co, Cr, Cs, Fe, K, La, Na, Rb, Sb, Sc, Se e Zn foram determinadas nestes suplementos utilizando o procedimento do método de análise por ativação com nêutrons (NAA). O procedimento experimental consistiu em irradiar alíquotas dos suplementos e os padrões sintéticos dos elementos no reator IEA-R1, seguida de espectrometria de raios gama. O controle da qualidade analítica dos resultados foi realizado pela análise de materiais de referência certificados. A comparação entre os resultados obtidos nos suplementos com os valores declarados nos rótulos, indicou que os suplementos multivitamínicos contêm quantidades de elementos concordantes com os valores dos rótulos, ao contrário dos suplementos proteicos, que apresentaram quantidades para alguns elementos que não concordaram com os valores apresentados nos rótulos. Comparando a quantidade de elemento por dose do suplemento dietético com o percentil de valor diário de ingestão recomendado, foi possível verificar que todos os elementos estão abaixo de 100%, exceto para os elementos Cr em dois suplementos e Se em um suplemento. Os resultados da ingestão dos elementos calculada para a porção diária recomendada pelo fabricante, mostrou que para os suplementos analisados, nenhum elemento ultrapassou o limite superior tolerável. Nos suplementos analisados, os elementos tóxicos Cd e Hg não foram detectados e foram calculados os limites de detecção. Os resultados obtidos neste estudo demonstraram a viabilidade de aplicar NAA na avaliação da composição dos suplementos para diversos elementos. / Dietary supplement consumption has grown to complement deficiency of essential nutrient intake, to improve physical activity performance in athletes, to prevent diseases and to delay the effects of age. These products are readily accessible and relatively cheap. Consequently, the evaluation of the elemental composition of these supplements are of great interest for its quality control and to assess risks to human health. This study evaluated elemental composition of multivitamin and protein dietary supplements, acquired in São Paulo city. Concentrations of As, Br, Ca, Co, Cr, Cs, Fe, K, La, Na, Rb, Sb, Sc, Se and Zn were determined in these dietary supplements, using neutron activation analysis (NAA). The NAA procedure consisted of irradiating aliquots of supplement samples and synthetic element standards at the IEA-R1 nuclear research reactor, followed by gamma ray spectrometry. Analytical quality control of the results was evaluated by analyzing certified reference materials. Comparison between the results obtained in these dietary supplements and the values declared on their labels indicated that the multivitamin supplements contain element amounts according to the label values. On the other hand, protein supplements presented amounts of some elements that disagreed with those values presented on the labels. Comparing the element amount per dose of the dietary supplement with the recommended daily intake percentile, it was possible to verify that all elements are below 100%, except for Cr in two supplements and element Se in one supplement. Element intakes per daily portion calculated according to the supplement intake recommendations, showed element quantities do not exceed the tolerable upper intake levels. In the analyzed supplement samples, toxic elements such as Cd and Hg were not detected, and their detection limits were calculated. To assess the risks of dietary supplement intake, the elemental doses calculated were compared with the daily recommended and the upper limit intake values. The results obtained in this study demonstrated the feasibility of applying NAA to evaluate composition of dietary supplements for several elements.
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Principales factores que influyen en la decisión de compra de Multivitamínicos del tipo Over The Counter (OTC), en mujeres de 25 a 39 años de nivel socioeconómico B de Lima Metropolitana, en el 2019Alcántara Rodriguez, Agnes Rocio, Sánchez De Olarte, Wendy Jennifer 20 July 2019 (has links)
El mercado de multivitamínicos Over the Counter (OTC), en los últimos años ha tenido un crecimiento exponencial a nivel mundial, el Perú no es ajeno a ello y viene evolucionando gracias a la mega tendencia del cuidado de la salud. Asimismo, encontramos a una mujer empoderada, que considera importante el cuidado de la salud, además de ser la principal decisora de compra.
El presente estudio busca identificar los principales factores que influyen en la decisión de compra de multivitamínicos OTC, en mujeres de 25 a 39 años, del Nivel Socioeconómico B de Lima Metropolitana, en el 2019; además determinará, qué influencias socioculturales, psicológicas y fuentes de comunicación, son las más relevantes.
El documento consta de cuatro capítulos:
Capítulo 1: establece la formulación del problema, los objetivos y el marco teórico, donde se define el comportamiento y los factores que influyen en la decisión de compra.
Capítulo 2: indica la metodología de investigación, la cual es del tipo exploratoria-descriptiva, con un enfoque mixto, con entrevistas a profundidad, focus group y encuestas.
Capítulo 3: desarrolla el análisis de resultados de la investigación.
Capítulo 4: hace mención a las conclusiones, hallazgos y recomendaciones a las que se llegaron luego de efectuar el análisis.
La principal motivación de la investigación, es brindar información de utilidad, para posteriores estudios de marketing en la industria farmacéutica. / The Over the Counter (OTC) multivitamin market, in recent years has had an exponential growth worldwide; Peru is no stranger to it and has been evolving thanks to the mega trend of health care. We also found an empowered woman, who considers health care important, as well as being the main purchasing decision maker.
The present study seeks to identify the main factors that influence the purchase decision of OTC multivitamins, in women aged 25 to 39, of Socioeconomic Level B of Metropolitan Lima, in 2019, it will also determine which sociocultural, psychological and communication sources are the most relevant.
The document consists of four chapters:
Chapter 1: establishes the formulation of the problem, the objectives and the theoretical framework, where the behavior and the factors that influence the purchase decision are defined.
Chapter 2: indicates the research methodology, which is of the exploratory-descriptive type, with a mixed approach, with in-depth interviews, focus groups and surveys.
Chapter 3: develop the analysis of research results.
Chapter 4: mentions the conclusions, findings and recommendations reached after the analysis.
The main motivation of the research is to provide useful information for subsequent marketing studies in the pharmaceutical industry. / Tesis
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La prise d’acide folique en période périconceptionnelle : une étude sur la concordance aux directives cliniques canadiennes et sur l’impact sur la prévalence des malformations congénitales au QuébecRichard-Tremblay, Audrey-Ann 09 1900 (has links)
La prise d’un supplément d’acide folique en période préconceptionnelle réduit le risque d’une anomalie du tube neural (ATN), une malformation du système nerveux. Dans le but d’en réduire la prévalence, la Société des Obstétriciens et Gynécologues du Canada a émis de nouvelles directives cliniques en 2007 qui tenaient compte de différents facteurs de risque pour les ATN et pour qui la dose recommandée variait selon le profil de risque de la femme, allant de 0,4 à 5,0 mg d’acide folique. Jusqu’à présent, peu de données sont disponibles sur les effets de la prise d’une haute dose d’acide folique.
Les objectifs de cette étude étaient: 1) d’évaluer la concordance entre la supplémentation en acide folique chez les femmes enceintes et les nouvelles recommandations canadiennes; 2) d’identifier les déterminants d’une utilisation concordante et 3) d’évaluer si la prise de hautes doses d’acide folique en période périconceptionnelle réduisait le risque de malformations congénitales autre que les ATN.
Pour répondre à ces objectifs, une étude transversale et une étude écologique ont été effectuées. La première incluait 361 femmes enceintes recrutées aux cliniques d’obstétriques du CHU Sainte-Justine et la deuxième utilisait le Registre Québécois des Grossesses, issu du jumelage de trois banques de données administratives au Québec (RAMQ, Med-Écho et ISQ), où 152 392 couples mère-enfant ont été identifiés.
Seul 27% des femmes enceintes ayant participé à l’étude transversale avaient une supplémentation en acide folique, avec ou sans ordonnance, concordante aux lignes directrices canadiennes. La concordance variait selon leur profil de facteurs de risque pour les ATN. Notre étude écologique montre que la prévalence annuelle de l’utilisation de haute dose d’acide folique (avec ordonnance) en période périconceptionnelle a augmenté de 0,17% à 0,80% (p < 0,0001) entre 1998 et 2008 et que la prévalence des malformations congénitales majeures a augmenté de 15% au cours de la même période (3,35% à 3,87%, p<0,0001).
Les résultats de nos deux études montrent que l’acide folique n’est pas largement utilisé par les femmes en âge de procréer et ce, peu importe la dose. De nouvelles campagnes de santé publique devront être mises sur pied, afin d’inciter les femmes à consommer de l’acide folique avant et pendant leur grossesse. Également, la prise de haute dose d’acide folique ne semble pas avoir diminué le risque de malformations congénitales, à l’échelle populationnelle. / The use of folic acid during the preconceptionnal period reduces the risk of neural tube defects (NTD), a malformation of the nervous system. In order to reduce it’s prevalence, the Society of Obstetricians and Gynaecologists of Canada proposed new practice clinical guidelines, in 2007, on the use of pre-conceptional vitamin/folic acid supplementation for the prevention of NTDs, with specific recommendations to prevent recurrences and occurrences among women with intermediate to high health risk factors and for whom the dose was different.
The objectives of this study were to evaluate the concordance between the new guidelines and folic acid use in real life; 2) to identify predictors associated with a recommended folic acid supplementation, and 3) to evaluate if the use of folic acid could reduce the risk of congenital malformations other than NTDs.
A cross-sectional study and an ecological study have been conducted. 361 women were recruited in obstetrics outpatient clinic at the CHU Ste-Justine for the first study and 152,392 pregnancies and babies were identified in the Quebec Pregnancy Registry, which results from the linkage of three administrative health care databases from Quebec (RAMQ, Med-Echo and ISQ) for the second study.
Only 27% of the wowen recruited for the first study had periconceptional folic acid supplementation intake that was concordant with guideline. Concordance varied according to their health risk factors profile for NTD. Our ecological study showed that the annual prevalence of periconceptional folic acid use increased from 0.17% to 0.80% (p < 0,0001) from 1998 to 2008 and birth prevalence of major congenital malformations increased by 15% (3.35% to 3.87%, p < 0,0001) during the same period.
Our findings highlight the fact that folic acid is not widely used by women of childbearing age, regardless of the dose. There is a need for new public health programs to encourange women to consume folic acid every day before and during pregnancy. Moreover, the use of high dose folic acid does not seem to be correlated with a decline in the prevalence of major congenital malformations, on a populational level.
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La prise d’acide folique en période périconceptionnelle : une étude sur la concordance aux directives cliniques canadiennes et sur l’impact sur la prévalence des malformations congénitales au QuébecRichard-Tremblay, Audrey-Ann 09 1900 (has links)
La prise d’un supplément d’acide folique en période préconceptionnelle réduit le risque d’une anomalie du tube neural (ATN), une malformation du système nerveux. Dans le but d’en réduire la prévalence, la Société des Obstétriciens et Gynécologues du Canada a émis de nouvelles directives cliniques en 2007 qui tenaient compte de différents facteurs de risque pour les ATN et pour qui la dose recommandée variait selon le profil de risque de la femme, allant de 0,4 à 5,0 mg d’acide folique. Jusqu’à présent, peu de données sont disponibles sur les effets de la prise d’une haute dose d’acide folique.
Les objectifs de cette étude étaient: 1) d’évaluer la concordance entre la supplémentation en acide folique chez les femmes enceintes et les nouvelles recommandations canadiennes; 2) d’identifier les déterminants d’une utilisation concordante et 3) d’évaluer si la prise de hautes doses d’acide folique en période périconceptionnelle réduisait le risque de malformations congénitales autre que les ATN.
Pour répondre à ces objectifs, une étude transversale et une étude écologique ont été effectuées. La première incluait 361 femmes enceintes recrutées aux cliniques d’obstétriques du CHU Sainte-Justine et la deuxième utilisait le Registre Québécois des Grossesses, issu du jumelage de trois banques de données administratives au Québec (RAMQ, Med-Écho et ISQ), où 152 392 couples mère-enfant ont été identifiés.
Seul 27% des femmes enceintes ayant participé à l’étude transversale avaient une supplémentation en acide folique, avec ou sans ordonnance, concordante aux lignes directrices canadiennes. La concordance variait selon leur profil de facteurs de risque pour les ATN. Notre étude écologique montre que la prévalence annuelle de l’utilisation de haute dose d’acide folique (avec ordonnance) en période périconceptionnelle a augmenté de 0,17% à 0,80% (p < 0,0001) entre 1998 et 2008 et que la prévalence des malformations congénitales majeures a augmenté de 15% au cours de la même période (3,35% à 3,87%, p<0,0001).
Les résultats de nos deux études montrent que l’acide folique n’est pas largement utilisé par les femmes en âge de procréer et ce, peu importe la dose. De nouvelles campagnes de santé publique devront être mises sur pied, afin d’inciter les femmes à consommer de l’acide folique avant et pendant leur grossesse. Également, la prise de haute dose d’acide folique ne semble pas avoir diminué le risque de malformations congénitales, à l’échelle populationnelle. / The use of folic acid during the preconceptionnal period reduces the risk of neural tube defects (NTD), a malformation of the nervous system. In order to reduce it’s prevalence, the Society of Obstetricians and Gynaecologists of Canada proposed new practice clinical guidelines, in 2007, on the use of pre-conceptional vitamin/folic acid supplementation for the prevention of NTDs, with specific recommendations to prevent recurrences and occurrences among women with intermediate to high health risk factors and for whom the dose was different.
The objectives of this study were to evaluate the concordance between the new guidelines and folic acid use in real life; 2) to identify predictors associated with a recommended folic acid supplementation, and 3) to evaluate if the use of folic acid could reduce the risk of congenital malformations other than NTDs.
A cross-sectional study and an ecological study have been conducted. 361 women were recruited in obstetrics outpatient clinic at the CHU Ste-Justine for the first study and 152,392 pregnancies and babies were identified in the Quebec Pregnancy Registry, which results from the linkage of three administrative health care databases from Quebec (RAMQ, Med-Echo and ISQ) for the second study.
Only 27% of the wowen recruited for the first study had periconceptional folic acid supplementation intake that was concordant with guideline. Concordance varied according to their health risk factors profile for NTD. Our ecological study showed that the annual prevalence of periconceptional folic acid use increased from 0.17% to 0.80% (p < 0,0001) from 1998 to 2008 and birth prevalence of major congenital malformations increased by 15% (3.35% to 3.87%, p < 0,0001) during the same period.
Our findings highlight the fact that folic acid is not widely used by women of childbearing age, regardless of the dose. There is a need for new public health programs to encourange women to consume folic acid every day before and during pregnancy. Moreover, the use of high dose folic acid does not seem to be correlated with a decline in the prevalence of major congenital malformations, on a populational level.
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GRAVIDA KVINNORS INTAG AV KOSTTILLSKOTT : En kvantitativ studie med fokus på järn och probiotika / PREGNANT WOMEN´S INTAKE OF DIETARY SUPPLEMENT : A quantitative study focusing on iron and probioticsLange Bålman, Miriam January 2019 (has links)
Sammanfattning Bakgrund Vitamin- och mineralbrister hos gravida kvinnor kan leda till missfall och allvarliga störningar i barnets utveckling. Moderns tarmflora överförs med stor sannolikhet till barnet under förlossningen och kan därför innebära ett viktigt steg i utvecklingen av barnets tarmflora. En tänkbar lösning för att säkra ett adekvat intag kan vara konsumtion av kosttillskott och probiotika. I dagsläget finns osäkra uppgifter om hur många gravida kvinnor som intar tillskott. Syfte Att undersöka hur många gravida kvinnor i Västerbottens län som valde att inta kosttillskott, främst järn och probiotika, samt om det fanns en skillnad mellan olika faktorer och intag. Metod En kvantitativ tvärsnittsstudie där gravida kvinnor (n=1473) från Northpop-studien i Västerbottens län svarade på ett frågeformulär gällande intag av kosttillskott och faktorer som ålder, utbildning, kostregim etc. De statistiska tester som användes var Chi-2-test, oberoende t-test och Mann Whitney U-test. Materialet analyserades i SPSS. Signifikansnivån sattes till p<0,05. Resultat Majoriteten av deltagarna svarade att de intog kosttillskott. Faktorer som ökade intaget av kosttillskott hos gravida kvinnor var högre ålder (p=0,030) jämfört med lägre ålder, högre utbildningsnivå (p=0,006) jämfört med lägre utbildningsnivå och vegetarisk/vegansk kost (p=0,021) jämfört med blandkost. Femtiofem procent uppgav att de intog järntillskott. De faktorer som ökade intaget av järntillskott hos gravida kvinnor var vegetarisk/vegansk kost (p=0,001) jämfört med blandkost. Probiotika intogs av 2 procent. Ett högre intag av probiotika sågs hos personer boende i stadsområde (p=0,024) jämfört med övriga boenderegioner samt de som åt vegetarisk/vegansk kost (p=0,001) jämfört med blandkost. Slutsats Majoriteten av deltagarna intog någon typ av kosttillskott, hälften intog järntillskott och en liten andel intog probiotika. Lågutbildade, yngre, de som äter blandkost och bor utanför stadsområde verkar vara i riskgruppen för att inte inta kosttillskott. / Abstract Background Vitamin and mineral deficiencies in pregnant women can lead to miscarriage and serious disturbances in children’s development. The intestinal flora of the mother is most likely transmitted to the child during childbirth and may lay the foundation for the child's health. One possible solution to ensure an adequate intake may be the consumption of dietary supplements and probiotics. At present, there is insufficient data on supplement consumption among pregnant women. Objective The purpose of the study was to examine how many pregnant women in Västerbotten County chose to consume dietary supplements, mainly iron and probiotics, and whether there was a difference between different factors and intake. Method A quantitative cross-sectional study where pregnant women (n=1473) from the Northpop-study in Västerbotten County responded to a questionnaire regarding consumption of dietary supplements and factors such as age, education, diet etc. The material was analyzed in SPSS with Chi-2-test, independent T-Test and Mann-Whitney U-Test. Using significance level <0.05. Results The majority of participants, 90 percent, responded that they consumed dietary supplements. The factors that increased the intake of dietary supplements in pregnant women were higher age (p=0.030), higher education (p=0.006) and vegetarian/vegan diet (p=0.021). Iron was reported to be consumed by 804 people, 55 percent. The factors that increased the intake of iron supplement in pregnant women were vegetarian/vegan diet (p=0.001). Probiotics were consumed by 25 people, 2 percent. Living in urban areas (p=0.024) and eating vegetarian/vegan diet (p=0.002) increased consumption of probiotics. Conclusion The majority of participants chose to consume some type of dietary supplement, half of the participants consumed iron supplements and a small part consumed probiotics. It appears that pregnant women who are low educated, younger, eating an omnivorous diet and living outside urban areas are in the risk zone for not consuming dietary supplements. / Northpop
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