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Nyuar, Kot Bol (2010) Nutritional status of displaced and non-displaced Sudanese women and neonates: a specific focus on the essential fatty acids, vitamin A and trace minerals. Doctoral thesis, London Metropolitan University.
The research described in this thesis is concerned with nutritional status of internally displaced and non-displaced pregnant and non-pregnant Sudanese women and their neonates. An adequate intake of EFA, LCPUFA and micronutrients is vital for women of childbearing age, particularly prior and during pregnancy and lactation, as these nutrients are important for normal growth and development in infants and children. We have investigated i) the Sudanese women daily intake of macro- and micronutrients with specific focus on dietary fat intake, ii) the relative proportion of EFA and their long chain derivatives in the plasma and milk and iii) determined the plasma concentration of retinal, β-carotene and trace minerals in Sudanese women and neonates.
Our dietary assessment reveals that carbohydrates provided over 60% of dietary energy for all the Sudanese women groups. The DSSW had significantly lower intake of energy, starch and carbohydrates compared to both NDSSW and NSW. Fat intake was also lower in the displaced group than in their non-displaced counterpart, but was not significantly different compared with northern Sudanese women. Intakes of iodine, Zn, retinal, riboflavin and DHA amongst Sudanese women were very low compared with recommendations. We further compared the status of EFA and LCPUFA in the plasma of non-pregnant and pregnant women and their neonates. We observed comparable proportions of LA and noticeably higher n-6 LCPUFA, viz. DHGLA, AA, adrenic, osbond; with much lower levels of DHA and other n-3 LCPUFA in plasma CPG of NSW; and DSSW and NDSSW in comparison to international data. Similarly levels of all n-3 FA in CE and TG were also lower compared to similar population elsewhere. The strikingly higher levels of osbond acid especially in the neonates, coupled with higher indices of DHA deficiency and lower indices of DHA sufficiency led us to conclude that maternal and foetal DHA and other n-3 FA are deficient and that insufficient intake of food rich in preformed DHA; and low maternal reserves are plausible explanation for inadequate maternal and neonatal plasma DHA status.
Analyses of the fatty acid composition of colostrum, transitional and mature milk of NSW; and DSSW and NDSSW reveal that the mean level of AA and other n-6 LCPUFA in the three phases of the Sudanese milk were broadly comparable with international data; however, the DHA content was lower especially in mature milk of DSSW and NSW. Although NDSSW had higher mean DHA compared with DSSW and NSW, it was slightly lower compare with other studies. It is suggested that low fish intake and depleted maternal reserves are probably the main causes of low n-3 FA in the Sudanese mothers' milk.
Sudanese women and neonates plasma retinol, β-carotene and trace minerals was assessed by ICP-MS. Results show that mean retinol and β-carotene in the pregnant and non-pregnant in the DSSW, NDSSW and NSW were very low compared with reported studies elsewhere. In fact over 50% of pregnant DSSW and NDSSW had plasma retinol concentration indicative of low retinol (<0.70 µmol/I) and about 15-20% are deficient (<0.35 µmol/I). The mean concentration of trace minerals Zn, Cu and Mn were found to be low in pregnant and non-pregnant Sudanese women and their neonates.
Thus, from these studies it is broadly clear that Sudanese women and neonatal status of DHA and other n-3 LCPUFA; retinol and some trace minerals is sub-optimal. Furthermore, the maternal milk DHA and other n-3 FA is also extremely low. Reliance on diets largely based on cereals; or seeds, which are LA rich and contained little ALA, is the main cause of poor maternal and neonatal DHA status and DHA levels in plasma and milk. In addition, cereals diets are not the best sources of micronutrients.
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