DIETARY REFERENCE INTAKES (DRIS) FOR MONGOLIANS · 2020. 11. 11. · DRIs • Based on evidence:...

DIETARY REFERENCE INTAKES (DRIS) FOR MONGOLIANS

Tuyatsetseg Jambal, Ph.DSchool of Industrial Technology, Mongolian

University of Science & Technology,

Outline

• Background

• Mongolian DRIs

• Briefly report of National Nutrition Surveys

• Conclusion

Background

1,564,116 square kilometresPopulation: 3.1 million

Background

Recommended Dietary Allowances (RDAs):

• 1981

• 1997

• 2008

• 2017

National Center for Public Health, Ministry of Health (MOH)

2017

DRIs• Based on evidence: National Nutrition Survey

• Addressed to the main public health problem for

population

• Recommended and guided the practice to obtain the

Balanced Diet in household daily.

Comparison of RDAs

1981 Calories: 3000 kcals

1997 Calories: 2600 kcals, protein: 98g, fat: 72g, CHO:390g

2008

2017

CHO: carbohydrate

Calories: 2500 kcals, protein: 94g, fat: 69g, CHO:375g

Calories: 2400 kcals, protein: 90g, fat: 67g, CHO:360g

Standard person: adult, 20-39 yo, male

Comparison of RDAs

Calories by RDA version

Ratio: 100 : 15 : 25 : 60 (cal : pro : fat : CHO)

Cal: caloriesPro: proteinCHO: carbohydrate

The last version of RDA is comparing and conclusion

with National Nutrition Surveys.

Dietary guideline• 2000, the first edition of dietary guidelines for

Mongolian was established and published “Ger” (traditional house) guidelines.

• Nutrition Research Center and MOH

Dietary guideline

Health status

Source: Health indicators 2016, Center for Health Development

Five leading causes of morbidity, 2006-2016, per 10 000 population

• Arterial hypertension accounts for 50.0% of all diseases of thecirculatory system, which is 503.9 per 10 000 population. By gender,there were 653.1 for females and 357.5 for males per 10 000population.

• Diabetes accounted for 48.9% of all diseases of endocrine, nutritionaland metabolic disorders and it was 78.6 per 10 000 population in2016 which increased by 14.8, compared to the previous year. Bygender, there were 75.5 for males and 82.9 for female per 10 000population.

Five leading causes of mortality, 2006-2016, per 10 000 population

Health statusMorbidity, 2006-2016

1. Diseases of the respiratory system

2. Diseases of the digestive system

3. Diseases of the circulatory system

4. Diseases of urinary system5. Injury, poisoning and certain

other consequences of external causes

Mortality, 2006-2016

1. Diseases of the circulatory system

2. Neoplasms3. Injury, poisoning and certain

other consequences of external causes

4. Diseases of the digestive system

5. Diseases of respiratory system

National Nutrition Surveys• To assess the nutrition status of Mongolian population. • National Nutrition Survey (NNS)

• NNS I: 1992• NNS II: 1999• NNS III: 2004• NNS IV: 2010 • NNS V: 2017

• By MOH with support from international organization.

• Based on these findings, the government of Mongolia implementedvarious initiatives to reduce the burden of malnutrition including:breastfeeding promotion, child growth promotion, salt fortificationwith iodine for reduce iodine deficiency, moreover vitamin A, vitaminD and multi-micronutrient supplementation.

Nutrition status: malnutrition in children under 5 yo of age

Underweight, wasting, stunting Overweight

Prevalence of child obesity is 1.8 times higher in children with high birth weight, as compared to those with normal birth weight.

Nutrition status: anemia and iron deficiency in children under 5 yo of age

Nutrition status: vitamin A and D deficiency in children under 5 yo of age

Nutrition status: prevalence of overweight in woman

5 times higher than NNS IV Higher prevalence in older age

Nutrition status: prevalence of obesity in woman

Nutrition status: prevalence of anemia in woman

Current prevalence of anemia in mothers is 16.2%, compared to 14.4% inthe NNS IV. Comparative analysis indicated 1.8 percentage point increase inthe prevalence of anemia in mothers 1549 years of age.

Nutrition status: prevalence of overweight and obesity among men

• Prevalence of overweight and obesity among men 15-49 year of age is 48.8%. At regional level, the highest prevalence is found in Western region at 53.3%.

• Prevalence of anemia among men was 3%. Mean serum ferritin concentration was 141 μg/l, indicating iron overload is less likely.

• Prevalence of vitamin D inadequacy among men is 82.3%, with vitamin D deficiency standing at 41.9%.

• Prevalence of vitamin A deficiency is 0.6%, with another 2.6% of men having insufficient amount of vitamin A.

• Survey results showed about 60% of men had minimally adequate dietary diversity, with percent distribution ranging from 47.9% among rural men to 40.2% in Eastern region.

Nutrition status: malnutrition among school children, 6-11 yo

Percentage of stunted and wasted children, aged 6-11 years, in Mongolia are 7.3% and 2.8%, respectively. The prevalence of overweight and obesity in school children aged 6-11years sharply increased from 2010 NNS IV level and reached 22.2% and 6.4%, respectively.

• Consumption of junk (high-calorie, low-nutrient) foods in the past week was nearly universal (99.0%) among children 6-11 years of age. Over half of children (51.4%) consumed junk foods at least once per week and 45.7% consumed junk foods a few times a week. Junk foods were consumed more frequently in urban (49.4%) compared to rural (35.7%) areas and was highest in Ulaanbaatar (53.3%) compared to the other regions (33.0% to 45.3%).

• Consumption of sugar-sweetened beverages was high with 80.9% of children consuming these at least once in the past week, 20.3% consuming them a few times per week and 4.1% of children consuming a sugar-sweetened beverage at least once per day. Higher consumption of sugar-sweetened beverages was reported in urban (82.6%) compared to rural (76.3%) areas with the highest consumption in Ulaanbaatar (85.8%) compared to other regions (69.6% to 79.5%).

• Consumption of sweet foods was high with nearly all children having consumed sweet foods in the past week, 45.9% of children 6-11 years having consumed sweet foods a few times per week and 6.1% of children consuming sweet foods at least once per day. In contrast to other junk foods, there was significant difference in consumption of sweet foods between urban and rural areas.

Conclusion• The prevalence overweight and obesity has been

increased among all age groups and do not differencebetween genders.

• Double-burden of malnutrition: micronutrient deficiencyand obesity.

• Consumption of junk food and sweetened beverageshad been increased quickly.

• To revise the RDAs for children and teenagers (proteinrecommendation).

• Dietary guideline: should be revise

RDA: 1997

Population group Calorie 2017(kcal)

Calorie 2008(kcal)

Comparison nowLife stage Age Sex

Infants

0-6 month Male 720 - -Female 660 - -


Early childhood, adolescence

1-3 age Male 1060 1260 -160Female 980 1200 -220

4-6 age Male 1470 1700 -230Female 1330 1600 -270

7-10 age Male 1820 2175 -350Female 1650 1800 -150

11-14 age Male 2500 2400 -100Female 2170 1850 -320

15-18 age Male 2700 2630 +70Female 2280 2180 +100

Adult

18-29.9 age Male 2400 2590 -190Female 1990 2040 -50

30-59.9 age Male 2380 2480 -100Female 1850 1960 -110

Senior, old age≥60 age Male 1920 2030 -110

Female 1680 1800 -120

Pregnant womanFirst trimester 2080 2040 +40

Second trimester 2280 2340 -60Third trimester 2470 - -

Lactating woman0-6 month 2490 - -≥6 month 2390 - -

Physically demanding workersMale 3300 - -

Female 2400 - -

Non-Physically demanding workers

Male 2100 - -Female 1620 - -

Population group Protein (g)Life stage Age Sex 2017 2008 Comparison

Infants

0-6 month Male 10 -Female 9 -



1-3 age Male 15 47 -32Female 14 45 -31

4-6 age Male 22 64 -42Female 20 60 -40

7-10 age Male 28 81 -73Female 29 67 -38

11-14 age Male 45 90 -45Female 46 69 -23

15-18 age Male 60 98 -38Female 52 82 -30

Adult

18-29.9 age Male 90 97 -7Female 72 76 -4

30-59.9 age Male 76 97 -26Female 66 73 -7


Female 54 67 -13

Pregnant womanFirst trimester 73 76 -3

Second trimester 81 88 -7Third trimester 97 -

Lactating woman0-6 month 91 -≥6 month 85 -

Physically demanding workers

Male 124 -Female 90 -



Population group Fat (g)Life stage Age Sex 2017 2008 Comparison

Infants




1-3 age Male 41 35 +6Female 38 33 +2

4-6 age Male 49 47 +2Female 44 44 +0

7-10 age Male 61 60 +1Female 55 50 +5

11-14 age Male 78 67 +11Female 67 51 +16

15-18 age Male 84 73 +11Female 71 60 +11

Adult

18-29.9 age Male 67 72 -5Female 55 57 -2

30-59.9 age Male 66 68 -2Female 51 54 -3


Female 47 50 -3








Population group Carbohydrate (g)Life stage Age Sex 2017 2008 Comparison

Infants




1-3 age Male 158 189 -31Female 144 180 -36

4-6 age Male 235 255 -20Female 212 240 -28

7-10 age Male 290 325 -35Female 260 270 -10

11-14 age Male 405 360 +45Female 344 277 +67

15-18 age Male 426 394 +32Female 358 327 +31

Adult

18-29.9 age Male 360 389 -29Female 302 306 -4

30-59.9 age Male 370 372 -2Female 280 294 -14


Female 261 270 -9








Slide Number 1OutlineBackgroundBackgroundDRIsComparison of RDAsComparison of RDAsDietary guidelineDietary guidelineSlide Number 10Health statusFive leading causes of morbidity, 2006-2016, per 10 000 populationSlide Number 13Five leading causes of mortality, 2006-2016, per 10 000 populationHealth statusNational Nutrition SurveysNutrition status: malnutrition in children under 5 yo of ageNutrition status: anemia and iron deficiency in children under 5 yo of ageNutrition status: vitamin A and D deficiency in children under 5 yo of ageNutrition status: prevalence of overweight in womanNutrition status: prevalence of obesity in womanNutrition status: prevalence of anemia in womanSlide Number 23Nutrition status: prevalence of overweight and obesity among menSlide Number 25Nutrition status: malnutrition among school children, 6-11 yoSlide Number 27ConclusionSlide Number 29Slide Number 30Slide Number 31Slide Number 32Slide Number 33

DIETARY REFERENCE INTAKES (DRIS) FOR MONGOLIANS · 2020. 11. 11. · DRIs • Based on evidence:...

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