IntroductionIn Mongolia, cardiovascular diseases (CVDs) and stroke have consistently been the number one cause of population mortality since 1990s. Hypertension is an independent risk factor for CVDs and stroke. There is a conclusive evidence that high salt intake is the strongest dietary factor for hypertension. However, in Mongolia, evidence on actual salt intake of the population, its potential sources and relations to high blood pressure has been in lack so far.GoalThe survey was aimed to determine actual daily salt intake and related behavior patterns in the population residing in Eastern and Khangai regions and in the city and to identify the directions of further activities to decrease the amount of salt consumed per day by the target population.Materials and MethodsThe survey recruited a total of 475 adults from Khentii, Bulgan aimags and Bayanzurkh district of Ulaanbaatar. Questionnaires, physical measurements and laboratory analyses were applied to collect and process the data on population demographics, behavior patterns and salt related KAP, blood pressure and sodium and potassium values in 24 hour urine samples to estimate daily salt intake. A survey database was developed using EPI INFO and the data was entered in twice. SPSS 18 software was used for the data analysis, mean and standard deviations were estimated using t and F statistics on continuous variables with normal distribution, and chi square test was applied to differences in proportions.ResultsMean age of the survey population was 44.5 years; the survey population was not differing in their age, gender and region. Average daily consumption of salt was 9.5 grams in the survey population; it was not differing in terms of region. Men consumed on average 10.1 grams of salt which is twice much higher than the WHO recommended amount. Salt consumption was higher among those aged 45-54 years and rural persons, particularly men. For men and people aged 45-54 years old, the salt consumption was directly related to their salt tea drinking habit (r= 0.14; p=0.04). Those who drink alcoholic drinks frequently have higher body mass index and/or less educational attainment were more likely to drink tea with salt. In the Eastern Region, regardless of a habit of drinking tea without salt, the high salt consumption seems to be caused by insufficient knowledge of salt containing meals and food products (r=.27; p=0.001), lack of awareness of health impacts of salt, as well as lack of attitude towards their control of daily salt intake (r= ; p= ). In the Khangai Region and the urban city, salt added to meals and food preparation (Partial r =.22; p=0.05), salt containing food products and salt tea are the main factors of high salt consumption. The survey population in these areas lacks attitude and practice to decrease and control their daily salt intake.ConclusionSalt consumption is generally high among the adults of the Eastern and Khangai Regions and in UB city; males and rural people are lacking in knowledge and attitude related with salt content of food, food choice and with the potential health impacts of excessive sodium intake.

Introduction. The high rate of malnutrition in young Mongolian children is a serious issue. Anemia, stunting and rickets have all been identified as significant problems. Low levels of serum folate have been reported among some young children in two previous surveys. Zinc is a growth-limiting micronutrient that may contribute to the persistent stunting in young Mongolian children. The traditional rice and wheat-based complementary foods used for young child feeding are likely to be inadequate in zinc. Certainly, the overall prevalence of stunting in Mongolia (i.e., 20%) is suggestive of substantial risk of zinc deficiency. It is possible that co-existing low selenium status may exacerbate zinc deficiency, because selenium compounds regulate the delivery of zinc from metallothioneine to zinc enzymes. To date, however, there have been no studies on the selenium and zinc status of the Mongolian population. Study objective. The objective of this study was to assess the biochemical indicators of micronutrient deficiency among 6-36 months old children. Subjects and methods. This cross-sectional study was conducted in four districts of Ulaanbaatar city and in centers of Bulgan, Bayanhongor, Dornod and Khovd aimags and included 243 (122 male and 121 female) apparently healthy children aged 6 to 36 months. Hemoglobin analysis was performed using a hemoglobinometer Hemocue AB, serum ferritin was analyzed by enzyme immunoassay technology, serum retinol by high-pressure liquid chromatography, serum zinc and selenium were analyzed by atomic absorption spectrophotometry and serum 25(OH)D analysis was performed using radioimmuno assay procedure. Results. Mean hemoglobin, serum ferritin, folate, 25(OH)D, retinol, zinc and selenium concentrations in children from Ulaanbaatar city and aimag centers were determined. Age-group differences for the means were significant for hemoglobin, serum ferritin, serum folate (p=0.001)and serum zinc(p=0.01). The differences between Ulaanbaatar and the aimag centers were also significant for hemoglobin, serum ferritin, serum zinc (p=0.05) and serum folate (p=0.001). 24.3% of the children were anemic. The prevalence of anemia was greater among the children in the aimag centers than in Ulaanbaatar city and in younger children than in the oldest age group. The prevalence of iron deficiency anemia was 15.3% and was independent of setting but was lowest in the oldest children aged 24 to 36 months. Of all the surveyed children, only 3.7% had low level of serum folate. The overall prevalence of low serum retinol levels indicative of vitamin A deficiency was 33.7%, with no differences by setting or age group. 74.7% of the children had low serum zinc concentrations. There was no significant difference in the prevalence between children living in Ulaanbaatar city and the aimag centers, or among the three age groups of children in either setting. The overall prevalence of low serum selenium concentrations was 57.7%, with no differences in the prevalence by setting or age-group. The prevalence of low serum levels of 25(OH)D was 61% and was highest among the children aged 6 to 12 months of Ulaanbaatar city. Conclusion: 1. Zinc deficiency had the highest prevalence (74.7%) among the surveyed children, followed by low serum selenium levels (57.7%). 2. 36% of the children were at risk of two and 64% of more than two coexisting micronutrient deficiencies. 3. There is a need for multi-micronutrient programs that take into account the potential interactions of micronutrients instead of the present single micronutrient based interventions on-going in Mongolia.

Selenium was discovered by the Swedish chemist Jo¨ns Jacob Berzelius in 1817 and has been recognized as an essential trace element for many life forms including man since 1957. As an essential trace element, the importance of selenium (Se) in humans is well established, and its deficiency has caused serious health effects in humans, such as Keshan disease. Foods are major natural source of Se, and its levels generally depend on soil Se levels. Since its discovery as an important component of antioxidant enzymes, such as glutathione peroxidase (GPx), thioredoxin reductase (TrxR) and iodothyronine deiodinases (IDD), there has been an increased interest in the study of other Se-containing proteins (selenoproteins) or enzymes (selenoenzymes)].Selenocysteine is recognised as the 21st amino acid, and it forms a predominant residue of selenoproteins and selenoenzymes in biological tissues. The molecular structure of selenocystiene is an analogue of cysteine where a sulphur atom is replaced by Se. Selenium can be measured in whole blood, blood fractions (plasma, serum, red blood cells), hair, nails, and urine. Plasma selenium levels below 0.6mM (40–50 ng/ml) are considered deficient, and risk of toxicity occurs at levels higher than 2mM (160 ng/ml), with reports of toxic effects at concentrations higher than 3mM (250 ng/ml)The increased production of ROS (reactive oxygen species) can exert oxidative stress in the physiological system, and if excess ROS are not properly regulated they can cause damage to cellular lipids, proteins and DNA. The damage caused by ROS has been linked to various human diseases, including heart diseases. The presence of ROS can also cause the oxidation of lowdensity lipoprotein (LDL),and it has been reported to be associated with initiation of atherogenesis in heart diseases. One hypothesis is that the presence of high Se as antioxidant selenoenzymes and selenoproteins may help to reduce the production of oxidised LDL and, therefore, would reduce the incidence of heart diseases.Thioredoxin reductase plays a significant role in preventing the development of atherosclerosis by reducing oxidative stress and increasing NO bioavailability

INTRODUCTION:The Government of Mongolia pays significant attention to reduce noncommunicable diseases and theirrisk factors. WHO Global strategy to reduce salt intake recommended to Member States to assessknowledge, attitude and practice (KAP) of the population on salt intake.GOAL:To determine KAP on salt intake was explored in relation to geographical location and its challenges.MATERIALS AND METHODS:This is a cross-sectional study that included 1,040 people with age range 25 - 64 years. The participantswere randomly selected from the four economic regions - western, khangai, central and eastern regions,and Ulaanbaatar city of Mongolia. The ethical aspect of the study was reviewed and approved at ameeting of the Ethics Review Committee in the medical sector at the Ministry of health, Mongolia onJuly 8, 2012 by Resolution number 14.RESULTS:The population with no knowledge of high salt content foods was 23.5% in the western region, 18.9%was in the khangai region, 16.2% was in the central region, 22.0% was in the eastern region, and15.0% was in Ulaanbaatar (ð<0.000). The participants that think a high salt diet and foods do not causehealth problems were higher in the western region 15.8%, and participants who do not know whether itcauses health problems were higher in the eastern region 11.2% compared to other regions (p<0.001).The study population from the central region and males from eastern region did not aware the negativeconsequences of salty meal/foods towards developing stomach cancer (p<0.001).Percentage of population who drink salty tea was 84.4% in the western region, 90.7% were in thekhangai region, 23.4% were in the central region, and 11.0% were in the eastern region, and 44.8%were in Ulaanbaatar (p<0.000).CONCLUSION:Salt reduction intervention especially interventions on changing attitude should be conducted aftertaking account the specific differences of the local areas.

Introduction. Population life expectancy and health status are directly related to adolescent health,as many chronic disease conditions are affi liated with adolescence. The Mongolia GSHS, 2010 wasstudied dietary behavior and some risk factors belong to non communicable diseases of secondaryschoolchildren among surveyed children. Overall, 5.5% of students have eating habits that are healthybased on the WHO recommendations developed form the Mongolian Ministry of Health. One in sixstudents (15.9%) ate fruits and vegetable fi ve or more times per day. 27.3% of students consumeddairy products valuable for childhood growth two or more times per day. More than one in four students(27.6%) drank carbonated beverages and soft drinks one or more times per day.Findings of this survey show that attention is needed into adolescence and period of young children toprevent and decrease NCD and thus this was a background of our study.Goal. Determine schoolchildren’s food consumption and dietary behavior.Material and Methods. The 2013 Mongolia GSHS employed a two-stage cluster sample designto produce is preventative sample of students in grades 7-12. In total, 60 schools (25 schools fromUlaanbaatar city and 35 rural, respectively) and 203 classes were selected to participate in the MongolianGSHS.School level: The fi rst-stage sampling frame consisted of all schools (urban, rural, public, or private)containing any grades 7-12. Schools were selected systematically with probability proportional to schoolenrollment size.Class level: The second-stage sampling frame consisted of randomly selecting intact classrooms(using a random start) from each school to participate. All relevant classes in each selected school wereincluded in the sampling frame. All students in the sampled classrooms were eligible to participate in theGSHS (2013).“Nationwide health survey based on schools in Mongolia 2013” covered 5393 schoolchildren (age 12-18) from 59 public and private schools. Coverage rate was 89% and total response rate was 88%.Result. According to the WHO recommendations, 18.6 percent (95%CI 17.2-20.1) of students consumedfruits and vegetables fi ve or more times per day. Additionally, consumption of fruits and vegetablesdecreases as age and grade increase.Totally, 31.3 percent (95%CI 29.3-33.3) of students consumed dairy products such as milk, yogurt andcheese two or more times per day in the past month. In addition, 33.0% (95%CI 30.5-35.5) of malestudents eat dairy products compared to 29.5% of female students; that is males consume 3.5% morefruits and vegetables; however there is no statistical difference. On the other hand, 43.4 percent ofchildren aged 12 years or younger consumed dairy products, 32.9 percent of children aged 13 to 15years old and 24.8 percent of children aged 16 years old or older consume dairy products; thus, showinga decreasing trend with age.One of three (33.6%) of students drank carbonated beverages one or more times per day during the pastmonth. Consumption of carbonated beverages differed between males and females (37.6% vs. 29.7%)and increased by age. By age group, high consumption of carbonated and soft drinks was observedamong students aged 16 years old or older (34.4-35.2 percent), while 33.8 percent of children aged13-15 years old, and 29.4 percent of students 12 years old or younger consumed carbonated and softdrinks.Amongst all students, 55.3 percent (95%CI 52.0-69.3) ate breakfast “usually or always”, 26.1 percentate breakfast “sometimes”, and 13.7 percent ate breakfast “rarely or never”. About 1.9% of studentswent hungry to school “usually or always” during the past one month because of insuffi cient food in theirhome.Among participated school children, 26.4 percent (95%CI 21.5-31.9) of students ate fast food three ormore times within the last seven days at restaurants such as Max Burger, Mondonald and their schoolcafeteria. Percentage of students that ate regularly at fast food restaurants or school canteens wasincreased by 8% than the indicator of the previous survey result.Conclusion1. Fruits and Vegetables: One in fi ve students consumed fruits and vegetables in accordance withthe dietary guidelines for healthy eating and this indicator are increased by 2.7% compared to theprevious study.2. Dairy products: Consumption of dairy products is increased by 4% compared to the previous study;however, it is decreased with age.3. Carbonated Beverages: Consumption of carbonated beverages by students was at similar level inboth, urban and rural areas, and it is increased by 6 points from the previous study level, especiallyhigher consumption was observed among male students.4. Fast Food: Percentage of students that ate regularly at fast food restaurants or school canteens wasincreased by 8% than the indicator of the previous survey result.

IntroductionAfter discovering an important biological function of selenium, selenium content and its deficiency arestarted to be extensively studied in numerous epidemiological studies that have been conducted inmany countries in the world. In Mongolia, as a country geographically located in unstable climate zone,there are no studies conducted on selenium so far since the last century, except one study determiningselenium deficiency signs in livestock.GoalTo determine selenium (Se) content in Mongolian wheat and livestock meatMaterials and MethodsIn total 30 samples of wheat planted in Dornod, Uvs, Tuv and Selenge aimags of Mongolia and 142samples of Mongolian beef and beef imported to Russia from China, respectively were underwent inlaboratory analysis. Wheat was hold at room temperature to reach the regular weight, and muscletissue of meat was dried in a lofildryer. Dried wheat and meat were then powdered into homogenousconsistency and were kept in air proof polyethylene container at room temperature until being analyzed.Selenium content was determined by fluorometric method [2].ResultsOut of wheat sorts grown in Mongolia, selenium was detected in extremely low level in wheat of Khalkhingol sort of Dornod aimag (7±1 mkg/kg) and Selenge sort of Selenge aimag (8±1 mkg/kg), and in wheatsold in retail outlets of Baruunturuun soum of Uvs aimag (7±1 mkg/kg) and Khongor soum of Darkhan-Uul aimag (8±1 mkg/kg). However, selenium content was relatively higher in wheat samples of Darkhan34 sort of Baruunturuun soum of Uvs aimag (31±5 mkg/kg) and of Altaiskaya sort of Jargalant (29±3mkg/kg) and Bornuur (32±1 mkg/kg) soums of Tuv aimag, and in sample of retail wheat of Sagil soum(29±1 mkg/kg) of Uvs aimag.When determined the selenium content in Mongolian livestock meat, in average, the selenium contentwere 109-296 mg/kg in beef, 94-200 mg/kg in lamb, 120-225 mg/kg in horse meat and 124-197 mg/kg ingoat, and the differences were not statistically significant (p>0.5). The highest selenium content of 400mg/kg was detected in horse meat of Govi-Altai aimag.Conclusion: The selenium content in wheat and livestock meat which are the mean stable food forMongolians is considerably low.

IntroductionOne key target of the United Nations Millennium Development goals is to reduce the prevalence of underweight among children younger than 5 years by half between 1990 and 2015. Child malnutrition is internationally recognized as an important public health indicator for monitoring nutritional status and health in populations. World Health Organization estimated the malnutrition was associated with 54% of child deaths in developing countries. The devastating effects of malnutrition on human performance, health, and survival are well-established and a recent global analysis demonstrated that child malnutrition is the leading cause of the global burden of disease. The importance of assessing population nutritional status every 5 years is widely recognized, and three rounds of National Nutrition Survey were carried out in Mongolia since 1992 with support from UNICEF. The most recent Third National Nutrition Survey was carried out with the purpose of assessing nutritional status of Mongolian children and women six years ago in 2004.ObjectiveTo describe the national prevalence of underweight in children under five.Materials and MethodsThe current cross-sectional survey was conducted in 21 provinces of 4 economic regions of the country and capital Ulaanbaatar city. Household was randomly selected based on local administrative and soum/family hospital registry and enrolled a total of 706 children aged 0-59 months were selected from sampled households. Interviews, anthropometric measurements and clinical examinations were used in the survey. Child growth was assessed based on z-scores calculated using the WHO Child Growth Standard. Low weight-for-age (underweight) can result from either long-term or short-term nutritional deficit.Results4.7% of the surveyed children were underweight. According to the WHO criteria the prevalence of underweight in Mongolian children less than 5 years of age was include “low prevalence rate”. The prevalence of the underweight among children less than 5 years was significantly higher in Rural area than the Urban.Conclusions:1. The national prevalence of underweight remains at “low” level according to WHO classification. 2. Child malnutrition reduction is needed to successfully meet the Millennium Development Goals.3. In rural area the prevalence of underweight among in 0-59 months old children was highest than urban area’s children.4. The prevalence of nutrition deficiencies varies between different regions calling for implementation of interventions specific for local conditions and needs.

BackgroundLactic acid bacteria (LAB) are significant to human health due to the production of some antimicrobial and ability to inhibit pathogenic bacteria. Recently researchers in the food biotechnologies are centred on careful isolation and selection of new strains of LAB. In this study were isolated and identificated strains of LAB from koumiss in Mongolia.Materials and MethodsMongolian traditional koumiss collected from Arkhangai, Bulgan, Dundgobi, Uvurkhangai, Tuv province in 2010. Phenotypical characterization methods of LAB and identification of strains was carried out by using API systems.ResultIn this study were isolated 35 strains of LAB. All strains were gram positive, catalase negative and had a cocci (T-8), bacilli (A-4, BL-12, Du-8, O-9, B-13 and A-7 ) in pair or chains. Optimal growth temperature occurred between 280C to 420C into a pH range between 3 to 8 and up to 0,5% NaCl. Purified 9 strains showed antimicrobial and proteolytic activity. The present study carries out the identification of 7 strains using the API 50 CH tests from Biomerieux. ConclusionSix strains of Lactobacillus sp (L.brevis, L.paracasei, L.plantarum,), one strain of Lactococcus sp (L.Lactis) have been isolated from traditional koumiss. Preliminary study of koumiss starter was carried out.

Introduction. More than 3.5 million mothers and children under five die unnecessarily each year due to the underlying cause of under nutrition, and millions more are permanently disabled by the physical and mental effects of a poor dietary intake in the earliest months of life. Malnutrition has a negative impact on the physical and intellectual development which can further affect health, living potentials and the quality of life. It has been established that to reduce child mortality and to prevent illnesses related to malnutrition the most effective actions are to breastfeed, feed with proper complementary foods, enrich child’s diet with vitamin A, zinc and other necessary vitamins and mineral supplements, and to treat chronic malnutrition. This can be achieved by implementing internationally reputed projects and programs. Goal. To assess the knowledge, attitude and practice of mothers in the project areas towards, infant and young child feeding.Materials and Methods. This survey conducted in each of 5 soums of Gobi-Altai, Sukhbaatar, Dundgobi, Tuv, and Arkhangai aimags and each of 5 khoroos of Chingeltei and Songinokhairkhan districts of Ulaanbaatar city. Survey recruited a total of 1077 mothers and caregivers of children aged 0-35 months.Results. 7 in 10 mothers participating in the study have “insufficient” level of knowledge of feeding young children and this is related to the mother’s education level. 2. 21.8% of mothers and caregivers were aware of the recommendations of breastfeeding the child within an hour after birth and 38.6% were not aware of exclusive breastfeeding until 6 months of age. 1 in 4 mothers participating in the survey (25.2%) had the wrong understanding of feeding a child 1-2 times a day while complementary feeding: 43.6% of mothers in Sukhbaatar aimag, and 33.8% in Gobi-Altai aimag had this insufficient knowledge of frequency of breast feeding while giving complementary food to the baby. Half (50.3%) of mothers and caregivers did not know the correct amount of food to be given at one time to feed a child and this knowledge was insufficient across all aimags and districts. Knowledge of illnesses caused by nutrition and their preventions was insufficient among mothers in all aimags and districts.Conclusions:1. 65, 7% of mothers exclusively breastfed their children until the age of 6 months. The percentage of exclusively breastfeeding in districts is similar to the national average; however, in rural aimags it is twice higher.2. Only 41, 5% of children up to 3 years of age were fed with complementary food at right time, while 42, 8% - too early and 15%- too late.3. Only 8, 7% of mothers and caretakers have correct practice of feeding children of 12-23 months old more than 5 times per day, which is not sufficient indicator.

Introduction. Malnutrition has a negative impact on the physical and intellectual development which can further affect health, living potentials and the quality of life. A lack of a sustained decrease in low birth weight and young child malnutrition is associated with the failure to provide nutritious food in adequate quantities to pregnant and breastfeeding women and children up to two years of age. The most recent estimate from the 2005 MICS survey of the prevalence of wasting is 2.8 percent, stunting is 26.8 percent, and underweight is 7.4 percent among children aged 0-59 months in Mongolia.Goal. To assess the current nutritional status of 0-59 months old children of Mongolia, and identify next steps to improve child nutrition.Materials and Methods. This cross-sectional survey was conducted in 21 aimags of 4 economic regions of the country and in the city Ulaanbaatar. A total of 706 children aged 0-59 months were selected from sampled households. Interviews, anthropometric measurements and clinical examinations were used in the survey.Results. The distribution of length/height-for-age Z-scores of the surveyed children was shifted to the left compared to the WHO Child Growth Standard. The weighted average z-score and its standard deviation was 0.78±1.5, which is characteristic of high proportion of "short" children in Mongolia. Of the surveyed children, 15.6% (95%CI 12.7¬18.9) were stunted about one-third of stunted children had severe stunting. The prevalence of stunting was highest in the Western Region, the differences between this region and all other regions were statistically significant. Rural children had statistically significantly prevalence rates of overall stunting, moderate stunting, and severe stunting compared to their urban counterparts. Underweight and stunting were much more prevalent in children who had a low birth weight. Of those with a low birth weight, 35.5% (95%C118.4- 57.3) were underweight and 54.1% (95%CI 35.3-71.8) stunted, but there were no wasted children.Conclusions:1. In rural area the prevalence of stunting among in 0-59 months old children was highest than urban area's children.2. The prevalence of stunting was highest in the Western Region and remains at "high" level according to WHO classification.3. Underweight and stunting were much more prevalent in children who had a low birth weight4. The high rate of stunting among under five year olds is likely related to dietary behavior, and requires further study and intervention efforts.