scholarly journals The effect of retinyl palmitate added to iron-fortified maize porridge on erythrocyte incorporation of iron in African children with vitamin A deficiency

2003 ◽  
Vol 90 (2) ◽  
pp. 337-343 ◽  
Author(s):  
Lena Davidsson ◽  
Pierre Adou ◽  
Christophe Zeder ◽  
Thomas Walczyk ◽  
Richard Hurrell
Keyword(s):  
Single Dose ◽  
Vitamin A ◽  
Test Meal ◽  
Vitamin A Deficiency ◽  
Geometric Mean ◽  
Retinyl Palmitate ◽  
Dietary Vitamin ◽  
Vitamin A Supplementation ◽  
Vitamin A Status ◽  
Before And After

Retinyl palmitate added to Fe-fortified maize bread has been reported to enhance Fe absorption in adult Venezuelan subjects but not in Western Europeans. It is not known to what extent these results were influenced by differences in vitamin A status of the study subjects. The objective of the present study was to evaluate the influence of retinyl palmitate added to Fe-fortified maize porridge on erythrocyte incorporation of Fe in children with vitamin A deficiency, before and after vitamin A supplementation. Erythrocyte incorporation of Fe-stable isotopes was measured 14 d after intake of maize porridge (2·0 mg Fe added as ferrous sulfate) with and without added retinyl palmitate (3·5 μmol; 3300 IU). The study was repeated 3 weeks after vitamin A supplementation (intake of a single dose of 210 μmol retinyl palmitate; ‘vitamin A capsule’). Vitamin A status was evaluated by the modified relative dose–response (MRDR) technique. Retinyl palmitate added to the test meal reduced the geometric mean erythrocyte incorporation of Fe at baseline from 4·0 to 2·6 % (P=0·008, n 13; paired t test). At 3 weeks after vitamin A supplementation, geometric mean erythrocyte incorporation was 1·9 and 2·3 % respectively from the test meal with and without added retinyl palmitate (P=0·283). Mean dehydroretinol:retinol molar ratios were 0·156 and 0·125 before and after intake of the single dose of 210 μmol retinyl palmitate; ‘vitamin A capsule’ (P=0·15). In conclusion, retinyl palmitate added to the labelled test meals significantly decreased erythrocyte incorporation of Fe in children with vitamin A deficiency at baseline but had no statistically significant effect 3 weeks after vitamin A supplementation. The difference in response to retinyl palmitate added to Fe-fortified maize porridge on erythrocyte incorporation of Fe before and after intake of the vitamin A capsule indicates, indirectly, changes in vitamin A status not measurable by the MRDR technique. The lack of conclusive data on the effect of retinyl palmitate on Fe absorption indicates the complexity of the interactions between vitamin A status, dietary vitamin A and Fe metabolism.

scholarly journals Evaluation of a two-generation rat model for vitamin A deficiency and the interrelationship with iron metabolism

1995 ◽  
Vol 74 (5) ◽  
pp. 689-700 ◽  
Author(s):  
Annet J. C. Roodenburg ◽  
Clive E. West ◽  
Robert Hovenier ◽  
Anton C. Beynen
Keyword(s):  
Vitamin A ◽  
Rat Model ◽  
Binding Capacity ◽  
Vitamin A Deficiency ◽  
Dietary Vitamin ◽  
Vitamin A Status ◽  
Normal Vitamin ◽  
Before And After ◽  
Pregnancy And Lactation ◽  
Plasma Retinol

In order to induce a range of vitamin A-deficient states in young growing rats and to study the effect of vitamin A deficiency on Fe status, we designed the following two-generation experiment. Dams were fed on diets with one of five vitamin A levels from 2 weeks before and throughout pregnancy and lactation. The pups received the same diets as their mothers both before and after weaning. The five dietary levels of vitamin A were 1200, 450, 150, 75 and 0 retinol equivalents/kg feed. Vitamin A intake did not affect reproduction outcome, nor were body and liver weights of the pups affected when they were 3·5 weeks old. Male pups with normal vitamin A status had higher plasma retinol levels than female pups. Vitamin A status of the offspring was affected from 3·5 weeks onwards. Body and liver weights were decreased in the male pups given the lowest dietary vitamin A levels from week 6·5 onwards but not in the female pups. Fe status was marginally affected. Haemoglobin levels were increased and total Fe-binding capacity was decreased in the groups given no dietary vitamin A at week 9·5. Splenic Fe was increased only in the male pups given the lowest levels of dietary vitamin A. However, as a whole, Fe status was only mildly affected and subject to considerable variation. We conclude that the two-generation rat model described here is not suitable for studying effects of vitamin A deficiency on Fe metabolism.

Effect of dietary vitamin A on the mixed function oxidases and the pneumotoxicity of 3-methylindole in goats

1983 ◽  
Vol 61 (8) ◽  
pp. 816-821 ◽  
Author(s):  
F. E. Burley ◽  
T. M. Bray
Keyword(s):  
Vitamin A ◽  
Clinical Signs ◽  
Weight Ratio ◽  
Dry Weight ◽  
Retinyl Palmitate ◽  
Lung Damage ◽  
Dietary Vitamin ◽  
Vitamin A Supplementation ◽  
High Vitamin ◽  
Alveolar Epithelial

To determine the effects of dietary vitamin A on the activity of the mixed function oxidase (MFO) system and on the susceptibility to 3-methylindole (3MI)-induced respiratory disease, goats were fed a high (supplemented with 12 000 IU retinyl palmitate/kg) or a low (no supplementation) vitamin A diet for 14 weeks. Four animals in each dietary group were then challenged with [14C]3MI. The remaining four animals served as controls. Enzyme assays were performed and severity of the 3MI-induced lung damage was scored. Consumption of the low vitamin A diet resulted in a significant reduction in the liver and lung contents of vitamin A; however, serum concentration of vitamin A was unaffected. High vitamin A supplementation did not alter the activity of the MFO system. Clinical signs, lung – body weight ratio and wet – dry weight ratio of the lungs of 3MI-infused goats were not significantly different; however, in the low vitamin A goats, the microscopic lesions such as the extent of alveolar epithelial hyperplasia were judged to be significantly more severe than those observed in the high vitamin A goats.

Vitamin A deficiency among children younger than 5 y in India: an analysis of national data sets to reflect on the need for vitamin A supplementation

2020 ◽  
Author(s):  
G Bhanuprakash Reddy ◽  
Raghu Pullakhandam ◽  
Santu Ghosh ◽  
Naveen K Boiroju ◽  
Shalini Tattari ◽  
...  
Keyword(s):  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Public Health Problem ◽  
Sample Survey ◽  
Dietary Vitamin ◽  
High Dose ◽  
Serum Retinol ◽  
Indian Children ◽  
Vitamin A Supplementation ◽  
National Prevalence

ABSTRACT Background Biochemical vitamin A deficiency (VAD) is believed to be a serious public health problem (low serum retinol prevalence >20%) in Indian children, justifying universal high-dose vitamin A supplementation (VAS). Objective To evaluate in Indian children younger than 5 y the risk of biochemical VAD from the Comprehensive National Nutrition Survey, as well as dietary vitamin A inadequacy and excess over the tolerable upper limit of intake (TUL) from national and subnational surveys, factoring in fortification and VAS. Methods Child serum retinol data, corrected for inflammation, were examined to evaluate national- and state-level prevalence of VAD. Simultaneously, dietary intakes from the National Sample Survey Office and the National Nutrition Monitoring Bureau were examined for risk of dietary vitamin A deficiency against its average requirement (AR) derived for Indian children. Theoretical estimates of risk reduction with oil and milk vitamin A fortification were evaluated along with the risk of exceeding the TUL, as well as when combined with intake from VAS. Results The national prevalence of biochemical VAD measured in 9563 children was 15.7% (95% CI: 15.2%, 16.3%), and only 3 states had prevalence significantly >20%. The AR of vitamin A was 198 and 191 µg/d for boys and girls; the risk of dietary inadequacy was ∼70%, which reduced to 25% with oil and milk fortification. Then, the risk of exceeding the TUL was 2% and 1% in 1- to 3-y-old and 4- to 5-y-old children, respectively, but when the VAS dose was added to this intake in a cumulative 6-mo framework, the risk of exceeding the TUL rose to 30% and 8%, respectively. Conclusion The national prevalence of VAD risk is below 20% in Indian children. Because there is risk of excess intake with food fortification and VAS, serious consideration should be given to a targeted approach in place of the universal VAS program in India.

scholarly journals Resolution of Bitot's spots following mega-dose vitamin A supplementation in children between 1 and 5 years of age

2013 ◽  
Vol 17 (7) ◽  
pp. 1614-1619 ◽  
Author(s):  
Umesh Kapil ◽  
Shraddha Dwivedi ◽  
Harshpal S Sachdev ◽  
SN Dwivedi ◽  
RM Pandey ◽  
...  
Keyword(s):  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Indian Subcontinent ◽  
Uttar Pradesh ◽  
Clinical Predictors ◽  
Vitamin A Supplementation ◽  
Public Health Burden ◽  
Predictors Of Response ◽  
Before And After

AbstractObjectiveThe prevalence of Bitot's spots (BS) is often used to quantify vitamin A deficiency burden in India, both before and after mega-dose vitamin A supplementation (MVAS) programmes. However, the proportion of BS cured following this intervention is unclear in contemporary times. The current study evaluated the responsiveness of BS over 1 year to MVAS administered as per the national programme in rural India.DesignProspective, community-based, 1-year follow-up of a cohort.SettingRural Uttar Pradesh, India.SubjectsTwo hundred and sixty-two children with BS, aged between 1 and 5 years, administered 60 mg (retinol equivalent) of vitamin A on diagnosis and after 1 month. Cure or resolution was defined if there was no discernible BS in either eye.ResultsDuring 1 year, only three children were lost to follow-up. At 6 months of follow-up (MVAS at baseline and 1 month later), 51·1 (95% CI 45·3, 57·3) % were classified as cured. The corresponding figure at 1 year (additional MVAS at 6 months) was 59·9 (95% CI 54·1, 65·9) %. Among those cured at 6 months, about half and three-quarters had resolved at 2 and 3 months, respectively. Apart from male gender, there were no significant sociodemographic or clinical predictors of response.ConclusionsSubstantial non-response to MVAS at 6 months (49%) and 1 year (40%) of follow-up suggests that presently in the Indian subcontinent, BS is a relatively crude indicator of severe current vitamin A deficiency. For programmatic decisions and evaluation, the public health burden of vitamin A deficiency should not be assessed solely through BS.

scholarly journals The effect of vitamin A on epithelial integrity

1999 ◽  
Vol 58 (2) ◽  
pp. 289-293 ◽  
Author(s):  
F. S. W. McCullough ◽  
C. A. Northrop-Clewes ◽  
D. I. Thurnham
Keyword(s):  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Retinyl Palmitate ◽  
Success Rates ◽  
Vitamin A Supplementation ◽  
Healthy Infants ◽  
Generic Term ◽  
Organ Specific ◽  
Epithelial Barriers ◽  
Retinol Equivalents

Vitamin A is the generic term for a variety of fat-soluble substances including retinol, retinyl palmitate and the provitamin A carotenoids such as all-trans-β-carotene. Vitamin A is commonly known as the anti-infective vitamin and has an essential role in vision and cellular differentiation, the latter providing a unique core mechanism helping to explain the influence of vitamin A on epithelial barriers. Alterations in the epithelial lining of vital organs occur early in deficiency, suggesting a potentially important role for the barrier function. Vitamin A deficiency (VAD) is most commonly recognized in the eye. The conjunctival-impression cytology test detects the presence of larger irregular keratinized cells and the absence of mucous-secreting goblet cells, indicative of VAD. The method is simple, quick and sensitive in populations where VAD is present. In the respiratory tract, observational studies all show an association with VAD, although vitamin A supplementation studies appear to have little effect on respiratory disease. Organ-specific targeting may improve success rates. The dual-sugar intestinal-permeability test allows the effect of vitamin A supplementation to be monitored on the gastrointestinal tract. Two vitamin A supplementation studies were carried out recently in Orissa State, India. Healthy infants of weaning age were administered orally eight weekly doses of 5.0 mg retinol equivalents and hospitalized infants received one large oral dose 60 mg retinol equivalents in the form of retinyl palmitate. Improvements in gut integrity and haematological status were observed in both studies. In summary, the response of the eye to vitamin A supplementation is well established; the present review highlights some of the more recent observations examining the effects of vitamin A.

scholarly journals Vitamin A intake and infection are associated with plasma retinol among pre-school children in rural Zambia

2012 ◽  
Vol 15 (9) ◽  
pp. 1688-1696 ◽  
Author(s):  
Christine Hotz ◽  
Justin Chileshe ◽  
Ward Siamusantu ◽  
Uma Palaniappan ◽  
Emmanuel Kafwembe
Keyword(s):  
Vitamin A ◽  
Dose Response ◽  
Acute Phase Proteins ◽  
Vitamin A Deficiency ◽  
Dietary Vitamin ◽  
Response Test ◽  
Post Harvest ◽  
Vitamin A Status ◽  
Plasma Retinol ◽  
Modified Relative Dose Response

AbstractObjectiveTo determine the prevalence of vitamin A deficiency, infection and adequacy of vitamin A intakes among Zambian children, and the contribution of dietary vitamin A and infection to vitamin A status.DesignA cross-sectional survey of vitamin A intakes by the 24 h recall method, vitamin A status by plasma retinol and the modified relative dose-response test, and infection by acute-phase proteins.SettingRural communities in Central and Eastern Provinces of Zambia.SubjectsChildren 2–5 years of age.ResultsThe prevalence of vitamin A deficiency was 56 % by plasma retinol, 48 % with infection-adjusted plasma retinol and 22 % by the modified relative dose-response test. The majority of children (61 %) had a current infection. Vitamin A intakes were relatively high (331 to 585 μg retinol activity equivalents/d in the harvest/early post-harvest and late post-harvest seasons, respectively) and the prevalence of inadequate intakes was <1 % when compared with the Estimated Average Requirement (210 and 275 μg retinol activity equivalents/d for children aged 1–3 and 4–8 years, respectively). Elevated α-1-acid glycoprotein was negatively associated with plasma retinol (P< 0·0 0 1) and vitamin A intake was positively associated with plasma retinol (P< 0·05), but only when estimated assuming a 26:1 retinol equivalence for provitamin A from green and yellow vegetables.ConclusionsInfection and vitamin A intakes were significant determinants of plasma retinol. We cannot conclude which indicator more accurately represents the true vitamin A status of the population. Reasons for the persistent high prevalence of vitamin A deficiency in the presence of adequate vitamin A intakes are unclear, but the high rates of infection may play a role.

The Vitamin A Status of Zambian Children in a Community of Vitamin A Supplementation and Sugar Fortification Strategies as measured by the Modified Relative Dose Response (MRDR) Test

2009 ◽  
Vol 79 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Emmanuel M. Kafwembe ◽  
James Chipipa ◽  
Eric Njunju ◽  
Roma Chilengi
Keyword(s):  
Vitamin A ◽  
Dose Response ◽  
Vitamin A Deficiency ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vitamin A Supplementation ◽  
Vitamin A Status ◽  
The Status ◽  
Modified Relative Dose Response

The main objective of the study was to determine the vitamin A status of Zambian children less than five years of age in a community where strategies of vitamin A supplementation and consumption of vitamin A fortified sugar have been introduced. In a cross-sectional study, a total of 537 children were enrolled. Their vitamin A status was measured using the modified relative dose response (MRDR) test. Their vitamin A status was compared to the status measured using a similar method in 1996, before vitamin A supplementation through capsule distribution and fortification of sugar was implemented as strategies to reduce vitamin A deficiency in the country. Results showed that the vitamin A status of children improved markedly as a result of these strategies.

scholarly journals The importance of controlling for the acute-phase response in the population-based assessment of vitamin A status: a study in children of pre-school age in Uganda

2012 ◽  
Vol 16 (9) ◽  
pp. 1540-1547 ◽  
Author(s):  
Rhona Baingana ◽  
Dennis Matovu-Kasozi ◽  
Dean Garrett
Keyword(s):  
Vitamin A ◽  
Acute Phase ◽  
Acute Phase Response ◽  
Vitamin A Deficiency ◽  
Geometric Mean ◽  
Population Based ◽  
Phase Response ◽  
Vitamin A Status ◽  
Group A ◽  
Group B

AbstractObjectiveTo improve estimates of vitamin A deficiency in children of pre-school age in the 2006 Uganda Demographic and Health Survey (UDHS 2006).DesignA cross-sectional study in which dried blood spot samples were analysed for C-reactive protein (CRP). Retinol-binding protein (RBP) had previously been analysed using a commercial enzyme immunoassay.SettingA population-based study in Uganda.SubjectsA systematically selected subset of the dried blood spot samples collected from children aged 6–59 months for UDHS 2006. Children were categorized into ‘normal CRP’ (Group A) and ‘raised CRP’ (Group B) using a CRP cut-off of 5 mg/l. A correction factor was calculated to adjust the Group B RBP values for the influence of the acute-phase response.ResultsGeometric mean CRP was 6·2 (95 % CI 5·5, 7·0) mg/l, 1·6 (95 % CI 1·5, 1·8) mg/l and 17·9 (95 % CI 16·4, 19·6) mg/l in all children, in Group A and in Group B, respectively. Geometric mean RBP in all children, in Group A and in Group B was 1·18 (95 % CI 1·14, 1·22) μmol/l, 1·26 (95 % CI 1·20, 1·33) μmol/l and 1·12 (95 % CI 1·07, 1·17) μmol/l, respectively, before correction. Correction increased mean RBP in Group B to 1·26 (95 % CI 1·21, 1·31) μmol/l. The prevalence of vitamin A deficiency (RBP < 0·825 μmol/l) reduced from 18·4 % (95 % CI 17·2, 23·0 %) to 13·9 % (95 % CI 11·3, 16·5 %).ConclusionsCorrecting for the acute-phase response significantly reduced the prevalence of vitamin A deficiency; thus, the acute-phase response should be considered when vitamin A status is assessed using RBP in order to improve population-level estimates of vitamin A deficiency.

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