scholarly journals Serum retinol in post‐partum mothers and newborns from an impoverished South African community where liver is frequently eaten and vitamin A deficiency is absent

2015 ◽  
Vol 13 (1) ◽  
Author(s):  
Martha E. Stuijvenberg ◽  
Serina E. Schoeman ◽  
Jana Nel ◽  
Carl J. Lombard ◽  
Muhammad A. Dhansay
Keyword(s):  
Vitamin A ◽  
South African ◽  
Vitamin A Deficiency ◽  
Post Partum ◽  
Serum Retinol ◽  
African Community

scholarly journals Factors associated with low serum retinol levels in children aged 6–24 months in a rural South African community

2000 ◽  
Vol 3 (4) ◽  
pp. 395-402 ◽  
Author(s):  
Mieke Faber ◽  
AJ Spinnler Benadé
Keyword(s):  
Risk Factors ◽  
Vitamin A ◽  
South African ◽  
Serum Retinol ◽  
Rural South ◽  
Vitamin A Status ◽  
Potential Risk Factors ◽  
African Community ◽  
Home Deliveries ◽  
Low Serum

AbstractObjectiveTo identify risk factors for variation in serum retinol levels in children younger than 2 years of age in a rural South African community.DesignChildren (n=97), 6–24 months of age, were divided into two groups according to their serum retinol levels, using 20 μg dl−1as the cut-off point. The chi-square test, Fischer exact two-tailed test and analysis of variance were used to identify related variables which were significantly different between the two groups. To evaluate simultaneously the association between several potential risk factors and low serum retinol levels, a multiple regression model for categorical data was developed which included potential risk factors that were statistically significant in the bivariate analysis as the independent variables, and either low or normal vitamin A status as the dependent variable.ResultsThere was an association between serum retinol levels and: (i) the place of birth (hospital vs. home deliveries); (ii) the attitude of the care-giver towards family life; and (iii) the health status of the child. Although not included in the multiple variable model because of small numbers, all children who had a previous episode of measles, all underweight children, and all children of widowed care-givers were in the low serum retinol group.ConclusionsThe care-giver's attitude towards family life was positively associated with the child's vitamin A status, while home deliveries were associated with a low vitamin A status.

scholarly journals Liver intake in 24–59-month-old children from an impoverished South African community provides enough vitamin A to meet requirements

2013 ◽  
Vol 17 (12) ◽  
pp. 2798-2805 ◽  
Author(s):  
Jana Nel ◽  
Martha E van Stuijvenberg ◽  
Serina E Schoeman ◽  
Muhammad A Dhansay ◽  
Carl J Lombard ◽  
...  
Keyword(s):  
South Africa ◽  
Vitamin A ◽  
South African ◽  
Vitamin A Deficiency ◽  
Cross Sectional ◽  
Vitamin A Supplementation ◽  
Targeted Interventions ◽  
Daily Vitamin ◽  
African Community ◽  
Retinol Equivalents

AbstractObjectiveTo assess the contribution of liver to the vitamin A intake of 24–59-month-old children from an impoverished South African community where liver is frequently consumed and vitamin A deficiency previously shown to be absent.DesignCross-sectional.SettingNorthern Cape Province, South Africa.SubjectsChildren aged 24–59 months (n 150). Vitamin A intake from liver was assessed using a single 24 h recall and a quantified liver frequency questionnaire. In addition, information on vitamin A intake via the national fortification programme was obtained from the 24 h recall and information on vitamin A supplementation from the Road-to-Health Chart. Height, weight and socio-economic data were also collected.ResultsStunting, underweight and wasting were prevalent in 36·9 %, 25·5 % and 12·1 % of children. Mean daily vitamin A intake from liver was 537 and 325 μg retinol equivalents measured by the 24 h recall and liver frequency questionnaire, respectively. Liver was consumed in 92·7 % of households and by 84·7 % of children; liver intake was inversely related to socio-economic status (P < 0·05). The food fortification programme contributed 80 μg retinol equivalents and the vitamin A supplementation programme 122 μg retinol equivalents to daily vitamin A intake.ConclusionsThe study showed that liver alone provided more than 100 % of the Estimated Average Requirement of the pre-school children in this impoverished community. The results also challenge the notion generally held by international health bodies that vitamin A deficiency, poor anthropometric status and poverty go together, and reinforces the fact that South Africa is a culturally diverse society for which targeted interventions are required.

Research Recommendations for Applying Vitamin A-Labelled Isotope Dilution Techniques to Improve Human Vitamin A Nutrition

2014 ◽  
Vol 84 (Supplement 1) ◽  
pp. 52-59 ◽  
Author(s):  
Sherry A. Tanumihardjo ◽  
Anura V. Kurpad ◽  
Janet R. Hunt
Keyword(s):  
Public Health ◽  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Human Subjects ◽  
The Body ◽  
Pool Size ◽  
Serum Retinol ◽  
Vitamin A Status ◽  
Status Assessment ◽  
Total Body

The current use of serum retinol concentrations as a measurement of subclinical vitamin A deficiency is unsatisfactory for many reasons. The best technique available for vitamin A status assessment in humans is the measurement of total body pool size. Pool size is measured by the administration of retinol labelled with stable isotopes of carbon or hydrogen that are safe for human subjects, with subsequent measurement of the dilution of the labelled retinol within the body pool. However, the isotope techniques are time-consuming, technically challenging, and relatively expensive. There is also a need to assess different types of tracers and doses, and to establish clear guidelines for the use and interpretation of this method in different populations. Field-friendly improvements are desirable to encourage the application of this technique in developing countries where the need is greatest for monitoring the risk of vitamin A deficiency, the effectiveness of public health interventions, and the potential of hypervitaminosis due to combined supplement and fortification programs. These techniques should be applied to validate other less technical methods of assessing vitamin A deficiency. Another area of public health relevance for this technique is to understand the bioconversion of β-carotene to vitamin A, and its relation to existing vitamin A status, for future dietary diversification programs.

Vitamin A Supplementation and Measles

1995 ◽  
Vol 16 (9) ◽  
pp. 358-359
Author(s):  
Glenn J. Fennelly
Keyword(s):  
Vitamin A ◽  
Acute Phase ◽  
Vitamin A Deficiency ◽  
Serum Levels ◽  
Morbidity And Mortality ◽  
Serum Retinol ◽  
Vitamin A Supplementation

Vitamin A deficiency resulting from inadequate intake or induced by infection is associated with increased morbidity and mortality. Measles, the major single infectious cause of mortality in children worldwide, is more severe in children who have preexisting vitamin A deficiency. Several recent studies suggest that: 1) measles is associated with depressed serum levels of vitamin A; 2) hyporetinemia, defined as a serum retinol of less than 0.7 µmol/L, is associated with increased mortality from measles, especially in children younger than 2 years of age; and 3) vitamin A will decrease the risk of complications and death when administered during the acute phase of illness (within 5 days of the onset of rash).

scholarly journals SEANUTS: the nutritional status and dietary intakes of 0.5–12-year-old Thai children

2013 ◽  
Vol 110 (S3) ◽  
pp. S36-S44 ◽  
Author(s):  
Nipa Rojroongwasinkul ◽  
Kallaya Kijboonchoo ◽  
Wanphen Wimonpeerapattana ◽  
Sasiumphai Purttiponthanee ◽  
Uruwan Yamborisut ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin A ◽  
Nutritional Status ◽  
Rural Areas ◽  
Urban Areas ◽  
Vitamin A Deficiency ◽  
Public Health Problem ◽  
Rural Children ◽  
Major Public Health Problem ◽  
Serum Retinol

In the present study, we investigated nutritional status and health-related factors in a multistage cluster sample of 3119 Thai urban and rural children aged 0·5–12·9 years. In a subsample, blood samples were collected for the measurement of Hb, transferrin receptor, vitamin A and vitamin D concentrations. The prevalence of stunting and underweight was higher in rural children than in urban children, whereas the wasting rate was similar in both rural and urban areas. Among children aged 3·0–5·9 years, the prevalence of overweight was significantly higher in urban areas than in rural areas and so was the obesity rate in children aged 6·0–12·9 years. Protein intakes of all age groups were relatively high in both the areas. Intakes of Ca, Fe, Zn and vitamin C were significantly higher in urban areas than in rural areas. The prevalence of anaemia in rural areas was twice as high as that in urban areas, particularly in infants and young children. However, the prevalence of Fe-deficiency anaemia was similar in both urban and rural areas. While the prevalence of vitamin A deficiency (by serum retinol cut-off < 0·7 μmol/l) seemed to be very low, vitamin A insufficiency (by serum retinol cut-off < 1·05 μmol/l) was more prevalent (29·4–31·7 %) in both the areas. The prevalence of vitamin D insufficiency ranged between 27·7 and 45·6 % among the children. The present study indicates that the double burden of malnutrition is still a major public health problem in Thailand. Further studies need to explore the associated risk factors for these nutrient deficiencies. Effective strategies and actions are needed to tackle the nutritional problems in Thai children.

scholarly journals Cassava with enhanced β-carotene maintains adequate vitamin A status in Mongolian gerbils (Meriones unguiculatus) despite substantial cis-isomer content

2009 ◽  
Vol 102 (3) ◽  
pp. 342-349 ◽  
Author(s):  
Julie A. Howe ◽  
Bussie Maziya-Dixon ◽  
Sherry A. Tanumihardjo
Keyword(s):  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Meriones Unguiculatus ◽  
Provitamin A ◽  
Carotenoid Content ◽  
Mongolian Gerbils ◽  
Serum Retinol ◽  
Vitamin A Status ◽  
Isomer Content ◽  
Β Carotene

Efforts to increase β-carotene in cassava have been successful, but the ability of high-β-carotene cassava to prevent vitamin A deficiency has not been determined. Two studies investigated the bioefficacy of provitamin A in cassava and compared the effects of carotenoid content and variety on vitamin A status in vitamin A-depleted Mongolian gerbils (Meriones unguiculatus). Gerbils were fed a vitamin A-free diet 4 weeks prior to treatment. In Expt 1, treatments (ten gerbils per group) included 45 % high-β-carotene cassava, β-carotene and vitamin A supplements (intake matched to high-β-carotene cassava group), and oil control. In Expt 2, gerbils were fed cassava feeds with 1·8 or 4·3 nmol provitamin A/g prepared with two varieties. Gerbils were killed after 4 weeks. For Expt 1, liver vitamin A was higher (P < 0·05) in the vitamin A (1·45 (sd 0·23) μmol/liver), lower in the control (0·43 (sd 0·10) μmol/liver), but did not differ from the β-carotene group (0·77 (sd 0·12) μmol/liver) when compared with the high-β-carotene cassava group (0·69 (sd 0·20) μmol/liver). The bioconversion factor was 3·7 μg β-carotene to 1 μg retinol (2 mol:1 mol), despite 48 % cis-β-carotene [(Z)-β-carotene] composition in cassava. In Expt 2, cassava feed with 4·3 nmol provitamin A/g maintained vitamin A status. No effect of cassava variety was observed. Serum retinol concentrations did not differ. β-Carotene was detected in livers of gerbils receiving cassava and supplements, but the cis-to-trans ratio in liver differed from intake. Biofortified cassava adequately maintained vitamin A status and was as efficacious as β-carotene supplementation in the gerbil model.

Vitamin A deficiency - experience from a tertiary referral UK hospital; not just a low- and middle-income country issue

2021 ◽  
pp. 1-15
Author(s):  
Alexandra Marley ◽  
Samuel CL Smith ◽  
Ruhina Ahmed ◽  
Peter Nightingale ◽  
Sheldon C Cooper
Keyword(s):  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Binary Logistic Regression ◽  
Signs And Symptoms ◽  
University Teaching ◽  
Serum Retinol ◽  
Middle Income ◽  
Reactive Protein ◽  
Active Inflammation ◽  
Low And Middle Income

Abstract Objective: Vitamin A (VA) deficiency, more common in low- and middle-income countries (LMIC) secondary to malnutrition, is associated with increased morbidity and mortality. The prevalence and impact of VA deficiency in high-income countries (HIC) where chronic conditions may predispose is less well understood. Setting: We examined the scale of low and deficient VA status in our tertiary University Teaching Hospital (HIC). Participants: Patients undergoing serum retinol concentrations 2012-2016 were identified from laboratory records, and records examined. Design: Interpretation of serum retinol may be affected by inflammation, so C-reactive protein (CRP) levels were sought. Binary logistic regression and generalised estimating equations were performed to review the relationship between CRP and VA. Results: 628 assays were requested, with 82 patients VA low (0.7-0.99umol/L) or deficient (<0.7umol/L). 16 patients were symptomatic (15 deficient), predominantly visual. Only one symptomatic patient’s VA deficiency was secondary to poor intake. Other symptomatic patients had chronic illnesses resulting in malabsorption. The incidence of a low VA level increases significantly with a raised CRP. Conclusion: The majority of patients tested either were replete or likely to have abnormal VA levels due to concomitant inflammation. A minority of patients had signs and symptoms of VA deficiency and was a cause of significant morbidity, but aetiology differs from LMIC, overwhelmingly malabsorption, most commonly secondary to surgery or hepatobiliary disease. A correlation between inflammation and low VA levels exists, which raises the possibility that requesting a VA level in an asymptomatic patient with active inflammation may be of questionable benefit.

scholarly journals A new approach to the assessment of marginal vitamin A deficiency in children in suburban Guwahati, India: hydrolysis of retinoyl glucuronide to retinoic acid

2008 ◽  
Vol 101 (6) ◽  
pp. 794-797 ◽  
Author(s):  
Pulin C. Sarma ◽  
Bhabesh C. Goswami ◽  
Krishna Gogoi ◽  
Harsha Bhattacharjee ◽  
Arun B. Barua
Keyword(s):  
Retinoic Acid ◽  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Serum Retinol ◽  
Serum Samples ◽  
Group I ◽  
High Prevalence ◽  
Hydrolysis Of ◽  
Β Carotene

The objective of the present study was to determine marginal vitamin A deficiency (VAD) by testing the hydrolysis of retinoyl glucuronide (RAG) to retinoic acid (RA) in children. Previous studies in rats showed that hydrolysis occurred when rats were vitamin A deficient. Children (n 61) aged 3–18 years, were divided into two groups, I and II. Blood was collected from the children in Group I (n 19) who were not dosed with RAG. Children in Group II (n 42) were administered all-trans retinoyl glucuronide (RAG) orally, and blood was collected 4 h after the dose. All serum samples were analysed for retinoids and carotenoids. RA was detected in serum only when serum retinol was < 0·85 μmol/l. Thus, hydrolysis of RAG to RA occurred in children with VAD or marginal VAD. Serum retinol was < 0·35 μmol/l in twenty-one children, 0·35–0·7 μmol/l in twenty-three children, 0·7–0·9 μmol/l in eleven children and >1 μmol/l in six children. Mean serum retinol in sixty-one children was 0·522 (sd 0·315) μmol/l. Mean β-carotene (0·016 (sd 0·015) μmol/l) was far below normal compared to the level of lutein (0·176 (sd 0·10) μmol/l) in sixty-one children. A low β-carotene level might be due to a low intake of carotene but high demand for vitamin A. The RAG hydrolysis test may prove to be a useful approach for the determination of marginal VAD with no clinical or subclinical signs of VAD. High prevalence of VAD amongst certain communities in Assam cannot be ruled out.

Vitamin A deficiency among children in a periurban South African settlement

1993 ◽  
Vol 57 (6) ◽  
pp. 904-907 ◽  
Author(s):  
A Coutsoudis ◽  
D Mametja ◽  
C C Jinabhai ◽  
H M Coovadia
Keyword(s):  
Vitamin A ◽  
South African ◽  
Vitamin A Deficiency

scholarly journals Use of the retinol-binding protein : transthyretin ratio for assessment of vitamin A status during the acute-phase response

2000 ◽  
Vol 83 (5) ◽  
pp. 513-520 ◽  
Author(s):  
Suzanne M. Filteau ◽  
Juana F. Willumsen ◽  
Keith Sullivan ◽  
Karin Simmank ◽  
Mary Gamble
Keyword(s):  
Vitamin A ◽  
Sensitivity And Specificity ◽  
Assessment Tool ◽  
Binding Protein ◽  
Vitamin A Deficiency ◽  
Retinol Binding Protein ◽  
Serum Retinol ◽  
Vitamin A Status ◽  
Plasma Retinol

The ratio plasma retinol-binding protein (RBP) : transthyretin (TTR) has been proposed as a means to improve the assessment of vitamin A status of individuals with concurrent infection or inflammation. We have measured RBP and TTR in stored sera from South African children who had accidentally ingested kerosene. Samples were collected from these children in hospital when suffering acute inflammation and respiratory distress, and from them and neighbourhood control children 3 months later. Vitamin A status was defined by modified relative dose response (MRDR) tests of liver retinol stores at 3 months and by serum retinol concentration both when children were ill and when they were well. Illness was defined as either being in hospital or, at follow-up, as having a raised plasma α1-acid glycoprotein (AGP) level. The RBP : TTR value was significantly decreased by both illness and low liver retinol stores. When the effects on RBP : TTR of illness and vitamin A stores were considered together for the 3-month follow-up samples, only vitamin A status significantly decreased the value. We calculated sensitivity and specificity of the RBP : TTR ratio against established measures of vitamin A status using a cut-off value of 0·3 for RBP : TTR and standard cut-off values for MRDR (0·06) and plasma retinol (0·7 μmol/l). Compared with MRDR, RBP : TTR had sensitivities of 76 % and 43 % and specificities of 22 % and 81 % to detect vitamin A deficiency in hospitalized and well children respectively. Compared with plasma retinol, sensitivities were 88 % and 44 % and specificities were 55 % and 64 % in hospitalized and well children respectively. Only for the case of clinically well children with biochemical evidence of subclinical inflammation did sensitivity (62 % and 100 % against MRDR and plasma retinol respectively) and specificity (100 % and 60 % against MRDR and retinol) approach useful levels for an assessment tool. Overall, although a trend supporting the theory behind the use of the RBP : TTR for assessment of vitamin A status in infection was observed in the current study, the ratio did not provide adequate sensitivity and specificity to be a useful assessment tool.

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