scholarly journals Retinyl palmitate supplementation by inhalation of an aerosol improves vitamin A status of preschool children in Gondar (Ethiopia)

1999 ◽  
Vol 82 (3) ◽  
pp. 179-182 ◽  
Author(s):  
Hans Biesalski ◽  
Ram Reifen ◽  
Peter Fürst ◽  
Melkie Edris
Keyword(s):  
Preschool Children ◽  
Vitamin A ◽  
Treated Group ◽  
Retinyl Palmitate ◽  
Retinol Binding Protein ◽  
Serum Retinol ◽  
Vitamin A Supplementation ◽  
Treatment Groups ◽  
Vitamin A Status ◽  
Novel Method

We report successful vitamin A supplementation by inhalation of retinyl palmitate in a placebo-controlled pilot study in twenty-five preschool children (2–5 years of age) in the rural district of Gondar, Ethiopia. Preschool children (n 161) were randomly selected from 220 households. Out of this cohort, twenty-five children were randomly assigned to each of two treatment groups: one receiving retinyl palmitate by inhalation of two puffs of an aerosol containing 1 mg (3000 IU) per delivery to give a total of 2 mg (6000 IU); and the other receiving an aerosol without retinyl palmitate. Both treatments were administered every 2 weeks for 3 months. Serum retinol and retinol-binding protein concentrations in the vitamin A-treated group were 0·68 (sd 0·31) μmol/l and 59·4 (sd 24·2) mg/l before and 1·43 (sd 0·46) μmol/l (P < 0·01) and 97·3 (sd 31·2) mg/l (P < 0·05) 3 months after supplementation with retinyl palmitate, suggesting that this novel method of delivery of retinyl palmitate by inhalation is effective in improving vitamin A status.

scholarly journals The effects of maternal and infant vitamin A supplementation on vitamin A status: a randomised trial in Kenya

2007 ◽  
Vol 98 (2) ◽  
pp. 422-430 ◽  
Author(s):  
R. A. Ayah ◽  
D. L. Mwaniki ◽  
P. Magnussen ◽  
A. E. Tedstone ◽  
T. Marshall ◽  
...  
Keyword(s):  
Vitamin A ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Maternal Serum ◽  
High Dose ◽  
Serum Retinol ◽  
Double Blind ◽  
Vitamin A Supplementation ◽  
Factors Affecting ◽  
Vitamin A Status

Postpartum vitamin A supplementation of mothers and infants is recommended, but the efficacy has been questioned. In this double-blind, placebo-controlled trial, Kenyan mother–infant pairs were randomised to maternal vitamin A (400 000 IU) or placebo < 24 h postpartum, and infant vitamin A (100 000 IU) or placebo at 14 weeks. Milk retinol was determined at weeks 4, 14 and 26, and maternal and infant serum retinol at weeks 14 and 26. Infant retinol stores were assessed at week 26, using a modified relative dose response (MRDR) test. Among 564 women, serum retinol at 36 weeks gestation was 0·81 (sd 0·21) μmol/l, and 33·3 % were < 0·7 μmol/l. Maternal serum retinol was not different between groups, but milk retinol was higher in the vitamin A group: (0·67 v. 0·60 μmol/l; 0·52 v. 0·44 μmol/l; 0·50 v. 0·44 μmol/l at 4, 14 and 26 weeks, respectively). When expressed per gram fat, milk retinol was higher in the vitamin A group only at 4 weeks. Infant serum retinol was not different between groups. However, although most infants had deficient vitamin A stores (MRDR>0·06 %) at 26 weeks, vitamin A to infants, but not mothers, resulted in a lower proportion of infants with deficient vitamin A stores (69 v. 78 %). High-dose postpartum vitamin A supplementation failed to increase serum retinol and infant stores, despite modest effects on milk retinol. Infant supplementation, however, increased stores. There is a need for a better understanding of factors affecting absorption and metabolism of vitamin A.

scholarly journals Daily consumption of pro-vitamin A biofortified (yellow) cassava improves serum retinol concentrations in preschool children in Nigeria: a randomized controlled trial

2020 ◽  
Vol 113 (1) ◽  
pp. 221-231
Author(s):  
Ibukun Afolami ◽  
Martin N Mwangi ◽  
Folake Samuel ◽  
Erick Boy ◽  
Paul Ilona ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Preschool Children ◽  
Vitamin A ◽  
Controlled Trial ◽  
Asymptomatic Malaria ◽  
Serum Retinol ◽  
Daily Consumption ◽  
Randomized Controlled ◽  
Vitamin A Status ◽  
Β Carotene

ABSTRACT Background Vitamin A deficiency is a public health problem in sub-Saharan Africa. Pro-vitamin A biofortified (yellow) cassava has the potential to contribute significantly to improve vitamin A status, especially in populations that are difficult to reach with other strategies. Objectives The study aimed at determining the efficacy of biofortified cassava to improve vitamin A status of Nigerian preschool children. Methods An open-label randomized controlled trial was conducted in southwestern Nigeria. In total, 176 preschool children (aged 3–5 y) were randomized into 2 parallel arms comprising an experimental group (n = 88), fed foods prepared from biofortified (yellow) cassava, and a control group (n = 88), fed foods prepared from white cassava, twice a day, 6 d a week for 93 d. Results A total of 159 children completed the trial (yellow cassava group, n = 80; white cassava group, n = 79). Children consumed 221 and 74 µg/d retinol activity equivalents from intervention foods in the yellow and white cassava groups, respectively. The treatment effect on serum retinol concentrations at the end of the feeding trial was 0.06 µmol/L (95% CI: 0.004, 0.124 µmol/L), after adjustment for baseline retinol concentrations, inflammation, and asymptomatic malaria status. No significant treatment effects were detected for serum β-carotene (adjusted effect: 3.9%; 95% CI: −0.6%, 8.6%) and gut permeability (adjusted effect: 0.002; 95% CI: −0.089, 0.092), but a significant effect was detected for hemoglobin concentrations (adjusted effect: 3.08 g/L; 95% CI: 0.38, 5.78 g/L). Conclusions Daily consumption of β-carotene from biofortified cassava improved serum retinol and hemoglobin concentrations modestly in Nigerian preschool children. This study was registered with clinicaltrials.gov as NCT02627222.

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.

scholarly journals Efficacy of massive oral doses of retinyl palmitate and mango (Mangifera indica L.) consumption to correct an existing vitamin A deficiency in Senegalese children

1992 ◽  
Vol 68 (2) ◽  
pp. 529-540 ◽  
Author(s):  
Cécile Carlier ◽  
Michel Etchepare ◽  
Jean-François Ceccon ◽  
Marie-Sophie Mourey ◽  
Olivier Amédée-Manesme
Keyword(s):  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Mangifera Indica ◽  
Retinyl Palmitate ◽  
Retinol Binding Protein ◽  
Serum Retinol ◽  
Abnormal Cytology ◽  
Normal Cytology ◽  
Oral Doses ◽  
Β Carotene

Administration of large oral doses of retinyl palmitate has become the most widely practised vitamin A deficiency prevention strategy in developing countries. We conducted a follow-up study among 220 Senegalese children aged 2–7 years suffering from moderate undernutrition to determine the efficacy of vitamin A treatment on their vitamin A status assessed by biochemical and cytological (impression cytology with transfer) methods. The first examination (T = 0 m[onth]) was carried out during April 1989, before the mango (Mangifera indica L,) harvest. The second examination (T = 2 m) was carried out 2 months after vitamin A treatment during June 1989 when ripe mangoes become widely available. Conjunctival cells of the eyes of the children with or without ocular inflammation were responsive to vitamin A administration (P < 0.01). There was a significant increase (P < 0.001) in mean serum retinol and β-carotene levels between T = 0 m and T = 2 m. Mean serum retinol-binding protein (RBP) and transthyretin (TTR) levels did not differ significantly (P > 0.05) at T = 0 m and T = 2 m. Despite the intake of vitamin A, 54% of the children who had abnormal cytology at T = 0 m remained abnormal at T = 2 m. This was due to inadequate levels of TTR and RBP, presumably due to the cereal diet eaten by the Senegalese population. Children with abnormal eye cytology had lower serum retinol levels than those with normal eyes at T = 0 m, and β-carotene values did not correlate with eye cytological abnormalities at T = 0 m. Children with normal cytology had higher serum retinol and also β-carotene levels than those with abnormal cytology after massive oral doses of vitamin A and consumption of mangoes at T = 2 m. Retinyl palmitate may, therefore, only lead to partial cytological improvement due to a lack of retinol-carrier proteins but dietary β-carotene may also be involved

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 Serum retinol binding protein as an indicator of vitamin A status in cirrhotic patients with night blindness

2008 ◽  
Vol 14 (1) ◽  
pp. 7 ◽  
Author(s):  
Khalid Mahmood ◽  
AkhtarH Samo ◽  
KrishanL Jairamani ◽  
Gohar Ali ◽  
Abu Talib ◽  
...  
Keyword(s):  
Vitamin A ◽  
Night Blindness ◽  
Binding Protein ◽  
Retinol Binding Protein ◽  
Serum Retinol ◽  
Vitamin A Status ◽  
Cirrhotic Patients

scholarly journals The Effects of Two Maternal Vitamin A Supplementation Regimens on Serum Retinol in Postpartum Mothers: A Randomised Controlled Trial in Brazil

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Luciana Marques Andreto ◽  
Ilma Kruze Grande de Arruda ◽  
Ariani Impieri Souza ◽  
José Natal Figueiroa ◽  
Alcides da Silva Diniz
Keyword(s):  
Randomised Controlled Trial ◽  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Controlled Trial ◽  
Serum Retinol ◽  
Double Blind ◽  
Vitamin A Supplementation ◽  
Treatment Groups ◽  
Randomised Controlled ◽  
Postpartum Mothers

Objective. To test whether the serum retinol level in mothers supplemented with 400,000 IU of vitamin A is higher than in those supplemented with 200,000 IU and to estimate duration of the protective effect of vitamin A supplementation in the serum retinol level. Methods. Double-blind, randomised controlled trial performed in two hospitals in the state of Pernambuco in northeast Brazil. Three hundred twelve mothers were recruited immediately postpartum. All women received a capsule containing 200,000 IU of vitamin A, and 10 days after delivery, they were randomly assigned to one of two treatment groups. One group received a second capsule containing vitamin A and the other group received a placebo. Each group was invited back after 2, 4, and 6 months for serum retinol analyses. Results. No difference was found between the two groups in serum maternal retinol concentration at 2 months (2.13 versus 2.03 μmol/L), 4 months (2.20 versus 2.24 μmol/L) or 6 months (2.29 versus 2.31 μmol/L). Because there was no further effect and because this population has a level of vitamin A deficiency considered mild, our results do not support a proposal to increase the dosing schedule for vitamin A in postpartum women as recommended by the IVACG.

scholarly journals Effects of Inflammation on Biomarkers of Vitamin A Status among a Cohort of Bolivian Infants

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1240 ◽  
Author(s):  
Rachel Burke ◽  
Ralph Whitehead ◽  
Janet Figueroa ◽  
Denis Whelan ◽  
Anna Aceituno ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Linear Regression ◽  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Retinol Binding Protein ◽  
Molar Ratio ◽  
Serum Retinol ◽  
Serum Samples ◽  
Mortality And Morbidity ◽  
Vitamin A Status

Globally, vitamin A deficiency (VAD) affects nearly 200 million children with negative health consequences. VAD can be measured by a retinol-binding protein (RBP) and serum retinol concentrations. Their concentrations are not always present in a 1:1 molar ratio and are affected by inflammation. This study sought to quantify VAD and its impact on infant mortality and infectious morbidity during the first 18 months of life in a cohort of mother-infant dyads in El Alto, Bolivia, while accounting for the previously mentioned measurement issues. Healthy mother-infant dyads (n = 461) were enrolled from two hospitals and followed for 12 to 18 months. Three serum samples were collected (at one to two, six to eight, and 12 to 18 months of infant age) and analyzed for RBP, and a random 10% subsample was analyzed for retinol. Linear regression of RBP on retinol was used to generate RBP cut-offs equivalent to retinol <0.7 µmol/L. All measures of RBP and retinol were adjusted for inflammation, which was measured by a C-reactive protein and alpha (1)-acid glycoprotein serum concentrations using linear regression. Infant mortality and morbidity rates were calculated and compared by early VAD status at two months of age. Retinol and RBP were weakly affected by inflammation. This association varied with infant age. Estimated VAD (RBP < 0.7 µmol/L) decreased from 71.0% to 14.8% to 7.7% at two, six to eight, and 12 to 18 months of age. VAD was almost nonexistent in mothers. Early VAD was not significantly associated with infant mortality or morbidity rates. This study confirmed a relationship between inflammation and vitamin A biomarkers for some subsets of the population and suggested that the vitamin A status in early infancy improves with age and may not have significantly affected morbidity in this population of healthy infants.

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