Factors to consider in Micronesian food-based interventions: a case study of preventing vitamin A deficiency

AbstractBackground:Many factors need to be considered in a food-based intervention. Vitamin A deficiency and chronic diseases, such as diabetes, heart disease and cancer, have become serious problems in the Federated States of Micronesia (FSM) following the decreased production and consumption of locally grown foods. However, agricultural and social conditions are still favourable for local food production.Aim:To identify key factors to consider in a Micronesian food-based intervention focusing on increased production and consumption of four major Micronesian staple foods: banana, breadfruit, giant swamp taro and pandanus.Methods:Ethnographic methods including key informant interviews and a literature review.Results:Pacific and Micronesian values, concepts of food and disease, and food classifications differ sharply from Western concepts. There are few FSM professionals with nutrition expertise. Traditional foods and food cultivars vary in nutrient content, consumption level, cost, availability, status, convenience in growing, storing and cooking, and organoleptic factors.Conclusions:A systematic consideration of the factors that relate to a food-based intervention is critical to its success. The evaluation of which food and cultivar of that food that might be most effectively promoted is also critical. Regional differences, for example FSM inter-island differences between the staple foods and cultivars, must be considered carefully. The evaluation framework presented here may be relevant to Pacific Island and other countries with similar foods where food-based interventions are being planned. An ethnographic approach was found to be essential in understanding the cultural context and in data collection and analysis.

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A large-scale intervention to introduce orange sweet potato in rural Mozambique increases vitamin A intakes among children and women

British Journal Of Nutrition ◽

10.1017/s0007114511005174 ◽

2011 ◽

Vol 108 (1) ◽

pp. 163-176 ◽

Cited By ~ 119

Author(s):

Christine Hotz ◽

Cornelia Loechl ◽

Alan de Brauw ◽

Patrick Eozenou ◽

Daniel Gilligan ◽

...

Keyword(s):

Vitamin A ◽

Sweet Potato ◽

Large Scale ◽

Vitamin A Deficiency ◽

Training Model ◽

Small Scale ◽

Effectiveness Study ◽

Older Children ◽

Household Level ◽

Production And Consumption

β-Carotene-rich orange sweet potato (OSP) has been shown to improve vitamin A status of infants and young children in controlled efficacy trials and in a small-scale effectiveness study with intensive exposure to project inputs. However, the potential of this important food crop to reduce the risk of vitamin A deficiency in deficient populations will depend on the ability to distribute OSP vines and promote its household production and consumption on a large scale. In rural Mozambique, we conducted a randomised, controlled effectiveness study of a large-scale intervention to promote household-level OSP production and consumption using integrated agricultural, demand creation/behaviour change and marketing components. The following two intervention models were compared: a low-intensity (1 year) and a high-intensity (nearly 3 years) training model. The primary nutrition outcomes were OSP and vitamin A intakes by children 6–35 months and 3–5·5 years of age, and women. The intervention resulted in significant net increases in OSP intakes (model 1: 46, 48 and 97 g/d) and vitamin A intakes (model 1: 263, 254 and 492 μg retinol activity equivalents/d) among the younger children, older children and women, respectively. OSP accounted for 47–60 % of all sweet potato consumed and, among reference children, provided 80 % of total vitamin A intakes. A similar magnitude of impact was observed for both models, suggesting that group-level trainings in nutrition and agriculture could be limited to the first project year without compromising impact. Introduction of OSP to rural, sweet potato-producing communities in Mozambique is an effective way to improve vitamin A intakes.

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Provitamin A Carotenoid Bioavailability:What Really Matters?

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000042 ◽

2010 ◽

Vol 80 (45) ◽

pp. 336-350 ◽

Cited By ~ 60

Author(s):

Sherry A. Tanumihardjo ◽

Natalia Palacios ◽

Kevin V. Pixley

Keyword(s):

Vitamin A ◽

Nutrition Education ◽

Vitamin A Deficiency ◽

Beta Carotene ◽

Provitamin A ◽

Provitamin A Carotenoids ◽

Micronutrient Malnutrition ◽

Staple Foods ◽

Key Steps ◽

Local Agencies

Micronutrient malnutrition, or hidden hunger, afflicts a large part of the worlds population, with vitamin A deficiency among the most prevalent public health problems. Provitamin A carotenoids in plant foods are a source of vitamin A for humans; however, several factors, including species of carotenoids, host status, and effectors of absorption can negatively, positively, or in yet undetermined ways affect the bioavailability of these compounds. Staple foods biofortified with provitamin A carotenoids have shown more efficient bioconversion to retinol than generally observed for vegetables (e. g., 3 - 6 versus 10 - 80 beta-carotene to 1 µg retinol). Staple foods such as maize, rice, and cassava, are generally more accessible than meat or vegetable sources of retinol or provitamin A carotenoids to poor consumers, who are most likely to suffer micronutrient malnutrition. Interdisciplinary teamwork, including plant breeders, nutritionists, government and local agencies, seed companies, and communities, is needed to avail biofortified crops to needy populations. Key steps include developing, validating the nutritional effects of, providing nutrition education concerning, and promoting the use of biofortified crops. Provitamin A carotenoid biofortification of sweet potato, maize, cassava, and rice are at different stages along this continuum. Close linkages between agriculture, nutrition, and health, are essential in the quest to eradicate hunger among the poor.

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Fortification of staple foods with vitamin A for vitamin A deficiency

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd010068.pub2 ◽

2019 ◽

Cited By ~ 2

Author(s):

Aditi S Hombali ◽

Juan Antonio Solon ◽

Bhumika T Venkatesh ◽

N Sreekumaran Nair ◽

Juan Pablo Peña-Rosas

Keyword(s):

Vitamin A ◽

Vitamin A Deficiency ◽

Staple Foods

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Fortification of staple foods with vitamin A for preventing vitamin A deficiency

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd010068 ◽

2012 ◽

Cited By ~ 4

Author(s):

Ingvil Saeterdal ◽

Jose O Mora ◽

Luz Maria De-Regil

Keyword(s):

Vitamin A ◽

Vitamin A Deficiency ◽

Staple Foods

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Quantification of Vitamin A in Fortified Rapeseed, Groundnut and Soya Oils Using a Simple Portable Device: Comparison to High Performance Liquid Chromatography

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000154 ◽

2013 ◽

Vol 83 (2) ◽

pp. 122-128 ◽

Cited By ~ 4

Author(s):

Cécile Renaud ◽

Jacques Berger ◽

Arnaud Laillou ◽

Sylvie Avallone

Keyword(s):

High Performance Liquid Chromatography ◽

Liquid Chromatography ◽

Vitamin A ◽

High Performance ◽

Vitamin A Deficiency ◽

Developed Countries ◽

Portable Device ◽

Least Developed Countries ◽

Control Food ◽

Assay Precision

Vitamin A deficiency is still one of the major public health problems in least developed countries. Fortification of vegetable oils is a strategy implemented worldwide to prevent this deficiency. For a fortification program to be effective, regular monitoring is necessary to control food quality in the producing units. The reference methods for vitamin A quantification are expensive and time-consuming. A rapid method should be useful for regular assessment of vitamin A in the oil industry. A portable device was compared to high-performance liquid chromatography (HPLC) for three plant oils (rapeseed, groundnut, and soya). The device presented a good linearity from 3 to 30 mg retinol equivalents per kg (mg RE.kg- 1). Its limits of detection and quantification were 3 mg RE.kg- 1 for groundnut and rapeseed oils and 4 mg RE.kg- 1 for soya oil. The intra-assay precision ranged from 1.48 % to 3.98 %, considered satisfactory. Accuracy estimated by the root mean squares error ranged from 3.99 to 5.49 and revealed a lower precision than HPLC (0.4 to 2.25). Although it offers less precision than HPLC, the device estimates quickly the vitamin A content of the tested oils from 3 or 4 to 15 mg RE.kg- 1.

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

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000185 ◽

2014 ◽

Vol 84 (Supplement 1) ◽

pp. 52-59 ◽

Cited By ~ 5

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.

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Vitamin A deficiency is associated with disease severity in patients with liver cirrhosis

10.1055/s-0039-3402154 ◽

2020 ◽

Author(s):

M Nagel ◽

C Labenz ◽

M Nguyen-Tat ◽

N Cabezas Wallscheid ◽

C Czauderna ◽

...

Keyword(s):

Liver Cirrhosis ◽

Vitamin A ◽

Disease Severity ◽

Vitamin A Deficiency

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Mitral Valve Replacement in an Adult with Left Pulmonary Agenesis

The Heart Surgery Forum ◽

10.1532/hsf.1311 ◽

2015 ◽

Vol 18 (3) ◽

pp. 109

Author(s):

Huseyin Saskin ◽

Mustafa Idiz ◽

Cagri Duzyol ◽

Huseyin Macika ◽

Rezan Aksoy

Keyword(s):

Mitral Valve ◽

Vitamin A ◽

Valve Replacement ◽

Viral Infections ◽

Vitamin A Deficiency ◽

Pulmonary Agenesis ◽

Pulmonary Vessels ◽

Live Births ◽

Factors Associated ◽

Female Predominance

Pulmonary agenesis is associated with the absence of pulmonary vessels, bronchi, or parenchyma. This condition usually occurs between the 4th and 5th week of gestation during the embryonic phase. Etiopathogenic factors associated with pulmonary agenesis are not fully understood. In the literature, genetic and teratogenic factors, viral infections, and vitamin-A deficiency are shown to be associated with pulmonary agenesis [Malcon 2012]. This condition may be seen unilaterally or bilaterally. Although the precise rate of incidence is unknown, it is estimated to occur in one of every 10,000 to 12,000 live births [Yetim 2011]. There is a 1.3:1 female predominance with unilateral agenesis [Halilbasic 2013]

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Retinol, α-Tocopherol and Vitamin D3 in White MuscleDisease

Medycyna Weterynaryjna ◽

10.21521/mw.6029 ◽

2018 ◽

Vol 74 (1) ◽

pp. 6029-2018

Author(s):

HANDAN MERT ◽

SERKAN YİLDİRİM ◽

IBRAHİM HAKKİ YORUK ◽

KİVANC IRAK ◽

BAHAT COMBA ◽

...

Keyword(s):

Vitamin A ◽

Vitamin D3 ◽

White Muscle ◽

Bone Structure ◽

Early Stage ◽

Vitamin A Deficiency ◽

Muscle Disease ◽

Control Group ◽

White Muscle Disease ◽

Fat Soluble Vitamins

Vitamins are essential for the health of all living organisms. Vitamins E, A, D and K are known as fat-soluble vitamins, and deprivation of vitamin E causes various disorders, especially in the reproduction and cardiovascular systems and in muscle functions. Vitamin A, on the other hand, has roles in various biological functions – like eyesight – and the growth, reproduction and differentiation of epithelial cells. Vitamin A deficiency leads to the keratinization of the epithelium, and disorders related to the metaplasies of the genital and genitourinary systems. Conversely, vitamin D is defined as a pro-hormone and is responsible for Cahomeostasis, and thus indirectly affects the bone metabolism, bone structure, and cellular and neural functions of Ca. White muscle disease (WMD) can occur in newborn lambs, but is more commonly seen in lambs of up to 3 months of age. In this study, 30 lambs of 3 to 50-days-old from different flocks diagnosed with White Muscle Disease (WMD) were selected as research material, while the control group consisted of 8 healthy lambs. With the aim of clarifying the cause of WMD, serum fat-soluble vitamins, retinol, α-tocopherol and vitamin D3 levels were determined in 16 lambs. Gluteal and heart musclet issue samples also were taken from 30 lambs with WMD. The vitamin levels of the samples were analysed by HPLC. The levels of serum α-tocopherol, retinols, and vitamin D3 were foundto be low in the diseased animals, but only retinol (p<0.001) and α-tocopherol (p<0.0011) level differences were statistically relevant. Macroscopically, Zenker’s necrosis was determined in the heart muscles of 17 lambs, and in the gluteal and chest muscles of 6 lambs. 7 lambs displayed necrosis in both their heart and in gluteal muscles. The samples were analyzed microscopically to reach similar findings: swollen homogeneous pink muscles, pycnotic nuclei, and hyperaemic and haemorrhagic blood vessels in gluteal, chest and heart muscles. Hyaline degeneration and Zenker's necrosis, dystrophic regions in necrotic areas, cc was detected as a severe disease in lambs at an early stage of life with advanced degeneration in different muscle tissues. Deficiency of fat-soluble vitamins was also detected in the sick animals. Control group lambs had higher levels of α tocopherol and retinol (p<0.001) compared to the sick lambs. .

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