scholarly journals Serum Carotenoids Reveal Poor Fruit and Vegetable Intake among Schoolchildren in Burkina Faso

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1422 ◽  
Author(s):  
Jean Bationo ◽  
Augustin Zeba ◽  
Souheila Abbeddou ◽  
Nadine Coulibaly ◽  
Olivier Sombier ◽  
...  
Keyword(s):  
Vitamin A ◽  
Burkina Faso ◽  
Fruits And Vegetables ◽  
Provitamin A ◽  
Total Serum ◽  
Fruit And Vegetable ◽  
Serum Retinol ◽  
Serum Carotenoids ◽  
Β Carotene ◽  
Low Serum

The health benefits of fruits and vegetables are well-documented. Those rich in provitamin A carotenoids are good sources of vitamin A. This cross-sectional study indirectly assessed fruit and vegetable intakes using serum carotenoids in 193 schoolchildren aged 7 to 12 years in the Western part of Burkina Faso. The mean total serum carotenoid concentration was 0.23 ± 0.29 µmol/L, which included α- and β-carotene, lutein, and β-cryptoxanthin, and determined with serum retinol concentrations in a single analysis with high performance liquid chromatography. Serum retinol concentration was 0.80 ± 0.35 µmol/L with 46% of children (n = 88) having low values <0.7 µmol/L. Total serum carotene (the sum of α- and β-carotene) concentration was 0.13 ± 0.24 µmol/L, well below the reference range of 0.9–3.7 µmol carotene/L used to assess habitual intake of fruits and vegetables. Individual carotenoid concentrations were determined for α-carotene (0.01 ± 0.05 µmol/L), β-carotene (0.17 ± 0.24 µmol/L), β-cryptoxanthin (0.07 ± 0.06 µmol/L), and lutein (0.06 ± 0.05 µmol/L). These results confirm the previously measured high prevalence of low serum vitamin A concentrations and adds information about low serum carotenoids among schoolchildren suggesting that they have low intakes of provitamin A-rich fruits and vegetables.

scholarly journals Relationship of serum carotenoids and retinol with anaemia among pre-school children in the northern mountainous region of Vietnam

2010 ◽  
Vol 13 (11) ◽  
pp. 1863-1869 ◽  
Author(s):  
Nguyen Cong Khan ◽  
Phan Van Huan ◽  
Nguyen Van Nhien ◽  
Le Danh Tuyen ◽  
Saskia de Pee ◽  
...  
Keyword(s):  
Vitamin A ◽  
School Children ◽  
Vitamin A Deficiency ◽  
Geometric Mean ◽  
Provitamin A ◽  
Mountainous Region ◽  
Serum Retinol ◽  
Provitamin A Carotenoids ◽  
Serum Carotenoids ◽  
Β Carotene

AbstractObjectiveTo characterize the relationship between serum carotenoids, retinol and anaemia among pre-school children.DesignA cross-sectional study was conducted in two groups: anaemic and non-anaemic. Serum levels of retinol, α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein and zeaxanthin were measured in the study subjects.SettingSix rural communes of Dinh Hoa, a rural and mountainous district in Thai Nguyen Province, in the northern mountainous region of Vietnam.SubjectsA total of 682 pre-school children, aged 12–72 months, were recruited.ResultsGeometric mean serum concentrations of carotenoids (μmol/l) were 0·056 for α-carotene, 0·161 for β-carotene, 0·145 for β-cryptoxanthin, 0·078 for lycopene, 0·388 for lutein and 0·075 for zeaxanthin. The mean levels of Hb and serum retinol were 108·8 g/l and 1·02 μmol/l, respectively. The prevalence of anaemia and vitamin A deficiency was 53·7 % and 7·8 %, respectively. After adjusting for sex and stunting, serum retinol concentrations (μmol/l; OR = 2·06, 95 % CI 1·10, 3·86, P = 0·024) and total provitamin A carotenoids (μmol/l; OR = 1·52, 95 % CI 1·01, 2·28, P = 0·046) were independently associated with anaemia, but non-provitamin A carotenoids (μmol/l; OR = 0·93, 95 % CI 0·63, 1·37, P = 0·710) were not associated with anaemia.ConclusionsAmong pre-school children in the northern mountainous region of Vietnam, the prevalences of vitamin A deficiency and anaemia are high, and serum retinol and provitamin A carotenoids are independently associated with anaemia. Further studies are needed to determine if increased consumption of provitamin A carotenoids will reduce anaemia among pre-school 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.

scholarly journals Overlapping Vitamin A Interventions with Provitamin A Carotenoids and Preformed Vitamin A Cause Excessive Liver Retinol Stores in Male Mongolian Gerbils

2020 ◽  
Vol 150 (11) ◽  
pp. 2912-2923 ◽  
Author(s):  
Margaret Sowa ◽  
Luciana Mourao ◽  
Jesse Sheftel ◽  
Mikayla Kaeppler ◽  
Gabrielle Simons ◽  
...  
Keyword(s):  
Vitamin A ◽  
Factorial Design ◽  
Scavenger Receptor ◽  
Public Health Problem ◽  
Negative Control ◽  
Provitamin A ◽  
Mongolian Gerbils ◽  
Serum Retinol ◽  
Class B ◽  
Β Carotene

ABSTRACT Background Vitamin A (VA) deficiency is a public health problem in some countries. Fortification, supplementation, and increased provitamin A consumption through biofortification are efficacious, but monitoring is needed due to risk of excessive VA intake when interventions overlap. Objectives Two studies in 28–36-d-old male Mongolian gerbils simulated exposure to multiple VA interventions to determine the effects of provitamin A carotenoid consumption from biofortified maize and carrots and preformed VA fortificant on status. Methods Study 1 was a 2 × 2 × 2 factorial design (n = 85) with high-β-carotene maize, orange carrots, and VA fortification at 50% estimated gerbil needs, compared with white maize and white carrot controls. Study 2 was a 2 × 3 factorial design (n = 66) evaluating orange carrot and VA consumption through fortification at 100% and 200% estimated needs. Both studies utilized 2-wk VA depletion, baseline evaluation, 9-wk treatments, and liver VA stores by HPLC. Intestinal scavenger receptor class B member 1 (Scarb1), β-carotene 15,15′-dioxygenase (Bco1), β-carotene 9′,10′-oxygenase (Bco2), intestine-specific homeobox (Isx), and cytochrome P450 26A1 isoform α1 (Cyp26a1) expression was analyzed by qRT-PCR in study 2. Results In study 1, liver VA concentrations were significantly higher in orange carrot (0.69 ± 0.12 μmol/g) and orange maize groups (0.52 ± 0.21 μmol/g) compared with baseline (0.23 ± 0.069 μmol/g) and controls. Liver VA concentrations from VA fortificant alone (0.11 ± 0.053 μmol/g) did not differ from negative control. In study 2, orange carrot significantly enhanced liver VA concentrations (0.85 ± 0.24 μmol/g) relative to baseline (0.43 ± 0.14 μmol/g), but VA fortificant alone (0.42 ± 0.21 μmol/g) did not. Intestinal Scarb1 and Bco1 were negatively correlated with increasing liver VA concentrations (P &lt; 0.01, r2 = 0.25–0.27). Serum retinol concentrations did not differ. Conclusions Biofortified carrots and maize without fortification prevented VA deficiency in gerbils. During adequate provitamin A dietary intake, preformed VA intake resulted in excessive liver stores in gerbils, despite downregulation of carotenoid absorption and cleavage gene expression.

scholarly journals Prediagnostic circulating carotenoid levels and the risk of non-Hodgkin lymphoma: the Multiethnic Cohort

Blood ◽  
2012 ◽  
Vol 119 (24) ◽  
pp. 5817-5823 ◽  
Author(s):  
Nicholas J. Ollberding ◽  
Gertraud Maskarinec ◽  
Shannon M. Conroy ◽  
Yukiko Morimoto ◽  
Adrian A. Franke ◽  
...  
Keyword(s):  
Los Angeles ◽  
Hodgkin Lymphoma ◽  
Fruits And Vegetables ◽  
Conditional Logistic Regression ◽  
Total Serum ◽  
Blood Draw ◽  
Non Hodgkin Lymphoma ◽  
Multiethnic Cohort ◽  
Serum Carotenoids ◽  
Β Carotene

Abstract This analysis examined the association of non-Hodgkin lymphoma (NHL) with prediagnostic carotenoid levels, a marker for a diet rich in fruits and vegetables. We conducted a nested case-control study within the Multiethnic Cohort with 271 NHL cases and 538 controls matched on sex, ethnicity, location (Hawaii or Los Angeles), birth year, date and time of blood draw, and hours fasting before blood draw. Serum carotenoid levels were obtained by high-pressure liquid chromatography with photodiode array detection. Conditional logistic regression was used to calculate odds ratios (ORs) according to tertiles of serum carotenoids and trend tests using continuous variables. Higher total serum carotenoids (ORT3 vs T1 = 0.66 [0.46-0.96]; Ptrend = .02), lycopene (OR = 0.54 [0.38-0.78]; Ptrend = .003), and α-cryptoxanthin (OR = 0.53 [0.36-0.78]; Ptrend = .003) were associated with a lower risk of NHL. For retinol (OR = 0.90 [0.61-1.33]; Ptrend = .04), a statistically significant inverse linear trend was detected. Risk estimates remained unchanged with adjustment for NHL risk factors and were similar in analyses stratified by sex and ethnicity; heterogeneity with NHL subtype was detected only for β-carotene. Other carotenoids, including α-carotene, β-carotene, lutein, β-cryptoxanthin, and zeaxanthin, showed no association with risk. These data provide support for a protective role of carotenoid-rich fruits and vegetables in the etiology of NHL.

scholarly journals Provitamin A-biofortified maize consumption increases serum xanthophylls and 13C-natural abundance of retinol in Zambian children

2017 ◽  
Vol 242 (15) ◽  
pp. 1508-1514 ◽  
Author(s):  
Jesse Sheftel ◽  
Bryan M Gannon ◽  
Christopher R Davis ◽  
Sherry A Tanumihardjo
Keyword(s):  
Vitamin A ◽  
Natural Abundance ◽  
Provitamin A ◽  
Dietary Vitamin ◽  
Mongolian Gerbils ◽  
Serum Retinol ◽  
Provitamin A Carotenoids ◽  
Effectiveness Studies ◽  
The Impact ◽  
Β Carotene

Plants that undergo C4 photosynthesis, such as maize, are enriched in the stable isotope of carbon (13C) compared with other dietary plants and foods. Consumption of maize that has been biofortified to contain elevated levels of provitamin A carotenoids (orange maize) increased the abundance of 13C in serum retinol of Mongolian gerbils. We evaluated this method in humans to determine if it has potential for further use in intervention effectiveness studies. A random subset of samples from a two-month randomized controlled feeding trial of rural three- to five-year old Zambian children were used to determine the impact of orange maize intake on serum carotenoid concentrations ( n = 88) and 13C-natural abundance in serum retinol ( n = 77). Concentrations of β-cryptoxanthin (a xanthophyll provitamin A carotenoid) and the dihydroxy xanthophylls lutein and zeaxanthin, which do not have vitamin A activity, were elevated in children consuming orange maize compared with those consuming a white maize control ( P < 0.001), while β-carotene was not different ( P > 0.3). Furthermore, 13C natural abundance was higher after two months’ intervention in the orange maize group compared with the white maize group ( P = 0.049). Predictions made from equations developed in the aforementioned gerbil study estimated that maize provided 11% (2–21%, 95% confidence interval) of the recent dietary vitamin A to these children. These results demonstrate that orange maize is efficacious at providing retinol to the vitamin A pool in children through provitamin A carotenoids, as monitored by the change in 13C enrichment, which was not reflected in serum β-carotene concentrations. Further effectiveness studies in countries who have adopted orange maize should consider determining differences in retinol 13C-enrichment among target groups in addition to profiling serum xanthophyll carotenoids with specific emphasis on zeaxanthin. Impact statement Maize biofortified with provitamin A carotenoids (orange) has been released in some African markets. Responsive and sensitive methods to evaluate dissemination effectiveness are needed. This study investigated methods to evaluate effectiveness of orange maize consumption using serum from Zambian children fed orange maize for two months. Many varieties of orange maize contain higher amounts of the xanthophyll carotenoids in addition to β-carotene compared with typical varieties. This study uniquely showed higher concentrations of the maize xanthophylls lutein, zeaxanthin, and β-cryptoxanthin in children who consumed orange maize compared with white. Furthermore, maize is a C4 plant and is therefore naturally enriched with 13C. Higher 13C was detected in the serum retinol of the orange maize consumers with no change in serum β-carotene concentration suggesting preferential bioconversion to retinol. The combined analyses of serum zeaxanthin specifically and 13C-natural abundance of retinol could prove useful in effectiveness studies between orange maize adopters and non-adopters.

Vitamin A Value of Plant Food Provitamin A - Evaluated by the Stable Isotope Technologies

2014 ◽  
Vol 84 (Supplement 1) ◽  
pp. 25-29 ◽  
Author(s):  
Guangwen Tang
Keyword(s):  
Stable Isotope ◽  
Vitamin A ◽  
Provitamin A ◽  
Animal Origin ◽  
Plant Food ◽  
Plant Foods ◽  
A Value ◽  
Provitamin A Carotenoids ◽  
Β Carotene

Humans need vitamin A and obtain essential vitamin A by conversion of plant foods rich in provitamin A and/or absorption of preformed vitamin A from foods of animal origin. The determination of the vitamin A value of plant foods rich in provitamin A is important but has challenges. The aim of this paper is to review the progress over last 80 years following the discovery on the conversion of β-carotene to vitamin A and the various techniques including stable isotope technologies that have been developed to determine vitamin A values of plant provitamin A (mainly β-carotene). These include applications from using radioactive β-carotene and vitamin A, depletion-repletion with vitamin A and β-carotene, and measuring postprandial chylomicron fractions after feeding a β-carotene rich diet, to using stable isotopes as tracers to follow the absorption and conversion of plant food provitamin A carotenoids (mainly β-carotene) in humans. These approaches have greatly promoted our understanding of the absorption and conversion of β-carotene to vitamin A. Stable isotope labeled plant foods are useful for determining the overall bioavailability of provitamin A carotenoids from specific foods. Locally obtained plant foods can provide vitamin A and prevent deficiency of vitamin A, a remaining worldwide concern.

scholarly journals South African preschool children habitually consuming sheep liver and exposed to vitamin A supplementation and fortification have hypervitaminotic A liver stores: a cohort study

2019 ◽  
Vol 110 (1) ◽  
pp. 91-101 ◽  
Author(s):  
Martha E van Stuijvenberg ◽  
Muhammad A Dhansay ◽  
Jana Nel ◽  
Devika Suri ◽  
Michael Grahn ◽  
...  
Keyword(s):  
South Africa ◽  
Preschool Children ◽  
Vitamin A ◽  
Total Serum ◽  
High Dose ◽  
Serum Retinol ◽  
Hypervitaminosis A ◽  
Total Liver ◽  
Before And After ◽  
Retinyl Esters

ABSTRACT Background In some regions, multiple vitamin A (VA) interventions occur in the same target groups, which may lead to excessive stores. Retinol isotope dilution (RID) is a more sensitive technique than serum retinol to measure VA status. Objective We evaluated VA status before and after a high-dose supplement in preschool children living in a region in South Africa with habitual liver consumption and exposed to VA supplementation and fortification. Methods After baseline blood samples, subjects (46.7 ± 8.4 mo; n = 94) were administered 1.0 μmol [14,15]-13C2-retinyl acetate to estimate total liver retinol reserves by RID with a follow-up 14-d blood sample. Liver intake was assessed with a frequency questionnaire. In line with current practice, a routine 200,000 IU VA capsule was administered after the RID test. RID was repeated 1 mo later. Serum retinyl esters were evaluated using ultra-performance liquid chromatography. Results At baseline, 63.6% of these children had hypervitaminosis A defined as total liver retinol reserves ≥1.0 μmol/g liver, which increased to 71.6% after supplementation (1.13 ± 0.43 to 1.29 ± 0.46 μmol/g; P < 0.001). Total serum VA as retinyl esters was elevated in 4.8% and 6.1% of children before and after supplementation. The odds of having hypervitaminosis A at baseline were higher in children consuming liver ≥1/mo (ratio 3.70 [95% CI: 1.08, 12.6]) and in children receiving 2 (4.28 [1.03, 17.9]) or 3 (6.45 [0.64, 65.41]) supplements in the past 12 mo. Total body stores decreased after the supplement in children in the highest quartile at baseline compared with children with lower stores, who showed an increase (P = 0.007). Conclusions In children, such as this cohort in South Africa, with adequate VA intake through diet, and overlapping VA fortification and supplementation, preschool VA capsule distribution should be re-evaluated. This trial was registered at https://clinicaltrials.gov/ct2/show/NCT02915731 as NCT02915731.

Abstract P070: The Relationship Between Weight and Fruit and Vegetable Consumption, Assessed by Serum Carotenoids and Self-Report: Results from the PREMIER Trial

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Jessie L Parker ◽  
Liwei Chen ◽  
Diane C Mitchell ◽  
Hsin-Chieh Yeh ◽  
Cheryl Anderson ◽  
...  
Keyword(s):  
Body Weight ◽  
Fruits And Vegetables ◽  
Vegetable Intake ◽  
Vegetable Consumption ◽  
Fruit And Vegetable Consumption ◽  
Fruit And Vegetable Intake ◽  
Fruit And Vegetable ◽  
Average Intake ◽  
Serum Carotenoids ◽  
The Relationship

Background: Increased intake of fruits and vegetables (F/V) may protect against adiposity, but effects on weight have been inconsistent. Our objective was to examine the relationship between fruit and vegetable intake and weight, using direct and indirect measures of dietary intake: self-reported 24-hour recall and serum carotenoid levels. Methods: Participants from the PREMIER lifestyle intervention trial were included in this analysis (n=554). Dietary measures included 24-hour dietary recalls and serum carotenoid levels, from a fasting blood sample. The outcome was weight in pounds. Nested linear mixed models were used to examine the association between F/V and weight. Results: Mean F/V increased from 4.6 (SD 2.4) to 5.6 (SD 3.2) (p=<.01), mean serum carotenoids increased from 53.2 (SD 31.9) to 68.1 (SD 42.5) (p=<.01). At 18 months, participants in the lowest quintile of fruit and vegetable change reported an average intake of 4.42.8 servings of fruits and vegetables, and those in the highest quintile of change reported an average intake of 7.73.2 servings. In a multivariate model adjusting for age, race, gender, intervention, energy, study site, and time, lower body weight was associated with higher F/V intake measured by dietary recall (−0.63 lbs, 95% CI −0.83 to −0.42, per 1 serving increase in F/V) and serum carotenoids (−0.13 lbs, 95% CI −0.15 to −0.11, per 1 ug/dl increase in carotenoids). Results were somewhat attenuated but consistent after additional adjustments for working heart rate, exercise, calories from sugar-sweetened beverages, marital and employment status, and alcohol use . Conclusions: Greater fruit and vegetable consumption was associated with decreased body weight. Results were consistent for both objective and self-reported measures of fruit and vegetable intake.

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 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.

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