Malaria and vitamin A deficiency in African children: a vicious circle?

Vitamin A deficiency and malaria are both highly prevalent health problems in Africa. Vitamin A deficiency affects over 30 million children, most of whom are in the age-group (under five years) most affected by malaria. Vitamin A deficiency increases all-cause mortality in this part of the population, and malaria is an important cause of death in children at this age. A low serum retinol concentration (a marker of vitamin A deficiency) is commonly found in children suffering from malaria, but it is not certain whether this represents pre-existing vitamin A deficiency, a contribution of malaria to vitamin A deficiency, or merely an acute effect of malaria on retinol metabolism or binding. In this paper, available evidence in support of a causal relationship in each direction between vitamin A deficiency and malaria is reviewed. If such a relationship exists, and especially if this is bidirectional, interventions against either disease may convey an amplified benefit for health

Maternal Night Blindness during Pregnancy Is Associated with Low Birthweight, Morbidity, and Poor Growth in South India

Maternal night blindness is common during pregnancy in many developing countries. Previous studies have demonstrated important consequences of maternal night blindness during pregnancy on the health of the mother and newborn infant. We compared birthweight, 6-mo infant mortality, morbidity, and growth among infants of women who did and did not report a history of night blindness from a community-based, randomized trial of newborn vitamin A supplementation in south India. Birthweight was measured within 72 h of delivery. Infants were followed until 6 mo of age for mortality and morbidity was assessed at household visits every 2 wk. Anthropometry was assessed at 6 mo of age. A total of 12,829 live-born infants were included, 680 of whom were infants of mothers with night blindness during the index pregnancy. Maternal night blindness was associated with an increased risk of low birthweight in a dose-dependent fashion based on birthweight cut-offs: \u3c2500 g, adjusted relative risk (RR) = 1.13 (95% CI = 1.01, 1.26); \u3c2000 g, adjusted RR = 1.70 (95% CI = 1.27, 2.26); \u3c1500 g, adjusted RR = 3.38 (95% CI = 1.18, 6.33); with an increased risk of diarrhea (adjusted RR = 1.16, 95% CI = 1.03, 1.30), dysentery (adjusted RR = 1.25, 95% CI = 1.03, 1.53), acute respiratory illness (adjusted RR = 1.32, 95% CI = 1.21, 1.44), and poor growth at 6 mo; underweight (adjusted RR = 1.14, 95% CI = 1.02, 1.26), stunting (adjusted RR = 1.19, 95% CI = 1.05, 1.34). Maternal night blindness was not associated with 6-mo infant mortality or wasting at 6 mo. This study demonstrates that there are important consequences to the infant of maternal vitamin A deficiency during pregnancy. © 2008 American Society for Nutrition

Lipid Composition and State of Oxidation of Fortified Infant Flours in Low‐Income Countries Are Not Optimal and Strongly Affected by the Time of Storage

International audienceFood fortification is widely used to address the public health problem of nutrient deficiencies. This study's purpose is to assess the lipid profile and nutritional quality of 13 fortified infant flours (FI) collected “in the field” in Africa and Asia after different periods of storage. The lipid content, fatty acid profiles, lipophilic vitamin content, and lipid oxidation state (peroxide values, secondary oxidation products) are determined. Mycotoxins and packaging materials are also characterized. The lipid content averages 9.1 ± 3.5 g/100 g. Fatty acid profiles are dominated by linoleic (43.3 ± 8.8%), oleic (29.5 ± 7.4%), and palmitic acid (17.8 ± 6.7%) and result in an average ω6/ω3 ratio of 12.2 ± 5.9 but with high values for some FI. Very high overages in vitamins A, D, and E are observed in products stored for short periods (1–6 months), whereas FI stored for more than 12 months has insufficient vitamin content. Lipid oxidation is acceptable but for six products presenting excessive peroxide values. Most products are contaminated by low amounts of mycotoxins but only two FI do not abide by the regulation. A strong correlation between peroxide values, hexanal content, and time of storage is observed. Practical Applications: The expiration dates for FI commercialized in low‐income countries should be shortened from 36 to 12 months so as to guarantee their nutritional quality of these functional foods and to abide by the fortified infant flour legislation. Indeed, FI quality significantly decreases over time of storage. The use of high barrier packaging materials must be generalized, although it is a necessary criterion but not sufficient to ensure the long‐term stability of FI. Special attention should be given to reduce lipophilic vitamin overages and to improve their lipid profile, especially the ω6/ω3 ratio, which has to be lower than 15