Impact of vitamin A with zinc supplementation on malaria morbidity in Ghana.

BACKGROUND: Malaria is a leading cause of morbidity and mortality among young children and is estimated to cause at least 1 million deaths each year especially among pregnant women and young children under the age of five years. Vitamin A supplementation is known to reduce morbidity and mortality in young children. Zinc is required for growth and immunity and we sought to replicate the study by Zeba et al. which showed 30% lower cases of clinical malaria in children on a combination of zinc and a large dose of vitamin A compared with children on vitamin A alone based on the hypothesis that combined vitamin A and zinc reduced symptomatic malaria compared to vitamin A alone. OBJECTIVES: The primary objective was to determine the effect of vitamin A alone vs. vitamin A and zinc supplements on the incidence of clinical malaria and other anthropometric indices. It also sought to assess the effects on the incidence of anaemia, diarrhoea and pneumonia. METHODS: The study was community-based and 200 children between the ages of 6-24 months were randomised to receive either vitamin A (100,000 IU for infants less than 12 months & 200,000 IU for children greater than 12 months and 10 mg daily zinc in the intervention group or vitamin A and zinc placebo for 6 months in the control group. RESULTS: The number of children who were diagnosed with uncomplicated malaria in the intervention group was 27% significantly lower compared with the children in the control group (p = 0.03). There were, however, no effects on severe malaria, pneumonia, anaemia and diarrhea. CONCLUSIONS: Our study confirms a significant role of vitamin A and zinc in reducing malaria morbidity

Vitamin A status and body pool size of infants before and after consuming fortified home-based complementary foods.

BACKGROUND: Home fortification using sachets of micronutrient powder (e.g. "Sprinkles") is a food-based approach offering an alternative to high dose vitamin A (VA) supplements for infants. The primary objective was to investigate the impact of VA-home fortification on infant VA pool size. The secondary objective was to compare VA status of infants assessed by the modified relative dose response (MRDR) test before and the (13)C-retinol isotope dilution ((13)C-RID) test in the same infants after vitamin A supplementation. METHODS: A randomized-controlled trial was conducted in 7-9 month old infants in Ghana. Eligible children were randomly allocated to receive a daily sachet of "Sprinkles" with or without VA for 5 months added to complementary foods. The MRDR test indirectly determined VA liver reserves at baseline and the (13)C-RID determined VA body pool at follow-up in the same cohort of children. RESULTS: At baseline, the MRDR values (95 % CI) for infants were comparable in the intervention and control groups: normal at 0·032 (SD 0·018) (0·025-0·038) and 0·031 (SD 0·018) (0·024-0·038), respectively. After intervention, total body stores (TBS) and liver retinol concentrations did not differ between intervention and control groups; TBS were 436 (SD 303) and 434 (SD 186) μmol, respectively, and estimated liver concentrations were 0·82 (SD 0·53) and 0·79 (SD 0·36) μmol/g liver, indicating adequate reserves in all children. CONCLUSIONS: Both the MRDR and (3)C-RID tests confirmed that the infants had adequate VA status before and after home fortification of their complementary foods. These tests offered more information than serum retinol concentrations alone, which predicted VA deficiency using current suggested cutoffs not corrected for inflammation status

Food-based approaches for ensuring adequate vitamin A nutrition

More than 250 million children under the age of five have vitamin A (VA) deficiency. Efforts to improve VA status globally have included supplementation and food fortification. Supplementation, however, can result in sharp spikes and declines in VA concentration in the body, while VA fortificants can lead to hypervitaminosis, which requires continuous monitoring to ensure that levels of total ‐ body VA are not excessive. Biofortifying staple crops with β‐carotene, a major source of provitamin A, is an emerging option for improving VA status without these shortcomings. This review tests the extent to which biofortification may be an alternative to supplementation and food fortification.Non-PRIFPRI1; HarvestPlusHarvestPlu

Serum retinyl esters are not elevated in postmenopausal women with and without osteoporosis whose preformed vitamin A intakes are high

Serum retinyl esters are not elevated in postmenopausal women with and without osteoporosis whose preformed vitamin A intakes are high1,2,3,4 Kristina L Penniston, Ning Weng, Neil Binkley and Sherry A Tanumihardjo 1 From the Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI (KLP, NW, NB, and SAT), and the University of Wisconsin Osteoporosis Clinical Center and Research Program, Madison, WI (NB) Background: Recent observational studies suggest that preformed vitamin A (VA) intakes of 1500\u962000 \ub5g/d may increase the risk of osteoporosis and hip fracture. However, few studies have examined associations between biologic indicators of VA and osteoporosis. Objective: This study characterized VA intake, serum VA, and bone turnover markers in postmenopausal women with and without osteoporosis. Design: Bone density was measured by dual-energy X-ray absorptiometry. Subjects were separated into those with osteoporosis (n =3D 30) and those with normal bone density (n =3D 29). Women with osteopenia were excluded. Complete blood chemistries were obtained. Serum was analyzed for retinol, retinyl esters, and metabolites. Assays for 3 bone turnover markers were performed by using commercially available kits. Diet records were quantified. Logistic regression was used to test for an association between dietary and serum variables and osteoporosis. Results: Dietary VA did not differ significantly between the groups but was nearly twice the Recommended Dietary Allowance in both groups. Body mass index (BMI) and serum triacylglycerols were significantly lower in the osteoporosis group. Retinyl esters were not elevated in either group, but a trend existed for the association of serum retinyl esters as a percentage of total VA with osteoporosis (P =3D 0.070) after adjustment for BMI and triacylglycerols in the statistical model. Milk, fruit, and vegetable intakes were below the current recommendations. Conclusions: Serum retinyl esters were not elevated in these postmenopausal women despite intakes of total VA that were nearly two-fold the Recommended Dietary Allowance. However, retinyl ester concentration (percentage of total VA) was marginally associated with osteoporosis and should be further investigated

History, global distribution, and nutritional importance of citrus fruits

Although the mysteries of its history and origin remain unsolved, worldwide cultivation and high‐demand production for citrus fruit (genus Citrus in family Rutaceae) make it stand high among fruit crops. Growth of the citrus industry, including rapid development of the processing technology of frozen concentrated orange juice after World War II, has greatly expanded with international trade and steadily increased consumption of citrus fruits and their products during the past several decades. Characterized by the distinct aroma and delicious taste, citrus fruits have been recognized as an important food and integrated as part of our daily diet, playing key roles in supplying energy and nutrients and in health promotion. With low protein and very little fat content, citrus fruits supply mainly carbohydrates, such as sucrose, glucose, and fructose. Fresh citrus fruits are also a good source of dietary fiber, which is associated with gastrointestinal disease prevention and lowered circulating cholesterol. In addition to vitamin C, which is the most abundant nutrient, the fruits are a source of B vitamins (thiamin, pyridoxine, niacin, riboflavin, pantothenic acid, and folate), and contribute phytochemicals such as carotenoids, flavonoids, and limonoids. These biological constituents are of vital importance in human health improvement due to their antioxidant properties, ability to be converted to vitamin A (for example, β‐cryptoxanthin), and purported protection from various chronic diseases