The metabolic availability of vitamin A (retinol) in streptozotocin-induced diabetic rats.

Using non-diabetic control and streptozotocin-induced diabetic male Wistar rats of 4-6 week duration, the metabolic availability of vitamin A (retinol) was examined. Animals were fed ad libitum a nutritionally complete semi-synthetic diet either with (36 RE/g) or without (basal diet, 3.6 RE/g) vitamin A supplementation; or pair-fed the basal diet. Rats induced with diabetes developed hyperglycemia, increased urinary glucose and increased water intake within 48 hours. Despite the fact that the diabetic rats consumed nearly 50% more food than their corresponding controls, they gained less weight. These animals had decreased concentrations of vitamin A in the plasma and in the retina, while their total hepatic concentrations were markedly elevated. The circulatory vitamin A levels remained low while their hepatic concentrations were further elevated following supplementation of vitamin A, 10 times the amount in the basal diet. This reduced status of vitamin A in diabetic animals was not caused by its impaired intestinal absorption as evident by an in vitro study where the uptake of ( H) retinol by the jejunum and ileum was not affected in the presence of diabetes. This was further supported by the fact that there was no difference in the hepatic concentrations of vitamin A in weight matched pair-fed control and diabetic animals. Free retinol concentrations in the liver were, however, higher in the diabetic than in control rats. These results suggest that there is an impaired mobilization of vitamin A from the liver to circulation. Retinol is mobilized from its storage site in the liver and secreted into the plasma as a retinol-RBP complex (holo-RBP). The holo-RBP normally circulates in the plasma as a 1:1 molar complex with TTR. The concentrations of these carrier proteins were depressed in the plasma, liver and kidney of the diabetic animals: however, plasma albumin concentrations were unaffected. The decreased plasma vitamin A concentrations may be due to decreased synthesis or decreased stability (shorter half-life) of the carrier proteins. Since zinc is an important factor for the hepatic synthesis of RBP and its metabolism is known to be affected in diabetes, the responses of circulatory vitamin A to zinc supplementation (120 ug/g diet) was examined. Further, the effect of insulin treatment (subcutaneous insulin pellet implant) on plasma and liver vitamin A concentrations was determined. The diabetes associated changes in vitamin A metabolism were reversed by insulin treatment but not by zinc supplementation. The results of this study clearly point to the fact that STZ-induced diabetic rats are associated with reduced vitamin A status due to impaired availability of its carrier proteins. Although the mechanism leading to blindness in vitamin A deficiency and in diabetes is different, it is conceivable that retinopathy precipitated by diabetes can be further aggravated by vitamin A deficiency

Effects of Fermentation on the Total Carotenoids, Fat, Free Fatty Acids and Minera ls in Soybean and Sweetp otato Flour Blends

Soybeans and sweetpotatoes are high in micronutrients and convertible carotenoids, respectively. Utilization of micronutrients is hampered by anti-nutritional factors intrinsic to nutrient sources. Carotenoids must first be converted to retinol before utilization by the body. This study determined the effects of fermentation on bioavailability of micronutrients and utilization of high carotenoid substrates. Soybean and sweetpotato flours were mixed in the ratio of 1:1 (Composite A) and 1:3 (Composite B) on dry weight basis. Fermentation was done using Lactobacillus plantarum at 37oC for 168 hours with sampling every 24 hours. Aspergillus oryzae fermentation was done at 25oC for six weeks with weekly sampling. Total carotenoids were determined using a spectrophotometer, while retinol, lipid and free fatty acids (FFA) were determined using standard methods. Mineral analysis was done using wet acid digestion and atomic absorption spectroscopy. There was a significant (P<0.001) decrease in total carotenoids in both the L. plantarum and A. oryzae fermentation with a concurrent increase in retinol of 3 μg/g and 4 μg/g, respectively. There was an overall 30% increase in FFA in A. oryzae-fermented samples as compared to 12% in the L. plantarum-fermented samples. There were significant (P<0.001) differences in zinc and calcium contents fermented by the different organisms, but none in iron and magnesium contents. Calcium and zinc extraction was highest after 24 hours of L. plantarum fermentation. The findings suggest that fermentation could be effective in increasing mineral bioavailability, free fatty acid and retinol formation from substrates rich in carotenoids. Therefore, optimal time and microbe fermentation can be used to develop supplementary and complementary foods for people deficient in Vitamin A and minerals

Effect of fermentation on protein digestibility of soybean and sweet potato blends: aspergillus oryzae vs. Lactobacillus plantarum

The improvement of nutritional quality of foods through fermentation has been practiced for long.Fermentation imparts desirable characteristics to products and makes them more utilizable nutrient sources than the unfermented products. Sweet potatoes have been under utilized industrially and are mainly used at household level. Soybeans are rich in proteins but their full utilization has been hampered by their anti-nutritional properties which are destroyed by heating and fermentation. The purpose of this study was to produce suitable blends of soybean and sweet potato flours targeted at alleviating protein related malnutrition. The quality characteristics of the fermented and unfermented soybean and sweet potato composite flours were compared. The fermentation with Lactobacillus plantarum was at 370C for 168 hours with sampling every 24 hours. The Aspergillus oryzae fermentation was performed at 250C for six weeks with samples taken weekly for laboratory analysis. In-vitro protein digestibility was determined enzymatically. The data obtained was subjected to General Linear Model (GLM) of the Statistical Analysis System (SAS). Protein digestibility was improved by an average 4% (p< O.05) in the bacterial fermented composites and by an average of 5.5% (p< O.05) in the composite flours fermented with the mould. The composite containing 50% soybean and 50% sweet potato reflected higher protein digestibility than the composite with 25% soybean and 75% sweet potato. Fermentation significantly increased protein digestibility but an initial drop was observed in the higher (50% soybean and 50% sweet potato) protein composite for both bacterial and mould fermentations. Optimum protein digestibility improvement was achieved thus a baseline for development of suitable blends targeting protein malnutrition

Effectiveness of community health workers in improving early initiation and exclusive breastfeeding rates in a low-resource setting: A cluster-randomized longitudinal study

Little evidence exists in Kenya on the potential of community health workers (CHWs) in promoting exclusive breastfeeding (EBF) and early breastfeeding initiation (EBI) in resource‐restricted settings where very low EBF rates (2% to 12%) have been documented. The study utilized CHWs and assessed their effectiveness in promoting EBF and EBI. The cluster‐randomized longitudinal design was used and sixteen villages from Kiandutu Slum in Thika randomly assigned into either intervention group (IG) or comparison group (CG). Pregnant women attending Maternal Child Health (MCH) clinic were recruited. The IG received nutrition education sessions conducted by CHWs at home, two prenatally and six postnatally, plus the routine MCH care. The CG went through routine MCH care only. Infants feeding data were collected at 6, 10, 14, and 24 weeks postpartum by research assistants blinded to the intervention allocation. Differences in EBF and EBI in the two groups were tested using χ² tests, Kaplan–Meier survival analysis and generalized estimating equations. Of the 526 recruited in the study, 431 remained and were included in the analysis (IG = 176) and CG (225). The prevalence of EBF at 24 weeks was 45.3% in the IG compared with 15.0% in the CG, revealing a statistically significant difference log rank = 20.277, (1, n = 314) p < .001. The difference was not statistically significant in EBI prevalence between the IG (58.2%) and CG (60.3%; χ² = 0.008, p = .928). The CHWs have potential effectiveness in promoting EBF but not EBI. The link between the health center and CHWs should be strengthened to promote EBF