Vitamin A Intake Research Articles

The change in retinoic acid receptor signaling induced by prenatal marginal vitamin A deficiency and its effects on learning and memory

This study investigated the prenatal marginal vitamin A deficiency (mVAD)-related impairment in learning and memory and the interactions between RARα, Src and NR1. Learning and memory were assessed in adult rats that were exposed to prenatal mVAD with Morris water maze. The average escape time was longer in mVAD rats, and they passed the hidden platform fewer times during the memory retention test than normal vitamin A intake (VAN) rats. The mRNA and protein levels of RARα, Src and NR1 in mVAD rats were significantly lower than those in VAN rats. RARα and Src, but not NR1, were in the same protein complex. RA treatment-induced increase in RARα, Src and NR1 expressions in mVAD neurons was much lower than that in VAN neurons. Overexpression of RARα gene in VAN neurons induced an increase in RARα, Src and NR1 expressions, while silencing of RARα gene induced a decrease in expressions of RARα and Src, but not that of of NR1. In mVAD neurons, however, overexpression of RARα did not induce an increase in NR1 expression, while silencing of RARα gene had no effect on Src and NR1 expressions. Furthermore, inhibition of Src was associated with a decrease in NR1 expression but not that of RARα. Prenatal mVAD was associated with impaired learning and memory in adult rats. It is possible that mVAD-related decrease in RARα led to a decrease in Src expression, which in turn down-regulated NR1 expression and Ca2+ influx and eventually caused learning and memory deficits.

Promotion of Orange-Fleshed Sweet Potato Increased Vitamin A Intakes and Reduced the Odds of Low Retinol-Binding Protein among Postpartum Kenyan Women

Background: Orange-fleshed sweet potato (OFSP) improves vitamin A (VA) status of young children; research with pregnant and lactating women is limited.Objective: We examined the effectiveness of the Mama SASHA (Sweetpotato Action for Security and Health in Africa) program to improve nutrition knowledge, diets, and nutritional status of pregnant and lactating women (PLW) in Western Kenya.Methods: Eight health facilities were allocated to the Mama SASHA intervention or comparison arms. PLW in intervention facilities received enhanced nutrition counseling at health clinics, were linked with community-based maternal support groups, and received vouchers for OFSP vine cuttings. Control PLW received clinic-based nutrition counseling only. A total of 505 women in early and midpregnancy, attending their first antenatal care visit, and with no previous engagement in project activities were enrolled from the 8 facilities. Nutrition and health-seeking knowledge, food security, dietary patterns, and anthropometric measurements were collected at 4 time points at ≤9 mo postpartum. VA intakes were assessed with multipass 24-h recalls in a subsample of 206 mothers at 8–10 mo postpartum. VA status was assessed by using serum retinol-binding protein (RBP). Impacts were estimated with multilevel mixed models adjusted for clustering and differences at enrollment.Results: At enrollment, 22.9% of women had RBP <1.17 μmol/L. By 9 mo postpartum, intervention women had significantly higher intakes of VA [adjusted difference = 297.0 retinol activity equivalent (RAE) units; 95% CI: 82, 513 RAE units; P = 0.01; n = 206], greater consumption of VA-rich fruit and vegetables in the previous 7 d (difference-in-difference estimate: 0.40 d; 95% CI: 0.23, 0.56 d; P < 0.01), and a 45% reduction in the odds of RBP <1.17 μmol/L (OR: 0.55; 95% CI: 0.33, 0.92; P = 0.01).Conclusion: Promotion of OFSP to PLW through health services is a feasible strategy to improve women’s nutrition knowledge, VA intakes, and maternal RBP.

Genetic Variations Associated with Vitamin A Status and Vitamin A Bioavailability.

Blood concentration of vitamin A (VA), which is present as different molecules, i.e., mainly retinol and provitamin A carotenoids, plus retinyl esters in the postprandial period after a VA-containing meal, is affected by numerous factors: dietary VA intake, VA absorption efficiency, efficiency of provitamin A carotenoid conversion to VA, VA tissue uptake, etc. Most of these factors are in turn modulated by genetic variations in genes encoding proteins involved in VA metabolism. Genome-wide association studies (GWAS) and candidate gene association studies have identified single nucleotide polymorphisms (SNPs) associated with blood concentrations of retinol and β-carotene, as well as with β-carotene bioavailability. These genetic variations likely explain, at least in part, interindividual variability in VA status and in VA bioavailability. However, much work remains to be done to identify all of the SNPs involved in VA status and bioavailability and to assess the possible involvement of other kinds of genetic variations, e.g., copy number variants and insertions/deletions, in these phenotypes. Yet, the potential usefulness of this area of research is exciting regarding the proposition of more personalized dietary recommendations in VA, particularly in populations at risk of VA deficiency.

The Association between Dietary Vitamin A and Carotenes and the Risk of Primary Liver Cancer: A Case-Control Study.

Dietary intake of vitamin A (VA) and carotenes has shown beneficial effects for decreasing the risk of some types of cancer, but findings on the risk of primary liver cancer (PLC) are inconsistent. This case–control study explored the associations between the dietary intake of VA and carotenes and the risk of PLC. We recruited 644 incident PLC patients (diagnosed within one month of each other) and 644 age- and gender-matched controls in Guangzhou, China. A food frequency questionnaire was used to assess habitual dietary intake. Logistic regression analyses found that higher intakes of VA and carotenes were independently associated with decreased PLC risk (all P-trend < 0.001). The multivariable-adjusted ORs (95% CI) of PLC for the highest (vs. lowest) quartile were 0.34 (0.24–0.48) for vitamin A and 0.35 (0.25–0.49) for carotenes. The associations were not significantly modified by smoking, alcohol, or tea drinking (P-interactions: 0.062–0.912). Dose–response analysis showed a U-shaped VA–PLC relationship, with sharply decreased risks at the intakes of about 1000 μg retinol equivalent (RE)/day, and then slowly went down toward the flat-bottomed risks with the lowest risk at 2300 μg RE/day. Our findings suggest that greater intake of retinol, carotenes, and total VA may decrease PLC risk among the Chinese population at an intake of 1000 μg RE/day or greater from food sources.

Socio-Economic and Cultural Influence on Vitamin A Intake of Lactating Mothers in Ngaoundere Cameroon

Background: Vitamin A deficiency (VAD) is a widespread public health problem in developing nations affecting greatly pregnant and lactating women. The intake of Vitamin A rich foods highly recommended to reduce the prevalence in these vulnerable groups are greatly influenced by the level of education, geographic origin and differences in food habits. Aims of the Study: To evaluate the Influence of socio-economic, cultural, geographic origin, and demographic factors on vitamin A (VA) intake of lactating mothers in Ngaoundere, Cameroon. Method: A total of 100 lactating mothers attending pediatric consultations at four major health structures in Ngaoundere were involved in the survey. A questionnaire was used to get information on socio-economic, cultural, demographic factors, geographic origin, anthropometric parameters and culinary practices. Dietary intake was assessed using a 24-hour dietary recall method. Meals potentially rich in VA consumed by these women were collected, their carotenoids contents quantified and VA activity determined. Results: Average VA intake of lactating women of Northern origin was significantly (p&lt; 0.05) lower (595.2±60.4μg/day) than that of women of Southern origin (737.6±55.6μg/day), although both were below the recommended intake of 850μg/day. VA intake was also higher in the more educated women. Marital status, number of children, age of the mother and body mass index did not significantly influence the daily VA intake of the women. Lactating women of Northern origin, with three or more children and having no formal education, are more at risk of acute VA Deficiency. Conclusion: While the level of education influenced the VA intake in lactating women from the Northern Region, the age of the baby influenced those from the Southern Region.

A Changing Landscape for Vitamin A Programs: Implications for Optimal Intervention Packages, Program Monitoring, and Safety.

Vitamin A deficiency (VAD) remains a widespread public health problem in the developing world, despite changes in under-5 mortality rates, morbidity patterns, and intervention options. This article considers the implications of a changing epidemiologic and programmatic landscape for vitamin A (VA) programs. We review progress to prevent VAD and its health consequences, assess gaps in VA status and intervention coverage data, and assess data needed to guide decisions regarding the optimal mix, targeting, and dose of VA interventions to maximize benefit and minimize risk. Vitamin A supplementation programs have contributed to the reduction in under-5 mortality rates, but alone, do not address the underlying problem of inadequate dietary VA intakes and VAD among preschool-aged children in the developing world. A combination of VA interventions (eg, supplementation, fortified foods, multiple micronutrient powders, and lipid-based nutrient supplements) will be required to achieve VA adequacy in most settings. Current efforts to measure the coverage of multiple VA interventions, as well as whether and how much VA children are receiving, are few and fragmented. Where intervention overlap exists, further effort is needed to monitor VA intakes, ensuring that targeted groups are consuming adequate amounts but not exceeding the tolerable upper intake level. Vitamin A status data will also be critical for navigating the changing landscape of VA programs. Data from these monitoring efforts will help to guide decisions on the optimal mix, targeting, and exposure to VA interventions to maximize public health benefit while minimizing any potential risk.

Variability in Vitamin A Intake of Pregnant Women in Ngaoundere-Cameroon with Geographic Origin, Socio-Professional and Demographic Factors

Variability in vitamin A (VA) intake of pregnant women in Ngaoundere town according to geographic origin, socio-professional and demographic factors was studied. A total of 100 pregnant women attending ante natal visits at the Regional Hospital in Ngaoundere were involved in the survey. A questionnaire was used to obtain information on geographic origin, socio-professional status, birth history, demographic and anthropometric factors. Dietary intake was assessed using 24-hour dietary recall. Meals potentially rich in VA consumed by these women were collected, their carotenoids contents quantified and VA activity determined by conversion. Results indicated that daily VA intake of these women varied significantly (p < 0.05) with geographic origin, level of education and age of pregnancy. VA intake of pregnant women of Northern origin (Adamawa, North and Far North Regions) was significantly (p < 0.05) lower (496 μg/day/woman) than that of women of Southern origin (588 μg/day/woman), although both were below the recommended intake of 800 μg/day/woman. The more educated a woman and the older her pregnancy, the higher her VA intake. VA consumption of pregnant women of Northern origin was significantly influenced by their age, whereas for pregnant women of Southern origin, BMI (Body Mass Index) equally had a significant influence on their VA intake. Socio-professional status, marital status and number of children did not significantly influence the daily VA intake of these women. Thus, a pregnant woman originating from the Northern part of the country and having no formal education, consumed less foods rich in carotenoids and therefore was more at risk for vitamin A deficiency.

Estimating the Effective Coverage of Programs to Control Vitamin A Deficiency and Its Consequences Among Women and Young Children in Cameroon.

To compare the cost-effectiveness of nutrition programs, the anticipated nutritional benefits of each intervention must be expressed using a common metric. We present the methodology for estimating the benefits of vitamin A (VA)-related interventions among women and children in Cameroon. We estimated "reach" (proportion of the population that receives a program), "coverage" (proportion that is deficient and receives a program), and "effective coverage" (proportion that "converts" from inadequate to adequate VA intake following an intervention) using dietary data collected during a national survey in 3 macro-regions of Cameroon (North, South, and Yaoundé/Douala). Effective coverage of programs such as (bio)fortification and micronutrient powders was estimated by adding the dietary VA contributed by the intervention to baseline VA intakes, including the contribution of increased maternal VA intake to infant VA intake through increases in breast milk VA. For interventions that provide VA-related benefits through other pathways (eg, periodic high-dose VA supplements and deworming), we developed alternative methods of estimating "daily VA intake equivalents. " Baseline VA intakes and intervention reach varied by geographic macro-region. On average, estimates of program reach were greater than the effective coverage estimates by ∼50%. Effective coverage varied by intervention package and macro-region, ranging from <20 000 (deworming, Yaoundé/Douala) to >400 000 (micronutrient powder or VA supplement, North) children effectively covered per year. These estimates of effective coverage, along with macro-region-specific information on the costs of each intervention package, serve as inputs into an economic optimization model to identify the most cost-effective package of VA interventions for each macro-region of Cameroon.

Measuring the Costs of Vitamin A Interventions: Institutional, Spatial, and Temporal Issues in the Context of Cameroon.

To address vitamin A (VA) deficiency, an array of interventions have been developed for increasing VA status among young children. With numerous possible combinations of interventions, however, comes the need to take decisions regarding which intervention or combination of interventions is most cost effective for achieving VA deficiency reduction targets. Detailed intervention-specific, "macro-region"-level data in Cameroon are used to generate estimates of the costs associated with delivering VA to children aged 6 to 59 months. In Cameroon, our estimates of costs per effectively-covered child (ie, children at risk of inadequate intake of VA who are exposed to an intervention and who achieve adequate intake) each year (2 rounds of Child Health Days [CHDs]) were US$3.31 for VA supplements. VA fortification of edible oil and bouillon cube was US$2.95 and US$2.41, respectively, per child effectively covered per year, and biofortification of maize was US$5.30 per child effectively covered per year. Combinations of interventions could reduce costs (eg, delivering additional interventions that affect VA status through the CHDs). Spatial differences in costs within Cameroon were also evident, for example, delivering high-dose VA capsules through CHDs leads to a cost of US$0.77 per child reached in the northern regions compared to US$1.40 per child reached in the southern regions. The costs associated with alternative VA interventions in Cameroon differ spatially, temporally, and in their cost-effectiveness. Choosing the appropriate combination of interventions can produce a more efficient portfolio of interventions to address VA deficiencies and VA-related deaths.

Uncertainties of assessing total body vitamin A stores in community settings in low-income countries using the stable-isotope dilution methodology

Uncertainties of assessing total body vitamin A stores in community settings in low-income countries using the stable-isotope dilution methodology

Association of dietary consumption and serum levels of vitamin A and β-carotene with bone mineral density in Chinese adults

BackgroundFormer studies suggested an adverse effect of hypervitaminosis A on bone health, while the effects of retinol and its precursor (β-carotene) remain uncertain in populations consuming vitamin A (VA) mainly from plant sources. ObjectiveWe investigated the association of serum, dietary retinol, and β-carotene with bone mineral density (BMD) in Chinese adults. MethodsWe recruited 2101 women and 1053 men (aged 40–75years) in Guangzhou, China. Dietary intake was assessed through face-to-face interviews with food-frequency questionnaires at baseline and 3years later. Serum levels of retinol and β-carotene were determined by HPLC using a baseline specimen, and the BMD for the whole body (WB), lumbar spine (LS), total hip (TH), and femur neck (FN) were measured using dual energy X-ray absorptiometry at follow-up. ResultsIn general, greater levels of serum retinol, β-carotene, and the β-carotene-to-retinol ratio were associated with a higher BMD after adjustment for potential covariates in the total sample. BMD values in the top (vs. bottom) quartile were increased by 2.06% (TH) for retinol; 2.87% (WB), 2.51% (LS), 3.10% (FN) for β-carotene; 2.21% (WB) and 2.05% (FN) for the β-carotene-to-retinol ratio in the total sample (all p<0.05). A significant positive association with BMD was observed for dietary intake of β-carotene and total VA in retinol equivalents at the hip sites in the total sample. ConclusionHigher circulating and dietary levels of VA and β-carotene and higher serum β-carotene-to-retinol ratios were positively associated with BMD in Chinese adults consuming relatively low levels of VA, mainly from plant foods.

Simulations Based on Representative 24-h Recall Data Predict Region-Specific Differences in Adequacy of Vitamin A Intake among Cameroonian Women and Young Children Following Large-Scale Fortification of Vegetable Oil and Other Potential Food Vehicles

Background:The WHO recommends assessing food and nutrient intakes to design food-fortification programs, but nationally representative dietary data are seldom available in low-income countries. Objective:Prior to initiation of food fortification in Cameroon, we measured intake of vitamin A (VA) and fortifiable foods (vegetable oil, sugar, wheat flour, and bouillon cube) to simulate the effects of fortification with different foods and VA amounts on prevalence of inadequate and excessive VA intake. Methods:Twenty-four-hour recalls were conducted among 912 women and 883 children (with duplicates in a subset) in a nationally representative cluster survey stratified by region (North, South, Yaoundé/Douala). Usual intake distributions were estimated by the National Cancer Institute method. Results:Nationally, 53% of women had a usual intake of <500 μg retinol activity equivalents/d, and 59% of nonbreastfeeding children had an intake of <210 μg retinol activity equivalents/d, although VA intake varied by region. The current fortification program (12 mg/kg VA in oil) would decrease the prevalence of inadequate intakes to 35% among both women and children, without increasing the proportion with retinol intakes >3000 μg/d among women or >600 μg/d among children. However, inadequate VA intake would remain >50% in the North, where VA deficiency was most common. Increasing VA in oil or fortifying a second food (sugar, wheat flour, or bouillon cube) would further decrease the prevalence of inadequate intakes, but, depending on the food vehicle and region, would also increase the prevalence of retinol intakes above the tolerable upper intake level, mainly among children. Conclusions:The current food-fortification program can be expected to improve dietary VA adequacy without increasing the risk of excessive intake among women and children in Cameroon. Modifications to the program must balance the potential to further increase VA intake with the risk of excessive intake among children.

Potential impact of the national food fortification program on adequacy of vitamin A intake among women in Cameroon: simulations using nationally‐representative 24‐hour recall data

The WHO recommends assessing food and nutrient intakes to design food fortification programs, but national‐level dietary data are seldom available in low‐income countries. Prior to initiation of food fortification in Cameroon, we measured intake of vitamin A (VA) and fortifiable foods (oil and sugar) and simulated the effects of fortification with different foods and VA levels on VA intake and dietary inadequacy. 24h recalls were conducted among 912 women (with duplicates in a subset) in a nationally‐representative, cluster survey. Usual intake distributions were estimated by the NCI method. Nationally, the median (25th, 75th percentile) VA intake was 431 (279, 650) μg RAE/d, and 60% of women had usual intakes &lt; 500 μg RAE/d, although the results differed by region (South, 28%; North, 100%; Cities, 52%). 54% of women consumed refined oil, 54% consumed sugar, 73% consumed either and 35% consumed both in the previous 24h. The current fortification level (12 mg VA per kg oil) would decrease the prevalence of inadequate intakes to 36% nationally (South, 19%; North, 64%; Cities, 16%) without affecting the prevalence of intakes &gt;; 3000 μg RAE/d (&lt; 0.5%). Increasing the VA in oil or fortifying a second food (sugar) would further decrease the proportion of women with VA intake &lt; 500 μg RAE/d. Food fortification should substantially improve dietary VA adequacy without increasing the risk of excess intake among women in Cameroon.Grant Funding Source: Michael and Susan Dell Foundation; Sight &amp; Life

Roles of dietary vitamin A in the regulation of hepatic gene expression in response to fasting‐refeeding cycle

We have shown that vitamin A (VA) status affects the plasma glucose and lipid levels, and hepatic gene expression in rats. Therefore, we hypothesize that dietary VA intake and its hepatic metabolism regulate the expression of genes involved in glucose and lipid metabolism in response to fasting‐refeeding cycle. Male Zucker lean rats were fed with a VA deficient (VAD) or a VA sufficient (VAS) diet for 8 weeks. The VAD or VAS rats were fed ad libitum, fasted for 48 hours (H) or refed a VAD or VAS diet for 6H. The plasma parameters were measured using commercial kits. The hepatic protein and mRNA levels were respectively examined by Western blot and real‐time PCR. The responses of plasma insulin and leptin levels to the feeding cycle were altered in VAD rats compared to VAS ones. The hepatic mRNA levels of Gck, Srebp‐1c, and Fas were reduced after 48H fasting regardless of VA status. The 6H refeeding of a VAS diet induced their mRNA levels in VAD and VAS rats. However, the 6H refeeding of a VAD diet only induced their expression levels in VAS, but not VAD rats. We conclude that dietary VA and its hepatic metabolism contribute to the regulation of plasma hormone levels and hepatic gene expression in rats.Grant Funding Source: American Heart Association

Establishing an upper level of intake for vitamin A in Atlantic salmon (Salmo salarL.) postsmolts

The vitamin A (VA) concentration in salmon aquaculture feeds is varying and may lead to sublethal adverse effects. In this study, 135 g Atlantic salmon postsmolts were given eight diets in duplicates with 6, 12, 26, 55, 82, 112, 360 and 749 mg retinol (ROL) kg−1 for 116 days. Subsequently, fish given 6, 82 and 749 mg ROL kg−1 were transferred to a common net pen and given a standard commercial diet for further 28 weeks. Feed conversion rate, liver functionality and markers of VA homoeostasis were not negatively affected by dietary VA level, but chronic high VA intakes led to adverse effects on growth and bone health. In plasma, there was an antagonistic effect of dietary ROL on circulating 1,25 (OH)2 vitamin D3 (calcitriol). Moreover, a dose–response of VA on craniofacial deformities, condition factor and vertebral morphometry and mechanical strength was observed. Vertebral deformities were observed after 28 weeks on a standard diet and not immediately after the 116 days on the experimental diet. Elevated VA is a risk factor for bone deformities, and the dietary intake of VA should not exceed 37 mg ROL kg−1 body weight day−1 in Atlantic salmon postsmolts.

Modelling potential β-carotene intake and cyanide exposure from consumption of biofortified cassava.

Vitamin A (VA) deficiency causes disability and mortality. Cassava can be crossbred to improve its β-carotene (BC) content; typical white cassava contains negligible amounts of BC. However, cassava contains cyanide and its continued consumption may lead to chronic disability. Our objective was to estimate the risk-benefit of consuming BC-enhanced cassava to increase VA intake. A total of ten American women were fed white and BC-enhanced cassava. BC and cyanide data from the feeding study were combined with African cassava consumption data to model the potential daily BC, VA and cyanide intakes of African women. If BC-enhanced cassava replaced white cassava in the diets, it could theoretically meet recommended VA intakes for the following percentages of individuals from six African countries that consume cassava as a staple crop: Angola (95%), Central African Republic (95%), Congo (about 100%), Ghana (99%), Mozambique (99%) and Nigeria (92%). Cyanide intake after minimal preparation of cassava could be thirteen to thirty-two times the reference dose (RfD), a toxicological exposure reference, but could be completely removed by extensive soaking. This study demonstrates that consumption of BC-enhanced cassava, processed to maintain BC and remove cyanide, theoretically increases VA intakes for African populations and other areas of the world where cassava is a staple crop.

High Prevalence of Vitamin A Deficiency Is Detected by the Modified Relative Dose-Response Test in Six-Month-Old Senegalese Breast-Fed Infants ,

To alleviate vitamin A (VA) deficiency (VAD) in Senegal, understanding the relationship between VA status of lactating women and their 6-mo-old infants is important. This study measured 6-mo-old infants' VA intake from human milk and assessed the VA status of mothers and infants. A comprehensive study was undertaken in 34 mother-infant pairs. Nonpregnant lactating women and their infants were included. None of the infants had received a VA supplement. Mothers were grouped as supplemented with 2 doses of 200,000 IU (60,000 μg; 210 μmol) retinol as retinyl palmitate (n = 13) or nonsupplemented (n = 19) after delivery. Breast milk intake was measured by the deuterium dilution technique. Plasma and breast milk retinol concentrations were measured by HPLC. Infants' VA liver stores were assessed by the modified relative dose-response (MRDR) test. Plasma retinol detected 15% VAD among infants and the MRDR test (≥0.06) indicated 73.5% with low VA liver stores. Infants' milk VA intakes were close to estimated requirements (375 μg/d). No correlation was found between infants' plasma retinol and MRDR value. Infants' MRDR value was lower in the group from supplemented mothers (0.055 ± 0.017 vs. 0.073 ± 0.017; P = 0.009), but no difference was observed between plasma retinol concentrations of both groups of mothers; 8.8% of mothers were VA deficient based on plasma retinol (≤0.7 μmol/L). Low VA liver stores were prevalent among Senegalese infants at the beginning of the complementary feeding period. Postpartum VA-supplemented mothers significantly enhanced their infants' VA liver stores.

Effect of Vitamin A Fortified Milk Intake on Total Body Vitamin A Stores in Mexican Preschoolers

In Mexico, vitamin A deficiency (VAD) is a public health problem for preschool children. Vitamin A (VA) fortified milk (Liconsa) is distributed nationally to fight VAD, nevertheless its effect has yet not been assessed. The aim of this study was to assess the effect of daily intake of VA fortified milk on the total body VA (TBVA) stores of preschoolers.We conducted a randomized controlled clinical trial in Mexico to assess the effect of daily intake of 250 mL of VA fortified Liconsa milk for 12 weeks on VA status of 24 VA‐deficient preschoolers. Subjects were randomly allocated to treatment (n=11) or control (n=13) groups respectively. TBVA stores were calculated using the Olson equation at baseline and three months after daily intake of VA fortified “Liconsa” milk.TBVA stores of the treatment group had a significant increase compared to their baseline value (P&lt;0.05) and stores had a significant difference of 0.75 mmol in treatment vs control groups (P=0.01). Serum retinol concentration was significantly reduced compared to its baseline value in the control group (P&lt;0.05) and serum retinol was 0.291μmol/L greater in the treatment vs control group (P=0.01).Daily intake of vitamin A fortified “Liconsa” milk during 12 weeks, significantly increased TBVA stores and serum retinol levels of Mexican preschoolers.Study supported by the IAEA. LTV received a fellowship from CONACyT.Grant Funding Source : IAEA‐CONACyT

The effect of agricultural strategies to improve household food production on the health and nutrition outcomes of women and young children: a systematic review

Increasing household food production (HHFP) is a common strategy to improve household food security and nutrition in resource‐poor settings. We systematically reviewed the effects of HHFP interventions on the nutrition and health outcomes of women and young children using a modified version of the Child Health Epidemiology Reference Group (CHERG) adaptation of the GRADE technique; 35 studies met inclusion criteria. HHFP interventions improved women's and children's diet diversity, intakes of micronutrient‐rich fruits and vegetables, and intakes of animal‐source foods. HHFP strategies improved vitamin A (VA), protein, energy, and/or iron intakes among women; effects on BMI, VA status and/or anemia were inconclusive. Among children, HHFP consistently improved VA intakes and nonsignificantly reduced stunting by 7%, underweight by 28%, and wasting by 6%; effects on anemia and VA status were mixed. The evidence base for HHFP strategies is limited because most studies are nonrandomized, lack adequate controls, have limited power, and do not use appropriate analytic methods. In conclusion, while strategies to improve HHFP positively impact dietary practices and increase vitamin A intakes, effects on biological and anthropometric indicators of nutrition are unclear. Additional, well designed studies are needed that examine a diverse array of nutrition indicators.

Perinatal Exposure to Vitamin A Differentially Regulates Chondrocyte Growth and the Expression of Aggrecan and Matrix Metalloprotein Genes in the Femur of Neonatal Rats1–3

Vitamin A (VA) and its active form, retinoic acid (RA), are regulators of skeletal development. In the present study, we investigated if maternal VA intake during pregnancy and lactation, as well as direct oral supplementation of neonates with VA + RA (VARA) in early life, alters neonatal bone formation and chondrocyte gene expression. Offspring of dams fed 3 levels of VA (marginal, adequate, and supplemented) for 10 wk were studied at birth (P0) and postnatal day 7 (P7). One-half of the newborns received an oral supplement of VARA on P1, P4, and P7. Tissues were collected on P0 and 6 h after the last dose on P7. Pup plasma and liver retinol concentrations were increased by both maternal VA intake and VARA (P < 0.01). Although maternal VA did not affect bone mineralization as assessed by von Kossa staining, newborn femur length was increased with maternal VA (P < 0.05). VARA supplementation of neonates increased the length of the hypertrophic zone only in VA-marginal pups, close to that in neonates from VA-adequate dams, suggesting VARA caused a catching up of growth that was limited by low maternal VA intake. Maternal diet did not alter type X nor type II collagen mRNA. However, VARA-treated pups from VA-supplemented dams had reduced mRNA for aggrecan, a major component of cartilage matrix, and increased mRNA for matrix metalloproteinase (MMP)13, which catalyzes the degradation of aggrecan and collagens. These results suggest that moderately high maternal VA intake combined with neonatal VARA supplementation can reduce the ratio of aggrecan:MMP, which may unfavorably alter early bone development.