Μg Retinol Activity Equivalents Research Articles

Development of nutrient-based nutritional standards for foodservice at shelters during disasters in the Republic of Korea.

In times of disaster, simplified and minimized nutritional standards are necessary for a quick response to provide nutritious relief food. This study aimed to develop nutrient-based nutritional standards for foodservice at shelters during disasters in the Republic of Korea (South Korea). The standards were developed in 2 phases. First, nutrients to be included in the standards were selected. Initial candidates were selected considering 3 aspects: preceding standards, insufficient intake during disasters, and inadequate intake among South Koreans. Final selection was made by excluding nutrients for 3 reasons: nutrients for which there is no deficiency concern in South Korea, nutrients whose intake data were not available, or nutrients whose values presented by Dietary Reference Intakes for Koreans are difficult to achieve based on the current diet among South Koreans. Second, the reference values of energy and the selected nutrients were calculated. The reference values for the entire population who were 1-year-old and over were calculated by multiplying the estimated energy requirements or the recommended nutrient intake and the proportion of each age and sex group. Respective reference values were also calculated for 4 different age groups (1-5, 6-11, 12-64, and ≥ 65-year-old). The standards for the entire population were 2,000 kcal for energy, 55 g for protein, 650 µg retinol activity equivalents for vitamin A, 95 mg for vitamin C, 1.1 mg for thiamin, 1.3 mg for riboflavin, 14 mg niacin equivalents for niacin, 350 µg dietary folate equivalents for folic acid, 750 mg for calcium, and 11 mg for iron. Four additional standards corresponding to each age group were developed. The nutritional standards during disasters were developed for South Korea, including energy and 9 nutrients with reference values for the entire population and 4 different age groups. The standards will contribute to maintaining the health of disaster evacuees in South Korea.

Filipino Children with High Usual Vitamin A Intakes and Exposure to Multiple Sources of Vitamin A Have Elevated Total Body Stores of Vitamin A But Do Not Show Clear Evidence of Vitamin A Toxicity

ABSTRACTBackgroundYoung children exposed to high-dose vitamin A supplements (VAS) and vitamin A (VA)–fortified foods may be at risk of high VA intake and high VA total body stores (TBS).ObjectivesTBS and estimated liver VA concentration were compared among children with adequate or high VA intake and different timing of exposure to VAS, and associations between estimated liver VA concentrations and biomarkers of VA toxicity were examined.MethodsChildren 12–18 mo of age (n = 123) were selected for 3 groups: 1) retinol intake >600 µg/d and VAS within the past mo, 2) retinol intake >600 µg/d and VAS in the past 3–6 mo, and 3) VA intake 200–500 µg retinol activity equivalents (RAE)/d and VAS in the past 3–6 mo. Dietary intake data were collected to measure VA intakes from complementary foods, breast milk, and low-dose, over-the-counter supplements. TBS were assessed by retinol isotope dilution, and VA toxicity biomarkers were measured. Main outcomes were compared by group.ResultsMean (95% CI) VA intakes excluding VAS were 1184 (942, 1426), 980 (772, 1187), and 627 (530, 724) µg RAE/d, in groups 1–3, respectively; mean VA intake was higher in groups 1 and 2 compared with group 3 (P < 0.05). Geometric mean (GM) (95% CI) TBS were 589 (525, 661), 493 (435, 559), and 466 (411, 528) µmol, respectively. GM TBS and GM liver VA concentrations were higher in group 1 compared with group 3 (liver VA concentration: 1.62 vs. 1.33 µmol/g; P < 0.05). Plasma retinyl ester and 4-oxo-retinoic acid concentrations and serum markers of bone turnover and liver damage did not indicate VA toxicity.ConclusionsIn this sample, most children had retinol intakes above the Tolerable Upper Intake Level (UL) and liver VA concentrations above the proposed cutoff for “hypervitaminosis A” (>1 µmol/g liver). There was no evidence of chronic VA toxicity, suggesting that the liver VA cutoff value should be re-evaluated. This trial was registered at www.clinicaltrials.gov as NCT03030339.

On the Effect of Microwave Heating on Quality Characteristics and Functional Properties of Persimmon Juice and Its Residue.

In this study, it was investigated whether integration of microwave-heating into the pretreatment step of persimmon juice processing allows the concomitant production of both functional juice and added-value solid residue from the Diospyros Kaki “Jiro” cultivar. In this direction, persimmon pulp was treated under three different microwave-heating conditions (0.7, 4.2, and 8.4 kJ/g) prior to enzymatic maceration and compared to the non-heated material. Irrespective of microwave energy employed, the proposed hybrid treatment was highly efficient in terms of juice yield (70% w/w). The mildest heating conditions resulted in juice and residue that were both of inferior quality. Intensification of the microwave energy reduced the microbial load of the juice up to 2-log without compromising the content in total soluble solids, sugars, and L-ascorbic acid. Under the most drastic conditions, the juice was enriched in gallic acid, polyphenols, and potent DPPH● scavengers, but its orange color faded and was more acidic. In parallel, the solid juice residue retained pro-vitamin A carotenoids (~278 µg retinol activity equivalents) and low-methoxy pectin (9 g/100 g DW). Overall, our findings can assist the efforts of the local juice processing industry to utilize persimmon fruits through energy-efficient technologies in a sustainable approach.

Findings in 3 clinical trials challenge the accuracy of the Institute of Medicine’s estimated average requirements for vitamin A in children and women

Vitamin A (VA) estimated average requirements (EARs) for women and children are extrapolated from rats and adult males. The retinol isotope dilution (RID) test can sensitively characterize VA status and intake requirements. These studies evaluated current EARs for children 4-8 y and women 19-30 y old. Zambian children (n=133, ages 5-7 y), US women (n=51, ages 19-27 y), and Indonesian women (n=29, ages 19-30 y) were provided diets or supplements containing 30%-155% of VA EARs for 42-90 d. RID was performed before and after the intervention to quantify changes in total body VA stores (TBSs) and total liver VA reserves (TLRs). Linear regression was performed between VA intake and change in TBSs or TLRs. Baseline mean±SD TLRs were hypervitaminotic in Zambian children (1.13±0.41 μmol VA/g liver), optimal in US women (0.46±0.32 μmol/g VA/g liver), and deficient to marginal in Indonesian women (0.10±0.08 μmol VA/g liver). VA intakes, resulting in no change in TBSs or TLRs, were 185 (95% CI: 18, 288) or 257 (95% CI: 124, 411) and 285 or 330 (CIs undefined) μg retinol activity equivalents (RAE)/d in the Zambian and US trials, respectively, but inconclusive in Indonesian women. The regression was not significant in either group of women. Point estimates of VA intakes to maintain stores were below the current EARs of 275 (children) and 500 (women) μg RAE/d despite the TLRs being higher than the EARs were formulated to maintain (i.e., 0.07 μmol VA/g liver). Interventions based on these EARs may need to be scaled back. Lack of change in VA stores in women taking lower doses may result from physiological adaptation resulting in lower VA utilization. Longer, larger, and controlled studies are needed to accurately define EARs for VA.These trials were registered at Clinicaltrials.gov as NCT04123210 and NCT01814891.

Vitamin A–fortified rice increases total body vitamin A stores in lactating Thai women measured by retinol isotope dilution: a double-blind, randomized, controlled trial

Lactating women are at increased risk for vitamin A (VA) deficiency due to demands for breast milk content and limited hepatic stores for women in some countries. Previously, consumption of triple-fortified rice, which included VA, iron, and zinc, successfully improved the VA status of Thai children in whom their total body VA stores (TBSs) were doubled in 2 mo. This study assessed the efficacy of consuming VA-fortified rice, which delivered 500 µg retinol activity equivalents (RAEs)/d, on TBSs and estimated total liver VA reserves (TLRs) in Thai lactating women using the retinol isotope dilution (RID) test. A randomized controlled trial was conducted with 70 lactating women (n=35/group) who received either VA-fortified rice (500 µg RAEs/d) or unfortified rice for 14 wk on weekdays only. Serum retinol concentrations (SRs), C-reactive protein, and TBSs were assessed before and after the intervention. The paired 13C-RID test was used to measure TBSs. After a baseline blood sample, 2.0 µmol [14,15]-13C2-retinyl acetate was administered orally. A follow-up blood sample was drawn 14 d later. The RID test was repeated after the intervention. TBSs increased significantly (P<0.05) in the intervention group from 240 (182, 316) to 331 (251, 447) [geometric means (95% CIs)] µmol retinol, and this change in TBSs was significantly higher (P<0.05) than that in the control group [+52.9 (-74, 453) compared with -4.3 (-106, 275) µmol retinol]. Estimated TLRs indicated a high prevalence of VA deficiency among these lactating women. Initial and final SRs did not differ by group and did not change over the course of the intervention. VA-fortified rice improved the VA status of lactating women by increasing TBSs. A targeted approach to disseminate VA interventions among vulnerable groups should be considered in some contexts. This trial was registered at clinicaltrials.gov as NCT03056625.

Development of a Screening Tool to Estimate Vitamin A Intake and Comparison with Detailed Dietary Assessment Methods

Abstract Objectives We aimed to develop and validate a tool to estimate vitamin A (VA) intake and identify children at risk of intake above the tolerable upper intake level (UL). Methods We developed, pilot-tested, and refined a screening tool to estimate VA intake among Filipino children 12–18 mo of age. Data were entered into tablets with pre-loaded food composition data to calculate VA intake immediately. The screening tool was used to identify children likely to have “adequate” (one group: 200–500 µg retinol activity equivalents, RAE/d) or “high” (two groups: &amp;gt;600 µg retinol/d) intake. Interviewers administered four 24-h recalls, one 12-h observed weighed record with 12-h recall, and a 30-d supplement questionnaire. Breastmilk intake and VA concentration were measured among breastfeeding children. We compared the screening tool and detailed dietary assessment (DDA) results for primary VA sources, group mean usual intake, and prevalence of intakes above the UL. Results Major VA sources were similar between methods: fortified milk powders, multivitamin supplements, and breastmilk; contributions from intervention programs (e.g., micronutrient powders, fortified staple foods) were low. Mean usual retinol intakes for the high groups (n = 47 and 39, respectively) were 1218 and 1313 µg/d by screening tool vs. 1096 and 931 by DDA; 70 and 77% had usual intake above 600 µg/d. In the adequate group (n = 37), mean total VA intake was 375 and 559 µg RAE/d by screening and DDA, respectively. Conclusions This screening tool provides a reasonably good rapid estimate of VA intake among Filipino children and can be useful for identifying groups with adequate to excessive intakes. Funding Sources Bill &amp; Melinda Gates Foundation.

Evaluating Provitamin A Carotenoids and Polar Metabolite Compositions during the Ripening Stages of the Agung Semeru Banana (Musa paradisiaca L. AAB).

Banana cultivars that are rich in provitamin A carotenoids and other nutrients may offer a potential food source to help alleviate vitamin A deficiencies, particularly in developing countries. The local plantain type banana, Agung Semeru (Musa paradisiaca L.), was investigated, in order to analyse the changes in the compositions of the provitamin A carotenoids and metabolite compounds, including the amino acids, organic acids, and sugars, during the ripening stage as this banana is widely processed for food products in either the unripe, ripe, or overripe stages. The bananas that had reached the desired ripening stages were subjected to high-performance liquid chromatography (HPLC) analysis, and the results indicated that the total provitamin A carotenoid concentrations ranged between 4748.83 μg/100 g dry weight (dw) and 7330.40 μg/100 g dw, with the highest level of vitamin A activity at 457.33 ± 5.18 μg retinol activity equivalents (RAE)/100 g dw. Compared to the Cavendish variety, which is consumed worldwide, the Agung Semeru banana had vitamin A activity that was 40 to 90 times higher, dependent on the stage of ripening. The breakdown of the starch during the ripening stages resulted in an increase of its sugar compounds, such as sucrose, fructose, and glucose, as well as its dominant organic acids, such as malic acid, oxalic acid, and citric acid, which were observed using gas chromatography-mass spectrometry (GC-MS) during the ripening stages. The findings of this study show that the Agung Semeru banana is a promising fruit that could be widely produced as a nutritional and energy food resource, due to its high levels of vitamin A activity and sugars.

Modeling the Potential of Fortified Biscuits Too Address Micronutrient Deficiencies Among Preschool Children and Women in Cameroon (P10-116-19)

ObjectivesTo model the impacts of biscuits fortified with micronutrients (MN) on dietary nutrient adequacy among young children and women of reproductive age (WRA) in Cameroon. MethodsIn a nationally-representative survey stratified by macro-region (North, South, and Yaoundé/Douala), 24-h dietary recall data were collected from 843 children 12–59 months and 912 WRA. We simulated total MN intake under various scenarios using observed biscuit intake and addition of different amounts of vitamin A (VA) (200–600 μg Retinol Activity Equivalents (RAE)/100 g), folic acid (46–300 μg/100 g), vitamin B12 (0.74–2 μg/100 g), zinc (2–8 mg/100 g) and iron (5–15 mg/100 g) to biscuits. Usual intake distributions and prevalence of inadequate intake for each scenario were estimated using the National Cancer Institute method. ResultsBiscuits were consumed on the previous day by 11.2% of children nationally (4.5% South, 9.1% North, 20.7% Yaoundé/Douala) and 4.3% of WRA (1.5% South, 5.6% North, 5.9% Yaoundé/Douala). National baseline prevalence ± SE of inadequate intake among children was 59 ± 2% for VA, 49 ± 2% for folate, 85 ± 2% for vitamin B12, 70 ± 2% for iron, and 20–50% for zinc (depending on the cutoff used). Vitamin-fortified biscuits were predicted to have the greatest impact in Yaoundé/Douala, with reductions in inadequate intake of 10.3 percentage points (pp) for VA, 12.3 pp for folate, and 3.7 pp for vitamin B12, in the absence of other fortification programs. When existing programs for VA-fortified oil (12 mg VA/kg) and folic acid-fortified wheat flour (5.0 ppm) were considered in the model, the expected marginal impacts of folic acid and VA-fortified biscuits were reduced substantially for both children and WRA. Iron and zinc fortified biscuits were predicted to have no detectable impact on the prevalence of inadequacy among children and WRA for all fortification doses simulated, either in the presence or in the absence of fortified wheat flour. ConclusionsGiven current patterns of biscuit consumption in Cameroon, biscuit fortification at the modeled levels is unlikely to reduce the population prevalence of inadequate intakes. Fortified biscuits may contribute modestly to dietary adequacy of some nutrients (VA and folate) in the absence of staple food fortification programs, particularly in urban areas. Funding SourcesMars Co., Michael and Susan Dell Foundation, Sight and Life, and Bill & Melinda Gates Foundation.

Dietary vitamin a intake among Chinese adults: findings from CNTCS2015

BackgroundVitamin A plays an important role in human functions, which mainly come from foods. This study aims to examine dietary vitamin A intake and major food sources of Chinese adults.MethodsWe analyzed the cross-sectional data from 12,246 adult aged 18 to 64 years old in 2015 China Nutritional Transition Cohort Study. Three consecutive 24-h dietary recalls combined with household weighing method were used to assess dietary vitamin A intake.ResultsThe average dietary vitamin A intakes were 480.9 μg retinol equivalents (RE) or 307.2 μg retinol activity equivalents (RAE). The carotenes and retinol intake of subjects were 2084.7 μg/day and 133.5 μg/day, respectively. Approximately 87% of adults consumed less vitamin A than the Chinese Estimated Average Requirement (EAR), and only 6% of adults consumed more than Chinese Recommended Nutrient Intake (RNI). Chinese adults derived vitamin A mainly from plant source foods, which is supplied as carotenes (67.4% RE or 56.4% RAE). Dark- and light- vegetables and fruits were major contributors of carotenes (accounted for 84.2%). The most import food sources of retinol were egg, meats and meat products, poultry, fish and milk, representing 94.7% of retinol intake. The major four contributors of total vitamin A (as both RE and RAE) were dark vegetables, egg, light vegetables, and meats and meat products. In conclusion, dietary vitamin A remains a problem for Chinese adults.ConclusionsPublic health actions are needed to increase vitamin A intake in China.

Comparing intake estimations based on food composition data with chemical analysis in Malian women.

Food composition databases are essential for estimating nutrient intakes in food consumption surveys. The present study aimed to evaluate the Mali food composition database (TACAM) for assessing intakes of energy and selected nutrients at population level. Weighed food records and duplicate portions of all foods consumed during one day were collected. Intakes of energy, protein, fat, available carbohydrates, dietary fibre, Ca, Fe, Zn and vitamin A were assessed by: (i) estimating the nutrient intake from weighed food records based on an adjusted TACAM (a-TACAM); and (ii) chemical analysis of the duplicate portions. Agreement between the two methods was determined using the Wilcoxon signed-rank test and Bland-Altman plots. Bamako, Mali. Apparently healthy non-pregnant, non-lactating women (n 36) aged 15-36 years. Correlation coefficients between estimated and analysed values ranged from 0·38 to 0·61. At population level, mean estimated and analysed nutrient intakes differed significantly for carbohydrates (203·0 v. 243·5 g/d), Fe (9·9 v. 22·8 mg/d) and vitamin A (356 v. 246 µg retinol activity equivalents). At individual level, all estimated and analysed nutrient intakes differed significantly; the differences tended to increase with higher intakes. The a-TACAM is sufficiently acceptable for measuring average intakes of macronutrients, Ca and Zn at population level in low-intake populations, but not for carbohydrate, vitamin A and Fe intakes, and nutrient densities.

The potential double-burden of vitamin A malnutrition: under- and overconsumption of fortified table sugar in the Guatemalan highlands.

In Guatemala, population-wide vitamin A fortification of table sugar has been operating for two decades. The objective of this study was to estimate the adequacy of vitamin A intakes in pregnant and lactating women from low-income, urban and rural communities. One or two previous-day dietary recalls were collected in a convenience sample of 234 pregnant and lactating women in the Western Highlands of Guatemala. Estimated daily intakes and main sources of total vitamin A, provitamin A and preformed vitamin A were calculated. Total intakes, adjusted for day-to-day variation, were examined in relation to estimated average requirements (EAR). Median estimated 1-day total vitamin A intake was 1177 μg retinol activity equivalents (RAE) (interquartile range (IQR) 832-1782) in the urban site and 567 μg RAE (IQR 441-737) in the rural site. Women not meeting their status-specific vitamin A requirement were 3.5 times more common in the rural communities (31%) than in the urban confines (9%). In the urban area, 26 women (21%) had preformed vitamin A intakes above 1500 μg on the day of data collection. Preformed vitamin A accounted for a median of 83.9% and 60.9% of the daily total vitamin A intake in the urban and rural sites, respectively. Sugar was the principal source of vitamin A, contributing 512 μg RAE (IQR 343-749) in the urban site and 256 μg RAE (IQR 189-363 μg) in the rural area. The vitamin A contribution from fortified sugar can be a determinant of reaching adequacy; nevertheless, a significant proportion of pregnant and lactating women do not meet the EAR, especially in the rural setting.

Biofortified orange maize is as efficacious as a vitamin A supplement in Zambian children even in the presence of high liver reserves of vitamin A: a community-based, randomized placebo-controlled trial

Background: Biofortification is a strategy to relieve vitamin A (VA) deficiency. Biofortified maize contains enhanced provitamin A concentrations and has been bioefficacious in animal and small human studies.Objective: The study sought to determine changes in total body reserves (TBRs) of vitamin A with consumption of biofortified maize.Design: A randomized, placebo-controlled biofortified maize efficacy trial was conducted in 140 rural Zambian children. The paired 13C-retinol isotope dilution test, a sensitive biomarker for VA status, was used to measure TBRs before and after a 90-d intervention. Treatments were white maize with placebo oil (VA−), orange maize with placebo (orange), and white maize with VA in oil [400 μg retinol activity equivalents (RAEs) in 214 μL daily] (VA+).Results: In total, 133 children completed the trial and were analyzed for TBRs (n = 44 or 45/group). Change in TBR residuals were not normally distributed (P < 0.0001); median changes (95% CI) were as follows: VA−, 13 (−19, 44) μmol; orange, 84 (21, 146) μmol; and VA+, 98 (24, 171) μmol. Nonparametric analysis showed no statistical difference between VA+ and orange (P = 0.34); both were higher than VA− (P = 0.0034). Median (95% CI) calculated liver reserves at baseline were 1.04 (0.97, 1.12) μmol/g liver, with 59% >1 μmol/g, the subtoxicity cutoff; none were <0.1 μmol/g, the deficiency cutoff. The calculated bioconversion factor was 10.4 μg β-carotene equivalents/1 μg retinol by using the middle 3 quintiles of change in TBRs from each group. Serum retinol did not change in response to intervention (P = 0.16) but was reduced with elevated C-reactive protein (P = 0.0029) and α-1-acid glycoprotein (P = 0.0023) at baseline.Conclusions: β-Carotene from maize was efficacious when consumed as a staple food in this population and could avoid the potential for hypervitaminosis A that was observed with the use of preformed VA from supplementation and fortification. Use of more sensitive methods other than serum retinol alone, such as isotope dilution, is required to accurately assess VA status, evaluate interventions, and investigate the interaction of VA status and infection. This trial was registered at clinicaltrials.gov as NCT01814891.

Vitamin A and anthropometric status of South African preschool children from four areas with known distinct eating patterns

ObjectiveThe aim of this study was to assess the vitamin A and anthropometric status of South African preschool children from four areas with known distinct eating patterns. MethodsSerum retinol, anthropometric indicators, and dietary intake were determined for randomly selected preschool children from two rural areas, i.e. KwaZulu-Natal (n = 140) and Limpopo (n = 206); an urban area in the Northern Cape (n = 194); and an urban metropolitan area in the Western Cape (n = 207). ResultsSerum retinol <20 μg/dL was prevalent in 8.2% to 13.6% children. Between 3% (urban-Northern Cape) and 44.2% (rural-Limpopo) children had received a high-dose vitamin A supplement during the preceding 6 mo. Vitamin A derived from fortified bread and/or maize meal ranged from 65 μg retinol activity equivalents (24%–31% of the Estimated Average Requirement) to 160 μg retinol activity equivalents (58%–76% Estimated Average Requirement). Fortified bread and/or maize meal contributed 57% to 59% of total vitamin A intake in rural children, and 28% to 38% in urban children. Across the four areas, stunting in children ranged from 13.9% to 40.9%; and overweight from 1.2% to 15.1%. ConclusionPrevalence of vitamin A deficiency was lower than national figures, and did not differ across areas despite differences in socioeconomics, dietary intake, and vitamin A supplementation coverage. Rural children benefited more from the national food fortification program in terms of vitamin A intake. Large variations in anthropometric status highlight the importance of targeting specific nutrition interventions, taking into account the double burden of overnutrition and undernutrition.

Breast Milk Retinol and Plasma Retinol-Binding Protein Concentrations Provide Similar Estimates of Vitamin A Deficiency Prevalence and Identify Similar Risk Groups among Women in Cameroon but Breast Milk Retinol Underestimates the Prevalence of Deficiency among Young Children1–3

Breast milk vitamin A (BMVA) has been proposed as an indicator of population vitamin A status but has rarely been applied in large-scale surveys or compared with conventional vitamin A biomarkers. We assessed the prevalence of, and risk factors for, low BMVA and its relation to vitamin A intake, plasma retinol-binding protein (pRBP), and markers of inflammation in a national survey in Cameroon. We randomly selected 30 clusters in each of 3 strata (South, North, and Cities). Casual milk samples were collected from approximately 5 women per cluster (n = 440). pRBP, plasma C-reactive protein (pCRP), plasma α1-acid glycoprotein (pAGP), and 24-h vitamin A intake were assessed in 10 women aged 15–49 y and 10 children aged 12–59 mo per cluster, including a subset of lactating women (n = 253). Low BMVA was infrequent: 7.2% (95% CI: 4.7, 9.8) of values were <1.05 μmol/L, and 9.3% (95% CI: 5.8, 12.7) were <8 μg/g fat, consistent with the low prevalence of pRBP <0.78 μmol/L among women (< 5%) but lower than the prevalence of pRBP <0.83 μmol/L among children (35%). Risk factors for both low BMVA and pRBP included living in the North and low maternal education. BMVA was positively associated with inflammation-adjusted pRBP among women in the lowest vitamin A intake tertile [<115 μg retinol activity equivalents (RAEs)/d, P < 0.01] but not in the highest tertile (>644 μg RAEs/d, P > 0.4). Controlling for milk fat, BMVA was negatively associated with pCRP (P < 0.02) but not pAGP (P > 0.5). BMVA and pRBP provide similar estimates of vitamin A deficiency prevalence and identify the same risk groups among women in Cameroon, but BMVA underestimates the prevalence of vitamin A deficiency among young children.

Dietary vitamin A intake below the recommended daily intake during pregnancy and the risk of congenital diaphragmatic hernia in the offspring

Vitamin A has been related to the etiology of congenital diaphragmatic hernia (CDH). We performed a case-control study to investigate whether maternal dietary vitamin A intake is related to CDH in the offspring. Thirty-one pregnancies diagnosed with CDH and 46 control pregnancies were included during the study. After CDH diagnosis and inclusion of controls by risk set sampling, maternal vitamin A intake was investigated with a food frequency questionnaire. Serum retinol and retinol-binding protein were determined. Univariable and multivariable logistic regression models were used to calculate risk estimates with adjustment for potential confounders. We found no significant differences in the overall nutrient and vitamin A intake between case and control mothers. After stratification in body mass index (BMI) categories, case mothers with normal weight showed a lower energy adjusted vitamin A intake (685 vs. 843 μg retinol activity equivalents [RAEs] / day; p = 0.04) and a slightly lower serum retinol (1.58 vs. 1.67 μmol/L; p = 0.08) than control mothers. Vitamin A intake <800 μg retinol activity equivalents (recommended daily intake) in normal weight mothers was associated with a significantly increased CDH risk (odds ratio [OR], 7.2; 95% confidence interval [CI], 1.5-34.4; p = 0.01). Associations were not significantly different in underweight and overweight mothers. In normal-weight mothers, dietary vitamin A intake during pregnancy below the recommended daily intake is significantly associated with an increased risk of a child with CDH. This finding supports the retinoid hypothesis in human CDH, but warrants further investigation in larger study populations. Birth Defects Research (Part A), 2013. © 2013 Wiley Periodicals, Inc.

Vitamin A status of 20- to 59-year-old adults living in Seoul and the metropolitan area, Korea.

Dietary intakes and plasma concentrations of retinol and carotenoids were estimated in assessing the vitamin A status of Korean adults living in Seoul and the metropolitan area. Three consecutive 24-h food recalls were collected from 106 healthy subjects (33 males and 73 females) aged 20-59 years. Fasting blood samples of the subjects were obtained and plasma retinol and carotenoids were analyzed. The daily vitamin A intakes (mean ± SD) were 887.77 ± 401.35 µg retinol equivalents or 531.84 ± 226.42 µg retinol activity equivalents. There were no significant differences in vitamin A intakes among age groups. The retinol intake of subjects was 175.92 ± 129.87 µg/day. The retinol intake of the subjects in their 50's was significantly lower than those in their 20's and 30's (P < 0.05). Provitamin A carotenoid intakes were 3,828.37 ± 2,196.29 µg/day β-carotene, 472.57 ± 316.68 µg/day α-carotene, and 412.83 ± 306.46 µg/day β-cryptoxanthin. Approximately 17% of the subjects consumed vitamin A less than the Korean Estimated Average Requirements for vitamin A. The plasma retinol concentration was 1.22 ± 0.34 µmol/L. There was no significant difference in plasma retinol concentrations among age groups. However, the concentrations of β-carotene, lycopene, and lutein of subjects in their 50's were significantly higher than those of in their 20's. Only one subject had a plasma retinol concentration < 0.70 µmol/L indicating marginal vitamin A status. Plasma retinol concentration in 30% of the subjects was 0.70- < 1.05 µmol/L, which is interpreted as the concentration possibly responsive to greater intake of vitamin A. In conclusion, dietary intakes and status of vitamin A were generally adequate in Korean adults examined in this study.

PHYSICOCHEMICAL, NUTRITIONAL AND MICROBIAL QUALITY OF FRESH‐CUT AND FROZEN PAPAYA PREPARED FROM CULTIVARS WITH VARYING RESISTANCE TO INTERNAL YELLOWING DISEASE

ABSTRACT Quality, nutritional and microbial analyses were completed for fresh‐cut and frozen papaya cubes prepared from cultivars with varying resistance to internal yellowing (IY) disease caused by the bacterium Enterobacter cloacae. In general, fresh‐cut and frozen papaya retained nutritional and microbial quality, but visual and textural quality declined. Fresh‐cut fruit pretreated with 1% calcium lactate solution were firmer than control fruit, but translucency limited the shelf life of cubes dipped in either water or calcium lactate. Vitamin C content averaged 61.5 mg/100 g and 52.2 mg/100 g for fresh‐cut and frozen fruit, respectively. Vitamin A content was greatest in fresh‐cut “Laie Gold” and “Rainbow” fruit, and averaged 35.1 µg retinol activity equivalents per 100 g for all cultivars. Microbial counts were very low or not detectable for most samples. Among the cultivars resistant to IY, “Rainbow” had the highest vitamin A and sugar contents, and did not develop translucency.PRACTICAL APPLICATIONSThis study provides new nutritional information for fresh‐cut and frozen papaya products that can be included in the U.S. Department of Agriculture National Nutrient Database. Also, data on cultivar attributes may assist processors of fresh‐cut or frozen papaya products in choosing the best cultivars by considering appearance, texture, flavor, nutritional content and microbial quality. The selection of papaya cultivars with resistance to internal yellowing disease will allow processors to produce nutritious value‐added products that conform to food safety guidelines.

Dietary intakes of vitamin A and E of Korean adults living in Seoul, Korea

To determine dietary intakes of vitamin A, carotenoids, vitamin E, and tocopherols of Korean adults by gender, 3 consecutive 24‐h food recalls were collected from 108 healthy adults (75 females, 33 males), aged 20–59 y, living in Seoul, Korea. The daily vitamin A intake (mean ± SD) was 893.7 ± 401.3 μg retinol equivalents (RE) or 539.0 ± 233.1 retinol activity equivalents (RAE). Provitamin A carotenoid intakes were 468.8 ± 315.3 μg/d alpha‐carotene, 3817 ± 2184 μg/d beta‐carotene, and 410.9 ± 304.1 μg/d beta‐cryptoxanthin. The daily vitamin E intake was 17.64 ± 14.22 mg alpha‐tocopherol equivalents (ATE), and alpha‐tocopherol was 5.72 ± 5.77 mg/d. There was no significant difference in vitamin A and carotenoid intakes between females and males. The vitamin E and gamma‐tocopherol intakes of males were significantly higher than those of females (p&lt;0.001). Approximately 11% of the subjects consumed &lt;Korean Estimated Average Requirements (EAR) for vitamin A given as μg RE, while 69% consumed &lt;vitamin A EARs for US/Canadians given as μg RAE. Six percent of subjects consumed &lt;Korean Adequate Intakes for vitamin E given as mg ATE, but 98% had &lt;vitamin E EARs for US/Canadians given as mg alpha‐tocopherol. Therefore, the majority of the subjects met the Korean EARs for vitamin A and AIs for vitamin E. Supported by 2009 research fund of National Research Foundation of Korea (20090066047).

Estimation of Antioxidant Intakes from Diet and Supplements in U.S. Adults1–3

The importance of antioxidants in reducing risks of chronic diseases has been well established; however, antioxidant intakes by a free-living population have not yet been estimated adequately. In this study, we aimed to estimate total antioxidant intakes from diets and supplement sources in the U.S. population. The USDA Flavonoid Database, food consumption data, and dietary supplement use data of 8809 U.S. adults aged ≥19 y in NHANES 1999–2000 and 2001–2002 were used in this study. Daily total antioxidant intake was 208 mg vitamin C (46 and 54% from diets and supplements, respectively), 20 mg α-tocopherol (36 and 64), 223 μg retinol activity equivalents carotenes (86 and 14), 122 μg selenium (89 and 11), and 210 mg flavonoids (98 and 2). Antioxidant intakes differed among sociodemographic subgroups and lifestyle behaviors. Energy-adjusted dietary antioxidant intakes were higher in women, older adults, Caucasians, nonconsumers of alcohol (only for vitamin C and carotenes), nonsmokers (only for vitamin C, vitamin E, and carotenes), and in those with a higher income and exercise level (except for flavonoids) than in their counterparts (P < 0.05). Consumption of fruits, vegetables, and whole grains may be a good strategy to increase antioxidant intake. The possible association between antioxidant intake and the prevalence of chronic diseases should be investigated further.

PERSPECTIVES OF PROCESSING PAPAYA (CARICA PAPAYA) FRUIT: NATIONAL AND INTERNATIONAL STRATEGIES

Papaya is a tropical fruit grown more prominently in recent years, production next to fruits such as mango, banana, citrus and pineapple at the global level. Even in India, the fruit is more common with a number of varieties. The fruit is characterise for its active pectinolytic enzymes during ripening. Papain, the proteolytic enzyme is of industrial importance. The fruit is known for its carotenoid content and retinol activity, to counteract vitamin A deficiency. Pro-vitamin A carotenoids average 232 μg beta-carotene and 594 μg beta-cryptoxanthin/100 g and vitamin A ranged from 18 to 74 μg RAE (retinol activity equivalents)/100 g. Lycopene content in the red-fleshed varieties ranged from 1350-3674 μg/100 g. Its vitamin C content is -50 mg/100 g. Because of faster fruit softening consequent to ripening, and the recorded transportation losses up to 40%, the fruit requires conversion into processed products, to ensure extended storage, for transportation, trade and consumption. Juice, blended beverages, jam (including low calorie), jelly, dehydrated, osmo dried, cereal flakes, fruit bar, candy, restructured and intermediate moisture and frozen products could be developed from the fresh fruit, besides minimal processing. The fruit is known to reduce blood cholesterol. The pectin content of the fruit aids in jam preparation and easy setting. Varieties with low sweetness suit the diabetic patients. Because of the mild flavor of the fruit, the products can be supplemented with other strong flavors, to obtain tailor made sensorial products. Its fast growth in nature, higher yields and diverse range of varieties offer papaya fruit for development of economically viable products on commercial scale, with ample scope for blending with other fruits. The biochemical constituents of the fruit related to health benefits and the provision for development of wide spectrum of processed products dictate the scientific merit of the fruit, with national and international strategies for the future.