Retinol Intake Research Articles

Vitamin A nutritional status in high‐ and low‐income postpartum women and its effect on colostrum and the requirements of the term newborn

ObjectiveTo evaluate the vitamin A status in serum and colostrum of postpartum women with different socioeconomic status, comparing the colostrum retinol supply with the vitamin A requirement of the newborn. MethodsCross-sectional study conducted with 424 postpartum women. Vitamin A maternal dietary intake was estimated using a food frequency questionnaire. Colostrum and serum retinol levels were measured by high performance liquid chromatography (HPLC). Serum retinol concentrations <20 μg/dL were indicative of vitamin A deficiency (VAD). Vitamin A levels provided by colostrum <400 μgRAE/day were considered as insufficient for term newborns. ResultsThe mean maternal vitamin A intake during pregnancy was 872.2 ± 639.2 μgRAE/day in low-income women and 1169.2 ± 695.2 μgRAE/day for high-income women (p < 0.005). The prevalence of vitamin A deficiency was 6.9% (n = 18) in the low-income group and 3.7% (n = 6) in the high-income group. The estimated mean retinol intake by infants of the high- and low-income mothers were 343.3 μgRAE/day (85.8% AI) and 427.2 μgRAE/day (106.8% AI), respectively. ConclusionsSerum vitamin A deficiency was considered a mild public health problem in both populations; however, newborns of low‐income women were more likely to receive lower retinol levels through colostrum when compared with newborns of high‐income mothers.

Dietary consumption of antioxidant vitamins and subsequent lung cancer risk: The Japan Public Health Center-based prospective study.

While many epidemiological studies have studied the association between lung cancer risk and fruits and vegetable consumption (the major sources of antioxidant vitamins), only a few have investigated the direct association with antioxidants in consideration of cancer subtypes and smoking status. Here, we examined the association between consumption of antioxidant vitamins and lung cancer risk in one of the largest prospective cohort studies in Japan. We investigated the association of dietary antioxidant vitamins intake, namely retinol, vitamin C, vitamin E, α-carotene, and β-carotene and subsequent incidence of lung cancer among 38,207 men and 41,498 women in the Japan Public Health Center-based prospective study. Cox proportional hazard regression was performed with adjustment for potential confounders and by strata of cancer subtypes and smoking status. Antioxidant and other dietary intakes were assessed using a food frequency questionnaire (FFQ). During 1,233,096 person-years of follow-up between 1995 and 2013, a total of 1,690 lung cancer cases were newly diagnosed. In a multivariate regression model, while higher retinol intake was positively associated with overall lung cancer risk in men (HR 1.26; 95% CI 1.05-1.51; ptrend = 0.003), the estimates were more evident with small cell carcinoma (HR 1.92; 95% CI 1.13-3.24; ptrend < 0.001). Null associations were observed for other antioxidant vitamins. Our prospective study suggests that higher consumption of retinol may be associated with an increased risk of lung cancer in men, especially with small cell carcinoma, although confirmation is required.

Differences in food and nutrient intakes between Australian- and Asian-born women living in Australia: Results from the Australian Longitudinal Study on Women's Health.

To determine differences in food and nutrient intakes between Australian- and Asian-born women living in Australia. Data were obtained from the Australian Longitudinal Study on Women's Health, including 6461 women born in Australia or Asia who completed food frequency questionnaires in 2001 and 2013. Diet was assessed using the Dietary Questionnaire for Epidemiological Studies version 2. Longitudinal generalised estimating-equation modelling was performed to determine the effect of country of birth and survey year on fruit and vegetable intake. Asian-born women ate more cereals, soybeans and fish but less vegetables, legumes, dairy, meat and meat products than Australian-born women both in 2001 and in 2013. Asian-born women ate less cereals, rice and noodles, meat and its products (P < 0.05) in 2013 than in 2001. The earlier people came to Australia, the less their rice and noodle intake per day. However, the reverse was demonstrated regarding vegetable intake. Asian-born women had a lower daily intake of fat, calcium, zinc, thiamin, riboflavin, folate and retinol compared with those born in Australia. Asian-born women living in Australia show different food and nutrient intakes from Australian-born women, although their diets tend to deviate from typical Asian characteristics and approach a Western diet.

Micronutrient Intake Changes With the Low FODMAP and mNICE Diets

Introduction: The role of the low FODMAP (fermentable oligo-, di-, mono-saccharides and polyols) diet has gained increasing acceptance for the treatment of irritable bowel syndrome (IBS) but potential safety concerns have been raised regarding nutritional adequacy. Changes in micronutrient intake with a low FODMAP diet have not been previously investigated. Daily micronutrient intake after 4 weeks of a low FODMAP diet or a modified NICE (mNICE) diet was compared to baseline. Methods: A post-hoc analysis of a single-center, randomized-controlled trial of adult patients with IBS-Diarrhea (IBS-D) was utilized which compared the efficacy of a low FODMAP and the mNICE diets on IBS symptoms over a 4-week period. The Nutrition Data System for Research (NDSR) computer program was used to analyze 3-day food diaries at baseline and at 4 weeks. Results: Data from 78 patients who completed the study were included. 41 patients were randomized to the low FODMAP diet and 37 patients were randomized to the mNICE diet. The average BMI in the low FODMAP group was 27.7 ± 6.5 compared to an average BMI of 31.4 ± 7.9 in the mNICE group (p=0.003). Both diets resulted in fewer daily kilocalories and number of daily meals consumed (Table 1). Among the patients on the low FODMAP diet, a statistically significant decrease from baseline in the daily intake retinol, thiamin, riboflavin, calcium, and trans-fatty acids was observed. There was a statistically significant increase from baseline in the intake of vitamin B6. In the mNICE group, there was a statistically significant decrease in the daily intake of polyunsaturated fatty acids only. The remaining micronutrient differences compared to baseline were not statistically significant.Table: No Caption availableConclusion: During a 4-week dietary intervention, the average daily intake of most micronutrients remained stable and within recommended dietary allowances. A low FODMAP diet was associated with a significantly lower daily intake of retinol, thiamin, riboflavin, calcium, trans-fatty acids, while the daily intake of vitamin B6 was increased. The mNICE diet was associated only with lower daily intake of polyunsaturated fatty acids. While statistically significant, the clinical significance of these findings are unclear and suggest that for a short-term elimination diet, the low FODMAP diet is not associated with major micronutrient inadequacies. These findings reinforce the importance of diversifying a patient's diet through reintroduction of foods containing FODMAPs.

Vitamin A nutritional status in high- and low-income postpartum women and its effect on colostrum and the requirements of the term newborn

ObjectiveTo evaluate the vitamin A status in serum and colostrum of postpartum women with different socioeconomic status, comparing the colostrum retinol supply with the vitamin A requirement of the newborn. MethodsCross-sectional study conducted with 424 postpartum women. Vitamin A maternal dietary intake was estimated using a food frequency questionnaire. Colostrum and serum retinol levels were measured by high performance liquid chromatography (HPLC). Serum retinol concentrations <20μg/dL were indicative of vitamin A deficiency (VAD). Vitamin A levels provided by colostrum <400μgRAE/day were considered as insufficient for term newborns. ResultsThe mean maternal vitamin A intake during pregnancy was 872.2±639.2μgRAE/day in low-income women and 1169.2±695.2μgRAE/day for high-income women (p<0.005). The prevalence of vitamin A deficiency was 6.9% (n=18) in the low-income group and 3.7% (n=6) in the high-income group. The estimated mean retinol intake by infants of the high- and low-income mothers were 343.3μgRAE/day (85.8% AI) and 427.2μgRAE/day (106.8% AI), respectively. ConclusionsSerum vitamin A deficiency was considered a mild public health problem in both populations; however, newborns of low-income women were more likely to receive lower retinol levels through colostrum when compared with newborns of high-income mothers.

The Effect of Vitamin A on Fracture Risk: A Meta-Analysis of Cohort Studies.

This meta-analysis evaluated the influence of dietary intake and blood level of vitamin A (total vitamin A, retinol or β-carotene) on total and hip fracture risk. Cohort studies published before July 2017 were selected through English-language literature searches in several databases. Relative risk (RR) with corresponding 95% confidence interval (CI) was used to evaluate the risk. Heterogeneity was checked by Chi-square and I2 test. Sensitivity analysis and publication bias were also performed. For the association between retinol intake and total fracture risk, we performed subgroup analysis by sex, region, case ascertainment, education level, age at menopause and vitamin D intake. R software was used to complete all statistical analyses. A total of 319,077 participants over the age of 20 years were included. Higher dietary intake of retinol and total vitamin A may slightly decrease total fracture risk (RR with 95% CI: 0.95 (0.91, 1.00) and 0.94 (0.88, 0.99), respectively), and increase hip fracture risk (RR with 95% CI: 1.40 (1.02, 1.91) and 1.29 (1.06, 1.57), respectively). Lower blood level of retinol may slightly increase total fracture risk (RR with 95% CI: 1.11 (0.94, 1.30)) and hip fracture risk (RR with 95% CI: 1.27 (1.05, 1.53)). In addition, higher β-carotene intake was weakly associated with the increased risk of total fracture (RR with 95% CI: 1.07 (0.97, 1.17)). Our data suggest that vitamin A intake and level may differentially influence the risks of total and hip fractures. Clinical trials are warranted to confirm these results and assess the clinical applicability.

Dietary intake of selected nutrients and persistence of HPV infection in men.

Human papillomavirus (HPV) infection is a common sexually transmitted disease. Although often transitory, persistent oncogenic HPV infection may progress to a precursor lesion and, if not treated, can further increase the risk of cancer. The purpose of this study was to investigate the relation between dietary intake and HPV persistent infection in men of a Brazilian cohort. The study population consisted of 1,248 men from the Brazilian cohort of the HIM (HPV in Men) Study, ages 18 to 70 years, who completed a quantitative food frequency questionnaire. U Mann-Whitney test was used to assess differences in median nutrient intake of selected nutrients. The association of dietary intake and persistent HPV infection was assessed in multivariate logistic models. The prevalence of any HPV infection at baseline was 66.6%. Of 1,248 participants analyzed, 1,211 (97.0%) were HPV positive at one or more times during the 4 years of follow-up and 781 (62.6%) were persistently HPV positive. Men with nonpersistent oncogenic HPV infections had higher median intake of retinol (p = 0.008), vitamin A (p < 0.001) and folate (DFE; p = 0.003) and lower median intake of energy (p = 0.005) and lycopene (p = 0.008) in comparison to men with persistent oncogenic infections. No significant association was found between selected nutrients and persistent oncogenic HPV infection. For nononcogenic persistent infections, only vitamin B12 intake was significantly associated (p = 0.003, test for trend). No association was observed between dietary intake and persistent oncogenic-type HPV infection; however, vitamin B12 intake was inversely associated with nononcogenic HPV persistence.

The dietary composition of women who delivered preterm and full-term infants

ObjectivesLiterature data show that excess and primary deficiency in particular nutrients, vitamins and minerals may lead to pre-eclampsia, gestational diabetes, hypertension and neural tube defects in the foetus. The aim of the study was to determine differences in average daily consumption of selected nutrients during pregnancy in women who did not supplement their diet and to evaluate the influence of dietary habits on the occurrence of pre-term delivery and hypertension in pregnant women. Sample group and methodsInformation on the course of pregnancy and the newborn's health status at birth was derived from the Charter of Pregnancy and documents recorded by the hospital. Women's eating habits and dietary composition were analyzed on the basis of a dietary questionnaire. The sample group was divided into four groups: women who delivered neonates appropriate for gestational age (AGA), women with gestosis who delivered AGA neonates by means of caesarean sections, women who delivered pre-term neonates (PTB) and women with gestosis who delivered PTB by means of caesarean sections. ResultsIn the case of women with vaginal delivery at term the average intake of iodine was always higher than in other groups. Analysis of average daily intake of folates revealed a higher intake in the group of women who gave birth to full-term neonates with proper neonatal weight in comparison with the groups of women with pre-term delivery. P≤0.05. ConclusionsStatistically significant differences in average daily intake of folates, iodine, retinol, magnesium and iron were observed between the group of women with vaginal delivery at term and the groups of women with diagnosed hypertension who delivered preterm. Correlation was demonstrated between average daily intake of iodine and vitamin D and the occurrence of arterial hypertension. Supplementation of the diet of women in the preconception and prenatal period with minerals and vitamins should be considered.

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.

Dietary vitamin C intake protects against COPD: the Korea National Health and Nutrition Examination Survey in 2012.

BackgroundVitamin C, as an antioxidant, has recently been suggested to provide protection against COPD; however, only few national cohort studies have investigated these effects. We aimed to confirm the protective effects of vitamin C against COPD in Korean patients.Patients and methodsWe analyzed the data of 3,283 adults aged ≥40 years (representing 23,541,704 subjects) who underwent pulmonary function tests and responded to questionnaires on smoking history and vitamin C intake, with stratification variables and sampling weight designated by the Korea 2012 National Health and Nutrition Examination Survey.ResultsAmong all the subjects, 512 (representing 3,459,679 subjects; 15.6%) were diagnosed as having COPD based on pulmonary function test results. Male gender, old age, residence in suburban/rural regions, low household income, low educational level, an occupation in agriculture or fisheries, and heavy smoking were significantly associated with COPD. Low intake of nutrients, including potassium, vitamin A, carotene, retinol, and vitamin C, was significantly associated with COPD. The prevalence of COPD in heavy smokers with the lowest quartile (Q1, <48.50 mg; 63.0%) and low-middle quartile (Q2, 48.50−84.38 mg; 56.4%) of vitamin C intake was significantly higher than that in subjects with the high-middle quartile (Q3, 84.38−141.63 mg; 29.5%) and highest quartile (Q4, >141.63 mg; 32.6%) of vitamin C intake (P=0.015). In multivariate analysis, male gender, old age, heavy smoking, and a low intake of vitamin C were significant independent risk factors for COPD. A significant reduction of 76.7% in COPD risk was observed with a Q3 vitamin C intake compared to Q1 vitamin C intake (odds ratio, 0.233; 95% confidence interval, 0.094−0.576) in heavy smokers.ConclusionThis large-scale national study suggests that dietary vitamin C provides protection against COPD, independent of smoking history, in the general Korean population.

Associations Between Dietary Intake And Frailty In Older Ethnically Diverse Migrant Women

PURPOSE: Frailty syndrome is a wasting disorder with weight loss commonly used as a proxy measure of inadequate dietary intake in older adults. However, many older adults are overweight/obese, and the absence of weight loss may not be adequately sensitive to identify individuals consuming a poor quality diet and are frail. This is particularly problematic in older ethnically diverse migrant women due to their relatively high rates of overweight/obesity. Our aim was to investigate the association between dietary intake and frailty syndrome in older (>60y) ethnically diverse migrant women (n=60). METHODS: Frailty was defined as meeting two of the following criteria: feelings of exhaustion, low level of accelerometry-measured physical activity (PA), low walking speed, and weakness. 24hr dietary recall was used to estimate daily intakes of energy, protein, retinol, Vitamins D, C, E, folate, Ca, Fe, and Zn; low intake was defined as the lowest quintile of intake in this sample. RESULTS: Twenty-three percent of participants (mean age 70.8±8.0y) were classified as frail. Mean BMI was 29.4±4.8kg/m2; no participant had a BMI indicative of underweight. However, 57.1% reported low intake values of at least 3 nutrients. Weight loss (p=0.3, Fisher’s exact test) and BMI (r= 0.05, p=0.7) were not associated with frailty. Logistic regression indicated that low energy intake was independently associated with frailty (OR:0.08, 95%CI:0.01-0.59). After controlling for low energy intake, low intakes of retinol (OR:0.06, 95%CI:0.006-0.64) and of >3 nutrients were associated with frailty (OR:0.008, 95%CI:0.001-0.41). Percentages of women with low levels of PA and slow walking speed increased with the number of nutrient intakes in the lowest quintile, with only slowness being independently related to frailty (OR:0.005, 95%CI:0.001-0.16). CONCLUSIONS: Low intakes of energy and selected nutrients were common in this sample and were associated with frailty. Due to the higher prevalence of overweight/obesity and related complications in older ethnic minority migrant women, dietary intake may be a better indicator of frailty rather than weight loss and BMI. Funding: The National Council on Science and Technology, Mexico; University of Birmingham Institute for Research Into Superdiversity.

Dietary intake of elderly outpatients with chronic obstructive pulmonary disease

PurposeChronic obstructive pulmonary disease (COPD) is often associated with malnutrition, which is in turn associated with poor outcomes. Accordingly, in COPD patients adequate nutrition might improve several clinical and functional outcomes. Nevertheless, information about nutrient intake of older populations with COPD is still scanty. Materials and methodsWe analysed data of 523 elderly attending a geriatric ambulatory. Of these, 165 had a diagnosis of COPD, while 358 were control participants, matched for demographic characteristics and free from respiratory diseases. COPD was diagnosed according to the global initiative for chronic obstructive lung disease (GOLD) criteria. The intake of micro and macronutrients was recorded using the European prospective investigation into cancer and nutrition (EPIC) questionnaire. Nutrient intake of COPD patients was compared with that of the control group and with recommended dietary allowances RDA. ResultsCOPD patients had a lower energy intake, as compared with control participants (29.4 vs 34.4kcal/kg of ideal weight; P<.0001), due to reduced intake of carbohydrates and proteins. Accordingly, in the energy intake was lower than recommended in 52% of COPD patients, vs 30% of controls (P<.0001). The intake of calcium, potassium, folate, cholecalciferol, retinol, and thiamine was lower than RDA in over 75% of COPD patients. ConclusionsThe diet of elderly COPD outpatients does not provide the recommended energy intake, nor does it meet the RDA for many micronutrients. Such deficits are more severe than in age matched non- respiratory subjects.

High Vitamin C Intake with High Serum β-Cryptoxanthin Associated with Lower Risk for Osteoporosis in Post-Menopausal Japanese Female Subjects: Mikkabi Cohort Study.

Recent epidemiological studies show that antioxidant vitamins and carotenoids might be beneficial to the maintenance of bone health. Recently, we found that serum carotenoids were inversely associated with the risk of developing osteoporosis in post-menopausal Japanese female subjects. However, little is known about the vitamin alone and/or the combination of the vitamin and carotenoid with the risk of osteoporosis. The objective of this study was to investigate longitudinally whether antioxidant vitamins and their combination with carotenoids are associated with the risk of developing of osteoporosis. We conducted a follow-up study on 187 post-menopausal female subjects from the Mikkabi prospective cohort study. Those who participated in previous bone mineral density (BMD) surveys and completed four years of follow-up were examined longitudinally. During a four-year follow-up, fifteen of the post-menopausal female subjects developed new-onset osteoporosis. After adjustment for confounders, the odds ratios (OR) for osteoporosis in the highest tertiles of vitamins C and E and retinol intakes against the lowest tertiles were 0.15 (95% confidence interval (CI): 0.02-0.99), 0.50 (CI: 0.08-3.23), and 1.49 (CI: 0.36-6.22), respectively. Furthermore, a significantly lower odds ratio was observed in the higher vitamin C intake group (169-625 mg/d) with higher serum β-cryptoxanthin (1.88-10.53 μM) against the lower vitamin C intake group (47-168 mg/d) with lower serum β-cryptoxanthin (0.24-1.84 μM) used for the reference group (p<0.05). The combination of β-cryptoxanthin and vitamin C is inversely associated with the risk of developing osteoporosis in post-menopausal Japanese female subjects.

The association between maternal dietary micronutrient intake and neonatal anthropometry - secondary analysis from the ROLO study.

BackgroundMicronutrients are necessary for fetal growth. However increasingly pregnant women are nutritionally replete and little is known about the effect of maternal micronutrient intakes on fetal adiposity in mothers with increased BMI. The aim of this study was to examine the association of maternal dietary micronutrient intake with neonatal size and adiposity in a cohort at risk of macrosomia.MethodsThis was a cohort analysis of 554 infants from the ROLO study. Three day food diaries from each trimester were collected. Neonatal weight, length, circumferences and skinfold thicknesses were measured at birth. Multiple linear regression was used to identify associations between micronutrient intakes and neonatal anthropometry.ResultsBirthweight was negatively associated with maternal trimester 3 vitamin D intake and positively associated with trimester 3 vitamin B12 intake R2adj 19.8 % (F = 13.19, p <0.001). Birth length was positively associated with trimester 3 magnesium intake R2adj 12.9 % (F = 8.06, p <0.001). In terms of neonatal central adiposity; abdominal circumference was positively associated with maternal trimester 3 retinol intake and negatively associated with trimester 3 vitamin E and selenium intake R2adj 11.9 % (F = 2.93, p = 0.002), waist:length ratio was negatively associated with trimester 3 magnesium intake R2adj 20.1 % (F = 3.92, p <0.001) and subscapular:triceps skinfold ratio was negatively associated with trimester 1 selenium intake R2adj7.2 % (F = 2.00, p = 0.047).ConclusionsMaternal micronutrient intake was associated with neonatal anthropometry even in women not at risk of malnutrition. Further research is necessary to determine optimal micronutrient intake in overweight and obese pregnant women.Trial registrationCurrent Controlled Trials ISRCTN54392969.Electronic supplementary materialThe online version of this article (doi:10.1186/s12937-015-0095-z) contains supplementary material, which is available to authorized users.

Determinants of Iron Deficiency Anemia in a Cohort of Children Aged 6-71 Months Living in the Northeast of Minas Gerais, Brazil.

Iron deficiency anemia is one of the most common nutritional disorders worldwide. The aim was to identify the prevalence and incidence of anemia in children and to identify predictors of this condition, including intestinal parasites, social, nutritional and environmental factors, and comorbidities. A population-based cohort study was conducted in a sample of 414 children aged 6–71 months living in Novo Cruzeiro in the Minas Gerais State. Data were collected in 2008 and 2009 by interview and included socio-economic and demographic information about the children and their families. Blood samples were collected for testing of hemoglobin, ferritin and C-reactive protein. Anthropometric measurements and parasitological analyses of fecal samples were performed. To identify risk factors associated with anemia multivariate analyses were performed using the generalized estimating equations (GEE). In 2008 and 2009, respectively, the prevalence rates of anemia were 35.9% (95%CI 31.2–40.8) and 9.8% (95%CI 7.2–12.9), the prevalence rates of iron deficiency were 18.4% (95%CI 14.7–22.6) and 21.8% (95%CI 17.8–26.2), and the incidence rates of anemia and iron deficiency were 3.2% and 21.8%. The following risk factors associated with anemia were: iron deficiency (OR = 3.2; 95%CI 2.0-.5.3), parasitic infections (OR = 1.9; 95%CI 1.2–2.8), being of risk of or being a low length/height-for-age (OR = 2.1; 95%CI 1.4–3.2), and lower retinol intake (OR = 1.7; 95%CI 1.1–2.7), adjusted over time. Nutritional factors, parasitic infections and chronic malnutrition were identified as risk factors for anemia. These factors can be verified in a chronic process and have been classically described as risk factors for these conditions.

Dietary vitamin A intake and bone health in the elderly: the Rotterdam Study.

High vitamin A intake may be associated with a decreased bone mineral density (BMD) and increased risk of fractures. Our objectives were to study whether dietary intake of vitamin A (total, retinol or beta-carotene) is associated with BMD and fracture risk and if associations are modified by body mass index (BMI) and vitamin D. Participants were aged 55 years and older (n=5288) from the Rotterdam Study, a population-based prospective cohort. Baseline vitamin A and D intake was measured by a food frequency questionnaire. BMD was measured by dual-energy X-ray absorptiometry at four visits between baseline (1989-1993) and 2004. Serum vitamin D was assessed in a subgroup (n=3161). Fracture incidence data were derived from medical records with a mean follow-up time of 13.9 years. Median intake of vitamin A ranged from 684 retinol equivalents (REs)/day (quintile 1) to 2000 REs/day (quintile 5). After adjustment for confounders related to lifestyle and socioeconomic status, BMD was significantly higher in subjects in the highest quintile of total vitamin A (mean difference in BMD (95% confidence interval (CI))=11.53 (0.37-22.7) mg/cm(2)) and retinol intake (mean difference in BMD (95% CI)=12.57 (1.10-24.05) mg/cm(2)) than in the middle quintile. Additional adjustment for BMI diluted these associations. Fracture risk was reduced in these subjects. Significant interaction was present between intake of retinol and overweight (BMI >25 kg/m(2)) in relation to fractures (P for interaction =0.05), but not BMD. Stratified analysis showed that these favourable associations with fracture risk were only present in overweight subjects (BMI >25 kg/m(2)). No effect modification by vitamin D intake or serum levels was observed. Our results suggest a plausible favourable relation between high vitamin A intake from the diet and fracture risk in overweight subjects, whereas the association between vitamin A and BMD is mainly explained by BMI.

Changes in dietary intake during puberty and their determinants: results from the GINIplus birth cohort study.

BackgroundUnderstanding changes in dietary intake during puberty could aid the mapping of dietary interventions for primary prevention. The present study describes dietary changes from childhood to adolescence, and their associations with parental education, family income, child education, body mass index (BMI), pubertal onset and screen-time sedentary behaviour.MethodsDietary data (n = 1232) were obtained from food frequency questionnaires at the 10- and 15-year follow-ups of the GINIplus birth cohort study. Intakes of 17 food groups, macronutrients and antioxidant vitamins, were described by a) paired Wilcoxon rank sum tests, comparing average intakes at each time-point, and b) Cohen’s kappa “tracking” coefficients, measuring stability of intakes (maintenance of relative tertile positions across time). Further, associations of changes (tertile position increase or decrease vs. tracking) with parental education, family income, child education, pubertal onset, BMI, and screen-time, were assessed by logistic regression and multinomial logistic regression models stratified by baseline intake tertile.ResultsBoth sexes increased average intakes of water and decreased starchy vegetables, margarine and dairy. Females decreased meat and retinol intakes and increased vegetables, grains, oils and tea. Males decreased fruit and carbohydrates and increased average intakes of meat, caloric drinks, water, protein, fat, polyunsaturated fatty acids (PUFAs), vitamin C and alpha-tocopherol. Both sexes presented mainly “fair” tracking levels [κw = 0.21–0.40]. Females with high (vs. low) parental education were more likely to increase their nut intake [OR = 3.8; 95 % CI = (1.7;8.8)], and less likely to decrease vitamin C intakes [0.2 (0.1;0.5)], while males were less likely to increase egg consumption [0.2 (0.1;0.5)] and n3 PUFAs [0.2 (0.1;0.5)]. Females with a higher (vs. low) family income were more likely to maintain medium wholegrain intakes [0.2 (0.1;0.7) for decrease vs. tracking, and 0.1 (0.0;0.5) for increase vs. tracking], and were less likely to decrease vitamin C intakes [0.2 (0.1;0.6)]. Males with high education were less likely to increase sugar-sweetened foods [0.1 (0.1;0.4)]. Finally, BMI in females was negatively associated with decreasing protein intakes [0.7 (0.6;0.9)]. In males BMI was positively associated with increasing margarine [1.4 (1.1;1.6)] and vitamin C intakes [1.4 (1.1;1.6)], and negatively associated with increasing n3 PUFA.ConclusionsAverage dietary intakes changed significantly, despite fair tracking levels, suggesting the presence of trends in dietary behaviour during puberty. Family income and parental education predominantly influenced intake changes. Our results support the rationale for dietary interventions targeting children, and suggest that sex-specific subpopulations, e.g. low socio-economic status, should be considered for added impact.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2189-0) contains supplementary material, which is available to authorized users.

Short communication: Effect of conjugated linoleic acid on concentrations of fat-soluble vitamins in milk of lactating ewes

Conjugated linoleic acids (CLA) are well known as milk fat-reducing feed supplements in diets for lactating ruminants. However, their effects on milk concentrations of fat-soluble vitamins are unknown. This study was performed to investigate the hypothesis that CLA affect the concentrations of retinol and tocopherol in ewe milk. For that purpose, group-housed Merino ewes (101±13.7kg) nursing twin lambs and fed with a hay:concentrate diet were supplemented with either 45g of a rumen-protected CLA supplement containing 3.4g of cis-9,trans-11-CLA and 3.4g of trans-10,cis-12-CLA (CLA group, n=11) or with 45g of a hydrogenated vegetable fat (control group, n=12) per ewe per day during the first 6 wk of lactation. Feed intake was recorded daily (concentrate) or weekly (hay) per group. Milk spot samples were collected at the beginning of the experiment (5±2.4 d postpartum) and then weekly after lambs had been separated for 2 h from their mothers. The milk fat content was determined and feed and milk were analyzed for concentrations of α-, γ-, and δ-tocopherol and for retinol by HPLC. Dietary intake of tocopherol and retinol was similar in both groups. Feeding CLA decreased milk fat concentration by 23% on average, and during the first 3 wk of the study milk tocopherol concentration tended to be increased by feeding CLA (+17%), but retinol concentrations were not influenced. When related to milk fat, CLA feeding significantly increased both milk tocopherol (+40%) and retinol (+32%) and these effects were evident during the whole experimental period corresponding to the first half of lactation.

Cardiovascular calcification and bone: a comparison of the effects of dietary and serum antioxidants

&lt;p&gt;Severe cardiovascular (CV) calcification can manifest as fully formed bone and is regularly found with osteoporosis; both have been shown to be associated with oxidative stress. Studies of the effect of antioxidants on CV calcification are few, but show that deficiency can induce both CV calcification and bone loss, while in conditions of oxidative stress such as renal failure, diabetes and smoking or in osteoporosis and fracture, antioxidants can reduce CV calcification and improve bone. The benefit of antioxidants in healthy adults is less clear and some may be detrimental. Higher intake of &lt;em&gt;α&lt;/em&gt;-tocopherol (105.5mg/d vs 76.4mg/d) and β-cryptoxanthin may increase risk of CV calcification while high intake of retinol (≥3000mcg/d) may increase hip fracture risk, although possibly only with vitamin D intake ≤440IU/d; the carotenoids lycopene and β-carotene, however, appear beneficial in bone. Vitamin C shows little effect on CV calcification, although longer term supplementation may improve bone mineral density where calcium intake is &amp;gt;500mg/d. Potential reasons for this include a U-shaped dose/response curve for the fat-soluble antioxidants vitamins A and E (with peak bone mass achieved with retinol intake of 600–840 mcg/d), a failure to measure baseline concentrations so that the response cannot be stratified by requirement, the need to be replete in calcium and vitamin D and supplementation of the wrong isomer of vitamin E. Finally, although little studied, tocotrienols, tocopherols (with the exception of α-tocopherol), resveratrol, epigallocatechin gallate, quercetin, α-lipoic acid and N-acetylcysteine may be effective in both the CV system and bone. &lt;/p&gt;

Immediate effects of retinoic acid on gene expression in primary murine osteoblasts.

Consistent with clinical observations demonstrating that hypervitaminosis A is associated with increased skeletal fracture risk, we have previously found that dietary retinol deprivation partially corrects the bone mineralization defects in a mouse model of X-linked hypophosphatemic rickets. That retinol-dependent signaling pathways impact the skeleton is further supported by various findings demonstrating a negative influence of retinoic acid (RA) on bone-forming osteoblasts. We hypothesized that RA would directly regulate the expression of specific target genes in osteoblasts, and we aimed to identify these by genome-wide expression analyses. Here we show that high dietary retinol intake in mice causes low bone mass associated with increased osteoclastogenesis and decreased osteoblastogenesis, but intact bone matrix mineralization. We additionally found that short-term treatment of primary osteoblasts with RA causes a rapid induction of specific genes involved in either retinol-dependent signaling (i.e. Rara, Crabp2) or skeletal remodeling (i.e. Twist2, Tnfsf11). In contrast, neither expression of established osteoblast differentiation markers nor the proliferation rate was immediately affected by RA administration. Collectively, our data suggest that the negative effects of vitamin A on skeletal integrity are explainable by an immediate influence of RA signaling on specific genes in osteoblasts that in turn influence bone remodeling.