1
|
Green MH, Lopez-Teros V, Avila-Prado J, Green JB. Use of Theoretical Women and Model-Based Compartmental Analysis to Evaluate the Impact of Vitamin A Intake with or without a Daily Vitamin A Supplement on Vitamin A Total Body Stores and Balance During Lactation. J Nutr 2024; 154:2374-2380. [PMID: 38857673 DOI: 10.1016/j.tjnut.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/29/2024] [Accepted: 06/05/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Inadequate vitamin A (VA) intake is common among lactating women in many communities worldwide, but high-dose VA supplementation for postpartum women is not recommended by the World Health Organization as an effective intervention. OBJECTIVES To simulate the impact of VA intake via diet and daily VA supplements on VA total body stores (TBS) and balance in theoretical lactating women with low/moderate TBS. METHODS We studied 6 theoretical subjects with assigned values for TBS from 219-624 μmol. Using Simulation, Analysis, and Modeling software and a previously published compartmental model for whole-body VA metabolism, we simulated TBS over 6 mo of established lactation for each subject under 4 conditions: 1) prelactation VA intake was increased to maintain VA balance (LSS); 2) prelactation VA intake was maintained (NLSS); 3) VA intake was the same as 2) but a daily VA supplement (2.8 μmol/d) was added (NLSS+S); and 4) VA intake was as 1) and the daily VA supplement was included (LSS+S). RESULTS To compensate for the loss of VA via milk while VA balance was maintained (LSS) over 6 mo of lactation, VA intake had to increase by 0.8-1.87 μmol/d (n = 6) compared with NLSS. Over 6 mo of NLSS treatment, VA balance was negative (geometric mean, -0.77 μmol/d) compared with LSS, whereas balance was positive under NLSS+S and LSS+S conditions (0.75 and 1.5 μmol/d, respectively). For LSS, the proportion of total VA disposal was 37% via breastmilk, 32% from VA stores, and 32% from nonstorage tissues. CONCLUSIONS Adding a daily VA supplement (2.8 μmol/d) to the diet of lactating women with suboptimal VA intake may effectively counterbalance the negative VA balance resulting from the output of VA via breastmilk and thus benefit both mother and infant by maintaining or increasing VA stores and breastmilk VA concentration.
Collapse
Affiliation(s)
- Michael H Green
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States
| | - Veronica Lopez-Teros
- Department of Chemical and Biological Sciences, Universidad de Sonora, Hermosillo, Sonora, Mexico.
| | - Jessica Avila-Prado
- Department of Chemical and Biological Sciences, Universidad de Sonora, Hermosillo, Sonora, Mexico
| | - Joanne Balmer Green
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States
| |
Collapse
|
2
|
Buzigi E, Pillay K, Siwela M, Mkhwanazi B, Ngidi M, Ssozi J, Mahinda BM, Isingoma EB. Lactating mothers' perceptions and sensory acceptability of a provitamin A carotenoid-iron-rich composite dish prepared from iron-biofortified common bean and orange-fleshed sweet potato in rural western Uganda. Food Sci Nutr 2024; 12:3949-3963. [PMID: 38873437 PMCID: PMC11167192 DOI: 10.1002/fsn3.4053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/10/2024] [Accepted: 02/14/2024] [Indexed: 06/15/2024] Open
Abstract
Uganda's lactating mothers are vulnerable to deficiencies of vitamin A and iron because they consume plant-based conventional foods such as white-fleshed sweet potato (WFSP) and non-iron biofortified common bean (NIBCB) that are low in provitamin A (PVA) and iron, respectively. A PVA carotenoid-iron-rich dish was prepared from a combination of orange-fleshed sweet potato (OFSP) and iron-biofortified common bean (IBCB). This study evaluated the perceptions and sensory acceptability of OFSP+IBCB (test food) against WFSP+NIBCB (control food) among lactating mothers in rural Uganda. A total of 94 lactating mothers participated in the study. The sensory attributes (taste, color, aroma, texture, and general acceptability) of test and control foods were rated using a five-point facial hedonic scale (1 = dislike very much, 2 = dislike, 3 = neutral, 4 = like 5 = like very much). An attribute was acceptable if the participant scored from like to like very much. Focus group discussions (FGDs) were conducted to assess participant perceptions about their future consumption of OFSP+IBCB. The chi-square test was used to detect the proportion difference for each sensory attribute between OFSP+IBCB and WFSP+NIBCB, while FGD data were analyzed by thematic analysis. Taste, color, and aroma were acceptable to the mothers and not significantly different between OFSP+IBCB and WFSP+NIBCB (p > .05). Participants had positive perceptions of the taste, aroma, and color of the OFSP+IBCB and negative perceptions about the soft texture of OFSP. The lactating mothers had positive perceptions of consuming OFSP+IBCB provided they were accessible, affordable, and feasible to prepare.
Collapse
Affiliation(s)
- Edward Buzigi
- Department of Community Health & Behavioural SciencesSchool of Public Health, College of Health Sciences, Makerere UniversityKampalaUganda
- Department of Dietetics and Human NutritionSchool of Agricultural, Earth and Environmental Sciences, University of KwaZulu‐NatalPietermaritzburgSouth Africa
- Department of Public Health & NutritionFaculty of Health Sciences Victoria UniversityKampalaUganda
| | - Kirthee Pillay
- Department of Dietetics and Human NutritionSchool of Agricultural, Earth and Environmental Sciences, University of KwaZulu‐NatalPietermaritzburgSouth Africa
| | - Muthulisi Siwela
- Department of Dietetics and Human NutritionSchool of Agricultural, Earth and Environmental Sciences, University of KwaZulu‐NatalPietermaritzburgSouth Africa
| | - Blessing Mkhwanazi
- Department of Dietetics and Human NutritionSchool of Agricultural, Earth and Environmental Sciences, University of KwaZulu‐NatalPietermaritzburgSouth Africa
| | - Mjabuliseni Ngidi
- Department of Dietetics and Human NutritionSchool of Agricultural, Earth and Environmental Sciences, University of KwaZulu‐NatalPietermaritzburgSouth Africa
| | - Joshua Ssozi
- Department of Public Health & NutritionFaculty of Health Sciences Victoria UniversityKampalaUganda
| | - Babra Muhindo Mahinda
- Department of Public Health & NutritionFaculty of Health Sciences Victoria UniversityKampalaUganda
| | | |
Collapse
|
3
|
Eyeberu A, Getachew T, Tiruye G, Balis B, Tamiru D, Bekele H, Abdurke M, Alemu A, Dessie Y, Shiferaw K, Debela A. Vitamin A deficiency among pregnant women in Ethiopia: a systematic review and meta-analysis. Int Health 2023; 15:630-643. [PMID: 37264928 PMCID: PMC10629954 DOI: 10.1093/inthealth/ihad038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 01/21/2023] [Accepted: 05/12/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Vitamin A deficiency (VAD) during pregnancy is a public health challenge in low-income countries. There are inconsistent findings that can affect policy in planning appropriate intervention. This systematic review and meta-analysis were conducted to summarize the evidence in order to identify existing gaps and propose strategies to reduce VAD during pregnancy in Ethiopia. METHODS This study included published and unpublished observational studies searched from different databases (PubMed, CINHAL [EBSCO], Embase, Google Scholar, Directory of Open Access Journals, Web of Sciences, MEDLINE, Cochrane Library, Scopus, Google Search and MedNar). Statistical analysis was conducted using Stata version 14 software. Heterogeneity and publication bias were assessed. Forest plots were used to present the pooled prevalence using the random effects model. RESULTS A total of 37 618 pregnant women from 15 studies were included. The overall pooled prevalence of VAD was 29% (95% confidence interval 21 to 36) with I2=99.67% and p<0.001. Socio-economic and sociodemographic factors were identified as affecting vitamin A deficiencies among pregnant women. CONCLUSIONS Nearly one-third of pregnant women in Ethiopia had VAD. Strengthening intervention modalities that aimed to increase the uptake of vitamin A-rich foods can avert VAD among pregnant women in Ethiopia.
Collapse
Affiliation(s)
- Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Getahun Tiruye
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawit Tamiru
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Habtamu Bekele
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohommed Abdurke
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kasiye Shiferaw
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Debela
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| |
Collapse
|
4
|
Lin K, Chern S, Sun J. Mapping the quality of prenatal and postnatal care and demographic differences on child mortality in 26 low to middle-income countries. World J Pediatr 2023; 19:835-850. [PMID: 36705781 DOI: 10.1007/s12519-022-00668-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 11/30/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Closing the gap between child mortality in low- and middle-income countries (LMICs) and high-income countries is a priority set by the WHO in sustainable development goals (SDGs). We aimed to examine poor nutrition and prenatal and postnatal care that could increase the risk of child mortality in LMICs. METHODS The Demographic and Health Survey (DHS) was used to examine data from 26 countries to compare prenatal, postnatal, nutritional, and demographic factors across LMICs. Outcome of child death was classified into death before one month of age, between 1 to 11 months, between one to two years, between three to five years, and overall death before five years. Chi-square analyses identified differences in prenatal care, postnatal care, nutrition, and demographic factors between children who died and those who survived. Logistic regression identified factors that increased child mortality risk. RESULTS The majority of deaths occurred before the ages of one month and one year. Considerably poorer quality of prenatal care, postnatal care, and nutrition were found in low-income and low-middle-income countries in the contemporary 2020s. High child mortality and poor quality of prenatal and postnatal care coincide with low income. Children in LMICs were exposed to less vitamin A-rich foods than children in higher-middle-income countries. The use of intestinal parasite drugs and the absence of postpartum maternal vitamin A supplementation significantly increased child mortality risk. Significant socio-demographic risk factors were associated with an increased mortality rate in children, including lack of education, maternal marital status, family wealth index, living rurally, and financial problems hindering access to healthcare. CONCLUSIONS Poor nutrition remains a vital factor across all LMICs, with numerous children being exposed to foods low in iron and vitamin A. Significantly, most deaths occur in neonates and infants, indicating an urgent need to address risk factors associated with early child death.
Collapse
Affiliation(s)
- Kelly Lin
- School of Medicine and Dentistry, Griffith University, Parkland Drive, Gold Coast, QLD, 4215, Australia
| | - Serena Chern
- School of Medicine and Dentistry, Griffith University, Parkland Drive, Gold Coast, QLD, 4215, Australia
| | - Jing Sun
- School of Medicine and Dentistry, Griffith University, Parkland Drive, Gold Coast, QLD, 4215, Australia.
- Institute for Integrated and Intelligent Systems, Griffith University, Gold Coast, 4222, Australia.
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| |
Collapse
|
5
|
Bezerra DS, de Melo ATA, de Oliveira KCDAN, de Araújo KQMA, Medeiros MSMDF, dos Santos FAPS, Medeiros JFP, Lima MSR, da Silva AGCL, Ribeiro KDDS, Dimenstein R, Osório MM. Breast Milk Retinol Levels after Vitamin A Supplementation at Different Postpartum Amounts and Intervals. Nutrients 2022; 14:3570. [PMID: 36079825 PMCID: PMC9460635 DOI: 10.3390/nu14173570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/16/2022] [Accepted: 08/24/2022] [Indexed: 11/16/2022] Open
Abstract
Maternal vitamin A (VA) supplementation in risk areas for Vitamin A deficiency (VAD) was launched to improve the level of this nutrient in nursing mothers and in their breast milk. This longitudinal and randomized study aimed to evaluate the levels of retinol in breast milk after supplementation with VA in varying amounts (200,000 IU or 400,000 IU) and different postpartum intervals. Women were distributed into four intervention groups and given a single 200,000 IU postnatal dosage of VA at time 0 h (postnatal morning) (G200 0H); a single 200,000 IU dosage of VA in week four (G200 4W); 200,000 IU of VA at time 0 h + 200,000 IU of VA 24 h after the first supplementation (G400 24H); and 200,000 IU of VA at time 0 h + 200,000 IU of VA one week after the first supplementation (G400 1W). Breast milk samples were collected over a 12-week period (0 h, 24 h and 1, 4, 12 weeks post-natal). Retinol levels were determined by high-performance liquid chromatography. The Generalized Estimated Equation (GEE) assessed the different retinol levels. The G200 (0H), G400 (24H), and G400 (1W) groups presented higher retinol levels at 24 h than the G200 (4W) group (p < 0.001). The retinol levels of all groups were similar at times 1, 4 and 12 weeks after delivery (p > 0.05). Maternal VA supplementation increased retinol levels in the colostrum. Different supplementation dosages or postpartum administration times did not result in added benefit to retinol levels in mature breast milk.
Collapse
Affiliation(s)
- Danielle S. Bezerra
- Department of Nutrition, School of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz 59200-000, Brazil
| | - Andressa T. A. de Melo
- Postgraduate Program in Nutrition, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil
| | | | | | | | | | - Jeane F. P. Medeiros
- Department of Health Sciences, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil
| | - Mayara S. R. Lima
- Postgraduate Program in Biochemistry, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil
| | | | | | - Roberto Dimenstein
- Postgraduate Program in Nutrition, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil
| | - Mônica M. Osório
- Postgraduate Program in Nutrition, Federal University of Pernambuco, Recife 50670-901, Brazil
| |
Collapse
|
6
|
Lopez-Teros V, Green MH, Avila-Prado J, Green JB. Development of a Compartmental Model for Studying Vitamin A Kinetics and Status in Theoretical Lactating Women. J Nutr 2022; 152:1621-1628. [PMID: 35349703 DOI: 10.1093/jn/nxac078] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/18/2022] [Accepted: 03/23/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Low vitamin A status and suboptimal milk vitamin A concentrations are problems in many populations worldwide. However, limited research has been done on whole-body vitamin A kinetics in women of reproductive age, especially during lactation. OBJECTIVES Goals were to develop compartmental models describing retinol kinetics in theoretical nonlactating (NL) and lactating (L) women and to determine whether the retinol isotope dilution (RID) method accurately predicted vitamin A total body stores (TBS) in the groups and individuals. METHODS We adapted 12 previously-used theoretical females with assigned values for retinol kinetic parameters and TBS (225-1348 μmol); subjects were NL or L (nursing one 3- to 6-mo-old infant) during 49-d kinetic studies after isotope dosing. We used an established compartmental model, adding a compartment for chylomicrons and, for L, another for mammary gland milk with inputs from holo-retinol-binding protein and chylomicron retinyl esters and output to milk. Using compartmental analysis, we simulated tracer responses in compartments of interest and calculated TBS using the RID equation TBS = FaS/SAp [Fa, fraction of dose in stores; S, retinol specific activity in plasma/specific activity in stores; SAp, specific activity of retinol in plasma]. RESULTS Models for both groups were well identified. Simulated plasma tracer responses were similar for NL and L, with L always below NL; milk tracer paralleled plasma from 10 d postdosing. Geometric mean FaS ratios (L/NL) were ∼0.75 during days 2-30. Using appropriate group FaS, RID provided accurate TBS predictions for >80% of NL and L subjects after day 18 when CV% for FaS was ∼10%. CONCLUSIONS These new physiologically-based models for vitamin A kinetics may be useful for future research in women of reproductive age. Results indicate that, in groups like these, RID to assess an individual's vitamin A status should be done at 21-28 d after isotope dosing.
Collapse
Affiliation(s)
- Veronica Lopez-Teros
- Department of Chemical and Biological Sciences, University of Sonora, Hermosillo, Mexico
| | - Michael H Green
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
| | - Jessica Avila-Prado
- Department of Chemical and Biological Sciences, University of Sonora, Hermosillo, Mexico
| | - Joanne B Green
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
| |
Collapse
|
7
|
Johnson CM, Rosario R, Brito A, Agrawal K, Fanter R, Lietz G, Haskell M, Engle-Stone R, Newman JW, La Frano MR. Multi-assay nutritional metabolomics profiling of low vitamin A status versus adequacy is characterized by reduced plasma lipid mediators among lactating women in the Philippines: A pilot study. Nutr Res 2022; 104:118-127. [DOI: 10.1016/j.nutres.2022.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 05/16/2022] [Accepted: 05/20/2022] [Indexed: 01/08/2023]
|
8
|
Plasma Retinoid Concentrations Are Altered in Pregnant Women. Nutrients 2022; 14:nu14071365. [PMID: 35405978 PMCID: PMC9002937 DOI: 10.3390/nu14071365] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/18/2022] [Indexed: 11/22/2022] Open
Abstract
Vitamin A is vital to maternal–fetal health and pregnancy outcomes. However, little is known about pregnancy associated changes in maternal vitamin A homeostasis and concentrations of circulating retinol metabolites. The goal of this study was to characterize retinoid concentrations in healthy women (n = 23) during two stages of pregnancy (25–28 weeks gestation and 28–32 weeks gestation) as compared to ≥3 months postpartum. It was hypothesized that plasma retinol, retinol binding protein 4 (RBP4), transthyretin and albumin concentrations would decline during pregnancy and return to baseline by 3 months postpartum. At 25–28 weeks gestation, plasma retinol (−27%), 4-oxo-13-cis-retinoic acid (−34%), and albumin (−22%) concentrations were significantly lower, and all-trans-retinoic acid (+48%) concentrations were significantly higher compared to ≥3 months postpartum in healthy women. In addition, at 28–32 weeks gestation, plasma retinol (−41%), retinol binding protein 4 (RBP4; −17%), transthyretin (TTR; −21%), albumin (−26%), 13-cis-retinoic acid (−23%) and 4-oxo-13-cis-retinoic acid (−48%) concentrations were significantly lower, whereas plasma all-trans-retinoic acid concentrations (+30%) were significantly higher than ≥3 months postpartum. Collectively, the data demonstrates that in healthy pregnancies, retinol plasma concentrations are lower, but all-trans-retinoic acid concentrations are higher than postpartum.
Collapse
|
9
|
Choobdar FA, Ghassemzadeh M, Aslanbeigi F, Attarian M, Robatmeili L, Rahimian H, Aski BH, Anari AM. Association of lower vitamin a levels in neonates and their mothers with increased risk of neonatal late-onset sepsis: A case-control study. JOURNAL OF MOTHER AND CHILD 2022; 26:78-86. [PMID: 36803946 PMCID: PMC10032317 DOI: 10.34763/jmotherandchild.20222601.d-22-00023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 12/02/2022] [Indexed: 02/23/2023]
Abstract
BACKGROUND In developing countries, neonatal sepsis is one of the major causes of mortality and morbidity. Vitamin A deficiency also affects the immune system severely and is associated with various neonatal infections. We aimed to compare maternal and neonatal vitamin A levels among neonates with and without late-onset sepsis. MATERIAL AND METHODS 40 eligible infants were entered into this case-control study according to inclusion criteria. The case group included 20 term or near-term infants who had late-onset neonatal sepsis from three to seven days of life. The control group consisted of 20 term or near-term infants who were icteric hospitalized neonates without sepsis. Demographic, clinical and paraclinical features, as well as neonatal and maternal vitamin A levels, were compared between the two groups. RESULTS The average gestational age of the neonates was 37.1 ± 1.2, ranging from 35 to 39 days. There was a significant difference between the septic and non-septic groups in terms of white blood cell and neutrophil count, C-reactive protein, and neonatal and maternal vitamin A levels. A Spearman correlation analysis showed a significant direct correlation among maternal and neonatal vitamin A levels (correlation coefficient = 0.507; P-value = 0.001). Multivariate regression analysis showed that neonates' vitamin A level had a significant direct association with sepsis (OR: 0.541; P-value=0.017). CONCLUSION Our findings demonstrated the association of lower vitamin A levels in neonates and their mothers with an increased risk of late-onset sepsis, which emphasizes the importance of the consideration of vitamin A level evaluation and its appropriate neonatal and maternal supplementation.
Collapse
Affiliation(s)
- Farhad Abolhasan Choobdar
- Department of Pediatrics, School of Medicine, Hazrat e Ali Asghar Pediatric Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Maral Ghassemzadeh
- Dr.Shariati general Hospital, Tehran University of Medical Sciences, Jalal Al-Ahmad Ave, Tehran, Iran
| | | | - Mohammad Attarian
- Firoozgar General Hospital related to Iran University of Medical SciencesKashan, Iran
| | - Leila Robatmeili
- Firoozgar General Hospital related to Iran University of Medical SciencesKashan, Iran
| | - Hanie Rahimian
- Firoozgar General Hospital related to Iran University of Medical SciencesKashan, Iran
| | - Behzad Haghighi Aski
- Department of Pediatrics, School of Medicine, Hazrat e Ali Asghar Pediatric Hospital, Iran University of Medical Sciences, Kashan, Iran
| | - Ali Manafi Anari
- Department of Pediatrics, School of Medicine, Hazrat e Ali Asghar Pediatric Hospital, Iran University of Medical Sciences, Kashan, Iran
| |
Collapse
|
10
|
Sajovic J, Meglič A, Glavač D, Markelj Š, Hawlina M, Fakin A. The Role of Vitamin A in Retinal Diseases. Int J Mol Sci 2022; 23:1014. [PMID: 35162940 PMCID: PMC8835581 DOI: 10.3390/ijms23031014] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 12/24/2022] Open
Abstract
Vitamin A is an essential fat-soluble vitamin that occurs in various chemical forms. It is essential for several physiological processes. Either hyper- or hypovitaminosis can be harmful. One of the most important vitamin A functions is its involvement in visual phototransduction, where it serves as the crucial part of photopigment, the first molecule in the process of transforming photons of light into electrical signals. In this process, large quantities of vitamin A in the form of 11-cis-retinal are being isomerized to all-trans-retinal and then quickly recycled back to 11-cis-retinal. Complex machinery of transporters and enzymes is involved in this process (i.e., the visual cycle). Any fault in the machinery may not only reduce the efficiency of visual detection but also cause the accumulation of toxic chemicals in the retina. This review provides a comprehensive overview of diseases that are directly or indirectly connected with vitamin A pathways in the retina. It includes the pathophysiological background and clinical presentation of each disease and summarizes the already existing therapeutic and prospective interventions.
Collapse
Affiliation(s)
- Jana Sajovic
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000 Ljubljana, Slovenia
| | - Andrej Meglič
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000 Ljubljana, Slovenia
| | - Damjan Glavač
- Department of Molecular Genetics, Institute of Pathology, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Špela Markelj
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000 Ljubljana, Slovenia
| | - Marko Hawlina
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000 Ljubljana, Slovenia
| | - Ana Fakin
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000 Ljubljana, Slovenia
| |
Collapse
|
11
|
Carazo A, Macáková K, Matoušová K, Krčmová LK, Protti M, Mladěnka P. Vitamin A Update: Forms, Sources, Kinetics, Detection, Function, Deficiency, Therapeutic Use and Toxicity. Nutrients 2021; 13:1703. [PMID: 34069881 PMCID: PMC8157347 DOI: 10.3390/nu13051703] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/07/2021] [Accepted: 05/13/2021] [Indexed: 12/12/2022] Open
Abstract
Vitamin A is a group of vital micronutrients widely present in the human diet. Animal-based products are a rich source of the retinyl ester form of the vitamin, while vegetables and fruits contain carotenoids, most of which are provitamin A. Vitamin A plays a key role in the correct functioning of multiple physiological functions. The human organism can metabolize natural forms of vitamin A and provitamin A into biologically active forms (retinol, retinal, retinoic acid), which interact with multiple molecular targets, including nuclear receptors, opsin in the retina and, according to the latest research, also some enzymes. In this review, we aim to provide a complex view on the present knowledge about vitamin A ranging from its sources through its physiological functions to consequences of its deficiency and metabolic fate up to possible pharmacological administration and potential toxicity. Current analytical methods used for its detection in real samples are included as well.
Collapse
Affiliation(s)
- Alejandro Carazo
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Králové, Czech Republic;
| | - Kateřina Macáková
- Department of Pharmacognosy, Faculty of Pharmacy, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Králové, Czech Republic;
| | - Kateřina Matoušová
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic; (K.M.); (L.K.K.)
| | - Lenka Kujovská Krčmová
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic; (K.M.); (L.K.K.)
- Department of Analytical Chemistry, Faculty of Pharmacy, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Králové, Czech Republic
| | - Michele Protti
- The Department of Pharmacy and Biotechnology (FaBiT), Alma Mater Studiorum–University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy;
| | - Přemysl Mladěnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Králové, Czech Republic;
| |
Collapse
|
12
|
Tanumihardjo SA. Biological evidence to define a vitamin A deficiency cutoff using total liver vitamin A reserves. Exp Biol Med (Maywood) 2021; 246:1045-1053. [PMID: 33765844 PMCID: PMC8113730 DOI: 10.1177/1535370221992731] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Vitamin A is a fat-soluble vitamin involved in essential functions including growth, immunity, reproduction, and vision. The vitamin A Dietary Reference Intakes (DRIs) for North Americans suggested that a minimally acceptable total liver vitamin A reserve (TLR) is 0.07 µmol/g, which is not explicitly expressed as a vitamin A deficiency cutoff. The Biomarkers of Nutrition for Development panel set the TLR cutoff for vitamin A deficiency at 0.1 µmol/g based on changes in biological response of several physiological parameters at or above this cutoff. The criteria used to formulate the DRIs include clinical ophthalmic signs of vitamin A deficiency, circulating plasma retinol concentrations, excretion of vitamin A metabolites in the bile, and long-term storage of vitamin A as protection against vitamin A deficiency during times of low dietary intake. This review examines the biological responses that occur as TLRs are depleted. In consideration of all of the DRI criteria, the review concludes that induced biliary excretion and long-term vitamin A storage do not occur until TLRs are >0.10 µmol/g. If long-term storage is to continue to be part of the DRI criteria, vitamin A deficiency should be set at a minimum cutoff of 0.10 µmol/g and should be set higher during times of enhanced requirements where TLRs can be rapidly depleted, such as during lactation or in areas with high infection burden. In population-based surveys, cutoffs are important when using biomarkers of micronutrient status to define the prevalence of deficiency and sufficiency to inform public health interventions. Considering the increasing use of quantitative biomarkers of vitamin A status that indirectly assess TLRs, i.e. the modified-relative-dose response and retinol-isotope dilution tests, setting a TLR as a vitamin A deficiency cutoff is important for users of these techniques to estimate vitamin A deficiency prevalence. Future researchers and policymakers may suggest that DRIs should be set with regard to optimal health and not merely to prevent a micronutrient deficiency.
Collapse
Affiliation(s)
- Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| |
Collapse
|
13
|
Gannon BM. Towards an Integrated Mathematical Model of Nutrient Metabolism: Linking β-Carotene and Vitamin A. J Nutr 2021; 151:465-467. [PMID: 33561260 DOI: 10.1093/jn/nxaa422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/19/2020] [Accepted: 12/02/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Bryan M Gannon
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| |
Collapse
|
14
|
Ross AC, Moran NE. Our Current Dietary Reference Intakes for Vitamin A-Now 20 Years Old. Curr Dev Nutr 2020; 4:nzaa096. [PMID: 32999953 PMCID: PMC7513583 DOI: 10.1093/cdn/nzaa096] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/14/2020] [Accepted: 05/21/2020] [Indexed: 02/06/2023] Open
Abstract
The DRI values for vitamin A were last reviewed and defined in 2001. At the time, there was very sparse data that could be used to set the DRI values for pregnancy, lactation, and infancy. In the subsequent 20 y since the last formal review, a number of findings relevant to the adequacy indicator of visual dark adaptation in pregnancy, the usual vitamin A content of breast milk across lactation stages, and vitamin A metabolism in women and children have been published. Furthermore, identification of genetic variables affecting the bioconversion of provitamin A carotenoids to vitamin A have provided an improved explanation for interindividual variability in responses to provitamin A carotenoids. The purpose of this collection of articles, introduced herein, is to review and apply recent findings about vitamin A status, address current gaps in knowledge, and suggest avenues for future research needed to refine the DRI values for pregnancy, lactation, and early life.
Collapse
Affiliation(s)
- A Catharine Ross
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
| | - Nancy E Moran
- USDA/Agricultural Research ServiceChildren's Nutrition Research Center/Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|