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Rathmann AM, Seifert R. Vitamin A-containing dietary supplements from German and US online pharmacies: market and risk assessment. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:6803-6820. [PMID: 38546747 PMCID: PMC11422271 DOI: 10.1007/s00210-024-03050-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/12/2024] [Indexed: 09/25/2024]
Abstract
Vitamin A supplements are used by many people, and the number of newly registered dietary supplements is continuously increasing. The preparations fall under food law and are not subject to the strict controls of pharmaceuticals. Risk indications and maximum quantity recommendations, e.g., from the Bundesinstitut für Risikobewertung (BfR) and the U.S. Food and Drug Administration (FDA) are not binding, which means that overdoses and potentially serious health problems can easily occur. The hepatotoxicity and teratogenicity of vitamin A are well documented, and other negative effects of high doses of vitamin A are also being discussed. Nevertheless, preparations with exorbitantly high doses are freely available for sale and unrestricted. In this study, 75 supplements containing vitamin A available in Germany and 26 available in the USA were critically examined on the basis of various parameters such as the recommended daily dose according to the manufacturer, daily therapy costs (DTC), the presence of warnings about overdose, use during pregnancy and breastfeeding, and information on adverse effects/interactions. The aim was to gain insights into their risk potential and to examine the need for closer monitoring and stricter guidelines for these preparations. The results show some considerable country-specific differences. Overall, there are serious deficiencies in compliance with the labeling requirements for both the German and the US preparations, and the dosages are often far too high in view of the applicable expert recommendations. Overall, these deficits can pose a risk for consumers that is difficult to assess in its entirety, especially for vulnerable consumer groups. It should be noted that the US preparations perform better overall than the German preparations. This suggests better regulation of dietary supplements in the US market. Based on the available data and literature research, it is doubtful whether the intake of vitamin A-containing preparations, without a diagnosed vitamin A deficiency, has a positive health benefit. Furthermore, it should be examined whether vitamin A should continue to be offered over-the-counter as a food supplement.
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Affiliation(s)
| | - Roland Seifert
- Institute of Pharmacology, Hannover Medical School, D-30625, Hannover, Germany.
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Yin P, Fu X, Feng H, Yang Y, Xu J, Zhang X, Wang M, Ji S, Zhao B, Fang H, Du X, Li Y, Hu S, Li K, Xu S, Li Z, Liu F, Xiao Y, Wang Y, Li J, Yang X. Linkage and association mapping in multi-parental populations reveal the genetic basis of carotenoid variation in maize kernels. PLANT BIOTECHNOLOGY JOURNAL 2024; 22:2312-2326. [PMID: 38548388 PMCID: PMC11258976 DOI: 10.1111/pbi.14346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/02/2024] [Accepted: 03/14/2024] [Indexed: 07/21/2024]
Abstract
Carotenoids are indispensable to plants and critical components of the human diet. The carotenoid metabolic pathway is conserved across plant species, but our understanding of the genetic basis of carotenoid variation remains limited for the seeds of most cereal crops. To address this issue, we systematically performed linkage and association mapping for eight carotenoid traits using six recombinant inbred line (RIL) populations. Single linkage mapping (SLM) and joint linkage mapping (JLM) identified 77 unique additive QTLs and 104 pairs of epistatic QTLs. Among these QTLs, we identified 22 overlapping hotspots of additive and epistatic loci, highlighting the important contributions of some QTLs to carotenoid levels through additive or epistatic mechanisms. A genome-wide association study based on all RILs detected 244 candidate genes significantly associated with carotenoid traits, 23 of which were annotated as carotenoid pathway genes. Effect comparisons suggested that a small number of loci linked to pathway genes have substantial effects on carotenoid variation in our tested populations, but many loci not associated with pathway genes also make important contributions to carotenoid variation. We identified ZmPTOX as the causal gene for a QTL hotspot (Q10/JLM10/GWAS019); this gene encodes a putative plastid terminal oxidase that produces plastoquinone-9 used by two enzymes in the carotenoid pathway. Natural variants in the promoter and second exon of ZmPTOX were found to alter carotenoid levels. This comprehensive assessment of the genetic mechanisms underlying carotenoid variation establishes a foundation for rewiring carotenoid metabolism and accumulation for efficient carotenoid biofortification.
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Affiliation(s)
- Pengfei Yin
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Xiuyi Fu
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
- Beijing Key Laboratory of Maize DNA Fingerprinting and Molecular BreedingMaize Research InstituteBeijing Academy of Agriculture and Forestry Sciences (BAAFS)BeijingChina
| | - Haiying Feng
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Yanyan Yang
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Jing Xu
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Xuan Zhang
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Min Wang
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Shenghui Ji
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Binghao Zhao
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Hui Fang
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Xiaoxia Du
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Yaru Li
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Shuting Hu
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Kun Li
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Shutu Xu
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Zhigang Li
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
| | - Fang Liu
- Center for Crop Functional Genomics and Molecular BreedingChina Agricultural UniversityBeijingChina
| | - Yingni Xiao
- Crops Research InstituteGuangdong Academy of Agricultural Sciences/Guangdong Provincial Key Laboratory of Crop Genetic ImprovementGuangzhouGuangdongChina
| | - Yuandong Wang
- Beijing Key Laboratory of Maize DNA Fingerprinting and Molecular BreedingMaize Research InstituteBeijing Academy of Agriculture and Forestry Sciences (BAAFS)BeijingChina
| | - Jiansheng Li
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
- Center for Crop Functional Genomics and Molecular BreedingChina Agricultural UniversityBeijingChina
| | - Xiaohong Yang
- State Key Laboratory of Plant Environmental Resilience and National Maize Improvement Center of ChinaChina Agricultural UniversityBeijingChina
- Center for Crop Functional Genomics and Molecular BreedingChina Agricultural UniversityBeijingChina
- Frontiers Science Center for Molecular Design BreedingChina Agricultural UniversityBeijingChina
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Moshirfar M, Melanson DG, Pandya S, Moin KA, Talbot CL, Hoopes PC. Implications of Celiac Disease in Prospective Corneal Refractive Surgery Patients: A Narrative Review. Cureus 2024; 16:e65761. [PMID: 39211645 PMCID: PMC11361327 DOI: 10.7759/cureus.65761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2024] [Indexed: 09/04/2024] Open
Abstract
Celiac disease (CeD) is a prevalent autoimmune disorder incited by gluten consumption, resulting in intestinal damage. Affecting approximately one in 133 people globally, CeD often remains undiagnosed due to its varied clinical presentations. The prevalence and diagnosis of CeD are influenced by several factors, including demographics and genetics, and it often coexists with other autoimmune diseases. Thus, the objective of this paper was to review the literature on ophthalmic manifestations of CeD and to create preliminary considerations for these patients wishing to undergo elective corneal refractive surgery (CRS). A literature review was conducted through July 2024, and relevant search terms were used to identify contributing papers. The review enabled the development of detailed considerations for the ocular manifestations of CeD and recommended management strategies for healthcare teams before and following CRS. The 24 papers included in this study illustrate that nutritional deficiencies and autoimmune concerns linked to CeD have distinctive ocular presentations. Based on these findings, patients with CeD may exhibit unconventional ocular manifestations beyond their typical gastrointestinal symptoms, such as decreased endothelial cell density (ECD), vitamin A deficiency leading to dryness, altered corneal nerve density, cataracts, uveitis, changes in choroidal thickness, papilledema, and neurological issues such as nystagmus. Patients with CeD may also experience synergistic impacts from concomitant autoimmune conditions such as Type 1 Diabetes Mellitus (T1DM) in addition to the coexistence of thyroid ophthalmopathy. Recognizing that CeD is an autoimmune disorder that can be exacerbated by other conditions, it is essential to conduct a thorough evaluation for elective CRS. Due to the variability in ocular manifestations among CeD patients, individualized evaluations are crucial for determining surgical candidacy and optimizing outcomes, especially for patients who may not be well controlled. Evaluations are likely to encompass a subjective assessment through a questionnaire exploring the patient's past medical history related to CeD. These questions can range from inquiring about general past medical history related to CeD regarding dietary gluten intake and weight loss to joint pain and cognitive impairments such as brain fog. Clinicians should also perform a comprehensive objective assessment utilizing slit-lamp biomicroscopy, Schirmer test, tear break-up time (TBUT), optical coherence tomography (OCT), Scheimpflug imaging, or fundoscopy. Although there is currently no specific information regarding CRS recommendations for patients with CeD, we believe the considerations outlined in this paper should serve as preliminary guidelines for clinicians. While our findings have formed considerations for future healthcare teams, further research is needed to fully understand the impact of CeD on CRS outcomes and refine these recommendations.
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Affiliation(s)
- Majid Moshirfar
- Ophthalmology, Hoopes Vision Research Center, Draper, USA
- Ophthalmology, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, USA
- Eye Banking and Corneal Transplantation, Utah Lions Eye Bank, Murray, USA
| | - David G Melanson
- Ophthalmology, Rocky Vista University College of Osteopathic Medicine, Ivins, USA
| | - Shreya Pandya
- Ophthalmology, University of Louisville School of Medicine, Louisville, USA
| | - Kayvon A Moin
- Ophthalmology, Hoopes Vision Research Center, Draper, USA
- School of Medicine, American University of the Caribbean, Cupecoy, SXM
| | - Chad L Talbot
- Ophthalmology, Rocky Vista University College of Osteopathic Medicine, Ivins, USA
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Stunes AK, Mosti MP, Gustafsson MK, Børsting T, Thorsby PM, Stafne SN, Syversen U. Maternal vitamin A and D status in second and third trimester of pregnancy and bone mineral content in offspring at nine years of age. Front Endocrinol (Lausanne) 2024; 15:1417656. [PMID: 39006361 PMCID: PMC11239386 DOI: 10.3389/fendo.2024.1417656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/17/2024] [Indexed: 07/16/2024] Open
Abstract
Introduction Maternal nutritional and vitamin status during pregnancy may have long-term effects on offspring health and disease. The aim of this study was to examine the associations between maternal vitamin A and D status in pregnancy and offspring bone mineral content (BMC) at nine years of age. Methods This is a post-hoc study of a randomized control trial including 855 pregnant women from two Norwegian cities; Trondheim and Stavanger. The women were randomized into an exercise intervention or standard antenatal care. Mother and child pairs for the present study were recruited from those still living in Trondheim after 8-10 years. Serum vitamin A (retinol) and vitamin D (25(OH)D) were measured in the 2nd and 3rd trimesters of pregnancy, and active vitamin D (1,25(OH)2D) in serum was measured in a subgroup. Spine BMC and trabecular bone score were measured in the children at nine years of age. Associations were analyzed with linear regression models. Results A total of 119 mother and child pairs were included in the analyses. Vitamin A insufficiency (retinol< 1.05 µmol/L) and vitamin D deficiency (25(OH)D< 50 mmol/L) increased from ~7% to ~43% and from ~28% to ~33%, respectively, from the 2nd to the 3rd trimester. An increase in serum 1,25(OH)2D from the 2nd to the 3rd trimester was observed in the subgroup. There was a negative association between serum retinol in the 2nd trimester and spine BMC in the boys, but not in the girls, when adjusted for maternal and child confounders. No other associations between maternal serum vitamin A or D and BMC in the children were found. Conclusion We observed a high prevalence of vitamin A insufficiency and vitamin D deficiency during pregnancy. A negative association between mid-pregnancy vitamin A status and spine BMC was observed in boys, but not girls, while no associations were found between maternal vitamin D status and child BMC. The implications of optimal vitamin A and D status in pregnancy for offspring bone health, remains a subject for further investigations.
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Affiliation(s)
- Astrid Kamilla Stunes
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Mats Peder Mosti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Miriam Katarina Gustafsson
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Torunn Børsting
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Per Medbøe Thorsby
- Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Signe Nilssen Stafne
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Clinic of Rehabilitation, St. Olavs University Hospital, Trondheim, Norway
| | - Unni Syversen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Endocrinology, Clinic of Medicine, St. Olavs University Hospital, Trondheim, Norway
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Safiri S, Mousavi SE, Nejadghaderi SA, Motlagh Asghari K, Karamzad N, Sullman MJM, Kolahi AA, Abdollahi M. Vitamin A deficiency in the MENA region: a 30-year analysis (1990-2019). Front Nutr 2024; 11:1413617. [PMID: 38903625 PMCID: PMC11187328 DOI: 10.3389/fnut.2024.1413617] [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: 04/07/2024] [Accepted: 05/27/2024] [Indexed: 06/22/2024] Open
Abstract
Background Vitamin A deficiency (VAD) is a common micronutrient deficiency that imposes a substantial burden worldwide. This study examined the burden of VAD from 1990 to 2019 in the Middle East and North Africa (MENA) region by age, sex and sociodemographic index (SDI). Methods The data were obtained from the Global Burden of Disease (GBD) 2019 database. We reported the prevalence, incidence, and years lived with disability (YLDs) that were attributable to VAD for the MENA region, along with its constituent countries. Results In 2019, the MENA region had 30.6 million prevalent cases of VAD, with an age-standardized prevalence rate of 5249.9 per 100,000 population. In addition, VAD was responsible for 62.2 thousand YLDs, with an age-standardized YLD rate of 10.2 per 100,000. The age-standardized prevalence [50.3% (-55.9 to -44.7)] and YLD [-49.3% (-55.3 to -43.1)] rates of VAD have significantly decreased since 1990. In 2019, the MENA region's VAD-attributable YLD rate was below the global average for males and females across all age groups. Additionally, SDI was negatively associated the age-standardized YLD rate of VAD. Conclusion This study underscores the necessity of frequently updating health data and developing guidelines and regulations to prevent, detect early, and effectively treat VAD in the MENA countries.
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Affiliation(s)
- Saeid Safiri
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Ehsan Mousavi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Aria Nejadghaderi
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Kimia Motlagh Asghari
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nahid Karamzad
- Department of Persian Medicine, School of Traditional Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mark J. M. Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Abdollahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Naik B, Kumar V, Rizwanuddin S, Mishra S, Kumar V, Saris PEJ, Khanduri N, Kumar A, Pandey P, Gupta AK, Khan JM, Rustagi S. Biofortification as a solution for addressing nutrient deficiencies and malnutrition. Heliyon 2024; 10:e30595. [PMID: 38726166 PMCID: PMC11079288 DOI: 10.1016/j.heliyon.2024.e30595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 04/30/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
Malnutrition, defined as both undernutrition and overnutrition, is a major global health concern affecting millions of people. One possible way to address nutrient deficiency and combat malnutrition is through biofortification. A comprehensive review of the literature was conducted to explore the current state of biofortification research, including techniques, applications, effectiveness and challenges. Biofortification is a promising strategy for enhancing the nutritional condition of at-risk populations. Biofortified varieties of basic crops, including rice, wheat, maize and beans, with elevated amounts of vital micronutrients, such as iron, zinc, vitamin A and vitamin C, have been successfully developed using conventional and advanced technologies. Additionally, the ability to specifically modify crop genomes to improve their nutritional profiles has been made possible by recent developments in genetic engineering, such as CRISPR-Cas9 technology. The health conditions of people have been shown to improve and nutrient deficiencies were reduced when biofortified crops were grown. Particularly in environments with limited resources, biofortification showed considerable promise as a long-term and economical solution to nutrient shortages and malnutrition. To fully exploit the potential of biofortified crops to enhance public health and global nutrition, issues such as consumer acceptance, regulatory permitting and production and distribution scaling up need to be resolved. Collaboration among governments, researchers, non-governmental organizations and the private sector is essential to overcome these challenges and promote the widespread adoption of biofortification as a key part of global food security and nutrition strategies.
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Affiliation(s)
- Bindu Naik
- Department of Food Science and Technology, Graphic Era (Deemed to Be) University, Bell Road, Clement Town, Dehradun, 248002, Uttarakhand, India
- School of Agriculture, Graphic Hill University, Clement Town, Dehradun, Uttarakhand, India
| | - Vijay Kumar
- Himalayan School of Biosciences, Swami Rama Himalayan University, Swami Rama Nagar, Jolly Grant, Dehradun, 248016, Uttarakhand, India
| | - Sheikh Rizwanuddin
- Department of Food Science and Technology, Graphic Era (Deemed to Be) University, Bell Road, Clement Town, Dehradun, 248002, Uttarakhand, India
| | - Sadhna Mishra
- Faculty of Agricultural Sciences, GLA University, Mathura, India
| | - Vivek Kumar
- Himalayan School of Biosciences, Swami Rama Himalayan University, Swami Rama Nagar, Jolly Grant, Dehradun, 248016, Uttarakhand, India
| | - Per Erik Joakim Saris
- Department of Microbiology, Faculty of Agriculture and Forestry, University of Helsinki, 00100, Helsinki, Finland
| | - Naresh Khanduri
- Himalayan School of Biosciences, Swami Rama Himalayan University, Swami Rama Nagar, Jolly Grant, Dehradun, 248016, Uttarakhand, India
| | - Akhilesh Kumar
- Himalayan School of Biosciences, Swami Rama Himalayan University, Swami Rama Nagar, Jolly Grant, Dehradun, 248016, Uttarakhand, India
| | - Piyush Pandey
- Soil and Environment Microbiology Laboratory, Department of Microbiology, Assam University, Silchur, 788011, Assam, India
| | - Arun Kumar Gupta
- Department of Food Science and Technology, Graphic Era (Deemed to Be) University, Bell Road, Clement Town, Dehradun, 248002, Uttarakhand, India
| | - Javed Masood Khan
- Department of Food Science and Nutrition, Faculty of Food and Agricultural Sciences, King Saud University, 2460, Riyadh, 11451, Saudi Arabia
| | - Sarvesh Rustagi
- Department of Food Technology, Uttaranchal University, Dehradun, 248007, Uttarakhand, India
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Cohen Vig L, Straussberg R, Ziv N, Hirschfeld-Dicker L, Konen O, Aharoni S. Neurologic complications of thiamine (B1) deficiency following bariatric surgery in adolescents. Eur J Paediatr Neurol 2024; 50:74-80. [PMID: 38705013 DOI: 10.1016/j.ejpn.2024.04.008] [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: 11/01/2023] [Revised: 04/07/2024] [Accepted: 04/17/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND The prevalence of obesity among children and adolescents is rising and poses a major health concern. Bariatric surgery is well established in adults and has become an option for adolescents. Thiamine (B1) deficiency is common following bariatric surgery in adults. It may present as Beri-Beri, Wernicke encephalopathy, or Korsakoff psychosis. OBJECTIVE Our aim was to describe the clinical features, diagnosis, and treatment of adolescents who presented with B1 deficiency after bariatric surgery at one center, and to summarize the data from the literature. PATIENTS Three adolescents with morbid obesity (two boys and one girl, aged 15.5 to- 17-years-old), presented at Schneider Children's Medical Center of Israel with progressive lower limb pain and weakness 2-3 month following a bariatric procedure (sleeve gastrectomy or narrowing of a bariatric band). The girl also had upper limb involvement and cerebellar signs. All three were non-compliant with micronutrient supplementation. After admission, they received intravenous B1 and oral multivitamin supplementation, and their symptoms improved considerably. CONCLUSIONS Micronutrient supplementation following bariatric surgery is crucial to prevent deficiencies. In adolescents, compliance with micronutrient supplementation should be assessed before and after such surgery. Thiamine deficiency may cause polyneuropathy, among other symptoms. Treatment reduces the severity of neurological complications.
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Affiliation(s)
- Lital Cohen Vig
- Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
| | - Rachel Straussberg
- Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Noa Ziv
- Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; Pediatric Department C, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Lior Hirschfeld-Dicker
- Pediatric Department C, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Osnat Konen
- Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; Institute of Pediatric Radiology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Sharon Aharoni
- Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
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Janmohamed A, Doledec D, Dissieka R, Jalloh UH, Juneja S, Beye M, Ndiaye F, Jumbe T, Baker MM. Vitamin A supplementation coverage and associated factors for children aged 6 to 59 months in integrated and campaign-based delivery systems in four sub-Saharan African countries. BMC Public Health 2024; 24:1189. [PMID: 38678255 PMCID: PMC11055222 DOI: 10.1186/s12889-024-18707-3] [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: 01/26/2024] [Accepted: 04/24/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Vitamin A deficiency (VAD) is a leading contributor to the poor health and nutrition of young children in sub-Saharan Africa. Funding constraints are compelling many countries to shift from longstanding campaigns to integrating vitamin A supplementation (VAS) into routine health services. We assessed child VAS coverage and associated factors for integrated delivery systems in Mozambique, Senegal, and Sierra Leone and for a campaign-based delivery strategy in Tanzania. METHODS Data were obtained using representative household surveys administered to primary caregivers of N = 16,343 children aged 6-59 months (Mozambique: N = 1,659; Senegal: N = 7,254; Sierra Leone: N = 4,149; Tanzania: N = 3,281). Single-dose VAS coverage was assessed and bivariate and multivariable associations were examined for child VAS receipt with respect to rural or urban residence; child age and sex; maternal age, education, and VAS program knowledge; and household wealth. RESULTS VAS coverage for children aged 6-59 months was 42.8% (95% CI: 40.2, 45.6) in Mozambique, 46.1% (95% CI: 44.9, 47.4) in Senegal, 86.9% (95% CI: 85.8, 87.9) in Sierra Leone, and 42.4% (95% CI: 40.2, 44.6) in Tanzania and was significantly higher for children 6-11 vs. 24-59 months in Mozambique, Senegal, and Tanzania. In Sierra Leone, children aged 12-23 months (aOR = 1.86; 95% CI: 1.20, 2.86) and 24-59 months (aOR = 1.55; 95% CI: 1.07, 2.25) were more likely to receive VAS, compared to those 6-11 months. Maternal awareness of VAS programs was associated with higher uptake in Mozambique (aOR = 4.00; 95% CI: 2.81, 5.68), Senegal (aOR = 2.72; 95% CI: 2.35, 3.15), and Tanzania (aOR = 14.50; 95% CI: 10.98, 19.17). Increased household wealth was associated with a higher likelihood of child VAS in Senegal and Tanzania. CONCLUSIONS Our findings indicate routine delivery approaches for VAS are not achieving the level of coverage needed for public health impact in these settings. Intensive outreach efforts contributed to the higher coverage in Sierra Leone and highlight the importance of reducing the burdens associated with seeking supplementation at health facilities. As countries move towards incorporating VAS into routine health services, the essentiality of informed communities and potential losses for older children and socio-economically disadvantaged populations are key considerations in the sub-Saharan African context.
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Affiliation(s)
- Amynah Janmohamed
- Helen Keller International Vitamin A Supplementation Africa Regional Office, Nairobi, Kenya
| | - David Doledec
- Helen Keller International Vitamin A Supplementation Africa Regional Office, Nairobi, Kenya
| | - Romance Dissieka
- Helen Keller International Vitamin A Supplementation Africa Regional Office, Nairobi, Kenya
| | - Umu H Jalloh
- Helen Keller International, Freetown, Sierra Leone
| | | | | | | | | | - Melissa M Baker
- Helen Keller International Vitamin A Supplementation Africa Regional Office, Nairobi, Kenya.
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Palma-Duran SA, Morgan D, Combet E. Quantification of Vitamin A in Edible Oils: Comparison of Portable Device iCheck Chroma3 to High-Performance Liquid Chromatography. FOOD ANAL METHOD 2024; 17:847-854. [PMID: 38765762 PMCID: PMC11101343 DOI: 10.1007/s12161-024-02613-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 03/11/2024] [Indexed: 05/22/2024]
Abstract
Fortification of edible oil with vitamin A is a widely adopted intervention to minimize the effects of vitamin A deficiency in vulnerable groups and mitigate some of its deleterious consequences. Regulatory monitoring is an important prerequisite to ensure that the fortification program is implemented effectively. Standard laboratory analysis methods for vitamin A in oils to assess adequate addition levels remain expensive and time-consuming. Portable testing devices are relatively less expensive in terms of capital investment and cost per test. However, the reliability of results needs to be assured to ensure acceptability and confidence. This study compared a portable device to high-performance liquid chromatography (HPLC) in terms of quantification of vitamin A in both spiked and commercially fortified oils. Nine oils (soybean, palm, cottonseed, rapeseed, corn, peanut, coconut, sunflower, and rice bran oils) were selected and spiked with retinyl palmitate at six different concentrations, and 112 commercially fortified oils were quantified for their vitamin A content using both methods. A good indicator of intra-day and inter-day repeatability (< 10% CV) was obtained for the measurement of vitamin A in the spiked oils for both methods, which denotes a high agreement between them. Vitamin A recoveries were 97-132% for HPLC and 74-127% for the portable device. A strong positive correlation, r = 0.88, is observed between the two methods for the quantification of vitamin A in the commercially fortified oils. The portable device provides a relatively low-cost, quick, and user-friendly alternative to HPLC.
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Affiliation(s)
- Susana A. Palma-Duran
- School of Medicine, College of Medical, Veterinary and Life Sciences, The University of Glasgow, Glasgow, UK
- Department of Food Science, Research Center in Food and Development A.C., Hermosillo, Mexico
| | - David Morgan
- Global Alliance for Improved Nutrition (GAIN), Geneva, CH Switzerland
| | - Emilie Combet
- School of Medicine, College of Medical, Veterinary and Life Sciences, The University of Glasgow, Glasgow, UK
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10
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Walsh NM, Flynn A, Walton J, Kehoe L. Optimal growth and development: are teenagers getting enough micronutrients from their diet? Proc Nutr Soc 2024:1-9. [PMID: 38433580 DOI: 10.1017/s002966512400017x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
The teenage years represent a crucial period of physical and cognitive growth and development with sufficient micronutrient intakes necessary to meet high nutritional requirements. This review examines current micronutrient intakes in teenagers in the Western world in the context of public health implications including the prevalence of inadequate intakes and risk of excessive intakes. Intakes of vitamins A, D, E and C, folate, calcium, iron, magnesium, zinc and potassium in teenagers are low when compared to generally accepted recommendations, while there is little risk of excessive micronutrient intakes based on current dietary patterns. Therefore, strategies should focus on increasing micronutrient intakes in order to decrease the risk of negative impacts resulting from these low intakes. These strategies should be mindful of guidance towards an environmentally sustainable diet whilst ensuring that nutrient intakes in teenagers are not further negatively impacted. In order to identify, implement and monitor the effectiveness of such strategies, intakes of micronutrients should be continually monitored in nationally representative samples of the population for all age groups including this vulnerable cohort of teenagers.
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Affiliation(s)
- Niamh M Walsh
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
- Department of Biological Sciences, Munster Technological University, Cork, Republic of Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
| | - Janette Walton
- Department of Biological Sciences, Munster Technological University, Cork, Republic of Ireland
| | - Laura Kehoe
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
- Department of Biological Sciences, Munster Technological University, Cork, Republic of Ireland
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11
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Yan J, Xiao L, Feng D, Chen B, Yang T, Tong B, Luo R, Wang Y, Chen J. Vitamin A deficiency suppresses CEACAM1 to impair colonic epithelial barrier function via downregulating microbial-derived short-chain fatty acids. Genes Dis 2024; 11:1066-1081. [PMID: 37692511 PMCID: PMC10491915 DOI: 10.1016/j.gendis.2023.03.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/08/2023] [Accepted: 03/29/2023] [Indexed: 09/12/2023] Open
Abstract
Vitamin A (VA) plays an essential role in modulating both the gut microbiota and gut barrier function. Short-chain fatty acids (SCFAs), as metabolites of the gut microbiota, protect the physiological intestinal barrier; however, they are compromised when VA is deficient. Thus, there is an urgent need to understand how and which SCFAs modulate colonic epithelial barrier integrity in VA deficiency (VAD). Herein, compared with normal VA rats (VAN), at the beginning of pregnancy, we confirmed that the colonic desmosome junction was impaired in the VAD group, and the amounts of acetate, propionate, and butyrate declined because of the decreased abundance of SCFA-producing bacteria (Romboutsia, Collinsella, and Allobaculum). The differentially expressed genes correlated with the gut barrier and the histone deacetylase complex between the VAD and VAN groups were enriched by RNA sequencing. In the VAD group, the expression levels of colonic CEA cell adhesion molecule 1 (CEACAM1) were down-regulated, and the levels of histone deacetylase 1 (HDAC1) and HDAC3 were up-regulated. Intriguingly, the above changes in the VAD groups were rescued by VA supplementation in the early postnatal period. Further study indicated that in Caco-2 cells, butyrate treatment significantly repressed the enrichment of HDAC3 on the promoter of the CEACAM1 gene to induce its expression. Our findings support that butyrate intervention can alleviate the impairment of colonic barrier function caused by VAD, and timely postnatal VA intervention may reverse the damage caused by VAD on gut barrier integrity during pregnancy.
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Affiliation(s)
- Junyan Yan
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing 401122, China
| | - Lu Xiao
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing 401122, China
- Department of Gastroenterology, Children's Hospital of Chongqing Medical University, Chongqing 401122, China
| | - Di Feng
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing 401122, China
| | - Baolin Chen
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing 401122, China
| | - Ting Yang
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing 401122, China
| | - Bei Tong
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing 401122, China
| | - Ruifang Luo
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing 401122, China
| | - Yuting Wang
- Department of Gastroenterology, Children's Hospital of Chongqing Medical University, Chongqing 401122, China
| | - Jie Chen
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing 401122, China
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12
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Philippin H, Morny EKA, Heinrich SP, Töws I, Maier PC, Guthoff RF, Qureshi BM, Reinhard T, Burton MJ, Finger RP. [Global ophthalmology : Update]. DIE OPHTHALMOLOGIE 2024; 121:157-170. [PMID: 38300260 DOI: 10.1007/s00347-023-01983-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 02/02/2024]
Abstract
The aim of global ophthalmology is to maximize vision, ocular health and functional ability, thereby contributing to overall health and well-being, social inclusion and quality of life of every individual worldwide. Currently, an estimated 1.1 billion people live with visual impairment, 90% of which can be prevented or cured through largely cost-effective interventions. At the same time, 90% of people affected live in regions with insufficient eye health coverage. This challenge drove the World Health Organization (WHO) and a group of nongovernmental organizations to launch "VISION 2020: the Right to Sight", a global campaign which recently concluded after 20 years. The achievements, challenges and lessons learned were identified and incorporated into the current campaign "2030 IN SIGHT".
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Affiliation(s)
- Heiko Philippin
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland.
- International Centre for Eye Health, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HTUK, London, Vereinigtes Königreich.
- CBM Christoffel-Blindenmission Christian Blind Mission, Bensheim, Deutschland.
| | - Enyam K A Morny
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Sven P Heinrich
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
| | - Ingrid Töws
- Institut für Evidenz in der Medizin, Universitätsklinikum und Medizinische Fakultät, Universität Freiburg, Freiburg i. Brsg., Deutschland
| | - Philip C Maier
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
| | - Rudolf F Guthoff
- Klinik und Poliklinik für Augenheilkunde, Universität Rostock, Rostock, Deutschland
| | - Babar M Qureshi
- CBM Christoffel-Blindenmission Christian Blind Mission, Cambridge, Vereinigtes Königreich
| | - Thomas Reinhard
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
| | - Matthew J Burton
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, Vereinigtes Königreich
| | - Robert P Finger
- Augenklinik, Universitätsklinikum Mannheim, Universität Heidelberg, Mannheim, Deutschland
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13
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Xu P, Xu J, Cao W, Yang T, Gan Q, Wang H, Luo R, Pan H, Zhang Q. Prevalence of Vitamin A Deficiency in Children Aged 6 to 17 Years - Western and Central Rural Areas, China, 2012-2021. China CDC Wkly 2024; 6:51-55. [PMID: 38269359 PMCID: PMC10803284 DOI: 10.46234/ccdcw2024.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/15/2024] [Indexed: 01/26/2024] Open
Abstract
What is already known about this topic? Vitamin A deficiency (VAD) is a leading global nutritional concern, ranking among the top four major nutritional deficiencies worldwide. The prevalence of VAD is unevenly distributed across various regions, both within China and globally. What is added by this report? The report adds valuable insights into the vitamin A nutritional status of rural students aged 6-17 years who participated in the Nutrition Improvement Programme for Rural Compulsory Education Students (NIPRCES). Over the decade from 2012 to 2021, there was a modest improvement in vitamin A status. The prevalence of VAD and sub-clinical VAD (SVAD) declined as the students aged. Throughout the majority of the survey years, the incidence of VAD was higher among males and western regions compared to females and central regions, respectively. What are the implications for public health practice? A comprehensive approach, incorporating dietary diversification, nutrition education, and food fortification, should be implemented to prevent VAD and SVAD especially in males, younger children and children in western areas.
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Affiliation(s)
- Peipei Xu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Juan Xu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Cao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Titi Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qian Gan
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hongliang Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ruihe Luo
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hui Pan
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qian Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
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14
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Lowe NM. Fortification or biofortification: complimentary strategies or duplication of effort? Proc Nutr Soc 2024:1-10. [PMID: 38197143 DOI: 10.1017/s0029665124000041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Micronutrient deficiencies continue to be a global concern, with the most common deficiencies being vitamin A, iron, zinc and B vitamins (folate and B12). Addressing this requires strategies that are scalable and equitable such that they reach all members of a population irrespective of socioeconomic status and geography. Fortification and biofortification offer potential large-scale solutions, however each have strengths and limitations depending on the context, particularly the cultural and political factors that may create barriers or opportunities for effectiveness. Planning how to target scarce resources for maximum impact requires an in-depth knowledge and understanding of local food systems and market dynamics, alongside strong government policy and legislative support. A food fortification programme was launched in Pakistan in 2016, supported by UK Aid and designed to address the high prevalence of vitamin A, iron and zinc deficiency, particularly in women and children. In the same year, the first zinc biofortified variety of wheat, Zincol-2016, was released in Pakistan, supported and developed through the HarvestPlus programme in collaboration with the Pakistan National Agriculture Research Centre. This review explores the challenges faced by fortification and biofortification, initiated independently, (but around the same time) in Pakistan.
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Affiliation(s)
- Nicola Mary Lowe
- Centre for Global Development, University of Central Lancashire, PrestonPR1 2HE, UK
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15
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Qadeer A, Ishaq MU, Safi A, Akbar A, Asif S, Komel A, Kunwar D, Bokhari SMA. Association of vitamin A with gestational diabetes and thyroid disorders in pregnancy and their influence on maternal, fetal, and neonatal outcomes. Ther Adv Reprod Health 2024; 18:26334941241271542. [PMID: 39220467 PMCID: PMC11366108 DOI: 10.1177/26334941241271542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 06/24/2024] [Indexed: 09/04/2024] Open
Abstract
Gestational diabetes mellitus (GDM) and thyroid disorders during pregnancy pose significant health concerns, impacting a substantial number of mothers globally. Globally, about 14% of pregnant women develop GDM, while thyroid disorders impact approximately 2%-3%. Both conditions contribute to adverse outcomes, including gestational hypertension, excessive fetal growth, and heightened perinatal morbidity. The central focus of this literature review is to examine the relationship between vitamin A, a crucial fat-soluble micronutrient in fetal development, and the occurrence of GDM and thyroid disorders during pregnancy. The primary research question investigates the association between vitamin A, GDM, and thyroid disorders, analyzing their combined impact on maternal, fetal, and neonatal outcomes. The review underscores the potential of vitamin A to modulate the risk and outcomes of GDM and thyroid disorders during gestation, emphasizing its role in GDM development and resolution and its influence on thyroid function in pregnancy.
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Affiliation(s)
- Abdul Qadeer
- Department of Cardiovascular Medicine, Shifa International Hospital, Islamabad, Pakistan
| | | | - Adnan Safi
- Department of Internal Medicine, Lahore General Hospital, Lahore, Pakistan
| | - Anum Akbar
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sana Asif
- Department of Medicine, Nishtar Medical University, Multan, Pakistan
| | - Aqsa Komel
- Department of Medicine, Nishtar Medical University, Multan, Pakistan
| | - Digbijay Kunwar
- Department of Medicine, Bagahi Primary Healthcare Center, Parsa, Birgunj 44300, Nepal
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16
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Li J, Martin C, Fernie A. Biofortification's contribution to mitigating micronutrient deficiencies. NATURE FOOD 2024; 5:19-27. [PMID: 38168782 DOI: 10.1038/s43016-023-00905-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 11/08/2023] [Indexed: 01/05/2024]
Abstract
Biofortification was first proposed in the early 1990s as a low-cost, sustainable strategy to enhance the mineral and vitamin contents of staple food crops to address micronutrient malnutrition. Since then, the concept and remit of biofortification has burgeoned beyond staples and solutions for low- and middle-income economies. Here we discuss what biofortification has achieved in its original manifestation and the main factors limiting the ability of biofortified crops to improve micronutrient status. We highlight the case for biofortified crops with key micronutrients, such as provitamin D3/vitamin D3, vitamin B12 and iron, for recognition of new demographics of need. Finally, we examine where and how biofortification can be integrated into the global food system to help overcome hidden hunger, improve nutrition and achieve sustainable agriculture.
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Affiliation(s)
- Jie Li
- Department of Biochemistry and Metabolism, John Innes Centre, Norwich, UK
| | - Cathie Martin
- Department of Biochemistry and Metabolism, John Innes Centre, Norwich, UK.
| | - Alisdair Fernie
- Max-Planck-Institut für Molekulare Pflanzenphysiologie, Potsdam, Germany
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17
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Abadie RB, Staples AA, Lauck LV, Dautel AD, Spillers NJ, Klapper RJ, Hirsch JD, Varrassi G, Ahmadzadeh S, Shekoohi S, Kaye AD. Vitamin A-Mediated Birth Defects: A Narrative Review. Cureus 2023; 15:e50513. [PMID: 38226115 PMCID: PMC10788247 DOI: 10.7759/cureus.50513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/14/2023] [Indexed: 01/17/2024] Open
Abstract
Vitamin A deficiency (VAD) or excess in expectant mothers can result in fetal abnormalities such as night blindness, bone anomalies, or epithelial cell problems. In contrast, excessive vitamin A in pregnancy can precipitate fetal central nervous system deformities. During pregnancy, a pregnant woman should monitor her vitamin A intake ensuring she gets the recommended dosage, but also ensuring she doesn't exceed the recommended dosage, because either one can result in teratogenicity in the fetus. The widespread and unregulated use of multivitamins and supplements makes consuming doses greater than the recommended quantity more common in developed countries. While vitamin A excess is more common in developed countries, deficiency is most prevalent in developing countries. With proper maintenance, regulation, and education about VAD and excess, a pregnant mother can diminish potential harm to her fetus and potential teratogenic risks.
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Affiliation(s)
- Raegan B Abadie
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Abigail A Staples
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Lillian V Lauck
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Alexandra D Dautel
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Noah J Spillers
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Rachel J Klapper
- Radiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Jon D Hirsch
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | | | - Shahab Ahmadzadeh
- Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Sahar Shekoohi
- Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Alan D Kaye
- Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
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18
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Baker MM, Janmohamed A, Toure D, Dissieka R, Ndiaye F, Khassanova R, Fofana ML, Doledec D. COVID-19 concerns among caregivers and vitamin A supplementation coverage among children aged 6-59 months in four countries in Western sub-Saharan Africa. Public Health Nutr 2023; 26:1935-1943. [PMID: 37395173 PMCID: PMC10564591 DOI: 10.1017/s1368980023001258] [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: 08/29/2022] [Revised: 04/12/2023] [Accepted: 06/15/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To assess child vitamin A supplementation (VAS) coverage in 2019 and 2020 and explore key factors, including COVID-19 concerns, that influenced VAS status in four sub-Saharan African countries. DESIGN Data from eight representative household surveys were used to assess VAS coverage. Multivariable logistic regression models examined the effect of rural/urban residence, child sex and age, caregiver education, COVID-19 concern and household wealth on VAS status. SETTING Nine (2019) and 12 (2020) districts in Burkina Faso, Côte d'Ivoire, Guinea and Mali. PARTICIPANTS 28 283 caregivers of children aged 6-59 months. RESULTS Between 2019 and 2020, VAS coverage increased in Burkina Faso (82·2-93·1 %), Côte d'Ivoire (90·3-93·3 %) and Mali (76·1-79·3 %) and decreased in Guinea (86·0 % to 81·7 %). Rural children had a higher likelihood of VAS uptake compared with urban children in Burkina Faso (adjusted OR (aOR) = 4·22; 95 % CI: 3·11, 5·72), Côte d'Ivoire (aOR = 5·19; 95 % CI: 3·10, 8·70) and Mali (aOR = 1·41; 95 % CI: 1·15, 1·74). Children aged 12-59 months had a higher likelihood of VAS uptake compared with children aged 6-11 months in Côte d'Ivoire (aOR = 1·67; 95 % CI: 1·12, 2·48) and Mali (aOR = 1·74; 95 % CI: 1·34, 2·26). Moderate-to-high COVID-19 concern was associated with a lower likelihood of VAS uptake in Côte d'Ivoire (aOR = 0·55; 95 % CI: 0·37, 0·80). CONCLUSION The increase in VAS coverage from 2019 to 2020 suggests that COVID-19 concerns may not have limited VAS uptake in some African countries, though geographic inequities should be considered.
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Affiliation(s)
- Melissa M Baker
- Helen Keller International, P.O. Box 14195 – 00800, Nairobi, Kenya
| | | | | | | | | | | | | | - David Doledec
- Helen Keller International, P.O. Box 14195 – 00800, Nairobi, Kenya
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19
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Song P, Adeloye D, Li S, Zhao D, Ye X, Pan Q, Qiu Y, Zhang R, Rudan I. The prevalence of vitamin A deficiency and its public health significance in children in low- and middle-income countries: A systematic review and modelling analysis. J Glob Health 2023; 13:04084. [PMID: 37565390 PMCID: PMC10416138 DOI: 10.7189/jogh.13.04084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Abstract
Background Vitamin A deficiency (VAD) is widely recognised as a major public health concern in low- and middle-income countries (LMICs). Despite various interventions implemented in many countries, a lack of reliable data is hindering progress. We aimed to consolidate available data and quantify estimates of the prevalence of VAD among children ≤18 years in LMICs. Methods We searched PubMed, Medline and Embase for studies reported the prevalence of VAD or marginal (m)VAD among children. A multilevel mixed-effects meta-regression approach was applied to establish the regression models for VAD and mVAD prevalence. The total numbers of children affected by VAD and mVAD in LMICs in 2019 were separately calculated from the estimated age- and socio-demographic index (SDI)-specific prevalence with their corresponding United Nations Population Division populations projections. We estimated areas of significant public health concern in 165 LMICs using the lower confidence interval (CI) of VAD prevalence. Results A total of 116 articles from 40 LMICs were retained. In 2019, VAD and mVAD affected 333.95 million (95% CI = 253.00-433.74) and 556.13 million (95% CI = 388.83-767.94) children and adolescents in 165 LMICs, respectively, corresponding to a prevalence of 14.73% (95% CI = 11.16-19.14) and 24.54% (95% CI = 17.15-33.88). The prevalence of both VAD and mVAD was the highest in children aged 0-5 years at 19.53% (95% CI = 15.03-24.91) and 28.22% (95% CI = 20.00-38.24), respectively, with both steadily decreasing to 10.09% (95% CI = 7.44-13.50) and 20.76% (95% CI = 14.16-29.50) in adolescents aged 13-18 years. The prevalence of VAD was significantly higher in the low SDI region at 29.67% (95% CI = 22.67-37.53) compared to 5.17% (95% CI = 3.14-8.43) estimated in the high-middle SDI region. 68 of the 165 LMICs (41.21%) were classified as areas of moderate to severe VAD public health significance. Conclusions VAD continues to pose a significant public health concern in many low-income settings. Development in LMICs is a crucial factor for VAD, with a disproportionately higher burden in low SDI regions. Registration This study protocol was registered with PROSPERO, CRD42020220654.
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Affiliation(s)
- Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Davies Adeloye
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Shuting Li
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Dong Zhao
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xinxin Ye
- College of Education, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qing Pan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yiwen Qiu
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ronghua Zhang
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
- Algebra University, Zagreb, Croatia
| | - Global Health Epidemiology Research Group (GHERG)
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang, China
- College of Education, Zhejiang University, Hangzhou, Zhejiang, China
- Algebra University, Zagreb, Croatia
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Hermes Sales C, de Mello Fontanelli M, Macedo Rogero M, Mori Sarti F, Fisberg RM. Dietary inadequacies overestimate the blood deficiencies of magnesium, zinc, and vitamins A, C, E, and D among residents of Sao Paulo. Clin Nutr ESPEN 2023; 53:196-205. [PMID: 36657914 DOI: 10.1016/j.clnesp.2022.12.015] [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: 07/04/2022] [Revised: 11/03/2022] [Accepted: 12/10/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND & AIMS We aimed to estimate the prevalence of the inadequate intake and status of magnesium, zinc, and vitamins A, C, E, and D and identify factors associated with micronutrient deficiency in serum/plasma among residents of São Paulo, Brazil. METHODS Data from 824 individuals aged ≥14 years were obtained from the 2015 ISA-Nutrition, a population-based, cross-sectional survey. Dietary and supplement intakes were assessed using two 24-h dietary recalls, and the micronutrient inadequacies were estimated using the National Cancer Institute method. Micronutrient status was measured in serum or plasma, and deficiency was established according to the lower limit of the reference values. Receiver operating characteristic curve analysis was used to identify the effect of intake on the micronutrient status in serum/plasma. Logistic regression analysis was applied to assess the association between micronutrient status and individual characteristics. RESULTS More than 80% of the population had an inadequate dietary intake of magnesium, vitamin E, and vitamin D. Males had a high prevalence of inadequate dietary intake of vitamin A and zinc. A high-to-moderate prevalence of inadequate vitamin C intake was observed. Vitamin D was the only nutrient with a deficient status comparable to its dietary inadequacy. The other nutrients demonstrated a lower deficiency prevalence compared to dietary inadequacy, and vitamin A demonstrated the lowest prevalence of deficiency in plasma. Generally, dietary intake showed a non-notable association with micronutrient deficiency in serum/plasma. Individuals with fasting glucose concentrations ≥100 mg/dL and those using diuretic drugs had a higher risk of serum magnesium deficiency. Those using lipid-lowering drugs and those with high plasma adiponectin concentrations had a higher risk of serum zinc deficiency. Individuals who smoked and those with hypertension showed a higher risk of plasma vitamin C deficiency. Individuals with average leptin concentrations had a higher risk of plasma vitamin E deficiency. Finally, those with sufficient leisure-time physical activity had a lower risk of serum vitamin D deficiency. CONCLUSIONS Residents of the urban areas of São Paulo demonstrated substantially inadequate intakes of most of the assessed micronutrients; however, micronutrient deficiency in serum/plasma was not associated with dietary inadequacy, and it usually demonstrated a lower prevalence than dietary indicators. Thus, using micronutrient intake to determine the serum/plasma profile should be done with caution. The status of the micronutrients varied according to individual characteristics, indicating the interplay of complex mechanisms underlying micronutrient balance.
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Affiliation(s)
- Cristiane Hermes Sales
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
| | | | - Marcelo Macedo Rogero
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
| | - Flávia Mori Sarti
- School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo 03828-000, Brazil.
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
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Global Burden of Nutritional Deficiencies among Children under 5 Years of Age from 2010 to 2019. Nutrients 2022; 14:nu14132685. [PMID: 35807863 PMCID: PMC9268233 DOI: 10.3390/nu14132685] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/25/2022] [Accepted: 06/25/2022] [Indexed: 12/10/2022] Open
Abstract
Under-five years of age is a critical period for children’s growth and development. Nutritional deficiency during this period is associated with wasting, underweight and stunting. We aimed to conduct an epidemiological study using data derived from the GBD2019 to found the global distribution and changing trends of nutritional deficiencies among children under 5 years old, as well as the correlation between social development status and nutritional deficiencies. Nutritional deficiencies in children under 5 years has been substantially improved in the past decade; however, the progress has been unevenly distributed globally. The incidence and DALY rate decreased with the increase of socio-demographic index. In 2019, the incidence (51,872.0 per 100,000) was highest in Central Sub-Saharan Africa and the DALY rate (5597.1 per 100,000) was the highest in Western Sub-Saharan Africa. Among five subcategories of nutritional deficiencies in children under 5 years, vitamin A deficiency accounted for the largest proportion of incident cases (100,511,850, 62.1% in 2019), while the proportion of DALYs caused by protein–energy malnutrition was the highest (9,925,276, 62.0%). Nutritional deficiency in some countries remains worrisome, for whom policies guarantees and sustained efforts to control nutritional deficiencies are urgently needed.
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