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Rivas JFG, Clugston RD. The etiology of congenital diaphragmatic hernia: the retinoid hypothesis 20 years later. Pediatr Res 2024; 95:912-921. [PMID: 37990078 PMCID: PMC10920205 DOI: 10.1038/s41390-023-02905-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/16/2023] [Accepted: 10/30/2023] [Indexed: 11/23/2023]
Abstract
Congenital diaphragmatic hernia (CDH) is a severe birth defect and a major cause of neonatal respiratory distress. Impacting ~2-3 in 10,000 births, CDH is associated with a high mortality rate, and long-term morbidity in survivors. Despite the significant impact of CDH, its etiology remains incompletely understood. In 2003, Greer et al. proposed the Retinoid Hypothesis, stating that the underlying cause of abnormal diaphragm development in CDH was related to altered retinoid signaling. In this review, we provide a comprehensive update to the Retinoid Hypothesis, discussing work published in support of this hypothesis from the past 20 years. This includes reviewing teratogenic and genetic models of CDH, lessons from the human genetics of CDH and epidemiological studies, as well as current gaps in the literature and important areas for future research. The Retinoid Hypothesis is one of the leading hypotheses to explain the etiology of CDH, as we continue to better understand the role of retinoid signaling in diaphragm development, we hope that this information can be used to improve CDH outcomes. IMPACT: This review provides a comprehensive update on the Retinoid Hypothesis, which links abnormal retinoic acid signaling to the etiology of congenital diaphragmatic hernia. The Retinoid Hypothesis was formulated in 2003. Twenty years later, we extensively review the literature in support of this hypothesis from both animal models and humans.
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Affiliation(s)
- Juan F Garcia Rivas
- Department of Physiology, University of Alberta, Edmonton, AB, Canada
- Women and Children's Health Research Institute, Edmonton, AB, Canada
| | - Robin D Clugston
- Department of Physiology, University of Alberta, Edmonton, AB, Canada.
- Women and Children's Health Research Institute, Edmonton, AB, Canada.
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2
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Chen X, Liang J, Yang Q, Huang J, Li L, Deng K. Age affects the association between socioeconomic status and infertility: a cross-sectional study. BMC Womens Health 2023; 23:675. [PMID: 38115086 PMCID: PMC10729442 DOI: 10.1186/s12905-023-02680-x] [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: 04/09/2023] [Accepted: 09/30/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Previous studies have shown the interaction between age and socioeconomic status (SES) on the risk of infertility in the UK, but the association is still unclear in the United States. Therefore, the present study investigated the effect of age on the relationship between SES and the risk of infertility in American women. METHODS The study included adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018. The poverty income ratio (PIR) was used to represent the SES of the population. With participants stratified according to age category (< 35 years; ≥ 35 years), we further assessed differences in the relationship between PIR and infertility risk among participants of different age groups using multivariate logistic regression and interaction tests. RESULTS Approximately 3,273 participants were enrolled in the study. There were 399 cases of infertility and 2,874 cases without infertility. In women ≥ 35 years of age, PIR levels were significantly higher in infertile participants than in non-infertile participants, but no such difference was found in those < 35 years of age. The association of PIR with the risk of infertility appeared to differ between age < 35 years and age ≥ 35 years (OR: 0.99, 95%Cl: 0.86-1.13 vs. OR: 1.24, 95%Cl: 1.12-1.39) in a fully adjusted model. Furthermore, an interaction between age and PIR increased the risk of infertility (p-value for interaction < 0.001). CONCLUSION Our study found that age may influence the association between PIR and infertility. It is imperative to perform further studies to provide more evidence.
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Affiliation(s)
- Xiting Chen
- Department of Gynecology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), No.1 Jiazi Road, Lunjiao, Shunde District, Foshan City, 528308, Guangdong Province, China
| | - Jiemei Liang
- Department of Gynecology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), No.1 Jiazi Road, Lunjiao, Shunde District, Foshan City, 528308, Guangdong Province, China
| | - Qian Yang
- Department of Gynecology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), No.1 Jiazi Road, Lunjiao, Shunde District, Foshan City, 528308, Guangdong Province, China
| | - Jinfa Huang
- Department of Gynecology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), No.1 Jiazi Road, Lunjiao, Shunde District, Foshan City, 528308, Guangdong Province, China
| | - Lixin Li
- Department of Gynecology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), No.1 Jiazi Road, Lunjiao, Shunde District, Foshan City, 528308, Guangdong Province, China
| | - Kaixian Deng
- Department of Gynecology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), No.1 Jiazi Road, Lunjiao, Shunde District, Foshan City, 528308, Guangdong Province, China.
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3
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Mawson AR. Understanding health disparities affecting people of West Central African descent in the United States: An evolutionary perspective. Evol Appl 2023; 16:963-978. [PMID: 37216026 PMCID: PMC10197229 DOI: 10.1111/eva.13549] [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: 01/28/2022] [Revised: 03/19/2023] [Accepted: 04/02/2023] [Indexed: 05/24/2023] Open
Abstract
Human populations adapting to diverse aspects of their environment such as climate and pathogens leave signatures of genetic variation. This principle may apply to people of West Central African descent in the United States, who are at increased risk of certain chronic conditions and diseases compared to their European counterparts. Less well known is that they are also at reduced risk of other diseases. While discriminatory practices in the United States continue to affect access to and the quality of healthcare, the health disparities affecting African Americans may also be due in part to evolutionary adaptations to the original environment of sub-Saharan Africa, which involved continuous exposure to the vectors of potentially lethal endemic tropical diseases. Evidence is presented that these organisms selectively absorb vitamin A from the host, and its use in parasite reproduction contributes to the signs and symptoms of the respective diseases. These evolutionary adaptations included (1) sequestering vitamin A away from the liver to other organs, to reduce accessibility to the invaders; and (2) reducing the metabolism and catabolism of vitamin A (vA), causing it to accumulate to subtoxic concentrations and weaken the organisms, thereby reducing the risk of severe disease. However, in the environment of North America, lacking vA-absorbing parasites and with a mainly dairy-based diet that is high in vA, this combination of factors is hypothesized to lead to the accumulation of vA and to increased sensitivity to vA as a toxin, which contribute to the health disparities affecting African Americans. vA toxicity is linked to numerous acute and chronic conditions via mitochondrial dysfunction and apoptosis. Subject to testing, the hypothesis suggests that the adoption of traditional or modified West Central African-style diets that are low in vA and high in vA-absorbing fiber hold promise for disease prevention and treatment, and as a population-based strategy for health maintenance and longevity.
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Affiliation(s)
- Anthony R. Mawson
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health SciencesJackson State UniversityJacksonMississippiUSA
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4
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Gilbert RM, Gleghorn JP. Connecting clinical, environmental, and genetic factors point to an essential role for vitamin A signaling in the pathogenesis of congenital diaphragmatic hernia. Am J Physiol Lung Cell Mol Physiol 2023; 324:L456-L467. [PMID: 36749917 PMCID: PMC10042603 DOI: 10.1152/ajplung.00349.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/09/2023] Open
Abstract
Congenital diaphragmatic hernia (CDH) is a developmental disorder that results in incomplete diaphragm formation, pulmonary hypoplasia, and pulmonary hypertension. Although a variety of genes have been linked to its etiology, CDH is not a monogenetic disease, and the cause of the condition is still unclear in the vast majority of clinical cases. By comparing human clinical data and experimental rodent data from the literature, we present clear support demonstrating the importance of vitamin A (vitA) during the early window of pregnancy when the diaphragm and lung are forming. Alteration of vitA signaling via dietary and genetic perturbations can create diaphragmatic defects. Unfortunately, vitA deficiency is chronic among people of child-bearing age, and this early window of diaphragm development occurs before many might be aware of pregnancy. Furthermore, there is an increased demand for vitA during this critical period, which exacerbates the likelihood of deficiency. It would be beneficial for the field to further investigate the connections between maternal vitA and CDH incidence, with the goal of determining vitA status as a CDH risk factor. Regular clinical monitoring of vitA levels in child-bearing years is a tractable method by which CDH outcomes could be prevented or improved.
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Affiliation(s)
- Rachel M Gilbert
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware, United States
| | - Jason P Gleghorn
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware, United States
- Department of Biological Sciences, University of Delaware, Newark, Delaware, United States
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5
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Cheng TYD, Ferderber C, Kinder B, Wei YJJ. Trends in Dietary Vitamin A Intake Among US Adults by Race and Ethnicity, 2003-2018. JAMA 2023; 329:1026-1029. [PMID: 36976287 PMCID: PMC10051065 DOI: 10.1001/jama.2023.0636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/17/2023] [Indexed: 03/29/2023]
Abstract
This study uses data from the 2003-2004 to 2017-2018 National Health and Nutrition Examination Surveys (NHANES) to assess whether a difference exists in dietary vitamin A intake as a marker of consumption of vitamin A–rich foods among Black, Hispanic, and White adults in the US.
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Affiliation(s)
| | | | - Benjamin Kinder
- Division of Outcomes and Translational Sciences, The Ohio State University, Columbus
| | - Yu-Jung Jenny Wei
- Division of Outcomes and Translational Sciences, The Ohio State University, Columbus
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6
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Suzuki M, Tomita M. Genetic Variations of Vitamin A-Absorption and Storage-Related Genes, and Their Potential Contribution to Vitamin A Deficiency Risks Among Different Ethnic Groups. Front Nutr 2022; 9:861619. [PMID: 35571879 PMCID: PMC9096837 DOI: 10.3389/fnut.2022.861619] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/23/2022] [Indexed: 12/01/2022] Open
Abstract
Vitamin A, an essential fat-soluble micronutrient, plays a critical role in the body, by regulating vision, immune responses, and normal development, for instance. Vitamin A deficiency (VAD) is a major cause of xerophthalmia and increases the risk of death from infectious diseases. It is also emerging that prenatal exposure to VAD is associated with disease risks later in life. The overall prevalence of VAD has significantly declined over recent decades; however, the rate of VAD is still high in many low- and mid-income countries and even in high-income countries among specific ethnic/race groups. While VAD occurs when dietary intake is insufficient to meet demands, establishing a strong association between food insecurity and VAD, and vitamin A supplementation is the primary solution to treat VAD, genetic contributions have also been reported to effect serum vitamin A levels. In this review, we discuss genetic variations associated with vitamin A status and vitamin A bioactivity-associated genes, specifically those linked to uptake of the vitamin in the small intestine and its storage in the liver, as well as their potential contribution to vitamin A deficiency risks among different ethnic groups.
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Affiliation(s)
- Masako Suzuki
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, United States
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7
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Czuba LC, Fay EE, LaFrance J, Smith CK, Shum S, Moreni SL, Mao J, Isoherranen N, Hebert MF. Plasma Retinoid Concentrations Are Altered in Pregnant Women. Nutrients 2022; 14:1365. [PMID: 35405978 PMCID: PMC9002937 DOI: 10.3390/nu14071365] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [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.
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Affiliation(s)
- Lindsay C. Czuba
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA 98195, USA; (L.C.C.); (J.L.); (S.S.); (N.I.)
| | - Emily E. Fay
- Department of Obstetrics and Gynecology, School of Medicine, University of Washington, Seattle, WA 98195, USA; (E.E.F.); (S.L.M.); (J.M.)
| | - Jeffrey LaFrance
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA 98195, USA; (L.C.C.); (J.L.); (S.S.); (N.I.)
| | - Chase K. Smith
- Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA 98195, USA;
| | - Sara Shum
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA 98195, USA; (L.C.C.); (J.L.); (S.S.); (N.I.)
| | - Sue L. Moreni
- Department of Obstetrics and Gynecology, School of Medicine, University of Washington, Seattle, WA 98195, USA; (E.E.F.); (S.L.M.); (J.M.)
| | - Jennie Mao
- Department of Obstetrics and Gynecology, School of Medicine, University of Washington, Seattle, WA 98195, USA; (E.E.F.); (S.L.M.); (J.M.)
| | - Nina Isoherranen
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA 98195, USA; (L.C.C.); (J.L.); (S.S.); (N.I.)
| | - Mary F. Hebert
- Department of Obstetrics and Gynecology, School of Medicine, University of Washington, Seattle, WA 98195, USA; (E.E.F.); (S.L.M.); (J.M.)
- Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA 98195, USA;
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8
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Zhou Y, Si K, Li H, Li X, Tanumihardjo SA, Liu J. Geographic and socio-demographic determinants of plasma retinol concentrations in Chinese pregnant and lactating women. Eur J Nutr 2021; 61:1561-1570. [PMID: 34860270 DOI: 10.1007/s00394-021-02759-x] [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: 07/14/2021] [Accepted: 11/25/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To examine plasma retinol status and its determinants in Chinese pregnant or lactating women. METHODS A cross-sectional study involving 1211 healthy women in mid-pregnancy, late pregnancy, or lactation was conducted in northern, central, and southern China. Plasma retinol concentration was determined by high-performance liquid chromatography. Multivariate quantile regression or modified Poisson regression was used to estimate adjusted medians, or to examine the associations of suboptimal retinol concentration (< 1.05 µmol/L) with various factors. RESULTS The overall median (interquartile range) retinol concentration was 1.25 (1.06-1.46) µmol/L. The adjusted concentration was higher in women at lactation (1.39 [1.20-1.63] µmol/L) and mid-pregnancy (1.26 [1.10-1.44] µmol/L) than late pregnancy (1.07 [0.92-1.28] µmol/L), and higher in women in the central area (1.34 [1.18-1.49] µmol/L) and the north (1.26 [1.10-1.43] µmol/L) than the south (1.19 [1.07-1.31] µmol/L). The retinol concentration was more likely to be low in women with lower pre-pregnancy BMI, younger age, less education, and in lactating women who had a caesarean birth or were breastfeeding exclusively. A total of 290 (24.0%) women had a suboptimal retinol concentration, and the prevalence was higher in women at late pregnancy, residing in the south, with younger age, and having underweight pre-pregnancy. CONCLUSION About one-fourth of pregnant or lactating women in China had suboptimal retinol concentrations that varied with phases of pregnancy and lactation, region of residence, and socio-demographic characteristics, indicating a need for population-specific public health strategies to optimize vitamin A status.
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Affiliation(s)
- Yubo Zhou
- Institute of Reproductive and Child Health/ National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Keyi Si
- Institute of Reproductive and Child Health/ National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Hongtian Li
- Institute of Reproductive and Child Health/ National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Xiucui Li
- Institute of Reproductive and Child Health/ National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Jianmeng Liu
- Institute of Reproductive and Child Health/ National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China. .,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
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9
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Holmes MD, Peng C. Vitamin A: A Potential Intervention for Breast Cancer Racial Disparities. J Nutr 2021; 151:3602-3603. [PMID: 34753173 PMCID: PMC8643599 DOI: 10.1093/jn/nxab359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Cheng Peng
- Channing Division of Network Medicine, Harvard Medical School, Boston, MA, USA
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10
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Yang C, Zhao A, Lan H, Zhang J, Ren Z, Szeto IM, Wang P, Zhang Y. Fruit and vegetable consumption and serum vitamin A in lactating women: A cross-sectional survey in urban China. Food Sci Nutr 2021; 9:5676-5688. [PMID: 34646536 PMCID: PMC8497839 DOI: 10.1002/fsn3.2532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/18/2021] [Accepted: 08/03/2021] [Indexed: 12/27/2022] Open
Abstract
During the lactation period, healthy eating behavior is essential to maternal and child health. However, Chinese lactating women may have some traditional food restrictions. Our aims were to evaluate the fruit and vegetable consumption of Chinese lactating women and to examine the associations between fruit and vegetable consumption and serum vitamin A concentrations. A total of 885 participants were included. Dietary intakes were assessed during the same time frame as blood collection via a one-time 24-h dietary recall (24HDR) and a semiquantitative food frequency questionnaire (SFFQ), respectively. Serum vitamin A concentrations were assessed with high-performance liquid chromatography. Based on 24HDR, 64.7% and 85.5% of lactating women did not consume the appropriate amount of fruits and vegetables, respectively. New mothers who adopt zuo yuezi behavior during the first month were negatively associated with fruit consumption. The median (25th to 75th) dietary vitamin A intake was 349.5 (202.5-591.4) μg RAE/day. Vegetable contributed 24.9% and fruit 4.8% of the dietary vitamin A intake. The median (25th to 75th) serum vitamin A concentration was 1.92 (1.61-2.30) μmol/L. 24HDR assessments of total fruit and vegetable consumption, and fruit consumption were positively associated with higher serum vitamin A concentrations, respectively (β = 0.200, 95%CI = 0.077, 0.323, p = .001; β = 0.241, 95%CI = 0.008, 0.474, p = .044). These positive associations were replicated in the SFFQ assessments (β = 0.102, 95%CI = 0.016, 0.188, p = .020; β = 0.215, 95%CI = 0.088, 0.341, p = .001). Chinese lactating women had inappropriate fruit and vegetable consumption. Fruit and vegetable consumption was associated with serum vitamin A concentrations.
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Affiliation(s)
- Chenlu Yang
- Department of Nutrition and Food HygieneSchool of Public HealthPeking UniversityBeijingChina
| | - Ai Zhao
- Vanke School of Public HealthTsinghua UniversityBeijingChina
| | - Hanglian Lan
- Inner Mongolia Dairy Technology Research Institute Co., Ltd.HohhotInner Mongolia Autonomous RegionChina
- Yili Maternal and Infant Nutrition InstituteInner Mongolia Yili Industrial Group Co., Ltd.HohhotInner Mongolia Autonomous RegionChina
| | - Jian Zhang
- Department of Nutrition and Food HygieneSchool of Public HealthPeking UniversityBeijingChina
| | - Zhongxia Ren
- Department of Nutrition and Food HygieneSchool of Public HealthPeking UniversityBeijingChina
| | - Ignatius Man‐Yau Szeto
- Inner Mongolia Dairy Technology Research Institute Co., Ltd.HohhotInner Mongolia Autonomous RegionChina
- Yili Maternal and Infant Nutrition InstituteInner Mongolia Yili Industrial Group Co., Ltd.HohhotInner Mongolia Autonomous RegionChina
| | - Peiyu Wang
- Department of Social Medicine and Health EducationSchool of Public HealthPeking UniversityBeijingChina
| | - Yumei Zhang
- Department of Nutrition and Food HygieneSchool of Public HealthPeking UniversityBeijingChina
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food SafetySchool of Public HealthPeking UniversityBeijingChina
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11
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Bitsie KR, Cheng TYD, McCann SE, Zirpoli G, Yao S, Bandera EV, Kolonel LN, Rosenberg L, Olshan AF, Palmer JR, Ambrosone CB. Dietary Vitamin A and Breast Cancer Risk in Black Women: The African American Breast Cancer Epidemiology and Risk (AMBER) Consortium. J Nutr 2021; 151:3725-3737. [PMID: 34494098 PMCID: PMC8643579 DOI: 10.1093/jn/nxab278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/11/2021] [Accepted: 07/29/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Studies in women of European descent showed an inverse association of dietary vitamin A (retinol and carotenoids) intake with breast cancer risks, mainly in premenopausal women. OBJECTIVES We examined whether higher compared with lower levels of dietary vitamin A are associated with reduced breast cancer risks among Black women by estrogen receptor (ER) and menopausal statuses. METHODS In this pooled analysis, data were from 3564 breast cancer cases and 11,843 controls (mean ages = 56.4 and 56.3 years, respectively) in the African American Breast Cancer Epidemiology and Risk (AMBER) Consortium. Dietary intake was assessed by FFQs. Multivariable logistic regressions were performed to estimate ORs and 95% CIs for study-specific quintiles of total vitamin A equivalents and individual carotenoids, and a pooled OR was estimated by a random-effect model. RESULTS We observed an inverse association of total vitamin A equivalents with ER-positive breast cancer (quintiles 5 compared with 1: pooled OR: 0.82; 95% CI: 0.67-1.00; P-trend = 0.045). The association was seen among premenopausal women (pooled OR: 0.60; 95% CI: 0.43-0.83; P-trend = 0.004), but not among postmenopausal women (pooled OR: 0.99; 95% CI: 0.77-1.28; P-trend = 0.78). Additionally, there were inverse associations of dietary β-carotene (quintiles 5 compared with 1: pooled OR: 0.70; 95% CI: 0.51-0.95; P-trend = 0.08) and lutein (pooled OR: 0.63; 95% CI: 0.45-0.87; P-trend = 0.020) with ER-positive breast cancer among premenopausal women. There was no evidence for an association of total vitamin A equivalents or individual carotenoids with ER-negative breast cancer, regardless of menopausal status. CONCLUSIONS Our findings on dietary vitamin A and breast cancer risks in Black women are consistent with observations in women of European descent and advance the literature showing an inverse association for ER-positive disease.
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Affiliation(s)
- Kevin R Bitsie
- Department of Epidemiology, University of Florida, Gainesville FL, USA
| | | | - Susan E McCann
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Gary Zirpoli
- Slone Epidemiology Center at Boston University, Boston MA, USA
| | - Song Yao
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Elisa V Bandera
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | - Lynn Rosenberg
- Slone Epidemiology Center at Boston University, Boston MA, USA
| | - Andrew F Olshan
- University of North Carolina Lineberger Cancer Center, Chapel Hill, NC, USA
| | - Julie R Palmer
- Slone Epidemiology Center at Boston University, Boston MA, USA
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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12
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Suzuki M, Wang T, Garretto D, Isasi CR, Cardoso WV, Greally JM, Quadro L. Disproportionate Vitamin A Deficiency in Women of Specific Ethnicities Linked to Differences in Allele Frequencies of Vitamin A-Related Polymorphisms. Nutrients 2021; 13:1743. [PMID: 34063790 PMCID: PMC8223783 DOI: 10.3390/nu13061743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 11/16/2022] Open
Abstract
Background: While the current national prevalence rate of vitamin A deficiency (VAD) is estimated to be less than 1%, it is suggested that it varies between different ethnic groups and races within the U.S. We assessed the prevalence of VAD in pregnant women of different ethnic groups and tested these prevalence rates for associations with the vitamin A-related single nucleotide polymorphism (SNP) allele frequencies in each ethnic group. Methods: We analyzed two independent datasets of serum retinol levels with self-reported ethnicities and the differences of allele frequencies of the SNPs associated with vitamin A metabolism between groups in publicly available datasets. Results: Non-Hispanic Black and Hispanic pregnant women showed high VAD prevalence in both datasets. Interestingly, the VAD prevalence for Hispanic pregnant women significantly differed between datasets (p = 1.973 × 10-10, 95%CI 0.04-0.22). Alleles known to confer the risk of low serum retinol (rs10882272 C and rs738409 G) showed higher frequencies in the race/ethnicity groups with more VAD. Moreover, minor allele frequencies of a set of 39 previously reported SNPs associated with vitamin A metabolism were significantly different between the populations of different ancestries than those of randomly selected SNPs (p = 0.030). Conclusions: Our analysis confirmed that VAD prevalence varies between different ethnic groups/races and may be causally associated with genetic variants conferring risk for low retinol levels. Assessing genetic variant information prior to performing an effective nutrient supplementation program will help us plan more effective food-based interventions.
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Affiliation(s)
- Masako Suzuki
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Tao Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (T.W.); (C.R.I.)
| | - Diana Garretto
- Department of Obstetrics and Gynecology and Women’s Health, Stony Brook University Medical Center, Stony Brook, NY 11794, USA;
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (T.W.); (C.R.I.)
| | - Wellington V. Cardoso
- Columbia Center for Human Development, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA;
| | - John M. Greally
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Loredana Quadro
- Department of Food Science and Rutgers Center for Lipid Research, and New Jersey Institute for Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ 08901, USA;
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13
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Bassey C, Crooks H, Paterson K, Ball R, Howell K, Humphries-Cuff I, Gaffigan K, Rao N, Whitty JA, Hooper L. Impact of home food production on nutritional blindness, stunting, wasting, underweight and mortality in children: a systematic review and meta-analysis of controlled trials. Crit Rev Food Sci Nutr 2020; 62:1856-1869. [PMID: 33272038 DOI: 10.1080/10408398.2020.1848786] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Vitamin A deficiency is highly prevalent and remains the major cause of nutritional blindness in children in low-and middle-income countries, despite supplementation programmes. Xeropthalmia (severe drying and thickening of the conjunctiva) is caused by vitamin A deficiency and leads to irreversible blindness. Vitamin A supplementation programmes effectively reduce vitamin A deficiency but many rural children are not reached. Home food production may help prevent rural children's vitamin A deficiency. We aimed to systematically review trials assessing effects of home food production (also called homestead food production and agricultural interventions) on xeropthalmia, nightblindness, stunting, wasting, underweight and mortality (primary outcomes). We searched Medline, Embase, Scopus, Cochrane CENTRAL and trials registers to February 2019. Inclusion of studies, data extraction and risk of bias were assessed independently in duplicate. Random-effects meta-analysis, sensitivity analyses, subgrouping and GRADE were used. We included 16 trials randomizing 2498 children, none reported xerophthalmia, night-blindness or mortality. Home food production may slightly reduce stunting (mean difference (MD) 0.13 (z-score), 95% CI 0.01 to 0.24), wasting (MD 0.05 (z-score), 95% CI -0.04 to 0.14) and underweight (MD 0.07 (z-score), 95% CI -0.01 to 0.15) in young children (all GRADE low-consistency evidence), and increase dietary diversity (standardized mean difference (SMD) 0.24, 95% CI 0.15 to 0.34). Home food production may usefully complement vitamin A supplementation for rural children. Large, long-duration trials with good randomization, allocation concealment and correct adjustment for clustering are needed to assess effectiveness of home food production on nutritional blindness in young children.
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Affiliation(s)
- Chizoba Bassey
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Harriet Crooks
- Student Services, University of East Anglia, Norwich, UK
| | - Katherine Paterson
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Rachel Ball
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Kristoffer Howell
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Iona Humphries-Cuff
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Kirsty Gaffigan
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Nitya Rao
- School of Developmental Studies, University of East Anglia, Norwich, UK
| | - Jennifer A Whitty
- Norwich Medical School, University of East Anglia, Norwich, UK.,National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England, UK
| | - Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich, UK
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14
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Garretto D, Kim YK, Quadro L, Rhodas RR, Pimentel V, Crnosija NA, Nie L, Bernstein P, Tropper P, Neal-Perry GS. Vitamin A and β-carotene in pregnant and breastfeeding post-bariatric women in an urban population. J Perinat Med 2019; 47:183-189. [PMID: 30231012 DOI: 10.1515/jpm-2018-0142] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/13/2018] [Indexed: 02/01/2023]
Abstract
Background As breastfeeding awareness and social acceptance are increased, maternal nutritional deficiency requires more investigation. Methods A prospective cohort study was conducted to determine if vitamin A deficiency is more common in pregnant, lactating post-bariatric surgery women in an inner city population. Antepartum, women after bariatric surgery and controls with no history of malabsorption were recruited. Third trimester, postpartum maternal blood and cord blood were collected as well as three breast milk samples: colostrum, transitional and mature milk. A nutritional survey of diet was completed. Each serum sample was analyzed for total retinol and β-carotene; breast milk samples were analyzed for retinol and retinyl esters, total retinol and β-carotene. Results Fifty-three women after bariatric surgery and 66 controls were recruited. Postpartum serum retinol was significantly higher in women after bariatric surgery in the univariate analysis (P<0.0001) and confirmed in the multiple linear mixed model (P=0.0001). Breast milk colostrum retinol and transitional milk total retinol were significantly greater in the bariatric surgery group in the univariate analysis (P=0.03 and P=0.02, respectively), but not after adjusting for confounders. Serum β-carotene in the third trimester and postpartum were lower (P<0.0001 and P=0.003, respectively) in the bariatric surgery group but not after adjusting for confounders. Vitamin A deficiency was high in both groups in serum and breast milk samples. Conclusion Nutritional deficiencies in breastfeeding women after bariatric surgeries may in fact be less common than in control women in an inner city.
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Affiliation(s)
- Diana Garretto
- Department of Obstetrics, Gynecology, and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA.,Department of Obstetrics and Gynecology and Women's Health, Stony Brook University Medical Center, Stony Brook, NY, USA
| | - Youn-Kyung Kim
- Department of Food Science and Rutgers Center for Lipid Research, and New Jersey Institute for Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ, USA
| | - Loredana Quadro
- Department of Food Science and Rutgers Center for Lipid Research, and New Jersey Institute for Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ, USA
| | - Rebekah R Rhodas
- Department of Food Science and Rutgers Center for Lipid Research, and New Jersey Institute for Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ, USA
| | - Veronica Pimentel
- Department of Obstetrics, Gynecology, and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Natalie A Crnosija
- Department of Obstetrics and Gynecology and Women's Health, Stony Brook University Medical Center, Stony Brook, NY, USA
| | - Lizhou Nie
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Peter Bernstein
- Department of Obstetrics, Gynecology, and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Pamela Tropper
- Department of Obstetrics, Gynecology, and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Genevieve S Neal-Perry
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Washington-Seattle, Seattle, WA, USA
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15
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Abstract
Determining the predictors of serum retinol at mid-pregnancy is relevant for planning interventions aimed at improving vitamin A status of pregnant women and their offspring. This prospective study assessed predictors of serum retinol at the beginning of the third trimester of pregnancy. We enrolled 442 pregnant women living in the urban area of Cruzeiro do Sul, Western Brazilian Amazon. Demographic, socio-economic, environmental and clinical characteristics as well as obstetric history, anthropometric, dietary and biochemical data, including serum retinol, were gathered between 16 and 20 gestational weeks. Serum retinol also measured at the beginning of the third trimester of pregnancy (approximately 28 gestational weeks) was the outcome of interest. Multiple linear regression models were used to evaluate associations with the outcome. Overall, the following variables explained serum retinol at the beginning of the third trimester of pregnancy in the adjusted model (R 2 = 11·1 %): seasonality (winter season - November to April; β=0·134; 95 % CI 0·063, 0·206), weekly consumption of Amazonian fruits (β=0·087; 95 % CI 0·012, 0·162) and retinol concentrations between 16 and 20 gestational weeks (β=0·045; 95 % CI 0·016, 0·074) were positively associated, whereas having a smoker in the house was negatively associated (β=-0·087; 95 % CI: -0·166, -0·009). Consumption of pro-vitamin A-rich fruits by pregnant women should be encouraged. Passive smoking may play a role in decreasing vitamin A status as a proxy of smoking exposure during pregnancy.
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16
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Hanson C, Lyden E, Anderson-Berry A, Kocmich N, Rezac A, Delair S, Furtado J, Van Ormer M, Izevbigie N, Olateju EK, Akaba GO, Anigilaje EA, Yunusa T, Obaro S. Status of Retinoids and Carotenoids and Associations with Clinical Outcomes in Maternal-Infant Pairs in Nigeria. Nutrients 2018; 10:E1286. [PMID: 30213044 PMCID: PMC6165164 DOI: 10.3390/nu10091286] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 09/07/2018] [Accepted: 09/10/2018] [Indexed: 01/22/2023] Open
Abstract
Vitamin A is an essential nutrient in pregnancy, and other carotenoids have been independently associated with maternal-infant outcomes. The objective of this study was to quantify the status of vitamin A and carotenoids in Nigerian maternal-infant pairs at delivery, compare these to a cohort from a developed nation, and determine the impact on clinical outcomes. Maternal and cord blood samples were collected in 99 Nigerian mother-infant pairs. Concentrations of lutein + zeaxanthin, β-cryptoxanthin, lycopene, α- and β-carotenes, and retinol were measured using HPLC. Descriptive statistics were calculated and Spearman coefficients were used to assess correlations between maternal and cord measurements; Mann-Whitney tests were used to compare median plasma values between dichotomous variables. Linear regression models were used to adjust for relevant confounders. A p < 0.05 was considered statistically significant. Thirty-five percent of mothers had plasma retinol concentrations ≤0.70 µmol/L; 82% of infants had plasma retinol concentrations ≤0.70 µmol/L at delivery. Maternal and infant concentrations of vitamin A compounds were highly correlated and were associated with newborn growth and Apgar scores. Despite plasma concentrations of pro-vitamin A carotenoids higher than those reported in other populations, pregnant Nigerian women have a high prevalence of vitamin A deficiency. As vitamin A related compounds are modifiable by diet, future research determining the clinical impact of these compounds is warranted.
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Affiliation(s)
- Corrine Hanson
- College of Allied Health Professions Medical Nutrition Education, University of Nebraska Medical Center, Omaha, NE 68198-4045, USA.
| | - Elizabeth Lyden
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4375, USA.
| | - Ann Anderson-Berry
- Pediatrics 981205 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198-1205, USA.
| | - Nicholas Kocmich
- Pediatrics 981205 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198-1205, USA.
| | - Amy Rezac
- Pediatrics 981205 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198-1205, USA.
| | - Shirley Delair
- Pediatrics 981205 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198-1205, USA.
| | - Jeremy Furtado
- Department of Nutrition, Harvard School of Public Health 655 Huntington Avenue, Boston, MA 02215, USA.
| | - Matthew Van Ormer
- Pediatrics 981205 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198-1205, USA.
| | - N Izevbigie
- University of Abuja Teaching Hospital Gwagwalada-Zuba, Gwagwalada P.M.B. 228, Nigeria.
| | - E K Olateju
- University of Abuja Teaching Hospital Gwagwalada-Zuba, Gwagwalada P.M.B. 228, Nigeria.
| | - Godwin O. Akaba
- University of Abuja Teaching Hospital Gwagwalada-Zuba, Gwagwalada P.M.B. 228, Nigeria.
| | - E A Anigilaje
- University of Abuja Teaching Hospital Gwagwalada-Zuba, Gwagwalada P.M.B. 228, Nigeria.
| | - Thairu Yunusa
- University of Abuja Teaching Hospital Gwagwalada-Zuba, Gwagwalada P.M.B. 228,
| | - Stephen Obaro
- Pediatrics 981205 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198-1205, USA.
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17
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Baker BC, Hayes DJ, Jones RL. Effects of micronutrients on placental function: evidence from clinical studies to animal models. Reproduction 2018; 156:R69-R82. [PMID: 29844225 DOI: 10.1530/rep-18-0130] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 05/29/2018] [Indexed: 12/23/2022]
Abstract
Micronutrient deficiencies are common in pregnant women due to low dietary intake and increased requirements for fetal development. Low maternal micronutrient status is associated with a range of pregnancy pathologies involving placental dysfunction, including fetal growth restriction (FGR), small-for-gestational age (SGA), pre-eclampsia and preterm birth. However, clinical trials commonly fail to convincingly demonstrate beneficial effects of supplementation of individual micronutrients, attributed to heterogeneity and insufficient power, potential interactions and lack of mechanistic knowledge of effects on the placenta. We aimed to provide current evidence of relationships between selected micronutrients (vitamin D, vitamin A, iron, folate, vitamin B12) and adverse pregnancy outcomes, combined with understanding of actions on the placenta. Following a systematic literature search, we reviewed data from clinical, in vitro and in vivo studies of micronutrient deficiency and supplementation. Key findings are potential effects of micronutrient deficiencies on placental development and function, leading to impaired fetal growth. Studies in human trophoblast cells and rodent models provide insights into underpinning mechanisms. Interestingly, there is emerging evidence that deficiencies in all micronutrients examined induce a pro-inflammatory state in the placenta, drawing parallels with the inflammation detected in FGR, pre-eclampsia, stillbirth and preterm birth. Beneficial effects of supplementation are apparent in vitro and in animal models and for combined micronutrients in clinical studies. However, greater understanding of the roles of these micronutrients, and insight into their involvement in placental dysfunction, combined with more robust clinical studies, is needed to fully ascertain the potential benefits of supplementation in pregnancy.
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Affiliation(s)
- Bernadette C Baker
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Dexter Jl Hayes
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Rebecca L Jones
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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18
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Hanson C, Schumacher MV, Lyden E, Su D, Furtado J, Cammack R, Bereitschaft B, Van Ormer M, Needelman H, McGinn E, Rilett K, Cave C, Johnson R, Weishaar K, Anderson-Berry A. Fat-soluble vitamins A and E and health disparities in a cohort of pregnant women at delivery. J Nutr Sci 2018; 7:e14. [PMID: 29686863 PMCID: PMC5906555 DOI: 10.1017/jns.2018.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 12/21/2022] Open
Abstract
The objective of the present study was to evaluate intakes and serum levels of vitamin A, vitamin E, and related compounds in a cohort of maternal-infant pairs in the Midwestern USA in relation to measures of health disparities. Concentrations of carotenoids and tocopherols in maternal serum were measured using HPLC and measures of socio-economic status, including food security and food desert residence, were obtained in 180 mothers upon admission to a Midwestern Academic Medical Center labour and delivery unit. The Kruskal-Wallis and independent-samples t tests were used to compare measures between groups; logistic regression models were used to adjust for relevant confounders. P < 0·05 was considered statistically significant. The odds of vitamin A insufficiency/deficiency were 2·17 times higher for non-whites when compared with whites (95 % CI 1·16, 4·05; P = 0·01) after adjustment for relevant confounders. Similarly, the odds of being vitamin E deficient were 3·52 times higher for non-whites (95 % CI 1·51, 8·10; P = 0·003). Those with public health insurance had lower serum lutein concentrations compared with those with private health insurance (P = 0·05), and living in a food desert was associated with lower serum concentrations of β-carotene (P = 0·02), after adjustment for confounders. Subjects with low/marginal food security had higher serum levels of lutein and β-cryptoxanthin compared with those with high food security (P = 0·004 and 0·02 for lutein and β-cryptoxanthin). Diet quality may be a public health concern in economically disadvantaged populations of industrialised societies leading to nutritional disadvantages as well.
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Affiliation(s)
- Corrine Hanson
- Medical Nutrition Education, University of Nebraska Medical Center, College of Allied Health Professions, Medical Nutrition Education, Omaha, NE, USA
| | - Marina Verdi Schumacher
- Medical Nutrition Education, University of Nebraska Medical Center, College of Allied Health Professions, Medical Nutrition Education, Omaha, NE, USA
| | - Elizabeth Lyden
- College of Public Health, University of Nebraska Medical Center,Omaha, NE, USA
| | - Dejun Su
- College of Public Health, University of Nebraska Medical Center,Omaha, NE, USA
| | - Jeremy Furtado
- Department of Nutrition, Harvard School of Public Health, Cambridge, MA, USA
| | - Rex Cammack
- Department of Geography/Geology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Bradley Bereitschaft
- Department of Geography/Geology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Matthew Van Ormer
- Department of Pediatrics, University of Nebraska Medical Center, 981205 Nebraska Medical Center, Omaha, NE, USA
| | - Howard Needelman
- Department of Pediatrics, University of Nebraska Medical Center, 981205 Nebraska Medical Center, Omaha, NE, USA
| | - Elizabeth McGinn
- Department of Pediatrics, University of Nebraska Medical Center, 981205 Nebraska Medical Center, Omaha, NE, USA
| | - Katherine Rilett
- Department of Pediatrics, University of Nebraska Medical Center, 981205 Nebraska Medical Center, Omaha, NE, USA
| | - Caleb Cave
- Department of Pediatrics, University of Nebraska Medical Center, 981205 Nebraska Medical Center, Omaha, NE, USA
| | - Rebecca Johnson
- Department of Pediatrics, University of Nebraska Medical Center, 981205 Nebraska Medical Center, Omaha, NE, USA
| | - Kara Weishaar
- Department of Pediatrics, University of Nebraska Medical Center, 981205 Nebraska Medical Center, Omaha, NE, USA
| | - Ann Anderson-Berry
- Department of Pediatrics, University of Nebraska Medical Center, 981205 Nebraska Medical Center, Omaha, NE, USA
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19
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Moran NE, Johnson EJ. Closer to clarity on the effect of lipid consumption on fat-soluble vitamin and carotenoid absorption: do we need to close in further? Am J Clin Nutr 2017; 106:969-970. [PMID: 28903956 PMCID: PMC5611788 DOI: 10.3945/ajcn.117.165894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Nancy E Moran
- USDA/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX; and
| | - Elizabeth J Johnson
- Jean Mayer USDA/Human Nutrition Research Center on Aging, Tufts University, Boston, MA
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20
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Hanson C, Schumacher M, Lyden E, Furtado J, Van Ormer M, McGinn E, Rilett K, Cave C, Johnson R, Weishaar K, Anderson-Berry A. Status of Vitamin A and Related Compounds and Clinical Outcomes in Maternal-Infant Pairs in the Midwestern United States. ANNALS OF NUTRITION AND METABOLISM 2017; 71:175-182. [PMID: 28942446 DOI: 10.1159/000481292] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 09/04/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Vitamin A is an essential nutrient for pregnant women, and other vitamin A-related compounds, including lutein and lycopene, have been associated with maternal-infant outcomes. The objective of this study was to quantify the status of vitamin A and related compounds in maternal-infant pairs at the time of delivery, and to determine its impact on clinical outcomes. METHODS Maternal and cord blood samples were collected in 189 mother-infant pairs. Concentrations of lutein + zeaxanthin, β-cryptoxanthin, lycopene, carotenes, and retinol were measured using high-performance liquid chromatography. Descriptive statistics was calculated and Spearman coefficients were used to assess correlations between maternal and cord measurements. Kruskal-Wallis and independent samples t test were used to compare measures between retinol groups. Linear and logistic regression models were used to adjust for relevant confounders. p < 0.05 was considered statistically significant. RESULTS Ten percent of mothers had serum retinol concentrations ≤0.70 µmol/L; 80% of infants had serum retinol concentrations ≤0.70 µmol/L. Low maternal retinol concentrations were associated with maternal anemia (p = 0.04) and a trend toward low birth weight (p = 0.06). Maternal and infant concentrations of vitamin A compounds were highly correlated. After adjustment for confounders, maternal lutein was associated with a C-section (p = 0.03) and a diagnosis of respiratory distress syndrome in the infant (p = 0.02). Maternal lycopene was associated with growth parameters in the infant. CONCLUSIONS As vitamin A-related compounds are modifiable by diet, future research determining the clinical impact of these compounds is warranted.
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Affiliation(s)
- Corrine Hanson
- University of Nebraska Medical Center, College of Allied Health Professions, Medical Nutrition Education, 984045 Nebraska Medical Center, Omaha, NE, USA
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21
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Bird JK, Murphy RA, Ciappio ED, McBurney MI. Risk of Deficiency in Multiple Concurrent Micronutrients in Children and Adults in the United States. Nutrients 2017; 9:nu9070655. [PMID: 28672791 PMCID: PMC5537775 DOI: 10.3390/nu9070655] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 06/16/2017] [Accepted: 06/20/2017] [Indexed: 01/07/2023] Open
Abstract
Certain population sub-groups in the United States are vulnerable to micronutrient malnutrition. Nationally representative data from the National Health and Nutrition Examination Survey (NHANES) describing the biochemical status of vitamins A, B6, B12, C, D, E, folate, and anemia, were aggregated to determine the overall risk of multiple concurrent deficiencies in U.S. children and adults (n = 15,030) aged >9 years. The prevalence of deficiency risk according to socio-demographic, life-stage, dietary supplement use, and dietary adequacy categories was investigated. Thirty-one percent of the U.S. population was at risk of at least one vitamin deficiency or anemia, with 23%, 6.3%, and 1.7% of the U.S. population at risk of deficiency in 1, 2, or 3-5 vitamins or anemia, respectively. A significantly higher deficiency risk was seen in women (37%), non-Hispanic blacks (55%), individuals from low income households (40%), or without a high school diploma (42%), and underweight (42%) or obese individuals (39%). A deficiency risk was most common in women 19-50 years (41%), and pregnant or breastfeeding women (47%). Dietary supplement non-users had the highest risk of any deficiency (40%), compared to users of full-spectrum multivitamin-multimineral supplements (14%) and other dietary supplement users (28%). Individuals consuming an adequate diet based on the Estimated Average Requirement had a lower risk of any deficiency (16%) than those with an inadequate diet (57%). Nearly one-third of the U.S. population is at risk of deficiency in at least one vitamin, or has anemia.
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Affiliation(s)
- Julia K Bird
- Nutrition Innovation Center, Human Nutrition and Health, DSM Nutritional Products, Kaiseraugst CH-4303, Switzerland.
| | - Rachel A Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
| | - Eric D Ciappio
- Scientific Affairs, DSM Nutritional Products, Parsippany, NJ 07054, USA.
| | - Michael I McBurney
- Scientific Affairs, DSM Nutritional Products, Parsippany, NJ 07054, USA.
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22
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Spíndola Garcêz L, de Sousa Paz Lima G, de Azevedo Paiva A, Maria Rebêlo Sampaio da Paz S, Lázaro Gomes EI, Nunes VS, Cotta de Faria E, de Barros-Mazon S. Serum Retinol Levels in Pregnant Adolescents and Their Relationship with Habitual Food Intake, Infection and Obstetric, Nutritional and Socioeconomic Variables. Nutrients 2016; 8:nu8110669. [PMID: 27792135 PMCID: PMC5133057 DOI: 10.3390/nu8110669] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 10/10/2016] [Accepted: 10/18/2016] [Indexed: 01/08/2023] Open
Abstract
Globally, vitamin A deficiency (VAD) affects about 19.1 million pregnant women. Its occurrence is classically associated with inadequate food intake and may also be associated with socioeconomic factors and the presence of infection. The aim of this study was to determine the factors related to serum retinol levels among pregnant teenagers. The sample consisted of 89 pregnant adolescents, from whom socioeconomic, obstetric, anthropometric, and food consumption data were collected. Serum concentrations of retinol and the supposed presence of infection were determined by high-performance liquid chromatography and C-reactive protein quantification, respectively. The serum retinol concentrations were classified according to the criteria of the World Health Organization. We adopted a 5% significance level for all statistical tests. Serum retinol levels were significantly and positively associated with sanitation (p = 0.008) and pre-gestational nutritional status (p = 0.002), and negatively with the trimester (p = 0.001). The appropriate sanitation conditions and pre-pregnancy body mass index (BMI) were shown to have a protective effect against VAD. Conversely, serum retinol levels were reduced with trimester progression, favoring VAD occurrence.
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Affiliation(s)
- Laís Spíndola Garcêz
- Post-Graduate Program in Food and Nutrition, Federal University of Piauí (UFPI), Teresina 64049550, Piauí, Brazil.
| | | | - Adriana de Azevedo Paiva
- Post-Graduate Program in Food and Nutrition, Federal University of Piauí (UFPI), Teresina 64049550, Piauí, Brazil.
- Department of Nutrition, Federal University of Piauí (UFPI), Teresina 64049550, Piauí, Brazil.
| | | | - Erica Ivana Lázaro Gomes
- Department of Clinical Pathology, Faculty of Medical Sciences of the State University of Campinas, Campinas 13083887, São Paulo, Brazil.
| | - Valéria Sutti Nunes
- Lipids Lab (LIM10), Endocrinology and Metabolism Division of Hospital das Clinicas, Faculty of Medical Sciences of the University of São Paulo, São Paulo 01246000, São Paulo, Brazil.
| | - Eliana Cotta de Faria
- Department of Clinical Pathology, Faculty of Medical Sciences of the State University of Campinas, Campinas 13083887, São Paulo, Brazil.
| | - Sílvia de Barros-Mazon
- Department of Clinical Pathology, Faculty of Medical Sciences of the State University of Campinas, Campinas 13083887, São Paulo, Brazil.
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