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Liu M, Fu J, Zhang X, Fu Q, Ji Y, Chen S. The association between serum vitamin A concentrations and virus hepatitis among U.S. adults from the NHANES database: a cross-sectional study. Front Nutr 2024; 11:1387461. [PMID: 39149555 PMCID: PMC11324588 DOI: 10.3389/fnut.2024.1387461] [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: 02/17/2024] [Accepted: 07/15/2024] [Indexed: 08/17/2024] Open
Abstract
Objective According to the present study, the relationship between vitamin A (VA) levels and hepatitis virus carriage has been unclear and controversial. This study aimed to determine the potential relationship between serum VA levels and viral hepatitis and to provide ideas for future clinical treatments. Methods A cross-sectional study was performed using the 2005-2006 and 2017-2018 National Health and Nutrition Examination Survey (NHANES) datasets. Multiple linear regression and logistic regression were adopted to analyze the association between serological hepatitis B surface antigen (HBsAg) or hepatitis C RNA (HCV-RNA) positivity and VA levels. There were 5,351 HBsAg-related responders and 242 HCV-RNA-related responders, including 52 HBsAg (+) and 104 HCV-RNA (+) responders. Results Compared with HBsAg (-) and HCV-RNA (-) respondents, HBsAg (+) and HCV-RNA (+) respondents tended to have lower serum VA levels, respectively [1.63 (1.33 ~ 2.01) vs. 1.92 (1.57 ~ 2.34), P < 0.001; 1.54 (1.25 ~ 1.83) vs. 1.78 (1.46 ~ 2.26), P < 0.001]. A greater percentage of responders in the subclinical VA deficiency (SVAD) group were HBsAg (+) and HCV-RNA (+) than were those in the normal VA (VAN) group [2.4% (9/374) vs. 0.9% (43/4977), p = 0.003; 61.5% (16/26) vs. 40.7% (88/215), p = 0.043]. According to the results of the multiple regression analyses of the different models, the serum VA concentration was negatively correlated with HBsAg (+) and HCV-RNA (+) status (β = -0.14, 95% CI = -0.30 to -0.01, p = 0.066; β = -0.29, 95% CI = -0.50 ~ -0.09, p = 0.005, respectively). Compared to those with SVAD, patients with VAN were less likely to be serologically HBsAg (+) or HCV-RNA (+) (OR = 0.53, 95% CI = 0.25 ~ 1.10, p = 0.089; OR = 0.39, 95% CI = 0.18 ~ 0.84, p = 0.016, respectively). Conclusion Our study provides evidence that patients who are HBsAg (+) or HCV-RNA (+) have a high incidence of SVAD. Moreover, HBsAg and HCV-RNA positivity are negatively correlated with VA levels, and patients with SVAD are more likely to carry HBsAg (+) or HCV-RNA (+). These findings suggest that the relationship between hepatitis viruses and vitamin A needs to be validated by more basic studies and clinical large-sample randomized controlled trials to provide ideas for new therapeutic targets.
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Affiliation(s)
- Maoxia Liu
- Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Jianlei Fu
- Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Xuepeng Zhang
- Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Qinyi Fu
- Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Yi Ji
- Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Siyuan Chen
- Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
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Olsen T, Lerner UH. Vitamin A - a scoping review for Nordic nutrition Recommendations 2023. Food Nutr Res 2023; 67:10229. [PMID: 38686175 PMCID: PMC11057411 DOI: 10.29219/fnr.v67.10229] [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: 08/31/2021] [Revised: 04/12/2022] [Accepted: 09/18/2023] [Indexed: 05/02/2024] Open
Abstract
Vitamin A refers to a group of fat-soluble compounds with retinol activity, including all-trans retinol and pro-vitamin A carotenoids. Bioactive compounds include retinal and all-trans retinoic acid with important functions in vision, immune function, growth, and development. The literature search that was performed for the current scoping review yielded a total of seven publications relevant to setting the recommended daily intake for vitamin A. In total, six publications assessed the relationship of serum retinol and/or dietary vitamin A intake with fracture risk (n = 2), cancer (n = 3), and deficiency after bariatric surgery (n = 1). One additional report by the European Food Safety Administration (EFSA) with updated average requirements was included. The outcomes-based systematic reviews and meta-analyses showed positive associations for vitamin A intake and serum retinol with risk of hip fracture. Weak or inconclusive associations were observed for cancer or obesity. One publication by EFSA with updated estimated average requirements and population reference intakes for dietary vitamin A intakes was published in 2015. The EFSA recommendations and estimated average requirements are based on a European reference population, with body weights derived from an assumed body mass index of 22, which might be too low and not representative of the Nordic and Baltic populations, and consequently resulting in lower estimated average requirements and recommendations. In conclusion, there were limited new outcomes-based data for vitamin A and health outcomes.
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Affiliation(s)
- Thomas Olsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ulf H. Lerner
- Department of Internal Medicine and Clinical Nutrition, Institute for Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Ford JL, Green MH, Brownell JN, Green JB, Oxley A, Lietz G, Schall JI, Stallings VA. Use of Compartmental Modeling and Retinol Isotope Dilution to Determine Vitamin A Stores in Young People with Sickle Cell Disease Before and After Vitamin A Supplementation. J Nutr 2023; 153:2762-2771. [PMID: 37468045 PMCID: PMC10517228 DOI: 10.1016/j.tjnut.2023.07.004] [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: 05/06/2023] [Revised: 06/18/2023] [Accepted: 07/11/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Suboptimal plasma retinol concentrations have been documented in US children with sickle cell disease (SCD) hemoglobin SS type (SCD-HbSS), but little is known about vitamin A kinetics and stores in SCD. OBJECTIVES The objectives were to quantify vitamin A total body stores (TBS) and whole-body retinol kinetics in young people with SCD-HbSS and use retinol isotope dilution (RID) to predict TBS in SCD-HbSS and healthy peers as well as after vitamin A supplementation in SCD-HbSS subjects. METHODS Composite plasma [13C10]retinol response data collected from 22 subjects with SCD-HbSS for 28 d after isotope ingestion were analyzed using population-based compartmental modeling ("super-subject" approach); TBS and retinol kinetics were quantified for the group. TBS was also calculated for the same individuals using RID, as well as for healthy peers (n = 20) and for the subjects with SCD-HbSS after 8 wk of daily vitamin A supplements (3.15 or 6.29 μmol retinol/d [900 or 1800 μg retinol activity equivalents/d]). RESULTS Model-predicted group mean TBS for subjects with SCD-HbSS was 428 μmol, equivalent to ∼11 mo of stored vitamin A; vitamin A disposal rate was 1.3 μmol/d. Model-predicted TBS was similar to that predicted by RID at 3 d postdosing (mean, 389 μmol; ∼0.3 μmol/g liver); TBS predictions at 3 compared with 28 d were not significantly different. Mean TBS in healthy peers was similar (406 μmol). RID-predicted TBS for subjects with SCD-HbSS was not significantly affected by vitamin A supplementation at either dose. CONCLUSIONS Despite differences in plasma retinol concentrations, TBS was the same in subjects with SCD-HbSS compared with healthy peers. Because 56 d of vitamin A supplementation at levels 1.2 to 2.6 times the Recommended Dietary Allowance did not increase TBS in these subjects with SCD-HbSS, further work will be needed to understand the effects of SCD on retinol metabolism. This trial was registered as NCT03632876 at clinicaltrials.gov.
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Affiliation(s)
- Jennifer Lynn Ford
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States
| | - Michael H Green
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States.
| | - Jefferson N Brownell
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Joanne Balmer Green
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States
| | - Anthony Oxley
- Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Georg Lietz
- Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Joan I Schall
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Virginia A Stallings
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
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Suri DJ, Sombié OO, Zeba AN, Nama GM, Bekele TH, Woldeyohannes M, van Stuijvenberg ME, Dhansay MA, Urio EM, Loechl CU, Gannon BM, Davis CR, Grahn M, Suchdev PS, Tanumihardjo SA. Association between Biomarkers of Inflammation and Total Liver Vitamin A Reserves Estimated by 13C-Retinol Isotope Dilution among Preschool Children in 5 African Countries. J Nutr 2023; 153:622-635. [PMID: 36931745 DOI: 10.1016/j.tjnut.2022.10.012] [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: 09/01/2022] [Revised: 10/11/2022] [Accepted: 10/28/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Vitamin A (VA) assessment is important for targeting public health programs. Retinol isotope dilution (RID) is a sensitive method to estimate total body VA stores (TBSs) and total liver reserves (TLRs), but the impact of subclinical inflammation on RID is unclear. OBJECTIVE We determined the association between TBSs and TLRs, estimated by RID, and inflammation among preschool children without clinical infection in Burkina Faso, Cameroon, Ethiopia, South Africa, and Tanzania. METHODS Five studies (n = 532; 47.9 ± 8.3 mo; 49.0% male) included 13C-RID and measurement of inflammation markers, CRP, and α1-acid glycoprotein (AGP). Spearman correlations were used to evaluate TBSs and TLRs with inflammation biomarkers. Wilcoxon and Kruskal-Wallis tests were used to compare TBSs and TLRs by inflammation categories [normal vs. elevated CRP (>5 mg/L) or AGP (>1 g/L)] and inflammation stage [reference, incubation (elevated CRP), early convalescence (elevated CRP and AGP), and late convalescence (elevated AGP)]. RESULTS Complete data were available for 439 children. Median (Q1, Q3) TLRs ranged from 0.12 (0.07, 0.18) μmol/g in Ethiopia to 1.10 (0.88, 1.38) μmol/g in South Africa. Elevated CRP ranged from 4% in Burkina Faso to 42% in Cameroon, and elevated AGP from 20% in Tanzania to 58% in Cameroon. Pooled analysis (excluding Cameroon) showed a negative correlation between TBSs and AGP (ρ = -0.131, P = 0.01). Children with elevated AGP had higher probability of having lower TBSs (probability = 0.61, P = 0.002). TBSs differed among infection stages (P = 0.020). Correlations between TLRs and CRP or AGP were not significant. CONCLUSIONS No indication of systematic bias in RID-estimated TLRs was found due to subclinical inflammation among preschool children. The inverse relationship between TBSs and AGP may reflect decreased stores after infection or an effect of inflammation on isotope partitioning. Further research should investigate potential confounding variables to improve TBS-estimate validity.
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Affiliation(s)
- Devika J Suri
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA.
| | - Olivier O Sombié
- Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Augustin N Zeba
- Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | | | | | | | - Martha E van Stuijvenberg
- Non-Communicable Diseases Research Unit, South African Medical Research Council, South Africa; Division of Human Nutrition, Stellenbosch University, South Africa
| | - Muhammad A Dhansay
- Division of Human Nutrition, Stellenbosch University, South Africa; Burden of Disease Research Unit, South African Medical Research Council, South Africa; Department of Paediatrics and Child Health, Stellenbosch University, South Africa
| | | | - Cornelia U Loechl
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Bryan M Gannon
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Christopher R Davis
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Michael Grahn
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA.
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Zhang K, Nulali J, Zhang C, Chen Y, Cheng J, Shi X, Zhu C, Lu Y, Wang N, Han B. The association between serum vitamin A and NAFLD among US adults varied in different BMI groups: a cross-sectional study. Food Funct 2023; 14:836-844. [PMID: 36321945 DOI: 10.1039/d2fo02204d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background and aims: The association between serum vitamin A (VA) and non-alcoholic fatty liver disease (NAFLD) has not been adequately studied. This study aimed to evaluate the association between them in different BMI groups among US adults. Methods: A cross-sectional study was performed using the 2017-2018 National Health and Nutrition Examination Survey (NHANES) datasets (N = 4.723). Linear/logistic regression, interaction effect and mediation analyses were adopted to analyze the association. Results: NAFLD tended to be more prevalent in adults in the middle and high tertiles of serum VA than in those in the low tertile of serum VA (OR [95% CI], 1.17 [0.94, 1.45] and 1.43 [1.16, 1.75]). In the sensitivity analysis, subjects in the middle or high tertile of serum VA had 10% (OR, 1.10 [0.88, 1.39] and 31% (OR, 1.31 [1.09, 1.58]) higher odds of NAFLD than those in the low tertile of serum VA. In the normal weight group, higher serum VA was associated with 125% and 333% higher odds of NAFLD in the middle and high tertiles, respectively, (OR, 2.25 [1.46, 3.48] and 4.33 [2.43, 7.69]) compared with the low tertile serum VA group. However, serum VA and NAFLD were not significantly associated with the obese group. Among different BMI groups (<30 compared with ≥30), serum triglycerides and insulin resistance mediated the association between VA and NAFLD in adults to varying degrees. Conclusions: In the weighted survey, serum VA was positively associated with the degree of NAFLD, especially in the non-obese population.
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Affiliation(s)
- Kaiwen Zhang
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Jiayida Nulali
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Caoxu Zhang
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Yingchao Chen
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Jing Cheng
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Xiaye Shi
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Chunfang Zhu
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Yingli Lu
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Ningjian Wang
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Bing Han
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
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Nimmannun K, Davis CR, Srisakda P, Gannon BM, Tanumihardjo SA, Udomkesmalee E. Breast Milk Retinol Concentrations Reflect Total Liver Vitamin A Reserves and Dietary Exposure in Thai Lactating Women from Urban and Rural Areas. J Nutr 2023; 152:2689-2698. [PMID: 36170963 DOI: 10.1093/jn/nxac223] [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: 08/11/2022] [Revised: 09/14/2022] [Accepted: 09/25/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Measuring vitamin A (VA) status during lactation is required to inform dietary recommendations. Limited data exist on VA stores in women. OBJECTIVES Our objective was to assess VA status in lactating Thai women by measuring total body VA stores (TBSs), serum and breast milk retinol concentrations, and dietary intake. METHODS Lactating women (n = 94), 6-8 wk postpartum, were enrolled from rural (Ayutthaya) and urban (Bangkok) areas. TBSs were measured by the 13C-retinol isotope dilution (RID) technique using 2.0 μmol 13C-retinyl acetate and a single blood sample 14 d post-dose. Natural 13C-enrichment was determined in nonenrolled women (n = 11). Estimated total liver VA reserves (TLRs) were determined using assumptions for lactation. Serum, foremilk, and hindmilk samples were analyzed for retinol by HPLC. Dietary VA intake was assessed by FFQ and 24-h dietary recalls for 3 d. Multiple regression and Pearson correlation were used to evaluate relations. RESULTS Median VA intakes were 51.8% of 2003 Thai daily recommendations for lactating women, with the majority from animal-source foods. Many women in Ayutthaya consumed liver weekly. Considering TLRs as 50% TBS, 20% and 11% of mothers in Ayutthaya and Bangkok, respectively, showed deficient reserves (≤0.10 μmol retinol/g). Median (quartile 1, quartile 3) serum [1.58 (1.34, 1.91) and 1.52 (1.30, 1.70) μmol/L] and milk [1.88 (1.29, 2.95) and 1.74 (0.96, 2.26) μmol/L] retinol in Ayutthaya and Bangkok, respectively, were normal. Women with deficient TLRs showed low milk retinol concentrations (≤1.0 μmol/L) and consumed less dietary VA, especially from animal-source foods. Breast milk retinol concentrations, especially hindmilk, demonstrated strong correlation with TBSs and TLRs estimated from the RID test. CONCLUSIONS Approximately 15% of Thai lactating women had deficient TLRs. Breast milk retinol concentrations in conjunction with dietary intake records show potential to screen mothers at risk of VA deficiency to guide interventions.The Thai Clinical Trials Registry number is TCTR20160824001 for the work in Thailand.
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Affiliation(s)
| | - Christopher R Davis
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Premmin Srisakda
- Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand
| | - Bryan M Gannon
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
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Xiao ML, Zhong HL, Lin HR, Liu CY, Yan Y, Ke YB, Chen YM. Higher serum vitamin A is associated with a worsened progression of non-alcoholic fatty liver disease in adults: a prospective study. Food Funct 2022; 13:970-977. [PMID: 35015002 DOI: 10.1039/d1fo03119h] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: The association between serum vitamin A and non-alcoholic fatty liver disease (NAFLD) remains uncertain due to inconsistent results and scarce longitudinal data. We examined the prospective associations between serum vitamin A and the evolution of the NAFLD severity score as well as the potential mediating effects in middle-aged and older Chinese adults. Method: A total of 2658 adults (between 40-75 years of age) were included in the analysis. We determined the serum concentrations of vitamin A at the onset of the study (the baseline), and the degree of NAFLD after years 3 and 6. Results: Subjects were classified into stable, progressed, and improved groups according to the changes in their severity score (0-3) of NAFLD between two visits. Analyses of covariance showed that the serum VA concentrations were positively associated with NAFLD progression (all p-trend < 0.05). After adjusting for potential confounders, the mean differences in the serum vitamin A were 7.7% lower in the improved group than those in the progressed group among the total population. Path analyses showed that vitamin A was positively associated with the serum retinol-binding protein 4, triglycerides, insulin resistance, and body mass index (standardized β 0.065-0.304, all p < 0.001), and all of these factors positively correlated with the prevalence and progression of NAFLD (standardized β 0.045-0.384, all p < 0.01). Conclusions: A higher serum vitamin A concentration was associated with NAFLD progression, which might be mediated by increases in the serum retinol-binding protein 4, triglycerides, insulin resistance, and body mass index.
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Affiliation(s)
- Mian-Li Xiao
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Hai-Li Zhong
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Hong-Rou Lin
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Chun-Ying Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Yan Yan
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Yue-Bin Ke
- Key Laboratory of Molecular Epidemiology of Shenzhen, Shenzhen Center for Disease Control and Prevention, Shenzhen, China.
| | - Yu-Ming Chen
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Stephensen CB, Lietz G. Vitamin A in resistance to and recovery from infection: relevance to SARS-CoV2. Br J Nutr 2021; 126:1663-1672. [PMID: 33468263 PMCID: PMC7884725 DOI: 10.1017/s0007114521000246] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/30/2020] [Accepted: 01/13/2021] [Indexed: 12/16/2022]
Abstract
SARS-CoV2 infects respiratory epithelial cells via its cellular receptor angiotensin-converting enzyme 2, causing a viral pneumonia with pronounced inflammation resulting in significant damage to the lungs and other organ systems, including the kidneys, though symptoms and disease severity are quite variable depending on the intensity of exposure and presence of underlying conditions that may affect the immune response. The resulting disease, coronavirus disease 2019 (COVID-19), can cause multi-organ system dysfunction in patients requiring hospitalisation and intensive care treatment. Serious infections like COVID-19 often negatively affect nutritional status, and the resulting nutritional deficiencies may increase disease severity and impair recovery. One example is the viral infection measles, where associated vitamin A (VA) deficiency increases disease severity and appropriately timed supplementation during recovery reduces mortality and hastens recovery. VA may play a similar role in COVID-19. First, VA is important in maintaining innate and adaptive immunity to promote clearance of a primary infection as well as minimise risks from secondary infections. Second, VA plays a unique role in the respiratory tract, minimising damaging inflammation, supporting repair of respiratory epithelium and preventing fibrosis. Third, VA deficiency may develop during COVID-19 due to specific effects on lung and liver stores caused by inflammation and impaired kidney function, suggesting that supplements may be needed to restore adequate status. Fourth, VA supplementation may counteract adverse effects of SARS-CoV2 on the angiotensin system as well as minimises adverse effects of some COVID-19 therapies. Evaluating interactions of SARS-CoV2 infection with VA metabolism may thus provide improved COVID-19 therapy.
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Affiliation(s)
- C. B. Stephensen
- Immunity and Disease Prevention Research Unit, USDA Western Human Nutrition Research Center, and Nutrition Department, University of California, Davis, CA, USA
| | - G. Lietz
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon TyneNE2 4HH, UK
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Sheftel J, Valentine AR, Hull AK, Fadjarwati T, Gannon BM, Davis CR, Tanumihardjo SA. Findings in 3 clinical trials challenge the accuracy of the Institute of Medicine's estimated average requirements for vitamin A in children and women. Am J Clin Nutr 2021; 113:1322-1331. [PMID: 32492125 PMCID: PMC8106803 DOI: 10.1093/ajcn/nqaa132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/11/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Vitamin A (VA) estimated average requirements (EARs) for women and children are extrapolated from rats and adult males. The retinol isotope dilution (RID) test can sensitively characterize VA status and intake requirements. OBJECTIVES These studies evaluated current EARs for children 4-8 y and women 19-30 y old. METHODS Zambian children (n = 133, ages 5-7 y), US women (n = 51, ages 19-27 y), and Indonesian women (n = 29, ages 19-30 y) were provided diets or supplements containing 30%-155% of VA EARs for 42-90 d. RID was performed before and after the intervention to quantify changes in total body VA stores (TBSs) and total liver VA reserves (TLRs). Linear regression was performed between VA intake and change in TBSs or TLRs. RESULTS Baseline mean ± SD TLRs were hypervitaminotic in Zambian children (1.13 ± 0.41 μmol VA/g liver), optimal in US women (0.46 ± 0.32 μmol/g VA/g liver), and deficient to marginal in Indonesian women (0.10 ± 0.08 μmol VA/g liver). VA intakes, resulting in no change in TBSs or TLRs, were 185 (95% CI: 18, 288) or 257 (95% CI: 124, 411) and 285 or 330 (CIs undefined) μg retinol activity equivalents (RAE)/d in the Zambian and US trials, respectively, but inconclusive in Indonesian women. The regression was not significant in either group of women. CONCLUSIONS Point estimates of VA intakes to maintain stores were below the current EARs of 275 (children) and 500 (women) μg RAE/d despite the TLRs being higher than the EARs were formulated to maintain (i.e., 0.07 μmol VA/g liver). Interventions based on these EARs may need to be scaled back. Lack of change in VA stores in women taking lower doses may result from physiological adaptation resulting in lower VA utilization. Longer, larger, and controlled studies are needed to accurately define EARs for VA.These trials were registered at Clinicaltrials.gov as NCT04123210 and NCT01814891.
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Affiliation(s)
- Jesse Sheftel
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Ashley R Valentine
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Angela K Hull
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Tetra Fadjarwati
- National Institute for Health Research and Development (Badan Litbang Kesehatan), Jakarta, Indonesia
| | - Bryan M Gannon
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Christopher R Davis
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Sherry A Tanumihardjo
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
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Pinkaew S, Udomkesmalee E, Davis CR, Tanumihardjo SA. Vitamin A-fortified rice increases total body vitamin A stores in lactating Thai women measured by retinol isotope dilution: a double-blind, randomized, controlled trial. Am J Clin Nutr 2021; 113:1372-1380. [PMID: 33675342 DOI: 10.1093/ajcn/nqaa418] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/10/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Lactating women are at increased risk for vitamin A (VA) deficiency due to demands for breast milk content and limited hepatic stores for women in some countries. Previously, consumption of triple-fortified rice, which included VA, iron, and zinc, successfully improved the VA status of Thai children in whom their total body VA stores (TBSs) were doubled in 2 mo. OBJECTIVE This study assessed the efficacy of consuming VA-fortified rice, which delivered 500 µg retinol activity equivalents (RAEs)/d, on TBSs and estimated total liver VA reserves (TLRs) in Thai lactating women using the retinol isotope dilution (RID) test. METHODS A randomized controlled trial was conducted with 70 lactating women (n = 35/group) who received either VA-fortified rice (500 µg RAEs/d) or unfortified rice for 14 wk on weekdays only. Serum retinol concentrations (SRs), C-reactive protein, and TBSs were assessed before and after the intervention. The paired 13C-RID test was used to measure TBSs. After a baseline blood sample, 2.0 µmol [14,15]-13C2-retinyl acetate was administered orally. A follow-up blood sample was drawn 14 d later. The RID test was repeated after the intervention. RESULTS TBSs increased significantly (P < 0.05) in the intervention group from 240 (182, 316) to 331 (251, 447) [geometric means (95% CIs)] µmol retinol, and this change in TBSs was significantly higher (P < 0.05) than that in the control group [+52.9 (-74, 453) compared with -4.3 (-106, 275) µmol retinol]. Estimated TLRs indicated a high prevalence of VA deficiency among these lactating women. Initial and final SRs did not differ by group and did not change over the course of the intervention. CONCLUSION VA-fortified rice improved the VA status of lactating women by increasing TBSs. A targeted approach to disseminate VA interventions among vulnerable groups should be considered in some contexts. This trial was registered at clinicaltrials.gov as NCT03056625.
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Affiliation(s)
- Siwaporn Pinkaew
- Department of Food Science and Nutrition, Faculty of Science and Technology, Prince of Songkla University, Pattani, Thailand
| | | | - Christopher R Davis
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
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11
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Tanumihardjo SA. Biological evidence to define a vitamin A deficiency cutoff using total liver vitamin A reserves. Exp Biol Med (Maywood) 2021; 246:1045-1053. [PMID: 33765844 PMCID: PMC8113730 DOI: 10.1177/1535370221992731] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Vitamin A is a fat-soluble vitamin involved in essential functions including growth, immunity, reproduction, and vision. The vitamin A Dietary Reference Intakes (DRIs) for North Americans suggested that a minimally acceptable total liver vitamin A reserve (TLR) is 0.07 µmol/g, which is not explicitly expressed as a vitamin A deficiency cutoff. The Biomarkers of Nutrition for Development panel set the TLR cutoff for vitamin A deficiency at 0.1 µmol/g based on changes in biological response of several physiological parameters at or above this cutoff. The criteria used to formulate the DRIs include clinical ophthalmic signs of vitamin A deficiency, circulating plasma retinol concentrations, excretion of vitamin A metabolites in the bile, and long-term storage of vitamin A as protection against vitamin A deficiency during times of low dietary intake. This review examines the biological responses that occur as TLRs are depleted. In consideration of all of the DRI criteria, the review concludes that induced biliary excretion and long-term vitamin A storage do not occur until TLRs are >0.10 µmol/g. If long-term storage is to continue to be part of the DRI criteria, vitamin A deficiency should be set at a minimum cutoff of 0.10 µmol/g and should be set higher during times of enhanced requirements where TLRs can be rapidly depleted, such as during lactation or in areas with high infection burden. In population-based surveys, cutoffs are important when using biomarkers of micronutrient status to define the prevalence of deficiency and sufficiency to inform public health interventions. Considering the increasing use of quantitative biomarkers of vitamin A status that indirectly assess TLRs, i.e. the modified-relative-dose response and retinol-isotope dilution tests, setting a TLR as a vitamin A deficiency cutoff is important for users of these techniques to estimate vitamin A deficiency prevalence. Future researchers and policymakers may suggest that DRIs should be set with regard to optimal health and not merely to prevent a micronutrient deficiency.
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Affiliation(s)
- Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
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12
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Nishimoto K, Toya Y, Davis CR, Tanumihardjo SA, Welham NV. Dynamics of vitamin A uptake, storage, and utilization in vocal fold mucosa. Mol Metab 2020; 40:101025. [PMID: 32473404 PMCID: PMC7322172 DOI: 10.1016/j.molmet.2020.101025] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/11/2020] [Accepted: 05/23/2020] [Indexed: 12/20/2022] Open
Abstract
Objective Extrahepatic vitamin A is housed within organ-specific stellate cells that support local tissue function. These cells have been reported in the vocal fold mucosa (VFM) of the larynx; however, it is unknown how vitamin A reaches and is disseminated among VFM target cells, how VFM storage and utilization vary as a function of total body stores, and how these parameters change in the context of pathology. Therefore, in this study, we investigated fundamental VFM vitamin A uptake and metabolism. Methods Using cadaveric tissue and serum from human donors representing the full continuum of clinical vitamin A status, we established a concentration range and analyzed the impact of biologic and clinical covariates on VFM vitamin A. We additionally conducted immunodetection of vitamin A-associated markers and pharmacokinetic profiling of orally dosed α-retinyl ester (a chylomicron tracer) in rats. Results Serum vitamin A was a significant predictor of human VFM concentrations, suggesting that VFM stores may be rapidly metabolized in situ and replenished from the circulatory pool. On a vitamin A-sufficient background, dosed α-vitamin A was detected in rat VFM in both ester and alcohol forms, showing that, in addition to plasma retinol and local stellate cell stores, VFM can access and process postprandial retinyl esters from circulating chylomicra. Both α forms were rapidly depleted, confirming the high metabolic demand for vitamin A within VFM. Conclusion This thorough physiological analysis validates VFM as an extrahepatic vitamin A repository and characterizes its unique uptake, storage, and utilization phenotype. Vocal fold mucosa (VFM) is a bone fide extrahepatic vitamin A repository in the larynx. VFM rapidly metabolizes vitamin A and can directly access postprandial retinyl esters from chylomicra. The VFM vitamin A uptake, storage, and utilization phenotype appears to be comparable in humans and rats.
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Affiliation(s)
- Kohei Nishimoto
- Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA
| | - Yutaka Toya
- Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA
| | - Christopher R Davis
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Nathan V Welham
- Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA.
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13
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Bationo JF, Zeba AN, Coulibaly ND, Sheftel J, Davis CR, N Bassole IH, Barro N, Ouedraogo JB, Tanumihardjo SA. Liver retinol estimated by 13C-retinol isotope dilution at 7 versus 14 days in Burkinabe schoolchildren. Exp Biol Med (Maywood) 2019; 244:1430-1437. [PMID: 31547685 PMCID: PMC6900701 DOI: 10.1177/1535370219877132] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/16/2019] [Indexed: 12/20/2022] Open
Abstract
Vitamin A status assessment is not straightforward. Retinol isotope dilution (RID) testing requires time for the tracer dose to mix with the total body stores of vitamin A (TBS). Researchers are interested in shortening the time interval between tracer administration and follow-up blood draws, and in re-examining current assumptions about liver mass for calculation of total liver vitamin A reserves (TLR, in µmol/g liver). Schoolchildren (aged 7–12 years; n = 72) were recruited from one school in Burkina Faso. After a baseline blood draw, 1.0 µmol [14,15]-13C2-retinyl acetate was administered to estimate TBS and TLR by retinol isotope dilution with follow-up blood samples at days 7 and 14. Correlations were determined to evaluate if sampling at day 7 could be used to predict TLR compared with day 14. Liver mass was estimated using body surface area and compared with the currently used assumption of liver weight equivalent to 3% of body weight. (This trial was registered at Pan African Clinical Trial Registry: PACTR201702001947398). Liver mass calculated using body surface area did not differ from the standard assumption of 3% of body weight and yielded similar TLR values. The children in this study had mean TLR (0.67 ± 0.35 µmol/g) in the adequate range, while serum retinol concentrations (0.92 ± 0.33 µmol/L) predicted 25% vitamin A deficiency. TLR values at seven days were highly correlated with, but significantly different from day 14 (P < 0.0001, r = 0.85) and needed a correction factor added to the equation to yield equivalency. Blood drawing at day 7, using correction factors in the prediction equation and the current assumption of liver mass as 3% of body weight, can be used to estimate TLR in schoolchildren with adequate vitamin A status in 13 C2-RID applications, but further investigations are needed to verify the seven-day predictive equation.
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Affiliation(s)
| | - Augustin N Zeba
- Institute de Recherche en Sciences
de la Santé, Bobo Dioulasso 01, Burkina Faso
| | - Nadine D Coulibaly
- Institute de Recherche en Sciences
de la Santé, Bobo Dioulasso 01, Burkina Faso
| | - Jesse Sheftel
- Department of Nutritional Sciences,
University of Wisconsin-Madison, WI 53706, USA
| | - Christopher R Davis
- Department of Nutritional Sciences,
University of Wisconsin-Madison, WI 53706, USA
| | | | - Nicolas Barro
- Université Ouaga 1 Joseph Ki-Zerbo,
Ouagadougou 03, Burkina Faso
| | - Jean B Ouedraogo
- Institute de Recherche en Sciences
de la Santé, Bobo Dioulasso 01, Burkina Faso
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14
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Tanumihardjo SA, Kaliwile C, Boy E, Dhansay MA, van Stuijvenberg ME. Overlapping vitamin A interventions in the United States, Guatemala, Zambia, and South Africa: case studies. Ann N Y Acad Sci 2019; 1446:102-116. [PMID: 30265402 PMCID: PMC7999526 DOI: 10.1111/nyas.13965] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/01/2018] [Accepted: 08/15/2018] [Indexed: 01/12/2023]
Abstract
Vitamin A (VA) deficiency is a serious public health problem, especially in preschool children who are at risk of increased mortality. In order to address this problem, the World Health Organization recommends periodic high-dose supplementation to children 6-59 months of age in areas of highest risk. Originally, supplementation was meant as a short-term solution until more sustainable interventions could be adopted. Currently, many countries are fortifying commercialized common staple and snack foods with retinyl palmitate. However, in some countries, overlapping programs may lead to excessive intakes. Our review uses case studies in the United States, Guatemala, Zambia, and South Africa to illustrate the potential for excessive intakes in some groups. For example, direct liver analysis from 27 U.S. adult cadavers revealed 33% prevalence of hypervitaminosis A (defined as ≥1 μmol/g liver). In 133 Zambian children, 59% were diagnosed with hypervitaminosis A using a retinol isotope dilution, and 16% had ≥5% total serum VA as retinyl esters, a measure of intoxication. In 40 South African children who frequently consumed liver, 72.5% had ≥5% total serum VA as retinyl esters. All four countries have mandatory fortified foods and a high percentage of supplement users or targeted supplementation to preschool children.
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Affiliation(s)
| | | | | | - Muhammad A. Dhansay
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa
| | - Martha E. van Stuijvenberg
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
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15
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Sheftel J, Surles RL, Tanumihardjo SA. Retinol isotope dilution accurately predicts liver reserves in piglets but overestimates reserves in lactating sows. Exp Biol Med (Maywood) 2019; 244:579-587. [PMID: 30889962 DOI: 10.1177/1535370219838785] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPACT STATEMENT Vitamin A (VA) deficiency and hypervitaminosis A have been reported in groups of people worldwide. Conventional biomarkers of VA deficiency (e.g. serum retinol concentration, dose response tests) are not able to distinguish between sufficiency and hypervitaminosis A. Retinol isotope dilution (RID) predictions of VA status have been validated in humans and animal models from deficiency through toxicity; however, RID during life stages with unique issues related to isotopic tracing, such as infancy and lactation, requires further evaluation. This study investigated RID in piglets and lactating sows as models for human infants and women. In piglets, RID successfully determined VA deficiency (confirmed with liver analysis), and that the tracer mixes quickly. Conversely, in lactating sows, although serum and milk enrichments were similar, traditional RID equations overestimated VA stores, likely due to losses of tracer and higher extrahepatic VA storage than predictions. These data inform researchers about the challenges of using RID during lactation.
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Affiliation(s)
- Jesse Sheftel
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Rebecca L Surles
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Sherry A Tanumihardjo
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
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16
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Olsen K, Suri DJ, Davis C, Sheftel J, Nishimoto K, Yamaoka Y, Toya Y, Welham NV, Tanumihardjo SA. Serum retinyl esters are positively correlated with analyzed total liver vitamin A reserves collected from US adults at time of death. Am J Clin Nutr 2018; 108:997-1005. [PMID: 30475970 PMCID: PMC6692705 DOI: 10.1093/ajcn/nqy190] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 07/16/2018] [Indexed: 12/31/2022] Open
Abstract
Background Minimal human data exist on liver vitamin A (VA) compared with serum biomarkers. Cutoffs of 5% and 10% total serum VA as retinyl esters (REs) suggest a VA intoxication diagnosis. Objectives We compared total liver VA reserves (TLRs) with the percentage of total serum VA as REs to evaluate hypervitaminosis with the use of US adult autopsy samples. Secondary objectives evaluated serum retinol sensitivity, TLRs among lobes, and hepatic α-retinol concentrations, an α-carotene cleavage product. Design Matched serum and liver samples were procured from cadavers (n = 27; mean ± SD age: 70.7 ± 14.9 y; range: 49-101 y). TLRs and α-REs were quantified by ultra-performance liquid chromatography. Pearson correlations showed liver and serum associations. Sensitivity and specificity were calculated for >5%, 7.5%, and 10% total serum VA as REs to predict TLRs and for serum retinol <0.7 and 1 μmol/L to predict deficiency. Results Serum RE concentrations were correlated with TLRs (r = 0.497, P < 0.001). Nine subjects (33%) had hypervitaminosis A (≥1.0 μmol VA/g liver), 2 of whom had >7.5% total serum VA as REs; histologic indicators corroborated toxicity at 3 μmol/g liver. No subject had >10% total serum VA as REs. Serum retinol sensitivity to determine deficiency (TLRs <0.1 μmol VA/g) was 83% at 0.7 and 1 μmol/L. Hepatic α-retinol was positively correlated with age (P = 0.047), but removing an outlier nullified significance. Conclusions This study evaluated serum REs as a biomarker of VA status against TLRs (gold standard), and abnormal histology suggested that 7.5% total serum VA as REs is diagnostic for toxicity at the individual level in adults. The long-term impact of VA supplements and fortificants on VA status is currently unknown. Considering the high prevalence of hypervitaminotic TLRs in this cohort, and given that many countries are adding preformed VA to processed products, population biomarkers diagnosing hypervitaminosis before toxicity are urgently needed. This trial was registered at clinicaltrials.govas NCT03305042.
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Affiliation(s)
- Kiersten Olsen
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin–Madison, Madison, WI
| | - Devika J Suri
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin–Madison, Madison, WI
| | - Christopher Davis
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin–Madison, Madison, WI
| | - Jesse Sheftel
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin–Madison, Madison, WI
| | - Kohei Nishimoto
- Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI,Present address for KN and YT: Department of Otolaryngology, Kumamoto University School of Medicine, Kumamoto, Japan
| | - Yusuke Yamaoka
- Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI,Present address for YY: Kyoto University Faculty of Medicine, Kyoto, Japan
| | - Yutaka Toya
- Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI,Present address for KN and YT: Department of Otolaryngology, Kumamoto University School of Medicine, Kumamoto, Japan
| | - Nathan V Welham
- Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Sherry A Tanumihardjo
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin–Madison, Madison, WI,Address correspondence to SAT (e-mail: )
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17
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Garcia‐Casal MN, Mowson R, Rogers L, Grajeda R. Risk of excessive intake of vitamins and minerals delivered through public health interventions: objectives, results, conclusions of the meeting, and the way forward. Ann N Y Acad Sci 2018; 1446:5-20. [DOI: 10.1111/nyas.13975] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/03/2018] [Accepted: 09/08/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Maria Nieves Garcia‐Casal
- Evidence and Programme Guidance Unit, Department of Nutrition for Health and Development World Health Organization Geneva Switzerland
| | - Robin Mowson
- Nutrition and Social Determinants the Pan American Health Organization Washington DC
| | - Lisa Rogers
- Evidence and Programme Guidance Unit, Department of Nutrition for Health and Development World Health Organization Geneva Switzerland
| | - Ruben Grajeda
- Nutrition and Social Determinants the Pan American Health Organization Washington DC
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18
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Gannon BM, Valentine AR, Davis CR, Howe JA, Tanumihardjo SA. Duration of Retinol Isotope Dilution Studies with Compartmental Modeling Affects Model Complexity, Kinetic Parameters, and Calculated Vitamin A Stores in US Women. J Nutr 2018; 148:1387-1396. [PMID: 30137477 PMCID: PMC6075605 DOI: 10.1093/jn/nxy095] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/26/2018] [Accepted: 04/11/2018] [Indexed: 11/14/2022] Open
Abstract
Background Retinol isotope dilution (RID) indirectly estimates vitamin A (VA) status. Multicompartment modeling of RID data is used to refine study designs and equations to calculate VA stores. Previous studies suggest that VA in slowly turning over pools is not traced if follow-up is not long enough; however, shorter RID studies are being investigated. Few long-term models have been published. Objective We determined the effect of time on mathematical models of VA kinetics, model parameters, and outcomes. Methods In this longitudinal study, women (mean ± SD age: 22 ± 3 y; n = 7) were given 2.0 µmol [14,15]-13C2-retinyl acetate. Blood samples were staggered from 4 h to 152 d; the fraction of dose in serum was modeled with compartmental models. Four model-time categories were created: full models that used all data (median: 137 d; range 97-152 d) and truncated shorter studies of 14, 27, and 52 d (range: 42-62 d). Outcomes included number of compartments to adequately model serum data, kinetic parameters, total traced VA mass, and time-to-dose equilibration. To gain insight into longer follow-up, an additional participant was given 17.5 µmol 13C4-VA, and data were modeled as long as enrichment was above baseline (5 y). Results Longer follow-up times affected kinetic parameters and outcomes. Compared with the 14-d models, long-term full models required an additional compartment for adequate fit (14.3% compared with 100%; P = 0.0056) and had longer [median (quartile 1, quartile 3)] whole-body half-life [15.0 d (10.5, 72.6 d) compared with 135 d (115, 199 d); P = 0.0006], time-to-dose equilibration [3.40 d (3.14, 6.75 d) compared with 18.9 d (11.2, 25.7 d); P < 0.0001], and total traced mass [166 µmol VA (162, 252 µmol VA) compared with 476 µmol VA (290, 752 µmol VA); P = 0.0031]. Conclusions Extended RID sampling alters numerous mathematically modeled, time-dependent outcomes in women. Length of study should be considered when using mathematical models for calculating total-body VA stores or kinetic parameters related to VA turnover. This study is registered at www.clinicaltrials.gov as NCT03248700.
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Affiliation(s)
- Bryan M Gannon
- University of Wisconsin-Madison, Interdepartmental Graduate Program in Nutritional Sciences, Department of Nutritional Sciences, Madison, WI
| | - Ashley R Valentine
- University of Wisconsin-Madison, Interdepartmental Graduate Program in Nutritional Sciences, Department of Nutritional Sciences, Madison, WI
| | - Christopher R Davis
- University of Wisconsin-Madison, Interdepartmental Graduate Program in Nutritional Sciences, Department of Nutritional Sciences, Madison, WI
| | - Julie A Howe
- University of Wisconsin-Madison, Interdepartmental Graduate Program in Nutritional Sciences, Department of Nutritional Sciences, Madison, WI
| | - Sherry A Tanumihardjo
- University of Wisconsin-Madison, Interdepartmental Graduate Program in Nutritional Sciences, Department of Nutritional Sciences, Madison, WI
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19
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Nuss ET, Valentine AR, Zhang Z, Lai HJ, Tanumihardjo SA. Serum carotenoid interactions in premenopausal women reveal α-carotene is negatively impacted by body fat. Exp Biol Med (Maywood) 2017; 242:1262-1270. [PMID: 28440717 DOI: 10.1177/1535370217706962] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Increasing body mass indices (BMIs) across the globe reflect pandemic shifts towards habitual positive energy imbalances. Excess body fat in individuals is often associated with high-energy and high-fat diets scanty in fresh produce. Carotenoids are fat-soluble pigments plentiful in many fruits and vegetables. They are well-known for provitamin A and antioxidant functions, but little research has been done related to carotenoid-body mass interactions. Serum carotenoids were analyzed relative to body fat to determine correlations between major serum carotenoids, retinol, BMI, fat mass, and lean mass. Healthy women ( n = 76), 19-50 years old, were categorized into two comparison groups determined by percent body fat measured by air displacement plethysomography (BOD POD®), i.e. <31% and ≥31% fat mass. Anthropometric and three-day diet records were completed for BMI and nutrient intake calculations, respectively. Serum α-carotene concentrations were strongly inversely associated with all measures of body composition ( P < 0.001 α-carotene) controlling for dietary intake and age, while β-carotene, lutein, and lycopene were not ( P > 0.05). Dietary intake between groups did not differ, including carrot consumption (a high dietary source of α-carotene). These results confirm previous carotenoid-health research and propose the need for further investigation of potential protective roles that α-carotene may perform for optimal health. Serum α-carotene may provide a deeper and clinically relevant purpose, beyond previous suggestions for its use as a biomarker for fruit and vegetable consumption, in that α-carotene may be a biomarker for chronic disease risk frequently linked with obesity. Impact statement Carotenoids are important pigments in fruit and vegetables and found in human serum. This study isolated a negative relationship between serum α-carotene and body fatness. As humans begin to live over a century, determining biomarkers of ultimate health is important. α-Carotene does not have the same distribution in the food supply as β-carotene and therefore is often overlooked in surveys. In part, this is due to the fact that β-carotene provides two molecules of vitamin A, while α-carotene provides one upon central cleavage. This study shows a very clear association between α-carotene and body fatness, which appears to go beyond its fat-soluble nature. Dietary intake data were not able to explain the association. Further work is needed to determine what dietary components infer health benefits.
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Affiliation(s)
- Emily Taylor Nuss
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Ashley R Valentine
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Zhumin Zhang
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - HuiChuan Jennifer Lai
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Sherry A Tanumihardjo
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
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20
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Tanumihardjo SA, Russell RM, Stephensen CB, Gannon BM, Craft NE, Haskell MJ, Lietz G, Schulze K, Raiten DJ. Biomarkers of Nutrition for Development (BOND)-Vitamin A Review. J Nutr 2016; 146:1816S-48S. [PMID: 27511929 PMCID: PMC4997277 DOI: 10.3945/jn.115.229708] [Citation(s) in RCA: 284] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 04/01/2016] [Accepted: 06/29/2016] [Indexed: 12/15/2022] Open
Abstract
The Biomarkers of Nutrition for Development (BOND) project is designed to provide evidence-informed advice to anyone with an interest in the role of nutrition in health. The BOND program provides information with regard to selection, use, and interpretation of biomarkers of nutrient exposure, status, function, and effect, which will be especially useful for readers who want to assess nutrient status. To accomplish this objective, expert panels are recruited to evaluate the literature and to draft comprehensive reports on the current state of the art with regard to specific nutrient biology and available biomarkers for assessing nutritional status at the individual and population levels. Phase I of the BOND project includes the evaluation of biomarkers for 6 nutrients: iodine, folate, zinc, iron, vitamin A, and vitamin B-12. This review of vitamin A is the current article in this series. Although the vitamin was discovered >100 y ago, vitamin A status assessment is not trivial. Serum retinol concentrations are under homeostatic control due in part to vitamin A's use in the body for growth and cellular differentiation and because of its toxic properties at high concentrations. Furthermore, serum retinol concentrations are depressed during infection and inflammation because retinol-binding protein (RBP) is a negative acute-phase reactant, which makes status assessment challenging. Thus, this review describes the clinical and functional indicators related to eye health and biochemical biomarkers of vitamin A status (i.e., serum retinol, RBP, breast-milk retinol, dose-response tests, isotope dilution methodology, and serum retinyl esters). These biomarkers are then related to liver vitamin A concentrations, which are usually considered the gold standard for vitamin A status. With regard to biomarkers, future research questions and gaps in our current understanding as well as limitations of the methods are described.
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Affiliation(s)
- Sherry A Tanumihardjo
- Interdepartmental Graduate Program in Nutritional Sciences, Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
| | | | | | - Bryan M Gannon
- Interdepartmental Graduate Program in Nutritional Sciences, Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
| | | | | | - Georg Lietz
- Newcastle University, Newcastle, United Kingdom
| | - Kerry Schulze
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; and
| | - Daniel J Raiten
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD
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Lietz G, Furr HC, Gannon BM, Green MH, Haskell M, Lopez-Teros V, Novotny JA, Palmer AC, Russell RM, Tanumihardjo SA, Van Loo-Bouwman CA. Current Capabilities and Limitations of Stable Isotope Techniques and Applied Mathematical Equations in Determining Whole-Body Vitamin A Status. Food Nutr Bull 2016; 37:S87-S103. [PMID: 27053491 DOI: 10.1177/0379572116630642] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Retinol isotope dilution (RID) methodology provides a quantitative estimate of total body vitamin A (VA) stores and is the best method currently available for assessing VA status in adults and children. The methodology has also been used to test the efficacy of VA interventions in a number of low-income countries. Infections, micronutrient deficiencies (eg, iron and zinc), liver disease, physiological age, pregnancy, and lactation are known or hypothesized to influence the accuracy of estimating total body VA stores using the isotope dilution technique. OBJECTIVE Our objectives were to review the strengths and limitations of RID methods, to discuss what is known about the impact of various factors on results, and to summarize contributions of model-based compartmental analysis to assessing VA status. METHODS Relevant published literature is reviewed and discussed. RESULTS Various equations and compartmental modeling have been used to estimate the total body VA stores using stable isotopes, including a newer 3-day equation that provides an estimate of total body VA stores in healthy adults. At present, there is insufficient information on absorption of the isotope tracer, and there is a need to further investigate how various factors impact the application of RID techniques in field studies. CONCLUSIONS Isotope dilution methodology can provide useful estimates of total body VA stores in apparently healthy populations under controlled study conditions. However, more research is needed to determine whether the method is suitable for use in settings where there is a high prevalence of infection, iron deficiency, and/or liver disease.
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Affiliation(s)
- Georg Lietz
- Newcastle University, Newcastle, United Kingdom
| | | | | | - Michael H Green
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Marjorie Haskell
- Program in International and Community Nutrition and Department of Nutrition, University of California, Davis, CA, USA
| | | | - Janet A Novotny
- Beltsville Human Nutrition Research Center, United States Department of Agriculture, Beltsville, MD, USA
| | - Amanda C Palmer
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Newton S, Owusu-Agyei S, Asante KP, Amoaful E, Mahama E, Tchum SK, Ali M, Adjei K, Davis CR, Tanumihardjo SA. Vitamin A status and body pool size of infants before and after consuming fortified home-based complementary foods. ACTA ACUST UNITED AC 2016; 74:10. [PMID: 26955479 PMCID: PMC4780150 DOI: 10.1186/s13690-016-0121-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/13/2016] [Indexed: 11/26/2022]
Abstract
Background Home fortification using sachets of micronutrient powder (e.g. “Sprinkles”) is a food-based approach offering an alternative to high dose vitamin A (VA) supplements for infants. The primary objective was to investigate the impact of VA-home fortification on infant VA pool size. The secondary objective was to compare VA status of infants assessed by the modified relative dose response (MRDR) test before and the 13C-retinol isotope dilution (13C-RID) test in the same infants after vitamin A supplementation. Methods A randomized-controlled trial was conducted in 7–9 month old infants in Ghana. Eligible children were randomly allocated to receive a daily sachet of “Sprinkles” with or without VA for 5 months added to complementary foods. The MRDR test indirectly determined VA liver reserves at baseline and the 13C-RID determined VA body pool at follow-up in the same cohort of children. Results At baseline, the MRDR values (95 % CI) for infants were comparable in the intervention and control groups: normal at 0·032 (SD 0·018) (0·025–0·038) and 0·031 (SD 0·018) (0·024–0·038), respectively. After intervention, total body stores (TBS) and liver retinol concentrations did not differ between intervention and control groups; TBS were 436 (SD 303) and 434 (SD 186) μmol, respectively, and estimated liver concentrations were 0·82 (SD 0·53) and 0·79 (SD 0·36) μmol/g liver, indicating adequate reserves in all children. Conclusions Both the MRDR and 3C-RID tests confirmed that the infants had adequate VA status before and after home fortification of their complementary foods. These tests offered more information than serum retinol concentrations alone, which predicted VA deficiency using current suggested cutoffs not corrected for inflammation status.
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Affiliation(s)
- Sam Newton
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Seth Owusu-Agyei
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Esi Amoaful
- Nutrition Department, Ghana Health Service, Accra, Ghana
| | - Emmanuel Mahama
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Samuel Kofi Tchum
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Martha Ali
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Kwame Adjei
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Christopher R Davis
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI USA
| | - Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI USA
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Hypercarotenodermia in Zambia: which children turned orange during mango season? Eur J Clin Nutr 2015; 69:1346-9. [DOI: 10.1038/ejcn.2015.143] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 07/09/2015] [Accepted: 07/13/2015] [Indexed: 11/08/2022]
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Gannon BM, Tanumihardjo SA. Comparisons among Equations Used for Retinol Isotope Dilution in the Assessment of Total Body Stores and Total Liver Reserves. J Nutr 2015; 145:847-54. [PMID: 25809683 PMCID: PMC6619684 DOI: 10.3945/jn.114.208132] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 01/27/2015] [Accepted: 02/20/2015] [Indexed: 11/14/2022] Open
Abstract
Vitamin A plays an essential role in animal biology and has negative effects associated with both hypo- and hypervitaminosis A. Many notable interventions are being done globally to eliminate vitamin A deficiency, including supplementation, fortification, and biofortification. At the same time, it is important to monitor vitamin A status in nations where preformed vitamin A intake is high because of consumption of animal source foods (e.g., liver, dairy, eggs), fortified foods (e.g., milk, cereals, oil, sugar, margarine), or vitamin supplements (e.g., one-a-day multivitamins) to ensure the population does not reach hypervitaminosis A. To accurately assess population status and evaluate interventions aimed at improving vitamin A status, accurate assessment methods are needed. The primary storage site of vitamin A is the liver; however, routinely obtaining liver samples from humans is impractical and unethical. Isotope dilution using deuterium- or (13)C-labeled retinol is currently the most sensitive indirect biomarker of vitamin A status across a wide range of liver reserves. The major drawback to its application is the increased technicality in sample analysis and data calculations when compared to less sensitive methodology, such as serum retinol concentrations and dose response tests. Two main equations have emerged for calculating vitamin A body pool size or liver concentrations from isotope dilution data: the "Olson equation" and the "mass balance equation." Different applications of these equations can lead to confusion and lack of consistency if the underlying principles and assumptions used are not clarified. The purpose of this focused review is to describe the evolution of the equations used in retinol stable-isotope work and the assumptions appropriate to different applications of the test. Ultimately, the 2 main equations are shown to be fundamentally the same and differ only in assumptions made for each specific research application.
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Affiliation(s)
- Bryan M Gannon
- Interdepartmental Graduate Program in Nutritional Sciences, Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
| | - Sherry A Tanumihardjo
- Interdepartmental Graduate Program in Nutritional Sciences, Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
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Gannon B, Kaliwile C, Arscott SA, Schmaelzle S, Chileshe J, Kalungwana N, Mosonda M, Pixley K, Masi C, Tanumihardjo SA. Biofortified orange maize is as efficacious as a vitamin A supplement in Zambian children even in the presence of high liver reserves of vitamin A: a community-based, randomized placebo-controlled trial. Am J Clin Nutr 2014; 100:1541-50. [PMID: 25411289 PMCID: PMC4232019 DOI: 10.3945/ajcn.114.087379] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 09/08/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Biofortification is a strategy to relieve vitamin A (VA) deficiency. Biofortified maize contains enhanced provitamin A concentrations and has been bioefficacious in animal and small human studies. OBJECTIVE The study sought to determine changes in total body reserves (TBRs) of vitamin A with consumption of biofortified maize. DESIGN A randomized, placebo-controlled biofortified maize efficacy trial was conducted in 140 rural Zambian children. The paired (13)C-retinol isotope dilution test, a sensitive biomarker for VA status, was used to measure TBRs before and after a 90-d intervention. Treatments were white maize with placebo oil (VA-), orange maize with placebo (orange), and white maize with VA in oil [400 μg retinol activity equivalents (RAEs) in 214 μL daily] (VA+). RESULTS In total, 133 children completed the trial and were analyzed for TBRs (n = 44 or 45/group). Change in TBR residuals were not normally distributed (P < 0.0001); median changes (95% CI) were as follows: VA-, 13 (-19, 44) μmol; orange, 84 (21, 146) μmol; and VA+, 98 (24, 171) μmol. Nonparametric analysis showed no statistical difference between VA+ and orange (P = 0.34); both were higher than VA- (P = 0.0034). Median (95% CI) calculated liver reserves at baseline were 1.04 (0.97, 1.12) μmol/g liver, with 59% >1 μmol/g, the subtoxicity cutoff; none were <0.1 μmol/g, the deficiency cutoff. The calculated bioconversion factor was 10.4 μg β-carotene equivalents/1 μg retinol by using the middle 3 quintiles of change in TBRs from each group. Serum retinol did not change in response to intervention (P = 0.16) but was reduced with elevated C-reactive protein (P = 0.0029) and α-1-acid glycoprotein (P = 0.0023) at baseline. CONCLUSIONS β-Carotene from maize was efficacious when consumed as a staple food in this population and could avoid the potential for hypervitaminosis A that was observed with the use of preformed VA from supplementation and fortification. Use of more sensitive methods other than serum retinol alone, such as isotope dilution, is required to accurately assess VA status, evaluate interventions, and investigate the interaction of VA status and infection. This trial was registered at clinicaltrials.gov as NCT01814891.
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Affiliation(s)
- Bryan Gannon
- From the Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI (BG, SAA, SS, and SAT); National Food and Nutrition Commission of Zambia, Lusaka, Zambia (CK, MM, and CM); Tropical Diseases Research Centre, Ndola, Zambia (JC and NK); and International Maize and Wheat Improvement Center, Texcoco, Mexico (KP)
| | - Chisela Kaliwile
- From the Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI (BG, SAA, SS, and SAT); National Food and Nutrition Commission of Zambia, Lusaka, Zambia (CK, MM, and CM); Tropical Diseases Research Centre, Ndola, Zambia (JC and NK); and International Maize and Wheat Improvement Center, Texcoco, Mexico (KP)
| | - Sara A Arscott
- From the Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI (BG, SAA, SS, and SAT); National Food and Nutrition Commission of Zambia, Lusaka, Zambia (CK, MM, and CM); Tropical Diseases Research Centre, Ndola, Zambia (JC and NK); and International Maize and Wheat Improvement Center, Texcoco, Mexico (KP)
| | - Samantha Schmaelzle
- From the Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI (BG, SAA, SS, and SAT); National Food and Nutrition Commission of Zambia, Lusaka, Zambia (CK, MM, and CM); Tropical Diseases Research Centre, Ndola, Zambia (JC and NK); and International Maize and Wheat Improvement Center, Texcoco, Mexico (KP)
| | - Justin Chileshe
- From the Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI (BG, SAA, SS, and SAT); National Food and Nutrition Commission of Zambia, Lusaka, Zambia (CK, MM, and CM); Tropical Diseases Research Centre, Ndola, Zambia (JC and NK); and International Maize and Wheat Improvement Center, Texcoco, Mexico (KP)
| | - Ngándwe Kalungwana
- From the Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI (BG, SAA, SS, and SAT); National Food and Nutrition Commission of Zambia, Lusaka, Zambia (CK, MM, and CM); Tropical Diseases Research Centre, Ndola, Zambia (JC and NK); and International Maize and Wheat Improvement Center, Texcoco, Mexico (KP)
| | - Mofu Mosonda
- From the Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI (BG, SAA, SS, and SAT); National Food and Nutrition Commission of Zambia, Lusaka, Zambia (CK, MM, and CM); Tropical Diseases Research Centre, Ndola, Zambia (JC and NK); and International Maize and Wheat Improvement Center, Texcoco, Mexico (KP)
| | - Kevin Pixley
- From the Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI (BG, SAA, SS, and SAT); National Food and Nutrition Commission of Zambia, Lusaka, Zambia (CK, MM, and CM); Tropical Diseases Research Centre, Ndola, Zambia (JC and NK); and International Maize and Wheat Improvement Center, Texcoco, Mexico (KP)
| | - Cassim Masi
- From the Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI (BG, SAA, SS, and SAT); National Food and Nutrition Commission of Zambia, Lusaka, Zambia (CK, MM, and CM); Tropical Diseases Research Centre, Ndola, Zambia (JC and NK); and International Maize and Wheat Improvement Center, Texcoco, Mexico (KP)
| | - Sherry A Tanumihardjo
- From the Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI (BG, SAA, SS, and SAT); National Food and Nutrition Commission of Zambia, Lusaka, Zambia (CK, MM, and CM); Tropical Diseases Research Centre, Ndola, Zambia (JC and NK); and International Maize and Wheat Improvement Center, Texcoco, Mexico (KP)
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Clugston RD, Blaner WS. Vitamin A (retinoid) metabolism and actions: What we know and what we need to know about amphibians. Zoo Biol 2014; 33:527-35. [PMID: 24958673 DOI: 10.1002/zoo.21140] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 02/17/2014] [Accepted: 05/14/2014] [Indexed: 01/06/2023]
Abstract
Vitamin A status is an important consideration in the health of both wild and captive amphibians. Data concerning whole body vitamin A homeostasis in amphibians are scarce, although these animals have been used as experimental models to study the actions of vitamin A in vision, limb regeneration and embryogenesis. The available data suggest that many aspects of vitamin A biology in amphibians are similar to the canonical characteristics of vitamin A metabolism and actions established in mammals. This is consistent with the evolutionary conservation of these important biological processes. Amphibians must obtain vitamin A in their diet, with captive animals being prone to vitamin A deficiency. There is still much to be learned about vitamin A biology in amphibians that can only be achieved through rigorous scientific research. Improved understanding of amphibian vitamin A biology will aid the conservation of endangered amphibians in the wild, as well as the successful maintenance of ex situ populations.
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Pinkaew S, Wegmuller R, Wasantwisut E, Winichagoon P, Hurrell RF, Tanumihardjo SA. Triple-fortified rice containing vitamin A reduced marginal vitamin A deficiency and increased vitamin A liver stores in school-aged Thai children. J Nutr 2014; 144:519-24. [PMID: 24500930 DOI: 10.3945/jn.113.182998] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Vitamin A (VA)-fortified rice is a potential intervention strategy to prevent VA deficiency in at-risk populations. Hot-extruded, triple-fortified rice grains with added VA, zinc, and iron were produced by hot extrusion technology and their ability to improve VA status was tested in Thai schoolchildren. The fortification levels were 10 mg of iron, 9 mg of zinc, and 1.05 mg of VA/g extruded rice. A paired stable isotope dilution technique with labeled ¹³C₂-retinyl acetate (¹³C-RID) was used to quantify VA pool size at the beginning and end of the feeding period. Fifty healthy schoolchildren with a serum retinol (SR) concentration of >0.7 μmol/L were randomly assigned to 2 groups to receive either triple-fortified rice (n = 25) or natural rice (n = 25) for 2 mo as part of the daily school meal. The fortified grains, mixed 1:50 with regular rice, were estimated to provide an extra 890 μg of VA/d, 5 d/wk. ¹³C₂-retinyl acetate (1.0 μmol) was administered orally to each child before and at the end of the feeding period to estimate total body reserves (TBRs) of VA, which increased significantly (P < 0.05) in the intervention group from 153 ± 66 μmol retinol at baseline to 269 ± 148 μmol retinol after 2 mo of feeding. There was no change in the TBRs of VA in the control group (108 ± 67 vs. 124 ± 89 μmol retinol) (P = 0.22). Serum retinol remained unchanged in both groups. We conclude that VA-fortified, hot-extruded rice is an efficacious vehicle to provide additional VA to at-risk populations, and that the efficacy of VA-fortified foods can be usefully monitored by the ¹³C-RID measurement of TBRs of VA but not by changes in SR concentration.
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Affiliation(s)
- Siwaporn Pinkaew
- Laboratory for Human Nutrition, Institute of Food, Nutrition, and Health, ETH, Zurich, Switzerland
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