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Sombié OO, Zeba AN, Somé JW, Kazienga A, Diendere J, Bationo JF, Davis C, Grahn M, Tanumihardjo S, De Henauw S, Abbeddou S. Dietary intake of preformed vitamin A and provitamin A carotenoids are not associated with serum retinol and carotenoid concentrations among children 36-59 months of age in rural Burkina Faso: a cross-sectional study. Eur J Nutr 2023; 62:3311-3327. [PMID: 37589896 DOI: 10.1007/s00394-023-03194-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 06/09/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE This study aimed to assess the association between dietary intake of preformed vitamin A (VA) and pro-VA carotenoids and serum retinol and carotenoid concentrations among 36-59-month-old children in a rural area in Burkina Faso. METHODS Two community-based cross-sectional studies were conducted in a rural area of Burkina Faso and included 115 children aged 36-59 months. Dietary intake of preformed VA and pro-VA was assessed directly by 24-h dietary recall. Serum retinol and carotenoid (α- and β-carotene, and β-cryptoxanthin) concentrations were measured. The associations between serum retinol and carotenoid concentrations and their respective dietary intake were assessed by multiple linear regression. RESULTS Geometric mean [95% CI] adjusted serum retinol concentration in children was 0.86 [0.81; 0.92] µmol/L. The prevalence of low adjusted serum retinol concentration (< 0.7 µmol/L) was 26.8%. Geometric mean [95% CI] serum carotenoid concentrations were: α-carotene (0.03 [0.02; 0.03] µmol/L), β-carotene (0.14 [0.12; 0.16] µmol/L), and β-cryptoxanthin (0.17 [0.15; 0.21] µmol/L). Dietary intakes of α- and β-carotene and adjusted serum retinol and α-carotene concentrations were significantly higher during the rainy season. In multiple linear regressions, no associations were found between dietary intakes of preformed VA and pro-VA carotenoids and serum retinol and carotenoid concentrations in children aged 36-59 months in Burkina Faso. There was no effect of season on the associations between preformed VA and pro-VA carotenoids intake and serum retinol and carotenoid concentrations. CONCLUSIONS This study shows that dietary intakes of preformed VA and pro-VA carotenoids based on 24-h dietary recall method cannot be used as proxy of serum retinol and carotenoid concentrations in this population. TRIAL REGISTRATION The study was registered retrospectively (22 March 2018) as a clinical trial with the Pan African Clinical Trials Registry (Cochrane South Africa; PACTR201803002999356).
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Affiliation(s)
- Olivier O Sombié
- Unité Nutrition et Maladies Métaboliques, Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest, Bobo Dioulasso, Burkina Faso.
- Public Health Nutrition Unit, Department of Public Health and Primary Care, Faculty of Health Sciences, Ghent University, 9000, Ghent, Belgium.
| | - Augustin N Zeba
- Unité Nutrition et Maladies Métaboliques, Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest, Bobo Dioulasso, Burkina Faso
| | - Jérome W Somé
- Unité Nutrition et Maladies Métaboliques, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Adama Kazienga
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Jeoffray Diendere
- Unité Nutrition et Maladies Métaboliques, Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest, Bobo Dioulasso, Burkina Faso
| | - Jean F Bationo
- African Union Development Agency-New Partnership for Africa's Development, Midrand, South Africa
| | - Christopher Davis
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, USA
| | - Michael Grahn
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, USA
| | - Sherry Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, USA
| | - Stefaan De Henauw
- Public Health Nutrition Unit, Department of Public Health and Primary Care, Faculty of Health Sciences, Ghent University, 9000, Ghent, Belgium
| | - Souheila Abbeddou
- Public Health Nutrition Unit, Department of Public Health and Primary Care, Faculty of Health Sciences, Ghent University, 9000, Ghent, Belgium
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Sombié OO, Zeba AN, Somé JW, Kazienga A, Grahn M, Tanumihardjo SA, De Henauw S, Abbeddou S. A comparative study on indicators of vitamin A status and risk factors for sensitivity and specificity of the methods to detect vitamin A deficiency. Nutr Metab (Lond) 2023; 20:49. [PMID: 37974246 PMCID: PMC10652566 DOI: 10.1186/s12986-023-00768-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Serum retinol (SR) and retinol-binding protein (RBP) are commonly used indicators, but they are affected by infections and inflammation. This study aimed to assess the sensitivity and specificity of VA indicators to detect vitamin A deficiency (VAD) in 36-59-month-old children living in a rural area in Burkina Faso. METHODS In a community-based study, two cross-sectional surveys were carried out from November 2016 to September 2017 in the health district of Dandé in Burkina Faso. The surveys included 115 children 36-59 months old. Indicators of VA and inflammation assessed in all children included SR, RBP and total liver VA reserves (TLR) estimated by retinol isotope dilution, and inflammation markers (C-reactive protein (CRP) and alpha 1-acid glycoprotein (AGP)). We calculated the sensitivity, specificity, positive and negative predictive values. In addition, the effects of inflammation, helminth infection, and season on sensitivity and specificity were assessed. RESULTS The prevalence of VAD assessed by SR (< 0.7 µmol/L), RBP (< 0.7 µmol/L), and TLR (< 0.1 µmol/g liver) were, respectively, 30.9%, 33.3%, and 0%. Compared to TLR, the specificity, positive predictive value, and negative predictive value of SR were 71.1%, 0%, and 100%, and of RBP, were 68.9%, 0%, and 100%, respectively. The sensitivity was indeterminable for SR and RBP. The specificity of SR and RBP was lower during the dry season. Elevated CRP (> 5.0 mg/L) and AGP (> 1.0 g/L) were detected in 1.9% and 28.6% of children, respectively. The adjustment of VA indicators for inflammation improved SR's specificity to 75.9% and decreased RBP's specificity to 67.8%. CONCLUSION No cases of VAD were identified by TLR. However, (inflammation-adjusted) SR and RBP had varying accuracy in the estimation of VAD. TRIAL REGISTRATION The study was registered, retrospectively, on 22 March 2018 as a clinical trial with the Pan African Clinical Trials Registry under the number Cochrane South Africa; PACTR201803002999356.
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Affiliation(s)
- Olivier O Sombié
- Unité Nutrition et Maladies Métaboliques, Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest, Bobo-Dioulasso, Burkina Faso.
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Augustin N Zeba
- Unité Nutrition et Maladies Métaboliques, Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest, Bobo-Dioulasso, Burkina Faso
| | - Jérome W Somé
- Unité Nutrition et Maladies Métaboliques, Institut de Recherche en Sciences de la Santé/Direction Générale, Ouagadougou, Burkina Faso
| | - Adama Kazienga
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Michael Grahn
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, USA
| | | | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Zoungrana S, Somé JW, Martin-Prével Y, Lanou HB, Kouanda S, Mouquet-Rivier C. Estimation of food portion sizes in women of childbearing age and young children in Ouagadougou (Burkina Faso) using a food photography atlas and salted replicas: Comparison with weighed records. PLoS One 2023; 18:e0291375. [PMID: 37721927 PMCID: PMC10506719 DOI: 10.1371/journal.pone.0291375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 08/26/2023] [Indexed: 09/20/2023] Open
Abstract
Quantitative assessment of foods consumed when using 24-hour dietary recall requires accurate tools to estimate portion sizes. Therefore, we developed a food portion photography atlas with age-appropriate portion sizes for 11 foods frequently consumed by young children (sizes for 6-11-month- and for 12-23-month-old children) and women of childbearing age in Ouagadougou, Burkina Faso capital. We then compared the accuracy and precision of portion estimation with this atlas and with salted replicas relative to weighed records (the reference). After weighing, we randomly assigned food portions to 67 women and their children. The next day, women estimated the served portions and leftovers by recall using the atlas and then salted replicas (n = 1156 measurements, ranging from 19 to 113 for each food). For most food types, the portions estimated with the atlas and salted replicas were positively correlated and showed good concordance with the weighed records. However, accuracy and precision varied in function of the estimation method, food type, and age group. The mean crude differences ranged from -28 to +12g (with errors in absolute values from 24 to 69%) for children, and from -32 to +44g (errors from 17 to 56%) for women. The atlas-based method showed the lowest Lin's concordances (coefficients of 0.1 to 0.2) for the leafy vegetable dish, meat, and fish in 12-23-month-old children. Bland-Altman plots indicated that the salted replicas allowed estimating the consumed portions with fewer errors than the photographic atlas (56 to 91% vs 46 to 79% between the limits of ±50%). Our study highlights that mothers have difficulties in perceiving the quantities of food consumed by their children. Our findings also indicate that the food atlas could be used in food consumption surveys when salted replicas are not available for all food types.
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Affiliation(s)
- Stéphanie Zoungrana
- Qualisud, Institut de Recherche pour le Développement, L’Institut Agro, Cirad, Avignon Université, Université de la Réunion, Université de Montpellier, Montpellier, France
| | - Jérome W. Somé
- Research Institute of Health Sciences, Ouagadougou, Burkina Faso
| | - Yves Martin-Prével
- Moisa, Institut de Recherche pour le Développement, L’Institut Agro, Cirad, Ciheam-Iamm, Université Montpellier, Montpellier, France
| | - Hermann B. Lanou
- Research Institute of Health Sciences, Ouagadougou, Burkina Faso
| | - Séni Kouanda
- Research Institute of Health Sciences, Ouagadougou, Burkina Faso
| | - Claire Mouquet-Rivier
- Qualisud, Institut de Recherche pour le Développement, L’Institut Agro, Cirad, Avignon Université, Université de la Réunion, Université de Montpellier, Montpellier, France
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Adams KP, Jarvis M, Vosti SA, Manger MS, Tarini A, Somé JW, Somda H, McDonald CM. Estimating the cost and cost-effectiveness of adding zinc to, and improving the performance of, Burkina Faso's mandatory wheat flour fortification programme. Matern Child Nutr 2023:e13515. [PMID: 37021818 DOI: 10.1111/mcn.13515] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/11/2023] [Accepted: 03/17/2023] [Indexed: 04/07/2023]
Abstract
Zinc is an essential micronutrient that promotes normal growth, development and immune function. In the context of persistent dietary zinc inadequacies, large-scale food fortification can help fill the gap between intake and requirements. Burkina Faso mandates wheat flour fortification with iron and folic acid. We used activity-based cost modelling to estimate the cost of adding zinc to the country's wheat flour fortification standard assuming (1) no change in compliance with the national standard, and (2) a substantial improvement in compliance. We used household food consumption data to model effective coverage, that is, the number of women of reproductive age (WRA) predicted to achieve adequate zinc density (zinc intake/1000 kcal) with the addition of fortification to diets. Without interventions, the prevalence of inadequate dietary zinc density was ~35.5%. With no change in compliance, the annual average incremental cost of adding zinc to fortified wheat flour was $10,347, which would effectively cover <1% of WRA at an incremental cost of ~$0.54/WRA effectively covered. Improving compliance added ~$300,000/year to the cost of the fortification programme without zinc; including zinc added another ~$78,000/year but only reduced inadequate intake among WRA by 3.6% at an incremental cost of ~$0.45/WRA effectively covered. Although the incremental cost of adding zinc to wheat flour is low ($0.01/wheat flour consumer/year), given low levels of wheat flour consumption, zinc fortification of wheat flour alone contributes marginally to, but will not fully close, the dietary zinc gap. Future research should explore potential contributions of zinc to a broader set of delivery vehicles.
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Affiliation(s)
- Katherine P Adams
- Institute for Global Nutrition, University of California, Davis, California, USA
| | - Michael Jarvis
- Independent Consultant, Washington DC, District of Columbia, USA
| | - Stephen A Vosti
- Institute for Global Nutrition, University of California, Davis, California, USA
- Department of Agricultural and Resource Economics, University of California, Davis, California, USA
| | - Mari S Manger
- International Zinc Nutrition Consultative Group, University of California, San Francisco, California, USA
- Independent Consultant, Laval, Quebec, Canada
| | - Ann Tarini
- Independent Consultant, Laval, Quebec, Canada
- IZiNCG Fortification Task Force, San Francisco, California, USA
| | - Jérome W Somé
- Institut de Recherche en Sciences de la Santé, Centre National de Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso
| | - Hervé Somda
- Développement Agricole et Transformation de l'Agriculture, University of Thomas Sankara, Ouagadougou, Burkina Faso
| | - Christine M McDonald
- Institute for Global Nutrition, University of California, Davis, California, USA
- International Zinc Nutrition Consultative Group, University of California, San Francisco, California, USA
- IZiNCG Fortification Task Force, San Francisco, California, USA
- Department of Pediatrics, School of Medicine, University of California, San Francisco, California, USA
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Landais E, Miotto-Plessis M, Bene C, Maitre d’Hotel E, Truong MT, Somé JW, Verger EO. Consumption of food away from home in low- and middle-income countries: a systematic scoping review. Nutr Rev 2022; 81:727-754. [PMCID: PMC10170323 DOI: 10.1093/nutrit/nuac085] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Context Consumption of food away from home represents an increasing share of people’s food consumption worldwide, although the percentage of food intake that is consumed away from home varies among countries and among individuals. Previous systematic reviews have reported that, overall, consumption away from home negatively affects an individual’s diet and nutritional status. However, these reviews have mainly focused on high-income countries, leaving a gap in knowledge and data for people in low- and middle-income countries (LMICs). Objective The present review aimed to describe trends in the consumption of food away from home in an apparently healthy population in low- and middle-income countries (LMICs) and to investigate any associations between this behavior and diet quality, nutritional status, and health outcomes. Data Sources A structured search strategy was developed for retrieving (from MEDLINE [via PubMed], Web of Science, and Scopus) peer-reviewed articles published in English from March 2011 until May 2021. Data Extraction Forty studies were included, and from them information was obtained based on data from 12 different countries. A qualitative and descriptive approach was used to review the evidence. Data Analysis It was found that there was large heterogeneity in the definition of food consumed away from home and the methods used to measure it, making comparisons and syntheses difficult. Consumption of food away from home in LMICs was relatively common and was positively driven by factors such as being a male, being young, having a high socio-economic status, being educated, and living in urban areas. As in high-income countries, consumption of food away from home in LMICs had unfavorable effects on an individual’s diet quality, nutritional status, and health. Conclusion There is a need to develop harmonized surveillance systems for better monitoring of the phenomenon of food consumption away from home in LMICs, including a need for a standardized definition for food consumed away from home, to enable the design of effective regulatory policies.
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Affiliation(s)
- Edwige Landais
- are with the MoISA, University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Mathilda Miotto-Plessis
- are with the MoISA, University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Chris Bene
- is with the International Center for Tropical Agriculture, Cali, Colombia
- is with the Wageningen Economic Research Group, Wageningen University, The Netherlands
| | - Elodie Maitre d’Hotel
- are with the MoISA, University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
- is with the CIRAD, UMR MOISA, Montpellier, France
| | - Mai Tuyet Truong
- is with the Nutrition-Network Department, National Institute of Nutrition, Hanoi, Vietnam
| | - Jérome W Somé
- is with the Département Biomédical et Santé Publique, Centre National de la Recherche Scientifique et Technologique, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Eric O Verger
- are with the MoISA, University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
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Abbeddou S, Yakes Jimenez E, Somé JW, Ouédraogo JB, Brown KH, Hess SY. Small-quantity lipid-based nutrient supplements containing different amounts of zinc along with diarrhea and malaria treatment increase iron and vitamin A status and reduce anemia prevalence, but do not affect zinc status in young Burkinabe children: a cluster-randomized trial. BMC Pediatr 2017; 17:46. [PMID: 28152989 PMCID: PMC5288861 DOI: 10.1186/s12887-016-0765-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 12/21/2016] [Indexed: 12/14/2022] Open
Abstract
Background We assessed the effects of providing a package of interventions including small-quantity lipid-based nutrient supplements (SQ-LNS) containing 0, 5 or 10 mg zinc and illness treatment to Burkinabe children from 9 to 18 months of age, on biomarkers of zinc, iron and vitamin A status at 18 months and compared with a non-intervention cohort (NIC). Methods Using a two-stage cluster randomized trial design, communities were randomly assigned to the intervention cohort (IC) or NIC, and extended family compounds within the IC were randomly assigned to different treatment groups. IC children (n = 2435) were provided with 20 g SQ-LNS/d containing 0, 5 or 10 mg zinc, 6 mg of iron and 400 μg of vitamin A along with malaria and diarrhea treatment. NIC children (n = 785) did not receive the intervention package. At 9 and 18 months, hemoglobin (Hb), zinc, iron and vitamin A status were assessed in a sub-group (n = 404). Plasma concentrations of zinc (pZC), ferritin (pF), soluble transferrin receptor (sTfR) and retinol-binding protein (RBP) were adjusted for inflammation. Results At baseline, 35% of children had low adjusted pZC (<65 μg/dL), 93% were anemic (Hb <110 g/L), 25% had low adjusted pF (<12 μg/L), 90% had high adjusted sTfR (>8.3 mg/L) and 47% had low adjusted RBP (<0.94 μmol/L), with no group-wise differences. Compared with the NIC, at 18 months IC children had significantly lower anemia prevalence (74 vs. 92%, p = 0.001) and lower iron deficiency prevalence (13% vs. 32% low adjusted pF and 41% vs. 71% high adjusted sTfR, p < 0.001), but no difference in pZC. Mean adjusted RBP was greater at 18 months in IC vs. NIC (0.94 μmol/L vs. 0.86 μmol/L, p = 0.015), but the prevalence of low RBP remained high in both cohorts. Within the IC, different amounts of zinc had no effect on the prevalence of low pZC or indicators of vitamin A deficiency, whereas children who received SQ-LNS with 10 mg zinc had a significantly lower mean pF at 18 months compared to children who received SQ-LNS with 5 mg zinc (p = 0.034). Conclusions SQ-LNS regardless of zinc amount and source provided along with illness treatment improved indicators of iron and vitamin A status, but not pZC. Trial registration NCT00944281 (July 21, 2009).
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Affiliation(s)
- Souheila Abbeddou
- Department of Nutrition, Program in International and Community Nutrition, University of California, One Shields Avenue, Davis, CA, 95616, USA
| | - Elizabeth Yakes Jimenez
- Center for Education Policy Research, University of New Mexico, Albuquerque, NM, USA.,Pacific Institute for Research and Evaluation, Albuquerque, NM, USA
| | - Jérome W Somé
- Department of Nutrition, Program in International and Community Nutrition, University of California, One Shields Avenue, Davis, CA, 95616, USA.,Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | | | - Kenneth H Brown
- Department of Nutrition, Program in International and Community Nutrition, University of California, One Shields Avenue, Davis, CA, 95616, USA.,Nutrition and Global Development, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Sonja Y Hess
- Department of Nutrition, Program in International and Community Nutrition, University of California, One Shields Avenue, Davis, CA, 95616, USA.
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