beta-carotene and Anemia

Pregnancy exacerbates vitamin A (VA) deficiency and anaemia among women in developing countries. Improving circulating haemoglobin (Hb) requires erythrocyte production and availability of iron. Insulin-like growth factor- 1 (IGF-1) functions in erythropoiesis, but its association with VA status and pregnancy-associated anaemia has not been studied. The aim of this study was to examine the relationship between serum retinol, IGF-1, and Hb among pregnant women in extant samples collected during a placebo-controlled trial of VA and beta-carotene (BC) supplementation in rural Nepal conducted from 1994 to 1997. Mid-pregnancy serum IGF-1 was measured in serum from n=589 randomly selected women of n=1186 in whom anthropometric, VA (retinol) and iron (Hb, erythrocyte zinc protoporphyrin (ZP), and ferritin) status data were available. Associations of IGF-1 with retinol, Hb or anaemia, and iron status were determined using multiple linear and logistic regression. Path analysis was used to explore the role of IGF-1 as a mediator between retinol and Hb, accounting for iron status. A 2.6 g/L increase in IGF-1 was observed per 0.1 mol/L increment in retinol (p<0.0001). Hb increased with each quartile of IGF-1, and odds of anaemia declined 68.8% from the 1st to 4th quartile. Improved iron status indicators explained only 29.1% of the association between IGF-1 and Hb, while IGF-1 explained 25.6% of the association between retinol and Hb. Increasing IGF-1 was likely one mechanism by which retinol improved circulating Hb in pregnant women of rural Nepal, although IGF-1 worked primarily through pathways independent of improved iron status indicators, perhaps by stimulating erythrocyte production.. 怀孕加剧了发展中国家妇女维生素A 的缺乏和贫血。提高循环血红蛋白 （Hb）需要红细胞的生成和可利用的铁。胰岛素样生长因子-1（IGF-1）在红 细胞生成中发挥其功能，但是尚没有其与维生素A 状况和妊娠相关贫血之间 关系的研究。本研究的目的是在1994 年到1997 年间在尼泊尔农村进行的补充 维生素A 和β-胡萝卜素（BC）的安慰剂-对照试验现存的样本中，研究怀孕妇 女血清视黄醇、IGF-1 和Hb 之间的关系。从1186 名有人体测量、维生素A （视黄醇）和铁（血红蛋白、红细胞锌原卟啉和铁蛋白）的资料的妇女中，随 机测定589 名妊娠中期妇女的血清IGF-1。采用多重线性回归和logistic 回归 来确定IGF-1 和视黄醇、Hb 或贫血与铁营养状况之间的关系。采用路径分析 探讨IGF-1 作为视黄醇和Hb 之间介物的作用来评估铁营养状况。观察到视黄 醇每增加0.1 mol/L，IGF-1 增加2.6 g/L（p<0.0001）。Hb 随着IGF-1 四分位 的增加而增加，并且从第1 个四分位到第4 个四分位，贫血风险降低了 68.8%。铁营养状况改善的指标只能解释IGF-1 和Hb 之间关系的29.1%，而 IGF-1 能够解释视黄醇和Hb 之间关系的25.6%。虽然IGF-1 主要通过独立改 善铁营养状态指标的途径发挥作用，增加的IGF-1 通过视黄醇改善尼泊尔农村 怀孕妇女的循环Hb 也可能是机制之一，可能是通过刺激红细胞生成。

Topics: Adult; Anemia; beta Carotene; Dietary Supplements; Double-Blind Method; Erythropoiesis; Female; Ferritins; Gestational Age; Hemoglobins; Humans; Insulin-Like Growth Factor I; Iron; Iron, Dietary; Nepal; Nutritional Status; Pregnancy; Pregnancy Complications; Rural Population; Vitamin A; Vitamin A Deficiency; Young Adult

The present study was aimed at assessing the effect of zinc- and micronutrient-rich food supplementation compared with ayurvedic zinc tablets on the blood levels of zinc and vitamin A in adolescent girls.. One hundred eighty apparently healthy schoolgirls (12.5 ± 0.85 y old) were recruited for a 10-wk intervention trial. They were randomized to three groups: one group received a food supplement that was prepared using zinc- and micronutrient-rich foods and by adopting food-processing methods that increase zinc bioavailability; the second group received ayurvedic zinc (Jasad) tablets as a natural elemental zinc supplement; and the third group served as the control without any supplementation. Diet was assessed by 24-h recall on 3 non-consecutive days. Fasting blood samples were analyzed for plasma levels of zinc, β-carotene, retinol, vitamin C, and hemoglobin at baseline and the end of the study period.. Food supplementation showed a significant increase in plasma levels of zinc (9.9%), β-carotene (56.2%), and vitamin C (28.0%, P < 0.05) and a non-significant increase in hemoglobin (1.7%), although small, non-significant changes in blood micronutrient levels were observed in the control group (P > 0.1). Food supplementation decreased the prevalence of zinc deficiency (73% to 53.1%), β-carotene deficiency (31.1% to 17.4%), and mild anemia (32.2% to 23.7%). Ayurvedic zinc supplementation significantly improved plasma zinc (61.3%) and plasma retinol (38.2%) and decreased the prevalence of zinc deficiency (73.7% to 36.2%) and vitamin A deficiency (65.4% to 20.4%, P < 0.05).. Zinc- and micronutrient-rich food supplementation was effective in improving the zinc and vitamin A status of adolescent girls.

Topics: Adolescent; Anemia; Ascorbic Acid; beta Carotene; Biological Availability; Child; Dietary Supplements; Female; Hemoglobins; Humans; Micronutrients; Nutritional Status; Vitamin A; Vitamin A Deficiency; Zinc

Anemia is a frequent complication among HIV-infected persons and is associated with faster disease progression and mortality.. We examined the effect of multivitamin supplementation on hemoglobin concentrations and the risk of anemia among HIV-infected pregnant women and their children.. HIV-1-infected pregnant women (n = 1078) from Dar es Salaam, Tanzania, were enrolled in a double-blind trial and provided daily supplements of preformed vitamin A and beta-carotene, multivitamins (vitamins B, C, and E), preformed vitamin A and beta-carotene + multivitamins, or placebo. All women received iron and folate supplements only during pregnancy according to local standard of care. The median follow-up time for hemoglobin measurement for mothers was 57.3 mo [interquartile range (IQR): 28.6-66.8] and for children it was 28.0 mo (IQR: 5.3-41.7).. During the whole period, hemoglobin concentrations among women who received multivitamins were 0.33 g/dL higher than among women who did not receive multivitamins (P=0.07). Compared with placebo, multivitamin supplementation resulted in a hemoglobin increase of 0.59 g/dL during the first 2 y after enrollment (P=0.0002). Compared with placebo, the children born to mothers who received multivitamins had a reduced risk of anemia. In this group, the risk of macrocytic anemia was 63% lower than in the placebo group (relative risk: 0.37: 95% CI: 0.18, 0.79; P=0.01).. Multivitamin supplementation provided during pregnancy and in the postpartum period resulted in significant improvements in hematologic status among HIV-infected women and their children, which provides further support for the value of multivitamin supplementation in HIV-infected adults.

Topics: Adult; Anemia; Anemia, Iron-Deficiency; beta Carotene; Child Nutritional Physiological Phenomena; Child, Preschool; Dietary Supplements; Double-Blind Method; Female; Follow-Up Studies; Hemoglobins; HIV Infections; Humans; Infant; Infant Nutritional Physiological Phenomena; Infant, Newborn; Male; Maternal Nutritional Physiological Phenomena; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Risk Factors; Tanzania; Vitamin A; Vitamin E; Vitamins

A study was done on school children infected with group A beta hemolytic streptococci to examine whether antioxidant vitamins play a role in improving the hemoglobin level. A total of 606 primary school children aged 5 to 15 years were randomly divided into two intervention groups. Group 1 (n=299) was treated with pehnoxymethyl penicillin V and group 2 (n=307) was treated with phenoxymethyl penicillin V plus antioxidant vitamins for eight weeks. From each group two blood samples were drawn in acute and convalescent (after eight weeks) states. Before treatment, mean hemoglobin values were 11.0 and 10.8 mg/dL in groups 1 and 2 respectively. After treatment hemoglobin values were 10.5 and 11.6 mg/dL respectively. Values were significantly decreased in group 1 (P=0.0001), whereas increased in group 2 (P=0.001). Adjustment for age and sex by ANCOVA confirmed the difference in hemoglobin levels between group (LS means-0.5 vs 0.8 in groups 1 and 2 respectively (P=0.0001). Hemoglobin level increases after antioxidant vitamin supplementation in children suffering from group A beta hemolytic streptococcal infection.

Topics: Adolescent; alpha-Tocopherol; Anemia; Antioxidants; Ascorbic Acid; beta Carotene; Child; Child, Preschool; Female; Hemoglobins; Humans; Male; Penicillins; Streptococcal Infections; Streptococcus pyogenes; Vitamins

There is little evidence to support the general assumption that dietary carotenoids can improve vitamin A status. We investigated in Bogor District, West Java, Indonesia, the effect of an additional daily portion of dark-green leafy vegetables on vitamin A and iron status in women with low haemoglobin concentrations (< 130 g/L) who were breastfeeding a child of 3-17 months. Every day for 12 weeks one group (n = 57) received stir-fried vegetables, a second (n = 62) received a wafer enriched with beta-carotene, iron, vitamin C, and folic acid, and a third (n = 56) received a non-enriched wafer to control for additional energy intake. The vegetable supplement and the enriched wafer contained 3.5 mg beta-carotene, 5.2 mg and 4.8 mg iron, and 7.8 g and 4.4 g fat, respectively. Assignment to vegetable or wafer groups was by village. Wafers were distributed double-masked. In the enriched-wafer group there were increases in serum retinol (mean increase 0.32 [95% CI 0.23-0.40] mumol/L), breastmilk retinol (0.59 [0.35-0.84] mumol/L), and serum beta-carotene (0.73 [0.59-0.88] mumol/L). These changes differed significantly from those in the other two groups, in which the only significant changes were small increases in breastmilk retinol in the control-wafer group (0.16 [0.02-0.30] mumol/L) and in serum beta-carotene in the vegetable group (0.03 [0-0.06] mumol/L). Changes in iron status were similar in all three groups. An additional daily portion of dark-green leafy vegetables did not improve vitamin A status, whereas a similar amount of beta-carotene from a simpler matrix produced a strong improvement. These results suggest that the approach to combating vitamin A deficiency by increases in the consumption of provitamin A carotenoids from vegetables should be re-examined.

Topics: Anemia; Ascorbic Acid; beta Carotene; Breast Feeding; Carotenoids; Diet; Double-Blind Method; Energy Intake; Female; Folic Acid; Follow-Up Studies; Food, Fortified; Hemoglobins; Humans; Indonesia; Infant; Iron; Milk, Human; Nutritional Status; Vegetables; Vitamin A

Vitamin A deficiency (VAD) and anemia are major challenges among children and expecting and lactating mothers in developing countries. Intervention with locally available dark green leafy vegetables (DGLV) is more sustainable to eradicate VAD, being cost-effective and readily adaptable to local communities. DGLV contain high levels of iron and β-carotene (BC) and therefore useful in fighting VAD and anemia. Since DGLVs are season-dependent sun-drying enables their availability during low seasons. However, their contribution to the bioavailability of BC and the improvement of hemoglobin are not well understood. The study therefore investigated the effect of consuming cooked recipe consisting of sun-dried amaranth and cowpea leaves on the levels of BC, retinol, and hemoglobin in preschool children from Machakos District, a semiarid region in Kenya.. Vegetables were purchased from local vegetable market, with some sun-dried in an open shade. Levels of BC and retinol in serum and BC in fresh and processed vegetables were determined by a HPLC method and hemoglobin using a portable Hemocue Analyzer.. All-trans-BC levels in uncooked fresh cowpea and amaranth leaves were 806.0 μg/g and 599.0 μg/g dry matter, respectively, while the dehydration and cooking processes retained the β-carotene levels at over 60 %. Consumption of the dehydrated vegetables significantly improved both serum BC and retinol levels (p < 0.05), while the baseline hemoglobin levels improved by 4.6 %.. The study has shown that intervention with locally available sun-dried vegetables improves the bioavailability of BC, retinol, and hemoglobin levels among preschool children.

Topics: Amaranthus; Anemia; beta Carotene; Child; Child, Preschool; Cooking; Developing Countries; Fabaceae; Hemoglobins; Humans; Iron, Dietary; Kenya; Linear Models; Plant Leaves; Prevalence; Vegetables; Vitamin A; Vitamin A Deficiency

To determine the effects of eating carotene-rich green and yellow vegetables on the prevalence of anaemia, iron deficiency and iron-deficiency anaemia in schoolchildren.. Schoolchildren (n=104), aged 9-12 years, received standardized meals containing 4.2 mg of provitamin A carotenoids/day (mainly beta-carotene) from yellow and green leafy vegetables and at least 7 g dietary fat/day. The meals were provided three times/day, 5 days/week, for 9 weeks at school. Before and after the dietary intervention, total-body vitamin A pool size was assessed by using the deuterated-retinol-dilution method; serum retinol and beta-carotene concentrations were measured by high-performance liquid chromatography; and whole blood haemoglobin (Hb) and zinc protoporphyrin (ZnPP) concentrations were measured by using a photometer and a hematofluorometer, respectively.. After 9 weeks, the mean total-body vitamin A pool size increased twofold (95% confidence interval (CI): -0.11, -0.07 micromol retinol; P<0.001), and serum beta-carotene concentration increased fivefold (95% CI: -0.97, -0.79 micromol/l; P<0.001). Blood Hb (95% CI: -1.02, -0.52 g per 100 ml; P<0.001) and ZnPP increased (95% CI: -11.82, -4.57 microol/mol haem; P<0.001). The prevalence of anaemia (Hb<11.5 g per 100 ml) decreased from 12.5 to 1.9% (P<0.001). There were no significant changes in the prevalence of iron deficiency or iron-deficiency anaemia.. Ingestion of carotene-rich yellow and green leafy vegetables improves the total-body vitamin A pool size and Hb concentration, and decreases anaemia rates in Filipino schoolchildren, with no effect on iron deficiency or iron-deficiency anaemia rates.

Topics: Anemia; Anemia, Iron-Deficiency; beta Carotene; Child; Dietary Fats; Female; Hemoglobins; Humans; Iron Deficiencies; Male; Philippines; Prevalence; Protoporphyrins; Vegetables; Vitamin A

Supplementation study was carried out in 66 children of 10-12 years of age for a period of about 4 months. On the basis of blood analysis, 33 children were taken as deficient having low level of both Hb (<10 g/dl) and serum retinol (< 20 microg/dl). Similar number of children (33) were selected as control purposively who had Hb > 10 g/dl and serum retinol > 20 microg/dl. Average daily consumption of cereals, pulses, vegetables, fruits, milk and milk products, fats and oils, and sugar and jaggery was below the recommended dietary intake in control as well as deficient subjects, however, control children consumed more when compared to deficient children. Among nutrients the daily mean intake of energy, protein, iron, n-carotene and vitamin C were found lower than RDA in deficient subjects as compared to control subjects. Feeding of 100 g/day of cauliflower leaves powder supplements i.e. biscuits and shakarpara improved the Hb, serum retinol, height, weight and nutritional status in deficient subjects. The increase in Hb, serum retinol, weight and height in supplemented group was 14.61, 33.27, 4.48 and 7.06%, respectively. Initially, 27.27% children had normal nutritional status in deficient group, but after supplementation this value was increased to 42.42%. Higher percentage of children having deficiency signs of vitamin A (6.06%), iron (66.67%), B-complex vitamin (9.09%), and symptoms of protein-energy-malnutrition (72.73%) was observed in deficient subjects as compared to control subjects.

Topics: Anemia; Antioxidants; beta Carotene; Brassica; Child; Dietary Supplements; Hemoglobins; Humans; India; Iron; Nutritional Status; Vitamin A; Vitamin A Deficiency

To review the association between major causes of maternal mortality and vitamin A, trying to determine if these associations are causal in nature, and to highlight possible biological pathways that may explain vitamin A effects.. Literature review, observational studies and clinical trials. The strength of association was determined by applying Bradford Hill criteria of causality.. In a vitamin A deficient population, vitamin A is essential for adequate treatment of anaemia. While vitamin A does not seem to be capable of preventing uterine atony, obstetric or surgical trauma, which are important causes of haemorrhage, it might be capable of preventing or decreasing coagulopathy. Possible effects on the placenta as regards implantation, site and size are not clear. As regards pregnancy-related infections, vitamin A supplementation can improve wound healing by decreasing fibrosis and increasing transforming growth factor-beta (TFG-beta). It can increase resistance to infection by increasing mucosal integrity, increasing surface immunoglobulin A (sIgA) and enhancing adequate neutrophil function. If infection occurs, vitamin A can act as an immune enhancer, increasing the adequacy of natural killer (NK) cells and increasing antibody production. beta-carotene in its provitamin form can act as an antioxidant by decreasing endothelial cell damage (the pathognomonic feature of pre-eclampsia) and promote the vasodilator effect of nitric oxide that might bring about a better outcome of toxaemia in pregnancy. It is unlikely that vitamin A or beta-carotene has an effect on obstructed labour.. Plausible biomedical pathways can only be constructed for obstetric haemorrhage, anaemia in pregnancy, hypertension in pregnancy and pregnancy-related infections. A 40% reduction in the maternal mortality ratio, as observed in Nepal, is unlikely to be solely explained through the aforementioned pathways.

Topics: Anemia; beta Carotene; Cause of Death; Dietary Supplements; Dystocia; Female; Hemorrhage; Humans; Hypertension; Maternal Mortality; Pregnancy; Pregnancy Complications; Pregnancy Complications, Infectious; Vitamin A; Vitamin A Deficiency