vitamin-b-12 and Vitamin-A-Deficiency

Micronutrient deficiencies are common in pregnant women due to low dietary intake and increased requirements for fetal development. Low maternal micronutrient status is associated with a range of pregnancy pathologies involving placental dysfunction, including fetal growth restriction (FGR), small-for-gestational age (SGA), pre-eclampsia and preterm birth. However, clinical trials commonly fail to convincingly demonstrate beneficial effects of supplementation of individual micronutrients, attributed to heterogeneity and insufficient power, potential interactions and lack of mechanistic knowledge of effects on the placenta. We aimed to provide current evidence of relationships between selected micronutrients (vitamin D, vitamin A, iron, folate, vitamin B12) and adverse pregnancy outcomes, combined with understanding of actions on the placenta. Following a systematic literature search, we reviewed data from clinical,

Topics: Animals; Dietary Supplements; Female; Fetal Development; Folic Acid; Folic Acid Deficiency; Humans; Infant, Newborn; Iron; Iron Deficiencies; Iron, Dietary; Micronutrients; Models, Animal; Placenta; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Randomized Controlled Trials as Topic; Trophoblasts; Vitamin A; Vitamin A Deficiency; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency

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.

Topics: Acute-Phase Proteins; Biomarkers; Dietary Supplements; Folic Acid; Humans; Iodine; Iron; Nutrition Assessment; Nutritional Status; Prevalence; Public Health; Randomized Controlled Trials as Topic; Recommended Dietary Allowances; Retinol-Binding Proteins; Vitamin A; Vitamin A Deficiency; Vitamin B 12; Zinc

Studies with low-income pregnant and lactating women from the city of Rio de Janeiro, concerned mainly with the changes in micronutrient homeostasis during pregnancy and lactation in the absence of overt clinical deficiencies, are reported. These studies focused on folate, cobalamin, iron, zinc and vitamin A. Factors that may affect the maternal micronutrient state, such as dietary intakes, use of supplements and interrelationships of micronutrients have been considered, as well as the implications of these changes for maternal-fetal transfer and milk composition. Although these studies were not designed to evaluate the prevalence of sub-clinical micronutrient deficiencies in pregnant and lactating women, they indicate that high frequencies of sub-clinical deficiencies of folate, iron, zinc and vitamin A, especially in pregnant women, are expected to be found in Rio de Janeiro.

Topics: Appetite Regulation; Brazil; Female; Folic Acid; Folic Acid Deficiency; Homeostasis; Humans; Iron; Iron Deficiencies; Lactation; Micronutrients; Pregnancy; Vitamin A; Vitamin A Deficiency; Vitamin B 12; Vitamin B 12 Deficiency; Zinc

Topics: Adjuvants, Immunologic; Antibody Formation; Antigen-Antibody Reactions; Ascorbic Acid; Flavonoids; Folic Acid; Humans; Niacinamide; Pantothenic Acid; Pyridoxine; Riboflavin; T-Lymphocytes; Thiamine; Vitamin A; Vitamin A Deficiency; Vitamin B 12; Vitamin D; Vitamin E; Vitamin K; Vitamins

Topics: Ascorbic Acid; Drug Synergism; Eye Diseases; Fatty Acids, Essential; Flavonoids; Humans; Niacinamide; Pantothenic Acid; Pyridoxine; Riboflavin; Thiamine; Thiamine Pyrophosphate; Vitamin A; Vitamin A Deficiency; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex; Vitamin D; Vitamin E; Vitamin K; Vitamins

Adequate vitamin A is essential for healthy pregnancy, but high levels may be teratogenic. We present a patient who underwent bariatric surgery, prior to child bearing, and suffered maternal and foetal complications during eleven pregnancies, possibly associated with vitamin A deficiency, amongst multiple micronutrient deficiencies and risk factors including smoking and obesity. Maternal complications included visual disturbance, night blindness and recurrent infections. Recurrent foetal pulmonary hypoplasia and microphthalmia led to foetal and neonatal loss, not previously described in the medical literature. Current guidance on vitamin A deficiency in pregnancy is focused on developing countries where aetiology of vitamin A deficiency is different to that of women in developed countries. We describe nutritional management of the micronutritient deficiencies, focusing on vitamin A, during her last pregnancy. The need for specific antenatal nutritional guidance for pregnant women post-bariatric surgery is becoming more urgent as more mothers and offspring will be affected.

Topics: Abortion, Spontaneous; Adult; Anemia, Iron-Deficiency; Biliopancreatic Diversion; Diet; Female; Fetal Diseases; Gestational Age; Humans; Infant, Newborn; Iron; Micronutrients; Obesity; Perinatal Death; Pregnancy; Pregnancy Complications; Premature Birth; Smoking; Vitamin A; Vitamin A Deficiency; Vitamin B 12

To utilize complementary biochemical and dietary data collected before the initiation of national flour fortification to (i) identify micronutrient insufficiencies or deficiencies and dietary inadequacies in Palestinian women and children in vulnerable communities and (ii) assess the suitability of the current wheat flour fortification formula.. Quantitative dietary intake questionnaires were administered and fasting venous blood samples collected in randomly selected households in Gaza City and Hebron. The impact of fortification was simulated by estimating the additional micronutrient content of fortified wheat flour.. Households in Gaza City and Hebron that were not receiving food aid from social programmes.. Non-pregnant women (18-49 years) and children aged 36-83 months.. The micronutrients with highest prevalence of insufficiency were vitamin D in women (84-97 % with serum 25-hydroxyvitamin D <50 nmol/l) and vitamin B12 in women and children (43-82 % with serum B12 <221 pmol/l). Deficiencies of vitamin A, Fe and Zn were also of public health concern. Current levels of wheat flour fortificants were predicted to improve, but not eliminate, micronutrient intake inadequacies. Modification of fortificant concentrations of vitamin D, thiamin, vitamin B12, Zn and folic acid may be indicated.. Micronutrient insufficiencies or deficiencies and intake inadequacies were prevalent based on either biochemical or dietary intake criteria. Adjustments to the current fortification formula for wheat flour are necessary to better meet the nutrient needs of Palestinian women and children.

Topics: Adolescent; Adult; Arabs; Child; Child, Preschool; Diet; Fasting; Female; Flour; Folic Acid; Food Assistance; Food, Fortified; Humans; Iron, Dietary; Male; Micronutrients; Middle Aged; Surveys and Questionnaires; Triticum; Vitamin A; Vitamin A Deficiency; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency; Vulnerable Populations; Young Adult; Zinc

Retinoic acid bound to the nuclear retinoic acid receptor-alpha is required for the differentiation of promyelocytes to mature neutrophils. However, severely vitamin A-deficient rats have normal numbers of neutrophils in the blood and inflamed tissues. This paradox was explored using four dietary groups of rats: 1) vitamin A-deficient rats; 2) vitamin A-deficient rats subsequently receiving vitamin A; 3) weight-matched pair-fed rats; and 4) nonrestricted, vitamin A-complete diet-fed rats. Plasma and liver retinol concentrations of the vitamin A-deficient rats were < 1 % of those of the other three groups. In contrast, the bone marrow retinol concentrations of the vitamin A-deficient rats were fourfold higher than those in the other three groups. The distribution of myeloid-derived cells in the bone marrow was similar in all four groups of rats with the exception of a significantly greater (P < 0.05) occurrence of hypersegmented neutrophils (six or more lobes) in the vitamin A-deficient rats (2. 1 %) relative to the control groups (0-0.1%). The blood of the vitamin A-deficient rats also contained significantly higher numbers (P < 0.01) of hypersegmented neutrophils (67%) relative to those in the control groups (2-7%). The hypersegmentation of the neutrophils in this group of rats was not due to a concurrent deficiency of vitamin B-12 or folate. The importance of bone marrow-derived cells to the survival of the animal is suggested by retinol sequestration in the bone marrow of vitamin A-deficient rats, allowing the differentiation of myeloid cells to neutrophils.

Topics: Animals; Bone Marrow; Chromatography, High Pressure Liquid; Diet; Female; Folic Acid; Liver; Male; Neutrophils; Rats; Vitamin A; Vitamin A Deficiency; Vitamin B 12

Serum vitamin levels of 40 patients undergoing parenteral nutrition over a 5-to 42-day period were studied while the subjects received daily water-soluble and once weekly fat soluble vitamin formulations intravenously. Initial serum deficiencies of vitamins A, C, and folate were noted in a large portion of the severely malnourished population. At the replacement levels used in this study a small number of patients developed subnormal levels of vitamins A and D. Improvement in levels for vitamin C and folate were noted for most patients. Vitamin B12 deficiencies were not noted in any patient. Currently available commercial vitamin preparations can be used with safety in the parenterally nourished population and recommended guidelines for weekly infusion of both water and fat soluble vitamins are presented.

Topics: Adolescent; Adult; Aged; Ascorbic Acid Deficiency; Child; Female; Folic Acid Deficiency; Humans; Male; Middle Aged; Neoplasms; Nutritional Requirements; Parenteral Nutrition; Parenteral Nutrition, Total; Vitamin A Deficiency; Vitamin B 12; Vitamin D; Vitamins

Topics: Adult; Aged; Aging; Ascorbic Acid; Ascorbic Acid Deficiency; Female; Humans; Male; Middle Aged; Nicotinic Acids; Nutritional Requirements; Thiamine; Thiamine Deficiency; Vitamin A; Vitamin A Deficiency; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin E; Vitamin E Deficiency; Vitamins

The nutritional status of 80 patients with non-alcoholic chronic liver disease was assessed by determination of various nutritional parameters in body fluids. With the exception of vitamin C there was a higher incidence (40%) of fat soluble vitamin deficiency (vitamins A, E, and carotene) than of the water soluble vitamins. Less than 10% of patients showed evidence of vitamin B12, nicotinic acid, thiamin, or riboflavin deficiency, and 17% had evidence of folic acid deficiency. The presence of deficiency was not related to age of the patient or fat absorption, and an inadequate dietary intake was not a major cause of deficiency. The incidence of nutritional deficiency is less frequent in non-alcoholic as compared with alcoholic liver disease.

Topics: Adult; Aged; Ascorbic Acid Deficiency; Carotenoids; Eating; Folic Acid Deficiency; Hepatitis; Humans; Iron; Liver Cirrhosis; Male; Middle Aged; Niacinamide; Nutrition Disorders; Riboflavin; Transketolase; Vitamin A Deficiency; Vitamin B 12; Vitamin E Deficiency

Restriction of the total diet or the number of calories fed to rats and mice inhibits the formation of tumors in several tissues. Unless animals are fed equivalent levels of food, or attain equivalent body weights, it is difficult to assess the significance of the effect of other nutritional modifications on carcinogenesis. The effects of altering the levels of protein or fat are much less than those seen with dietary restriction. Feeding a protein-free diet is tolerated for a limited period and can alter the metabolism of carcinogens. It may thus affect the tumor incidence induced by one-shot carcinogens. Vitamins have specific effects on the activity of certain carcinogens, the fullest information being available for vitamin A, which has been shown to inhibit or enhance carcinogenesis, and vitamin C, which by reducing sodium nitrite, prevents nitrosation of secondary and tertiary amines occurring in acidic conditions of the stomach. Inorganic substances, such as iodine (thyroid) and copper (liver), may affect the tumor incidence in specific tissues. The metabolic activation of carcinogens is modified by enzyme induction and the administration of antioxidants. The relevance of these results to the induction of cancer in humans is briefly discussed.

Topics: Animals; Antioxidants; Ascorbic Acid; Copper; Diet; Dietary Fats; Dietary Proteins; Enzyme Induction; Iodine; Lipotropic Agents; Mice; Neoplasms, Experimental; Nutritional Physiological Phenomena; Rats; Selenium; Vitamin A Deficiency; Vitamin B 12; Vitamin B 6 Deficiency; Vitamin B Deficiency; Vitamins

Topics: Aged; Aging; Ascorbic Acid; Ascorbic Acid Deficiency; Avitaminosis; Germany, West; Humans; Quackery; Vitamin A; Vitamin A Deficiency; Vitamin B 12; Vitamin B Deficiency; Vitamin E; Vitamin E Deficiency; Vitamins

Topics: Accidents, Traffic; Adolescent; Adult; Ascorbic Acid Deficiency; Calcium; Cheilitis; Diet; Dietary Fats; Gangrene; Hemoglobins; Humans; Intestinal Absorption; Intestine, Small; Iron; Leukocyte Count; Magnesium; Magnesium Deficiency; Male; Oligosaccharides; Pain; Prothrombin Time; Tetany; Vitamin A Deficiency; Vitamin B 12; Vitamin D

Topics: Adult; Dietary Fats; Gastrointestinal Motility; Glucose; Humans; Intestinal Absorption; Intestine, Small; Jejunum; Malabsorption Syndromes; Male; Methods; Postoperative Complications; Vitamin A Deficiency; Vitamin B 12; Xylose

Topics: Adult; Ascorbic Acid Deficiency; Celiac Disease; Diarrhea; Employment; Fatty Liver; Female; Humans; Intestinal Absorption; Intestine, Small; Magnesium Deficiency; Male; Middle Aged; Obesity; Vitamin A Deficiency; Vitamin B 12

The importance of deficiency of the folic acid group of compounds (folates) in the pathogenesis of nutritional anaemias is receiving increasing recognition. There is evidence that the megaloblastic anaemias, due to either vitamin B(12) or folate deficiency, may be the cause of widespread morbidity in malnourished populations. It was therefore considered timely to review certain aspects of the role of folates in megaloblastic anaemia, with special reference to the dietary intake in relation to human requirements, and the recognition of folate deficiency in man.

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Folic Acid; Folic Acid Deficiency; Humans; Male; Vitamin A Deficiency; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Animals; Menstrual Cycle; Pigments, Biological; Rats; Reproduction; Vitamin A Deficiency; Vitamin B 12; Xanthophylls

Topics: Biochemical Phenomena; Corrinoids; Ether; Humans; Lipid Metabolism; Methionine; Vitamin A; Vitamin A Deficiency; Vitamin B 12