Impact of vitamin A and beta-carotene supplementation in lactating women in Bangladesh on biochemica...

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" Impact of vitamin A and beta-carotene supplementation in lactating women in Bangladesh on biochemical indicators of maternal and infant vitamin A status "
A. L. Rice R. J. Stoltzfus

Document Type	:	Latin Dissertation
Language of Document	:	English
Record Number	:	1113364
Doc. No	:	TLpq304419172
Main Entry	:	A. L. Rice
	:	R. J. Stoltzfus
Title & Author	:	Impact of vitamin A and beta-carotene supplementation in lactating women in Bangladesh on biochemical indicators of maternal and infant vitamin A status\ A. L. RiceR. J. Stoltzfus
College	:	The Johns Hopkins University
Date	:	1998
student score	:	1998
Degree	:	Ph.D.
Page No	:	181
Abstract	:	This study assessed the impact of vitamin A and usd\betausd-carotene supplementation in lactating women on biochemical indicators of vitamin A status because evidence for the efficacy of the currently recommended 200,000 IU dose of vitamin A or usd\betausd-carotene interventions in lactating women was limited. We conducted a randomized, double-blind trial in which 220 rural Bangladeshi women received either a single dose of 200,000 IU vitamin A, daily doses of 7.6 mg synthetic usd\betausd-carotene, or daily placebos from 2 weeks to 9 months post-partum. Serum and milk samples were collected from women at multiple time points. Serum was collected from 6 month old infants. A new high performance liquid chromatography method was developed to determine the vitamin A content in 400 muL samples of breast milk because previous methods did not add an internal standard before saponification. Prior to supplementation, 25% of women had low liver stores of vitamin A. Vitamin A supplementation improved modified relative dose response (MRDR) ratios and breast milk vitamin A content at 3 months post-partum, but these improvements were not sustained. Beta-carotene supplementation acted more slowly, resulting in higher milk vitamin A only at 9 months. Irrespective of treatment group, over 50% of women produced milk with low vitamin A throughout the study. Vitamin A was more effective than usd\betausd-carotene for improving the vitamin A status of 6 months old infants. However, 85% of all infants had low liver stores and 33% had serum retinol concentrations usd\lequsd0.70 mumol/L. Although both were beneficial, neither intervention was sufficient to correct the subclinical vitamin A deficiency among the women or infants in this population. We used receiver-operating characteristic analyses to compare the performance of serum retinol, the MRDR ratio and breast milk vitamin A as indicators of risk and response. Milk vitamin A was more sensitive than either maternal or infant serum retinol as an indicator of risk of deficiency (defined as low liver stores by the MRDR ratio). The MRDR ratio and milk vitamin A were more responsive indicators than serum retinol. Expressing milk vitamin A content per gram of fat rather than per volume improved indicator performance.
Subject	:	Gynecology
	:	Health and environmental sciences
	:	Nutrition
	:	Nutrition
	:	Obstetrics
	:	Public health