Absorption of labelled vitamin A in children during infection

Sivakumar, B.; Reddy, Vinodini

doi:10.1079/bjn19720094

Cited by 129 publications

(63 citation statements)

References 9 publications

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“…A may not be completely absorbed (Sivakumar & Reddy, 1972) and can be expected to be excreted in high quantity (Lawrie et al, 1941;Stephensen et al, 1994). Alternatively, a lack of growth response to vitamin A may be due to nonspecific responses to fever during respiratory infections (Clausen & McCoord, 1938;Mendez et al, 1959) such that sufficient vitamin A is not available to improve growth.…”

Section: Complex Interactions With Infection and Diet H Hadi Et Almentioning

confidence: 99%

Complex interactions with infection and diet may explain seasonal growth responses to vitamin A in preschool aged Indonesian children

2004

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Objective: To explore the potential contribution of respiratory infections and vitamin A intakes to the seasonal effect of vitamin A supplementation on child growth. Methods: Data from a randomized double-blind placebo-controlled trial, in which a single high dose of vitamin A or placebo was given every 4 months to 1405 children aged 6-48 months were used for the analysis. In total, 4430 child-treatment cycles were examined, and for each cycle the children had their dietary intake, weight, and height assessed at the start and end. Linear regression models of the difference in height and weight during each treatment cycle were used and the within-child correlation was adjusted using the generalized estimating equations (GEE). Other covariables in the model included age, sex, percentage of days with acute lower respiratory infection and diarrhea, and cumulative doses of vitamin A. Results: This study showed that a significant effect of vitamin A supplementation on linear growth was observed in all seasons in children with a low burden of respiratory infections, that is, o21.5% of days with respiratory illness. In each season, the highest effect was found in children with a low burden of respiratory infections and low vitamin A intakes, that is, intakes o400 RE/day. Children with a high burden of respiratory infections or high vitamin A intakes benefited less from vitamin A supplementation for their linear growth than children with a low burden of respiratory infections and low vitamin A intakes. Finally, there was no benefit for linear growth from vitamin A supplementation in children with both a high burden of respiratory infections and high vitamin A intakes regardless of the season. Conclusions: The effect of vitamin A supplementation on growth is dependent on season. Respiratory infections and vitamin A intakes are important factors underlying the seasonal effect of vitamin A supplementation on growth.

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Section: Complex Interactions With Infection and Diet H Hadi Et Almentioning

confidence: 99%

Complex interactions with infection and diet may explain seasonal growth responses to vitamin A in preschool aged Indonesian children

2004

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“…Absorption of preformed vitamin A Preformed vitamin A is efficiently absorbed in the intestine, in the range of 70-90 % Sivakumar and Reddy, 1972;Kusin et al, 1974). Almost complete absorption was observed in five healthy Indian children administered 1 000 µg retinyl acetate in oil .…”

Section: Intestinal Absorptionmentioning

confidence: 99%

“…Using a radio-isotopic method, whole-body retinol retention was assessed in groups of Indian children (2-10 years) by measuring radioactivity in urine and faeces over four to six days after administration of a labelled dose Sivakumar and Reddy, 1972). When the labelled dose of retinyl acetate was administered with 1 000 µg unlabelled retinyl acetate, mean retention was 82.2 ± 2.0 % in healthy children (n = 5) and 57.6 ± 6.0 % in a group of children (n = 8) with infection.…”

Section: Efficiency Of Storagementioning

confidence: 99%

Scientific Opinion on Dietary Reference Values for vitamin A

Products¹

2015

EFSA Journal

116

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Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies derived Dietary Reference Values for vitamin A. The Panel considered that a concentration of 20 µg retinol/g liver can be used as a target for establishing the Average Requirement (AR) for vitamin A. In the absence of a better characterisation of the relationship between vitamin A intake and liver stores, a factorial approach was applied. This approach considered a total body/liver retinol store ratio of 1.25, a liver/body weight ratio of 2.4 %, a fractional catabolic rate of body retinol of 0.7 % per day, an efficiency of storage in the whole body for ingested retinol of 50 % and reference weights for women and men in the EU of 58.5 and 68.1 kg, respectively. ARs of 570 µg retinol equivalent (RE)/day for men and 490 µg RE/day for women were derived. Assuming a coefficient of variation (CV) of 15 %, Population Reference Intakes (PRIs) of 750 µg RE/day for men and 650 µg RE/day for women were set. For infants aged 7-11 months and children, the same equation as for adults was applied by using specific values for reference weight and liver/body weight ratio. For catabolic rate, the adult value corrected on the basis of a growth factor was used. ARs range from 190 µg RE/day in infants aged 7-11 months to 580 µg RE/day in boys aged 15-17 years. PRIs for infants and children were estimated using a CV of 15 % and range from 250 to 750 µg RE/day. For pregnancy and lactation, additional vitamin A requirements related to the accumulation of retinol in fetal and maternal tissues and transfer of retinol into breast milk were considered and PRIs of 700 and 1 300 µg RE/day, respectively, were set. Vitamin A is involved in vision as retinal, which plays a central role in the mechanisms of phototransduction, and in the systemic maintenance of the growth and integrity of cells in body tissues through the action of retinoic acid, which acts as regulator of genomic expression. The most specific clinical consequence of vitamin A deficiency is xerophthalmia, which encompasses a clinical spectrum of ocular manifestations. In low-income countries, vitamin A deficiency in young infants and children has been associated with increased infectious morbidity and mortality, including respiratory infection and diarrhoea. © EuropeanPreformed vitamin A is efficiently absorbed (70-90 %). The absorption of β-carotene appears to be highly variable (5-65 %), depending on food-and diet-related factors, genetic characteristics and the health status of the subject. The intestine is the primary tissue where dietary provitamin A carotenoids are converted to retinol. Retinol, in the form of retinyl esters, and provitamin A carotenoids enter the body as a component of nascent chylomicrons secreted into the lymphatic system. Most dietary retinol (in chylomicrons and chylomicron remnants) is taken up by the liver, which is the major site of retinol metabolism and storage. Hepatic retinyl esters are hydrolysed to free retinol, and delivered to ti...

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“…In the application of the 13 C-VALID test, 100 % absorption was assumed in well-nourished Americans [18] and hypervitaminotic monkeys [17]. This was based upon the facts that a 1 mg dose, which had radioactive carbon added to it, was almost completely absorbed (99.2 %) in 5 Indian children [26] and no 13 C enrichment was detected in the feces of the monkeys. However, in application of the test in groups of individuals who might have micronutrient co-defi ciencies and to account for underlying repeated infections, 90 % absorption of the dose is recommended to be used [22].…”

Section: Mass Balance Equationmentioning

confidence: 99%

“…Further, if study design and resources allow it, researchers or evaluators may want to measure the acute phase protein C-reactive protein at baseline [27]. If elevated >10 mg/L, the child or adult likely had an active infection and the dose may be less wellabsorbed, and in this case, 80 % absorption could be assumed [26]. Absorption of a 5 mg dose was 81.2 % in 3 Zambian children without illness using accelerator mass spectrometry for analysis [28].…”

Section: Mass Balance Equationmentioning

confidence: 99%

Usefulness of Vitamin A Isotope Methods for Status Assessment: From Deficiency through Excess

Tanumihardjo

2014

International Journal for Vitamin and Nutrition Research

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A variety of methods exist to assess vitamin A status of groups and populations. Vitamin A status is usually defi ned by the liver retinol concentration. Most indicators of status do not measure or estimate liver stores of retinol. Clinical signs only have utility when liver reserves are almost exhausted, and serum retinol concentrations have utility in the zone of overt defi ciency. Dose response tests offer more coverage, but cannot distinguish among liver vitamin A stores in the adequate through toxic range. Different countries continue, or are beginning, to add preformed vitamin A to a variety of staple foods through fortifi cation, and vitamin A supplements are still being distributed in many countries, especially to preschool children. Further, provitamin A biofortifi ed crops are currently being released in several countries. Assessing population vitamin A status in response to these interventions needs to move beyond serum retinol concentrations. Indicators that work in the excessive to toxic range of liver reserves are needed. To date, the only indirect indicator that has been validated in this range of liver reserves in animals and humans is the retinol isotope dilution test using deuterium or 13 C, which spans the entire liver reserve continuum from defi ciency through excess.

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Absorption of labelled vitamin A in children during infection

Cited by 129 publications

References 9 publications

Complex interactions with infection and diet may explain seasonal growth responses to vitamin A in preschool aged Indonesian children

Complex interactions with infection and diet may explain seasonal growth responses to vitamin A in preschool aged Indonesian children

Scientific Opinion on Dietary Reference Values for vitamin A

Usefulness of Vitamin A Isotope Methods for Status Assessment: From Deficiency through Excess

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