Determination of Vitamins A, C and D Status Using Serum Markers and a 24-Hour Dietary Recall among Maasai Women of Reproductive Age

Abstract

We previously reported that the prevalence of oral thrush among Maasai women of reproductive age in Ngorongoro Conservation Area was abnormally high (32%) in the absence of immune-compromising diseases such as HIV. This study was undertaken to test the hypothesis that Maasai women of reproductive age are prone to oral thrush because they are deficient in micronutrients such as Vitamins A, C, D, and B12, as well as iron and folate which are known to have immune modulating functions. Method: The study recruited 210 participants out of which 180 agreed to donate blood for serum separation and analyses. A total of 107 participants (including 28 with oral thrush and 79 without oral thrush) were assessed for dietary intake of iron, folate, Vitamins A, C, and B12 using a 24 hours dietary recall method. Further, 40 serum samples randomly selected from the 180 serum samples were tested for concentrations of Vitamins A and C using commercially available HPLC kit while the concentration of Vitamin D was tested using the commercially available 25-OH Vitamin D ELISA Assay kit. Statistical analysis was performed using IBM SPSS Statistics 20™, where descriptive and inferential statistics were applied to demographic, socioeconomic and biochemical variables. Student's t-test was used to test for significant differences among variables at 95% confidence level. The proportion of women with deficiency was calculated for single and multiple micronutrients. Results: Results from the 24-hour dietary recall method revealed that with the exception of folate (p = 0.000), there were no significant differences in iron, Vitamins A, C, and B12 intake between participants with and without oral thrush. Of note, the intake of these four micronutrients was below the Recommended Nutrient Intake (RNI). A similar trend was observed for serum vitamin concentrations as established by HPLC and ELISA testing. While there was no significant difference in serum concentration of Vitamins A, C, and D between participants with and without oral thrush (p > 0.05), the serum levels were all below normal sig-* Corresponding author. nifying deficiency of micronutrients in the sample. Conclusion: Overall, this study revealed micronutrient deficiency in the women of reproductive age in the Ngorongoro Conservation Area, which may contribute to the previously reported high levels of oral thrush. Recommendations: Nutrition education directed to this community on the importance of eating micronutrient rich foods such as fruits and vegetables is highly recommended.

A Review of the Extraction and Determination Methods of Thirteen Essential Vitamins to the Human Body: An Update from 2010

“…Besides the methods mentioned above, several effective methods have also been developed, e.g., immunoassays [ 99 ], high performance thin-layer chromatography [ 81 ] and supercritical fluid chromatography [ 98 ]. The use of these methods is justified when it is necessary to carry out routine quality control of relatively simple sample compositions.…”

“…These methods can drastically reduce the number of analyses required to detect vitamins in different samples. Martin et al [ 99 ] used the 25-OH vitamin D ELISA Assay kit to determine the quantity of vitamin D; the method was successfully applied into serum samples.…”

<p>Knowledge and Dietary Practices on Vitamin A and Iron Among Maasai Pregnant Women: A Mixed-Method Study, Ngorongoro, Tanzania</p>

“…This is a unique finding as most previous studies did not suggest adequate micronutrient knowledge in a pastoral society. 9,18,[31][32][33] Furthermore, participants mentioned swollen legs and maternal/infant mortality as the symptoms and consequences of anemia during pregnancy. These findings were in part supported by Klopovich who mentioned swollen legs as one of the symptoms of maternal chronic anemia/iron deficiency anemia.…”

“…8 Although vitamin A is not a vitamin of interest during pregnancy, the current research decided to study it after different studies reported 100% of vitamin A deficiency to women of reproductive age and pregnant women in this population. 9,10 Further, the current study aimed to inform the level of knowledge on maternal vitamin A to the intervention study for an aim of formulating nutrition education and food-basket intervention. 10 Most important, the use of plant-based vitamin A foods and nutrition education has been seen to increase serum retinol levels to the vitamin A deficient population without toxicity.…”

“…19 One such belief is reducing the portions of maternal diet during the second and third trimesters with the purpose of delivering smaller, lower birth-weight babies, as it is believed that bigger babies increase complications during delivery. 9 The complications are being experienced because these pregnant women give birth at home as, it is estimated that 90% of pregnant women attend ANCs; however, only 7% give birth in these clinics. 20 Lennox et al (2017) showed these beliefs have a direct impact on dietary behaviors and health of Maasai pregnant women.…”