Impact of disease on markers of micronutrient status

Thurnham, David I.

doi:10.1079/pns19970043

Cited by 42 publications

(23 citation statements)

References 54 publications

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“…It was possible that impaired feeding in these sick children further aggravated the already precariously low circulating levels of these micronutrients as seen in the rural children without noma (Table 3). Nonetheless, plasma concentration of retinol lower than 0.7 mol/L was reflective of very low dietary intake, 53 and levels of approximately 0.35 mol/L or less indicated a dangerously depleted hepatic store of the vitamin. 54 Most of our patients with noma and many of the village children without noma were in a precarious situation with respect to vitamin A status (Table 3).…”

Section: Discussionmentioning

confidence: 99%

“…51 In the interpretation of our biochemical data, it must be underscored that infections (e.g., malaria, measles) and chronic diseases, as well as trauma, could elicit negative effects on the plasma levels of micronutrients such as ascorbate, ''␣-tocopherol, retinol, zinc, and iron. 42,52,53 It is well established that retinol, zinc, and iron are among the negative acute-phase reactants whose plasma levels decrease in response to infection. 52 The latter might explain the observation of the significant reduction in plasma retinol and zinc concentrations in children with noma compared with the other impoverished children without noma (Table 3), although we would not exclude the potential contribution of infectioninduced anorexia.…”

Section: Discussionmentioning

confidence: 99%

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Pathogenesis of cancrum oris (noma): confounding interactions of malnutrition with infection.

Enwonwu¹,

Falkler²,

Idigbe³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

105

129

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Abstract. This study showed that impoverished Nigerian children at risk for cancrum oris (noma) had significantly reduced plasma concentrations of zinc (Ͻ 10.8 mol/L), retinol (Ͻ 1.05 mol/L), ascorbate (Ͻ 11 mol/L), and the essential amino acids, with prominently increased plasma and saliva levels of free cortisol, compared with their healthy counterparts. The nutrient deficiencies, in concert with previously reported widespread viral infections (measles, herpesviruses) in the children, would impair oral mucosal immunity. We postulate, subject to additional studies, that evolution of the oral mucosal ulcers including acute necrotizing gingivitis to noma is triggered by a consortium of microorganisms of which Fusobacterium necrophorum is a key component. Fusobacterium necrophorum elaborates several dermonecrotic toxic metabolites and is acquired by the impoverished children via fecal contamination resulting from shared residential facilities with animals and very poor environmental sanitation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pathogenesis of cancrum oris (noma): confounding interactions of malnutrition with infection.

Enwonwu¹,

Falkler²,

Idigbe³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

105

129

View full text Add to dashboard Cite

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“…These proteins combine to transport retinol in the plasma as a fairly large molecular complex. Thus, the amount of retinol released into the circulation decreases (Thurnham, 1997). The fall in circulating retinol may be a protective measure to prevent urinary losses of retinol or of the retinol-RBP complex, since in the absence of transthyretin the size of the complex is such that it is more easily lost in the urine, especially in severe infection (Stephensen et al 1994).…”

Section: Impact Of Infection On Plasma Retinol Homeostasismentioning

confidence: 99%

Optimal nutrition: vitamin A and the carotenoids

Thurnham

Northrop-Clewes

1999

Proc. Nutr. Soc.

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There are two major dietary sources of vitamin A: easily absorbed retinyl palmitate in foods of animal origin, and poorly bioavailable carotenoids from plant foods. Plasma retinol is tightly controlled, probably by regulation of retinol-binding protein (RBP) formation in the liver, and only hormonal factors (e.g. oral contraceptives) and infection will alter the homeostasis. Delivery of retinol to the tissues is facilitated by the RBP-retinol complex; however, there is evidence that this mechanism can be bypassed when very high doses of vitamin A are given. Some retinyl ester may be released to tissues from chylomicrons when the latter bind to tissue lipoprotein receptors during their passage from the gut to the liver following a meal. High-dose vitamin A therapy is a means of rapidly improving vitamin A status in persons with sub-optimal vitamin A nutrition but there are dangers of toxic symptoms (e.g. teratogenicity) from excess vitamin A usage. Evidence is presented to suggest that the plasma retinol : RBP may be a guide to optimal vitamin A status, since values less than one frequently occur in less-developed countries and during infection. In contrast to plasma retinol, plasma carotenoids reflect the dietary intake of plant foods. However, absorption is limited by poor bioavailability and a saturable uptake mechanism in competition with other phytochemicals. Recent work on bioavailability suggests that the calculation of plant food vitamin A activity should be re-examined. Illness has little influence on plasma levels except by suppressing appetite. Carotenoids are generally regarded as non-toxic yet intervention studies with β-carotene in smokers have been associated with increased lung cancer and heart disease. Some carotenoids are important as vitamin A precursors, but the physiological importance of their antioxidant properties is not known and consequently the amount needed for optimal nutrition is uncertain.

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“…Because these carotenoids are carried mainly on lipoproteins, adjustment for plasma cholesterol may improve the results. Plasma cholesterol was not measured in this survey; although carotenoids are concentrated in lipoproteins 11 , we have found in other studies that this correction makes little difference (TK Ha et al, unpublished observations).…”

Section: Estimated Antioxidant Vitamin Intakes and Antioxidant Blood mentioning

confidence: 93%

Evaluation of a bar-code system for nutrient analysis in dietary surveys

Anderson

Maher

et al. 1999

Public Health Nutr.

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Objective: A novel system for nutrient analysis has been developed and tested over 5 years. Its key features are a nutrient database of 600 commonly eaten foods (95% of foods eaten in 7-day surveys); a booklet identifying each food with a bar code, bar codes for gram weight and for portion sizes (small, medium, large) and a bar-code reader with dietary analysis software for PCs. In the present study the bar-code system has been evaluated by comparison with a commonly used manual entry nutrient analysis software for dietitians' use. Design: Cross-sectional. Setting: Glasgow city district. Subjects: One hundred and sixty adults aged 18-65 years old. Results: Comparing mean intakes for macro-and micronutrients, using the Bland and Altman method 1 , the bias between the two methods was small, ranging from 0.93 to 1.03. The bar-code system took significantly less professional time in data entry and nutrient analysis than the widely used manual system (29 min per 7-day diary vs. 47 min per 7-day diary, P Ͻ 0.001). Conclusions: It is suggested that the bar-code system offers greater speed with a saving of professional time needed for nutrient analysis of dietary surveys. This system is commended for maintaining accuracy while promoting economy.

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Impact of disease on markers of micronutrient status

Cited by 42 publications

References 54 publications

Pathogenesis of cancrum oris (noma): confounding interactions of malnutrition with infection.

Pathogenesis of cancrum oris (noma): confounding interactions of malnutrition with infection.

Optimal nutrition: vitamin A and the carotenoids

Evaluation of a bar-code system for nutrient analysis in dietary surveys

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