Vitamin A supplementation selectively improves the linear growth of Indonesian preschool children: results from a randomized controlled trial

Hadi, Hamam; Stoltzfus, Rebecca J.; Dibley, Michael J.; Moulton, Lawrence H.; West, Keith P.; Kjolhede, Chris L.; Sadjimin, Tonny

doi:10.1093/ajcn/71.2.507

Cited by 73 publications

(69 citation statements)

References 18 publications

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“…16,26 In comparison with the neighboring countries in Southeast Asia, a higher prevalence of VAD (serum retinol concentration < 0.70 μmol/L) was reported among children in rural regions of southern Vietnam and along the southern coast of central Java in Indonesia. 10,27 During the 1990s, Indonesia showed good progress in reducing VAD but the prevalence of the transition changed after the tsunami disaster of 2004 that killed more than 200,000 persons in the territories of Ache, Nias, and Sumatra. This disaster, together with poverty, propagated the prevalence of health problems, including VAD, among children.…”

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confidence: 99%

Giardiasis and Poor Vitamin A Status among Aboriginal School Children in Rural Malaysia

Al-Mekhlafi¹,

Surin²,

Sallam³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract.A cross-sectional study was carried out on 241 primary schoolchildren in Pahang, Malaysia to update their vitamin A status and to investigate the association of poor vitamin A status with their health and socioeconomic factors. All children were screened for intestinal parasitic infections. Blood samples were collected and vitamin A status was assessed. Socioeconomic data were collected by using pre-tested questionnaires. The results showed that 66 (27.4%) children had low serum retinol levels (< 0.70 μmol/L). Giardiasis and severe ascariasis were significantly associated with low serum retinol levels ( P = 0.004 and P = 0.018, respectively). Logistic regression confirmed the significant association of giardiasis with low serum retinol (odds ratio = 2.7, 95% confidence interval = 1.3-5.5). In conclusion, vitamin A deficiency is still a public health problem in rural Malaysia. Vitamin A supplementation and treatment of intestinal parasitic infections should be distributed periodically to these children to improve their health and nutritional status. 18 Iintensity of infection was graded as heavy, moderate, or light according to criteria proposed by the World Health Organization.19 Scores for intensity of infections were given to each soil-transmitted helminth species (light = 1, mild = 2, and severe = 3) and mixed infections with a worm score ≥ 5 were included in the analysis. Samples were also examined for Giardia duodenalis trophozoites or cysts by using the trichrome staining technique.Assessment of vitamin A status. Approximately 2-3 mL of venous blood were collected from each participant into tubes for biochemical analysis. Blood was left at room temperature to ensure clot formation. The tubes were then centrifuged at 3,000 rpm for 10 minutes to obtain serum that was stored at -20°C until further analysis. Serum retinol concentrations were determined using a reverse-phase high performance liquid chromatography (LC-10AD; Shimadzu, Kyoto, Japan) as described. 16,20 One hundred microliters of ethanol containing retinyl acetate as an internal standard was added to 100 μL of serum. Refiltered petroleum ether (RPE) (500 μL) was added and the mixture was mixed with a vortex mixer for 1 minute and centrifuged at 5,000 rpm for 10 minutes. A 150-μL sample from the refiltered petroleum ether layer was transferred into a clean test tube and evaporated. The extract was dissolved in 200 μL of ethanol. Eighty microliters of this mixture was injected into the high performance liquid chromatography apparatus. Methanol:water (95:5 [v/v]) was used as the mobile phase and all-trans retinol was used as the standard. For quality control, 20% of the samples were randomly selected and examined in duplicate. Serum retinol was measured in picomoles per liter.Use of serum retinol to assess vitamin A status may be influenced by inflammation and reductions in plasma retinol, which have been described during the acute phase of a wide range of infections. 21 The design of this study did not consider the inflammatory status of the...

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confidence: 99%

Giardiasis and Poor Vitamin A Status among Aboriginal School Children in Rural Malaysia

Al-Mekhlafi¹,

Surin²,

Sallam³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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“…The lack of effect of vitamin A on ponderal growth but the presence of an effect on linear growth was probably due to the fact that vitamin A deficiency was not severe enough to be a growth-limiting factor in this population. Vitamin A supplementation does improve ponderal growth in severely vitamin A-deficient (Hadi et al, 2000) and xerophthalmic (West et al, 1997) children.…”

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

confidence: 98%

“…Among those articles reporting a positive effect, some noted that the effect was greater in children Z2 y (Muhilal et al, 1988;Hadi et al, 2000), and in non-breastfed children (Hadi et al, 2000). Furthermore, the positive effect of vitamin A supplementation on growth was restricted to children with low serum retinol concentrations (Hadi et al, 2000) or children with xerophthalmia (West et al, 1997), and was only observed in summer (Bahl et al, 1997) or the late dry season (West et al, 1997). The strongest effect was found in the late dry season (Hadi et al, 2002), while the least effect (Hadi et al, 2002) or a slightly negative effect (West et al, 1997) of vitamin A supplementation on growth was found during winter.…”

Section: Introductionmentioning

confidence: 99%

“…Part of the biological mechanism behind the age-specific effect of vitamin A supplementation on growth can be explained by the presence of breastfeeding (Hadi et al, 2000). Non-breastfed children benefit more in height from vitamin A than breastfed children regardless of their age (Hadi et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

“…Non-breastfed children benefit more in height from vitamin A than breastfed children regardless of their age (Hadi et al, 2000). Thus, breastfeeding might protect children from vitamin A deficiency (West et al, 1986) and maintain their vitamin A status at normal levels, such that breastfed children respond less to vitamin A supplementation than nonbreastfed children (Hadi et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

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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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Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age

Imdad

Herzer²,

Mayo‐Wilson

et al. 2010

Cochrane Database of Systematic Reviews

162

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Vitamin A supplementation selectively improves the linear growth of Indonesian preschool children: results from a randomized controlled trial

Abstract: High-dose vitamin A supplementation improves the linear growth of children with very low serum retinol and the effect is modified by age and breast-feeding.

Cited by 73 publications

References 18 publications

Giardiasis and Poor Vitamin A Status among Aboriginal School Children in Rural Malaysia

Giardiasis and Poor Vitamin A Status among Aboriginal School Children in Rural Malaysia

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

Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age

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