Maternal vitamin A or beta-carotene supplementation in lactating bangladeshi women benefits mothers and infants but does not prevent subclinical deficiency.
The effects of maternal postpartum vitamin A or beta-carotene supplementation on maternal and infant serum retinol concentrations, modified relative dose-response (MRDR) ratios and breast milk vitamin A concentrations were assessed during a community-based trial in Matlab, Bangladesh. At 1-3 wk postpartum, women were randomly assigned to receive either (1) a single dose of 200,000 international units [60,000 retinol equivalents (RE)] vitamin A followed by daily placebos (n = 74), (2) daily doses of beta-carotene [7.8 mg (1300 RE)] (n = 73) or (3) daily placebos (n = 73) until 9 mo postpartum. Compared to placebos, vitamin A supplementation resulted in lower maternal MRDR ratios (i.e., increased liver stores) and higher milk vitamin A concentrations at 3 mo, but these improvements were not sustained. The beta-carotene supplementation acted more slowly, resulting in milk vitamin A concentrations higher than the placebo group only at 9 mo. Irrespective of treatment group, over 50% of women produced milk with low vitamin A concentrations (/=0. 06. We conclude that while both interventions were beneficial, neither was sufficient to correct the underlying subclinical vitamin A deficiency in these women nor to bring their infants into adequate vitamin A status. (+info)
Effect of vitamin A and beta carotene supplementation on women's health.(2/7067)
Double blind, cluster randomised trial of low dose supplementation with vitamin A or beta carotene on mortality related to pregnancy in Nepal. The NNIPS-2 Study Group.
OBJECTIVE: To assess the impact on mortality related to pregnancy of supplementing women of reproductive age each week with a recommended dietary allowance of vitamin A, either preformed or as beta carotene. DESIGN: Double blind, cluster randomised, placebo controlled field trial. SETTING: Rural southeast central plains of Nepal (Sarlahi district). SUBJECTS: 44 646 married women, of whom 20 119 became pregnant 22 189 times. INTERVENTION: 270 wards randomised to 3 groups of 90 each for women to receive weekly a single oral supplement of placebo, vitamin A (7000 micrograms retinol equivalents) or beta carotene (42 mg, or 7000 micrograms retinol equivalents) for over 31/2 years. MAIN OUTCOME MEASURES: All cause mortality in women during pregnancy up to 12 weeks post partum (pregnancy related mortality) and mortality during pregnancy to 6 weeks postpartum, excluding deaths apparently related to injury (maternal mortality). RESULTS: Mortality related to pregnancy in the placebo, vitamin A, and beta carotene groups was 704, 426, and 361 deaths per 100 000 pregnancies, yielding relative risks (95% confidence intervals) of 0. 60 (0.37 to 0.97) and 0.51 (0.30 to 0.86). This represented reductions of 40% (P<0.04) and 49% (P<0.01) among those who received vitamin A and beta carotene. Combined, vitamin A or beta carotene lowered mortality by 44% (0.56 (0.37 to 0.84), P<0.005) and reduced the maternal mortality ratio from 645 to 385 deaths per 100 000 live births, or by 40% (P<0.02). Differences in cause of death could not be reliably distinguished between supplemented and placebo groups. CONCLUSION: Supplementation of women with either vitamin A or beta carotene at recommended dietary amounts during childbearing years can lower mortality related to pregnancy in rural, undernourished populations of south Asia. (+info)
Effectiveness of 1,25-dihydroxyvitamin D supplementation on blood pressure reduction in a pseudohypoparathyroidism patient with high renin activity.
A 42-year-old man had biochemical and somatic abnormalities compatible with pseudohypoparathyroidism type I (PsHP) and also had high plasma renin activity (PRA). After 1,25-dihydroxyvitamin D (calcitriol) supplementation the systolic/diastolic blood pressure, assessed by 24-hour non-invasive ambulatory blood pressure monitoring, was reduced from 145/96 mm Hg to 128/85 mm Hg with normalization of the serum calcium level and its related hormones, as well as decreased PRA. Calcitriol supplementation successfully reduced the blood pressure in this patient with PsHP and a high PRA, suggesting that calcium-related hormones and/or the renin-angiotensin system were involved in lowering the blood pressure. (+info)
Important micronutrient deficiencies in at-risk populations can be addressed simultaneously with programmatically cost-effective results. Because of the interaction between many micronutrients, this would also be biologically effective. With adequate investment and political support, the chances of eliminating iodine deficiency as a problem in women of reproductive age and young children and of eliminating vitamin A deficiency as a problem in young children in the future are high. To eliminate iron deficiency and folic-acid-dependent neural tube defects (FADNTDs) in low-income populations, a new set of approaches will have to be developed. These same approaches, if successful, could be used to tackle other important micronutrient deficiencies. (+info)
Effects of pre- or postpartum selenium supplementation on selenium status in beef cows and their calves.
The effect of Se supplementation before or after calving on Se status in deficient cows and their calves was studied using 72 beef cows in two experiments. In Exp. 1, cows calving in February or March 1997 were supplemented orally for 15 d in late pregnancy with 13.0, 32.5, or 45.5 mg of Se/d as sodium selenite. Glutathione peroxidase (GSH-Px) activities were measured in red blood cells (RBC) or plasma of cows and calves at d 15 and between d 17 and 88 after calving. In Exp. 2, cows calving in January 1997 were supplemented orally with .0, 13.0, or 32.5 mg of Se/d for 15 d postpartum, and calves were injected with 1.38 mg of Se when 2 d old and at an average age of 49 d. The GSH-Px activities were measured in 30-d-old calves and in cows and calves between d 77 and 115 after calving. In both experiments, Se supplementation resulted in adequate Se status for the dams. The increase in RBC GSH-Px activity was faster with 45.5 mg of Se/d, and GSH-Px activities remained high for up to 98 d after the end of supplementation. The improvement in Se status in calves as a result of maternal supplementation was greater in Exp. 1 than in Exp. 2, suggesting that the placental transfer of Se is more efficient than milk transfer. Prepartum oral Se supplementation of deficient beef cows with 13.0 mg of Se/d for 15 d allowed adequate Se status of dams and calves, and 45.5 mg of Se/d resulted in a faster improvement of Se status. Parenteral administration of 1.38 mg of Se to newborn calves did not sustain normal Se status in calves issued from deficient cows. (+info)
The effects of low-copper diets with or without supplemental molybdenum on specific immune responses of stressed cattle.
Angus bull calves (n = 42; 7 mo of age; 254 kg initial BW) were used to investigate the effects of dietary Cu and Mo on immune function of stressed cattle. Randomly selected calves (n = 22) were injected with 90 mg of Cu as Cu glycinate 28 d before weaning and castrated at weaning. These calves received 7.5 and 5 mg of supplemental Cu/kg of DM during a 41-d receiving phase and a 196-d growing phase, respectively. The remainder of the steers received no supplemental Cu during the experiment. Copper-supplemented steers had adequate Cu status at weaning, whereas unsupplemented calves were marginally Cu-deficient. Cell-mediated response to intradermal injection of phytohemagglutinin was not affected by dietary treatment during the receiving phase. During the growing phase, half of the steers in each Cu treatment were given 5 mg of supplemental Mo/kg of DM. Copper supplementation increased (P<.05) humoral response to ovalbumin injected on d 133 of the growing phase. On d 168 of the growing phase, calves receiving only supplemental Mo were severely Cu-deficient based on plasma and liver Cu concentrations. The other treatment groups had adequate Cu status. Before feeding on d 168 of the growing phase, half of the steers were loaded onto trailers and transported 2.5 h, and they remained on the trailers an additional 9.5 h. Humoral response to porcine erythrocytes (PRBC) and delayed-type hypersensitivity (DTH) to dinitrochlorobenzene was tested at the end of the stress period. There was a Cu x stress interaction for humoral response to PRBC, with Cu decreasing antibody titers in unstressed calves and increasing titers in stressed steers. Stressed steers had lower (P = .03) ADG during the 28 d following stress. The results of this study indicate that Cu deficiency and 5 mg of supplemental Mo/kg of DM do not dramatically alter the specific immunity of stressed cattle. (+info)
Separate and joint effects of micronutrient deficiencies on linear growth.
Recent studies have investigated the effect of micronutrient deficiencies on growth stunting, with special attention toward the effect of zinc, iron, vitamin A and iodine deficiencies. In Mexico, the prevalence of growth stunting in children <5 y old is approximately 24%; it is higher in rural areas and lower in urban areas. In an initial study, the effect of zinc and/or iron supplementation on linear growth was investigated in a longitudinal, placebo-controlled design. After 12 mo of supplementation, there was no difference between the groups supplemented with zinc, iron or zinc plus iron and the placebo group. At baseline, 82% of the children in this study were deficient in at least two out of the five micronutrients that were determined, and 73% were anemic. In another study, a mixture of those micronutrients that were documented to be lacking in Mexican children was formulated in a supplement and given to Mexican children over a period of 12 mo in a longitudinal, placebo-controlled, supplementation design. Children in the low and medium socioeconomic status grew about 1 cm more than similar children in the placebo group. This difference was not found in children of high socioeconomic status. It is suggested that, in most cases, growth stunting is associated with marginal deficiencies of several micronutrients and that in populations with multiple micronutrient deficiencies, the effect on linear growth of supplementation with single nutrients will not be significant. Supplementation with multiple micronutrients is expected to be more effective, but even in that case the actual increment in height was less than the expected potential increment. (+info)