PREVALENCE AND PREDICTORS OF VITAMIN A DEFICIENCY AMONG INFANTS IN WESTERN KENYA USING A CROSS-SECTIONAL ANALYSIS

Vitamin A (VA) deficiency (VAD) is a major nutritional public health problem among children under-5-years-old in the developing world including Kenya. A community-based cross-sectional survey among 1,630 children (aged 6-23 mos) was undertaken in Western Kenya. A questionnaire was administered to collect demographic, socio-economic and dietary intake information. Prevalence of low retinol-binding protein (RBP) concentrations was assessed using Dried Blood Spot (DBS) methodology. Analysis of RBP was carried out using rapid enzyme immunoassay (EIA) and C-reactive protein (CRP) was carried out using enzyme linked immunosorbent assay (ELISA) to estimate VA and sub-clinical inflammation statuses, respectively. Values were adjusted for influence of inflammation using CRP (CRP >5 mg/L) and population prevalence of VAD (RBP <0.825 μmol/L, biologically equivalent to 0.70 μmol/L retinol) estimated. Anthropometric data gave three indices: stunting, wasting and underweight—all of which took age and sex into consideration. Mean (geometric± SD) concentration of RBP was adequate (1.56±0.79μmol/L) but the inflammation-adjusted mean (±SE) prevalence of VAD was high (20.1±1.1%) in this population. The level of CRP was within normal range (1.06±4.95 mg/L) whilst 18.4±0.9% of the children had subclinical inflammation (CRP>5 mg/L). Intake of VA capsule (VAC) by a child was a predictor of VAD with children who have not taken VA during the past 1 year prior to the survey having a 30% increased risk of VAD (OR (CI): 1.3 (1.1-1.7); p=0.025. Additionally, age of the child was a predictor with older children (18-23 mos) having a 30 % increased risk of VAD (OR (CI): 1.3 (1.1-1.9); p=0.035); the caretaker’s knowledge on VA and nutrition was also a predictor of VAD with children whose caretaker’s had poor knowledge having a 40 % increased risk of VAD (OR (CI): 1.4 (1.0-1.9); p=0.027. A child’s district of residence was also a significant predictor of VAD. Prevalence of VAD in this sample of infants was high. Predictors of VAD included child intake of VAC in the last 1 year before the survey, older children, children whose caretakers had poor VA and nutritional knowledge and a child’s district of residence. There is a need to improve knowledge on nutrition and VA of caretakers; undertake a targeted VAC distribution, particularly in children older than 1 year and above and use a sustainable food-based intervention in the areas with severe VAD.

Vitamin D status in the first-trimester: effects of Vitamin D deficiency on pregnancy outcomes.

Objective: To assess serum levels of 25-hydroxyvitamin D [25(OH)D] in the first trimester and to determine the factors affecting deficiency levels and its association with pregnancy outcomes. Methods: Serum 25(OH)D concentrations were measured at 11-14 weeks’ gestation in 229 singleton pregnancies using liquid chromatography-tandem mass spectrometry. Results: The median serum 25(OH)D concentration was 10.8 ng/mL and 45.9% of women had severe vitamin D deficiency with concentrations of <10 ng/mL. Logistic regression analysis revealed that covered dressing style, lack of multivitamin intake, season of blood sampling (November-April) were factors associated with 25(OH)D deficiency. There was a negative correlation between 25(OH)D levels and gestational age at sampling. Low 25(OH)D levels were not associated with adverse pregnancy outcomes. Higher rate of cesarean section (CS) was noted in women with 25(OH)D ≥10 ng/mL compared to those with 25(OH)D < 10mg/ml ( p= 0.01). Conclusion: A high prevalence of vitamin D deficiency was observed in early pregnancy which was related to dress code, use of multi-vitamins and season at sampling. Low 25(OH)D levels were not related with adverse pregnancy outcomes. Women with severe vitamin D deficiency were more likely to deliver vaginally.

Prevalence and factors associated with anthropometric failure, vitamin A and iron deficiency among adolescents in a Nigerian urban community.

Background: Under nutrition is a problem of severe magnitude in low income countries like Nigeria. Adolescent school children might also be vulnerable. The dearth of data hinders planning of school health and nutrition programmes for school children. Objective: To determine the prevalence of stunting, thinness; vitamin A and iron deficiencies among adolescent students in Nsukka urban, Nigeria and to determine factors that are associated with these nutritional problems. Methods: A total of 400 participants were randomly selected from 717 students aged 12 – 18 years in 3 randomly selected secondary schools. Questionnaires, anthropometric measurements, and blood analyses were the data collection methods employed. Results: The prevalence of stunting was 33.3% and thinness 31.0%. Neither overweight nor obesity was observed. While 64.0% were anaemic; 44.0% had vitamin A deficiency (VAD). A total of 48.0% had both anaemia and stunting, 42% had VAD + thinness; while 40% had anaemia + VAD. Household income was a predictor of vitamin A status. Children from medium/ high income households had higher odds of having VAD than those from low income households (AOR=0.14; 95% CI=0.031, 0.607; P=0.009). Household income (AOR=0.12; 95% CI=0.021, 0.671; P=0.016), and age (AOR=0.09; 95% CI=0.014, 0.587; P=0.012) were independent determinants of height-for-age status. Conclusion: Among urban adolescent students in Nigeria, stunting, thinness, anaemia and VAD were problems of public health significance. Age and household monthly income played major roles.

VITAMIN “A” FOOD CONSUMPTION BY PREGNANT WOMEN IN BRAZIL: A SYSTEMATIC REVIEW

Objective: To conduct a systematic review of the Vitamin “A” food consumption by pregnant women in Brazil. Methods: The review consisted of a search for articles published in the period from 1999 to 2015 in SciELO, PubMed, and LILACS databases. At the end, eight articles were selected for this review. Results: The methods used for the analysis of the intake of vitamin “A” were: food frequency questionnaire (FFQ) – considering the diet or only vitamin “A” foods and the dietary recall (24hDR). Only two articles estimated the adequacy of the Vitamin “A” food consumption by the population assessed. Some methodological limitations were quite frequent, emphasizing the lack and/or limitation of information on the sample representativeness, loss of studies, accuracy of the methods applied and the control of confounding variables. Conclusion: It is observed that there are still few studies that critically assess the Vitamin “A” food consumption by pregnant women in Brazil, and that the identification and control of possible biases of the dietary surveys can improve the reliability of the information found.

NUTRITIONAL COMPOSITION AND ANTIOXIDANT PROPERTIES OF RAPHIONACME SPLENDENS (SCHL.) TUBERS

People of Western Kordofan (Sudan) are endowed with a deep knowledge concerning the use of wild plants. Tubers of Raphionacme splendens Schl. subspecies splendens Flickr (family Apocynaceae), locally known as Elfayo, are used as a food reserve during times of famine or poor harvest. The aim of this study was to analyze the nutritional composition and antioxidant capacity of root tubers of R. splendens. Samples were collected from South-West Kordofan. Analyses included determination of moisture, carbohydrate, crude protein, fat, fibre, ash, minerals, vitamin C, amino acids and fatty acids composition. Antioxidant activity was determined by the DPPH (1,1-diphenyl-2-picrylhydrazyl) and ABTS (2.2’-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) assays. The total phenolic content was also assessed. The results, which are referred to as (%) dry weight, showed that the tubers contained 3.2% protein, 18% carbohydrate, 0.5% lipid, 2.4% crude fibre, 3.5% ash, 79.2% moisture and gross energy 101.7 kJ/g. The total amino acids were 10776 mg/100g where the essential amino acids represented 28.2%. The more abundant essential amino acids were leucine (792mg/100g), isoleucine (712mg/100g) and threonine (536mg/100g). Methionine and lysine were the limiting amino acids. Minerals were potassium (259mg/100g), calcium (183mg/100g), magnesium (64mg/100g), phosphorus (37mg/100g), copper (3.6mg/100g), manganese (2.4mg/100g), zinc (1.8mg/100g) and iron (1.2mg/100g). Total saturated fatty acids were 45.6% whereas total unsaturated fatty acids were 54.4%. Oleic acid (32.56%) and palmitic acid (30.23%) were the most abundant fatty acids. Tubers displayed good antioxidant activity with IC50 values 0.987 and 1.559mg/mL against DPPH and ABTS radicals respectively. Vitamin C was 31.5mg/100g and total phenolic content was 60mg gallic acid equivalent (GAE) per 100g dry sample and they could be the main contributor to the antioxidant capacity of the tubers. In conclusion, the results of this study suggested that tubers of R. splendens could have beneficial effect for food and/or nutraceutical application for normal growth and adequate protection against diseases associated with reactions of free radicals.

Liver injury from ampicillin-induced intestinal microbiota distresses in rats fed carbohydrate- and protein-rich diets

Purpose: To investigate the effect of ampicillin on rat intestinal microflora and liver in the presence of high carbohydrate and protein diets. Methods: Male Wistar albino rats were divided into four groups. The first group served as the control, the second group was treated with ampicillin (50 mg/kg for 3 weeks) and fed with a standard diet, while the third and fourth groups were treated with the same dose of ampicillin and fed with acarbohydrateand protein-rich diets, respectively, to observe the effect of diet on gut flora and liver. Fecal specimens were collected and used for qualitative determination of gut microbiota composition. Serum hepatospecific markers (AST, ALT and ALP) were estimated. The antioxidant status of liver tissues was estimated for GSH, MDA, GST, LDH and vitamin C l, in addition to sodium and potassium. Results: Administration of orogastric dose of ampicillin for 3 weeks induced inhibition of E.coli, yeasts, total anaerobes, and anaerobic lactobacilli with new growth of P. vulgaris and K. pneumonia. The levels of serum AST, ALT and ALP showed significant (p ˂ 0.05) increase to 163, 112.38 and 115.35 %, respectively in ampicillin-treated animals, compared to control. Also significant (p ˂ 0.05) increase in lipid peroxidation (120 %) and LDH (111 %) coupled with significant (p ˂ 0.05) decrease in glutathione (74.57 %), vitamin C (63.49 %) and glutathione S-transferase (41.51 %) were observed in ampicillintreated groups. No significant variation (p ˂ 0.05) in sodium and potassium levels were found between control and the treated group after 3 weeks of treatment. Conclusion: These results confirm that extended ampicillin therapy disrupts gut flora, which results in liver injury; hence, overuse of antibiotics should be avoid.