The experimental evidence that forms the basis for setting recommended intake levels of vitamin C for humans is currently undergoing review. A recent study suggests that a vitamin C intake of 100 mg‐200 mg/day is needed, which is two to threefold greater than the current Recommended Dietary Allowance. This study also proposes that individuals consume no more than 1 gram of vitamin C per day.

Objectives We aimed to assess prevalence of iron and vitamin A deficiencies in Ugandan mothers and infants using the BRINDA (Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia) adjustment and to ascertain any differences by prevalence of malaria. Methods From a prospective birth cohort (N = 5000) conducted in rural Uganda (2014–2016), samples from mothers (n = 1652, at birth) and infants (n = 695, 5–7 m/o) were analyzed for ferritin (FER), soluble transferrin receptor (sTFR), retinol binding protein (RBP), CRP, AGP, hemoglobin (Hb) and malaria. FER, sTFR and RBP were adjusted for inflammation using CRP and AGP. Depleted iron stores were defined as: FER <12 µg/L and <15 µg/L in children and mothers respectively; sTFR >8.3 mg/L for Fe-deficient erythropoiesis; RBP <1.05 µmol/L for vitamin A deficiency; and Hb <110 g/L for anemia. Prevalence estimates were stratified by malaria status. Results Adjustment for inflammation in mothers increased depleted iron stores (FER) from 7 to 12%, and decreased iron-deficient erythropoiesis (sTFR) from 27 to 22%. For children, adjustment increased depleted Fe stores from 17 to 40%, and iron-deficient erythropoiesis from 76 to 64%. Vitamin A deficiency in mothers was 9% and in infants decreased after adjustment (15% vs 4%). The prevalence of altitude adjusted anemia was 18% in mothers and 72% in infants. The prevalence of tissue iron deficiency (BIS <0 mg/kg) using adjusted sTFR and FER was 10% for mothers and 50% for infants compared to 8% and 34% using unadjusted markers respectively (Tables 1,2). Almost 14% of children (n = 75) were diagnosed with malaria. Malaria prevalence in mothers was low (5%), possibly due to the high (82%) prevalence of IPT prophylaxis reported during pregnancy. No significant differences were found in adjusted versus unadjusted estimates for Fe markers stratifying by malaria. Conclusions Fe deficiency adjusted estimates varied by biomarker and were not correlated with malaria in line with BRINDA recommendations. For mothers and children, the prevalence of Fe deficiency (sTFR) and anemia (Hb) were similar, suggesting that a big part of anemia in Uganda could be due to Fe deficiency as opposed to other micronutrients. Funding Sources Support provided by Feed the Future Innovation Lab for Nutrition, funded by the United States Agency for International Development (USAID). Supporting Tables, Images and/or Graphs

Objectives Environmental enteric dysfunction (EED), characterized by altered intestinal permeability/inflammation, microbial translocation, and systemic inflammation (SI), may be a significant contributor to poor growth and micronutrient deficiencies in infants from low-resource setting. The objective of this study was to examine relationships among EED, SI, growth, and iron status in a sample of 6-months old infants from rural Uganda. Methods We performed a cross-sectional analysis using a subset of infants (n = 548) enrolled in a birth cohort study conducted in 16 sub-counties across northern and southwestern Uganda. EED was assessed via serum levels of antibodies to the bacterial components flagellin and lipopolysaccharide (LPS); SI was assessed via serum levels of alpha(1)-acid glycoprotein (AGP) and C-reactive protein (CRP); iron status was assessed via serum levels of hemoglobin (Hb), soluble transferrin receptor (sTfR), and ferritin. Associations were assessed using adjusted linear regression analysis. Results At 6 months, ∼35% of infants were stunted (LAZ &lt; −2), and ∼53% were anemic (Hb &lt; 11.0 g/dL). Nearly half (∼46%) had elevated AGP (&gt;1 g/L) and ∼30% had elevated CRP (&gt;5 mg/L). EED biomarkers were significantly correlated with SI biomarkers (r = 0.142–0.193, P &lt; 0.001 for all). In adjusted linear regression models, which included adjustments for SI, higher anti-flagellin IgA, anti-LPS IgA, and anti-LPS IgG levels were significantly associated with lower LAZ [β: −0.21 (95% CI: −0.41, 0.00), β: −0.23 (95% CI: −0.44, −0.03), and β: −0.33 (95% CI: −0.58, −0.09)]. Furthermore, higher anti-flagellin IgA, anti-flagellin IgG, and anti-LPS IgA levels were significantly associated with lower Hb levels [β: −0.24 (95% CI: −0.45, −0.02), β: −0.58 (95% CI: −1.13, 0.00), and β: −0.26 (95% CI: −0.51, 0.00)]; higher anti-flagellin IgG and anti-LPS IgG levels were significantly associated with higher sTfR levels [β: 2.31 (95% CI: 0.34, 4.28) and β: 3.13 (95% CI: 0.75, 5.51)]. Conclusions Independent of SI, EED is associated with both low LAZ and iron status in 6-months old infants. Further research on the mechanisms by which EED affects growth and micronutrient status is warranted. Funding Sources USAID, award AID-OAA-L-10–00006 to the Friedman School of Nutrition Science and Policy at Tufts University. CD was supported in part by NIH grants K24DK104676 and 2P30 DK040561.

Objectives β-Cryptoxanthin (BCX), a provitamin A carotenoid, is cleaved by carotenoid cleavage enzymes including β-carotene-15, 15′-oxygenase (BCO1) to generate vitamin A, and β-carotene-9′, 10′-oxygenase (BCO2) which yields bioactive apo-carotenoids. Dietary supplementation of BCX can prevent non-alcoholic fatty liver disease (NAFLD), which is the most common chronic liver disease worldwide. This study aimed to investigate whether BCX-mediated protection against NAFLD proceeds through the liver-mesenteric adipose tissue axis depending on the presence or absence of BCO1/BCO2. Methods Six-week-old male wild type (WT) mice (n = 30) and congenic BCO1−/−/BCO2−/− double KO (DKO) mice (n = 30) were randomly fed either a high-refined carbohydrate diet (HRCD, 66.5% CHO) or HRCD with BCX (10 mg/kg diet) for 24 weeks. Results Hepatic levels of BCX, but not retinol and retinyl palmitate, were significantly (P < 0.001) higher (33-fold) in the DKO mice than in the WT mice. BCX significantly reduced hepatic steatosis and total cholesterol levels in both WT and DKO mice in comparison with their HRCD counterparts (P < 0.01 and P < 0.001, respectively), albeit through different mechanisms. In the liver, BCX significantly (P < 0.05) down-regulated mRNA for cholesterol synthesis genes Hmgcr and Hmgs1 and nuclear bile acid receptor Fxr, and up-regulated cholesterol catabolism gene Cyp7a1 in DKO mice in comparison with their HRCD counterparts. Furthermore, BCX significantly (P < 0.05) up-regulated antioxidant enzymes Sod1 and Cat in DKO mice in comparison with HRCD littermates. In WT mice, BCX significantly (P < 0.05) up-regulated hepatic mRNA for cholesterol efflux gene Abcg5 and nuclear receptor Shp in comparison with their HRCD counterparts. In mesenteric adipose tissue, BCX significantly down-regulated (P < 0.05) the inflammatory cytokine Il6 and up-regulated fatty acid β-oxidation marker Acox1 and Sirt1 in DKO mice but significantly (P < 0.05) suppressed lipogenesis marker Acc1 in WT mice. Conclusions The protective effects of dietary BCX against HRCD-induced NAFLD are achieved through different molecular mechanisms in the liver-mesenteric adipose tissue axis and depend on the carotenoid cleavage enzymes. Funding Sources NIFA/AFRI (2017-67017-26363) and USDA/ARS (58-1950-0074).

Background: Micronutrient status, body composition, gastrointestinal (GI) functioning, and neurological functioning are important facets of pediatric nutrition and health. When studied in low- and middle-income countries (LMIC), information about these elements is usually obtained via standardized surveys and traditional anthropometry. While convenient, these evaluations offer limited information that may be prone to error and bias. However, a variety of underutilized objective measurement tools exist which can promote a more objective, comprehensive, and deeper understanding of these aspects of pediatric nutrition and health in LMIC. Objective: Identify field-friendly, relatively low-cost, and portable tools that provide objective measurements of micronutrient status, body composition, GI functioning, and neurological functioning in young children. Methods: A narrative review of the literature was conducted to assess the state-of-the-art field-friendly research tools targeting micronutrient status, body composition, GI functioning, and neurological functioning in children in LMIC. Results: A number of field-friendly tools addressing the domains of micronutrient status, GI health, body composition, and neurological functioning were identified. While many tools remain to be fully validated, these tools have yet to be used to their full potential in field-based pediatric nutrition and health research in LMICs. Conclusions: More robust, field-friendly assessment methods will help to refine knowledge on the state of pediatric health of vulnerable children in LMIC. Such awareness could contribute to the design of interventions, programs and policies, and further research.