Serum retinol concentrations in children are affected by food sources of ²-carotene, fat intake, and anthelmintic drug treatment

Abstract

The provision of vitamin A in food sources of beta-carotene is an alternative to the distribution of high-dose capsules. To examine factors that may influence the success of food-based programs, a study was carried out in Sumatra, Indonesia, of the effect of food sources of beta-carotene, extra dietary fat, and Ascaris lumbricoides infection on serum retinol concentrations in children. Meals and snacks with various amounts of beta-carotene and fat were fed at midday to children 3-6 y of age for 3 wk. Some groups of children were dewormed with the anthelmintic levamisole before the feeding period, whereas others remained infected. Results showed that the incorporation of beta-carotene sources (mainly in the form of red sweet potatoes) into the meal significantly increased serum retinol concentrations. The greatest rise in serum retinol occurred when meals contained added beta-carotene sources and added fat and the children were dewormed. Adding more fat to the meal and deworming the children caused a rise in serum retinol similar to that seen when feeding additional beta-carotene sources. Moreover, the effects of fat and deworming together were additive to the effects of additional beta-carotene sources. When the meal contained additional beta-carotene sources, added fat caused a further improvement in serum retinol concentrations but only if A. lumbricoides infection was low. These studies indicated that food-based interventions in vitamin A-deficient areas might be successful and that other interventions such as increasing dietary fat concentrations and anthelmintic treatment should be considered along with increasing consumption of beta-carotene-rich food.

Increase in serum beta-carotene following dark green leafy vegetable supplementation in Mebendazole-treated school children in Bangladesh

“…Jalal et al (1998) in their 3 week intervention study included children aged 3 ± 6 y positive for Ascaris lumbricoides with a baseline serum retinol concentration of 0.57 ± 0.66 mmolal. They found that b-carotene-rich foods (750 REaday mainly in the form of red sweet potatoes for a total cumulative dose of 15 750 RE) together with deworming increased serum retinol more than b-carotene rich foods alone in children heavily infected with Ascaris lumbricoides ( b 3200 epg) (net increase 0.37 compared to 0.20 mmolal).…”

“…However, in one of the studies with poor DGLV response (de Pee et al, 1998), the mean baseline retinol concentration was`0.70 mmolal, de®ning it as a group with a severe VAD problem (WHOaUNICEF, 1995). Another cause for poor response could be intestinal parasites, in particular Ascaris lumbricoides (Curtale et al, 1994;Jalal et al, 1998). It has been postulated that`a high parasite load may make the freeing of b-carotene more dif®cult from a complex matrix (vegetables) ' (de Pee et al, 1995a).…”

Effects on serum retinol of multi-micronutrient supplementation and multi-helminth chemotherapy: a randomised, controlled trial in Kenyan school children

“…Other studies have failed to detect any effects (Ahmed et al, 1993). Associations between A. lumbricoides infection and low serum retinol have been found among preschool children in Panama (Taren et al, 1987) and Nepal (Curtale et al, 1994), as well as among Indonesian preschool children where the low serum retinol was reversible after deworming (Jalal et al, 1998). In contrast, another study among young children in Indonesia found neither effect of deworming on serum retinol nor modified relative dose response test (Tanumihardjo et al, 1996).…”

Estimation of carotenoid accessibility from carrots determined by an in vitro digestion method

“…Another way of reducing matrix effects is by homogenization or particle size reduction (van Zeben & Hendriks, 1948;Gärtner et al, 1997;Castenmiller et al, 1999;van het Hof et al, 1999). Dietary fat, as well, has a documented positive effect on bioavailability of carotenoids (Roels et al, 1958;Dimitrov et al, 1988;Shiau et al, 1994;Jalal et al, 1998), although the amount of fat required to optimize carotenoid bioavailability has not been clearly identified.…”