Vitamin A deficiency and associated factors in preschoolers from the outskirts of La Plata, Buenos Aires

Disalvo, Liliana; Varea, Ana; Matamoros, Natalia; Malpeli, Agustina; Fasano, María Victoria; González, Horacio F.

doi:10.5546/aap.2019.eng.19

Cited by 4 publications

(3 citation statements)

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“…Although in favour of a direct relationship between vitamin A status (n=10 of 17 studies, accounting for 19,443 participants), 5 found an inverse association and 2 found no association ( Figure 4C ). In the 10 studies that found a direct relationship, these were reported in a variety of ways, such as: lower risk of VAD in the context of overweight or obese 69 73–77 , or elevated serum levels of vitamin A or plasma retinol in children with overweight or obesity 67 78–80 . Interestingly, of the 5 studies that concluded an inverse association between overnutrition and vitamin A deficiency, 4 focused on Brazilian children.…”

Section: Resultsmentioning

confidence: 99%

Overnutrition is a risk factor for iron deficiency in children and young people: a systematic review and meta-analysis of micronutrient deficiencies and the double burden of malnutrition

Tan,

Gong

et al. 2024

Preprint

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IntroductionTraditionally associated with undernutrition, increasing evidence suggests micronutrient deficiencies can co-exist with overnutrition. Therefore, this work aimed to systematically review the associations between iron, zinc and vitamin A status and weight status (both under- and overweight) in children and young people.MethodsOvid Medline, Ovid Embase, Scopus, and Cochrane databases were systematically searched for observational studies assessing micronutrient status (blood, serum, or plasma levels of iron, zinc, or vitamin A biomarkers) and weight status (body mass index or other anthropometric measurement) in humans under 25 years of any ethnicity and gender. Risk of bias assessment was conducted using the American Dietetic Association Quality Criteria Checklist. Where possible, random effects restricted maximum likelihood (REML) meta-analyses were performed. PROSPERO (CRD42020221523).ResultsAfter screening, 83 observational studies involving 190,443 participants from 44 countries were identified, with many studies having reported on more than one micronutrient and/or weight status indicator. Iron was the most investigated micronutrient, with 46, 28, and 27 studies reporting data for iron, zinc, and vitamin A status, respectively. Synthesizing 16 records of odds ratio (OR) from 7 eligible studies, overnutrition (overweight and obesity) increased odds of iron deficiency (OR [95%CI]: 1.51 [1.20, 1.82], p<0.0001, I2=40.7%). Odds appeared to be higher for children living with obesity (1.88 [1.33, 2.43], p<0.0001 I2=20.6%) in comparison to those with overweight (1.31 [0.98, 1.64], p<0.0001 I2=40.5%), although between group differences were not significant (p=0.08).ConclusionsOvernutrition is associated with increased risk of iron deficiency, but not zinc or vitamin A deficiencies, with an inverted U-shaped relationship observed between iron status and bodyweight. Our results highlight significant heterogeneity in the reporting of micronutrient biomarkers and how deficiencies were defined. Inflammation status was rarely adequately accounted for, and the burden of iron deficiency may well be under-recognised, particularly in children and young people living with overnutrition.Key questionsWhat is already known on this topic-summarise the state of scientific knowledge on this subject before you did your study and why this study needed to be doneLow-and middle-income countries are increasingly facing a double burden of malnutrition; that is, the coexistence of undernutrition (stunting, wasting, underweight) with overnutrition (overweight and obesity).While the relationship between undernutrition and critical micronutrients for childhood growth and development (e.g., iron, zinc, and vitamin A) is well established, less is known about the risk of micronutrient deficiencies in children and adolescents with overweight or obese, a hidden form of malnutrition.There are limited data summarising associations between biomarkers of the most commonly limiting micronutrients and body weight status, particularly in children and young people.What this study adds-summarise what we now know as a result of this study that we did not know beforeOvernutrition increases the risk of iron deficiency, but not zinc or vitamin A deficiencies.There is an inverted U-shaped relationship observed between iron status and bodyweight in children and young people, with iron deficiencies observed more frequent in both under- and overnutrition.Studies done to date have been heterogeneous in terms of populations studied, diagnostic criteria, and approaches to data analysis; few followed current guidelines for measuring inflammation and defining micronutrient deficiencies.How this study might affect research, practice or policy-summarise the implications of this studyIncreased recognition by healthcare practitioners that children and young people living with overweight, or obesity are likely to be iron deficient; thereby improving clinical practice and care.The gaps in evidence highlighted are addressed, with more research from currently underrepresented counties examining micronutrient deficiencies and the double burden of malnutrition.The weaknesses in study design and reporting highlighted are addressed, with improved quality and reporting of micronutrient assessment in children and young people.

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Section: Resultsmentioning

confidence: 99%

Overnutrition is a risk factor for iron deficiency in children and young people: a systematic review and meta-analysis of micronutrient deficiencies and the double burden of malnutrition

Tan,

Gong

et al. 2024

Preprint

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“…Interestingly, the burden of VAD differed between males and females, with the age-standardized incidence and DALY rates being higher in males than in females. The male sex is considered a risk factor for VAD [ 40 ]. Additionally, the serum vitamin A concentration is negatively correlated with the occurrence of some male diseases, such as prostate cancer [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Global Burden of Vitamin A Deficiency in 204 Countries and Territories from 1990–2019

et al. 2022

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Vitamin A deficiency (VAD) is one of the important public health issues worldwide. However, a detailed understanding of the incidence and disability-adjusted life years (DALYs) due to VAD in recent years is lacking. We aimed to estimate the incidence and DALYs of VAD at global, regional, and national levels in terms of sex, age, and socio-demographic index (SDI). Using data from the 2019 Global Burden of Disease (GBD) study, the estimated annual percentage change (EAPC) was measured to assess trends in the age-standardized incidence and DALY rates from 1990 to 2019. The global age-standardized incidence and DALY rates of VAD decreased with an EAPC of −3.11% (95% confidence interval (CI): −3.24% to −2.94%) and −2.18% (95% CI: −2.38% to −1.93%), respectively. The age-standardized incidence and DALY rates decreased least in low-SDI regions, which had the highest age-standardized incidence and DALY rates of all SDI regions. Sub-Saharan Africa, especially central sub-Saharan Africa, had the highest age-standardized incidence and DALY rates in 2019. At the national level, Somalia and Niger had the highest age-standardized incidence and DALY rates. The age-standardized incidence and DALY rates were higher in males than in females. Younger children, especially those aged < 5 years in low-SDI regions, had a higher VAD burden than other age groups. Although the global burden of VAD has decreased, future work should aim to improve the prevention and treatment strategies for VAD, particularly in children aged < 5 years in countries and territories with low SDI values, such as sub-Saharan Africa.

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“… 3 Vit A deficiency remains a moderate public health problem for school‐age children. 4 , 5 , 6 This vitamin is important for child health, and its deficiency not only affects existing health but also extends to long‐term health in adulthood. 7 The prevalence of Vit D deficiency is high among children aged 0–6 years in China, especially among preschoolers.…”

Section: Introductionmentioning

confidence: 99%

Correlation analysis between vitamin A, D, and E status with altitude, seasonal variation, and other factors, among children aged 0–6 years in a Chinese population living in the Tibetan plateau of Ganzi prefecture

Huang¹,

Ke²,

Lin³

et al. 2022

Clinical Laboratory Analysis

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Objective We attempted to understand the status of vitamin (Vit) A, D, and E in children aged 0–6 living in the Tibetan plateau areas of Ganzi prefecture, to provide the basis for relevant government departments to carry out physical examinations of these children and to prevent and cure four key diseases (Infantile diarrhea, nutritional anemia, rickets, and infantile pneumonia). Methods Serum retinol and tocopherol levels were detected using high‐performance liquid chromatography (HPLC). Serum levels of 25‐(OH)D were detected by high‐performance liquid chromatography–tandem mass spectrometry (LC–MS). The polynomial logistic regression was used to analyze the effects of age, season, altitude, and gender on Vit A, D, and E levels. Results Vit A and D had the lowest mean serum levels before the age of 1 year and with the most significant deficiency rates. The lowest Vit E levels were seen in the Toddlerhood group. The rates of deficiency and insufficiency were the highest. Vit A, D, and E levels were significantly affected by seasonal changes and were significantly higher in the summer than in any other season. Vit A and D were significantly affected by altitude, and their levels were lowest above 4 km. Conclusion The overall levels of Vit A, D, and E in children aged 0–6 in the Tibetan plateau areas of Ganzi prefecture were lower than those in the plain's areas.

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Vitamin A deficiency and associated factors in preschoolers from the outskirts of La Plata, Buenos Aires

Cited by 4 publications

References 19 publications

Overnutrition is a risk factor for iron deficiency in children and young people: a systematic review and meta-analysis of micronutrient deficiencies and the double burden of malnutrition

Overnutrition is a risk factor for iron deficiency in children and young people: a systematic review and meta-analysis of micronutrient deficiencies and the double burden of malnutrition

Global Burden of Vitamin A Deficiency in 204 Countries and Territories from 1990–2019

Correlation analysis between vitamin A, D, and E status with altitude, seasonal variation, and other factors, among children aged 0–6 years in a Chinese population living in the Tibetan plateau of Ganzi prefecture

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