Vitamin A supplementation in children with poor vitamin A and iron status increases erythropoietin and hemoglobin concentrations without changing total body iron

Zimmermann, Michael; Biebinger, Ralf; Rohner, Fabian; Dib, Abdeljawad; Zeder, Christophe; Hurrell, Richard F.; Chaouki, Nourredine

doi:10.1093/ajcn/84.3.580

Cited by 140 publications

(137 citation statements)

References 56 publications

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“…Nutritional surveys have shown a close association between vitamin A deficiency and anemia (Mejia and Chew, 1988;Bloem et al, 1989). Vitamin A repletion may reduce anemia by improving utilization of stored Fe for erythropoiesis (Zimmermann et al, 2006), and by enhancing immunity and reducing the anemia of infection (Semba and Bloem, 2002). Intervention studies in preschool and school-going children also confirm that vitamin A supplementation improves Hb concentration and other measures of Fe status (Mohanram et al, 1977;Mejia and Chew, 1988;Mwanri et al, 2000).…”

Section: Urban Andmentioning

confidence: 99%

Low anemia prevalence in school-aged children in Bangalore, South India: possible effect of school health initiatives

et al. 2007

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Section: Urban Andmentioning

confidence: 99%

Low anemia prevalence in school-aged children in Bangalore, South India: possible effect of school health initiatives

et al. 2007

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“…Vitamin A repletion in vitamin A-deficient rats enhanced optimum erythropoiesis and iron mobilization from iron stores (Roodenburg et al, 1996). A number of studies among children, aged 1-13 years, showed significant improvement in mean haemoglobin (Hb) concentrations and a decrease in anaemia prevalence after supplementation with vitamin A capsules (Bloem et al, 1989(Bloem et al, , 1990Smith et al, 1999;Zimmermann et al, 2006). Greater improvements in iron status were also seen among anaemic 1-to 8-year-old (Mejia and Chew, 1988) and 9-to 12-year-old children (Mwanri et al, 2000) and in pregnant women (Panth et al, 1990;Suharno et al, 1993;Kolsteren et al, 1999;Muslimatum et al, 2001) when iron and vitamin A supplements were given simultaneously rather than when iron or vitamin A were supplemented alone.…”

Section: Introductionmentioning

confidence: 99%

Influence of carotene-rich vegetable meals on the prevalence of anaemia and iron deficiency in Filipino schoolchildren

et al. 2010

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Objective: To determine the effects of eating carotene-rich green and yellow vegetables on the prevalence of anaemia, iron deficiency and iron-deficiency anaemia in schoolchildren. Subjects and methods: Schoolchildren (n ¼ 104), aged 9-12 years, received standardized meals containing 4.2 mg of provitamin A carotenoids/day (mainly b-carotene) from yellow and green leafy vegetables and at least 7 g dietary fat/day. The meals were provided three times/day, 5 days/week, for 9 weeks at school. Before and after the dietary intervention, total-body vitamin A pool size was assessed by using the deuterated-retinol-dilution method; serum retinol and b-carotene concentrations were measured by high-performance liquid chromatography; and whole blood haemoglobin (Hb) and zinc protoporphyrin (ZnPP) concentrations were measured by using a photometer and a hematofluorometer, respectively. Results: After 9 weeks, the mean total-body vitamin A pool size increased twofold (95% confidence interval (CI): À0.11, À0.07 mmol retinol; Po0.001), and serum b-carotene concentration increased fivefold (95% CI: À0.97, À0.79 mmol/l; Po0.001). Blood Hb (95% CI: À1.02, À0.52 g per 100 ml; Po0.001) and ZnPP increased (95% CI: À11.82, À4.57 mmol/mol haem; Po0.001). The prevalence of anaemia (Hbo11.5 g per 100 ml) decreased from 12.5 to 1.9% (Po0.001). There were no significant changes in the prevalence of iron deficiency or iron-deficiency anaemia. Conclusions: Ingestion of carotene-rich yellow and green leafy vegetables improves the total-body vitamin A pool size and Hb concentration, and decreases anaemia rates in Filipino schoolchildren, with no effect on iron deficiency or iron-deficiency anaemia rates.

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“…Although its role in vision is well known, VA also participates in the regulation of cell proliferation and differentiation, reproduction, fetal development, immune function and many other metabolic processes (McLaren and Frigg, 2001;Zimmermann et al, 2006). Vitamin A deficiency (VAD) is a public health problem among preschool children in 118 countries of the world.…”

Section: Introductionmentioning

confidence: 99%

Vitamin A deficiency among Brazilian school-aged children in a healthy child service

et al. 2007

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Background/Objectives: Vitamin A deficiency (VAD) is a world public health problem contributing to the increase in childhood morbidity and mortality in developing countries and severe deficiency of vitamin A may lead to xerophthalmia and blindness. The objective of this study was to determine the prevalence of VAD among Brazilian school-aged children attended at a primary health unit and to verify if some considered risk factor was associated with VAD in this group. Subjects/Methods: A descriptive prospective transverse study was conducted on 103 randomly selected children. A total of 54 boys and 49 girls aged 5.5-11 years had the relative dose-response (RDR) test performed on. Possible ocular alterations related to vitamin A and the status of anemia, serum zinc, some acute-phase proteins, and anthropometric situation were determinate by an analytic design. Results: No child presented xerophthalmia. Serum retinol values lower than 1.05 and 0.7 mmol l À1 , respectively were found in 26.2 and 5.8% of the children. The prevalence of hypovitaminosis detected by RDR test was 20.4%. The following variables and their relationship with VAD were evaluated: sex (P ¼ 0.33; 95% confidence interval 0.61-4.34), weight and height (PX0.5), hemoglobin (P ¼ 0.15), C-reactive protein (P ¼ 0.56; 95% confidence interval 0.75-18.26), a-1-acid-glycoprotein (P ¼ 0.56; 95% confidence interval 0.15-15.42) and serum zinc (P ¼ 0.31). None of these variables was related to VAD. Conclusions: In this population, the prevalence of VAD detected could be considered a public health problem. School-aged children can be considered at risk for VAD mainly of a subclinical level, even without some associated risk factors.

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Vitamin A supplementation in children with poor vitamin A and iron status increases erythropoietin and hemoglobin concentrations without changing total body iron

Abstract: In children deficient in vitamin A and iron, vitamin A supplementation mobilizes iron from existing stores to support increased erythropoiesis, an effect likely mediated by increases in circulating EPO.

Cited by 140 publications

References 56 publications

Low anemia prevalence in school-aged children in Bangalore, South India: possible effect of school health initiatives

Low anemia prevalence in school-aged children in Bangalore, South India: possible effect of school health initiatives

Influence of carotene-rich vegetable meals on the prevalence of anaemia and iron deficiency in Filipino schoolchildren

Vitamin A deficiency among Brazilian school-aged children in a healthy child service

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