Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-23T11:33:09.712Z Has data issue: false hasContentIssue false
  • English
  • Français

Efficacy of massive oral doses of retinyl palmitate and mango (Mangifera indica L.) consumption to correct an existing vitamin A deficiency in Senegalese children

Published online by Cambridge University Press:  09 March 2007

Cécile Carlier ,
Michel Etchepare ,
Jean-François Ceccon ,
Marie-Sophie Mourey  and
Olivier Amédée-Manesme
Cécile Carlier
Affiliation:
Institut National de la Santé et de la Recherche Médicale (INSERM), Unité 56, Hôpital de Bicêtre, 78 Avenue de Général Leclerc, 94275 Le Kremlin-Bicêtre, France
Michel Etchepare
Affiliation:
Organisme de Recherche sur l'Alimentation et la Nutrition Africaines (ORANA), 39 boulevard Pasteur, BP 2089, Dakar, Sénégal
Jean-François Ceccon
Affiliation:
Organisme de Recherche sur l'Alimentation et la Nutrition Africaines (ORANA), 39 boulevard Pasteur, BP 2089, Dakar, Sénégal
Marie-Sophie Mourey
Affiliation:
Institut National de la Santé et de la Recherche Médicale (INSERM), Unité 56, Hôpital de Bicêtre, 78 Avenue de Général Leclerc, 94275 Le Kremlin-Bicêtre, France
Olivier Amédée-Manesme
Affiliation:
Institut National de la Santé et de la Recherche Médicale (INSERM), Unité 56, Hôpital de Bicêtre, 78 Avenue de Général Leclerc, 94275 Le Kremlin-Bicêtre, France Association de Recherche en Vitaminologie Pédiatrique (ARVP), 11 Parc Alexandre Dumas, Marly le Roi, 78160, France
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Administration of large oral doses of retinyl palmitate has become the most widely practised vitamin A deficiency prevention strategy in developing countries. We conducted a follow-up study among 220 Senegalese children aged 2–7 years suffering from moderate undernutrition to determine the efficacy of vitamin A treatment on their vitamin A status assessed by biochemical and cytological (impression cytology with transfer) methods. The first examination (T = 0 m[onth]) was carried out during April 1989, before the mango (Mangifera indica L,) harvest. The second examination (T = 2 m) was carried out 2 months after vitamin A treatment during June 1989 when ripe mangoes become widely available. Conjunctival cells of the eyes of the children with or without ocular inflammation were responsive to vitamin A administration (P < 0.01). There was a significant increase (P < 0.001) in mean serum retinol and β-carotene levels between T = 0 m and T = 2 m. Mean serum retinol-binding protein (RBP) and transthyretin (TTR) levels did not differ significantly (P > 0.05) at T = 0 m and T = 2 m. Despite the intake of vitamin A, 54% of the children who had abnormal cytology at T = 0 m remained abnormal at T = 2 m. This was due to inadequate levels of TTR and RBP, presumably due to the cereal diet eaten by the Senegalese population. Children with abnormal eye cytology had lower serum retinol levels than those with normal eyes at T = 0 m, and β-carotene values did not correlate with eye cytological abnormalities at T = 0 m. Children with normal cytology had higher serum retinol and also β-carotene levels than those with abnormal cytology after massive oral doses of vitamin A and consumption of mangoes at T = 2 m. Retinyl palmitate may, therefore, only lead to partial cytological improvement due to a lack of retinol-carrier proteins but dietary β-carotene may also be involved

Keywords

Oral retinyl palmitateCarotenoidsUndernutritionImpression cytology with transfer
Type
Vitamin A Supplementation
Information
British Journal of Nutrition , Volume 68 , Issue 2 , September 1992 , pp. 529 - 540
Copyright
Copyright © The Nutrition Society 1992

References

REFERENCES

Amédée-Manesme, O., Anderson, D. & Olson, J. A. (1984). Relation of the relative dose response test to liver concentrations of vitamin A in generally well nourished surgical patients. American Journal of Clinical Nutrition 39, 898–902.CrossRefGoogle Scholar
Amédée-Manesme, O., Luzeau, R., Carlier, C. & Ellrodt, A. (1987). Simple impression cytology method for detecting vitamin A deficiency. Lancet i, 1263.CrossRefGoogle Scholar
Amédée-Manesme, O., Luzeau, R., Wittpenn, J. R., Hanck, A. & Sommer, A. (1988 a). Impression cytology detects subclinical vitamin A deficiency. American Journal of Clinical Nutrition 47, 875–878.CrossRefGoogle ScholarPubMed
Amédée-Manesme, O., Mourey, M. S., Couturier, M., Lemonnier, F., Hanck, A. & Allagille, D. (1988 b). Short- and long-term vitamin A treatment in children with chronic cholestasis. American Journal of Clinical Nutrition 47, 690–693.CrossRefGoogle Scholar
Carlier, C. (1991). L'impression oculaire transférée: une nouvelle méthode de diagnostique du déficit en vitamine A. PhD Thesis, University of Jussieu, Paris, France.Google Scholar
Carlier, C. & Amédée-Manesme, O. (1991). Impression cytology with transfer: a novel nutritional index. Journal of Pediatric Gastroenterology and Nutrition 90, 9359.Google Scholar
Carlier, C., Mourey, M. S., Luzeau, R., Lemonnier, D. & Amédée-Manesme, O. (1989). Assessment of vitamin A status in an elderly French population using impression cytology with transfer. International Journal for Vitamin and Nutrition Research 59, 3–7.Google Scholar
Carlier, C., Moulia-Pelat, J. P., Ceccon, J. F., Mourey, M. S., Fall, M., N'Diaye, A. M. & Amédée-Manesme, O. (1991 a). Prevalence of malnutrition and vitamin A deficiency in the Diourbel, Fatick and Kaolack regions of Senegal. Epidemiological study. American Journal of Clinical Nutrition 53, 70–73.CrossRefGoogle ScholarPubMed
Carlier, C., Moulia-Pelat, J. P., Ceccon, J. F., Mourey, M. S., Malvy, D., Fall, M., N'Diaye, A. M. & Amédée-Manesme, O. (1991 b). Prevalence of malnutrition and vitamin A deficiency in the Diourbel, Fatick and Kaolack regions of Senegal. Controlled study. American Journal of Clinical Nutrition 53, 74–77.CrossRefGoogle ScholarPubMed
De Luca, L. M., Glover, J., Heller, J., Olson, J. A. & Underwood, B. A. (1979). Recent Advances in the Metabolism and Function of Vitamin A and their Relationship to Applied Nutrition. Washington, DC: International Vitamin A Consultative Group, Nutrition Foundation.Google Scholar
Fink, P. C., Romer, M., Haechkel, R., Fateh-Moghdam, A. & Delauche, J. (1989). Measurement of proteins with the Behring nephelemeter. A multicenter evaluation. Journal of Clinical and Biochemical Chemistry 27, 261–276.Google Scholar
Glover, G. & Muhilal. (1976). Nutritional factors affecting the biosynthesis of retinol-binding protein in the liver and its release into the plasma. International Journal for Vitamin and Nutrition Research 46, 239–243.Google Scholar
Glover, J. (1983). Factors affecting vitamin A transport in animals and man. Proceedings of the Nutrition Society 42, 19–30.CrossRefGoogle Scholar
Goodman, D. S. (1984). Plasma retinol-binding protein. In The Retinoids, vol. 2, pp. 41–88 [Sporn, M. B., Roberts, A. B. and Goodman, D. S., editors]. New York: Academic Press.CrossRefGoogle Scholar
Haller, L. & Lauber, E. (1980). Santé de l'enfant d'âge scolaire en Côte d'lvoire (Health status of school-age children in the Ivory Coast). Acta Tropica 37, Suppl. 11.Google Scholar
Hathcock, J. N., Hattan, D. G., Jenkins, M. Y., McDonald, J. T., Ramnathan Sundaresan, P. & Wilkening, V. L. (1990). Evaluation of vitamin A toxicity. American Journal of Clinical Nutrition 52, 183–202.CrossRefGoogle ScholarPubMed
Ingenbleek, Y., Van Den Schrieck, H. G., De Nayer, P. & De Visscher, M. (1975). The role of retinol-binding protein in protein-calorie malnutrition. Metabolism 24, 633–641.CrossRefGoogle ScholarPubMed
Kanai, M., Raz, A. & Goodman, D. S. (1986). Retinol-binding protein: the transport protein for vitamin A in human plasma. Journal of Clinical Investigation 47, 2025–2044.CrossRefGoogle Scholar
Keenum, D. G., Semba, R., Wirasasmita, S., Natadisastra, G., Muhilal, West, K. P. & Sommer, A. (1990). Assessment of vitamin A status by a disk applicator for conjunctival impression cytology. Archives of Ophthalmology 108, 1436–1441.CrossRefGoogle ScholarPubMed
Kusin, J. A., Sinaga, H. S. R. P. & Smit, E. M. (1980). Vitamin A status of preschool children in Suka village, North Sumatra after an oral massive dose. Meeting on Vitamin A Deficiency and Xerophthalmia. NUT/80. Jakarta: WHO.Google Scholar
Large, S., Neal, G., Glover, J., Thanangkul, O. & Olson, R. E. (1980). The early changes of retinol-binding protein and prealbumin concentrations in plasma of protein-energy malnourished children after treatment with retinol and an improved diet. British Journal of Nutrition 43, 393–402.CrossRefGoogle Scholar
Luzeau, R., Carlier, C., Ellrodt, A. & Amédé-Manesme, O. (1988). Impression cytology with transfer: an easy method for detection of vitamin A deficiency. International Journal for Vitamin and Nutrition Research 58, 166–170.Google ScholarPubMed
Mariath, J. G. R., Lima, M. C. C. & Santos, L. M. P. (1989). Vitamin A activity of buriti (Mauritia vinifera Mart) and its effectiveness in the treatment and prevention of xerophthalmia. American Journal of Clinical Nutrition 49, 849–853.CrossRefGoogle ScholarPubMed
Moore, T. (1957). Vitamin A, pp. 3–16. New York: Elsevier.Google Scholar
Mourey, M. S., Siegenthaler, G. & Amédée-Manesme, O. (1990). Regulation of metabolism of retinol-binding protein in children with biliary atresia. American Journal of Clinical Nutrition 51, 638–643.CrossRefGoogle ScholarPubMed
Napoli, J. L. & Race, K. R. (1988). Biogenesis of retinoic acid from β-carotene. Journal of Biology and Chemistry 263, 17372–17377.CrossRefGoogle ScholarPubMed
Natadisastra, G., Wittpenn, J. R., West, K. P., Muhilal & Sommer, A. (1987). Impression cytology for detection of vitamin A deficiency. Archives of Ophthalmology 105, 1224–1228.CrossRefGoogle ScholarPubMed
Olson, J. A. (1978). Evaluation of vitamin A status in children. World Review of Nutrition and Dietetics 31, 130–134.CrossRefGoogle ScholarPubMed
Olson, J. A. (1980). Evaluation of vitamin A status in individuals and populations. Philippines Journal of Nutrition 3, 2–10.Google Scholar
Ong, D. & Amédée-Manesme, O. (1987). Cellular retinol-binding protein and vitamin A status of patients with biliary atresia. Hepatology 7, 253–256.CrossRefGoogle Scholar
Oomen, H. A. P. C. (1954). Xerophthalmia in the presence of kwashiorkor. British Journal of Nutrition 8, 307.CrossRefGoogle ScholarPubMed
Pereira, S. M. & Begum, A. (1971). Failure of a massive single oral dose of vitamin A to prevent deficiency. Archives of Disease in Childhood 46, 525.CrossRefGoogle ScholarPubMed
Ramsden, R. B., Prince, H. P., Burr, W. A., Bradwell, A. R., Black, E. G., Evans, A. & Hoffenberg, R. (1978). The interrelationship of thyroid hormones, vitamin A and their binding proteins following acute stress. Clinical Endocrinology 8, 109–122.CrossRefGoogle ScholarPubMed
Reddy, V., Rao, V., Reddy, A. M. (1989). Conjunctival impression cytology for assessment of vitamin A status. American Journal of Clinical Nutrition 50, 814–817.CrossRefGoogle ScholarPubMed
Reddy, V. & Sivakumar, B. (1972). Studies on vitamin A absorption in children. Indian Pediatrics 9, 307–310.Google ScholarPubMed
Schwartz, D. (1986). Méthodes statistiques à l'usage des médecins et des biologistes. 3rd ed. Paris: Flammarion Médecine-Sciences.Google Scholar
Sivakumar, B. & Reddy, V. (1972). Absorption of labelled vitamin A in children during infection. British Journal of Nutrition 27, 299–304.CrossRefGoogle ScholarPubMed
Smith, F. R., Goodman, D. S., Arroyave, G. & Viteri, F. (1973 a). Serum albumin, retinol-binding protein and prealbumin concentrations in protein-calorie malnutrition. 11. Treatment including supplemental vitamin A. American Journal of Clinical Nutrition 26, 982–987.CrossRefGoogle Scholar
Smith, F. R., Goodman, D. S., Zaklama, M. S., Gabr, M. K., Maraghy, S. & Patwardhan, V. S. (1973 b). Serum vitamin A, retinol-binding protein and prealbumin concentrations in protein-calorie malnutrition. I, A functional defect in hepatic retinol release. American Journal of Clinical Nutrition 26, 973–981.CrossRefGoogle Scholar
Sommer, A. (1982). Field Guide to the Detection and Control of Xerophthalmia, 2nd ed. Geneva: WHO.Google Scholar
Sommer, A., Quesada, J., Doty, M. & Faich, G. (1975). Xerophthalmia and anterior-segment blindness among preschool-age children in El Salvador. American Journal of Ophthalmology 80, 1066.CrossRefGoogle ScholarPubMed
Tarwotjo, I., Sommer, A., Soegiharto, T., Susanto, D. & Muhilal. (1982). Dietary practices and xerophthalmia among Indonesian children. American Journal of Clinical Nutrition 35, 574–581.CrossRefGoogle ScholarPubMed
Thanangkul, O., Promkutkaew, C., Waniyapong, T. & Damrongsak, D. (1980). Comparison of the effects of a single high dose of vitamin A given to mother and infant upon plasma levels of vitamin A in the infant. Meeting on Vitamin A Deficiency and Xerophthalmia. NUT/WP/74.14. Jakarta: WHO.Google Scholar
Thatcher, R. W., Darougar, S. & Jones, B. (1977). Conjunctival impression cytology. Archives of Ophthalmology 95, 678–681.CrossRefGoogle ScholarPubMed
Thurnham, D. I. (1991). Vitamin A and childhood mortality. Lancet 337, 232.CrossRefGoogle Scholar
Thylefors, B., Dawson, C. R., Jones, B. R., West, S. K. & Taylor, H. R. (1987). A simple system for the assessment of trachoma and its complications. Bulletin of the World Health Organization 65, 477–483.Google ScholarPubMed
Tsou, S. C. S., Gershon, J., Simpson, K. L. & Chichester, C. O. (1984). Promoting household gardens for nutrition improvement. In Human Nutrition, Better Nutrition, Better Life. Proceedings 4th Asian Congress of Nutrition, [Tanphaichitri, V., Dahlan, V., Suphakarn, V. and Valyavesi, A., editors]. Bangkok: Aksornsmai Press.Google Scholar
Vahlquist, A., Rask, L., Peterson, P. A. & Berg, T. (1975). The concentrations of retinol-binding proteins, prealbumin and transferrin in the sera of newly delivered mothers and children of various ages. Scandinavian Journal of Clinical and Laboratory Investigation 35, 569–575.CrossRefGoogle ScholarPubMed
Waterlow, J. C. (1976). Classification and definition of protein-energy malnutrition. In Nutrition in Preventive Medicine. Technical Report Series no. 62, pp. 530–555 [Beaton, G. H. and Bengoa, J. M., editors]. Geneva: WHO.Google Scholar
West, K. P. & Sommer, A. (1984). Periodic, Large Oral Doses of Vitamin A for the Prevention of Vitamin A Deficiency and Xerophthalmia: A Summary of Experiences A Report of the International Vitamin A Consultative Group (IVAGC). Washington, DC: The Nutrition Foundation.Google Scholar
Wittpenn, J. R., Scheffer, C., Tseng, G. & Sommer, A. (1986). Detection of early xerophthalmia by impression cytology. Archives of Ophthalmology 104, 237–239.CrossRefGoogle ScholarPubMed
Wolbach, S. B. & Howe, P. R. (1925). Tissue changes following deprivation of fat-soluble A vitamin. Journal of Experimental Medicine 42, 753–777.CrossRefGoogle ScholarPubMed
World Health Organization (1982). Control of vitamin A deficiency and Xerophthalmia. Report of a joint WHO/UNICEF/USAID/Helen Keller International/IVAGC meeting. Technical Report Series no. 672. Geneva: WHO.Google Scholar
World Health Organization (1983). Measuring Change in Nutritional Status. Geneva: WHO.Google Scholar