1. Vitamin A intake and status in populations facing economic stress
West KP Jr , Mehra S .
Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
J Nutr. 2010 Jan
Dietary quality and diversity reflect adequacy of vitamin A. Both can deteriorate in response to economic crises. Although the nutritional consequences of the 2008 world food price crisis remain unclear, past studies of diet, status, and socioeconomic standing under usual (deprived) and unusually disruptive times suggest dietary quality and vitamin A status decline in mothers and young children. This is presumably the result of shifting diets to include less preformed vitamin A-rich animal source foods and, to a lesser extent, vegetables and fruits. Cross-sectional assessments of diet, deficiency, and socioeconomic status in a number of countries and surveillance data collected during the Indonesian economic crisis of 1997-8 indicate that the prevalence of vitamin A deficiency, night blindness, and other related disorders (e.g., anemia) may have increased during the 2008 crisis, and that it might not have necessarily recovered once food prices waned later in 2008. Lost employment may be a factor in slow nutritional recovery, despite some easing of food prices. Vitamin A deficiency should still be preventable amid economic instabilities through breast feeding promotion, vitamin A supplementation, fortification of foods targeted to the poor, and homestead food production that can bolster income and diversify the diet.
2. Achievements, challenges, and promising new approaches in vitamin and mineral deficiency control
Boy E , Mannar V , Pandav C , de Benoist B , Viteri F , Fontaine O , Hotz C .
HarvestPlus, International Food Policy Research Institute (IFPRI-CIAT), Ottawa, Ontario, Canada
Nutr Rev. 2009 May
Micronutrient deficiencies (MNDs) contribute significantly to the world's disease and mortality burden. Global efforts addressing MNDs have achieved significant yet heterogeneous progress across and within regions and countries. For vitamin A and iodine interventions, enhancing achievements in coverage require further political and financial commitment and targeting of hard-to-reach populations. Anemia control must focus on prevention among preschoolers and adolescent women and on integrated public health programs. Current international guidelines on iron supplementation and cut-off values for anemia need revision. For zinc, advocacy to accelerate the application of revised diarrhea management guidelines is critical, as are efficacy studies on food-based interventions and preventive supplementation.
3. The antioxidant effects of vitamin A, C, and E on aflatoxin B1-induced oxidative stress in human lymphocytes
Alpsoy L , Yildirim A , Agar G .
Fatih University, Faculty of Art and Science, Department of Biology, Istanbul, Turkey
Toxicol Ind Health. 2009
The aim of this study was to investigate the possible protective role of vitamin A, C, and E on aflatoxin B(1)-induced in human lymphocytes using biochemical approaches. The control group received dimethyl sulfoxide, the second group of cultures were administered aflatoxin B(1) (AFB(1)) at a dose of 5 muM. The other group of cultures were treated with AFB(1)+vitamin A (0.5 and 1.0 and 1.5 microM) and AFB(1)+vitamin C (25, 50, and 100 microM) and AFB(1)+vitamin E (40, 100, and 200 microM). The results of this experiment show that AFB(1) significantly decreased the level of GSH and the activities of superoxide dismutase and GPx and increased level of malondialdehyde. Simultaneous supplementation with vitamin A, C, and E restored these parameters to that of normal range. In conclusion, vitamin A, C, and E exhibited protective effects in human lymphocytes by inhibiting AFB(1)-induced ROS generation.
4. Acne quality of life and patient satisfaction following treatment with tretinoin pump
Fried R , Nighland M .
Yardley Dermatology Associates,Yardley, PA 19067, USA
J Drugs Dermatol. 2009
Patient satisfaction and quality of life are important considerations when assessing products used to treat acne vulgaris, as these factors may affect treatment adherence and subsequent treatment outcomes. The objective of this analysis was to determine patient satisfaction and improvement in quality of life after treatment with tretinoin gel microsphere (TGM) in a pump dispenser. Assessments were made during a phase IV, prospective, 12-week, open-label, community-based trial in which 544 patients who were dissatisfied with their current acne treatments received TGM 0.04% or 0.1% in addition to < or = 2 concurrent non-retinoid acne therapies. At week 12, significant improvement was reported in both patient acne therapy satisfaction and in the overall mean Acne Quality of Life Index scale (P < 0.0001 versus baseline for both measures). The majority of patients (82.3%) rated the pump dispenser as an "excellent" or "very good" means of dispensing medication, and 86.0% rated their overall satisfaction with the pump treatment application as "very satisfied" or "extremely satisfied." The results of this study indicate that the use of TGM in a pump dispenser in patients with acne vulgaris is associated with significant increases in both quality of life and patient satisfaction.
5. Permanent visual loss due to dietary vitamin A deficiency in an autistic adolescent
McAbee GN , Prieto DM , Kirby J , Santilli AM , Setty R .
Department of Pediatrics, Division of Child Neurology, Robert Wood Johnson School of Medicine, Children's Regional Hospital, Camden, New Jersey 08013, USA
J Child Neurol. 2009 Oct
Children with autism often have restrictive diets. Here, we report an adolescent with autism who developed dietary vitamin A deficiency because of a restrictive diet. Despite supplementation with vitamin A, some of the visual loss was permanent with optic atrophy. Children with autism who have restrictive diets may need periodic serum vitamin levels assessed.
6. A comparison of vitamin a and cyclosporine a 0.05% eye drops for treatment of dry eye syndrome
Kim EC , Choi JS , Joo CK .
Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea,
Am J Ophthalmol. 2009 Feb
PURPOSE: To compare the efficacy of vitamin A (retinyl palmitate) and cyclosporine A 0.05% eye drops in treating patients with dry eye disease. DESIGN: Prospective, randomized, controlled, parallel group study. METHODS: A total of 150 patients with defined dry eye disease participated (50 in each treatment group). In 3 identical clinical trials, patients were treated twice daily with cyclosporine A 0.05%, or four times daily with retinyl palmitate 0.05%, or with neither cyclosporine or retinyl palmitate. Adjunctive treatment with preservative-free artificial tears was undertaken four times daily in all 3 groups. Corneal fluorescein staining results, Schirmer tear test (without anesthesia) results, tear film break-up time (BUT), dry eye symptom score, and impression cytologic analysis results were obtained before treatment and at the first, second, and third months after initiation of treatment. RESULTS: Both vitamin A eye drops and topical cyclosporine A 0.05% treatments led to significant improvement in blurred vision, tear film BUT, Schirmer I score results, and impression cytologic findings in patients with dry eye syndrome (P < .05) compared to the control group treated with preservative-free artificial tears alone. CONCLUSIONS: Both vitamin A eye drops and topical cyclosporine A 0.05% treatments are effective for the treatment of dry eye disorder.
7. Pediatric ophthalmology in the developing world
Maida JM , Mathers K , Alley CL .
Department of Ophthalmology, Temple University, Philadelphia, Pennsylvania 19140, USA
Curr Opin Ophthalmol. 2008 Sep
PURPOSE OF REVIEW: It is estimated that of the 45 million people who are blind worldwide in 2000, 1.4 million are children from middle-income and low-income countries, the majority of whom live in the poorest regions of Africa and Asia. The focus of this paper is to discuss the status of pediatric ophthalmology in developing countries and the progress that has been made in the areas of avoidable childhood blindness and visual impairment, particularly corneal scarring as a result of vitamin A deficiency, congenital cataract and retinopathy of prematurity. In addition, we will review the prevalence of uncorrected refractive error and discuss the access to pediatric ophthalmologists in developing countries. RECENT FINDINGS: Some developing countries have begun incorporating vitamin A supplementation and measles immunizations and have seen a decrease in xerophthtalmia. With improvement in vitamin A status, cataract is becoming a more apparent cause of treatable childhood blindness. Amblyopia and uncorrected refractive errors are important and inexpensively treatable causes of visual impairment, with myopia being most common. As neonatal intensive care services in middle-income developing countries improve the survival of premature infants, retinopathy of prematurity is emerging as a significant cause of childhood blindness. SUMMARY: Childhood blindness and visual impairment in developing countries remains a significant public health issue, but recent initiatives have shown promise of future improvements.
8. Maternal postpartum vitamin A supplementation programme: is there a need in Pakistan?
Siddiqi N , Iqbal R .
Department of Epidemiology, Michigan State University, East Lansing, MI 48823, USA.
J Pak Med Assoc. 2008
Maternal postpartum vitamin A supplementation is a safe and effective practice to replenish maternal vitamin A stores after delivery and in addition to provide the breastfeeding newborn with sufficient vitamin A. This strategy has been implemented in many countries around the world where Vitamin A deficiency (VAD) is prevalent. Recently, this supplementation has also been suggested by the Ministry of Health, Pakistan. In the light of literature available to date on VAD, we have attempted to appraise the need for this supplementation in Pakistan.
9. Micronutrient status, cognition and behavioral problems in childhood
Benton D ; ILSI Europe a.i.s.b.l .
Department of Psychology, University of Swansea, Swansea, Wales, SA2 8PP, UK
Eur J Nutr. 2008
It is widely accepted that the rapid rate of growth of the brain during the last third of gestation and the early postnatal stage makes it vulnerable to an inadequate diet, although brain development continues into adulthood and micronutrient status can influence functioning beyond infancy. A deficiency of various micro-nutrients in developing countries has been found to have long-term implication for cognitive development. Vitamin A plays a critical role in visual perception and a deficiency is the leading cause of childhood blindness. A lack of iodine during a critical period in brain development is associated with reduced intellectual ability. Iron shortage is a widespread problem in the developing world but also in industrialized countries. There is evidence that iron deficiency in early life adversely effects brain development. In addition in industrialized countries a role for folate in the prevention of neural tube defects is well established and in a few individuals impaired cognitive functioning is associated with the inadequate provision of vitamin B(12. )The controversial suggestions that sub-clinical deficiencies of micronutrients may in industrialized societies influence anti-social behavior and intelligence are also discussed.
10. Environmental risk factors in congenital malformations of the eye
Hornby SJ , Ward SJ , Gilbert CE , Dandona L , Foster A , Jones RB .
Department of Epidemiology & International Eye Health, Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK
Ann Trop Paediatr. 2002
Developmental eye defects such as coloboma are a significant cause of visual morbidity in children, and are more common in India than elsewhere. The possible role of environmental factors in the aetiology of these conditions was investigated by studying birth order, symptoms of vitamin A deficiency (night blindness), drug use and maternal illness in pregnancy, rubella antibodies and exposure to agricultural chemicals. Through hospital records and community-based rehabilitation programmes in Andhra Pradesh, children with colobomata were recruited from schools for the blind. Eighty-three mothers of affected children were interviewed. The results showed that 43% of parents were consanguineous, that 19% had a positive family history and that the frequency of coloboma was highest in second-born children. Eleven (16%) mothers had a history of night blindness while pregnant with the affected child; seven (8%) took medication during the 1st trimester, abortifacients in two cases; three reported fever in the 1st trimester; and 11 (13%) reported exposure to agricultural chemicals.
11. Dietary supplement use in the prevention of age-related macular degeneration progression
Raniga A , Elder MJ .
Ophthalmology, Christchurch Hospital, Christchurch, New Zealand
N Z Med J. 2009
PURPOSE: The Age-Related Eye Disease Study Group (AREDS) has found high-dose vitamin supplementation may have a role in preventing the progression of Category 3 and 4 age-related maculopathy. The aim of this study is to compare dietary antioxidant, zinc, and copper intakes of Australia, New Zealand, United Kingdom, and the United States to determine the difference between the actual and suggested AREDS intakes for these nutrients. A further aim is to investigate the constituents of commonly available single and multivitamin preparations in New Zealand and carry out a cost analysis. METHODS: The total median intake of vitamins A, C, and E; zinc; and copper is analysed from the most recent nutrition data published by the four countries. Forty multivitamin brands and 32 individual nutrient brands were analysed. An average price per tablet for each brand has been calculated in New Zealand dollars. RESULTS: The median intakes of antioxidants, zinc, and copper for these countries were comparable, but lower than the AREDS suggested intakes. Sixteen of the 40 multivitamin preparations contained all recommended nutrients. Of these, only two fulfilled the AREDS-recommended levels. The cost of different preparations is similar. CONCLUSION: Dietary supplementation is required to achieve the AREDS nutrient intake recommendations. This may be achieved by using any combination of multivitamin and individual supplement preparations available. Comprehensive tables have been constructed to guide ophthalmologists in the process of suggesting supplementation to prevent the progression of Category 3 and 4 age-related maculopathy.
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