Vitamin A deficiency remains a nutritional concern in sub-Saharan Africa. Conventionally bred maize hybrids with high provitamin A carotenoid concentrations may have the potential to improve vitamin ...A status in maize-consuming populations. We evaluated the efficacy of regular provitamin A carotenoid-biofortified "orange" maizemeal (~15 μg β-carotene/g) consumption in improving vitamin A status and reducing vitamin A deficiency in children. This was a cluster-randomized controlled trial in the rural farming district of Mkushi, Zambia. All 4- to 8-y-old children in an ~400-km2 area were identified and grouped by proximity into clusters of ~15-25 children. We randomly assigned clusters to 1) orange maizemeal (n = 25), 2) white maizemeal (n = 25), or 3) a parallel, nonintervention group (n = 14). Children in intervention clusters (n = 1024) received 200 g maizemeal for 6 d/wk over 6 mo; the maizemeal was prepared according to standardized recipes and served in cluster-level kitchens. Staff recorded attendance and leftovers. We collected venous blood before and after the intervention to measure serum retinol, β-carotene, C-reactive protein, and a1-acid glycoprotein. Intervention groups were comparable at baseline, and vitamin A status was better than anticipated (12.1% deficient on the basis of serum retinol <0.7 μmol/L). Although attendance at meals did not differ (85%), median daily maize intake was higher in white (154 g/d) than in orange (142 g/d) maizemeal clusters. At follow-up, mean serum β-carotene was 0.14 μmol/L (95% CI: 0.09, 0.20 μmol/L) higher in orange maizemeal clusters (P < 0.001), but mean serum retinol (1.00 ± 0.33 μmol/L overall) and deficiency prevalence (17.1% overall) did not differ between arms. In this marginally nourished population, regular biofortified maizemeal consumption increased serum β-carotene concentrations but did not improve serum retinol.
B1a lymphocytes arise from an early wave of progenitors unique to fetal life. B1a cells constitutively produce natural antibodies (NAb), which protect against bacterial pathogens and regulate ...oxidative stress. VA regulates early lymphopoiesis; deficiency in fetal mice compromises B1 populations. We investigated the impact of weekly maternal VA or β‐carotene supplementation (7,000 μg retinol equivalents) on plasma NAb concentrations of offspring. Subjects (n=290) were born to participants of a randomized, placebo‐controlled trial in Sarlahi, Nepal (1994–97) and assessed at ages 9–13 years (2006–08). We used a commercial immunoassay to measure anti‐double stranded DNA immunoglobulin M (ALPCO Diagnostics, Salem, NH; Catalog # 35‐DSSHU‐E01). Unadjusted geometric mean (95% confidence interval) concentrations were 20.08 U/mL (17.82, 22.64) in the VA group, compared to 17.64 U/mL (15.70, 19.81) and 15.96 U/mL (13.43, 18.96) in β‐carotene & placebo groups (p=0.07), respectively. After adjustment, VA increased NAb by 0.39 standard deviations (p<0.05). This effect was mediated by infant serum retinol. Although girls had 1.4‐fold higher NAb levels (p<0.001), sex did not modify the VA effect. Fetal VA receipt via routine maternal supplementation enhances the B1a lineage, which may alter infant and longer‐term chronic disease risk.
Grant Funding Source: Procter and Gamble, the Bill & Melinda Gates Foundation, and USAID
We assessed the internal validity of the Food Access Survey Tool (FAST) using data from households (
n
= 907) enrolled in an efficacy trial of biofortified maize in rural Zambia. This scale assesses ...food insecurity over a 6-month recall period. A Rasch partial credit model was used to evaluate item performance. Unidimensionality was assessed by principal component analysis, monotonicity was assessed by non-parametric methods, and differential item functioning (DIF) by several characteristics was assessed by cumulative ordinal logistic regression models. One item (frequency of consuming three square meals) did not fit the partial credit model. The remaining eight items fit in a primary single statistical dimension and item category severity increased monotonically with increasing severity of food insecurity. We identified statistically significant DIF in three subgroup comparisons, but effect sizes of total DIF were considered practically insignificant (<2 %). After excluding the item on “square meals,” the FAST serves as an internally valid tool to measure household food insecurity in rural Zambia.
Inflammation-induced hyporetinolemia (IIH), a reduction in serum retinol (SR) during inflammation, may bias population estimates of vitamin A deficiency (VAD). The optimal adjustment for IIH depends ...on the type and extent of inflammation. In rural Zambian children (4-8 years,
= 886), we compared three models for defining inflammation: α-1-acid glycoprotein (AGP) only (inflammation present if > 1 g/L or normal if otherwise), C-reactive protein (CRP) only (moderate inflammation, 5-15 mg/L; high inflammation, > 15 mg/L; or normal if otherwise) and a combined model using both AGP and CRP to delineate stages of infectious episode. Models were compared with respect to 1) the variance in SR explained and 2) comparability of inflammation-adjusted VAD estimated in low and high malaria seasons. Linear regression was used to estimate the variance in SR explained by each model and in estimating the adjustment factors used in generating adjusted VAD (retinol < 0.7 μmol/L). The variance in SR explained were 2% (AGP-only), 11% (CRP-only), and 11% (AGP-CRP) in the low malaria season; and 2% (AGP-only), 15% (CRP-only), and 12% (AGP-CRP) in the high malaria season. Adjusted VAD estimates in the low and high malaria seasons differed significantly for the AGP (8.2 versus 13.1%) and combined (5.5 versus 9.1%) models but not the CRP-only model (6.1 versus 6.3%). In the multivariate regression, a decline in SR was observed with rising CRP (but not AGP), in both malaria seasons (slope = -0.06;
< 0.001). In this malaria endemic setting, CRP alone, as opposed to CRP and AGP, emerged as the most appropriate model for quantifying IIH.
Biofortification is the breeding of crops to increase their nutritional value, including increased contents of micronutrients or their precursors. Biofortification aims to increase nutrient levels in ...crops during plant growth rather than during processing of the crops into foods. Emerging research from 8 human trials conducted in the past decade with staple food crops that have been biofortified by traditional plant breeding methods were presented in this symposium. Specifically, data from 6 efficacy and 2 effectiveness trials were discussed to assess the effects of regular consumption of these enhanced staple crops on improving population vitamin A and iron status and reducing the burden of micronutrient deficiencies in targeted populations living in South Asia, Sub-Saharan Africa, and Latin America. Biofortified food crops appear to have a positive impact on nutritional and functional health outcomes, as the results from the trials suggest. Additional implementation research will be needed to ensure maximization of the beneficial impact of this intervention and a smooth scaling up to make biofortification a sustainable intervention in public health. The challenge for the global health community remains how to take this efficacious intervention and implement at large scale in the real world.
Infant feeding in rural South Asia often diverges from recommendations: while breastfeeding is nearly universal, prelacteal feeding and early introduction of other foods are common. We investigated ...effects of breastfeeding frequency (BFF), colostrum receipt and introduction of other foods on infant mid‐upper arm circumference (MUAC) in the 1st 6 months of life. Infant feeding and MUAC data were analyzed on 8,339 infants born to participants in a vitamin A supplementation trial in the rural, southeast plains of Nepal. Although 94% of infants received colostrum and 90% were breastfed > 10x/day (“high”), substantial percentages received animal/powdered milk (53%) or another mother's milk (15%) before 3 months. High BFF was associated with greater 3 month MUAC (p<0.001), with a significant interaction between BFF and colostrum receipt (p<0.001): multiple adjusted mean 3 month MUAC was 12.5 cm among high BFF/colostrum versus 11.75cm among infrequently breastfed/no colostrum infants. Receipt of animal/powdered milk or another mother's milk before 3 months was associated with reductions of 0.31cm (p<0.001) and 0.11cm (p<0.01) in MUAC, respectively. Feeding colostrum plus frequent breastfeeding, and refraining from feeding other milks in the 1st 3 months of life, helps maintain ponderal growth in early infancy in rural South Asia.
Funded by USAID, Bill & Melinda Gates Foundation and Sight & Life Research Institute.
Background. Maternal undernutrition is a major public health problem in the developing world. A growing body of evidence attests to the impact of maternal undernutrition on the emerging organ systems ...of the fetus, with functional alterations persisting throughout life. Research regarding nutritional programming of the immune system is limited to date. This study explores relationships between early life nutrition, including randomized exposure to maternal vitamin A or β-carotene supplementation, on three vulnerable aspects of immune development: early lymphopoiesis, thymic organogenesis, and inflammatory mechanisms. Methods. A double-blind, cluster-randomized, placebo-controlled trial of maternal vitamin A or β-carotene supplementation (7,000 µg retinol equivalents) was conducted in the Sarlahi district of Nepal from 1994–1997. Field workers collected extensive data on maternal and infant health, nutritional status, and environmental exposures at multiple time points in pregnancy and the first half of infancy. From 2006–2008, we contacted participants of this trial and their children, aged 9–13 years, to assess current health and nutritional status. Using commercial immunoassays, we measured children's plasma concentrations of natural antibodies (NAb) as a marker for early B1a cells, thymulin as a marker for thymic size, and interleukin 6 (IL-6), C-reactive protein (CRP) and α1-acid glycoprotein (AGP) as indicators of inflammation. Results. Geometric mean (95% confidence interval) immune protein concentrations of sampled children were as follows: 18.36 U/mL (17.01, 19.81) for NAb; 1.37 ng/mL (1.27, 1.47) for thymulin; 1.66 pg/mL (1.51, 1.82) for IL-6; 0.24 mg/L (0.20, 0.29) for CRP; and 0.84 mg/mL (0.81, 0.86) for AGP. Girls had significantly higher NAb levels (p<0.001); NAb concentrations were also significantly associated (p<0.05) with ear discharge and symptoms of acute lower respiratory tract infection. Plasma thymulin was most strongly associated with nutritional status variables and season of interview. IL-6, CRP and AGP concentrations were reliably higher among children who were sick in the previous week, compared to those with no reported morbidity symptoms. We observed consistent U-shaped relationships between measures of body fat and inflammatory proteins. Maternal vitamin A supplementation increased NAb concentrations by 0.39 standard deviations compared to the placebo (p<0.05). NAb levels in boys were strongly associated with neonatal size, growth from 0-3 months, and size at 3 months of age. Girls born during the harvest season had higher NAb levels than their peers (p=0.07). Thymulin concentrations did not differ by maternal supplementation group, but were directly associated with weight (p<0.01) and length gains (p<0.05) from 0–3 months in both sexes. Levels of inflammatory proteins tended to be highest in children (particularly girls) born to β-carotene supplemented mothers. Maternal wasting (arm circumference <21.5 cm) and, in boys, neonatal size were also associated with higher concentrations of inflammatory proteins. We found no evidence of a link between infant feeding practices and any of the measured immune proteins. Conclusions. Our findings suggest that early life nutritional insults may have a lasting impact on the emerging immune system. Perturbations to the immune system, particularly the processes by which immune reactions are regulated, may have immediate consequences for infant health and survival, as well as longer term implications for the development of immune-mediated and/or inflammatory disorders such as cardiovascular disease and cancer.
Integration into a soft material of all the molecular components necessary to generate storable fuels is an interesting target in supramolecular chemistry. The concept is inspired by the internal ...structure of photosynthetic organelles, such as plant chloroplasts, which colocalize molecules involved in light absorption, charge transport and catalysis to create chemical bonds using light energy. We report here on the light-driven production of hydrogen inside a hydrogel scaffold built by the supramolecular self-assembly of a perylene monoimide amphiphile. The charged ribbons formed can electrostatically attract a nickel-based catalyst, and electrolyte screening promotes gelation. We found the emergent phenomenon that screening by the catalyst or the electrolytes led to two-dimensional crystallization of the chromophore assemblies and enhanced the electronic coupling among the molecules. Photocatalytic production of hydrogen is observed in the three-dimensional environment of the hydrogel scaffold and the material is easily placed on surfaces or in the pores of solid supports.
Maternal smoking during pregnancy (MSDP) may impact offspring biological (e.g., deoxyribonucleic acid methylation DNAm) and behavioral (e.g., attention-deficit/hyperactivity disorder ...hyperactive/impulsive ADHD-HI symptoms) development. There has been consistency in findings of differential methylation in global DNAm, and the specific genes
and
in relation to MSDP. The current study aims to (a) replicate the associations of MSDP and DNAm in prior literature in middle childhood-adolescence (cross-sectionally) using a sibling-comparison design where siblings were discordant for MSDP (
= 328 families;
Sibling 1 = 13.02; Sibling 2 = 10.20), adjusting for prenatal and postnatal covariates in order to isolate the MSDP exposure on DNAm. We also (b) cross-sectionally explored the role of DNAm in the most robust MSDP-ADHD associations (i.e., with ADHD-HI) previously found in this sample. We quantified smoking exposure severity for each sibling reflecting time and quantity of MSDP, centered relative to the sibling pair's average (i.e., within-family centered, indicating child-specific effects attributable MSDP exposure) and controlling for the sibling average MSDP (i.e., between-family component, indicating familial confounding related to MSDP). We found that child-specific MSDP was associated with global DNAm, and
and
methylation after covariate adjustment, corroborating emerging evidence for a potentially causal pathway between MSDP and DNAm. There was some evidence that child-specific
and
methylation partially explained associations between MSDP and ADHD-HI symptoms, though only on one measure (of two). Future studies focused on replication of these findings in a longitudinal genetic design could further solidify the associations found in the current study. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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