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Sociocultural influences on vitamin A deficiency in a rural Malay community

Chen PC

J Trop Med Hyg, 1972 Dec;75(12):231-6.
PMID: 4539605
Matched MeSH terms: Vitamin A Deficiency/epidemiology*; Vitamin A Deficiency/prevention & control
Fulltext Does vitamin A supplementation protect schoolchildren from acquiring soil-transmitted helminthiasis? A randomized controlled trial

Al-Mekhlafi HM, Anuar TS, Al-Zabedi EM, Al-Maktari MT, Mahdy MA, Ahmed A, et al.

Parasit Vectors, 2014;7:367.
PMID: 25127885 DOI: 10.1186/1756-3305-7-367

Despite the intensive global efforts to control intestinal parasitic infections, the prevalence of soil-transmitted helminth (STH) infections is still very high in many developing countries particularly among children in rural areas.

Matched MeSH terms: Vitamin A/administration & dosage; Vitamin A/pharmacology*
Giardiasis as a predictor of childhood malnutrition in Orang Asli children in Malaysia

Al-Mekhlafi MS, Azlin M, Nor Aini U, Shaik A, Sa'iah A, Fatmah MS, et al.

Trans R Soc Trop Med Hyg, 2005 Sep;99(9):686-91.
PMID: 15992838

A cross-sectional study to examine the association of giardiasis with protein-energy malnutrition, vitamin A deficiency and iron deficiency anaemia was conducted among Orang Asli children in Selangor, Malaysia. A total of 281 children aged 2-15 years were studied. The data were collected using structured questionnaires, anthropometric measurements and laboratory analysis of blood and faecal samples. The results showed that 24.9% of the children were infected with Giardia duodenalis, while 56.5, 61.3 and 15.1% had significant underweight, stunting and wasting, respectively. Giardiasis was statistically identified as a strong predictor of significant wasting in this study population.

Matched MeSH terms: Vitamin A Deficiency/epidemiology*; Vitamin A Deficiency/parasitology
Dynamic Changes in Health-Promoting Properties and Eating Quality During Off-Vine Ripening of Tomatoes

Siddiqui MW, Lara I, Ilahy R, Tlili I, Ali A, Homa F, et al.

Compr Rev Food Sci Food Saf, 2018 Nov;17(6):1540-1560.
PMID: 33350145 DOI: 10.1111/1541-4337.12395

Tomato (Solanum lycopersicon L.) fruit is rich in various nutrients, vitamins and health-promoting molecules. Fresh tomatoes are an important part of the Mediterranean gastronomy, and their consumption is thought to contribute substantially to the reduced incidence of some chronic diseases in the Mediterranean populations in comparison with those of other world areas. Unfortunately, tomato fruit is highly perishable, resulting in important economic losses and posing a challenge to storage, logistic and supply management. This review summarizes the current knowledge on some important health-promoting and eating quality traits of tomato fruits after harvest and highlights the existence of substantial cultivar-to-cultivar variation in the postharvest evolution of the considered traits according to maturity stage at harvest and in response to postharvest manipulations. It also suggests the need for adapting postharvest procedures to the characteristics of each particular genotype to preserve the optimal quality of the fresh product.

Matched MeSH terms: Vitamin A
Fulltext Fortification of Rice Noodles with Vitamin A: Quality, Sensory Evaluation, and Enhancement of Vitamin A Intakes

Malahayati N, Muhammad K, Bakar J, Karim R

J Nutr Sci Vitaminol (Tokyo), 2020;66(Supplement):S179-S183.
PMID: 33612590 DOI: 10.3177/jnsv.66.S179

Vitamin A deficiency is common in many countries where rice is the staple food. Food fortification is an important strategy to address this problem. As rice noodle is the second principal form of rice products widely consumed in Asia, rice noodles could be a potential vehicle for fortification of vitamin A. In this study, rice noodles were prepared from 0, 300, 600, 1,050, and 1,500 μg of vitamin A per 100 g of rice flour. Samples were analyzed for quality, sensory evaluation, and enhancement of vitamin A intakes. Increasing level of vitamin A fortification did not influence quality and sensory properties of the rice noodles, except for the ash content, color, and appearance of the noodles. Rice noodle that was fortified with the highest level of vitamin A was found to be the darkest in color. However, this sample received scores higher than 6 (like slightly) for appearance. Furthermore, sample fortified with the highest level of vitamin A produced rice noodles with the highest level of vitamin A retention suggesting that noodles were good vehicle for vitamin A fortification. Fortification of rice flour with 1,500 μg of vitamin A produced rice noodles with 24.88% of the RDI for vitamin A per serving and provided an effective means of enhancing vitamin A intake.

Matched MeSH terms: Vitamin A
Fulltext The Development of Expanded Snack Product Made from Pumpkin Flour-Corn Grits: Effect of Extrusion Conditions and Formulations on Physical Characteristics and Microstructure

Nor NM, Carr A, Hardacre A, Brennan CS

Foods, 2013 May 14;2(2):160-169.
PMID: 28239106 DOI: 10.3390/foods2020160

Pumpkin products confer natural sweetness, desirable flavours and β-carotene, a vitamin A precursor when added as ingredients to extruded snacks. Therefore, a potential use for dried pumpkin flour is as an ingredient in ready-to-eat (RTE) snack foods. Growth in this market has driven food manufacturers to produce a variety of new high value snack foods incorporating diverse ingredients to enhance the appearance and nutritional properties of these foods. Ready-to-eat snacks were made by extruding corn grits with 5%, 10%, 15% and 20% of pumpkin flour. Snacks made from 100% corn grits were used as control products for this work. The effect of formulation and screw speeds of 250 rpm and 350 rpm on torque and specific mechanical energy (SME, kWh/kg), physical characteristics (expansion ratio, bulk density, true density and hardness) and the microstructure of the snacks were studied. Increasing the screw speed resulted in a decrease of torque for all formulations. When pumpkin flour was added the specific mechanical energy (SME) decreased by approximately 45%. Increasing the percentage of pumpkin flour at the higher screw speed resulted in a harder texture for the extruded products. X-ray tomography of pumpkin flour-corn grit snacks showed that increased levels of pumpkin flour decreased both the bubble area and bubble size. However, no significant differences (p > 0.05) in bubble wall thickness were measured. By understanding the conditions during extrusion, desirable nutritional characteristics can be incorporated while maximizing expansion to make a product with low bulk density, a fine bubble structure and acceptable organoleptic properties.

Matched MeSH terms: Vitamin A
Some observations on food deficiency diseases in Malaya

Pallister RA

Journal of the Malaya Branch of the British Medical Association, 1940;4:191-97.

Matched MeSH terms: Vitamin A Deficiency
High prevalence of malnutrition and vitamin A deficiency among schoolchildren of rural areas in Malaysia using a multi-school assessment approach

Tan PY, Mohd Johari SN, Teng KT, Loganathan R, Lee SC, Ngui R, et al.

Br J Nutr, 2023 Feb 14;129(3):454-467.
PMID: 35506400 DOI: 10.1017/S0007114522001398

Childhood malnutrition is known as a public health concern globally. The present study aims to assess the anthropometry and blood biochemical status of rural primary schoolchildren in Malaysia. A total of 776 children (7-11 years old) from ten rural primary schools from five states were included in this study. Nutritional outcomes were assessed based on sex, age group and school categories among the children (median age: 9 years (P25:8, P75:10)). The overall prevalence of malnutrition was 53·4 %. Vitamin A deficiency (VAD) was recorded at 20·6 and 39·8 % based on retinol and retinol-binding protein (RBP) levels, respectively. Anaemia, iron deficiency (ID), iron-deficiency anaemia (IDA) and elevated inflammation were found at 14·9, 17·9, 9·1 and 11·5 %, respectively. Malnutrition, VAD, anaemia, ID, IDA and elevated inflammation were more prevalent among Orang Asli (OA) schoolchildren compared with Non-Orang Asli schoolchildren. Higher occurrences of VAD and anaemia were also found among children aged <10 years. Retinol, RBP, α-carotene, ferritin and haemoglobin levels were lower among undernourished children. Besides, overweight/obese children exhibited a higher level of high-sensitivity C-reactive protein. Multivariate analysis demonstrated that OA school children (adjusted OR (AOR): 6·1; 95 % CI 4·1, 9·0) and IDA (AOR: 3·6; 95 % CI 1·9, 6·6) were associated with stunting among this population. The present study revealed that malnutrition, micronutrient deficiencies and anaemia are prevalent among rural primary schoolchildren in Malaysia, especially those from OA schools and younger age children (<10 years). Hence, more appropriate and targeted measures are needed to improve the nutritional status of these children.

Matched MeSH terms: Vitamin A
Clinical Recommendations for the use of Neurotropic B vitamins (B1, B6, and B12) for the Management of Peripheral Neuropathy: Consensus from a Multidisciplinary Expert Panel

Pinzon RT, Schellack N, Matawaran BJ, Tsang MW, Deerochanawong C, Hiew FL, et al.

J Assoc Physicians India, 2023 Jul;71(7):11-12.
PMID: 37449697 DOI: 10.59556/japi.71.0290

INTRODUCTION: Peripheral neuropathy (PN) is an insidious disease that is often asymptomatic during the early stages but which can have a significant impact on quality of life at later stages when nerve damage occurs. There is currently no guidance on the use of neurotropic B vitamins (B1, B6, and B12) for the management of asymptomatic and symptomatic PN.
OBJECTIVE: To provide guidance to primary care physicians on an integrated approach to managing PN with neurotropic B vitamins (B1, B6, and B12).
MATERIALS AND METHODS: A multidisciplinary panel of eight experts participated in an iterative quasi-anonymous Delphi survey consisting of two rounds of questions and a virtual meeting. A literature review formed the basis of the survey questions. The first round included multiple select, qualitative, and Likert Scale questions; the subsequent round consisted of 2-point scale (agree or disagree) questions that sought to develop consensus-based statements refined from the first round and recommendations derived from discussions during the virtual expert panel meeting.
RESULTS: Clinical recommendations for the use of neurotropic B vitamins (B1, B6, and B12) have been developed for the prevention of PN progression or to delay onset in patients at high risk of developing PN. Recommendations have also been provided for the assessment of PN etiology and considerations for the use of loading dose (high dose) and maintenance dose (lower dose) of these neurotropic B vitamins (B1, B6, and B12).
CONCLUSION: These clinical recommendations provide an initial step towards formulating comprehensive guidelines for the early and long-term management of PN with neurotropic B vitamins (B1, B6, and B12) and move beyond addressing only neuropathic pain associated with the late stages of PN.

Matched MeSH terms: Vitamin A
Fulltext Multiple micronutrient supplementation improves growth and reduces the risk of anemia among infants in Gaza Strip, Palestine: a prospective randomized community trial

Albelbeisi A, Shariff ZM, Mun CY, Rahman HA, Abed Y

Nutr J, 2020 12 05;19(1):133.
PMID: 33278899 DOI: 10.1186/s12937-020-00652-7

BACKGROUND: Infants and young children 6-24 months of age are the most nutritionally vulnerable groups, as their needs for vitamins and minerals are high relative to the amount of food they consume. This study determines the effect of Micronutrient Powder Supplementation (MNP) on growth and hemoglobin of infants in Gaza Strip, Palestine.
METHOD: This was a two-arm parallel-group randomized controlled trial conducted in two health care clinics of the United Nations Relief and Work Agency (UNRWA) at the Middle Area governorate of Gaza Strip, Palestine. A total of 200 healthy infants aged 6-month-old were recruited and randomized to receive 3 sachets/week of MNP for 12 months alongside with the National Micronutrient Supplement (NMS) (n = 100) or NMS alone (n = 100). Weight, length, blood hemoglobin, and dietary intakes were measured at 6, 9, 12, 15, 18, and 21 (3 months after the end of intervention) months of age. Analysis was by intention to treat.
RESULTS: The experimental group had a higher concentration of hemoglobin at 12 and 15 months than did the control group, and a significant difference (p

Matched MeSH terms: Vitamin A
Fulltext Intestinal parasitic infections and micronutrient deficiency: a review

Hesham MS, Edariah AB, Norhayati M

Med J Malaysia, 2004 Jun;59(2):284-93.
PMID: 15559182

Malnutrition including vitamin A and iron deficiency and parasitic diseases have a strikingly similar geographical distribution with the same people experiencing both insults together for much of their lives. Parasitic infections are thought to contribute to child malnutrition and micronutrient deficiency through subtle reduction in digestion and absorption, chronic inflammation and loss of nutrients. Parasites may affect the intake of food; it's subsequent digestion and absorption, metabolism and the maintenance of nutrient pools. The most important parasites related to nutritional status are intestinal parasites especially soil transmitted helminthes, Giardia duodenalis, Entamoeba histolytica, followed by other parasites such as the coccidia, Schistosoma sp. and malarial parasites.

Matched MeSH terms: Vitamin A Deficiency/etiology*
Fulltext Diet and cancer

Med J Malaysia, 1988 Dec;43(4):348-9.
PMID: 2853823
Matched MeSH terms: Vitamin A/adverse effects
Fulltext Supplementation with red palm oil increases β-carotene and vitamin A blood levels in patients with cystic fibrosis

Sommerburg O, De Spirt S, Mattern A, Joachim C, Langhans CD, Nesaretnam K, et al.

Mediators Inflamm, 2015;2015:817127.
PMID: 25688177 DOI: 10.1155/2015/817127

Patients with cystic fibrosis (CF) show decreased plasma concentrations of antioxidants due to malabsorption of lipid soluble vitamins and consumption by chronic pulmonary inflammation. β-Carotene is a major source of retinol and therefore is of particular significance in CF. The aim of this study was to investigate the effect of daily intake of red palm oil (RPO) containing high amounts of β-carotene on the antioxidant levels in CF patients. Sixteen subjects were recruited and instructed to enrich their food with 2 to 3 tablespoons of RPO (~1.5 mg of β-carotene) daily over 8 weeks. Carotenoids, retinol, and α-tocopherol were measured in plasma at baseline and after intervention. In addition β-carotene, lycopene, α-tocopherol, and vitamin C were measured in buccal mucosa cells (BMC) to determine the influence of RPO on antioxidant tissue levels. Eleven subjects completed the study properly. Plasma β-carotene, retinol, and α-carotene of these patients increased, but plasma concentrations of other carotenoids and α-tocopherol as well as concentrations of β-carotene, lycopene, α-tocopherol, and vitamin C in BMC remained unchanged. Since RPO on a daily basis did not show negative side effects the data suggest that RPO may be used to elevate plasma β-carotene in CF.

Matched MeSH terms: Vitamin A/blood*
Fulltext Vitamin A and Bone Health: A Review on Current Evidence

Yee MMF, Chin KY, Ima-Nirwana S, Wong SK

Molecules, 2021 Mar 21;26(6).
PMID: 33801011 DOI: 10.3390/molecules26061757

Vitamin A is a fat-soluble micronutrient essential for growth, immunity, and good vision. The preformed retinol is commonly found in food of animal origin whereas provitamin A is derived from food of plant origin. This review summarises the current evidence from animal, human and cell-culture studies on the effects of vitamin A towards bone health. Animal studies showed that the negative effects of retinol on the skeleton were observed at higher concentrations, especially on the cortical bone. In humans, the direct relationship between vitamin A and poor bone health was more pronounced in individuals with obesity or vitamin D deficiency. Mechanistically, vitamin A differentially influenced the stages of osteogenesis by enhancing early osteoblastic differentiation and inhibiting bone mineralisation via retinoic acid receptor (RAR) signalling and modulation of osteocyte/osteoblast-related bone peptides. However, adequate vitamin A intake through food or supplements was shown to maintain healthy bones. Meanwhile, provitamin A (carotene and β-cryptoxanthin) may also protect bone. In vitro evidence showed that carotene and β-cryptoxanthin may serve as precursors for retinoids, specifically all-trans-retinoic acid, which serve as ligand for RARs to promote osteogenesis and suppressed nuclear factor-kappa B activation to inhibit the differentiation and maturation of osteoclasts. In conclusion, we suggest that both vitamin A and provitamin A may be potential bone-protecting agents, and more studies are warranted to support this hypothesis.

Matched MeSH terms: Vitamin A/metabolism*
Fulltext Use of red palm oil in local snacks can increase intake of provitamin A carotenoids in young aborigines children: a Malaysian experience

Ng TK, Low CX, Kong JP, Cho YL

Malays J Nutr, 2012 Dec;18(3):393-7.
PMID: 24568080 MyJurnal

Carotenoid-rich red palm oil (RPO)-based snacks have been provided to children in impoverished communities to improve their vitamin A status. The non-availabilty of information on the acceptability of RPO-based snacks by Malaysian aborigines (Orang Asli) children forms the basis of this study.

Matched MeSH terms: Vitamin A/administration & dosage*
Treatment of skin diseases: recent trends

Adam BA

Med J Malaysia, 1973 Mar;27(3):192-4.
PMID: 4268922
Matched MeSH terms: Vitamin A/therapeutic use
Fulltext Vitamin A reserve of liver in health and coronary heart disease among ethnic groups in Singapore

Saha N, Ng TB, Tan PY, Wee KP

Br J Nutr, 1988 Nov;60(3):407-12.
PMID: 3219311 DOI: 10.1079/bjn19880112

1. The vitamin A content of human liver tissue was determined in 363 autopsy samples. The sample comprised a total of 181 subjects dying after accidents and 182 dying from coronary heart disease among Singapore ethnic groups of both sexes. 2. The medium vitamin A reserve was 146 mg/kg in accident victims and 141 mg/kg in those who had died of coronary heart disease. Of all the samples 16% contained less than 40 mg/kg, 45% had 100-300 mg/kg, while 9% contained more than 500 mg/kg liver. 3. Among the accident victims, Indians had the lowest median liver vitamin A reserve (118 mg/kg) compared with that in other ethnic groups (137 mg/kg in Chinese, 191 mg/kg in Malays, 155 mg/kg in Caucasians). 4. The ethnic distribution of vitamin A reserve in coronary deaths was similar to that in accident victims. 5. There was no significant difference between the sexes in hepatic vitamin A reserve. 6. The distribution of vitamin A reserve in all the groups was skewed to the right.

Matched MeSH terms: Vitamin A/analysis*
alpha 2-Macroglobulin in vitamin A-deficient children

Kiorpes TC, Wolf G, Arroyave G, Wai TN

Am J Clin Nutr, 1979 Sep;32(9):1842-6.
PMID: 89810 DOI: 10.1093/ajcn/32.9.1842

Serum samples were obtained from 43 children 14 years old or younger in Malaysia and Guatemala. The levels of the serum glycoprotein alpha 2-macroglobulin (alpha 2-M) were assayed by two methods: the trypsin-binding assay of Ganrot (Clin. Chim. Acta 14:493, 1960) and a radial immunodiffusion assay against alpha 2-M antiserum. The two methods gave the same results. When serum alpha 2-M levels were plotted against serum vitamin A concentrations, they were significantly correlated (r = 0.505, P less than 0.001); children with serum vitamin A levels greater than 40 micrograms/100 ml had alpha 2-M levels of 3.71 +/- 0.79 mg/ml (mean +/- SD, n = 13), while those with level less than 40 micrograms/100 ml had alpha 2-M levels of 2.78 +/- 0.51 mg/ml (n = 30); the difference was significant (P less than 0.001). Normal, apparently healthy children had alpha 2-M levels of 3.90 +/- 0.39 mg/ml. Most of the children sampled suffered from a variety of infections; of these, measles appeared to counteract the effect of vitamin A deficiency by elevating alpha 2-M levels. Vitamin A-deficient children with measles had alpha 2-M levels not significantly lower than those of normal children. The difference between deficient and normal values of alpha 2-M was still significant (P less than 0.05) when expressed per milligram of serum protein, showing that the effect was not caused by lowered serum protein concentrations associated with protein-calorie malnutrition, from which most of the deficiency children suffered.

Matched MeSH terms: Vitamin A Deficiency/blood*
Fulltext Effects of vitamin A supplementation on iron status indices and iron deficiency anaemia: a randomized controlled trial

Al-Mekhlafi HM, Al-Zabedi EM, Al-Maktari MT, Atroosh WM, Al-Delaimy AK, Moktar N, et al.

Nutrients, 2014 Jan;6(1):190-206.
PMID: 24384995 DOI: 10.3390/nu6010190

Iron deficiency anaemia (IDA) is the most common nutritional deficiency in the world including developed and developing countries. Despite intensive efforts to improve the quality of life of rural and aboriginal communities in Malaysia, anaemia and IDA are still major public health problems in these communities particularly among children. A randomized, double-blind, placebo-controlled trial was conducted on 250 Orang Asli (aboriginal) schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation (200,000 IU) on iron status indices, anaemia and IDA status. The effect of the supplement was assessed after 3 months of receiving the supplements; after a complete 3-day deworming course of 400 mg/day of albendazole tablets. The prevalence of anaemia was found to be high: 48.5% (95% CI=42.3, 54.8). Moreover, 34% (95% CI=28.3, 40.2) of the children had IDA, which accounted for 70.1% of the anaemic cases. The findings showed that the reduction in serum ferritin level and the increments in haemoglobin, serum iron and transferrin saturation were found to be significant among children allocated to the vitamin A group compared to those allocated to the placebo group (p<0.01). Moreover, a significant reduction in the prevalence of IDA by almost 22% than prevalence at baseline was reported among children in the vitamin A group compared with only 2.3% reduction among children in the placebo group. In conclusion, vitamin A supplementation showed a significant impact on iron status indices and IDA among Orang Asli children. Hence, providing vitamin A supplementation and imparting the knowledge related to nutritious food should be considered in the efforts to improve the nutritional and health status of these children as a part of efforts to improve the quality of life in rural and aboriginal communities.

Matched MeSH terms: Vitamin A/administration & dosage*; Vitamin A/blood
Fulltext Antioxidant intake and status, and oxidative stress in relation to breast cancer risk: a case-control study

Sharhar S, Normah H, Fatimah A, Fadilah RN, Rohi GA, Amin I, et al.

Asian Pac J Cancer Prev, 2008 Apr-Jun;9(2):343-49.
PMID: 18712988

A case control study was carried out to investigate associations between breast cancer risk, antioxidant status and oxidative stress among women in Klang Valley and Selangor. A total of 57 newly diagnosed cases aged 30 to 66 years old participated and were matched for age and ethnicity with 139 controls with no diagnosis of cancer or other chronic diseases. An interview based questionnaire designed to collect information on demographic and socioeconomic status, as well as reproductive, medical and dietary history was used. Anthropometric measurements including weight, height, waist and hip circumference were made and a 10 ml fasting venous blood sample was taken for glucose testing and analysis of plasma vitamin antioxidants and malondialdehyde. Hair and toenail samples were taken for selenium analysis. Results showed that the mean intake of vitamin A, vitamin E and selenium among cases (606.8 +/- 334.8 microg/d, 6.1 +/- 2.4 g/d, 56.9 +/- 16.2 microg/d) was lower than controls (724.7 +/- 414 microg/day, 6.9 +/- 3.0 g/d, 60.8 +/- 17.5 microg/d, respectively) (p<0.05 for all parameters). A similar trend was noted for plasma vitamin A and E and also selenium in hair and toenails. Poor antioxidant status as indicated by low plasma vitamin A (<284.3 microg/l or <366.3 microg/l) increased risk of breast cancer by approximately two fold, whilst low plasma vitamin E (<2.5 mg/dl, <2.8 mg/dl and <3.1 mg/dl) increased the risk by two to three fold [Adjusted OR 2.97 (95% CI 1.38-3.48), 2.32 (95% CI 1.07-2.41) and 2.12 (95% CI 1.00-4.21)]. Cases had a greater level of malondialdehyde 4.4 +/- 1.1 mmol/g protein), an indicator of oxidative stress, as compared to controls (3.2 +/- 1.7 mmol/g protein) (p<0.05). A high level of MDA (> or = 4.8 mmol/g protein) was associated with breast cancer [Adjusted OR 6.82 (95% CI 1.95-23.9)]. It is concluded that a poor antioxidant status and high oxidative stress are associated with breast cancer risk. Thus, it is essential for Malaysian women to obtain a good antioxidant status by consuming a diet rich in vitamins A and E as well as selenium and adopt healthy behaviour to reduce oxidative stress in order to prevent breast cancer.

Matched MeSH terms: Vitamin A/administration & dosage; Vitamin A/blood

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