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Determination of vitamin A total body stores and toxicity indicators in children exposed to large scale food fortification and inflammation

posted on 05.09.2019 by Georg Lietz, Marjorie Haskell, Reina Engle-Stone, Kenneth H. Brown, Michael Henry Green, Jennifer Lynn Ford, Shaikh Mesbah Ahmad, Dora Ines Mazariegos, Erick Boy, Anthony Oxley, Matthew Wright, Carl Vincent Cabanilla, Mario Capenzana, Ame Stormer, Dolly Reario

To combat vitamin A deficiency, a serious public health problem in low income settings, vitamin A supplementation and fortification programs have been implemented as some of the most cost-effective health interventions. However, recent survey data indicate that fortification of multiple food vehicles could mean that more than 20% of young children might have vitamin A intakes above the safe upper level of intake, if fortification levels are not adjusted to account for the impact of other programs.

Since the assessment of excessive intake of vitamin A and associated risk remains problematic, this multi-disciplinary and multi-national research program assessed whether multiple exposure to vitamin A programs is associated with intake levels above the safe upper level of intake, excess hepatic stores and/or biomarkers of vitamin A toxicity.

The collected data of this project will aid in the validation of the vitamin A tracer dilution technique in individuals with inflammation, to evaluate the effectiveness and safety of vitamin A interventions across the full spectrum of vitamin A status, and the establishment of dietary assessment methods. Furthermore, the collected data will help evaluate new and sensitive biomarkers of vitamin A toxicity to develop potential non-invasive serum markers of toxicity in human populations. The collected data was collected from 1-5 year old children from Bangladesh, Guatemala and the Philippines who were selected based on multiple exposure to vitamin A intervention programs. The data consists of dietary and biochemical data describing the nutritional status as well as socioeconomic and demographic status of all participants. Furthermore, a pig model was used to evaluate traditional and novel biomarkers of hypervitaminosis A.


To support research in three low income countries to assess the safety and effectiveness of large-scale intervention programs to control Vitamin A deficiency

Bill & Melinda Gates Foundation

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Public Health, Health Services and Primary Care