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For: Ahmad SM, Huda MN, Raqib R, Qadri F, Alam MJ, Afsar MNA, Peerson JM, Tanumihardjo SA, Stephensen CB. High-Dose Neonatal Vitamin A Supplementation to Bangladeshi Infants Increases the Percentage of CCR9-Positive Treg Cells in Infants with Lower Birthweight in Early Infancy, and Decreases Plasma sCD14 Concentration and the Prevalence of Vitamin A Deficiency at Two Years of Age. J Nutr 2020;150:3005-3012. [PMID: 32939553 PMCID: PMC7675026 DOI: 10.1093/jn/nxaa260] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/08/2020] [Accepted: 08/04/2020] [Indexed: 12/12/2022] Open

For:	Ahmad SM, Huda MN, Raqib R, Qadri F, Alam MJ, Afsar MNA, Peerson JM, Tanumihardjo SA, Stephensen CB. High-Dose Neonatal Vitamin A Supplementation to Bangladeshi Infants Increases the Percentage of CCR9-Positive Treg Cells in Infants with Lower Birthweight in Early Infancy, and Decreases Plasma sCD14 Concentration and the Prevalence of Vitamin A Deficiency at Two Years of Age. J Nutr 2020;150:3005-3012. [PMID: 32939553 PMCID: PMC7675026 DOI: 10.1093/jn/nxaa260] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/08/2020] [Accepted: 08/04/2020] [Indexed: 12/12/2022] Open

Number

Cited by Other Article(s)

Morales F, Montserrat-de la Paz S, Leon MJ, Rivero-Pino F. Effects of Malnutrition on the Immune System and Infection and the Role of Nutritional Strategies Regarding Improvements in Children's Health Status: A Literature Review. Nutrients 2023;16:1. [PMID: 38201831 PMCID: PMC10780435 DOI: 10.3390/nu16010001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/15/2023] [Accepted: 12/17/2023] [Indexed: 01/12/2024] Open

Gholizadeh M, Basafa Roodi P, Abaj F, Shab-Bidar S, Saedisomeolia A, Asbaghi O, lak M. Influence of Vitamin A supplementation on inflammatory biomarkers in adults: a systematic review and meta-analysis of randomized clinical trials. Sci Rep 2022;12:21384. [PMID: 36496428 PMCID: PMC9735279 DOI: 10.1038/s41598-022-23919-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 11/07/2022] [Indexed: 12/13/2022] Open

Abstract

Vitamin A is an anti-oxidant which has been presumed to act as an anti-infective vitamin in many studies. This study aimed to evaluate the association between vitamin A supplementation and c-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and interleukin 6 (IL-6) levels in randomized control trials (RCTs) studies on adults. A systematic search was performed on databases including PUBMED, SCOPUS, and the Cochrane library. The studies included were considered for data extraction and subsequently assessed for effect. Weighted mean differences (WMD) and 95% confidence intervals (CIs) were evaluated. Among 13,219 articles 13 studies were included for analysis of CRP and TNF-α, as well as 9 studies included for IL-6 in quality and quantity. The pooled WMD analysis of CRP demonstrated that vitamin A supplementation significantly increased CRP concentration with (WMD: 0.84 mg/L; 95% CI 0.29-1.39, I² = 0.96.2% and p value < 0.003). However, there was no significant correlation between vitamin A supplementation and lower plasma TNF-α (p < 0.45)). Subgroup analysis by dosage demonstrate significant association between vitamin A supplementation and IL-6 in dosage with 50,000 with (WMD: - 1.53 mg/L; 95% CI - 2.36 to - 0.71, p value < 0.00001) as well as a negative significant association was seen at 44 weeks of supplementation with 50,000 IU/day retinyl palmitate and TNF-a in chronic hepatitis B conditions with (- 0.94 (- 1.19, - 0.69) p < 0.0001). The result of this study demonstrates that supplementation of vitamin A at low and high dosages for short and long durations increases the CRP plasma concentrations on adults and vitamin A supplementation decreases the TNF-α concentrations in chronic hepatitis B on adults. Therefore, there is an inverse association between vitamin A supplementation and plasma and fecal IL-6 concentrations in many infection conditions.

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Imdad A, Mayo-Wilson E, Haykal MR, Regan A, Sidhu J, Smith A, Bhutta ZA. Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age. Cochrane Database Syst Rev 2022;3:CD008524. [PMID: 35294044 PMCID: PMC8925277 DOI: 10.1002/14651858.cd008524.pub4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]

Abstract

BACKGROUND

Vitamin A deficiency (VAD) is a major public health problem in low- and middle-income countries, affecting 190 million children under five years of age and leading to many adverse health consequences, including death. Based on prior evidence and a previous version of this review, the World Health Organization has continued to recommend vitamin A supplementation (VAS) for children aged 6 to 59 months. The last version of this review was published in 2017, and this is an updated version of that review.

OBJECTIVES

To assess the effects of vitamin A supplementation (VAS) for preventing morbidity and mortality in children aged six months to five years.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, six other databases, and two trials registers up to March 2021. We also checked reference lists and contacted relevant organisations and researchers to identify additional studies.

SELECTION CRITERIA

Randomised controlled trials (RCTs) and cluster-RCTs evaluating the effect of synthetic VAS in children aged six months to five years living in the community. We excluded studies involving children in hospital and children with disease or infection. We also excluded studies evaluating the effects of food fortification, consumption of vitamin A rich foods, or beta-carotene supplementation.

DATA COLLECTION AND ANALYSIS

For this update, two review authors independently assessed studies for inclusion resolving discrepancies by discussion. We performed meta-analyses for outcomes, including all-cause and cause-specific mortality, disease, vision, and side effects. We used the GRADE approach to assess the quality of the evidence.

MAIN RESULTS

The updated search identified no new RCTs. We identified 47 studies, involving approximately 1,223,856 children. Studies were set in 19 countries: 30 (63%) in Asia, 16 of these in India; 8 (17%) in Africa; 7 (15%) in Latin America, and 2 (4%) in Australia. About one-third of the studies were in urban/periurban settings, and half were in rural settings; the remaining studies did not clearly report settings. Most studies included equal numbers of girls and boys and lasted about one year. The mean age of the children was about 33 months. The included studies were at variable overall risk of bias; however, evidence for the primary outcome was at low risk of bias. A meta-analysis for all-cause mortality included 19 trials (1,202,382 children). At longest follow-up, there was a 12% observed reduction in the risk of all-cause mortality for VAS compared with control using a fixed-effect model (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.83 to 0.93; high-certainty evidence). Nine trials reported mortality due to diarrhoea and showed a 12% overall reduction for VAS (RR 0.88, 95% CI 0.79 to 0.98; 1,098,538 children; high-certainty evidence). There was no evidence of a difference for VAS on mortality due to measles (RR 0.88, 95% CI 0.69 to 1.11; 6 studies, 1,088,261 children; low-certainty evidence), respiratory disease (RR 0.98, 95% CI 0.86 to 1.12; 9 studies, 1,098,538 children; low-certainty evidence), and meningitis. VAS reduced the incidence of diarrhoea (RR 0.85, 95% CI 0.82 to 0.87; 15 studies, 77,946 children; low-certainty evidence), measles (RR 0.45, 95% CI 0.30 to 0.69; 2 studies, 1,982 children; low-certainty evidence), Bitot's spots (RR 0.42, 95% CI 0.33 to 0.53; 5 studies, 1,063,278 children; moderate-certainty evidence), night blindness (RR 0.32, 95% CI 0.21 to 0.50; 2 studies, 22,972 children; moderate-certainty evidence), and VAD (RR 0.71, 95% CI 0.65 to 0.78; 4 studies, 2262 children, moderate-certainty evidence). However, there was no evidence of a difference on incidence of respiratory disease (RR 0.99, 95% CI 0.92 to 1.06; 11 studies, 27,540 children; low-certainty evidence) or hospitalisations due to diarrhoea or pneumonia. There was an increased risk of vomiting within the first 48 hours of VAS (RR 1.97, 95% CI 1.44 to 2.69; 4 studies, 10,541 children; moderate-certainty evidence).

AUTHORS' CONCLUSIONS

This update identified no new eligible studies and the conclusions remain the same. VAS is associated with a clinically meaningful reduction in morbidity and mortality in children. Further placebo-controlled trials of VAS in children between six months and five years of age would not change the conclusions of this review, although studies that compare different doses and delivery mechanisms are needed. In populations with documented VAD, it would be unethical to conduct placebo-controlled trials.

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Hooper L, Esio-Bassey C, Brainard J, Fynn J, Jennings A, Jones N, Tailor BV, Abdelhamid A, Coe C, Esgunoglu L, Fallon C, Gyamfi E, Hill C, Howard Wilsher S, Narayanan N, Oladosu T, Parkinson E, Prentice E, Qurashi M, Read L, Getley H, Song F, Welch AA, Aggett P, Lietz G. Evidence to Underpin Vitamin A Requirements and Upper Limits in Children Aged 0 to 48 Months: A Scoping Review. Nutrients 2022;14:407. [PMID: 35276767 PMCID: PMC8840537 DOI: 10.3390/nu14030407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/31/2021] [Accepted: 01/10/2022] [Indexed: 02/04/2023] Open

Affiliation(s)

Lee Hooper Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Chizoba Esio-Bassey Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Julii Brainard Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Judith Fynn Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Amy Jennings Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Natalia Jones School of Environmental Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK;
Bhavesh V. Tailor Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Asmaa Abdelhamid Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Calvin Coe Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Latife Esgunoglu Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Ciara Fallon Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Ernestina Gyamfi Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Claire Hill Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Stephanie Howard Wilsher Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Nithin Narayanan Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Titilopemi Oladosu Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Ellice Parkinson School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK;
Emma Prentice Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Meysoon Qurashi Department of Medicine, Luton and Dunstable Hospital NHS Foundation Trust, Lewsey Road, Luton LU4 0DZ, UK;
Luke Read Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Harriet Getley Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Fujian Song Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Ailsa A. Welch Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
Peter Aggett Lancashire School of Postgraduate Medicine and Health, University of Central Lancashire, Preston PR1 2HE, UK;
Georg Lietz Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne NE2 4HH, UK;

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Hernáez Á, Lassale C, Castro-Barquero S, Babio N, Ros E, Castañer O, Tresserra-Rimbau A, Pintó X, Martínez-González MÁ, Corella D, Salas-Salvadó J, Alonso-Gómez ÁM, Lapetra J, Fiol M, Gómez-Gracia E, Serra-Majem L, Sacanella E, García-Arellano A, Sorlí JV, Díaz-López A, Cofán M, Estruch R. Mediterranean Diet and White Blood Cell Count-A Randomized Controlled Trial. Foods 2021;10:1268. [PMID: 34199545 PMCID: PMC8227102 DOI: 10.3390/foods10061268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 05/31/2021] [Indexed: 12/26/2022] Open

Affiliation(s)

Álvaro Hernáez August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.) Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Blanquerna School of Health Sciences, Universitat Ramon Llull, 08025 Barcelona, Spain Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, 0473 Oslo, Norway
Camille Lassale Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
Sara Castro-Barquero August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.) Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
Nancy Babio Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
Emilio Ros August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.) Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, 08036 Barcelona, Spain
Olga Castañer Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
Anna Tresserra-Rimbau Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
Xavier Pintó Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Lipids and Vascular Risk Unit, Internal Medicine Service, Hospital Universitario de Bellvitge, 08907 L’Hospitalet de Llobregat, Spain
Miguel Ángel Martínez-González Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
Dolores Corella Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Department of Preventive Medicine, Universidad de Valencia, 46010 Valencia, Spain
Jordi Salas-Salvadó Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
Ángel M. Alonso-Gómez Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
José Lapetra Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain
Miquel Fiol Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Health Research Institute of the Balearic Islands (IdISBa), Hospital Son Espases, 07120 Palma de Mallorca, Spain
Enrique Gómez-Gracia Department of Preventive Medicine and Public Health, Universidad de Málaga, 29071 Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
Lluis Serra-Majem Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas, Spain Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Servicio Canario de Salud, 35016 Las Palmas, Spain
Emilio Sacanella August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.) Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain
Ana García-Arellano Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain Servicio Navarro de Salud (Osasunbidea), 31003 Pamplona, Spain
José V. Sorlí Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Department of Preventive Medicine, Universidad de Valencia, 46010 Valencia, Spain
Andrés Díaz-López Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain Serra Hunter Fellow, Universitat Rovira i Virgili, 43201 Reus, Spain Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili, 43201 Reus, Spain
Montserrat Cofán August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.) Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, 08036 Barcelona, Spain
Ramón Estruch August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.) Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (N.B.); (O.C.); (A.T.-R.); (X.P.); (M.Á.M.-G.); (D.C.); (J.S.-S.); (Á.M.A.-G.); (J.L.); (M.F.); (L.S.-M.); (A.G.-A.); (J.V.S.); (A.D.-L.) Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain

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Sheftel J, Tanumihardjo SA. Systematic Review and Meta-Analysis of the Relative Dose-Response Tests to Assess Vitamin A Status. Adv Nutr 2021;12:904-941. [PMID: 33130884 PMCID: PMC8166547 DOI: 10.1093/advances/nmaa136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/18/2020] [Accepted: 09/22/2020] [Indexed: 12/20/2022] Open

Abstract

Vitamin A (VA) is an essential nutrient often lacking in the diets of people in developing countries. Accurate biomarkers of VA status are vital to inform public health policy and monitor interventions. The relative dose-response (RDR) and modified-RDR (MRDR) tests are semi-quantitative screening tests for VA deficiency that have been used in Demographic and Health Surveys and VA intervention studies. A systematic review and meta-analysis of sensitivity and specificity were conducted to summarize the physiological evidence to support the RDR tests as methods to assess VA status and investigate the impact of different pathological and physiological states on the tests. A total of 190 studies were screened for inclusion, with 21 studies comparing the RDR tests with the gold-standard biomarker, liver VA concentration (68% and 80% sensitivity and 85% and 69% specificity for the RDR and MRDR, respectively). Nearly all studies with VA interventions in VA-deficient populations demonstrated a response of the tests to VA intake that would be expected to improve VA status. The impacts of chronic liver disease, protein malnutrition, age, pregnancy and lactation, infection and inflammation, and various other conditions were examined in 51 studies. The RDR and MRDR tests were reported to have been used in 39 observational studies, and the MRDR has been used in at least 6 national micronutrient surveys. The RDR and MRDR are sensitive tests for determining population VA status and assessing VA interventions. Although they are robust to most physiological and pathological states, caution may be warranted when using the tests in neonates, individuals with chronic liver disease, and those with protein or iron malnutrition. Research on further improvements to the tests to increase accessibility, such as sampling breast milk instead of blood or using intramuscular doses in subjects with malabsorption, will allow wider adoption. This review was registered with PROSPERO as CRD42019124180.

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Tourkochristou E, Triantos C, Mouzaki A. The Influence of Nutritional Factors on Immunological Outcomes. Front Immunol 2021;12:665968. [PMID: 34135894 PMCID: PMC8201077 DOI: 10.3389/fimmu.2021.665968] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/05/2021] [Indexed: 12/19/2022] Open

Abstract

Through food intake, humans obtain a variety of nutrients that are essential for growth, cellular function, tissue development, energy, and immune defense. A special interaction between nutrients and gut-associated lymphoid tissue occurs in the intestinal tract. Enterocytes of the intestinal barrier act as sensors for antigens from nutrients and the intestinal microbiota, which they deliver to the underlying immune system of the lamina propria, triggering an immune response. Studies investigating the mechanism of influence of nutrition on immunological outcomes have highlighted an important role of macronutrients (proteins, carbohydrates, fatty acids) and micronutrients (vitamins, minerals, phytochemicals, antioxidants, probiotics) in modulating immune homeostasis. Nutrients exert their role in innate immunity and inflammation by regulating the expression of TLRs, pro- and anti-inflammatory cytokines, thus interfering with immune cell crosstalk and signaling. Chemical substrates derived from nutrient metabolism may act as cofactors or blockers of enzymatic activity, influencing molecular pathways and chemical reactions associated with microbial killing, inflammation, and oxidative stress. Immune cell function appears to be influenced by certain nutrients that form parts of the cell membrane structure and are involved in energy production and prevention of cytotoxicity. Nutrients also contribute to the initiation and regulation of adaptive immune responses by modulating B and T lymphocyte differentiation, proliferation and activation, and antibody production. The purpose of this review is to present the available data from the field of nutritional immunology to elucidate the complex and dynamic relationship between nutrients and the immune system, the delineation of which will lead to optimized nutritional regimens for disease prevention and patient care.

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Tanumihardjo SA. Biological evidence to define a vitamin A deficiency cutoff using total liver vitamin A reserves. Exp Biol Med (Maywood) 2021;246:1045-1053. [PMID: 33765844 PMCID: PMC8113730 DOI: 10.1177/1535370221992731] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open

Abstract

Vitamin A is a fat-soluble vitamin involved in essential functions including growth, immunity, reproduction, and vision. The vitamin A Dietary Reference Intakes (DRIs) for North Americans suggested that a minimally acceptable total liver vitamin A reserve (TLR) is 0.07 µmol/g, which is not explicitly expressed as a vitamin A deficiency cutoff. The Biomarkers of Nutrition for Development panel set the TLR cutoff for vitamin A deficiency at 0.1 µmol/g based on changes in biological response of several physiological parameters at or above this cutoff. The criteria used to formulate the DRIs include clinical ophthalmic signs of vitamin A deficiency, circulating plasma retinol concentrations, excretion of vitamin A metabolites in the bile, and long-term storage of vitamin A as protection against vitamin A deficiency during times of low dietary intake. This review examines the biological responses that occur as TLRs are depleted. In consideration of all of the DRI criteria, the review concludes that induced biliary excretion and long-term vitamin A storage do not occur until TLRs are >0.10 µmol/g. If long-term storage is to continue to be part of the DRI criteria, vitamin A deficiency should be set at a minimum cutoff of 0.10 µmol/g and should be set higher during times of enhanced requirements where TLRs can be rapidly depleted, such as during lactation or in areas with high infection burden. In population-based surveys, cutoffs are important when using biomarkers of micronutrient status to define the prevalence of deficiency and sufficiency to inform public health interventions. Considering the increasing use of quantitative biomarkers of vitamin A status that indirectly assess TLRs, i.e. the modified-relative-dose response and retinol-isotope dilution tests, setting a TLR as a vitamin A deficiency cutoff is important for users of these techniques to estimate vitamin A deficiency prevalence. Future researchers and policymakers may suggest that DRIs should be set with regard to optimal health and not merely to prevent a micronutrient deficiency.

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