Efficacy of massive oral doses of retinyl palmitate and mango (Mangifera indicaL.) consumption to correct an existing vitamin A deficiency in Senegalese children

Abstract

Administration of large oral doses of retinyl palmitate has become the most widely practised vitamin A deficiency prevention strategy in developing countries. We conducted a follow-up study among 220 Senegalese children aged 2–7 years suffering from moderate undernutrition to determine the efficacy of vitamin A treatment on their vitamin A status assessed by biochemical and cytological (impression cytology with transfer) methods. The first examination (T= 0 m[onth]) was carried out during April 1989, before the mango (Mangifera indicaL,) harvest. The second examination (T= 2 m) was carried out 2 months after vitamin A treatment during June 1989 when ripe mangoes become widely available. Conjunctival cells of the eyes of the children with or without ocular inflammation were responsive to vitamin A administration (P< 0.01). There was a significant increase (P< 0.001) in mean serum retinol and β-carotene levels betweenT= 0 m andT= 2 m. Mean serum retinol-binding protein (RBP) and transthyretin (TTR) levels did not differ significantly (P> 0.05) atT= 0 m andT= 2 m. Despite the intake of vitamin A, 54% of the children who had abnormal cytology atT= 0 m remained abnormal atT= 2 m. This was due to inadequate levels of TTR and RBP, presumably due to the cereal diet eaten by the Senegalese population. Children with abnormal eye cytology had lower serum retinol levels than those with normal eyes atT= 0 m, and β-carotene values did not correlate with eye cytological abnormalities atT= 0 m. Children with normal cytology had higher serum retinol and also β-carotene levels than those with abnormal cytology after massive oral doses of vitamin A and consumption of mangoes atT= 2 m. Retinyl palmitate may, therefore, only lead to partial cytological improvement due to a lack of retinol-carrier proteins but dietary β-carotene may also be involved