Small-Quantity Lipid-Based Nutrient Supplements Do Not Affect Plasma or Milk Retinol Concentrations Among Malawian Mothers, or Plasma Retinol Concentrations among Young Malawian or Ghanaian Children in Two Randomized Trials

Author:

Haskell Marjorie J12ORCID,Young Rebecca12,Adu-Afaruwah Seth3,Lartey Anna3ORCID,Okronipa Harriet Eyram Teiko123,Maleta Kenneth4,Ashorn Ulla5,Jorgensen Josh M12,Fan Yue-Mei5ORCID,Arnold Charles D12ORCID,Allen Lindsay H126,Ashorn Per57,Dewey Kathryn G12

Affiliation:

1. Institute for Global Nutrition, University of California, Davis, Davis, CA, USA

2. Department of Nutrition, University of California, Davis, Davis, CA, USA

3. Department of Nutrition and Food Science, University of Ghana, Accra, Ghana

4. Department of Public Health, Blantyre, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Malawi

5. Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland

6. USDA, ARS Western Human Nutrition Research Center, Davis, CA, USA

7. Department of Paediatrics, Tampere University Hospital, Tampere, Finland

Abstract

ABSTRACT Background Vitamin A (VA) deficiency is prevalent in preschool-aged children in sub-Saharan Africa. Objectives We assessed the effect of small-quantity lipid-based nutrient supplements (SQ-LNS) given to women during pregnancy and lactation and their children from 6 to 18 mo of age on women's plasma and milk retinol concentrations in Malawi, and children's plasma retinol concentration in Malawi and Ghana. Methods Pregnant women (≤20 wk of gestation) were randomized to receive daily: 1) iron and folic acid (IFA) during pregnancy only; 2) multiple micronutrients (MMN; 800 μg retinol equivalent (RE)/capsule), or 3) SQ-LNS (800 μg RE/20g) during pregnancy and the first 6 mo postpartum. Children of mothers in the SQ-LNS group received SQ-LNS (400 μg RE/20 g) from 6 to 18 mo of age; children of mothers in the IFA and MMN groups received no supplement. Plasma retinol was measured in mothers at ≤20 and 36 wk of gestation and 6 mo postpartum, and in children at 6 and 18 mo of age. Milk retinol was measured at 6 mo postpartum. VA status indicators were compared by group. Results Among Malawian mothers, geometric mean (95% CI) plasma retinol concentrations at 36 wk of gestation and 6 mo postpartum were 0.97 μmol/L (0.94, 1.01 μmol/L) and 1.35 μmol/L (1.31, 1.39 μmol/L), respectively; geometric mean (95% CI) milk retinol concentration at 6 mo postpartum was 1.04 μmol/L (0.97, 1.13 μmol/L); results did not differ by intervention group. Geometric mean (95% CI) plasma retinol concentrations for Malawian children at 6 and 18 mo of age were 0.78 μmol/L (0.75, 0.81 μmol/L) and 0.81 μmol/L (0.78, 0.85 μmol/L), respectively, and for Ghanaian children they were 0.85 μmol/L (0.82, 0.88 μmol/L) and 0.88 μmol/L (0.85, 0.91 μmol/L), respectively; results did not differ by intervention group in either setting. Conclusions SQ-LNS had no effect on VA status of mothers or children, possibly because of low responsiveness of the VA status indicators.

Funder

Bill & Melinda Gates Foundation

Publisher

Oxford University Press (OUP)

Subject

Nutrition and Dietetics,Medicine (miscellaneous)

Reference40 articles.

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2. University of Ghana, GroundWork, University of Wisconsin-Madison, KEMRI-Wellcome Trust, UNICEF. Ghana Micronutrient Survey,2017

3. Malawi Micronutrient Survey 2015–16;National Statistical Office (NSO), Community Health Sciences Unit (CHSU) [Malawi], Centers for Disease Control and Prevention (CDC), and Emory University,2017

4. National Micronutrient and Anthropometric Nutrition Survey, Somalia 2009;Food Security and Nutrition Analysis Unit.,2009

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