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April 2001, Volume 55, Number 4, Pages 252-259
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Original Communication
Circulating levels of retinol, tocopherol and carotenoid in Nepali pregnant and postpartum women following long-term bold beta-carotene and vitamin A supplementation
S Yamini1, K P West Jr1, L Wu1, M L Dreyfuss1, D-X Yang1 and S K Khatry2

1Center for Human Nutrition, Department of International Health and the Sight and Life Institute, The Johns Hopkins School of Public Health, Baltimore, Maryland, USA

2National Society for the Prevention of Blindness, Kathmandu, Nepal

Correspondence to: K P West Jr, Division of Human Nutrition, Room 2041, Department of International Health, Johns Hopkins School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA. E-mail: kwest@jhsph.edu

Guarantor: KP West Jr.

Contributors: SY oversaw the laboratory analysis of serum retinol, carotenoid and tocopherol concentrations and wrote the manuscript; KPW served as principal investigator of the intervention trial and assisted in writing the manuscript; LW performed statistical analyses of the data, including derivation of multivariate modeling; MLD served as field scientist overseeing the conduct of the substudy of the trial, including the collection, handling and transport of specimens and other aspects of data collection; DXY carried out the laboratory analyses and helped interpret biochemical data; and SKK served as senior clinician for the substudy.

Abstract

Objective: To characterize circulating carotenoid and tocopherol levels in Nepali women during pregnancy and post-partum and to determine the effects of beta-carotene and vitamin A supplementation on their concentration in serum.

Design: Randomized community supplementation trial.

Setting: The study was carried out from 1994 to 1997 in the Southern, rural plains District of Sarlahi, Nepal.

Subjects: A total of 1431 married women had an ascertained pregnancy, of whom 1186 (83%) provided an analyzable serum sample during pregnancy; 1098 (77%) provided an analyzable 3-4 months post-partum serum sample.

Interventions: Women received a weekly dose of vitamin A (7000 mug RE), beta-carotene (42 mg) or placebo before, during and after pregnancy. Serum was analyzed for retinol, alpha-tocopherol, gamma-tocopherol, beta-carotene, alpha-carotene, lycopene, lutein+zeaxanthin, and beta-cryptoxanthin concentrations during mid-pregnancy and at ~3 months post-partum.

Results: Compared to placebo, serum retinol, beta-carotene, gamma-tocopherol, beta-cryptoxanthin and lutein+zeaxanthin concentrations were higher among beta-carotene recipients during pregnancy and, except for beta-cryptoxanthin, at postpartum. In the vitamin A group, serum retinol and beta-cryptoxanthin were higher during pregnancy, and retinol and gamma-tocopherol higher at postpartum. Lutein+zeaxanthin was the dominant carotenoid, regardless of treatment group, followed by serum beta-carotene. Serum lycopene level was lowest, and very low compared to the US population. Serum retinol was higher, and carotenoid and alpha-tocopherol lower, at postpartum than during pregnancy in all groups.

Conclusions: Pregnant and lactating Nepali women have lower serum carotenoid and tocopherol levels than well-nourished populations. beta-carotene supplementation appeared to increase levels of tocopherol and other carotenoids in this population.

Sponsorship: This study was carried out under Cooperative Agreement no DAN 0045-A-5094 and HRN A-00-97-00015-00 between the Office of Health and Nutrition, US Agency for International Development (USAID), Washington, DC and the Center for Human Nutrition, Johns Hopkins School of Public Health, Baltimore, MD, with additional support from Task Force Sight and Life, Basle, Switzerland, NIH grant no RR04060, and the Bill and Melinda Gates Foundation, Seattle, WA. The study was a joint undertaking between the Center for Human Nutrition and the National Society for the Prevention of Blindness, Kathmandu, Nepal.

European Journal of Clinical Nutrition (2001) 55, 252-259

Keywords

supplements; beta-carotene; vitamin A; Nepali women

Received 2 May 2000; revised 2 November 2000; accepted 6 November 2000
April 2001, Volume 55, Number 4, Pages 252-259
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