Factors to consider in Micronesian food-based interventions: a case study of preventing vitamin A deficiency

BACKGROUND: Many factors need to be considered in a food-based intervention. Vitamin A deficiency and chronic diseases, such as diabetes, heart disease and cancer, have become serious problems in the Federated States of Micronesia (FSM) following the decreased production and consumption of locally grown foods. However, agricultural and social conditions are still favourable for local food production. AIM: To identify key factors to consider in a Micronesian food-based intervention focusing on increased production and consumption of four major Micronesian staple foods: banana, breadfruit, giant swamp taro and pandanus. METHODS: Ethnographic methods including key informant interviews and a literature review. RESULTS: Pacific and Micronesian values, concepts of food and disease, and food classifications differ sharply from Western concepts. There are few FSM professionals with nutrition expertise. Traditional foods and food cultivars vary in nutrient content, consumption level, cost, availability, status, convenience in growing, storing and cooking, and organoleptic factors. CONCLUSIONS: A systematic consideration of the factors that relate to a food-based intervention is critical to its success. The evaluation of which food and cultivar of that food that might be most effectively promoted is also critical. Regional differences, for example FSM inter-island differences between the staple foods and cultivars, must be considered carefully. The evaluation framework presented here may be relevant to Pacific Island and other countries with similar foods where food-based interventions are being planned. An ethnographic approach was found to be essential in understanding the cultural context and in data collection and analysis.     

Vitamin C,provitamin A carotenoids,and other carotenoids in high-pressurized orange juice during refrigerated storage

Vitamin C, provitamin A carotenoids, and other carotenoids were measured in freshly squeezed juices from oranges (Citrus sinensis L. var. Valencia late) that were subjected to high-pressure (HP) treatment. Also, the stability of these compounds was studied during refrigerated storage at 4 degrees C. HP treatment is an alternative to heat preservation methods for foods; therefore, it is essential to assess the impact of HP on bioactive compounds. Several processes that combine HP treatment with heat treatment for various time periods were assayed: T0, fresh juice (without treatment); T1, 100 MPa/60 degrees C/5 min; T2, 350 MPa/30 degrees C/2.5 min; T3, 400 MPa/40 degrees C/1 min. Fresh and treated samples were kept refrigerated (4 degrees C) over 10 days. After application of HP and during the refrigeration period, the qualitative and quantitative determination of vitamin C, provitamin A carotenoids (beta- and alpha-carotene; beta- and alpha-cryptoxanthin), and the xanthophylls zeaxanthin and lutein was achieved by high-performance liquid chromatography. T1 and T3 juices showed a decrease in ascorbic acid and total vitamin C just after HP treatment (D0) compared with T0 juices. On the contrary, T2 juices, just after HP treatment (D0), had the same levels of both compounds compared to untreated juices. T1, T2, and T3 treatments led to an increase in the extraction of carotenoids and provitamin A carotenoids. Total carotenoid content after the 10-day refrigerated storage period resulted in no significant quantitative changes in T1 juices, whereas in T2 and T3 juices small losses were found at the end of the storage period (20.56 and 9.16%, respectively). These losses could be influenced by the depleted protection of vitamin C toward carotenoid oxidation during the same period. A similar trend was found in provitamin A carotenoids for the different treated juices.     

Effect of high-pressure treatment on the carotenoid composition and the radical scavenging activity of persimmon fruit purees

The carotenoid composition of persimmon fruit purees of two cultivars, cvs. Rojo Brillante and Sharon, grown in Spain was determined by HPLC to assess the effects of high-pressure processing on some sensory (carotenoids), nutritional (provitamin A value), and health-related (radical-scavenging capacity) parameters. Total carotenoid content was higher in untreated Rojo Brillante puree (22. 11 microg g(-)(1)) than in untreated Sharon puree (15.22 microg g(-)(1)). Purees of both untreated cultivars showed similar carotenoid patterns after saponification with beta-cryptoxanthin, beta-carotene, and zeaxanthin as the main pigments. A high content of lycopene was quantified in Rojo Brillante (5.34 microg g(-)(1)), whereas only traces were detected in Sharon. The provitamin A value, reported as retinol equivalents (RE), was in untreated Rojo Brillante puree (77 RE/100 g) similar to that of Sharon (75 RE/100 g). Scavenging free radical capacity, measured as antiradical efficiency (AE), showed in untreated Rojo Brillante puree a value (12.14 x 10(-)(3)) 8.5 times higher than that in untreated Sharon (1. 42 x 10(-)(3)). Nonuniform behavior of high-pressure treatment was detected. Pressure treatments at 50 and 300 MPa/15 min/25 degrees C for Rojo Brillante and at 50 and 400 MPa/15 min/25 degrees C for Sharon increased the amount of extractable carotenoids (9-27%), which are related with the increase of vitamin A value (75-87 RE/100 g). No correlation with the increase of AE (from 1.42 x 10(-)(3) to 16.73 x 10(-)(3) and 19.58 x 10(-)(3)) after some pressure treatments (150 and 300 MPa/15 min/25 degrees C) was found.     

Carotenoids in white- and red-fleshed loquat fruits

Fruits of 23 loquat ( Eriobotrya japonica Lindl.) cultivars, of which 11 were white-fleshed and 12 red-fleshed, were analyzed for color, carotenoid content, and vitamin A values. Color differences between two loquat groups were observed in the peel as well as in the flesh. beta-Carotene and lutein were the major carotenoids in the peel, which accounted for about 60% of the total colored carotenoids in both red- and white-fleshed cultivars. beta-Cryptoxanthin and, in some red-fleshed cultivars, beta-carotene were the most abundant carotenoids in the flesh, and in total, they accounted for over half of the colored carotenoids. Neoxanthin, violaxanthin, luteoxanthin, 9- cis-violaxanthin, phytoene, phytofluene, and zeta-carotene were also identified, while zeaxanthin, alpha-carotene, and lycopene were undetectable. Xanthophylls were highly esterified. On average, 1.3- and 10.8-fold higher levels of colored carotenoids were observed in the peel and flesh tissue of red-fleshed cultivars, respectively. The percentage of beta-carotene among colored carotenoids was higher in both the peel and the flesh of red-fleshed cultivars. Correlations between the levels of total colored carotenoids and the color indices were analyzed. The a* and the ratio of a*/ b* were positively correlated with the total content of colored carotenoids, while L*, b*, and H degrees correlated negatively. Vitamin A values, as retinol equivalents (RE), of loquat flesh were 0.49 and 8.77 microg/g DW (8.46 and 136.41 microg/100 g FW) on average for white- and red-fleshed cultivars, respectively. The RE values for the red-fleshed fruits were higher than fruits such as mango, red watermelon, papaya, and orange as reported in the literature, suggesting that loquat is an excellent source of provitamin A.     

Identification and quantification of carotenoids, by HPLC-PDA-MS/MS, from Amazonian fruits

The major and minor carotenoids from six fruits, buriti (Mauritia vinifera), mamey (Mammea americana), marimari (Geoffrola striata), peach palm (Bactrys gasipaes), physalis (Physalis angulata), and tucuma (Astrocaryum aculeatum), all native to the Amazonia region, were determined by high-performance liquid chromatography-photodiode array detector-mass spectrometry detector (HPLC-PDA-MS/MS), fulfilling the recommended criteria for identification. A total of 60 different carotenoids were separated on a C30 column, all-trans-beta-carotene being the major carotenoid found in all fruits. The presence of apo-10'-beta-carotenol, found in mamey, was not previously reported in foods. In addition, this is the first time that the identification of beta-zeacarotene in natural sources is supported by MS data. The total carotenoid content ranged from 38 microg/g in marimari to 514 microg/g in buriti. All fruits analyzed can be considered good sources of provitamin A, especially buriti, with 7280 RE/100 g.     

Antioxidant profiling of native Andean potato tubers (Solanum tuberosum L.) reveals cultivars with high levels of beta-carotene, alpha-tocopherol, chlorogenic acid, and petanin

The antioxidant profile of 23 native Andean potato cultivars has been investigated from a human nutrition perspective. The main carotenoid and tocopherol compounds were studied using high-performance liquid chromatography coupled with a diode array detector (HPLC-DAD) and a fluorescence detector, respectively, whereas polyphenols (including anthocyanins in colored tubers) were identified by means of both HPLC-mass spectrometry and HPLC-DAD. Antioxidant profiling revealed significant genotypic variations as well as cultivars of particular interest from a nutritional point of view. Concentrations of the health-promoting carotenoids, lutein and zeaxanthin, ranged from 1.12 to 17.69 microg g(-1) of dry weight (DW) and from 0 to 17.7 microg g(-1) of DW, with cultivars 704353 and 702472 showing the highest levels in lutein and zeaxanthin, respectively. Whereas beta-carotene is rarely reported in potato tubers, remarkable levels of this dietary provitamin A carotenoid were detected in 16 native varieties, ranging from 0.42 to 2.19 microg g(-1) of DW. The amounts of alpha-tocopherol found in Andean potato tubers, extending from 2.73 to 20.80 microg g(-1) of DW, were clearly above the quantities generally reported for commercial varieties. Chlorogenic acid and its isomers dominated the polyphenolic profile of each cultivar. Dark purple-fleshed tubers from the cultivar 704429 contained exceptionally high levels of total anthocyanins (16.33 mg g(-1) of DW). The main anthocyanin was identified as petanin (petunidin-3-p-coumaroyl-rutinoside-5-glucoside). The results suggest that Andean potato cultivars should be exploited in screening and breeding programs for the development of potato varieties with enhanced health and nutritional benefits.     

Thermal degradation of antioxidant micronutrients in citrus juice: kinetics and newly formed compounds

The thermal degradation kinetics of vitamin C, two carotenoids (beta-carotene and beta-cryptoxanthin), and hesperidin, as a function of temperature, were determined for Citrus juice [Citrus sinensis (L.) Osbeck and Citrus clementina Hort. ex Tan]. The influence of dissolved oxygen on the rate of ascorbic acid degradation was also assessed. Analysis of kinetic data suggested a first-order reaction for the degradation of vitamin C and carotenoids. The kinetics parameters Dtheta, z, and Ea have been calculated. Following the Arrhenius relationship, the activation energy of ascorbic acid was 35.9 kJ mol-1 and agreed with the range of literature reported value. The results on vitamin C and carotenoids from citrus juice made it possible to validate the predicting model. Thermal degradation of carotenoids revealed differences in stability among the main provitamin A carotenoids and between these and other carotenoids belonging to the xanthophyll family. The activation energies for the two provitamin A carotenoids were 110 and 156 kJ mol-1 for beta-carotene and beta-cryptoxanthin, respectively. On the other hand, no degradation of hesperidin was observed during thermal treatment. Finally, the vitamin C in citrus juice was not as heat sensitive as expected and the main provitamin A carotenoids present in citrus juice displayed a relative heat stability. The high-performance liquid chromatography-diode array detection-mass spectrometry analysis of degradation products showed that the isomerization of the epoxide function in position 5,6 into a furanoxide function in position 5,8 was a common reaction for several xanthophylls. These findings will help determine optimal processing conditions for minimizing the degradation of important quality factors such as vitamin C and carotenoid in citrus juice.     

Carotenoids from new apricot (Prunus armeniaca L.) varieties and their relationship with flesh and skin color

Thirty-seven apricot varieties, including four new releases (Rojo Pasión, Murciana, Selene, and Dorada) obtained from different crosses between apricot varieties and three traditional Spanish cultivars (Currot, Mauricio, and Búlida), were separated according to flesh color into four groups. The L*, a*, b*, hue angle, and chroma color measurements on the skin and flesh as well as other quality indices including flesh firmness, soluble solids, titratable acidity, and pH were plotted against the total carotenoid content measured by HPLC. Among the 37 apricot varieties, the total carotenoid content ranged from 1,512 to 16,500 microg 100 g(-1) of edible portion, with beta-carotene as the main pigment followed by beta-cryptoxanthin and gamma-carotene. The wide range of variability in the provitamin A content in the apricot varieties encouraged these studies in order to select the breeding types with enhanced carotenoid levels as the varieties with a higher potential health benefit. The carotenoid content was correlated with the color measurements, and the hue angle in both flesh and peel was the parameter with the best correlation (R = 0.92 and 0.84, respectively). An estimation of the carotenoid content in apricots could be achieved by using a portable colorimeter, as a simple and easy method for field usage applications.     

Collection and characterization of yellow endosperm sorghums from West Africa for biofortification

Sorghum is a good candidate crop for breeding to increase provitamin A, i.e., biofortification. Yellow endosperm sorghums contain carotenoids, including precursors of vitamin A, and sorghum is a major staple crop in areas of Asia and Africa where vitamin A deficiency is prevalent. Our objective was to collect and characterize yellow endosperm sorghums as a potential new source of genetic diversity to increase provitamin A content. A set of 164 landraces were collected from southern Niger and northern Nigeria. The most important use of these cultivars was as food. The endosperm exhibited a significant variation in yellow intensity. Lutein, zeaxanthin and β-carotene were the most abundant carotenoids in the ten landraces with the most intense yellow color. Cluster analysis, principal coordinate analysis and population differentiation test revealed that this set of 164 landraces represent a new genetic pool that might increase the genetic diversity of yellow endosperm sorghums in applied breeding programs.     

Vitamin A status in Cuban children aged 6-11 years

OBJECTIVE AND SETTING: A nationwide study was performed in Cuba to assess vitamin A status and the intake of vitamin-A-providing foods in children aged 6-11 years. DESIGN AND SUBJECTS: The sample comprised 1191 schoolchildren from first to sixth grade, both sexes, from municipalities randomly selected from the five eastern provinces of Cuba in 2002 (first semester) and from the four western and four central provinces in 2003 (first semester). A food-frequency questionnaire was completed by 2038 mother-and-child pairs. RESULTS: Mean (+/-standard deviation) plasma retinol concentrations were 1.77 +/- 0.48 micromol l-1 in the western, 2.01 +/- 0.56 micromol l-1 in the central and 1.40 +/- 0.41 micromol l-1 in the eastern region. No child had plasma retinol concentration below 0.35 micromol l-1, indicative of a high risk of clinical deficiency. Subclinical deficiency, plasma retinol concentration of 0.35-0.7 micromol l-1, was seen in 1.05 micromol l-1) was present in >90% of subjects in all western and central provinces, and in one of the eastern provinces (Holguín), whereas in the four remaining eastern provinces, adequate status was present in >75%. Only nine fruits and vegetables were consumed frequently (>3 times per week) by >50% of children. Thirty-seven per cent regularly consumed a supplement containing vitamin A. CONCLUSIONS: Most Cuban children aged 6-11 years had adequate vitamin A status. Consumption of foods rich in vitamin and provitamin A, especially vegetables, was frequent but limited to a small variety of foods.     

Assessment of carotenoid bioavailability of whole foods using a Caco-2 cell culture model coupled with an in vitro digestion

Epidemiological studies have shown that consumption of carotenoid-rich fruits and vegetables is associated with a reduced risk of developing chronic diseases. beta-Carotene, alpha-carotene, and beta-cryptoxanthin are precursors of vitamin A, a nutrient essential for human health. However, little is known about the bioavailability of carotenoids from whole foods. This study characterized the intestinal uptake performance of carotenoids using monolayers of differentiated Caco-2 human intestinal cells and mimicked human digestion to assess carotenoid absorption from carrots and corn. Results showed that Caco-2 cellular uptake of beta-carotene and zeaxanthin was higher than that of lutein. Uptake performances of pure carotenoids and carotenoids from whole foods by Caco-2 cells were both curvilinear, reaching saturated levels after 4 h of incubation. The time kinetics and dose response of carotenoid uptake presented a similar pattern in Caco-2 cells after plating for 2 and 14 days. Furthermore, the applicability of this new model was verified with whole grain corn, showing that cooked corn grain significantly enhanced carotenoid bioavailability. These results support the feasibility of the in vitro digestion cell model for assessing carotenoid absorption from whole foods as a suitable and cost-effective physiological alternative to current methodologies.     

Vitamin A deficiency and child mortality in Mozambique

BACKGROUND: In areas where vitamin A deficiency (VAD) is prevalent, vitamin A repletion reduces child mortality by 23% on average. OBJECTIVES: To estimate the potential child survival benefits of policies and programmes aimed at controlling VAD in Mozambique, and to make policy and programme recommendations. METHODS: The potential contribution of VAD to child mortality in Mozambique was estimated by combining the observed VAD prevalence in the under-5s (71.2%), the measured child mortality effects of VAD (risk of death in children with VAD=1.75 times higher than in children without VAD) and the observed under-5 mortality rate in the country (210 per 1000 live births). RESULTS: In Mozambique, an estimated 2.3 million children below the age of 5 years are vitamin-A-deficient. In the absence of appropriate policy and programme action, VAD will be the attributable cause of over 30,000 deaths annually in the under-5s. This represents 34.8% of all-cause mortality in this age group. DISCUSSION: Vitamin A supplementation (VAS) has been adopted as a short- to medium-term strategy to control VAD in children, and is integrated into routine child health services. However, the last VAS coverage survey showed that only 46% of children received a vitamin A supplement in the 6 months preceding the survey. If VAS coverage is to increase significantly in the foreseeable future, four areas appear to be of paramount importance: (1) reduce missed opportunities for VAS such as visits of sick children to child health services and community outreach activities; (2) take advantage of all potential opportunities for accelerating VAS coverage, such as additional vaccination campaigns and emergency response activities; (3) strengthen health workers' training, supervision and monitoring skills; and (4) increase community demand for VAS of children. Biannual VAS, as the primary component of an integrated strategy for VAD control in children, has the promise to be among the most cost-effective/high-impact child survival interventions in Mozambique.     

Vitamin A status among children in China

OBJECTIVE: The objective of this study was to assess the prevalence of vitamin A deficiency (VAD) in children under 6 years old in China and to identify risk groups for VAD. DESIGN: A cross-sectional survey was conducted in 14 provinces from coastal, inland and western geographic areas in China. SETTING: One city (urban) and two counties (rural) were randomly selected from each province as survey areas. SUBJECTS: About 200 children aged 0-6 years were randomly selected in each survey area. A blood sample was collected from each child. Data on sociodemographics and nutrition were obtained by interview of the mother or principal caregiver. Fluorescence microanalysis was used to analyse serum retinol concentration. RESULTS: VAD (serum retinol <0.7 micro mol l(-1)) was observed in 957 out of 7,826 children aged 0-6 years (12.2% of the entire study population), whereas severe VAD (serum retinol <0.35 micro mol l(-1)) was found in 39 children (0.5%). The highest prevalences of VAD at >1 year of age were observed among children of mothers with minority ethnicity (22.7%) or poor education (19.8%) and in the poor western area (17.4%). CONCLUSIONS: VAD is a nutritional problem in children in China. Children living in the poor western area, having a mother with minority ethnicity or a mother with poor education have a high risk of VAD.     

Evaluation of analytical methods for carotenoid extraction from biofortified maize (Zea mays sp.)

Biofortification of maize with beta-carotene has the potential to improve vitamin A status in vitamin A deficient populations where maize is a staple crop. Accurate assessment of provitamin A carotenoids in maize must be performed to direct breeding efforts. The objective was to evaluate carotenoid extraction methods and determine essential steps for use in countries growing biofortified maize. The most reproducible method based on coefficient of variation and extraction efficiency was a modification of Kurilich and Juvik (1999). Heat and saponification are required to release carotenoids from biofortified maize and remove oils interfering with chromatographic analysis. For maize samples with high oil content, additional base may be added to ensure complete saponification without compromising results. Degradation of internal standard before carotenoids were released from the maize matrix required the addition of internal standard after heating to prevent overestimation of carotenoids. This modified method works well for lutein, zeaxanthin, beta-cryptoxanthin, alpha-carotene, and beta-carotene.     

Identification of zeinoxanthin in orange juices

The monohydroxycarotenoid fraction of orange juice has been isolated by TLC and studied to determine whether the carotenoid accompanying beta-cryptoxanthin was alpha-cryptoxanthin or zeinoxanthin. The provitamin A carotenoid alpha-cryptoxanthin has been widely reported in orange juice, although its identification has been carried out mainly on the basis of its spectral features, which are virtually identical with those of its non-provitamin A isomer, zeinoxanthin. As a result of a study of the UV-vis and mass spectra of the monohydroxycarotenoid fraction and of the methylation test, it was concluded that the carotenoid accompanying beta-cryptoxanthin was the non-provitamin A carotenoid zeinoxanthin.     

Sampling strategies and variability in fruit pulp micronutrient contents of west and central african bananas and plantains (Musa species)

The variability in fruit micronutrient contents in a selection of Central and West African Musa varieties cultivated under standardized field conditions was studied. Analysis of the within-fruit, within-hand, and within-plant as well as the between-plant variations demonstrated that both provitamin A carotenoids (pVACs) and mineral micronutrient (Fe, Zn) contents vary significantly across all sample groups. The variations in pVACs contents appear to be at least partly related to differences in the developmental status of the fruit, but the observed trends were genotype-specific. The mean pVACs concentrations per genotype indicated that there is substantial genetic variation in the fruit pVACs contents between Musa cultivars, with orange-fleshed plantain varieties (AAB) having generally higher fruit pVACs contents than dessert bananas (AAA). It was not possible to identify consistent trends between the sampling position and fruit Fe/Zn contents. Once the within-bunch micronutrient variability has been accounted for, the mean variations in fruit micronutrient contents between individual plants of a variety generally fell to within acceptable limits. Results are discussed within the framework of standardizing sampling and developing strategies to screen for the nutritional values of new and existing Musa varieties.     

Simultaneous extraction and quantitation of carotenoids, chlorophylls, and tocopherols in Brassica vegetables

Brassica oleracea vegetables, such as broccoli (B. oleracea L. var. italica) and cauliflower (B. oleracea L. var. botrytis), are known to contain bioactive compounds associated with health, including three classes of photosynthetic lipid-soluble compounds: carotenoids, chlorophylls, and tocopherols. Carotenoids and chlorophylls are photosynthetic pigments. Tocopherols have vitamin E activity. Due to genetic and environmental variables, the amounts present in vegetables are not constant. To aid breeders in the development of Brassica cultivars with higher provitamin A and vitamin E contents and antioxidant activity, a more efficient method was developed to quantitate carotenoids, chlorophylls, and tocopherols in the edible portions of broccoli and cauliflower. The novel UPLC method separated five carotenoids, two chlorophylls, and two tocopherols in a single 30 min run, reducing the run time by half compared to previously published protocols. The objective of the study was to develop a faster, more effective extraction and quantitation methodology to screen large populations of Brassica germplasm, thus aiding breeders in producing superior vegetables with enhanced phytonutrient profiles.     

Carotenoid biosynthesis changes in five red pepper (Capsicum annuum L.) cultivars during ripening. Cultivar selection for breeding

Changes in the biosynthesis of individual carotenoid pigments have been investigated during fruit ripening of five cultivars of red pepper (Capsicum annuum L.): Mana, Numex, Belrubi, Delfin, and Negral (a chlorophyll-retaining mutant when ripe). The study was carried out throughout the ripening process, and with special emphasis on the ripe stage, to discover possible differences between cultivars and to characterize these by their carotenoid pattern and content for selecting the best varieties for breeding programs. Ripening fruit of the five cultivars showed the typical and characteristic pattern of carotenoid biosynthesis for the Capsicum genus. In the five cultivars, lutein and neoxanthin, both characteristic chloroplast pigments, decreased in concentration with ripening and eventually disappeared. beta-Carotene, antheraxanthin, and violaxanthin increased in concentration, and other pigments were biosynthesized de novo: zeaxanthin, beta-cryptoxanthin, capsanthin, capsorubin, capsanthin-5,6-epoxide, and cucurbitaxanthin A. A pool of zeaxanthin stands out of the rest of pigment during ripening, which reveals the importance of this pigment as a branching point in the carotenoid biosynthesis in Capsicum. Quantitatively, Negral cultivar showed the highest increase in total carotenoid content (48. 39-fold), followed by Mana and Delfin with 38.03- and 36.8-fold, respectively, and by Belrubi and Numex with 28.03- and 23.48-fold, respectively. In all the red varieties, there was an inverse relationship between total carotenoid content and the red to yellow isochromic pigment fraction ratio (R/Y) and the capsanthin-to-zeaxanthin ratio (Caps/Zeax). This seems to be related to the carotenogenic capacity of the cultivar, and thus selection and breeding should not only seek a higher total carotenoid content but also attempt to increase these ratios. In the present study, the cultivar Mana had the highest total carotenoid content (13 208 mg/kg dwt), but the lowest R/Y (1.25) and Caps/Zeax (3.38) ratios, which are therefore the parameters to improve. The cultivar Negral had a high carotenoid content (8797 mg/kg dwt) and high R/Y and Caps/Zeax ratios and could be used for transfer of these characters in direct crosses with the cultivar Mana. The cultivar Numex had the highest Caps/Zeax ratio (7.17) and is thus an ideal progenitor for this character.     

Unique patterns of dietary adequacy in three cultures of Canadian Arctic indigenous peoples

BACKGROUND: Information is needed on dietary adequacy of Arctic indigenous populations in Canada. Extensive work has been completed on composition of Arctic food and food use, and dietary reference intakes are available. OBJECTIVE: To complete the first comprehensive dietary adequacy assessment of three populations of adult Arctic indigenous people. SETTING AND SUBJECTS: Dietary assessment interviews were conducted with randomly selected indigenous adults during two seasons in 44 representative communities of Yukon First Nations (n = 797), Dene/Métis, (n = 1007) and Inuit (n = 1525). METHODS: Twenty-four-hour recalls were used to derive adjusted distributions of usual nutrient intakes in four age/gender groups for assessment of dietary adequacy for carbohydrate, dietary fibre, protein, n-3 fatty acids, n-6 fatty acids, calcium, copper, iron, magnesium, manganese, phosphorus, selenium, zinc, vitamin A, riboflavin, folate, vitamin B6, vitamin C, vitamin D and vitamin E. RESULTS: Nutrients with high prevalence of adequacy for most age/gender groups in all three cultures were protein, carbohydrate, n-3 fatty acids, iron, copper, zinc, manganese, selenium, riboflavin and vitamin B6; some individuals exceeded the upper intake level for iron, zinc, selenium, vitamin A and vitamin D. Estimated average requirement nutrients of concern for adequacy were magnesium, folate, vitamin A, vitamin C and vitamin E; however, a few age/gender groups were exceptions. Prevalence of inadequacy for AI nutrients which may be undesirably high were fibre, n-6 fatty acids and calcium. Vitamin D was more adequate in Inuit women and men than for Yukon First Nations or Dene/Métis. CONCLUSIONS: Unique patterns of dietary adequacy exist among Arctic indigenous peoples. Local wildlife food sources and market food sources should be maximised for their nutrient contributions to Arctic diets.     

Full-term, peri-urban South African infants under 6 months of age are at risk for early-onset anaemia

OBJECTIVE: There is a paucity of data on the micronutrient status of low-income, lactating South African women and their infants under 6 months of age. The aim of this study was to elucidate the level of anaemia and vitamin A deficiency (VAD) in peri-urban breast-feeding women and their young infants. DESIGN: Cross-sectional study including anthropometric, biochemical and infant feeding data.Setting: Peri-urban settlement in Cape Town, South Africa. SUBJECTS: Breast-feeding women (n=113) and their infants (aged 1-6 months) attending a peri-urban clinic. RESULTS: Mean (standard deviation (SD)) haemoglobin (Hb) of the lactating mothers was 12.4 (1.3) g dl(-1), with 32% found to be anaemic (Hb<12 g dl(-1)). Maternal serum retinol was 49.8 (SD 13.3) microg dl(-1), with 4.5% VAD. Using breast milk, mean (SD) retinol concentration was found to be 70.6 (24.6) microg dl(-1) and 15.7 (8.3) microg/g milk fat, with 13% below the cut-off level of <8 microg/g fat. There was no correlation found between breast milk retinol and infant serum retinol. Z-scores (SD) of height-for-age, weight-for-age and weight-for-height were -0.69 (0.81), 0.89 (1.01) and 1.78 (0.83), respectively. Mean (SD) infant Hb was 10.9 (1.1) g dl(-1), with the prevalence of anaemia being 50%, 33% and 12% using Hb cut-offs below 11 g dl(-1), 10.5 g dl(-1) and 9.5 g dl(-1), respectively. Mean (SD) infant serum retinol was 26.9 (7.2) microg dl(-1), with 10% being VAD. None of the infants was exclusively breast-fed, 22% were predominantly breast-fed and 78% received complementary (mixed) breast-feeding. Thirty-two per cent of infants received weaning foods at an exceptionally young age (< or =1 month old). CONCLUSION: A high rate of anaemia is present in lactating women residing in resource-poor settings. Moreover, their seemingly healthy infants under 6 months of age are at an elevated risk of developing early-onset anaemia and at lower risk of VAD.