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American Journal of Clinical Nutrition, Vol. 84, No. 6, 1344-1349, December 2006
© 2006 American Society for Nutrition


ORIGINAL RESEARCH COMMUNICATION

Evaluation of vitamin A supplementation regimens in Ghanaian postpartum mothers with the use of the modified-relative-dose-response test1,2,3,4

Samuel K Tchum, Sherry A Tanumihardjo, Samuel Newton, Bruno de Benoist, Seth Owusu-Agyei, Fareed KN Arthur and Antonia Tetteh

1 From the Kintampo Health Research Centre, Health Research Unit, Ghana Health Service, Accra, Ghana (SKT, SN, and SO-A); the Department of Nutritional Sciences, University of Wisconsin, Madison, WI (SAT); the Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland (BdB); and the Department of Biochemistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (FKNA and AT)

Background: Vitamin A deficiency is an important public health problem in many developing countries. Women of childbearing age and children are documented as the most affected groups.

Objective: The objective was to determine the length of time mothers are protected postpartum against vitamin A depletion after receiving either 400 000 IU vitamin A in 2 divided doses or 200 000 IU as a single dose plus a placebo 24 h apart.

Design: Mothers (n = 168) were recruited by trained fieldworkers 7–10 d after delivery. Modified-relative-dose-response (MRDR) tests were performed at baseline in 167 women, and vitamin A was administered within 6 wk after delivery. The women were randomly assigned to 2 main treatment groups, and each treatment group was divided into 3 follow-up subgroups. Each subgroup was invited back once at month 1, 3, or 5 for a second MRDR test.

Results: The serum retinol concentration and the MRDR value were 1.4 ± 0.5 µmol/L and 0.048 ± 0.037, respectively, at baseline. A significant improvement in vitamin A status occurred after vitamin A treatment as assessed by the MRDR test (P < 0.0001). Serum retinol concentrations were not different after vitamin A treatment (P = 0.87).

Conclusions: The mothers had marginally depleted liver reserves of vitamin A at baseline on the basis of MRDR test results. Liver reserves of vitamin A significantly improved in both treatment groups, and the improvement was maintained for ≥ 5 mo.

Key Words: Modified relative dose response • vitamin A • 3,4-didehydroretinol • lactation • vitamin A status




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