RESUMO
Vitamin E is an important nutrient from the earliest stages of life. It plays key roles as an antioxidant and in the maintenance of the immune system, among others. Vitamin E deficiency (VED), which occurs more frequently in children, is rarely addressed in the literature. This narrative review aims to summarise the chemistry, biology, serum indicators and clinical trials that have evaluated the impact of fortification and other relevant aspects of vitamin E, in addition to the prevalence of its deficiency, in children worldwide. Vitamin E intake in recommended amounts is essential for this nutrient to perform its functions in the body. Serum α-tocopherol is the most widely used biochemical indicator to assess the prevalence of VED. VED has been associated with symptoms secondary to fat malabsorption and may lead to peripheral neuropathy and increased erythrocyte haemolysis. Reduced concentrations of α-tocopherol may be caused by the combination of diets with low amounts of vitamin E and inadequate consumption of fats, proteins and calories. The lowest prevalence of VED was found in Asia and the highest in North America and Brazil. High proportions of VED provide evidence that this nutritional deficiency is a public health problem in children and still little addressed in the international scientific literature. The planning, evaluation and implementation of health policies aimed at combatting VED in the paediatric population are extremely important.
Assuntos
Desnutrição , Deficiência de Vitamina E , Criança , Humanos , alfa-Tocoferol , Alimentos Fortificados , Deficiência de Vitamina E/complicações , Deficiência de Vitamina E/epidemiologia , Estado NutricionalRESUMO
Multiple micronutrient powder supplementation is a health promotion strategy, but data on its effectiveness regarding vitamin E are rare. The objective was to evaluate the impact of home fortification with powdered micronutrients on α-tocopherol concentrations, growth, and inflammation in Brazilian children aged 6-15 months. This is a pragmatic, controlled clinical trial, in which the intervention group received micronutrient powder sachets for up to 3 months. Vitamin E deficiency was considered when α-tocopherol was less than 11.6 µmol/L. The Poisson regression model was used to estimate adjusted values for prevalence ratios (PR) for the outcome variable. A total of 224 children participated in the study. The intervention group had a higher median α-tocopherol level (17.2 versus 3.6 µmol/L; p < 0.001) and an 82.0% reduction in the prevalence of vitamin deficiency (PR = 0.18; 95% CI 0.11-0.30) when compared with the control group. Consumption of multiple micronutrients in powder increases serum α-tocopherol concentrations, promotes better linear growth, and reduces morbidity in children.
Assuntos
Suplementos Nutricionais , Micronutrientes , Deficiência de Vitamina E/tratamento farmacológico , alfa-Tocoferol/sangue , Tamanho Corporal , Brasil , Promoção da Saúde , Humanos , Lactente , Micronutrientes/administração & dosagem , Micronutrientes/uso terapêutico , Pós , Prevalência , Deficiência de Vitamina E/sangue , Deficiência de Vitamina E/epidemiologiaRESUMO
OBJECTIVE: To investigate the correlation of serum vitamin A, D, and E levels with a recurrent respiratory infection (RRI) in children. PATIENTS AND METHODS: The medical records of 422 children with RRI (a study group) in Cangzhou Central Hospital from January 2015 to December 2018 were retrospectively analyzed (the study group was divided into an active group and a stable group). Further 100 healthy children who underwent physical examination at the same time were enrolled as a control group. High-performance liquid chromatography (HPLC) was used to determine vitamin A, D, and E levels, so as to analyze their differences between the groups. RESULTS: Vitamin A, D, and E in the active and stable groups were significantly lower than those in the control group (p < 0.001); in the active group they were significantly lower than those in the stable group (p < 0.001). According to partial correlation analysis, in children with active RRI, vitamin A was respectively positively correlated with vitamin D (r=0.945, p < 0.001), and vitamin E (r=0.988, p < 0.001). Moreover, vitamin E was positively correlated with vitamin D (r=0.959, p < 0.001). CONCLUSIONS: The deficiency of vitamin A, D, and E is positively correlated with the disease activity of children with RRI. Therefore, the supplement of vitamin A, D, and E through dietary adjustment is beneficial to the rehabilitation of the children.
Assuntos
25-Hidroxivitamina D 2/sangue , Infecções Respiratórias/sangue , Vitamina A/sangue , Vitamina E/sangue , Estudos de Casos e Controles , Pré-Escolar , China/epidemiologia , Cromatografia Líquida de Alta Pressão , Feminino , Humanos , Lactente , Masculino , Recidiva , Infecções Respiratórias/epidemiologia , Estudos Retrospectivos , Deficiência de Vitamina A/sangue , Deficiência de Vitamina A/epidemiologia , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina E/sangue , Deficiência de Vitamina E/epidemiologiaRESUMO
BACKGROUND: fat-soluble vitamin deficiency may be a health problem not recognized in children and adolescents. OBJECTIVE: to estimate the prevalence and factors associated with the deficiency of vitamins A, D and E among adolescent students from Northeastern Brazil. METHODS: transversal study with adolescents aged 12 to 19 of both genders. A questionnaire to collect socioeconomic and lifestyle data and food intake was applied to adolescents. Then, an anthropometric evaluation and a blood sampling were performed to analyze serum concentrations of retinol, ß-carotene, α-tocopherol and 25-hydroxy vitamin D (25[OH]D). RESULTS: the intake of vitamins A (50.3%), E (94.0%) and D (99.8%), as well as α-tocopherol (88.1%), ß-carotene (74.1%), 25(OH)D (50.9%) and retinol (46.6%) serum levels were mostly deficient/insufficient. An increased risk of α-tocopherol deficiency was observed in girls (PR = 1.11) and an increased risk of 25(OH)D deficiency was observed in boys (PR = 1.41). An increased likelihood of ß-carotene (PR = 1.14) and 25(OH) D (PR = 1.38) insufficiency was observed in overweight individuals. CONCLUSIONS: the adolescents had a deficit in the intake and in serum levels of fat-soluble vitamins. The greatest risk of inadequacy was associated with gender and weight excess. However, the behavior of fat-soluble vitamins in adolescents needs further research.
Assuntos
Deficiência de Vitaminas/epidemiologia , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Brasil/epidemiologia , Criança , Estudos Transversais , Dieta , Feminino , Humanos , Estilo de Vida , Masculino , Sobrepeso/epidemiologia , Prevalência , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Deficiência de Vitamina A/epidemiologia , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina E/epidemiologia , Adulto JovemRESUMO
Background: Few studies have previously assessed how pre-existing vitamin E status is associated with risk of tuberculosis (TB) disease progression. Objective: We evaluated the association between baseline plasma concentrations of 3 vitamin E isomers (α-tocopherol, γ-tocopherol, and δ-tocopherol) and TB disease risk. Methods: We conducted a case-control study nested within a longitudinal cohort of household contacts (HHCs) of pulmonary TB cases in Lima, Peru. We defined cases as HHCs who developed active TB disease ≥15 d after the diagnosis of the index patient, and we matched each case to 4 control cases who did not develop active TB based on age by year and gender. We used univariate and multivariate conditional logistic regression to calculate ORs for incident TB disease by plasma concentrations of α-tocopherol, γ-tocopherol, and δ-tocopherol. Results: Among 6751 HIV-negative HHCs who provided baseline blood samples, 180 developed secondary TB during follow-up. After controlling for possible confounders, we found that baseline α-tocopherol deficiency conferred increased risk of incident TB disease (adjusted OR: 1.59; 95% CI: 1.02, 2.50; P = 0.04). Household contacts in the lowest tertile of δ-tocopherol were also at increased risk of progression to TB disease compared to those in the highest tertile (tertile 1 compared with tertile 3, adjusted OR: 2.29; 95% CI: 1.29, 4.09; P-trend = 0.005). We found no association between baseline concentration of γ-tocopherol and incident TB disease. Conclusions: Vitamin E deficiency was associated with an increased risk of progression to TB disease among HHCs of index TB cases. Assessment of vitamin E status among individuals at high risk for TB disease may play a role in TB control efforts.
Assuntos
Tuberculose Pulmonar/sangue , Tuberculose Pulmonar/epidemiologia , Deficiência de Vitamina E/epidemiologia , Vitamina E/sangue , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Progressão da Doença , Características da Família , Feminino , Humanos , Incidência , Modelos Logísticos , Masculino , Peru/epidemiologia , Fatores de Risco , Fatores Socioeconômicos , Vitamina E/administração & dosagem , Deficiência de Vitamina E/sangue , Adulto JovemRESUMO
BACKGROUND: Maternal supplementation with vitamin A is one of the strategies for controlling its deficiency in the mother-child dyad, although studies with animals showed that supplementation with high doses of vitamin A reduces the levels of α-tocopherol (vitamin E) in the mother's serum and milk. The objective of the present study was to assess the influence of maternal supplementation with vitamin A on the concentration of retinol and α-tocopherol in human milk. METHODS: Healthy puerperal women were randomly distributed into a control group (n = 44) and a supplemented group (n = 44). Blood and colostrum samples were collected after delivery, and mature milk samples were collected 30 days later. The supplemented group received 200 000 IU of retinyl palmitate after the first colostrum collection. The retinol and α-tocopherol levels in the samples were determined by high-performance liquid chromatography. RESULTS: The mean (SD) retinol and α-tocopherol levels in the maternal serum were considered adequate at 46.4 (15.9) and 1023.6 (380.4) µg dL(-1) , respectively. The colostrum retinol levels of the supplemented group increased significantly 24 h after the intervention (P < 0.001). However, the retinol levels in the mature milk of both groups did not differ (P > 0.05). Moreover, after maternal supplementation with vitamin A, the colostrum α-tocopherol level decreased by 16.4%, which is a significant reduction (P < 0.05). However, vitamin A supplementation did not affect the α-tocopherol level of mature milk (P > 0.05). CONCLUSIONS: Maternal supplementation with high doses of vitamin A increased the colostrum level of this nutrient but reduced the bioavailability of α-tocopherol, which may harm the newborn's health because newborns have limited vitamin E reserves.
Assuntos
Colostro/metabolismo , Suplementos Nutricionais/efeitos adversos , Lactação/metabolismo , Fenômenos Fisiológicos da Nutrição Materna , Estado Nutricional , Vitamina A/análogos & derivados , alfa-Tocoferol/antagonistas & inibidores , Brasil/epidemiologia , Países em Desenvolvimento , Diterpenos , Feminino , Maternidades , Humanos , Recém-Nascido , Lactação/sangue , Perda de Seguimento , Masculino , Leite Humano/metabolismo , Período Pós-Parto , Ésteres de Retinil , Risco , Vitamina A/administração & dosagem , Vitamina A/efeitos adversos , Vitamina A/sangue , Vitamina A/metabolismo , Vitamina A/toxicidade , Deficiência de Vitamina A/sangue , Deficiência de Vitamina A/epidemiologia , Deficiência de Vitamina A/metabolismo , Deficiência de Vitamina A/prevenção & controle , Deficiência de Vitamina E/sangue , Deficiência de Vitamina E/epidemiologia , Deficiência de Vitamina E/etiologia , Deficiência de Vitamina E/metabolismo , alfa-Tocoferol/sangue , alfa-Tocoferol/metabolismoRESUMO
BACKGROUND AND AIMS: Evaluate the nutritional status, plasma concentration of vitamin E and markers of cardiovascular risk in ataxia telangiectasia (AT) patients. METHODS: Cross-sectional study with 13 patients with AT and 22 healthy controls, evaluating the following factors: nutritional status, food intake, lipid profile, plasma concentration of vitamin E, malondialdehyde and high sensitivity C-reactive protein, linking them with atherosclerosis risk in AT patients. RESULTS: Average age was 14.6 in the AT group, 30.8% were malnourished and 23.1% had stunting. A greater impairment of lean body mass was found in these patients. Concentrations of triglycerides (TG), total cholesterol (CT), LDL-c, non-HDL cholesterol (NHDL-c) were significantly higher in patients and HDL-c, lower. Vitamin E/total lipids and vitamin E/TG ratios were lower in the AT group, and significant inverse correlation between these ratios and NHDL-c, CT/HDL-c, and LDL-c/HDL-c, log TG/HDL-c was observed in the AT group. Alanine aminotransferase correlated directly and significantly with NHDL-c, CT/HDL-c and LDL-c/HDL-c, in patients. CONCLUSION: The alterations of lipid metabolism biomarkers suggestive of atherosclerotic risk of male AT patients coupled with lower vitamin E/total lipids ratio and low lean body mass may complicate the clinical course of the disease and emphasizes the importance of multidisciplinary care, routine monitoring of cardiovascular biomarkers and appropriate nutritional guidance.
Assuntos
Ataxia Telangiectasia/fisiopatologia , Aterosclerose/etiologia , Dislipidemias/complicações , Transtornos do Crescimento/complicações , Estresse Oxidativo , Magreza/complicações , Deficiência de Vitamina E/complicações , Adolescente , Adulto , Ataxia Telangiectasia/sangue , Ataxia Telangiectasia/complicações , Aterosclerose/epidemiologia , Biomarcadores/sangue , Índice de Massa Corporal , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Dislipidemias/epidemiologia , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Peroxidação de Lipídeos , Masculino , Prontuários Médicos , Prevalência , Risco , Fatores Sexuais , Magreza/epidemiologia , Deficiência de Vitamina E/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: We examined associations between the frequency of fruit and vegetable (F&V) consumption and nutritional deficiencies among Brazilian schoolchildren. DESIGN: A cross-sectional, population-based study was performed. A short FFQ was used to assess consumption of fruits and vegetables (F&V) over the past month. The prevalence ratios (PR) and 95 % confidence intervals for stunting, obesity, anaemia, vitamin A and folate deficiencies, vitamin E and vitamin D insufficiencies were estimated for low F&V consumption frequency (vegetables ≤ 3 times/month and fruits ≤ 3 times/week) and compared with children with usual F&V consumption frequency (vegetables ≥ 1 time/week and fruits ≥ 4 times/week). SETTING: Acrelândia, Western Brazilian Amazon. SUBJECTS: A total of 702 children aged 4-10 years. RESULTS: Only 5 % of children consumed F&V ≥ 5 times/d. Prevalence of deficiency was 31 %, 15 %, 9 % and 2 % for vitamins D, A, E and folate, respectively. Overall, 6.3% of children were anaemic, 3.3% were stunted, 2.7% were obese and 33 % had multiple nutritional deficiencies. Low frequency of F&V consumption was associated with lower plasma concentrations of carotenoids and vitamin E. Nutritional deficiencies were higher among non-consumers of F&V when compared with usual consumers: anaemia (PR=1.9; 95 % CI 1.0, 3.7), vitamin E insufficiency (PR=2.5; 95% CI 1.5, 4.2), vitamin D insufficiency (PR=1.5; 95% CI 1.1, 1.9) and stunting (PR=2.6; 95% CI 1.1, 6.1). CONCLUSIONS: In our study, the occurrence of nutritional deficiencies in children with low F&V consumption was twice as high as in children with usual F&V consumption, reinforcing the importance of effective actions to promote the consumption of F&V.
Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Deficiências Nutricionais/etiologia , Dieta/efeitos adversos , Frutas , Política Nutricional , Cooperação do Paciente , Verduras , Anemia Ferropriva/sangue , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/etnologia , Anemia Ferropriva/etiologia , Brasil/epidemiologia , Criança , Fenômenos Fisiológicos da Nutrição Infantil/etnologia , Pré-Escolar , Estudos Transversais , Deficiências Nutricionais/sangue , Deficiências Nutricionais/epidemiologia , Deficiências Nutricionais/etnologia , Dieta/etnologia , Feminino , Humanos , Masculino , Cooperação do Paciente/etnologia , Prevalência , Fatores de Risco , Inquéritos e Questionários , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/etnologia , Deficiência de Vitamina D/etiologia , Deficiência de Vitamina E/sangue , Deficiência de Vitamina E/epidemiologia , Deficiência de Vitamina E/etnologia , Deficiência de Vitamina E/etiologiaRESUMO
The adequate supply of vitamins A and E to newborns is essential. However, factors such as maternal nutritional status and nutrient interaction may limit its bioavailability. The aim of this study was to establish nutritional status for vitamins A and E and evaluate the correlation of retinol on colostrum alpha-tocopherol in lactating women. A total of 103 lactating women were recruited at a Brazilian public maternity hospital. Fasting serum and colostrum samples were collected in the immediate post-partum. Retinol and alpha-tocopherol levels were determined by high-performance liquid chromatography and nutritional status for these vitamins was defined from specific cut-off points for serum and colostrum. Mean serum and colostrum retinol (1.49 µmol L(-1) , 2.18 µmol L(-1) ) and alpha-tocopherol (26.4 µmol L(-1) , 26.1 µmol L(-1) ) indicated satisfactory biochemical status. However, we found a prevalence of subclinical deficiency of vitamin A and vitamin E in serum (15.5% and 16%) and colostrum (50% and 60%). Lactating women with serum retinol ≥ 1.05 µmol L(-1) showed an inverse correlation between serum retinol and alpha-tocopherol concentration in the colostrum (P = 0.008, r = -0.28). This association was not observed in serum level < 1.05 µmol L(-1) . The nutritional status of lactating women for vitamins A and E was adequate, although there is a risk of subclinical deficiency. The negative correlation of serum retinol on alpha-tocopherol concentration in the colostrum must be carefully evaluated in situations of vitamin A supplementation, because alpha-tocopherol bioavailability in maternal milk may be compromised.
Assuntos
Colostro/química , Lactação/metabolismo , Estado Nutricional , Vitamina A/sangue , alfa-Tocoferol/análise , Adulto , Disponibilidade Biológica , Brasil/epidemiologia , Cromatografia Líquida de Alta Pressão , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Necessidades Nutricionais , Vitamina A/análise , Vitamina A/farmacologia , Deficiência de Vitamina A/epidemiologia , Deficiência de Vitamina A/metabolismo , Deficiência de Vitamina E/epidemiologia , Deficiência de Vitamina E/metabolismo , Adulto Jovem , alfa-Tocoferol/farmacocinéticaRESUMO
Micronutrient insufficiency, low dietary fiber, and high saturated fat intake have been associated with chronic diseases. Micronutrient insufficiencies may exacerbate poor health outcomes for persons with type 2 diabetes and minority status. We examined dietary intakes using the Recommended Dietary Allowances (RDAs) of micronutrients, and Adequate Intakes (AIs) of fiber, and Dietary Guidelines for Americans (DGA) for saturated fat in Haitian-, African-, and Cuban- Americans (n = 868), approximately half of each group with type 2 diabetes. Insufficient intakes of vitamins D and E and calcium were found in over 40 % of the participants. Over 50 % of African- and Cuban- Americans consumed over 10 % of calories from saturated fat. Haitian-Americans were more likely to have insufficiencies in iron, B-vitamins, and vitamins D and E, and less likely to have inadequate intake of saturated fat as compared to Cuban-Americans. Vitamin D insufficiency was more likely for Haitian-Americans as compared to African- Americans. Diabetes status alone did not predict micronutrient insufficiencies; however, Haitian-Americans with no diabetes were more likely to be insufficient in calcium. Adjusting for age, gender, energy, smoking, physical activity, access to health care, and education negated the majority of micronutrient insufficiency differences by ethnicity. These findings suggest that policies are needed to ensure that low-cost, quality produce can be accessed regardless of neighborhood and socioeconomic status.