title: Chronic low intakes of vitamin A-rich foods in households with xerophthalmic children: a case-control study in Nepal.
abstract: Dietary patterns in 81 rural Nepali households with a 1-6-y-old child with a history of xerophthalmia were compared with dietary patterns of 81 households with an age-matched nonxerophthalmic control subject. Weekly food-frequency questionnaires were collected from case and control "focus" children, a younger sibling (if present), and the household 1-2 y after recruitment and treatment of cases. Control households and children were more likely than case households and children to consume vitamin A-rich foods during the monsoon (July-September) and major rice harvesting (October-December) seasons. Cases were less likely to consume preformed vitamin A-rich foods throughout the year [odds ratio (OR) = 1.2-4.5] with the strongest differences observed from October to December (OR = 2.0-4.2). Dietary risks were generally shared by younger siblings of cases, suggesting that infrequent intake of beta-carotene and preformed vitamin-A rich foods begins early in life and clusters among siblings within households, a pattern that is consistent with their higher risk of xerophthalmia and mortality. In developing countries where vitamin A deficiency is endemic, dietary counseling for children with xerophthalmia should be extended to their younger siblings. Moreover, dietary intake of preformed vitamin A may be as, or more, important as carotenoid-containing food consumption in protecting children and other members of households from vitamin A deficiency.
authors.affiliation: Department of International Health, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
authors.forename: A V
authors.initials: AV
authors.lastname: Shankar
authors.forename: K P
authors.initials: KP
authors.lastname: West
authors.forename: J
authors.initials: J
authors.lastname: Gittelsohn
authors.forename: J
authors.initials: J
authors.lastname: Katz
authors.forename: R
authors.initials: R
authors.lastname: Pradhan
mesh_terms: D002338:Carotenoids / Q000008:administration & dosage; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004032:Diet; D005247:Feeding Behavior; D005638:Fruit; D006801:Humans; D007223:Infant; D009390:Nepal / Q000453:epidemiology; D012621:Seasons; D011795:Surveys and Questionnaires; D014675:Vegetables; D014801:Vitamin A / Q000008:administration & dosage*; D014802:Vitamin A Deficiency / Q000150:complications; D014985:Xerophthalmia / Q000453:epidemiology / Q000209:etiology*; D019207:beta Carotene
chemical_list: D019207:beta Carotene; D014801:Vitamin A; D002338:Carotenoids