title: Breast milk retinol and plasma retinol-binding protein concentrations provide similar estimates of vitamin A deficiency prevalence and identify similar risk groups among women in Cameroon but breast milk retinol underestimates the prevalence of deficiency among young children.
abstract: Breast milk vitamin A (BMVA) has been proposed as an indicator of population vitamin A status but has rarely been applied in large-scale surveys or compared with conventional vitamin A biomarkers. We assessed the prevalence of, and risk factors for, low BMVA and its relation to vitamin A intake, plasma retinol-binding protein (pRBP), and markers of inflammation in a national survey in Cameroon. We randomly selected 30 clusters in each of 3 strata (South, North, and Cities). Casual milk samples were collected from approximately 5 women per cluster (n = 440). pRBP, plasma C-reactive protein (pCRP), plasma α1-acid glycoprotein (pAGP), and 24-h vitamin A intake were assessed in 10 women aged 15-49 y and 10 children aged 12-59 mo per cluster, including a subset of lactating women (n = 253). Low BMVA was infrequent: 7.2% (95% CI: 4.7, 9.8) of values were <1.05 μmol/L, and 9.3% (95% CI: 5.8, 12.7) were <8 μg/g fat, consistent with the low prevalence of pRBP <0.78 μmol/L among women (< 5%) but lower than the prevalence of pRBP <0.83 μmol/L among children (35%). Risk factors for both low BMVA and pRBP included living in the North and low maternal education. BMVA was positively associated with inflammation-adjusted pRBP among women in the lowest vitamin A intake tertile [<115 μg retinol activity equivalents (RAEs)/d, P < 0.01] but not in the highest tertile (>644 μg RAEs/d, P > 0.4). Controlling for milk fat, BMVA was negatively associated with pCRP (P < 0.02) but not pAGP (P > 0.5). BMVA and pRBP provide similar estimates of vitamin A deficiency prevalence and identify the same risk groups among women in Cameroon, but BMVA underestimates the prevalence of vitamin A deficiency among young children.
authors: Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA.
authors: Reina
authors: R
authors: Engle-Stone
authors: Marjorie J
authors: MJ
authors: Haskell
authors: Martin
authors: M
authors: Nankap
authors: Alex O
authors: AO
authors: Ndjebayi
authors: Kenneth H
authors: KH
authors: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding; D002097:C-Reactive Protein / Q000378:metabolism; D002163:Cameroon / Q000453:epidemiology; D002675:Child, Preschool; D004522:Educational Status; D002149:Energy Intake; D005260:Female; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000097:blood / Q000378:metabolism; D007774:Lactation / Q000378:metabolism*; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D008875:Middle Aged; D008895:Milk, Human / Q000378:metabolism*; D009961:Orosomucoid / Q000378:metabolism; D015995:Prevalence; D054839:Retinol-Binding Proteins, Plasma / Q000378:metabolism*; D012307:Risk Factors; D014801:Vitamin A / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism*; D014802:Vitamin A Deficiency / Q000097:blood / Q000453:epidemiology* / Q000378:metabolism; D055815:Young Adult
chemical_list: D009961:Orosomucoid; D054839:Retinol-Binding Proteins, Plasma; D014801:Vitamin A; D002097:C-Reactive Protein