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Am J Clin Nutr. 2007 May;85(5):1375-84.

Supplementation with iron and riboflavin enhances dark adaptation response to vitamin A-fortified rice in iron-deficient, pregnant, nightblind Nepali women.

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1
Program in International Nutrition, Department of Nutritional Biology, University of California Davis, Davis, CA 95616, USA.

Abstract

BACKGROUND:

Nightblindness affects 16-52% of pregnant women in areas of Nepal and in some cases persists after vitamin A treatment. Iron and riboflavin affect vitamin A utilization and photoreceptor function, respectively, and pilot data in the study population showed a high prevalence of iron and riboflavin deficiencies.

OBJECTIVE:

The objective was to assess the effect of supplemental iron and riboflavin on pupillary threshold (PT) and plasma retinol in nightblind, pregnant Nepali women given vitamin A-fortified rice.

DESIGN:

Nightblind pregnant women were randomly assigned to receive, 6 d/wk under supervision for 6 wk, a vitamin A-fortified rice curry dish providing 850 microg retinal activity equivalents/d with either a 30-mg Fe and 6-mg riboflavin (FeR + VA) capsule or a placebo control (VA only) capsule. Hemoglobin, erythrocyte riboflavin, and plasma ferritin and retinol were measured before and after the intervention. Dark adaptation was assessed by PT score.

RESULTS:

Women who were iron deficient at baseline (n=38) had significantly greater improvement in PT score with iron and riboflavin supplementation than without (P=0.05). Iron and riboflavin supplements significantly reduced the prevalences of riboflavin deficiency (from 60% to 6%; P<0.0001), iron deficiency anemia (from 35% to 15%; P<0.007), and abnormal PT (from 87% to 30%; P<0.05) from baseline. Mean increases in erythrocyte riboflavin (P<0.0001) and plasma ferritin (P=0.01) were greater in the FeR + VA group than in the VA only group.

CONCLUSIONS:

Iron deficiency may limit the efficacy of vitamin A to normalize dark adaptation in pregnant Nepali women. Further studies are needed to assess the effect of simultaneous delivery of iron and vitamin A for the treatment of nightblindness.

PMID:
17490976
[Indexed for MEDLINE]
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