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Failure to thrive and its relationship to serum vitamin A levels and diet
P R Donald1, J Shires, M L Langenhoven
1Department of Paediatrics, Tygerberg Hospital, W. Cape.
Insights
Children with failure to thrive showed no significant difference in vitamin A or retinol-binding protein (RBP) levels, but had lower essential fatty acid intake. This may impact infectious disease outcomes.
Area of Science:
- Nutritional Science
- Pediatric Health
- Biochemistry
Background:
- Failure to thrive (FTT) in children is a complex condition often linked to nutritional deficiencies.
- Vitamin A status is crucial for immune function and growth, and its deficiency can exacerbate infectious diseases.
- Retinol-binding protein (RBP) serves as a marker for vitamin A status.
Purpose of the Study:
- To investigate serum vitamin A and RBP levels in children with FTT compared to healthy controls.
- To assess anthropometric measurements and dietary intake, including essential fatty acids, in children with FTT.
- To explore the potential contribution of subclinical vitamin A deficiency to infectious disease morbidity in the studied population.
Main Methods:
- Serum vitamin A and RBP levels were measured in 34 children with FTT (ages 1-4) and 34 matched controls.
- Anthropometric data (weight, height, arm circumference, head circumference) were collected for all participants.
- Dietary intake, including vitamin A and linoleic acid (C 18:2), was assessed for both groups.
Main Results:
- No significant differences were found in median serum vitamin A or RBP levels between children with FTT and controls.
- A higher proportion of children with FTT (42%) had vitamin A levels below 10 µg/100 ml compared to controls (12%).
- Children with FTT exhibited significantly poorer anthropometric measurements and lower intake of linoleic acid and vitamin A, despite intake within recommended ranges.
Conclusions:
- While overt vitamin A deficiency was not clinically evident, a higher prevalence of biochemical deficiency was observed in children with FTT.
- Suboptimal intake of vitamin A and essential fatty acids in children with FTT may contribute to increased susceptibility to infectious diseases.
- Further research is warranted to understand the role of vitamin A status in the high rates of infectious disease morbidity and mortality in the Cape Town community.
Abstract:
Serum vitamin A and retinol-binding protein (RBP) levels were determined in a group of 34 children between 1 and 4 years of age with failure to thrive and in 34 age- and sex-matched controls. Both groups of children were also assessed in respect of anthropometry and diet. Vitamin A levels in patients (0-32.2 micrograms/100 ml; median 16.9 micrograms/100 ml) did not differ significantly from controls (6.4-47.2 micrograms/100 ml; median 16.1 micrograms/100ml). Fourteen patients (42%) and 4 controls (12%) had vitamin A levels below 10 micrograms/100 ml. RBP levels in patients (0.45-3.50 mg/100 ml; median 2.17 mg/100 ml) also did not differ significantly from those in controls (1.21-3.66 mg/100 ml; median 2.06 mg/100 ml). No clinical features of vitamin A deficiency were detected. Weight and height for age, weight for height, mid-upper arm circumference and head circumference differed significantly between patients and controls (P < 0.0001 in each instance). Although within the recommendations for intake, patients had a significantly lower intake of the essential fatty acid C 18:2 (N = 6) (linoleic acid) and vitamin A. In view of the current proposed relationship between vitamin A status and infectious diseases, the prevalence of biochemical vitamin A deficiency in children in the Cape Town community studied may contribute to the morbidity and mortality associated with infectious diseases in the area to a greater degree than has been suspected.