Trial reportThe American journal of clinical nutrition2015
High provitamin A carotenoid serum concentrations, elevated retinyl esters, and saturated retinol-binding protein in Zambian preschool children are consistent with the presence of high liver vitamin A stores.
Trial report in The American journal of clinical nutrition, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Selected laboratory-based biomarkers for assessing vitamin A deficiency in at-risk individuals.The Cochrane database of systematic reviews · 2025Pooled it
- Provitamin A-biofortified maize consumption increases serum xanthophylls andExperimental biology and medicine (Maywood, N.J.) · 2017Trial
- Simulated Impact of Vitamin A-Fortified Sugar on Dietary Adequacy and Association of Usual Sugar Intake With Plasma and Breast Milk Retinol Among Lactating Zambian Women.Maternal & child nutrition · 2025Article
- Carotenoid Supplementation for Alleviating the Symptoms of Alzheimer's Disease.International journal of molecular sciences · 2024Review
- Scientific opinion on the tolerable upper intake level for preformed vitamin A and β-carotene.EFSA journal. European Food Safety Authority · 2024Article
- Inadequate Niacin Intake Disrupts Growth and Retinol Homeostasis Resulting in Higher Liver and Lower Serum Retinol Concentrations in Male Rats.The Journal of nutrition · 2023Article
- Aligning the Epidemiology of Malnutrition with Food Fortification: Grasp Versus Reach.Nutrients · 2023Article
- Evidence to Underpin Vitamin A Requirements and Upper Limits in Children Aged 0 to 48 Months: A Scoping Review.Nutrients · 2022Article
- Inflammation Adjustments to Serum Retinol and Retinol-Binding Protein Improve Specificity but Reduce Sensitivity when Estimating Vitamin A Deficiency Compared with the Modified Relative Dose-Response Test in Ghanaian Children.Current developments in nutrition · 2021Article
- Use of Model-Based Compartmental Analysis and Theoretical Data to Further Explore Choice of Sampling Time for Assessing Vitamin A Status in Groups and Individual Human Subjects by the Retinol Isotope Dilution Method.The Journal of nutrition · 2021Article
- Determination of Vitamin A Total Body Stores in Children from Dried Serum Spots: Application in a Low- and Middle-Income Country Community Setting.The Journal of nutrition · 2021Article
- Findings in 3 clinical trials challenge the accuracy of the Institute of Medicine's estimated average requirements for vitamin A in children and women.The American journal of clinical nutrition · 2021Article
- Biological evidence to define a vitamin A deficiency cutoff using total liver vitamin A reserves.Experimental biology and medicine (Maywood, N.J.) · 2021Review
- Daily consumption of pro-vitamin A biofortified (yellow) cassava improves serum retinol concentrations in preschool children in Nigeria: a randomized controlled trial.The American journal of clinical nutrition · 2021Article
- Overlapping Vitamin A Interventions with Provitamin A Carotenoids and Preformed Vitamin A Cause Excessive Liver Retinol Stores in Male Mongolian Gerbils.The Journal of nutrition · 2020Article
- Perspective: Integration to Implementation (I-to-I) and the Micronutrient Forum-Addressing the Safety and Effectiveness of Vitamin A Supplementation.Advances in nutrition (Bethesda, Md.) · 2020Article
- Restricting vitamin A intake increases bone formation in Zambian children with high liver stores of vitamin.Archives of osteoporosis · 2019Article
- Weighing the risks of high intakes of selected micronutrients compared with the risks of deficiencies.Annals of the New York Academy of Sciences · 2019Article
- Overlapping vitamin A interventions in the United States, Guatemala, Zambia, and South Africa: case studies.Annals of the New York Academy of Sciences · 2019Article
- Dietary Intake Patterns among Lactating and Non-Lactating Women of Reproductive Age in Rural Zambia.Nutrients · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundBiomarkers of micronutrient status are needed to best define deficiencies and excesses of essential nutrients.
objectiveWe evaluated several supporting biomarkers of vitamin A status in Zambian children to determine whether any of the biomarkers were consistent with high liver retinol stores determined by using retinol isotope dilution (RID).
designA randomized, placebo-controlled, biofortified maize efficacy trial was conducted in 140 rural Zambian children from 4 villages. A series of biomarkers were investigated to better define the vitamin A status of these children. In addition to the assessment of total-body retinol stores (TBSs) by using RID, tests included analyses of serum carotenoids, retinyl esters, and pyridoxal-5'-phosphate (PLP) by using high-pressure liquid chromatography, retinol-binding protein by using ELISA, and alanine aminotransferase (ALT) activity by using a colorimetric assay.
resultsChildren (n = 133) were analyzed quantitatively for TBSs by using RID. TBSs, retinyl esters, some carotenoids, and PLP differed by village site. Serum carotenoids were elevated above most nonintervened reference values for children. α-Carotene, β-carotene, and lutein values were >95th percentile from children in the US NHANES III, and 13% of children had hypercarotenemia (defined as total carotenoid concentration >3.7 μmol/L). Although only 2% of children had serum retinyl esters >10% of total retinol plus retinyl esters, 16% of children had >5% as esters, which was consistent with high liver retinol stores. Ratios of serum retinol to retinol-binding protein did not deviate from 1.0, which indicated full saturation. ALT activity was low, which was likely due to underlying vitamin B-6 deficiency, which was confirmed by very low serum PLP concentrations.
conclusionsThe finding of hypervitaminosis A in Zambian children was supported by high circulating concentrations of carotenoids and mildly elevated serum retinyl esters. ALT-activity assays may be compromised with co-existing vitamin B-6 deficiency. Nutrition education to improve intakes of whole grains and animal-source foods may enhance vitamin B-6 status in Zambians.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.