Evidence map›Paper›PMID 33693468›Full record

Trial reportThe American journal of clinical nutrition2021

Biofortified and fortified maize consumption reduces prevalence of low milk retinol, but does not increase vitamin A stores of breastfeeding Zambian infants with adequate reserves: a randomized controlled trial.

Amanda C Palmer, Modou L Jobarteh, Mackford Chipili, Matthew D Greene, Anthony Oxley, Georg Lietz, Rose Mwanza, Marjorie J Haskell

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The American journal of clinical nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02804490 (Efficacy of Biofortified Maize to Improve Maternal and Infant Vitamin A Status), which is not on this map. Cited by 8 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 3 pooled it
1.1field-weighted citation impact, top 24% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT02804490 phase3completednot on this map

Efficacy of Biofortified Maize to Improve Maternal and Infant Vitamin A Status

TypeinterventionalSponsorJohns Hopkins Bloomberg School of Public HealthRan2016 to 2017Enrolled255ConditionsVitamin A DeficiencyArmsConventional white maize, Provitamin A carotenoid biofortified maize, Preformed vitamin A fortified maize
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 3 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Review
  6. Article
  7. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 3 countries.

Amanda C PalmerDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Modou L JobartehInstitute for Global Nutrition, Department of Nutrition, University of California, Davis, CA, USA.
Mackford ChipiliDistrict Medical Office for Mkushi District, Mkushi, Zambia.
Matthew D GreeneDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Anthony OxleyHuman Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom.
Georg LietzHuman Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom.
Rose MwanzaProvincial Medical Office for Central Province, Kabwe, Zambia.
Marjorie J HaskellInstitute for Global Nutrition, Department of Nutrition, University of California, Davis, CA, USA.
Johns Hopkins University · USNewcastle University · GBUniversity of California, Davis · USMulungushi University · ZM

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReplacement of conventional staples with biofortified or industrially fortified staples in household diets may increase maternal breast milk retinol content and vitamin A intakes from complementary foods, improving infant total body stores (TBS) of vitamin A.

objectivesTo determine whether biofortified or industrially fortified maize consumption by Zambian women and their breastfeeding infants could improve milk retinol concentration and infant TBS.

methodsWe randomly assigned 255 lactating women and their 9-mo-old infants to a 90-d intervention providing 0 µg retinol equivalents (RE)/d as conventional maize or ∼315 µg RE/d to mothers and ∼55 µg RE/d to infants as provitamin A carotenoid-biofortified maize or retinyl palmitate-fortified maize. Outcomes were TBS, measured by retinol isotope dilution in infants (primary), and breast milk retinol, measured by HPLC in women (secondary).

resultsThe intervention groups were comparable at baseline. Loss to follow-up was 10% (n = 230 mother-infant pairs). Women consumed 92% of the intended 287 g/d and infants consumed 82% of the intended 50 g/d maize. The baseline geometric mean (GM) milk retinol concentration was 1.57 μmol/L (95% CI: 1.45, 1.69 μmol/L), and 24% of women had milk retinol <1.05 μmol/L. While mean milk retinol did not change in the biofortified arm (β: 0.11; 95% CI: -0.02, 0.24), the intervention reduced low milk retinol (RR: 0.42; 95% CI: 0.21, 0.85). Fortified maize increased mean milk retinol (β: 0.17; 95% CI: 0.04, 0.30) and reduced the prevalence of low milk retinol (RR: 0.46; 95% CI: 0.25, 0.82). The baseline GM TBS was 178 μmol (95% CI: 166, 191 μmol). This increased by 24 µmol (± 136) over the 90-d intervention period, irrespective of treatment group.

conclusionsBoth biofortified and fortified maize consumption improved milk retinol concentration. This did not translate into greater infant TBS, most likely due to adequate TBS at baseline. This trial was registered at clinicaltrials.gov as NCT02804490.

Indexed as

BiofortificationAdultBreast FeedingCohort StudiesDiterpenesFemaleFood, FortifiedHumansInfantMilk, HumanRetinyl EstersVitamin AZambiaZea maysDiterpenesretinol palmitateRetinyl EstersVitamin Abiofortificationbreast milkfortificationtotal body storesvitamin A

Identifiers

PMID33693468
OpenAlexW3133843679

What OpenQuestion holds

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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.