Effects of vitamin a on growth of vitamin A-deficient children: Field studies in Nepal

Keith P. West, Steven C. LeClerq, Sharada R. Shrestha, Lee S.F. Wu, Elizabeth K. Pradhan, Subarna K. Khatry, Joanne Katz, Ramesh Adhikari, Alfred Sommer, R. P. Pokhrel, B. D. Chataut, D. Calder, J. Gmunder, J. Humphrey, J. Tielsch, H. Taylor, M. R. Pandey, D. Piet, J. Canner, N. N. AchariyaD. N. Mandal, T. R. Sakya, B. B. Shrestha, R. K. Shrestha

Research output: Contribution to journalArticle

Abstract

Inconsistencies have been observed in the impure of vitamin A (VA) supplementation on early child growth. To help clarify this issue, a cohort of 3377 rural Nepalese, nonxerophthalmic children 12-60 mo of age were randomized by ward to receive vitamin A [60,000 μg retinol equivalents (RE)] or placebo-control (300 RE) supplementation once every 4 mo and followed for 16 mo. VA had no impact on annual weight gain or linear growth. However, arm circumference (AC) and muscle area (MA) growth improved in VA recipients by 0.13 cm and 25 mm2, respectively, over controls. Growth of children with xerophthalmia, who were treated with ≤ 120.000 RE at base line, was also compared to that of nonxerophthalmic children stratified by initial wasting status and adjusted for sex, baseline age and measurement status. Among initially nonwasted children (AC ≤ 13.5 cm), VA-treated xerophthalmic children (n = 86) gained 0.7 cm more in linear growth than nonxerophthalmic children. Among initially wasted children (AC < 13.5 cm), VA-treated children (n = 34) gained additional weight (672 g), height (~1 cm), muscle (76 mm2) and fat (79 mm2) areas, and subscapular skinfold (1.3 mm) compared to changes observed in nonxerophthalmic children. Relative increments in soft tissue growth occurred within 4 mo of VA treatment, while the effect on linear growth was gradual. Moderate-to-severe VA deficiency, marked by xerophthalmia, is likely to impair normal physical growth, but milder stages of deficiency may not have this effect in rural South Asia.

Original languageEnglish (US)
Pages (from-to)1957-1965
Number of pages9
JournalJournal of Nutrition
Volume127
Issue number10
DOIs
StatePublished - Oct 1997

Keywords

  • Children
  • Community trial
  • Growth
  • Vitamin A deficiency
  • Xerophthalmia

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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    West, K. P., LeClerq, S. C., Shrestha, S. R., Wu, L. S. F., Pradhan, E. K., Khatry, S. K., Katz, J., Adhikari, R., Sommer, A., Pokhrel, R. P., Chataut, B. D., Calder, D., Gmunder, J., Humphrey, J., Tielsch, J., Taylor, H., Pandey, M. R., Piet, D., Canner, J., ... Shrestha, R. K. (1997). Effects of vitamin a on growth of vitamin A-deficient children: Field studies in Nepal. Journal of Nutrition, 127(10), 1957-1965. https://doi.org/10.1093/jn/127.10.1957