Relationship between serum aflatoxin concentrations and the nutritional status of children aged 6-24 months from Zambia.

In Zambia, mothers/caregivers feed their children cereal-based complementary foods that are prone to aflatoxin contamination. This study evaluated the relationship between exposure to aflatoxins and the nutritional status of young children. It covered 400 mothers with children aged 6-24 months. Their nutritional status assessed by measuring weight and height using standard procedures. Serum samples analysed for aflatoxin B1-lysine (AFB1-lys), a reliable biomarker of aflatoxin exposure. Child sickness and age, exposure to aflatoxin in foods, and albumin-normalised AFB1-lys level were found to be significantly (p < .05) associated with child stunting except for child age that was not significant at p = .05. Children with an increase in the blood serum aflatoxin B1 lysine adduct are more likely to be stunted. These results have shown that dietary exposure to aflatoxin could lead to an increase in serum aflatoxin concentrations, both of which are associated with stunting.

Biofortified yellow cassava and vitamin A status of Kenyan children: a randomized controlled trial.

BACKGROUND: Whereas conventional white cassava roots are devoid of provitamin A, biofortified yellow varieties are naturally rich in ß-carotene, the primary provitamin A carotenoid. OBJECTIVE: We assessed the effect of consuming yellow cassava on serum retinol concentration in Kenyan schoolchildren with marginal vitamin A status. DESIGN: We randomly allocated 342 children aged 5-13 y to receive daily, 6 d/wk, for 18.5 wk 1) white cassava and placebo supplement (control group), 2) provitamin A-rich cassava (mean content: 1460 µg ß-carotene/d) and placebo supplement (yellow cassava group), and 3) white cassava and ß-carotene supplement (1053 µg/d; ß-carotene supplement group). The primary outcome was serum retinol concentration; prespecified secondary outcomes were hemoglobin concentration and serum concentrations of ß-carotene, retinol-binding protein, and prealbumin. Groups were compared by using ANCOVA, adjusting for inflammation, baseline serum concentrations of retinol and ß-carotene, and stratified design. RESULTS: The baseline prevalence of serum retinol concentration <0.7 µmol/L and inflammation was 27% and 24%, respectively. For children in the control, yellow cassava, and ß-carotene supplement groups, the mean daily intake of cassava was 378, 371, and 378 g, respectively, and the total daily supply of provitamin A and vitamin A from diet and supplements was equivalent to 22, 220, and 175 µg retinol, respectively. Both yellow cassava and ß-carotene supplementation increased serum retinol concentration by 0.04 µmol/L (95% CI: 0.00, 0.07 µmol/L); correspondingly, serum ß-carotene concentration increased by 524% (448%, 608%) and 166% (134%, 202%). We found no effect on hemoglobin concentration or serum concentrations of retinol-binding protein and prealbumin. CONCLUSIONS: In our study population, consumption of yellow cassava led to modest gains in serum retinol concentration and a large increase in ß-carotene concentration. It can be an efficacious, new approach to improve vitamin A status. This study was registered with clinicaltrials.gov as NCT01614483.