Correction to: Different effects of γ-linolenic acid (GLA) supplementation on plasma and red blood cell phospholipid fatty acid composition and calcium oxalate kidney stone risk factors in healthy subjects from two race groups with different risk profiles pose questions about the GLA-arachidonic acid-oxaluria metabolic pathway: pilot study.

The authors would like to add the following paragraph in the acknowledgement section of the original version of the paper.

Hepatic Vitamin A Concentrations in Vervets (Chlorocebus aethiops) Supplemented with Carotenoids Derived from Oil Palm.

Commonly used in biomedical research, vervets (Chlorocebus aethiops) are omnivorous but primarily meet their vitamin A requirements from provitamin A carotenoids. Hypervitaminosis A has occurred in vervets that consume feed high in preformed vitamin A. We investigated the vitamin A status of vervets supplemented daily with various antioxidants derived from palm oil. Male vervets (n = 40) were placed for 23 wk on a high-fat diet (34.9% energy) containing 645 µ g retinol activity equivalents (RAE), with 515 µ g RAE from preformed vitamin A. Vervets were randomized to 5 treatments (duration, 20 mo): control; 100 mg d-α-tocopheryl acetate; 100 mg oil palm (Elaeis guineensis)-derived vitamin E; 50 mg oil palm-derived vitamin E + 50 mg carotenoid complex + unrestricted palm-derived water-soluble antioxidants; and 5) unrestricted water-soluble antioxidants. Livers (n = 38) were analyzed for vitamin A, α-retinol (α-vitamin A), and carotenoids. Median hepatic vitamin A and total carotenoid concentrations were 6.49 µ mol/g and 4.30 nmol/g, respectively. Compared with controls, vervets fed the carotenoid complex had higher hepatic vitamin A (11.9 ± 5.1 µ mol/g), α -vitamin A (1.3 ± 0.7 µ mol/g), α -carotene (11.5 ± 5.3 nmol/g), ß-carotene (15.6 ± 8.6 nmol/g), and total carotenoids (28.1 ± 13.9 nmol/g) but lower lutein (0.66 ± 0.28 nmol/g) and zeaxanthin (0.24 ± 0.06 nmol). NHP may benefit from replacement of preformed vitamin A with carotenoids in feeds; however, bioconversion efficiency in these models should be investigated to determine optimal levels.

Sensitivity of fatty acid desaturation and elongation to plasma zinc concentration: a randomised controlled trial in Beninese children.

Zn status may affect fatty acid (FA) metabolism because it acts as a cofactor in FA desaturase and elongase enzymes. Zn supplementation affects the FA desaturases of Zn-deficient rats, but whether this occurs in humans is unclear. We evaluated the associations between baseline plasma Zn (PZn) concentration and plasma total phospholipid FA composition, as well as the effect of daily consumption of Zn-fortified water on FA status in Beninese children. A 20-week, double-blind randomised controlled trial was conducted in 186 school age children. The children were randomly assigned to receive a daily portion of Zn-fortified, filtered water delivering on average 2·8 mg Zn/d or non-fortified filtered water. Plasma total phospholipid FA composition was determined using capillary GLC and PZn concentrations by atomic absorption spectrometry. At baseline, PZn correlated positively with dihomo-γ-linolenic acid (DGLA, r 0·182; P=0·024) and the DGLA:linoleic acid (LA) ratio (r 0·293; P<0·000), and negatively with LA (r -0·211; P=0·009) and the arachidonic acid:DGLA ratio (r -0·170; P=0·036). With the intervention, Zn fortification increased nervonic acid (B: 0·109; 95 % CI 0·001, 0·218) in all children (n 186) and more so in children who were Zn-deficient (n 60) at baseline (B: 0·230; 95 % CI 0·023, 0·488). In conclusion, in this study, Zn-fortified filtered water prevented the reduction of nervonic acid composition in the plasma total phospholipids of children, and this effect was stronger in Zn-deficient children. Thus, Zn status may play an important role in FA desaturation and/or elongation.

Different effects of γ-linolenic acid (GLA) supplementation on plasma and red blood cell phospholipid fatty acid composition and calcium oxalate kidney stone risk factors in healthy subjects from two race groups with different risk profiles pose questions about the GLA-arachidonic acid-oxaluria metabolic pathway: pilot study.

Fatty acid (FA) composition of phospholipids in plasma and red blood cells (RBC) can influence calciuria, oxaluria and renal stone formation. In this regard, the ratio of arachidonic acid (AA) and its precursor linoleic acid (LA) appears to be important. Administration of γ-linolenic acid (GLA) has been shown to increase the concentration of dihomo-gamma linoleic acid (DGLA) relative to AA indicating that it may attenuate biosynthesis of the latter. Such effects have not been investigated in race groups having difference stone occurrence rates. Black (B) and white (W) healthy males ingested capsules containing linoleic acid (LA) and GLA, for 30 days. Plasma and RBC total phospholipid (TPL) FA profiles, serum and 24 h urine biomarkers of hypercalciuria and urinary stone risk factors were determined on days 0 and 30. Data were tested for statistical significance using GraphPadInstat version 3.02. Concentration and percentage content of DGLA in plasma TPL increased in W but not in B. Arachidonic acid (AA) did not change in either group. There was no change in calcium excretion in either group but oxalate and citrate excretion increased in W. We suggest that elongation of GLA to DGLA may occur more rapidly than desaturation of DGLA to AA in W and that depressed activity of the enzyme elongase may occur in B. Calciuric and citraturic effects may be dependent on the quantity of LA or on the mass ratio of LA/GLA in the FA supplement. Questions about the mooted DGLA-AA-oxaluria pathway arise. We speculate that there exists a potential for using GLA as a conservative treatment for hypocitraturia. The observation of different responses in B and W indicates that such differences may play a role in stone formation and prevention.

Vitamin A, Iron, and Zinc Content of Fortified Maize Meal and Bread at the Household Level in 4 Areas of South Africa.

BACKGROUND: A national mandatory food fortification program, fortifying wheat flour and maize meal with various micronutrients, was introduced in South Africa in 2003 to address micronutrient deficiencies. OBJECTIVE: This study aimed to determine vitamin A, iron, and zinc content of raw maize meal and wheat flour bread sampled at household level from 2 urban and 2 rural areas in South Africa and to compare with the regulatory minimum requirements. METHODS: Maize meal (250 g) and/or supermarket/local shop bread (3 inner slices) were collected from 50 randomly selected households from each study area. Maize meal samples were reduced to 10 composite samples per area. Bread samples were composited similarly; 1 composite sample consisted of 15 intact slices. Overall, 8 composite samples were obtained for both brown and white bread. The Southern African Grain Laboratory analyzed the samples for vitamin A, iron, and zinc. RESULTS: Mean content of maize meal (100 g) represented ratios of 0.56 to 0.98 of the minimum fortification requirement for vitamin A, 0.76 to 1.08 for iron, and 0.89 to 1.00 for zinc; brown bread (100 g) represented ratios of 0.57, 1.97, and 1.67 of the minimum requirement for vitamin A, iron, and zinc, respectively, and white bread (100 g) represented ratios of 0.89, 2.22, and 2.07 for vitamin A, iron, and zinc, respectively. CONCLUSION: The variation in vitamin A, iron, and zinc content in maize meal and the higher than required iron and zinc content in wheat bread needs to be investigated in further studies.

Vitamin A and anthropometric status of South African preschool children from four areas with known distinct eating patterns.

OBJECTIVE: The aim of this study was to assess the vitamin A and anthropometric status of South African preschool children from four areas with known distinct eating patterns. METHODS: Serum retinol, anthropometric indicators, and dietary intake were determined for randomly selected preschool children from two rural areas, i.e. KwaZulu-Natal (n = 140) and Limpopo (n = 206); an urban area in the Northern Cape (n = 194); and an urban metropolitan area in the Western Cape (n = 207). RESULTS: Serum retinol <20 µg/dL was prevalent in 8.2% to 13.6% children. Between 3% (urban-Northern Cape) and 44.2% (rural-Limpopo) children had received a high-dose vitamin A supplement during the preceding 6 mo. Vitamin A derived from fortified bread and/or maize meal ranged from 65 µg retinol activity equivalents (24%-31% of the Estimated Average Requirement) to 160 µg retinol activity equivalents (58%-76% Estimated Average Requirement). Fortified bread and/or maize meal contributed 57% to 59% of total vitamin A intake in rural children, and 28% to 38% in urban children. Across the four areas, stunting in children ranged from 13.9% to 40.9%; and overweight from 1.2% to 15.1%. CONCLUSION: Prevalence of vitamin A deficiency was lower than national figures, and did not differ across areas despite differences in socioeconomics, dietary intake, and vitamin A supplementation coverage. Rural children benefited more from the national food fortification program in terms of vitamin A intake. Large variations in anthropometric status highlight the importance of targeting specific nutrition interventions, taking into account the double burden of overnutrition and undernutrition.

The potential contribution of bread buns fortified with beta-carotene-rich sweet potato in Central Mozambique.

BACKGROUND: Orange-fleshed sweet potato is an efficacious source of vitamin A. Substituting wheat flour with orange-fleshed sweet potato in processed products could reduce foreign exchange outlays, create new markets for producers, and result in increased vitamin A consumption among consumers provided there is adequate retention of beta-carotene during processing. OBJECTIVE: To explore whether substituting 38% of wheat flour (by weight) in bread buns ("golden bread") with boiled and mashed orange-fleshed sweet potato from fresh roots or rehydrated chips would produce economically viable beta-carotene-rich products acceptable to Mozambican rural consumers. METHODS: Modified local recipes maximized sweet potato content within the limits of consumer acceptability. Sensitivity analysis determined parameters underlying economic viability. Two samples each of buns from five varieties of orange-fleshed sweet potato were analyzed for beta-carotene content. Processed products with at least 15 microg/g product of trans-beta-carotene were considered good sources of vitamin A. RESULTS: Golden bread made from fresh roots of medium-intensity orange-fleshed sweet potato varieties met the good source criterion, but bread from lighter-intensity sweet potato varieties did not. Bread from rehydrated dried chips was not economically viable. Consumers strongly preferred golden bread over pure wheat flour bread because of its heavier texture and attractive appearance. The ratio of the price of wheat flour to that of raw sweet potato root varied from 3.1 to 3.5 among the bakers, whose increase in profit margins ranged from 54% to 92%. CONCLUSIONS: Golden bread is a good source of beta-carotene and is economically viable when the price ratio of wheat flour to raw orange-fleshed sweet potato root is at least 1.5. Widespread adoption during sweet potato harvesting periods is feasible; year-round availability requires storage.

Beta-carotene-rich orange-fleshed sweet potato improves the vitamin A status of primary school children assessed with the modified-relative-dose-response test.

BACKGROUND: Beta-carotene-rich orange-fleshed sweet potato (OFSP) is an excellent source of provitamin A. In many developing countries, sweet potato is a secondary staple food and may play a role in controlling vitamin A deficiency. OBJECTIVE: The objective was to determine the efficacy of daily consumption of boiled and mashed OFSP in improving the vitamin A status of primary school children. DESIGN: Children aged 5-10 y were randomly assigned to 2 groups. The treatment group (n = 90) consumed 125 g boiled and mashed OFSP (1031 retinol activity equivalents/d as beta-carotene), and the control group (n = 90) consumed an equal amount of white-fleshed sweet potato devoid of beta-carotene for 53 school days. All children were dewormed to exclude helminthic infection. The modified-relative-dose-response test for vitamin A status was conducted before and after intervention. RESULTS: The estimated intervention effect for the ratio of 3,4-didehydroretinol to retinol (DR:R) was -0.008 (95% CI: -0.015, -0.001; P = 0.0203), which indicated a greater improvement in vitamin A liver stores in the treatment group than in the control group. The proportions of children with normal vitamin A status (DR:R < 0.060) in the treatment group tended to increase from 78% to 87% (P = 0.096) and did not change significantly (from 86% to 82%) in the control group (P = 0.267). These proportions were not used to test the intervention effect or within-group changes because the study was powered to test the intervention effect on DR:R. CONCLUSIONS: Consumption of OFSP improves vitamin A status and can play a significant role in developing countries as a viable long-term food-based strategy for controlling vitamin A deficiency in children.

Effect of palm olein oil in a moderate-fat diet on low-density lipoprotein composition in non-human primates.

Plasma low-density lipoprotein cholesterol (LDL-C) concentrations in vervet monkeys (Cercopithecus aethiops) can be modulated by the type and amount of fat in the diet. There is, however, a paucity of information on the effect of different types and quantity of dietary fat on the plasma LDL composition in vervets. The objective of this study was to determine the effect of different sources of dietary fat on the concentrations and composition of circulating plasma LDL in vervets consuming moderate-fat diets containing either animal fat, sunflower oil or palm olein. Fifty adult male vervets, never exposed to a Western-type atherogenic diet, were randomly assigned to two groups. For 6 weeks 30 vervets were fed a moderate-fat (28%E) moderate-cholesterol (26 mg cholesterol/1000 kJ) diet (MFD) with a polyunsaturated to saturated fatty acid ratio (P/S) of 0.4; 20 vervets were fed a high-fat (34%E) high-cholesterol (98 mg cholesterol/1000 kJ) diet (HFD) with a P/S ratio of 0.6. Fasting blood samples were collected from all 50 vervets for plasma lipid measurements. The 30 vervets receiving the MFD were stratified into three comparable experimental groups of 10 each according to their LDL-C and high-density lipoprotein cholesterol (HDL-C) concentrations and bodyweight. One group continued with the MFD, in which 11%E was derived from lard (MFD-AF); in the other two groups the lard was substituted isocalorically with either sunflower oil (SO) (MFD-SO) or palm olein oil (PO) (MFD-PO). The three groups were fed the respective experimental diets for 24 months and LDL component concentrations and composition were assessed at 6-monthly intervals. In the long-term study the MFD-AF, MFD-SO and MFD-PO groups showed no significant time-specific group differences at 6, 12, 18 or 24 months with regard to the LDL component concentrations, composition, as well as the LDL molecular weight. As expected, after 6 weeks of dietary exposure the HFD group had significantly higher plasma and lipoprotein total cholesterol, LDL component and apolipoprotein AI concentrations, as well as a higher LDL-C : HDL-C ratio compared to the MFD group (P 0.0005). LDL particle size was not significantly different between the HFD and MFD groups, but the HFD group had significantly fewer triacylglycerol and significantly more unesterified cholesterol molecules per LDL particle compared to the MFD group (P 0.0018). PO in a MFD is no different from AF or SO in its effect on LDL component concentrations, composition or particle size. The increased LDL-C concentration seen with the HFD could be accounted for by a more than two-fold increase in the number of circulating LDL particles and not as a result of enrichment of particles with cholesterol.

Effect of palm olein oil in a moderate-fat diet on plasma lipoprotein profile and aortic atherosclerosis in non-human primates.

Several studies have reported on the effect of palm olein oil (PO; palmitic acid content approximately 38%) incorporation into the diet on blood cholesterol concentration. Information on the effect of PO on atherosclerosis is, however, lacking. In vervet monkeys (Cercopithecus aethiops), low-density lipoprotein cholesterol (LDL-C) concen-trations can be modulated by the type and amount of fat in the diet. The vervet is a proven model for both the type and composition of human atherosclerotic lesions. The aim of this study was to determine the effect of PO in a moderate-fat moderate-cholesterol diet (MFD) on plasma lipoproteins and the progression of atherosclerosis in a non-human primate model after 25.5 months of dietary exposure. Thirty adult male vervets, never exposed to a Western-type atherogenic diet, were stabilised on a MFD (28%E fat; 26 mg cholesterol/1000 kJ) with a polyunsaturated to saturated fatty acid (P/S) ratio of 0.4 for six weeks. Baseline LDL-C, high-density lipoprotein (HDL)-C and bodyweight were used to stratify the vervets into three comparable groups of 10 each. One group continued with the MFD in which 11.0%E was derived from lard (AF). In the other two groups, the AF was substituted isocalorically with either sunflower oil (SO) or PO. Plasma lipids were measured at 6-monthly intervals and atherosclerosis was assessed in the aorta and in five peripheral arteries after 25.5 months of dietary exposure. The frequency of atherosclerosis in peripheral arteries and aortas was low. PO, relative to SO and AF, significantly reduced the risk for developing early lesions in peripheral arteries (P = 0.0277 and P = 0.0038, respectively) and, relative to AF, in aortas (P = 0.0335). The cholesterolaemic effect of MFD-PO was not significantly different from MFD-SO and MFD-AF. However, at 24 months the plasma total cholesterol concentration with MFD-AF was significantly higher than with MFD-SO (P = 0.0256). It is confirmed that a MFD with PO is no different from AF or SO in its cholesterolaemic effect. The anti-atherogenic efficacy of a MFD with PO, relative to SO and AF, was demonstrated in a non-human primate model of atherogenesis.