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Book: Assessing Vitamin A safety in large-scale nutrition intervention programmes

Tanumihardjo, Sherry A.

setting the research agenda

(Food and nutrition bulletin ; Volume 37, Supplement 2 (June 2016))

2016

Author's details	guest editor: Sherry A. Tanumihardjo
Series title	Food and nutrition bulletin ; Volume 37, Supplement 2 (June 2016)
Collection
Language	English
Size	103 Seiten, Illustrationen
Publisher	SAGE Publications
Publishing place	Thousand Oaks, CA
Publishing country	United States
Document type	Book
HBZ-ID	HT019026950
Database	Catalogue ZB MED Nutrition, Environment, Agriculture

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Shelf mark	Loan status	Location
Z 4308 (37,Suppl2)	available for loan (reading room)	Freihandmagazin (U1)

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Book: Carotenoids and human health

Tanumihardjo, Sherry A.

(Nutrition and health)

2013

Author's details	Sherry A. Tanumihardjo ed
Series title	Nutrition and health
Keywords	Carotenoids--Health aspects ; Vitamin A in human nutrition
Language	English
Size	XXIII, 331 S. : Ill., graph. Darst., Kt.
Publisher	Humana Press
Publishing place	New York u.a.
Publishing country	United States
Document type	Book
HBZ-ID	HT017485172
ISBN	978-1-62703-202-5 ; 9781627032032 ; 1-62703-202-9 ; 1627032037
Database	Catalogue ZB MED Medicine, Health

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2012 A 4525	order for loan	Magazin

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Article ; Online: Incremental Improvements in Vitamin A Model-Based Compartmental Analysis in Anticipation of Real Data in Lactating Women.

Tanumihardjo, Sherry A

The Journal of nutrition

2022 Volume 152, Issue 12, Page(s) 2640–2642

MeSH term(s)	Female ; Humans ; Animals ; Vitamin A/blood ; Milk ; Lactation ; Nutritional Status
Chemical Substances	Vitamin A (11103-57-4)
Language	English
Publishing date	2022-10-22
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	218373-0
ISSN	1541-6100 ; 0022-3166
ISSN (online)	1541-6100
ISSN	0022-3166
DOI	10.1093/jn/nxac210
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Article ; Online: Biological evidence to define a vitamin A deficiency cutoff using total liver vitamin A reserves.

Tanumihardjo, Sherry A

Experimental biology and medicine (Maywood, N.J.)

2021 Volume 246, Issue 9, Page(s) 1045–1053

Abstract: Vitamin A is a fat-soluble vitamin involved in essential functions including growth, immunity, reproduction, and vision. The vitamin A Dietary Reference Intakes (DRIs) for North Americans suggested that a minimally acceptable total liver vitamin A ... ...

Abstract	Vitamin A is a fat-soluble vitamin involved in essential functions including growth, immunity, reproduction, and vision. The vitamin A Dietary Reference Intakes (DRIs) for North Americans suggested that a minimally acceptable total liver vitamin A reserve (TLR) is 0.07 µmol/g, which is not explicitly expressed as a vitamin A deficiency cutoff. The Biomarkers of Nutrition for Development panel set the TLR cutoff for vitamin A deficiency at 0.1 µmol/g based on changes in biological response of several physiological parameters at or above this cutoff. The criteria used to formulate the DRIs include clinical ophthalmic signs of vitamin A deficiency, circulating plasma retinol concentrations, excretion of vitamin A metabolites in the bile, and long-term storage of vitamin A as protection against vitamin A deficiency during times of low dietary intake. This review examines the biological responses that occur as TLRs are depleted. In consideration of all of the DRI criteria, the review concludes that induced biliary excretion and long-term vitamin A storage do not occur until TLRs are >0.10 µmol/g. If long-term storage is to continue to be part of the DRI criteria, vitamin A deficiency should be set at a minimum cutoff of 0.10 µmol/g and should be set higher during times of enhanced requirements where TLRs can be rapidly depleted, such as during lactation or in areas with high infection burden. In population-based surveys, cutoffs are important when using biomarkers of micronutrient status to define the prevalence of deficiency and sufficiency to inform public health interventions. Considering the increasing use of quantitative biomarkers of vitamin A status that indirectly assess TLRs, i.e. the modified-relative-dose response and retinol-isotope dilution tests, setting a TLR as a vitamin A deficiency cutoff is important for users of these techniques to estimate vitamin A deficiency prevalence. Future researchers and policymakers may suggest that DRIs should be set with regard to optimal health and not merely to prevent a micronutrient deficiency.
MeSH term(s)	Biomarkers/metabolism ; Humans ; Liver/chemistry ; Liver/metabolism ; Reference Values ; Vitamin A/analysis ; Vitamin A/metabolism ; Vitamin A Deficiency/diagnosis
Chemical Substances	Biomarkers ; Vitamin A (11103-57-4)
Language	English
Publishing date	2021-03-25
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	4015-0
ISSN	1535-3699 ; 1525-1373 ; 0037-9727
ISSN (online)	1535-3699 ; 1525-1373
ISSN	0037-9727
DOI	10.1177/1535370221992731
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Article ; Online: The Dawn of a New Era in Vitamin A Assessment.

Tanumihardjo, Sherry A

The Journal of nutrition

2019 Volume 150, Issue 2, Page(s) 185–187

MeSH term(s)	Biomarkers/metabolism ; Chromatography, Liquid ; Humans ; Isotopes ; Limit of Detection ; Tandem Mass Spectrometry ; Vitamin A/metabolism
Chemical Substances	Biomarkers ; Isotopes ; Vitamin A (11103-57-4)
Language	English
Publishing date	2019-11-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	218373-0
ISSN	1541-6100 ; 0022-3166
ISSN (online)	1541-6100
ISSN	0022-3166
DOI	10.1093/jn/nxz283
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Article ; Online: Maize: A Paramount Staple Crop in the Context of Global Nutrition.

Nuss, Emily T / Tanumihardjo, Sherry A

Comprehensive reviews in food science and food safety

2021 Volume 9, Issue 4, Page(s) 417–436

Abstract: The maize plant (Zea mays), characterized by an erect green stalk, is one of the 3 great grain crops of the world. Its kernels, like other seeds, are storage organs that contain essential components for plant growth and reproduction. Many of these kernel ...

Abstract	The maize plant (Zea mays), characterized by an erect green stalk, is one of the 3 great grain crops of the world. Its kernels, like other seeds, are storage organs that contain essential components for plant growth and reproduction. Many of these kernel constituents, including starch, protein, and some micronutrients, are also required for human health. For this reason, and others, maize has become highly integrated into global agriculture, human diet, and cultural traditions. The nutritional quality and integrity of maize kernels are influenced by many factors including genetic background, environment, and kernel processing. Cooking procedures, including nixtamalization and fermentation, can increase accessibility of micronutrients such as niacin. However, man cannot live on maize alone. For one-third of the world's population, namely in sub-Saharan Africa, Southeast Asia, and Latin America, humans subsist on maize as a staple food but malnutrition pervades. Strategies to further improve kernel macronutrient and micronutrient quality and quantities are under intense investigation. The 2 most common routes to enhance grain nutritional value are exogenous and endogenous fortification. Although exogenous fortification, such as addition of multivitamin premixes to maize flour, has been successful, endogenous fortification, also known as "biofortification," may provide a more sustainable and practical solution for chronically undernourished communities. Recent accomplishments, such as low-phytate, high-lysine, and multivitamin maize varieties, have been created using novel genetic and agronomic approaches. Investigational studies related to biofortified maize are currently underway to determine nutrient absorption and efficacy related to human health improvement.
Language	English
Publishing date	2021-01-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2185829-9
ISSN	1541-4337 ; 1541-4337
ISSN (online)	1541-4337
ISSN	1541-4337
DOI	10.1111/j.1541-4337.2010.00117.x
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Article ; Online: Total Liver Vitamin A Reserves, Determined With 13C2-Retinol Isotope Dilution, are Similar Among Tanzanian Preschool Children in Areas With Low and High Vitamin A Exposure.

Urio, Elisaphinate M / Tanumihardjo, Sherry A / Fweja, Leonard W / Ndossi, Godwin D

The Journal of nutrition

2023 Volume 152, Issue 12, Page(s) 2699–2707

Abstract: Background: In Tanzania, some districts have single vitamin A (VA) interventions and others have multiple interventions. There is limited information on total liver VA reserves (TLRs) among preschool children (PSC) in Tanzania.: Objectives: We ... ...

Abstract	Background: In Tanzania, some districts have single vitamin A (VA) interventions and others have multiple interventions. There is limited information on total liver VA reserves (TLRs) among preschool children (PSC) in Tanzania. Objectives: We assessed total body VA stores (TBSs) and TLRs among PSC living in 2 districts with low and high exposures to VA interventions using 13C-retinol isotope dilution. Methods: A cross-sectional, health facility-based study was conducted in 2 districts with access to VA supplementation only (low exposure to VA interventions) or multiple interventions (high exposure to VA interventions) to determine TLRs in 120 PSC aged 36-59 months. A questionnaire was used to collect data. Height and weight were measured, and the prevalence of undernutrition was based on z-scores. Blood samples were collected for measurement of TBSs, TLRs, retinol, biomarkers of infection and inflammation, and hemoglobin. 13C2-retinyl acetate (1.0 μmol) was administered to each child after blood collection, and the second sample was taken 14 days later. Serum was analyzed with HPLC and gas chromatography-combustion-isotope ratio mass spectrometry. Mann-Whitney U test was used to compare medians of nonnormally distributed variables. Pearson χ2 test was used to assess associations between 2 categorical variables. Results: Median TBSs differed between PSC from low-exposure (196 μmol; IQR, 120 μmol) and high-exposure (231 μmol; IQR, 162 μmol) intervention areas (P = 0.015). Median TLRs were 0.23 μmol/g liver (IQR, 0.14 μmol/g liver) and 0.26 μmol/g liver (IQR, 0.16 μmol/g liver) from low- and high-exposure areas, respectively, which did not significantly differ (P = 0.12). Prevalences of VA deficiency (VAD; ≤0.1 μmol/g liver) were 6.3% and 1.7% for PSC from low- and high-exposure areas, respectively. There was no significant difference in VAD (P = 0.25). No child had hypervitaminosis A (≥1.0 μmol/g liver). Conclusions: TLRs in Tanzanian PSC from 2 districts did not differ between low and high exposures to VA interventions. The majority had adequate VA stores. VAD in the study area presented a mild public health problem.
MeSH term(s)	Humans ; Child, Preschool ; Vitamin A ; Tanzania/epidemiology ; Cross-Sectional Studies ; Vitamin A Deficiency/epidemiology ; Liver ; Carbon Isotopes
Chemical Substances	Vitamin A (11103-57-4) ; Carbon-13 (FDJ0A8596D) ; Carbon Isotopes
Language	English
Publishing date	2023-03-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	218373-0
ISSN	1541-6100 ; 0022-3166
ISSN (online)	1541-6100
ISSN	0022-3166
DOI	10.1093/jn/nxac227
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Article ; Online: Time Since Dose and Dietary Vitamin A Intake Affect Tracer Mixing in the 13C-Retinol Isotope Dilution Test in Male Rats.

Sheftel, Jesse / Smith, Jordan B / Tanumihardjo, Sherry A

The Journal of nutrition

2022 Volume 152, Issue 6, Page(s) 1582–1591

Abstract: Background: Retinol isotope dilution (RID) estimates total liver vitamin A reserves (TLRs), the gold-standard vitamin A (VA) biomarker. RID equation assumptions are based on limited data.: Objectives: We measured the impact of tracer choice, mixing ... ...

Abstract	Background: Retinol isotope dilution (RID) estimates total liver vitamin A reserves (TLRs), the gold-standard vitamin A (VA) biomarker. RID equation assumptions are based on limited data. Objectives: We measured the impact of tracer choice, mixing period, and VA intake on tracer mixing [ratio of tracer enrichment in serum to that in liver stores (S)] in VA-deficient, -adequate, and hypervitaminotic rats. Methods: Study 1 was a 3 × 2 × 3 design (18 groups, n = 5/group). Male Sprague-Dawley rats (21 d old) received 50, 100, or 3500 nmol VA/d for 21 d, were administered 52 nmol 13C2- or 13C10-retinyl acetate orally, and killed 5, 10, or 15 d later. Unlabeled VA (50 nmol/d) was given on days 11-14. Study 2 used 100 nmol VA/d for 21 d with 3 groups (n = 6-7): 52 nmol 13C2- or 13C10-retinyl acetate and 100 nmol VA/d throughout 14-d mixing, or 13C2-retinyl acetate without VA. Repeated-measures, 1-factor, and 3-factor ANOVAs were used for analysis. Results: Mean ± SD TLRs (μmol/g liver) reflected intake: 0.11 ± 0.04 (50 nmol VA/d), 0.16 ± 0.04 (100 nmol VA/d), and 5.07 ± 1.58 (3500 nmol VA/d) in Study 1 and 0.24 ± 0.08 (100 nmol VA/d) in Study 2. In Study 1, mean ± SD S was 1.65 ± 0.26 (5 d), 1.16 ± 0.09 (10 d), and 0.92 ± 0.08 (15 d). The interactions tracerVA intake and timeVA intake were significant between days 10 and 15 (P < 0.05). In Study 2, mean ± SD S was 1.07 ± 0.02 without VA during mixing, and 0.81 ± 0.04 (13C2) and 0.79 ± 0.03 (13C10) with VA intake throughout. Estimated:measured TLRs varied by VA intake and time in Study 1 but not between groups in Study 2. Conclusions: The 13C-content effect on RID through S is inconsistent. S is highly variable at 5 d, contraindicating early-time point RID. VA intake effects on S vary with timing and quantity. Assuming S = 0.8 at 14 d with consistent VA intake in human studies is likely appropriate.
MeSH term(s)	Animals ; Carbon Isotopes ; Liver ; Male ; Rats ; Rats, Sprague-Dawley ; Vitamin A ; Vitamin A Deficiency
Chemical Substances	Carbon Isotopes ; Vitamin A (11103-57-4) ; Carbon-13 (FDJ0A8596D)
Language	English
Publishing date	2022-03-08
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	218373-0
ISSN	1541-6100 ; 0022-3166
ISSN (online)	1541-6100
ISSN	0022-3166
DOI	10.1093/jn/nxac051
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Article ; Online: Systematic Review and Meta-Analysis of the Relative Dose-Response Tests to Assess Vitamin A Status.

Sheftel, Jesse / Tanumihardjo, Sherry A

Advances in nutrition (Bethesda, Md.)

2020 Volume 12, Issue 3, Page(s) 904–941

Abstract: Vitamin A (VA) is an essential nutrient often lacking in the diets of people in developing countries. Accurate biomarkers of VA status are vital to inform public health policy and monitor interventions. The relative dose-response (RDR) and modified-RDR ( ... ...

Abstract	Vitamin A (VA) is an essential nutrient often lacking in the diets of people in developing countries. Accurate biomarkers of VA status are vital to inform public health policy and monitor interventions. The relative dose-response (RDR) and modified-RDR (MRDR) tests are semi-quantitative screening tests for VA deficiency that have been used in Demographic and Health Surveys and VA intervention studies. A systematic review and meta-analysis of sensitivity and specificity were conducted to summarize the physiological evidence to support the RDR tests as methods to assess VA status and investigate the impact of different pathological and physiological states on the tests. A total of 190 studies were screened for inclusion, with 21 studies comparing the RDR tests with the gold-standard biomarker, liver VA concentration (68% and 80% sensitivity and 85% and 69% specificity for the RDR and MRDR, respectively). Nearly all studies with VA interventions in VA-deficient populations demonstrated a response of the tests to VA intake that would be expected to improve VA status. The impacts of chronic liver disease, protein malnutrition, age, pregnancy and lactation, infection and inflammation, and various other conditions were examined in 51 studies. The RDR and MRDR tests were reported to have been used in 39 observational studies, and the MRDR has been used in at least 6 national micronutrient surveys. The RDR and MRDR are sensitive tests for determining population VA status and assessing VA interventions. Although they are robust to most physiological and pathological states, caution may be warranted when using the tests in neonates, individuals with chronic liver disease, and those with protein or iron malnutrition. Research on further improvements to the tests to increase accessibility, such as sampling breast milk instead of blood or using intramuscular doses in subjects with malabsorption, will allow wider adoption. This review was registered with PROSPERO as CRD42019124180.
MeSH term(s)	Breast Feeding ; Dose-Response Relationship, Drug ; Female ; Humans ; Infant, Newborn ; Lactation ; Milk, Human/chemistry ; Nutritional Status ; Vitamin A/analysis ; Vitamin A Deficiency/diagnosis
Chemical Substances	Vitamin A (11103-57-4)
Language	English
Publishing date	2020-11-03
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2583634-1
ISSN	2156-5376 ; 2156-5376
ISSN (online)	2156-5376
ISSN	2156-5376
DOI	10.1093/advances/nmaa136
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Article ; Online: Recommendations to adjust national vitamin A intervention policy must follow a consistent framework.

Sheftel, Jesse / Suri, Devika J / Tanumihardjo, Sherry A

The American journal of clinical nutrition

2021 Volume 113, Issue 6, Page(s) 1707–1708

MeSH term(s)	Child ; Dietary Supplements ; Humans ; India ; Nutrition Policy ; Vitamin A ; Vitamin A Deficiency/epidemiology ; Vitamin A Deficiency/prevention & control
Chemical Substances	Vitamin A (11103-57-4)
Language	English
Publishing date	2021-06-01
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	280048-2
ISSN	1938-3207 ; 0002-9165
ISSN (online)	1938-3207
ISSN	0002-9165
DOI	10.1093/ajcn/nqab104
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