Prevention of post-mole malignant trophoblastic disease with vitamin A.

OBJECTIVE: Around 15-28% of hydatidiform mole patients suffer from malignant degeneration following evacuation. Since retinoic acid can control cell proliferation and stimulate apoptosis, vitamin A could be used as a therapy for preventing such malignant transformation. The objective of this study was to demonstrate the use of vitamin A as a chemoprevention following hydatidiform mole development. MATERIALS AND METHODS: The study made use of a randomized clinical trial, double blind protocol. Subjects were patients with complete hydatidiform moles, not receiving cytostatics. The intervention was administration of placebo or vitamin A at 200,000 IU per day, performed until the patients were declared as having recovered or having malignant trophoblastic disease (MTD). The outcome variables were the incidence of regression and MTD, established based on WHO criteria. RESULTS: At clinical trial as many as 67 cases met the requirements for the study. Two cases were lost from observation and three experienced pregnancy. The incidence rate of malignant trophoblastic disease in the control group was 28.6%, and in the therapy group was 6.3%. No difference was found in the changes of SGOT and SGPT levels of the therapy group compared with the control group. CONCLUSION: The rate of malignant trophoblastic disease (MTD) was reduced in the group receiving vitamin A therapy.

Extraction of carotenoids from feces, enabling the bioavailability of beta-carotene to be studied in Indonesian children.

Previously, we have presented a method for quantifying beta-carotene bioavailability based on analysis in serum, following administration of (13)C-labeled beta-carotene. Because stool samples can be collected noninvasively, we have now extended the method to measure the bioavailability based on measurements in feces. An extraction method was developed to enable measurement of concentrations and degree of isotopic enrichment of retinol, retinyl palmitate and carotenoids in feces. Relative bioavailability of beta-carotene from pumpkin (n = 6) was found to be 1.8 times (interval, 0.6, 5.5) greater than that from spinach (n = 8), based on data from feces compared with 1.7 times (interval, 0.9, 3.1) based on data from serum.

Transitions in diet and health: implication of modern lifestyles in Indonesia.

Indonesia is in the midst of major transitions in food intake and health patterns. These changes are predicated on economic growth, rising levels of education and globalisation of culture. Somehow retaining the food-health advantages of traditional Indonesian lifestyle and accommodating the advances which the West has made, especially in life expectancy, without their increasing health problems and costs, is required. From 1972 to 1992, mortality ranking for cardiovascular disease (CVD) in Indonesia had gone from the 11th most common to the most common. The Jakarta Monica studies (1988 and 1993) provide prima facie evidence that similar cardiovascular risk factors to those in industrialised countries are operative for the emergent CVD problem - positive energy balance with obesity, increased animal fat consumption and decreased intake of plant-derived foods, with their many biologically active components, both nutrient and non-nutrient. Nutrition surveys show that the contribution of fat to energy intake has doubled from 1974 to 1992 (10.4% in 1974 to 20.5% in 1992). Effort is now required to enable consumers to overcome prejudice against plant foods, for whatever reason, to use low fat animal-derived food and for food products and their promotion to favour healthy choice.

Vitamin A and vitamin E status of rural preschool children in West Java, Indonesia, and their response to oral doses of vitamin A and of vitamin E.

Vitamin A and E status was studied in five groups (satisfactory growth, reduced growth, night blindness, Bitot's spots, and corneal xerosis) of rural Indonesian preschool children. All groups except corneal xerosis showed satisfactory weight-height ratios. Initial serum retinol values were less than 0.35 mumol/L in 34% of all children. After oral administration of 24.4 mumol vitamin A, mean serum retinol values rose from 0.42 to 0.70 mumol/L at 10 d. After oral treatment of children with 244 or 314 mumol vitamin A, mean serum retinol remained greater than 0.56 mumol/L for 165 d. Of particular note were the low mean initial serum alpha-tocopherol concentrations (6.3 mumol/L) and alpha-tocopherol-total lipid ratios (1.5 mumol/g). Total serum lipids fell in the normal range. Oral administration of 84 mumol vitamin E raised serum alpha-tocopherol and alpha-tocopherol-total-lipid ratios by 46 and 44%, respectively. Thus, vitamin E inadequacy, which impairs vitamin A absorption and storage, may well contribute to the high incidence of clinical vitamin A deficiency in West Javan children.