The effect of daily consumption of the small fish Amblypharyngodon mola or added vitamin A on iron status: a randomised controlled trial among Bangladeshi children with marginal vitamin A status.

BACKGROUND AND OBJECTIVES: Mola (Amblypharyngodon mola) is a nutrient-rich, small fish found in ponds and rice fields in Bangladesh. The aim of the present intervention was to assess the effect of mola consumption on iron status in children with marginal vitamin A status. METHODS AND STUDY DESIGN: Bangladeshi children (n=196), aged 3-7 years, with marginal vitamin A status were randomly allocated to one of three intervention groups served different fish curries: mola curry (experimental group); rui (Labeo rohita) curry with added retinyl palmitate (positive control group); or rui curry (negative control group). The intervention meals were served 6 days/week for 9 weeks. The experimental and positive control meals were designed to contain similar amounts of retinol activity equivalents per portion. The mola curry contained four times more iron compared to the rui curries due to different iron content in the two fish species. Haemoglobin, ferritin, serum transferrin receptor and Creactive protein were measured at screening and endpoint. RESULTS: In the experimental group receiving mola, serum transferrin receptor concentration declined 0.73 mg/L (95% CI 0.17, 1.28, p=0.01) compared to the positive control group, while there were no differences between groups in ferritin or haemoglobin. CONCLUSIONS: Consumption of mola instead of rui has potentially an effect on iron status in children with marginal vitamin A status, seen as a decrease in serum transferrin receptor concentration.

Effect of consumption of the nutrient-dense, freshwater small fish Amblypharyngodon mola on biochemical indicators of vitamin A status in Bangladeshi children: a randomised, controlled study of efficacy.

In Bangladesh, some commonly consumed, indigenous, freshwater small fish species (eaten whole with bone, head and eyes) such as mola (Amblypharyngodon mola) are nutrient-dense, containing preformed vitamin A as retinol and especially 3,4-dehydroretinol. The objective of the present randomised, controlled efficacy study was to evaluate the effects of mola on biochemical indicators of vitamin A status. Children (n 196), aged 3-7 years, with serum retinol 0.36-0.75 micromol/l, were randomly allocated to one of three treatment groups to receive a daily test meal (6 d/week for 9 weeks) of rice and vegetable curry (no vitamin A) ad libitum and 50 g fish curry consisting of: (1) mola, 600 retinol activity equivalents (RAE) (using 40 % biological activity of 3,4-dehydroretinol isomers) (experimental group, n 66); (2) rui (Labeo rohita), a large fish (no vitamin A), with added retinyl palmitate, 600 RAE (positive control group, n 65); or (3) rui, 0 RAE (negative control group, n 65). The nutrient compositions of the dishes were analysed. After 9 weeks, no significant treatment effects were observed for serum retinol (P = 0.52) and retinol-binding protein (P = 0.81) in the experimental group compared with the negative control, whereas the positive control improved significantly (P < 0.001). The present results do not suggest conversion of the large amount of 3,4-dehydroretinol in mola curry to retinol. Further research on the functional effect of mola in humans is needed. Mola is a nutrient-dense animal-source food, rich in haem Fe, Zn and especially Ca, thus consumption of mola in Bangladesh should continue to be encouraged.

Acute-phase protein levels, diarrhoea, Trichuris trichiura and maternal education are predictors of serum retinol: a cross-sectional study of children in a Dhaka slum, Bangladesh.

The objectives of the present study were to identify predictors of serum retinol concentration as well as to assess the prevalence of low serum retinol concentration, in both the whole population after correcting for the effect of serum C-reactive protein (CRP) (using multiple categories), and the healthy subgroup. A cross-sectional study of 579 apparently healthy children, aged 3-7 years from a Dhaka slum, Bangladesh, was conducted. The effects of age, gender, serum CRP and alpha1-antichymotrypsin, reported morbidity (during the previous 2 weeks), Ascaris lumbricoides and Trichuris trichiura infections, parental education, wasting, stunting and underweight on serum retinol were estimated using multiple linear regression. The mean serum retinol concentration was 0.84 (sd 0.27) micromol/l. Elevated serum CRP levels, reported diarrhoea, reported nasal discharge and T. trichiura infection were negative predictors of serum retinol, whereas maternal education was a positive predictor. Compared with a serum CRP level of < 1 mg/l, CRP levels of 2 to < 5, 5 to < 10 and > or = 10 mg/l were associated with 0.12, 0.16 and 0.32 micromol/l lower serum retinol, respectively. The prevalence of low serum retinol (< 0.70 micromol/l) fell from 31.2 % to 15.6 % in the whole population, after correcting for the effect of CRP, and was 20.1 % in the healthy subgroup (CRP < 2 mg/l). The prevalence of low serum retinol was high but overestimated due to the effect of CRP. Interventions are needed to address low serum retinol in Bangladesh. Controlling diarrhoea, nasal discharge and T. trichiura infection and improving maternal education may be important interventions. The use of multiple categories of acute-phase proteins and cut-off values that indicate elevated levels need further research.

Acute phase protein levels, T. trichiura, and maternal education are predictors of serum zinc in a cross-sectional study in Bangladeshi children.

Zinc deficiency is a public health issue in Bangladesh. The objectives were to identify predictors of serum zinc concentration and to assess the prevalence of low serum zinc, in both the whole population, after correcting for the effect of serum C-reactive protein (CRP) (using multiple categories), and the healthy subgroup. A cross-sectional study was conducted among 579 apparently healthy 3-7 y old children from a Dhaka slum, Bangladesh. Using multiple linear regression, the effects of age, gender, serum CRP and alpha 1-antichymotrypsin, reported morbidity, Ascaris lumbricoides and Trichuris trichiura infections, parental education as well as stunting, underweight, and wasting on serum zinc were estimated. Serum zinc (mean +/- SD) was 9.7 +/- 1.1 micromol/L. Elevated serum CRP levels, T. trichiura infection, and stunting were negative predictors of serum zinc, whereas maternal education was a positive predictor. Compared with serum CRP <1 mg/L, CRP levels of 2 to <5, 5 to <10 and > or =10 mg/L were associated with 0.33, 0.73, and 0.89 micromol/L lower serum zinc, respectively. The prevalence of low serum zinc (<9.9 micromol/L) fell from 59.3 to 49.7% in the whole population, after correcting for the effect of CRP and was 50.0% in the healthy subgroup (CRP <2 mg/L). The prevalence of low serum zinc was high but overestimated due to the effect of the acute phase response. Interventions to address low serum zinc in Bangladesh are warranted. Controlling T. trichiura infection and improving maternal education may be important interventions. The use of multiple categories of acute phase proteins and cut-off values that indicate elevated levels warrant further research.