31019
document
Supplementation with iron and riboflavin enhances dark adaptation response to vitamin A-fortified rice in iron-deficient , pregnant , nightblind Nepali women . BACKGROUND Nightblindness affects 16-52 % of pregnant women in areas of Nepal and in some cases persists after vitamin A treatment . Iron and riboflavin affect vitamin A utilization and photoreceptor function , respectively , and pilot data in the study population showed a high prevalence of iron and riboflavin deficiencies . OBJECTIVE The objective was to assess the effect of supplemental iron and riboflavin on pupillary threshold ( PT ) and plasma retinol in nightblind , pregnant Nepali women given vitamin A-fortified rice . DESIGN Nightblind pregnant women were randomly assigned to receive , 6 d/wk under supervision for 6 wk , a vitamin A-fortified rice curry dish providing 850 microg retinal activity equivalents/d with either a 30-mg Fe and 6-mg riboflavin ( FeR + VA ) capsule or a placebo control ( VA only ) capsule . Hemoglobin , erythrocyte riboflavin , and plasma ferritin and retinol were measured before and after the intervention . Dark adaptation was assessed by PT score . RESULTS Women who were iron deficient at baseline ( n=38 ) had significantly greater improvement in PT score with iron and riboflavin supplementation than without ( P=0.05 ) . Iron and riboflavin supplements significantly reduced the prevalences of riboflavin deficiency ( from 60 % to 6 % ; P < 0.0001 ) , iron deficiency anemia ( from 35 % to 15 % ; P < 0.007 ) , and abnormal PT ( from 87 % to 30 % ; P < 0.05 ) from baseline . Mean increases in erythrocyte riboflavin ( P < 0.0001 ) and plasma ferritin ( P=0.01 ) were greater in the FeR + VA group than in the VA only group . CONCLUSIONS Iron deficiency may limit the efficacy of vitamin A to normalize dark adaptation in pregnant Nepali women . Further studies are needed to assess the effect of simultaneous delivery of iron and vitamin A for the treatment of nightblindness .
31020
Intervention_Pharmacological
Supplementation with iron and riboflavin
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Intervention_Pharmacological
vitamin A-fortified rice
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Intervention_Pharmacological
Iron
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Intervention_Pharmacological
riboflavin
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Intervention_Pharmacological
supplemental iron and riboflavin
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Intervention_Pharmacological
vitamin A-fortified rice curry dish
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Intervention_Pharmacological
30-mg Fe
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Intervention_Pharmacological
6-mg riboflavin
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Intervention_Control
placebo control
31029
Intervention_Pharmacological
iron
31030
Intervention_Pharmacological
riboflavin
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Intervention_Pharmacological
vitamin A
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Outcome_Mental
Hemoglobin , erythrocyte riboflavin , and plasma ferritin and retinol
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Outcome_Physical
PT score with iron and riboflavin supplementation
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Outcome_Physical
riboflavin deficiency
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Outcome_Physical
iron deficiency anemia
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Outcome_Physical
abnormal PT
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Outcome_Other
plasma ferritin
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Participant_Condition
iron-deficient , pregnant , nightblind
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Participant_Sex
women
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Participant_Condition
pregnant
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Participant_Sex
women
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Participant_Condition
Nightblind pregnant
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Participant_Sex
women
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Participant_Condition
pregnant