Circulating levels of retinol, tocopherol and carotenoid in Nepali pregnant and postpartum women following long-term β-carotene and vitamin A supplementation

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Abstract
Objective: To characterize circulating carotenoid and tocopherol levels in Nepali women during pregnancy and post-partum and to determine the effects of β-carotene and vitamin A supplementation on their concentration in serum. Design: Randomized community supplementation trial. Setting: The study was carried out from 1994 to 1997 in the Southern, rural plains District of Sarlahi, Nepal. Subjects: A total of 1431 married women had an ascertained pregnancy, of whom 1186 (83%) provided an analyzable serum sample during pregnancy; 1098 (77%) provided an analyzable 3–4 months post-partum serum sample. Interventions: Women received a weekly dose of vitamin A (7000 μg RE), β-carotene (42 mg) or placebo before, during and after pregnancy. Serum was analyzed for retinol, α-tocopherol, γ-tocopherol, β-carotene, α-carotene, lycopene, lutein+zeaxanthin, and β-cryptoxanthin concentrations during mid-pregnancy and at ∼ 3 months post-partum. Results: Compared to placebo, serum retinol, β-carotene, γ-tocopherol, β-cryptoxanthin and lutein+zeaxanthin concentrations were higher among β-carotene recipients during pregnancy and, except for β-cryptoxanthin, at postpartum. In the vitamin A group, serum retinol and β-cryptoxanthin were higher during pregnancy, and retinol and γ-tocopherol higher at postpartum. Lutein+zeaxanthin was the dominant carotenoid, regardless of treatment group, followed by serum β-carotene. Serum lycopene level was lowest, and very low compared to the US population. Serum retinol was higher, and carotenoid and α-tocopherol lower, at postpartum than during pregnancy in all groups. Conclusions: Pregnant and lactating Nepali women have lower serum carotenoid and tocopherol levels than well-nourished populations. β-carotene supplementation appeared to increase levels of tocopherol and other carotenoids in this population. Sponsorship: This study was carried out under Cooperative Agreement no DAN 0045-A-5094 and HRN A-00-97-00015-00 between the Office of Health and Nutrition, US Agency for International Development (USAID), Washington, DC and the Center for Human Nutrition, Johns Hopkins School of Public Health, Baltimore, MD, with additional support from Task Force Sight and Life, Basle, Switzerland, NIH grant no RR04060, and the Bill and Melinda Gates Foundation, Seattle, WA. The study was a joint undertaking between the Center for Human Nutrition and the National Society for the Prevention of Blindness, Kathmandu, Nepal. European Journal of Clinical Nutrition (2001) 55, 252–259

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