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

Objective: To characterize circulating carotenoid and tocopherol levels in Nepali women during pregnancy and post-partum and to determine the effects of beta -carotene and vitamin A supplementation on their concentration in s erum. 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 wh om 1186 (83%) provided an analyzable serum sample during pregnancy; 1098 (7 7%) provided an analyzable 3-4 months post-partum serum sample. Interventions: Women received a weekly dose of vitamin A (7000 mug RE), bet a -carotene (42 mg) or placebo before, during and after pregnancy. Serum wa s analyzed for relinol, alpha -tocopherol, gamma -tocopherol, beta -caroten e, alpha -carotene, lycopene, lutein+zeaxanthin, and beta -cryptoxanthin co ncentrations during mid-pregnancy and at similar to3 months post-partum. Results: Compared to placebo, serum retinol, beta -carotene, gamma -tocophe rol, beta -cryptoxanthin and lutein + zeaxanthin concentrations were higher among beta -carotene recipients during pregnancy and, except for beta -cry ptoxanthin, at postpartum. In the vitamin A group, serum retinol and beta - cryptoxanthin were higher during pregnancy, and retinol and gamma -tocopher ol higher at postpartum. Lutein + zeaxanthin was the dominant carotenoid, r egardless of treatment group, followed by serum beta -carotene. serum lycop ene level was lowest, and very low compared to the US population. Serum ret inol was higher, and carotenoid and alpha -tocopherol lower, at postpartum than during pregnancy in all groups. Conclusions: Pregnant and lactating Nepali women have lower serum carotenoi d and tocopherol levels than well-nourished populations. beta -carotene sup plementation appeared to increase levels of tocopherol and other carotenoid s 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 Nutri tion, US Agency for international Development (USAID), Washington, DC and t he Center for Human Nutrition, Johns Hopkins School of Public Health, Balti more, MD, with additional support from Task Force Sight and Life, Basle, Sw itzerland, MH 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, Kathma ndu, Nepal.