Vitamin developing countries

Butter, fresh and salted, was once a primary trade commodity, but is no longer in as high a demand. There has been a shift in emphasis from fat content to the protein, mineral, and vitamin content of milk and milk products, particularly in developed countries. 

Globally, undernutrition is widespread, leading to impaired growth, defective immune systems, and reduced work capacity. By contrast, in developed countries, there is often excessive food consumption (especially of fat), leading to obesity and to the development of cardiovascular disease and some forms of cancer. Deficiencies of vitamin A, iron, and iodine pose major health concerns in many countries, and deficiencies of other vitamins and minerals are a major cause of iU health. In developed countries, nutrient deficiency is rare, though there are vulnerable sections of the population at risk. Intakes of minerals and vitamins that are adequate to prevent deficiency may be inadequate to promote optimum health and longevity. 

The progeny, called Golden Rice , has received massive publicity for its potential to alleviate vitamin A deficiency in developing countries (Potrykus,... 

Iron-deficiency anaemia results from a discrepancy between iron availability and the amount required for production of red blood cells. The causes of acquired iron deficiency in so-called underdeveloped and developed countries must be differentiated. In underdeveloped countries, the main causes of iron deficiency are (a) the poor availability of iron in the diet due to low haem and high fibre and phytate content (D Souza et ah, 1987), and (b) chronic blood loss due to hookworm, schistosomiasis and malaria (Stoltzfus et ah, 1997 Olsen et ah, 1998 Dreyfuss et ah, 2000). Inflammation and vitamin A deficiency often interfere with the above causes of iron deficiency, causing a mixed type of anaemia. In underdeveloped countries diet improvement, iron fortification of natural foods and eradication of parasites will have a much higher impact than will refinement of diagnostic procedures and therapy of iron-deficiency anaemia. 

Vitamin A deficiency affects more than 100 million children around the world (Miller and others 2002) and thus remains an important public health problem in many countries. Vitamin A is essential for vision, reproduction, growth, immune function, and general health of humans (van Lieshout and others 2001). The major sources of vitamin A in the human diet are retinyl esters (preformed vitamin A) found in foods of animal origin and provitamin A carotenoids from fruits and vegetables. Unfortunately, foods containing preformed vitamin A (meat, milk, eggs, etc.) are frequently too expensive for some economically deprived developing countries, and therefore dietary carotenoids are the main source of vitamin A in these countries. 

Nutritional Deficiency-Related Dementias. We have already mentioned that chronic alcoholics are subject to thiamine deficiency that can cause dementia. It usually occurs only after heavy, prolonged abuse of alcohol. In developed countries, the other key nutritional concern is vitamin deficiency. Vitamin deficiency can surprisingly strike even those with a healthy diet. Such people are missing a vital protein, intrinsic factor, which would enable them to absorb it from their digestive tract. 

Retinol and p-carotene levels were highly significant correlated between maternal plasma versus cord blood and colostrum. In addition, significantly lower levels were found in cord blood [31.2 13% (retinol), 4.1 1.4% (p-carotene)] compared with maternal plasma. Despite the fact that vitamin A- and p-carotene-rich food is generally available, in contrast to developing countries, risk groups for low vitamin A supply indeed exist in the western world. 

Recommended dietary allowances for vitamins have proved to be useful guidelines however it has to be appreciated that these guidelines are not more than estimates made from experiments on only a limited number of subjects. These recommended dietary allowances also need periodic reevaluation. While vitamin deficiencies due to inadequate intakes are encountered in developing countries, few cases are seen in the Western world apart from patients with an increased risk for deficiencies such as diabetics or alcoholics. On the contrary, the widely held belief that vitamins promote better health is deceptive and may lead to overdose disorders. 

Non-compliance is a serious problem in the prevention of osteoporosis and osteoporotic fractures. This is due to adverse effects, lack of noticeable benefit and ignorance. It is difficult to convince regular intake of oral calcium, biphosphonates, vitamin D and in post-menopausal women hormone replacement. Long-term compliance to hormone replacement is worse in developing countries. The most cost-effective therapy for osteoporosis is primary prevention. 

The fortification of these milk products with vitamin A is endorsed by the American Medical Association, with the concurrence of the Food and Nutrition Board, National Academy of Sciences, National Research Council and the Expert Panel on Food Safety and Nutrition of the Institute of Food Technologists (AMA 1982). The fortification of dried skim milk with vitamin A is viewed by the World Health Organization and the Food and Agricultural Organization (WHO 1977) as an important measure to combat vitamin A deficiency in developing countries, where 20,000 to 100,000 children yearly develop blindness from a lack of vitamin A in their diets (DeLuca et al. 1979). 

Citrus fruits and their products are important sources of vitamin C in the American diet, and are becoming increasingly more important to other developed and developing countries. Consumer awareness of the healthful aspects of citrus, together... 

Atrial fibrillation is increasing in incidence in developed countries and, because of the risk of embolic stroke, most patients require continuous anticoagulation. A large number of patients with atrial fibrillation are currently treated with vitamin K antagonists. Results of clinical trials in patients with atrial fibrillation indicate that oral direct TIs may become potential drugs for the prevention of embolic stroke and may replace warfarin (62,78,79-81). 

Rice and corn that express vitamin A and promise to reduce blindness and save lives in many developing countries... 

Fat is a concentrated source of energy that provides 30-40% of dietary calories in developed countries. Fat imparts palatability to food, serves as a vehicle for fat-soluble vitamins A, D, E and K and supplies essential fatty acids. The digestion products of fats, along with endogenously synthesized lipids, provide a diverse group of molecules that play a critical role in multiple metabolic processes. 

The major emphasis should be the prevention of rickets by providing adequate calcium and vitamin D in the diet, particularly if exposure to sunlight is restricted. One teaspoon (4mL) of cod-liver oil provides 360 IU of vitamin D. In developing countries where dairy products are prohibitively expensive, local foods such as dried fish containing small soft bones can add to the calcium intake (Larsen et al., 2000). 

Vitamin A deficiency is a major problem of children under five in developing countries, being the single most common preventable cause of blindness. Table 2.1 shows the prevalence of vitamin A deficiency in different regions of the world. The increased susceptibility to infection and impairment of immune responses in vitamin A deficiency causes significant childhood mortality. A number of trials of vitamin A supplementation in areas of endemic deficiency show a 20% to 35% reduction in child mortality. 

It is not strictly correct to regard niacin as a vitamin. Its metabolic role is as the precursor of the nicotinamide moiety of the nicotinamide nucleotide coenzymes, nicotinamide adenine dinucleotide (NAD) and NADP, and this can also be synthesized in vivo from the essential amino acid tryptophan. At least in developed countries, average intakes of protein provide more than enough tryptophan to meet requirements for NAD synthesis without any need for preformed niacin. It is only when tryptophan metabolism is disturbed, or intake of the amino acid is inadequate, that niacin becomes a dietary essential. 

A variety of studies have shown that 10% to 20% of the population of developed countries have marginal or inadequate stams, as assessed by erythrocyte transaminase activation coefficient (Section 9.5.36) or plasma pyridoxal phosphate (Section 9.5.1 Bender, 1989b). This may be sufficient to enhance the responsiveness of target tissues to steroid hormones (Section 9.3.3), and may be important in the induction and subsequent development of hormone-dependent cancer of the breast and prostate. Vitamin Be supplementation may be a useful adjunct to other therapy in these common cancers certainly, there is evidence that poor vitamin Be nutritional stams is associated with a poor prognosis in women with breast cancer. 

Folate deficiency is relatively common 8% to 10% of the population of developed countries have low or marginal folate stores. By contrast, dietary deficiency of vitamin B12 is rare, and deficiency is most often the result of impaired absorption (Section 10.7.1). 

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