Chronic low intakes of vitamin A-rich foods in households with xerophthalmic children: a case-control study in Nepal
Shankar, A.V.; West, K.P.; Gittelsohn, J.; Katz, J.; Pradhan, R.
American Journal of Clinical Nutrition 64(2): 242-248
1996
ISSN/ISBN: 0002-9165 PMID: 8694027 DOI: 10.1093/ajcn/64.2.242Document Number: 313940
Dietary patterns in 81 rural Nepali households with a 1-6-y-old child with a history of xerophthalmia were compared with dietary patterns of 81 households with an age-matched nonxerophthalmic control subject. Weekly food-frequency questionnaires were collected from case and control "focus" children, a younger sibling (if present), and the household 1-2 y after recruitment and treatment of cases. Control households and children were more likely than case households and children to consume vitamin A-rich foods during the monsoon (July-September) and major rice harvesting (October-December) seasons. Cases were less likely to consume preformed vitamin A-rich foods throughout the year (odds ratio (OR) = 1.2-4.5) with the strongest differences observed from October to December (OR = 2.0-4.2). Dietary risks were generally shared by younger siblings of cases, suggesting that infrequent intake of beta-carotene and preformed vitamin-A rich foods begins early in life and clusters among siblings within households, a pattern that is consistent with their higher risk of xerophthalmia and mortality. In developing countries where vitamin A deficiency is endemic, dietary counseling for children with xerophthalmia should be extended to their younger siblings. Moreover, dietary intake of preformed vitamin A may be as, or more, important as carotenoid-containing food consumption in protecting children and other members of households from vitamin A deficiency.