Fat-soluble vitamins A and E and health disparities in a cohort of pregnant women at delivery

Abstract

The objective of the present study was to evaluate intakes and serum levels of vitamin A, vitamin E, and related compounds in a cohort of maternal-infant pairs in the Midwestern USA in relation to measures of health disparities. Concentrations of carotenoids and tocopherols in maternal serum were measured using HPLC and measures of socio-economic status, including food security and food desert residence, were obtained in 180 mothers upon admission to a Midwestern Academic Medical Center labour and delivery unit. The Kruskal-Wallis and independent-samples t tests were used to compare measures between groups; logistic regression models were used to adjust for relevant confounders. P < 0·05 was considered statistically significant. The odds of vitamin A insufficiency/deficiency were 2·17 times higher for non-whites when compared with whites (95 % CI 1·16, 4·05; P = 0·01) after adjustment for relevant confounders. Similarly, the odds of being vitamin E deficient were 3·52 times higher for non-whites (95 % CI 1·51, 8·10; P = 0·003). Those with public health insurance had lower serum lutein concentrations compared with those with private health insurance (P = 0·05), and living in a food desert was associated with lower serum concentrations of β-carotene (P = 0·02), after adjustment for confounders. Subjects with low/marginal food security had higher serum levels of lutein and β-cryptoxanthin compared with those with high food security (P = 0·004 and 0·02 for lutein and β-cryptoxanthin). Diet quality may be a public health concern in economically disadvantaged populations of industrialised societies leading to nutritional disadvantages as well.

Keywords: Carotenoids; Food deserts; Food security; NHANES, Third National Health and Nutrition Examination Survey; Poverty; USDA, United States Department of Agriculture; Vitamin A.

Fig. 1.

Frequency of vitamin A deficiency, insufficiency and sufficiency by race. The frequency of serum retinol levels <0·70 and ≤1·05 μmol/l was significantly different in non-whites v. whites (P = 0·04, Fisher's exact test).

Fig. 2.

Frequency of vitamin E insufficiency and sufficiency by race. The frequency of serum α-tocopherol levels ≤8620·7 µg/l (<20 µmol/l) was significantly different in non-whites v. whites (P = 0·004, Fisher's exact test).