Efficacy of Biofortified Maize to Improve Maternal and Infant Vitamin A Status

NCT ID: NCT02804490

Last Updated: 2017-08-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

255 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-03-31

Study Completion Date

2017-06-02

Brief Summary

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The purpose of this randomized control trial is to test the impact of provitamin A carotenoid biofortified maize meal consumption on maternal and infant vitamin A status.

Detailed Description

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Vitamin A deficiency remains a major public health problem in low and middle income countries. Approximately 50% of Zambian children are thought to be affected. This randomized control trial will test the efficacy of provitamin A carotenoid biofortified maize meal consumption as a strategy to improve vitamin A status among lactating Zambian mothers and their infants. The investigators will enroll up to 255 mother/infant pairs to a three-month study, during which they will receive one of the following three interventions: 1) conventional white maize, 2) provitamin A carotenoid biofortified orange maize, or 3) preformed vitamin A fortified white maize.

Conditions

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Vitamin A Deficiency

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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White maize

Conventional maize flour

Group Type PLACEBO_COMPARATOR

Conventional white maize

Intervention Type DIETARY_SUPPLEMENT

Women and their infants will receive 2 meals/day prepared with conventional white maize flour (287 g dry weight/d for women; 50 g dry weight/d for infants), 6 days/week for 15 weeks

Biofortified maize

Provitamin A carotenoid biofortified maize flour

Group Type EXPERIMENTAL

Provitamin A carotenoid biofortified maize

Intervention Type DIETARY_SUPPLEMENT

Women and their infants will receive 2 meals/day prepared with provitamin A carotenoid biofortified orange maize flour (287 g dry weight/d for women; 50 g dry weight/d for infants), 6 days/week for 15 weeks

Fortified maize

Retinyl palmitate fortified maize flour

Group Type ACTIVE_COMPARATOR

Preformed vitamin A fortified maize

Intervention Type DIETARY_SUPPLEMENT

Women and their infants will receive 2 meals/day prepared with preformed vitamin A fortified, conventional white maize flour (287 g dry weight/d for women; 50 g dry weight/d for infants), 6 days/week for 15 weeks

Interventions

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Conventional white maize

Women and their infants will receive 2 meals/day prepared with conventional white maize flour (287 g dry weight/d for women; 50 g dry weight/d for infants), 6 days/week for 15 weeks

Intervention Type DIETARY_SUPPLEMENT

Provitamin A carotenoid biofortified maize

Women and their infants will receive 2 meals/day prepared with provitamin A carotenoid biofortified orange maize flour (287 g dry weight/d for women; 50 g dry weight/d for infants), 6 days/week for 15 weeks

Intervention Type DIETARY_SUPPLEMENT

Preformed vitamin A fortified maize

Women and their infants will receive 2 meals/day prepared with preformed vitamin A fortified, conventional white maize flour (287 g dry weight/d for women; 50 g dry weight/d for infants), 6 days/week for 15 weeks

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Singleton birth
* No birth defects
* Free from chronic health conditions
* Infant received 100,000 IU vitamin A at 6 months of age
* Currently breastfeeding
* Not pregnant at 9 months post partum
* Hemoglobin \> 8.0 g/dL for women and \> 7.0 g/dL for infants

Exclusion Criteria

* Multiple birth
* Birth defects
* Any chronic health condition requiring regular medical visits
* Infant did not receive vitamin A capsule at 6 months of age
* No longer breastfeeding
* Pregnant
* Hemoglobin ≤ 8.0 g/dL for women or ≤ 7.0 g/dL for infants
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of California, Davis

OTHER

Sponsor Role collaborator

Newcastle University

OTHER

Sponsor Role collaborator

HarvestPlus

OTHER

Sponsor Role collaborator

Johns Hopkins Bloomberg School of Public Health

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Amanda C Palmer, PhD

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins Bloomberg School of Public Health

Marjorie Haskell, PhD

Role: STUDY_DIRECTOR

University of California, Davis

Rose Mwanza, MD

Role: STUDY_DIRECTOR

Provincial Medical Office, Central Province, Zambia

Locations

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JHU Office

Mkushi, Central Province, Zambia

Site Status

Countries

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Zambia

References

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Gannon B, Kaliwile C, Arscott SA, Schmaelzle S, Chileshe J, Kalungwana N, Mosonda M, Pixley K, Masi C, Tanumihardjo SA. Biofortified orange maize is as efficacious as a vitamin A supplement in Zambian children even in the presence of high liver reserves of vitamin A: a community-based, randomized placebo-controlled trial. Am J Clin Nutr. 2014 Dec;100(6):1541-50. doi: 10.3945/ajcn.114.087379. Epub 2014 Oct 8.

Reference Type BACKGROUND
PMID: 25411289 (View on PubMed)

Palmer AC, Siamusantu W, Chileshe J, Schulze KJ, Barffour M, Craft NE, Molobeka N, Kalungwana N, Arguello MA, Mitra M, Caswell B, Klemm RD, West KP Jr. Provitamin A-biofortified maize increases serum beta-carotene, but not retinol, in marginally nourished children: a cluster-randomized trial in rural Zambia. Am J Clin Nutr. 2016 Jul;104(1):181-90. doi: 10.3945/ajcn.116.132571. Epub 2016 May 11.

Reference Type BACKGROUND
PMID: 27169838 (View on PubMed)

Oxley A, Berry P, Taylor GA, Cowell J, Hall MJ, Hesketh J, Lietz G, Boddy AV. An LC/MS/MS method for stable isotope dilution studies of beta-carotene bioavailability, bioconversion, and vitamin A status in humans. J Lipid Res. 2014 Feb;55(2):319-28. doi: 10.1194/jlr.D040204. Epub 2013 Oct 24.

Reference Type BACKGROUND
PMID: 24158962 (View on PubMed)

Labrique AB, Palmer AC, Healy K, Mehra S, Sauer TC, West KP Jr, Sommer A. A novel device for assessing dark adaptation in field settings. BMC Ophthalmol. 2015 Jul 9;15:74. doi: 10.1186/s12886-015-0062-7.

Reference Type BACKGROUND
PMID: 26156587 (View on PubMed)

Muzhingi T, Gadaga TH, Siwela AH, Grusak MA, Russell RM, Tang G. Yellow maize with high beta-carotene is an effective source of vitamin A in healthy Zimbabwean men. Am J Clin Nutr. 2011 Aug;94(2):510-9. doi: 10.3945/ajcn.110.006486. Epub 2011 Jun 29.

Reference Type BACKGROUND
PMID: 21715509 (View on PubMed)

Li S, Nugroho A, Rocheford T, White WS. Vitamin A equivalence of the ss-carotene in ss-carotene-biofortified maize porridge consumed by women. Am J Clin Nutr. 2010 Nov;92(5):1105-12. doi: 10.3945/ajcn.2010.29802. Epub 2010 Sep 1.

Reference Type BACKGROUND
PMID: 20810977 (View on PubMed)

Palmer AC, Jobarteh ML, Chipili M, Greene MD, Oxley A, Lietz G, Mwanza R, Haskell MJ. Biofortified and fortified maize consumption reduces prevalence of low milk retinol, but does not increase vitamin A stores of breastfeeding Zambian infants with adequate reserves: a randomized controlled trial. Am J Clin Nutr. 2021 May 8;113(5):1209-1220. doi: 10.1093/ajcn/nqaa429.

Reference Type DERIVED
PMID: 33693468 (View on PubMed)

Other Identifiers

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2014H8314.JHU

Identifier Type: -

Identifier Source: org_study_id

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