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Wafaie W Fawzi - One of the best experts on this subject based on the ideXlab platform.
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sex differences in the effects of maternal Vitamin Supplements on mortality and morbidity among children born to hiv infected women in tanzania
British Journal of Nutrition, 2010Co-Authors: Kosuke Kawai, Eduardo Villamor, Karim Manji, Gernard I Msamanga, Ellen Hertzmark, Ronald J Bosch, Wafaie W FawziAbstract:We examined whether there are sex differences in the effect of Vitamin Supplements on birth outcomes, mortality and morbidity by 2 years of age among children born to HIV-infected women in Tanzania. A randomised placebo-controlled trial was conducted among 959 mother– infant pairs. HIV-infected pregnant women were randomly assigned to receive a daily oral dose of one of four regimens: multiVitamins (Vitamins B-complex, C and E), Vitamin A plus b-carotene, multiVitamins including Vitamin A plus b-carotene or placebo. Supplements were administered during pregnancy and continued after delivery. The beneficial effect of multiVitamins on decreasing the risk of low birth weight was stronger among girls (relative risks (RR) ¼ 0·39, 95 % CI 0·22, 0·67) than among boys (RR ¼ 0·81, 95 % CI 0·44, 1·49; P for interaction ¼ 0·08). Maternal multiVitamin Supplements resulted in 32 % reduction in mortality among girls (RR ¼ 0·68, 95 % CI 0·47, 0·97), whereas no effect was found among boys (RR ¼ 1·20, 95 % CI 0·80, 1·78; P for interaction ¼ 0·04). MultiVitamins had beneficial effects on the overall risks of diarrhoea that did not differ by sex. Vitamin A plus b-carotene alone increased the risk of HIV transmission, but had no effects on mortality, and we found no sex differences in these effects. Sex differential effects of multiVitamins on mortality may be due to sex-related differences in the immunological or genetic factors. More research is warranted to examine the effect of Vitamins by sex and better understand biological mechanisms mediating such effects.
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Vitamin Supplements socioeconomic status and morbidity events as predictors of wasting in hiv infected women from tanzania
The American Journal of Clinical Nutrition, 2005Co-Authors: Eduardo Villamor, Elmar Saathoff, Karim Manji, Gernard I Msamanga, David J Hunter, Wafaie W FawziAbstract:Background: Wasting is a strong independent predictor of mortality in HIV-infected persons. Vitamin Supplements delay the disease progression, but their effect on wasting is not known. Data are lacking on the risk factors for wasting in African HIV-infected persons. Objectives: The objectives were to examine the effect of Vitamin Supplements on wasting in HIV-infected women and to assess the effects of sociodemographic characteristics, morbidity events, and immunologic progression on the risk of wasting. Design: HIV-infected women (n = 1078) from Tanzania were randomly assigned to receive 1 of 4 daily oral regimens: multiVitamins (B complex, C, and E), Vitamin A plus β-carotene, multiVitamins that included Vitamin A plus β-carotene, or placebo. The endpoints of the study included first episodes of a midupper arm circumference <22 cm or a body mass index (BMI; in kg/m 2 ) <18 and the incidence of weight loss episodes during a median 5.3 y of follow-up. Results: MultiVitamins alone significantly reduced the risk of a first episode of a midupper arm circumference <22 cm (relative risk: 0.66; 95% CI: 0.47, 0.94; P = 0.02). In multivariate-adjusted Cox models, the woman's age, education level, and height were inversely related to the incidence of wasting. Episodes of diarrhea, nausea or vomiting, lower respiratory tract infections, oral ulcers, thrush, severe anemia, and low CD4 + cell counts were each significantly related to an increased risk of wasting. Conclusions: Vitamins C and E and the Vitamin B complex have a protective effect on wasting in HIV-infected women. Prevention of diarrhea, severe respiratory tract infections, and anemia are likely to decrease the burden of wasting.
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randomized trial of Vitamin Supplements in relation to vertical transmission of hiv 1 in tanzania
Journal of Acquired Immune Deficiency Syndromes, 2000Co-Authors: Wafaie W Fawzi, Gernard I Msamanga, David J Hunter, Ernest J N Urassa, Boris Renjifo, Davis Mwakagile, Ellen Hertzmark, Jenny Coley, Miriam Garland, Saidi KapigaAbstract:Observational studies suggest that poor nutritional status among HIV-infected pregnant women is associated with a higher risk of vertical transmission of HIV. The authors randomized 1083 pregnant women infected with HIV-1 in a double-blind placebo-controlled trial to examine the effects of Supplements of Vitamin A and/or multiVitamins (excluding Vitamin A) using a 2-x-2 factorial design. They report the effects of the Supplements on HIV infection defined using polymerase chain reaction or death up to 6 weeks postpartum. Of babies in the multiVitamin arm 38 (10.1%) were HIV-positive at birth compared with 24 (6.6%) in the no-multiVitamin arm (relative risk [RR] = 1.54; 95% confidence interval [CI] 0.94-2.51; p = 0.08). Of babies born to mothers in the Vitamin A arm 38 (10.0%) were HIV-positive at birth compared with 24 (6.7%) in the no-Vitamin A arm (RR = 1.49; 95% CI 0.91-2.43; p = 0.11). Neither multiVitamins nor Vitamin A had an effect on HIV status at 6 weeks among those who were HIV-negative at birth (RR = 1.04; 95% CI 0.65-1.66; p = 0.88 and RR = 1.30; 95% CI 0.80-2.09; p = 0.29 respectively). Similarly neither supplement was associated with being either HIV-infected or dead at birth (RR = 0.98; 95% CI 0.76-1.27; p = 0.89 and RR = 1.01; 95% CI 0.78-1.31; p = 0.95 respectively). A beneficial effect of multiVitamins on birth weight was limited to babies who were HIV-negative at birth; babies in the multiVitamin arm weighed 94 g more compared with those in the no-multiVitamin arm (p = 0.02). Among babies who were HIV-positive at birth the corresponding difference was -31 g (p = 0.82). Vitamin A and multiVitamins did not affect the risk of vertical transmission of HIV in utero nor during the intrapartum and early breast-feeding periods. MultiVitamins resulted in a significant improvement in birth weight of babies who were HIV-negative at birth but had no effect among those who were HIV-positive. The effect of Vitamin Supplements on HIV transmission through breast-feeding and on clinical progression of HIV disease is yet to be ascertained. (authors)
David J Erickson - One of the best experts on this subject based on the ideXlab platform.
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Vitamin Supplements and the risk for congenital anomalies other than neural tube defects
American Journal of Medical Genetics Part C-seminars in Medical Genetics, 2004Co-Authors: Lorenzo D Botto, Richard S Olney, David J EricksonAbstract:Randomized trials, supported by many observational studies, have shown that periconceptional use of folic acid, alone or in multiVitamin Supplements, is effective for the primary prevention of neural tube defects (NTDs). Whether this is true also for other congenital anomalies is a complex issue and the focus of this review. It is useful to consider the evidence not only for specific birth defects separately but, importantly, also for all birth defects combined. For the latter, the Hungarian randomized clinical trial indicated, for periconceptional multiVitamin use, a reduction in the risk for all birth defects (odds ratio (OR) = 0.53, 95% confidence interval (CI) = 0.35–0.70), even after excluding NTDs (OR = 0.53, 95% CI = 0.38–0.75). The Atlanta population-based case-control study, the only large observational study to date on all major birth defects, also found a significant risk reduction for all birth defects (OR = 0.80, 95% CI = 0.69–0.93) even after excluding NTDs (OR = 0.84, 95% CI = 0.72–0.97). These and other studies also evaluated specific anomalies, including those of the heart, limb, and urinary tract, as well as orofacial clefts, omphalocele, and imperforate anus. For cardiovascular anomalies, two studies were negative, whereas three, including the randomized clinical trial, suggest a possible 25–50% overall risk reduction, more marked for some conotruncal and septal defects. For orofacial clefts, six of seven case-control studies suggest an apparent reduced risk, which could vary by cleft type and perhaps, according to some investigators, by pill dosage. For limb deficiencies, three case-control studies and the randomized trial estimated approximately a 50% reduced risk. For urinary tract defects, three case-control studies and the randomized trial reported reduced risks, as did one study of nonsyndromic omphalocele. All these studies examined multiVitamin supplement use. With respect to folic acid alone, a reduced rate of imperforate anus was observed among folic acid users in China. We discuss key gaps in knowledge, possible avenues for future research, and counseling issues for families concerned about occurrence or recurrence of these birth defects. © 2004 Wiley-Liss, Inc.
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Vitamin Supplements and the risk for congenital anomalies other than neural tube defects
American Journal of Medical Genetics Part C-seminars in Medical Genetics, 2004Co-Authors: Lorenzo D Botto, Richard S Olney, David J EricksonAbstract:Randomized trials, supported by many observational studies, have shown that periconceptional use of folic acid, alone or in multiVitamin Supplements, is effective for the primary prevention of neural tube defects (NTDs). Whether this is true also for other congenital anomalies is a complex issue and the focus of this review. It is useful to consider the evidence not only for specific birth defects separately but, importantly, also for all birth defects combined. For the latter, the Hungarian randomized clinical trial indicated, for periconceptional multiVitamin use, a reduction in the risk for all birth defects (odds ratio (OR) = 0.53, 95% confidence interval (CI) = 0.35-0.70), even after excluding NTDs (OR = 0.53, 95% CI = 0.38-0.75). The Atlanta population-based case-control study, the only large observational study to date on all major birth defects, also found a significant risk reduction for all birth defects (OR = 0.80, 95% CI = 0.69-0.93) even after excluding NTDs (OR = 0.84, 95% CI = 0.72-0.97). These and other studies also evaluated specific anomalies, including those of the heart, limb, and urinary tract, as well as orofacial clefts, omphalocele, and imperforate anus. For cardiovascular anomalies, two studies were negative, whereas three, including the randomized clinical trial, suggest a possible 25-50% overall risk reduction, more marked for some conotruncal and septal defects. For orofacial clefts, six of seven case-control studies suggest an apparent reduced risk, which could vary by cleft type and perhaps, according to some investigators, by pill dosage. For limb deficiencies, three case-control studies and the randomized trial estimated approximately a 50% reduced risk. For urinary tract defects, three case-control studies and the randomized trial reported reduced risks, as did one study of nonsyndromic omphalocele. All these studies examined multiVitamin supplement use. With respect to folic acid alone, a reduced rate of imperforate anus was observed among folic acid users in China. We discuss key gaps in knowledge, possible avenues for future research, and counseling issues for families concerned about occurrence or recurrence of these birth defects.
Richard S Olney - One of the best experts on this subject based on the ideXlab platform.
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Vitamin Supplements and the risk for congenital anomalies other than neural tube defects
American Journal of Medical Genetics Part C-seminars in Medical Genetics, 2004Co-Authors: Lorenzo D Botto, Richard S Olney, David J EricksonAbstract:Randomized trials, supported by many observational studies, have shown that periconceptional use of folic acid, alone or in multiVitamin Supplements, is effective for the primary prevention of neural tube defects (NTDs). Whether this is true also for other congenital anomalies is a complex issue and the focus of this review. It is useful to consider the evidence not only for specific birth defects separately but, importantly, also for all birth defects combined. For the latter, the Hungarian randomized clinical trial indicated, for periconceptional multiVitamin use, a reduction in the risk for all birth defects (odds ratio (OR) = 0.53, 95% confidence interval (CI) = 0.35–0.70), even after excluding NTDs (OR = 0.53, 95% CI = 0.38–0.75). The Atlanta population-based case-control study, the only large observational study to date on all major birth defects, also found a significant risk reduction for all birth defects (OR = 0.80, 95% CI = 0.69–0.93) even after excluding NTDs (OR = 0.84, 95% CI = 0.72–0.97). These and other studies also evaluated specific anomalies, including those of the heart, limb, and urinary tract, as well as orofacial clefts, omphalocele, and imperforate anus. For cardiovascular anomalies, two studies were negative, whereas three, including the randomized clinical trial, suggest a possible 25–50% overall risk reduction, more marked for some conotruncal and septal defects. For orofacial clefts, six of seven case-control studies suggest an apparent reduced risk, which could vary by cleft type and perhaps, according to some investigators, by pill dosage. For limb deficiencies, three case-control studies and the randomized trial estimated approximately a 50% reduced risk. For urinary tract defects, three case-control studies and the randomized trial reported reduced risks, as did one study of nonsyndromic omphalocele. All these studies examined multiVitamin supplement use. With respect to folic acid alone, a reduced rate of imperforate anus was observed among folic acid users in China. We discuss key gaps in knowledge, possible avenues for future research, and counseling issues for families concerned about occurrence or recurrence of these birth defects. © 2004 Wiley-Liss, Inc.
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Vitamin Supplements and the risk for congenital anomalies other than neural tube defects
American Journal of Medical Genetics Part C-seminars in Medical Genetics, 2004Co-Authors: Lorenzo D Botto, Richard S Olney, David J EricksonAbstract:Randomized trials, supported by many observational studies, have shown that periconceptional use of folic acid, alone or in multiVitamin Supplements, is effective for the primary prevention of neural tube defects (NTDs). Whether this is true also for other congenital anomalies is a complex issue and the focus of this review. It is useful to consider the evidence not only for specific birth defects separately but, importantly, also for all birth defects combined. For the latter, the Hungarian randomized clinical trial indicated, for periconceptional multiVitamin use, a reduction in the risk for all birth defects (odds ratio (OR) = 0.53, 95% confidence interval (CI) = 0.35-0.70), even after excluding NTDs (OR = 0.53, 95% CI = 0.38-0.75). The Atlanta population-based case-control study, the only large observational study to date on all major birth defects, also found a significant risk reduction for all birth defects (OR = 0.80, 95% CI = 0.69-0.93) even after excluding NTDs (OR = 0.84, 95% CI = 0.72-0.97). These and other studies also evaluated specific anomalies, including those of the heart, limb, and urinary tract, as well as orofacial clefts, omphalocele, and imperforate anus. For cardiovascular anomalies, two studies were negative, whereas three, including the randomized clinical trial, suggest a possible 25-50% overall risk reduction, more marked for some conotruncal and septal defects. For orofacial clefts, six of seven case-control studies suggest an apparent reduced risk, which could vary by cleft type and perhaps, according to some investigators, by pill dosage. For limb deficiencies, three case-control studies and the randomized trial estimated approximately a 50% reduced risk. For urinary tract defects, three case-control studies and the randomized trial reported reduced risks, as did one study of nonsyndromic omphalocele. All these studies examined multiVitamin supplement use. With respect to folic acid alone, a reduced rate of imperforate anus was observed among folic acid users in China. We discuss key gaps in knowledge, possible avenues for future research, and counseling issues for families concerned about occurrence or recurrence of these birth defects.
Johanna M Seddon - One of the best experts on this subject based on the ideXlab platform.
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multiVitamin multimineral Supplements and eye disease age related macular degeneration and cataract
The American Journal of Clinical Nutrition, 2007Co-Authors: Johanna M SeddonAbstract:The prevalence and effects of age-related macular degeneration (AMD) and cataract are increasing dramatically as the proportion of elderly in our population continues to rise. A multiVitamin-multimineral supplement with a combination of Vitamin C, Vitamin E, βcarotene, and zinc (with cupric oxide) is recommended for AMD but not cataract. Weak support exists for multiVitamins or other Vitamin Supplements from observational studies of cataract. The results of observational studies suggest that a healthy lifestyle with a diet containing foods rich in antioxidants, particularly lutein and zeaxanthin, as well as n-3 fatty acids, appears beneficial for AMD and possibly cataract. The Age-Related Eye Disease Study II will evaluate some of these additional nutrients as dietary Supplements in a randomized trial.
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the use of Vitamin Supplements and the risk of cataract among us male physicians
American Journal of Public Health, 1994Co-Authors: Johanna M Seddon, William G Christen, Joann E Manson, Frances Lamotte, Robert J Glynn, Julie E Buring, C H HennekensAbstract:OBJECTIVES. The purpose of this study was to examine prospectively the association between reported use of Vitamin Supplements and risk of cataract and cataract extraction. METHODS. The study population consisted of 17,744 participants in the Physicians' Health Study, a randomized trial of aspirin therapy and beta-carotene among US male physicians 40 to 84 years of age in 1982 who did not report cataract at baseline and provided complete information about Vitamin supplementation and other risk factors for cataract. Self-reports of cataract and cataract extraction were confirmed by medical record review. RESULTS. During 60 months of follow-up, there were 370 incident cataracts and 109 cataract extractions. In comparison with physicians who did not use any Supplements, those who took only multiVitamins had a relative risk of cataract of 0.73 after adjustment for other risk factors. For cataract extraction, the corresponding relative risk was 0.79. Use of Vitamin C and/or E Supplements alone was not associat...
Lorenzo D Botto - One of the best experts on this subject based on the ideXlab platform.
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Vitamin Supplements and the risk for congenital anomalies other than neural tube defects
American Journal of Medical Genetics Part C-seminars in Medical Genetics, 2004Co-Authors: Lorenzo D Botto, Richard S Olney, David J EricksonAbstract:Randomized trials, supported by many observational studies, have shown that periconceptional use of folic acid, alone or in multiVitamin Supplements, is effective for the primary prevention of neural tube defects (NTDs). Whether this is true also for other congenital anomalies is a complex issue and the focus of this review. It is useful to consider the evidence not only for specific birth defects separately but, importantly, also for all birth defects combined. For the latter, the Hungarian randomized clinical trial indicated, for periconceptional multiVitamin use, a reduction in the risk for all birth defects (odds ratio (OR) = 0.53, 95% confidence interval (CI) = 0.35–0.70), even after excluding NTDs (OR = 0.53, 95% CI = 0.38–0.75). The Atlanta population-based case-control study, the only large observational study to date on all major birth defects, also found a significant risk reduction for all birth defects (OR = 0.80, 95% CI = 0.69–0.93) even after excluding NTDs (OR = 0.84, 95% CI = 0.72–0.97). These and other studies also evaluated specific anomalies, including those of the heart, limb, and urinary tract, as well as orofacial clefts, omphalocele, and imperforate anus. For cardiovascular anomalies, two studies were negative, whereas three, including the randomized clinical trial, suggest a possible 25–50% overall risk reduction, more marked for some conotruncal and septal defects. For orofacial clefts, six of seven case-control studies suggest an apparent reduced risk, which could vary by cleft type and perhaps, according to some investigators, by pill dosage. For limb deficiencies, three case-control studies and the randomized trial estimated approximately a 50% reduced risk. For urinary tract defects, three case-control studies and the randomized trial reported reduced risks, as did one study of nonsyndromic omphalocele. All these studies examined multiVitamin supplement use. With respect to folic acid alone, a reduced rate of imperforate anus was observed among folic acid users in China. We discuss key gaps in knowledge, possible avenues for future research, and counseling issues for families concerned about occurrence or recurrence of these birth defects. © 2004 Wiley-Liss, Inc.
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Vitamin Supplements and the risk for congenital anomalies other than neural tube defects
American Journal of Medical Genetics Part C-seminars in Medical Genetics, 2004Co-Authors: Lorenzo D Botto, Richard S Olney, David J EricksonAbstract:Randomized trials, supported by many observational studies, have shown that periconceptional use of folic acid, alone or in multiVitamin Supplements, is effective for the primary prevention of neural tube defects (NTDs). Whether this is true also for other congenital anomalies is a complex issue and the focus of this review. It is useful to consider the evidence not only for specific birth defects separately but, importantly, also for all birth defects combined. For the latter, the Hungarian randomized clinical trial indicated, for periconceptional multiVitamin use, a reduction in the risk for all birth defects (odds ratio (OR) = 0.53, 95% confidence interval (CI) = 0.35-0.70), even after excluding NTDs (OR = 0.53, 95% CI = 0.38-0.75). The Atlanta population-based case-control study, the only large observational study to date on all major birth defects, also found a significant risk reduction for all birth defects (OR = 0.80, 95% CI = 0.69-0.93) even after excluding NTDs (OR = 0.84, 95% CI = 0.72-0.97). These and other studies also evaluated specific anomalies, including those of the heart, limb, and urinary tract, as well as orofacial clefts, omphalocele, and imperforate anus. For cardiovascular anomalies, two studies were negative, whereas three, including the randomized clinical trial, suggest a possible 25-50% overall risk reduction, more marked for some conotruncal and septal defects. For orofacial clefts, six of seven case-control studies suggest an apparent reduced risk, which could vary by cleft type and perhaps, according to some investigators, by pill dosage. For limb deficiencies, three case-control studies and the randomized trial estimated approximately a 50% reduced risk. For urinary tract defects, three case-control studies and the randomized trial reported reduced risks, as did one study of nonsyndromic omphalocele. All these studies examined multiVitamin supplement use. With respect to folic acid alone, a reduced rate of imperforate anus was observed among folic acid users in China. We discuss key gaps in knowledge, possible avenues for future research, and counseling issues for families concerned about occurrence or recurrence of these birth defects.
