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International Food Research Journal 20(4): 1873-1875 (2013)
Journal homepage: http://www.ifrj.upm.edu.my
Wageesha, N. D. A.,
*
Ekanayake, S. and Jansz, E. R.
Department of Biochemistry, Faculty of Medical Sciences, University of Sri
Jayewardenepura, Nugegoda, Sri Lanka
Prevalence of hypercarotenaemia in nursery/kindergarten children in the
Western province in Sri Lanka: a preliminary survey
Abstract
Hypercarotenaemia is seen more frequently among young infants and children. This condition
develops mainly due to excessive intake of carotenoid bearing foods. Evidence shows that,
not all infants develop hypercarotenaemia due to excessive intake of carotenoid containing
foods. The objective of this study was to study the prevalence of hypercarotenaemia among
nursery/kindergarten children in the Western province of Sri Lanka and to correlate the food
intake with development of hypercarotenaemia. The occurrence of hypercarotenaemia among
their siblings fed similar diets was also observed. A self administrated questionnaire was
given to the parents (n = 780) of nursery/kindergarten children (2-5 years) in the Western
province to collect information on the intake of carotenoid rich foods and development of
hypercarotenaemia among the children attending these nurseries and their siblings. Among
all the subjects investigated twelve (n = 12) had developed hypercarotenaemia. Children fed
with high carotenoid bearing food/fruits were categorized in to two groups depending on the
whether they have received a vitamin A mega dose (n = 287) or not (n = 328). The prevalence
of hypercarotenaemia among children fed high quantity of carotenoid foods (n = 615) was 2%,
while the group fed with vitamin A mega dose and not fed vitamin A mega dose were 1.4%
and 2.5% respectively. We suggest a genetic effect that is probably recessive, involved with
absorption or the metabolism of carotenoids in children who develop hypercarotenaemia. In
conclusion, the study showed the prevalence of hypercarotenaemia to be <2%, irrespective of
the amount of carotenoids ingested and vitamin A mega dosing.
Introduction
Hypercarotenaemia is commonly observed
among young infants and children in Sri Lanka. The
main cause for development of hypercarotenaemia is
excessive ingestion of carotenoid bearing food and
fruits more than three times per week (Priyadarshani
et al., 2009; Wageesha et al., 2011). Due to the
lipophilic nature, carotenoids deposit in the adipose
tissue and impart a yellow colouration especially
to palms, soles and areas where subcutaneous fat is
abound. There is some evidence that not all infants
fed high carotenoid diets develop this clinical
feature of hypercarotenaemia. Hypercarotenaemia
can be verified by elevated serum carotenoids level,
a normal or slightly elevated vitamin A level and
normal liver and thyroid function tests. Children with
liver diseases, hypothyroidism or diabetes mellitus
are easily distinguished from hypercarotenaemia
unassociated with excessive intake of carotenoids.
It was proven that a mutation in carotenoid 15,
15´ monooxygenase (CMO1) which catalyses the
first step in the conversion of dietary pro-vitamin A
carotenoids to vitamin A in the small intestine cause
symptoms of hypercarotenaemia (Lindqvist et al.,
2007). The possibility of a role of genetically based
metabolic factor was postulated (Lindqvist et al.,
2007). The sequence of the metabolism of carotenoids
involves the conversion of these hydrocarbons to
mono-hydroxy metabolites and to poly-hydroxy
metabolites. The liver cytochrome P450 system
increases the polarity and thus the solubility by the
addition of hydroxy groups, first to the hydrocarbon
and then to the metabolites in order to promote
excretion from the body (Rock, 1997).
There were no reported detailed studies on
the prevalence of hypercarotenaemia globally
except for a study which had investigated the
prevalence of hypercarotenaemia among anorexia
nervosa populations (Boland et al., 2001). Since
hypercarotenaemia among children is presenting an
increasing prevalence (unpublished data) an attempt
was made to find the frequency of occurrence of
hypercarotenaemia among Sri Lankan children.
Since it was practically difficult to conduct such a
study in the whole island the Western province was
selected.
The main objectives were to study the prevalence
Keywords
Hypercarotenaemia
Prevalence
Children
Article history
Received: 22 May 2012
Received in revised form:
31 January 2013
Accepted: 4 February 2013