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The effect of a biscuit with red palm oil as a source of β-carotene on the vitamin A status of primary school children: a comparison with β-carotene from a synthetic source in a randomised controlled trial

Abstract

Objective: To determine the effect of a biscuit with red palm oil as a source of β-carotene on the vitamin A status of primary school children and to compare this with the effect of a biscuit with β-carotene from a synthetic source.

Design: Randomised controlled trial.

Setting: A rural community in KwaZulu-Natal, South Africa.

Subjects: A total of 437 primary school children, aged 5–11 y; 400 completed the study.

Intervention: Subjects were randomly assigned to one of three groups, receiving, respectively: (i) a placebo biscuit; (ii) a biscuit with synthetic β-carotene as a vitamin A fortificant (SB); (iii) a biscuit with red palm oil as a source of β-carotene (PB); SB and PB supplied 30% of the RDA for vitamin A per serving of three biscuits. Biscuits were distributed daily during the school week; vitamin A status was assessed at baseline and after 3 months.

Results: There was a significant improvement in serum retinol compared to the control group in both the SB and PB groups (P<0.005); the treatment effect for the two groups was equivalent (difference in treatment effect 0.62 µg/dl, with a 90% CI−0.33–1.57).

Conclusions: A biscuit with red palm oil as a source of β-carotene is as effective as a biscuit with synthetic β-carotene in improving the vitamin A status of primary school children. The additional qualities of red palm oil (ie no trans fatty acids; rich source of antioxidants) make it an excellent alternative fortificant for addressing vitamin A deficiency.

Sponsorship: Financial support from Palm Oil Research Institute of Malaysia (PORIM).

European Journal of Clinical Nutrition (2001) 55, 657–662

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References

  • Bautista A, Barker PA, Dunn JT, Sanchez M & Kaiser DL (1982) The effects of oral iodized oil on intelligence, thyroid status, and somatic growth in school-age children from an area of endemic goiter Am. J. Clin. Nutr. 35 127–134

    Article  CAS  Google Scholar 

  • Catignani GL & Bieri JG (1983) Simultaneous determination of retinol and α-tocopherol in serum or plasma by liquid chromatography Clin. Chem. 29 708–712

    PubMed  Google Scholar 

  • Cottrell RC (1991) Nutritional aspects of palm oil Am. J. Clin. Nutr. 53 989S–1009S

    Article  CAS  Google Scholar 

  • De Pee S, West CE, Muhilal, Karyadi D & Hautvast JGAJ (1995) Lack of improvement in vitamin A status with increased consumption of dark-green leafy vegetables Lancet 346 75–81

    Article  CAS  Google Scholar 

  • Erdman JW, Bierer TL & Gugger ET (1993) Absorption and transport of carotenoids Ann. N.Y. Acad. Sci. 691 76–85

    Article  CAS  Google Scholar 

  • Faber M, Smuts CM & Benade´ AJS (1999) Dietary intake of primary school children in relation to food production in a rural area in KwaZulu-Natal, South Africa Int. J. Food. Sci. Nutr. 50 57–64

    Article  CAS  Google Scholar 

  • Filteau SM, Morris SS, Abbott RA, Tomkins AM, Kirkwood BR, Arthur P, Ross DA, Gyapong JO & Raynes JG (1993) Influence of morbidity on serum retinol of children in a community-based study in northern Ghana Am. J. Clin. Nutr. 58 192–197

    Article  CAS  Google Scholar 

  • Hamill PVV, Drizd TA, Johnson CL, Reed RB, Roche AF & Moore WM (1979) Physical growth: National Center for Health Statistics percentiles Am. J. Clin. Nutr. 32 607–629

    Article  CAS  Google Scholar 

  • Jalal F, Nesheim MC, Agus Z, Sanjur D & Habicht JP (1998) Serum retinol concentrations in children are affected by food sources of β-carotene, fat intake, and anthelmintic drug treatment Am. J. Clin. Nutr. 68 623–629

    Article  CAS  Google Scholar 

  • Judd JT, Clevidence BA, Muesing RA, Wittes J, Sunkin ME & Podczasy JJ (1994) Dietary trans fatty acids: effects on plasma lipids and lipoproteins of healthy men and women Am. J. Clin. Nutr. 59 861–868

    Article  CAS  Google Scholar 

  • Kaptchuk TJ (1998) Powerful placebo: the dark side of the randomised controlled trial Lancet 351 1722–1725

    Article  CAS  Google Scholar 

  • Khosla P & Hayes KC (1996) Dietary trans-monosaturated fatty acids negatively impact plasma lipids in humans: critical review of the evidence J. Am. Coll. Nutr. 15 325–339

    Article  Google Scholar 

  • Koletzko B (1992) Trans fatty acids may impair biosynthesis of long-chain polyunsaturates and growth in man Acta Paediatr. 81 302–306

    Article  CAS  Google Scholar 

  • Mahapatra S & Manorama R (1997) The protective effect of red palm oil in comparison with massive vitamin A dose in combating vitamin A deficiency in Orissa, India Asia Pacific J. Clin. Nutr. 6 246–250

    Google Scholar 

  • Manorama R, Sarita M & Rukmini C (1997) Red palm oil for combating vitamin A deficiency Asia Pacific J. Clin. Nutr. 6 56–59

    CAS  Google Scholar 

  • Mejía LA & Chew F (1988) Hematological effect of supplementing anemic children with vitamin A alone and in combination with iron Am. J. Clin. Nutr. 48 595–600

    Article  Google Scholar 

  • Murakoshi M, Nishino H & Satomi Y (1992) Potent preventive action of alpha-carotene against carcinogenesis: spontaneous liver carcinogenesis and promoting stage of lung and skin carcinogenesis in mice are suppressed more effectively by alpha-carotene than by beta-carotene Cancer Res. 52 6583–6587

    CAS  PubMed  Google Scholar 

  • National Research Council (1989) Recommended Dietary Allowances, 10th edn. Washington DC: National Academy Press

  • Nesaretnam K, Stephen R, Dils R & Darbre P (1998) Tocotrienols inhibit the growth of human breast cancer cells irrespective of estrogen receptor status Lipids 33 461–469

    Article  CAS  Google Scholar 

  • Pollitt E (1993) Iron deficiency and cognitive function Annu. Rev. Nutr. 13 521–537

    Article  CAS  Google Scholar 

  • Qureshi AA, Bradlow BA, Brace L, Manganello J, Peterson DM, Pearce BC, Wright JJK, Gapor A & Elson CE (1995) Response of hypercholesterolemic subjects to administration of tocotrienols Lipids 30 1171–1177

    Article  CAS  Google Scholar 

  • Ramalingaswami V (1992) Challenges and opportunities - one vitamin, two minerals World Health Forum 13 222–231

    CAS  PubMed  Google Scholar 

  • Soemantri AG, Pollitt E & Kim I (1985) Iron deficiency anemia and educational achievement Am. J. Clin. Nutr. 42 1221–1228

    Article  CAS  Google Scholar 

  • Sommer A (1990) Vitamin A status, resistance to infection, and childhood mortality Ann. N.Y. Acad. Sci. 587 17–23

    Article  CAS  Google Scholar 

  • South African Vitamin A Consultative Group (1996) Anthropometric, vitamin A, iron and immunisation coverage status in children aged 6–71 months in South Africa. S. Afr. Med. J. 86 354–357

    Google Scholar 

  • Van Stuijvenberg ME, Kruger M, Badenhorst CJ, Mansvelt EPG & Laubscher JA (1997) Response to an iron fortification programme in relation to vitamin A status in 6–12-year-old school children Int. J. Food Sci. Nutr. 48 41–49

    Article  CAS  Google Scholar 

  • Van Stuijvenberg ME, Kvalsvig JD, Faber M, Kruger M, Kenoyer DG & Benade´ AJS (1999) Effect of iron-, iodine-, and β-carotene-fortified biscuits on the micronutrient status of primary school children: a randomized controlled trial Am. J. Clin. Nutr. 69 497–503 (Erratum in Am. J. Clin. Nutr. (1999): 69, 1294).

    Article  Google Scholar 

  • Van Stuijvenberg ME, Faber M, Dhansay MA, Lombard CJ, Vorster N & Benade´ AJS (2000) Red palm oil as a source of β-carotene in a school biscuit used to address vitamin A deficiency in primary school children Int. J. Food Sci. Nutr. 51 S43–S50

    Article  CAS  Google Scholar 

  • WHO (1996) Indicators for assessing vitamin A deficiency and their application in monitoring and evaluating intervention programmes Geneva: WHO

Download references

Acknowledgements

We thank Eldrich Harmse, Martelle Marais and De Wet Marais for their excellent technical support; the Department of Haematology, University of Natal for performing the full blood counts; the headmasters, staff and pupils of the Ndunakazi and Intongela Primary Schools for their friendly co-operation; the team of nutrition monitors for their invaluable support and dedication to the study; Nonnie Vorster from SASKO Pty Ltd for formulating the recipe of the biscuits; Bud's Biscuits for baking and delivering the biscuits; and Global Palm Products SDN, BHD for supplying the refined red palm oil.

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van Stuijvenberg, M., Dhansay, M., Lombard, C. et al. The effect of a biscuit with red palm oil as a source of β-carotene on the vitamin A status of primary school children: a comparison with β-carotene from a synthetic source in a randomised controlled trial. Eur J Clin Nutr 55, 657–662 (2001). https://doi.org/10.1038/sj.ejcn.1601196

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