Evaluation of a green leafy vegetable intervention in Ghanaian postpartum mothers.

Abstract

Vitamin A deficiency is a major public health problem in many developing countries and women of childbearing age and children are most affected. Low dietary intakes and increased requirements during different life stages contribute to inadequate vitamin A liver reserves and hence the importance of assessing vitamin A status to determine population groups at risk of deficiency. This study was a community-based, exploratory intervention trial of postpartum mothers selected from villages in Ejisu/Juabeng District of the Ashanti Region in Ghana. The objective was to determine the improvement in vitamin A status of postpartum Ghanaian mothers fed daily with African eggplant leaves using the modified-relative-ose-response (MRDR) test for indirect assessment of liver vitamin A stores. Potential mothers were visited at home by trained field workers 7-10 days after their delivery and recruited into the trial. Baseline MRDR tests were performed for all the women (n = 61). The women were randomly assigned into control (n =10) and intervention (n =51) groups and invited back each month for follow-up MRDR assessment over period of three months. A daily portion of 200 g (2.6 mg of Beta-carotene) of African eggplant leaves were given to mothers in the intervention groups for three months while those in the control group did not receive any additional vegetables. The baseline mean serum retinol concentration and MRDR value were 1.5 ± 0.6 µmol/l and 0.09 ± 0.05 respectively indicating a marginal vitamin A status. Serum retinol concentrations did not differ between (p = 0.47) and within the two groups by time point (p= 0.41). The African eggplant leaves were well accepted and there was a significant improvement in the vitamin A status as assessed by MRDR test within the intervention group over the three months period (P = 0.0001). Vitamin A status also improved in the control group but there was loss of statistical power due to number of dropouts. Dietary modification and nutrition education to women of childbearing age to include natural food sources rich in provitamin A may provide the long-term solution to prevent vitamin A deficiency in developing countries because indigenous leafy vegetables can be easily cultivated in our communities making them sustainable and cheaper compared to periodic oral dosing with vitamin A.