The positive impact of red palm oil in school meals on vitamin A status: study in Burkina Faso

Augustin N Zeba,Yves Martin Prével,Hélène F Delisle,Issa T Somé

doi:10.1186/1475-2891-5-17

Abstract

BackgroundVitamin A (VA) deficiency is widespread in sub-Saharan Africa and school-age children are a vulnerable group. In Burkina Faso, the production and consumption of red palm oil (RPO) is being promoted as a food supplement for VA. The objective of the study was to assess the impact on serum retinol of adding RPO to school lunch in two test zones of Burkina Faso.MethodsOver one school year, 15 ml RPO was added to individual meals 3 times a week in selected primary schools in two sites. Serum retinol was measured with HPLC at baseline and exactly 12 months later to take account of seasonality. A simple pre-post test design was used in the Kaya area (north-central Burkina), where 239 pupils from 15 intervention schools were randomly selected for the evaluation. In Bogandé (eastern Burkina), 24 schools were randomised for the controlled intervention trial: 8 negative controls (G1) with only the regular school lunch; 8 positive controls (G2) where the pupils received a single VA capsule (60 mg) at the end of the school year; and 8 schools with RPO through the school year (G3). A random sample of 128 pupils in each school group took part in the evaluation.ResultsIn Kaya, serum retinol went from 0.77 ± 0.37 μmol/L at baseline to 1.07 ± 0.40 μmol/L one year later (p < 0.001). The rate of low serum retinol (<0.7 μmol/L) declined from 47.2% to 13.1%. In Bogandé, serum retinol increased significantly (p < 0.001) only in the capsule and RPO groups, going from 0.77 ± 0.28 to 0.98 ± 0.33 μmol/L in the former, and from 0.82 ± 0.3 to 0.98 ± 0.33 μmol/L in the latter. The rate of low serum retinol went from 46.1 to 17.1% in the VA capsule group and from 40.4% to 14.9% in the RPO group. VA-deficient children benefited the most from the capsule or RPO. Female sex, age and height-for-age were positively associated with the response to VA capsules or RPO.ConclusionRPO given regularly in small amounts appears highly effective in the reduction of VA deficiency. RPO deserves more attention as a food supplement for VA and as a potential source of rural income in Sahelian countries.

Highlights

Vitamin A (VA) deficiency is widespread in sub-Saharan Africa and school-age children are a vulnerable group
An important finding of this study is that VA deficiency at school age is a serious public health problem in the intervention areas, since 47.2% in Kaya and 37.1% in Bogandé had low serum retinol at baseline, whereas the cut-off for a severe public health problem is 20% low serum retinol according to WHO [33]
This study disclosed a high rate of VA deficiency in school children in Burkina Faso

Summary

Introduction

Vitamin A (VA) deficiency is widespread in sub-Saharan Africa and school-age children are a vulnerable group. In Burkina Faso, the production and consumption of red palm oil (RPO) is being promoted as a food supplement for VA. Sahelian countries, including Burkina Faso, are the most affected by VA deficiency in sub-Saharan Africa. In a small community-based study conducted in 1999 in the north-central part of Burkina Faso, 84.5% of under-five children and 61.8% of their mothers were VA-deficient according to serum retinol concentrations [4]. Several studies have shown the efficacy of community- or hospital-based VA supplementation [2,6,7]. It should only be a short-term approach to control the deficiency as it is not sustainable. There is a wide variety of plant sources of provitamin A carotenoids, but their availability is often seasonal and their bio-efficacy may be quite low as in the case of green leaves [12,13]

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