Plant sources of vitamin A and human nutrition: red palm oil does the job

Impact of Crude Palm Oil Fortified Cookies Supplementation on Anthropometry, Vitamin A and Hematological Status of School Children in India

Abstract. Objectives: Food-based strategies remain the most sustainable solutions for combating micronutrient deficiencies. Crude palm oil being the richest natural source of β-carotene, the study aimed to assess the impact of crude palm oil fortified cookies supplementation on anthropometry, vitamin A and hematological status of school children.

Methods: 444 children (boys-226, girls-218), aged 5-13 years from two Municipal Corporation of Delhi primary schools were enrolled. By draw of lot, children from one of the schools formed the experimental (n = 224; boys-119, girls-105) while other formed the placebo group (n = 220; boys-107; girls-113). Children from the experimental group received six crude palm oil fortified cookies providing 2152 μg of β-carotene while the placebo group received similar but non-fortified cookies each day for 50 school days. Anthropometry, vitamin A, and hematological status were assessed at baseline and post supplementation.

Results: Post supplementation, the number of stunted subjects reduced significantly (p < 0.05) in the experimental group. There was a significant increase in plasma retinol (170.9%; mean change: 1.55 ± 1.30 μmol/L - experimental group vs. 0.45 ± 0.99 μmol/L - placebo group) and β-carotene (p < 0.01; median change from 0.55 to 0.76 μmol/L - experimental group vs. 0.59 to 0.55 μmol/L -placebo group) concentrations of the experimental group. The increase in hematological parameters (mean change in Hemoglobin: 1.64 g/dL in experimental group vs. 2.10 g/dL in placebo group) of both the groups were however, comparable.

Conclusion: To address micronutrient deficiencies particularly in developing nations, the use of crude palm oil should be encouraged through supplementary feeding programs by way of ready-to-eat snacks.

Conventional and food-to-food fortification: An appraisal of past practices and lessons learned

Food fortification is an important nutrition intervention to fight micronutrient deficiencies and to reduce their incidence in many low- and middle-income countries. Food fortification approaches experienced a significant rise in the recent years and have generated a lot of criticism. The present review aimed to shed light on the actual effect of food fortification approaches on the reduction of malnutrition. A set of 100 articles and reports, which have dealt with the impact of food fortification on malnutrition, were included in this review. This review identified a broad selection of local raw materials suitable for a food-to-food fortification approach.

The Effect of Red Palm Oil on Vitamin A Deficiency: A Meta-Analysis of Randomized Controlled Trials

Red palm oil (RPO) has been investigated for preventing or alleviating vitamin A deficiency (VAD). Previous data has offered inconclusive and inconsistent results about the effects of RPO in patients with VAD. Our objective was to undertake a meta-analysis to assess the effects of RPO in preventing VAD in the population. After conducting a comprehensive literature search, nine randomized controlled trials (RCTs) were included. Overall, when trial results were pooled, the results indicated that RPO reduced the risk of VAD (relative risk (RR) (95% confidence interval (CI)) = 0.55 (0.37, 0.82), p = 0.003), increasedserum retinol levels in both children (p < 0.00001) and adults (p = 0.002), and increased β-carotene levels (p = 0.01). However, RPO supplementation did not have a significant overall effect on serum α-carotene levels (p = 0.06), body weight (p = 0.45), and haemoglobin levels (p = 0.72). The results also showed that low level of PRO intake (≤8 g RPO) could increase serum retinol concentrations whereas PRO intake above 8 g did not lead to further increase of serum retinol concentrations. This meta-analysis demonstrated that RPO might be effective for preventing or alleviating VAD.

Red Palm Oil in the Maternal Diet Improves the Vitamin A Status of Lactating Mothers and Their Infants

Improvement of the vitamin A status of lactating mothers and their nursing infants following maternal palm oil consumption was comparable to that following supplementation with purified β-carotene. Mothers who consumed β-carotene as red palm oil had 2.1- and 2.5-fold increases in their serum and milk β-carotene concentrations, respectively, and 2.8- and 3.2-fold increases in their serum and milk α-carotene concentrations, respectively. Infant serum retinol concentrations were significantly increased following maternal supplementation with red palm oil or β-carotene. Maternal intake of red palm oil or β-carotene supplements did not alter infant serum carotenoids, maternal serum retinol, or milk retinol. Because the local diet includes foods prepared with oil, the possibility that red palm oil could provide a significant source of provitamin A carotenoids for Honduran women and children should be further investigated.

Transgenic soya bean seeds accumulating β-carotene exhibit the collateral enhancements of oleate and protein content traits

Transgenic soya bean (Glycine max) plants overexpressing a seed-specific bacterial phytoene synthase gene from Pantoea ananatis modified to target to plastids accumulated 845 μg β carotene g(-1) dry seed weight with a desirable 12:1 ratio of β to α. The β carotene accumulating seeds exhibited a shift in oil composition increasing oleic acid with a concomitant decrease in linoleic acid and an increase in seed protein content by at least 4% (w/w). Elevated β-carotene accumulating soya bean cotyledons contain 40% the amount of abscisic acid compared to nontransgenic cotyledons. Proteomic and nontargeted metabolomic analysis of the mid-maturation β-carotene cotyledons compared to the nontransgenic did not reveal any significant differences that would account for the altered phenotypes of both elevated oleate and protein content. Transcriptomic analysis, confirmed by RT-PCR, revealed a number of significant differences in ABA-responsive transcripton factor gene expression in the crtB transgenics compared to nontransgenic cotyledons of the same maturation stage. The altered seed composition traits seem to be attributed to altered ABA hormone levels varying transcription factor expression. The elevated β-carotene, oleic acid and protein traits in the β-carotene soya beans confer a substantial additive nutritional quality to soya beans.

Red palm oil as a source of vitamin A for mothers and children: impact of a pilot project in Burkina Faso

Objective:

To demonstrate the effectiveness of the commercial introduction of red palm oil (RPO) as a source of vitamin A (VA) for mothers and children in a non-consuming area, as a dietary diversification strategy.

Design:

A pre–post intervention design (no control area) was used to assess changes in VA intake and status over a 24-month pilot project.

Setting and subjects:

The pilot project involved RPO promotion in 10 villages and an urban area in east-central Burkina Faso, targeting approximately 10?000 women and children aged < 5 years. A random sample of 210 mother–child (12–36-months-old) pairs was selected in seven out of the 11 pilot sites for the evaluation.

Results:

After 24 months, RPO was reportedly consumed by nearly 45% of mothers and children in the previous week. VA intake increased from 235 ± 23 μg retinol activity equivalents (RAE) to 655 ± 144 μg RAE in mothers (41 to 120% of safe intake level), and from 164 ± 14 μg RAE to 514 ± 77 μg RAE in children (36 to 97%). Rates of serum retinol < 0.70 μmoll−1decreased from 61.8 ± 8.0% to 28.2 ± 11.0% in mothers, and from 84.5 ± 6.4% to 66.9 ± 11.2% in children. Those with a lower initial concentration of serum retinol showed a higher serum retinol response adjusted for VA intake.

Conclusions:

Commercial distribution of RPO was effective in reducing VA deficiency in the pilot sites. While it is promising as part of a national strategy, additional public health and food-based measures are needed to control VA malnutrition, which remained high in the RPO project area

Bioavailability and vitamin A value of carotenes from red palm oil assessed by an extrinsic isotope reference method

Red palm oil (RPO) contains high concentrations of beta- and alpha-carotene, and is presumed to possess a higher vitamin A value than other foods. The objective was to determine the metabolic vitamin A and carotene values of refined red palm oil in healthy adult subjects, using a stable isotope reference method. Twelve healthy subjects were administered a small standardised meal containing 10 g RPO (2.4 mg beta-carotene and 1.8 mg alpha-carotene) in a blended juice-based drink also containing 2 mg tetradeuterated retinyl acetate (d4-RA) as a metabolic reference. At baseline and at several times after the test meal, the concentrations of carotenes and of d4- and d0-(unlabelled) retinyl esters, in the plasma chylomicron-rich (d < 1.006) fraction were determined by high high-performance liquid chromatography and gas chromatography mass spectrometry, respectively. The masses of palm oil-derived vitamin A and carotenes absorbed ('yield') were calculated assuming 80% absorption of the d4-RA reference dose. The mean yield of retinol from the RPO was 0.41 mg, ranging from 0.17 mg to 0.86 mg. The mean yields of beta- and alpha-carotene were 0.29 mg and 0.25 mg, respectively, suggesting that beta-carotene was more extensively metabolised than alpha-carotene. Subjects assimilated an average of 23% of the dose of carotenes, as the sum of retinol and unmetabolised carotenes. The vitamin A values of red palm oil obtained under these conditions, a mean of 0.17 mg retinol absorbed per mg beta-carotene consumed (beta-carotene : retinol equivalency of 5.7:1) is higher than that of all other vegetable sources we have evaluated to date.

Fortification strategies to meet micronutrient needs: successes and failures

Food fortification is likely to have played an important role in the current nutritional health and well-being of populations in industrialized countries. Starting in the early part of the 20th century, fortification was used to target specific health conditions: goitre with iodized salt; rickets with vitamin D-fortified milk; beriberi, pellagra and anaemia with B-vitamins and Fe-enriched cereals; more recently, in the USA, risk of pregnancy affected by neural-tube defects with folic acid-fortified cereals. A relative lack of appropriate centrally-processed food vehicles, less-developed commercial markets and relatively low consumer awareness and demand, means it has taken about another 50 years for fortification to be seen as a viable option for the less-developed countries. The present paper reviews selected fortification initiatives in developing countries to identify different factors that contributed to their successful implementation, as well as the challenges that continually threaten the future of these programmes. Ultimately, the long-term sustainability of fortification programmes is ensured when consumers are willing and able to bear the additional cost of fortified foods. There has been an enormous increase in fortification programmes over the last couple of decades in developing countries. Considerable progress has been made in reducing vitamin A and I deficiencies, although less so with Fe, even as Zn and folic acid deficiencies are emerging as important public health problems. Food fortification based on sound principles and supported by clear policies and regulations can play an increasingly large role in this progress towards prevention and control of micronutrient malnutrition.

Plant sources of vitamin A and human nutriture: how much is still too little?

In a randomized controlled 12-week feeding trial among malnourished, anemic, and largely vitamin A-deficient Ghanaian preschool children, the hypothesis that the ability of provitamin A carotenoids in dark green, leafy vegetables (DGLV) to raise vitamin A status in different formats--with or without fat and with fat plus anthelmintic treatment for intestinal worms--was tested by comparison with a low vitamin A fare and with pure chemical beta-carotene. The 12-week increments in retinol concentrations over baseline ranged from 5% to 44%, but over half of the DGLV-fed population had persistently low circulating retinol. The very modest impact on vitamin A status of these maneuvers to optimize dietary use of provitamin A in DGLV has major implications for public policy to eradicate hypovitaminosis A.