title: Efficacy of a vitamin A-fortified wheat-flour bun on the vitamin A status of Filipino schoolchildren.
abstract: BACKGROUND
  Wheat flour is a possible food vehicle for vitamin A fortification.
  
  
  OBJECTIVE
  This study assessed the efficacy of consumption of a vitamin A-fortified wheat-flour bun (pandesal) on the vitamin A status of school-age children.
  
  
  METHODS
  This was a double-masked clinical trial conducted in 396 and 439 children aged 6-13 y attending 4 rural schools in the Philippines. The children were randomly assigned to a vitamin A-fortified (experimental) or nonfortified (control) group. A 60-g vitamin A-fortified pandesal (containing approximately 133 microg retinol equivalents) or a nonfortified pandesal was consumed by the children 5 d/wk for 30 wk. Vitamin A status, hemoglobin concentration, anthropometric status, morbidity, and dietary intake were assessed at baseline and 30 wk later. A modified relative dose response (MRDR) was assessed in a subsample of 20% of the children ( approximately 75/group) with the lowest initial serum retinol concentration at the 30-wk follow-up.
  
  
  RESULTS
  Baseline serum retinol significantly modified the effect of the intervention. The fortified group, whose initial serum retinol concentrations were below the median, had a 0.07 +/- 0.03-micromol/L greater improvement in serum retinol at the 30-wk follow-up than did the control group (P: = 0.02). Improved vitamin A status was also evident in the MRDR subsample. End-of-study differences in the MRDR showed that vitamin A- fortified pandesal intake decreased the percentage of children with inadequate liver vitamin A stores by 50% (15.3% compared with 28.6%; P: = 0.05).
  
  
  CONCLUSIONS
  Daily consumption of vitamin A-fortified pandesal significantly improved the vitamin A status of Filipino school-age children with marginal-to-low initial serum retinol concentrations.
authors.affiliation: Nutrition Center of the Philippines, Manila.
authors.forename: F S
authors.initials: FS
authors.lastname: Solon
authors.forename: R D
authors.initials: RD
authors.lastname: Klemm
authors.forename: L
authors.initials: L
authors.lastname: Sanchez
authors.forename: I
authors.initials: I
authors.lastname: Darnton-Hill
authors.forename: N E
authors.initials: NE
authors.lastname: Craft
authors.forename: P
authors.initials: P
authors.lastname: Christian
authors.forename: K P
authors.initials: KP
authors.lastname: West
mesh_terms: D000293:Adolescent; D001939:Bread; D002648:Child; D004311:Double-Blind Method; D005260:Female; D005433:Flour; D005527:Food, Fortified; D006801:Humans; D008099:Liver / Q000378:metabolism; D008297:Male; D009994:Osmolar Concentration; D010679:Philippines; D012574:Schools; D014908:Triticum; D014801:Vitamin A / Q000097:blood / Q000378:metabolism* / Q000494:pharmacology*
chemical_list: D014801:Vitamin A