title: The effect of a biscuit with red palm oil as a source of beta-carotene on the vitamin A status of primary school children: a comparison with beta-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 beta-carotene on the vitamin A status of primary school children and to compare this with the effect of a biscuit with beta-carotene from a synthetic source.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  A rural community in KwaZulu-Natal, South Africa.
  
  
  METHODS
  A total of 437 primary school children, aged 5--11 y; 400 completed the study.
  
  
  METHODS
  Subjects were randomly assigned to one of three groups, receiving, respectively: (i) a placebo biscuit; (ii) a biscuit with synthetic beta-carotene as a vitamin A fortificant (SB); (iii) a biscuit with red palm oil as a source of beta-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 microg/dl, with a 90% CI -0.33--1.57).
  
  
  CONCLUSIONS
  A biscuit with red palm oil as a source of beta-carotene is as effective as a biscuit with synthetic beta-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.
authors.affiliation: Nutritional Intervention Research Unit, Medical Research Council, Parow, South Africa. lvstuijv@mrc.ac.za
authors.forename: M E
authors.initials: ME
authors.lastname: van Stuijvenberg
authors.forename: M A
authors.initials: MA
authors.lastname: Dhansay
authors.forename: C J
authors.initials: CJ
authors.lastname: Lombard
authors.forename: M
authors.initials: M
authors.lastname: Faber
authors.forename: A J
authors.initials: AJ
authors.lastname: Benadé
mesh_terms: D000886:Anthropometry; D001939:Bread; D002648:Child; D002675:Child, Preschool; D005527:Food, Fortified; D006801:Humans; D008297:Male; D009752:Nutritional Status; D000073878:Palm Oil; D010938:Plant Oils / Q000008:administration & dosage* / Q000737:chemistry; D012423:Rural Health; D012574:Schools; D013019:South Africa / Q000453:epidemiology; D014801:Vitamin A / Q000032:analysis*; D014802:Vitamin A Deficiency / Q000178:diet therapy* / Q000453:epidemiology; D019207:beta Carotene / Q000008:administration & dosage* / Q000378:metabolism
chemical_list: D010938:Plant Oils; D019207:beta Carotene; D014801:Vitamin A; D000073878:Palm Oil