title: Serum retinol in 1-6-year-old children from a low socio-economic South African community with a high intake of liver: implications for blanket vitamin A supplementation.
abstract: OBJECTIVE
  To assess serum retinol, liver intake patterns, breast-feeding history and anthropometric status in pre-school children of a low socio-economic community where liver is regularly consumed.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Northern Cape Province, South Africa.
  
  
  METHODS
  Children aged 1-6 years (n 243) who attended the local primary health-care facility and had not received a vitamin A supplement in the 6 months preceding the study. Non-pregnant female caregivers (n 225), below 50 years of age, were also assessed.
  
  
  RESULTS
  Despite stunting, underweight and wasting being prevalent in 40·5%, 23·1% and 8·4% of the children, only 5·8% had serum retinol concentrations < 20 μg/dl, which is in sharp contrast to the national prevalence of 63·6%. None of the caregivers were vitamin A deficient. Liver was eaten by 89·2% of children, with 87% of households eating liver at least once monthly and 30% eating it at least once weekly; liver was introduced into the diet of the children at a median age of 18 months. Ninety-three per cent of the children were being breast-fed or had been breast-fed in the past; children were breast-fed to a median age of 18 months. A significant negative correlation was found between educational level of the caregiver and frequency of liver intake (r = -0·143, P=0·032). There was no correlation between serum retinol and indicators of anthropometric or socio-economic status.
  
  
  CONCLUSIONS
  The blanket approach in applying the national vitamin A supplementation programme may not be appropriate for all areas in the country, even though the community may be poor and undernourished.
authors.affiliation: Nutritional Intervention Research Unit, Medical Research Council, PO Box 19070, Tygerberg 7505, Cape Town, South Africa. lize.van.stuijvenberg@mrc.ac.za
authors.forename: Martha E
authors.initials: ME
authors.lastname: van Stuijvenberg
authors.forename: Serina E
authors.initials: SE
authors.lastname: Schoeman
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lombard
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Dhansay
mesh_terms: D000886:Anthropometry; D001942:Breast Feeding / Q000706:statistics & numerical data; D002648:Child; D015362:Child Nutrition Disorders / Q000097:blood / Q000453:epidemiology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007223:Infant; D008099:Liver; D008297:Male; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D014801:Vitamin A / Q000008:administration & dosage* / Q000097:blood*; D014802:Vitamin A Deficiency / Q000097:blood / Q000453:epidemiology
chemical_list: D014801:Vitamin A