LACK OF IMPROVEMENT IN VITAMIN-A STATUS WITH INCREASED CONSUMPTION OFDARK-GREEN LEAFY VEGETABLES

There is little evidence to support the general assumption that dietar y carotenoids can improve vitamin A status. We investigated in Bogor D istrict, West Java, Indonesia, the effect of an additional daily porti on of dark-green leafy vegetables on vitamin A and iron status in wome n with low haemoglobin concentrations (<130 g/L) who were breastfeedin g a child of 3-17 months. Every day for 12 weeks one group (n=57) rece ived stir-fried vegetables, a second (n=62) received a wafer enriched with beta-carotene, iron, vitamin C, and folic acid, and a third (n=56 ) received a non-enriched wafer to control for additional energy intak e. The vegetable supplement and the enriched wafer contained 3.5 mg be ta-carotene, 5.2 mg and 4.8 mg iron, and 7.8 g and 4.4 g fat, respecti vely. Assignment to vegetable or wafer groups was by village. Wafers w ere distributed double-mashed. In the enriched-wafer group there were increases in serum retinol (mean increase 0.32 [95% CI 0.23-0.40] mu m ol/L), breastmilk retinol (0.59 [0.35-0.84] mu mol/L), and serum beta- carotene (0.73 [0.59-0.88] mu mol/L). These changes differed significa ntly from those in the other two groups, in which the only significant changes were small increases in breastmilk retinol in the control-waf er group (0.16 [0.02-0.30] mu mol/L) and in serum beta-carotene in the vegetable group (0.03 [0-0.06] mu mol/L). Changes in iron status were similar in all three groups. An additional daily portion of dark-gree n leafy vegetables did not improve vitamin A status, whereas a similar amount of beta-carotene from a simpler matrix produced a strong impro vement. These results suggest that the approach to combating Vitamin A deficiency by increases in the consumption of provitamin A carotenoid s from vegetables should be re-examined.