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.