The positive impact of red palm oil in school meals on vitamin A status: study in Burkina Faso

Abstract

Background: Vitamin A (VA) deficiency is widespread in sub-Saharan Africa and school-age children are a vulnerable group. In Burkina Faso, the production and consumption of red palm oil (RPO) is being promoted as a food supplement for VA. The objective of the study was to assess the impact on serum retinol of adding RPO to school lunch in two test zones of Burkina Faso.

Methods: Over one school year, 15 ml RPO was added to individual meals 3 times a week in selected primary schools in two sites. Serum retinol was measured with HPLC at baseline and exactly 12 months later to take account of seasonality. A simple pre-post test design was used in the Kaya area (north-central Burkina), where 239 pupils from 15 intervention schools were randomly selected for the evaluation. In Bogandé (eastern Burkina), 24 schools were randomised for the controlled intervention trial: 8 negative controls (G1) with only the regular school lunch; 8 positive controls (G2) where the pupils received a single VA capsule (60 mg) at the end of the school year; and 8 schools with RPO through the school year (G3). A random sample of 128 pupils in each school group took part in the evaluation.

Results: In Kaya, serum retinol went from 0.77 +/- 0.37 micromol/L at baseline to 1.07 +/- 0.40 micromol/L one year later (p < 0.001). The rate of low serum retinol (< 0.7 micromol/L) declined from 47.2% to 13.1%. In Bogandé, serum retinol increased significantly (p < 0.001) only in the capsule and RPO groups, going from 0.77 +/- 0.28 to 0.98 +/- 0.33 micromol/L in the former, and from 0.82 +/- 0.3 to 0.98 +/- 0.33 micromol/L in the latter. The rate of low serum retinol went from 46.1 to 17.1% in the VA capsule group and from 40.4% to 14.9% in the RPO group. VA-deficient children benefited the most from the capsule or RPO. Female sex, age and height-for-age were positively associated with the response to VA capsules or RPO.

Conclusion: RPO given regularly in small amounts appears highly effective in the reduction of VA deficiency. RPO deserves more attention as a food supplement for VA and as a potential source of rural income in Sahelian countries.

Figure 1

Study pupils in Kaya and Bogandé.

Figure 2

Mean serum retinol changes according to treatment group, Bogandé. The continuous and blue line represents the negative control group of 8 schools, where the pupils received only the regular school lunch during the 2003–04 school year. The dashed green line represents the positive control group of 8 schools, where the pupils received a single VA capsule (60 mg) at the end of the 2003–4 school year. The dashed red line represents the last 8 schools where fortified RPO meals were served to pupils from November 2003 until June 2004.