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Palmer, Amanda; Chileshe, Justin; Schulze, Kerry; Siamusantu, Ward; Klemm, Rolf; Molobeka, Ngosa; Barffour, Maxwell; Kalungwana, Ng'andwe; Arguello, Margia; West, Keith
The FASEB journal, April 2014, 2014-04-00, Volume: 28, Issue: S1Journal Article
Vitamin A (VA) deficiency remains a nutritional concern in Sub‐Saharan Africa. We conducted a cluster‐randomized controlled trial to test the impact of proVA biofortified maize flour consumption on VA status. All 4‐8 y old children (n=1,226) in a study area of ~400 km² in Mkushi, Zambia were enrolled and grouped by proximity into clusters of ~15‐25. We randomized clusters to: a) biofortified “orange” maize flour (n=25 clusters); b) white maize flour (n=25); or 3) non‐intervened control (n=14). Intervened clusters received 200 g maize flour, 6 d/wk for 6 mo prepared as per standardized recipes. Food packages were given in non‐intervened clusters after the trial. At baseline and follow‐up, we collected venous blood to measure serum retinol, beta‐carotene, CRP, and AGP. Groups were comparable at baseline. Although attendance did not differ (85%), median daily intake was higher in white (156 g/d) vs orange (140 g/d; providing ~75% RDA for VA) clusters. At follow‐up, serum β‐carotene was 0.3 μmol/L (95% CI: 0.2‐0.4) higher in orange clusters (p<0.001), but mean serum retinol (1.06 ± 0.43 μmol/L overall) and VA deficiency prevalence (18.6% overall; <0.7 μmol/L) did not differ by trial arm. In this marginally nourished population, regular biofortified maize flour consumption did not improve VA status. Grant Funding Source: Supported by HarvestPlus and the Canadian International Development Agency
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