retinol-palmitate and Anemia--Iron-Deficiency

A 32-mo-long, double-blind field study involving one highland control community receiving only vitamin A-fortified sugar and three vitamin A- and FeNaEDTA-sugar-fortified communities, two in the lowlands and one in the highlands of Guatemala, was undertaken to test the effectiveness of this approach in controlling iron deficiency. The communities' population ranged between 1200 and 17000. Sugar fortified with 1 g FeNaEDTA and 15 mg retinol as retinyl palmitate/kg was stable, did not segregate, and was well accepted by the communities. The impact of fortification on iron nutrition was estimated at 8, 20, and 32 mo of intervention. All pregnant women and subjects with severe anemia received supplements or treatment and were excluded from the analysis. Iron stores in the fortified communities increased significantly except for women 18-48 y of age in one lowland community and > 49 y in the highland community. Iron stores in the control community remained unchanged except for a rise among adult males.

Topics: Adolescent; Adult; Anemia, Iron-Deficiency; Child; Child, Preschool; Cohort Studies; Dietary Carbohydrates; Diterpenes; Double-Blind Method; Edetic Acid; Feasibility Studies; Female; Ferric Compounds; Food, Fortified; Guatemala; Humans; Infant; Iron; Male; Middle Aged; Nutritional Status; Patient Acceptance of Health Care; Retinyl Esters; Rural Population; Vitamin A

Vitamin A deficiency in Central America was first identified as a public health problem in the 1950s. It affected primarily children. The main underlying cause was a deficient intake of pre-formed vitamin A, but infection and intestinal parasitism also played important roles. INCAP focused its efforts on overcoming this problem and developed, as a short-term solution, the technology to fortify sugar with vitamin A. Fortification programs were implemented in several Central American countries. Evaluation of these programs revealed a significant impact-not only on vitamin A status, but also on iron nutrition and hematological condition. Longer-term solutions, like increasing the availability and consumption of vitamin A-rich foods, were later suggested and operational tools were developed to assist the countries in the region in the implementation, evaluation and monitoring of their own fortification programs.

Topics: Academies and Institutes; Anemia, Iron-Deficiency; Carotenoids; Central America; Diet; Dietary Sucrose; Diterpenes; Food Analysis; Food Supply; Food, Fortified; History, 20th Century; Humans; Nutrition Policy; Retinyl Esters; Vitamin A; Vitamin A Deficiency