Influence of carotene-rich vegetable meals on the prevalence of anaemia and iron deficiency

Original Article

European Journal of Clinical Nutrition (2010) 64, 468–474; doi:10.1038/ejcn.2010.23; published online 10 March 2010

Influence of carotene-rich vegetable meals on the prevalence of anaemia and iron deficiency in Filipino schoolchildren

Contributors: CCM coordinated the implementation of the study, participated in data analysis and writing of the manuscript; JDR-M was principal investigator, participated in the study design and writing of the manuscript; PR-S contributed to data analysis and writing of the manuscript; JAAS contributed to the writing of the manuscript; LWT coordinated the implementation of the study; JBB coordinated the procedure at Tufts University; FSS participated in the study design and was overall coordinator of procedures in the Philippines. The authors critically reviewed the manuscript.

C C Maramag1, J D Ribaya-Mercado2, P Rayco-Solon1, J A A Solon3, L W Tengco1, J B Blumberg2 and F S Solon1

1Research Division, Nutrition Center of the Philippines, Taguig City, Philippines
2Jean Mayer US Department of Agriculture, Human Nutrition Research Center at Tufts University, Boston, MA, USA
3Department of Parasitology, College of Public Health, University of the Philippines, Ermita, City of Manila, Philippines
Correspondence: Professor CC Maramag, Nutrition Center of the Philippines, 2322 Chino Roces Avenue Extension, Western Bicutan, Taguig City 1630, Philippines. E-mail: cmaramag@ncp.org.ph

Received 22 February 2009; Revised 22 January 2010; Accepted 27 January 2010; Published online 10 March 2010.

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Abstract
Objective: To determine the effects of eating carotene-rich green and yellow vegetables on the prevalence of anaemia, iron deficiency and iron-deficiency anaemia in schoolchildren.
Subjects and methods: Schoolchildren (n=104), aged 9–12 years, received standardized meals containing 4.2 mg of provitamin A carotenoids/day (mainly β-carotene) from yellow and green leafy vegetables and at least 7 g dietary fat/day. The meals were provided three times/day, 5 days/week, for 9 weeks at school. Before and after the dietary intervention, total-body vitamin A pool size was assessed by using the deuterated-retinol-dilution method; serum retinol and β-carotene concentrations were measured by high-performance liquid chromatography; and whole blood haemoglobin (Hb) and zinc protoporphyrin (ZnPP) concentrations were measured by using a photometer and a hematofluorometer, respectively.
Results: After 9 weeks, the mean total-body vitamin A pool size increased twofold (95% confidence interval (CI): −0.11, −0.07 μmol retinol; P<0.001), and serum β-carotene concentration increased fivefold (95% CI: −0.97, −0.79 μmol/l; P<0.001). Blood Hb (95% CI: −1.02, −0.52 g per 100 ml; P<0.001) and ZnPP increased (95% CI: −11.82, −4.57 μmol/mol haem; P<0.001). The prevalence of anaemia (Hb<11.5 g per 100 ml) decreased from 12.5 to 1.9% (P<0.001). There were no significant changes in the prevalence of iron deficiency or iron-deficiency anaemia.
Conclusions: Ingestion of carotene-rich yellow and green leafy vegetables improves the total-body vitamin A pool size and Hb concentration, and decreases anaemia rates in Filipino schoolchildren, with no effect on iron deficiency or iron-deficiency anaemia rates.
Keywords: β-carotene; vitamin A; anaemia; iron deficiency; iron-deficiency anaemia; schoolchildren; Philippines

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