Orange fruit is more effective than are dark-green, leafy vegetables in increasing serum concentrationsof retinol and b-carotene in schoolchildren in Indonesia123

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Abstract

The objectives of this study were to quantify the effectiveness of dietary retinol sources, orange fruit, and dark-green, leafy vegetables in improving vitamin A status, and to test whether orange fruit is a better source of vitamin A and carotenoids than are leafy vegetables. Anemic schoolchildren aged 7–11 y (n = 238) in West Java, Indonesia, were randomly allocated to 1 of 4 groups to consume 2complete meals/d, 6 d/wk, for 9 wk: 1) 556 retinol equivalents (RE)/d from retinolrich food (n = 48); 2) 509 RE/d from fruit (n = 49); 3) 684 RE/d from dark-green, leafy vegetables and carrots (n = 45);and 4) 44 RE/d from low-retinol, low-carotene food (n = 46). Mean changes in serum retinol concentrations of the retinol-rich,fruit, vegetable, and low-retinol, low-carotene groups were 0.23 (95%CI: 0.18, 0.28), 0.12 (0.06,0.18), 0.07 (0.03,0.11), and 0.00(20.06, 0.05) mmol/L, respectively. Mean changes in serum bcaroteneconcen rations in the vegetable and fruit groups were 0.14 (0.12, 0.17) and 0.52 (0.43, 0.60) mmol/L, respectively. Until now, it has been assumed that 6 mg dietary b-carotene is equivalent to 1 RE. On the basis of this study, however, the equivalent of 1 RE would be 12 mg b-carotene (95% CI: 6 mg, 29 mg) for fruit and 26 mg b-carotene (95% CI: 13 mg, 76 mg) for leafy vegetables and carrots. Thus, the apparent mean vitamin A activity of carotenoids in fruit and in leafy vegetables and carrots was 50% (95% CI: 21%, 100%) and 23% (95% CI: 8%,46%) of that assumed, respectively. This has important implications for choosing strategies for controlling vitamin A deficiency. Research should be directed toward ways of improving bioavailability and bioconversion of dietary carotenoids, focusing on factors suchas intestinal parasites, absorption inhibitors, and food matrixes. Am J Clin Nutr 1998;68:1058–67.

Keywords

Vitamin A
carotenoids
bioavailability
fruit
vegetables
food-based strategies
schoolchildren
fortified food
parasitic infestation
children
Indonesia

Cited by (0)

1

From the Division of Human Nutrition and Epidemiology, Wageningen Agricultural University, Wageningen, Netherlands; the Nutrition Research and Development Centre, Bogor,Indonesia; and the Department of International Health, Rollins School of Public Health, Emory University, Atlanta.

2

Supported by the Netherlands Committee for UNICEF.

3

Address reprint requests to S de Pee, Helen Keller International, Jl Patra Kuningan XIV no. 12, Jakarta 12950, PO Box 4338, Jakarta Pusat, Indonesia. E-mail: [email protected].