THE EFFECT OF VITAMIN-A FORTIFICATION OF SUGAR ON IRON-METABOLISM IN PRESCHOOL-CHILDREN IN GUATEMALA

The effect of improvement in vitamin A nutriture on biochemical indicators of Fe nutrition during national vitamin A fortification of sugar was investigated longitudinally. Four paired-comparison subgroups of preschoolers were studied before fortification (survey 1) and, respectively, at 6 mo. (survey 1 vs. 2), 1 yr (survey 1 vs. 3), 1.5 yr (survey 1 vs. 4), and 2 yr (survey 1 vs. 5) after fortification began. Comparing 1 vs. 2 gave a positive correlation (P < 0.001) between changes in serum retinol or retinol-binding protein and changes in Fe, total Fe-binding capacity, and percentage transferrin saturation. In contrast, changes in serum ferritin correlated negatively (P < 0.05). Comparing 5 with 1, retinol, retinol-binding protein, Fe, and percentage transferrin saturation increased, but ferritin also increased (P < 0.05). Consequently, the distribution of serum Fe and ferritin values of the children improved (P < 0.05). Because dietary Fe did not change through the study period, the results suggest that vitamin A fortification had a favorable effect on Fe metabolism and nutritional status.