Abstract
Background
Vitamin A (VA) deficiency affects approximately 15% of preschool-aged children in the Philippines (serum retinol <0.7 μmol/L). Data on school-aged children are lacking.
Objective
To characterize intake of VA-rich foods and VA status among school-aged children in 3 areas of the Philippines at high risk of undernutrition.
Methods
We conducted a cross-sectional study, randomly selecting n = 520 children from primary schools in 3 high-risk provinces. We collected data on household characteristics, past-week food intake, and children's weights and heights. Venous blood samples were drawn and analyzed for plasma retinol, C-reactive protein, and α1-acid glycoprotein.
Results
Most children (96.7%) had consumed preformed VA-rich foods at least once in the prior week, mainly eggs and fortified foods, with a median consumption frequency of 7 times [p25, p75: 4, 12]. While 93.7% had consumed proVA-rich foods—mainly dark green leafy vegetables—the frequency was lower (5 times [2, 9]). Approximately one-quarter took multinutrient supplements (median 600 μg retinol equivalents [400, 1185]). The mean (± SD) plasma retinol concentration was 0.95 ± 0.23 μmol/L. The prevalence of VA deficiency (retinol <0.70 μmol/L) was 13.6% (4.9% adjusted for inflammation), and 59.0% (52.0% adjusted for inflammation) had marginal status (0.70-1.05 μmol/L).
Conclusions
The VA status of school-aged children in high-risk areas was similar to that of preschool-aged children nationally. Despite adjusting for inflammation, most children were classified as having marginal VA status that could be improved by increasing intake of the available preformed and proVA-rich foods in the study area.
Plain language title
Vitamin A intakes and status of school-aged children in high-risk areas of the Philippines
Vitamin A (VA) deficiency is a nutritional concern in the Philippines, affecting about 15% of young children nationally. However, there has been little research on VA deficiency among school-aged children. This age group may be at particular risk as they are not targeted with interventions like high-dose VA supplements. Our study focused on school-aged children in 3 areas of the country known for high rates of undernutrition. We examined their intake of VA-rich foods and measured their VA status. We found that ∼14% of schoolchildren were affected by VA deficiency, similar to the prevalence found among younger children. Additionally, a large proportion of children with marginal VA levels could benefit from increased intake of the VA-rich foods available in this setting. For example, while some children were consuming eggs and milk, the frequency of consumption was low. Our findings highlight the importance of ensuring that children have regular access to VA-rich foods, particularly in areas where undernutrition is prevalent. Incorporating more VA-rich foods into school-based feeding programs could be a crucial step in addressing this nutritional gap and improving the health of school-aged children in the Philippines.
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