Improving Vitamin A and Antioxidant Status

Red Palm Fruit Oil

A. Improving Vitamin A and Antioxidant Status

1. Changes in vitamin A intake following the social marketing of red palm oil among children and women in Burkina Faso
Zagre, N. et al. (2002). Changes in vitamin A intake following the social marketing of red palm oil among children and women in Burkina Faso, Sante. 12(1):38-44

This paper focuses on changes in vitamin A (VA) intakes as part of the evaluation of a pilot project on social marketing of red palm oil (RPO) as a VA supplement for mothers and children in central-north Burkina Faso. The objectives of the 30-month project are to demonstrate the feasibility and effectiveness of introducing RPO in non-consuming areas. RPO is collected from women in the South-West region and it is sold in project sites by village volunteers. RPO is promoted by community workers trained in persuasive communication and social marketing. The target population is free to buy and consume RPO. Evaluation design includes data collected at onset, then 12 and 24 months later, from the same sample of 210 mothers and their children randomly selected in seven project sites. Children were 1 to 3 years old at onset. Blood samples were collected at baseline from mothers and children for serum retinol determination by HPLC. VA intakes are estimated by a semi-quantitative food frequency questionnaire, using the conventional beta-carotene to retinol conversion factors and the newly revised lower factors. VA deficiency is a major public health problem in the area: 64% of mothers and 85% of children had serum retinol concentrations < 0,70 mumol/l at baseline. VA came mainly from plant foods, particularly fruits and dark green vegetables which provided more than 90% of the dietary VA at onset of the project. Mean vitamin A intakes are low. We found 138 106 mug ER for the children and 302 +/- 235 microg ER for the mothers with conventional factors and 64 +/- 58 microg ER and 133 +/- 162 microg ER, respectively, with the revised factors. One year later, one third of respondents had consumed RPO in the previous week, and it supplied around 56% of the VA intake of children and 67% of mothers (36% and 46% respectively for the whole group). VA intakes were significantly increased at 510 +/- 493 microg ER and 801 +/- 913 microg ER for the children and their mothers respectively (347 +/- 443 microg ER and 568 +/- 803 microg ER respectively, with the revised factors). Analyzing serum retinol and dietary data collected at baseline, it was found that VA intakes < 62,5% of safe level of intake were highly sensitive to low serum retinol (< 0,70 micromol/l) and using revised conversion factors to assess total VA intake slightly enhanced sensitivity. The proportion of mothers and children at risk of inadequate VA intake changed from nearly 100% at baseline to 60% one year later. The results show that promoting RPO (and other VA rich foods) was effective in improving VA intakes. This improvement will hopefully be sustained and even further enhanced during the remaining 12 months of the project, after which repeated measurement of serum retinol and VA intakes will allow the actual impact of the project to be truly assessed.
2. Impact of vitamin A supplementation through different dosages of red palm oil and retinol palmitate on preschool children.
Sivan, Y.S. et al. (2002). Impact of vitamin A supplementation through different dosages of red palm oil and retinol palmitate on preschool children. Journal of Tropical Pediatrics. Vol 48:24-28

Red palm oil (5 ml and 10 ml), ground nut oil fortified with 400 and 800 retinol equivalent retinol palmitate, and ground nut oil (5 and 10 ml), were administered to six groups of preschool children (four experimental and two control groups) in randomly assigned balwadis of Ramanathapuram District of Tamil Nadu for a period of 7 months, to monitor the difference in the efficacy of the mode of supplementation and the optimum dose for improving vitamin A status. Results show that red palm oil groups recorded more gain in retinol and beta-carotene levels compared to other dosage groups, and that administration of 10 ml did not offer any substantial improvement over the 5-ml daily dose.
3. A European multicentre, placebo-controlled supplementation study with alpha-tocopherol, carotene-rich palm oil, lutein or lycopene: analysis of serum responses.
Olmedilla, B. et al. (2002). A European multicenter, placebo-controlled supplementation study with alpha-tocopherol, carotene-rich palm oil, lutein or lycopene:analysis of serum responses. Clin Sc (Lon). 102(4):447-456

Increased levels of oxidative stress have been implicated in tissue damage and the development of chronic diseases, and dietary antioxidants may reduce the risk of oxidative tissue damage. As part of a European multicentre project, several studies were undertaken with the aim of testing whether the consumption of foods rich in carotenoids reduces oxidative damage to human tissue components. We describe here the serum response of carotenoids and tocopherols upon supplementation with carotenoids from natural extracts (alpha-carotene+beta-carotene, lutein or lycopene; 15 mg/day) and/or with alpha-tocopherol (100 mg/day) in a multicentre, placebo-controlled intervention study in 400 healthy male and female volunteers, aged 25-45 years, from five European regions (France, Northern Ireland, Republic of Ireland, The Netherlands and Spain). Supplementation with alpha-tocopherol increased serum alpha-tocopherol levels, while producing a marked decrease in serum gamma-tocopherol. Supplementation with alpha- + beta-carotene (carotene-rich palm oil) resulted in 14-fold and 5-fold increases respectively in serum levels of these carotenoids. Supplementation with lutein (from marigold extracts) elevated serum lutein (approx. 5-fold), zeaxanthin (approx. doubled) and ketocarotenoids (although these were not present in the supplement), whereas lycopene supplementation (from tomato paste) resulted in a 2-fold increase in serum lycopene. The isomer distributions of beta-carotene and lycopene in serum remained constant regardless of the isomer composition in the capsules. In Spanish volunteers, additional data showed that the serum response to carotenoid supplementation reached a plateau after 4 weeks, and no significant side effects (except carotenodermia) or changes in biochemical or haematological indices were observed throughout the study. This part of the study describes dose-time responses, isomer distribution, subject variability and side effects during supplementation with the major dietary carotenoids in healthy subjects.
4. Impact of beta-carotene supplementation through red palm oil
Sivan Y.S., et al. (2001). Impact of beta-carotene supplementation through red palm oil. Journal of Tropical Pediatrics,47(2):67-72.

A 10‐month long feeding trial was conducted to assess the impact of β‐carotene supplementation through red palm oil (RPO) with the focus on vitamin A status, morbidity status and acceptability of an RPO‐incorporated noon‐meal as a dietary supplement among two cohorts of 409 (experimental) and 346 (control) preschool children in two southern districts of rural Tamil Nadu, selected by stratified random sampling. Information was gathered on ocular symptoms of vitamin A deficiency and anthropometry, and blood samples were drawn at baseline and final rounds for estimation of serum β‐carotene, retinol and tocopherol. Data about Socioeconomic Status (SES) were collected once during the study period, while information on attendance, consumption and morbidity was recorded by preschool teachers. The results showed the following. 1. Significant improvement in the vitamin A status of children in terms of disappearance of Bitot's spots (50.0 per cent) in the experimental group vs. 28.0 per cent in the control group. 2. After feeding of RPO, incidence rate of new Bitot's spots cases was low at 2.13 in the experimental children vs. 4.78 in control children. 3. Marked improvement in the serum β‐carotene levels after 10 months of feeding. 4.RPO is acceptable to children as an edible grade oil as there is no perceptible difference in the consumption pattern between experimental and control children.
5. Red palm oil in the maternal diet improves the vitamin A status of lactating mothers and their infants
Canfield, L.M. et al. (2000). Red palm oil in the maternal diet improves the vitamin A status of lactating mothers and their infants. European Jouranl of Nutrition. 40(1):30-8.

Improvement of the vitamin A status of lactating mothers and their nursing infants following maternal palm oil consumption was comparable to that following supplementation with purified β-carotene. Mothers who consumed β-carotene as red palm oil had 2.1- and 2.5-fold increases in their serum and milk β-carotene concentrations, respectively, and 2.8- and 3.2-fold increases in their serum and milk α-carotene concentrations, respectively. Infant serum retinol concentrations were significantly increased following maternal supplementation with red palm oil or β-carotene. Maternal intake of red palm oil or β-carotene supplements did not alter infant serum carotenoids, maternal serum retinol, or milk retinol. Because the local diet includes foods prepared with oil, the possibility that red palm oil could provide a significant source of provitamin A carotenoids for Honduran women and children should be further investigated.
6. Nutritional potential of red palm oil for combating vitamin A deficiency
Scrimshaw, N.S. (2000). Nutritional potential of red palm oil for combating vitamin A deficiency. Food and Nutrition Bulletin. 21(2):195-201

Although the severe vitamin A deficiency responsible for ocular damage is now rare, subclinical vitamin A deficiency still contributes importantly to high child mortality in the developing countries of Asia. This demands urgent and effective preventive action. Although periodic large doses of vitamin A for this purpose have been a favoured approach of international agencies, the coverage achieved has been inadequate and is usually not sustainable without external support. For this reason, there has been increasing emphasis on a sustainable dietary approach to the prevention of subclinical vitamin A deficiency. One part of this can be the production and use of red palm oil as a salad and cooking oil or blended into other vegetable cooking oils. The latter will also improve the caloric density of the diets, a serious limiting factor for young children in the region. It will also add antioxidant activity to the diet.
7. Potential use of red palm oil in combating vitamin A deficiency in India
Narasinga, R. B.S. (2000). Potential use of red palm oil in combating vitamin A deficiency in India. Food and Nutrition Bulletin. 202-211(10)

Vitamin A deficiency is widespread among pre-school children in India. Severe forms of vitamin A deficiency lead to nutritional blindness. Massive-dose vitamin A prophylaxis has been in operation in India since the early 1970s to prevent nutritional blindness. With a decline in the severe forms of vitamin A deficiency, the emphasis has shifted to a food-based approach to control the still widespread mild to moderate forms of vitamin A deficiency by promoting consumption of carotene-rich foods such as fruits and vegetables, especially green leafy vegetables. Compared with these sources, red palm oil is a richer source of carotenes, with 500-600 μg of carotenes per gram of oil. Further, the carotenes in red palm oil may be better absorbed than carotenes from other plant sources because they are in an oil medium,. The value of red palm oil as a rich source of carotenes to cure and prevent vitamin A deficiency was recognized and studied in India as far back as the mid-1930s. Later, during the 1980s, systematic studies in both animals and humans established the safety, acceptability, and nutritional potential of crude red palm oil as a rich source of provitamin A. During the early 1990s, community studies were carried out with edible-grade crude palm oil to improve the vitamin A status of children and mothers. With the current availability of highly refined edible-grade red palm oil, its use as a source of provitamin A at home and in feeding programmes for children should pose no problem, because it is more acceptable than crude palm oil. It can indeed prove to be a potential source of carotene to eradicate vitamin A deficiency in the country.
8. South African experience with the use of red palm oil to improve the vitamin A status of primary school children
Benade, A.J.S. et al. (2000). South African experience with the use of red palm oil to improve the vitamin A status of primary school children. Food and Nutrition Bulletin. 212-214(3).

A randomized, controlled, three-month trial compared the effect of biscuits containing red palm oil as a source of β-carotene and biscuits containing synthetic β-carotene on the vitamin A status of primary schoolchildren. Children consuming either type of fortified biscuit had a significant improvement in serum retinol concentrations compared with control children who received an unfortified biscuit. Using a red palm oil shortening in the biscuit has several other advantages. Unlike the commercial fat normally used in the baking industry, red palm oil contains no trans fatty acids. Because of its high carotenoid and vitamin E contents, the need to add synthetic β-carotene and antioxidant to the baking mix is eliminated. Quality control is simplified. Production costs for the red palm oil biscuit are slightly lower than those for the synthetic β-carotene biscuit. Red palm oil is thus ideally suited for use as a source of β-carotene in food fortification in the baking industry.
9. Red palm oil as a source of beta-carotene in a school biscuits used to address vitamin A deficiency in primary school children
Stuijvenberg, M.E. et al.(2000). Red palm oil as a source of beta-carotene in a school biscuits used to address vitamin A deficiency in primary school children. International Journal of Food Science and Nutrition. 51:S43-50.

The effect of a biscuit with red palm oil as a source of beta-carotene was compared with the effect of a biscuit with beta-carotene from a synthetic source on the vitamin A status of primary school children in a randomised controlled trial. Children aged 5-11 years (n = 265) were randomly assigned to one of three groups: (1) placebo biscuit; (2) biscuit with synthetic beta-carotene as a vitamin A fortificant; and (3) biscuit with red palm oil as a source of beta-carotene. The two non-placebo biscuits were designed to provide 34% of the RDA for vitamin A per serving (4 x 15 g biscuits). The biscuits were distributed daily during the school week and compliance was closely monitored and recorded. Children were assessed at baseline and after 6 months of intervention. Mean serum retinol in all three groups increased significantly compared to baseline (P < 0.0001). The prevalence of low serum retinol levels (< 20 micrograms/dL) dropped from 50 to 24.4% in the control group, from 48.2 to 16.9% in the synthetic beta-carotene group, and from 50.6 to 22.8% in the red palm oil group. There was no significant treatment effect compared to the control group in either the synthetic beta-carotene or red palm oil group. The increase in the control group was probably due to a school feeding scheme (providing 33% of the RDA for vitamin A) introduced during the latter part of the study. Our results were thus confounded and the 'true' effect of the red palm oil biscuit on vitamin A status could not be established. The study has, however, shown that red palm oil can be incorporated in a biscuit and that the end product with regard to taste and appearance was well accepted by the school children. A follow-up study in a school where there is no school feeding is indicated.
10. Use of red palm oil for promotion of maternal vitamin A status
Lietz, G. et al. (2000). Use of red palm oil for promotion of maternal vitamin A statu. Food and Nutrition Bulletin. 21(2):215-218.

Ninety rural Tanzanian women were recruited during the last three months of pregnancy and divided into three study groups: a control group given dietary advice to promote intake of dark-green leafy vegetables, a group given dietary advice plus sunflower oil, and a group given dietary advice plus red palm oil. Supplementing pregnant women with red palm oil, which is rich in provitamin A, increased their plasma and breastmilk concentrations of α- and β-carotene significantly, whereas women given sunflower oil had significantly higher amounts of α-tocopherol in their plasma and breastmilk than the control group. Moreover, the consumption of either red palm oil or sunflower oil retarded the decline in the concentration of retinol in breastmilk as seen in the control group during the progression of lactation. This indicates that the consumption of an oil rich in α- and β-carotene or α-tocopherol promotes retinol levels in breastmilk.
11. Red palm oil for combating vitamin A deficiency
Manorama, R. et al. (1997). Red palm oil for combating vitamin A deficiency. Asia Pacific Journal of Clinical Nutrition. 6(1): 56-59.

Twenty four school children of 7-9 years of age were divided into two groups of six boys and six girls each. One group was given a daily supplement of 'Suji halwa', a sweet snack made with semolina and red palm oil, supplying 2400 mu g of beta-carotene and the second group was the control group which was given 600 mu g of oral vitamin A palmitate, for 60 days. Vitamin A status before and after supplementation was assessed by the Modified Relative Dose Response Assay (MRDR). Results indicated that serum vitamin A levels increased from the basal level of 0.86 +/- 0.13 mu m mol/l to 1.891 +/- 0.23 mu mol/l in the Red Palmoil (RPO) group and from 0.74 +/- 0.09 to 1.94 +/- 0.21 mu mol/l in the control vitamin A group. Dehydroretinol/Retinol (DR/R) ratio decreased from 0.073 +/- 0.025 to 0.023 +/- 0.004 in the RPO group and from 0.090 +/- 0.023 to 0.023 +/- 0.004 in the vitamin A group, indicating liver saturation with vitamin A after feeding RPO snacks, comparable to synthetic vitamin A. This study indicates that RPO is an efficient source of beta-carotene which is found to be bioavailable in all the subjects tested, hence it can be used for supplementary feeding programmes to combat vitamin A deficiency in target population.
12. Red palm oil to combat vitamin A deficiency in developing countries
Rukmini, C. (1994). Red palm oil to combat vitamin A deficiency in developing countries. Food and Nutrition Bulletin. 15(2): 126-129.

Red palm oil (RPO), besides providing calorie density to the diet, is also the richest natural source of carotene, a precursor of vitamin A and an antioxidant that destroys singlet oxygen and free radicals. Chemical analysis of the fatty acid composition of RPO indicates that it has 50% saturated, 40% mono-unsaturated, and 10% polyunsaturated fatty acids. RPO contains 550 mg/g of total carotenoids, of which 375 mg/g represent carotene. It also contains 1,000 mg/g of tocopherols and tocotrienols. Nutritional values in rats fed 10% RPO in a 10% casein diet were comparable to those fed 10% ground nut oil (GNO) or 10% RBDPO (refined, bleached, deodorized palm oil). Rats fed RPO or RBDPO had significantly lower plasma cholesterol concentrations than those fed GNO. Significant inhibition of micro-somal 3-hydroxy-3-methylglutaryl coenzyme A reductase activity was observed in the RPO and RBDPO groups, indicating reduced synthesis of endogenous cholesterol. Toxicological studies also indicate that RPO is safe for human consumption. Indian school children fed supplementary snacks prepared with RPO for 60 days had significant increases in serum retinol levels as well as an increased liver retinol store, suggesting the ready bioavailability of carotene.
13. Red palm oil: nutritional, physiological and therapeutic roles in improving human wellbeing and quality of life.
Truter, E. J. et al. (2009).Red palm oil: nutritional, physiological and therapeutic roles in improving human wellbeing and quality of life. British Journal of Biomedical Scienc. 66(4):216-222.

The link between dietary fats and cardiovascular disease has created a growing interest in dietary red palm oil research. Also, the link between nutrition and health, oxidative stress and the severity or progression of disease has stimulated further interest in the potential role of red palm oil (a natural antioxidant product) to improve oxidative status by reducing oxidative stress in patients with cardiovascular disease, cancer and other chronic diseases. In spite of its level of saturated fatty acid content (50%), red palm oil has not been found to promote atherosclerosis and/or arterial thrombosis. This is probably due to the ratio of its saturated fatty acid to unsaturated fatty acid content and its high concentration of antioxidants such as beta-carotene, tocotrienols, tocopherols and vitamin E. It has also been reported that the consumption of red palm oil reduces the level of endogenous cholesterol, and this seems to be due to the presence of the tocotrienols and the peculiar isomeric position of its fatty acids. The benefits of red palm oil to health include a reduction in the risk of arterial thrombosis and/or atherosclerosis, inhibition of endogenous cholesterol biosynthesis, platelet aggregation, a reduction in oxidative stress and a reduction in blood pressure. It has also been shown that dietary red palm oil, taken in moderation in animals and humans, promotes the efficient utilisation of nutrients, activates hepatic drug metabolising enzymes, facilitates the haemoglobinisation of red blood cells and improves immune function. This review provides a comprehensive overview of the nutritional, physiological and biochemical roles of red palm oil in improving wellbeing and quality of life.
14. Impact of red palm oil on human nutrition and health
K, David. (2000). Impact of red palm oil on human nutrition and heath. Food and Nutriotion Bulletin, 21(2): 182-188.

The oil that is first obtained in harvesting the fruit of the oil palm is red because it contains carotenes, tocopherols, and tocotrienols. In the past, this fraction was separated from the palm olein and used separately. However, the presence of the palm oil tocopherol-rich fraction (TRF) is what makes red palm oil unique. Red palm oil has been shown to increase retinol levels in populations with marginal vitamin A deficiency. Red palm oil also reduces the severity of cholesterol-induced atherosclerosis in rabbits (compared with palm olein). There has been considerably more work done with TRF than with red palm oil per se. Some authors find it to be hypocholesterolaemic, whereas others do not. Many, but not all, studies show TRF to have antitumorigenic properties as well. More data concerning the health effects of red palm oil are needed.