Children’s Consumption of Dark Green, Leafy Vegetables with Added Fat Enhances Serum Retinol

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Abstract
A randomized, double-blind, controlled study was conducted to determine whether the consumption of leafy vegetables by preschool children would enhance their serum vitamin A concentration to acceptable levels. Preschool children (n = 519; 2.5–6 y) in Saboba, northern Ghana, were randomly assigned to five feeding groups, differing essentially in the amount of fat and β-carotene, fed once per d, 7 d per wk, for 3 mo. Serum retinol levels, anthropometric measurements, hemoglobin, rapid turnover proteins (pre-albumin and retinol-binding protein), worm infestation (stool examinations) and level of acute and chronic infection (serum C-reactive protein and acid glycoprotein) were determined before and after study. Relative to the baseline serum retinol values, consumption of dark green, leafy vegetables (Manihot sp. and Ceiba sp.) with fat (10 g/100 g) significantly (P < 0.05) enhanced serum retinol; consequently, the percentage of children with adequate retinol status increased from 28.2–48.2% after feeding (P < 0.05). There were no significant differences among groups, ages or pre- versus post-anthropometric measurements, hemoglobin concentration, or levels of worm infestation. The importance of these findings in alleviating and/or controlling vitamin A deficiency in developing countries is discussed.