The effect of vitamin A fortification of sugar on iron metabolism in preschool children in Guatemala

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Abstract
The effect of improvement in vitamin A nutriture on biochemical indicators of iron nutrition during national vitamin A fortification of sugar was investigated longitudinally. Four “paired-comparison-subgroups” of preschoolers were studied before fortification (survey I) and, respectively, at 6 months (survey I versus II), at 1 yr (survey I versus III), at I ½ yr (survey I versus IV), and at 2 yr (survey I versus V) after fortification began. Comparing I versus II gave a positive correlation (p < 0.001) between changes in serum retinol or retinol-binding protein and changes in iron, total iron binding capacity, and percentage transferrin saturation. In contrast, changes in serum ferritin correlated negatively (p < 0.05). Comparing V with I, retinol, retinol-binding protein, iron, and percentage transferritin saturation increased, but ferritin also increased (p < 0.05). Consequently, the distribution of serum iron and ferritin values of the children improved (p < 0.05). Because dietary iron did not change through the study period, the results suggest that vitamin A fortification had a favorable effect on iron metabolism and nutritional status.

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