Liver intake in 24-59-month-old Children from an Impoverished South African Community Provides Enough Vitamin A to Meet Requirements

Abstract

Objectives: To assess the contribution of liver to the vitamin A intake of 24-59-month-old children from an impoverished South African community where liver is frequently consumed. Vitamin A deficiency was previously shown to be absent in this community, but the prevalence of stunting was high. Methods: Vitamin A intake from liver was assessed in 150 children using a single 24-hour recall and a quantified liver frequency questionnaire. In addition, information on vitamin A intake via the national fortification programme was obtained from the 24 h-recall, and information on vitamin A supplementation from the Road-to-Health Chart.  Height, weight, and socio-economic data were also collected. Results: Stunting, underweight and wasting were prevalent in 36.9%, 25.5% and 12.1% of children. Mean vitamin A intake from liver was 537 and 325 µg RE measured by the 24-hour recall and liver frequency questionnaire, respectively. Liver was consumed in 92.7% of households and by 84.7% of children; liver intake was inversely related to several indicators of socio-economic status (p< 0.05). The food fortification programme contributed 80 µg RE, and the vitamin A supplementation programme 122 µg RE to vitamin A intake. Conclusions: The study showed that liver alone provided more than 100% of the Estimated Average Requirement of the pre-school children in this impoverished community. The results also challenge the notion generally held by international health bodies that vitamin A deficiency, poor anthropometric status, and poverty go together, and reinforces the fact that South Africa is a diverse country for which targeted rather than blanket interventions are required.