To demonstrate the effectiveness of the commercial introduction of red palm oil (RPO) as a source of vitamin A (VA) for mothers and children in a non-consuming area, as a dietary diversification strategy.

A pre–post intervention design (no control area) was used to assess changes in VA intake and status over a 24-month pilot project.

The pilot project involved RPO promotion in 10 villages and an urban area in east-central Burkina Faso, targeting approximately 10?000 women and children aged < 5 years. A random sample of 210 mother–child (12–36-months-old) pairs was selected in seven out of the 11 pilot sites for the evaluation.

After 24 months, RPO was reportedly consumed by nearly 45% of mothers and children in the previous week. VA intake increased from 235 ± 23 μg retinol activity equivalents (RAE) to 655 ± 144 μg RAE in mothers (41 to 120% of safe intake level), and from 164 ± 14 μg RAE to 514 ± 77 μg RAE in children (36 to 97%). Rates of serum retinol < 0.70 μmoll−1 decreased from 61.8 ± 8.0% to 28.2 ± 11.0% in mothers, and from 84.5 ± 6.4% to 66.9 ± 11.2% in children. Those with a lower initial concentration of serum retinol showed a higher serum retinol response adjusted for VA intake.

Commercial distribution of RPO was effective in reducing VA deficiency in the pilot sites. While it is promising as part of a national strategy, additional public health and food-based measures are needed to control VA malnutrition, which remained high in the RPO project area

To study pregnant women's diet at food and nutrient levels and how these match recommendations; to describe how factors such as education level, economy and folk dietetics influence the women's food choice; and to give suggestions for the improvement of nutrition education in the existing antenatal care systems.

Thirty pregnant women in the last trimester were interviewed three times using a 24-hour dietary recall with weighing of foods and recipes of dishes. Interviews regarding health, nutrition and socio-economic status, and measurements of weight and height of the women, were conducted.

Rural parts of Salem District, Tamil Nadu, South India.

The women's diet (without supplements) was insufficient in energy and all nutrients except fat, compared with the Indian recommendations. Aggravating low intakes of micronutrients were found which were reflected in low intakes of foods other than rice. Eating customs and economy appeared to influence the women's food choice negatively in relation to recommendations while factors such as education level, family type, pregnancy number and folk dietetics did not seem to have a negative effect. The amounts of foods recommended, especially green leafy vegetables, must be shown to the women. The nutrition advice given by all levels of health providers must be the same and based on cheap, local, commonly consumed foods.

The impact on vitamin A status of the distribution of vitamin A during national immunisation days (NIDs) has not been well established despite strong promotion by international agencies and donors. Using a pre–post design, the change in prevalence of vitamin A deficiency was examined in pre-school children in Mali.

Two cross-sectional surveys were conducted in Mopti region, the first in March 1997 before this strategy was adopted and the second in March 1999, four-and-a-half months after a mass distribution of vitamin A during NIDs.

We compared the vitamin A status of children aged 12 to 66 months targeted in 1999 by NIDs with the status of children in the same age group in 1997. Infectious events of the previous two weeks were concurrently recorded. Within the 1999 sample, the status of recipient and non-recipient children was also compared.

In 1997, the prevalence of xerophthalmia (defined by the presence of night blindness and/or Bitot spots) was 6.9% (95% confidence interval (CI) 5.1–9.2) and the modified retinol dose response (MRDR) test proved abnormal in 77.8% of 12–66-month-old children (95% CI 68.27–85.17). In 1999 this picture had improved significantly, both for xerophthalmia prevalence, 3.3% (95% CI 2.1–5.2), and abnormal MRDR test response, 63.1% (95% CI 54.25–71.23). The infectious morbidity rates between 1997 and 1999 tended to decrease. No significant improvement was found among children older than those targeted by NIDs. In 1999, children who received vitamin A had a lower risk for xerophthalmia (3.0% for recipients vs. 8.7% for non-recipients) and experienced fewer infectious events.

The clinical and biological vitamin A status of pre-school children improved between 1997 and 1999. Mass distribution of vitamin A appears to reduce the occurrence of xerophthalmia and would seem to be associated with a decrease in other related illnesses. Vitamin A supplementation during NIDs should be given a high priority when vitamin A deficiency remains a public health problem.

Northern rural areas of Tehran have been shown to have severe iodine deficiency in our previous studies. In 1989 the inhabitants of these villages received an injection of iodised oil, followed by iodised salt distribution in 1993. The aim of the present study was to evaluate the effect of the iodine supplementation on iodine-deficient schoolchildren with hypothyroidism in these villages.

In total, 571 students aged 6–14 years were studied. Goitre was graded according to the World Health Organization classification. Serum concentrations of thyroid hormones (thyroxine (T4) and triiodothyronine (T3)) and thyroid-stimulating hormone (TSH) were determined using commercial kits, and urinary iodine was measured using a digestion method. The results were compared with data from our previous study in 1989.

Total goitre rate decreased by 42% in 1999 compared with that in 1989. A significant decrease in Grade 2 goitre concomitant with an increase in Grade 1 goitre was seen (P < 0.001). Values of the variables studied before (1989) and 10 years after iodine supplementation (1999) were: median urinary iodine excretion, 2.0 vs. 19.0 μg dl−1 (P < 0.001); T4, 6.5 ± 2.0 vs. 8.4 ± 1.6 μg dl−1 (P < 0.001); T3, 177 ± 38.0 vs. 145 ± 29.0 ng dl−1 (P < 0.001); TSH, 10.8 ± 15.1 vs. 1.8 ± 0.8 μU ml−1 (P < 0.001). No correlation was found between thyroid hormones and TSH on the one hand, and goitre and urinary iodine, on the other. Serum T4, T3 and TSH concentrations were within normal ranges in all schoolchildren in 1999.

This study showed that euthyroidism induced by administration of iodised oil in iodine-deficient schoolchildren with hypothyroidism is sustained following the consumption of iodised salt.

To study risk factors associated with overweight and obesity among adolescents enrolled in private high schools in the city of Pelotas, southern Brazil.

This was a case–control study. The subjects were 264 overweight (body mass index (BMI) ≥85th percentile of the National Center for Health Statistics (NCHS) reference population) and 264 non-overweight (BMI > 5th and <85th NCHS percentiles) adolescents identified by means of an anthropometric survey which included 1608 students. The adolescents were weighed, measured and interviewed about food habits and physical activity at school. Parents provided their own weights and heights when contacted by telephone, and parental BMI was calculated.

Hierarchical multiple conditional logistic regression showed that overweight and obesity were positively associated with mother's (odds ratio (OR) 2.86, 95% confidence interval (Cl) 1.43–5.74) and father's (OR 2.43, 95% Cl 1.37–4.30) BMI ≥ 30 kg m−2, being overweight before 10 years of age (OR 2.26, 95% Cl 1.30–3.90) and the habit of dieting (OR 3.53, 95% Cl 1.76–7.22). Having more than three meals per day was found to be a protective factor against overweight and obesity (OR 0.54, 95% Cl 0.29–1.00).

The present study showed that a family history of obesity, overweight during childhood and the habit of dieting for weight-loss purposes are factors associated with obesity during adolescence. The habit of having more than three daily meals turned out to be a protective factor against overweight. These results suggest the necessity for early intervention at the family and general community levels aimed at the prevention of obesity through actions directed towards the modification of established behaviours.