Vitamins A and D Fortification of Milk and Their Impact on Nutritional Status of School Children in Rural Regions of Morocco

Abstract

Objectives: Vitamins A and D deficiencies constitute a major public health problem in Morocco. The objective of this study is to assess the impact of consumption of  vitamins A and D fortified milk on the nutritional status of school children in rural areas Methods: This study is a double-blinded longitudinal one targeting children, 7-9y old (n = 380). Children were divided in two groups: a non fortified group (NFG) received 200 ml of non fortified UHT milk and a fortified group (FG) received 200 ml UHT milk fortified with vitamin A (retinyl palmitate) and vitamin D (D3) to cover 30% of RDA.  Clinical assessment, anthropometry, morbidity, alimentary and socioeconomic surveys, blood samples collection were performed at baseline (T0), 4 months (T4) and 9 months (T9). Vitamins A and D were assessed in serum. Cognitive test based on Raven matrix was assigned to children at T0 and T9. Results: At T9 FG showed: 18% reduction of stunting, elimination of the vitamin A deficiency (from 50% to 4,3%),  reduction of vitamin D deficiency (from 60% to 25,5%). Cognitive tests showed no significant difference between the two groups. At T9 in the NFG we observed a decrease in vitamins A and D deficiency prevalence probably    due to the fact that non fortified whole milk contains  residus of Vit A (27 µg/100 ml) and Vit D (0,5 µg/100 ml). Conclusions: The national strategy of vitamins (A and D3) fortification is a success story in Morocco. This study was performed with the support of "Fondation Centrale Laitière pour la nutrition de l'enfant".