Liver intake in 24-59-month-old children from an impoverished South African community provides enough vitamin A to meet requirements

Objective: 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 and vitamin A deficiency previously shown to be absent. Design: Cross-sectional. Setting: Northern Cape Province, South Africa. Subjects: Children aged 24-59 months (n 150). Vitamin A intake from liver was assessed using a single 24 h 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 daily vitamin A intake from liver was 537 and 325 mu g retinol equivalents measured by the 24 h 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 socio-economic status (P<0.05). The food fortification programme contributed 80 mu g retinol equivalents and the vitamin A supplementation programme 122 mu g retinol equivalents to daily 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 culturally diverse society for which targeted interventions are required.