Efficacy of a vitamin A-fortified wheat-flour bun on the vitamin A status of Filipino schoolchildren

Am J Clin Nutr. 2000 Sep;72(3):738-44. doi: 10.1093/ajcn/72.3.738.


Background: Wheat flour is a possible food vehicle for vitamin A fortification.

Objective: This study assessed the efficacy of consumption of a vitamin A-fortified wheat-flour bun (pandesal) on the vitamin A status of school-age children.

Design: This was a double-masked clinical trial conducted in 396 and 439 children aged 6-13 y attending 4 rural schools in the Philippines. The children were randomly assigned to a vitamin A-fortified (experimental) or nonfortified (control) group. A 60-g vitamin A-fortified pandesal (containing approximately 133 microg retinol equivalents) or a nonfortified pandesal was consumed by the children 5 d/wk for 30 wk. Vitamin A status, hemoglobin concentration, anthropometric status, morbidity, and dietary intake were assessed at baseline and 30 wk later. A modified relative dose response (MRDR) was assessed in a subsample of 20% of the children ( approximately 75/group) with the lowest initial serum retinol concentration at the 30-wk follow-up.

Results: Baseline serum retinol significantly modified the effect of the intervention. The fortified group, whose initial serum retinol concentrations were below the median, had a 0.07 +/- 0.03-micromol/L greater improvement in serum retinol at the 30-wk follow-up than did the control group (P: = 0.02). Improved vitamin A status was also evident in the MRDR subsample. End-of-study differences in the MRDR showed that vitamin A- fortified pandesal intake decreased the percentage of children with inadequate liver vitamin A stores by 50% (15.3% compared with 28.6%; P: = 0.05).

Conclusions: Daily consumption of vitamin A-fortified pandesal significantly improved the vitamin A status of Filipino school-age children with marginal-to-low initial serum retinol concentrations.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Bread*
  • Child
  • Double-Blind Method
  • Female
  • Flour*
  • Food, Fortified*
  • Humans
  • Liver / metabolism
  • Male
  • Osmolar Concentration
  • Philippines
  • Schools
  • Triticum*
  • Vitamin A / blood
  • Vitamin A / metabolism*
  • Vitamin A / pharmacology*


  • Vitamin A