Combined consumption of a single high-dose vitamin A supplement with provision of vitamin A fortified oil to households maintains adequate milk retinol concentrations for 6 months in lactating Moroccan women.

In Morocco, postpartum women systematically receive a single, high dose of vitamin A (VA; 200 000 IU) within the first month of giving birth and vegetable oil is fortified to increase the VA intake. The efficacy of this combined approach of supplementation and fortification for increasing maternal VA status during lactation is not known. The purpose of the study is to evaluate the effect of postpartum high dose VA supplementation and provision of VA fortified oil for household consumption on plasma and milk retinol concentrations of lactating Moroccan women during the first 6 months after giving birth. Postpartum women aged 19-40 years received a VA supplement and thereafter were randomly assigned to one of two groups to receive weekly vitamin A fortified oil (FO) or non-fortified oil (NFO) for 6 months. Serum retinol concentration was higher in the FO group than in the NFO group at 6 months after giving birth (p < 0.0001). Milk retinol per gram fat at baseline did not differ by group; by 3 months after giving birth, milk retinol per gram fat was higher in the FO group than in the NFO group (p = 0.02) and remained higher throughout the 6 months (p < 0.0001). The combination of supplementation and fortification has a more sustained impact on milk retinol concentrations than supplementation alone, which did not have a sustained impact on milk VA concentrations. The fortification approach seems to be more effective for maintaining adequate milk VA concentrations among lactating Moroccan women. Fortification seems to be a long-term solution for the problem of VA deficiency, especially among women in low-income communities.

Effect of multiple micronutrient fortified milk consumption on vitamin D status among school-aged children in rural region of Morocco.

Vitamin D deficiency is a health problem in both developed and developing countries. The aim of this study was to determine the effect of multi-vitamin fortified milk consumption on vitamin D status among children living in the mountainous region of Morocco. Children aged 7 to 9 years (n = 239; 49% of girls vs 51% of boys) participated in a double-blind longitudinal study, where they were divided in 2 groups: a fortified group that received daily 200 mL of fortified ultra-high-temperature (UHT) milk enriched with 3 µg of vitamin D3 and a nonfortified group that received 200 mL of nonfortified UHT milk with a natural abundance of vitamin D3 (about 1.5 µg). Blood samples were collected 3 times (at baseline, then at the fourth and ninth months). The average weight, height, and z score of body mass index for age of participants were 22.8 ± 2.6 kg, 121.5 ± 5.2 cm, and -0.2 ± 0.6 kg/m2, respectively. At baseline, 47.5% of children had a concentration of 25-hydroxyvitamin D below 50 nmol/L. At the end of the study the prevalence of vitamin D <50 nmol/L decreased significantly by 37.6% in the fortified group. These results reveal prevalent vitamin D insufficiency (<50 nmol/L) during winter among rural Moroccan school-aged children, which seems to be better improved by consuming the fortified milk instead of the nonfortified one.

Body composition in children with juvenile idiopathic arthritis: effect of dietary intake of macronutrient: results from a cross sectional study.

INTRODUCTION: The aim of this study was to evaluate the relationship between macronutrient intake, body composition (lean body mass and fat mass) and bone mineral content in Moroccan children with juvenile idiopathic arthritis (JIA). METHODS: A cross-sectional study, conducted between May 2010 and June 2011, covering out patient with JIA. The characteristics of patients were collected. The nutritional status was assessed by a food questionnaire including data of food intake during 7 consecutive days using 24-hour dietary recall. Food intake was quantified using the software Bilnut (Bilnut version 2.01, 1991). Dietary intake of macronutrients was expressed as percentage contribution to total energy. Body composition was evaluated with DXA total-body measurements (bone mineral content BMC expressed in g, lean body mass LBM and fat mass FM expressed in kg). RESULTS: 33 patients were included. The mean age was 10.4 ± 4.3 years. The median disease duration was 2 (1-4.5) years. The median of LBM, FM and BMC were 19 kg (13.82-33.14), 5 kg (3.38-9.14) and 1044.90 g (630.40-1808.90) respectively. We found a positive correlation between LBM and dietary intake of carbohydrate (r= 0.4; p = 0.03). There were no significant association between LBM and intake of lipids, or protein. Moreover, no association was found between FM, BMC and intake of carbohydrates, lipids and proteins. CONCLUSION: This study suggests that there is a positive correlation between carbohydrates intake and LBM; however, dietary intake does not influence FM and BMC. Prospective studies with larger numbers of patients appear to be needed to confirm our findings.