High prevalence of xerophthalmia linked to socio-demographic and nutritional factors among vitamin A-deficient rural primary schoolchildren in Malaysia.

Vitamin A deficiency (VAD) remains a major health issue in developing nations, contributing to preventable childhood blindness. However, there is lack of recent data on xerophthalmia, especially among school-aged children in Malaysia. We hypothesized that xerophthalmia persists among rural schoolchildren in Malaysia and potentially associated with socio-demographic status and malnutrition. We conducted a cross-sectional study on 596 schoolchildren (8-12 years) from ten rural primary schools located in five states across Malaysia. Children meeting the criteria for xerophthalmia assessment included those diagnosed with vitamin A deficiency (VAD) (plasma retinol < 0.70 µmol/L) and marginal VAD (plasma retinol 0.70 to < 1.05 µmol/L). The overall prevalence of xerophthalmia was 48.8%, with the most common ocular sign being conjunctival xerosis (38.9%). The occurrence of xerophthalmia was negatively associated with retinol-binding protein 4 (RPB4) (P=0.003), alpha-carotene (P=0.04), hemoglobin (P=0.004), weight (P=0.02), body mass index (BMI) (P=0.04) and WAZ (weight-for-age z-score) (P=0.04) status. Based on multivariate logistic regression analysis, a higher risk of xerophthalmia was observed in boys (Adjusted odd ratio [AOR]: 1.7, 95% confidence interval [CI]: 1.2-2.5) and Orang Asli (OA, indigenous) schoolchildren (AOR: 2.0, 95% CI: 1.3-3.0), while schoolchildren with overweight/obesity status (AOR: 0.5, 95% CI: 0.3-0.8) were associated with a reduced risk of xerophthalmia. The present study unveils a high prevalence of xerophthalmia among vitamin A-deficient primary schoolchildren in rural areas of Malaysia, especially among the indigenous community. The identified socio-demographic and nutritional factors associated to xerophthalmia would facilitate the implementation of more targeted interventions in addressing these issues.

Diverse impacts of red palm olein, extra virgin coconut oil and extra virgin olive oil on cardiometabolic risk markers in individuals with central obesity: a randomised trial.

PURPOSE: Dietary fats with an abundance of phytonutrients have garnered public attention beyond fatty acids per se. This study was set to investigate the impact of consuming diets with red palm olein (RPOO), extra virgin coconut oil (EVCO) and extra virgin olive oil (EVOO, as a control) on cardiometabolic risk biomarkers and lipid profile. METHODS: We recruited a total of 156 individuals with central obesity, aged 25-45 years, with waist circumference ≥ 90 cm for men and ≥ 80 cm for women in a parallel single-blind 3-arm randomised controlled trial. The participants consumed isocaloric diets (~ 2400 kcal) enriched with respective test fats (RPOO, EVCO or EVOO) for a 12-week duration. RESULTS: The mean of the primary outcome plasma high sensitivity C-reactive protein was statistically similar between the three diets after a 12-week intervention. EVOO resulted in significantly lower mean LDL cholesterol compared with RPOO and EVCO, despite similar effects on LDL and HDL cholesterol subfractions. The RPOO diet group showed elevated mean α and ß -carotenes levels compared with EVCO and EVOO diet groups (P < 0.05), corresponding with the rich carotenoid content in RPOO. CONCLUSION: The three oils, each of which has unique phytonutrient and fatty acid compositions, manifested statistically similar cardiometabolic effects in individuals with central obesity at risk of developing cardiovascular diseases with distinct circulating antioxidant properties. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (NCT05791370).

Supplementation of red palm olein-enriched biscuits improves levels of provitamin A carotenes, iron, and erythropoiesis in vitamin A-deficient primary schoolchildren: a double-blinded randomised controlled trial.

PURPOSE: Vitamin A deficiency (VAD) remains a significant contributor to childhood morbidity and mortality in developing countries; therefore, the implementation of sustainable and cost-effective approaches to control VAD is of utmost pertinence. This study aims to investigate the efficacy of red palm olein (RPO)-enriched biscuit supplementation in improving vitamin A, haematological, iron, and inflammatory status among vitamin A-deficient schoolchildren. METHODS: We conducted a double-blinded, randomised controlled trial involving 651 rural primary schoolchildren (8-12 years) with VAD in Malaysia. The schoolchildren were randomised to receive either RPO-enriched biscuits (experimental group, n = 334) or palm olein-enriched biscuits (control group, n = 317) for 6-month duration. RESULTS: Significant improvements in retinol and retinol-binding protein 4 levels were observed in both groups after supplementation (P < 0.001). The improvement in retinol levels were similar across groups among subjects with confirmed VAD (P = 0.40). Among those with marginal VAD, greater improvement in retinol levels was recorded in the control group (P < 0.001) but lacked clinical significance. The levels of α- and ß-carotenes, haematological parameters (haemoglobin, packed cell volume, mean corpuscular volume and mean corpuscular haemoglobin) and iron enhanced more significantly in the experimental group (P < 0.05). The significant reduction in the prevalence of microcytic anaemia (- 21.8%) and high inflammation (- 8.1%) was only observed in the experimental group. CONCLUSION: The supplementation of RPO-enriched biscuits enhanced levels of provitamin A carotenes, iron, and erythropoiesis, and exhibited anti-inflammatory effects. Therefore, the incorporation of RPO into National Nutritional Intervention Programs may be a potential measure to improve the health status of vitamin A-deficient children, among various other interventions. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (NCT03256123).

Red palm olein-enriched biscuit supplementation lowers Ascaris lumbricoides reinfection at 6-month after anthelmintic treatment among schoolchildren with vitamin A deficiency (VAD).

Notwithstanding the global efforts made to control intestinal parasitic infections, soil-transmitted helminth (STH) infections are still one of the most prevalent infections globally, especially in developing countries. A double-blinded, randomized controlled trial was conducted on 343 primary schoolchildren (8-12 years old) with vitamin A deficiency (VAD) in rural areas of Malaysia to investigate the effects of red palm olein (RPO)-enriched biscuits on STH reinfection rates and infection intensities. The effects of the RPO-enriched biscuits (experimental group, n = 153) and palm olein (PO)-enriched biscuits (control group, n = 190), were assessed at 3- and 6-month after the administration of complete triple-dose albendazole (one dose of 400 mg for three consecutive days). The overall STH infection rate at baseline was recorded at 65.6%. At 6-month, a significantly lower reinfection rate of A. lumbricoides was observed in the experimental group (35.3%) compared to the control group (60.0%) (P< 0.05), and a significant reduction in fecal egg count (epg) of A. lumbricoides was observed in the experimental group from baseline (P< 0.001), but no significant reduction was observed in the control group. No significant differences in the reduction of infection intensities of T. trichiura and hookworm were observed between experimental and control groups at 3- and 6-month (P>0.05). These findings suggest the potential beneficial effects of RPO-enriched biscuit supplementation on the reinfection of A. lumbricoides, which could be attributed to its high carotenoids content by enhancing host immune response and mucosal epithelium integrity. However, further studies are warranted to confirm whether RPO supplementation could result in similar parasite-specific beneficial effects in other community settings, as well as to explore the underlying mechanisms.

High prevalence of malnutrition and vitamin A deficiency among schoolchildren of rural areas in Malaysia using a multi-school assessment approach.

Childhood malnutrition is known as a public health concern globally. The present study aims to assess the anthropometry and blood biochemical status of rural primary schoolchildren in Malaysia. A total of 776 children (7-11 years old) from ten rural primary schools from five states were included in this study. Nutritional outcomes were assessed based on sex, age group and school categories among the children (median age: 9 years (P25:8, P75:10)). The overall prevalence of malnutrition was 53·4 %. Vitamin A deficiency (VAD) was recorded at 20·6 and 39·8 % based on retinol and retinol-binding protein (RBP) levels, respectively. Anaemia, iron deficiency (ID), iron-deficiency anaemia (IDA) and elevated inflammation were found at 14·9, 17·9, 9·1 and 11·5 %, respectively. Malnutrition, VAD, anaemia, ID, IDA and elevated inflammation were more prevalent among Orang Asli (OA) schoolchildren compared with Non-Orang Asli schoolchildren. Higher occurrences of VAD and anaemia were also found among children aged <10 years. Retinol, RBP, α-carotene, ferritin and haemoglobin levels were lower among undernourished children. Besides, overweight/obese children exhibited a higher level of high-sensitivity C-reactive protein. Multivariate analysis demonstrated that OA school children (adjusted OR (AOR): 6·1; 95 % CI 4·1, 9·0) and IDA (AOR: 3·6; 95 % CI 1·9, 6·6) were associated with stunting among this population. The present study revealed that malnutrition, micronutrient deficiencies and anaemia are prevalent among rural primary schoolchildren in Malaysia, especially those from OA schools and younger age children (<10 years). Hence, more appropriate and targeted measures are needed to improve the nutritional status of these children.

Diets enriched with palm olein, cocoa butter, and extra virgin olive oil exhibited similar lipid response: a randomized controlled study in young healthy adults.

Vegetable oils having unsaturated fatty acids in the sn-2 position of triglyceride (TG) backbone might not raise serum cholesterol levels. We investigated the chronic effects of diets enriched with palm olein (IV64) (PO), cocoa butter (CB), or extra virgin olive oil (EVOO) with oleic acid primarily at the sn-2 position (66%, 75%, 87% sn-2 oleic acid, respectively) of the TG molecule in 40 healthy volunteers participated in this randomized, controlled, single-blinded, crossover trial. Following a 2-week run-in period, the subjects were given standardization meals (breakfast, lunch, and dinner) cooked with palm olein (IV72). Subjects were randomized to 1 of the 3 intervention groups; receiving baked products (brownies for breakfast and cookies for teatime) prepared with respective test fats accompanied with standardized low-fat meals for breakfast, lunch, and dinner prepared with palm olein (IV72) for all groups for 4 weeks in a crossover manner with 2-week washout period (given standardization meals). Anthropometric measurements, blood samples, and dietary intakes were measured before run-in and pre- and post-intervention. No significant difference was observed on the primary outcome of the study total: high-density lipoprotein cholesterol. All 3 test fats were found to exhibit similar lipid responses (total cholesterol, TG, lipoprotein (a), apolipoprotein-A1, apolipoprotein-B/A-1). Statistical difference was found on low-density lipoprotein cholesterol (CB>EVOO by 0.3 mmol/L, P = .003), high-density lipoprotein cholesterol (PO>CB by 0.04 mmol/L, P = .02) and apolipoprotein-B (EVOO

Antioxidant Potential of Red Palm-Pressed Mesocarp Olein.

Oxidative stress occurs due to the imbalance amount of the free radicals and antioxidants in human body which often associated with numerous chronic diseases. The antioxidant properties of red palm-pressed mesocarp olein (PPMO) have not been widely studied. Therefore, antioxidant properties of PPMO relative to commercially available edible oils, namely red palm olein (RPO), palm olein (PO), extra virgin olive oil (OO) and extra virgin coconut oil (CNO) were studied. PPMO exhibited significant higher phytonutrients which more than 2-fold compared to the edible oils. Overall, antioxidant screening indicated that PPMO has significantly higher antioxidant activities than RPO, PO and CNO in term of DPPH, H2O2, NO scavenging and FIC; and significantly higher H2O2 and FIC than OO. The outcomes of this study reveal that PPMO is as good as commercially available edible oil, also a good source for food applications and dietary nutritional supplements. More importantly, the utilization of PPMO could mitigate oil palm waste problem and results in positive environmental impact.

Storage Stability Assessment of Red Palm Olein in Comparison to Palm Olein.

Sixty-four bottles of red palm olein and palm olein (constituted as control) samples were stored at permutations of common home setting variables which are: temperature (room temperature (24°C) or 8°C), light (kept in dark or exposure under light) and oxygen (opened or sealed caps). The effects of temperature, oxygen and light on the stability of red palm olein and palm olein were studied over 4 months of storage at simulated domestic conditions. The degree of auto- and photo-oxidations was evaluated by monitoring the following quality parameters: acidity, peroxide and p-anisidine values, fatty acids composition, carotenes and vitamin E. It is noted from the study that opened bottles of red palm olein was found to be stable for 4 months in comparison to its counterpart (palm olein) evidenced from their primary oxidative constituents (peroxides) and hydrolytic behavior (free fatty acids). Opened bottles are better off when stored at 8°C and protected from light for a longer shelf-life. Sealed bottles of palm olein showed better storage stability in the dark at 8°C; whereas sealed bottles of red palm olein was found to be stable at both temperatures studied without the influence of light. After 4 months of varying storage conditions, the fatty acid composition, vitamin E and carotenes of both oils remained unchanged. The phytonutrients in red palm olein rendered better storage stability when compared to palm olein.

Thermal Stability and Sensory Acceptance of Cupcakes Containing Red Palm Olein.

The study was designed to evaluate the nutritive value, thermal stability and consumer acceptance of cupcakes baked with red palm olein compared to palm olein. Thermal stability was evaluated for acidity, peroxide, p-anisidine and total oxidation value (cumulative between peroxide and p-anisidine values), as well as fatty acid composition. The concentrations of phytonutrients including tocopherols and tocotrienols, alpha- and beta-carotene after baking were also determined. Acceptance of the cupcakes was assessed using a structured hedonic scale of five points by 29 panelists. As compared to initial test oil (red palm olein), acidity (red palm olein, 0.07±0.01% vs cupcakes containing red palm olein, 0.09±0.01%; P=0.0232), peroxide value (red palm olein, 0.33±0.05 meq O2 kg-1 vs cupcakes containing red palm olein 0.73±0.06 meq O2 kg-1; P=0.0011) and total oxidation value (red palm olein, 2.24±0.13 unit vs cupcakes containing red palm olein, 3.09±0.17 unit; P=0.0012) were found to be higher in cupcakes containing red palm olein, which is within the acceptable rancidity range (peroxide value < 7.5 meq O2 kg-1) for snack food category. No changes were found on oxidative parameters (acidity, peroxide, p-anisidine values and total oxidation value) in cupcakes containing palm olein. Cupcakes made with red palm olein retained nearly 100% of alpha- and beta-carotenes upon baking. Tocopherol homologues were stable in both comparisons, with 95% retention as compared to tocotrienol homologues (~85%). Cupcakes made from red palm olein received higher score (mean=3.29) in sensory evaluation as compared to cupcakes containing palm olein (mean=3.07). The study, therefore, encourages the inclusion of red palm olein in the formulation of bakery products.

Retention of Carotenes and Vitamin E, and Physico-chemical Changes Occurring upon Heating Red Palm Olein Using Deep-fat Fryer, Microwave Oven and Conventional Oven.

Red palm olein is known to be high in carotenes and vitamin E (tocols) and possess various nutritional benefits. This study evaluates the effect of prolonged heating using three common cooking techniques i.e. deep-fat fryer, microwave oven and conventional oven, on the profiles of carotenes and tocols as well as the physico-chemical changes occurring in red palm olein when compared to conventional palm olein. Physico-chemical changes in all oils were gauged based on their peroxide, p-anisidine and total oxidation values, acidity, and fatty acid composition. Both red palm olein and palm olein were thermally stable based on their lower rate of hydrolytic and oxidative degradations as well as higher tocols retention, which allow the oils to undergo heating up to 3 hours using deep-fat fryer and conventional oven. Nevertheless, red palm olein seemed not suitable for prolonged heating processes considering lower retention of carotenes. Microwave heating also influenced the stability of phytonutrients.

Red palm olein supplementation on cytokines, endothelial function and lipid profile in centrally overweight individuals: a randomised controlled trial.

BACKGROUND/OBJECTIVES: The consumption of antioxidant-rich cooking oil such as red palm olein may be cardioprotective from the perspective of subclinical inflammation and endothelial function. SUBJECTS/METHODS: Using a crossover design, we conducted a randomised controlled trial in 53 free-living high-risk abdominally overweight subjects, comparing the effects of incorporating red palm olein (with palm olein as control) in a supervised isocaloric 2100 kcal diet of 30% en fat, two-thirds (45 g/day) of which were derived from the test oil for a period of 6 weeks each. RESULTS: We did not observe a significant change in interleukin-6 (IL-6), in parallel with other pro-inflammatory (tumour necrosis factor-ß, interleukin-1ß, IL-1ß, high sensitivity C-reactive protein, hsCRP) and endothelial function (soluble intercellular adhesion molecules, sICAM, soluble intravascular adhesion molecules, sVCAM) parameters. Interestingly, we observed a significant reduction in oxidised LDL levels (P < 0.0386) while on the red palm olein diet, together with the increase in plasma alpha tocopherol (P < 0.0002), alpha carotene (P < 0.0001) and beta carotene (P < 0.0001) concentrations compared with palm olein diet. CONCLUSION: Red palm olein did not improve subclinical inflammation and endothelial function despite profound increase in antioxidant levels. The positive improvement in oxidised LDL merits further attention in this group of subjects at risk of developing cardiovascular disease.

Health-promoting effects of red palm oil: evidence from animal and human studies.

The fruit of the oil palm tree (Elaeis guineesis) is the source of antioxidant-rich red palm oil. Red palm oil is a rich source of phytonutrients such as tocotrienols, tocopherols, carotenoids, phytosterols, squalene, and coenzyme Q10, all of which exhibit nutritional properties and oxidative stability. Mutagenic, nutritional, and toxicological studies have shown that red palm oil contains highly bioavailable ß-carotene and vitamin A and is reasonably stable to heat without any adverse effects. This review provides a comprehensive overview of the nutritional properties of red palm oil. The possible antiatherogenic, antihemorrhagic, antihypertensive, anticancer, and anti-infective properties of red palm oil are examined. Moreover, evidence supporting the potential effectiveness of red palm oil to overcome vitamin A deficiency in children and pregnant women, to improve ocular complications of vitamin A deficiency, to protect against ischemic heart disease, to promote normal reproduction in males and females, to aid in the management of diabetes, to ameliorate the adverse effects of chemotherapy, and to aid in managing hypobaric conditions is presented.