School Fortified Milk Improves Vitamin A Status Of Rural Children In Morocco: A Longitudinal Interventional And Controlled Study

BACKGROUND: Schoolchildren in Morocco are rarely targeted by micronutrient interventions. A school-milk program could be a good strategy for the administration of micronutrients, including vitamin A, in Moroccan school age children.OBJECTIVE: Our study aims to evaluate the effect of consumption of multiple micronutrients fortified milk on reducing vitamin A deficiency (VAD) in a pilot school milk program.METHODS: This longitudinal, interventional and double-blind study aimed to investigate the effects of consuming multi-micronutrient fortified whole milk, including vitamin A, for a period of 9 months, as part of a geographical targeted school-milk program, on vitamin A status of school-aged children living in a rural and mountainous area. Children were divided in two groups: a non-fortified milk group (NFMG, n = 111) received daily 200 ml of a whole ultra-high temperature (UHT) milk and a fortified milk group (FMG, n = 69) received daily 200 ml of an UHT milk fortified with multiple micronutrients, including vitamin A (retinyl palmitate). The vitamin A status of children has been assessed on the basis of serum retinol concentrations, using high performance liquid chromatography (HPLC). Children were not dewormed during the study.RESULTS: At the endline, albeit it was observed a significant decrease of VAD prevalence from 49.3% to 4.3% in the fortified group (P < 0.001) and from 45% to 25.2% in the non-fortified group (P = 0.001), the remaining prevalence of VAD in the endline was significantly lower in the fortified milk group (P < 0.001).CONCLUSIONS: A fortified school milk program seems to be effective to combat VAD among schoolchildren in this rural region of Morocco.