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Objective: To assess serum retinol, liver intake patterns, breast-feeding history and anthropometric status in pre-school children of a low socio-economic community where liver is regularly consumed. Design: Cross-sectional study. Setting: Northern Cape Province, South Africa. Subjects: Children aged 1-6 years (n 243) who attended the local primary healthcare facility and had not received a vitamin A supplement in the 6 months preceding the study. Non-pregnant female caregivers (n 225), below 50 years of age, were also assessed. Results: Despite stunting, underweight and wasting being prevalent in 40?5 %, 23?1 % and 8?4 % of the children, only 5?8 % had serum retinol concentrations , 20 mg/dl, which is in sharp contrast to the national prevalence of 63?6 %. None of the caregivers were vitamin A deficient. Liver was eaten by 89?2 % of children, with 87 % of households eating liver at least once monthly and 30 % eating it at least once weekly; liver was introduced into the diet of the children at a median age of 18 months. Ninety-three per cent of the children were being breast-fed or had been breast-fed in the past; children were breast-fed to a median age of 18 months. A significant negative correlation was found between educational level of the caregiver and frequency of liver intake (r 5 20?143, P50?032). There was no correlation between serum retinol and indicators of anthropometric or socio-economic status. Conclusions: The blanket approach in applying the national vitamin A supplementation programme may not be appropriate for all areas in the country, even though the community may be poor and undernourished.

This is the first controlled study to clearly demonstrate that iodine repletion in school-age children increases IGF-I and IGFBP-3 concentrations and improves somatic growth.

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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 mg 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 mg retinol equivalents and the vitamin A supplementation programme 122 mg 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.