Medical research council scientists have developed a novel way to address dietary deficiencies of essential micronutrients - find out about Carotino, the MRC's "Red Palm Oil" biscuit.
In 1995 the Nutritional Intervention Research Unit of the Medical Research Council conducted a community survey in a rural area in KwaZulu-Natal to determine the nutritional status of the mothers and their children in the area. This survey revealed a high prevalence of micronutrient deficiencies to the extent that the deficiencies of iron, iodine and vitamin A could be considered a public health problem. Subsequently the research team of the Nutritional Intervention Research Unit developed, in collaboration with the food industry, a micronutrient fortified biscuit to address the nutritional problems in the schoolchildren of this community. This biscuit, fortified with iron, iodine and ß-carotene, was tested in the children of the local primary school over a period of one year 1. Biscuits were distributed daily during the school week during the first two hours of the school day and the micronutrient status of the pupils measured before and after one year on the biscuit programme. Results showed a significant improvement in the iron, iodine and vitamin A status of these children compared to a control group. There was also a significant improvement in cognitive tests measuring short-term memory and attention span, as well as a significant reduction in the number of school days missed as a result of respiratory and diarrhoea-related illnesses. The researchers concluded that a biscuit can successfully be used as a vehicle for fortification in a school setting and that it is a practical and effective way of improving the micronutrient status of schoolchildren from poor rural communities. A major advantage of using a biscuit as a carrier for micronutrients is that a biscuit is regarded as a snack rather than a meal and is therefore unlikely to replace meals given to the child at home. Additional advantages are that it needs no preparation, is easy to distribute, has a long shelf life and can easily be monitored and is therefore less open to misuse. After the success of this biscuit the MRC felt that they could still improve on their product. Firstly, a hydrogenated oil, normally used in the baking industry, was used as baking fat in the original biscuit. Hydrogenated oils contain trans fatty acids and because of the negative effects of the latter on plasma lipids and lipoproteins, its use in school feeding schemes in the long term may not be desirable. Secondly, a synthetic form of ß-carotene was used to fortify the biscuit. This posed problems with regard to quality control in that the correct amount of ß-carotene may not always be added and also that the ß-carotene may not be evenly distributed throughout the baking mixture. That was when red palm oil came into the picture. Red palm oil is produced in Malaysia from the yellow flesh surrounding the seed (palm kernel) of the fruit of the palm trees and is a rich natural source of ß-carotene. Because red palm oil has a moderate level of saturation it does not require hydrogenation for use as a fat component in foods and is therefore free of trans fatty acids. In addition it contains large amounts of other carotenoids which possess significant anti-oxidant properties, thereby keeping the body cells healthy and controlling degenerative diseases such as cancer. Red palm oil is also a rich source of tocopherols and tocotrienols (vitamin E) which, being powerful antioxidants, protect the oil against oxidative deterioration; the shelf life of products in which red palm oil is used is therefore prolonged without having to add synthetic antioxidants. The MRC thus negotiated with Global Palm Products of Malaysia to develop a shortening manufactured from red palm oil. By using this shortening in the biscuit instead of the commercial hydrogenated shortening, the biscuit will not only be free of trans fatty acids, but there will also be no need to add synthetic ß-carotene and a synthetic antioxidant to the biscuit and quality control with regard to the fortification process will concomitantly be simplified. The effectiveness of this new biscuit was subsequently evaluated against the original biscuit in a randomised controlled trial 2. Results showed that the biscuit with red palm oil shortening was as effective as the original biscuit, in which synthetic ß-carotene was used, in improving the vitamin A status of the schoolchildren. This, together with additional qualities of the red palm oil, make it an excellent alternative for use as a food fortificant for addressing vitamin A deficiency, not only in schoolchildren but also in other segments of the population. The production costs for the red palm oil biscuit was slightly lower than that of the original biscuit. Although the red palm oil may be more expensive than the hydrogenated shortening, the fact that it already contains ß-carotene and antioxidants, and that there is no need to additionally buy and add these components to the mixture, reduces costs. The time saved by this simplification of the baking process further contributes to the lowering of the production costs. The biscuit is currently commercially available on the South African market under the registered trademark "Carotino Enriched Biscuit" and has a shelf life of at least 6 months.