Vitamin D deficiency is a global public health concern with significant implications for bone health and chronic disease prevention. Our aim was to summarize the evidence from Cochrane and other systematic reviews evaluating the benefits or harms of vitamin D fortification of staple foods for household use. In April 2023, we systematically searched Ovid MEDLINE, Embase, Epistemonikos and the Cochrane Database of Systematic Reviews for systematic reviews investigating the effects of vitamin D fortification of food in general populations of any age. We used Cochrane methodology and assessed the methodological quality of included studies using AMSTAR (A MeaSurement Tool to Assess Systematic Reviews). We assessed the degree of overlap among reviews. All outcomes included in systematic reviews were assessed. The protocol is registered in PROSPERO (registration number: CRD42023420991). We included 27 systematic reviews out of 5028 records for analysis. Overall, 11 out of 12 systematic reviews calculating pooled estimates reported a significant increase in serum 25(OH)D concentrations. The mean change in serum 25(OH)D concentrations per additional 100 units of vitamin D ranged from 0.7 to 10.8 nmol/L. Fortification of food with vitamin D showed a reduction in the prevalence of vitamin D deficiency based on high-certainty evidence. Parathormone (PTH) levels were described to decrease, bone mineral density to increase, while the effects on other bone turnover markers were inconsistent. Fortification did not significantly impact most anthropometric parameters, but it seemed to positively influence lipid profiles. In summary, fortification of food with vitamin D results in a reduction of vitamin D deficiency and might increase serum 25(OH)D concentrations, to varying extents depending on the fortified vehicle and population characteristics. Additionally, fortification may have a positive impact on bone turnover and lipid metabolism but may only have a limited effect on anthropometric parameters.

This systematic review aims to assess whether edible vegetable oils and fats fortified with vitamin A and/or D are effective and safe in improving vitamin intake and ameliorating deficiency states in the general population. In November 2022, we systematically searched MEDLINE, Cochrane CENTRAL, Scopus, Global Index Medicus, ClinicalTrials.gov, and WHO ICTRP (International Clinical Trials Registry Platform) for randomized controlled trials (RCT) and non-randomized studies of interventions (NRSI) investigating the fortification of edible vegetable oils and fats with either vitamin A or vitamin D or both as compared to the same vegetable oils and/or fats without vitamin A and D fortification or no interventions, in the general population, without age restriction. We assessed the methodological quality of included RCTs using Cochrane’s risk of bias tool 2.0 and of NRSIs using ROBINS-I tool. We performed random-effects meta-analysis and assessed certainty of evidence using GRADE. We included eight studies. Available evidence showed no significant effect of fortification with vitamin A on serum retinol levels (RCTs: MD 0.35 µmol/L, 95% CI −0.43 to 1.12; two trials; 514 participants; low-certainty evidence; CCTs: MD 0.31 µmol/L, 95% CI −0.18 to 0.80; two trials; 205 participants; very low-certainty evidence) and on subclinical vitamin A deficiency. Low-certainty evidence showed no effect of vitamin D fortification on serum 25-hydroxy vitamin D concentration (MD 6.59 nmol/L, 95% CI −6.89 to 20.07; one trial; 62 participants). In conclusion, vitamin A-fortified vegetable oils and fats may result in little to no difference in serum retinol levels in general populations. The dose of vitamin A used in the trials may be safe but may not be sufficient to reduce subclinical vitamin A deficiency. Further, the evidence suggests that vitamin D fortification results in little to no difference in serum 25-hydroxy vitamin D concentration. Several aspects of providing fortified oils and fats to the general population as a public health intervention should be further investigated, including optimal fortification dose, effects on vitamin D deficiency and its clinical symptoms and potential adverse effects.

Introduction: Tea consumption with meals affects iron absorption, increasing the risk of iron deficiency. Our study investigated the association between tea consumption patterns and serum ferritin levels among women of childbearing age (WCA) in Nandi County, Kenya. Methods: We conducted a cross-sectional analytical study among 160 WCA selected using a systematic random sampling technique from Kapsabet Ward. Information on tea consumption practices was gathered using a researcher-administered questionnaire, and serum ferritin and C-reactive protein were measured. We assessed associations between tea consumption and iron status of respondents by multivariable regression analysis, adjusting for potential confounders, including parasitic infections and recent severe blood losses. Results: The prevalence of anaemia and iron deficiency among the study participants were 86.2% and 45%, respectively. Majority (90.6%) of the respondents consumed tea or coffee, with an infusion time of more than 5 min (60.0%) and a moderate tea strength (64.1%), within 1 h before or after meals. Iron deficiency was associated the number of teacups consumed (adjusted odds ratio = 7.282, 95% CI = 3.580–14.812). Conclusion: High tea consumption is positively associated with iron deficiency among WCA. Lower tea infusion strength, shorter tea infusion duration, and a lower number of teacups overall consumed, as well as consuming tea 1 h before or after meals instead of with meals, may be recommended for better outcomes in iron status among WCA.

Information on consumption patterns of iron- and ascorbate-rich foods and their influence on iron status among women of childbearing age (WCA) is scarce in Kenya despite iron deficiency being rampant. The present study investigated consumption patterns of iron- and ascorbate-rich foods on iron status among WCA in Kapsabet Ward, Kenya. The study adopted a cross-sectional analytical design. A sample of 160 respondents was systematically selected proportionately in the eight villages. Consumption patterns of iron- and ascorbate-rich foods were assessed using a modified 7-d Food Frequency Questionnaire. Venous blood (2 ml) was drawn from participants. Serum ferritin and C-reactive proteins were measured by enzyme immunoassay. Consumption patterns of iron- and ascorbate-rich foods were analysed using descriptive statistics. Multivariable regression was conducted to investigate the association between iron- and ascorbate-rich foods consumption and iron status. Confounding variables such as consumption of foods high phytate levels, milk and milk products, recent major blood losses and parasitic infections were controlled for during analysis. The prevalence of iron deficiency among the WCA was 45⋅0 %. Iron-rich foods were rarely (<2 times/week) consumed by the respondents with the majority reporting infrequent consumption: meat (61⋅3 %), sardines (61⋅9 %), oranges (54⋅4 %) and fortified breakfast cereals (94⋅4 %), except for kale and beans. Iron- (iron-fortified porridge, meat, sardines, beans, amaranth and spider plants) and ascorbate- (oranges and mangoes) rich foods positively predicted (AOR = 4⋅851,P= 0⋅021) the normal iron status of WCA. WCA should consume above 2 intakes per week of each iron- and ascorbate-rich food for better iron status outcomes.

With the emergence of COVID-19 coupled with the advent of the digital era, face-to-face learning has been challenged in addressing the learning and teaching needs of both trainees and trainers. Online learning has been adopted to address this unique challenge, however, teaching skills-based courses online has not been explored. Therefore, the current study investigated eLearning readiness and perceptions of TVET trainers to teach skills-based courses in North Imenti Constituency, Meru County. The study adopted a cross-sectional descriptive design to conduct the investigation among 177 TVET trainers who were selected using proportionate sampling from two TVET institutions and a simple random sampling was done within each institution. A semi-structured consolidated, Likert-scale, digital questionnaire was sent by online platforms, that is, email and WhatsApp to solicit data on elearning readiness and perceptions and the competency of teaching skills-based courses online. Data was downloaded from google drive, exported to SPSS, coded, cleaned and transformed. The five-Likert scale was compressed into dichotomous variables. Descriptive statistics such as means, standard deviations, percentages and inferential statistics, that is, logistic regression was performed to get associations. Most of the respondents were young (65%), employed by PSC (61.0%), and were not ready to teach online (75.1%), however, a few of them (33.9%) were enthusiastic. The enthusiastic respondents were 2.6 times (OR= 2.573, p = 0.006) more likely to be competent in teaching skills-based courses online as compared with those whose perception was neutral. One in three trainers had a positive perception, and one in two trainers was competent in teaching skills-based courses online; however, three in four trainers were not ready for the same. The Ministry of Education should develop training and sensitization packages for TVET trainers on ICT integration in education, e-learning, and effective change management.

Background:This systematic review summarizes the effect of consuming ascorbate-rich fruits or fruit juices with meals on iron bioavailability. Methods: We carried out a systematic review and meta-analysis of interventions. Searches were conducted in December 2024 in Scopus, Ovid Medline, ClinicalTrials.gov, Cochrane Controlled Register of Trials (CENTRAL), and WHO International Clinical Trials Registry Platform (ICTRP). Randomized controlled trials and controlled clinical trials were considered, with main outcomes being iron absorption and serum ferritin among women of childbearing age and children. Two independent reviewers were involved in screening titles and abstracts, full texts, extracting data, assessing risk of bias, and GRADE assessment. Conflicts were resolved through discussions to reach a consensus. Results: After screening 2400 unique records, 18 met the inclusion criteria. The main vitamin C-rich fruits used as interventions were oranges and guavas. Including ascorbate-rich fruits in meals had a positive effect on iron absorption (mean difference, MD = 3.36% µg/L, 95% CI: -0.29 to 7.00; p =0.07), serum ferritin (MD = 9.39 µg/L, 95% CI: 5.38 to 13.40; p < 0.001), haemoglobin (MD = 1.34 µg/L, 95% CI: 0.33 to 2.35; p = 0.01), and iron balance (MD = 2.4, 95% CI: 1.42 to 3.38), serum transferrin receptor (MD = 0.37 mg/L, 95% CI: -0.50 to -0.24; p < 0.00001). There was no impact on plasma ferritin (MD = -0.11 µg/L; 95% CI: -1.09 to 0.86; p = 0.82), and body iron stores (–0.29 mg/kg body weight, 95% CI: –0.85 to 0.28; p = 0.32). Conclusion: Consuming vitamin C-rich fruits and fruit juices with meals may positively influence iron absorption, serum ferritin levels, haemoglobin levels, serum transferrin receptors, and iron balance among women of childbearing age and children. Keywords: iron bioavailability, ascorbate-rich fruits, haemoglobin, enhancers, maternal and child nutrition