Compared to the control group, children who ate RPO-fortified biscuits had significantly higher levels of gut microbes including Christensenellaceae R-7 group, Anaerostipes, Lachnospiraceae_NK4A136_group, and Ruminococcus, which have been linked to improved gut and metabolic health.
Prior literature has shown that vitamin A deficiency can alter the gut microbiome, leading to adverse health effects. To this end, researchers wanted to find out if the supplementation of vitamin A-rich red palm olein (RPO) can modulate the gut microbiome of vitamin A-deficient children.
“This study represents the first multi-school supplementation programme involving RPO conducted in Malaysia, which sheds light on the potential modulatory effects of the consumption of RPO-enriched biscuits on the gut health of children with vitamin A deficiency,” they wrote in Nature Communications.
Data collection
The study involved 328 primary school children between the ages of eight and 12, who were diagnosed with vitamin A deficiency. They were recruited from 10 rural schools across five Malaysian states, including Pahang, Perak, Johor, Sabah and Sarawak.
Participants were randomised to receive RPO-fortified biscuits or palm olein-fortified biscuits for four days weekly over six months. The difference between the biscuits was carotenoid content.
The experimental group received higher total carotene content of 4.6 mg per 36 g serving, as compared to 0.2 mg per 36 g serving received by the control group.
The experimental group consumed approximately 326.3 µg of vitamin A daily, which met about 60% of the Recommended Nutrient Intakes (RNI) for vitamin A among children.
Stool samples were collected at baseline, the 3rd and 6th month of supplementation. Blood samples were also taken.
The primary outcome was changes in gut microbiota composition, while secondary outcomes include gut microbiota diversity, micronutrient bioavailability, blood biomarkers, and microbial network structure.
Better gut health
Researchers found that six months of consuming RPO-fortified biscuits significantly increased the abundance of several potentially beneficial gut microbes compared to the control group.
For instance, the experimental group had significantly higher levels of Christensenellaceae R-7 group, which is associated with a healthier metabolic profile and reduced cardiovascular risk.
They also reported significantly higher levels of Anaerostipes, Atopobiaceae, Slackia_isoflavoniconverte, and Lachnospiraceae_NK4A136_group which have anti-inflammatory properties, as well as Ruminococcus and Treponema_succinifaciens that play a role in supporting gut barrier integrity.
Others such as Butyricicoccus, Enterorhabdus, and Desulfovibrio_piger - known to protect against inflammatory bowel disease - were also significantly higher in levels as compared to the control group.
In contrast, the control group saw more microbes that were associated to gut inflammation and impaired intestinal barrier integrity, compared to the experimental group.
Some of these bacterial groups include Lactococcus garvieae, Clostridium perfringens, Weissella, Clostridium sensu stricto 1, [Ruminococcus] gnavus group, Blautia, Megamonas, and Enterobacteriaceae.
“Their lower abundance in the RPO group suggests a protective effect from the carotenoid-rich biscuits, possibly due to RPO’s bioactive phytonutrients creating a gut environment less favourable for harmful bacteria,” the researchers wrote.
Better nutrient absorption and blood health
RPO-fortified biscuit consumption was also found to be linked to improvements in micronutrient and blood markers, including antioxidants provitamin A carotenoids and vitamin E.
This finding suggests that the beneficial microbes such as Anaerostipes, Lachnospiraceae_NK4A136_group, and UCG-010 may support better absorption and transport of carotenoids and vitamin E through improved gut barrier function and metabolic activity.
The RPO group had improved iron status and red blood cell indicators, which could be attributed to the better nutrient absorption.
These results suggest that RPO’s high carotenoid levels may improve micronutrient bioavailability and blood health through favourable gut microbiota modulation.
Stronger microbial networks
Microbial network analysis also revealed more than two-fold increase in microbial network connections after six months for the RPO-group, compared to the control.
The RPO-group exhibited higher network cohesion which researchers suggested were linked to sustained beneficial functions, and a more resilient and stable gut microbial ecosystem.
In conclusion, this study demonstrated that six months supplementation with provitamin A carotenoid-rich RPO-fortified biscuits could positively modulate gut microbiota and enhance nutrient status in vitamin A-deficient school children.
Participants did not report any adverse health effects from the supplementation, indicating that RPO-fortified biscuits could serve as a safe and low-cost option for nutrition intervention programmes.
Source: Nature Communications, 16 (1), 9341. doi: https://doi.org/10.1038/s41467-025-64395-x. “Red palm olein biscuit supplementation modulates gut microbiota in vitamin A deficient rural Malaysian schoolchildren: a randomised controlled trial.” Authors: Tan, P.Y., et al.
Biscuits fortified with red palm olein can increase beneficial gut microbes and improve nutrient status in vitamin A-deficient school children, according to a 6-month trial in Malaysia ©Getty Images