Vitamin A-fortified cooking oil reduces Vitamin A deficiency in infants, young children and women: Results from a programme evaluation in Indonesia

Sandjaja, Idrus Jusat, Abas B. Jahari, Ifrad, Min Kyaw Htet, Robert L. Tilden, Damayanti Soekarjo, Budi Utomo, Regina Moench-Pfanner, Soekirman, Eline L. Korenromp

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


Objective To assess oil consumption, vitamin A intake and retinol status before and a year after the fortification of unbranded palm oil with retinyl palmitate. Design Pre-post evaluation between two surveys. Setting Twenty-four villages in West Java. Subjects Poor households were randomly sampled. Serum retinol (adjusted for subclinical infection) was analysed in cross-sectional samples of lactating mothers (baseline n 324/endline n 349), their infants aged 6-11 months (n 318/n 335) and children aged 12-59 months (n 469/477), and cohorts of children aged 5-9 years (n 186) and women aged 15-29 years (n 171), alongside food and oil consumption from dietary recall. Results Fortified oil improved vitamin A intakes, contributing on average 26 %, 40 %, 38 %, 29 % and 35 % of the daily Recommended Nutrient Intake for children aged 12-23 months, 24-59 months, 5-9 years, lactating and non-lactating women, respectively. Serum retinol was 2-19 % higher at endline than baseline (P<0·001 in infants aged 6-11 months, children aged 5-9 years, lactating and non-lactating women; non-significant in children aged 12-23 months; P=0·057 in children aged 24-59 months). Retinol in breast milk averaged 20·5 μg/dl at baseline and 32·5 μg/dl at endline (P<0·01). Deficiency prevalence (serum retinol <20 μg/dl) was 6·5-18 % across groups at baseline, and 0·6-6 % at endline (P≤0·011). In multivariate regressions adjusting for socio-economic differences, vitamin A intake from fortified oil predicted improved retinol status for children aged 6-59 months (P=0·003) and 5-9 years (P=0·03). Conclusions Although this evaluation without a comparison group cannot prove causality, retinyl contents in oil, Recommended Nutrient Intake contributions and relationships between vitamin intake and serum retinol provide strong plausibility of oil fortification impacting vitamin A status in Indonesian women and children.

Original languageEnglish
Pages (from-to)2511-2522
Number of pages12
JournalPublic Health Nutrition
Issue number14
Publication statusPublished - 22 Jan 2015


  • Children
  • Food fortification
  • Impact evaluation
  • Mothers
  • Vitamin A


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