TY - JOUR
T1 - Vitamin A-fortified cooking oil reduces Vitamin A deficiency in infants, young children and women
T2 - Results from a programme evaluation in Indonesia
AU - Sandjaja,
AU - Jusat, Idrus
AU - Jahari, Abas B.
AU - Ifrad,
AU - Htet, Min Kyaw
AU - Tilden, Robert L.
AU - Soekarjo, Damayanti
AU - Utomo, Budi
AU - Moench-Pfanner, Regina
AU - Soekirman,
AU - Korenromp, Eline L.
N1 - Publisher Copyright:
© The Authors 2015.
PY - 2015/1/22
Y1 - 2015/1/22
N2 - 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.
AB - 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.
KW - Children
KW - Food fortification
KW - Impact evaluation
KW - Mothers
KW - Vitamin A
UR - http://www.scopus.com/inward/record.url?scp=84941937979&partnerID=8YFLogxK
U2 - 10.1017/S136898001400322X
DO - 10.1017/S136898001400322X
M3 - Article
C2 - 25591926
AN - SCOPUS:84941937979
SN - 1368-9800
VL - 18
SP - 2511
EP - 2522
JO - Public Health Nutrition
JF - Public Health Nutrition
IS - 14
ER -