The Impact of Vitamin a Fortified Vegetable Oil on Vitamin a Status of Children Under Five Years of Age: a Cohort-like Study

Abstract

Introduction: Sub-clinical vitamin A deficiency (VAD) and anemia remain major nutritional problem in Indonesia. Although the government has implemented distribution of vitamin A capsules (VAC), there are one third of children missed VAC distribtion. The prevalence of anemia is also still high. Objectives: Part of this study was conducted to measure the effectiveness of vitamin A fortification in unbranded cooking oil among 6-59-month-old children of poor families in 2 districts in Indonesia prior mandatory vitamin A fortification in cooking oil. Materials and Methods: Total number of samples were 126 children. Venous blood was drawn by trained phlebotomist. Serum retinol and hemoglobin were measured by HPLC and hemoque respectively at baseline just before cooking oil fortification and 12 months after at endline. Trained enumerators collected data of morbidity and measurement of vitamin A content in cooking oil from the households, food stalls and markets was done periodically during the study. There was not any intervention from the study team on distribution and purchase of fortified cooking oil by the families, because cooking oil was distributed and sold through exsisting market mechanism. Enumerators collected socio-demographic variables. They also collected 24-hr dietary recall and food frequency questionnaires to measure nutrient intakes at base- and endline. Results: Serum retinol significantly increased by 5.07, 6.82, 6.01 µg/dL in 6-11, 12-23, and 24-59 month-old children respectively. Hemoglobin increased by 0.13 (p>0.05) , 0.56 (p<0.05), 0.81 g/dL (p<0.05) in 6-11, 12-35, 36-59 month-old children respectively. Conclusions: Vitamin A fortification in cooking oil significantly improved serum retinol in underfive children in all age groups and hemoglobin only in older age groups