Estimating the impact of vitamin A-fortified vegetable oil in Bangladesh in the absence of dietary assessment data.
OBJECTIVE
Vitamin A deficiency is a serious health problem in Bangladesh. The 2011-12 Bangladesh Micronutrient Survey found 76·8% of children of pre-school age were vitamin A deficient. In the absence of nationally representative, individual dietary assessment data, we use an alternative--household income and expenditure survey data--to estimate the potential impact of the introduction of vitamin A-fortified vegetable oil in Bangladesh.


METHODS
Items in the household income and expenditure survey were matched to food composition tables to estimate households' usual vitamin A intakes. Then, assuming (i) the intra-household distribution of food is in direct proportion to household members' share of the household's total adult male consumption equivalents, (ii) all vegetable oil that is made from other-than mustard seed and that is purchased is fortifiable and (iii) oil fortification standards are implemented, we modelled the additional vitamin A intake due to the new fortification initiative.


METHODS
Nationwide in Bangladesh.


METHODS
A weighted sample of 12,240 households comprised of 55,580 individuals.


RESULTS
Ninety-nine per cent of the Bangladesh population consumes vegetable oil. The quantities consumed are sufficiently large and, varying little by socio-economic status, are able to provide an important, large-scale impact. At full implementation, vegetable oil fortification will reduce the number of persons with inadequate vitamin A intake from 115 million to 86 million and decrease the prevalence of inadequate vitamin A intake from 80% to 60%.


CONCLUSIONS
Vegetable oil is an ideal fortification vehicle in Bangladesh. Its fortification with vitamin A is an important public health intervention.
1The Strengthening Partnerships,Results and Innovations in Nutrition Globally (SPRING),Project PHND & HarvestPlus,International Food Policy Research Institute (IFPRI),Washington,DC 20006,USA.
John L
JL
Fiedler
2HarvestPlus,International Food Policy Research Institute (IFPRI),Washington,DC,USA.
Keith
K
Lividini
3Tufts University School of Medicine,Department of Public Health and Community Medicine,Boston,MA,USA.
Odilia I
OI
Bermudez
D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D003198:Computer Simulation; D016208:Databases, Factual; D004032:Diet / Q000009:adverse effects / Q000191:economics / Q000208:ethnology; D004034:Diet Surveys; D004042:Dietary Fats, Unsaturated; D005191:Family Characteristics; D005240:Feasibility Studies; D005260:Female; D005527:Food, Fortified / Q000032:analysis*; D062489:Health Impact Assessment; D006801:Humans; D008297:Male; D008954:Models, Biological; D018673:Nutrition Policy; D010938:Plant Oils / Q000737:chemistry*; D015995:Prevalence; D014801:Vitamin A / Q000008:administration & dosage* / Q000627:therapeutic use; D014802:Vitamin A Deficiency / Q000178:diet therapy / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*
D004042:Dietary Fats, Unsaturated; D010938:Plant Oils; D014801:Vitamin A
Bangladesh; Fortification; Household surveys; Micronutrients; Nutrition; Policy; Vegetable oil; Vitamin A