title: Biofortified β-carotene rice improves vitamin A intake and reduces the prevalence of inadequacy among women and young children in a simulated analysis in Bangladesh, Indonesia, and the Philippines.
abstract: BACKGROUND
  Vitamin A deficiency continues to be a major public health problem affecting developing countries where people eat mostly rice as a staple food. In Asia, rice provides up to 80% of the total daily energy intake.
  
  
  OBJECTIVE
  We used existing data sets from Bangladesh, Indonesia, and the Philippines, where dietary intakes have been quantified at the individual level to 1) determine the rice and vitamin A intake in nonpregnant, nonlactating women of reproductive age and in nonbreastfed children 1-3 y old and 2) simulate the amount of change that could be achieved in the prevalence of inadequate intake of vitamin A if rice biofortified with β-carotene were consumed instead of the rice consumed at present.
  
  
  METHODS
  We considered a range of 4-20 parts per million (ppm) of β-carotene content and 10-70% substitution levels for the biofortified rice. Software was used to estimate usual rice and vitamin A intake for the simulation analyses.
  
  
  RESULTS
  In an analysis by country, the substitution of biofortified rice for white rice in the optimistic scenario (20 ppm and 70% substitution) decreased the prevalence of vitamin A inadequacy from baseline 78% in women and 71% in children in Bangladesh. In Indonesia and the Philippines, the prevalence of inadequacy fell by 55-60% in women and dropped by nearly 30% in children from baseline.
  
  
  CONCLUSIONS
  The results of the simulation analysis were striking in that even low substitution levels and modest increases in the β-carotene of rice produced a meaningful decrease in the prevalence of inadequate intake of vitamin A. Increasing the substitution levels had a greater impact than increasing the β-carotene content by >12 ppm.
authors: HarvestPlus, International Food Policy Research Institute, Washington, DC; demoura.ff@gmail.com.
authors: Fabiana F
authors: http://orcid.org/0000-0001-8176-5352
authors: FF
authors: De Moura
authors: HarvestPlus, International Food Policy Research Institute, Washington, DC;
authors: Mourad
authors: http://orcid.org/0000-0002-5071-8534
authors: M
authors: Moursi
authors: HarvestPlus, International Food Policy Research Institute, Washington, DC;
authors: Moira
authors: http://orcid.org/0000-0002-9732-3329
authors: M
authors: Donahue Angel
authors: Department of Science and Technology, Food and Nutrition Research Institute, Taguig, Philippines;
authors: Imelda
authors: I
authors: Angeles-Agdeppa
authors: National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia;
authors: Atmarita
authors: A
authors: Atmarita
authors: Department of Science and Technology, Food and Nutrition Research Institute, Taguig, Philippines;
authors: Glen M
authors: GM
authors: Gironella
authors: Department of Food Science, Indonesia International Institute for Life Sciences, Jakarta, Indonesia; and.
authors: Siti
authors: S
authors: Muslimatun
authors: Department of Statistics, Iowa State University, Ames, IA.
authors: Alicia
authors: A
authors: Carriquiry
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D000072759:Biofortification; D002664:Child Nutritional Physiological Phenomena / Q000208:ethnology; D002675:Child, Preschool; D003198:Computer Simulation; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004032:Diet / Q000009:adverse effects / Q000208:ethnology; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena / Q000208:ethnology; D008954:Models, Biological; D009749:Nutrition Surveys; D012275:Oryza / Q000009:adverse effects / Q000737:chemistry* / Q000378:metabolism; D010679:Philippines / Q000453:epidemiology; D015995:Prevalence; D012639:Seeds / Q000009:adverse effects / Q000737:chemistry / Q000378:metabolism; D014801:Vitamin A / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D014802:Vitamin A Deficiency / Q000178:diet therapy / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*; D055815:Young Adult; D019207:beta Carotene / Q000008:administration & dosage* / Q000009:adverse effects / Q000096:biosynthesis
chemical_list: D019207:beta Carotene; D014801:Vitamin A
keywords: Asia; Bangladesh; Indonesia; Philippines; biofortification; dietary intake; rice; simulation; vitamin A; β-carotene