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. 2015 Feb;18(3):414-20.
doi: 10.1017/S1368980014000640. Epub 2014 Apr 24.

Estimating the impact of vitamin A-fortified vegetable oil in Bangladesh in the absence of dietary assessment data

John L Fiedler  1 , Keith Lividini  2 , Odilia I Bermudez  3
Affiliations

Estimating the impact of vitamin A-fortified vegetable oil in Bangladesh in the absence of dietary assessment data

John L Fiedler et al. Public Health Nutr. 2015 Feb.

Abstract

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.

Design: 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.

Setting: Nationwide in Bangladesh.

Subjects: 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.

Keywords: Bangladesh; Fortification; Household surveys; Micronutrients; Nutrition; Policy; Vegetable oil; Vitamin A.

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Figures

Fig. 1
Fig. 1
(colour online) Prevalence of inadequate vitamin A intake in Bangladesh (percentage of persons with vitamin A intake less than their Estimated Average Requirement) before (baseline) and after (endline) introduction of fortified vegetable oil, by poverty status. Weighted sample of 12 240 households comprised of 55 580 individuals from the Bangladesh 2010 Household Income and Expenditure Survey
Fig. 2
Fig. 2
(colour online) Prevalence of inadequate vitamin A intake in Bangladesh (percentage of persons with vitamin A intake less than their Estimated Average Requirement) before (baseline) and after (endline) introduction of fortified vegetable oil, by division. Weighted sample of 12 240 households comprised of 55 580 individuals from the Bangladesh 2010 Household Income and Expenditure Survey
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References

    1. World Bank (2005) Maintaining Momentum in 2015? An Impact Evaluation of Interventions to Improve Maternal and Child Health and Nutrition in Bangladesh. Washington, DC: World Bank.
    1. icddr,b, UNICEF, Bangladesh, GAIN et al. (2013) National Micronutrients Status Survey 2011–12. Final Report. Dhaka: icddr,b and UNICEF, Bangladesh; available at http://www.icddrb.org/what-we-do/publications/cat_view/52-publications/1...
    1. National Institute of Population Research and Training, Mitra and Associates & ICF International (2013) Bangladesh Demographic and Health Survey 2011. Dhaka and Calverton, MD: NIPORT, Mitra and Associates and ICF International.
    1. Choudhury RA & Costa MC (2012) Impact of Government Law on edible oil supply chain in Bangladesh perspective. Int J Supply Chain Mgt 1, 33–38.
    1. Food and Agriculture Organization of the United Nations (2013) FAOSTAT database, Commodity balances. http://faostat.fao.org/site/368/default.aspx#ancor (accessed January 2013).

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