Vitamin A-fortified cooking oil reduces vitamin A deficiency in infants, young children and women: results from a programme evaluation in Indonesia.

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.

Consumption and sources of added sugar in Indonesia: a review.

BACKGROUND AND OBJECTIVES: The present report summarized the best available evidence regarding consumption level and sources of free or added sugars in Indonesia. METHODS AND STUDY DESIGN: Information was extracted from food balance sheets, household expenditure surveys, nutrition surveys, published studies, unpublished theses/ dissertations, and government reports. RESULTS: A total of 18 references were obtained, showing varying results. Indonesia's national surveys suggested intakes of sugar below 50 grams per day or below 10% of energy intake. Published studies suggested higher levels of intake. Studies used expenditure surveys or a single day of recall to determine dietary intake. None made use of biomarkers to determine the level of sugar intake. The 2014 Total Diet Study estimated that 11.8% of the population consumed >50 grams sugar per day. Common food sources were table sugar, wheat products, milk products, sweetened drinks, condiments, candies and chocolate products. CONCLUSIONS: Insufficient evidence exists regarding the levels and sources of added sugar intake of different population groups in Indonesia. A nationwide survey using multiple (at least two) 24-hour recalls to allow estimation of usual intake and to identify food sources, and the use of biomarkers to validate intake will provide more accurate information on which to base policy decisions.