Vitamin A Intake, Status and Improvement Using the Dietary Approach : Studies of Vulnerable Groups in Three Asian Countries

Sammanfattning: Studies were performed on methodological issues on vitamin A intake, status and improvement in three Asian countries, to improve the dietary approach recommended by FAO/WHO to alleviate vitamin A deficiency in low-income countries.The reliability of the practical 24-hour dietary recall method to assess individual intake of vitamin A during pregnancy was investigated in Central Java, Indonesia. The usual mean intake of vitamin A can be reliably measured, but data on attenuation of simple regression coefficients suggest that it is difficult to establish associations between vitamin A intake and some health outcome. The majority of women was below the recommended daily intake of vitamin A in all three trimesters and strategies to improve vitamin A intake in all women are thus needed.The applicability of the simplified "Helen Keller International Food Frequency Method" to assess community risk of vitamin A deficiency in South Asia, even though it excludes breastmilk and animal milk, was tested in rural Bangladesh and rural India. Breast milk was found to be an important source of vitamin A even in the second and third years of life in rural areas of Bangladesh. Similarly, animal milk is likely to be an important source of vitamin A among preschoolers in certain areas of India. The method should be revalidated to make it a useful tool even in settings where breastmilk and animal milk are common in the diets of preschool children.Whether it is possible to improve vitamin A status with dark green leafy vegetables in children free of Ascaris lumbricoides was investigated in northern Bangladesh. A substantial increase in serum β-carotene was seen after supplementary feeding of these vegetables for 6 weeks. The impact on serum retinol concentrations was less substantial.