The impact of vitamin A fortified vegetable oil on vitamin A status of children under five years of age: A cohort study

Latar belakang: Defisiensi vitamin A sub-klinis dan anemia merupakan masalah gizi utama di Indonesia. Meski pemerintah telah melaksanakan program distribusi kapsul vitamin A, masih ada sepertiga anak yang tidak mendapatkan distribusi vitamin A. Penelitian ini bertujuan untuk mengukur efektivitas fortifikasi vitamin A pada minyak goreng tidak bermerek di antara kohort anak-anak keluarga miskin berusia 6-59 bulan di dua kabupaten di Indonesia sebelum mendapat fortifikasi vitamin A dalam minyak goreng. Metode: Jumlah sampel sebanyak 126 anak. Darah vena diambil oleh phlebotomist terlatih. Serum retinol dan hemoglobin diukur pada awal sebelum fortifikasi minyak goreng dan 12 bulan setelah intervensi. Tidak ada intervensi dari tim peneliti mengenai distribusi dan pembelian minyak goreng, karena minyak goreng didistribusikan dan dijual melalui mekanisme pasar yang ada. Enumerator terlatih mengumpulkan variabel sosio-demografi. Mereka juga mengumpulkan recall makanan 24 jam dan kuesioner frekuensi makanan untuk mengukur asupan nutrisi pada awal dan akhir penelitian. Hasil: Serum retinol meningkat secara signifikan sebesar 5,07, 6,82, 6,01 μg / dL pada anak usia 6-11, 12-23, dan 24-59 bulan. Hemoglobin meningkat sebesar 0,13 (p> 0,05), 0,56 (p <0,05), 0,81 g / dL (p <0,05) pada anak usia 6-11, 12-35, 36-59 bulan. Kesimpulan: Fortifikasi vitamin A dalam minyak goreng secara bermakna meningkatkan serum retinol pada balita di semua kelompok umur dan hemoglobin hanya pada kelompok usia 12 bulan ke atas. Kata kunci: defisiensi vitamin A, fortifikasi vitamin A, minyak goreng Abstract Introduction: Sub-clinical vitamin A deficiency (VAD) and anemia remain major nutritional problem in Indonesia. Although the government has implemented distribution of vitamin A capsules (VAC), there are one third of children missed VAC distribution. This study aimed to measure the effectiveness of vitamin A fortification in unbranded cooking oil among cohort of 6-59-month-old children of poor families in 2 districts in Indonesia prior mandatory vitamin A fortification in cooking oil. Methods: Total number of samples were 126 children. Venous blood was drawn by trained phlebotomist. Serum retinol and hemoglobin were measured by HPLC and hemoque respectively at baseline just before cooking oil fortification and 12 months after at endline. There was not any intervention from the study team on distribution and purchase of fortified cooking oil by the families, because cooking oil was distributed and sold through exsisting market mechanism. Enumerators collected socio-demographic variables. They also collected 24-hr dietary recall and food frequency questionnaires to measure nutrient intakes at base- and endline. Results: Serum retinol significantly increased by 5.07, 6.82, 6.01 µg/dL in 6-11, 12-23, and 24-59 month-old children respectively. Hemoglobin increased by 0.13 (p>0.05) , 0.56 (p<0.05), 0.81 g/dL (p<0.05) in 6-11, 12-35, 36-59 month-old children respectively. Conclusion: Vitamin A fortification in cooking oil significantly improved serum retinol in underfive children in all age groups and hemoglobin only in older age groups. Keywords: vitamin A deficiency, anemia, vitamin A fortification, cooking oil