Potential impact of the national food fortification program on adequacy of vitamin A intake among women in Cameroon: simulations using nationally‐representative 24‐hour recall data

Abstract

The WHO recommends assessing food and nutrient intakes to design food fortification programs, but national‐level dietary data are seldom available in low‐income countries. Prior to initiation of food fortification in Cameroon, we measured intake of vitamin A (VA) and fortifiable foods (oil and sugar) and simulated the effects of fortification with different foods and VA levels on VA intake and dietary inadequacy. 24h recalls were conducted among 912 women (with duplicates in a subset) in a nationally‐representative, cluster survey. Usual intake distributions were estimated by the NCI method. Nationally, the median (25th, 75th percentile) VA intake was 431 (279, 650) μg RAE/d, and 60% of women had usual intakes < 500 μg RAE/d, although the results differed by region (South, 28%; North, 100%; Cities, 52%). 54% of women consumed refined oil, 54% consumed sugar, 73% consumed either and 35% consumed both in the previous 24h. The current fortification level (12 mg VA per kg oil) would decrease the prevalence of inadequate intakes to 36% nationally (South, 19%; North, 64%; Cities, 16%) without affecting the prevalence of intakes >; 3000 μg RAE/d (< 0.5%). Increasing the VA in oil or fortifying a second food (sugar) would further decrease the proportion of women with VA intake < 500 μg RAE/d. Food fortification should substantially improve dietary VA adequacy without increasing the risk of excess intake among women in Cameroon.Grant Funding Source: Michael and Susan Dell Foundation; Sight & Life