Estimating the Impact of Vitamin A-fortified Vegetable Oil in Bangladesh in the Absence of Dietary Assessment Data

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 used an alternative–household income and expenditure survey (HCES) 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 modeled 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 percent 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.