Who has a high vitamin A intake from plant foods, but a low serum retinol concentration? Data from women in Indonesia

Abstract

Objective: To examine whether the relationship between vitamin A intake, from plant and animal foods, and vitamin A status is the same throughout a population.

Design: Analysis of cross-sectional data on vitamin A intake, vitamin A status, physiological condition and socio-economic status.

Setting: Central Java, Indonesia.

Subjects: Women with a child ≤24 months old (n=600).

Results: Mean serum retinol concentration of women with animal vitamin A intake below or above the median (50 RE/d) was 1.28 and 1.38 μmol/L, respectively (P<0.05). For those with intake above the median the distribution curve for serum retinol concentration was shifted towards the right, to higher concentrations. Serum retinol concentration of women with plant vitamin A intake below or above the median (279 RE/d) was 1.30 and 1.36 μmol/L, respectively (P<0.05). Again, the distribution curve for serum retinol was shifted towards higher concentrations for women with an intake above the median, except for the subgroup of 25% with the lowest serum retinol concentration (<1.10 μmol/L). These women did not seem to benefit from their relatively high vegetable intake. They also had the lowest socio-economic status.

Conclusions: The subgroup that was most in need of vitamin A could not obtain it from plant foods. It may well be that, because of their lower socio-economic status, their hygiene conditions were worse and therefore host-related factors that affect carotene bioavailability, such as parasitic infestation, were less favourable in this group. They depended on supplements and, if affordable, on animal foods, fruits and/or fortified products.

Sponsorship: This study was carried out as part of the contract between UNICEF Indonesia and Helen Keller International Indonesia for the implementation and evaluation of the project: Social marketing of vitamin A rich foods in Central Java, which is funded by a grant of the Micronutrient Initiative Canada to UNICEF Indonesia.