Biofortified β-carotene rice improves vitamin A intake and reduces the prevalence of inadequacy among women and young children in a simulated analysis in Bangladesh, Indonesia, and the Philippines1

• Published in: The American journal of clinical nutrition Vol. 104; no. 3; pp. 769 - 775
• Main Authors: De Moura, Fabiana F, Moursi, Mourad, Donahue Angel, Moira, Angeles-Agdeppa, Imelda, Atmarita, Atmarita, Gironella, Glen M, Muslimatun, Siti, Carriquiry, Alicia
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-09-2016; American Society for Nutrition
• Subjects: Asia; Bangladesh; biofortification; dietary intake; Indonesia; Nutritional Epidemiology and Public Health; Philippines; rice; simulation; vitamin A; β-carotene; vitamin A; biofortification; simulation; Philippines; β-carotene; rice; ppm; HIES; Bangladesh; dietary intake; Asia; EAR; RAE; Indonesia
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.115.129270

Background: Vitamin A deficiency continues to be a major public health problem affecting developing countries where people eat mostly rice as a staple food. In Asia, rice provides up to 80% of the total daily energy intake.
Objective: We used existing data sets from Bangladesh, Indonesia, and the Philippines, where dietary intakes have been quantified at the individual level to 1) determine the rice and vitamin A intake in nonpregnant, nonlactating women of reproductive age and in nonbreastfed children 1–3 y old and 2) simulate the amount of change that could be achieved in the prevalence of inadequate intake of vitamin A if rice biofortified with β-carotene were consumed instead of the rice consumed at present.
Design: We considered a range of 4–20 parts per million (ppm) of β-carotene content and 10–70% substitution levels for the biofortified rice. Software was used to estimate usual rice and vitamin A intake for the simulation analyses.
Results: In an analysis by country, the substitution of biofortified rice for white rice in the optimistic scenario (20 ppm and 70% substitution) decreased the prevalence of vitamin A inadequacy from baseline 78% in women and 71% in children in Bangladesh. In Indonesia and the Philippines, the prevalence of inadequacy fell by 55–60% in women and dropped by nearly 30% in children from baseline.
Conclusions: The results of the simulation analysis were striking in that even low substitution levels and modest increases in the β-carotene of rice produced a meaningful decrease in the prevalence of inadequate intake of vitamin A. Increasing the substitution levels had a greater impact than increasing the β-carotene content by >12 ppm.