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  • Title: Evaluation of indicators for use in vitamin A intervention trials targeted at women.
    Author: Stoltzfus RJ, Habicht JP, Rasmussen KM, Hakimi M.
    Journal: Int J Epidemiol; 1993 Dec; 22(6):1111-8. PubMed ID: 8144294.
    Abstract:
    This paper examines the ability of three indicators to detect changes in women's vitamin A status. Serum retinol concentration, milk vitamin A concentration, and milk vitamin A per gram milk fat were used to assess the vitamin A status of mildly deficient Indonesian women before and after supplementation in a randomized intervention trial. Choice of indicator made a fourfold difference in the sample size required to measure a statistically significant change in vitamin A status. Milk vitamin A per gram milk fat was the best indicator of response, milk vitamin A concentration was intermediate, and serum retinol concentration performed most poorly. Serum retinol concentration was equally responsive across the range of vitamin A status in this population. The milk indicators were more responsive among women of lower status than women of higher status. Milk vitamin A is an efficient indicator for monitoring the effects of vitamin A interventions in women. Vitamin A deficiency adversely affects child survival. In order to develop and evaluate vitamin A interventions, however, good indicators of vitamin A status are needed. The authors used serum retinol concentration, milk vitamin A concentration, and milk vitamin A per gram milk fat to assess the vitamin A status of 153 lactating, mildly deficient Indonesian women before and after supplementation in a randomized intervention trial. Milk vitamin A per gram milk fat was the best indicator of response, milk vitamin A concentration was the 2nd best, and serum retinol concentration was equally responsive across the range of vitamin A status in the population. Furthermore, these milk indicators were more responsive among women of lower status than among women of higher status. The authors conclude on the basis of these findings that milk vitamin A is an efficient indicator for monitoring the effects of vitamin A intervention is women.
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