{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T05:43:53Z","timestamp":1780551833437,"version":"3.54.1"},"reference-count":64,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2012,3,9]],"date-time":"2012-03-09T00:00:00Z","timestamp":1331251200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1368980012000560_abs1\" sec-type=\"general\"><jats:title>Objective<\/jats:title><jats:p>Developing countries have adopted universal, high-potency vitamin A (VA) supplementation and food fortification as major strategies to control deficiency, prevent nutritional blindness and reduce child mortality. Yet questions persist regarding how best to measure impact and when to phase out supplementation. The present paper provides guidance on the use and interpretation of serum retinol (SROL) distributions as indicators of both programme impact and adequate VA intake in a population.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980012000560_abs2\" sec-type=\"general\"><jats:title>Design<\/jats:title><jats:p>We reviewed extant data on SROL's response to high-potency VA supplementation and VA-fortified foods in children.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980012000560_abs3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Supplementation virtually eliminates xerophthalmia and reduces child mortality; however, it shifts the SROL distribution only transiently (&lt;2 months). Regular consumption of VA-fortified foods prevents xerophthalmia, lowers mortality and sustainably improves SROL distributions, from which both compliance and public health impact can be inferred.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980012000560_abs4\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>Given SROL's limited responsiveness to high-potency VA supplementation, target population coverage remains the preferred performance indicator. However, periodic SROL surveys do reflect underlying dietary risk and can guide programming: low or marginal SROL distributions in areas with high supplementation coverage do not signify programme failure, but rather suggest the need to continue supplementation while working to effectively raise dietary VA intakes. We propose that a sustained rise in the SROL distribution, defined as \u22645 % prevalence of SROL &lt; 0\u00b770 \u03bcmol\/l among vulnerable population groups in at least two consecutive surveys (\u22651 year apart), be used as an indicator of stable and adequate dietary VA intake and status in a population, at which point programmes may re-evaluate the need for continued universal supplementation.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1368980012000560","type":"journal-article","created":{"date-parts":[[2012,3,9]],"date-time":"2012-03-09T11:33:30Z","timestamp":1331292810000},"page":"1201-1215","source":"Crossref","is-referenced-by-count":69,"title":["The use and interpretation of serum retinol distributions in evaluating the public health impact of vitamin A programmes"],"prefix":"10.1017","volume":"15","author":[{"given":"Amanda C","family":"Palmer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Keith P","family":"West","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nita","family":"Dalmiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Schultink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2012,3,9]]},"reference":[{"key":"S1368980012000560_ref52","volume-title":"Vitamin A Deficiency and Its Consequences: A Field Guide to Detection and Control","author":"Sommer","year":"1995"},{"key":"S1368980012000560_ref44","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1093\/ajcn\/34.1.41","article-title":"The effect of vitamin A fortification of sugar on the serum vitamin A levels of preschool Guatemalan children: a longitudinal evaluation","volume":"34","author":"Arroyave","year":"1981","journal-title":"Am J Clin Nutr"},{"key":"S1368980012000560_ref43","volume-title":"Evaluation of Sugar Fortification with Vitamin A at the National Level","author":"Arroyave","year":"1979"},{"key":"S1368980012000560_ref10","doi-asserted-by":"crossref","first-page":"2845S","DOI":"10.1093\/jn\/132.9.2845S","article-title":"Assessment and control of vitamin A deficiency: the Annecy Accords","volume":"132","author":"Sommer","year":"2002","journal-title":"J Nutr"},{"key":"S1368980012000560_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-658101-0.50012-3"},{"key":"S1368980012000560_ref28","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1093\/jn\/126.2.451","article-title":"Vitamin A status of Indonesian children infected with Ascaris lumbricoides after dosing with vitamin A supplements and albendazole","volume":"126","author":"Tanumihardjo","year":"1996","journal-title":"J Nutr"},{"key":"S1368980012000560_ref64","doi-asserted-by":"publisher","DOI":"10.3945\/jn.109.112730"},{"key":"S1368980012000560_ref1","volume-title":"Control of Vitamin A Deficiency and Xerophthalmia","year":"1982"},{"key":"S1368980012000560_ref46","volume-title":"Sistema Integrado de Vigilancia de Intervenciones Nutricionales (SIVIN). 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