{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T14:54:10Z","timestamp":1758639250144,"version":"3.44.0"},"reference-count":79,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>In Zambia, mandatory sugar fortification with vitamin A (VA) has been implemented, but its impact on VA inadequacy and status has yet to be assessed. This study evaluated the contribution of VA\u2010fortified sugar to dietary VA adequacy and the relationship between dietary intakes and VA status in 243 lactating women, based on 24\u2010h dietary recalls in Mkushi, Zambia. We estimated usual intake distributions and the prevalence of VA adequacy using the National Cancer Institute (NCI) method across five scenarios: without sugar fortification; with fortification at 3.1 or 8.8\u2009mg\/kg (median levels previously measured in Mkushi); at 10\u2009mg\/kg (the minimum legal requirement at the household level), and at 15\u2009mg\/kg (the minimum legal requirement at the factory level). We applied the regression calibration method to examine associations of usual intake of sugar and dietary VA with plasma and breast milk retinol concentrations. Without fortified sugar, the estimated prevalence of dietary VA inadequacy was 83% (standard error [SE]: 6). Projected reductions in VA inadequacy were 7 (SE: 6), 24 (SE: 14), 30 (SE: 15) and 47 (SE: 18) percentage points for sugar fortification at 3.1, 8.8, 10 and 15\u2009mg\/kg, respectively. Usual sugar intake was not significantly associated with plasma or breast milk retinol concentrations. The potential impacts of sugar fortification on VA intakes are limited if the programme is not implemented as planned. Even if the target fortification levels are achieved (10\u2009mg\/kg), sugar fortification alone is unlikely to eliminate dietary VA inadequacy among lactating women in Zambia.<\/jats:p>","DOI":"10.1111\/mcn.70077","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T10:36:21Z","timestamp":1754476581000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Simulated Impact of Vitamin A\u2010Fortified Sugar on Dietary Adequacy and Association of Usual Sugar Intake With Plasma and Breast Milk Retinol Among Lactating Zambian Women"],"prefix":"10.1111","volume":"21","author":[{"given":"Demewoz","family":"Haile","sequence":"first","affiliation":[{"name":"Institute for Health Metrics and Evaluation University of Washington Seattle Washington USA"},{"name":"Institute for Global Nutrition University of California, Davis Davis California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2446-6166","authenticated-orcid":false,"given":"Reina","family":"Engle\u2010Stone","sequence":"additional","affiliation":[{"name":"Institute for Global Nutrition University of California, Davis Davis California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bess","family":"Caswell","sequence":"additional","affiliation":[{"name":"Institute for Global Nutrition University of California, Davis Davis California USA"},{"name":"Western Human Nutrition Research Center, Agricultural Research Service US Department of Agriculture Davis California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6253-5818","authenticated-orcid":false,"given":"Hanqi","family":"Luo","sequence":"additional","affiliation":[{"name":"Institute for Global Nutrition University of California, Davis Davis California USA"},{"name":"Hubert Department of Global Health, Rollings School of Public Health Emory University Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin W.","family":"Dodd","sequence":"additional","affiliation":[{"name":"National Cancer Institute National Institutes of Health Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles D.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Institute for Global Nutrition University of California, Davis Davis California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Modou","family":"Jobarteh","sequence":"additional","affiliation":[{"name":"Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mackford","family":"Chipili","sequence":"additional","affiliation":[{"name":"District Medical Office for Mkushi District Mkushi Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjorie J.","family":"Haskell","sequence":"additional","affiliation":[{"name":"Institute for Global Nutrition University of California, Davis Davis California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda C.","family":"Palmer","sequence":"additional","affiliation":[{"name":"The Johns Hopkins Bloomberg School of Public Health Center for Human Nutrition Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"volume-title":"USDA National Nutrient Database for Standard Reference, Release 27","year":"2014","author":"Agricultural Research Service & US Department of Agriculture","key":"e_1_2_11_2_1"},{"key":"e_1_2_11_3_1","unstructured":"Alaofe H. 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