{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:17:07Z","timestamp":1783099027369,"version":"3.54.6"},"reference-count":79,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-050527"],"award-info":[{"award-number":["INV-050527"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Food Nutr Bull"],"abstract":"<jats:p>Dietary vitamin A inadequacy remains a serious public health problem, especially among young children. Food and condiment fortification programs and policies are in place in many countries to address this issue, but degradation of the vitamin A added via fortification can reduce the quantity of vitamin A reaching consumers. We modeled the impacts of vitamin A degradation on program effectiveness and cost-effectiveness in fortified wheat flour, sugar, and (hypothetical) bouillon cubes in Nigeria. We used secondary data to estimate the prevalence of vitamin A inadequacy among young children (6-59 months), and the programs\u2019 modeled contributions to reducing vitamin A inadequacy at selected levels of vitamin A degradation. The Lives Saved Tool was used to estimate child-lives saved. Program costs were estimated using activity-based models. Vitamin A degradation had a large negative impact on program effectiveness. Over the 0% to 80% vitamin A degradation range, accounting for other existing programs, fortification of sugar (7.5\u2005mg\/kg), wheat flour (2\u2005mg\/kg), and bouillon cubes (96\u2005mg\/kg) would reduce inadequacies among children by 2.9 to 0.7 percentage points, 3.9 to 0.7 percentage points, and 20.6 to 9.6 percentage points, respectively. Over the same vitamin A degradation range, average annual child-lives saved ranged from 3984 to 769 (sugar), 3036 to 739 (wheat flour), and 15\u2005301 to 7153 (bouillon cubes); estimated cost\/child-life saved ranged from US$ 550 to US$ 2848 (sugar), US$ 1039 to US$ 4271 (wheat flour), and US$ 944 to US$ 2018 (bouillon cubes). Vitamin A fortificant selection, technological innovations in vitamin A fortificants, and\/or changes in premix and fortified food handling and storage could reduce degradation; these options could increase program costs, but merit consideration.<\/jats:p>","DOI":"10.1177\/03795721261458490","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:24:19Z","timestamp":1782912259000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impacts of Vitamin A Degradation on the Effectiveness and Cost-Effectiveness of Vitamin A Fortification Programs: Modeled Evidence for Preschool Children in Nigeria"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8928-5396","authenticated-orcid":false,"given":"Stephen A","family":"Vosti","sequence":"first","affiliation":[{"name":"Department of Agricultural and Resource Economics, University of California, Davis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Jarvis","sequence":"additional","affiliation":[{"name":"Department of Agricultural and Resource Economics, University of California, Davis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Nutrition, University of California, Davis, Davis, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2446-6166","authenticated-orcid":false,"given":"Reina","family":"Engle-Stone","sequence":"additional","affiliation":[{"name":"Department of Nutrition, University of California, Davis, Davis, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1060-2473","authenticated-orcid":false,"given":"Katherine P","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Nutrition, University of California, Davis, Davis, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00367-9"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101299"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/nxab066"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1079\/BJN20031043"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/nure.12102"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000371618"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm7090258"},{"issue":"3","key":"e_1_3_4_9_2","article-title":"Impact of vitamin A supplementation on infant and childhood mortality","volume":"11","author":"Imdad A","year":"2011","unstructured":"Imdad A, Yakoob MY, Sudfeld C, Haider BA, Black RE, Bhutta ZA. 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