{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:42:30Z","timestamp":1790682150309,"version":"4.1.0"},"reference-count":31,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2017,5,20]],"date-time":"2017-05-20T00:00:00Z","timestamp":1495238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000880","name":"Michael and Susan Dell Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000880","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Sight and Life"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Vitamin A (VA) fortification of cooking oil is considered a cost-effective strategy for increasing VA status, but few large-scale programs have been evaluated. We conducted representative surveys in Yaound\u00e9 and Douala, Cameroon, 2 years before and 1 year after the introduction of a mandatory national program to fortify cooking oil with VA. In each survey, 10 different households were selected within each of the same 30 clusters (n = ~300). Malaria infection and plasma indicators of inflammation and VA (retinol-binding protein, pRBP) status were assessed among women aged 15\u201349 years and children aged 12\u201359 months, and casual breast milk samples were collected for VA and fat measurements. Refined oil intake was measured by a food frequency questionnaire, and VA was measured in household oil samples post-fortification. Pre-fortification, low inflammation-adjusted pRBP was common among children (33% &lt;0.83 \u00b5mol\/L), but not women (2% &lt;0.78 \u00b5mol\/L). Refined cooking oil was consumed by &gt;80% of participants in the past week. Post-fortification, only 44% of oil samples were fortified, but fortified samples contained VA concentrations close to the target values. Controlling for age, inflammation, and other covariates, there was no difference in the mean pRBP, mean breast milk VA, prevalence of low pRBP, or prevalence of low milk VA between the pre- and post-fortification surveys. The frequency of refined oil intake was not associated with VA status indicators post-fortification. In sum, after a year of cooking oil fortification with VA, we did not detect evidence of increased plasma RBP or milk VA among urban women and preschool children, possibly because less than half of the refined oil was fortified. The enforcement of norms should be strengthened, and the program should be evaluated in other regions where the prevalence of VA deficiency was greater pre-fortification.<\/jats:p>","DOI":"10.3390\/nu9050522","type":"journal-article","created":{"date-parts":[[2017,5,23]],"date-time":"2017-05-23T01:47:33Z","timestamp":1495504053000},"page":"522","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Vitamin A Status of Women and Children in Yaound\u00e9 and Douala, Cameroon, is Unchanged One Year after Initiation of a National Vitamin A Oil Fortification Program"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2446-6166","authenticated-orcid":false,"given":"Reina","family":"Engle-Stone","sequence":"first","affiliation":[{"name":"Department of Nutrition, University of California, One Shields Ave, Davis, CA 95616, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Nankap","sequence":"additional","affiliation":[{"name":"Helen Keller International, Yaound\u00e9, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Ndjebayi","sequence":"additional","affiliation":[{"name":"Helen Keller International, Yaound\u00e9, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Madeleine","family":"Gimou","sequence":"additional","affiliation":[{"name":"Centre Pasteur of Cameroon, Yaound\u00e9, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avital","family":"Friedman","sequence":"additional","affiliation":[{"name":"Helen Keller International, New York, NY 10010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjorie","family":"Haskell","sequence":"additional","affiliation":[{"name":"Department of Nutrition, University of California, One Shields Ave, Davis, CA 95616, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2538-8016","authenticated-orcid":false,"given":"Ann","family":"Tarini","sequence":"additional","affiliation":[{"name":"Independent Consultant, Laval, QC, H7G 3Z5 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Nutrition, University of California, One Shields Ave, Davis, CA 95616, USA"},{"name":"Bill &amp; Melinda Gates Foundation, PO Box 23350, Seattle, WA 98102, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e528","DOI":"10.1016\/S2214-109X(15)00039-X","article-title":"Trends and mortality effects of vitamin A deficiency in children in 138 low-income and middle-income countries between 1991 and 2013: A pooled analysis of population-based surveys","volume":"3","author":"Stevens","year":"2015","journal-title":"Lancet Glob. 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