Indonesian women of childbearing age are at greater risk of clinical vitamin A deficiency in families that spend more on rice and less on fruits/vegetables and animal-based foods

Campbell, Ashley A.; Thorne-Lyman, Andrew; Sun, Kai; de Pee, Saskia; Kraemer, Klaus; Moench-Pfanner, Regina; Sari, Mayang; Akhter, Nasima; Bloem, Martin W.; Semba, Richard D.

doi:10.1016/j.nutres.2008.12.004

Next »Nutrition Research
Volume 29, Issue 2 , Pages 75-81, February 2009

Indonesian women of childbearing age are at greater risk of clinical vitamin A deficiency in families that spend more on rice and less on fruits/vegetables and animal-based foods

Ashley A. Campbell
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Nutrition Service, Policy, Strategy and Programme Support Division, World Food Programme, 00148 Rome, Italy
Andrew Thorne-Lyman
- Nutrition Service, Policy, Strategy and Programme Support Division, World Food Programme, 00148 Rome, Italy
Kai Sun
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
Saskia de Pee
- Nutrition Service, Policy, Strategy and Programme Support Division, World Food Programme, 00148 Rome, Italy
Klaus Kraemer
- Sight and Life, DSM, 4002 Basel, Switzerland
Regina Moench-Pfanner
- Global Alliance for Improved Nutrition, 1202 Geneva, Switzerland
Mayang Sari
- Helen Keller International, New York, NY 10010, USA
Nasima Akhter
- Helen Keller International Asia Pacific, Dhaka 1212, Bangladesh
Martin W. Bloem
- Nutrition Service, Policy, Strategy and Programme Support Division, World Food Programme, 00148 Rome, Italy
Richard D. Semba
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Corresponding author. Tel.: +1 410 955 3572; fax: +1 410 955 0629.

Received 29 September 2008; received in revised form 17 December 2008; accepted 19 December 2008.

Abstract

Clinical vitamin A deficiency is characterized by night blindness and greater morbidity and mortality. The aim of this study was to examine the relationships between household food expenditures and night blindness among nonpregnant women of childbearing age among families in the slums of Jakarta, Indonesia. In a cross-sectional study of 42 974 households in the Indonesian Nutrition Surveillance System, 1998 to 2003, night blindness was assessed in nonpregnant women. Food expenditures were divided into 5 major categories as follows: plant-based foods (fruits and vegetables), animal-based foods, eggs, other nongrain foods, and grain foods (primarily rice), calculated as percentage of total weekly per capita food expenditure, and expressed in quintiles. The proportion of households with night blindness in nonpregnant women was 0.72%. Plant-based food, animal-based food, and eggs were associated with reduced odds of night blindness (odds ratio [OR], 0.47; 95% confidence interval [CI], 0.33-0.67; P < .0001, and OR, 0.47; 95% CI, 0.29-0.76; P = .002; OR, 0.62; 95% CI, 0.44-0.85; P = .004), respectively, among families in the highest compared with the lowest quintile, adjusting for potential confounders. Grain food expenditures were associated with increased odds of night blindness among nonpregnant women (OR, 2.80; 95% CI, 1.86-4.22; P < .0001) among families in the highest compared with the lowest quintile, adjusting for potential confounders. This study suggests that nonpregnant women are at greater risk of clinical vitamin A deficiency where families spend more on rice and less on animal and plant-based foods, a situation that is more typical when food prices are high.

Abbreviations: CI, confidence interval, NSS, Nutrition Surveillance System, OR, odds ratio

Keywords: Economics, Food, Night blindness, Vitamin A, Women, Indonesia