Blindness, Vitamin A, and Policy Recommendations
“In setting public policy to control vitamin deficiency, no interventions should be necessary if normal vitamin status is sustained from a diversified diet”. Wise words from West and colleagues in their commentary on vitamin A policies. We are what we eat.
Unfortunately, many people in many countries for many reasons do not eat diversified diets. Failure to consume adequate amounts of vitamins and minerals occur in the stunted and the overweight. The choices for policy makers are simple: endorse and promote the use of nutrient dense foods, including fortified foods, and supplements, to prevent nutrient-dependent non-chronic diseases (NCD).
Many practical solutions have been identified. Yet, malnutrition and hidden hunger persist. Two billion lives are affected by chronic deficiency of essential vitamins and minerals. Children are especially vulnerable because growth and development is nutrient dependent and does not stop.
It is difficult to change cultural habits and eating behaviors. Trends in food choices and eating behaviors on nutrient intake may need to be considered when evaluating policy because food patterns change.
The quest to evaluate efficacy of options is both a research agenda and a policy question. It is important to understand the contribution of different nutrient vehicles, fortified foods and supplements, to nutrient intake. Without question. However, the intent of policy is to ensure people are adequately nourished. Nutritional status can only be assessed accurately with biological evaluations.
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Mason J, Greiner T, Shrimpton R, Sanders D, Yukich J. Vitamin A policies need rethinking. 2014 Int J Epidemiol doi: 10.1093/ije/dyu194
Muthayya S, Rah JH, Sugimoto JD, Roos FR, Kraemer K, Black RE. The global hidden hunger indices and maps: An advocacy tool for action. 2015 PLoS ONE doi: 10.1371/journal.pone.0067860
Branca F, Ferrari M. Impact of micronutrient deficiencies on growth: The stunting syndrome. 2002 Annal Nutr Metab doi: 10.1159/000066397
Aggarwal S, Reider C, Brooks JR, Fulgoni VL. Comparison of prevalence of inadequate nutrient intake based on body weight status of adults in the United States: An analysis of NHANES 2001-2008. 2015 J Am Coll Nutr doi:10.1080/07315724.2014.901196