Use of the deuterated-retinol-dilution technique to monitor the vitamin A status of Nicaraguan schoolchildren 1 y after initiation of the Nicaraguan national program of sugar fortification with vitamin A

Background: Nicaragua initiated a national program of vitamin A fortification of its domestic sugar supply starting with the 1999-2000 sugarcane harvest. Objective: This study was conducted to document any change in the vitamin A status of a cohort of children during the first year of the program. Design: The vitamin A status of 21 Nicaraguan schoolchildren (mean age: 6.7 y; range: 5.3-9.3 y) was assessed in March 2000 and in March 2001. Total-body vitamin A stores and liver vitamin A concentrations were estimated with the deuterated-retinol-dilution (DRD) technique at a dose of 5 mg [ 2 H 4 ]retinyl acetate at baseline and 5 mg [ 2 H 8 ]retinyl acetate during the repeat test I y later. Plasma retinol and carotenoids were measured by HPLC. Results: Median total-body vitamin A stores increased from 0.33 to 0.72 mmol (P = 0.0001), liver vitamin A concentrations from 0.52 to 0.78 μmol/g (P = 0.0003), and plasma retinol concentrations increased from 0.97 to 1.17 μmol/L (P = 0.01). Conclusion: The vitamin A status of Nicaraguan schoolchildren improved during the year after the initial distribution of vitamin A-fortified sugar in Nicaragua.