© 1993 Oxford University Press
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Evaluation of Indicators for Use in Vitamin A Intervention Trials Targeted at Women
* Division of Nutritional Sciences, Cornell University Ithaca, NY, USA
Clinical Epidemiology and Biostatistics Unit, Faculty of Medicine, Gadjah Mada University Yogyakarta, Indonesia
Reprint requests to: Dr Rebecca J Stoltzfus, Division of Human Nutrition, Department of International Health, School of Hygiene and Public Health, The Johns Hopkins University, 615 N Wolfe Street, Baltimore, MD 21205, USA.
This paper examines the ability of three indicators to detect changes in women's vitamin A status. Serum retinol concentration, milk vitamin A concentration, and milk vitamin A per gram milk fat were used to assess the vitamin A status of mildly deficient Indonesian women before and after supplementation in a randomized intervention trial. Choice of indicator made a fourfold difference in the sample size required to measure a statistically significant change in vitamin A status. Milk vitamin A per gram milk fat was the best indicator of response, milk vitamin A concentration was intermediate, and serum retinol concentration performed most poorly. Serum retinol concentration was equally responsive across the range of vitamin A status in this population. The milk indicators were more responsive among women of lower status than women of higher status. Milk vitamin A is an efficient indicator for monitoring the effects of vitamin A interventions in women.
Received 1 May 1993
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