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[Advances in the process of fortification of sugar with vitamin A in Central America].

Fortifying sugar with vitamin A was adopted by various Central American countries as their main strategy for reducing vitamin A deficiency in the seventies, but after being in effect a few years, such fortification became lax. Nationwide studies from the late eighties and early nineties showed that vitamin A deficiency was still a widely prevalent public health problem in Guatemala, El Salvador, Honduras, and Nicaragua. The situation led to the reappearance and strengthening of national programs for the fortification of sugar. Experience gathered over the past three years confirms the fact that such fortification is technically feasible and that it is safer, more effective, and more practical than other types of interventions. Essential to the success of this program is the establishment of a reliable and permanent quality control system for guaranteeing that, through sugar, households receive vitamin A in sufficient amounts to complete an adequate dietary supply. At present a quality control system is being implemented at three levels: production, government supervision, and community monitoring. INCAP has developed analytical methodologies that are fit to support control measures in each of these three levels. It is surmised that a program aimed at fortifying sugar with vitamin A, if optimally executed, would render a preventive supplementation program unnecessary. However, constant monitoring and supplementation of natural sources of vitamin A are always recommended in children under 3 and lactating mothers.