人類需要維生素A來完成諸如生長，視力和對傳染病的抵抗等基本過程。維生素A缺乏癥（VAD）是由于長期攝入不足以及生理需求旺盛期引起的，例如在兒童期生長驟增，懷孕和哺乳期，或者在感染期間增加了利用率（Sommer and West 1996）。因此，幼兒以及孕婦和哺乳期婦女處于最大的風險中，并且是最常見的受害者。它主要發(fā)生在食物選擇有限的人群中，特別是在那些以低營養(yǎng)主食為主要飲食的窮國中，這些國家的社會經(jīng)濟地位較低（Sommer and West 1996）。 VAD是導致失明和死亡的重要原因。它還具有經(jīng)濟意義。改善人的營養(yǎng)狀況可以使一生的收入至少增加10％?？傮w而言，人口的營養(yǎng)狀況可以使一個國家的國內(nèi)生產(chǎn)總值（GDP）減少2％至3％。相反，由于維生素A，鐵和碘的攝入不足，每年約損失南亞國民生產(chǎn)總值的5％（世界銀行，2005年）。 食物中的維生素A可作為肉類，乳制品和母乳等動物性食物中的視黃醇或許多水果和蔬菜中的類胡蘿卜素獲得。它通過動物而不是植物性食物更有效地在體內(nèi)吸收（IOM 2000）。盡管吸收量會有所不同，但取決于人的現(xiàn)有商店，食物的制備方法和其他因素，依靠蔬菜和水果攝入維生素A的人可能無法通過正常食物攝入獲得足夠的維生素A。婦女，特別是5歲以下的兒童一直是全世界改善維生素A狀況的工作重點，其中包括定期高劑量補充，常用食用食物的維生素A強化以及其他基于食物的方法，例如營養(yǎng)教育和家庭園藝計劃。這些努力在任何國家都難以實施，但在印度的影響卻非常有限。在印度，補充計劃面臨著獨特的挑戰(zhàn)，與免疫計劃覆蓋率低以及科學界和政府中許多人對VAD的公共衛(wèi)生重要性缺乏認識有關(guān)。由于數(shù)量眾多，設(shè)防取得的成功有限 小型食品生產(chǎn)商和監(jiān)管體系不夠強大，無法執(zhí)行設(shè)防規(guī)則。在以多種多樣的農(nóng)業(yè)條件和飲食方式為背景的國家，其他以食物為基礎(chǔ)的方法并未取得重大進展。 由于這些限制，可能需要采用新方法來減少印度的VAD。近年來，孟山都公司和能源與資源研究所開發(fā)了創(chuàng)新的方法，其中涉及基因重組技術(shù)以使芥菜生物強化，芥菜是印度北部許多州（VAD流行率很高的州）常用的烹飪和酸洗油的來源，它的維生素A含量。與用于開發(fā)生物強化或“黃金”大米的技術(shù)一樣，這項技術(shù)可以比傳統(tǒng)的強化方法在更大程度上強化芥末。 該出版物開始回答有關(guān)進一步開發(fā)該技術(shù)的可行性的一些問題。我們關(guān)注于芥菜的生產(chǎn)和消費方式是否表明芥菜油作為增加低收入兒童以及孕婦和哺乳期婦女目標人群維生素A攝入量的媒介的適當性。此外，我們提出了與高劑量補充和傳統(tǒng)食品強化相比，生物強化芥末的成本效益分析結(jié)果。

Humans need vitamin A for such essential processes as growth, vision, and resistance to infectious disease. Vitamin A deficiency (VAD) arises from prolonged inadequate intake combined with periods of higher physiological demand, such as during childhood growth spurts, pregnancy, and lactation, or through increased utilization during infection (Sommer and West 1996). Thus, young children and pregnant and lactating women are at greatest risk and are the most common victims. It occurs primarily among people with limited food choices, particularly those in the lower socioeconomic strata of poor countries with diets predominated by less nutritious staple foods (Sommer and West 1996).

VAD is a significant cause of blindness and death. It also has economic implications. Improving a person’s nutritional status can result in an increase in lifetime earnings of at least 10 percent. Taken collectively, a population’s nutritional status can make a difference of 2 to 3 percent in a country’s gross domestic product. Conversely, about 5 percent of the gross national product of South Asia is lost each year because of deficiencies in the intakes of vitamin A, iron, and iodine (World Bank 2005).

Vitamin A in food is available as retinol in animal foods, such as meat, dairy products, and breast milk, or as carotenoids, present in many fruits and vegetables. It is much more efficiently absorbed in the body through animal rather than plant foods (IOM 2000). Although absorption varies, depending on a person’s existing stores, the method of food preparation, and other factors, people who rely on vegetables and fruits for their vitamin A intake may not get sufficient amounts through normal food consumption.

Women and especially children under age 5 have been the focus of worldwide efforts to improve vitamin A status, including periodic high-dosage supplementation, vitamin A fortification of commonly eaten foods, and other food-based approaches, such as nutrition education and home gardening programs. These efforts, challenging to implement in any country, have had a very limited reach in India. Supplementation programs face unique challenges in the Indian context, related to poor coverage by immunization programs and the lack of recognition of the public health importance of VAD by many in the scientific community and government. Fortification has had limited success because of the large number of

small manufacturers of food and a regulatory system not strong enough to enforce fortification rules. And other food-based approaches have not made significant inroads in a country with very diverse agricultural conditions and dietary patterns.

Because of those limitations, new approaches may be needed to reduce VAD in India. In recent years, the Monsanto Company and The Energy and Resource Institute have developed innovative methods involving genetic recombinant technology to biofortify mustard, the source of a commonly used cooking and pickling oil in many states in northern India, where VAD prevalence is high, to increase its vitamin A content. This technology, like that used to develop biofortified or “golden” rice¹, can fortify mustard to a far greater extent than is possible through traditional methods of fortification.

This publication begins to answer some of the questions that arise about the feasibility of further development of this technology. We focus on whether mustard production and consumption patterns indicate the appropriateness of mustard oil as a vehicle to increase vitamin A intake in target groups of lower-income children and pregnant and lactating women. Further, we present results of our analysis of the cost-effectiveness of biofortified mustard compared with high-dosage supplementation and traditional fortification of foods.