Predicted efficacy of the Palestinian wheat flour fortification programme: complementary analysis of biochemical and dietary data
Date
2014-08-29
Authors
Abdeen, Ziad
Ramlawi, Asa’d
Qaswari, Radwan
Abu Alrub, Ala’
Dary, Omar
Rambeloson, Zo
Shahab-Ferdows, Setareh
Dror, Daphna
Allen, Lindsay H
Carriquiry, Alicia
Journal Title
Journal ISSN
Volume Title
Publisher
Crossmark
Abstract
To utilize complementary biochemical and dietary data collected
before the initiation of national flour fortification to (i) identify micronutrient
insufficiencies or deficiencies and dietary inadequacies in Palestinian women and
children in vulnerable communities and (ii) assess the suitability of the current
wheat flour fortification formula.
Design: Quantitative dietary intake questionnaires were administered and fasting
venous blood samples collected in randomly selected households in Gaza City
and Hebron. The impact of fortification was simulated by estimating the additional
micronutrient content of fortified wheat flour.
Setting: Households in Gaza City and Hebron that were not receiving food aid
from social programmes.
Subjects: Non-pregnant women (18–49 years) and children aged 36–83 months.
Results: The micronutrients with highest prevalence of insufficiency were vitamin
D in women (84–97 % with serum 25-hydroxyvitamin D <50 nmol/l) and vitamin
B12 in women and children (43–82 % with serum B12 <221 pmol/l). Deficiencies of
vitamin A, Fe and Zn were also of public health concern. Current levels of wheat
flour fortificants were predicted to improve, but not eliminate, micronutrient
intake inadequacies. Modification of fortificant concentrations of vitamin D,
thiamin, vitamin B12, Zn and folic acid may be indicated.
Conclusions: Micronutrient insufficiencies or deficiencies and intake inadequacies
were prevalent based on either biochemical or dietary intake criteria. Adjustments
to the current fortification formula for wheat flour are necessary to better meet the
nutrient needs of Palestinian women and children.
Description
Keywords
Flour fortification , Nutritional status , Gaza , West Bank , Palestinian Authority