|dc.contributor.author||Abu Alrub, Ala’||
|dc.contributor.author||Allen, Lindsay H||
|dc.description.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.||en_US
|dc.description.sponsorship||Financial support: This article was made possible by the
generous support of the US Agency for International Development (USAID) under the terms of Cooperative
Agreement No. GHS-A-00-05-00012-00 to FHI-360 (and
before to AED). USAID had no role in the design, analysis,
or writing of this article. Conflict of interest: None.
Authorship: Z.A. was responsible for field work and data
collection, and contributed in interpretation of results.
A.’A.A. contributed in the interpretation of the results.
L.H.A. advised the project, supervised biochemical analyses
and assisted with data interpretation and publication.
A.C. calculated estimates of usual food and nutrient intakes.
O.D. acted as study coordinator. S.D. was responsible for
field work and data collection. D.D. assisted with data
interpretation and was responsible for manuscript preparation.
R.Q. entered and cleaned data, and assisted with
statistical analysis. Z.R. carried out statistical analyses. A.R.
assisted with study design and liaised with the Ministry of
Health of the Palestinian Authority. R.S. facilitated transfer of
biological specimens and coordinated data analysis. S.S.-F.
conducted biochemical analyses of the serum samples.
Ethics of human subject participation: The study was
conducted according to the guidelines laid down in the
Declaration of Helsinki and all procedures involving
human subjects were approved by the Committee on
Human Subjects Research at the Directorate of Primary
Health Care and Public Health of the Ministry of Health of
the Palestinian Authority, as well as the Office of Research
of Al-Quds University.||en_US
|dc.title||Predicted efficacy of the Palestinian wheat flour fortification programme: complementary analysis of biochemical and dietary data||en_US