Predicted efficacy of the Palestinian wheat flour fortification programme: complementary analysis of biochemical and dietary data

dc.contributor.authorAbdeen, Ziad
dc.contributor.authorRamlawi, Asa’d
dc.contributor.authorQaswari, Radwan
dc.contributor.authorAbu Alrub, Ala’
dc.contributor.authorDary, Omar
dc.contributor.authorRambeloson, Zo
dc.contributor.authorShahab-Ferdows, Setareh
dc.contributor.authorDror, Daphna
dc.contributor.authorAllen, Lindsay H
dc.contributor.authorCarriquiry, Alicia
dc.contributor.authorSalman, Rand
dc.contributor.authorDkeidek, Sahar
dc.date.accessioned2018-09-05T11:24:20Z
dc.date.available2018-09-05T11:24:20Z
dc.date.issued2014-08-29
dc.description.abstractTo 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.sponsorshipFinancial 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.identifier.issn1475-2727
dc.identifier.urihttps://dspace.alquds.edu/handle/20.500.12213/845
dc.language.isoen_USen_US
dc.publisherCrossmarken_US
dc.subjectFlour fortificationen_US
dc.subjectNutritional statusen_US
dc.subjectGazaen_US
dc.subjectWest Banken_US
dc.subjectPalestinian Authorityen_US
dc.titlePredicted efficacy of the Palestinian wheat flour fortification programme: complementary analysis of biochemical and dietary dataen_US
dc.typeArticleen_US
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