Dietary iron intakes based on food composition data may underestimate the contribution of potentially exchangeable contaminant iron from soil

Metal(loid)s Profile of Four Traditional Ethiopian Teff Brands: Geographic Origin Discrimination

Among the most renowned Ethiopian food crops, teff (Eragrostis tef (Zucc.)Trotter) is the most nutritious and gluten-free cereal. Because of the increase in demand for teff, it is necessary to establish geographic origin authentication of traditional teff brands based on multi-element fingerprint. For this purpose, a total of 60 teff samples were analysed using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Accuracy of the laboratory procedure was verified by the analysis of rice flour standard reference material (NIST SRM 1568b). In this context, four traditional teff brands (Ada'a, Ginchi, Gojam and Tulu Bolo) were analytically characterized using multi-element fingerprint and further treated statistically using linear discriminant analysis (LDA). Due to obvious extrinsic Fe, Al and V contamination, these elements were excluded from the discriminant model. Five elements (Cu, Mo, Se, Sr, and Zn) significantly contributed to discriminate the geographical origin of white teff. On the other hand, Mn, Mo, Se and Sr were used as discriminant variables for brown teff. LDA revealed 90 and 100% correct classifications for white and brown teff, respectively. Overall, multi-element fingerprint coupled with LDA can be considered a suitable tool for geographic origin discrimination of traditional teff brands.

Microbial Phytases: Properties and Applications in the Food Industry

Microbial phytases are enzymes that break down phytic acid, an anti-nutritional compound found in plant-based foods. These enzymes which are derived from bacteria and fungi have diverse properties and can function under different pH and temperature conditions. Their ability to convert phytic acid into inositol and inorganic phosphate makes them valuable in food processing. The application of microbial phytases in the food industry has several advantages. Firstly, adding them to animal feedstuff improves phosphorus availability, leading to improved nutrient utilization and growth in animals. This also reduces environmental pollution by phosphorus from animal waste. Secondly, microbial phytases enhance mineral bioavailability and nutrient assimilation in plant-based food products, counteracting the negative effects of phytic acid on human health. They can also improve the taste and functional properties of food and release bioactive compounds that have beneficial health effects. To effectively use microbial phytases in the food industry, factors like enzyme production, purification, and immobilization techniques are important. Genetic engineering and protein engineering have enabled the development of phytases with improved properties such as enhanced stability, substrate specificity, and resistance to degradation. This review provides an overview of the properties and function of phytases, the microbial strains that produce them, and their industrial applications, focusing on new approaches.

Child-Owned Poultry Intervention Effects on Hemoglobin, Anemia, Concurrent Anemia and Stunting, and Morbidity Status of Young Children in Southern Ethiopia: A Cluster Randomized Controlled Community Trial

Cereal-based diets contribute to anemia in Ethiopian children. Eggs have nutrients to boost hemoglobin levels as well as counter concurrent anemia and stunting (CAS) and morbidity status. A community trial, targeting 6-18 months old children, was conducted in Halaba. Two clusters were randomly selected and allocated to intervention (N = 122) and control (N = 121) arms. Intervention group (IG) children received egg-laying hens with caging in a cultural ceremony declaring child ownership of the chickens. Parents promised to feed eggs to the child. Health and agriculture extension workers promoted egg feeding, poultry husbandry, and sanitation to IG families. Control group (CG) had standard health and agriculture education. At baseline, groups were not different by hemoglobin, anemia, CAS, and morbidity status. Mean hemoglobin was 11.0 mg/dl and anemia prevalence was 41.6%. About 11.9% of children had CAS and 52.3% were sick. Using generalized estimating equations, the intervention increased hemoglobin by 0.53 g/dl (ß:0.53; p < 0.001; 95%CI: 0.28-0.79). IG children were 64% (p < 0.001; odds ratio [OR]:0.36; 95%CI: 0.24-0.54) and 57% (p = 0.007; OR: 0.43; 95%CI: 0.21-0.73) less likely to be anemic and have CAS, respectively, than CG, with no difference in morbidity. Child-owned poultry intervention is recommended in settings where anemia is high and animal-source food intake is low.

Suboptimal feeding practices and impaired growth among children in largely food insecure areas of north Wollo, Ethiopia

In Ethiopia, information is limited about energy and micronutrient intakes from complementary foods consumed by children in Productive Safety Net Program districts. Therefore, we assessed feeding practices and intakes of energy and selected micronutrients from complementary foods of children aged 6-23 months in a food insecure rural area of Ethiopia. Energy and micronutrient intakes were estimated from multiple-pass 24 h recall. Data were collected using a structured questionnaire. Only 1⋅9 % of children in the age range 6-8 months met recommended minimum dietary diversity of ≥5 food groups; this value slightly increased to 4 and 10⋅1 % in the older age groups (9-11 months and 12-23 months, respectively). Overwhelmingly, none of the children (9-11 months) did get the minimum acceptable diet (Children receiving minimum acceptable diet were 4 and 2⋅6 % in 6-8 months and 12-23 months, respectively). The overall prevalence of stunting was 34 % in younger children (6-8 months) and 51 % in older children aged 12-23 months. Median energy and selected micronutrient intakes from complementary foods were below corresponding WHO recommendations assuming average breast-milk amount and composition. The worst shortfalls were for vitamins A and C and for Ca. In contrast, median iron, protein and niacin intakes and densities were above the WHO recommendation. Caretakers and community leaders in the study setting need nutrition education on IYCF-related practices and on the importance of men's involvement in IYCF. Ensuring the accessibility and affordability of animal source foods (ASFs), fruits and vegetables, and feasible complementary foods is critical to address the quality of complementary feedings. This can be achieved through promoting nutrition-sensitive agriculture such as poultry and home gardening in this setting.

Estimates of Dietary Mineral Micronutrient Supply from Staple Cereals in Ethiopia at a District Level

Recent surveys have revealed substantial spatial variation in the micronutrient composition of cereals in Ethiopia, where a single national micronutrient concentration values for cereal grains are of limited use for estimating typical micronutrient intakes. We estimated the district-level dietary mineral supply of staple cereals, combining district-level cereal production and crop mineral composition data, assuming cereal consumption of 300 g capita⁻¹ day⁻¹ proportional to district-level production quantity of each cereal. We considered Barley (Hordeum vulgare L.), maize (Zea mays L.), sorghum (Sorghum bicolor (L.) Moench), teff (Eragrostis tef (Zuccagni) Trotter), and wheat (Triticum aestivum L.) consumption representing 93.5% of the total cereal production in the three major agrarian regions. On average, grain cereals can supply 146, 23, and 7.1 mg capita⁻¹ day⁻¹ of Ca, Fe, and Zn, respectively. In addition, the Se supply was 25 µg capita⁻¹ day⁻¹. Even at district-level, cereals differ by their mineral composition, causing a wide range of variation in their contribution to the daily dietary requirements, i.e., for an adult woman: 1–48% of Ca, 34–724% of Fe, 17–191% of Se, and 48–95% of Zn. There was considerable variability in the dietary supply of Ca, Fe, Se, and Zn from staple cereals between districts in Ethiopia.

Association between hypertension, obesity and dietary intake in post-menopausal women from rural Zambian communities

BACKGROUND

Amongst the cardiovascular risk (CVR) factors, hypertension (HT) and obesity appear to be prominent in post-menopausal women. The underlying mechanisms of HT development in menopause are not fully understood.

AIM

To determine the association between HT, obesity and dietary intakes in post-menopausal women from rural Zambia.

SETTING

This study was conducted in Twatasha Compound of Kitwe and Ndeke Community of Ndola.

METHODS

Blood pressure (BP), weight, height and dietary intakes (24-h recall) were measured in 153 women (> 50 years) from households. The South African Hypertension Society (SAHS), the World Health Organization (WHO) and estimated average requirements (EARs) guidelines were followed for HT, obesity and dietary intake definitions, respectively. Statistical Package for the Social Sciences (SPSS) version 26 was used for descriptive and inferential statistical analyses.

RESULTS

Prevalence of HT was 70%, whilst 37.25% and 28.10% of the participants were overweight and obese, respectively. The median interquartile range (IQR) dietary intakes showed inadequate intakes for most nutrients, except for carbohydrates (170 g [133; 225]). The total fat intake represented 14% of total energy intake. All median fatty acid intakes and sodium intakes (409 mg [169; 662]) were below the recommended levels. Only body mass index (BMI) correlated with HT (r = 0.268; p = 0.001).

CONCLUSIONS

Despite low dietary intakes, an alarming prevalence of HT and obesity was found in our population. Hormonal changes, a high energy-dense diet and poor treatment adherence, may be possible underlying factors. We recommend measures to better manage HT as a CVR factor.

CONTRIBUTION

This article supplements evidence on the prevalence of obesity-related hypertension in post-menopausal women and the link to dietary intake.

Iron deficiency and anemia in adolescent girls consuming predominantly plant-based diets in rural Ethiopia

Rapid physical growth and the onset of menstruation during adolescence can increase the risk of iron deficiency (ID) and related adverse effects. However, little is known about the risk of anemia and ID among adolescent girls in Ethiopia. Therefore, we aimed to determine the prevalence of ID, low iron stores, and anemia and characterize selected risk factors in Huruta, Arsi Zone, Oromia Region, Ethiopia. A cross-sectional study was conducted among non-pregnant adolescent girls (15–19 years of age; n = 257). Data on household socio-demographic characteristics, anthropometric measurements, and women’s dietary diversity score (WDDS) were collected. Hemoglobin (Hb) and serum ferritin (SF), C-reactive protein (CRP), and α−1-acid-glycoprotein (AGP) concentrations were measured. Diets were predominantly plant-based, with a low consumption of animal source foods, fruits, and dark-green leafy vegetables. Only 4% of the adolescent girls had adequate dietary diversity (WDDS ≥5), and 35% were underweight. The prevalence of anemia (Hb <11 g/dL, 8.7%) and clinical ID (SF <15 µg/L, 8.7%) was low, but 41% had marginal iron stores (SF <50 µg/L). The low prevalence of ID, despite a predominantly plant-based diet is atypical and calls for adapted strategies to address low iron stores in this and other similar settings of Ethiopia.

Source apportionment of micronutrients in the diets of Kilimanjaro,Tanzania and Counties of Western Kenya

Soil, water and food supply composition data have been combined to primarily estimate micronutrient intakes and subsequent risk of deficiencies in each of the regions studied by generating new data to supplement and update existing food balance sheets. These data capture environmental influences, such as soil chemistry and the drinking water sources to provide spatially resolved crop and drinking water composition data, where combined information is currently limited, to better inform intervention strategies to target micronutrient deficiencies. Approximately 1500 crop samples were analysed, representing 86 food items across 50 sites in Tanzania in 2013 and >230 sites in Western Kenya between 2014 and 2018. Samples were analysed by ICP-MS for 58 elements, with this paper focussing on calcium (Ca), copper (Cu), iron (Fe), magnesium (Mg), selenium (Se), iodine (I), zinc (Zn) and molybdenum (Mo). In general, micronutrient supply from food groups was higher from Kilimanjaro,Tanzania than Counties in Western Kenya, albeit from a smaller sample. For both countries leafy vegetable and vegetable food groups consistently contained higher median micronutrient concentrations compared to other plant based food groups. Overall, calculated deficiency rates were <1% for Cu and Mo and close to or >90% for Ca, Zn and I in both countries. For Mg, a slightly lower risk of deficiency was calculated for Tanzania at 0 to 1% across simplified soil classifications and for female/males, compared to 3 to 20% for Kenya. A significant difference was observed for Se, where a 3 to 28% risk of deficiency was calculated for Tanzania compared to 93 to 100% in Kenya. Overall, 11 soil predictor variables, including pH and organic matter accounted for a small proportion of the variance in the elemental concentration of food. Tanzanian drinking water presented several opportunities for delivering greater than 10% of the estimated average requirement (EAR) for micronutrients. For example, 1 to 56% of the EAR for I and up to 10% for Se or 37% for Zn could be contributed via drinking water.

The geochemistry of geophagic material consumed in Onangama Village, Northern Namibia: a potential health hazard for pregnant women in the area

Ingestion of geophagic materials might affect human health and induce diseases by different ways. The purpose of this study is to determine the geochemical composition of geophagic material consumed especially by pregnant women in Onangama Village, Northern Namibia and to assess its possible health effects. X-ray fluorescence and inductively coupled plasma mass spectrometry were used in order to determine the major, and trace elements as well as anions concentrations of the consumed material. The geochemical analysis revealed high concentrations of aluminium (Al), calcium (Ca), iron (Fe), magnesium (Mg), manganese (Mn), potassium (K), sodium (Na), and silica (Si); and trace elements including arsenic (As), chromium (Cr), mercury (Hg), nickel (Ni) and vanadium (V) as well as sulphate (SO₄^2-), nitrate (NO₃^-), and nitrite (NO₂^-) anions comparing to the recommended daily allowance for pregnant women. The pH for some of the studied samples is alkaline, which might increase the gastrointestinal tract pH (pH < 2) and cause a decrease in the bioavailability of elements. The calculated health risk index (HRI > 1) revealed that Al and Mn might be a potential risk for human consumption. Based on the results obtained from the geochemical analysis, the consumption of the studied material might present a potential health risk to pregnant women including concomitant detrimental maternal and foetal effects.

Fertilizer management and soil type influence grain zinc and iron concentration under contrasting smallholder cropping systems in Zimbabwe

Micronutrient deficiencies remain prevalent in food systems of southern Africa, although advances in biofortification through crop breeding and agronomy provide opportunities to address these. We determined baseline soil availability of zinc (Zn) and iron (Fe) and the effects of soil type and farmer management on extractable soil Zn and Fe and subsequent concentration in cereal and legume grains under two contrasting agro-ecologies in Zimbabwe. Soil and crop surveys were conducted in Hwedza and Mutasa Districts of Zimbabwe in 2015-16 on 350 locations over different soil types. Fields with different levels of productivity (designated as "most" and "least" productive fields) were sampled using an inherited hierarchical randomized sampling design. Grain Zn and Fe concentration in maize (Zea mays), sorghum (Sorghum bicolor), finger millet (Eleusine coracana) and cowpea (Vigna unguiculata) were generally insufficient for adequate human nutrition. A Linear Mixed Effects (LME) model revealed that diethylene triamine penta-acetic acid- (DTPA) extractable soil Zn concentration and grain Zn concentration were affected primarily by field productivity level. DTPA-extractable soil Zn concentration was more than two-fold greater on the most productive fields (mean 0.8 mg kg^-1) than on the least productive fields, with mean grain Zn concentration of 25.2 mg grain Zn kg^-1 which was 13% greater than seen on the least productive fields.  An interaction effect of field productivity level and total soil Zn concentration on DTPA-extractable soil Zn concentration suggests potential contribution of organic matter management to unlocking unavailable forms of soil Zn. DTPA-extractable soil Fe and grain Fe concentration were primarily affected by soil type and crop type, respectively. The LME modelling approach revealed additional soil geochemical covariates affected DTPA-extractable soil Zn and Fe concentration and grain Zn and Fe concentration within Districts. Future studies can therefore be powered to detect their roles at wider spatial scales for sustainable management of crop Zn and Fe nutrition.

Maximising benefits and minimising adverse effects of micronutrient interventions in low- and middle-income countries

Micronutrient deficiencies are widespread and disproportionately affect women and children in low- and middle-income countries (LMIC). Among various interventions, food fortification and supplementation with micronutrients have been proven to be cost-effective. The aim of the present paper is to review existing literature to assess risks of excessive intake in LMIC to then highlight programmatic changes required to maximise benefits of micronutrient interventions while minimising risks of adverse effects. While very few LMIC have national food consumption surveys that can inform fortification programmes, many more are implementing mandatory fortification programmes. The risks of inadequate micronutrient intakes were common, but risks of excessive intakes were also present for iodine, vitamin A, folic acid and iron. Excessive salt consumption, high concentrations of iodine in ground-water and excessive levels of iodisation were linked with excessive iodine intake. For vitamin A, overlapping interventions were the main risk for excessive intake; whereas for iron, contamination with iron from soil and screw-wares of millers and high iron concentration in drinking-water increased the risk of excessive intake, which could be further exacerbated with fortification. Before implementing micronutrient interventions, adherence to the basic principles of documenting evidence confirming that the deficiency in question exists and that fortification will correct this deficiency is needed. This can be supported with dietary intake assessments and biochemical screening that help diagnose nutrient deficiencies. Targeting micronutrient interventions, although programmatically challenging, should be considered whenever possible. Moreover, closer monitoring of appropriate fortification of foods and overlapping interventions is needed.

Extrinsic iron from soil contributes to Hb regeneration of anaemic rats: implications for foods contaminated with soil iron

Contamination of foods with extrinsic (soil) Fe is common in developing countries. However, the bioavailability of this extrinsic Fe and the extent to which it contributes to Fe nutrition remains unknown. The present study compared the bioavailability of laboratory- and field-threshed teff (Eragrostisis tef (Zucc) Trotter) to evaluate the bioavailablity of extrinsic soil Fe that resulted from the traditional threshing of the staple grain. Using sequential extraction, Fe was fractionated and its solubility was evaluated. The contribution of the additional extrinsic (soil) Fe to the Hb regeneration of Fe-depleted rats was evaluated using a rat Hb depletion–repletion assay. Weanling male Wistar rats (n24) were fed Fe-deficient diet for 21 d, and were then repleted for 14 d with diets: either laboratory-threshed teff (35 mg Fe/kg;n 8), field-threshed teff (35 mg intrinsic Fe/kg+ 120 mg soil Fe/kg;n 8), or FeSO4(control;n8). Fe content of field-threshed teff (29·4 mg/100 g) was four times greater than that of the laboratory-threshed (6·7 mg/100 g) teff (P<0·05). Soil contamination significantly increased the exchangeable, acid-soluble and reducible fractions obtained after sequential extraction. The relative biological value of the field-threshed teff (88 %) was higher than that of the laboratory-threshed (68 %) teff (P<0·05). Soil Fe can contribute to Hb regeneration in Fe-deficient rats. Considering that contamination of foods with soil is common in Ethiopia and other developing countries, it needs to be accounted for in the design and implementation of fortification programmes to prevent excessive intakes. Human studies are needed to confirm the present findings.

Iron and zinc bioaccessibility of fermented maize, sorghum and millets from five locations in Zimbabwe

The present study is an evaluation of iron and zinc bioaccessibility of fermented maize, sorghum, pearl millet and finger millet from five different locations in Zimbabwe. Iron and zinc contents ranged between 3.22 and 49.7 and 1.25-4.39mg/100gdm, respectively. Fermentation caused a reduction of between 20 and 88% of phytic acid (PA) while a general increase in soluble phenolic compounds (PC) and a decrease of the bound (PC) was observed. Bioaccessibility of iron and zinc ranged between 2.77 and 26.1% and 0.45-12.8%, respectively. The contribution of the fermented cereals towards iron and zinc absolute requirements ranged between 25 and 411% and 0.5-23% with higher contribution of iron coming from cereals that were contaminated with extrinsic iron. Populations subsisting on cereals could be more at risk of zinc rather than iron deficiency.

Elemental composition of Malawian rice

Widespread potential dietary deficiencies of calcium (Ca), iron (Fe), iodine (I), selenium (Se) and zinc (Zn) have been identified in Malawi. Several deficiencies are likely to be compounded by high phytic acid (PA) consumption. Rice (Oryza sativa) is commonly consumed in some Malawian populations, and its mineral micronutrient content is important for food security. The considerable irrigation requirements and flooded conditions of paddy soils can also introduce or mobilise potentially toxic elements including arsenic (As), cadmium (Cd) and lead (Pb). The aim of this study was to determine the mineral composition of rice sampled from farmers' fields and markets in Malawi. Rice was sampled from 18 extension planning areas across Malawi with 21 white (i.e. polished) and 33 brown samples collected. Elemental composition was determined by inductively coupled plasma-mass spectrometry (ICP-MS). Arsenic speciation was performed using high-performance liquid chromatography (HPLC)-ICP-MS. Concentration of PA was determined using a PA-total phosphorus assay. Median total concentrations (mg kg^-1, dry weight) of elements important for human nutrition in brown and white rice, respectively, were: Ca = 66.5 and 37.8; Cu = 3.65 and 2.49; Fe = 22.1 and 7.2; I = 0.006 and <0.005; Mg = 1130 and 265; Mn = 18.2 and 9.6; Se = 0.025 and 0.028; and Zn = 17.0 and 14.4. In brown and white rice samples, respectively, median PA concentrations were 5438 and 1906 mg kg^-1, and median PA:Zn molar ratios were 29 and 13. Concentrations of potentially toxic elements (mg kg^-1, dry weight) in brown and white rice samples, respectively, were: As = 0.030 and 0.006; Cd  ≤ 0.002 and 0.006; Pb = 0.008 and 0.008. Approximately 95 % of As was found to be inorganic As, where this could be quantified. Malawian rice, like the more widely consumed staple grain maize, contains inadequate Ca, I, Se or Zn to meet dietary requirements. Biofortification strategies could significantly increase Se and Zn concentrations and require further investigation. Concentrations of Fe in rice grain varied greatly, and this was likely due to contamination of rice samples with soil. Risk of As, Cd or Pb toxicity due to rice consumption in Malawi appears to be minimal.

Health risk assessment of potentially harmful elements and dietary minerals from vegetables irrigated with untreated wastewater, Pakistan

In the developing world, vegetables are commonly grown in suburban areas irrigated with untreated wastewater containing potentially harmful elements (PHEs). In Pakistan, there is no published work on the bioaccessibility aspect of PHEs and dietary minerals (DMs) in sewage-irrigated soil or the vegetables grown on such soils in Pakistan. Several industrial districts of Pakistan were selected for assessment of the risk associated with the ingestion of vegetables grown over sewage-irrigated soils. Both the total and bioaccessible fraction of PHEs (Cd, Co, Cr, Ni, and Pb) and DMs (Fe, Cu, Mn, Zn, Ca, Mg, and I) in soils and vegetable samples were measured. The concentrations of these PHEs and DMs in sewage-irrigated and control soils were below published upper threshold limits. However, compared to control soils, sewage irrigation over the years decreased soil pH (7.7 vs 8.1) and enhanced dissolved organic carbon (1.8 vs 0.8 %), which could enhance the phyto-availability of PHEs and DMs to crops. Of the PHEs and DMs, the highest transfer factor (soil to plant) was noted for Cd and Ca, respectively. Concentrations of PHEs in most of the sewage-irrigated vegetables were below the published upper threshold limits, except for Cd in the fruiting portion of eggplant and bell pepper (0.06-0.08 mg/kg Cd, dry weight) at three locations in Gujarat and Kasur districts. The bioaccessible fraction of PHEs can reduce the context of dietary intake measurements compared to total concentrations, but differences between both measurements were not significant for Cd. Since the soils of the sampled districts are not overly contaminated compared to control sites, vegetables grown over sewage-irrigated soils would provide an opportunity to harvest mineral-rich vegetables potentially providing consumers 62, 60, 12, 104, and 63 % higher dietary intake of Cu, Mn, Zn, Ca, and Mg, respectively. Based on Fe and vanadium correlations in vegetables, it is inferred that a significant proportion of total dietary Fe intake could be contributed by soil particles adhered to the consumable portion of vegetables. Faecal sterol ratios were used to identify and distinguish the source of faecal contamination in soils from Gujranwala, Gujarat, and Lahore districts, confirming the presence of human-derived sewage biomarkers at different stages of environmental alteration. A strong correlation of some metals with soil organic matter concentration was observed, but none with sewage biomarkers.

Simulated effects of home fortification of complementary foods with micronutrient powders on risk of inadequate and excessive intakes in West Gojjam, Ethiopia

Home fortification of complementary foods (CFs) with multiple micronutrient powders (MNPs) is being scaled up in various countries, but little is known about the prevailing complementary feeding practices and the type and nutrient gaps to be filled with MNPs. The present study evaluated the complementary feeding practices of young children and simulated the risk of inadequate and excessive intakes associated with home fortification with MNPs. We have assessed the sociodemographic status, anthropometry, and complementary feeding practices of young children (N = 122) in Mecha district, rural Ethiopia. Using a 2-day, quantitative 24-hr recall, usual intakes of energy, protein, iron, zinc, and calcium were estimated. The risks of inadequate and excessive iron and zinc intakes with or without home fortification scenarios were assessed. The simulations considered intakes from CFs assuming average breast milk contributions and additional nutrients provided by the MNPs. Stunting was highly prevalent (50%) and was associated with a lower dietary diversity (P = .009) and nutrient intakes from the CFs. Median energy, zinc, and calcium intakes were below the estimated needs from CFs; protein needs were met. Median dietary iron intake appeared adequate, but 76%, 95% CI [68%, 84%], of children had inadequate intake (assuming low bioavailability), whereas another 8%, 95% CI: [3%, 13%], had excessive intakes. Simulation of daily and alternative day's fortification with MNP decreased the prevalence of inadequate iron and zinc intake but significantly increased the risk of excessive intakes that remained unacceptably high for iron (>2.5%). Untargeted MNP interventions may lead to excessive intakes, even in settings where poor complementary feeding practices are prevalent.

Comparing intake estimations based on food composition data with chemical analysis in Malian women

OBJECTIVE

Food composition databases are essential for estimating nutrient intakes in food consumption surveys. The present study aimed to evaluate the Mali food composition database (TACAM) for assessing intakes of energy and selected nutrients at population level.

DESIGN

Weighed food records and duplicate portions of all foods consumed during one day were collected. Intakes of energy, protein, fat, available carbohydrates, dietary fibre, Ca, Fe, Zn and vitamin A were assessed by: (i) estimating the nutrient intake from weighed food records based on an adjusted TACAM (a-TACAM); and (ii) chemical analysis of the duplicate portions. Agreement between the two methods was determined using the Wilcoxon signed-rank test and Bland-Altman plots.

SETTING

Bamako, Mali.

SUBJECTS

Apparently healthy non-pregnant, non-lactating women (n 36) aged 15-36 years.

RESULTS

Correlation coefficients between estimated and analysed values ranged from 0·38 to 0·61. At population level, mean estimated and analysed nutrient intakes differed significantly for carbohydrates (203·0 v. 243·5 g/d), Fe (9·9 v. 22·8 mg/d) and vitamin A (356 v. 246 µg retinol activity equivalents). At individual level, all estimated and analysed nutrient intakes differed significantly; the differences tended to increase with higher intakes.

CONCLUSIONS

The a-TACAM is sufficiently acceptable for measuring average intakes of macronutrients, Ca and Zn at population level in low-intake populations, but not for carbohydrate, vitamin A and Fe intakes, and nutrient densities.

Ethiopian pre-school children consuming a predominantly unrefined plant-based diet have low prevalence of iron-deficiency anaemia

Objective

Children from low-income countries consuming predominantly plant-based diets but little animal products are considered to be at risk of Fe deficiency. The present study determined the Fe status of children from resource-limited rural households.

Design

A cross-sectional study.

Setting

Twenty six kebeles (the smallest administrative unit) from six zones of the Amhara region, Ethiopia.

Subjects

Children aged 54–60 months (n 628).

Results

Grain, roots or tubers were the main dietary components consumed by 100 % of the study participants, followed by pulses, legumes or nuts (66·6 %). Consumption of fruit and vegetables (19·3 %) and meat, poultry and fish (2·2 %) was low. Children had a mean dietary diversity score of 2·1 (sd 0·8). Most children (74·8 %, n 470) were in the lowest dietary diversity group (1–2 food groups). Rate of any morbidity in the preceding 14 d was 22·9 % (n 114). Infection or inflammation (α1-acid glycoprotein >1·2 g/l) was present in 30·2 % (n 184) of children. Children had a high rate of stunting (43·2 %). Of the total sample, 13·6 % (n 82) of children were anaemic, 9·1 % (n 57) were Fe deficient and 5·3 % (n 32) had Fe-deficiency anaemia. Fe-deficiency erythropoiesis was present in 14·2 % (n 60) of children.

Conclusions

Despite consuming a predominantly plant-based diet and little animal-source foods, there was a low prevalence of Fe-deficiency anaemia. This illustrates that dietary patterns can be inharmonious with Fe biochemical status; thus, Fe-related interventions require biochemical screening.