The importance of using food and nutrient intake data to identify appropriate vehicles and estimate potential benefits of food fortification in Uganda

William Kyamuhangire, Abdelrahman Lubowa, Archileo Kaaya, Joyce Kikafunda, Philip W.J. Harvey, Zo Rambeloson, Omar Dary, Daphna K. Dror, Lindsay H. Allen

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Concern over micronutrient inadequacies in Uganda has prompted the introduction of mass fortification. Objective. To use food intake to determine nutrient inadequacies in children aged 24 to 59 months and nonpregnant women of reproductive age, and to model the adequacy of mass fortification. Methods. Data were collected by the 24-hour recall method in three regions. Usual nutrient intakes were calculated by adjusting actual intake distribution for the intraindividual variance. The impact of fortification on intake adequacy was simulated. Results. The nutrients with the highest prevalence of inadequate intake across regions were vitamin A (30% to 99%), vitamin B12 (32% to 100%), iron (55% to 89%), zinc (18% to 82%), and calcium (84% to 100%). According to simulations, fortification of vegetable oil and sugar with vitamin A would reduce the prevalence of vitamin A inadequacy in the Western and Northern regions; in Kampala it would eliminate vitamin A inadequacy but would cause 2% to 48% of children to exceed the Tolerable Upper Intake Level (UL). The proposed fortification of wheat flour would reduce the prevalence of inadequate intakes of thiamine, riboflavin, folate, and niacin in Kampala, but would have little impact in the other two regions due to low flour consumption. Conclusions. Micronutrient fortification of vegetable oil and sugar in all regions and of wheat flour in Kampala would reduce the prevalence of micronutrient inadequacies. However, the wheat flour formulation should be modified to better meet requirements, and the vitamin A content in sugar should be reduced to minimize the risk of high intakes. Maize flour may be suitable for targeted fortification, but prior consolidation of the industry would be required for maize flour to become a good vehicle for mass fortification.

Original languageEnglish (US)
Pages (from-to)131-142
Number of pages12
JournalFood and nutrition bulletin
Volume34
Issue number2
DOIs
StatePublished - Jun 2013

Keywords

  • Calcium
  • Folate
  • Folic acid
  • Food fortification
  • Iron
  • Maize flour fortification
  • Micronutrient inadequacy
  • Niacin
  • Oil fortification
  • Riboflavin
  • Sugar fortification
  • Thiamine
  • Uganda
  • Vitamin A
  • Vitamin C
  • Wheat flour fortification
  • Zinc

ASJC Scopus subject areas

  • Food Science
  • Geography, Planning and Development
  • Nutrition and Dietetics

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