Estimating food consumption, micronutrient intake and the contribution of large-scale food fortification to micronutrient adequacy in Tanzania

Abstract Objective: To assess the potential contribution of large-scale food fortification (LSFF) towards meeting dietary micronutrient requirements in Tanzania. Design: We used household food consumption data from the National Panel Survey 2014–15 to estimate fortifiable food vehicle coverage and consumption (standardised using the adult female equivalent approach) and the prevalence at risk of inadequate apparent intake of five micronutrients included in Tanzania’s fortification legislation. We modelled four LSFF scenarios: no fortification, status quo (i.e. compliance with current fortification contents) and full fortification with and without maize flour fortification. Setting: Tanzania. Participants: A nationally representative sample of 3290 Tanzanian households. Results: The coverage of edible oils and maize and wheat flours (including products of wheat flour and oil such as bread and cakes) was high, with 91 percent, 88 percent and 53 percent of households consuming these commodities, respectively. We estimated that vitamin A-fortified oil could reduce the prevalence of inadequate apparent intake of vitamin A (retinol activity equivalent) from 92 percent without LSFF to 80 percent with LSFF at current fortification levels. Low industry LSFF compliance of flour fortification limits the contribution of other micronutrients, but a hypothetical full fortification scenario shows that LSFF of cereal flours could substantially reduce the prevalence at risk of inadequate intakes of iron, zinc, folate and vitamin B12. Conclusions: The current Tanzania LSFF programme likely contributes to reducing vitamin A inadequacy. Policies that support increased compliance could improve the supply of multiple nutrients, but the prominence of small-scale maize mills restricts this theoretical benefit

High Prevalence of Stunting and Anaemia Is Associated with Multiple Micronutrient Deficiencies in School Children of Small-Scale Farmers from Chamwino and Kilosa Districts, Tanzania

Inadequate macro- and micronutrient nutrition and its consequences, such as anaemia, iron and vitamin deficiency, and growth retardation, could particularly affect children of small-scale farmers. In the present cross-sectional study, 666 school children aged 5–10 years from villages of Chamwino and Kilosa districts were studied for associations between nutritional and micronutrient status and dietary intake. The overall prevalence of stunting, underweight, and overweight was 28.1, 14.4, and 5%, while that of anaemia and deficiency of iron (ID), vitamin A (VAD), and zinc (ZnD) was 42.9, 29.3, 24.9, and 26.4%, respectively. Dietary recalls (24h) revealed that, except of iron (74%), only small proportions of children reached the recommended daily micronutrient intakes: 4% for zinc, 19% for vitamin A, and 14–46% for B vitamins. Stunting was highly associated with wasting in both districts and with VAD in Chamwino. Anaemia was predicted by ID, VAD, and ZnD in Chamwino and by elevated infection markers, C-reactive protein (CRP) and α-1 glycoprotein (AGP), in Kilosa. Overall, elevated CRP and/or AGP increased the risk while higher serum carotenoids indicating a diet of more fruit and vegetables reduced the risk of VAD. The significantly lower prevalence of anaemia and ID in Chamwino was related to higher iron and vitamin A intake and the consumption of mainly bulrush millet with dark green leafy vegetables compared to maize or rice with legumes in Kilosa. Nutrition and hygiene education integrated with home and school garden programmes could reduce the multiple burdens of anaemia; micronutrient deficiencies and infections; and, in the long term, the prevalence of stunting

Similarities in functional attributes and nutritional effects of magadi soda and bean debris-ash used in cooking African traditional dishes

African Journal of Biotechnology Vol. 10(7), pp. 1181-1185, 14 February, 2011Magadi soda and bean debris-ash have been used as condiments for a long time by various ethnic groups in East and Central Africa in cooking traditional dishes. The aim of the study was to investigate whether magadi soda and bean debris-ash had similar effects and functional attributes when added to traditional dishes during cooking. Reason for the addition of the two condiments has not been revealed by researchers. Mineral content, in-vitro bioavailability studies and pH of non-ashed and ashed magadi soda and bean debris were evaluated. The results indicated that high concentrations of sodium ions (30.2%) and potassium ions (64.2%) were observed in magadi soda and bean debris-ash, respectively. In-vitro iron and zinc bioavailability decreased significantly with the addition of magadi soda and bean debris-ash in maize, beans and sorghum. Equally, the cooking time was significantly reduced. The mean pH for both magadi soda (9.66) and bean debris-ash (9.75) were not significantly different indicating that both aqueous solutions had alkaline properties. The similarity in properties especially in mineral profile, alkalinity, decreased cooking time and lowered mineral uptake by magadi soda and bean debris-ash explain similar functionality in foods they are added to during cooking. Despite the similarities observed, communities should be informed of the negative nutritional effects of these condiments so as to diversify their meal patterns accordingly

Similarities in functional attributes and nutritional effects of magadi soda and bean debris-ash used in cooking African traditional dishes

African Journal of Biotechnology Vol. 10(7), pp. 1181-1185, 14 February, 2011Magadi soda and bean debris-ash have been used as condiments for a long time by various ethnic groups in East and Central Africa in cooking traditional dishes. The aim of the study was to investigate whether magadi soda and bean debris-ash had similar effects and functional attributes when added to traditional dishes during cooking. Reason for the addition of the two condiments has not been revealed by researchers. Mineral content, in-vitro bioavailability studies and pH of non-ashed and ashed magadi soda and bean debris were evaluated. The results indicated that high concentrations of sodium ions (30.2%) and potassium ions (64.2%) were observed in magadi soda and bean debris-ash, respectively. In-vitro iron and zinc bioavailability decreased significantly with the addition of magadi soda and bean debris-ash in maize, beans and sorghum. Equally, the cooking time was significantly reduced. The mean pH for both magadi soda (9.66) and bean debris-ash (9.75) were not significantly different indicating that both aqueous solutions had alkaline properties. The similarity in properties especially in mineral profile, alkalinity, decreased cooking time and lowered mineral uptake by magadi soda and bean debris-ash explain similar functionality in foods they are added to during cooking. Despite the similarities observed, communities should be informed of the negative nutritional effects of these condiments so as to diversify their meal patterns accordingly

Whole Blood Levels of the n-6 Essential Fatty Acid Linoleic Acid Are Inversely Associated with Stunting in 2-to-6 Year Old Tanzanian Children: A Cross-Sectional Study.

BACKGROUND:In Tanzania, 35% of all children below five years of age are stunted. Dietary fatty acids (FA) are critical for growth and development. However, whole blood FA levels in Tanzanian children are poorly described. OBJECTIVE:The objectives of this cross-sectional study were to assess 1) whole blood levels of essential fatty acids and 2) the association between whole blood FA levels and growth parameters in Tanzanian children 2-6 years of age. METHODS:A drop of blood was collected on an antioxidant treated card and analyzed for FA composition. Weight and height were measured and z-scores calculated. Relationships between FAs and growth parameters were analyzed by linear regression. RESULTS:Of the 334 children that participated, 30.3% were stunted. The average whole blood level of Mead acid was 0.15%. The anthropometric z-score height-for-age (HAZ) was inversely associated with Mead acid, the Mead acid to arachidonic acid (T/T) ratio, and total n-9 FA. Additionally, HAZ was positively associated with linoleic acid and total n-6 FA. BMI-for-age was positively associated with oleic acid, total n-9 FA and T/T ratio but inversely associated with arachidonic acid and total n-6 FA. Weight-for-height was inversely associated with arachidonic acid and total n-6 FAs and positively associated with oleic acid and total n-9 FA. Weight-for-age was not associated with any FA tested. Total n-3 FAs were not associated with any growth parameters measured. CONCLUSIONS:The EFA linoleic acid and the markers of FA deficiency were associated with HAZ, an indicator for stunting in 2-6 year old Tanzanian children. Total n-6, total n-9, and a number of individual FAs were associated with growth. Increasing dietary intake of EFA and n-6 FAs may be a strategy to combat stunting in this population

Vitamin A supplementation coverage and associated factors for children aged 6 to 59 months in integrated and campaign-based delivery systems in four sub-Saharan African countries

Abstract Background Vitamin A deficiency (VAD) is a leading contributor to the poor health and nutrition of young children in sub-Saharan Africa. Funding constraints are compelling many countries to shift from longstanding campaigns to integrating vitamin A supplementation (VAS) into routine health services. We assessed child VAS coverage and associated factors for integrated delivery systems in Mozambique, Senegal, and Sierra Leone and for a campaign-based delivery strategy in Tanzania. Methods Data were obtained using representative household surveys administered to primary caregivers of N = 16,343 children aged 6–59 months (Mozambique: N = 1,659; Senegal: N = 7,254; Sierra Leone: N = 4,149; Tanzania: N = 3,281). Single-dose VAS coverage was assessed and bivariate and multivariable associations were examined for child VAS receipt with respect to rural or urban residence; child age and sex; maternal age, education, and VAS program knowledge; and household wealth. Results VAS coverage for children aged 6–59 months was 42.8% (95% CI: 40.2, 45.6) in Mozambique, 46.1% (95% CI: 44.9, 47.4) in Senegal, 86.9% (95% CI: 85.8, 87.9) in Sierra Leone, and 42.4% (95% CI: 40.2, 44.6) in Tanzania and was significantly higher for children 6–11 vs. 24–59 months in Mozambique, Senegal, and Tanzania. In Sierra Leone, children aged 12–23 months (aOR = 1.86; 95% CI: 1.20, 2.86) and 24–59 months (aOR = 1.55; 95% CI: 1.07, 2.25) were more likely to receive VAS, compared to those 6–11 months. Maternal awareness of VAS programs was associated with higher uptake in Mozambique (aOR = 4.00; 95% CI: 2.81, 5.68), Senegal (aOR = 2.72; 95% CI: 2.35, 3.15), and Tanzania (aOR = 14.50; 95% CI: 10.98, 19.17). Increased household wealth was associated with a higher likelihood of child VAS in Senegal and Tanzania. Conclusions Our findings indicate routine delivery approaches for VAS are not achieving the level of coverage needed for public health impact in these settings. Intensive outreach efforts contributed to the higher coverage in Sierra Leone and highlight the importance of reducing the burdens associated with seeking supplementation at health facilities. As countries move towards incorporating VAS into routine health services, the essentiality of informed communities and potential losses for older children and socio-economically disadvantaged populations are key considerations in the sub-Saharan African context

Regression¹ Results Between HAZ and Selected Fatty Acids.

<p>Regression<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0154715#t004fn001" target="_blank">¹</a> Results Between HAZ and Selected Fatty Acids.</p

Nutrition and Growth Status of Children¹.

<p>Nutrition and Growth Status of Children<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0154715#t002fn001" target="_blank">¹</a>.</p

Demographic Characteristics of the Participants¹.

<p>Demographic Characteristics of the Participants<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0154715#t001fn001" target="_blank">¹</a>.</p

Whole Blood Fatty Acid Proportions¹.

<p>Whole Blood Fatty Acid Proportions<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0154715#t003fn001" target="_blank">¹</a>.</p