Fortified Foods Are Major Contributors to Apparent Intakes of Vitamin A and Iodine, but Not Iron, in Diets of Women of Reproductive Age in 4 African Countries.
Adolescent
Adult
Africa South of the Sahara
/ epidemiology
Dietary Supplements
Female
Food, Fortified
Humans
Iodine
/ administration & dosage
Iron, Dietary
/ administration & dosage
Middle Aged
Trace Elements
/ administration & dosage
Vitamin A
/ administration & dosage
Vitamins
/ administration & dosage
Young Adult
fortified foods
iodine
iron
large-scale food fortification
nutrient intakes
vitamin A
women of reproductive age
Journal
The Journal of nutrition
ISSN: 1541-6100
Titre abrégé: J Nutr
Pays: United States
ID NLM: 0404243
Informations de publication
Date de publication:
01 08 2020
01 08 2020
Historique:
received:
17
01
2020
revised:
16
04
2020
accepted:
19
05
2020
pubmed:
14
6
2020
medline:
11
11
2020
entrez:
14
6
2020
Statut:
ppublish
Résumé
Food fortification is implemented to increase intakes of specific nutrients in the diet, but contributions of fortified foods to nutrient intakes are rarely quantified. We quantified iron, vitamin A, and iodine intakes from fortified staple foods and condiments among women of reproductive age (WRA). In subnational (Nigeria, South Africa) and national (Tanzania, Uganda) cross-sectional, clustered household surveys, we assessed fortifiable food consumption. We estimated daily nutrient intakes from fortified foods among WRA by multiplying the daily apparent fortifiable food consumption (by adult male equivalent method) by a fortification content for the food. Two fortification contents were used: measured, based on the median amount quantified from individual food samples collected from households; and potential, based on the targeted amount in national fortification standards. Results for both approaches are reported as percentages of the estimated average requirement (EAR) and recommended nutrient intake (RNI). Fortified foods made modest contributions to measured iron intakes (0%-13% RNI); potential intakes if standards are met were generally higher (0%-65% RNI). Fortified foods contributed substantially to measured vitamin A and iodine intakes (20%-125% and 88%-253% EAR, respectively); potential intakes were higher (53%-655% and 115%-377% EAR, respectively) and would exceed the tolerable upper intake level among 18%-56% of WRA for vitamin A in Nigeria and 1%-8% of WRA for iodine in Nigeria, Tanzania, and Uganda. Fortified foods are major contributors to apparent intakes of vitamin A and iodine, but not iron, among WRA. Contributions to vitamin A and iodine are observed despite fortification standards not consistently being met and, if constraints to meeting standards are addressed, there is risk of excessive intakes in some countries. For all programs assessed, nutrient intakes from all dietary sources and fortification standards should be reviewed to inform adjustments where needed to avoid risk of low or excessive intakes.
Sections du résumé
BACKGROUND
Food fortification is implemented to increase intakes of specific nutrients in the diet, but contributions of fortified foods to nutrient intakes are rarely quantified.
OBJECTIVES
We quantified iron, vitamin A, and iodine intakes from fortified staple foods and condiments among women of reproductive age (WRA).
METHODS
In subnational (Nigeria, South Africa) and national (Tanzania, Uganda) cross-sectional, clustered household surveys, we assessed fortifiable food consumption. We estimated daily nutrient intakes from fortified foods among WRA by multiplying the daily apparent fortifiable food consumption (by adult male equivalent method) by a fortification content for the food. Two fortification contents were used: measured, based on the median amount quantified from individual food samples collected from households; and potential, based on the targeted amount in national fortification standards. Results for both approaches are reported as percentages of the estimated average requirement (EAR) and recommended nutrient intake (RNI).
RESULTS
Fortified foods made modest contributions to measured iron intakes (0%-13% RNI); potential intakes if standards are met were generally higher (0%-65% RNI). Fortified foods contributed substantially to measured vitamin A and iodine intakes (20%-125% and 88%-253% EAR, respectively); potential intakes were higher (53%-655% and 115%-377% EAR, respectively) and would exceed the tolerable upper intake level among 18%-56% of WRA for vitamin A in Nigeria and 1%-8% of WRA for iodine in Nigeria, Tanzania, and Uganda.
CONCLUSIONS
Fortified foods are major contributors to apparent intakes of vitamin A and iodine, but not iron, among WRA. Contributions to vitamin A and iodine are observed despite fortification standards not consistently being met and, if constraints to meeting standards are addressed, there is risk of excessive intakes in some countries. For all programs assessed, nutrient intakes from all dietary sources and fortification standards should be reviewed to inform adjustments where needed to avoid risk of low or excessive intakes.
Identifiants
pubmed: 32534454
pii: S0022-3166(22)02282-9
doi: 10.1093/jn/nxaa167
pmc: PMC7398785
doi:
Substances chimiques
Iron, Dietary
0
Trace Elements
0
Vitamins
0
Vitamin A
11103-57-4
Iodine
9679TC07X4
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2183-2190Informations de copyright
Copyright © The Author(s) on behalf of the American Society for Nutrition 2020.
Références
Nat Rev Endocrinol. 2014 Mar;10(3):136-42
pubmed: 24342882
Int J Vitam Nutr Res. 2011 Sep;81(5):335-42
pubmed: 22419204
Food Nutr Bull. 2012 Dec;33(4 Suppl):S330-5
pubmed: 23444714
Public Health Nutr. 2015 Feb;18(3):414-20
pubmed: 24762782
J Nutr. 2017 May;147(5):984S-994S
pubmed: 28404836
J Nutr. 2017 May;147(5):981S-983S
pubmed: 28404838
Food Nutr Bull. 2008 Dec;29(4):306-19
pubmed: 19227055
S Afr Med J. 2016 Dec 21;107(1):20-21
pubmed: 28112084
Glob Health Sci Pract. 2015 Sep 02;3(3):446-61
pubmed: 26374804
Public Health Nutr. 2015 Jun;18(8):1358-68
pubmed: 25171194
J Nutr. 2006 Apr;136(4):1068-71
pubmed: 16549479
Int J Vitam Nutr Res. 2013;83(2):122-8
pubmed: 24491885
J Nutr. 2019 Aug 1;149(8):1404-1412
pubmed: 31132112
J Nutr. 2011 Oct;141(10):1847-54
pubmed: 21865568
Food Nutr Bull. 2010 Jun;31(2):251-69
pubmed: 20707231
Food Nutr Bull. 2013 Jun;34(2):131-42
pubmed: 23964386
Am J Clin Nutr. 2010 May;91(5):1461S-1467S
pubmed: 20200263
J Nutr. 2014 Nov;144(11):1826-34
pubmed: 25332482
Food Nutr Bull. 2019 Mar;40(1):71-86
pubmed: 30606057
Food Nutr Bull. 2012 Sep;33(3 Suppl):S157-62
pubmed: 23193766
Proc Nutr Soc. 2013 Nov;72(4):433-40
pubmed: 24020749
J Am Diet Assoc. 2001 Mar;101(3):294-301
pubmed: 11269606
N Engl J Med. 2014 Aug 14;371(7):624-34
pubmed: 25119608
J Acad Nutr Diet. 2014 Jul;114(7):1009-1022.e8
pubmed: 24462266
Ann N Y Acad Sci. 2019 Jun;1446(1):153-169
pubmed: 30942488
Food Nutr Bull. 2018 Jun;39(2):175-205
pubmed: 29478333
Food Nutr Bull. 2007 Jun;28(2):181-8
pubmed: 24683677