Summary
This double-blind, cluster-randomised controlled trial evaluated the effectiveness of zinc-biofortified wheat flour in improving micronutrient status among 517 adolescent girls in rural Pakistan over 25 weeks. Whilst consumption of biofortified flour increased dietary zinc intake by 21% (1.5 mg/day) and iron intake by 1.2 mg/day, there was no significant effect on plasma zinc concentrations. However, the intervention did reduce the prevalence of storage iron deficiency from 11.8% to 1.0%, suggesting differential impacts on different micronutrient pathways. The authors highlight the need for more sensitive biomarkers of zinc status to better detect intervention efficacy.
UK applicability
This trial's findings on biofortified wheat flour efficacy may have limited direct application to UK settings, where zinc deficiency is less prevalent and dietary diversity is generally greater. However, the methodological insights regarding zinc biomarker sensitivity and the modest plasma zinc response despite increased intake are relevant to UK food fortification policy and nutrition research.
Key measures
Plasma zinc concentration (µg/L), serum ferritin (SF; <15 µg/L for storage iron deficiency), transferrin receptor, dietary zinc and iron intake (mg/day), selenium and copper concentrations, alpha 1-acid glycoprotein, C-reactive protein
Outcomes reported
The study measured plasma zinc concentrations, serum ferritin, and other micronutrient biomarkers in adolescent girls consuming zinc-biofortified wheat flour versus control flour for 25 weeks. It assessed both dietary zinc and iron intake and haematological indicators of micronutrient status.
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