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In Rwandese Women with Low Iron Status, Iron Absorption from Low-Phytic Acid Beans and Biofortified Beans Is Comparable, but Low-Phytic Acid Beans Cause Adverse Gastrointestinal Symptoms

Petry N, Rohner F, Gahutu JB, Campion B, Boy E, Tugirimana PL, Zimmerman MB, Zwahlen C, Wirth JP, and Moretti D.

March 2016 – Journal of Nutrition

Phytic acid (PA) is a major inhibitor of iron bioavailability from beans, and high PA concentrations might limit the positive effect of biofortified beans (BBs) on iron status. As low-phytic acid (lpa) bean varieties could increase iron bioavailability, we tested whether lpa beans provide more bioavailable iron than a BBs and control beans (CBs) (regular iron and PA concentrations) by comparing iron absorption in 25 nonpregnant young women with low iron status with the use of a multiple-meal crossover design. Iron absorption was measured with stable iron isotopes. The total amount of iron absorbed from lpa beans and BBs was 421 μg (95% CI: 234, 756 μg) and 431 μg (95% CI: 237, 786 μg), respectively, and did not significantly differ, but was >50% higher (P < 0.005) than from CBs (278 μg; 95% CI: 150, 499 μg). In our trial, the lpa beans were hard to cook, and their consumption caused transient adverse digestive side effects in ∼95% of participants. Gel electrophoresis analysis showed phytohemagglutinin L (PHA-L) residues in cooked lpa beans. In conclusion, BBs and lpa beans provided more bioavailable iron than control beans and could reduce dietary iron deficiency. Digestive side effects of lpa beans were likely caused by PHA-L, but it is unclear to what extent the associated digestive problems reduced iron bioavailability.

The Effects of an Oil and Wheat Flour Fortification Program on Pre-School Children and Women of Reproductive Age Living in Côte d’Ivoire, a Malaria-Endemic Area

Rohner F, Raso G, Aké-Tano SOP, Tschannen AB, Mascie-Taylor CGN, Northrop-Clewes CA

March 2016 – Nutrients

Anemia and micronutrient deficiencies are widespread in sub-Saharan Africa, but the impact of food fortification is still debated. The objective of this study was to estimate the iron and vitamin A status of preschool children (PSC) and women of reproductive age (WRA) in households consuming fortified oil and wheat flour. The survey was cross-sectional in a rural and an urban area. Data on demographics, socioeconomic status, and fortified foods were collected at households. Hemoglobin (Hb), retinol binding protein (RBP), ferritin, soluble transferrin receptors (sTfR), subclinical inflammation, and Plasmodium spp. infection data were collected. In PSC, vitamin A deficiency (VAD) was prevalent, but for each 1 mg retinol equivalents (RE)/kg of oil consumed, RBP increased by 0.37 µmol/L (p = 0.03). In WRA, there was no significant VAD in the population (0.7%). Anemia was found in 92.2% of rural and 56.3% of urban PSC (p < 0.001). PSC with access to adequately fortified flour had Hb concentrations 15.7 g/L higher than those who did not (p < 0.001). Hb levels increased by +0.238 g/L per mg/kg increase in iron fortification levels (p < 0.001). The national program fortifying vegetable oil with vitamin A and wheat flour with iron and folic acid may have contributed to improved micronutrient status of PSC from two areas in Côte d’Ivoire.

Iodine Status of Women of Reproductive Age in Sierra Leone and Its Association with Household Coverage with Adequately Iodized Salt

Rohner F, Wirth JP, Woodruff BA, Chiwile F, Yankson H, Sesay F, Koroma AS, Petry N, Pyne-Bailey S, Dominguez E, Kupka R, Hodges MH, & de Onis M.

February 2016 – Nutrients

Salt iodization programs are a public health success in tackling iodine deficiency. Yet, a large proportion of the world’s population remains at risk for iodine deficiency. In a nationally representative cross-sectional survey in Sierra Leone, household salt samples and women’s urine samples were quantitatively analyzed for iodine content. Salt was collected from 1123 households, and urine samples from 817 non-pregnant and 154 pregnant women. Household coverage with adequately iodized salt (ě15 mg/kg iodine) was 80.7%. The median urinary iodine concentration (UIC) of pregnant women was 175.8 µg/L and of non-pregnant women 190.8 µg/L. Women living in households with adequately iodized salt had higher median UIC (for pregnant women: 180.6 µg/L vs. 100.8 µg/L, respectively, p < 0.05; and for non-pregnant women: 211.3 µg/L vs. 97.8 µg/L, p < 0.001). Differences in UIC by residence, region, household wealth, and women’s education were much smaller in women living in households with adequately iodized salt than in households without. Despite the high household coverage of iodized salt in Sierra Leone, it is important to reach the 20% of households not consuming adequately iodized salt. Salt iodization has the potential for increasing equity in iodine status even with the persistence of other risk factors for deficiency.

Implementation of Multiple Irish Aid-Funded Orange Flesh Sweet Potato Projects

Petry N, Wirth JP, Siddle, B, Gaynor, M.

December 2015 – Sight and Life

Biofortification of sweet potatoes is a promising and sustainable agricultural approach to reduce vitamin A deficiency (VAD), particularly in remote areas where individuals have limited access to commercial markets and mainly rely on household-produced crops. Due to its large genetic variability, its favorable growing characteristics, and the high consumption in remote areas, the orange flesh sweet potato (OFSP) is one of the major targeted crops of biofortification initiatives. OFSP have high concentrations of provitamin A and are the most advanced biofortified crop in terms of research studies demonstrating bioavailability, efficacy, and effectiveness. Irish Aid has provided funding to five projects in Sub-Saharan Africa promoting and disseminating OFSP, a review was undertaken to better understand the common accomplishments and challenges of these five projects in order to identify common factors for success. The review found that the three following components of decentralized vine multiplication systems were indispensable for the successful OFSP projects: 1) growing large quantities of OFSP vines for dissemination by trained decentralized vine multipliers; 2) distributing vines to project farmers; and 3) teaching project farmers in OFSP growing techniques.

Sierra Leone Micronutrient Survey Report

Ministry of Health and Sanitation, UNICEF, WHO, HKI, GroundWork LLC

December 2015 – Report Release, Freetown, Sierra Leone

The 2013 Sierra Leone Micronutrient Survey (SLMS) is the first nationally-representative comprehensive micronutrient survey in Sierra Leone. Conducted by the Ministry of Health and Sanitation and nutrition partners (e.g. UNICEF, WHO, Helen Keller International, and others), the SLMS collected data on micronutrient deficiencies, anemia, and malaria of children <5 years of age, and non-pregnant women 15-49 years of age, and pregnant women. The SLMS was conducted prior to the Ebola outbreak in Sierra Leone, and the information collected by the SLMS will enable the government and international agencies to monitor the current status of national nutrition programs (e.g. salt iodization and vitamin A supplementation) and to plan future nutrition interventions. GroundWork supported the SLMS by designing the survey protocol, developing the questionnaires, training survey staff, analyzing data, and writing the report.

RAIN+ Baseline Survey Report 2015

Concern Worldwide-Zambia, GroundWork LLC

October 2015 – Report Release, Lusaka, Zambia

Concern Worldwide is conducting a second phase of its Realigning Agriculture for Improved Nutrition (RAIN) project in Zambia’s Mumbwa District. This second phase (referred to as RAIN+) aims to improve nutrition and health outcomes for women and young children by providing integrated agriculture, nutrition, health, and women’s empowerment interventions. The objective of the baseline survey was to collect information on priority outcome and output indicators of the RAIN+ project related to agriculture, maternal, infant and young child feeding practices (MIYCF), gender equality, and water, sanitation, and hygiene (WASH). GroundWork supported the RAIN+ baseline survey by designing the survey protocol, training interviewers and supervisors, analyzing the data, and writing the report.

Comparative Validation of Five Quantitative Rapid Test Kits for the Analysis of Salt Iodine Content: Laboratory Performance, User- and Field-Friendliness

Rohner F, Kangambèga MO, Khan N, Kargougou R, Garnier D, Sanou I, Ouaro BD, Petry N, Wirth JP, & Jooste P.

September 2015 – PLOS ONE

To render national salt iodization programs sustainable and ensure adequate iodization levels, simple methods to quantitatively assess whether salt is adequately iodized are required. Several methods claim to be simple and reliable, and are available on the market or are in development. This work has validated the currently available quantitative rapid test kits (quantRTK) in a comparative manner for both their laboratory performance and ease of use in field settings. Laboratory performance parameters (linearity, detection and quantification limit, intra- and inter-assay imprecision) were conducted on 5 quantRTK. We assessed inter-operator imprecision using salt of different quality along with the comparison of 59 salt samples from across the globe; measurements were made both in a laboratory and a field setting by technicians and non-technicians. Most of the devices showed acceptable laboratory performance, but for some of the devices, use by non-technicians revealed poorer performance when working in a routine manner. Of the quantRTK tested, the iCheck1 and I-Reader1 showed most consistent performance and ease of use, and a newly developed paper-based method (saltPAD) holds promise if further developed.

Literature review and meta-analysis: The potential of biofortification to reduce malnutrition during the 1,000 day window

Project Completed

During its new phase of operations (2014-2018), HarvestPlus aims to scale up biofortification programs and establish new scientific evidence. Specifically, HarvestPlus seeks to extend its proof of concept from a single biofortified crop to a multiple-biofortified food basket approach. HarvestPlus is also expanding its programs to pregnant women and children 0-24 months of age to improve nutrition during the “1000-day window”. To better understand the potential impact of biofortified foods on these new target groups, GroundWork is conducting a comprehensive review and meta-analysis of single and multiple micronutrient supplementation and fortification interventions on birth outcomes, growth, anemia and micronutrient status among children of less than two years of age.

Baseline survey and monitoring support to Concern’s RAIN+ project in Zambia

Project Completed

Concern Worldwide is conducting a second phase of its Realigning Agriculture for Improved Nutrition (RAIN) project in Zambia’s Mumbwa District. This second phase (referred to as RAIN+ ) aims to improve nutrition and health outcomes for women and young children by providing integrated agriculture, nutrition, health, and women’s empowerment interventions. GroundWork is providing technical assistance related to project monitoring and is designing the project’s baseline survey by detailing the sampling procedures, drafting the survey questionnaire, training data collection staff, analyzing the data collected, and reporting the results.

Inflammatory and metabolic responses to high-fat meals with and without dairy products in men

Schmid A, Petry N, Walther B, Bütikofer U, Luginbühl W, Gille D, Chollet M, McTernan PG, Gijs MAM, Vionnet N, Pralong FP, Laederach K, Vergères G

May 2015 – British Journal of Nutrition

Postprandial inflammation is an important factor for human health since chronic low-grade inflammation is associated with chronic diseases. Dairy products have a weak but significant anti-inflammatory effect on postprandial inflammation. The objective of the present study was to compare the effect of a high-fat dairy meal (HFD meal), a high-fat non-dairy meal supplemented with milk (HFM meal) and a high-fat non-dairy
control meal (HFC meal) on postprandial inflammatory and metabolic responses in healthy men. A cross-over study was conducted in nineteen male subjects. Blood samples were collected before and 1, 2, 4 and 6 h after consumption of the test meals. Plasma concentrations of insulin, glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol, TAG and C-reactive protein (CRP) were measured at each time point. IL-6, TNF-a and endotoxin concentrations were assessed at baseline and endpoint (6 h). Time-dependent curves of these metabolic parameters were plotted, and the net incremental AUC were found to be significantly higher for TAG and lower for CRP after consumption of the HFM meal compared with the HFD meal; however, the HFM and HFD meals were not different from the HFC meal. Alterations in IL-6, TNF-a and endotoxin concentrations were not significantly different between the test meals. The results suggest that full-fat milk and dairy products (cheese and butter) have no significant impact on the inflammatory response to a high-fat meal.