Kyamuhangire William, Lubowa Abdelrahman, Kaaya Archileo, Kikafunda Joyce, Harvey Philip W J, Rambeloson Zo, Dary Omar, Dror Daphna K, Allen Lindsay H
School of Food Technology Nutrition and Bioengineering, Makerere University, Kampala, Uganda.
Food Nutr Bull. 2013 Jun;34(2):131-42. doi: 10.1177/156482651303400202.
Concern over micronutrient inadequacies in Uganda has prompted the introduction of mass fortification.
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.
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.
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.
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.
对乌干达微量营养素不足的担忧促使该国引入了大规模强化措施。
利用食物摄入量来确定24至59个月大儿童及育龄非孕妇女的营养素不足情况，并模拟大规模强化的充足性。
通过24小时回顾法在三个地区收集数据。通过调整个体内差异的实际摄入量分布来计算通常营养素摄入量。模拟了强化对摄入量充足性的影响。
各地区摄入量不足患病率最高的营养素为维生素A（30%至99%）、维生素B12（32%至100%）、铁（55%至89%）、锌（18%至82%）和钙（84%至100%）。根据模拟结果，用维生素A强化植物油和糖将降低西部和北部地区维生素A不足的患病率；在坎帕拉，这将消除维生素A不足，但会导致2%至48%的儿童超过可耐受最高摄入量（UL）。提议强化小麦粉将降低坎帕拉硫胺素、核黄素、叶酸和烟酸摄入量不足的患病率，但由于面粉消费量低，对其他两个地区影响不大。
所有地区对植物油和糖进行微量营养素强化以及坎帕拉对小麦粉进行强化将降低微量营养素不足的患病率。然而，应修改小麦粉配方以更好地满足需求，并且应降低糖中的维生素A含量以将高摄入量风险降至最低。玉米粉可能适合有针对性的强化，但玉米粉要成为大规模强化的良好载体，需要先整合该行业。
