Greene Matthew D, Kabaghe Gladys, Musonda Mofu, Palmer Amanda C
1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
2 National Food and Nutrition Commission, Lusaka, Zambia.
Food Nutr Bull. 2017 Dec;38(4):594-598. doi: 10.1177/0379572117733841. Epub 2017 Oct 4.
Industrial food fortification is a major strategy to improve dietary micronutrient intakes and prevent deficiencies. Zambia introduced mandatory sugar fortification with vitamin A, at a target of 10 mg/kg, in 1998. Representative surveys conducted since that time do not support marked improvement in vitamin A status.
To describe vitamin A concentrations in retail sugar, as well as vendor practices, perceptions of fortified foods, and sugar use practices.
We conducted a census of sugar vendors in one Zambian community, capturing information on vendors, available brands and packaging options, and storage conditions. We purchased all brands and package types of sugar available at each vendor. In a 15% subsample, we conducted semi-structured interviews with vendor-consumer pairs. We tested 50% of sugar samples at random for vitamin A using an iCheck portable fluorimeter.
The distribution of vitamin A in sugar in market samples was highly skewed, with a median of 3.1 mg/kg (25th-75th percentiles: 1.8-5.5) and a range from 0.2 to 29.9 mg/kg. Only 11.3% of samples met the 10 mg/kg statutory requirement. Sugar was primarily repackaged and sold in small quantities, with rapid turnover of stocks. Perceptions of fortification by vendors and consumers were generally positive.
Vitamin A in fortified sugar fell well below statutory requirements. Our data point to challenges at regional depot and/or poor adherence to fortification standards at the factory level. A renewed commitment to monitoring and enforcement will be required for Zambia to benefit from a food fortification strategy.
工业食品强化是改善膳食微量营养素摄入和预防缺乏症的一项主要战略。赞比亚于1998年引入了强制添加维生素A的食糖强化措施，目标添加量为每千克10毫克。自那时以来进行的代表性调查并不支持维生素A状况有显著改善。
描述零售食糖中的维生素A浓度，以及供应商的做法、对强化食品的认知和食糖使用习惯。
我们对赞比亚一个社区的食糖供应商进行了普查，收集了有关供应商、现有品牌和包装选项以及储存条件的信息。我们购买了每个供应商处所有品牌和包装类型的食糖。在15%的子样本中，我们对供应商与消费者进行了半结构化访谈。我们使用iCheck便携式荧光计随机检测了50%的食糖样本中的维生素A。
市场样本中食糖中维生素A的分布高度不均衡，中位数为每千克3.1毫克（第25至75百分位数：1.8至5.5），范围为每千克0.2至29.9毫克。只有11.3%的样本符合每千克10毫克的法定要求。食糖主要被重新包装并小批量销售，库存周转迅速。供应商和消费者对强化的认知总体上是积极的。
强化食糖中的维生素A远低于法定要求。我们的数据表明区域仓库存在问题和/或工厂层面未严格遵守强化标准。赞比亚要从食品强化战略中受益，需要重新致力于监测和执法。
