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Nutrients 2016, 8(3), 148;

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

GroundWork LLC, 40 b Les Landes, Crans-près-Céligny 1299, Switzerland
Global Alliance for Improved Nutrition (GAIN), PO Box 55, Geneva 1211, Switzerland
Centre Suisse des Recherches Scientifiques en Côte d’Ivoire, PO Box 1303, Abidjan, Côte d’Ivoire
Swiss Tropical and Public Health Institute, PO Box, Basel 4002, Switzerland
University of Basel, PO Box, Basel 4003, Switzerland
Institut National de Santé Publique, PO Box V 47, Abidjan, Côte d’Ivoire
UFR des Sciences Médicales, Université Félix Houphouet-Boigny, PO Box V 34, Abidjan, Côte d’Ivoire
Department of Biological Anthropology, University of Cambridge, Pembroke Street, Cambridge CB2 3QG, UK
Currently affiliated with Barry Callebaut AG, Pfingstweidstrasse 60, Zürich 8005, Switzerland
Author to whom correspondence should be addressed.
Received: 18 January 2016 / Revised: 22 February 2016 / Accepted: 29 February 2016 / Published: 7 March 2016
(This article belongs to the Special Issue Fortification to Combat Micronutrient Deficiencies)
Full-Text   |   PDF [235 KB, uploaded 7 March 2016]


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. View Full-Text
Keywords: flour; oil; fortification; children; women; iron; vitamin A; anemia flour; oil; fortification; children; women; iron; vitamin A; anemia
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Rohner, F.; Raso, G.; Aké-Tano, S.O.P.; Tschannen, A.B.; Mascie-Taylor, C.G.N.; Northrop-Clewes, C.A. 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. Nutrients 2016, 8, 148.

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