Efficacy of high zinc biofortified wheat in improvement of micronutrient status, and prevention of morbidity among preschool children and women - a double masked, randomized, controlled trial

Biofortification of staple food crops with zinc (Zn) can be one of the cost-effective and sustainable strategies to combat zinc deficiency and prevent morbidity among the target population. Agronomic approaches such as application of Zn fertilizers to soil and/or foliar spray seem to be a practical...

Full description

Bibliographic Details
Main Authors: Sazawal, Sunil, Dhingra, Usha, Dhingra, Pratibha, Dutta, Arup, Deb, Saikat, Kumar, Jitendra, Devi, Prabhabati, Prakash, Ashish
Format: Journal Article
Language:Inglés
Published: Springer 2018
Subjects:
Online Access:https://hdl.handle.net/10568/171148
_version_ 1855529002819649536
author Sazawal, Sunil
Dhingra, Usha
Dhingra, Pratibha
Dutta, Arup
Deb, Saikat
Kumar, Jitendra
Devi, Prabhabati
Prakash, Ashish
author_browse Deb, Saikat
Devi, Prabhabati
Dhingra, Pratibha
Dhingra, Usha
Dutta, Arup
Kumar, Jitendra
Prakash, Ashish
Sazawal, Sunil
author_facet Sazawal, Sunil
Dhingra, Usha
Dhingra, Pratibha
Dutta, Arup
Deb, Saikat
Kumar, Jitendra
Devi, Prabhabati
Prakash, Ashish
author_sort Sazawal, Sunil
collection Repository of Agricultural Research Outputs (CGSpace)
description Biofortification of staple food crops with zinc (Zn) can be one of the cost-effective and sustainable strategies to combat zinc deficiency and prevent morbidity among the target population. Agronomic approaches such as application of Zn fertilizers to soil and/or foliar spray seem to be a practical tool for Zn biofortification of wheat. However, there is a need to evaluate its efficacy from randomized controlled trials. This study aimed to evaluate the efficacy of zinc biofortified wheat flour on zinc status and its impact on morbidity among children aged 4–6 years and non-pregnant non lactating woman of child bearing age (WCBA) in Delhi, India. In a community based, double-masked randomized controlled trial, 6005 participants (WCBA and child pairs) were enrolled and randomly allocated to receive either high zinc biofortified wheat flour (HZn, 30 ppm zinc daily) or low zinc biofortified wheat flour (LZn, 20 ppm zinc daily) for 6 months (WCBA @ 360 g/day and children @ 120 g/day). Baseline and endline blood samples were obtained for assessing hematological markers; zinc status and data on compliance and morbidity were collected. Compliance rates were high; ~ 88% of the WCBAs in both the groups consumed 50% or more of recommended amount of biofortfied wheat flour during the follow up. Similarly 86.9% children in HZn and 87.5% in LZn consumed 50% or more of recommended wheat flour intake. There was no significant difference in mean zinc levels between the groups at end study. This observation might be due to a marginal difference in zinc content (10 ppm) between the HZn and LZn wheat flour, and a short intervention period. However a positive impact of bio-fortification on self-reported morbidity was observed. Compared to children in LZn group, children in HZn group had 17% (95% CI: 6 to 31%, p = 0.05) and 40% (95% CI: 16 to 57%; p = 0.0019) reduction in days with pneumonia and vomiting respectively. WCBA in the HZn group also showed a statistically significant 9% fewer days with fever compared to LZn group. Biofortified wheat flour had a good compliance among children and WCBAs. Significant improvement on some of the self-reported morbidity indicators suggests that evaluating longer-term effects of biofortification with higher grain zinc content would be more appropriate. http://ctri.nic.in/Clinicaltrials/ , CTRI/2014/04/004527, Registered April 7, 2014.
format Journal Article
id CGSpace171148
institution CGIAR Consortium
language Inglés
publishDate 2018
publishDateRange 2018
publishDateSort 2018
publisher Springer
publisherStr Springer
record_format dspace
spelling CGSpace1711482025-09-25T13:01:42Z Efficacy of high zinc biofortified wheat in improvement of micronutrient status, and prevention of morbidity among preschool children and women - a double masked, randomized, controlled trial Sazawal, Sunil Dhingra, Usha Dhingra, Pratibha Dutta, Arup Deb, Saikat Kumar, Jitendra Devi, Prabhabati Prakash, Ashish zinc children nutrition malnutrition women morbidity micronutrient deficiencies wheat trace elements biofortification Biofortification of staple food crops with zinc (Zn) can be one of the cost-effective and sustainable strategies to combat zinc deficiency and prevent morbidity among the target population. Agronomic approaches such as application of Zn fertilizers to soil and/or foliar spray seem to be a practical tool for Zn biofortification of wheat. However, there is a need to evaluate its efficacy from randomized controlled trials. This study aimed to evaluate the efficacy of zinc biofortified wheat flour on zinc status and its impact on morbidity among children aged 4–6 years and non-pregnant non lactating woman of child bearing age (WCBA) in Delhi, India. In a community based, double-masked randomized controlled trial, 6005 participants (WCBA and child pairs) were enrolled and randomly allocated to receive either high zinc biofortified wheat flour (HZn, 30 ppm zinc daily) or low zinc biofortified wheat flour (LZn, 20 ppm zinc daily) for 6 months (WCBA @ 360 g/day and children @ 120 g/day). Baseline and endline blood samples were obtained for assessing hematological markers; zinc status and data on compliance and morbidity were collected. Compliance rates were high; ~ 88% of the WCBAs in both the groups consumed 50% or more of recommended amount of biofortfied wheat flour during the follow up. Similarly 86.9% children in HZn and 87.5% in LZn consumed 50% or more of recommended wheat flour intake. There was no significant difference in mean zinc levels between the groups at end study. This observation might be due to a marginal difference in zinc content (10 ppm) between the HZn and LZn wheat flour, and a short intervention period. However a positive impact of bio-fortification on self-reported morbidity was observed. Compared to children in LZn group, children in HZn group had 17% (95% CI: 6 to 31%, p = 0.05) and 40% (95% CI: 16 to 57%; p = 0.0019) reduction in days with pneumonia and vomiting respectively. WCBA in the HZn group also showed a statistically significant 9% fewer days with fever compared to LZn group. Biofortified wheat flour had a good compliance among children and WCBAs. Significant improvement on some of the self-reported morbidity indicators suggests that evaluating longer-term effects of biofortification with higher grain zinc content would be more appropriate. http://ctri.nic.in/Clinicaltrials/ , CTRI/2014/04/004527, Registered April 7, 2014. 2018-12 2025-01-29T12:57:46Z 2025-01-29T12:57:46Z Journal Article https://hdl.handle.net/10568/171148 en Open Access Springer Sazawal, Sunil; Dhingra, Usha; Dhingra, Pratibha; Dutta, Arup; Deb, Saikat; Kumar, Jitendra; Devi, Prabhabati; and Prakash, Ashish. 2018. Efficacy of high zinc biofortified wheat in improvement of micronutrient status, and prevention of morbidity among preschool children and women - a double masked, randomized, controlled trial. Nutrition Journal 17:86. https://doi.org/10.1186/s12937-018-0391-5
spellingShingle zinc
children
nutrition
malnutrition
women
morbidity
micronutrient deficiencies
wheat
trace elements
biofortification
Sazawal, Sunil
Dhingra, Usha
Dhingra, Pratibha
Dutta, Arup
Deb, Saikat
Kumar, Jitendra
Devi, Prabhabati
Prakash, Ashish
Efficacy of high zinc biofortified wheat in improvement of micronutrient status, and prevention of morbidity among preschool children and women - a double masked, randomized, controlled trial
title Efficacy of high zinc biofortified wheat in improvement of micronutrient status, and prevention of morbidity among preschool children and women - a double masked, randomized, controlled trial
title_full Efficacy of high zinc biofortified wheat in improvement of micronutrient status, and prevention of morbidity among preschool children and women - a double masked, randomized, controlled trial
title_fullStr Efficacy of high zinc biofortified wheat in improvement of micronutrient status, and prevention of morbidity among preschool children and women - a double masked, randomized, controlled trial
title_full_unstemmed Efficacy of high zinc biofortified wheat in improvement of micronutrient status, and prevention of morbidity among preschool children and women - a double masked, randomized, controlled trial
title_short Efficacy of high zinc biofortified wheat in improvement of micronutrient status, and prevention of morbidity among preschool children and women - a double masked, randomized, controlled trial
title_sort efficacy of high zinc biofortified wheat in improvement of micronutrient status and prevention of morbidity among preschool children and women a double masked randomized controlled trial
topic zinc
children
nutrition
malnutrition
women
morbidity
micronutrient deficiencies
wheat
trace elements
biofortification
url https://hdl.handle.net/10568/171148
work_keys_str_mv AT sazawalsunil efficacyofhighzincbiofortifiedwheatinimprovementofmicronutrientstatusandpreventionofmorbidityamongpreschoolchildrenandwomenadoublemaskedrandomizedcontrolledtrial
AT dhingrausha efficacyofhighzincbiofortifiedwheatinimprovementofmicronutrientstatusandpreventionofmorbidityamongpreschoolchildrenandwomenadoublemaskedrandomizedcontrolledtrial
AT dhingrapratibha efficacyofhighzincbiofortifiedwheatinimprovementofmicronutrientstatusandpreventionofmorbidityamongpreschoolchildrenandwomenadoublemaskedrandomizedcontrolledtrial
AT duttaarup efficacyofhighzincbiofortifiedwheatinimprovementofmicronutrientstatusandpreventionofmorbidityamongpreschoolchildrenandwomenadoublemaskedrandomizedcontrolledtrial
AT debsaikat efficacyofhighzincbiofortifiedwheatinimprovementofmicronutrientstatusandpreventionofmorbidityamongpreschoolchildrenandwomenadoublemaskedrandomizedcontrolledtrial
AT kumarjitendra efficacyofhighzincbiofortifiedwheatinimprovementofmicronutrientstatusandpreventionofmorbidityamongpreschoolchildrenandwomenadoublemaskedrandomizedcontrolledtrial
AT deviprabhabati efficacyofhighzincbiofortifiedwheatinimprovementofmicronutrientstatusandpreventionofmorbidityamongpreschoolchildrenandwomenadoublemaskedrandomizedcontrolledtrial
AT prakashashish efficacyofhighzincbiofortifiedwheatinimprovementofmicronutrientstatusandpreventionofmorbidityamongpreschoolchildrenandwomenadoublemaskedrandomizedcontrolledtrial