Modeling food fortification contributions to micronutrient requirements in Malawi using Household Consumption and Expenditure Surveys.

Kevin Tang ORCID logo; Katherine P Adams ORCID logo; Elaine L Ferguson ORCID logo; Monica Woldt; Alexander A Kalimbira; Blessings Likoswe; Jennifer Yourkavitch; Benjamin Chrisinger; Sarah Pedersen; Lucia Segovia De La Revilla ORCID logo; +3 more... Omar Dary; E Louise Ander; Edward JM Joy ORCID logo; (2021) Modeling food fortification contributions to micronutrient requirements in Malawi using Household Consumption and Expenditure Surveys. Annals of the New York Academy of Sciences, 1508 (1). pp. 105-122. ISSN 0077-8923 DOI: 10.1111/nyas.14697
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Large-scale food fortification may be a cost-effective intervention to increase micronutrient supplies in the food system when implemented under appropriate conditions, yet it is unclear if current strategies can equitably benefit populations with the greatest micronutrient needs. This study developed a mathematical modeling framework for comparing fortification scenarios across different contexts. It was applied to model the potential contributions of three fortification vehicles (oil, sugar, and wheat flour) toward meeting dietary micronutrient requirements in Malawi through secondary data analyses of a Household Consumption and Expenditure Survey. We estimated fortification vehicle coverage, micronutrient density of the diet, and apparent intake of nonpregnant, nonlactating women for nine different micronutrients, under three food fortification scenarios and stratified by subpopulations across seasons. Oil and sugar had high coverage and apparent consumption that, when combined, were predicted to improve the vitamin A adequacy of the diet. Wheat flour contributed little to estimated dietary micronutrient supplies due to low apparent consumption. Potential contributions of all fortification vehicles were low in rural populations of the lowest socioeconomic position. While the model predicted large-scale food fortification would contribute to reducing vitamin A inadequacies, other interventions are necessary to meet other micronutrient requirements, especially for the rural poor.


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