To evaluate the efficacy of zinc biofortified wheat flour on the morbidity, micronutrient status, acute phase markers and growth among children aged 4-6 years and women aged 15-49 years in Delhi, India.
In a community based double-masked randomized controlled trial 6000 subjects (WRA-3000 and Children-3000) were enrolled and randomly allocated to receive either high zinc bio-fortified wheat flour (BFW, 30 ppm of zinc daily) or regular wheat flour (NBFW, 20 ppm zinc) daily for 6 months (WRA@360 g/day and children @120g/day). Baseline and end study measurements were obtained and data on compliance, morbidity, dietary intake were collected.
Overall the compliance was 85% and did not vary between the biofortified and regular wheat flour groups. 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 biofortified and regular wheat flour, and a short intervention period. However a positive impact of bio-fortification on morbidity was observed. Compared to children in NBFW group, children in BFW 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. Women in the BFW group also showed a statistically significant 9% fewer days with fever compared to NBFW group.
Biofortified wheat flour had a good compliance. Significant improvement on some of the morbidity indicators suggests that evaluating longer term effects of biofortification with higher zinc content would be more appropriate.