Fortification Study Benefits Indonesian Children

Children in Indonesia have a better chance of growing taller and healthier thanks to CNRC researchers.

"Indonesian children, like those in many developing countries, suffer high rates of zinc deficiency," said Dr. Ian Griffin, a CNRC mineral researcher and assistant professor of pediatrics at Baylor College of Medicine. "However, there has been little understanding of how best to address this problem until now."

Zinc deficiencies are common in developing countries where there is little access to animal proteins and nuts, which are the best sources of this mineral. According to Griffin, zinc deficiency, which can cause poor growth, reduced resistance to infections, and life-threatening bouts of diarrhea and pneumonia, is particularly devastating for children.

"Simply adding zinc to iron-fortified flour appeared to be an easy, inexpensive and attractive solution to this serious problem," Griffin said. "But because zinc has the potential to interfere with iron absorption, health officials were hesitant to do so."

Iron is regularly added to wheat flour in many countries, including the United State, to prevent iron deficiency anemia.

"With so little money available to solve nutritional problems, health officials in Indonesia wanted to be sure that adding zinc to flour would not negate the benefit of the added iron, and that the added zinc was actually absorbed," Griffin said.

To assess the feasibility of adding zinc to iron-fortified flour, Griffin worked with fellow CNRC researcher Dr. Steven Abrams and Dr. Susi Herman from the nutritional research and development center in Bogor, Indonesia. Griffin and Abrams are known internationally for their mineral nutrition studies using stable isotopes. Stable isotopes are rare, naturally occurring, non-radioactive "variations" of elements like iron, zinc, oxygen, hydrogen and calcium that are used as "tracers" in studies of nutrient absorption and metabolism.

The team tested the effects of two forms of zinc, known as zinc sulfate and zinc oxide, which could feasibly be used to fortify flour. Their studies revealed that both forms of zinc were well absorbed. But adding zinc sulfate to iron-fortified flour did indeed interfere with iron absorption. However, adding zinc oxide did not.

In light of these results, the Indonesian government plans to begin fortifying flour sold in that country with zinc oxide in the near future.

"Fortifying common foods with critical nutrients can be a complicated and challenging endeavor," Griffin said. "But when done properly, it can make an immeasurable difference in the health of millions of children."