{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:02:02Z","timestamp":1777640522302,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2013,12,1]],"date-time":"2013-12-01T00:00:00Z","timestamp":1385856000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Food Nutr Bull"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Zambia was a pioneer when it started fortifying sugar with vitamin A in 1998. Micronutrient deficiencies\u2014especially among young children\u2014have changed little over the past decade. In 2008 an initiative to introduce fortified flours was halted when last-hour questions about the program could not be answered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To provide information about the need, coverage, and impact of alternative fortification portfolio options to help Zambia overcome its fortification impasse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using household data from the 2006 Living Conditions Monitoring Survey, apparent micronutrient intake levels and apparent consumption levels of sugar, vegetable oil, wheat flour and maize meal were estimated. The household level data were used to estimate individual intakes by assuming that food was distributed among household members in direct proportion to their share of the household's total adult consumption equivalent. Intake adequacy was measured relative to age- and gender-specific Estimated Average Requirements. Combining information on the industrial structure and estimated fortifiable quantities consumed of each food, and assuming the nutrient content is that specified in official regulations, simulations were conducted of the coverage and impact of 14 fortification portfolios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Maize, the most commonly consumed food, is consumed in a fortifiable form by only 23% of the population. Sugar fortification is estimated to have reduced inadequate intake of vitamin A from 87% to 79%. Introducing oil fortification could reduce the prevalence of inadequate vitamin A intake to 61%, and fortifying roller and breakfast maize meal would further reduce it to 57%, and reduce inadequate iron and zinc intakes by 2.2% and 5.5%, respectively. Implementing WHO flour guidelines would triple the potential iron and zinc impacts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Analysis of LCMS apparent consumption data have helped address important information gaps and provide better understanding of the coverage and impacts of alternative fortification portfolios.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/156482651303400412","type":"journal-article","created":{"date-parts":[[2015,11,25]],"date-time":"2015-11-25T15:54:13Z","timestamp":1448466853000},"page":"480-500","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":25,"title":["Identifying Zambia's Industrial Fortification Options: Toward Overcoming the Food and Nutrition Information Gap-Induced Impasse"],"prefix":"10.1177","volume":"34","author":[{"given":"John L.","family":"Fiedler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Lividini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodah","family":"Zulu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gladys","family":"Kabaghe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Tehinse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Odilia I.","family":"Bermudez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,12,1]]},"reference":[{"key":"bibr1-156482651303400412","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1177\/156482651303400412","volume":"34","author":"Fiedler JL","year":"2013","journal-title":"Food Nutr Bull"},{"key":"bibr2-156482651303400412","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780195171693.001.0001"},{"key":"bibr3-156482651303400412","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-375083-9.00206-3"},{"key":"bibr4-156482651303400412","doi-asserted-by":"publisher","DOI":"10.1016\/j.gfs.2012.09.002"},{"key":"bibr5-156482651303400412","doi-asserted-by":"publisher","DOI":"10.1177\/156482651303400304"},{"key":"bibr6-156482651303400412","unstructured":"World Bank. Available at: http:\/\/data.worldbank.org\/country\/zambia. Accessed 24 September 2013."},{"key":"bibr7-156482651303400412","unstructured":"Zambia Central Statistical Office (CSO). Zambia-Living Conditions Monitoring Survey V 2006. Living conditions monitoring branch, CSO: Lusaka 2011. Available at: http:\/\/catalog.ihsn.org\/index.php\/catalog\/2258. Accessed 13 August 2013."},{"key":"bibr8-156482651303400412","volume-title":"Report of the national survey to evaluate the impact of vitamin A interventions in Zambia in July and November 2003","author":"National Food and Nutrition Commission (NFNC) of Zambia, University of Zambia, Micronutrient Operational Strategies and Technologies (MOST), Centers for Disease Control and Prevention (CDC)","year":"2003"},{"key":"bibr9-156482651303400412","volume-title":"Government of the Republic of Zambia. Living Conditions Monitoring Survey Report: 2005 and 2010","author":"Central Statistical Office (CSO)","year":"2011"},{"key":"bibr10-156482651303400412","volume-title":"Position paper on concerns raised about maize meal fortification","author":"National Food and Nutrition Commission and National Fortification Alliance","year":"2007"},{"key":"bibr11-156482651303400412","volume-title":"Zambia Demographic and Health Survey 2007","author":"Central Statistical Office (CSO), Ministry of Health, Tropical Diseases Research Centre (TDRC), University of Zambia, and Macro International","year":"2013"},{"key":"bibr12-156482651303400412","volume-title":"Zambia National Malaria Indicator Survey 2010","author":"Ministry of Health","year":"2011"},{"key":"bibr13-156482651303400412","volume-title":"Nutrition survey in central and eastern provinces, Zambia, 2009. Focus on vitamin A and maize intakes and vitamin A status among women and children","author":"National Food and Nutrition Commission (NFNC) of Zambia, Tropical Diseases Research Centre, Zambia, HarvestPlus","year":"2010"},{"key":"bibr14-156482651303400412","volume-title":"Analyzing the health benefits of biofortified staple crops by means of the disability-adjusted life years approach: a handbook focusing on iron, zinc and vitamin A. HarvestPlus Technical Monograph Series 4","author":"Stein AJ","year":"2005"},{"key":"bibr15-156482651303400412","volume-title":"Vitamin A fortification of sugar in Zambia, 1998\u20132001. A consultancy report submitted to the USAID Micronutrient Project: MOST","author":"Serlemitsos JA","year":"2001"},{"key":"bibr16-156482651303400412","unstructured":"Food and Agriculture Organization (FAO). FAOSTAT. Available at: http:\/\/faostat.fao.org\/site\/368\/default.aspx#ancor. Accessed 13 August 2013."},{"key":"bibr17-156482651303400412","unstructured":"Motts N. 2002. Zambia: case study report of the workability of fortification via service hammer mills. Micronutrient Initiative. Available at: http:\/\/www.micronutrient.org\/CMFiles\/PubLib\/Zambia-Case-Study-Report1NTT-3242008-1130.pdf. Accessed 13 August 2013."},{"key":"bibr18-156482651303400412","volume-title":"Project Grant Agreement between the Global Alliance for Improved Nutrition (GAIN) and the Ministry of Health of the Republic of Zambia","author":"National Food and Nutrition Commission (NFNC), Ministry of health, Government of the Republic of Zambia","year":"2006"},{"key":"bibr19-156482651303400412","doi-asserted-by":"publisher","DOI":"10.18356\/0537e82a-en"},{"key":"bibr20-156482651303400412","unstructured":"Scaling Up Nutrition: a framework for action. September 2010. Available at: http:\/\/siteresources.worldbank.org\/NUTRITION\/Resources\/281846-1131636806329\/PolicyBriefNutrition.pdf Accessed 13 August 2013."},{"key":"bibr21-156482651303400412","volume-title":"Food Composition Table","author":"National Food and Nutrition Commission (NFNC), Ministry of Health, Government of the Republic of Zambia","year":"2007","edition":"3"},{"key":"bibr22-156482651303400412","volume-title":"Human energy requirements. Report of a Joint FAO\/WHO\/UNU Expert Consultation, 17\u201324 October 2001","author":"Food and Agriculture Organization","year":"2001"},{"key":"bibr23-156482651303400412","volume-title":"Institute of Medicine of the US National Academy of Sciences. Dietary guidelines dietary reference intakes: the essential guide to nutrient requirements","author":"Otten JJ","year":"2005"},{"key":"bibr24-156482651303400412","volume-title":"Dietary reference intakes for vitamin A","author":"Institute of Medicine of the US National Academy of Sciences","year":"2001"},{"key":"bibr25-156482651303400412","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)15099-4"},{"key":"bibr26-156482651303400412","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980012000924"},{"key":"bibr27-156482651303400412","volume-title":"Guidelines on food fortification with micronutrients","author":"Allen L","year":"2006"},{"key":"bibr28-156482651303400412","unstructured":"Key catalyst, collective voice: the East, Central and Southern Africa health community's initiative on food fortification as a public health intervention. Available at: http:\/\/www.a2zproject.org\/\u223ca2zorg\/pdf\/ECSA_Report_03%20Low_Complete.pdf Accessed 13 August 2013."},{"key":"bibr29-156482651303400412","volume-title":"Recommendations on wheat and maize flour fortification meeting report: Interim Consensus Statement (Stone Mountain Guidelines)","author":"World Health Organization","year":"2009"}],"container-title":["Food and Nutrition Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/156482651303400412","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/156482651303400412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:17:30Z","timestamp":1777443450000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/156482651303400412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,12]]},"references-count":29,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["10.1177\/156482651303400412"],"URL":"https:\/\/doi.org\/10.1177\/156482651303400412","relation":{},"ISSN":["0379-5721","1564-8265"],"issn-type":[{"value":"0379-5721","type":"print"},{"value":"1564-8265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,12]]}}}