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Fortification of Flour and Outcomes: Oman’s Perspective—Contextual Considerations and Outcome

  • Deena AlasfoorEmail author
  • Medhat K. ElSayed
Chapter
Part of the Nutrition and Health book series (NH)

Abstract

Flour fortification is a recognized strategy for anemia and NTD prevention. The impact is well documented through clinical trials. Oman was the first country in the Middle East to make fortification of flour with folic acid a national compulsory legislation. This chapter discusses the demographic, health, and nutritional context in 1996 when the decision was made, and the impact on anemia among various population groups as well as the impact on NTDs.

More than 80 % of the flour and bread supply in Oman was through one large mill that was well equipped to manage fortification of flour. White flour was fortified at 30 ppm iron and 1.5 folate. The political well was manifested by an expedited legislation and execution of the program. Studies showed that awareness of anemia and fortification was very limited before and after fortification.

Anemia among preschool children at the age of 3–5 years increased by 20 % from 1996 to 2009, whereas the rate among school children went down by 23 % from 1996 to 2004. Women of childbearing age had declined by 0.8 % annually. The rates of NTDs went down by 80 %.

Keywords

Fortification Oman Iron Folate Flour fortification Anemia NTDs Spina bifida School children Women Men 

Abbreviations

UAE

United Arab Emirates

KSA

Kingdom of Saudi Arabia

Km

Kilometers

Sq

Square

GDP

Gross Domestic Product

US

United States

$

Dollars

UNICEF

United Nations Children Fund

PEM

Protein energy malnutrition

Hb

Hemoglobin

g/dL

Grams per deciliter

mg

Milligram

μg

Microgram

IU

International units

μg/dL

Microgram per deciliter

WHO

World Health Organization

EMRO

Eastern Mediterranean Regional office of the World Health Organization

CDC

Centers for Disease Control

USA

United States of America

ppm

Parts per million

Mt/day

Metric tons per day

OR

Omani Rials

RNI

Recommended nutrients intake

UN

United Nations

EAR

Estimated average requirements

mg/d

Milligram per day

NTDs

Neural tube defects

QALYs

Quality adjusted life years

MoH

Ministry of Health

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of NutritionMinistry of HealthAl GhubraOman
  2. 2.Ministry of HealthMuscatOman

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