Food fortification improves the intake of all fortified nutrients, but fails to meet the estimated dietary requirements for vitamins A and B6, in lactating South African women

Objective: To investigate the impact of fortification by comparing food records and selected biochemical indicators of nutritional status preand post-fortification. Design: Mean intake from 24 h recalls (n 142) was compared with the Estimated Average Requirement (EAR) to determine the proportion with inadequate intake. In a subsample (n 34), diet and serum retinol, folate, ferritin and Zn were compared preand post-fortification for fortified nutrients vitamin A, thiamin, riboflavin, niacin, folic acid, Fe and Zn. Setting: South Africa. Subjects: Breast-feeding women (ninety-four HIV-infected, forty eight HIV­ uninfected) measured at , 6, 14, 24 weeks, and 9 and 12 months postpartum. Results: Pre-fortification, .80 % of women did not meet the EAR for vitamins A, C, D, thiamin, riboflavin, niacin, B6, B12 and folate and minerals Zn, iodine and Ca. Dietary intake post-fortification increased for all fortified nutrients. In postfortification food records, .70 % did not meet the EAR for Zn and vitamins A, riboflavin and B6. Serum folate and Zn increased significantly post-fortification (P , 0?001 for both), with no change in ferritin and a reduction in retinol. Postfortification marginal/deficient folate status was reduced (73?5 % pre v. 3?0% post; P , 0?001), as was Zn deficiency (26?5 % pre v. 5?9 % post; P , 0?05). Preand post-fortification, .93 % were retinol replete. There was no change in Fe deficiency (16?7 % pre v. 19?4 % post; P 5 0?728).