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

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Handbook of Food Fortification and Health

Part of the book series: Nutrition and Health ((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 %.

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Notes

  1. 1.

    Exchange rate: US$1  =  0.388 Omani Rial (OR); 30 OR  =  US$77.

  2. 2.

    Calculated from the national dietary intake survey.

  3. 3.

    Analysis of data from the National Diabetes Survey 1993.

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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Author information

Authors and Affiliations

  1. Department of Nutrition, Ministry of Health, 18th November Street, Al Ghubra, Muscat, Oman

    Deena Alasfoor MSc

  2. Ministry of Health, Muscat, Oman

    Medhat K. ElSayed PhD

Authors
  1. Deena Alasfoor MSc
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  2. Medhat K. ElSayed PhD
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Corresponding author

Correspondence to Deena Alasfoor MSc .

Editor information

Editors and Affiliations

  1. Diabetes and Nutritional Sciences, School of Medicine, King's College London, 150 Stamford Street, London, SE1 9NH, United Kingdom

    Victor R. Preedy

  2. University Hospital Lewisham, Department of Gastroenterology, Department of Gastroenterology, Kings College Hospital, London, SM68SU, United Kingdom

    Rajaventhan Srirajaskanthan

  3. Department of Biomedical Sciences, School of Life Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, United Kingdom

    Vinood B. Patel

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Alasfoor, D., ElSayed, M.K. (2013). Fortification of Flour and Outcomes: Oman’s Perspective—Contextual Considerations and Outcome. In: Preedy, V., Srirajaskanthan, R., Patel, V. (eds) Handbook of Food Fortification and Health. Nutrition and Health. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4614-7110-3_25

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  • DOI: https://doi.org/10.1007/978-1-4614-7110-3_25

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  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4614-7109-7

  • Online ISBN: 978-1-4614-7110-3

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