Investigating the Effects of Biofortified Wheat Flour on Plasma Zinc, Selenium, and Enterobacteria in Pediatric Populations

Abstract

Introduction: Zinc and Selenium deficiency affects 39% children in Pakistan, according to the recent National Nutritional Survey 2011. Keeping in view deficiency states of zinc in our population, interventional strategies have been employed such as fortification of cereals, food products, and zinc preparations in suspension forms. Zinc biofortification is a better option as wheat flour is most common and easily assessed food in resource-poor settings compared to the other fortification methods. Although zinc has been used in the prevention and treatment of diarrhoea, the relationship of plasma zinc status with potentially pathogenic bacteria has not been studied.

Objective: Primary objective of this study was to assess the impact of zinc biofortified wheat flour on plasma zinc and selenium status in resource-poor rural settings of Peshawar where wheat is a major food staple. Furthermore, the secondary objective was to observe the relationship of change in zinc and selenium concentration (with biofortified wheat flour) with absolute quantities of potentially pathogenic gut bacteria such as Campylobacter jejuni.

Study design & Setting: Children aged 5-10 years (n=10) were randomly allocated into a control group (n=5) or an intervention group (n=5). The study was pilot randomized control parallel trial in rural area of Peshawar.

Methods: Dietary zinc intake was assessed using 24 hours’ dietary recall, Plasma zinc and selenium status were analyzed through Inductively Coupled Plasma Mass Spectrometry ICP-MS and Enterobacteria (Campylobacter jejuni) was amplified with TaqMan probes and primers through 7500 Real-Time qPCR.

Results: No difference in the plasma zinc and selenium levels was observed in pre- and post-intervention (918.0 µg/L & 90.7 µg/L VS 880.9 µg/L & 78.5 µg/L). Similarly, no significant difference in the change in plasma zinc (ΔZn = 37.1 µg/L) and selenium (ΔSe = 12.2 µg/L) was observed between the two groups. 16S RNA gene qPCR amplification of Campylobacter jejuni was negative in all the samples from both the groups before and after the intervention.

Conclusion: Biofortified flour consumption did not affect plasma zinc and selenium status although this may be because of a small sample size. Large community-based studies are needed to study the effectiveness of this intervention.