Equity implications of rice fortification: a modelling study from Nepal

Area of Science:

• Nutrition Science
• Public Health
• Food Fortification

Background:

• Unfortified diets in Nepal show significant inadequacy in key micronutrients, including vitamins B12, A, B9, and minerals like zinc and iron.
• Rice is a staple food, making it a potential vehicle for micronutrient fortification to address widespread deficiencies.

Purpose of the Study:

• To model the impact of rice fortification on nutritional adequacy across different subpopulations in Nepal.
• To assess the equity implications of rice fortification, particularly concerning gender and regional disparities.

Main Methods:

• Utilized 24-hour dietary recall and household consumption data from Nepal.
• Modeled the probability of adequacy (PA) and mean probability of adequacy (MPA) for 11 micronutrients under different fortification scenarios.
• Compared nutrient adequacy improvements between various demographic and geographic subgroups.

Main Results:

• Fortifying purchased rice increased the probability of adequacy for thiamin, niacin, B6, folate, and zinc to over 0.9 in rice-purchasing households.
• Vitamin B12 and iron remained inadequate (PA 0.3-0.9) even after fortification.
• Nutrient adequacy gains showed differential impacts: pregnant women benefited more in some nutrients, men in others. Improvements were greater in hilly and mountainous regions compared to rural areas.

Conclusions:

• Consumption of fortified rice enhances nutrient intake adequacy and improves gender equity.
• Rice fortification is particularly beneficial in non-rice-growing areas, suggesting targeted strategies for maximum impact.