Micronutrient intake and prevalence of micronutrient inadequacy among women (15-49 y) and children (6-59 mo) in South Kivu and Kongo Central, Democratic Republic of the Congo (DRC)

Abstract

Iron biofortified beans and carotenoid enriched cassava are proposed as a solution to combat iron and vitamin A deficiencies, respectively, in the Democratic Republic of Congo (DRC). To inform the need for biofortified foods we conducted a survey in 2014, in two provinces of the DRC, South Kivu and Kongo Central. Unexpectedly, women of reproductive age (WRA; 15-49 y) and their children (6-59 m) had a low prevalence of biochemical iron and vitamin A deficiency, based on ferritin and retinol binding protein, respectively. However, to better understand the lack of biochemical deficiency of these nutrients we examined the prevalence of inadequate intake for these and other select nutrients. Dietary intake was assessed using 24-hour recalls (with repeats) among 744 mother-child dyads. In WRA the prevalence of inadequate iron intakes was 32% (10% bioavailability). The prevalence of inadequate vitamin A intakes was low in South Kivu (18%) and negligible in Kongo Central (1%). The prevalence of inadequate iron intake was 74% in infants (6-11 m) and ~22% in the older children (12-59 months). There was a high prevalence of inadequate zinc intake in women and children (i.e. 83% WRA) consistent with our findings of a high prevalence of low serum zinc in the same sample. Dietary data here corroborate the low prevalence of biochemical vitamin A deficiency but not iron. However, any change to the supply of red palm oil would dramatically reduce population vitamin A intakes, thus a carotenoid enriched cassava program may be beneficial as a safety net measure. Additionally, iron biofortified beans may be warranted given the high rates of dietary inadequacy and uncertainty around the validity of iron biomarkers. Crops biofortified with zinc also appear warranted. We caution that our findings cannot be extrapolated to the entire Congo where diverse agro-ecological landscape exist or when political and environmental shocks occur which challenge food production.