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Rice flour was proposed as a vehicle for iron and zinc fortification in Sri Lanka. Although widely consumed, rice flour has not been evaluated as a fortified food, and the absorption of minerals including iron and zinc from this flour is unknown. Determination of the bioavailability of these nutrients is a critical step before commencing a fortification program. We randomly divided 53 Sri Lankan schoolchildren ages 6-10 y into 4 groups that consumed a local dish prepared with 25 g of fortified rice flour labeled with one of the following: 1) (58)FeSO(4) 2) (58)FeSO(4) + Na(2)EDTA 3) (58)FeSO(4) + (67)ZnO or, 4) (58)FeSO(4) + Na(2)EDTA + (67)ZnO. The levels of iron and zinc were 60 mg/kg; the rice flour also contained folate at 2 mg/kg in each group. Na(2)EDTA was added at a Fe:Na(2)EDTA, 1:1 molar ratio. A total of 48 children completed the trial. Absorption of (58)Fe from a meal was significantly greater (P < 0.01) in the groups administered FeSO(4) + Na(2)EDTA (4.7 +/- 3.6%) than in those administered FeSO(4) without Na(2)EDTA (2.2 +/- 1.3%). Fractional absorption of zinc was 13.5 +/- 6.0% in the FeSO(4) + Na(2)EDTA group and 8.8 +/- 2.0% in the FeSO(4) group (P = 0.037). Although zinc absorption was low, our results demonstrated a benefit in using Na(2)EDTA to improve both iron and zinc absorption. We conclude that the fortification of rice flour is feasible, although additional strategies such as dephytinization or an increase in the level of iron and zinc fortification should be considered to obtain a higher proportion of the daily requirement of total absorbed iron and zinc. [ABSTRACT FROM AUTHOR]

In order to determine the prevalence of micronutrient deficiencies (iron, zinc and folate) in Sri Lankan adolescent school children and the extent to which multiple micronutrient deficiencies exist in this population, a cross-sectional survey (2003) in the Galle district of the micronutrient and anthropometric status of 945 school children of ages 12 - 16 years was performed. The prevalence of anemia (Hb <120.0 g/L) was 49.5% in males and 58.1% in females (overall 54.8%, gender difference, P=0.004). In anemic children 30.2% of males and 47.8% of females were iron deficient (serum ferritin <30.0 µg/L). Folate deficiency (<6.80 nmol/L) was found in 54.6% and 52.5% of boys and girls respectively whereas zinc deficiency (<9.95 µmol/L) occurred in 51.5% and 58.3%. Anemic boys had a 1.5 (95% confidence interval (CI) 0.9-2.6) and 1.6-fold (CI; 1.1-2.6) greater risk of being stunted and underweight, whereas the risk among anemic girls was 1.7 (CI; 1.1-2.7) and 1.0 (CI; 0.7-1.5) for being stunted and underweight. The relative risks of having at least two deficiencies in iron, zinc and folate among anemic children were 1.6 (CI; 0.6- 4.2) among boys and 0.8 (CI; 0.5- 1.5) among girls. Iron deficient subjects had a significantly increased risk of 1.8 (CI, 1.1-3.0) of being deficient in folate and 1.7 (CI, 1.2-2.6) of being deficient in zinc. Zinc deficient subjects had a risk of 1.3 (CI, 1.0-1.8) being iron deficient and 1.2 (CI, 0.9-1.7) of being folate deficient. Multiple micronutrient deficiencies are prevalent in Sri Lankan adolescents. [ABSTRACT FROM AUTHOR]

The Thriposha programme is a community-level nutrition intervention in Sri Lanka that provides a combination of energy, protein and micronutrients as a 'ready-to-eat' cereal-based food. We measured the bioavailability of Fe and Zn from Thriposha formula at two different molar ratios of Zn:Fe in order to determine the effect on Fe and Zn absorption. Children 4-7 years (n 53) were given a meal prepared with 50 g Thriposha containing 1.5 mg Zn as zinc sulphate and either 9 mg (high Fe concentration (HiFe)) or 4.5 mg (low Fe concentration (LoFe)) Fe as ferrous fumarate. Zn and Fe percent absorption were measured using stable isotopes by tracer:tracee ratio and by incorporation of erythrocytes, respectively. Percent Fe absorption from the two meals was similar (6.6 % (4.8) v. 4.8 % (2.6); P = 0.15), but total Fe absorption was significantly higher from the HiFe meal (0.59 (0.43) mg) than the LoFe meal (0.20 (0.12) mg; P = 0.01). There was no significant difference between the two groups in Zn absorption (10.7 % (0.9) v. 8.8 % (1.4), P = 0.13, respectively). Decreasing the amount of Fe in Thriposha did not cause a significant change in the percent absorption of Fe and Zn, but significantly lowered the total amount of absorbed Fe. These results demonstrate the utility of maintaining a higher Fe content in this supplement. Further studies to increase Zn content are warranted while maintaining a HiFe.

Objective: Growth and dietary intake data are essential for formulation of nutritional policies and interventions for children., Design: 945 school children (11-16 years) were subjected to growth assessment and their nutrient intake was determined using the 24-hour dietary recall method on three consecutive days., Results: 21.3% of boys and 21.1% of girls were stunted (-2SD below the median height-for-age). 141 (14.9%) children were both stunted and wasted (-2 SD below the median weight-for-age). Mean body mass index of girls was significantly higher (p < 0.001) than boys at all ages. The mean daily dietary intake of energy was 3.2 (+/- 2.4) MJ, protein 29.1 (+/- 2.1) g, fat 4.5 (+/- 1.1) g, iron 11.5 (+/- 1.0) mg, and zinc 0.8 (+/- 0.7) mg among boys. Among girls, energy intake was 4.2 (+/- 1.8) MJ, protein 29.0 (+/- 2.3) g, fat 4.4 (+/- 1.0) g, iron 11.4 (+/- 1.0) mg, and zinc 0.5 (+/- 0.6) mg. Fat comprised about 4.0% of the daily energy intake., Conclusions: High rate of growth deficiency and undernutrition among adolescents mandates innovative nutritional intervention strategies. The observed mean intakes of nutrients in the sample showed a worrisome deviation from the recommendations of the dietary guidelines for Sri Lanka.