|New and Noteworthy in Nutrition (World Bank, 150 pages)|
|No. 28 December 10, 1996|
39. Movers and Shakers. Since 1990, an additional 1.5 billion people have begun shaking salt that is iodized. This impressive achievement was announced by the UN Secretary-General September 30 on the sixth anniversary of the World Summit for Children. UNICEF deserves much of the credit.
40. Milling Around: A Food Summitette. Promising progress can be reported on the fortification front. Latin America was the first part of the world to be polio-free and it is now trying to be the first to control anemia. In Paraguay, on October 30, the Bank joined several other agencies in discussing, with millers, iron fortification of centrally processed wheat and maize flour in the region. . . A breakthrough also has been made to fortify wheat flour in the Middle East, with iron and folate, to address that areas number-one nutrition problem. Luckily, virtually the whole region consumes wheat flour, which can be easily and cheaply fortified. Millers from eight countries, pulled together recently by WHOs regional office and the Micronutrient Initiative, all agreed to begin fortification.
41. Iron Works. Even in the absence of anemia, iron supplementation apparently improves verbal learning and memory among adolescent girls. This, at least, is the conclusion of a study, published recently in The Lancet by I.N. Bruner and coworkers at Johns Hopkins. During an eight-week study, half of a group of teenage girls with mild iron deficiency (but who were not anemic) received iron supplements and half received placebos. When they were retested, girls who had received the iron performed better on a test for verbal learning and memory than girls in the control group. Task Managers of education projects take note.
42. Zinc Boomlet. The increased interest in zinc as a micronutrient worthy of being added to the nutritionists catechism has reached the point that a special meeting sponsored by UNICEF and USAID was held two weeks ago at Johns Hopkins to take a hard look. What came out were reports of a powerful 23 percent impact of zinc supplementation on reducing the prevalence of acute diarrhea, a 30 percent reduction in the days of malaria-induced fever, and interesting positive links with cognitive function of school children and child growth. Definitive recommendations for using zinc in programs, however, were not yet forthcoming; this all is so new that the researchers are still nervously cautious.
43. Many Happy Returns. An iodine celebration conference of sorts was recently held in Harare, one with quite a history. Fifteen years ago, in the first year of Zimbabwes independence, a sector mission unexpectedly observed quite a few goiters during field visits. There was nothing in the professional literature to suggest iodine deficiency disorders, nor were members of the biomedical community of the view that this was a problem. Nonetheless, as part of a broader snapshot survey, a mission questionnaire was sent to NGOs, public health officials and others in the field asking whether they saw goiter often/occasionally/seldom/never. The surprising number of positive responses made it possible to begin drawing a goiter belt on the map of Zimbabwe and this, in turn, led the government to undertake a national survey. Conducted by Judith Mutamba, this confirmed a major IDD problem in the country. She was at the Bank not long ago, discussing legislation that now amends the Food Standards Act to require all salt for human consumption to be iodized. A monitoring system has been set in place and important training undertaken. In short, the Government made an investment -- and the returns on it apparently are high. The problem has almost been taken care of, says Ms. Mutamba. The experience culminated in the Africa-wide conference that discussed the Zimbabwe experience and ways that other countries might replicate it. One of the lessons here for the Bank, perhaps, is the value of such informal studies in the absence of hard data.