Publications

BACKGROUND: Agronomic zinc biofortification of wheat by foliar application increases wheat zinc content and total zinc absorption in humans. OBJECTIVES: To  assess the effect of agronomically biofortified whole wheat flour (BFW) on plasma  zinc (PZC) compared with a postharvest fortified wheat (PHFW) and unfortified  control wheat (CW) when integrated in a midday school meal scheme. METHODS: We  conducted a 20-wk double-blind intervention trial in children (4-12 y, n = 273)  individually randomly assigned to 3 groups to receive a daily school lunch  consisting of 3 chapattis prepared with the 3 different wheat flour types.  Measurements of anthropometry, blood biochemistry, and leukocyte DNA strand  breaks were conducted. We applied sparse serial sampling to monitor PZC over  time, and analysis was performed using linear mixed-effects models. RESULTS: Mean  zinc content in BFW, PHFW, and CW were 48.0, 45.1, and 21.2 ppm, respectively (P  < 0.001). Mean (standard deviation) daily zinc intakes in the study intervention  in BFW, PHFW, and CW groups were 4.4 (1.6), 5.9 (1.9) and 2.6 (0.6) mg Zn/d,  respectively, with intake in groups PHFW and BFW differing from CW (P < 0.001)  but no difference between BFW and PHFW. There were no time effect, group  difference, or group × time interaction in PZC. Prevalence of zinc deficiency  decreased in the BFW (from 14.1%-11.2%), PHFW (from 8.9%-2.3%), and CW  (9.8%-8.8%) groups, but there was no time × treatment interaction in the  prevalence of zinc deficiency (P = 0.191). Compliance with consuming the study  school meals was associated with PZC (P = 0.006). DNA strand breaks were not  significantly associated with PZC (n = 51; r = 0.004, P = 0.945). CONCLUSIONS:  Consumption of either PHFW or BFW provided an additional ∼1.8 to 3.3 mg Zn/d, but  it did not affect PZC or zinc deficiency, growth, or DNA strand breaks. This  trial was registered on clinicaltrials.gov as NCT02241330 and ctri.nic.in as  CTRI/2015/06/005913.