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Biofortified Maize Improves Selenium Status of Women and Children in a Rural Community in Malawi: Results of the Addressing Hidden Hunger With Agronomy Randomized Controlled Trial

Joy, Edward J.M.; Kalimbira, Alexander A.; Sturgess, Joanna; Banda, Leonard; Chiutsi-Phiri, Gabriella; Manase, Hastings; Gondwe, Jellita; Ferguson, Elaine L.; Kalumikiza, Zione; Bailey, Elizabeth H.; Young, Scott D.; Matandika, Limbanazo; Mfutso-Bengo, Joseph; Millar, Kate; Niksic, Maja; Segovia de la Revilla, Lucia; Likoswe, Blessings H.; Phuka, John C.; Phiri, Felix P.; Lark, R. Murray; Gashu, Dawd; Langley-Evans, Simon C.; Ander, E. Louise; Lowe, Nicola M.; Dangour, Alan D.; Nalivata, Patson C.; Broadley, Martin R.; Allen, Elizabeth

Biofortified Maize Improves Selenium Status of Women and Children in a Rural Community in Malawi: Results of the Addressing Hidden Hunger With Agronomy Randomized Controlled Trial Thumbnail


Authors

Edward J.M. Joy

Alexander A. Kalimbira

Joanna Sturgess

Leonard Banda

Gabriella Chiutsi-Phiri

Hastings Manase

Jellita Gondwe

Elaine L. Ferguson

Zione Kalumikiza

LIZ BAILEY LIZ.BAILEY@NOTTINGHAM.AC.UK
Professor of Environmental Geochemistry

Scott D. Young

Limbanazo Matandika

Joseph Mfutso-Bengo

KATE MILLAR KATE.MILLAR@NOTTINGHAM.AC.UK
Professor of Applied Bioethics

Maja Niksic

Lucia Segovia de la Revilla

Blessings H. Likoswe

John C. Phuka

Felix P. Phiri

Profile image of MURRAY LARK

MURRAY LARK MURRAY.LARK@NOTTINGHAM.AC.UK
Professor of Geoinformatics

Dawd Gashu

Simon C. Langley-Evans

E. Louise Ander

Nicola M. Lowe

Alan D. Dangour

Patson C. Nalivata

Elizabeth Allen



Abstract

Background: Selenium deficiency is widespread in the Malawi population. The selenium concentration in maize, the staple food crop of Malawi, can be increased by applying selenium-enriched fertilizers. It is unknown whether this strategy, called agronomic biofortification, is effective at alleviating selenium deficiency.

Objectives: The aim of the Addressing Hidden Hunger with Agronomy (AHHA) trial was to determine whether consumption of maize flour, agronomically-biofortified with selenium, affected the serum selenium concentrations of women, and children in a rural community setting.

Design: An individually-randomized, double-blind placebo-controlled trial was conducted in rural Malawi. Participants were randomly allocated in a 1:1 ratio to receive either intervention maize flour biofortified with selenium through application of selenium fertilizer, or control maize flour not biofortified with selenium. Participant households received enough flour to meet the typical consumption of all household members (330 g capita−1 day−1) for a period of 8 weeks. Baseline and endline serum selenium concentration (the primary outcome) was measured by inductively coupled plasma mass spectrometry (ICP-MS).

Results: One woman of reproductive age (WRA) and one school-aged child (SAC) from each of 180 households were recruited and households were randomized to each group. The baseline demographic and socioeconomic status of participants were well-balanced between arms. No serious adverse events were reported. In the intervention arm, mean (standard deviation) serum selenium concentration increased over the intervention period from 57.6 (17.0) μg L−1 (n = 88) to 107.9 (16.4) μg L−1 (n = 88) among WRA and from 46.4 (14.8) μg L−1 (n = 86) to 97.1 (16.0) μg L−1 (n = 88) among SAC. There was no evidence of change in serum selenium concentration in the control groups.

Conclusion: Consumption of maize flour biofortified through application of selenium-enriched fertilizer increased selenium status in this community providing strong proof of principle that agronomic biofortification could be an effective approach to address selenium deficiency in Malawi and similar settings.

Clinical Trial Registration: http://www.isrctn.com/ISRCTN85899451, identifier: ISRCTN85899451.

Citation

Joy, E. J., Kalimbira, A. A., Sturgess, J., Banda, L., Chiutsi-Phiri, G., Manase, H., …Allen, E. (2022). Biofortified Maize Improves Selenium Status of Women and Children in a Rural Community in Malawi: Results of the Addressing Hidden Hunger With Agronomy Randomized Controlled Trial. Frontiers in Nutrition, 8, Article 788096. https://doi.org/10.3389/fnut.2021.788096

Journal Article Type Article
Acceptance Date Dec 7, 2021
Online Publication Date Jan 6, 2022
Publication Date Jan 6, 2022
Deposit Date Jul 27, 2022
Publicly Available Date Jul 28, 2022
Journal Frontiers in Nutrition
Electronic ISSN 2296-861X
Publisher Frontiers Media
Peer Reviewed Peer Reviewed
Volume 8
Article Number 788096
DOI https://doi.org/10.3389/fnut.2021.788096
Keywords Nutrition and Dietetics; Endocrinology, Diabetes and Metabolism; Food Science
Public URL https://nottingham-repository.worktribe.com/output/7378246
Publisher URL https://www.frontiersin.org/articles/10.3389/fnut.2021.788096/full

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