Iron and vitamin D deficiencies among preschool children remain key nutrition challenges in Jordan – study
While Jordan has experienced a rapid nutrition transition, with a shift from undernutrition to rising rates of overweight, obesity and diet-related non-communicable diseases, the problem of micronutrient deficiencies has lingered over the years.
To elucidate the severity of these micronutrient deficiencies, a study funded by UNICEF Jordan was conducted to compare the results of the Jordan National Micronutrient & Nutrition Survey (JNMNS) 2019 with that of the survey done in 2010.
JNMNS 2019 was a national cross-sectional survey structured across four strata and involved 1,296 eligible preschool children.
It was found that anaemia prevalence in this age group decreased by 5 to 6% between 2010 and 2019, whereas iron deficiency prevalence rose by 7%, and iron deficiency anaemia (IDA) remained largely unchanged.
Although severe anaemia was rare, the findings from JNMNS 2019 revealed that 11% of preschoolers aged between 12 and 59 months were anaemic, and 22.4% had iron deficiency, including 5% with IDA.
Notably, there was a significantly higher prevalence of anaemia among male children and those aged between six and 11 months.
Additionally, vitamin D deficiency increased in 2019, with nearly two-thirds of children having inadequate vitamin D status.
Aside from the increasing prevalence of vitamin D deficiency along with age, a gender disparity was also observed, with a higher proportion of girls experiencing vitamin D deficiency compared to boys.
On the other hand, the prevalence of vitamin A deficiency decreased. Approximately 4 to 8% of preschool children were identified as having vitamin A deficiency, which is considered a mild public health concern based on WHO criteria.
While stunting and wasting improved, childhood overweight and obesity rates remained consistent.
The prevalence of overweight in children under five years was higher among boys (11.7%) than girls (6.7%), in urban and rural areas (10% versus 5.2%), and in wealthier households (14.2% in the wealthiest income quintile versus 4.8% in the poorest income quintile).
“Iron deficiency poses a risk to cognitive development, and vitamin D deficiency impacts growth and immunity. Although malnutrition rates are low, the persistent issues of vitamin D and iron deficiencies, along with childhood obesity, require sustained attention and targeted interventions to improve children’s health in Jordan.
“Our study aims to align with global objectives, such as the Sustainable Development Goal (SDG) of achieving zero hunger. By understanding the severity of micronutrient deficiencies and assessing the double burden of malnutrition, the study findings will contribute directly to the global effort to improve nutrition and food security,” the authors wrote.
A need for multisector collaboration
Since 1996, Jordan’s Ministry of Health has implemented a national salt iodisation programme to combat the burden of micronutrient deficiencies. A survey carried out in 2010 showed a significant improvement in iodine nutrition among school-age children.
In addition, the observed declines in overall anaemia and severe anaemia in this study may be partly attributed to the national wheat flour fortification programme introduced in 2002.
As part of the programme, wheat flour is fortified with iron and folic acid, and subsequently expanded to include zinc, vitamin A, B vitamins (B1, B2, B3, and B12), and vitamin D.
Nevertheless, Jordan’s nutrition challenges are impeded by low levels of exclusive breastfeeding and “alarming levels” of low birth weight.
The COVID-19 pandemic and ongoing geopolitical turmoil around the world, which have led to rising food prices, have also impacted the country’s food security and her population’s nutritional health.
“There is a significant opportunity to improve the health and standard of living for both Jordanians and the numerous refugees hosted in the nation. Our research underscores the significance in addressing local nutritional challenges and informing policy intervention.”
For instance, vitamin D deficiency remains a concern, and signifies a need to encourage sun exposure and to consider increasing the levels of vitamin D3 in flour fortification.
“The implementation of a national nutrition strategy using a multisectoral approach through collaboration with significant stakeholders is expected to yield more effective results and outcomes.
“It is also essential to integrate education for parents into the strategy to enhance the nutritional status of children. This can empower parents with the knowledge and tools needed to make informed decisions about their children’s diet and health.”
Source: Frontiers in Nutrition
https://doi.org/10.3389/fnut.2024.1423904
“Evaluation of micronutrient and nutritional status among preschool children in Jordan: results from a Nationwide survey”
Authors: Rawhieh Barham, et al
