AMMAN // Jordan plans to fortify its domestic flour with vitamin D this month after a study found that more than 70 per cent of the kingdom's women were lacking the essential nutrient. Despite sunshine being the main source of vitamin D, levels of deficiency are particularly high across the Arab world. Not getting enough of the vitamin not only affects bone health, but is linked to a raft of other medical conditions including heart disease and cancer.
Jordanians do not get enough sunshine and they do not get enough of the vitamin from foods such as milk, eggs or fish, mostly because the prices are beyond their reach, said Kamel Ajlouni, the president of the National Centre for Diabetes, Endocrinology and Genetics. Because bread remains a staple on Jordanian tables, health officials hope that by fortifying it with the vitamin many Jordanians will get a much-needed boost.
"By fortifying flour, we can ensure that vitamin D bread is something that everybody eats and it is also subsidised," he said. A study published last month by Dr Aljouni's centre showed that 73.7 per cent of Jordanian women older than 25 suffer from vitamin D deficiency, while 22 per cent of men are also deficient. The study surveyed more than 5,600 people from all the kingdom's governorates last year.
"The results are alarming," Dr Ajlouni said. "There is a link between vitamin D deficiency and bone heath, coronary artery disease, different cancers, high blood pressure ... infections," he said. According to the June 2007 issue of the American Journal of Clinical Nutrition, vitamin D deficiency was highly prevalent among Arab and East Indian women living in the UAE. In the study that surveyed 90 lactating women, and 88 who had never given birth before, only two women - one in each group - were not vitamin D deficient.
"Vitamin D deficiency is a worldwide epidemic," Dr Ajlouni said. "When it comes to Arab countries, many people are lactose intolerant and cannot digest the milk," he said. "Besides, in Jordan, milk is not subsidised too, while bread is and that is why fortifying (the bread) is a feasible measure." A litre of fresh milk costs US$1.40, a hefty price in a country where 14.7 per cent of the population live below a poverty line of less than $800 (Dh2,938) a year.
Taking the preventive health measure of fortifying domestic flour will not entail an increased price for bread, because the vitamin will be provided free of charge. In fact, Jordan launched a fortification programme in 2002 to treat iron deficiency, and four years later it expanded the programme to include other vitamins such as A and different B vitamins. By adding vitamin D to flour this year, the funds for the health ministry's fortification programme has increased from $1.25 million to $2.1m, according to the state-run news agency Petra.
Adel Belbeisi, the director of the primary health care directorate at the health ministry, said the ministry is also finalising another study in co-operation with the Globe Alliance for Improved Nutrition and Unicef targeting children less than five years old and women to determine vitamin D deficiency. "Once we finish taking the blood samples from these groups we will use the study as a baseline to gauge the improvement," Dr Belbeisi said.
Ninety per cent of a person's daily requirement of vitamin D comes from sun exposure but lifestyle and traditional clothing in parts of the Arab world mean people do not get enough sunlight. Patients suffering from the deficiency exhibit symptoms such as muscle aches, back pain, fatigue and susceptibility to fractures. email@example.com