Using Reference Nutrient Density Goals with Food Balance Sheet Data to Identify Likely Micronutrient Deficits for Fortification Planning in Countries in the Western Pacific Region

Background Collection of nationwide food consumption data at the individual level is the preferred option for planning fortification programs. However, such data are seldom collected in low-income countries. In con- trast, Food Balance Sheets (FBS), published annually for approximately 180 countries, may provide a source of national data for program planning. Objective To explore the use of micronutrient densi- ties from FBS data to identify likely deficits for eight micronutrients in national diets. Methods Micronutrient densities in the daily avail- able food supply per capita were calculated from the micronutrient contents of 95 food commodities in 17 Western Pacific Region countries. Densities were com- pared with reference nutrient density goals developed to ensure that at least 95% of individuals, irrespective of life-stage group, are likely to have adequate intakes. Results Of the eight micronutrients, Cambodia and Korea D.P.R. had likely deficits for six; China, Fiji, Kiri- bati, Korea Republic, Lao P.D.R., Philippines, Solomon Islands, Vanuatu, and Viet Nam had likely deficits for five; Brunei Darussalam, Malaysia, Mongolia, New Zealand, and Papua New Guinea had likely deficits for four; and New Caledonia had likely deficits for three. The most frequent deficits were for iron, zinc, and calcium (all countries), followed by vitamin B2 and vitamin A (n = 13), vitamin B1 (n = 2), and vitamin B12 (n = 1). Conclusions The nutrient density approach could be applied to FBS data for ranking countries according to likely micronutrient deficits, but it provides no information on distribution of nutrient supply for fortification program planning. The approach described here could be applied to data from Household Consumption and Expenditures Surveys (HCES) to characterize households at greatest risk.