Jordan is experiencing a rapid nutritional shift, from undernourishment to an increase in overweight, obesity and diet-related non-communicable diseases, while micronutrient deficiencies have persisted for many years.
To understand the severity of these micronutrient deficiencies, a UNICEF-funded study in Jordan compared results from the 2019 Jordan National Micronutrient and Nutrition Survey (JNMNS) with those from a survey conducted in 2010.
The JNMNS 2019 was a nationwide cross-sectional survey structured in four strata and included 1,296 eligible preschool children.
The prevalence of anaemia in this age group decreased by 5-6% between 2010 and 2019, while the prevalence of iron deficiency increased by 7%, with iron deficiency anaemia (IDA) remaining almost unchanged.
While severe anemia was rare, the JNMNS 2019 findings revealed that 11% of preschool children aged 12-59 months were anemic and 22.4% were iron deficient, of which 5% had iron deficiency anemia.
Of particular note was the significantly higher prevalence of anemia among boys and infants aged 6–11 months.
Additionally, vitamin D deficiency increased in 2019, with almost two-thirds of children having insufficient vitamin D.
Not only does the prevalence of vitamin D deficiency increase with age, but gender disparities are also observed, with a higher proportion of girls experiencing vitamin D deficiency than boys.
Meanwhile, the prevalence of vitamin A deficiency has decreased: about 4-8% of preschool children were identified as having vitamin A deficiency, which is considered a minor public health concern based on WHO criteria.
Stunting and wasting improved, but rates of childhood overweight and obesity remained stable.
The prevalence of overweight among children under 5 years of age was higher in boys (11.7%) than girls (6.7%), in urban and rural areas (10% vs. 5.2%), and among wealthy families (14.2% in the richest income quintile vs. 4.8% in the poorest income quintile).
“Iron deficiency poses risks to cognitive development, while vitamin D deficiency affects growth and immunity. Although rates of malnutrition are low, the persistent problems of vitamin D and iron deficiency, as well as childhood obesity, require continued attention and targeted interventions to improve the health of Jordanian children.”
“Our research aims to align with global goals 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, our findings will directly contribute to global efforts to improve nutrition and food security.” The authors write:
The need for multi-sectoral collaboration
The Jordanian Ministry of Health has implemented a country-wide salt iodization program to combat the burden of micronutrient deficiencies since 1996. A survey conducted in 2010 showed significant improvements in iodine nutrition among school-age children.
Furthermore, the reduction in overall and severe anemia observed in this study can be partially attributed to the National Wheat Flour Fortification Programme introduced in 2002.
As part of this program, wheat flour was fortified with iron and folic acid, and later on also included zinc, vitamin A, the B vitamins (B1, B2, B3, B12) and vitamin D.
However, Jordan’s nutritional problems are hampered by low rates of exclusive breastfeeding and “alarming levels” of low birth weight.
The COVID-19 pandemic and ongoing geopolitical turmoil around the world have led to rising food prices, affecting the country’s food security and nutritional status of its people.
“There is a huge opportunity to improve the health and living standards of Jordanians and the large number of refugees they host in the country. Our research highlights the importance of addressing local nutrition issues and informing policy interventions.”
For example, vitamin D deficiency remains a concern, indicating the need to encourage sunlight exposure and consider increasing levels of vitamin D3 in fortification of wheat flour.
“Implementing the National Nutrition Strategy using a multi-sectoral approach through collaboration with key stakeholders is expected to yield more effective results and outcomes.
“It is also important that strategies to improve child nutrition also incorporate parent education, so that parents have the knowledge and tools they need to make informed decisions about their children’s diet and health.”
Source: Frontiers in Nutrition
https://doi.org/10.3389/fnut.2024.1423904
“Assessment of micronutrients and nutritional status of preschool children in Jordan: Results of a national survey.”
Author: Rawhieh Barham et al.
