Launch Ceremony of The BiZiFED Project: Biofortified Wheat Flour to Eliminate Zinc and Iron Deficiency in Pakistan

Dietary zinc deficiency is a global public health problem, affecting 17% of the world’s population, with the greatest burden in low and middle-income countries. The most recent national nutrition survey in Pakistan indicated that over 40% of women were zinc deficient1. The health consequences of zinc deficiency include stunted growth and impaired neurodevelopment in children, increased susceptibility to infections in children and adults, and complications during pregnancy and childbirth2. It is imperative for global health and prosperity that sustainable, cost-effective solutions to zinc deficiency are found.

The BiZiFED project aims to investigate traditional crop breeding techniques, coupled with the application of nutrient rich fertilizer to enrich wheat with essential nutrients such as zinc and iron, known as “Biofortification”. The outcomes of this research will provide valuable evidence for policy makers in Pakistan to guide decisions regarding the scaling up of biofortification on a national level.

BiZiFED is an interdisciplinary and collaborative project, including international experts in agriculture and food systems, human nutrition and social sciences from Pakistan and the UK from the Lead institution University of Central Lancashire (UCLan) and collaborative partners Abaseen Foundation, Khyber Medical University (KMU); Fauji Fertilizer Company (FFC); University of Nottingham (UoN); London School of Hygiene & Tropical Medicine (LSHTM); King’s College London (KCL); and the British Geological Survey (BGS). The BiZiFED project is supported by the Biotechnology and Biological Sciences Research Council (BBSRC) within the Global Challenges Research Fund (GCRF).

GCRF is a £1.5 billion funding stream for challenge-led research from the UK Government Official Development Assistance (ODA) budget.

Factors affecting the reach of biofortified wheat in Pakistan

The prevalence of zinc deficiency is greatest in poor and marginalised populations. These same populations are likely to grow or purchase wheat that is processed into flour at small-scale, local mills (known as chakkis). Up to 65% of wheat is processed at chakkis in Pakistan.

Through our stakeholder engagement activities, we developed an infographic to illustrate the wheat system in Pakistan. Biofortifed wheat seed can be distributed to local subsistence farmers, as well as large commercial farmers, so that even the remotest rural communities can benefit. Thus, biofortification may be an equitable approach to alleviating zinc deficiency.

We identified risks and opportunties pertinent to the production, processing, sale and consumption of biofortified wheat in Pakistan (Fig 1). These include issues around crop yield, support for farmers, national pricing and subsidies, quality control and consumer awareness.

Nutritional impact

It is essential that we understand the impact of consuming biofortified flour on dietary zinc intake, zinc status in the human body and health outcomes. In 2017-18, we conducted a double-blind, randomised controlled trial (RCT) to examine the effect of consuming flour made from a high zinc variety of biofortified wheat (Zincol-2016/NR-421) on dietary zinc intake and status4. This community-based trial was designed to provide ‘real-world’ evidence on the effectiveness of biofortification as a strategy to reduce zinc deficiency.

The trial was conducted in a rural brick kiln community in Peshawar District, Khyber Pakhtunkhwa Province, North West Pakistan. Baseline dietary assessment confirmed that the diet is based on vegetables and unrefined cereal grains, with low intake of animal protein2. Analysis of 24 hour recall data revealed that 80% of participants failed to meet the dietary zinc recommendations for high phytate diets (IZiNCG2) and average plasma zinc concentration was below the healthy range.

Cost effectiveness

This aspect of our work builds on previous studies, which showed that zinc fertilisation can increase yield and enhance zinc concentration in the edible part of the wheat grain5 6. The BiZiFED project will determine the value of adding zinc fertilisers to wheat production in Pakistan, both in terms of yield and potential health benefits. This is important because the plant-available zinc concentration of most soils in Pakistan is very low compared to other parts of the world.

The agronomy surveys at 720 locations and 2880 sites of 36 Districts of Punjab KP will provide information on the performance of biofortified wheat on different soils and with different fertiliser management.

Stakeholder acceptance

The impact of biofortification is contingent on uptake, which in turn is dependent on the socio-cultural acceptability of biofortified wheat. In 2018, we used mixed methods to explore the views and perspectives of local stakeholders on biofortified wheat and flour.

This is the first study to explore the socio-cultural acceptability of biofortification in Pakistan. The findings will improve our understanding of factors that are likely to affect the sustainable uptake of biofortified wheat.