Iron biofortified beans and
carotenoid enriched cassava are proposed as a
solution to combat
iron and
vitamin A deficiencies, respectively, in the Democratic Republic of Congo (DRC). To inform the need for biofortified foods, we conducted a survey in 2014 in two provinces of the DRC, South Kivu and Kongo Central. Unexpectedly, women of reproductive age (WRA; 15-49 y) and their children (6-59 m) had a low prevalence of biochemical
iron and
vitamin A deficiency, based on
ferritin and
retinol binding protein, respectively. To better understand the lack of biochemical deficiency of these nutrients, we examined the prevalence of inadequate intake for these and other select nutrients. Dietary intake was assessed using 24-hour recalls among 744 mother-child dyads. Repeat recalls on a non-consecutive day were conducted with a subsample of the study population to account for intra-individual variation and estimate usual intake. In WRA, the prevalence of inadequate
iron intakes were 33% and 29% in South Kivu and Kongo Central, respecitvely. The prevalence of inadequate
vitamin A intakes among WRA was low in South Kivu (18%) and negligible in Kongo Central (1%).
Iron inadequacy was highest in infants (6-11 m) at 82% and 64% in South Kivu and Kongo Central, respectively. Among older children (12-59 m) in both provinces, the prevalence of
iron inadequacy was similar at ~20%. There was a high prevalence of inadequate
zinc intake in women and children (i.e. 79-86% among WRA and 56-91% among children 6-59 m) consistent with our findings of a high prevalence of low serum
zinc in the same sample. Dietary data here corroborate the low prevalence of biochemical
vitamin A deficiency but not
iron. However, any change to the supply of red
palm oil (primary source of
vitamin A) would dramatically reduce population
vitamin A intakes, thus a
carotenoid enriched cassava program may be beneficial as a safety net measure. Crops biofortified with
zinc also appear warranted. We caution that our findings cannot be extrapolated to the entire Congo where diverse agro-ecological landscape exist or when political and environmental shocks occur which challenge food production.