Purpose of the manual
Deficiencies of iron and zinc are a widespread public health concern. Dietary inadequacies of these two micronutrients are likely to occur in developing countries where staple diets are predominantly plant-based, and consumption of animal protein foods such as red meat, poultry, and fish is often small because of economic, cultural and religious constraints. As a result the amount of iron and zinc available for absorption from such diets is often low. This manual has been written as a tool for collecting, analyzing, and interpreting dietary data on intakes of iron and zinc. Such data are essential for identifying groups at high risk of dietary inadequacies of iron and zinc and for implementing intervention programs for combating deficiencies of these micronutrients and evaluating their effectiveness.
A simplified semi-quantitative dietary method has been developed by the International Vitamin A Consultative Group and by Helen Keller International to identify groups at risk for suboptimal intake and thus deficiency of vitamin A. However, this method is not appropriate for assessing intakes of iron and zinc and evaluating their adequacy in relation to nutrient reference levels. To accomplish these objectives, a quantitative dietary method must be used that has the ability to measure actual or usual intakes of iron and zinc at an individual or group level, and intakes of dietary modifiers known to influence the bioavailability of these micronutrients must also be measured. This manual contains practical guidelines and procedures for carrying out an interactive 24-hour recall method that has been especially modified to collect such information on rural populations in developing countries. Recall data collected for 1 day for each individual can be used for assessing or comparing average intakes of iron and zinc for one or more groups. Alternatively, recall data collected for 2 or more days on at least a sub-sample of individuals can be used to determine the proportion of the population at risk to inadequate intakes of iron and zinc, and to examine associations between dietary and other variables measured on the same individuals.