Biofortification with Zinc and Iron for Eliminating Deficiency in Pakistan (BiZIFED2)

Lead Research Organisation: University of Central Lancashire
Department Name: Sch of Sport and Health Sciences

Abstract

Zinc and iron deficiencies are a global public health problem, with the greatest burden occurring in low and middle-income countries. In Pakistan, over 40% of women are zinc deficient and over 20% have iron deficiency anaemia. These micronutrient deficiencies have negative consequences for maternal and child health, and it is imperative that sustainable and cost-effective solutions are found.

The project will investigate the potential of biofortification to reduce zinc and iron deficiencies in Pakistan. Biofortification is a process by which the nutritional quality of food crops is improved through conventional plant breeding techniques and addition of nutrient-rich fertilisers. HarvestPlus has developed a variety of wheat with significantly greater zinc and iron concentrations, compared to standard varieties. Wheat is the staple crop in Pakistan and most families consume chapatis (made from wheat flour) with every meal. Therefore, we believe that biofortified flour may benefit communities who cannot afford to consume a diverse range of foods.

The project has three main components, to be delivered over two years. The first component is a randomised controlled trial effectiveness study, to assess the impact of consuming biofortified flour on zinc and iron status. The participants will be 500 adolescent girls (aged 10-16 years) and 500 children (aged 1-5 years) living in a low-resource community in North West Pakistan. In phase 1 (months 1-6), the participants and their families will consume their usual locally purchased flour. The cost of the flour will be reimbursed as an incentive to participate in the study. In phase 2 (months 7-12), they will consume either biofortified flour (intervention group) or standard flour (control group), both of which will be grown locally. The participants will be randomly allocated to the intervention or control group and they will not know which flour they are consuming (nor will the research team). A range of biochemical measures will be taken to assess the impact of consuming biofortified flour on zinc and iron status. We will also record the incidence of diarrhoea and upper respiratory tract infections (in children), which are known to be associated with zinc deficiency.

The second component focuses on understanding wheat growing conditions in Pakistan, and supporting farmers to improve the yield and grain quality of biofortified wheat. Variations in soil fertility and grain quality will be mapped across Punjab Province, where 80% of Pakistan's wheat is grown. Computer modelling techniques will be used to predict which soil properties (e.g. soil organic matter, fertility) and management options would lead to optimal zinc concentrations in the wheat grain. Cost-benefit analyses will be conducted for different scenarios, such as standard vs. biofortified wheat, addition of zinc fertilisers, improved soil organic inputs etc.

The third component focuses on promoting the sustainable production and consumption of biofortified wheat in Pakistan. Mixed methods will be used to explore the views and perspectives of farmers (wheat producers) and community members (wheat flour consumers) to understand what factors influence their decisions to adopt biofortified wheat or not. Participants will be recruited from marginalised communities, who often have the poorest diets and may not access other types of nutrition interventions such as centralised flour fortification. The wheat market system in Pakistan will be mapped through consultations with a range of stakeholders. This information will be used to develop and pilot interventions to promote the sustainable production and consumption of biofortified wheat.

As well as intensive communication activities with farmers and consumer, findings will be disseminated to researchers, policy makers, donors, world-wide, through a comprehensive Pathways-to-Impact activities.

Technical Summary

The overall aim of BiZiFED2 is to investigate the potential of biofortification as a strategy to reduce zinc and iron deficiencies in Pakistan. Three main objectives, corresponding to three Work Packages (WPs) are summarised below:

Obj. 1. To determine the potential for biofortified wheat to improve zinc and iron status among adolescent girls and children, living in a low resource community in Khyber Pakhtunkhwa Province (KPK) Province, Pakistan.

Obj. 2. To quantify spatial variation in grain and soil zinc status across Punjab Province, Pakistan, to enable ex-ante evaluations of farmer crop and soil management options to improve grain quality.

Obj. 3. To improve understanding of the socio-cultural factors and market systems that affect the sustainable uptake of biofortified wheat in Pakistan.

WP1: A trial effectiveness study (double-blind, randomised controlled trial) will be conducted to assess the impact of consuming biofortified flour on zinc and iron status among 500 adolescent girls (aged 10-16 years) and 500 children (aged 1-5 years) in a low-resource community in NW Pakistan.

WP2: Spatial variation in wheat grain and soil zinc status will be mapped using data across Punjab Province, where 80% of Pakistan's wheat is grown. Geospatial modelling will be used to predict which soil properties and farm management practices would lead to optimal zinc concentrations in the wheat grain, and determine cost-benefit (and uncertainties) at provincial, district and farm scales.

WP3: Mixed methods will be used to explore the views and perspectives of farmers (wheat producers) and community members (flour consumers) to understand what factors influence their decisions around adoption of biofortified wheat. The wheat market system in Pakistan will be mapped through consultations with a range of stakeholders to develop and pilot interventions to promote the sustainable production and consumption of biofortified wheat.

Planned Impact

Our goal is to reduce the prevalence of zinc and iron deficiencies in Pakistan by delivering evidence on: (1) the effectiveness of a new variety of biofortified wheat to increase individual zinc and iron status; (2) optimal strategies for crop and soil management to optimise wheat grain quality; (3) sustainable production and consumption of biofortified wheat in Pakistan.

The interdisciplinary nature of this research means that the results will be relevant to a very broad community, with whom we will interact. The team already has a diverse involvement in a range of professional and informal networks, also with policy/donor groups, and with academic networks at national and international level. The team is therefore credible to engage with effective knowledge exchange across a wide range of scales and across subject disciplines.

Communities in Pakistan where zinc and iron deficiencies are prevalent will benefit from this research. The project will provide data that will contribute to the evidence base for the potential impact of biofortification of a staple crop to alleviate zinc and iron deficiencies among the poorest communities. An integral part of this research is dialogue with community members, leaders and farmers regarding their views about biofortification. The outcomes of this study will be disseminated to communities via culturally appropriate mechanisms, such as committees of village elders (Jirga).

Industrial partners will benefit from this project through the opportunity to promote a range of crop and soil management options, during engagement with farmers involved in soil and crop sampling activities and dissemination of seed. Such activities can help to inform product development and marketing.

As zinc and iron deficiencies are common in low and middle-income countries, particularly in Sub-Saharan Africa and South Asia, the findings of the research will be applicable more widely to other countries on the Development Assistance Committee (DAC) List of ODA Recipients. Team members with on-going activities in these areas will ensure these linkages are followed for greatest impact.

Policy makers and non-profit organisations engaged in finding sustainable solutions to micronutrient deficiencies will benefit from the data and knowledge generated during this research, in particular, they will be informed by ex ante evaluations of farmer management options in terms of adoption of new crop varieties and soil management options.

Researchers within the team delivering this project will benefit from this research through training and capacity strengthening. Knowledge exchange between researchers from the Pakistan and UK teams will be encouraged and facilitated.

Publications

10 25 50

publication icon
Zaman M (2020) Equitable partnerships in global health research in Nature Food

publication icon
Brazier A (2022) Food insecurity: the adolescent experience in rural Pakistan in Proceedings of the Nutrition Society

publication icon
Lowe NM (2021) The global challenge of hidden hunger: perspectives from the field. in The Proceedings of the Nutrition Society

 
Title Research Partnerships to address hidden hunger in Pakistan 
Description This is a short film that describes the BIZIFED study and highlights the importance of equitable partnerships. The film describes the rational for the research and the science behind the study in lay-language. 
Type Of Art Film/Video/Animation 
Year Produced 2021 
Impact The short film has just been released (January 2021) therefore no notable impacts to date. The purpose of the film is to convey the message of equitable partnerships in action, and the rationale for our research, in a way that is accessible to a lay audience. The film can be located here : https://youtu.be/Z-8O2vVwN9U 
 
Description Zinc-biofortified flour may be a cost-effective approach to improve zinc status of populations in low-resource settings. The success of biofortification programmes is subject to acceptability and uptake by consumers. This study explored community leaders' and community members' (n = 72) experiences and attitudes towards the flour provided during a cluster randomised controlled trial of zinc biofortified wheat in rural Pakistan (BiZiFED2). Focus group discussions (n = 12) were conducted and thematic analysis applied using an inductive, semantic, contextualist approach. Five themes were identified: (1) Contribution to food security; (2) Better sensory and baking properties than local flour; (3) Perceived health benefits; (4) Willingness to pay for the flour; and (5) Importance of trusted promoters/suppliers. Although the participants were blind to whether they had received control or biofortified flour, referred to collectively as "study flour", the results indicated that the study flour performed well in terms of its taste and bread making qualities, with no adverse reports from participants in either arm of the BIZIFED2 RCT. Participants suggested that they would buy the biofortified wheat if this was available at a fair price due to perceived health benefits, reporting positive sensory characteristics and cooking attributes when compared to the flour available in the local markets. Overall, there was a positive reception of the programme and flour among the participants, and members of the community hoped for its continuation and expansion.
We have analysed the quantitative data regarding the impact of consuming zinc-biofortified flour on health outcomes such as mineral status. Consumption of zinc-biofortified flour increased zinc intake by about 21% but was not associated with an increase in zinc status assessed by plasma zinc. However, plasma zinc has the limitation of not being sensitive to respond to a small change in zinc intake. Other potentially sensitive biomarkers were tested and we are analyzing these. Preliminary analysis suggests that hair zinc appears to pick up such a modest improvement in zinc intakes via biofortification in our study. Consumption of the biofortified zinc variety leads to an overall reduction in the rate of storage iron deficiency in adolescent girls. Currently, we are analyzing the sickness-related data, and anthropometry for adolescents and children. Also the performance of the biofortified wheat variety (Zincol-2016) under different soil conditions and agronomic practices in Pakistan. This work is still in progress.
Exploitation Route Analysis of data from the Randomised Controlled trial is still underway. However, early findings indicate a positive health benefit of consuming zinc biofortified wheat in the study community in rural Pakistan. The findings, once finalised, will be useful for policy makers to inform the scale up of the release of biofortified wheat varieties in Pakistan.
Sectors Agriculture, Food and Drink

URL https://www.uclan.ac.uk/research/activity/bizifed
 
Description BIZIFED2 is the first large-scale investigation into the potential of biofortified wheat to reduce zinc and iron deficiencies among adolescent girls and children in Pakistan. Therefore, this research has direct relevance to Sustainable Development Goal 2: End hunger, achieve food security and improved nutrition and promote sustainable agriculture. The findings will be applicable more widely to other countries on the Development Assistance Committee (DAC) list countries where zinc deficiency is common, particularly in Sub-Saharan Africa and South Asia. Team members with on-going activities in these areas will ensure these linkages are followed for greatest impact. Gender is a central consideration in this project because zinc and iron deficiencies have negative long-term consequences for health, particularly among women of reproductive age (WRA), adolescent girls and children. In Pakistan, the National Nutrition Survey in 2018 indicated that 22.1% of WRA and 18.6% of children under 5 were zinc deficient; likewise, 18.2% of WRA and 28.6% of children under 5 had Iron Deficiency Anaemia (Government of Pakistan and UNICEF 2019). The prevalence of zinc and iron deficiencies is likely to be even higher in low-resource, rural communities where diets are dominated by plant-source foods (with lower concentrations and bioavailability of these micronutrients). Based on our present study, rates of zinc deficiency are as high as 69% among the adolescent girls in these marginalized communities. The primary study participants in our randomised controlled trial are adolescent girls (aged 10-16 years) because this is a critical time in the life-course to influence maternal and neonatal outcomes, and the health of future generations. Benefits for research participants included free four provided to 500 households for 16 months during the RCT (economic benefit). The wider community including non-participants has benefited from the improvement of local health facilities, increased awareness of nutritional deficiencies, and employment of local staff (including specific roles for women in our research team). This project has led to awareness about biofortification among local consumers and producers, as well as an appreciation of the health benefits to the community from increasing zinc intake through biofortification. Consequently, this has led to demand for growing and purchasing biofortified flour within the study area. In fact, our survey suggests that seeds from the biofortified Zincol-2016 harvest are being preserved by the farmers to be used for sowing in the next season thus generating a possible momentum for the production and uptake of zinc biofortified crops. During the last community meeting of the implementation lead Prof. Zaman to thank the communities for their cooperation, a community representative requested to take steps to ensure the supply of this flour for available in the local market. Abaseen Foundation (collaborating non-profit organization with a trusted relationship with the community) is planning to facilitate the setting up of local mills to continue with the production of such flour within the community.
First Year Of Impact 2019
Sector Agriculture, Food and Drink,Healthcare
Impact Types Cultural,Societal,Economic

 
Description GCRF_NF225 - Improving community engagement with COVID-19 public health messages in hard to reach communities
Amount £239,298 (GBP)
Funding ID EP/V04320X/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 10/2020 
End 04/2022
 
Description BIZIFED2 collaborators and partners 
Organisation British Geological Survey
Country United Kingdom 
Sector Academic/University 
PI Contribution UCLan's contributions include research management, knowledge and expertise, data management, data analysis, capacity building.
Collaborator Contribution The project partners listed above have contributed in many ways to the ongoing success of this project, including knowledge and expertise, development and distribution of seed, development of zinc fertilizers, management of field experiments, stakeholder engagement, community engagement, participant recruitment and retention, data collection, laboratory facilities, data entry, capacity building. For example, Fauji Fertilizer Company has recently trained 50 Field Assistants, who will engage with and collect data from over 2,800 farmers in Punjab Province. This partnership is essential to the success of Work Package 2.
Impact Multidisciplinary collaborations across the academic fields of human nutrition, plant nutrition, soil science, agriculture, geology and social sciences. Private sector and charity sector implementation partners in Pakistan.
Start Year 2019
 
Description BIZIFED2 collaborators and partners 
Organisation Fauji Fertilizer Company
Country Pakistan 
Sector Private 
PI Contribution UCLan's contributions include research management, knowledge and expertise, data management, data analysis, capacity building.
Collaborator Contribution The project partners listed above have contributed in many ways to the ongoing success of this project, including knowledge and expertise, development and distribution of seed, development of zinc fertilizers, management of field experiments, stakeholder engagement, community engagement, participant recruitment and retention, data collection, laboratory facilities, data entry, capacity building. For example, Fauji Fertilizer Company has recently trained 50 Field Assistants, who will engage with and collect data from over 2,800 farmers in Punjab Province. This partnership is essential to the success of Work Package 2.
Impact Multidisciplinary collaborations across the academic fields of human nutrition, plant nutrition, soil science, agriculture, geology and social sciences. Private sector and charity sector implementation partners in Pakistan.
Start Year 2019
 
Description BIZIFED2 collaborators and partners 
Organisation Khyber Medical University
Country Pakistan 
Sector Hospitals 
PI Contribution UCLan's contributions include research management, knowledge and expertise, data management, data analysis, capacity building.
Collaborator Contribution The project partners listed above have contributed in many ways to the ongoing success of this project, including knowledge and expertise, development and distribution of seed, development of zinc fertilizers, management of field experiments, stakeholder engagement, community engagement, participant recruitment and retention, data collection, laboratory facilities, data entry, capacity building. For example, Fauji Fertilizer Company has recently trained 50 Field Assistants, who will engage with and collect data from over 2,800 farmers in Punjab Province. This partnership is essential to the success of Work Package 2.
Impact Multidisciplinary collaborations across the academic fields of human nutrition, plant nutrition, soil science, agriculture, geology and social sciences. Private sector and charity sector implementation partners in Pakistan.
Start Year 2019
 
Description BIZIFED2 collaborators and partners 
Organisation King's College London
Country United Kingdom 
Sector Academic/University 
PI Contribution UCLan's contributions include research management, knowledge and expertise, data management, data analysis, capacity building.
Collaborator Contribution The project partners listed above have contributed in many ways to the ongoing success of this project, including knowledge and expertise, development and distribution of seed, development of zinc fertilizers, management of field experiments, stakeholder engagement, community engagement, participant recruitment and retention, data collection, laboratory facilities, data entry, capacity building. For example, Fauji Fertilizer Company has recently trained 50 Field Assistants, who will engage with and collect data from over 2,800 farmers in Punjab Province. This partnership is essential to the success of Work Package 2.
Impact Multidisciplinary collaborations across the academic fields of human nutrition, plant nutrition, soil science, agriculture, geology and social sciences. Private sector and charity sector implementation partners in Pakistan.
Start Year 2019
 
Description BIZIFED2 collaborators and partners 
Organisation London School of Hygiene and Tropical Medicine (LSHTM)
Country United Kingdom 
Sector Academic/University 
PI Contribution UCLan's contributions include research management, knowledge and expertise, data management, data analysis, capacity building.
Collaborator Contribution The project partners listed above have contributed in many ways to the ongoing success of this project, including knowledge and expertise, development and distribution of seed, development of zinc fertilizers, management of field experiments, stakeholder engagement, community engagement, participant recruitment and retention, data collection, laboratory facilities, data entry, capacity building. For example, Fauji Fertilizer Company has recently trained 50 Field Assistants, who will engage with and collect data from over 2,800 farmers in Punjab Province. This partnership is essential to the success of Work Package 2.
Impact Multidisciplinary collaborations across the academic fields of human nutrition, plant nutrition, soil science, agriculture, geology and social sciences. Private sector and charity sector implementation partners in Pakistan.
Start Year 2019
 
Description BIZIFED2 collaborators and partners 
Organisation The Abaseen Foundation U.K.
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution UCLan's contributions include research management, knowledge and expertise, data management, data analysis, capacity building.
Collaborator Contribution The project partners listed above have contributed in many ways to the ongoing success of this project, including knowledge and expertise, development and distribution of seed, development of zinc fertilizers, management of field experiments, stakeholder engagement, community engagement, participant recruitment and retention, data collection, laboratory facilities, data entry, capacity building. For example, Fauji Fertilizer Company has recently trained 50 Field Assistants, who will engage with and collect data from over 2,800 farmers in Punjab Province. This partnership is essential to the success of Work Package 2.
Impact Multidisciplinary collaborations across the academic fields of human nutrition, plant nutrition, soil science, agriculture, geology and social sciences. Private sector and charity sector implementation partners in Pakistan.
Start Year 2019
 
Description BIZIFED2 collaborators and partners 
Organisation University of Nottingham
Country United Kingdom 
Sector Academic/University 
PI Contribution UCLan's contributions include research management, knowledge and expertise, data management, data analysis, capacity building.
Collaborator Contribution The project partners listed above have contributed in many ways to the ongoing success of this project, including knowledge and expertise, development and distribution of seed, development of zinc fertilizers, management of field experiments, stakeholder engagement, community engagement, participant recruitment and retention, data collection, laboratory facilities, data entry, capacity building. For example, Fauji Fertilizer Company has recently trained 50 Field Assistants, who will engage with and collect data from over 2,800 farmers in Punjab Province. This partnership is essential to the success of Work Package 2.
Impact Multidisciplinary collaborations across the academic fields of human nutrition, plant nutrition, soil science, agriculture, geology and social sciences. Private sector and charity sector implementation partners in Pakistan.
Start Year 2019
 
Description Novel biomarker of zinc status: DNA damage analysis by comet assay 
Organisation University of Peshawar
Country Pakistan 
Sector Academic/University 
PI Contribution Blood samples were provided to the University of Peshawar within the context of an MTA detailing the analyses to be undertaken and remuneration for completion of these analyses.
Collaborator Contribution Colleagues at the University of Peshawar, who are experienced in undertaking the comet assay (a measure of DNA damage) performed the analyses in accordance with the MTA.
Impact The sample analyses are complete. The collaboration will result in a conference presentation, and full peer reviewed publication by the end of 2022.
Start Year 2021
 
Description Novel biomarker of zinc status: Lipid profile 
Organisation University of California, Davis
Department Department of Nutrition
Country United States 
Sector Academic/University 
PI Contribution The collaboration with UCD was within the context of an MTA detailing the analyses to be undertaken by UCD and the remuneration for this. My research team provided the blood samples collected during the BIZIFED2 RCT for lipid profile analysis at UCD
Collaborator Contribution Our partners provided the technical and academic expertise in fatty acid metabolism and lipid analysis of the samples, with statistical analysis of the findings
Impact The analyses are ongoing. The collaboration is multi-disciplinary including experts in biochemistry (lipid metabolism), nutrition and statistics. It is expected that this collaboration will result in a conference abstract and presentation, and full peer reviewed publication.
Start Year 2021
 
Description Novel biomarker of zinc status: hair analysis by XRF 
Organisation Mount Allison University
Country Canada 
Sector Academic/University 
PI Contribution This collaboration was initiated within the context of the BIZIFED2 grant to explore new biomarkers of zinc status, which was one of the overarching objectives of the programme. The collaboration held within a Material Transfer Agreement and financial agreement to cover the costs of the analyses by a novel X-Ray fluorescence technique in two laboratories (MTA and NeurobioTex) and by a standard reference method at Yale. Hair samples collected within the BIZIFED2 RCT were provided by my research team.
Collaborator Contribution NeurobioTex. MTA and Yale analysed the hair samples according to the agreed MTA. NeurobioTex performed additional analyses as an "in kind" contribution.
Impact This is a multi-disciplinary collaboration. Disciplines involved include: Nutrition, Analytical Chemistry, Medical and Biological Physics. The analyses are still underway. Output expected are a conference abstract and presentation in June 2022, with a full paper to follow by the end of 2022.
Start Year 2021
 
Description Novel biomarker of zinc status: hair analysis by XRF 
Organisation NeuroBioTex
Country United States 
Sector Private 
PI Contribution This collaboration was initiated within the context of the BIZIFED2 grant to explore new biomarkers of zinc status, which was one of the overarching objectives of the programme. The collaboration held within a Material Transfer Agreement and financial agreement to cover the costs of the analyses by a novel X-Ray fluorescence technique in two laboratories (MTA and NeurobioTex) and by a standard reference method at Yale. Hair samples collected within the BIZIFED2 RCT were provided by my research team.
Collaborator Contribution NeurobioTex. MTA and Yale analysed the hair samples according to the agreed MTA. NeurobioTex performed additional analyses as an "in kind" contribution.
Impact This is a multi-disciplinary collaboration. Disciplines involved include: Nutrition, Analytical Chemistry, Medical and Biological Physics. The analyses are still underway. Output expected are a conference abstract and presentation in June 2022, with a full paper to follow by the end of 2022.
Start Year 2021
 
Description Novel biomarker of zinc status: hair analysis by XRF 
Organisation Yale University
Country United States 
Sector Academic/University 
PI Contribution This collaboration was initiated within the context of the BIZIFED2 grant to explore new biomarkers of zinc status, which was one of the overarching objectives of the programme. The collaboration held within a Material Transfer Agreement and financial agreement to cover the costs of the analyses by a novel X-Ray fluorescence technique in two laboratories (MTA and NeurobioTex) and by a standard reference method at Yale. Hair samples collected within the BIZIFED2 RCT were provided by my research team.
Collaborator Contribution NeurobioTex. MTA and Yale analysed the hair samples according to the agreed MTA. NeurobioTex performed additional analyses as an "in kind" contribution.
Impact This is a multi-disciplinary collaboration. Disciplines involved include: Nutrition, Analytical Chemistry, Medical and Biological Physics. The analyses are still underway. Output expected are a conference abstract and presentation in June 2022, with a full paper to follow by the end of 2022.
Start Year 2021
 
Description A harvest to reduce zinc and iron deficiencies in people -June 2020 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact This was done to create a wider awareness and dissemination of our research project
Year(s) Of Engagement Activity 2020
URL https://www.uclan.ac.uk/articles/research/a-harvest-to-reduce-zinc-and-iron-deficiencies-in-people
 
Description BIZIFED2 update from Pakistan - October 2019 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Wider dissemination and awareness of our research project.
Year(s) Of Engagement Activity 2019
URL https://www.uclan.ac.uk/research/explore/assets/images/bizifed2-blog-for-c4globe-website.pdf
 
Description BIZIFED: Biofortified Zinc and Iron Flour to Eliminate Deficiency. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Talk delivered on May 04, 2020 at Pakistan Zinc and Iodine Day organized by NIAB Faisalabad Pakistan at University of Sargodha.
Year(s) Of Engagement Activity 2020
 
Description BiZiFED2 formally comes to a close but the collaboration continues -July 2022 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Wider dissemination of our research and its progress, as well as, future plans
Year(s) Of Engagement Activity 2022
URL https://www.uclan.ac.uk/articles/research/bizifed2-comes-to-close
 
Description Conference Plenary Lecture 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Prof Lowe was invited to give a plenary lecture at the Nutrition Society Winter Conference. The lecture was entitled: The Global Challenge of Hidden Hunger: Perspectives from the Field". The presentation was followed by a panel discussion and Q and A from the audience. The lecture lead to 2 further invitations to give research seminars at UK Universities.
Year(s) Of Engagement Activity 2020
URL https://www.nutritionsociety.org/events/winter-conference-live-2020
 
Description Consultation workshop 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Prof Nicola Lowe and Prof Martin Broadley participated in a series of 3 consultation workshops, facilitated by HarvestPlus, attended by experts. The purpose was to discuss the potential for Zinc biofortified wheat to impact on chronic disease, and to reach a consensus regarding the next steps towards an effectiveness study.
Year(s) Of Engagement Activity 2020
URL https://www.harvestplus.org/knowledge-market/in-the-news/experts-agree-zinc-biofortification-holds-p...
 
Description Forum for Global Challenges, Presentation title: 'Improving Nutrition in Food Supply Chains' May 3rd-5th. University of Birmingham 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact 851 delegates
The intended outcomes of this session were as follows:
The Forum intends to further share, develop and promote solutions to global challenges after the
conference has finished. It may do that through further Forum for Global Challenges conferences,
through the Online Community but also through follow-up activity, which may include:
1. Publications: policy briefs, blog posts, magazine/newsletter articles, academic journal articles or
special issues, edited books.
2. Policy influence: identifying policy recommendations and opportunities to influence policy at the
international, national and local levels of different organisations, regions and countries.
3. Business advice: identifying best practice and sharing lessons.
4. Formation of new partnerships and networks, focused on specific issues or solutions, bringing
people/organisations together from different countries and sectors.
5. Generation of ideas for new research programmes and projects.
Year(s) Of Engagement Activity 2022
URL https://virtual.forumforglobalchallenges.com/
 
Description Guest blog for IZiNCG: BIZIFED2 - Biofortification with Zinc and Iron for Eliminating Deficiency in Pakistan 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Wider dissemination and awareness of our research project.
Year(s) Of Engagement Activity 2019
URL https://www.izincg.org/new-blog-1/2019/5/22/bizifed2-biofortification-with-zinc-and-iron-for-elimina...
 
Description HarvestPlus Sponsored Seminar at the 22nd IUNS-ICN in Tokyo, Japan: "Preventing and Controlling Zinc Deficiency Across the Life Course" 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Seminar aims: Discuss recent developments in our understanding of zinc's role in health and the impact of the changing global context on zinc intake; the measurement of zinc status; and solutions for improving population zinc intake. Spur on action towards the implementation of evidence-based interventions for preventing and controlling zinc deficiency across the life course.
Year(s) Of Engagement Activity 2022
URL https://icn22.org/
 
Description International Conference of Trace Elements and Minerals (Aachen 2022) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Dr. Swarnim Gupta presented a scientific poster (abstract details below) displaying the findings from the BiZiFED2 study which highlighted an increase in Zn intake moderately (21%) due consumption of Zn-biofortified flour increased but this was not reflected in an increase in the zinc biomarker . A large number of researchers (>100) and experts working in the area of trace mineral attended to it. There were individual discussions around the study that also continued after the presentation and several students and researcher reorganized that establishing a sensitive biomarker of Zn status is an ongoing priority to enable the impact of moderate changes in dietary Zn to be monitored .
Details: Swarnim Gupta, Shahzad B, Bailey EH, Wilson L, Broadley MR, Zaman M, Sinclair J, Fatima S, Brazier AKM, Moran VH, Lowe NM. Impact of consuming zinc-biofortified wheat flour on the trace mineral status of adolescent girls: a cluster randomized, double blind, controlled trial. International Conference of Trace Elements and Minerals held at the University Hospital Aachen, Germany from 5th - 10th June 2022.
Year(s) Of Engagement Activity 2022
URL https://www.ukaachen.de/kliniken-institute/ictem/
 
Description International Conference of Trace Elements and Minerals (ICTEM) in Aachen, GE, June 5-10, Symposium 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Lecture entitled "The response of DNA fragmentation to moderate increases in zinc intake from biofortified wheat: a cluster randomized controlled trial " The symposium lecture, given by Prof Nicola Lowe at the International Conference of Trace Elements and Minerals held in Achen, Germany 2022 was attended by about 100 participants. She presented early findings from the BiIZFED2 study regarding the DNA fragmentation, measured using the Comet assay as a biomarker of zinc status. This sparked questions and discussion afterwards.
Year(s) Of Engagement Activity 2022
URL https://www.ukaachen.de/kliniken-institute/ictem/program/
 
Description International Conference of Trace Elements and Minerals, June 2022 (virtually) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The online presentation given by Dr. Hall AG (details below) at the International Conference of Trace Elements and Minerals held in Achen, Germany 2022 was attended by about 100 participants. He presented early finding from the BiIZFED2 study that add to the evidence demonstrating the sensitivity of zinc dependent lipid metabolism products in responding to small changes in dietary zinc intake in free living community settings. This sparked questions and discussion afterwards.

Details: Hall AG, Holt RR, Swarnim Gupta, Shahzad B, and Lowe NM. Biofortification with Zinc and Iron for Eliminating Deficiency in Pakistan: Effects on Plasma Markers of Fatty Acid Metabolism.
Year(s) Of Engagement Activity 2022
URL https://www.ukaachen.de/kliniken-institute/ictem/program/
 
Description International Fertilizer Association (IFA) virtual Sustainable Fertilizer Academy (SFA) August 2022 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Prof. Martin Broadley contributed 30 minute lecture for International Fertilizer Association (IFA) virtual Sustainable Fertilizer Academy (SFA). The SFA is targeting hundreds of fertilizer professionals and external stakeholders; its educational goal is to significantly accelerate the sustainability transformation of the industry.
Year(s) Of Engagement Activity 2022
URL https://ifa-sfa.org
 
Description Lecture delivered at the Nutrition Society and the Sabri Ülker Foundation, conference on Nutrition for healthcare professionals: achieving healthcare through diet 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The lecture delivered by Prof Lowe was entitled: Hidden Hunger: Global Challenges and Novel Solutions .
The primary objective of this event was to present and discuss a range of topics aimed at inspiring healthcare professionals to better consider the role of nutrition in achieving and maintaining optimum health
The combination of UK, Turkish and other contributions provided a unique opportunity for delegates to share experiences and learn from each other
Examples of best practice were shared in a format that can be adopted by healthcare professionals in their interactions with patients and with the general public at large
Future actions were identified via round table discussions and a workshop
A summary of the proceedings has been published with a view to becoming a 'go to' reference for those seeking to underline the role of nutrition in achieving optimal health

4,200 delegates following the conference online from 62 different countries
Year(s) Of Engagement Activity 2022
URL https://www.nutritionsociety.org/events/nutrition-healthcare-professionals-achieving-healthcare-thro...
 
Description Podcast on Agronomic biofortification to overcome hidden hunger for International Fertilizer Association (IFA), April 2022 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Martin Broadley, Professor and Science Director, Rothamsted Research, UK (and Co-investigator for BiZiFED2) discussed how fertilizers can improve the micronutrient content of food crops - biofortification - and help tackle hidden hunger via this Podcase facilitated by IFA Chief Scientist Achim Dobermann to
Year(s) Of Engagement Activity 2022
URL https://www.fertilizer.org/Public/IFA_Resources/Podcasts/Podcasts.aspx
 
Description Presentation at 2nd Pakistan Nutrition and Dietetics Association Conference on Triple Burden of Malnutrition in Pakistan. Karachi, March 2022 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The invited lecture was delivered at an international conference hosted in Karachi, Pakistan. The Audience was comprised of Nutritionists, Dieticians and academic researchers in the field of nutrition, as well as policy makers. The conference was attended by approximately 200 delegates in person, with additional delegates attending online. The lecture sparked discussion about the role of biofortification in addressing micronutrient deficiencies in Pakistan and globally.
Year(s) Of Engagement Activity 2022
URL https://iuns.org/events/2nd-international-conference-of-pakistan-nutrition-and-dietetic-society-trip...
 
Description Presentation at the International Society for Trace Element Research in Humans (ISTERH) Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Prof Nicola Lowe was invited to give a presentation at the ISTERH meeting in a session on novel biomarkers, entitled "Novel approaches to Biomarkers of Zinc Status:  the BiZiFED study" The presentation sparked a lot of interest in future collaboration in with experts in the field of zinc biomarkers.
Year(s) Of Engagement Activity 2019
URL https://www.isterh2019.com/
 
Description Presentation at the Pakistan National Dietetics and Nutrition Society, first international conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Prof Nicola Lowe was invited by the Pakistan National Dietetics and Nutrition Society to give a presentation at their first international conference, to share my experience in successful grant writing, and to use the BIZIFED project as a successful case study. The presentation was entitled "What makes a successful international research grant proposal? Key principles from the UKRI Global Challenges Research Fund  ". There was a great deal of interest in this topic, and questions about the UKRI/GCRF fund. Prof Lowe was invited to do a similar presentation at the Agha Khan University in Karachi, which is the leading research University in Pakistan.
Year(s) Of Engagement Activity 2019
URL http://rdn.pnds.org/2019/05/21/first-pnds-international-conference-on-non-communicable-diseases-in-c...
 
Description Punjab province, Pakistan - farmer uptake of biofortified zinc post-experiment 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Supporters
Results and Impact Early findings from work at the intersection of WP2 (farmer field experiment/survey) and WP3 (farmer knowledge, experience, practice) was provided to international funder in this field the Bill & Melinda Gates Foundation during a small meeting: considerable interest and a request for the slide deck to be shared in confidence ahead of publication. Informing thinking around scale-up of biofortified crops and consumption by farming households.
Year(s) Of Engagement Activity 2021
 
Description Research Seminar Presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact The activity was a research seminar given by Professor Lowe during a visit to the Rehman Medical institute in (RMI) Peshawar, Pakistan. The seminar sparked questions and discussions with potential new collaborators. Since the seminar, a new research proposal has been submitted to the MRC, with a new collaborator from RMI.
Year(s) Of Engagement Activity 2020
 
Description Research Seminar Presentation 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Prof. Martin Broadley and Prof Nicola Lowe gave presentations at a GCRF/UKRI supported workshop, held in Islamabad in March 2020. The audience was made up of both UK and Pakistani based researchers, as well as senior Pakistani Ministers. The purpose of the workshop was to facilitate new research collaborations in the areas of Health, Agriculture, Nutrition and Sustainable Energy. In the interactive sessions, new, interdisciplinary collaborative groups were formed, some of which have submitted grant applications to fund the projects discussed and designed during the workshops. During the workshops, Nicola Lowe had an opportunity to meet with Prime Minister Imran Khan to discuss biofortification as a way of addressing malnutrition in Pakistan. In addition conversations were held with the Higher Education Commission in Pakistan regarding future research collaborations.
Year(s) Of Engagement Activity 2020
URL https://jadarr9.wixsite.com/mysite/copy-of-hidden-pak-event-global-ws2
 
Description Research Seminar at the University of Reading 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Undergraduate students
Results and Impact Prof Nicola LoweI was invited by Prof Simon Andrews at the University of Reading to give a seminar to undergraduate and postgraduate students entitled "Biofortification of wheat as a strategy to improve zinc status in Pakistan:  the BiZiFED study" Approximately 25 students attended. Interest in this "real world" research with impact was expressed and appreciated by the students.
Year(s) Of Engagement Activity 2019
 
Description The Impact of COVID-19 Lockdown on BiZiFED2 - January 2021 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact This blog was published to disseminate our research to a wider audience and its progress particularly how Covid-19 wave affected the project and the response of the team to it.
Year(s) Of Engagement Activity 2021
URL https://www.uclan.ac.uk/articles/research/the-impact-of-covid-19-lockdown-on-bizifed2
 
Description Webinar - Mitigating Hidden Hunger: Is Fortification a Sustainable Answer? Hosted by Institute for Global Health and Development, Aga Khan University, Pakistan 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Mitigating Hidden Hunger: Is Fortification a Sustainable Answer?
Hidden hunger is a form of undernutrition that occurs when intake and absorption of vitamins and minerals (such as zinc, iodine, and iron) are too low to sustain good health and development. It is a global health crisis, driven in large part by poverty. More than 3 billion people around the world-mostly in Africa, Asia, and Latin America-simply cannot afford a diet of nourishing, diverse foods that provide enough essential vitamins and minerals (micronutrients). According to World Health Organization (WHO), the estimated annual loss in GDP from the impacts of hidden hunger amounts to USD 3 billion in Pakistan, USD 145 million in Uganda, and USD 289 million in Tanzania. Sustainably embedding fortified crops in food systems requires a comprehensive approach, from crop research and development stage to reaching its consumers. This webinar will not only explore the impacts of hidden hunger in low- and middle-income countries, but also sustainable solutions to mitigating this challenge. The programme will be enriched by some of the global leading researchers in the field. The webinar had 348 views on YouTube
Year(s) Of Engagement Activity 2022
URL https://www.youtube.com/watch?v=wEjBjL2ahnE
 
Description Wind-up of field work and unwinding information from the BiZiFED2 study - July 2021 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact This blog was created to disseminate our research in wider group and provide update on it.
Year(s) Of Engagement Activity 2021
URL https://www.uclan.ac.uk/articles/research/wind-up-fieldwork-information-bizifed2-study
 
Description Workshop on the Global Code of Conduct for Research in Resource Poor Settings 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Third sector organisations
Results and Impact This workshop was for the BIZIFED2 research team during our project meeting in Islamabad in October 2019. It started with an introduction to the concept of ethics dumping and the development of the Global Code of Conduct. We then divided into four groups to consider the four values of fairness, respect, care and honesty. Each group discussed the articles within the code and identified those they felt were especially relevant to BIZIFED2. We identified what we are already doing well, areas where we could improve and ways we could focus on developing equitable partnerships.
Year(s) Of Engagement Activity 2019
URL https://www.uclan.ac.uk/research/explore/assets/images/bizifed2-blog-for-c4globe-website.pdf
 
Description World Food Day 2022; Leave No one Behind Addressing Pakistan Food Security Challenge - Post Floods 11th October 2022 Jointly organized by COMSTECH, UPSIGN, SAWIE, ICCFS, IFS and PSF 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact To mark this year's World Food Day, we have organized keynote talks and panel discussions with experts coming from all over the world with several years of experience working in Agri-food research systems. The webinar will be discussing the key challenge faced by our food system from Climate change and other threats. As a result, our food system is suffering from malnutrition and food security. The debate will uncover how sustainable use of natural resources could help to enhance productivity, soil health, water, and the role of biodiversity. How can we address the food production crisis, protecting our soil microbes, plants, animals & natural capital? How can we produce healthy food to support a healthy life and a healthy planet?

The panelists will also be discussing a way forward post covid and Pakistan floods affect food security. How the research, and knowledge exchange of good practices could be translated to develop climate change adaptation strategies, mitigation, and taking specific measures to support the climate crisis victims. This symposium will set out key research priorities to develop collaborations for short- and longer-term plans to deliver tangible benefits through engaging stakeholders from research, academia, policy makers and farming industry. Such collaborations will support vulnerable groups through delivering the impact of research, the use of digital transformation approaches for promoting climate-smart agriculture practices, producing high-quality food, and enhancing the income of these poor communities through linking with the markets. Particularly delivering impact on women and youth inclusion in the Agri-Food systems to achieve sustainable, inclusive, and resilient growth that does not Leave NO ONE behind.
Year(s) Of Engagement Activity 2022
URL https://www.comstech.org/world-food-day-2022