Evidence map›Paper›PMID 40218895›Full record

Trial reportNutrients2025

The Effectiveness of Zinc-Biofortified Wheat Flour Intake on the Growth and Morbidity Outcomes of Rural Pakistani Children and Adolescent Girls: A Cluster-Randomised, Double-Blind, Controlled Trial.

Swarnim Gupta, Mukhtiar Zaman, Sadia Fatima, Victoria H Moran, Jonathan K Sinclair, Nicola M Lowe

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Nutrients, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Nutritional composition ofOpen research Africa · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Swarnim GuptaCentre for Global Development, University of Central Lancashire, Preston PR1 2HE, UK.ORCID 0000-0002-5846-4954
Mukhtiar ZamanDepartment of Pulmonology, Rehman Medical Institute, Peshawar 25000, Pakistan.
Sadia FatimaInstitute of Basic Medical Sciences, Khyber Medical University, Peshawar 25100, Pakistan.ORCID 0000-0002-1677-5535
Victoria H MoranCentre for Global Development, University of Central Lancashire, Preston PR1 2HE, UK.ORCID 0000-0003-3165-4448
Jonathan K SinclairCentre for Global Development, University of Central Lancashire, Preston PR1 2HE, UK.ORCID 0000-0002-2231-3732
Nicola M LoweCentre for Global Development, University of Central Lancashire, Preston PR1 2HE, UK.ORCID 0000-0002-6934-2768

Funding

UKRI BB/S013989/1
6 · The paper itself

Abstract

backgroundZinc-biofortified cereals are a promising strategy to combat zinc deficiency, though evidence on health outcomes is limited. This study assessed the effectiveness of consuming zinc-biofortified wheat flour on growth and zinc-related morbidity among adolescent girls (10-16 years; N = 517) and children (1-5 years; N = 517) living in rural north-west Pakistan.

methodsIn this double-blind, cluster-randomised controlled effectiveness trial, 486 households received either zinc-biofortified or control wheat flour for 25 weeks. Anthropometric measurements and lung function tests (LFTs) were performed at the beginning, middle, and endline. Data on the incidence and duration of respiratory tract infection (RTI) and diarrhoea in the preceding two weeks were collected fortnightly. Analyses included baseline-adjusted linear mixed models for continuous outcomes and Pearson's chi-square for categorical data.

resultsAt a zinc differential of 3.7 mg/kg for adolescent girls provided by zinc-biofortified wheat flour, the intervention had no significant effect on height or weight. For children, head circumference was significantly greater in the biofortified group at endline (control 48.47 ± 2.03 cm vs. intervention 48.76 ± 1.82 cm;

conclusionsThe provision of zinc-biofortified wheat flour for 25 weeks did not have a significant effect on the growth of adolescent girls but modestly improved head circumference in children. Longer-term interventions are needed to monitor changes in functional outcomes with the national scale-up of zinc-biofortified wheat varieties.

Indexed as

BiofortificationFlourFood, FortifiedTriticumZincAdolescentChildChild, PreschoolDiarrheaDouble-Blind MethodFemaleHumansInfantPakistanRespiratory Tract InfectionsRural PopulationZincadolescent girlsbiofortificationchildreneffectivenessgrowthmorbidityPakistanwheat flourzinc

Identifiers

PMID40218895
PMCPMC11990903

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.