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Objective:To review existing publications using Household Consumption and Expenditure Survey (HCES) data to estimate household dietary nutrient supply to (1) describe scope of available literature, (2) identify the metrics reported and parameters used to construct these metrics, (3) summarise comparisons between estimates derived from HCES and individual dietary assessment data and (4) explore the demographic and socio-economic sub-groups used to characterise risks of nutrient inadequacy.Design:This study is a systematic review of publications identified from online databases published between 2000 to 2019 that used HCES food consumption data to estimate household dietary nutrient supply. Further publications were identified by ‘snowballing’ the references of included database-identified publications.Setting:Publications using data from low- and lower-middle income countries.Results:In total, fifty-eight publications were included. Three metrics were reported that characterised household dietary nutrient supply: apparent nutrient intake per adult-male equivalent per day (n 35), apparent nutrient intake per capita per day (n 24) and nutrient density (n 5). Nutrient intakes were generally overestimated using HCES food consumption data, with several studies finding sizeable discrepancies compared with intake estimates based on individual dietary assessment methods. Sub-group analyses predominantly focused on measuring variation in household dietary nutrient supply according to socio-economic position and geography.Conclusion:HCES data are increasingly being used to assess diets across populations. More research is needed to inform the development of a framework to guide the use of and qualified interpretation of dietary assessments based on these data.

A proper understanding of the residual value of zinc (Zn) is necessary for sustainable biofortification of food crops. This study aimed to establish the extent to which application of Zn at the national rate, plus two experimentally elevated rates, in one year provided any benefit to plant yield and nutritional quality in the following growing season. Residual effects of soil-applied Zn on grain Zn concentration and uptake were estimated by an experiment in which maize was grown in successive seasons at two agricultural research stations in Malawi, with Zn applied to the soil in the first season but not the second. At each site two common soil types were used: Lixisols and Vertisols. The study used three Zn fertilizer rates of 1, 30 and 90 kg Zn ha -1 applied to the soil in the previous cropping season, arranged in a randomized complete block design (RCBD) with 10 replications at each experimental site. At harvest, maize grain yield and Zn concentration in grain and stover were measured; Zn uptake by maize grain and stover were determined and Zn harvest index was calculated. Effects on grain yield and Zn uptake by the crop were assessed in relation to residual Zn fertilizer and soil type. Maize grain yield on plots in the second season where 30 kg Zn ha -1 had been applied exceeded that on second season plots where 1 kg Zn ha -1 had been applied by 25%. The grain Zn concentration and Zn uptake in the second season after fertilizer application were larger by 13% and 30% respectively on the plots which had received 30 kg Zn ha -1 than those which had received 1 kg Zn ha -1 . There was no evidence that applying Zn at 90 kg Zn ha -1 resulted in larger crop yield, grain Zn concentration, or Zn uptake the second year after application than was seen in plots the second year after application of 30 kg Zn ha -1 . The magnitude of the benefits attributed to residual effects of soil-applied Zn did not depend on soil type. Conclusively, the residual effects of 30 kg ha -1 of soil-applied Zn in the preceding season benefited the subsequent maize compared to the national recommendation of 1 kg Zn ha -1 . The benefits of larger applications of Zn than the current national recommendations should be considered across at least two seasons and for different crops.

Background: Folate is essential for the synthesis and integrity of DNA, normal cell formation, and body growth. Folate deficiency among women of reproductive age (WRA) increases the risk of poor birth outcomes including neural tube defect (NTD)-affected pregnancies. Folate status is largely dependent on dietary intakes. Objectives: We aimed to explore the spatial distribution of biomarkers of folate status and their association with farming systems among nonpregnant WRA in Ethiopia. Methods: Serum and RBC folate concentration data were derived from the Ethiopia National Micronutrient Survey of 2015. The spatial dependencies of folate concentration of WRA were investigated and its relation with the dominant local farming system was explored. Results: The median serum folate and RBC folate concentrations were 12.3 nmol/L and 567.3 nmol/L, respectively. The national prevalence of folate deficiency using homocysteine concentration as a metabolic indicator based on serum and RBC folate concentration was 11.6% and 5.7%, respectively. The majority of women (77.9%) had low RBC folate concentrations consistent with increased risk of NTD-affected pregnancies. Folate nutrition was spatially dependent at distances of ≤ 300 km. A marked variability in folate concentration was observed between farming systems: greater RBC folate concentration (median: 1036 nmol/L) was found among women from the Lake Tana fish-based system, whereas the lowest RBC folate concentration (median: 386.7 nmol/L) was observed in the highland sorghum chat mixed system. Conclusions: The majority (78%) of WRA in Ethiopia had low folate status potentially increasing the risk of NTD-affected pregnancies. These findings may help national and subnational nutrition intervention strategies to target the most affected areas in the country.

Aim Magnesium (Mg) deficiency (known as grass tetany) is a serious metabolic disorder that affects grazing ruminants. We tested whether Mg-fertiliser can increase Mg concentration of Italian ryegrasses (Lolium multiflorum L.) including a cultivar (cv. Bb2067; ‘Magnet’), bred to accumulate larger concentrations of Mg. Methods Under controlled environment (CE) conditions, three cultivars (cv. Bb2067, cv. Bb2068, cv. RvP) were grown in low-nutrient compost at six fertiliser rates (0–1500 μM MgCl2.6H2O). Under field conditions, the three cultivars in the CE condition and cv. Alamo were grown at two sites, and four rates of MgSO4 fertiliser application rates (0–200 kg ha−1 MgO). Multiple grass cuts were taken over two-years. Results Grass Mg concentration increased with increasing Mg-fertiliser application rates in all cultivars and conditions. Under field conditions, cv. Bb2067 had 11–73% greater grass Mg concentration and smaller forage tetany index (FTI) than other cultivars across the Mg-fertiliser application rates, sites and cuts. Grass dry matter (DM) yield of cv. Bb2067 was significantly (p p ≥ 0.05). Conclusions Biofortification of grass with Mg through breeding and agronomy can improve the forage Mg concentration for grazing ruminants, even in high-growth spring grass conditions when hypomagnesaemia is most prevalent. Response to agronomic biofortification varied with cultivar, Mg-fertiliser rate, site and weather. The cost:benefit of these approaches and farmer acceptability, and the impact on cattle and sheep grazing on grasses biofortified with Mg requires further investigation.

Large-scale food fortification may be a cost-effective intervention to increase micronutrient supplies in the food system when implemented under appropriate conditions, yet it is unclear if current strategies can equitably benefit populations with the greatest micronutrient needs. This study developed a mathematical modeling framework for comparing fortification scenarios across different contexts. It was applied to model the potential contributions of three fortification vehicles (oil, sugar, and wheat flour) toward meeting dietary micronutrient requirements in Malawi through secondary data analyses of a Household Consumption and Expenditure Survey. We estimated fortification vehicle coverage, micronutrient density of the diet, and apparent intake of nonpregnant, nonlactating women for nine different micronutrients, under three food fortification scenarios and stratified by subpopulations across seasons. Oil and sugar had high coverage and apparent consumption that, when combined, were predicted to improve the vitamin A adequacy of the diet. Wheat flour contributed little to estimated dietary micronutrient supplies due to low apparent consumption. Potential contributions of all fortification vehicles were low in rural populations of the lowest socioeconomic position. While the model predicted large-scale food fortification would contribute to reducing vitamin A inadequacies, other interventions are necessary to meet other micronutrient requirements, especially for the rural poor.

Zinc (Zn) is an essential nutrient for human health. In Ethiopia, a high prevalence of Zn deficiency has been reported. To explore demographic variation and spatial dependencies in the Zn status of the Ethiopian population, we analyzed archived serum samples (n = 3373) from the 2015 Ethiopian National Micronutrient Survey (ENMS), a cross-sectional survey of young children, school-age children, women of reproductive age (WRA) and men conducted in all 9 regions and two city administration of Ethiopia. Serum Zn concentrations, measured using inductively coupled plasma-mass spectrometry (ICPMS), were compared to thresholds based on age, sex, fasting status, and time of blood collection, after adjusting for inflammation status. Median serum Zn concentration of the population was 57.5 μg dL−1. Overall, it is estimated that 72% of the population was Zn deficient, with high prevalence in all demographic groups. Spatial statistical analysis showed that there was spatial dependence in Zn status of WRA at distances of up to 45 km. Zinc deficiency is spatially dependent over short distances. Although WRA in most areas are likely to be Zn deficient, prevalence of deficiency varies at regional scale and between rural and urban inhabitants, suggesting there is scope to explore drivers of this variation, prioritize nutritional interventions, and to design more representative surveillance programs.

Surveys of soil fertility and quality provide essential information, at multiple scales, for policy and management decisions on agricultural and environmental questions. Such surveys are expensive, and national-scale agricultural or geochemical surveys are conducted infrequently by public sector organisations. Where resources are scarce, the costs of management, sample collection, analysis, and data management can be prohibitive. This is likely to create a particular barrier to understanding how soil fertility may influence crop production in contexts where small-scale production is prevalent. Private sector soil laboratories conduct soil fertility analyses on thousands of samples annually: samples are often collected in a systematic way by experienced technical staff. The simple step of collecting location coordinates can greatly extend the utility of the data, beyond the immediate value to the farmer and without an added burden on them. Here we use a dataset of soil organic matter (SOM), plant-available phosphorus (P) and exchangeable potassium (K), from c. 27,000 georeferenced sample points collected in 2014-2017 in Pakistan by Fauji Fertilizer Company (FFC). Geostatistical methods are used to model the spatial variation of these soil properties and predict their values at unsampled locations. The geostatistical model allows the probability that soil properties fall below recommended thresholds for wheat production, and these probabilities are displayed as maps using "calibrated phrases" for probability ranges in the legend. The resulting maps provide a comprehensive overview of key agronomic data across ~194,000 km 2 of cropland, realised as a direct consequence of sample location data collection being implemented by FFC. There is spatial structure in the SOM and K data, but not in the P data. These maps can be used to educate agronomists and farmers about typical soil fertility conditions in their region, and where soil analysis is a priority. They can also support more strategic planning of fertiliser needs in Pakistan where widespread nutrient deficiencies are found. This research demonstrates the potential for this approach to be used in many wider geographic contexts where there are few data from one-off survey activities. Additional benefits address concerns about data privacy have thus far limited their integration into a spatially disaggregated output that could benefit wider society.

IntroductionMicronutrient deficiencies, commonly referred to as ‘hidden hunger’, affect more than two billion people worldwide, with zinc and iron-deficiency frequently reported. The aim of this study is to examine the impact of consuming zinc biofortified flour (Zincol-2016) on biochemical and functional measures of status in adolescent girls and children living in a low-resource setting in Pakistan.Methods and analysisWe are conducting a pragmatic, cluster-randomised, double-blind, controlled trial. A total of 482 households have been recruited from two catchment areas approximately 30–40 km distance from Peshawar. Household inclusion criteria are the presence of both an adolescent girl, aged 10–16 years, and a child aged 1–5 years. The study duration is 12 months, divided into two 6-month phases. During phase 1, all households will be provided with locally procured flour from standard varieties of wheat. During phase 2, clusters will be paired, and randomised to either the control or intervention arm of the study. The intervention arm will be provided with zinc biofortified wheat flour, with a target zinc concentration of 40 mg/kg. The control arm will be provided with locally procured wheat flour from standard varieties with an expected zinc concentration of 20 mg/kg. The primary outcome measure is plasma zinc concentration. Secondary outcomes include anthropometric measurements, biomarkers of iron and zinc status, and the presence and duration of respiratory tract infections and diarrhoea.Ethics and disseminationEthical approval was granted from the University of Central Lancashire STEMH Ethics Committee (reference number: STEMH 1014) and Khyber Medical University Ethics Committee (DIR/KMU-EB/BZ/000683). The final study methods will be published in peer-reviewed journals, alongside the study outcomes. In addition, findings will be disseminated to the scientific community via conference presentations and abstracts and communicated to the study participants through the village elders at an appropriate community forum.Trial registration numberISRCTN17107812; Pre-results.

Zinc (Zn) is an essential micronutrient, and Zn deficiency remains a major global public health challenge. Recognised biomarkers of population Zn status include blood plasma or serum Zn concentration and proxy data such as dietary Zn intake and prevalence of stunting. Urine Zn concentration is rarely used to assess population Zn status. This study assessed the value of urine Zn concentration as a biomarker of population Zn status using a nationally representative sample of non-pregnant women of reproductive age (WRA) and school-aged children (SAC) in Malawi. Spot (casual) urine samples were collected from 741 WRA and 665 SAC. Urine Zn concentration was measured by inductively coupled plasma mass spectrometry with specific gravity adjustment for hydration status. Data were analysed using a linear mixed model with a spatially correlated random effect for between-cluster variation. The effect of time of sample collection (morning or afternoon), and gender (for SAC), on urine Zn concentration were examined. There was spatial dependence in urine Zn concentration between clusters among SAC but not WRA, which indicates that food system or environmental factors can influence urine Zn concentration. Mapping urine Zn concentration could potentially identify areas where the prevalence of Zn deficiency is greater and thus where further sampling or interventions might be targeted. There was no evidence for differences in urine Zn concentration between gender (P = 0.69) or time of sample collection (P = 0.85) in SAC. Urine Zn concentration was greater in afternoon samples for WRA (P = 0.003). Relationships between urine Zn concentration, serum Zn concentration, dietary Zn intake, and potential food systems covariates warrant further study. Electronic supplementary material The online version of this article (10.1007/s10653-020-00700-5) contains supplementary material, which is available to authorized users.

Selenium (Se) is an essential element for human health and livestock productivity. Globally, human Se status is highly variable, mainly due to the influence of soil types on the Se content of crops, suggesting the need to identify areas of deficiency to design targeted interventions. In sub-Saharan Africa, including Ethiopia, data on population Se status are largely unavailable, although previous studies indicated the potential for widespread Se deficiency. Serum Se concentration of a nationally representative sample of the Ethiopian population was determined, and these observed values were combined with a spatial statistical model to predict and map the Se status of populations across the country. The study used archived serum samples (n = 3269) from the 2015 Ethiopian National Micronutrient Survey (ENMS). The ENMS was a cross-sectional survey of young and school-age children, women and men. Serum Se concentration was measured using inductively coupled plasma mass spectrometry (ICPMS). The national median (Q1, Q3) serum Se concentration was 87.7 (56.7, 123.0) &mu, g L&minus, 1. Serum Se concentration differed between regions, ranging from a median (Q1, Q3) of 54.6 (43.1, 66.3) &micro, 1 in the Benishangul-Gumuz Region to 122.0 (105, 141) &micro, 1 in the Southern Nations, Nationalities, and Peoples&rsquo, Region and the Afar Region. Overall, 35.5% of the population were Se deficient, defined as serum Se &lt, 70 &micro, 1. A geostatistical analysis showed that there was marked spatial dependence in Se status, with serum concentrations greatest among those living in North-East and Eastern Ethiopia and along the Rift Valley, while serum Se concentrations were lower among those living in North-West and Western Ethiopia. Selenium deficiency in Ethiopia is widespread, but the risk of Se deficiency is highly spatially dependent. Policies to enhance Se nutrition should target populations in North-West and Western Ethiopia.

Assessing the reactions of iodine (I) in soil is critical to evaluate radioiodine exposure and understand soil-to-crop transfer rates. Our mechanistic understanding has been constrained by method limitations in assessing the dynamic interactions of iodine between soil solution and soil solid phase over short periods (hours). We use microdialysis to passively extract soil solution spiked with radioiodine (129I- and 129IO3-) to monitor short-term (≤40 h) in situ fixation and speciation changes. We observed greater instantaneous adsorption of 129IO3- compared to 129I- in all soils and the complete reduction of 129IO3- to 129I- within 5 h of addition. Loss of 129I from solution was extremely rapid; the average half-lives of 129I- and 129IO3- in soil solution were 4.06 and 10.03 h, respectively. We detected the presence of soluble organically bound iodine (org-129I) with a low molecular weight (MW) range (0.5-5 kDa) in all soils and a slower (20-40 h) time-dependent formation of larger MW org-I compounds (12-18 kDa) in some samples. This study highlights the very short window of immediate availability in which I from rainfall or irrigation remains in soil solution and available to crops, thus presenting significant challenges to phytofortification strategies in soil-based production systems.

Plasma selenium (Se) concentration is an established population level biomarker of Se status, especially in Se-deficient populations. Previously observed correlations between dietary Se intake and urinary Se excretion suggest that urine Se concentration is also a potentially viable biomarker of Se status. However, there are only limited data on urine Se concentration among Se-deficient populations. Here, we test if urine is a viable biomarker for assessing Se status among a large sample of women and children in Malawi, most of whom are likely to be Se-deficient based on plasma Se status. Casual (spot) urine samples (n = 1406) were collected from a nationally representative sample of women of reproductive age (WRA, n =741) and school aged children (SAC, n=665) across Malawi as part of the 2015/16 Demographic and Health Survey. Selenium concentration in urine was determined using inductively coupled plasma mass spectrometry (ICP-MS). Urinary dilution corrections for specific gravity, osmolality, and creatinine were applied to adjust for hydration status. Plasma Se status had been measured for the same survey participants. There was between-cluster variation in urine Se concentration that corresponded with variation in plasma Se concentration, but not between households within a cluster, or between individuals within a household. Corrected urine Se concentrations explained more of the between-cluster variation in plasma Se concentration than uncorrected data. These results provide new evidence that urine may be used in the surveillance of Se status at the population level in some groups. This could be a cost-effective option if urine samples are already being collected for other assessments, such as for iodine status analysis as in the Malawi and other national Demographic and Health Surveys. Keywords: Biomarkers, Biomonitoring, Micronutrient survey, Selenium status, Sub Saharan Africa, Urine

Background Micronutrient deficiencies including selenium (Se) are widespread in Malawi and potentially underlie a substantial disease burden, particularly among poorer and marginalised populations. Concentrations of Se in staple cereal crops can be increased through application of Se fertilisers – a process known as agronomic biofortification (agro-biofortification) – and this may contribute to alleviating deficiencies. The Addressing Hidden Hunger with Agronomy (AHHA) trial aims to establish the efficacy of this approach for improving Se status in rural Malawi. Methods A double-blind, randomised, controlled trial will be conducted in a rural community in Kasungu District, Central Region, Malawi. The hypothesis is that consumption of maize flour agro-biofortified with Se will increase serum Se concentration. We will recruit 180 women of reproductive age (WRA) (20–45 years) and 180 school-age children (SAC) (5–10 years) randomly assigned in a 1:1 ratio to receive either maize flour enriched through agro-biofortification with Se or a control flour not enriched with Se. Households will receive flour (330 g per capita per day) for 12 weeks. The primary outcome is Se concentration in serum (μg/L). Serum will be extracted from venous blood samples drawn at baseline (prior to flour distribution) and end-line. Selenium concentration will be measured by using inductively coupled plasma mass spectrometry. Discussion Findings will be communicated to policy stakeholders and participating communities and reported in peer-reviewed journals. Trial registration The Addressing Hidden Hunger with Agronomy (Malawi) trial is registered (5th March 2019; ISCRTN85899451).

Novel ANOVA methodology was used to benchmark ICP-QMS against MC-ICP-MS for Pb isotope ratios, demonstrating “fitness-for-purpose” in environmental source apportionment. The precision and accuracy of lead (Pb) isotope measurements obtained from quadrupole-based mass spectrometers (ICP-QMS) are considered to be limited by a number of factors originating in different components of the instruments. In this study, experimental and instrumental protocols were optimised for determining lead isotope ratios in urban soil digests. Experimental measures included individual dilution of all samples and isotopic standards (SRM-981, NIST) to a single Pb concentration intended to produce an intensity which was high enough to negate blanks and interferences but low enough to ensure the detector operated only in pulse counting mode. Instrumental protocols included batch dead time correction, optimisation of dwell time and the number of scans employed and correction of mass discrimination by sequential application of both internal (203Tl/205Tl ratio) and external (SRM-981, NIST) standards. This optimised methodology was benchmarked against multi-collector mass spectrometer (MC-ICP-MS) measurements of Pb isotope ratios using replicate digest solutions of the same soil; but after these had been subjected to Pb separation using an ion-exchange procedure. On the assumption that MC-ICP-MS measurements are more accurate, small additive and multiplicative differences were observed in only the 4th decimal place. ANOVA was used to compare the precisions of the two techniques demonstrating equal precisions c. 0.08% for 207Pb/206Pb, suggesting a sample heterogeneity limitation. By contrast, for 207Pb/204Pb, the worst-case ratio, ICP-QMS had a 10-fold poorer precision, despite negligible interference from 204Hg, implying an instrumental limitation. The study concludes that ICP-QMS can provide valuable source apportionment information for most Pb isotope ratios but further efforts should focus on improving assay of the 207Pb/204Pb ratio.

Background and aims Use of zinc (Zn) fertilisers may be cost-effective in increasing crop yields and in alleviating dietary Zn deficiency. However, Zn fertilisers are underutilised in many countries despite the widespread occurrence of Zn-deficient soils. Here, increased Zn fertiliser-use scenarios were simulated for wheat production in Punjab and Sindh Provinces, Pakistan. Inputs and outputs were valued in terms of both potential yield gains as well as health gains in the population. Methods The current dietary Zn deficiency risk of 23.9 % in Pakistan was based on food supply and wheat grain surveys. “Disability-adjusted life years (DALYs) lost” are a common metric of disease burden; an estimated 245,000 DALYs y−1 are lost in Punjab and Sindh due to Zn deficiency. Baseline Zn fertiliser-use of 7.3 kt y−1 ZnSO4.H2O was obtained from published and industry sources. The wheat area currently receiving Zn fertilisers, and grain yield responses of 8 and 14 % in Punjab and Sindh, respectively, were based on a recent survey of >2500 farmers. Increased grain Zn concentrations under Zn fertilisation were estimated from literature data and converted to improved Zn intake in humans and ultimately a reduction in DALYs lost. Results Application of Zn fertilisers to the area currently under wheat production in Punjab and Sindh, at current soil: foliar usage ratios, could increase dietary Zn supply from ~12.6 to 14.6 mg capita −1 d−1, and almost halve the prevalence of Zn deficiency, assuming no other changes to food consumption. Gross wheat yield could increase by 2.0 and 0.6 Mt. grain y−1 in Punjab and Sindh, respectively, representing an additional return of US$ >800 M and an annual increased grain supply of 19 kg capita −1. Conclusions There are potential market- and subsidy-based incentives to increase Zn fertiliser-use in Pakistan. Benefit-Cost Ratios (BCRs) for yield alone are 13.3 and 17.5 for Punjab and Sindh, respectively. If each DALY is monetised at one to three fold Gross National Income per capita on purchasing power parity (GNIPPP), full adoption of Zn fertiliser for wheat provides an additional annual return of 405–1216 M International Dollars (I$) in Punjab alone, at a cost per DALY saved of I$ 461–619. Electronic supplementary material The online version of this article (doi:10.1007/s11104-016-2961-7) contains supplementary material, which is available to authorized users.

In sub-Saharan Africa, inherited causes of anemia are common, but data are limited regarding the geographical prevalence and coinheritance of these conditions and their overall contributions to childhood anemia. To address these questions in Malawi, we performed a secondary analysis of the 2015-2016 Malawi Micronutrient Survey, a nationally and regionally representative survey that estimated the prevalence of micronutrient deficiencies and evaluated both inherited and noninherited determinants of anemia. Children age 6 to 59 months were sampled from 105 clusters within the 2015-2016 Malawi Demographic Health Survey. Hemoglobin, ferritin, retinol binding protein, malaria, and inflammatory biomarkers were measured from venous blood. Molecular studies were performed using dried blood spots to determine the presence of sickle cell disease or trait, α-thalassemia trait, and glucose-6-phosphate dehydrogenase (G6PD) deficiency. Of 1279 eligible children, 1071 were included in the final analysis. Anemia, iron deficiency, and malaria were common, affecting 30.9%, 21.5%, and 27.8% of the participating children, respectively. α-Thalassemia trait was common (>40% of children demonstrating deletion of 1 [33.1%] or 2 [10.0%] α-globin genes) and associated with higher prevalence of anemia (P < .001). Approximately 20% of males had G6PD deficiency, which was associated with a 1.0 g/dL protection in hemoglobin decline during malaria infection (P = .02). These data document that inherited blood disorders are common and likely play an important role in the prevalence of anemia and malaria in Malawian children.

Background Long-term, low-level exposure to toxic elements in soil may be harmful to human health but large longitudinal cohort studies with sufficient follow-up time to study these effects are cost-prohibitive and impractical. Linkage of routinely collected medical outcome data to systematic surveys of soil quality may offer a viable alternative. Methods We used the Geochemical Baseline Survey of the Environment (G-BASE), a systematic X-ray fluorescence survey of soil inorganic chemistry throughout England and Wales to obtain estimates of the concentrations of 15 elements in the soil contained within each English and Welsh postcode area. We linked these data to the residential postcodes of individuals enrolled in The Health Improvement Network (THIN), a large database of UK primary care medical records, to provide estimates of exposure. Observed exposure levels among the THIN population were compared with expectations based on UK population estimates to assess representativeness. Results Three hundred seventy-seven of three hundred ninety-five English and Welsh THIN practices agreed to participate in the linkage, providing complete residential soil metal estimates for 6,243,363 individuals (92% of all current and former patients) with a mean period of prospective computerised medical data collection (follow-up) of 6.75 years. Overall agreement between the THIN population and expectations was excellent; however, the number of participating practices in the Yorkshire & Humber strategic health authority was low, leading to restricted ranges of measurements for some elements relative to the known variations in geochemical concentrations in this area. Conclusions The linked database provides unprecedented population size and statistical power to study the effects of elements in soil on human health. With appropriate adjustment, results should be generalizable to and representative of the wider English and Welsh population. Electronic supplementary material The online version of this article (10.1186/s12963-018-0168-2) contains supplementary material, which is available to authorized users.

Data conditioning procedures involve the verification, quality control and data levelling processes that are necessary to make data fit for the purpose for which it is to be used. It is something that has to be planned at the outset of any project generating geochemical data. Whether it is in the sampling phase, for example, determining how sites and samples should have a unique identity, or through to the data presentation phase in which disparate data sets may have to be joined to form a seamless map. This account describes the methods currently used by the British Geological Survey's regional geochemical mapping project that has been generating geochemical data for various sample media for nearly 40 years. It is important that users of the data are given information that will help them ascertain whether the provided environmental data is suitable for the purpose of its intended use.

The collection of drainage samples from active stream channels for geochemical mapping is now a well-established procedure that has readily been adapted for environmental studies. This account details the sampling methods used by the British Geological Survey in order to establish a geochemical baseline for the land area of Great Britain. This involves the collection of stream sediments, waters, and panned heavy mineral concentrates for inorganic chemical analysis. The methods have been adapted and used in many different environments around the world. Detailed sampling protocols are given and sampling strategy, equipment and quality control are discussed.

Approximately one million people in the UK are served by private water supplies (PWS) where main municipal water supply system connection is not practical or where PWS is the preferred option. Chronic exposure to contaminants in PWS may have adverse effects on health. SouthWest England is an area with elevated arsenic concentrations in groundwater and over 9000 domestic dwellings here are supplied by PWS. There remains uncertainty as to the extent of the population exposed to arsenic (As), and the factors predicting such exposure. We describe a hazard assessment model based on simplified geology with the potential to predict exposure to As in PWS. Households with a recorded PWS in Cornwall were recruited to take part in a water sampling programme from 2011 to 2013. Bedrock geologies were aggregated and classified into nine Simplified Bedrock Geological Categories (SBGC), plus a cross-cutting “mineralized” area. PWS were sampled by random selection within SBGCs and some 508 households volunteered for the study. Transformations of the data were explored to estimate the distribution of As concentrations for PWS by SBGC. Using the distribution per SBGC, we predict the proportion of dwellings that would be affected by high concentrations and rank the geologies according to hazard. Within most SBGCs, As concentrations were found to have log-normal distributions. Across these areas, the proportion of dwellings predicted to have drinking water over the prescribed concentration value (PCV) for As ranged from 0% to 20%. From these results, a pilot predictive model was developed calculating the proportion of PWS above the PCV for As and hazard ranking supports local decision making and prioritization. With further development and testing, this can help local authorities predict the number of dwellings that might fail the PCV for As, based on bedrock geology. The model presented here for Cornwall could be applied in areas with similar geologies. Application of the method requires independent validation and further groundwater-derived PWS sampling on other geological formations.

Iron intakes calculated from one-day weighed records were compared with those from same day analyzed duplicate diet composites collected from 120 Malawian women living in two rural districts with contrasting soil mineralogy and where threshing may contaminate cereals with soil iron. Soils and diet composites from the two districts were then subjected to a simulated gastrointestinal digestion and iron availability in the digests measured using a Caco-2 cell model. Median analyzed iron intakes (mg/d) were higher (p

Widespread potential dietary deficiencies of calcium (Ca), iron (Fe), iodine (I), selenium (Se) and zinc (Zn) have been identified in Malawi. Several deficiencies are likely to be compounded by high phytic acid (PA) consumption. Rice (Oryza sativa) is commonly consumed in some Malawian populations, and its mineral micronutrient content is important for food security. The considerable irrigation requirements and flooded conditions of paddy soils can also introduce or mobilise potentially toxic elements including arsenic (As), cadmium (Cd) and lead (Pb). The aim of this study was to determine the mineral composition of rice sampled from farmers' fields and markets in Malawi. Rice was sampled from 18 extension planning areas across Malawi with 21 white (i.e. polished) and 33 brown samples collected. Elemental composition was determined by inductively coupled plasma-mass spectrometry (ICP-MS). Arsenic speciation was performed using high-performance liquid chromatography (HPLC)-ICP-MS. Concentration of PA was determined using a PA-total phosphorus assay. Median total concentrations (mg kg(-1), dry weight) of elements important for human nutrition in brown and white rice, respectively, were: Ca = 66.5 and 37.8; Cu = 3.65 and 2.49; Fe = 22.1 and 7.2; I = 0.006 and

Introduction: Many properties in the UK are served by private water supplies (PWS) where mains connection is not possible. Chronic exposure to chemicals in PWS may have an adverse effect on health ...

Dietary mineral deficiencies are widespread in Africa. Our previous studies in Malawi revealed population-level shortfalls in dietary calcium and selenium supply but adequate dietary magnesium (Mg) supply. Here we examine dietary Mg supply throughout Africa. Food supply data from 1961 to 2007 were compiled using Food and Agriculture Organization (FAO) Food Balance Sheets (FBSs). Magnesium supply was estimated for each country using regional food Mg composition tables. Mean Mg supply in 2007 was 649 mg capita −1 d−1, ranging from 188 mg d−1 in Eritrea to 1,828 mg d−1 in Burkina Faso. Magnesium supply was greater in West Africa than in other regions, was dominated by sorghum, maize and wheat and was correlated with calorie supply. The World Health Organization (WHO) Estimated Average Requirement (EAR) for Mg (217 mg capita −1 d−1 for adult males) was exceeded in most countries. Using the EAR cut-point method, the risk of dietary Mg deficiency in Africa is

Background In this review, we examine the potential of Zn-enriched fertilisers to alleviate human dietary Zn deficiency. The focus is on ten African countries where dietary Zn supply is low and where fertiliser subsidies are routinely deployed on cereal crops. Scope Dietary Zn supply and deficiency prevalence were quantified from food supply and composition data. Typical effects of soil (granular) and foliar Zn applications on Zn concentrations in maize (Zea mays L.), rice (Oryza sativa L.) and wheat (Triticum aestivum L.) grains were based on a systematic literature review. Reductions in disease burdens attributable to Zn deficiency and cost-effectiveness were estimated using a disability-adjusted life years (DALYs) approach. Conclusions Baseline Zn supply in 2009 ranged from 7.1 (Zambia) to 11.9 (Mali) mg capita−1 day−1; prevalence of Zn deficiency ranged from 24 (Nigeria) to 66 % (Zambia). In reviewed studies, soil Zn application led to an increase in median Zn concentration in maize, rice and wheat grains of 23, 7 and 19 %; foliar application led to increases of 30, 25 and 63 %. Enriching granular fertilisers within current subsidy schemes would be most effective in Malawi, reducing DALYs lost due to Zn deficiency by 10 %. The cost per DALY saved ranged from US$ 624 to 5893 via granular fertilisers and from US$ 46 to 347 via foliar fertilisers. Foliar applications are likely to be more cost effective than soil applications due to fixation of Zn in the soil but may be more difficult to deploy. Zinc fertilisation is likely to be less cost-effective than breeding in the longer term although other micronutrients such as selenium could be incorporated.

Globally, more than 800 million people are undernourished while >2 billion people have one or more chronic micronutrient deficiencies (MNDs). More than 6% of global mortality and morbidity burdens are associated with undernourishment and MNDs. Here we show that, in 2011, 3.5 and 1.1 billion people were at risk of calcium (Ca) and zinc (Zn) deficiency respectively due to inadequate dietary supply. The global mean dietary supply of Ca and Zn in 2011 was 684 ± 211 and 16 ± 3 mg capita−1 d−1 (±SD) respectively. Between 1992 and 2011, global risk of deficiency of Ca and Zn decreased from 76 to 51% and 22 to 16%, respectively. Approximately 90% of those at risk of Ca and Zn deficiency in 2011 were in Africa and Asia. To our knowledge, these are the first global estimates of dietary Ca deficiency risks based on food supply. We conclude that continuing to reduce Ca and Zn deficiency risks through dietary diversification and food and agricultural interventions including fortification, crop breeding and use of micronutrient fertilisers will remain a significant challenge.

Environmental context There is growing concern that lead in the environment may cause adverse health effects in human populations. We investigated the combined use of isotopic abundance and isotopic dilution to show how the origins of soil Pb and soil characteristics affect lability. Soil pH and soil Pb content are the dominant controls on Pb lability; the lability of recent petrol-derived Pb is similar to that of other sources in urban soils but greater than geogenic Pb in rural roadside topsoils. Abstract Lability of lead in soils is influenced by both soil properties and source(s) of contamination. We investigated factors controlling Pb lability in soils from (i) land adjacent to a major rural road, (ii) a sewage processing farm and (iii) an archive of the geochemical survey of London. We measured isotopically exchangeable Pb (E-values; PbE), phase fractionation of Pb by a sequential extraction procedure (SEP) and inferred source apportionment from measured Pb isotopic ratios. Isotopic ratios (206Pb/207Pb and 208Pb/207Pb) of total soil Pb fell on a mixing line between those of petrol and UK coal or Pb ore. The main determinant of the isotopically exchangeable Pb fraction (%E-value) was soil pH: %E-values decreased with increasing pH. In rural roadside topsoils, there was also evidence that petrol-derived Pb remained more labile (35%) than Pb from soil parent material (27%). However, in biosolid-amended and London soils, %E-values were low (~25%), covered a restricted range and showed no clear evidence of source-dependent lability.

Moringa oleifera (MO) and M. stenopetala (MS) are two commonly cultivated species of the Moringaceae family. Some households in southern Ethiopia (S. ETH) and Kenya (KEN) plant MS and MO, respectively. The edible parts of these species are rich in amino acids, vitamins and minerals, especially selenium. Despite their nutritional value, Moringa is sometimes considered as a "famine food". The aim of this study was to determine the extent of dietary utilization of these plants by Moringa Growing Households (MGHs). Moringa growing households were surveyed in 2015. Twenty-four and 56 heads of MGHs from S. ETH and KEN, respectively, were interviewed using semi-structured questionnaires. Subsistence agriculture was the main source of livelihood for all MGHs in S. ETH and 71% of those in KEN. All MGHs in S. ETH cultivated MS while those in KEN cultivated MO. Of the MGH heads in S. ETH, 71% had grown MS as long as they remember; the median cultivation period of MO in KEN was 15 years. All MGHs in S. ETH and 79% in KEN used Moringa leaves as a source of food. Forms of consumption of leaves were boiled fresh leaves, and leaf powder used in tea or mixed with other dishes. Other uses of Moringa include as medicine, fodder, shade, agroforestry, and as a source of income. Although MO and MS have multiple uses, MGHs face several challenges, including a lack of reliable information on nutritional and medicinal values, inadequate access to markets for their products, and pest and disease stresses to their plants. Research and development to address these challenges and to promote the use of these species in the fight against hidden hunger are necessary.

Dietary micronutrient deficiencies (MNDs) are widespread, yet their prevalence can be difficult to assess. Here, we estimate MND risks due to inadequate intakes for seven minerals in Africa using food supply and composition data, and consider the potential of food-based and agricultural interventions. Food Balance Sheets (FBSs) for 46 countries were integrated with food composition data to estimate per capita supply of calcium (Ca), copper (Cu), iron (Fe), iodine (I), magnesium (Mg), selenium (Se) and zinc (Zn), and also phytate. Deficiency risks were quantified using an estimated average requirement (EAR) 'cut-point' approach. Deficiency risks are highest for Ca (54% of the population), followed by Zn (40%), Se (28%) and I (19%, after accounting for iodized salt consumption). The risk of Cu (1%) and Mg (1%) deficiency are low. Deficiency risks are generally lower in the north and west of Africa. Multiple MND risks are high in many countries. The population-weighted mean phytate supply is 2770 mg capita(-1) day(-1). Deficiency risks for Fe are lower than expected (5%). However, 'cut-point' approaches for Fe are sensitive to assumptions regarding requirements; e.g. estimates of Fe deficiency risks are 43% under very low bioavailability scenarios consistent with high-phytate, low-animal protein diets. Fertilization and breeding strategies could greatly reduce certain MNDs. For example, meeting HarvestPlus breeding targets for Zn would reduce dietary Zn deficiency risk by 90% based on supply data. Dietary diversification or direct fortification is likely to be needed to address Ca deficiency risks.

Selenium (Se) is an essential human micronutrient with critical roles in immune functioning and antioxidant defence. Estimates of dietary Se intakes and status are scarce for Africa although crop surveys indicate deficiency is probably widespread in Malawi. Here we show that Se deficiency is likely endemic in Malawi based on the Se status of adults consuming food from contrasting soil types. These data are consistent with food balance sheets and composition tables revealing that >80% of the Malawi population is at risk of dietary Se inadequacy. Risk of dietary Se inadequacy is >60% in seven other countries in Southern Africa, and 22% across Africa as a whole. Given that most Malawi soils cannot supply sufficient Se to crops for adequate human nutrition, the cost and benefits of interventions to alleviate Se deficiency should be determined; for example, Se-enriched nitrogen fertilisers could be adopted as in Finland.

The revised Environmental Protection Act Part 2A contaminated land Statutory Guidance (England and Wales) makes reference to ‘normal’ levels of contaminants in soil. The British Geological Survey has been commissioned by the United Kingdom Department for Environment, Food and Rural Affairs (Defra) to estimate contaminant levels in soil and to define what is meant by ‘normal’ for English soil. The Guidance states that ‘normal’ levels of contaminants are typical and widespread and arise from a combination of both natural and diffuse pollution contributions. Available systematically collected soil data sets for England are explored for inorganic contaminants (As, Cd, Cu, Hg, Ni and Pb) and benzo[a]pyrene (BaP). Spatial variability of contaminants is studied in the context of the underlying parent material, metalliferous mineralisation and associated mining activities, and the built (urban) environment, the latter being indicative of human activities such as industry and transportation. The most significant areas of elevated contaminant concentrations are identified as contaminant domains. Therefore, rather than estimating a single national contaminant range of concentrations, we assign an upper threshold value to contaminant domains. Our representation of this threshold is a Normal Background Concentration (NBC) defined as the upper 95% confidence limit of the 95th percentile for the soil results associated with a particular domain. Concentrations of a contaminant are considered to be typical and widespread for the identified contaminant domain up to (and including) the calculated NBC. A robust statistical methodology for determining NBCs is presented using inspection of data distribution plots and skewness testing, followed by an appropriate data transformation in order to reduce the effects of point source contamination.

Selenium is an essential element in human diets but the risk of suboptimal intake increases where food choices are narrow. Here we show that suboptimal dietary intake (i.e. 20-30 µg Se person(-1) d(-1)) is widespread in Malawi, based on a spatial integration of Se concentrations of maize (Zea mays L.) grain and soil surveys for 88 field sites, representing 10 primary soil types and75% of the national land area. The median maize grain Se concentration was 0.019 mg kg(-1) (range 0.005-0.533), a mean intake of 6.7 µg Se person(-1) d(-1) from maize flour based on national consumption patterns. Maize grain Se concentration was up to 10-fold higher in crops grown on soils with naturally high pH (6.5) (Eutric Vertisols). Under these less acidic conditions, Se becomes considerably more available to plants due to the greater solubility of Se((IV)) species and oxidation to Se((VI)).

Geochemical mapping is a technique rooted in mineral exploration but has now found worldwide application in studies of the urban environment. Such studies, involving multidisciplinary teams including geochemists, have to present their results in a way that nongeochemists can comprehend. A legislatively driven demand for urban geochemical data in connection with the need to identify contaminated land and subsequent health risk assessments has given rise to a greater worldwide interest in the urban geochemical environment. Herein, the aims and objectives of some urban studies are reviewed and commonly used terms such as baseline and background are defined. Geochemists need to better consider what is meant by the term urban. Whilst the unique make up of every city precludes a single recommended approach to a geochemical mapping strategy, more should be done to standardise the sampling and analytical methods. How (from a strategic and presentational point of view) and why we do geochemical mapping studies is discussed. Keywords Background - Baseline - Geochemical mapping - Heavy metals - Pollution - Soil - Urban

Magnesium (Mg) is an essential mineral micronutrient in humans. Risks of dietary Mg deficiency are affected by the quantity of Mg ingested and its bioavailability, which is influenced by the consumption of other nutrients and ‘anti-nutrients’. Here, we assess global dietary Mg supplies and risks of dietary deficiency, including the influence of other nutrients. Food supply and food composition data were used to derive the amount of Mg available per capita at national levels. Supplies of Mg were compared with estimated national per capita average requirement ‘cut points’. In 2011, global weighted mean Mg supply was 613 ± 69 mg person–1 day–1 compared with a weighted estimated average requirement for Mg of 173 mg person–1 day–1. This indicates a low risk of dietary Mg deficiency of 0.26% based on supply. This contrasts with published data from national individual-level dietary surveys, which indicate greater Mg deficiency risks. However, individuals in high-income countries are likely to under-report food consumption, which could lead to overestimation of deficiency risks. Furthermore, estimates of deficiency risk based on supply do not account for potential inhibitors of Mg absorption, including calcium, phytic acid and oxalate, and do not consider household food wastage.