scholarly journals Quadruple Fortification of Salt with Iodine, Iron, Vitamins B9 and B12 to Reduce Maternal and Neonatal Mortality by Reducing Anemia and Nutritional Deficiency Prevalence (P24-041-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Venkatesh Mannar ◽  
Levente Diosady

Abstract Objectives To develop a quadruple fortified salt(QFS) formulation that provides100 + % of RDA for iodine and vitamin B12 and 30–50% of RDA for iron and folic acid in forms that are organoleptically stable, bioavailable and acceptable to consumers Methods Iodine was sprayed onto salt as an aqueous solution of potassium iodate. Iron was admixed as a solid premix, which was colour masked with TiO2 and encapsulated in soy stearine to provide a water-impervious coating. The iron core was made of ferrous fumarate, which was agglomerated to an average size matching salt grain, i.e., 300–500 µm. Folic acid and vitamin B12 were added either in the iodate spray solution or in the solid iron premix. The premixes and salt were stored at 25, 35 and 45°C at 65% RH for up to a year. The loss of iodine, folic acid and vitamin B12 were monitored. An optimized formulation was tested on the pilot scale at JVS Foods Pvt, Jaipur, India. Results Folic acid can be stabilized in the iodine spray solution, and triple fortified salt containing iodine, folic acid and encapsulated ferrous fumarate retained >90% of both the added iodine and folic acid for 6 months. Stable QFS was made by incorporating vitamin B12 in the solid iron premix at a 1:200 ratio. The process was scaled up to produce some 25 kg of iron and B12premix, sufficient for 5 tons of salt, or 500,000 daily doses of salt. Organoleptic testing of Indian meals produced with quadruple fortified salt were found to be acceptable by a consumer panel at the University of Delhi. Conclusions Stable quadruple fortified salt that can provide up to 50% of RDA of folic acid and iron and 100 + % of RDA of vitamin B12 and iodine has been developed. The product was pilot tested and had high consumer acceptability. The formulation could reduce the incidence of maternal and infant mortality at a cost of less than 20¢/annum. Funding Sources This research was funded by Grand Challenges Canada through the Saving Lives at Birth program, and by the Bill and Melinda Gates Foundation.

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Neal Craft ◽  
Francisco Arredondo ◽  
Matthew Fleshman ◽  
Eleanor Brindle ◽  
Lorraine Lillis ◽  
...  

Abstract Objectives Conduct time and temperature stability experiments on Nutritional Biomarkers (NBs) and inflammation markers extracted from ViveBio Dry Plasma Spots (DPS). Methods Blood samples of 3 hematocrits (20, 30 and 45%) were created by combining purchased red blood cells (RBC) and sera. Blood samples of 35 µL were loaded onto ViveBio plasma separators. The underlying pads with plasma were stored at 45°, 23°, 4°, -20° and -70°C. Samples were tested on days 0, 1, 3, 7, 14, 28, 84 and 168. Ferritin, Retinol Binding Protein (RBP4), soluble Transferrin Receptors (sTfR), Thyroglobulin (Tg), α-acid Glycoprotein (AGP), and C-Reactive Protein (CRP) were measured using the Quansys Biosciences, Q-Plex Micronutrient Array (Q-Plex). Values measured in the liquid sera were used as reference values for the DPS. Red blood cell (RBC) folates and serum vitamin B12 were measured using a 96 well plate microbiological assay (ALPCO-Immundiagnostik AG). 25OH-Vitamin D3, Retinol, Methylmalonic acid (MMA) and Homocysteine (HCY) were measured using LC-MS/MS. The Q-Plex was compared at 3 independent laboratories using a group of 80 whole blood samples, non-spiked and spiked with AGP, CRP, HRP2 and sTfR. Liquid plasma and extracted plasma from ViveBio pads were generated and stored at -80°C four weeks prior to assay. Results Overall, the measured values for Ferritin, RBP4, Tg, AGP, CRP, 25OH-D, Retinol and MMA decrease with increasing storage temperature and length of storage. Ferritin and Tg exhibited the best stability at 16.8% and 8.0% over a 6 month period. Vitamin B12 exhibited very poor stability declining to below the LOQ within day 3. Most of the NBs at 1 month correlated well with liquid plasma values (r2 = 0.42 to 0.99) (AGP at 23°C, r2 = 0.428; at -70°C r2 = 0.990 Ferritin stored at 23°C, r2 = 0.854; at -70°C r2 = 0.992; Thyroglobulin at 23°C, r2 = 0.916; at -70°C r2 = 0.830). Conclusions We have demonstrated that NBs can be analyzed in low volumes of DPS generated by the ViveBio plasma separator. The Q-Plex performed reproducibly on split samples among 3 labs. These tools offer great potential to improve nutritional assessment in population studies. Funding Sources Funding provided by the Bill and Melinda Gates foundation.


2021 ◽  
Author(s):  
Oluwasegun Modupe ◽  
Juveria Siddiqui ◽  
Akhila Jonnalagadda ◽  
Levente Diosady

Abstract The addition of folic acid to Double Fortified Salt aims to ameliorate iron, iodine, and folic acid deficiencies in vulnerable populations. Folic acid was added either to the iodine spray solution or to the iron premix used to prepare salt fortified with iron and iodine. When added through the solution, sodium carbonate was needed to dissolve folic acid and to adjust pH. Alternately, folic acid was added either to the iron core or sandwiched between the core and the TiO2 layer of the ferrous fumarate premix. Folic acid and iodine were stable in all three cases, retaining more than 70% of the added micronutrients after six months at 45 oC/ 60-70% RH. Adding folic acid to the premix's iron core is preferred as folic acid retention was slightly higher, and the added folic acid did not impact a yellow colour to the salt. Folic acid in this salt was stable in cooking and did not affect selected cooked foods' sensory properties. The technology is a cost-effective approach for simultaneously combating iron, iodine, and folic acid deficiencies.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 640-640
Author(s):  
Reina Engle-Stone ◽  
Katherine Adams ◽  
Sika Kumordzie ◽  
Hanqi Luo ◽  
K. Ryan Wessells ◽  
...  

Abstract Objectives We modeled the potential impacts of bouillon fortification with different levels of vitamin A, folic acid, vitamin B12, iron, and zinc on dietary micronutrient adequacy to inform multi-stakeholder discussions around bouillon fortification programs. Methods We used individual dietary intake data in Cameroon from women of reproductive age (WRA) and children 1–5 y (n = 902 and 872), and household (HH) survey data in Cameroon (n = 11,384 HH), Ghana (n = 11,870 HH), and Haiti (n = 4,951 HH) to estimate micronutrient (MN) intake. The Adult Male Equivalent method was applied to estimate “apparent intake” of WRA, children, and men from HH surveys. We examined intake of bouillon and calculated prevalence of inadequate (below the estimated average requirement) and high (above the tolerable upper intake level, UL) micronutrient intake. Analyses included the contributions of mandatory fortification of oil or wheat flour at estimated current micronutrient levels. We simulated the impacts of bouillon fortification with varying levels of vitamin A, folic acid, vitamin B12, iron, and zinc on inadequate and high intakes of each nutrient. Results Bouillon was commonly consumed in all countries, with any reported consumption ranging from 67–81% in Ghana to over 90% in Cameroon and Haiti. Median (apparent) bouillon consumption ranged from 1.6–2.1 g/d for women, 0.7–1.0 g/d for children, and 1.8–2.2 g/d for men. Bouillon fortification with vitamins was predicted to reduce dietary inadequacy (120 μg/g vitamin A: 15–33 percentage points, pp, depending on the country and target group; 80 μg/g folate: 11–33 pp; 1.2 μg/g B12: 12–67 pp) with minimal risk of high intake. In contrast, predicted effects on dietary iron inadequacy were modest (5–12 pp reduction at 5 mg iron/g, assuming 2% absorption). Simulated zinc fortification showed reductions in inadequate absorbable zinc intake (14–42 pp at 3 mg/g), but children's intakes commonly exceeded the UL. Conclusions Modeling suggests that bouillon fortification could reduce inadequate MN intakes in these countries. Further work is needed to identify fortification levels that will meet criteria for nutritional benefits, technical feasibility, and cost-effectiveness. Funding Sources This analysis was supported by a grant to UC Davis from Helen Keller International.


1966 ◽  
Vol 96 (3) ◽  
pp. 310-315 ◽  
Author(s):  
Fred Benjamin ◽  
Frank A. Bassen ◽  
Leo M. Meyer
Keyword(s):  

Sign in / Sign up

Export Citation Format

Share Document