Large-scale food fortification has great potential to improve child health and nutrition

Background: Food fortification and biofortification are well-established strategies to address micronutrient deficiencies in vulnerable populations. However, the effectiveness of fortification programs is not only determined by the biological efficacy of the fortified foods but also by effective and sustainable implementation, which requires continual monitoring, quality assurance and control, and corrective measures to ensure high compliance. Objective: To provide an overview of efficacy, effectiveness, economics of food fortification and biofortification, and status of and challenges faced by large-scale food fortification programs in low- and middle-income countries (LMIC). Methods: A literature review of PubMed publications in English from 2000 to 2017, as well as gray literature, targeting nongovernmental organizations whose work focuses on this topic, complemented by national reports and a “snowball” process of citation searching. The article describes remaining technical challenges, barriers, and evidence gap and prioritizes recommendations and next steps to further accelerate progress and potential of impact. Results: The review identifies and highlights essential components of successful programs. It also points out issues that determine poor program performance, including lack of adequate monitoring and enforcement and poor compliance with standards by industry. Conclusions: In the last 17 years, large-scale food fortification initiatives have been reaching increasingly larger segments of populations in LMIC. Large-scale food fortification and biofortification should be part of other nutrition-specific and nutrition-sensitive efforts to prevent and control micronutrient deficiencies. There are remaining technical and food system challenges, especially in relation to improving coverage and quality of delivery and measuring progress of national programs.

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Using cash transfers to improve child health in low- and middle-income countries

10.31485/pi.2523.2020 ◽

2020 ◽

Keyword(s):

Child Health ◽

Cash Transfers ◽

Middle Income ◽

Middle Income Countries ◽

Improve Child Health ◽

Low And Middle Income

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Conception and Creation of the American Academy of Pediatrics

PEDIATRICS ◽

10.1542/peds.92.3.469 ◽

1993 ◽

Vol 92 (3) ◽

pp. 469-470

Author(s):

James G. Hughes

Keyword(s):

United States ◽

Child Health ◽

The United States ◽

Mortality Rates ◽

American Academy Of Pediatrics ◽

Improve Child Health ◽

Women And Children ◽

National Programs ◽

The 19Th Century ◽

Pregnant Mothers

In the latter years of the 19th century, and to an increasing degree in the first decades of the 20th, there arose in the United States and elsewhere a growing concern for the health and welfare of women and children, especially pregnant mothers and infants. Compared with current figures, maternal and infant mortality rates were extremely high, and there were virtually no widespread programs to avoid malnutrition and a host of preventable diseases and disabilities in childhood. Isolated instances of good maternal and infant programs existed, but it became obvious that our country needed national programs to improve child health and welfare.

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Can a new paediatric sub-specialty improve child health in South Africa?

South African Medical Journal ◽

10.7196/samj.5714 ◽

2012 ◽

Vol 102 (9) ◽

pp. 738 ◽

Cited By ~ 2

Author(s):

George Swingler ◽

Michael Hendricks ◽

David Hall ◽

Susan Hall ◽

David Sanders ◽

...

Keyword(s):

South Africa ◽

Child Health ◽

Improve Child Health

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Microalgae for High-Value Products Towards Human Health and Nutrition

Marine Drugs ◽

10.3390/md17050304 ◽

2019 ◽

Vol 17 (5) ◽

pp. 304 ◽

Cited By ~ 56

Author(s):

Ines Barkia ◽

Nazamid Saari ◽

Schonna R. Manning

Keyword(s):

Bioactive Compounds ◽

Large Scale ◽

Commercial Production ◽

Health Conditions ◽

Omega 3 Fatty Acids ◽

Omega 3 ◽

Scale Growth ◽

Health And Nutrition ◽

Potential Source ◽

Common Problems

Microalgae represent a potential source of renewable nutrition and there is growing interest in algae-based dietary supplements in the form of whole biomass, e.g., Chlorella and Arthrospira, or purified extracts containing omega-3 fatty acids and carotenoids. The commercial production of bioactive compounds from microalgae is currently challenged by the biorefinery process. This review focuses on the biochemical composition of microalgae, the complexities of mass cultivation, as well as potential therapeutic applications. The advantages of open and closed growth systems are discussed, including common problems encountered with large-scale growth systems. Several methods are used for the purification and isolation of bioactive compounds, and many products from microalgae have shown potential as antioxidants and treatments for hypertension, among other health conditions. However, there are many unknown algal metabolites and potential impurities that could cause harm, so more research is needed to characterize strains of interest, improve overall operation, and generate safe, functional products.

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Assessing the Coverage of Biofortified Foods: Development and Testing of Methods and Indicators in Musanze, Rwanda

Current Developments in Nutrition ◽

10.1093/cdn/nzaa067_060 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1833-1833

Author(s):

Nicolai Petry ◽

James Wirth ◽

Valerie Friesen ◽

Fabian Rohner ◽

Arcade Nkundineza ◽

...

Keyword(s):

Urban Areas ◽

Large Scale ◽

Household Survey ◽

Test Methods ◽

Food Fortification ◽

Program Performance ◽

Sweet Potatoes ◽

Cross Sectional ◽

Funding Sources ◽

Gates Foundation

Abstract Objectives Biofortification is a promising approach to increase micronutrient intakes, especially among populations that are hard to reach with other interventions. Information on the coverage of biofortified foods is needed to ascertain potential for impact, understand program performance, and identify bottlenecks. In this study, we aimed to develop and test methods and indicators for assessing household coverage of biofortified foods. Methods We developed five recall-based indicators of household coverage to assess biofortification programs building on approaches previously used to assess targeted and large-scale food fortification programs. These were: 1) consumption of the food; 2) awareness of the biofortified food; 3) availability of the biofortified food; 4) consumption of the biofortified food (ever); and 5) consumption of the biofortified food (current). We tested these indicators in a cross-sectional, cluster, household survey in 20 rural and five peri-urban areas in Musanze, Rwanda where two biofortification programs, i.e., biofortified beans and orange fleshed sweet potatoes (OFSP), were implemented. Results Among the 242 households surveyed, consumption of beans and sweet potatoes was high (99% and 96%, respectively) while awareness of biofortified beans or OFSP was 66% and 49%, respectively, and availability was 24% and 11%, respectively. Overall, 15% and 11% of households had ever consumed biofortified beans and OFSP, respectively, and 10% and 2% of households were currently consuming them, respectively. The major bottlenecks to coverage were awareness and availability of the biofortified foods. Conclusions The proposed methods and indicators fill a gap in the availability of tools to assess biofortification program coverage and the results of the survey highlight their utility for assessing program performance and identifying bottlenecks. Further testing is warranted to confirm the generalizability of the coverage indicators and inform their operationalization when deployed in different contexts. Funding Sources Bill & Melinda Gates Foundation.

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