scholarly journals Food fortification: good to have or need to have?

2004 ◽  
Vol 10 (6) ◽  
pp. 771-777
Author(s):  
A. Verster
Keyword(s):  
Developing Countries ◽  
Folic Acid ◽  
Food Fortification ◽  
Micronutrient Deficiencies ◽  
Vicious Cycle ◽  
Child Bearing ◽  
Large Populations ◽  
Life Threatening ◽  
Iron And Folic Acid ◽  
Staple Foods

Only very small quantities of vitamins and minerals are needed for human health but deficiencies can have disproportionately large, often life-threatening, effects. Micronutrient deficiencies lead to a vicious cycle of malnutrition and infection in poorly nourished populations. Fortification of staple foods is the cheapest, most efficient and most effective way to supply large populations with essential micronutrients. This paper reviews the case for fortification of flour supplies with iron and folic acid and concludes that it is the best way to provide daily doses of these nutrients to populations in developing countries, especially for women of child-bearing age

Food Fortification: A Tool for Fighting Hidden Hunger

1998 ◽  
Vol 19 (1) ◽  
pp. 49-60 ◽  
Author(s):  
Alberto Nilson ◽  
Jaime Piza
Keyword(s):  
Developing Countries ◽  
Economic Development ◽  
Food Fortification ◽  
Micronutrient Deficiencies ◽  
Staple Food ◽  
Industrialized Countries ◽  
Hidden Hunger ◽  
Socio Economic Development ◽  
Staple Foods ◽  
The Impact

This paper reviews the fortification of staple food as a tool to prevent micronutrient deficiencies. The rationale for fortifying salt, wheat flour, milk, and margarine was developed in the 1920s and 1940s, mainly in industrialized countries. At that time, fortification of staple foods was considered by only a few developing countries. Recent research has shown that the prevalences of some deficiencies (clinical and marginal) in some developing countries are higher than expected. Even more important has been the realization that the impact of marginal deficiencies on health and socio-economic development is considerably more important than the impact of clinical deficiencies. Iron, vitamin A, and iodine have gained more attention, but deficiencies of other micronutrients are also relevant. This paper shows that fortification of staple foods to prevent micronutrient deficiencies is effective, easy, fast, safe, and relatively inexpensive.

Efficacy of Adding Folic Acid to Foods

2012 ◽  
Vol 82 (3) ◽  
pp. 177-186 ◽  
Author(s):  
Violeta Fajardo ◽  
Gregorio Varela-Moreiras
Keyword(s):  
Folic Acid ◽  
Age Groups ◽  
Nutritional Deficiencies ◽  
Physiological Status ◽  
Food Fortification ◽  
Limited Information ◽  
Dietary Recommendations ◽  
Nutritional Education ◽  
Food Composition Tables ◽  
Staple Foods

In the past, food fortification along with nutritional education and the decrease in food costs relative to income have proven successful in eliminating common nutritional deficiencies. These deficiencies such as goiter, rickets, beriberi, and pellagra have been replaced with an entirely new set of “emergent deficiencies” that were not previously considered a problem [e.g., folate and neural tube defects (NTDs)]. In addition, the different nutrition surveys in so-called affluent countries have identified “shortfalls” of nutrients specific to various age groups and/or physiological status. Complex, multiple-etiology diseases, such as atherosclerosis, diabetes, cancer, and obesity have emerged. Food fortification has proven an effective tool for tackling nutritional deficiencies in populations; but today a more reasonable approach is to use food fortification as a means to support but not replace dietary improvement strategies (i. e. nutritional education campaigns). Folic acid (FA) is a potential relevant factor in the prevention of a number of pathologies. The evidence linking FA to NTD prevention led to the introduction of public health strategies to increase folate intakes: pharmacological supplementation, mandatory or voluntary fortification of staple foods with FA, and the advice to increase the intake of folate-rich foods. It is quite contradictory to observe that, regardless of these findings, there is only limited information on food folate and FA content. Data in Food Composition Tables and Databases are scarce or incomplete. Fortification of staple foods with FA has added difficulty to this task. Globally, the decision to fortify products is left up to individual food manufacturers. Voluntary fortification is a common practice in many countries. Therefore, the “worldwide map of vitamin fortification” may be analyzed. It is important to examine if fortification today really answers to vitamin requirements at different ages and/or physiological states. The real impact of vitamin fortification on some key biomarkers is also discussed. An important question also to be addressed: how much is too much? It is becoming more evident that chronic excessive intakes may be harmful and a wide margin of safety seems to be a mandatory practice in dietary recommendations. Finally, the “risk/benefit” dilemma is also considered in the “new” FA-fortified world.

Food Fortification: Safety and Legislation

1998 ◽  
Vol 19 (2) ◽  
pp. 109-116 ◽  
Author(s):  
Gregory D. Orriss
Keyword(s):  
Developing Countries ◽  
Nutrition Education ◽  
Target Population ◽  
Food Preservation ◽  
World Health ◽  
Final Report ◽  
Food Fortification ◽  
Micronutrient Deficiencies ◽  
Food And Agriculture ◽  
Health Organization

The Food and Agriculture Organization/World Health Organization (FAO/WHO) International Conference on Nutrition (ICN), held in Rome in December 1992, recognized the widespread occurrence of micronutrient deficiencies, particularly in developing countries. The conference recognized food-based approaches as the most effective way to address existing micronutrient deficiencies. These approaches must include appropriate strategies to assure dietary diversification, improved food availability, food preservation, nutrition education, and food fortification. The final report of the conference included strategies and actions for preventing and controlling specific micronutrient deficiencies. It was proposed to ensure and legislate the fortification of foods or water with necessary micronutrients, where possible, when existing supplies fail to provide adequate levels in the diet. Food fortification has been successfully used in both developed and developing countries as one strategy to address micronutrient deficiencies. The primary purposes of food legislation are to protect the health of the consumer, protect the consumer from fraud, and facilitate trade. In the case of fortified foods, the target population must be protected from receiving either toxic or nutritionally ineffective levels of micronutrients. Legislation may be necessary to require adequate control over this fortification process by the food processors to ensure that levels of micronutrients are consistently within acceptable limits. Legislation may also be required to prohibit the addition of nutrients to commodities where it is nutritionally unnecessary or unsafe or where fortification may create an erroneous impression as to the nutritional value of the food. Any legislation regarding food fortification should incorporate the standards, recommendations, and guidelines of the Codex Alimentarius. The World Trade Organization (WTO) Agreement on the Application of Sanitary and Phytosanitary Measures (the SPS Agreement) and the WTO Agreement on Technical Barriers to Trade (the TBT Agreement) have placed new importance on Codex standards, guidelines, codes, and recommendations.

scholarly journals Examining Heterogeneity of Food Fortification and Biofortification Business Models: Emerging Evidence for a Typology

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1233
Author(s):  
Baqir Lalani ◽  
Rania Hassan ◽  
Ben Bennett
Keyword(s):  
Large Scale ◽  
Business Models ◽  
Food Fortification ◽  
Micronutrient Deficiencies ◽  
Middle Income ◽  
Middle Income Countries ◽  
Comprehensive Literature Review ◽  
Business Conditions ◽  
Staple Foods ◽  
Measurement Of Success

Efforts to address Micronutrient deficiencies (MNDs) in lower-and middle-income countries (LMICs) have been gaining pace in recent years. Commodities such as staple foods (e.g., cereals, roots, and tubers) and condiments (e.g., salt) have been targeted as ‘vehicles’ for fortification and biofortification through numerous projects and initiatives. To date, there have been mixed experiences with delivery and coverage with very little documented on the range of business models applied in different geographies, business conditions and polities and this makes classification and measurement of success and failure difficult. This research aims to address this gap in knowledge through proposing a typology that clarifies similarities (internal heterogeneity) and differences (external heterogeneity) between models and that can allow all types to be defined by the combination of attributes. Building on a comprehensive literature review; NVivo was used to code initiatives from 34 key references (955 cases in total) which have been grouped into 17 categories. Using non-metric multidimensional scaling (NMDS) we find evidence of four business model groupings that typify fortification initiatives: (1) Large-scale private, unregulated, (2) Mixed-Scale, private, unregulated (3) Large-scale, public-private, regulated; and (4) Large-scale, private, regulated. We characterise these four groups with country examples and suggest that this typology can help the discourse around viability of food fortification initiatives.

scholarly journals Fortification strategies to meet micronutrient needs: sucesses and failures

2002 ◽  
Vol 61 (2) ◽  
pp. 231-241 ◽  
Author(s):  
Ian Darnton-Hill ◽  
Ritu Nalubola
Keyword(s):  
Developing Countries ◽  
Folic Acid ◽  
Well Being ◽  
Developed Countries ◽  
Successful Implementation ◽  
Food Fortification ◽  
Industrialized Countries ◽  
The Usa ◽  
Micronutrient Malnutrition ◽  
And Control

Food fortification is likely to have played an important role in the current nutritional health and well-being of populations in industrialized countries. Starting in the early part of the 20th century, fortification was used to target specific health conditions: goitre with iodized salt; rickets with vitamin D-fortified milk; beriberi, pellagra and anaemia with B-vitamins and Fe-enriched cereals; more recently, in the USA, risk of pregnancy affected by neural-tube defects with folic acid-fortified cereals. A relative lack of appropriate centrally-processed food vehicles, less-developed commercial markets and relatively low consumer awareness and demand, means it has taken about another 50 years for fortification to be seen as a viable option for the less-developed countries. The present paper reviews selected fortification initiatives in developing countries to identify different factors that contributed to their successful implementation, as well as the challenges that continually threaten the future of the se programmes. Ultimately, the long-term sustainability of fortification programmes is ensured when consumers are willing and able to bear the additional cost of fortified foods. There has been an enormous increase in fortification programmes over the last couple of decades in developing countries. Considerable progress has been made in reducing vitamin A and I deficiencies, although less so with Fe, even as Zn and folic acid deficiencies are emerging as important public health problems. Food fortification based on sound principles and supported by clear policies and regulations can play an increasingly large role in this progress towards prevention and control of micronutrient malnutrition.

scholarly journals SERUM VITAMIN B12, IRON AND FOLIC ACID DEFICIENCIES IN OBESE INDIVIDUALS SUBMITTED TO DIFFERENT BARIATRIC TECHNIQUES

2016 ◽  
Vol 29 (suppl 1) ◽  
pp. 62-66 ◽  
Author(s):  
Rafaella de Andrade SILVA ◽  
Flávia Monteiro França MALTA ◽  
Maria Flora Ferreira Sampaio Carvalho CORREIA ◽  
Maria Goretti Pessoa de Araújo BURGOS
Keyword(s):  
Gastric Bypass ◽  
Folic Acid ◽  
Gastric Banding ◽  
Vitamin B12 ◽  
Surgical Techniques ◽  
Serum Vitamin ◽  
Micronutrient Deficiencies ◽  
Nutrient Deficiencies ◽  
Restrictive Procedures ◽  
Iron And Folic Acid

ABSTRACT Background: Different surgical techniques to combat obesity combine malabsorption with restrictive procedures and can lead to metabolic problems, such as micronutrient deficiencies. Aim: Assess vitamin B12, iron and folic acid deficiencies associated with the lifestyle of obese individuals having been submitted to different bariatric techniques. Methods: A retrospective analysis was performed using the electronic charts of patients submitted to bariatric surgery involving adjustable gastric banding and Roux-en-Y gastric bypass at the São João Hospital Center in the city of Porto, Portugal, between 2005 and 2010. The following data were collected: surgical technique, sex, age, marital status, serum concentrations of vitamin B12, iron and folic acid and postoperative lifestyle. A 5% significance level was used for the statistical analysis (p<0.05). Results: Among 286 individuals evaluated, females accounted for 90.9% of the overall sample (both techniques). Gastric banding was performed more (68.9%), but greater nutrient deficiencies were found following gastric bypass. Iron was the most prevalent deficiency (21.3%), followed by vitamin B12 (16.9%) and folic acid (4.5%). Mild to moderate alcohol intake, adherence to the diet and the use of multivitamins reduced the frequency, but did not avoid micronutrient deficiency. Conclusion: Vitamin B12, iron and folic acid deficiencies were found in the first and second year following the two bariatric techniques analyzed and were more frequent among individuals submitted to gastric bypass.

scholarly journals Flour Fortification in South Africa: Post-Implementation Survey of Micronutrient Levels at Point of Retail

2012 ◽  
Vol 33 (4_suppl3) ◽  
pp. S321-S329 ◽  
Author(s):  
Rizwan Yusufali ◽  
Nigel Sunley ◽  
Maude de Hoop ◽  
Dora Panagides
Keyword(s):  
South Africa ◽  
Vitamin A ◽  
White Bread ◽  
Food Fortification ◽  
Effective Strategy ◽  
Micronutrient Deficiencies ◽  
Staple Food ◽  
Effective Delivery ◽  
Maize Meal ◽  
Staple Foods

Background Fortification of staple foods is an effective strategy to deliver and increase the intake of micronutrients in the diet and can reduce micronutrient deficiencies. It is important to ensure that the food vehicle consistently contains adequate amounts of nutrients at the point of consumption for effective impact. Objective This survey aimed to gauge the level of fortification of maize and wheat flour at the retail level compared with staple food fortification regulations in South Africa to better understand the current obstacles to effective delivery of micronutrients through flour fortification and consider approaches to strengthening the program. Methods White bread flour and maize meal samples were collected from retail points across all provinces and analyzed for vitamin A, iron, and nicotinamide, and a database capturing the origins of the sample was populated. Nicotinamide and vitamin A results were compared against each other and evaluated against food regulations. Results The level of compliance with statutory fortification requirements was low, both for bread flour and for maize meal. There is evidence of insufficient addition of premix as opposed to losses due to vitamin A stability as seen from the strong correlation between vitamin A and nicotinamide in maize meal. Conclusions The current levels of micronutrients added to maize meal and bread flour are unsatisfactory. This is likely to be because of insufficient addition of premix at the mills. This affects the availability and intake by consumers of fortified product and potentially prevents the desired reduction in vitamin and mineral deficiencies expected from the flour fortification program.

scholarly journals A root cause analysis of sub-optimal uptake and compliance to iron and folic acid supplementation in pregnancy in 7 districts of Zambia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Moses C. Simuyemba ◽  
Phoebe A. Bwembya ◽  
Mumbi Chola ◽  
Charles Michelo
Keyword(s):  
Folic Acid ◽  
Supply And Demand ◽  
Root Cause Analysis ◽  
Folic Acid Supplementation ◽  
Cause Analysis ◽  
Acid Supplementation ◽  
Root Cause ◽  
Child Bearing ◽  
Iron And Folic Acid ◽  
In Pregnancy

Abstract Background Iron and Folic Acid are two of the micronutrients recommended for pregnant women to support optimal maternal outcomes with regard to preventing anaemia and foetal birth defects. It is difficult to establish if women provided with iron and folic acid supplementation in Zambia benefit from it and how well it is implemented. The overall objective of this study was to determine the levels of uptake and compliance to iron and folic acid in pregnancy among women of child-bearing age in Zambia, with a focus on both supply and demand factors. Methods A cross sectional, mixed method study was done. Data was collected in August and September 2015 from six of the 14 districts in which Scaling Up Nutrition interventions were being undertaken as well as Lusaka district. A household survey covering 402 males and females of child-bearing age, 27 key informant interviews amongst key stakeholders and 12 focus group discussions at community level were conducted. Results Antenatal clinic attendance was almost universal (98.7%); the majority of both men (92.1%) and women (97.4%) had heard messages about iron and folic acid supplementation; the majority (96.5%) of women reported having taken iron and folic acid tablets during their last pregnancy, with 61.3% starting in the second trimester, 27.2% during the first trimester, and 7.7% in their third trimester. Eighty-five per cent (80.5%) of the women reported that they had taken all the tablets they were given with about 13.4% not taking all the tablets received. Conclusions Root cause analysis, using both qualitative and quantitative findings, showed that the main challenges faced were long distances to health facilities and high transport costs; some women not being reached with supplementation messaging; lack of formalised and uniform training around delivery of antenatal messages across health care workers; women not attending antenatal monthly to replenish supplements; and forgetfulness to take the drugs daily. While male involvement may be a supportive factor, it sometimes hinders women from accessing antenatal services. Results showed that both uptake and compliance to iron and folic acid supplementation in pregnancy in Zambia were sub-optimal.

Emerging Nutrition Gaps in a World of Affluence - Micronutrient Intake and Status Globally

2011 ◽  
Vol 81 (4) ◽  
pp. 238-239 ◽  
Author(s):  
Manfred Eggersdorfer ◽  
Paul Walter
Keyword(s):  
Developing Countries ◽  
Human Health ◽  
Old Age ◽  
Molecular Basis ◽  
Health Benefit ◽  
Developed Countries ◽  
Micronutrient Deficiencies ◽  
New Science ◽  
Health And Nutrition ◽  
Micronutrient Intake

Nutrition is important for human health in all stages of life - from conception to old age. Today we know much more about the molecular basis of nutrition. Most importantly, we have learnt that micronutrients, among other factors, interact with genes, and new science is increasingly providing more tools to clarify this interrelation between health and nutrition. Sufficient intake of vitamins is essential to achieve maximum health benefit. It is well established that in developing countries, millions of people still suffer from micronutrient deficiencies. However, it is far less recognized that we face micronutrient insufficiencies also in developed countries.

Sign in / Sign up

Export Citation Format

Share Document