1
|
Kumari M, Kumari R, Nataraj BH, Shelke PA, Ali SA, Nagpal R, Behare PV. Physicochemical and rheological characterizations of a novel exopolysaccharide EPSKar1 and its iron complex EPSKar1-Fe: Towards potential iron-fortification applications. Curr Res Food Sci 2023; 6:100478. [PMID: 36935848 PMCID: PMC10017363 DOI: 10.1016/j.crfs.2023.100478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/13/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
Iron is a micronutrient essential for human health and physiology. Iron-deficiency anemia, the most common form of anemia, may occur from an iron homeostasis imbalance. Iron fortification is a promising and most sustainable and affordable solution to tackle the global prevalence of this anemia. Herein, we investigate physicochemical, rheological and stability characteristics of a novel exopolysaccharide 'EPSKar1' (derived from Lacticaseibacillus rhamnosus strain Kar1) and its iron complex 'EPSKar1-Fe (II)'. Our findings demonstrate that EPSKar1 is a high molecular-weight (7.8 × 105 Da) branched-chain heteropolysaccharide composed of galactose, N-acetylglucosamine, and mannose in a molar ratio of 8:4:1, respectively, and exhibits strong emulsifying and water-holding capacities. We find that EPSKar1 forms strong complexes with Fe, wherein the interactions between EPSKar1-Fe (II) complexes are mediated by sulfate, carboxyl, and hydroxyl groups. The rheological analyses reveal that the EPSKar1 and EPSKar1-Fe (II) complexes exhibited shear thickening and thinning properties in skim milk and water, respectively; however, the suspension of EPSKar1 in skim milk is viscoelastic with predominantly elastic response (G'>G" and tan δ < 1). In comparison, EPSKar1-Fe (II) complex exhibits remarkable stability under various processing conditions, highlighting its usefulness for the development of fortified dairy products. Together, these findings underpin considerable prospects of EPSKar1-Fe (II) complex as a novel iron-fortifier possessing multifarious rheological benefits for food applications.
Collapse
Affiliation(s)
- Manorama Kumari
- Technofunctional Starter Lab, National Collection of Dairy Cultures (NCDC), Dairy Microbiology Division, National Dairy Research Institute, Karnal, 132001, Haryana, India
| | - Rolly Kumari
- Technofunctional Starter Lab, National Collection of Dairy Cultures (NCDC), Dairy Microbiology Division, National Dairy Research Institute, Karnal, 132001, Haryana, India
| | - Basavaprabhu Haranahalli Nataraj
- Technofunctional Starter Lab, National Collection of Dairy Cultures (NCDC), Dairy Microbiology Division, National Dairy Research Institute, Karnal, 132001, Haryana, India
| | - Prashant Ashok Shelke
- Dairy Technology Division, National Dairy Research Institute, Karnal, 132001, Haryana, India
| | - Syed Azmal Ali
- Proteomics of Stem Cells and Cancer, German Cancer Research Center (DKFZ), Heidelberg, 69121, Germany
- Corresponding author.
| | - Ravinder Nagpal
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL, 32306, USA
- Corresponding author.
| | - Pradip V. Behare
- Technofunctional Starter Lab, National Collection of Dairy Cultures (NCDC), Dairy Microbiology Division, National Dairy Research Institute, Karnal, 132001, Haryana, India
- Corresponding author.
| |
Collapse
|
2
|
Kaur N, Agarwal A, Sabharwal M. Food fortification strategies to deliver nutrients for the management of iron deficiency anaemia. Curr Res Food Sci 2022; 5:2094-2107. [PMID: 36387591 PMCID: PMC9641006 DOI: 10.1016/j.crfs.2022.10.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 09/16/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
A rising trend in the global prevalence of anaemia is still prevailing. To combat micronutrient deficiencies, World Health Organisation/Food Agriculture Organisation (2006) guidelines recommended four chief strategies - supplementation, fortification, nutrition education and dietary diversity. Of the four strategies, food fortification has been considered as the most efficacious and economical approach. However, it is the directives themselves that highlight two major bottlenecks associated with conventional fortification - uniform dissemination of the fortifier in food vehicle that mostly include staple foods, and internal and external compliance evaluation of fortification regulations and standards by the producers. As a result, researchers envisaged a new strategy - Food-to-food fortification that complements conventional fortification. This strategy involves fortification of food vehicles with nutrient-rich food-based fortifiers. The major advantage of utilising food-based fortifiers is that they hold the potential of enhancing the bioavailability of the fortified food and providing additional nutrients and thus, resulting in dietary diversification. It also facilitates the utilisation of underutilised crops as food-based fortifiers. Underutilised crops have been recognised as potential beneficial food source accounting to their nutritional, ecological, and fiscal benefits. This review paper delves into the strengths and shortcomings of conventional iron fortification. It delineates the concept of food-to-food fortification, while precisely discussing about the best practices to be followed to address the possible challenges associated with this strategy. It also promotes the utilisation of underutilised iron rich foods to develop fortified foods and avert global food insecurity. Furthermore, it provides a summary of the studies conducted around the world to develop fortified foods using iron compounds and iron-rich foods, and to investigate their efficacy in managing iron deficiency anaemia.
Collapse
Affiliation(s)
- Naman Kaur
- Department of Food and Nutrition, Lady Irwin College, University of Delhi, Sikandra Road, New Delhi, 110001, India
| | - Aparna Agarwal
- Food Technology, Department of Food and Nutrition, Lady Irwin College, University of Delhi, Sikandra Road, New Delhi, 110001, India
| | - Manisha Sabharwal
- Department of Food and Nutrition, Lady Irwin College, University of Delhi, Sikandra Road, New Delhi, 110001, India
| |
Collapse
|
3
|
Csölle I, Felső R, Szabó É, Metzendorf MI, Schwingshackl L, Ferenci T, Lohner S. Health outcomes associated with micronutrient-fortified complementary foods in infants and young children aged 6–23 months: a systematic review and meta-analysis. THE LANCET CHILD & ADOLESCENT HEALTH 2022; 6:533-544. [PMID: 35753314 PMCID: PMC9279162 DOI: 10.1016/s2352-4642(22)00147-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 12/02/2022]
Abstract
Background Appropriate feeding of infants and young children is essential for healthy growth and the prevention of stunting, wasting, and overweight. We aimed to assess the beneficial versus harmful effects of providing fortified complementary foods to children in the complementary feeding period. Methods In this systematic review and meta-analysis, we searched the databases Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Global Index Medicus, Web of Science, ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform from inception to March 9, 2021. We included randomised controlled trials and controlled clinical trials done in infants and children aged 6–23 months with no identified health problems. Consumption of foods fortified centrally (ie, during industrial processing) with one micronutrient or a combination of vitamins, minerals, or both was compared with the same complementary foods, but without micronutrient fortification. Two review authors independently screened studies for eligibility, extracted data, assessed risk of bias, and rated the certainty of the evidence. The main outcomes were growth (measured by Z scores for weight for age, weight for height or length, and height or length for age, or other growth measures), stunting, wasting, nutrient adequacy or excess, anaemia, haemoglobin concentration, iron status, serum zinc concentration, and serum retinol concentration. We used a random-effects meta-analysis for combining data. This study is registered with PROSPERO, CRD42021245876. Findings We included 16 studies with 6423 participants, 13 of which were done in malaria-endemic areas. Overall, 12 studies were included in the quantitative syntheses. We identified five further ongoing studies. There was no difference between participants who received fortified complementary foods and those who received non-fortified complementary foods in weight-for-age Z scores (mean difference −0·01, 95% CI −0·07 to 0·06; five trials; 1206 participants; moderate-certainty evidence), weight-for-height or length Z scores (−0·05, −0·19 to 0·10; four trials; 1109 participants; moderate-certainty evidence), and height or length-for-age Z scores (−0·01, −0·21 to 0·20; four trials; 811 participants; low-certainty evidence); stunting and wasting were not assessed in any study as outcomes. Moderate-certainty evidence from six trials with 1209 patients showed that providing fortified complementary foods to children aged 6–23 months reduced the risk of anaemia (risk ratio 0·57, 95% CI 0·39 to 0·82). Those who received fortified complementary foods compared with those who did not had higher haemoglobin concentrations (mean difference 3·44 g/L, 95% CI 1·33 to 5·55; 11 trials; 2175 participants; moderate-certainty evidence) and ferritin concentration (0·43 μg/L on log scale, 0·14 to 0·72; six trials; 903 participants; low-certainty evidence). The intervention led to no effects on serum zinc concentration (−0·13 g/dL, −0·82 to 0·56; two trials; 333 participants; low-certainty evidence) and serum retinol concentration (0·03 μmol/L, −0·02 to 0·08; five trials; 475 participants; moderate-certainty evidence). Interpretation Fortified complementary foods are effective strategies to prevent anaemia in infants and young children aged 6–23 months in malaria-endemic regions. Effects of complementary food fortification should be further investigated in low-income and middle-income countries, but should also be assessed in high-income countries, and in regions where malaria is not endemic. Funding WHO.
Collapse
|
4
|
Harrison OA, Hays NP, Ansong RS, Datoghe D, Vuvor F, Steiner‐Asiedu M. Effect of iron-fortified infant cereal on nutritional status of infants in Ghana. Food Sci Nutr 2022; 10:286-294. [PMID: 35035929 PMCID: PMC8751428 DOI: 10.1002/fsn3.2669] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/29/2021] [Accepted: 10/30/2021] [Indexed: 01/07/2023] Open
Abstract
Iron deficiency anemia is prevalent among infants in Ghana. This study evaluated the effect of micronutrient-fortified infant cereal on the nutritional status of infants in the La Nkwantanang Municipality of the Greater Accra Region of Ghana, located in western Africa. In this double-blind, controlled trial, infants aged 6-18 months were cluster-randomized to receive either micronutrient-fortified infant cereal containing 3.75 mg iron as ferrous fumarate/50 g cereal (INT; n = 107) or the same cereal without iron (CTL; n = 101) to complement other foods and breast milk. The intervention phase lasted six months followed by a two-month post-intervention phase (with no further study product feeding). Hemoglobin and anthropometry were assessed every 2 months for the 8-month study period. After the 6-month intervention phase, adjusted mean ± standard error change in hemoglobin from baseline in INT and CTL was 1.97 ± 0.19 and 1.16 ± 0.21 g/dl, respectively (p < .01 for each); the increase in hemoglobin was significantly larger in INT versus CTL (increase 0.68 ± 0.30 g/dl; p = .02). Prevalence of anemia declined to a significantly greater extent in INT (84.1% to 42.8%) compared to CTL (89.1% to 62.8%; p = .006). There was no significant difference between groups in weight gain (p = .41) or height gain (p = .21) over the study period. In infants aged 6-18 months, micronutrient-fortified infant cereal consumed for 6 months promoted greater reductions in iron-deficiency anemia, which is a significant public health concern not only in Ghana but also in many developing countries globally.
Collapse
Affiliation(s)
| | | | - Richard S. Ansong
- Department of Nutrition and Food ScienceUniversity of GhanaLegon‐AccraGhana
| | - Dominic Datoghe
- Department of Nutrition and Food ScienceUniversity of GhanaLegon‐AccraGhana
| | - Frederick Vuvor
- Department of Nutrition and Food ScienceUniversity of GhanaLegon‐AccraGhana
| | | |
Collapse
|
5
|
Community Preventive Health Education Intervention for Pediatric Iron-Deficiency Anemia in Rural Southeast Nigeria. Ann Glob Health 2022; 88:105. [PMID: 36474896 PMCID: PMC9695148 DOI: 10.5334/aogh.3625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 10/19/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives Iron-deficiency anemia (IDA) is a global cause of morbidity in children under five, particularly in sub-Saharan Africa. In southeast Nigeria, poor dietary intake and caregiver knowledge about childhood anemia are observed; however, there is no consensus on how to best prevent it. This study seeks to test the effectiveness of caregiver education on improving anemia knowledge and dietary prevention strategies and promoting sustainable lifestyle changes to reduce the prevalence of childhood IDA. Study Design A questionnaire was administered to the primary caregivers of 41 patients under age five with anemia in southeast Nigeria regarding socioeconomic status (SES), diet diversity, and risk factors for anemia. Caregivers were administered a preeducation questionnaire, poster education on anemia and iron-rich foods, and a posteducation questionnaire. All patients underwent a medical exam to confirm a diagnosis of anemia or anemia-related conditions. Results Ninety-five percent of patients had moderate diet diversity, but there was no correlation between diet diversity and SES. Barriers to healthier diets were associated with SES. Preeducation scores were not associated with caregivers' education levels; however, posteducation scores were significantly higher in university-educated than technical-trained caregivers. Caregiver-reported self-efficacy increased after the education program. Conclusion Caregivers' SES was associated with financial and knowledge barriers to a healthier diet but not diet diversity, suggesting that nutritional education could benefit all SES groups. Overall, the education program increased caregivers' anemia knowledge across educational levels. A community-based health education program could improve caregivers' anemia knowledge and self-efficacy in applying this information and potentially reduce this area's pediatric IDA.
Collapse
|
6
|
Wu B, Choy CC, Rivara AC, Soti-Ulberg C, Naseri T, Reupena MS, Duckham RL, Hawley NL. Persistence of anaemia among Samoan preschool age children: a longitudinal study. Public Health Nutr 2021; 24:5995-6006. [PMID: 34521497 PMCID: PMC8608721 DOI: 10.1017/s1368980021003980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/27/2021] [Accepted: 09/10/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To characterise the prevalence and persistence of anaemia among Samoan children over a 2-3-year period. DESIGN Data were from two consecutive waves (2015 and 2017-2018) of the Ola Tuputupua'e 'Growing up' study. Anaemia (Hb < 11·0 or 11·5 g/dl for 2-4 and ≥ 5 years old, respectively) was considered 'transient' when it occurred at only one wave or 'persistent' if it was present at two consecutive waves. Child, maternal and household correlates of anaemia were examined using log-binomial and modified Poisson regressions. SETTING Eleven Samoan villages. PARTICIPANTS Mother-child pairs (n 257) recruited in 2015 and reassessed in 2017-2018. RESULTS Anaemia prevalence was 33·9 % in 2015 and 28·0 % in 2017-2018; 35·6 % of cases identified in 2015 were persistent. Risk of anaemia at only one wave was lower among children who were older in 2015 (age 4 v. 2 years, adjusted relative risk (aRR) = 0·54, (95 % CI 0·35, 0·84), P = 0·007), had older mothers (≥ 40 v. 18-29 years, aRR = 0·61, (95 % CI 0·39, 0·95), P = 0·029) and had higher daily sodium intake (for every 100 mg/d, aRR = 0·97, (95 % CI 0·95, 0·99), P = 0·003) than children with no anaemia. Children whose anaemia persisted were more likely to have had a mother with anaemia (aRR = 2·13, (95 % CI 1·17, 3·89), P = 0·013) and had higher daily dietary iron intake (for every 10 mg/d, aRR = 4·69, (95 % CI 1·33, 16·49), P = 0·016) than those with no anaemia. CONCLUSIONS Alongside broadly targeted prevention efforts, which are warranted given the moderate-high anaemia prevalence observed, specific attention should be paid to children with risk factors for persistent anaemia. Routine screening of children whose mothers have anaemia should be encouraged.
Collapse
Affiliation(s)
- Bohao Wu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, New Haven, CT06510, USA
| | - Courtney C Choy
- Department of Epidemiology, International Health Institute, Brown University, School of Public Health, Providence, RI, USA
| | - Anna C Rivara
- Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, New Haven, CT06510, USA
| | | | - Take Naseri
- Department of Epidemiology, International Health Institute, Brown University, School of Public Health, Providence, RI, USA
- Ministry of Health, Apia, Samoa
| | | | - Rachel L Duckham
- Institute of Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Sciences, Melbourne, VIC, Australia
| | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, New Haven, CT06510, USA
| |
Collapse
|