1
|
Monge-Rojas R, Vargas-Quesada R, Previdelli AN, Kovalskys I, Herrera-Cuenca M, Cortés LY, García MCY, Liria-Domínguez R, Rigotti A, Fisberg RM, Ferrari G, Fisberg M, Gómez G. A Landscape of Micronutrient Dietary Intake by 15- to 65-Years-Old Urban Population in 8 Latin American Countries: Results From the Latin American Study of Health and Nutrition. Food Nutr Bull 2024; 45:S11-S25. [PMID: 38112070 DOI: 10.1177/03795721231215267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
BACKGROUND Latin American countries have shifted from traditional diets rich in micronutrients to a Westernized diet rich in high energy-dense foods and low in micronutrients. OBJECTIVE This study aimed to determine the prevalence of adequate micronutrient intakes in urban populations of 8 Latin American countries. METHOD Micronutrient dietary intake data were collected from September 2014 to August 2015 from 9216 men and women aged 15.0 to 65.0 years living in urban populations of 8 Latin American countries. Dietary intake was collected using two 24-hour recalls on nonconsecutive days. Micronutrient adequacy of intake was calculated using the Estimated Average Requirement cut-off method. RESULTS In general terms, the prevalence of inadequate intake of thiamine, riboflavin, niacin, folate, cobalamin, iron, phosphorus, copper, and selenium ranged from 0.4% to 9.9%. In contrast, the prevalence of inadequacy of pyridoxine, zinc, vitamin C, and vitamin A ranged from 15.7% to 51.5%. The nutrients with a critical prevalence of inadequacy were magnesium (80.5%), calcium (85.7%), and vitamin D (98.2%). The highest prevalence of inadequate intakes was observed in the low educational level, participants with overweight/obesity, in men, and varies according to socioeconomic status. CONCLUSIONS There is an urgent need to define direct regional actions and strategies in Latin America aimed at improving micronutrient adequacy, either through staple food fortification programs, agronomic biofortification, or food policies that facilitate economic access to micronutrient-rich foods.
Collapse
Affiliation(s)
- Rafael Monge-Rojas
- Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | - Rulamán Vargas-Quesada
- Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | | | - Irina Kovalskys
- Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Marianella Herrera-Cuenca
- Universidad Central de Venezuela, Caracas, Venezuela
- Framingham State University, Framingham, MA, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Baudron F, Cairns JE, Haefele SM, Hassall KL, Ndhlela T, Nyagumbo I, Manzeke-Kangara MG, Joy EJ. Projecting the Contribution of Provitamin A Maize Biofortification and Other Nutrition Interventions to the Nutritional Adequacy and Cost of Diets in Rural Zimbabwe. J Nutr 2024:S0022-3166(24)00178-0. [PMID: 38599385 DOI: 10.1016/j.tjnut.2024.04.009] [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: 02/03/2024] [Revised: 03/14/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Evidence of the effectiveness of biofortified maize with higher provitamin A (PVA) to address vitamin A deficiency in rural Africa remains scant. OBJECTIVES This study projects the impact of adopting PVA maize for a diversity of households in an area typical of rural Zimbabwe and models the cost and composition of diets adequate in vitamin A. METHODS Household-level weighed food records were generated from 30 rural households during a week in April and November 2021. Weekly household intakes were calculated, as well as indicative costs of diets using data from market surveys. The impact of PVA maize adoption was modeled assuming all maize products contained observed vitamin A concentrations. The composition and cost of the least expensive indicative diets adequate in vitamin A were calculated using linear programming. RESULTS Very few households would reach adequate intake of vitamin A with the consumption of PVA maize. However, from a current situation of 33%, 50%-70% of households were projected to reach ≤50% of their requirements (the target of PVA), even with the modest vitamin A concentrations achieved on-farm (mean of 28.3 μg RAE per 100 g). This proportion would increase if higher concentrations recorded on-station were achieved. The estimated daily costs of current diets (mean ± standard deviation) were USD 1.43 ± 0.59 in the wet season and USD 0.96 ± 0.40 in the dry season. By comparison, optimization models suggest that diets adequate in vitamin A could be achieved at daily costs of USD 0.97 and USD 0.79 in the wet and dry seasons, respectively. CONCLUSIONS The adoption of PVA maize would bring a substantial improvement in vitamin A intake in rural Zimbabwe but should be combined with other interventions (e.g., diet diversification) to fully address vitamin A deficiency.
Collapse
Affiliation(s)
- Frédéric Baudron
- International Maize and Wheat Improvement Center-Zimbabwe, Harare, Zimbabwe; Centre de coopération Internationale en Recherche Agronomique pour le Développement, UPR AIDA, Montpellier, France; Agroécologie et Intensification Durable des cultures Annuelles, Université de Montpellier, CIRAD, Montpellier, France.
| | - Jill E Cairns
- International Maize and Wheat Improvement Center-Zimbabwe, Harare, Zimbabwe
| | - Stephan M Haefele
- Sustainable Soils and Crops, Rothamsted Research, Harpenden, United Kingdom
| | - Kirsty L Hassall
- Sustainable Soils and Crops, Rothamsted Research, Harpenden, United Kingdom
| | - Thokozile Ndhlela
- International Maize and Wheat Improvement Center-Zimbabwe, Harare, Zimbabwe
| | - Isaiah Nyagumbo
- International Maize and Wheat Improvement Center-Zimbabwe, Harare, Zimbabwe
| | | | - Edward Jm Joy
- Sustainable Soils and Crops, Rothamsted Research, Harpenden, United Kingdom; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| |
Collapse
|
3
|
Palma-Duran SA, Morgan D, Combet E. Quantification of Vitamin A in Edible Oils: Comparison of Portable Device iCheck Chroma3 to High-Performance Liquid Chromatography. FOOD ANAL METHOD 2024; 17:847-854. [PMID: 38765762 PMCID: PMC11101343 DOI: 10.1007/s12161-024-02613-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 03/11/2024] [Indexed: 05/22/2024]
Abstract
Fortification of edible oil with vitamin A is a widely adopted intervention to minimize the effects of vitamin A deficiency in vulnerable groups and mitigate some of its deleterious consequences. Regulatory monitoring is an important prerequisite to ensure that the fortification program is implemented effectively. Standard laboratory analysis methods for vitamin A in oils to assess adequate addition levels remain expensive and time-consuming. Portable testing devices are relatively less expensive in terms of capital investment and cost per test. However, the reliability of results needs to be assured to ensure acceptability and confidence. This study compared a portable device to high-performance liquid chromatography (HPLC) in terms of quantification of vitamin A in both spiked and commercially fortified oils. Nine oils (soybean, palm, cottonseed, rapeseed, corn, peanut, coconut, sunflower, and rice bran oils) were selected and spiked with retinyl palmitate at six different concentrations, and 112 commercially fortified oils were quantified for their vitamin A content using both methods. A good indicator of intra-day and inter-day repeatability (< 10% CV) was obtained for the measurement of vitamin A in the spiked oils for both methods, which denotes a high agreement between them. Vitamin A recoveries were 97-132% for HPLC and 74-127% for the portable device. A strong positive correlation, r = 0.88, is observed between the two methods for the quantification of vitamin A in the commercially fortified oils. The portable device provides a relatively low-cost, quick, and user-friendly alternative to HPLC.
Collapse
Affiliation(s)
- Susana A. Palma-Duran
- School of Medicine, College of Medical, Veterinary and Life Sciences, The University of Glasgow, Glasgow, UK
- Department of Food Science, Research Center in Food and Development A.C., Hermosillo, Mexico
| | - David Morgan
- Global Alliance for Improved Nutrition (GAIN), Geneva, CH Switzerland
| | - Emilie Combet
- School of Medicine, College of Medical, Veterinary and Life Sciences, The University of Glasgow, Glasgow, UK
| |
Collapse
|
4
|
Estevinho BN, López-Rubio A. Recent Advances in Encapsulation for Food Applications. Foods 2024; 13:579. [PMID: 38397556 PMCID: PMC10888041 DOI: 10.3390/foods13040579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
Food-related research is closely related to health [...].
Collapse
Affiliation(s)
- Berta Nogueiro Estevinho
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Departamento de Engenharia Química, Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
- ALiCE—Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Amparo López-Rubio
- Food Safety and Preservation Department, CSIC—Consejo Superior de Investigaciones Científicas, Instituto de Agroquimica y Tecnologia de los Alimentos (IATA), 46980 Paterna, Valencia, Spain
| |
Collapse
|
5
|
Lowe NM. Fortification or biofortification: complimentary strategies or duplication of effort? Proc Nutr Soc 2024:1-10. [PMID: 38197143 DOI: 10.1017/s0029665124000041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Micronutrient deficiencies continue to be a global concern, with the most common deficiencies being vitamin A, iron, zinc and B vitamins (folate and B12). Addressing this requires strategies that are scalable and equitable such that they reach all members of a population irrespective of socioeconomic status and geography. Fortification and biofortification offer potential large-scale solutions, however each have strengths and limitations depending on the context, particularly the cultural and political factors that may create barriers or opportunities for effectiveness. Planning how to target scarce resources for maximum impact requires an in-depth knowledge and understanding of local food systems and market dynamics, alongside strong government policy and legislative support. A food fortification programme was launched in Pakistan in 2016, supported by UK Aid and designed to address the high prevalence of vitamin A, iron and zinc deficiency, particularly in women and children. In the same year, the first zinc biofortified variety of wheat, Zincol-2016, was released in Pakistan, supported and developed through the HarvestPlus programme in collaboration with the Pakistan National Agriculture Research Centre. This review explores the challenges faced by fortification and biofortification, initiated independently, (but around the same time) in Pakistan.
Collapse
Affiliation(s)
- Nicola Mary Lowe
- Centre for Global Development, University of Central Lancashire, PrestonPR1 2HE, UK
| |
Collapse
|
6
|
Monge-Rojas R, Barboza LA, Vargas-Quesada R. Reducing dietary intake of added sugars could affect the nutritional adequacy of vitamin A in adolescents: the Costa Rica case. BMC Public Health 2023; 23:2503. [PMID: 38097973 PMCID: PMC10720178 DOI: 10.1186/s12889-023-17243-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND In countries where sugar fortification with vitamin A is mandatory, strategies to reduce the prevalence of overweight/obesity in adolescents that involve lowering added sugar intake could lead to vitamin A inadequate intakes, since vitamin A-fortified sugar for home consumption contributes to a high proportion of this vitamin intake in the adolescent diet. METHODS The study employed a hierarchical linear model to perform a mediation analysis on a cross-sectional sample of adolescents (13-18 years old) in the province of San José, Costa Rica. RESULTS Lowering the total energy intake derived from added sugars to less than 10% significantly increases the prevalence of vitamin A inadequate intake in adolescents by 12.1% (from 29.6% to 41.7%). This is explained by the mediation model in which, the reduced adequacy of vitamin A intake is mediated by a reduction in total energy intake derived from added sugars fortified with vitamin A. CONCLUSIONS The vitamin A fortification of sugar for household consumption should be reassessed according to the current epidemiological profile in Costa Rica to promote strategies that reduce the prevalence of overweight/obesity in adolescents by lowering the consumption of added sugars without affecting vitamin A intake.
Collapse
Affiliation(s)
- Rafael Monge-Rojas
- Nutrition and Health Unit, Researcher, Costa Rican Institute for Research and Education On Nutrition and Health (INCIENSA), 4-2250 Tres Ríos, Cartago, Costa Rica.
| | - Luis A Barboza
- Center for Pure and Applied Mathematics (CIMPA), Researcher, Department of Mathematics, Universidad de Costa Rica, San José, 2060, Costa Rica
| | - Rulamán Vargas-Quesada
- Nutrition and Health Unit, Researcher, Costa Rican Institute for Research and Education On Nutrition and Health (INCIENSA), 4-2250 Tres Ríos, Cartago, Costa Rica
| |
Collapse
|
7
|
Li X, Guo C, Zhang Y, Yu L, Ma F, Wang X, Zhang L, Li P. Contribution of Different Food Types to Vitamin A Intake in the Chinese Diet. Nutrients 2023; 15:4028. [PMID: 37764811 PMCID: PMC10535670 DOI: 10.3390/nu15184028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/27/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Vitamin A is a fat-soluble micronutrient that is essential for human health. In this study, the daily vitamin A intake of Chinese residents was evaluated by investigating the vitamin A content of various foods. The results show that the dietary intake of vitamin A in common foods was 460.56 ugRAE/day, which is significantly lower than the recommended dietary reference intake of vitamin A (800 ugRAE/day for adult men and 700 ugRAE/day for adult women). Vegetables contributed the most to daily vitamin A dietary intake, accounting for 54.94% of vitamin A intake (253.03 ugRAE/day), followed by eggs, milk, aquatic products, meat, fruit, legumes, coarse cereals, and potatoes. Therefore, an increase in the vitamin A content of vegetables and the fortification of vegetable oils with vitamin A are effective ways to increase vitamin A intake to meet the recommended dietary guidelines in China. The assessment results support the design of fortified foods.
Collapse
Affiliation(s)
- Xue Li
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
| | - Can Guo
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
| | - Yu Zhang
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
| | - Li Yu
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
| | - Fei Ma
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
| | - Xuefang Wang
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
| | - Liangxiao Zhang
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
- College of Food Science and Engineering, Collaborative Innovation Center for Modern Grain Circulation and Safety, Nanjing University of Finance and Economics, Nanjing 210023, China
- Hubei Hongshan Laboratory, Wuhan 430070, China
| | - Peiwu Li
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
- College of Food Science and Engineering, Collaborative Innovation Center for Modern Grain Circulation and Safety, Nanjing University of Finance and Economics, Nanjing 210023, China
- Hubei Hongshan Laboratory, Wuhan 430070, China
- Xianghu Laboratory, Hangzhou 311231, China
| |
Collapse
|
8
|
Van Wayenbergh E, Verheijen J, Langenaeken NA, Foubert I, Courtin CM. A simple method for analysis of vitamin A palmitate in fortified cereal products using direct solvent extraction followed by reversed-phase HPLC with UV detection. Food Chem 2023; 404:134584. [DOI: 10.1016/j.foodchem.2022.134584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/27/2022] [Accepted: 10/09/2022] [Indexed: 11/11/2022]
|
9
|
Zou Y, Huang LC, Zhao D, He MJ, Su D, Zhang RH. Assessment of serum Vit A, D and zinc nutritional status and related dietary and exercise behaviors of children and adolescents in rural and urban area. Front Nutr 2023; 9:1088155. [PMID: 36712499 PMCID: PMC9877439 DOI: 10.3389/fnut.2022.1088155] [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: 11/03/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
Vitamin A and vitamin D deficiency in children and adolescents has a negative impact on their growth and development. This study aimed to learn the nutritional status of vitamin A and D among rural children and adolescents and to explore related dietary and exercise behaviors. A total of 10 counties (cities, districts) from 90 counties (cities, districts) in Zhejiang Province were selected by the method of random cluster sampling. Children and adolescents were investigated and their food and nutrient intake were calculated. The concentration of serum vitamin A in urban area was 0.38 ng/ml, which was higher than that in rural area (p < 0.05); while the concentration of serum vitamin D in urban area was 21.25 mg/L, which was lower than that in rural area (p < 0.05). The concentration of serum zinc was 101 μg/dl in urban area and 107 μg/dl in rural area (p < 0.05). The intake of dietary fiber, calcium, vitamin A, vitamin B1, vitamin B2, and vitamin C was lower than the recommended value. In rural area, the intakes of cereals, tubers and beans, livestock, poultry and meat of children and adolescents were higher than the recommended values; while the intake of vegetables, fruits, eggs, milk, fish and shrimp, soybean and nuts was lower than the recommended value. The intake of edible oil and salt is higher than the recommended value. The time of medium and high intensity exercise time in rural area is more than that in urban area in the age group of 12-17 years, while the sitting time is less than that in urban area. Children and adolescents living in rural area should be guided to eat reasonably, and to choose foods with high nutrient density and with low oil, salt and sugar.
Collapse
|
10
|
Reconnoitring the Usage of Agroindustrial Waste in Carotenoid Production for Food Fortification: a Sustainable Approach to Tackle Vitamin A Deficiency. FOOD BIOPROCESS TECH 2022. [DOI: 10.1007/s11947-022-02888-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
11
|
Atuna RA, Amagloh FC, Denwar NN, Asase VR, Faisal S, Baako E, Koomson G, Gulkirpik E, Toc M, Donnelly A, Amagloh FK, Andrade Laborde JE. Filling the Protein Gap in Ghana: The Role of Soy. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2021.781571] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The study assessed the nutrient value and desirability of eight improved soybean varieties, for use in soymilk, tofu and as an ingredient to enhance staple foods. The soymilk, tofu, and soybean residue (okara) yields were determined across all varieties. The okara was subsequently used in composite with cassava, as a recipe refinement of gari, a popular cassava-based ready-to-eat food. Multiple composite ratios were compared against a control of 100% cassava gari; 80% cassava: 20% okara, 70% cassava: 30% okara, and 50% cassava: 50% okara. The soymilk and tofu from the various varieties and okara enriched-gari were also evaluated for proximate and sensory qualities (n = 50) using standard protocols. No differences (p > 0.05) existed among soybean varieties in terms of soymilk (p = 0.55; 13.0–14.1 L), tofu (p = 0.05; 0.12–0.15 kg/L) or okara (p = 0.08; 3.17–3.97 kg) yields. The proximate parameters evaluated for soymilk did not vary significantly (p > 0.05) among varieties. However, for total solids (3.33–7.93°Brix; p < 0.01) there were significant differences. Generally, there was an increasing trend in the crude protein, moisture, crude fat and total ash contents for the okara-enriched gari as the okara inclusion increased from 20 to 50%. Thus, the crude protein content of the 50% okara-enriched gari, the formulation with the highest okara incorporation was almost 11-times higher than the 100% cassava gari. The swelling capacity of the okara-enriched gari ranged from 3.29–5.47 and for water holding capacity 439.7–482.1%. The okara-enriched gari was equally preferred by consumers, except for colour which consumers were mostly indifferent towards. The 50%-okara enriched gari composite was compared equally with 100% cassava gari control. The sensory data showed that the “Favour” soybean variety was desirable for soymilk production while Salintuya 1 was desirable for tofu production. Recipe refinements using the desired varieties and compositing okara with cassava may help fill the protein gap among the vulnerable group in Ghana by improving the protein quality of ready-to-eat foods such as gari.
Collapse
|
12
|
da Silva Lopes K, Yamaji N, Rahman MO, Suto M, Takemoto Y, Garcia-Casal MN, Ota E. Nutrition-specific interventions for preventing and controlling anaemia throughout the life cycle: an overview of systematic reviews. Cochrane Database Syst Rev 2021; 9:CD013092. [PMID: 34564844 PMCID: PMC8464655 DOI: 10.1002/14651858.cd013092.pub2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Anaemia is a prevalent health problem worldwide. Some types are preventable or controllable with iron supplementation (pills or drops), fortification (sprinkles or powders containing iron added to food) or improvements to dietary diversity and quality (e.g. education or counselling). OBJECTIVES To summarise the evidence from systematic reviews regarding the benefits or harms of nutrition-specific interventions for preventing and controlling anaemia in anaemic or non-anaemic, apparently healthy populations throughout the life cycle. METHODS In August 2020, we searched MEDLINE, Embase and 10 other databases for systematic reviews of randomised controlled trials (RCTs) in anaemic or non-anaemic, apparently healthy populations. We followed standard Cochrane methodology, extracting GRADE ratings where provided. The primary outcomes were haemoglobin (Hb) concentration, anaemia, and iron deficiency anaemia (IDA); secondary outcomes were iron deficiency (ID), severe anaemia and adverse effects (e.g. diarrhoea, vomiting). MAIN RESULTS We included 75 systematic reviews, 33 of which provided GRADE assessments; these varied between high and very low. Infants (6 to 23 months; 13 reviews) Iron supplementation increased Hb levels and reduced the risk of anaemia and IDA in two reviews. Iron fortification of milk or cereals, multiple-micronutrient powder (MMNP), home fortification of complementary foods, and supplementary feeding increased Hb levels and reduced the risk of anaemia in six reviews. In one review, lipid-based nutrient supplementation (LNS) reduced the risk of anaemia. In another, caterpillar cereal increased Hb levels and IDA prevalence. Food-based strategies (red meat and fortified cow's milk, beef) showed no evidence of a difference (1 review). Preschool and school-aged children (2 to 10 years; 8 reviews) Daily or intermittent iron supplementation increased Hb levels and reduced the risk of anaemia and ID in two reviews. One review found no evidence of difference in Hb levels, but an increased risk of anaemia and ID for the intermittent regime. All suggested that zinc plus iron supplementation versus zinc alone, multiple-micronutrient (MMN)-fortified beverage versus control, and point-of-use fortification of food with iron-containing micronutrient powder (MNP) versus placebo or no intervention may increase Hb levels and reduce the risk of anaemia and ID. Fortified dairy products and cereal food showed no evidence of a difference on the incidence of anaemia (1 review). Adolescent children (11 to 18 years; 4 reviews) Compared with no supplementation or placebo, five types of iron supplementation may increase Hb levels and reduce the risk of anaemia (3 reviews). One review on prevention found no evidence of a difference in anaemia incidence on iron supplementation with or without folic acid, but Hb levels increased. Another suggested that nutritional supplementation and counselling reduced IDA. One review comparing MMN fortification with no fortification observed no evidence of a difference in Hb levels. Non-pregnant women of reproductive age (19 to 49 years; 5 reviews) Two reviews suggested that iron therapy (oral, intravenous (IV), intramuscular (IM)) increased Hb levels; one showed that iron folic acid supplementation reduced anaemia incidence; and another that daily iron supplementation with or without folic acid or vitamin C increased Hb levels and reduced the risk of anaemia and ID. No review reported interventions related to fortification or dietary diversity and quality. Pregnant women of reproductive age (15 to 49 years; 23 reviews) One review apiece suggested that: daily iron supplementation with or without folic acid increased Hb levels in the third trimester or at delivery and in the postpartum period, and reduced the risk of anaemia, IDA and ID in the third trimester or at delivery; intermittent iron supplementation had no effect on Hb levels and IDA, but increased the risk of anaemia at or near term and ID, and reduced the risk of side effects; vitamin A supplementation alone versus placebo, no intervention or other micronutrient might increase maternal Hb levels and reduce the risk of maternal anaemia; MMN with iron and folic acid versus placebo reduced the risk of anaemia; supplementation with oral bovine lactoferrin versus oral ferrous iron preparations increased Hb levels and reduced gastrointestinal side effects; MNP for point-of-use fortification of food versus iron and folic acid supplementation might decrease Hb levels at 32 weeks' gestation and increase the risk of anaemia; and LNS versus iron or folic acid and MMN increased the risk of anaemia. Mixed population (all ages; 22 reviews) Iron supplementation versus placebo or control increased Hb levels in healthy children, adults, and elderly people (4 reviews). Hb levels appeared to increase and risk of anaemia and ID decrease in two reviews investigating MMN fortification versus placebo or no treatment, iron fortified flour versus control, double fortified salt versus iodine only fortified salt, and rice fortification with iron alone or in combination with other micronutrients versus unfortified rice or no intervention. Each review suggested that fortified versus non-fortified condiments or noodles, fortified (sodium iron ethylenediaminetetraacetate; NaFeEDTA) versus non-fortified soy sauce, and double-fortified salt versus control salt may increase Hb concentration and reduce the risk of anaemia. One review indicated that Hb levels increased for children who were anaemic or had IDA and received iron supplementation, and decreased for those who received dietary interventions. Another assessed the effects of foods prepared in iron pots, and found higher Hb levels in children with low-risk malaria status in two trials, but no difference when comparing food prepared in non-cast iron pots in a high-risk malaria endemicity mixed population. There was no evidence of a difference for adverse effects. Anaemia and malaria prevalence were rarely reported. No review focused on women aged 50 to 65 years plus or men (19 to 65 years plus). AUTHORS' CONCLUSIONS Compared to no treatment, daily iron supplementation may increase Hb levels and reduce the risk of anaemia and IDA in infants, preschool and school-aged children and pregnant and non-pregnant women. Iron fortification of foods in infants and use of iron pots with children may have prophylactic benefits for malaria endemicity low-risk populations. In any age group, only a limited number of reviews assessed interventions to improve dietary diversity and quality. Future trials should assess the effects of these types of interventions, and consider the requirements of different populations.
Collapse
Affiliation(s)
| | - Noyuri Yamaji
- Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Md Obaidur Rahman
- Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Maiko Suto
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Yo Takemoto
- Department of Obstetrics and Gynaecology, School of Medicine, Juntendo University, Tokyo, Japan
| | | | - Erika Ota
- Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University , Tokyo, Japan
| |
Collapse
|
13
|
Salam A, Briawan D, Martianto D, Razak Thaha A, Virani D. Effect of Vitamin A Supplementation, Cooking Oil Fortification, and Nutrition Education to Postpartum Mother on Breast Milk Retinol Levels. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: The study aims to determine the effect of two forms of Vitamin A supplementation (dose of 2 × 200 000 IU and dose of 1 × 200 000 IU), Vitamin A fortified cooking oil and nutritional education on retinol levels of breast milk.
METHODS: A quasi-experiment design was used in this study with a total of 129 subjects divided into four groups; Group A (given 2 capsule of Vitamin A), Group B (given 1 capsule of Vitamin A), Group C (given cooking oil fortification), and Group D (given nutritional education). Retinol levels of the breast milk were measured 3 times (before, during, and after intervention).
RESULTS: There were no differences in subject characteristics in terms of age, education, occupation, parity, and nutritional status between intervention groups (p > 0.05). The average of breast milk retinol levels was 52.15 μg/dl at the beginning. At the end of the measurement, the average decrease in breast milk retinol levels was higher in Group D (−27.2 μg/dl), and the lowest was in Group C (−9.9 μg/dl). The results of statistical tests showed that there was no difference in breast milk retinol levels between intervention groups in before, during, and after the intervention (p > 0.05).
CONCLUSIONS: Fortified cooking oil and Vitamin A supplementation (1 × 200 000 IU) tend to maintain normal levels of retinol in breast milk compared to Vitamin A supplementation (2 × 200 000 IU) and nutrition education.
Collapse
|
14
|
Using Community-Based Prevention Marketing to Generate Demand for Healthy Diets in Jordan. Nutrients 2021; 13:nu13093068. [PMID: 34578946 PMCID: PMC8464799 DOI: 10.3390/nu13093068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 12/03/2022] Open
Abstract
Jordan has been experiencing a nutrition transition with high rates of micronutrient deficiencies and rising overweight and obesity rates. This highlights the need to generate demand for healthy diets. This study used a community-based prevention marketing approach and worked with local communities as partners to develop a set of behavior change interventions to improve healthy eating within vulnerable communities. Individual, family, and paired-friendship interviews, and co-creation workshops were conducted with 120 people. The aim of these interviews was to gain an in-depth understand of school-aged children and their families’ nutrition knowledge, attitudes, and practices, including social and cultural norms and behavioral determinants, and then use this information to co-create interventions, activities and materials targeted at supporting school-aged child nutrition. Analysis of the interviews revealed that dietary habits are both deeply personal and profoundly entwined by emotions and social norms, and that parents often gave in to their children’s demands for unhealthy foods and beverages due to their perception of what a ‘good parent’ looks like and the desire to see their child ‘smile’. These key insights were then shared during the co-creation workshops to develop behavior change interventions—ensuring that interventions were developed by the community, for the community.
Collapse
|
15
|
Begum R, Rahman N, Hasan R, Jamil Y, Anjom Tamanna S, Islam R. Vitamin A Fortified Edible Oils and Rice: The Knowledge Level and Consumption Rate among Different Place of Residences in Tangail District, Bangladesh. J Nutr Sci Vitaminol (Tokyo) 2021; 67:13-20. [PMID: 33642460 DOI: 10.3177/jnsv.67.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A population based cross-sectional study was conducted in four residential areas of Tangail Sadar Upazila, Bangladesh aiming to explore the knowledge about vitamin A fortified edible oils and rice as well as the their consumption rate. A total of 400 participants were randomly selected. Data were collected through face to face interviews. Only 15.0% and 3.5% participants had knowledge about vitamin A fortified edible oils and rice respectively. Precisely vitamin A fortified edible oils knowledge level was found inferior in rural (11.7%) and slum (0%) than urban (48.3%) and semi-urban (40.0%) participants. Knowledge about vitamin A fortified rice was found higher in urban (78.6%) than rural (14.3%) and slum (0%) participants. Most of the participants received knowledge through advertisements (N=45 and N=12 for fortified oils and rice respectively). Maximum participants (62.3%) did not consume vitamin A fortified edible oils and consumption rate in rural (11.8%) and slum (10.2%) areas were poorer than urban (53.5%) and semi-urban (24.4%) areas. Consumption rate of vitamin A fortified rice was found nil in all the study areas. Lack of knowledge about vitamin A fortified rice and oils accounted solely for poor consumption. Knowledge level about vitamin A fortified edible oils and rice and consumption rate were found statistically significantly (p<0.05) with participant's place of residences, education level and monthly income. Finally, this study indicates that the overall knowledge level and consumption rate of vitamin A fortified edible oils and rice is poor especially in rural and slum populations in Tangail Sadar Upazila.
Collapse
Affiliation(s)
- Rokeya Begum
- Department of Food Technology and Nutritional Science, Faculty of Life Science, Mawlana Bhashani Science and Technology University
| | - Nannur Rahman
- Department of Food Technology and Nutritional Science, Faculty of Life Science, Mawlana Bhashani Science and Technology University.,Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong
| | - Rakibul Hasan
- Department of Food Technology and Nutritional Science, Faculty of Life Science, Mawlana Bhashani Science and Technology University
| | - Yusuf Jamil
- Department of Food Technology and Nutritional Science, Faculty of Life Science, Mawlana Bhashani Science and Technology University
| | - Sanjida Anjom Tamanna
- Department of Food Technology and Nutritional Science, Faculty of Life Science, Mawlana Bhashani Science and Technology University
| | - Robiul Islam
- Department of Food Technology and Nutritional Science, Faculty of Life Science, Mawlana Bhashani Science and Technology University
| |
Collapse
|
16
|
Beta-carotene/cyclodextrin-based inclusion complex: improved loading, solubility, stability, and cytotoxicity. J INCL PHENOM MACRO 2021. [DOI: 10.1007/s10847-021-01100-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
17
|
Abaasa CN, Rukundo GZ, Ayesiga S, Atukunda SP, Campisi S, O'Hearn S, MacDonald N. Healthcare providers and caregivers' perspectives on factors responsible for persistent malnutrition of under 5 children in Buhweju district, South Western Uganda; a phenomenological qualitative study. BMC Public Health 2021; 21:1495. [PMID: 34344341 PMCID: PMC8330056 DOI: 10.1186/s12889-021-11432-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 06/30/2021] [Indexed: 12/02/2022] Open
Abstract
Background Unacceptably high levels of childhood malnutrition have been registered in all regions of Uganda over the years. Buhweju district alone contributed 46% prevalence of childhood malnutrition to the 47.8% estimated national prevalence for the whole of western Uganda in 2014. This study assessed health provider and caregiver opinions on factors responsible for persistent malnutrition among under five children in Engaju and Nyakishana sub counties. Methods In this phenomenological qualitative study, we conducted two key informant interviews and six focus group discussions with Village Health Team members and care takers of under five children in Engaju and Nyakishana sub-counties respectively.to explore their opinions on the factors responsible for persistent malnutrition in Buhweju District in May 2018. Data were thematically analyzed manually and using Atals Ti 7.5. Results Historical and geographical challenges, poverty and economic occupation, parental alcoholism and domestic violence as well as inadequate childcare services were identified as factors responsible for persistent malnutrition among under five children in Engaju and Nyakishana sub counties. Conclusion Persistent malnutrition in under five children is mainly due to historical and geographical challenges and its associated factors that include poverty and economic occupation, parental alcoholism and domestic violence and inadequate childcare services. Thus literacy education for mothers and young adolescent boys and girls through engaging local leaders, local nongovernmental organizations and Companies operating in the district to contribute to social services provision would limit the domestic violence and increase sensitization on male responsibilities in the children care in Buhweju district. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11432-1.
Collapse
Affiliation(s)
- Catherine N Abaasa
- Department of Medical Laboratory Sciences, Mbarara University of Science and Technology, P. O. Box 1410, Mbarara, Uganda.
| | - Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Savino Ayesiga
- Department of Anatomy, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Susan Campisi
- Hospital for Sick Children, Toronto, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Shawna O'Hearn
- Global Health, Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - Noni MacDonald
- Department of Paediatrics, Faculty of Medicine, Dalhousie University, Halifax, Canada
| |
Collapse
|
18
|
Whitfield KC, Smith TJ, Rohner F, Wieringa FT, Green TJ. Thiamine fortification strategies in low- and middle-income settings: a review. Ann N Y Acad Sci 2021; 1498:29-45. [PMID: 33496051 PMCID: PMC8451796 DOI: 10.1111/nyas.14565] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/30/2020] [Accepted: 01/09/2021] [Indexed: 12/13/2022]
Abstract
Thiamine (vitamin B1 ) is an essential micronutrient in energy metabolism and cognitive and neurological health. Thiamine deficiency disorders (TDDs) have a range of clinical presentations that result in various morbidities and can be fatal if not promptly recognized and treated, especially in infants. To intervene, thiamine intakes by breastfeeding mothers and others at risk of thiamine deficiency should be increased to ensure adequate thiamine intake. Although thiamine fortification programs have a long history in high-income countries, there are few mandatory fortification programs to address TDDs in low- and middle-income countries (LMICs), particularly in the regions of greatest concern, South and Southeast Asia. This review highlights essential aspects for consideration in the development of a mandatory fortification program in LMICs, including an overview of the data required to model fortification dosing schemes, available thiamine fortificants, and potential fortification vehicles, as well as identifies current knowledge gaps.
Collapse
Affiliation(s)
- Kyly C. Whitfield
- Department of Applied Human NutritionMount Saint Vincent UniversityHalifaxNova ScotiaCanada
| | - Taryn J. Smith
- Institute for Global NutritionUniversity of California DavisDavisCalifornia
| | | | - Frank T. Wieringa
- UMR‐95 QualiSud, French National Research Institute for Sustainable Development (IRD)CIRAD/IRD/University of Montpellier/SupAgro/University of Avignon/University of RéunionAvignonFrance
| | - Tim J. Green
- SAHMRI Women and KidsSouth Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
- School of MedicineUniversity of AdelaideAdelaideSouth AustraliaAustralia
| |
Collapse
|
19
|
Amoakoah Twum L, Ocloo FC, Duah-Bisiw D, Odai BT. Determining the effect of heat treatment on iron fortified soybean gari blend and its potential bioavailability. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2021.e00763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
20
|
Ikram A, Nadeem M, Imran M. Impact of vitamin A supplementation on composition, lipolysis, stability, and sensory of refrigerated stored Cheddar cheese. J FOOD PROCESS PRES 2021. [DOI: 10.1111/jfpp.15651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Ayesha Ikram
- Department of Dairy Technology University of Veterinary and Animal Sciences Lahore Pakistan
| | - Muhammad Nadeem
- Department of Dairy Technology University of Veterinary and Animal Sciences Lahore Pakistan
| | - Muhammad Imran
- Department of Food Science Faculty of Life Sciences Government College University Faisalabad Pakistan
| |
Collapse
|
21
|
Mulongo G, Munyua H, Mbabu A, Maru J. What is required to scale-up and sustain biofortification? Achievements, challenges and lessons from scaling-up Orange-Fleshed Sweetpotato in Sub-Sahara Africa. JOURNAL OF AGRICULTURE AND FOOD RESEARCH 2021; 4:100102. [PMID: 34085049 PMCID: PMC8135120 DOI: 10.1016/j.jafr.2021.100102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 12/17/2020] [Accepted: 01/15/2021] [Indexed: 06/12/2023]
Abstract
This review presents results of the ex-post survey on Reaching Agents of Change (RAC) project, highlighting experiences, lessons, challenges and recommendations for scaling up orange-fleshed sweetpotato (OFSP). The RAC project was a three-and halfyear initiative (2011 and 2015), implemented in three primary countries, namely Tanzania, Mozambique, Nigeria, and to a lesser extent Ghana and Burkina Faso. The project advocated for policy change and increased investments to scale-up the orangefleshed sweetpotato (OFSP) to combat vitamin A deficiency. RAC planned to generate new investments totaling US$ 18 million for OFSP activities in the three years of its life but exceeded this target by 20%. RAC further expected to benefit at least 600,000 households directly and is currently on track, having reached 309,974 direct beneficiaries (of whom 20.3% were women). The RAC experience demonstrated a potential scaling-up model for biofortified crops based on the hypothesis that scaling up can be achieved through supportive policies (and investments), strong institutional capacities and appropriate innovative technologies working through a partnership of governmental and non-governmental organizations and civil society.
Collapse
Affiliation(s)
| | - Hilda Munyua
- International Potato Center, Box 25171, 00603, Nairobi, Kenya
| | | | - Joyce Maru
- International Potato Center, Box 25171, 00603, Nairobi, Kenya
| |
Collapse
|
22
|
Pinkaew S, Udomkesmalee E, Davis CR, Tanumihardjo SA. Vitamin A-fortified rice increases total body vitamin A stores in lactating Thai women measured by retinol isotope dilution: a double-blind, randomized, controlled trial. Am J Clin Nutr 2021; 113:1372-1380. [PMID: 33675342 DOI: 10.1093/ajcn/nqaa418] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/10/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Lactating women are at increased risk for vitamin A (VA) deficiency due to demands for breast milk content and limited hepatic stores for women in some countries. Previously, consumption of triple-fortified rice, which included VA, iron, and zinc, successfully improved the VA status of Thai children in whom their total body VA stores (TBSs) were doubled in 2 mo. OBJECTIVE This study assessed the efficacy of consuming VA-fortified rice, which delivered 500 µg retinol activity equivalents (RAEs)/d, on TBSs and estimated total liver VA reserves (TLRs) in Thai lactating women using the retinol isotope dilution (RID) test. METHODS A randomized controlled trial was conducted with 70 lactating women (n = 35/group) who received either VA-fortified rice (500 µg RAEs/d) or unfortified rice for 14 wk on weekdays only. Serum retinol concentrations (SRs), C-reactive protein, and TBSs were assessed before and after the intervention. The paired 13C-RID test was used to measure TBSs. After a baseline blood sample, 2.0 µmol [14,15]-13C2-retinyl acetate was administered orally. A follow-up blood sample was drawn 14 d later. The RID test was repeated after the intervention. RESULTS TBSs increased significantly (P < 0.05) in the intervention group from 240 (182, 316) to 331 (251, 447) [geometric means (95% CIs)] µmol retinol, and this change in TBSs was significantly higher (P < 0.05) than that in the control group [+52.9 (-74, 453) compared with -4.3 (-106, 275) µmol retinol]. Estimated TLRs indicated a high prevalence of VA deficiency among these lactating women. Initial and final SRs did not differ by group and did not change over the course of the intervention. CONCLUSION VA-fortified rice improved the VA status of lactating women by increasing TBSs. A targeted approach to disseminate VA interventions among vulnerable groups should be considered in some contexts. This trial was registered at clinicaltrials.gov as NCT03056625.
Collapse
Affiliation(s)
- Siwaporn Pinkaew
- Department of Food Science and Nutrition, Faculty of Science and Technology, Prince of Songkla University, Pattani, Thailand
| | | | - Christopher R Davis
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| |
Collapse
|
23
|
Food fortification technologies: Influence on iron, zinc and vitamin A bioavailability and potential implications on micronutrient deficiency in sub-Saharan Africa. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2020.e00667] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
24
|
Tan Y, McClements DJ. Improving the bioavailability of oil-soluble vitamins by optimizing food matrix effects: A review. Food Chem 2021; 348:129148. [PMID: 33515946 DOI: 10.1016/j.foodchem.2021.129148] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/21/2020] [Accepted: 01/17/2021] [Indexed: 02/07/2023]
Abstract
The potency of oil-soluble vitamins (vitamins A, D, E and K) in fortified foods can be improved by understanding how food matrices impact their bioavailability. In this review, the major food matrix effects influencing the bioavailability of oil-soluble vitamins are highlighted: oil content, oil composition, particle size, interfacial properties, and food additives. Droplet size and aggregation state in the human gut impact vitamin bioavailability by modulating lipid digestion, vitamin release, and vitamin solubilization. Vitamins in small isolated oil droplets typically have a higher bioavailability than those in large or aggregated ones. Emulsifiers, stabilizers, or texture modifiers can therefore affect bioavailability by influencing droplet size or aggregation. The dimensions of the hydrophobic domains in mixed micelles depends on lipid type: if the domains are too small, vitamin bioavailability is low. Overall, this review highlights the importance of carefully designing food matrices to improve vitamin bioavailability.
Collapse
Affiliation(s)
- Yunbing Tan
- Department of Food Science, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - David Julian McClements
- Department of Food Science, University of Massachusetts Amherst, Amherst, MA 01003, USA; Department of Food Science & Bioengineering, Zhejiang Gongshang University, 18 Xuezheng Street, Hangzhou, Zhejiang 310018, China.
| |
Collapse
|
25
|
Rowe LA. Addressing the Fortification Quality Gap: A Proposed Way Forward. Nutrients 2020; 12:E3899. [PMID: 33419334 PMCID: PMC7766708 DOI: 10.3390/nu12123899] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/08/2020] [Accepted: 12/15/2020] [Indexed: 11/16/2022] Open
Abstract
Large-scale food fortification is an effective, sustainable, and scalable intervention to address vitamin and mineral deficiencies, however, pressing gaps exist globally around ensuring the quality of fortified foods. This paper summarizes the global challenges and gaps faced in monitoring the quality of fortified foods, the guidance produced in response to these challenges, where we are today in terms of effective implementation, and what approaches and opportunities may be usefully applied to enhance the quality of fortified foods moving forward.
Collapse
Affiliation(s)
- Laura A Rowe
- Food Fortification Initiative, Atlanta, GA 30322, USA
| |
Collapse
|
26
|
Bassey C, Crooks H, Paterson K, Ball R, Howell K, Humphries-Cuff I, Gaffigan K, Rao N, Whitty JA, Hooper L. Impact of home food production on nutritional blindness, stunting, wasting, underweight and mortality in children: a systematic review and meta-analysis of controlled trials. Crit Rev Food Sci Nutr 2020; 62:1856-1869. [PMID: 33272038 DOI: 10.1080/10408398.2020.1848786] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Vitamin A deficiency is highly prevalent and remains the major cause of nutritional blindness in children in low-and middle-income countries, despite supplementation programmes. Xeropthalmia (severe drying and thickening of the conjunctiva) is caused by vitamin A deficiency and leads to irreversible blindness. Vitamin A supplementation programmes effectively reduce vitamin A deficiency but many rural children are not reached. Home food production may help prevent rural children's vitamin A deficiency. We aimed to systematically review trials assessing effects of home food production (also called homestead food production and agricultural interventions) on xeropthalmia, nightblindness, stunting, wasting, underweight and mortality (primary outcomes). We searched Medline, Embase, Scopus, Cochrane CENTRAL and trials registers to February 2019. Inclusion of studies, data extraction and risk of bias were assessed independently in duplicate. Random-effects meta-analysis, sensitivity analyses, subgrouping and GRADE were used. We included 16 trials randomizing 2498 children, none reported xerophthalmia, night-blindness or mortality. Home food production may slightly reduce stunting (mean difference (MD) 0.13 (z-score), 95% CI 0.01 to 0.24), wasting (MD 0.05 (z-score), 95% CI -0.04 to 0.14) and underweight (MD 0.07 (z-score), 95% CI -0.01 to 0.15) in young children (all GRADE low-consistency evidence), and increase dietary diversity (standardized mean difference (SMD) 0.24, 95% CI 0.15 to 0.34). Home food production may usefully complement vitamin A supplementation for rural children. Large, long-duration trials with good randomization, allocation concealment and correct adjustment for clustering are needed to assess effectiveness of home food production on nutritional blindness in young children.
Collapse
Affiliation(s)
- Chizoba Bassey
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Harriet Crooks
- Student Services, University of East Anglia, Norwich, UK
| | - Katherine Paterson
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Rachel Ball
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Kristoffer Howell
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Iona Humphries-Cuff
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Kirsty Gaffigan
- Department of Nutrition and Dietetics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Nitya Rao
- School of Developmental Studies, University of East Anglia, Norwich, UK
| | - Jennifer A Whitty
- Norwich Medical School, University of East Anglia, Norwich, UK.,National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England, UK
| | - Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich, UK
| |
Collapse
|
27
|
Buzigi E, Pillay K, Siwela M. Child acceptability of a novel provitamin A carotenoid, iron and zinc-rich complementary food blend prepared from pumpkin and common bean in Uganda: a randomised control trial. BMC Pediatr 2020; 20:412. [PMID: 32873263 PMCID: PMC7461249 DOI: 10.1186/s12887-020-02326-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 08/27/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Ugandan children are fed homemade complementary foods (CFs) which are usually deficient in vitamin A, iron and zinc. Novel homemade CFs rich in vitamin A, iron and zinc need to be developed, and assessed for their acceptability among target children. OBJECTIVE Homemade provitamin A carotenoids (PVACs), iron and zinc-rich complementary food (CF), common bean pumpkin blend (BPB) formulated from pumpkin (Sweet cream) and common bean (Obwelu) and PVAC-rich pumpkin blend (PB) from Sweet cream were prepared by expert peer mothers. This study compared child acceptability of BPB and PB (control). METHODS The crossover acceptability study randomly assigned Ugandan children 6 to 24 months old to either receive 100 g of BPB (n = 35) or 100 g of PB (n = 35) on day one. After a washout period of one day, children crossed over to receive either BPB (n = 35) or PB (n = 35). The amount of CF consumed, duration of consumption, and micronutrient intake were assessed. The CF was acceptable if children consumed ≥50 g (50%) of served food (100 g). A paired t-test was used to determine the mean differences within participants between BPB and PB. The level of statistical significant difference was set at a probability value of 5% (p = 0.05). RESULTS The mean consumption of BPB and PB was 53.9 g and 54.4 g, respectively. The mean duration for consumption of BPB and PB was 20.6 and 20.3 min, respectively. There was no significant difference in the amounts consumed, and duration of consumption in BPB and PB (p > 0.05). The mean intake of vitamin A was significantly higher (p < 0.00001) in PB (152.5 μgRAE) compared to BPB (100.9 μgRAE). The mean iron intake was significantly higher in BPB (1.1 mg) (p < 0.00001) compared to PB (0.3 mg). Furthermore, zinc intake was significantly higher (p < 0.00001) in BPB (0.58 mg) compared to PB (0.13 mg). CONCLUSION A homemade complementary food, BPB, made from locally available common bean and pumpkin is rich in PVACs, iron and zinc and is acceptable to children in the age range of complementary feeding in Uganda. TRIAL REGISTRATION Pan African Clinical Trials Registry www.pactr.org as PACTR202002576768667 . Retrospectively registered. Date of registration: 29/January/2020.
Collapse
Affiliation(s)
- Edward Buzigi
- Department of Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg, 3201, South Africa.
- Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, Westville Campus, J Block 4th Floor, Durban, 4041, South Africa.
- Department of Human Nutrition & Home Economics, Kyambogo University, P.O. Box 1 Kyambogo, Kampala, Uganda.
| | - Kirthee Pillay
- Department of Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg, 3201, South Africa
| | - Muthulisi Siwela
- Department of Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg, 3201, South Africa
| |
Collapse
|
28
|
Wang Y, Song X, Geng Y. Effects of IC 50 dose of retinol on metabolomics of RAW264.7 cells. J Food Biochem 2020; 44:e13327. [PMID: 32539219 DOI: 10.1111/jfbc.13327] [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: 02/01/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/01/2022]
Abstract
Vitamin A is one of the most multifunctional vitamins in normal human physiology and is involved in several basic physiological processes from embryonic development to adulthood, such as embryogenesis, vision, immunity, cell differentiation, and proliferation. In this study, we conducted 1 H- NMR to evaluate the metabolomic changes in RAW264.7 cells after treatment with retinol at an IC50 dose to identify its effects on the differential metabolites and main metabolic pathways. Our results showed that the IC50 dose (140 μM) of retinol affected the metabolism of RAW264.7 cells, with a total of 22 differential metabolites identified via 1 H-NMR, including amino acids, sugars, organic acids, glutathione, glycerin, and creatine. Additionally, multiple metabolic pathways were affected by retinol treatment, including downregulation of amino acid biosynthesis, protein synthesis, and pyruvate metabolism. We speculate that the cytotoxicity of retinol at the IC50 dose is attributed to mitochondrial dysfunction as a result of oxidative stress or lipid peroxidation. PRACTICAL APPLICATIONS: With the general improvement of people's living standards, people use dietary supplements to improve the level of retinol to prevent non-specific diseases. But there are more and more cases of acute or chronic poisoning caused by excessive intake of vitamin A. Therefore, it is necessary to study the toxicity of vitamin A, and more attention should be paid to the excessive intake of vitamin A. From the perspective of metabolomics, this experiment studies the adverse effects of high dose retinol through the changes of metabolites and metabolic pathways at the cellular level. This study will assist further analyses of the toxic mechanism of excessive retinol as fortified foods and nutrient supplementation.
Collapse
Affiliation(s)
- Yali Wang
- Key Laboratory of Food Nutrition and Safety of SDNU, Provincial Key Laboratory of Animal Resistant Biology, College of Life Science, Shandong Normal University, Jinan, China
| | - Xiao Song
- Key Laboratory of Food Nutrition and Safety of SDNU, Provincial Key Laboratory of Animal Resistant Biology, College of Life Science, Shandong Normal University, Jinan, China
| | - Yue Geng
- Key Laboratory of Food Nutrition and Safety of SDNU, Provincial Key Laboratory of Animal Resistant Biology, College of Life Science, Shandong Normal University, Jinan, China
| |
Collapse
|
29
|
Natesan S, Singh TS, Duraisamy T, Chandrasekharan N, Chandran S, Adhimoolam K, Muniyandi SJ, Sampathrajan V, Kalipatty Nalliappan G, Muthurajan R, Meitei LJ. Characterization of crtRB1 Gene Polymorphism and β-Carotene Content in Maize Landraces Originated From North Eastern Himalayan Region (NEHR) of India. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2020. [DOI: 10.3389/fsufs.2020.00078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
30
|
Resende D, Costa Lima SA, Reis S. Nanoencapsulation approaches for oral delivery of vitamin A. Colloids Surf B Biointerfaces 2020; 193:111121. [PMID: 32464354 DOI: 10.1016/j.colsurfb.2020.111121] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/14/2020] [Accepted: 05/07/2020] [Indexed: 01/15/2023]
Abstract
Vitamin A is essential to human health. Encapsulation in lipid nanoparticles was used to overcome vitamin A poor water solubility in beverages. This work aimed to develop and characterize lipid nanoparticles, containing vitamin A, for food fortification, assuring its stability and oral bioaccessibility. Lipid nanoparticles optimized for the oral administration of vitamin A using the hot homogenization method. The nanoparticles subjected to conditions used in food processing suffered no changes in their size or vitamin content. In vitro assays simulating gastrointestinal digestion suggested that the nanoparticles are not altered in the stomach, and the biocompatibility of the formulations showed no toxicity in fibroblasts. With the developed nanoparticles 80% of the added vitamin reached the intestine in the digestibility assay, demonstrating suitability as a nanotechnology application in the food research for the food industry.
Collapse
Affiliation(s)
- Daniela Resende
- LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Portugal, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| | - Sofia A Costa Lima
- LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Portugal, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal.
| | - Salette Reis
- LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Portugal, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| |
Collapse
|
31
|
Paucity of Nutrition Guidelines and Nutrient Quality of Meals Served to Kenyan Boarding High School Students. SUSTAINABILITY 2020. [DOI: 10.3390/su12083463] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Adequate nutrition is vital for the optimal growth, development, and general well-being of adolescents. A lack of nutritional guidelines for school meals poses a major challenge in the provision of nutritious meals to students in Kenyan boarding high schools. The aim of the study was to investigate the nutrient quality and portion sizes of meals served to students and the adequacy of the meals in meeting students’ health requirements. A cross-sectional study was carried out among 50 catering or kitchen managers of 50 high schools in Kenya. Data were obtained through researcher-assisted questionnaires. It was established that menus were simplistic in nature, lacked variety, and were repetitive. With regard to nutrients, menus offered to students were excessively highin dietary fiber, containing three or five times more than the recommended daily intake. In most cases, students were underfed on nutrients such as carbohydrates, vitamin A, folic acid, potassium, calcium, proteins, and vitamins B1–12, resulting in low energy provision. It is concluded that a majority ofthe Kenyan high schools studied do not provide nutritionally adequate meals. The government of Kenya should have nutrition guidelines to ensure that schools provide diets with high foodand nutrient quality to students.
Collapse
|
32
|
de Souza Mesquita LM, Neves BV, Pisani LP, de Rosso VV. Mayonnaise as a model food for improving the bioaccessibility of carotenoids from Bactris gasipaes fruits. Lebensm Wiss Technol 2020. [DOI: 10.1016/j.lwt.2020.109022] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
33
|
Raiten DJ, Darnton-Hill I, Tanumihardjo SA, Suchdev PS, Udomkesmalee E, Martinez C, Mazariegos DI, Mofu M, Kraemer K, Martinez H. Perspective: Integration to Implementation (I-to-I) and the Micronutrient Forum-Addressing the Safety and Effectiveness of Vitamin A Supplementation. Adv Nutr 2020; 11:185-199. [PMID: 31566677 PMCID: PMC7442412 DOI: 10.1093/advances/nmz100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/07/2019] [Accepted: 08/27/2019] [Indexed: 01/03/2023] Open
Abstract
An ongoing challenge to our ability to address the role of food and nutrition in health promotion and disease prevention is how to design and implement context-specific interventions and guidance that are safe, efficacious, and avoid unintended consequences. The integration to effective implementation (I-to-I) concept is intended to address the complexities of the global health context through engagement of the continuum of stakeholders involved in the generation, translation, and implementation of evidence to public health guidance/programs. The I-to-I approach was developed under the auspices of the Micronutrient Forum and has been previously applied to the question of safety and effectiveness of interventions to prevent and treat nutritional iron deficiency. The present article applies the I-to-I approach to questions regarding the safety and utility of large-dose vitamin A supplementation programs, and presents the authors' perspective on key aspects of the topic, including coverage of the basic and applied biology of vitamin A nutrition and assessment, clinical implications, and an overview of the extant data with regard to both the justification for and utility of available intervention strategies. The article includes some practical considerations based on specific country experiences regarding the challenges of implementing vitamin A-related programs. This is followed by an overview of some challenges associated with engagement of the enabling communities that play a critical role in the implementation of these types of public health interventions. The article concludes with suggestions for potential approaches to move this important agenda forward.
Collapse
Affiliation(s)
- Daniel J Raiten
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Ian Darnton-Hill
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- The Gerald J and Dorothy R Friedman School of Nutrition Science and Policy, Tufts University, Medford, MA, USA
| | - Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Parminder S Suchdev
- Department of Pediatrics and Emory Global Health Institute, Emory University, Atlanta, GA, USA
| | - Emorn Udomkesmalee
- Department of Human Nutrition, Institute of Nutrition, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Carolina Martinez
- Instituto de Nutrición de Centro América y Panamá (INCAP), Guatemala City, Guatemala
| | - Dora Inés Mazariegos
- Instituto de Nutrición de Centro América y Panamá (INCAP), Guatemala City, Guatemala
| | - Musonda Mofu
- National Food and Nutrition Commission, Lusaka, Zambia
| | - Klaus Kraemer
- Sight and Life, Basel, Switzerland
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Homero Martinez
- Nutrition International, Ottawa, Ontario, Canada
- Hospital Infantil de México Federico Gomez, Mexico City, Mexico
| |
Collapse
|
34
|
Mkambula P, Mbuya MNN, Rowe LA, Sablah M, Friesen VM, Chadha M, Osei AK, Ringholz C, Vasta FC, Gorstein J. The Unfinished Agenda for Food Fortification in Low- and Middle-Income Countries: Quantifying Progress, Gaps and Potential Opportunities. Nutrients 2020; 12:nu12020354. [PMID: 32013129 PMCID: PMC7071326 DOI: 10.3390/nu12020354] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 12/18/2022] Open
Abstract
Large-scale food fortification (LSFF) is a cost-effective intervention that is widely implemented, but there is scope to further increase its potential. To identify gaps and opportunities, we first accessed the Global Fortification Data Exchange (GFDx) to identify countries that could benefit from new fortification programs. Second, we aggregated Fortification Assessment Coverage Toolkit (FACT) survey data from 16 countries to ascertain LSFF coverage and gaps therein. Third, we extended our narrative review to assess current innovations. We identified 84 countries as good candidates for new LSFF programs. FACT data revealed that the potential of oil/ghee and salt fortification is not being met due mainly to low coverage of adequately fortified foods (quality). Wheat, rice and maize flour fortification have similar quality issues combined with lower coverage of the fortifiable food at population-level (<50%). A four-pronged strategy is needed to meet the unfinished agenda: first, establish new LSFF programs where warranted; second, systems innovations informed by implementation research to address coverage and quality gaps; third, advocacy to form new partnerships and resources, particularly with the private sector; and finally, exploration of new fortificants and vehicles (e.g. bouillon cubes; salt fortified with multiple nutrients) and other innovations that can address existing challenges.
Collapse
Affiliation(s)
- Penjani Mkambula
- Global Alliance for Improved Nutrition, Rue de Varembé 7, 1202 Geneva, Switzerland; (V.M.F.); (F.C.V.)
- Correspondence: (P.M.);
| | - Mduduzi N. N. Mbuya
- Global Alliance for Improved Nutrition, Rue de Varembé 7, 1202 Geneva, Switzerland; (V.M.F.); (F.C.V.)
- Correspondence: (P.M.);
| | - Laura A. Rowe
- Food Fortification Initiative, 1518 Clifton Road, Atlanta, GA 30322, USA;
| | | | - Valerie M. Friesen
- Global Alliance for Improved Nutrition, Rue de Varembé 7, 1202 Geneva, Switzerland; (V.M.F.); (F.C.V.)
| | - Manpreet Chadha
- Nutrition International 180 Elgin St., Suite 1000, Ottawa, ON K2P 2K3, Canada;
| | - Akoto K. Osei
- Helen Keller International, Regional Office for Africa, Dakar BP 29.898, Senegal;
| | - Corinne Ringholz
- World Food Programme, Via Cesare Giulio Viola, 68, 00148 Rome, Italy;
| | - Florencia C. Vasta
- Global Alliance for Improved Nutrition, Rue de Varembé 7, 1202 Geneva, Switzerland; (V.M.F.); (F.C.V.)
| | | |
Collapse
|
35
|
Jan Y, Malik M, Yaseen M, Ahmad S, Imran M, Rasool S, Haq A. Vitamin D fortification of foods in India: present and past scenario. J Steroid Biochem Mol Biol 2019; 193:105417. [PMID: 31247324 DOI: 10.1016/j.jsbmb.2019.105417] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/18/2019] [Accepted: 06/23/2019] [Indexed: 02/07/2023]
Abstract
India is a densely populated country known for its traditional, cultural and lingual diversity. In India Deficiency of vitamin D is seen in both the genders and among all the age groups. Micronutrient deficiencies are steadily adding to the increasing burden of health related co-morbidities with low dietary calcium and magnesium intake in Indian population. Despite lots of sunshine, vitamin D insufficiency is widespread in India according to the age and regions (50-90%). In order to increase vitamin D intake with normal diet, the food industry will have to find a more effective strategy to improve general health conditions. The breadth of widely used foods, including milk, cheese, margarine, dairy products, and various breakfast drinks, can improve the condition of vitamin D deficiency in Asian countries such as India. The requirements for calculating the necessary micronutrients and vitamin D fortification of foods and drinks, successful strategies should be developed and emphasized. There is need to improve the effectiveness of various fruit drinks through fortification of vitamin D, which can reduce vitamin D deficiency in the general population as well as in different age groups.
Collapse
Affiliation(s)
- Yasmeena Jan
- Department of Food Technology, School of Interdisciplinary Sciences and Technology, Jamia Hamdard, New Delhi, 110062, India
| | - Muneeb Malik
- Department of Food Technology, School of Interdisciplinary Sciences and Technology, Jamia Hamdard, New Delhi, 110062, India
| | - Mifftha Yaseen
- Department of Food Technology, School of Interdisciplinary Sciences and Technology, Jamia Hamdard, New Delhi, 110062, India
| | - Sayeed Ahmad
- Department of Pharmacognosy & Phytochemistry, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
| | - Mohammad Imran
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
| | - Suhail Rasool
- Department of Neurosciences, University of California, San Diego, 9500 Gilman Dr. La Jolla CA, 92093, USA
| | - Afrozul Haq
- Department of Food Technology, School of Interdisciplinary Sciences and Technology, Jamia Hamdard, New Delhi, 110062, India.
| |
Collapse
|
36
|
Which Choice of Delivery Model(s) Works Best to Deliver Fortified Foods? Nutrients 2019; 11:nu11071594. [PMID: 31337126 PMCID: PMC6683040 DOI: 10.3390/nu11071594] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 12/15/2022] Open
Abstract
Micronutrient deficiencies (MNDs) occur as a result of insufficient intake of minerals and vitamins that are critical for body growth, physical/mental development, and activity. These deficiencies are particularly prevalent in lower-and middle-income countries (LMICs), falling disproportionately on the poorest and most vulnerable segments of the society. Dietary diversity is considered the most effective method in reducing this deficiency but is often a major constraint as most foods rich in micronutrients are also expensive and thereby inaccessible to poorer members of society. In recent years, affordable commodities such as staple foods (e.g., cereals, roots, and tubers) and condiments (e.g., salt and oil) have been targeted as "vehicles" for fortification and biofortification. Despite efforts by many countries to support such initiatives, there have been mixed experiences with delivery and coverage. An important but little understood driver of success and failure for food fortification has been the range of business models and approaches adopted to promote uptake. This review examines the different models used in the delivery of fortified food including complementary foods and biofortified crops. Using a keyword search and pearl growing techniques, the review located 11,897 texts of which 106 were considered relevant. Evidence was found of a range of business forms and models that attempt to optimise uptake, use, and impact of food fortification which are specific to the 'food vehicle' and environment. We characterise the current business models and business parameters that drive successful food fortification and we propose an initial structure for understanding different fortification business cases that will offer assistance to future designers and implementors of food fortification programmes.
Collapse
|
37
|
Tanumihardjo SA, Kaliwile C, Boy E, Dhansay MA, van Stuijvenberg ME. Overlapping vitamin A interventions in the United States, Guatemala, Zambia, and South Africa: case studies. Ann N Y Acad Sci 2019; 1446:102-116. [PMID: 30265402 PMCID: PMC7999526 DOI: 10.1111/nyas.13965] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/01/2018] [Accepted: 08/15/2018] [Indexed: 01/12/2023]
Abstract
Vitamin A (VA) deficiency is a serious public health problem, especially in preschool children who are at risk of increased mortality. In order to address this problem, the World Health Organization recommends periodic high-dose supplementation to children 6-59 months of age in areas of highest risk. Originally, supplementation was meant as a short-term solution until more sustainable interventions could be adopted. Currently, many countries are fortifying commercialized common staple and snack foods with retinyl palmitate. However, in some countries, overlapping programs may lead to excessive intakes. Our review uses case studies in the United States, Guatemala, Zambia, and South Africa to illustrate the potential for excessive intakes in some groups. For example, direct liver analysis from 27 U.S. adult cadavers revealed 33% prevalence of hypervitaminosis A (defined as ≥1 μmol/g liver). In 133 Zambian children, 59% were diagnosed with hypervitaminosis A using a retinol isotope dilution, and 16% had ≥5% total serum VA as retinyl esters, a measure of intoxication. In 40 South African children who frequently consumed liver, 72.5% had ≥5% total serum VA as retinyl esters. All four countries have mandatory fortified foods and a high percentage of supplement users or targeted supplementation to preschool children.
Collapse
Affiliation(s)
| | | | | | - Muhammad A. Dhansay
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa
| | - Martha E. van Stuijvenberg
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| |
Collapse
|
38
|
Hombali AS, Solon JA, Venkatesh BT, Nair NS, Peña‐Rosas JP. Fortification of staple foods with vitamin A for vitamin A deficiency. Cochrane Database Syst Rev 2019; 5:CD010068. [PMID: 31074495 PMCID: PMC6509778 DOI: 10.1002/14651858.cd010068.pub2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Vitamin A deficiency is a significant public health problem in many low- and middle-income countries, especially affecting young children, women of reproductive age, and pregnant women. Fortification of staple foods with vitamin A has been used to increase vitamin A consumption among these groups. OBJECTIVES To assess the effects of fortifying staple foods with vitamin A for reducing vitamin A deficiency and improving health-related outcomes in the general population older than two years of age. SEARCH METHODS We searched the following international databases with no language or date restrictions: Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 6) in the Cochrane Library; MEDLINE and MEDLINE In Process OVID; Embase OVID; CINAHL Ebsco; Web of Science (ISI) SCI, SSCI, CPCI-exp and CPCI-SSH; BIOSIS (ISI); POPLINE; Bibliomap; TRoPHI; ASSIA (Proquest); IBECS; SCIELO; Global Index Medicus - AFRO and EMRO; LILACS; PAHO; WHOLIS; WPRO; IMSEAR; IndMED; and Native Health Research Database. We also searched clinicaltrials.gov and the International Clinical Trials Registry Platform to identify ongoing and unpublished studies. The date of the last search was 19 July 2018. SELECTION CRITERIA We included individually or cluster-randomised controlled trials (RCTs) in this review. The intervention included fortification of staple foods (sugar, edible oils, edible fats, maize flour or corn meal, wheat flour, milk and dairy products, and condiments and seasonings) with vitamin A alone or in combination with other vitamins and minerals. We included the general population older than two years of age (including pregnant and lactating women) from any country. DATA COLLECTION AND ANALYSIS Two authors independently screened and assessed eligibility of studies for inclusion, extracted data from included studies and assessed their risk of bias. We used standard Cochrane methodology to carry out the review. MAIN RESULTS We included 10 randomised controlled trials involving 4455 participants. All the studies were conducted in low- and upper-middle income countries where vitamin A deficiency was a public health issue. One of the included trials did not contribute data to the outcomes of interest.Three trials compared provision of staple foods fortified with vitamin A versus unfortified staple food, five trials compared provision of staple foods fortified with vitamin A plus other micronutrients versus unfortified staple foods, and two trials compared provision of staple foods fortified with vitamin A plus other micronutrients versus no intervention. No studies compared staple foods fortified with vitamin A alone versus no intervention.The duration of interventions ranged from three to nine months. We assessed six studies at high risk of bias overall. Government organisations, non-governmental organisations, the private sector, and academic institutions funded the included studies; funding source does not appear to have distorted the results.Staple food fortified with vitamin A versus unfortified staple food We are uncertain whether fortifying staple foods with vitamin A alone makes little or no difference for serum retinol concentration (mean difference (MD) 0.03 μmol/L, 95% CI -0.06 to 0.12; 3 studies, 1829 participants; I² = 90%, very low-certainty evidence). It is uncertain whether vitamin A alone reduces the risk of subclinical vitamin A deficiency (risk ratio (RR) 0.45, 95% CI 0.19 to 1.05; 2 studies; 993 participants; I² = 33%, very low-certainty evidence). The certainty of the evidence was mainly affected by risk of bias, imprecision and inconsistency.It is uncertain whether vitamin A fortification reduces clinical vitamin A deficiency, defined as night blindness (RR 0.11, 95% CI 0.01 to 1.98; 1 study, 581 participants, very low-certainty evidence). The certainty of the evidence was mainly affected by imprecision, inconsistency, and risk of bias.Staple foods fortified with vitamin A versus no intervention No studies provided data for this comparison.Staple foods fortified with vitamin A plus other micronutrients versus same unfortified staple foods Fortifying staple foods with vitamin A plus other micronutrients may not increase the serum retinol concentration (MD 0.08 μmol/L, 95% CI -0.06 to 0.22; 4 studies; 1009 participants; I² = 95%, low-certainty evidence). The certainty of the evidence was mainly affected by serious inconsistency and risk of bias.In comparison to unfortified staple foods, fortification with vitamin A plus other micronutrients probably reduces the risk of subclinical vitamin A deficiency (RR 0.27, 95% CI 0.16 to 0.49; 3 studies; 923 participants; I² = 0%; moderate-certainty evidence). The certainty of the evidence was mainly affected by serious risk of bias.Staple foods fortified with vitamin A plus other micronutrients versus no interventionFortification of staple foods with vitamin A plus other micronutrients may increase serum retinol concentration (MD 0.22 μmol/L, 95% CI 0.15 to 0.30; 2 studies; 318 participants; I² = 0%; low-certainty evidence). When compared to no intervention, it is uncertain whether the intervention reduces the risk of subclinical vitamin A deficiency (RR 0.71, 95% CI 0.52 to 0.98; 2 studies; 318 participants; I² = 0%; very low-certainty evidence) . The certainty of the evidence was affected mainly by serious imprecision and risk of bias.No trials reported on the outcomes of all-cause morbidity, all-cause mortality, adverse effects, food intake, congenital anomalies (for pregnant women), or breast milk concentration (for lactating women). AUTHORS' CONCLUSIONS Fortifying staple foods with vitamin A alone may make little or no difference to serum retinol concentrations or the risk of subclinical vitamin A deficiency. In comparison with provision of unfortified foods, provision of staple foods fortified with vitamin A plus other micronutrients may not increase serum retinol concentration but probably reduces the risk of subclinical vitamin A deficiency.Compared to no intervention, staple foods fortified with vitamin A plus other micronutrients may increase serum retinol concentration, although it is uncertain whether the intervention reduces the risk of subclinical vitamin A deficiency as the certainty of the evidence has been assessed as very low.It was not possible to estimate the effect of staple food fortification on outcomes such as mortality, morbidity, adverse effects, congenital anomalies, or breast milk vitamin A, as no trials included these outcomes.The type of funding source for the studies did not appear to distort the results from the analysis.
Collapse
Affiliation(s)
- Aditi S Hombali
- Institute of Mental HealthDepartment of ResearchBlock 7, Buangkok View, Buangkok Green Medical ParkSingaporeSingapore539747
| | | | - Bhumika T Venkatesh
- Prasanna School of Public Health, Manipal Academy of Higher EducationPublic Health Evidence South Asia (PHESA)ManipalUdupiIndia
| | - N Sreekumaran Nair
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) (Institution of National Importance Under Ministry of Health and Family Welfare, Government of India)Department of Medical Biometrics & Informatics (Biostatistics)4th Floor, Administrative BlockDhanvantri NagarPuducherryIndia605006
| | - Juan Pablo Peña‐Rosas
- World Health OrganizationEvidence and Programme Guidance, Department of Nutrition for Health and Development20 Avenue AppiaGenevaGESwitzerland1211
| | | |
Collapse
|
39
|
Coronel J, Pinos I, Amengual J. β-carotene in Obesity Research: Technical Considerations and Current Status of the Field. Nutrients 2019; 11:E842. [PMID: 31013923 PMCID: PMC6521044 DOI: 10.3390/nu11040842] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/02/2019] [Accepted: 04/06/2019] [Indexed: 12/21/2022] Open
Abstract
Over the past decades, obesity has become a rising health problem as the accessibility to high calorie, low nutritional value food has increased. Research shows that some bioactive components in fruits and vegetables, such as carotenoids, could contribute to the prevention and treatment of obesity. Some of these carotenoids are responsible for vitamin A production, a hormone-like vitamin with pleiotropic effects in mammals. Among these effects, vitamin A is a potent regulator of adipose tissue development, and is therefore important for obesity. This review focuses on the role of the provitamin A carotenoid β-carotene in human health, emphasizing the mechanisms by which this compound and its derivatives regulate adipocyte biology. It also discusses the physiological relevance of carotenoid accumulation, the implication of the carotenoid-cleaving enzymes, and the technical difficulties and considerations researchers must take when working with these bioactive molecules. Thanks to the broad spectrum of functions carotenoids have in modern nutrition and health, it is necessary to understand their benefits regarding to metabolic diseases such as obesity in order to evaluate their applicability to the medical and pharmaceutical fields.
Collapse
Affiliation(s)
- Johana Coronel
- Department of Food Sciences and Human Nutrition, University of Illinois Urbana Champaign, Urbana, IL 61801, USA.
| | - Ivan Pinos
- Division of Nutritional Sciences, University of Illinois Urbana Champaign, Urbana, IL 61801, USA.
| | - Jaume Amengual
- Department of Food Sciences and Human Nutrition, University of Illinois Urbana Champaign, Urbana, IL 61801, USA.
- Division of Nutritional Sciences, University of Illinois Urbana Champaign, Urbana, IL 61801, USA.
| |
Collapse
|
40
|
Raghavan R, Aaron GJ, Nahar B, Knowles J, Neufeld LM, Rahman S, Mondal P, Ahmed T. Household coverage of vitamin A fortification of edible oil in Bangladesh. PLoS One 2019; 14:e0212257. [PMID: 30943194 PMCID: PMC6447147 DOI: 10.1371/journal.pone.0212257] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 01/24/2019] [Indexed: 12/24/2022] Open
Abstract
Mandatory fortification of edible oil (soybean and palm) with vitamin A was decreed in Bangladesh in 2013. Yet, there is a dearth of data on the availability and consumption of vitamin A fortifiable oil at household level across population sub-groups. To fill this gap, our study used a nationally representative survey in Bangladesh to assess the purchase of fortifiable edible oil among households and project potential vitamin A intake across population sub-groups. Data is presented by strata, age range and poverty-the factors that potentially influence oil coverage. Across 1,512 households, purchase of commercially produced fortifiable edible oil was high (87.5%). Urban households were more likely to purchase fortifiable oil (94.0%) than households in rural low performing (79.7%) and rural other strata (88.1%) (p value: 0.01). Households in poverty were less likely to purchase fortifiable oil (82.1%) than households not in poverty (91.4%) (p <0.001). Projected estimates suggested that vitamin A fortified edible oil would at least partially meet daily vitamin A estimated average requirement (EAR) for the majority of the population. However, certain population sub-groups may still have vitamin A intake below the EAR and alternative strategies may be applied to address the vitamin A needs of these vulnerable sub-groups. This study concludes that a high percentage of Bangladeshi population across different sub-groups have access to fortifiable edible oil and further provides evidence to support mandatory edible oil fortification with vitamin A in Bangladesh.
Collapse
Affiliation(s)
- Ramkripa Raghavan
- Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States of America
| | - Grant J. Aaron
- Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland
| | - Baitun Nahar
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Jacky Knowles
- Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland
| | | | | | - Prasenjit Mondal
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
- James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| |
Collapse
|
41
|
Ruz M, Solomons NW. A Vision for Nutritional Research for the Latin American Region. Food Nutr Bull 2019; 40:14-25. [PMID: 30827120 DOI: 10.1177/0379572119832780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Manuel Ruz
- 1 Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Noel W Solomons
- 2 Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Guatemala City, Guatemala
| |
Collapse
|
42
|
Ara G, Khanam M, Rahman AS, Islam Z, Farhad S, Sanin KI, Khan SS, Rahman MM, Majoor H, Ahmed T. Effectiveness of micronutrient-fortified rice consumption on anaemia and zinc status among vulnerable women in Bangladesh. PLoS One 2019; 14:e0210501. [PMID: 30629717 PMCID: PMC6328150 DOI: 10.1371/journal.pone.0210501] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 12/22/2018] [Indexed: 12/28/2022] Open
Abstract
Micronutrient deficiency is one of the biggest public health concerns in Bangladesh. As per World Health Organisation (WHO) in the 2016 report, 40% women of reproductive age suffer from anaemia. According to the National Micronutrient Survey 2011–2012, 57% women suffer from zinc deficiency. The objective of the present study was to determine the effectiveness of fortified rice (FFR in addressing anaemia and zinc deficiency among vulnerable women. Baseline and endline surveys were conducted among female Vulnerable Group Development (VDG) beneficiaries in five districts in Bangladesh before and after 12 months of FFR distribution. The intervention group received 30 kg FFR; the control group received 30 kg non-FFR for every month from January 2013 to December 2013. The sample sizes were 870 women (435/group) at baseline and 800 (400/group) at endline. Difference-in-difference (DID) was estimated to measure the effect of FFR on anaemia and serum zinc. In the baseline survey, 39% of the FFR group and 34% of the non-FFR group had anaemia. At endline, 34% of women in the FFR group were anaemic compared to 40.7% in the non-FFR group. At endline, prevalence of anaemia was reduced in the FFR group by 4.8% but increased in the non-FFR group by 6.7%. The DID estimation showed the reduction in anaemia after 12 months of FFR consumption was significant (p = 0.035). The DID in mean haemoglobin level after 12 months of FFR consumption was also statistically significant (p = 0.002). Zinc deficiency decreased by 6% in the FFR group at endline, though the DID was not significant. Most of the respondents of the FFR group reported that they received their entitled rice on a regular basis however only half of the non-FFR respondents received every month in 12 months. Anaemia was significantly associated with not consuming fortified rice, geographical region, older age and heavy menstrual bleeding (P<0.05). FFR reduced anaemia and zinc deficiency prevalence. Replacement of regular rice with FFR in the VGD programme is recommended to reduce anaemia among vulnerable groups.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Herma Majoor
- United Nations World Food Programme, IDB Bhaban, Begum Rokeya Sarani, Dhaka, Bangladesh
| | | |
Collapse
|
43
|
Effect of Multiple Micronutrient Fortification on Physico-Chemical and Sensory Properties of Chhash (Traditional Indian Yogurt-Based Drink). Foods 2018; 8:foods8010005. [PMID: 30583509 PMCID: PMC6351923 DOI: 10.3390/foods8010005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Micronutrient malnutrition is a persistent problem in India mainly due to low dietary diversity and poor nutrient density of staple foods. The addition of a commercial micronutrient mix in terms of physico-chemical and sensory characteristics was evaluated. METHODS The yogurt prepared with reduce-fat milk (2%), 20 g/L CHN-11 fermentation culture and 12 h incubation (42 °C) was diluted at a rate of 35% to yield a 32 mg/100 mL concentration. The premix provided vitamin A, vitamin D, folic acid, iodine, iron, and zinc oxide to cover ~20⁻35% recommended RDA (recommended dietary allowance) per serving (250 mL). A three-factorial design, 2 treatments (control and fortified), 3 temperatures (4, 25, and 40 °C) and 4 time points (1, 2, 3 and 6 days), was used to analyze the physico-chemical properties in terms of titratable acidity, pH, color, and viscosity. A discriminatory sensory test (triangle) was performed with college students (n = 58) and mothers with young children (n = 25), who were living in Mehsana, India to evaluate the difference between fortified and non-fortified cooled (4 °C) product. RESULTS Fortification did not affect most of the physico-chemical properties of chhash. As expected, titratable acidity increased whereas pH decreased with increasing storage time and temperature. Fortified samples showed higher b* values, whereas L* and a* were not affected. Viscosity changed due to temperature and time, but not fortification. Participants could not discriminate between samples in terms of color, aroma, and taste. CONCLUSION Fortification of chhash is technically feasible.
Collapse
|
44
|
Olsen K, Suri DJ, Davis C, Sheftel J, Nishimoto K, Yamaoka Y, Toya Y, Welham NV, Tanumihardjo SA. Serum retinyl esters are positively correlated with analyzed total liver vitamin A reserves collected from US adults at time of death. Am J Clin Nutr 2018; 108:997-1005. [PMID: 30475970 PMCID: PMC6692705 DOI: 10.1093/ajcn/nqy190] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 07/16/2018] [Indexed: 12/31/2022] Open
Abstract
Background Minimal human data exist on liver vitamin A (VA) compared with serum biomarkers. Cutoffs of 5% and 10% total serum VA as retinyl esters (REs) suggest a VA intoxication diagnosis. Objectives We compared total liver VA reserves (TLRs) with the percentage of total serum VA as REs to evaluate hypervitaminosis with the use of US adult autopsy samples. Secondary objectives evaluated serum retinol sensitivity, TLRs among lobes, and hepatic α-retinol concentrations, an α-carotene cleavage product. Design Matched serum and liver samples were procured from cadavers (n = 27; mean ± SD age: 70.7 ± 14.9 y; range: 49-101 y). TLRs and α-REs were quantified by ultra-performance liquid chromatography. Pearson correlations showed liver and serum associations. Sensitivity and specificity were calculated for >5%, 7.5%, and 10% total serum VA as REs to predict TLRs and for serum retinol <0.7 and 1 μmol/L to predict deficiency. Results Serum RE concentrations were correlated with TLRs (r = 0.497, P < 0.001). Nine subjects (33%) had hypervitaminosis A (≥1.0 μmol VA/g liver), 2 of whom had >7.5% total serum VA as REs; histologic indicators corroborated toxicity at 3 μmol/g liver. No subject had >10% total serum VA as REs. Serum retinol sensitivity to determine deficiency (TLRs <0.1 μmol VA/g) was 83% at 0.7 and 1 μmol/L. Hepatic α-retinol was positively correlated with age (P = 0.047), but removing an outlier nullified significance. Conclusions This study evaluated serum REs as a biomarker of VA status against TLRs (gold standard), and abnormal histology suggested that 7.5% total serum VA as REs is diagnostic for toxicity at the individual level in adults. The long-term impact of VA supplements and fortificants on VA status is currently unknown. Considering the high prevalence of hypervitaminotic TLRs in this cohort, and given that many countries are adding preformed VA to processed products, population biomarkers diagnosing hypervitaminosis before toxicity are urgently needed. This trial was registered at clinicaltrials.govas NCT03305042.
Collapse
Affiliation(s)
- Kiersten Olsen
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin–Madison, Madison, WI
| | - Devika J Suri
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin–Madison, Madison, WI
| | - Christopher Davis
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin–Madison, Madison, WI
| | - Jesse Sheftel
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin–Madison, Madison, WI
| | - Kohei Nishimoto
- Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI,Present address for KN and YT: Department of Otolaryngology, Kumamoto University School of Medicine, Kumamoto, Japan
| | - Yusuke Yamaoka
- Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI,Present address for YY: Kyoto University Faculty of Medicine, Kyoto, Japan
| | - Yutaka Toya
- Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI,Present address for KN and YT: Department of Otolaryngology, Kumamoto University School of Medicine, Kumamoto, Japan
| | - Nathan V Welham
- Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Sherry A Tanumihardjo
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin–Madison, Madison, WI,Address correspondence to SAT (e-mail: )
| |
Collapse
|
45
|
da Silva Lopes K, Takemoto Y, Garcia-Casal MN, Ota E. Nutrition-specific interventions for preventing and controlling anaemia throughout the life cycle: an overview of systematic reviews. Cochrane Database Syst Rev 2018. [DOI: 10.1002/14651858.cd013092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Katharina da Silva Lopes
- St. Luke's International University; Global Health Nursing, Graduate School of Nursing Sciences; 10-1 Akashi-cho Chuo-Ku Tokyo Japan 104-0044
| | - Yo Takemoto
- Juntendo University; Department of Obstetrics and Gynaecology, School of Medicine; 2-1-1, Hongo, Bunkyo-KU Tokyo Japan 1138421
| | - Maria N Garcia-Casal
- World Health Organization; Evidence and Programme Guidance, Department of Nutrition for Health and Development; Avenue Appia 20 Geneva Geneva Switzerland 1211
| | - Erika Ota
- St. Luke's International University; Global Health Nursing, Graduate School of Nursing Sciences; 10-1 Akashi-cho Chuo-Ku Tokyo Japan 104-0044
| |
Collapse
|
46
|
Toffano RBD, Hillesheim E, Mathias MG, Coelho-Landell CA, Salomão RG, Almada MORV, Camarneiro JM, Barros TT, Camelo-Junior JS, Rezzi S, Goulet L, Giner MP, Silva LD, Martin FP, Montoliu I, Moco S, Collino S, Kaput J, Monteiro JP. Validation of the Brazilian Healthy Eating Index-Revised Using Biomarkers in Children and Adolescents. Nutrients 2018; 10:E154. [PMID: 29385742 PMCID: PMC5852730 DOI: 10.3390/nu10020154] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 12/26/2017] [Accepted: 01/08/2018] [Indexed: 12/22/2022] Open
Abstract
The Brazilian Healthy Eating Index-Revised (BHEI-R) can be used to determine overall dietary patterns. We assessed the BHEI-R scores in children and adolescents, aged from 9 to 13 years old, and associated its component scores with biomarkers of health and dietary exposure. Three 24-h recalls were used to generate BHEI-R. Biomarkers were analyzed in plasma and red blood cells. Correlation tests, agreement, and covariance analyses were used to associate BHEI-R components with biomarkers. Data from 167 subjects were used. The strongest correlations were between fruits, vegetables and legumes with omega-6 and omega-3 fatty acids, and β-carotene intakes. Milk and dairy correlated with plasma retinol and pyridoxine. All components rich in vegetable and animal protein sources correlated with plasma creatine. Total BHEI-R scores were positively associated with intakes of omega-6, omega-3, fiber and vitamin C, and inversely associated with energy and saturated fat intakes of individuals. Plasma β-carotene and riboflavin biomarkers were positively associated with total BHEI-R. An inadequate food consumption pattern was captured by both biomarkers of health and dietary exposure. BHEI-R was validated for the above dietary components and can be associated with metabolomics and nutritional epidemiological data in future pediatric studies.
Collapse
Affiliation(s)
- Roseli B D Toffano
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Elaine Hillesheim
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Mariana G Mathias
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Carolina A Coelho-Landell
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Roberta G Salomão
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Maria O R V Almada
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Joyce M Camarneiro
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Tamiris T Barros
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - José S Camelo-Junior
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Serge Rezzi
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Laurence Goulet
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Maria P Giner
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Laeticia Da Silva
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Francois-Pierre Martin
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Ivan Montoliu
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Sofia Moco
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Sebastiano Collino
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Jim Kaput
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Jacqueline P Monteiro
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| |
Collapse
|
47
|
Song P, Wang J, Wei W, Chang X, Wang M, An L. The Prevalence of Vitamin A Deficiency in Chinese Children: A Systematic Review and Bayesian Meta-Analysis. Nutrients 2017; 9:nu9121285. [PMID: 29186832 PMCID: PMC5748736 DOI: 10.3390/nu9121285] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 11/19/2017] [Accepted: 11/21/2017] [Indexed: 11/16/2022] Open
Abstract
Vitamin A deficiency (VAD), a leading cause of preventable childhood blindness, has been recognized as an important public health problem in many developing countries. In this study, we conducted a systematic review to identify all population-based studies of VAD and marginal VAD (MVAD) in Chinese children published from 1990 onwards. Hierarchical Bayesian meta-regressions were performed to examine the effects of age, sex, setting and year on the prevalence of VAD and MVAD, separately. The estimated prevalence was applied to the Chinese pediatric population in the year 2015 to generate prevalence estimates of VAD and MVAD for defined age groups, with 95% credible intervals (CrIs). Fifty-four studies met the inclusion criteria. The prevalence of VAD and MVAD both decreased with increasing age, and rural children had a higher prevalence of VAD and MVAD than urban children. In 2015, the prevalence of VAD was 5.16% (95% CrI: 1.95-12.64) and that of MVAD was 24.29% (95% CrI: 12.69-41.27) in Chinese children aged 12 years and under. VAD remains a public health problem in China. Efforts to reduce VAD in younger children are needed, especially for those in rural areas.
Collapse
Affiliation(s)
- Peige Song
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China.
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH8 9AG, UK.
| | - Jiawen Wang
- Institute of Medical Humanities, Peking University, Beijing 100191, China.
| | - Wei Wei
- School of Foundational Education, Peking University, Beijing 100191, China.
| | - Xinlei Chang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Manli Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Lin An
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China.
| |
Collapse
|
48
|
Silalahi DKN, Yuliyanti D, da Silva M, Christianti I, Mulyono K, Wassell P. The stability of vitamin A in fortified palm olein during extended storage and thermal treatment. Int J Food Sci Technol 2017. [DOI: 10.1111/ijfs.13462] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Dewi Kristina Natalia Silalahi
- Sinarmas agribusiness and food; R&D PT; SMART Tbk; Marunda center; Blok D1, Desa Segara Makmur; Kec. Tarumajaya Jawa Barat Indonesia
| | - Dewi Yuliyanti
- Sinarmas agribusiness and food; R&D PT; SMART Tbk; Marunda center; Blok D1, Desa Segara Makmur; Kec. Tarumajaya Jawa Barat Indonesia
| | - Monica da Silva
- Sinarmas agribusiness and food; R&D PT; SMART Tbk; Marunda center; Blok D1, Desa Segara Makmur; Kec. Tarumajaya Jawa Barat Indonesia
| | - Isti Christianti
- Sinarmas agribusiness and food; R&D PT; SMART Tbk; Marunda center; Blok D1, Desa Segara Makmur; Kec. Tarumajaya Jawa Barat Indonesia
| | - Karyanto Mulyono
- Sinarmas agribusiness and food; R&D PT; SMART Tbk; Marunda center; Blok D1, Desa Segara Makmur; Kec. Tarumajaya Jawa Barat Indonesia
| | - Paul Wassell
- Sinarmas agribusiness and food; R&D PT; SMART Tbk; Marunda center; Blok D1, Desa Segara Makmur; Kec. Tarumajaya Jawa Barat Indonesia
| |
Collapse
|
49
|
Yeh EB, Schiano AN, Jo Y, Barbano DM, Drake MA. The effect of vitamin concentrates on the flavor of pasteurized fluid milk. J Dairy Sci 2017; 100:4335-4348. [PMID: 28434730 DOI: 10.3168/jds.2017-12613] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 02/13/2017] [Indexed: 11/19/2022]
Abstract
Fluid milk consumption in the United States continues to decline. As a result, the level of dietary vitamin D provided by fluid milk in the United States diet has also declined. Undesirable flavor(s)/off flavor(s) in fluid milk can negatively affect milk consumption and consumer product acceptability. The objectives of this study were to identify aroma-active compounds in vitamin concentrates used to fortify fluid milk, and to determine the influence of vitamin A and D fortification on the flavor of milk. The aroma profiles of 14 commercial vitamin concentrates (vitamins A and D), in both oil-soluble and water-dispersible forms, were evaluated by sensory and instrumental volatile compound analyses. Orthonasal thresholds were determined for 8 key aroma-active compounds in skim and whole milk. Six representative vitamin concentrates were selected to fortify skim and 2% fat pasteurized milks (vitamin A at 1,500-3,000 IU/qt, vitamin D at 200-1,200 IU/qt, vitamin A and D at 1,000/200-6,000/1,200 IU/qt). Pasteurized milks were evaluated by sensory and instrumental volatile compound analyses and by consumers. Fat content, vitamin content, and fat globule particle size were also determined. The entire experiment was done in duplicate. Water-dispersible vitamin concentrates had overall higher aroma intensities and more detected aroma-active compounds than oil-soluble vitamin concentrates. Trained panelists and consumers were able to detect flavor differences between skim milks fortified with water-dispersible vitamin A or vitamin A and D, and unfortified skim milks. Consumers were unable to detect flavor differences in oil-soluble fortified milks, but trained panelists documented a faint carrot flavor in oil-soluble fortified skim milks at higher vitamin A concentrations (3,000-6,000 IU). No differences were detected in skim milks fortified with vitamin D, and no differences were detected in any 2% milk. These results demonstrate that vitamin concentrates may contribute to off flavor(s) in fluid milk, especially in skim milk fortified with water-dispersible vitamin concentrates.
Collapse
Affiliation(s)
- E B Yeh
- Department of Food, Bioprocessing and Nutrition Sciences, Southeast Dairy Foods Research Center, North Carolina State University, Raleigh 27695
| | - A N Schiano
- Department of Food, Bioprocessing and Nutrition Sciences, Southeast Dairy Foods Research Center, North Carolina State University, Raleigh 27695
| | - Y Jo
- Department of Food, Bioprocessing and Nutrition Sciences, Southeast Dairy Foods Research Center, North Carolina State University, Raleigh 27695
| | - D M Barbano
- Department of Food Science, Northeast Dairy Foods Research Center, Cornell University, Ithaca, NY 14853
| | - M A Drake
- Department of Food, Bioprocessing and Nutrition Sciences, Southeast Dairy Foods Research Center, North Carolina State University, Raleigh 27695.
| |
Collapse
|
50
|
Lee H. Transgenic Pro-Vitamin A Biofortified Crops for Improving Vitamin A Deficiency and Their Challenges. ACTA ACUST UNITED AC 2017. [DOI: 10.2174/1874331501711010011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Vitamin A Deficiency (VAD) has been a public health problem among children in developing countries. To alleviate VAD, Vitamin A Supplementation (VAS), food fortification, biofortification and nutrition education have been implemented in various degrees of success with their own merits and limits. While VAS is the most widely utilized intervention in developing countries to ease the burden of VAD, some have raised questions on VAS’ effectiveness. Biofortification, often touted as an effective alternative to VAS, has received significant attention. Among the available biofortification methods, adopting transgenic technology has not only facilitated rapid progress in science for enhanced pro-Vitamin A (pVA) levels in target crops, but drawn considerable skepticism in politics for safety issues. Additionally, VAD-afflicted target regions of transgenic pVA crops widely vary in their national stance on Genetically Modified (GM) products, which further complicates crop development and release. This paper briefly reviews VAS and its controversy which partly demanded shifts to food-based VAD interventions, and updates the current status of transgenic pVA crops. Also, this paper presents a framework to provide potential influencers for transgenic pVA crop development under politically challenging climates with GM products. The framework could be applicable to other transgenic micronutrient biofortification.
Collapse
|