What is food-to-food fortification? A working definition and framework for evaluation of efficiency and implementation of best practices

Formulation of new sourdough bread prototypes fortified with non-compliant chickpea and pea residues

Purpose

Nowadays, the promotion of a circular economy is fundamental to reduce food losses and waste. In this context, the possibility of using food supply chains non-compliant residues emerges. Much interest has been directed toward legume residues, in general and, in particular, to the possibility of combining different plant-matrices to improve nutritional profile, providing high-quality products.

Methods

Five different formulations of breads, with a combination of seeds and cereals, were fortified with chickpea and pea protein concentrates. Samples were analyzed and compared with their relative control recipe to determine differences in composition, actual protein quality and integrity, and protein digestibility (performed with the INFOGEST method).

Results

Samples showed a clear improvement in the nutritional profile with higher values of proteins, from averagely 12.9 (control breads) to 29.6% (fortified breads) (17.7-24.7 g/100 g of dry matter respectively), and an improvement in amino acidic profile, with a better balancing of essential amino acids (lysine and sulfur amino acid contents), without affecting protein integrity. Regarding in vitro gastro-intestinal digestibility, sample C (19% chickpea proteins) showed the best results, having a comparable protein digestibility to its control bread-48.8 ± 1.1% versus 51.7 ± 2.3%, respectively.

Conclusion

The results showed how the fortification with chickpea and/or pea protein concentrate improved the nutritional profile of bread. These prototypes seem to be a valid strategy to also increase the introduction of high biological value proteins. Furthermore, the not-expected lower digestibility suggested the possible presence of residual anti-nutritional factors in the protein concentrates interfering with protein digestibility. Therefore, it seems of fundamental importance to further investigate these aspects.

Designing sustainable weaning foods for developing countries: not only a matter of nutrients

Blended complementary foods from cereals and high-protein sources are used worldwide to cope with infants' malnutrition. However, the usefulness of the food matrix during traditional processes reaches suboptimal effectiveness due to cereal gelatinization and viscosity, which reduce consumption. The interplay between nutritional and physical qualities needed for weaning children presents further significant constraints. A combination of processing methods can improve and optimize the overall product quality. This paper investigated the nutritional, functional, and anti-nutritional factors of a complementary infant porridge made by combining fermented sorghum flour with germinated bottle gourd seed flour. Overall, the combination improved the functional and physical properties of the porridge suitable for children of 10 months and over. A serving of 100 g would contribute 115-145% and 23-31% of the recommended nutritional intake of protein and energy, respectively, for low breast milk energy between 6-24 months. The results demonstrate that a combination of strategies and technologies are needed to balance nutritional and physical quality.

Implementing micronutrient fortification programs as a potential practical contribution to achieving sustainable diets

Due to sustainability concerns related to current diets and environmental challenges, it is crucial to have sound policies to protect human and planetary health. It is proposed that sustainable diets will improve public health and food security and decrease the food system's effect on the environment. Micronutrient deficiencies are a well-known major public health concern. One-third to half of the world's population suffers from nutrient deficiencies, which have a negative impact on society in terms of unrealised potential and lost economic productivity. Large-scale fortification with different micronutrients has been found to be a useful strategy to improve public health. As a cost-effective strategy to improve micronutrient deficiency, this review explores the role of micronutrient fortification programmes in ensuring the nutritional quality (and affordability) of diets that are adjusted to help ensure environmental sustainability in the face of climate change, for example by replacing some animal-sourced foods with nutrient-dense, plant-sourced foods fortified with the micronutrients commonly supplied by animal-sourced foods. Additionally, micronutrient fortification considers food preferences based on the dimensions of a culturally sustainable diet. Thus, we conclude that investing in micronutrient fortification could play a significant role in preventing and controlling micronutrient deficiencies, improving diets and being environmentally, culturally and economically sustainable.

Effect of Marjoram Leaf Powder Addition on Nutritional, Rheological, Textural, Structural, and Sensorial Properties of Extruded Rice Noodles

Food-to-food fortification is an emerging technique to enrich the micronutrients in foods. Pertaining to this technique, noodles could also be fortified with natural fortificants. In this study, marjoram leaf powder (MLP) at a level of 2-10% was used as a natural fortificant to produce fortified rice noodles (FRNs) through an extrusion process. The MLP addition caused a significant increase in the iron, calcium, protein, and fiber in the FRNs. The noodles had a lower whiteness index than unfortified noodles but had a similar water absorption index. The water solubility index increased significantly due to the higher water retention ability of MLP. A rheological study showed a minimal effect of fortification on the gelling strength of the FRNs at lower levels. The microstructural studies found incremental cracks, which facilitated a lower cooking time and hardness but had an insignificant effect on the cooked noodle texture. Fortification improved the total phenolic content, antioxidant capacity, and total flavonoid content. However, no significant changes in bonds were observed, but a reduction in the noodles' crystallinity could be seen. The sensory analysis of the noodles reflected a higher acceptability of the 2-4% MLP fortified samples compared to the others. Overall, the MLP addition improved the nutritional content, antioxidant activity, and the cooking time but slightly affected the rheological, textural, and color properties of the noodles.

Can consumption of local micronutrient- and absorption enhancer-rich plant foods together with starchy staples improve bioavailable iron and zinc in diets of at-risk African populations?

Iron and zinc deficiencies remain prevalent in developing countries, often due to monotonous starchy diets that are low in bioavailable minerals. This review addresses the question as to whether consumption of starchy staple foods in Africa together with micronutrient-dense and absorption enhancer-rich plant foods can enhance iron and zinc bioavailability in the diets of at-risk populations. While green leafy vegetables (GLVs) fortification of starchy staples can improve mineral contents, especially iron, it may not improve bioavailable iron and zinc, due to GLVs' high contents of mineral absorption inhibitors, notably polyphenols, phytate and calcium. Fruits, although low in minerals, could improve bioavailable iron and zinc in the staples because of their high ascorbic and citric acid and/or β-carotene contents, which can form soluble chelates with the minerals. More human studies are needed to establish whether such a technology or fortification strategy can improve bioavailable iron and zinc in African-type plant-based diets.

Exploring the Complementarity of Fortification and Dietary Diversification to Combat Micronutrient Deficiencies: A Scoping Review

Achieving a balanced and diverse diet remains a challenge for many people, contributing to an ongoing burden of micronutrient deficiencies, particularly in low-income settings. Fortification or dietary diversification are common food-based approaches. We conducted a scoping review to: 1) find evidence on whether combined food-based strategies are more effective than single strategies, and 2) understand how strategies implemented together could complement each other to achieve optimal nutritional impact on populations. Peer-reviewed articles selected (n = 21) included interventions or observational studies (n = 13) and reviews (n = 8). We found little evidence of an added nutritional impact. On the other hand, it is apparent that fortification and dietary diversification target different types of settings (urban compared with rural) and foods (that is, low priced compared with highly priced). Further research is needed to understand the complementarity of these approaches and establish evidence of the effectiveness of combined strategies to foster policy adoption.

Food-to-Food Fortification of a Traditional Pearl Millet Gruel with a Natural Source of β-Carotene (Sweet Potato) Improves the Bioaccessibility of Iron and Zinc

Iron and zinc deficiencies are still a major public health concern in the Far North Region of Cameroon where staple foods are mainly mineral rich cereals which equally contain inhibitors of their bioaccessibility. The effect of food-to-food fortification of a traditional pearl millet gruel with a natural source of β-carotene on the bioaccessibility of iron and zinc was assessed. A sensory evaluation of gruels fortified at 20, 30, and 40% with mashed sweet potato was carried out. The samples were analysed for carotenoids, phytates, polyphenols, iron, and zinc contents. Bioaccessible iron and zinc were evaluated using in vitro digestion method. The gruel fortified at 20% with mashed sweet potato had better scores ( $P$  < 0.05) of taste (3.93), colour (3.36), and overall acceptability (3.80) compared to the control. Carotenoid, polyphenol, and phytate contents were higher in fortified gruels ( $P$  < 0.05) compared to the control, while iron and zinc contents were lower. A significant increase ( $P$  < 0.05) in bioaccessibility of 8.08% and 26.96% for iron and 53.79% and 62.92% for zinc was observed at 20 and 30% incorporation level, respectively. However, at 40% incorporation level, the increase in bioaccessible iron was less important and bioaccessible zinc decreased. Mashed sweet potato can be used as a fortificant to improve the bioaccessibility of iron and zinc contents of local pearl millet gruel, if added moderately.

Food fortification strategies to deliver nutrients for the management of iron deficiency anaemia

A rising trend in the global prevalence of anaemia is still prevailing. To combat micronutrient deficiencies, World Health Organisation/Food Agriculture Organisation (2006) guidelines recommended four chief strategies - supplementation, fortification, nutrition education and dietary diversity. Of the four strategies, food fortification has been considered as the most efficacious and economical approach. However, it is the directives themselves that highlight two major bottlenecks associated with conventional fortification - uniform dissemination of the fortifier in food vehicle that mostly include staple foods, and internal and external compliance evaluation of fortification regulations and standards by the producers. As a result, researchers envisaged a new strategy - Food-to-food fortification that complements conventional fortification. This strategy involves fortification of food vehicles with nutrient-rich food-based fortifiers. The major advantage of utilising food-based fortifiers is that they hold the potential of enhancing the bioavailability of the fortified food and providing additional nutrients and thus, resulting in dietary diversification. It also facilitates the utilisation of underutilised crops as food-based fortifiers. Underutilised crops have been recognised as potential beneficial food source accounting to their nutritional, ecological, and fiscal benefits. This review paper delves into the strengths and shortcomings of conventional iron fortification. It delineates the concept of food-to-food fortification, while precisely discussing about the best practices to be followed to address the possible challenges associated with this strategy. It also promotes the utilisation of underutilised iron rich foods to develop fortified foods and avert global food insecurity. Furthermore, it provides a summary of the studies conducted around the world to develop fortified foods using iron compounds and iron-rich foods, and to investigate their efficacy in managing iron deficiency anaemia.

Leafy vegetables fortification enhanced the nutritional profile and reduced the glycemic index of yellow cassava pasta

Food-to-food fortification of yellow cassava flour with leafy vegetable powders (Amaranthus and Telfairia occidentalis) was employed in this study to develop cassava-vegetable spaghetti-like pasta products (YP, YPA5, YPA10, YPU5, YPU10, YPA5O). The nutritional profile, micronutrient retention, bioaccessibility, starch digestibility and in vitro glycemic index were assessed. The incorporation of leafy vegetable powder enhanced the nutritional quality of the yellow cassava pasta (YCP) products. The fortification increased (up to 3-fold) the protein in fortified YCP, increased the fibre (11%), doubled the ash and increased the beta-carotene (about 7-fold), iron (72%) and zinc contents by 10%. The phenolic content of fluted pumpkin leaf-fortified pasta with 10% leaf powder inclusion (YPU10) was 1100 μg GAE g^-1, almost four times higher than that of the unfortified YCP. Leaf powders in the cassava pasta also favoured the retention of micronutrients during cooking and slowed down the starch digestibility. The retention during cooking was up to 91% in YPU10 for beta-carotene with no loss in iron, while the bioaccessibility of beta-carotene was impeded, the zinc retention was high and became significantly more bioaccessible with leaf addition and cooking. The estimated glycemic index of YCP was reduced by 19% and 15% in YPU10 and YPA10, respectively. The inclusion of the vegetables also reduced the glycemic index of the fortified YCP. Thus, adding leafy vegetable powder up to 10% into YCP is a promising approach to both valorise yellow provitamin A biofortified cassava and enhance the nutritional value.

Effect of dietary fiber addition on the content and in vitro bioaccessibility of antioxidants in red raspberry puree

The aim of the present study was to understand how the addition of pectin (2.5% and 5%) affected the content and bioaccessibility of phenolics in red raspberry puree. The results showed that the concentration of antioxidants in red raspberry puree was reduced with the addition of pectin. Similarly, addition of pectin to red raspberry puree significantly reduced the total phenolic content (15-20%), total antioxidant capacity (18-70%), and total monomeric anthocyanin (25-30%) after in vitro digestion. On the other hand, significant decreases in the bioaccessible amount of cyanidin (41%), cyanidin-3-glucoside (14%), cyanidin-3-rutinoside (17%), pelargonidin 3-glucoside (16%), and peonidin (28%) were observed after the addition of pectin (5% (w/w)) compared to the control (p < 0.05) as analyzed with the HPLC method. According to the LC-MS/MS analysis of red raspberry samples, five flavonoids (rutin, quercetin, kaempferol, myricetin, and phlorizin) and six phenolic acids (gallic acid, caffeic acid, chlorogenic acid, sinapic acid, p-coumaric acid, and ferulic acid) were detected. The effect of in vitro gastrointestinal digestion varied depending on the type of the phenolic compounds. Sinapic acid and phlorizin were not detected at all in the intestinal phase, indicating that they were completely degraded during digestion. The percentage bioaccessibility of gallic acid (49-88%), rutin (6-16%), and quercetin (23-33%) was decreased proportionally with the increase in the pectin content in red raspberry purees (p < 0.05). On the other hand, only 5% pectin addition to red raspberry puree resulted with a significant decrease in the amount of bioaccessible caffeic acid (8% to 5%), kaempferol (24% to 13%), ferulic acid (26% to 10%), and myricetin (91% to 57%) (p < 0.05). Overall, the present study highlighted that incorporation of pectin to red raspberry puree reduced the amount of bioaccessible polyphenols.

Valorization of Mango By-Products to Enhance the Nutritional Content of Maize Complementary Porridges

Mango by-products are disregarded as waste contributing to greenhouse gas emissions. This study used mango seed and kernel to enhance the nutritional content of maize complementary porridges. Composite maize-based porridges (MBP) were formulated by fortifying maize flour with fine ground mango seed and kernel at different levels (31%, 56%, 81%). The by-products and formulated porridges were characterized for their nutritional composition, mineral content, total phenolic content, and antioxidant capacity. Furthermore, the bioaccessibility of essential minerals during in vitro gastrointestinal digestion of the formulated porridges was determined using inductively coupled plasma optical emission spectrometry. Mango seed had a high fat (12.0 g/100 g dw) and protein content (4.94 g/100 g dw), which subsequently doubled the fat content of the porridges. Mango by-products increased the total phenolic content of maize porridge by more than 40 times and the antioxidant capacity by 500 times. However, fortification with mango by-products significantly decreased the bioaccessibility of minerals, especially manganese, copper, and iron, as the highest percentages of insoluble minerals were recorded in MBP 81 at 78.4%, 71.0%, and 62.1%, respectively. Thus, the results suggest that mango seed and kernel could increase the nutritional value of maize porridge, but fortification should be done at lower levels of about 31-56%.

Potential of moringa leaf and baobab fruit food-to-food fortification of wholegrain maize porridge to improve iron and zinc bioaccessibility

Food-to-food fortification (FtFF) with moringa leaf (iron source) and/or baobab fruit (citric acid and ascorbic acid source) (each 13-15 g/100 g porridge dry basis (db)) was studied to improve iron and zinc nutritive quality in African-type wholegrain maize-based porridges using in vitro dialysability assay. Moringa FtFF decreased percentage and total bioaccessible iron and zinc, by up to 84% and 45%, respectively. Moringa was very high in calcium, approximately 3% db and calcium-iron-phytate complexes inhibit iron bioavailability. Baobab FtFF increased percentage and total bioaccessible iron and zinc, especially in porridges containing carrot + mango (β-carotene source) and conventionally fortified with FeSO₄, by up to 111% and 60%, respectively. The effects were similar to those when ascorbic and citric acids were added as mineral absorption enhancers. While moringa FtFF could be inhibitory to iron and zinc bioavailability in cereal-based porridges, baobab fruit FtFF could improve their bioavailability, especially in combination with conventional iron fortification.