1
|
Moravcová M, Siatka T, Krčmová LK, Matoušová K, Mladěnka P. Biological properties of vitamin B 12. Nutr Res Rev 2024:1-33. [PMID: 39376196 DOI: 10.1017/s0954422424000210] [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: 10/09/2024]
Abstract
Vitamin B12, cobalamin, is indispensable for humans owing to its participation in two biochemical reactions: the conversion of l-methylmalonyl coenzyme A to succinyl coenzyme A, and the formation of methionine by methylation of homocysteine. Eukaryotes, encompassing plants, fungi, animals and humans, do not synthesise vitamin B12, in contrast to prokaryotes. Humans must consume it in their diet. The most important sources include meat, milk and dairy products, fish, shellfish and eggs. Due to this, vegetarians are at risk to develop a vitamin B12 deficiency and it is recommended that they consume fortified food. Vitamin B12 behaves differently to most vitamins of the B complex in several aspects, e.g. it is more stable, has a very specific mechanism of absorption and is stored in large amounts in the organism. This review summarises all its biological aspects (including its structure and natural sources as well as its stability in food, pharmacokinetics and physiological function) as well as causes, symptoms, diagnosis (with a summary of analytical methods for its measurement), prevention and treatment of its deficiency, and its pharmacological use and potential toxicity.
Collapse
Affiliation(s)
- Monika Moravcová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Tomáš Siatka
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Lenka Kujovská Krčmová
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czech Republic
- Department of Analytical Chemistry, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Kateřina Matoušová
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Přemysl Mladěnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| |
Collapse
|
2
|
Issa-Zacharia A, Mareni GB. Compliance Level and Stability of Micronutrients in Fortified Maize Flour in Tanzania. INTERNATIONAL JOURNAL OF FOOD SCIENCE 2024; 2024:7746750. [PMID: 38433769 PMCID: PMC10904681 DOI: 10.1155/2024/7746750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 03/05/2024]
Abstract
Maize flour fortification was introduced in Tanzania in 2011 to address the risk of micronutrient deficiency to children, adolescents, and women of childbearing age. Fortified maize flours are processed by small-scale processors who are exempted from mandatory fortification. The current study is aimed at assessing the compliance and stability of fortified processed maize flour with zinc, iron, and folic acid by small-scale processors in comparison to the recommended Tanzania national standards (TZS 328). A total of 69 samples of fortified maize flour were collected at the point of production and retail outlets in Dar es Salaam and Morogoro municipalities, Tanzania. Micronutrients (zinc and iron) were analysed using microwave plasma atomic emission spectrometry (MP-AES), and folic acid was analysed using high-performance liquid chromatography (HPLC). The mean concentrations of micronutrient were significantly (p < 0.05) higher at the production site compared to the retail outlet. The amount of iron, zinc, and folic acid in the samples at the production site was 27.17 ± 1.63 mg/kg, 30.56 ± 2.01 mg/kg, and 0.69 ± 0.02 mg/kg, respectively, while it was 19.34 ± 0.97 mg/kg, 21.71 ± 1.50 mg/kg, and 0.49 ± 0.02 mg/kg for iron, zinc, and folic acid, respectively, at the retail outlets. Only 31.6% of the assessed samples from production and 12.9% from retail outlets complied with the recommended national standard. The stability of iron, zinc, and folic acid for the fortified maize flour stored at room temperature (20-32°C) for six months was 95.8%, 96.9%, and 66.9%, respectively. Further investigation on the consistency performance of the dosifier and consistency training of working in the processing unit on the requirements of fortification standards should be done.
Collapse
Affiliation(s)
- Abdulsudi Issa-Zacharia
- Department of Food Science and Agro-processing, School of Engineering and Technology, Sokoine University of Agriculture, P.O. Box 3006, Chuo Kikuu, Morogoro, Tanzania
| | - Gudila Boniface Mareni
- Department of Food Science and Agro-processing, School of Engineering and Technology, Sokoine University of Agriculture, P.O. Box 3006, Chuo Kikuu, Morogoro, Tanzania
| |
Collapse
|
3
|
Fatemi SF, Irankhah K, Kruger J, Bruins MJ, Sobhani SR. Implementing micronutrient fortification programs as a potential practical contribution to achieving sustainable diets. NUTR BULL 2023; 48:411-424. [PMID: 37503811 DOI: 10.1111/nbu.12630] [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] [Received: 02/22/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
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.
Collapse
Affiliation(s)
- Seyedeh Fatemeh Fatemi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kiyavash Irankhah
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Johanita Kruger
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany
| | | | - Seyyed Reza Sobhani
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
4
|
Acosta-Estrada BA, Serna-Saldívar SO, Chuck-Hernández C. Nutritional assessment of nixtamalized maize tortillas produced from dry masa flour, landraces, and high yield hybrids and varieties. Front Nutr 2023; 10:1183935. [PMID: 37485394 PMCID: PMC10358733 DOI: 10.3389/fnut.2023.1183935] [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: 03/10/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
In the scientific literature there are different analyses of the nutritional profiles of maize tortillas, whether they are landraces or hybrid maize versus those made with dry masa flour (DMF). In general terms, there is agreement in the reported content of moisture. However, for the other nutrients, a great disparity is reported for each type of tortilla which may be due to various factors such as the type of maize or processing methods. In this study, the nutritional aspects of maize tortillas made with different genotypes (five hybrids, two varieties, five landraces, six hybrid mixtures and six dry masa flours) under controlled conditions, were compared. More than 30 characteristics were analyzed. High performance hybrids and varieties (HPHV) and landraces had the highest (p < 0.05) antioxidant capacity (58.8% free, 150.2% bound). In terms of vitamins contents, the tortillas produced from DMF contained 11.2 and 3.5 times more B1, 18.6 and 7.8 times more B2, and 2.7 and 5.3 times more B3 than HPHV and landraces respectively; and only in these samples was detected folic acid. DMF tortilla samples contained 1.75 times more sodium and 2.75 times more iron than the other groups, and 0.75 times less calcium than HPHV. Zinc was present in higher concentration (p < 0.05) in DMF tortilla samples. The landraces had the highest protein content (average 10.28%), but the tortillas produced from DMF presented the highest protein quality evaluated by protein digestibility-corrected amino acid score (PDCAAS) (p < 0.05) that represents 27, 25 and 19% more than hybrids mixture, HPHV and landraces, respectively. This work gives valuable information on how different types of grains differ in the nutritional quality affecting the final product to provide more elements in the decision-making of processors. There is no a perfect maize, but there are genotypes that can be combined as mixtures and the processing method to design superior nutritional tortillas and related products for populations that highly consume them and improve their human health.
Collapse
|
5
|
Chepkoech B, Sila DN, Orina IN. Effect of Storage Condition on Retention of Vitamins in Selected Commercial Fortified Maize Flour in Kenya. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2022. [DOI: 10.12944/crnfsj.10.3.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Food fortification is one strategy that has been used to overcome micronutrient deficiencies among vulnerable populations. Maize, a common staple food in Kenya, has been used as a suitable fortification vehicle. However, several factors, including storage conditions, impact micronutrient stability in fortified maize flour.This study aimed to to assess the influence of storage condition on the retention of retinol and B-vitamins in selected commercial fortified maize flour. Fresh samples of fortified maize flours from two brands (coded XX1 and XY2) were sampled from the manufacturers at the point of production. The storage stability of retinol and B-vitamins in the two brands (XX1 and XY2) was monitored for 6 months at 25 °C/ 75 % relative humidity and 35 °C/ 83 % relative humidity. Retinol and thiamine were the least stable vitamins in both flour brands, while riboflavin and folate were relatively stable. Niacin was the most stable vitamin. Retinol was the least stable vitamin for brand XXI at both 25 °C/75% RH and 35 °C/83% RH, followed by thiamine, riboflavin, folate, and niacin. However, brand XY2 showed that under both storage conditions, thiamine was the least stable vitamin, followed by retinol, riboflavin, folate, and niacin. Vitamin retention was higher in samples stored at a lower temperature and relative humidity (25 °C/ 75 % RH) than in samples stored at higher temperature and relative humidity (35 °C/ 83 % RH) for both brands. In conclusion, thiamine and retinol were generally more susceptible to storage losses. Although the vitamin content in the flour samples decreased during storage, the changes in both storage conditions (except for riboflavin) and both brands were not significantly different.
Collapse
Affiliation(s)
- Brenda Chepkoech
- Department of Food Science and Technology, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Daniel Ndaka Sila
- Department of Food Science and Technology, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Irene Nyangoge Orina
- Department of Food Science and Technology, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| |
Collapse
|
6
|
Hrubša M, Siatka T, Nejmanová I, Vopršalová M, Kujovská Krčmová L, Matoušová K, Javorská L, Macáková K, Mercolini L, Remião F, Máťuš M, Mladěnka P. Biological Properties of Vitamins of the B-Complex, Part 1: Vitamins B 1, B 2, B 3, and B 5. Nutrients 2022; 14:484. [PMID: 35276844 PMCID: PMC8839250 DOI: 10.3390/nu14030484] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 02/06/2023] Open
Abstract
This review summarizes the current knowledge on essential vitamins B1, B2, B3, and B5. These B-complex vitamins must be taken from diet, with the exception of vitamin B3, that can also be synthetized from amino acid tryptophan. All of these vitamins are water soluble, which determines their main properties, namely: they are partly lost when food is washed or boiled since they migrate to the water; the requirement of membrane transporters for their permeation into the cells; and their safety since any excess is rapidly eliminated via the kidney. The therapeutic use of B-complex vitamins is mostly limited to hypovitaminoses or similar conditions, but, as they are generally very safe, they have also been examined in other pathological conditions. Nicotinic acid, a form of vitamin B3, is the only exception because it is a known hypolipidemic agent in gram doses. The article also sums up: (i) the current methods for detection of the vitamins of the B-complex in biological fluids; (ii) the food and other sources of these vitamins including the effect of common processing and storage methods on their content; and (iii) their physiological function.
Collapse
Affiliation(s)
- Marcel Hrubša
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Kralove, Czech Republic; (M.H.); (M.V.); (P.M.)
| | - Tomáš Siatka
- Department of Pharmacognosy, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Kralove, Czech Republic; (T.S.); (K.M.)
| | - Iveta Nejmanová
- Department of Biological and Medical Sciences, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Kralove, Czech Republic;
| | - Marie Vopršalová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Kralove, Czech Republic; (M.H.); (M.V.); (P.M.)
| | - Lenka Kujovská Krčmová
- Department of Analytical Chemistry, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Kralove, Czech Republic;
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Kralove, Czech Republic; (K.M.); (L.J.)
| | - Kateřina Matoušová
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Kralove, Czech Republic; (K.M.); (L.J.)
| | - Lenka Javorská
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Kralove, Czech Republic; (K.M.); (L.J.)
| | - Kateřina Macáková
- Department of Pharmacognosy, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Kralove, Czech Republic; (T.S.); (K.M.)
| | - Laura Mercolini
- Research Group of Pharmaco-Toxicological Analysis (PTA Lab), Department of Pharmacy and Biotechnology (FaBiT), Alma Mater Studiorum, University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy;
| | - Fernando Remião
- UCIBIO—Applied Molecular Biosciences Unit, REQUINTE, Toxicology Laboratory, Biological Sciences Department Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal;
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Marek Máťuš
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University Bratislava, Odbojárov 10, 83232 Bratislava, Slovak Republic
| | - Přemysl Mladěnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203, 500 05 Hradec Kralove, Czech Republic; (M.H.); (M.V.); (P.M.)
| | | |
Collapse
|
7
|
Sun X, Ma L, Lux PE, Wang X, Stuetz W, Frank J, Liang J. The distribution of phosphorus, carotenoids and tocochromanols in grains of four Chinese maize (Zea mays L.) varieties. Food Chem 2021; 367:130725. [PMID: 34390908 DOI: 10.1016/j.foodchem.2021.130725] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/07/2021] [Accepted: 07/27/2021] [Indexed: 11/26/2022]
Abstract
Grains of three specialty maize varieties and one conventional maize variety cultivated in China were collected and dissected to obtain the germ, endosperm, and pericarp fraction, and the distribution pattern of phosphorus, carotenoids, and tocochromanols was determined. The results showed that phytochemical contents varied significantly among different maize fractions. The germ fraction accounted for 78.3 to 86.5% of the total phosphorus present in the maize kernels. Over 86.9% of carotenoids were located in the endosperm. Except for waxy maize, 64.5 to 74.8% of the tocochromanols were contributed by the germ. Considerable differences in phytochemical contents were observed between the genotypes. Waxy maize contained the highest content of tocopherols, tocotrienols and tocochromanols meanwhile waxy maize had the lowest carotenoid and phytate phosphorus content. High lysine maize contained the highest levels in carotenoids and lowest tocochromanols. Over all, total carotenoids were significantly inversely associated with total tocochromanols.
Collapse
Affiliation(s)
- Xiaohong Sun
- Beijing Key Laboratory of Functional Food from Plant Resources, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, PR China
| | - Lei Ma
- Beijing Key Laboratory of Functional Food from Plant Resources, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, PR China
| | - Peter E Lux
- Department of Food Biofunctionality, Institute of Nutritional Sciences, University of Hohenheim, Garbenstrasse 28, 70599 Stuttgart, Germany
| | - Xuan Wang
- Beijing Key Laboratory of Functional Food from Plant Resources, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, PR China; Department of Food Science and Technology, Zhejiang University of Technology, Zhejiang, Hangzhou 310014, PR China
| | - Wolfgang Stuetz
- Department of Food Biofunctionality, Institute of Nutritional Sciences, University of Hohenheim, Garbenstrasse 28, 70599 Stuttgart, Germany
| | - Jan Frank
- Department of Food Biofunctionality, Institute of Nutritional Sciences, University of Hohenheim, Garbenstrasse 28, 70599 Stuttgart, Germany
| | - Jianfen Liang
- Beijing Key Laboratory of Functional Food from Plant Resources, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, PR China.
| |
Collapse
|
8
|
Compliance status and stability of vitamins and minerals in Fortified Maize Flour in Kenya. SCIENTIFIC AFRICAN 2020. [DOI: 10.1016/j.sciaf.2020.e00384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
9
|
Centeno Tablante E, Pachón H, Guetterman HM, Finkelstein JL. Fortification of wheat and maize flour with folic acid for population health outcomes. Cochrane Database Syst Rev 2019; 7:CD012150. [PMID: 31257574 PMCID: PMC6599881 DOI: 10.1002/14651858.cd012150.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Folate is a B-vitamin required for DNA synthesis, methylation, and cellular division. Wheat and maize (corn) flour are staple crops consumed widely throughout the world and have been fortified with folic acid in over 80 countries to prevent neural tube defects. Folic acid fortification may be an effective strategy to improve folate status and other health outcomes in the overall population. OBJECTIVES To evaluate the health benefits and safety of folic acid fortification of wheat and maize flour (i.e. alone or in combination with other micronutrients) on folate status and health outcomes in the overall population, compared to wheat or maize flour without folic acid (or no intervention). SEARCH METHODS We searched the following databases in March and May 2018: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and MEDLINE In Process, Embase, CINAHL, Web of Science (SSCI, SCI), BIOSIS, Popline, Bibliomap, TRoPHI, ASSIA, IBECS, SCIELO, Global Index Medicus-AFRO and EMRO, LILACS, PAHO, WHOLIS, WPRO, IMSEAR, IndMED, and Native Health Research Database. We searched the International Clinical Trials Registry Platform and ClinicalTrials.gov for ongoing or planned studies in June 2018, and contacted authors for further information. SELECTION CRITERIA We included randomised controlled trials (RCTs), with randomisation at the individual or cluster level. We also included non-RCTs and prospective observational studies with a control group; these studies were not included in meta-analyses, although their characteristics and findings were described. Interventions included wheat or maize flour fortified with folic acid (i.e. alone or in combination with other micronutrients), compared to unfortified flour (or no intervention). Participants were individuals over two years of age (including pregnant and lactating women), from any country. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility, extracted data, and assessed risk of bias. MAIN RESULTS We included 10 studies: four provided data for quantitative analyses (437 participants); five studies were randomised trials (1182 participants); three studies were non-RCTs (1181 participants, 8037 live births); two studies were interrupted time series (ITS) studies (1 study population of 2,242,438, 1 study unreported). Six studies were conducted in upper-middle-income countries (China, Mexico, South Africa), one study was conducted in a lower-middle-income country (Bangladesh), and three studies were conducted in a high-income country (Canada). Seven studies examined wheat flour fortified with folic acid alone or with other micronutrients. Three studies included maize flour fortified with folic acid alone or with other micronutrients. The duration of interventions ranged from two weeks to 36 months, and the ITS studies included postfortification periods of up to seven years. Most studies had unclear risk of bias for randomisation, blinding, and reporting, and low/unclear risk of bias for attrition and contamination.Neural tube defects: none of the included RCTs reported neural tube defects as an outcome. In one non-RCT, wheat flour fortified with folic acid and other micronutrients was associated with significantly lower occurrence of total neural tube defects, spina bifida, and encephalocoele, but not anencephaly, compared to unfortified flour (total neural tube defects risk ratio (RR) 0.32, 95% confidence interval (CI) 0.21 to 0.48; 1 study, 8037 births; low-certainty evidence).Folate status: pregnant women who received folic acid-fortified maize porridge had significantly higher erythrocyte folate concentrations (mean difference (MD) 238.90 nmol/L, 95% CI 149.40 to 328.40); 1 study, 38 participants; very low-certainty evidence) and higher plasma folate (MD 14.98 nmol/L, 95% CI 9.63 to 20.33; 1 study, 38 participants; very low-certainty evidence), compared to no intervention. Women of reproductive age consuming maize flour fortified with folic acid and other micronutrients did not have higher erythrocyte folate (MD -61.80 nmol/L, 95% CI -152.98 to 29.38; 1 study, 35 participants; very low-certainty evidence) or plasma folate (MD 0.00 nmol/L, 95% CI -0.00 to 0.00; 1 study, 35 participants; very low-certainty evidence) concentrations, compared to women consuming unfortified maize flour. Adults consuming folic acid-fortified wheat flour bread rolls had higher erythrocyte folate (MD 0.66 nmol/L, 95% CI 0.13 to 1.19; 1 study, 30 participants; very low-certainty evidence) and plasma folate (MD 27.00 nmol/L, 95% CI 15.63 to 38.37; 1 study, 30 participants; very low-certainty evidence), versus unfortified flour. In two non-RCTs, serum folate concentrations were significantly higher among women who consumed flour fortified with folic acid and other micronutrients compared to women who consumed unfortified flour (MD 2.92 nmol/L, 95% CI 1.99 to 3.85; 2 studies, 657 participants; very low-certainty evidence).Haemoglobin or anaemia: in a cluster-randomised trial among children, there were no significant effects of fortified wheat flour flatbread on haemoglobin concentrations (MD 0.00 nmol/L, 95% CI -2.08 to 2.08; 1 study, 334 participants; low-certainty evidence) or anaemia (RR 1.07, 95% CI 0.74 to 1.55; 1 study, 334 participants; low-certainty evidence), compared to unfortified wheat flour flatbread. AUTHORS' CONCLUSIONS Fortification of wheat flour with folic acid may reduce the risk of neural tube defects; however, this outcome was only reported in one non-RCT. Fortification of wheat or maize flour with folic acid (i.e. alone or with other micronutrients) may increase erythrocyte and serum/plasma folate concentrations. Evidence is limited for the effects of folic acid-fortified wheat or maize flour on haemoglobin levels or anaemia. The effects of folic acid fortification of wheat or maize flour on other primary outcomes assessed in this review is not known. No studies reported on the occurrence of adverse effects. Limitations of this review were the small number of studies and participants, limitations in study design, and low-certainty of evidence due to how included studies were designed and reported.
Collapse
Affiliation(s)
| | - Helena Pachón
- Food Fortification Initiative & Emory University1518 Clifton Rd NE, Room 2049AtlantaGeorgiaUSA
| | | | | | | |
Collapse
|
10
|
Garcia‐Casal MN, Peña‐Rosas JP, De‐Regil LM, Gwirtz JA, Pasricha S. Fortification of maize flour with iron for controlling anaemia and iron deficiency in populations. Cochrane Database Syst Rev 2018; 12:CD010187. [PMID: 30577080 PMCID: PMC6517107 DOI: 10.1002/14651858.cd010187.pub2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Approximately 800 million women and children have anaemia, a condition thought to cause almost 9% of the global burden of years lived with disability. Around half this burden could be amenable to interventions that involve the provision of iron. Maize (corn) is one of the world's most important cereal grains and is cultivated across most of the globe. Several programmes around the world have fortified maize flour and other maize-derived foodstuffs with iron and other vitamins and minerals to combat anaemia and iron deficiency. OBJECTIVES To assess the effects of iron fortification of maize flour, corn meal and fortified maize flour products for anaemia and iron status in the general population. SEARCH METHODS We searched the following international and regional sources in December 2017 and January 2018: Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; MEDLINE (R) In Process; Embase; Web of Science (both the Social Science Citation Index and the Science Citation Index); CINAHL Ebsco; POPLINE; AGRICOLA (agricola.nal.usda.gov); BIOSIS (ISI); Bibliomap and TRoPHI; IBECS; Scielo; Global Index Medicus - AFRO (includes African Index Medicus); EMRO (includes Index Medicus for the Eastern Mediterranean Region); LILACS; PAHO (Pan American Health Library); WHOLIS (WHO Library); WPRO (includes Western Pacific Region Index Medicus); IMSEAR, Index Medicus for the South-East Asian Region; IndMED, Indian medical journals; and the Native Health Research Database. We searched clinicaltrials.gov and the International Clinical Trials Registry Platform (ICTRP) for any ongoing or planned studies on 17 January 2018 and contacted authors of such studies to obtain further information or eligible data if available.For assistance in identifying ongoing or unpublished studies, we also contacted relevant international organisations and agencies working in food fortification on 9 August 2016. SELECTION CRITERIA We included cluster- or individually randomised controlled trials and observational studies. Interventions included (central/industrial) fortification of maize flour or corn meal with iron alone or with other vitamins and minerals and provided to individuals over 2 years of age (including pregnant and lactating women) from any country. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the eligibility of studies for inclusion, extracted data from included studies and assessed the risk of bias of the included studies. Trial designs with a comparison group were included to assess the effects of interventions. Trial designs without a control or comparison group (uncontrolled before-and-after studies) were included for completeness but were not considered in assessments of the overall effectiveness of interventions or used to draw conclusions regarding the effects of interventions in the review. MAIN RESULTS Our search yielded 4529 records. After initial screening of titles and abstracts, we reviewed the full text of 75 studies (80 records). We included 5 studies and excluded 70. All the included studies assessed the effects of providing maize products fortified with iron plus other vitamins and minerals versus unfortified maize flour. No studies compared this intervention to no intervention or looked at the relative effect of flour and products fortified with iron alone (without other vitamins and minerals). Three were randomised trials involving 2610 participants, and two were uncontrolled before-and-after studies involving 849 participants.Only three studies contributed data for the meta-analysis and included children aged 2 to 11.9 years and women. Compared to unfortified maize flour, it is uncertain whether fortifying maize flour or corn meal with iron and other vitamins and minerals has any effect on anaemia (risk ratio (RR) 0.90, 95% confidence interval (CI) 0.58 to 1.40; 2 studies; 1027 participants; very low-certainty evidence), or on the risk of iron deficiency (RR 0.75, 95% CI 0.49 to 1.15; 2 studies; 1102 participants; very low-certainty evidence), haemoglobin concentration (mean difference (MD) 1.25 g/L, 95% CI -2.36 to 4.86 g/L; 3 studies; 1144 participants; very low-certainty evidence) or ferritin concentrations (MD 0.48 µg/L, 95% CI -0.37 to 1.33 µg/L; 1 study; 584 participants; very low-certainty evidence).None of the studies reported on any adverse effects. We judged the certainty of the evidence to be very low based on GRADE, so we are uncertain whether the results reflect the true effect of the intervention. We downgraded evidence due to high risk of selection bias and unclear risk of performance bias in one of two included studies, high heterogeneity and wide CIs crossing the line of no effect for anaemia prevalence and haemoglobin concentration. AUTHORS' CONCLUSIONS It is uncertain whether fortifying maize flour with iron and other vitamins and minerals reduces the risk of anaemia or iron deficiency in children aged over 2 years or in adults. Moreover, the evidence is too uncertain to conclude whether iron-fortified maize flour, corn meal or fortified maize flour products have any effect on reducing the risk of anaemia or on improving haemoglobin concentration in the population.We are uncertain whether fortification of maize flour with iron reduces anaemia among the general population, as the certainty of the evidence is very low. No studies reported on any adverse effects.Public organisations funded three of the five included studies, while the private sector gave grants to universities to perform the other two. The presence of industry funding for some of these trials did not appear to positively influence results from these studies.The reduced number of studies, including only two age groups (children and women of reproductive age), as well as the limited number of comparisons (only one out of the four planned) constitute the main limitations of this review.
Collapse
Affiliation(s)
- Maria N Garcia‐Casal
- World Health OrganizationEvidence and Programme Guidance, Department of Nutrition for Health and DevelopmentAvenue Appia 20GenevaGenevaSwitzerland1211
| | - Juan Pablo Peña‐Rosas
- World Health OrganizationEvidence and Programme Guidance, Department of Nutrition for Health and DevelopmentAvenue Appia 20GenevaGenevaSwitzerland1211
| | - Luz Maria De‐Regil
- Nutrition InternationalGlobal Technical Services180 Elgin Street, Suite 1000OttawaONCanadaK2P 2K3
| | - Jeffrey A Gwirtz
- Kansas State UniversityDepartment of Grain Science and IndustryManhattanKansasUSA66502
| | - Sant‐Rayn Pasricha
- Walter and Eliza Hall Institute of Medical ResearchDivision: Population Health and ImmunityParkville, MelbourneVictoriaAustralia3052
| | | |
Collapse
|
11
|
Roth DE, Abrams SA, Aloia J, Bergeron G, Bourassa MW, Brown KH, Calvo MS, Cashman KD, Combs G, De-Regil LM, Jefferds ME, Jones KS, Kapner H, Martineau AR, Neufeld LM, Schleicher RL, Thacher TD, Whiting SJ. Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low- and middle-income countries. Ann N Y Acad Sci 2018; 1430:44-79. [PMID: 30225965 PMCID: PMC7309365 DOI: 10.1111/nyas.13968] [Citation(s) in RCA: 296] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 08/23/2018] [Indexed: 12/15/2022]
Abstract
Vitamin D is an essential nutrient for bone health and may influence the risks of respiratory illness, adverse pregnancy outcomes, and chronic diseases of adulthood. Because many countries have a relatively low supply of foods rich in vitamin D and inadequate exposure to natural ultraviolet B (UVB) radiation from sunlight, an important proportion of the global population is at risk of vitamin D deficiency. There is general agreement that the minimum serum/plasma 25-hydroxyvitamin D concentration (25(OH)D) that protects against vitamin D deficiency-related bone disease is approximately 30 nmol/L; therefore, this threshold is suitable to define vitamin D deficiency in population surveys. However, efforts to assess the vitamin D status of populations in low- and middle-income countries have been hampered by limited availability of population-representative 25(OH)D data, particularly among population subgroups most vulnerable to the skeletal and potential extraskeletal consequences of low vitamin D status, namely exclusively breastfed infants, children, adolescents, pregnant and lactating women, and the elderly. In the absence of 25(OH)D data, identification of communities that would benefit from public health interventions to improve vitamin D status may require proxy indicators of the population risk of vitamin D deficiency, such as the prevalence of rickets or metrics of usual UVB exposure. If a high prevalence of vitamin D deficiency is identified (>20% prevalence of 25(OH)D < 30 nmol/L) or the risk for vitamin D deficiency is determined to be high based on proxy indicators (e.g., prevalence of rickets >1%), food fortification and/or targeted vitamin D supplementation policies can be implemented to reduce the burden of vitamin D deficiency-related conditions in vulnerable populations.
Collapse
Affiliation(s)
- Daniel E. Roth
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Steven A. Abrams
- Department of Pediatrics, Dell Medical School at the University of Texas at Austin, Austin, Texas
| | - John Aloia
- NYU Winthrop Hospital, Mineola, New York
| | - Gilles Bergeron
- The Sackler Institute for Nutrition Science, The New York Academy of Sciences, New York, New York
| | - Megan W. Bourassa
- The Sackler Institute for Nutrition Science, The New York Academy of Sciences, New York, New York
| | | | - Mona S. Calvo
- Retired, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Kevin D. Cashman
- Cork Centre for Vitamin D and Nutrition Research, University College Cork, Cork, Ireland
| | | | | | | | - Kerry S. Jones
- MRC Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | | | | | | | | | | | | |
Collapse
|
12
|
Wang C, Zheng H, Liu T, Wang D, Guo M. Physiochemical Properties and Probiotic Survivability of Symbiotic Corn-Based Yogurt-Like Product. J Food Sci 2017; 82:2142-2150. [DOI: 10.1111/1750-3841.13823] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 06/28/2017] [Accepted: 06/29/2017] [Indexed: 02/03/2023]
Affiliation(s)
- Cuina Wang
- Dept. of Food Science, College of Food Science and Engineering; Jilin Univ.; Changchun Jilin 130062 China
| | - Huajie Zheng
- HeiLongJiang Wandashan Dairy Co., Ltd; Harbin 150030 China
| | - Tingting Liu
- College of Food Science and Engineering; Jilin Agricultural Univ.; Changchun 130118 China
| | - Dawei Wang
- College of Food Science and Engineering; Jilin Agricultural Univ.; Changchun 130118 China
| | - Mingruo Guo
- Dept. of Nutrition and Food Sciences, College of Agriculture and Life Sciences; Univ. of Vermont; Burlington Vt. 05405 U.S.A
- College of Food Science; Northeast Agriculture Univ.; Harbin 150030 China
| |
Collapse
|
13
|
Biofortification of crops with nutrients: factors affecting utilization and storage. Curr Opin Biotechnol 2017; 44:115-123. [DOI: 10.1016/j.copbio.2016.12.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/15/2016] [Accepted: 12/17/2016] [Indexed: 02/07/2023]
|
14
|
de Mejia EG, Aguilera-Gutiérrez Y, Martin-Cabrejas MA, Mejia LA. Industrial processing of condiments and seasonings and its implications for micronutrient fortification. Ann N Y Acad Sci 2015; 1357:8-28. [DOI: 10.1111/nyas.12869] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Elvira González de Mejia
- Department of Food Science and Human Nutrition; University of Illinois at Urbana-Champaign; Urbana Illinois
| | - Yolanda Aguilera-Gutiérrez
- Instituto de Investigación de Ciencias de la Alimentación (CIAL); Facultad de Ciencias, Universidad Autónoma de Madrid; Madrid Spain
| | - Maria Angeles Martin-Cabrejas
- Instituto de Investigación de Ciencias de la Alimentación (CIAL); Facultad de Ciencias, Universidad Autónoma de Madrid; Madrid Spain
| | - Luis A. Mejia
- Department of Food Science and Human Nutrition; University of Illinois at Urbana-Champaign; Urbana Illinois
| |
Collapse
|
15
|
Peña‐Rosas JP, Garcia‐Casal MN, Pachón H, Mclean MS, Arabi M. Technical considerations for maize flour and corn meal fortification in public health: consultation rationale and summary. Ann N Y Acad Sci 2014; 1312:1-7. [DOI: 10.1111/nyas.12434] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Juan Pablo Peña‐Rosas
- Department of Nutrition for Health and Development World Health Organization (WHO) Geneva Switzerland
| | - Maria Nieves Garcia‐Casal
- Department of Nutrition for Health and Development World Health Organization (WHO) Geneva Switzerland
| | - Helena Pachón
- Flour Fortification Initiative and Emory University Atlanta Georgia
| | | | - Mandana Arabi
- The Sackler Institute for Nutrition Science The New York Academy of Sciences New York New York
| |
Collapse
|