Food Fortification in a Globalized World

383 Pages·2018·19.191 MB·English

by  M.G.Venkatesh Mannar, Richard F. Hurrell

Food Fortification in a Globalized World
Food Fortification
in a Globalized World
Edited by
M.G. Venkatesh Mannar
Richard F. Hurrell
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Contents
LisotfC ontributors xv 2.3C onclusions 24
Foreword xvii References 25
FurthReera ding 28
3.D evelopiNnagt ionSatlrat egietso
SectiIo n
Prevenatn dC ontroMli crountrient
Needa ndA pproach 1 Deficiency:R olTeoh feF ood
Fortification
1.F oodF ortificaPtaisoEtnx p:e rience,
MduduzNi. N.M buyaa ndL ynnetMc.eN eufeld
CurrenStt ataunsdP, o tenftoira l
Globalization 3.1I ntroductTioowna:r dCso untry Led
StrategfioerPs r eventiaonndC ontrol
M.GV.e nkatMeasnhn aarn dR ichard F. Hurrell ofM icronutriDeenfti ciencies 29
3.2F oodF oritfication andN utrienntta kIes:
1.1B ackground 3
The Evidence 30
'1.2 Early SWucithc eFsosodeF so rtification5
1.3T ypeosf F ortification 6 3.2.L1 agre-Scale FoodF ortificaanldi on
HeallOhu tcomes 31
1.4S election ofV ehicles 7
1.5B iofortification 8 3.2.L2S FaFn dN utrient Intakes 31
1.6C urrenSti tuatiIsosune,s andC hallenges 9 3.2.T3a rgetFeodr tificNauttiroine,n t
1.7C oncludiTnhgou ghts 10 Intakaensd. Health Outcome3s 1
References 11 3.2.F4o odF ortificaantdiR oins okf
AdverEfsfeec ts 32
3.3Im plicatnsif oorN ationFaolr tification
2.P revalenCcaeu,s esa,n dC onsequences Plans 32
3.4F oodF ortificaantdiO otnh er
ofM icrountirenDte ficiencTiheeG sa.p
ApproachteosC o ntroolf M icronutrient
BetweeNne eda ndA ction
Deficiencies 33
3.5E videncDee cainsdMi aokni ng:
JaDnrl rnton-Hjlf
A Needf orD ata-DriCvoeonrd ination 34
2.1I ntroduction 13 3.6N utritiAocnt iontso E nalbea nd
2.2T heG api nM icronutrIinetnatk aets SupporFto od Fortification 35
Popualtion levealn d theR esultant 3.0.N1 utritAicotni onEs.v:e rybody's
DeficiencOyu tcomeBse inAgd dressed 13 Business.N oabnod dy's
2.2.I1r oDne ficiaendnA cnyem ia 15 Responsibility 35
2.2.to2d ine 17 3.6.N2u tritAicotni ollCs.a:l lAilln Hga nds
2.2.F3o late Naenudra lT ubeD efects on Deck 36
INTDs) 18 3.0.N3 utritAicotni oAnss:k itnhgeR ight
2.2.V4i tdmiAn D eficiency 19 Questions 37
2.2.Z5i nc 21 3.7C onclusion 38
2.2.O6t heMri cronutrients 22 References 38
v
vi Contents.
SectiIoIn 5.7T he Way Forwarfdo rN ational
MandateFdo ritficatPiroong rams 60
RecommendatiaonndGs u idance4 1
Acknowledgments 61
References 61
4.U sinDgi etaRreyf erenVcael uetso Further eRading 62
DefinFeo rtificaLetvieolnfs o r
NationParlo rgams 6.M arke-tDriveFno rtification
LindsaAyl lHe.n
PetrKal assen-aWnidgD geenriV sB arclay
4.1I mportanocfFe o odF ortification 43 6.1C ontexfto rt heF oodI ndustry 63
4.2A pplicatoifRo enc ommendeIdn take 6.2K eyC onsiderations 63
Values 43
6.21 Documented Evidenocfe MD 63
4.2.A1v eragRee quiremeanntdUs p per
6.2.N2u tritiRoenlaelv anocfe
Levels 43
Markel-drFiovretni ficVaetcitoonr s 63
4.2.R2e commendIendt akaensdA d equate
6.2.F3 ortification level 64
Intakes 44
6.2.S4a fety 64
4.3C alculattihnePg r evalenocfIe n adequate
6.25 Cosotf F ortificaantdAi fofno rdabi6l5i ty
Intakes 44
6.2.C6o mmunication-Nutarnidt ion
4.4N utrieDnatt aB ases 45
HealtChl aima,n dR egulations 65
4.5C orrectfionrDg a y-tn-Vdaaryi anicne
Intake 45 6.2.O7r ganoleIpmtpiacc atn dS tability6 5
4.6B ioavailaFbaicltiotrys 45 6.28B ioavailaVbeirlisOturysg a noleptic
4.7E xceediUnpgp erl eveolfsI ntake 46 QualiExtaypm:le o fI ron 66
4.8U sinSgo ft.wtaorP el aFno rtificBaatsieodn 6.2.E9v aluatoifMo anr ket-driven
on DietaryR eferenIcnet akes 46 FortificIanttieornv entions 66
4.9A lternaAtpipvreo achteosS etting 6.3So lutiaonndsO utlook 66
FortificLaetvieonl s 47 6.3.D1e velopmoenfFt o rtificants
References 49
WithI mprovBeido availaabnidl ity
OrganolePprtoipce rties 66
6.3.2 Bio(oiritciiaoln 66
SectiIoIIn
6.33P ublci-Priv.leP artnerships 67
Delivery Methods 51
References 67
FurthReera ding 67
5.N ationMaaln dateFdo od
FortificPartoigorna ms
7.B iofortificatAigorni:c ulAtnT uoroall
GreSg.G arrett toA ddresMsi neraaln dV itamin
Deficiieensc
5.1I ntroducTthieoR na:t ionfaolre
NationFaolo dF ortificPartoigorna ms 53 How.lrEt. hB ou;s
5.2A SnapshooftN ationFaolo dF ortification
Programs Around the World 53 7.A1g ricultaunrdeM ineraanld V iLamin
5.3S electainnA gp proacMha:n datory DeficienicniD eesv elopiCnogu ntries 69
FortificVaotliuonnt/a ry Fortification, 7.J2u stificfaort Biioonf ortification 70
andP ubliDci stribuotfFi oornt ifFioeodd s 54 7.2.C1o mparatAidvvea ntages 70
5.3.M1a ndatoFroyr tification 54 7.2.C2o st-Efefelvienses 70
5.3.V2o luntaFroyr tification 56 7.3Nu ttriionBailo avbaiilliaatnyd E fficacy
5.3.F3 ortiFofoidesasd aC omponent Evidenec 71
of PuDbilstirci buStyisotne ms 57 7.3.Ir1o Cnro ps 71
5.4A ctorisnN ationFaolo dF ortification5 7 7.3.V2i tamAi Cnr ops 71
5.5N ationFaolo dF ortificAaltliioann ces 57 7.3.Z3i nCcr ops 72
5.6F rameworfokrsN ationMaaln dated 7.3.F4u tuArree aosf I nvestigation 72
FortificPartoigorna ms 58 7.4C ropD evelopment 72
5.0.T1h eB uild/ExSptaangde 58 7.4.T1r ansgeAnpipcr oaches 73
5.0.T2 heIm proSvet age 59 7.4.I2n ternatiNounrasle ries/Global73 Testing
5.0.T3h e Measure/SuSsttaagien 60 7.34 low-Co,Hti,g hT hroughMpeulth ods 74
Contenvtiis
7.4.R4e leaseso fB iofortCirofpise d 74 9.2.S2 tageFsi naonfc ionfNg a tional
7.5D elivery ExperienicneT sa rgeCto unties 74 FoudF ortifiPrcoagtriamosn 94
7.5.V1e getatiPvroeplagya ted Crops 75 9.2.L3 evelFn ianocfi nRge quired 95
7.5.C2a ssavianN igerainad D RC ongo 75 9.2.S4o urcoesfF inancing 95
7.5.S3e lf-iPnooltlCe rdo ps 75 9.2.A5f fordaboiflF iotryt ification 95
7.5.B4e anisn R wandaan dD R Cogno 76 9.3E nhancitnhgeS ustainaboifl iFtoyo d
7.5.R5i ce Biann gladesh 76 Fortification 96
7.5.H6 ybrCirdo ps 76 9.3.E1c ology 96
7.5.7 Maizien Z ambia 77 9.3.E2c onomic 97
7.58. PearMli llientI ndia 77 9.3.P3o iltical 97
7.5.L9e sosns LearnedF romD elivery 77 9.3.C4u ltural 98
7.6B uildiBnlgo ckfso Grl obDaelliv ery 77 9.4C onculsion 98
7.6.S1t andJarnddsR egulatryo 78 References 99
7.6.M2 uliltateralI nsituttoins 78
7.6.P3 rivSaetcet or 78
7.6.N4C Os 78 10.C reatgi CnonsumerD emanda nd
7.6.M5o vingBe yondT argCeotu ntrtioe s DriviAnpgp rorpiatUet ilizaotfi on
PartnerCsohuinpt Srtyr ategies 79 FortifFioeodd s
7.7A Future VisioTno D rivea ndG uide
Mainstreaming 79 Martji. van aLnideS rues anS hulman
References 79
10.1I ntroduction 101
Annex1 :E videnocne t heB ioavailability,
10.2S upplFya ctoWrshi hc Plaayl l
EfficaacnydE, f fectiveonfeB si5o fortified
ImportatnR olein Driving Demand 102
Foods 81
10.2.A1f fordabainldVi atlyu -efor-
Money 102
SectiIoVn 10.2.A2v ailabaisla i Dtryi voefr
Demand 104
TechniacnadlB usiness
10.2.P3e rceiQveuadli ty andP roduct
Considerations 83 Attributes 106
10.2.P4a ckilgaisnM ge anst o
8.G raiFno rtificaPtrioocne sses, Communicate 106
10.3D emand Fafocr Ftoorrtsi fFioeodd s 107
TechnologainedsI ,m plementation
10.3.F1r omA warenetsoCs o nsumer
Criteria
Relevanacned P reference 107
SaraZhi mmermana ndS cotMto}n.tg omeyr 10.32. FromF irTsrital t oR egulUars e 108
10.4C omplianacned E ffectUisvee 108
8.1G raiFno rtificPartoicoens ses, 10.5C onclusiaonndsR ecommendations1 10
TechnologainedsI ,m plementatCiroint eri8a5 Refreences 110
8.l.I1n trdouction 85 FurtheRre ading 112
8.2P rocesses 86
8.3T echnologies 87
8.4I mplementaCtriiotne ria 87
11.T heI mpotrancoef P ublicr-iPvate
8.5C onclusion 90
CollaboraitniF oono d Fortification
Acknowlgemdents 90
References 91 Programs
FurthReer ading 92
GregS . GarrCeatrto,l iMnaen usa ndA ndreas
Bleuthner
9. FinancianngdS ustainaboifl ity
11.1I ntroduction 113
FoodF oritfication
11.2W hy CollaborotBeitwoene n the
Luc Laviolette Privaantdeu blPic Sectoirs Critical
forS uccess 114
9.1I ntroduction 93 113. FrameworkTso,o lasn,d P rocessefso r
9.2F inancing ofF oodF ortification 93 EffectPiuvbel ic-PriCvoaltlea borati1o1n4
9.2.F1o oFdor tificatoni isa G ood 11.E4x ampleof5P ubic-lPrivate
Investment 93 Collabroation 115
viiiC ontents
11.4.N1a tionFaolr tificAaltliioann ce1s1 5 13.5.D2e liveOrpyt ionsF ofrtoirf ied
11.5G apsa ndO pporutnitiesf or mIproved Rice 138
Public-PriCvoaltlea boration 116 13.6C onclusion 140
11.5.H1u manC apacity 118 References 140
11.5.S2e ttiLnegg islaatnidSotn a ndards
foIrm pact 11S
14.S alt
11.6R egulatoMroyn itoring 116
11.7C onclusion 116 M.G.V enkatesh M.lnnar
References 119
FurthRere ading 119 14.1S alats a CarrioefrN utrients 143
14.2l odizatoifSo anl t 143
14.2.C1o nsolidaatnido n
SectiVo n Modernizaotfit ohneS alt
FortificVaethiiocnl es 121 Industry 144
14.2.M2o nitoringa ndE valuation 145
14.2.I3n ternational Suppor1t4 5
12.W heata nd MaiFzleo uFro trifaitcion
14.3K eyD eterminatnoAt csh ieve
HelenPa achon UniversSaalll to dization 145
14.3.M1a kinSga llto dizatai Golno bal
12.1I tnroduction 123 IndusNtorrym 145
12.2F ortificIantduisotrny Structufroer 14.3.S2u staiPnuebdl iEcd ucation
WheatF louarn dM aizeF lour 123 andS ociMaolb ilization 147
12.3G lobaGlu ideliensf orF ortification12 4 14.3.S3u pportSimnagl Slal tP roducer1s4 7
12.4C Olitnr iWeist hM andaotry and
VoluntaLreygis lation 124 14.3.E4ng aging thPer ocessed Food
Industry 148
12.5N utrienFtosr,t ificaanndtl se,v els
IncluidnLe edg islation/Standar1d2s4 14.3.5 MonitorainndgA djustIiondgi ne
12.6C overagaen dC omplianicne Intakes 148
Mandaotry andV oluntary 14.3.D6o ublFeo rlifSiaeidl 148
Countries 126 14.4M ultipleF ortificoaftS iaolnt 149
12.7H ealtIhm pacFtr om Flour 14.5 Scale oUfpD FS 150
Fortification 127 14.6C osot.f M ultipFloer tification 150
12.8W ay Forward toA ccelertahtee 14.7C onclusions 150
Coveragaen dI mpacotf F lour References 151
Fortificatino 127 Further Reading 151
Acknowledgements 128
References 128
15.C ondimenatsn dS auces
Vis;Ct.hha vasaintd j untimPah oti
13.R iceF ortification
15.1I ntroduction 153
Saskia de PeeL, .TB seacnkg,y
15.2F ormosf C ondiments 153
SaraZhi mmerman aSncda lMio ntgomery
15.3F ortification Process 154
13.1I ntroducttioRo ince Fortification1 31 15.3.S1o liCdo ndiments 154
13.2H istoorfyR iceF ortification 132 15.3.S2e mi-SoCloindd iments 1.\5
13.3C hoice ofT echnologiest oP roduce 15.3.L3i quCiodn diments 155
FortifRiiecdeK ernels 133 15.4C hallenges 156
13.3.C1o nsiderRiincgFe o rtification 15.5P otential 156
TechnologieFsro m aC onusmer References 156
Perspective 133
13.3.C2o nsidgRe irciFneo rtification
16.B ouillCounb es
TechnologFireos.am
ManufactuPreirnsgp ective 135 DiegMoor ettRii,c harHudr rFe.l l and
13.4W hichM icronutriteonA tdsd toR ice 136 ColiIn.C ercamondi
13.5I ntroducingF oRritcief icaHtoiwo n-
16.1B ouillCounb es 159
andW here? 136
13.5.R1i ceL andscaApnea lysis 138 16.2E stimatUeseda nd Consumption
ofBo uillon Cubes 159
Contents j"
16.3C urrenFto rtificPartaicotni ces 160 19.B reakfaCsetre als
16.3.I1o dine 160
Kathryn Wiemer
16.3.Ir2o n 161
16.33F uturRee searDcirhec tions 163 19.1I ntroduction 163
16.34O ther ForAtdidfeidt coa nts 19.1.1P olicy andR egulatHoisrtoyr y 183
BouillCounb es 164 19.2C erealF ortifciation Considerations 164
16.4C onclusioannds O utlook 164 19.2.1S cientifci 184
Reefrences 164 19.2.T2e chnaincdaP lr ocessing
Method 186
17.M icronutriFeonrittif catioofn Edible 19.3I mpacotf C ereaFlo rtificoanti on
NutriIenntta kes 169
Oils
19.4F uturCeo nsiderations 169
LevenLities zOli6o saadnyd References 190
KiruKbrai shnaswamy
17.1 Introduction 167 SectiVoIn
17.2R ationafloerF ortificoaftE idoibnl e
NutrieWnits eR evieowfE vidence
Oils 167
17.3N ecessfiotryF ortificoaftO iiolWn i th andS afeotfyF ortification
Micronutrients 166
17.4T echnologyf orE dibOliel F ortificat17i0o n
20.E fficaacnydS afetoyfI ron
17.5P ostprocReesqsuiinrge mineO nilt s
Fortiifcation 170 Fortiicfation
17.5.Q1u aliCtoyn trol 171 RichaF. rHdu rrell
17.5.S2t ialibtoyfV itamins 171
17.5.S3a featnyd T oxicity 20.1I roFn ortiicfatiCoonm poundsW ith
Considerations 172 ConfirmeEdf ficacy 196
17.6S tandaradnsd R egulations 172 20.11. Defining thIreon Fortification
17.6.Q1u aliSttya ndards 172 Level 196
17.6.2 Monitorinagn dE nforcement 172 20.1.A2s corbAicci d 197
17.6.C3o mmercialyl Available 20.1.F3e rrSouusl fate 197
PremfioxOr i l Fortific17a2t ion 20.1.Fe4r orus G[ucontae 198
17.7B iolcaolg iEfoffiF coratciyfO iield 173 20.1.F5e rroFuusm arate 198
17.8C urrentS tatuosfM icronutrient 20.1.6 FerrPiycr ophosphate 198
FortificoaftE idoinb Olei ls 173 20.1.E7le ctrloyitc Iron 199
17.9C onclusion 173 20.1.SBo diuImr on
References 174 EthylenediaillineAtceitrd2a 0a0c etic
FurthReera ding 174 20.1.F9er rous Bisglycinate 201
20.2T echnologiMcoadlilfyi eIrdon
18.M ilka nd DairPyr oducts CompoundWsi thC onfirmed Efficacy 201
20.2.E1n capsulFaetrerdo Suusl fate 201
DaniLeople zd eR omaiia, 20.2.E2nc apsulated FerroFuusm arate2 02
Mc1(HlOelJi varaensd F ernandPoi zarro 20.2.M3i cronizDiespde rsibleF erric
18.1I ntroduction 175 Pyrophosphaet SunAcliFvee 202
18.2H istory 175 20.3O ther Potentially UseCfoumlp ounds 202
18.3C urrentP rcatice,s Micronutrients 20.3.1 FerArmimco nium Citrate 202
Addeda,n dC ompounds Used 176 20.3.F2e rroLuasc tate 203
18.4V ehicCloen sumption Patterns 177 20.3.F3e rric Orthophosphat2e0 3
18.5T echnologies 177 20.3.F4e rroSuusc cinate 203
18.0P otnetialf orI mpact 179 20.4C urretnD evelompents iInr on
18.7 Challenges 160 Fortiftiicoan 203
References 160 20.4.1 Phytase 203
" Contenls
20.4.N2a noIr on 203 22.3N utritionalG oitrogeTnhsa tI nfluence
20.4.3 irAons p 203 IodinEef ficacy 224
20.5 SuggestIerdo Cno mpoundfso r 22.4A ssessmeonfIt o dineat uSsit n
DiffereFnoto dV ehicles 203 Populations 225
20.5.C1e reaFli ourBsrle ad Paansdt2 a0 3 22.5T heS afetoyfI odizSeadl Ptro grmas
20.5.R2i ce 204 andt he EffecotfIs o dinExec ess 225
20.5.S3a lt 204 22.6C onclusions 228
20.5.S4o yS aucaned F isSha uce 204 References 228
FurtheRera ding 230
20.5B.o5u illCounb easn dS pice
Mixes 205
20.5.M6i I kP roducts 205 23.G lobaSlt atuosf FoAlciicd
20.S.B7e verages 205 Fortific-aPtrioognr easnsd G aps
20.5.C8e rel-aBasedC omplementary
Foods 205 CregS .C arreatntd L ynnB .B ailey
20.5M.i9c ronuPtorwideenrts 205 23.1In torduction 231
20.5.1C0h ocolaDtrei nPko wders 205 23.2G lobaSlt atoufsF oliAcc id
20.5.1B1re akafstC ereals 205 Fortifictioan- Progressan d Gaps 232
20.6P otentHieaall tRhi skosfI ron 23.3R esearcGha psO,t herP otential
Fortification 205 FortifiVaebhliec laensdI n novations 235
20.6.I1n fecDtiisoeuasse 205 23.4 Summary andC onclusion 237
20.6.I2r oOnve rload 206 Acknowledgments 237
20.6.C3a rdiovasDciusleaars e 206 CompetinIgnt erests 237
References 237
20.6.D4i abetTeysp e2 207
FurthReera ding 239
20.6.C5a ncer 207
20.7B alancBee tweeBne nefaintd R isk 207
References 207
24.A ssessianltglh eE videncfeo r
Riskasn dB enefiWtitsh F olAicc id
21.Zin c Fortiictfaion Fortifiiocnaa ntdS upplementation
JaiK. D as, RSaj.Ka h aann dZ ulfiqAa.Br h utta Irwin RHo.s engba enrJda coSbe lhub
21.1I ntroduction 213 24.1F oliAcd d FortificoaftG iroani n
21.2Z incB ioavailaabnidlM iettya bolism 213 Products 241
21.3M easuring SZtiantcau nsd D eficienc2y1 5 24.2I nvestigaotfiE ofnf ecoftH si gh
21.4H ealtRhi skasn dB enefiotfZs i nc 215 Folic Acid Intakes 241
21.5Z incFo rtifciants 216 24,3V itamiB1n2 - FolAicc idI nterventio2n4 2
21.6N ative Zinacn dZ incF-ortifFioeodd s 216 24.4U nmetabolizFoelidc A cidan dF olic
21.7 SafaentdEy f ficoacfFy o rtificatio2n1 7 AcidE xcess 243
21.8C onclusions 218 24.5E videnocfeIn creased Vulnerability
References 218 toF oliAcc idE xcesisnP opulations
WithG enetiPco lymorphisrns 244
24.6C oncludiRnegm arks 245
22.E fficaancdyS afetoyfI odine
References 245
Fortification
MichaeBl.Z ;mmerm�nn
25.N utrite-nWiseR eview Eovfi dence
221. IntroductTihoenI :o dinDee ficiency
andS afetoyf F orticiaftiVoint:a miAn
Disorders 221
22.1D.i1f fGuosieta enrd M utinodular SheryrA .T anumihc:1fdjo
ToxiGco iter 221
25.1C hemicaFlo rmso fF ortificants 247
22.1.N2e urocogniItmpiJivreme nt 221 25.2E ficfayc Studies 247
22.2E fficoafcI yo dizSeadl Nta:t ional 25.3E ffectivSetnuedsise s 248
andG lobaIlo dinSet atus 223 25.4C ost-EffectiAnvaelynseess s 248