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.

Genus Brassica By-Products Revalorization with Green Technologies to Fortify Innovative Foods: A Scoping Review

Food losses and waste reduction are a worldwide challenge involving governments, researchers, and food industries. Therefore, by-product revalorization and the use of key extracted biocompounds to fortify innovative foods seems an interesting challenge to afford. The aim of this review is to evaluate and elucidate the scientific evidence on the use of green technologies to extract bioactive compounds from Brassica by-products with potential application in developing new foods. Scopus was used to search for indexed studies in JCR-ISI journals, while books, reviews, and non-indexed JCR journals were excluded. Broccoli, kale, cauliflower, cabbage, mustard, and radish, among others, have been deeply reviewed. Ultrasound and microwave-assisted extraction have been mostly used, but there are relevant studies using enzymes, supercritical fluids, ultrafiltration, or pressurized liquids that report a great extraction effectiveness and efficiency. However, predictive models must be developed to optimize the extraction procedures. Extracted biocompounds can be used, free or encapsulated, to develop, reformulate, and/or fortify new foods as a good tool to enhance healthiness while preserving their quality (nutritional, functional, and sensory) and safety. In the age of recycling and energy saving, more studies must evaluate the efficiency of the processes, the cost, and the environmental impact leading to the production of new foods and the sustainable extraction of phytochemicals.

The Potential of Condiments, Seasonings, and Bouillon Cubes to Deliver Essential Micronutrients in Asia: Scenario Analyses of Iodine and Iron Fortification

Micronutrient deficiencies are still highly prevalent in Asia. Fortification of cooking aids, such as condiments (fish and soy sauces), seasonings, and bouillon cubes, may be an additional strategy to improve micronutrient intake. The current study evaluated the potential impact of iodine and iron fortification of cooking aids on micronutrient intake in Asian countries. A systematic literature search was performed to collect consumption data from different countries in Asia. Data from 18 studies in nine Asian countries were included. Scenario analyses were performed using different fortification levels based on regulations and literature. Mean intake of cooking aids ranged from 3.2-15.9 g/day for condiments and 0.4-11.7 g/day for seasonings and bouillon cubes. When replacing salt with iodized salt (30 µg of iodine/g of salt), iodine intake would increase by 13-119 µg/day for soy and fish sauces (9-80% of the Nutrient Reference Value (NRV)), and 5-83 µg/day for bouillon cubes and seasonings (4-56% of the NRV). Fortification with iron 0.5 mg/g food product for condiments or 1 mg/g food product for bouillon cubes and seasonings improved iron intake for soy and fish sauces by 1.6-8.0 mg/day (11-57% of the NRV), and for bouillon cubes and seasonings by 0.4-5.6 mg/day (3-40% of the NRV). These results indicate that, depending on the consumption pattern, fortification of cooking aids can be a suitable strategy to increase intake of micronutrients.

Effect of Targeted vs. Standard Fortification of Breast Milk on Growth and Development of Preterm Infants (≤32 Weeks): Results from an Interrupted Randomized Controlled Trial

Human milk is recommended for very low birth weight infants. Their nutritional needs are high, and the fortification of human milk is a standard procedure to optimize growth. Targeted fortification accounts for the variability in human milk composition. It has been a promising alternative to standard fixed-dose fortification, potentially improving short-term growth. In this trial, preterm infants (≤32 weeks of gestation) were randomized to receive human milk after standard fortification (HMF, Nutricia) or tailored fortification with modular components of proteins (Bebilon Bialko, Nutricia), carbohydrates (Polycal, Nutricia), and lipids (Calogen, Nutricia). The intervention started when preterms reached 80 mL/kg/day enteral feeds. Of the target number of 220 newborns, 39 were randomized. The trial was interrupted due to serious intolerance in five cases. There was no significant difference in velocity of weight gain during the supplementation period (primary outcome) in the tailored vs. standard fortification group: 27.01 ± 10.19 g/d vs. 25.84 ± 13.45 g/d, p = 0.0776. Length and head circumference were not significantly different between the groups. We found the feasibility of targeted fortification to be limited in neonatal intensive care unit practice. The trial was registered at clinicaltrials.gov NCT:03775785.

Supplementation of Mother's Own Milk with Preterm Donor Human Milk: Impact on Protein Intake and Growth in Very Low Birth Weight Infants-A Randomized Controlled Study

This randomized study investigates whether feeding very low birth weight (VLBW) infants with mother's own milk (MOM) supplemented with either preterm (PDM) or term donor milk (TDM), when MOM is insufficient, has a positive impact on infants' protein intake and growth. A hundred and twenty VLBW infants were randomized into two groups. Group A (43 infants) received MOM supplemented with PDM, whereas Group B (77 infants) was fed with MOM supplemented with TDM, for the first three weeks of life (donor milk period). Breast milk fortifier was added when milk feeds exceeded 50 mL/Kg/day. After the donor milk period, both groups were fed with formula when MOM was not available or the milk bank was unable to provide TDM. Protein intake was higher in Group A than in Group B at initiation of milk fortification (p = 0.006), as well as during the 3-week donor milk period (p = 0.023) and throughout hospitalization (p = 0.014). Moreover, Group A presented higher Δz-score for body weight (p = 0.019) and head circumference (p = 0.001) from birth to the end of donor milk period, and higher mean body weight at discharge (p = 0.047) compared to Group B. In conclusion, when donor milk is required, PDM positively impacts protein intake and growth in VLBW infants (NCT05675397).

Fortification by design: A rational approach to designing vitamin D delivery systems for foods and beverages

Over the past few decades, vitamin D deficiency has been recognized as a serious global public health challenge. The World Health Organization has recommended fortification of foods with vitamin D, but this is often challenging because of its low water solubility, poor chemical stability, and low bioavailability. Studies have shown that these challenges can be overcome by encapsulating vitamin D within well-designed delivery systems containing nanoscale or microscale particles. The characteristics of these particles, such as their composition, size, structure, interfacial properties, and charge, can be controlled to attain desired functionality for specific applications. Recently, there has been great interest in the design, production, and application of vitamin-D loaded delivery systems. Many of the delivery systems reported in the literature are unsuitable for widespread application due to the complexity and high costs of the processing operations required to fabricate them, or because they are incompatible with food matrices. In this article, the concept of "fortification by design" is introduced, which involves a systematic approach to the design, production, and testing of colloidal delivery systems for the encapsulation and fortification of oil-soluble vitamins, using vitamin D as a model. Initially, the challenges associated with the incorporation of vitamin D into foods and beverages are reviewed. The fortification by design concept is then described, which involves several steps: (i) selection of appropriate vitamin D form; (ii) selection of appropriate food matrix; (iii) identification of appropriate delivery system; (iv) identification of appropriate production method; (vii) establishment of appropriate testing procedures; and (viii) system optimization.

The role of neurosurgeons in global public health: the case of folic acid fortification of staple foods to prevent spina bifida

OBJECTIVE

The global neurosurgery movement arose at the crossroads of unmet neurosurgical needs and public health to address the global burden of neurosurgical disease. The case of folic acid fortification (FAF) of staple foods for the prevention of spina bifida and anencephaly (SBA) represents an example of a new neurosurgical paradigm focused on public health intervention in addition to the treatment of individual cases. The Global Alliance for the Prevention of Spina Bifida-F (GAPSBiF), a multidisciplinary coalition of neurosurgeons, pediatricians, geneticists, epidemiologists, food scientists, and fortification policy experts, was formed to advocate for FAF of staple foods worldwide. This paper serves as a review of the work of GAPSBiF thus far in advocating for universal FAF of commonly consumed staple foods to equitably prevent SBA caused by folic acid insufficiency.

METHODS

A narrative review was performed using the PubMed and Google Scholar databases.

RESULTS

In this review, the authors describe the impact of SBA on patients, caregivers, and health systems, as well as characterize the multifaceted requirements for proper spina bifida care, including multidisciplinary clinics and the transition of care, while highlighting the role of neurosurgeons. Then they discuss prevention policy approaches, including supplementation, fortification, and hybrid efforts with folic acid. Next, they use the example of FAF of staple foods as a model for neurosurgeons' involvement in global public health through clinical practice, research, education and training, and advocacy. Last, they describe mechanisms for involvement in the above initiatives as a potential academic tenure track, including institutional partnerships, organized neurosurgery, neurosurgical expert groups, nongovernmental organizations, national or international governments, and multidisciplinary coalitions.

CONCLUSIONS

The role of neurosurgeons in caring for children with spina bifida extends beyond treating patients in clinical practice and includes research, education and training, and advocacy initiatives to promote context-specific, evidence-based initiatives to public health problems. Promoting and championing FAF serves as an example of the far-reaching, impactful role that neurosurgeons worldwide may play at the intersection of neurosurgery and public health.

Vitamin D Fortification of Eggs Alone and in Combination with Milk in Women Aged 44-65 Years: Fortification Model and Economic Evaluation

Introduction

For almost nine decades, the fortification of foods with vitamin D has been proven effective in preventing rickets. This study aims to build and economically evaluate a fortification model based on egg biofortification and milk (including yoghurt) fortification.

Methods

A cross-sectional study was carried out between 1. March and 31. May 2021. Three hundred and nineteen healthy women from the Central Slovenian region aged between 44 and 65 were recruited for the study, with 176 participants included in the final analysis. For the fortification model calculations, the vitamin D contents of unenriched milk (including yoghurt) and eggs were replaced by enriched foods containing vitamin D. The economic evaluation was done using available drug and food supplement prices. Fortification costs were calculated using vitamin D prices provided by suppliers.

Results

Mean vitamin D intake from food was 2.19±1.34 µg/d. With fortification Model 1 (enriched eggs), it would be: 6.49±4.45 µg/d, and with Model 2 (enriched eggs and milk): 10.53±6.49 µg/d. Without fortification, none of the participants would reach a daily vitamin D intake >10 µg. With fortification Model 1 (egg fortification), 15.3% would reach >10 µg and with Model 2 (egg and milk fortification) 46.2% would reach >10 µg. The economic comparison of the annual cost of 10 µg vitamin D/d/person was EUR 6.17 for prescription drugs, EUR 6.37 for food supplements, EUR 0.09 for direct milk fortification and EUR 0.12 for egg biofortification with vitamin D.

Conclusions

Egg and milk (including yoghurt) fortification could cost-effectively increase vitamin D intake in the Slovenian population of women between 44 and 65 by almost five-fold, and could significantly lower the prevalence of vitamin D deficiency. Additional research and changes to legislation are needed before this can be introduced.

Nutritional characterization of the extrusion-processed micronutrient-fortified corn snacks enriched with protein and dietary fiber

The current study focused on developing protein- and dietary fiber-enriched, micronutrient-fortified corn snacks using extrusion technology. Corn, soybean, and chickpea flour were used to develop micronutrient-fortified (Fe, Zn, I, and vitamin A, and C) extruded snacks, followed by an exploration of their nutritional traits. Soybean and chickpea were supplemented discretely (20-40/100 g) or in a combination of both (10:10, 15:15, and 20:20/100 g). According to the results, the relative proportion of the raw material composition was reflected in corn snacks' proximate composition and mineral and vitamin levels. Corn snacks with 40/100 g soy flour showed the best nutrient profile, with a maximum percent increase in protein (171.9%) and fiber (106%), as compared to the snacks developed using chickpea and/or mixed supplementation with soy and chickpea. Total dietary fiber (18.44 ± 0.34%), soluble dietary fiber (10.65 ± 0.13%), and insoluble dietary fiber (7.76 ± 0.38%) were also found to be highest in the soy-supplemented snacks (40/100 g). It was discovered that 100 g of corn snacks could provide 115-127% of the RDA for iron, 77-82% of the RDA for zinc, 90-100% of the RDA for vitamin A, and 45-50% of the RDA for vitamin C. The results for the effect of extrusion processing on amino acids showed a 2.55-45.1% reduction in essential amino acids, with cysteine and valine showing the greatest decrease and leucine and tryptophan remaining relatively stable during extrusion.

Improving nutrition through biofortification-A systematic review

Nutritious foods are essential for human health and development. However, malnutrition and hidden hunger continue to be a challenge globally. In most developing countries, access to adequate and nutritious food continues to be a challenge. Although hidden hunger is less prevalent in developed countries compared to developing countries where iron (Fe) and zinc (Zn) deficiencies are common. The United Nations (UN) 2nd Sustainable Development Goal was set to eradicate malnutrition and hidden hunger. Hidden hunger has led to numerous cases of infant and maternal mortalities, and has greatly impacted growth, development, cognitive ability, and physical working capacity. This has influenced several countries to develop interventions that could help combat malnutrition and hidden hunger. Interventions such as dietary diversification and food supplementation are being adopted. However, fortification but mainly biofortification has been projected to be the most sustainable solution to malnutrition and hidden hunger. Plant-based foods (PBFs) form a greater proportion of diets in certain populations; hence, fortification of PBFs is relevant in combating malnutrition and hidden hunger. Agronomic biofortification, plant breeding, and transgenic approaches are some currently used strategies in food crops. Crops such as cereals, legumes, oilseeds, vegetables, and fruits have been biofortified through all these three strategies. The transgenic approach is sustainable, efficient, and rapid, making it suitable for biofortification programs. Omics technology has also been introduced to improve the efficiency of the transgenic approach.

A Data Driven Approach to Identify Safe and Adequate Schemes for Vitamin D Fortification

Food fortification is a strategy to increase low vitamin D intake. In order to avoid the intake of a population exceeding the upper tolerable intake level, the right choice of food groups to fortify is of crucial importance. An automated fortification tool was developed based on dietary intake data from the Danish National Survey of Dietary Habits and Physical Activity 2011-2013 (DANSDA), taking into account the energy contribution of the fortified food. The fortification of food group is a variant in the linear modelling, where the optimization ensures the lowest possible variation in deviation of the calculated intake and the target intake. The resulting tool demonstrated that the lowest limit of fortification, where the model works, is 12 µg/10 MJ, when fortification of any food group is allowed. The tool also demonstrated that, by increasing the allowed upper level of fortification from 12 µg/10 MJ up to 30 µg/10 MJ, the food groups selected for fortification and the level of fortification in those food groups may change. Specifically, fewer food groups seem to be needed as the upper level of fortification is increased. The optimized scenarios, using the food groups, including milk, cheese, cereals, fats, and juice, were tested on dietary-survey data and demonstrated that all the projected scenarios manage to lift the median vitamin D intake to the targeted intake safely. A data-driven approach was used to develop a simple, fast, and automated fortification tool to test different vitamin D food fortification strategies.

Bovine milk-based and human milk-based fortification for postnatal weight gain in very preterm neonates-a cohort study

BACKGROUND AND OBJECTIVES

Postnatal growth failure happens in about half of the very low birth weight infants and this can have long-term consequences. Human milk-based multi-nutrient fortifiers (HMBF) are thought to be better tolerated than bovine milk-based multi-nutrient fortifiers (BMBF), thus facilitating early progression to full feeds and improved growth in preterm neonates. This study was done to find the advantage of HMBF over BMBF on postnatal growth and other clinical outcomes.

METHODS

This is a retrospective cohort study where babies <1500 g birth weight or gestational age <32 weeks were included to compare the velocity of weight gain (g/kg/day), duration of hospital stay and clinical outcomes between fortification using HMBF and BMBF till 34 weeks postmenstrual age.

RESULTS

Eligible neonates included in the study were 322, out of whom 123 (37%) received HMBF and 209 (63%) received BMBF. During the stay, 18 babies were changed from BMBF to HMBF and vice versa in 24 babies due to logistic reasons and parents' preferences. The mean birth weight of the babies was 1124 ± 237 g. Weight gain was higher in the exclusive HMBF group [mean difference 0.77 (0.14, 1.39) g/kg/day; p-value = 0.018]. Feed intolerance [odds ratio (OR) 0.45 (0.22, 0.95), p-value 0.037] was also significantly less in this group. However, other morbidities did not differ significantly between the groups.

CONCLUSION

Higher weight gain and lower feed intolerance in the HMBF group underscores the possible advantage of using HMBF over BMBF. Larger prospective studies might bring out its effect on the duration of hospital stay and other morbidities.

Improving Calcium Status of Women: Results of a Study of Bio-Availability of Calcium From Slaked Lime Fortified Rice

BACKGROUND

Fortification of rice with slaked lime is an acceptable and inexpensive way to combat calcium (Ca) deficiency. However, bioavailability of calcium after intake of slaked lime fortified rice is yet to be investigated.

OBJECTIVE

To measure the fractional absorption of Ca (FAC) from slaked lime fortified cooked rice.

DESIGN

We conducted an experimental study using stable isotopes of Ca to measure FAC during a single morning test meal containing rice fortified with slaked lime. Participants (n = 22) were given slaked lime fortified rice 3 times a day for 4 days. On the morning of the fifth day, the participants were served the same amount of rice as previous the 4 days at the breakfast test meal with an accurately measured amount of ⁴⁴Ca stable isotope oral tracer followed by an intravenous injection of ⁴²Ca. Urine was collected over the next 24 hours in 3 consecutive 8-hour pools. Fractional absorption of Ca was calculated from the measurement of the relative enrichment of the of each administered tracer ⁴⁴Ca and ⁴²Ca using inductively coupled plasma mass spectrometry.

RESULTS

The mean Ca concentration in the test meal was 879.5 ± 152.9 µg/g with a coefficient of variance (CV) of 17.2%. Although Ca absorption efficiency decreases with higher calcium intake, the total amount of calcium absorbed from test meal using FAC = 0.391 calculated from the third 8-hour urine pool was 69.0 (CV of 15.6) mg.

CONCLUSIONS

We showed that one-fifth of daily calcium recommendation for women of reproductive age could be met by ingesting ∼200 g cooked slake fortified rice.

Promoting Protein Intake in an Ageing Population: Product Design Implications for Protein Fortification

Protein is a macronutrient of interest for an ageing population and intake requirements increase with age. Accordingly, protein is often fortified into products for older adults to help alleviate malnutrition and impede sarcopenia. However, more emphasis needs to be placed upon designing protein-fortified products to ensure suitability for older adults. This study involved a two-stage approach: (1) an initial review of products commonly fortified with protein and (2) two questionnaires for younger and older adults (n = 73; 18-30; 65+) to investigate optimal portion sizes (drinks and cakes) as well as attitudes, consumption habits and preferences towards protein fortification. The initial literature and market review demonstrated protein-fortified products are typically in liquid or snack format; however, there is considerable variability in terms of product types, serving size and protein sources. There were no age-related differences found for ideal cakes portion size whereas there were for liquids. Older adults are typically not consuming protein-fortified products; therefore, more importance should be placed on the consumption moment (breakfast or as snacks between meals) and on cereals, pasta, porridge, cakes, and biscuits. Older adults need increased awareness of, and more education on, the benefits of protein consumption, coupled with products tailored and designed to encourage intake.

Effect of Thermal and Non-Thermal Processing on Nutritional, Functional, Safety Characteristics and Sensory Quality of White Cabbage Powder

This study was aimed to improve nutritional, functional and consumer safety aspects of cabbage powder (CP). White cabbage (Brassica oleracea var. capitata f. alba) was dehydrated to CP following microwave heating, blanching, alkali or acid washing treatments. The results for nutrients and mineral composition of raw and processed CP elucidated raw CP to exhibit significantly (p < 0.05) higher amounts of protein (12.2%), dietary fiber (25.2%), Na (52 mg/100 g), Ca (355 mg/100 g), K (286 mg/100 g), Fe (14 mg/100 g) and Zn (32 mg/100 g). Among different processing techniques, microwave treatment resulted in a higher rate of reduction for alkaloids, oxalates, tannins and phytates contents, i.e., 77%, 85%, 85%, and 86%, respectively. Likewise, microwave treatment was found more effective in reducing residual levels of neonicotinoids, pyrethroids, organophosphates including imidacloprid, cypermethrin, bifenthrin, chlorpyrifos and deltamethrin in cabbage in the range of 0.98−0.12 ppm, 1.22−0.23 ppm, 1.03−0.15 ppm, 1.97−0.43 ppm, and 2.12−0.36 ppm, respectively. CP supplementation at the rate of 5% in unleavened flatbreads was observed to maintain textural and sensory attributes of the product. The results suggest microwave heating as a cost-effective technique to reduce toxicants load in cabbage powder. Further, ~5% supplementation of CP in wheat flour may also improve nutritional and functional properties of the baked goods.

Sustainability and Gender Perspective in Food Innovation: Foods and Food Processing Coproducts as Source of Macro- and Micro-Nutrients for Woman-Fortified Foods

Micro- and macro-nutrient deficiencies among women are considered a global issue that the food industry has not adequately considered until recently. The industry must provide and guarantee a diversity of food products worldwide that allow women to get a correct and balanced diet according their life stage. The food industry must focus on this challenge within a framework of sustainable production, minimizing the use of natural resources and avoiding the emission of waste and pollutants throughout the life cycle of food. Food coproducts are presented as potential bioactive functional compounds which can be useful for technological purposes, due to the fact that they can serve as non-chemical, natural and health-improving food ingredients. In this review, we focus on the potential use of food processing coproducts which must be part of a strategy to promote and improve women's health and well-being. This knowledge will make it possible to select potential ingredients from coproducts to be used in the fortification of foods intended for consumption by females and to introduce sustainability and gender perspectives into food innovation. The attainment of fortifications for foods for women has to be linked to the use of sustainable sources from food coproducts in order to be economically viable and competitive.

Childhood and Adolescent Anemia Burden in India: The Way Forward

The burden of anemia in Indian children, based on capillary blood sampling, is believed to be profound and worsening (67.1%) according to the successive National Family Health Surveys (NFHS). This might be an overestimate. The recent Comprehensive National Nutrition Survey of Indian children, that used venous blood sampling, found only less than half (30.7%) the NFHS prevalence, of which only one third was due to iron deficiency (ID). Unfortunately, the apparently worsening NFHS anemia burden estimate has been interpreted as an inadequacy of the present iron supplementation policy. This has led to additional iron supply through mandatory rice fortification. However, the lack of efficacy of iron supplementation appears inevitable, if the true prevalence of iron deficiency anemia is only about 10%. Thus, etiology is a critical consideration when devising appropriate and effective prevention policies. Future policies must focus on precision, thoughtfulness, restraint, and community engagement.

Micro-Encapsulated Microalgae Oil Supplementation Has No Systematic Effect on the Odor of Vanilla Shake-Test of an Electronic Nose

In this study, we aimed to carry out the efficient fortification of vanilla milkshakes with micro-encapsulated microalgae oil (brand: S17-P100) without distorting the product’s odor. A 10-step oil-enrichment protocol was developed using an inclusion rate of 0.2 to 2 w/w%. Fatty acid (FA) profile analysis was performed using methyl esters with the GC-MS technique, and the recovery of docosahexaenoic acid (C22:6 n3, DHA) was robust (r = 0.97, p < 0.001). The enrichment process increased the DHA level to 412 mg/100 g. Based on this finding, a flash-GC-based electronic nose (e-nose) was used to describe the product’s odor. Applying principal component (PC) analysis to the acquired sensor data revealed that for the first four PCs, only PC3 (6.5%) showed a difference between the control and the supplemented products. However, no systematic pattern of odor profiles corresponding to the percentages of supplementation was observed within the PC planes. Similarly, when discriminant factor analysis (DFA) was applied, though a classification of the control and supplemented products, we obtained a validation score of 98%, and the classification pattern of the odor profiles did not follow a systematic format. Again, when a more targeted approach such as the partial least square regression (PLSR) was used on the most dominant sensors, a weak relationship (R2 = 0.50) was observed, indicating that there was no linear combination of the qualitative sensors’ signals that could accurately describe the supplemented concentration variation. It can therefore be inferred that no detectable off-odor was present as a side effect of the increase in the oil concentration. Some volatile compounds of importance in regard to the odor, such as ethylacetate, ethyl-isobutarate, pentanal and pentyl butanoate, were found in the supplemented product. Although the presence of yeasts and molds was excluded from the product, ethanol was detected in all samples, but with an intensity that was insufficient to cause an off-odor.

Simultaneous Enhancement of iron Deficiency Tolerance and Iron Accumulation in Rice by Combining the Knockdown of OsHRZ Ubiquitin Ligases with the Introduction of Engineered Ferric-chelate Reductase

Iron is an essential micronutrient for living organisms, but its solubility is extremely low under alkaline conditions. Plants often suffer from iron deficiency chlorosis in calcareous soils, which consist of approximately 30% of the world's cultivated area, severely limiting plant productivity. Iron deficiency anemia is also a widespread problem in humans, especially in Asian and African people who take up iron mainly from staple foods containing low iron concentrations. Transgenic manipulation of genes involved in plant iron uptake, translocation, and storage has made improvements in enhancing iron deficiency tolerance or iron accumulation in edible parts, but these two properties have been characterized separately. We previously produced transgenic rice lines, with concomitant improvement of iron deficiency tolerance and grain iron accumulation by knocking-down OsHRZ ubiquitin ligases, which negatively regulate iron deficiency response and iron accumulation in rice. In the present report, we aimed to further improve the iron deficiency tolerance and grain iron accumulation of OsHRZ knockdown rice by the simultaneous introduction of the engineered ferric-chelate reductase gene Refre1/372 under the control of the OsIRT1 promoter for further enhancement of iron uptake. We obtained several transgenic rice lines with repressed OsHRZ expression and induced Refre1/372 expression. These lines showed a variable degree of iron deficiency tolerance in calcareous soils, with increased iron accumulation in brown seeds under both iron-deficient and iron-sufficient soil cultures. Selected OsHRZ knockdown plus Refre1/372 lines showed similar or better growth compared with that of singly introduced OsHRZ knockdown or Refre1/372 lines in calcareous soils under both non-submerged and submerged conditions. After submerged calcareous soil cultivation, these OsHRZ knockdown plus Refre1/372 lines accumulated 2.5-4.3 times and 17-23 times more iron concentrations than that of non-transformants in brown rice and straw, respectively, which was comparable or superior to a single OsHRZ knockdown line. Our results indicate that the combined introduction of OsHRZ knockdown and OsIRT1 promoter-Refre1/372 is highly effective in further improving the iron deficiency tolerance without compromising the iron accumulation of the OsHRZ knockdown effects.

Review of protein intake and suitability of foods for protein-fortification in older adults in the UK

Protein is a vital dietary component for combating negative health outcomes associated with malnutrition in older adults, including sarcopenia, functional decline and reduced quality of life. Yet, recommended daily protein intake is consistently unmet, as evidenced in the literature and reaffirmed in this review. Poor appetite is recognized as a major determinant of protein-energy undernutrition and thus fortification of regular food or drinks provides a flexible and relevant approach for older adults with reduced appetite. To increase the likelihood of fortified products being successfully incorporated into the diets of older adults, they must be adaptable to older adults eating patterns, cater for their preferences and take the specific age-related problems that complicate food intake into account. This paper aims to highlight older adults' current sources of protein, shopping habits, typical eating patterns and commonly consumed foods, and hence consider appropriate carriers for protein enrichment. Data were reanalyzed from a combination of freely available UK datasets, including the National Dietary and Nutrition Survey and the Food and You Survey, alongside data purchased from market research consultancy, Kantar. These insights draw attention to the potential suitability of foods for fortification purposes, with the ultimate objective to promote eating pleasure and prevent malnutrition.

Novel isochoric impregnation to develop high-quality and nutritionally fortified plant materials (apples and sweet potatoes)

Isochoric impregnation was explored as a novel pressure-assisted infusion technique to fortify plant materials with bioactive compounds. Apple and potato cylinders were impregnated with a sucrose solution containing 4% ascorbic acid (AA) while freezing under isochoric conditions. Isochoric impregnation resulted in greater infusion of AA compared to infusion at atmospheric pressure, which demonstrated the feasibility of this impregnation technology. Processing temperatures (-3°C and -5°C) and processing times (1, 3, and 5 h) significantly affected the AA infusion. The AA content values ranged from 446 to 516 mg/100 g for apples and 322 to 831 mg/100 g for sweet potatoes under isochoric conditions. For both plant materials, isochoric impregnation at -3°C did not cause major changes in texture and microstructure of the biological tissues. These results indicated that isochoric impregnation of solid foods could be a feasible technology for infusion of bioactive compounds without significantly altering their matrix. PRACTICAL APPLICATION: The findings of this study showed that the use of isochoric impregnation as a fortification technique is a promising way to develop fresh-like and value-added products with improved nutrition during preservation at subfreezing temperatures.

Formulation and Effect of Iron Fortified Instant Bose Corn on Addressing Anemia among Adolescent Girls in Kupang, Indonesia

This study aimed to develop Fe-fortified instant Bose corn (IBC), a traditional Timorese food, as a strategy to address anemia among adolescent girls in Kupang, Indonesia. Instant corn and cowpea grits were made to shorten the preparation time with various times of soaking (IBC1=10 min; IBC2=15 min; IBC3=20 min) to select the best formula. The selected IBC was then fortified with NaFeEDTA·3H₂O and nutrient content was evaluated. In the intervention study, a pre-post controlled trial was applied to 40 anemic adolescent girls aged 16∼19 years. Subjects with severe anemia (Hb=8.5∼10.4 g/dL) received the fortified selected IBC, whereas those with moderate anemia (Hb=10.5∼11.5 g/dL) received the unfortified selected IBC. A total of 100 g IBC were provided three times/week for 2 months. The hemoglobin and soluble transferrin receptor (sTfR) levels were measured at baseline and endline, respectively. IBC3 produced the highest acceptance level as compared to other formulas. The fortified IBC3 met 127.4% recommended dietary allowances for iron. Moreover, both fortified and unfortified IBC3 significantly increased the hemoglobin levels of adolescent girls with the higher improvement found in the group of fortified IBC3 (1.73±1.21 g/dL; P<0.05). However, the beneficial effects of the fortified IBC3 could not be observed on sTfR levels. Since the effect on Hb levels was significant with less effect, the intervention of IBC3 for only 2 months did not adequate to improve sTfR levels. Nevertheless, this study suggests that Fe-fortified IBC may be effective in preventing anemia among adolescent girls in Kupang, Indonesia.

High Dietary Folic Acid Intake Is Associated with Genomic Instability in Peripheral Lymphocytes of Healthy Adults

Mandatory fortification of food with synthetic folic acid (FA) was instituted in 1998 to reduce the incidence of neural tube defects. Adequate folate status is correlated with numerous health benefits. However, elevated consumption of FA is controversially associated with deleterious effects on health. We previously reported that excess FA mimicked folate depletion in a lymphoblastoid cell line. To explore the impact of FA intake from fortified food, we conducted an observational human study on 33 healthy participants aged 18-40 not taking any supplements. Food intake, anthropomorphic measurements, and blood samples were collected and analyzed. Our results show that individuals belonging to the highest tertile of folic acid intake, as well as ones with the highest folic acid to total folate intake ratio (FAR), display a significantly greater incidence of lymphocyte genomic damage. A decrease in global DNA methylation is observed in the highest tertile of FAR compared to the lowest (p = 0.055). A downward trend in the overall gene expression of select DNA repair and one carbon cycle genes (MGMT, MLH1, UNG, MTHFR, MTR) is noted with increased folate status and FA intake. These results provide supporting evidence that high consumption of FA from fortified foods can precipitate genomic instability in peripheral lymphocyte in vivo.

Amelioration for oxidative stability and bioavailability of N-3 PUFA enriched microalgae oil: an overview

Technological improvements in dietary supplements and nutraceuticals have highlighted the significance of bioactive molecules in a healthy lifestyle. Eicosapentaenoic acid and Cervonic acid (DHA), omega-3 polyunsaturated fatty acids seem to be famed for their ability to prevent diverse physiological abnormalities. Selection of appropriate pretreatments and extraction techniques for extraction of lipids from robust microalgae cell wall are very important to retain their stability and bioactivity. Therefore, extraction techniques with optimized extraction parameters offer an excellent approach for obtaining quality oil with a high yield. Oils enriched in omega-3 are particularly imperiled to oxidation which ultimately affects customer acceptance. Bio active encapsulation could be one of the effective approaches to overcome this dilemma. This review paper aims to give insight into the cultivation methods, and downstream processes, various lipid extraction approaches, techniques for retaining oxidative stability, bioavailability and food applications based on extracted or encapsulated omega-3.

Commercial Complementary Food in Germany: A 2020 Market Survey

As consumption of commercial complementary food (CCF) during infancy and toddlerhood is common, the aim of the present study was to describe the current (2020) German market of CCF products targeted at infants and toddlers with a special focus on ingredients, macronutrients, and the practice of nutrient fortification. Information on age declarations, ingredients, energy and nutrient contents, and nutrient fortification was obtained in a market survey by contacting the producers and searching manufacturers’ websites. Each product was assigned to 1 of 13 product categories (menus, milk−cereal−meal, fruit−cereal−meal, oil, vegetables, meat, fish, fruits, cereals, snack foods, pouches, desserts, beverages). Descriptive statistics were used. We identified 1057 CF products on the German market (infants’ CCF (<12 months): n = 829; toddlers’ CCF (>12 months): n = 228)). The highest protein content (% of energy content, %E) was found in meat products. In pouches, beverages, cereal fruit meals, and fruits, more than 50% of energy came from total sugar. The highest median salt content was found in toddlers’ menus and desserts. Around one-third of infants’ CCF products and one quarter of toddlers’ products were fortified with nutrients. Vitamin B1 (thiamin) was the most frequently fortified nutrient, followed by vitamin C, iron, calcium, and vitamin D. Apple was the type of fruit listed most often in products with fruits, whereas carrot was the most frequent vegetable among CCF with vegetables. In particular, the high total sugar content of most CCFs currently available on the German market may promote unhealthy dietary habits. Parents need to be advised about the optimal selection of products.