1
|
The Potential of Condiments, Seasonings, and Bouillon Cubes to Deliver Essential Micronutrients in Asia: Scenario Analyses of Iodine and Iron Fortification. Nutrients 2023; 15:nu15030616. [PMID: 36771323 PMCID: PMC9920952 DOI: 10.3390/nu15030616] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/27/2023] Open
Abstract
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.
Collapse
|
2
|
Qiu L, Zhang M, Mujumdar AS, Liu Y. Recent developments in key processing techniques for oriental spices/herbs and condiments: a review. FOOD REVIEWS INTERNATIONAL 2020. [DOI: 10.1080/87559129.2020.1839492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Liqing Qiu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China
| | - Min Zhang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China
- School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China
| | - Arun S. Mujumdar
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China
- Department of Bioresource Engineering, Macdonald Campus, McGill University, Quebec, Canada
| | - Yaping Liu
- R & D Center, Guangdong Galore Food Co. Ltd, Zhongshan, China
| |
Collapse
|
3
|
Study on the risks of metal detection in food solid seasoning powder and liquid sauce to meet the core concepts of ISO 22000:2018 based on the Taiwanese experience. Food Control 2020. [DOI: 10.1016/j.foodcont.2019.107071] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
4
|
Prieto-Patron A, V. Hutton Z, Fattore G, Sabatier M, Detzel P. Reducing the burden of iron deficiency anemia in Cote D'Ivoire through fortification. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2020; 39:1. [PMID: 32033590 PMCID: PMC7006106 DOI: 10.1186/s41043-020-0209-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 12/05/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Iron deficiency anemia (IDA) is highly prevalent in the Cote d'Ivoire and has severe health and economic consequences. In this paper, we apply a health economic model to quantify the burden of IDA, and the contribution of nationwide mandatory iron fortification of wheat flour and voluntary iron fortification of condiments to the reduction of this burden. METHODS The analysis for the population from 6 months to 64 years builds on published reviews and publicly available datasets and is stratified by age-groups and socioeconomic strata using comparative risk assessment model. RESULTS Without the impact of these fortification strategies, the annual burden of IDA is estimated at 242,100 disability adjusted life years (DALYs) and 978.1 million USD. Wheat flour and condiment fortification contributed to a reduction of the IDA burden by approximately 5% each. CONCLUSION In places with high prevalence of malaria and other infectious diseases, such as the Côte D'Ivoire, food fortification as a nutritional intervention should be accompanied with infectious disease prevention and control. The findings of this study provide additional input for policy makers about the magnitude of the impact and can support the conception of future fortification strategies.
Collapse
Affiliation(s)
| | - Zsuzsa V. Hutton
- Nestlé Research Center, Vers-chez-les-Blanc, Lausanne, Switzerland
| | - Giovanni Fattore
- Department of Policy Analysis and Public Management, CERGAS – Centre for Research in Healthcare Management, Bocconi University, Milan, Italy
| | - Magalie Sabatier
- Nestlé Research Center, Vers-chez-les-Blanc, Lausanne, Switzerland
| | - Patrick Detzel
- Nestlé Research Center, Vers-chez-les-Blanc, Lausanne, Switzerland
| |
Collapse
|
5
|
Waller AW, Andrade JE, Mejia LA. Performance Factors Influencing Efficacy and Effectiveness of Iron Fortification Programs of Condiments for Improving Anemia Prevalence and Iron Status in Populations: A Systematic Review. Nutrients 2020; 12:nu12020275. [PMID: 31973015 PMCID: PMC7070935 DOI: 10.3390/nu12020275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 11/16/2022] Open
Abstract
Iron fortification of staple foods is a common practice around the world to reduce the prevalence of iron-deficiency anemia. More recently, fortified condiments, including salts, sauces, and powders, have been tested in various efficacy trials. However, there is limited information on how nutritional, environmental, and experimental factors affect their efficacy and effectiveness. The purpose of the present work was to systematically review performance factors affecting the efficacy of condiment fortification trials. Three databases were searched using a standardized keyword search and included based on four-point inclusion criteria. Studies were evaluated against a quality assessment tool and effect sizes were calculated. Studies were ranked as low or high performing, based on whether or not they significantly improved iron-deficiency outcomes (hemoglobin, anemia prevalence, and ferritin levels). Of the 955 retrieved studies, 23 were included-of which, nine performed poorly, eight performed highly, and six were classified as neither because they did not meet the criteria of assessing the three iron outcomes. Results showed that unsuccessful trials did not consider environmental factors such as parasitic infections, nutritional factors such as micronutrient deficiencies other than iron, consumer acceptability of the product or experimental factors such as monitoring and adherence to the trials. Two common performing factors identified among those studies performing highly vs. those that did not were the control of sensory changes and monitoring of consumption compliance (i.e., dose delivery). The present work can be used as decision-making support for nutrition policy makers when determining the appropriate implementation of condiment fortification programs.
Collapse
Affiliation(s)
- Anna W. Waller
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign. 260 Bevier Hall-MC 182. 905 Goodwin Ave, Urbana, IL 61801, USA; (A.W.W.); (J.E.A.)
| | - Juan E. Andrade
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign. 260 Bevier Hall-MC 182. 905 Goodwin Ave, Urbana, IL 61801, USA; (A.W.W.); (J.E.A.)
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Luis A. Mejia
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign. 260 Bevier Hall-MC 182. 905 Goodwin Ave, Urbana, IL 61801, USA; (A.W.W.); (J.E.A.)
- Correspondence: ; Tel.: +1-217-493-0242
| |
Collapse
|
6
|
Darnton-Hill I. Public Health Aspects in the Prevention and Control of Vitamin Deficiencies. Curr Dev Nutr 2019; 3:nzz075. [PMID: 31598578 PMCID: PMC6775441 DOI: 10.1093/cdn/nzz075] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/11/2019] [Accepted: 06/17/2019] [Indexed: 02/06/2023] Open
Abstract
Vitamin deficiencies remain major etiological factors in the global burden of disease, especially in low- and middle-income countries. The purpose of this state-of-the-art review was to update current information on deficiencies of vitamins and public health approaches to addressing them. Some stages of life present a higher risk of deficiency than others: risks are higher in pregnant women, children (from conception to young childhood), adolescents, the elderly, and all of the over 800 million people globally who are undernourished. At risk are approximately 125 million preschool children with vitamin A deficiency, as well as sub-populations at risk of deficiencies of folate, thiamin, vitamin B12, niacin, riboflavin, other B vitamins. and vitamin D. Addressing micronutrient deficiencies requires identifying those at risk and then working to prevent and manage that risk. Public health approaches include improved, diversified diets; supplementation; fortification and biofortification; and other supportive public health measures. Historically, as with pellagra and beriberi and, in the last 3 decades, with vitamin A and folic acid, there has been encouraging progress, but much remains to be done.
Collapse
Affiliation(s)
- Ian Darnton-Hill
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine, University of Sydney, New South Wales 2006, Australia
- The Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 021111, USA
| |
Collapse
|
7
|
Blanco-Rojo R, Vaquero MP. Iron bioavailability from food fortification to precision nutrition. A review. INNOV FOOD SCI EMERG 2019. [DOI: 10.1016/j.ifset.2018.04.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
8
|
More than two-thirds of dietary iodine in children in northern Ghana is obtained from bouillon cubes containing iodized salt. Public Health Nutr 2016; 20:1107-1113. [PMID: 27903312 DOI: 10.1017/s1368980016003098] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Bouillon cubes are widely consumed by poor households in sub-Saharan Africa. Because their main ingredient is salt, bouillon cubes could be a good source of iodine if iodized salt is used in their production and if their consumption by target groups is high. Our objective was to measure the iodine content of bouillon cubes, estimate their daily intake in school-aged children and evaluate their potential contribution to iodine intakes. DESIGN In a cross-sectional study, we measured urinary iodine concentrations (UIC) and estimated total daily iodine intakes. We administered a questionnaire on usage of bouillon cubes. We measured the iodine content of bouillon cubes, household salt, drinking-water and milk products. SETTING Primary schools in northern Ghana. SUBJECTS Schoolchildren aged 6-13 years. RESULTS Among school-aged children (n 250), median (interquartile range) UIC and estimated iodine intake were 242 (163-365) µg/l and 129 (85-221) µg/d, indicating adequate iodine status. Median household salt iodine concentration (n 100) was only 2·0 (0·83-7·4) µg/g; 72 % of samples contained <5 µg iodine/g. Iodine concentrations in drinking-water and milk-based drinks were negligible. Median iodine content of bouillon cubes was 31·8 (26·8-43·7) µg/g, with large differences between brands. Estimated median per capita consumption of bouillon cubes was 2·4 (1·5-3·3) g/d and median iodine intake from bouillon cubes was 88 (51-110) µg/d. CONCLUSIONS Despite low household coverage with iodized salt, iodine nutrition in school-aged children is adequate and an estimated two-thirds of their dietary iodine is obtained from bouillon cubes.
Collapse
|
9
|
Jalal C, Wuehler S, Osendarp S, De-Regil LM. Estimating nutrient fortification levels in condiments and seasonings for public health programs: considerations and adaptations. Ann N Y Acad Sci 2016; 1379:28-37. [PMID: 27737493 DOI: 10.1111/nyas.13227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 08/08/2016] [Accepted: 08/15/2016] [Indexed: 11/29/2022]
Abstract
Condiments and seasonings have been considered as potential vehicles for fortification in place of, or in addition to, fortifiable staple foods. Methodologies for establishing fortification programs focus primarily on use of staple foods, which are consumed in larger portions than condiments and seasonings. Some fortification models assume self-limiting consumption relative to the maximum energy consumed by target populations. However, this assumption may prove incorrect for estimating fortification concentrations of condiments and seasonings because they may only provide negligible energy. Although flavor or color may limit consumption, these limits would vary across each condiment or seasoning vehicle. In addition, the small volume of condiments and seasonings consumed relative to staple foods can lead to proportionally larger potential errors than with staple foods when measuring usual dietary intakes for establishing safe and effective fortification concentrations. This paper reviews available methods for setting fortification levels, whether or how available methods or conceptual frameworks could be adapted to condiments and seasonings, and gaps in knowledge for appropriately using condiments and seasonings as vehicles for fortification in public health.
Collapse
Affiliation(s)
- Chowdhury Jalal
- Technical Services, Micronutrient Initiative, Ottawa, Ontario, Canada
| | - Sara Wuehler
- Technical Services, Micronutrient Initiative, Ottawa, Ontario, Canada.
| | - Saskia Osendarp
- Technical Services, Micronutrient Initiative, Ottawa, Ontario, Canada
| | | |
Collapse
|
10
|
Zamora G, Flores-Urrutia MC, Mayén AL. Large-scale fortification of condiments and seasonings as a public health strategy: equity considerations for implementation. Ann N Y Acad Sci 2016; 1379:17-27. [PMID: 27525672 DOI: 10.1111/nyas.13183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/16/2016] [Accepted: 06/20/2016] [Indexed: 12/20/2022]
Abstract
Fortification of staple foods with vitamins and minerals is an effective approach to increase micronutrient intake and improve nutritional status. The specific use of condiments and seasonings as vehicles in large-scale fortification programs is a relatively new public health strategy. This paper underscores equity considerations for the implementation of large-scale fortification of condiments and seasonings as a public health strategy by examining nonexhaustive examples of programmatic experiences and pilot projects in various settings. An overview of conceptual elements in implementation research and equity is presented, followed by an examination of equity considerations for five implementation strategies: (1) enhancing the capabilities of the public sector, (2) improving the performance of implementing agencies, (3) strengthening the capabilities and performance of frontline workers, (3) empowering communities and individuals, and (4) supporting multiple stakeholders engaged in improving health. Finally, specific considerations related to intersectoral action are considered. Large-scale fortification of condiments and seasonings cannot be a standalone strategy and needs to be implemented with concurrent and coordinated public health strategies, which should be informed by a health equity lens.
Collapse
Affiliation(s)
- Gerardo Zamora
- Evidence and Programme Guidance, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland.
| | - Mónica Crissel Flores-Urrutia
- Evidence and Programme Guidance, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
| | - Ana-Lucia Mayén
- Institut Universitaire de Médecine Sociale et Préventive, Lausanne, Switzerland
| |
Collapse
|