Consuming Iron Biofortified Beans Increases Iron Status in Rwandan Women after 128 Days in a Randomized Controlled Feeding Trial

Review of the facilitators and barriers to adoption of biofortified foods and food products

Biofortification - the process of increasing the concentrations of essential nutrients in staple crops - is a means of addressing the burden of micronutrient deficiencies at a population level via existing food systems, such as smallholder farms. To realise its potential for global impact, we need to understand the factors that are associated with decisions to adopt biofortified crops and food products. We searched the literature to identify adoption determinants, i.e. barriers to (factors negatively associated) or facilitators of (factors positively associated) adoption, of biofortified crops and food products. We found 41 studies reporting facilitator(s) and/or barrier(s) of adoption. We categorised the factors using the Consolidated Framework of Implementation Research 2.0, resulting in a set of factors that enable or constrain adoption of biofortified foods across twenty-four constructs and five domains of this meta-theoretical determinant framework from implementation science. Facilitators of orange sweet potato adoption included knowledge about importance, relative advantage, efficient production and management practices; barriers included lacking timely access to quality vines and market remoteness (28 studies total). Facilitators of vitamin A cassava adoption included awareness of its benefits and access to information; barriers included poor road networks and scarcity of improved technology including inadequate processing/storage facilities (8). Facilitators of high-iron bean adoption included farmers' networking and high farming experience; barriers included low knowledge of bean biofortification (8). Barriers to vitamin A maize adoption included low awareness and concerns regarding yield, texture and aflatoxin contamination (1). These barriers and facilitators may be a starting point for researchers to move towards testing implementation strategies and/or for policymakers to consider before planning scale-up and continuous optimisation of ongoing projects promoting adoption of biofortified crops and food products.

Advances in breeding for enhanced iron and zinc concentrations in common bean in eastern Africa

Micronutrient malnutrition is one of the most serious health challenges facing vast sectors of the population of Africa, particularly resource-poor women and children. The main deficiencies include iron (Fe), zinc (Zn), and vitamin A. Plant breeding has frequently been advocated as the most sustainable strategy to provide varieties of different food crop species with enhanced micronutrient density to combat the global hidden hunger problem which affects >2 billion people. However, there are few research programmes which have implemented this approach, from concept stage to finished products, which can be widely disseminated and commercialized to create meaningful impact. The east African bean biofortification programme offers a case study of such a programme. The aim of this programme was to develop well-adapted, high-yielding, Fe- and Zn-rich bush and climbing bean cultivars and agronomic approaches that enhance expression of the high mineral trait. The objective of this review is to provide a synthesis of the progress made in the last 22 years, with a focus on genetic diversity, inheritance, bioavailability of Fe and Zn, and cooking quality, as well as to identify research gaps and suggest future directions.

Fortification or biofortification: complimentary strategies or duplication of effort?

Micronutrient deficiencies continue to be a global concern, with the most common deficiencies being vitamin A, iron, zinc and B vitamins (folate and B12). Addressing this requires strategies that are scalable and equitable such that they reach all members of a population irrespective of socioeconomic status and geography. Fortification and biofortification offer potential large-scale solutions, however each have strengths and limitations depending on the context, particularly the cultural and political factors that may create barriers or opportunities for effectiveness. Planning how to target scarce resources for maximum impact requires an in-depth knowledge and understanding of local food systems and market dynamics, alongside strong government policy and legislative support. A food fortification programme was launched in Pakistan in 2016, supported by UK Aid and designed to address the high prevalence of vitamin A, iron and zinc deficiency, particularly in women and children. In the same year, the first zinc biofortified variety of wheat, Zincol-2016, was released in Pakistan, supported and developed through the HarvestPlus programme in collaboration with the Pakistan National Agriculture Research Centre. This review explores the challenges faced by fortification and biofortification, initiated independently, (but around the same time) in Pakistan.

Improvement of Iron and β-Carotene Bioaccessibility in Complementary Foods: Biofortification of Local Crops With Organic Residual Products and Microorganisms

Micronutrient deficiencies remain a great public health challenge worldwide with iron, zinc, and vitamin A being the most problematic. It has been shown that biofortification through agronomic strategies can increase their micronutrient content, but data on the bioavailability remain limited. In Senegal, consumption of cereals and legumes is high, and orange-fleshed sweet potato (OFSP), rich in β-carotene, has been introduced a decade ago. The objective of the present work was to assess the bioaccessibility of iron, zinc, and β-carotene in local complementary foods prepared with millet, cowpea, and OFSP alone or in combination, produced using different agronomic biofortification strategies. Organic residual products were used alone or in combination with microorganisms to produce the abovementioned crops that were used to prepare the complementary foods. Static in vitro digestion was performed to assess the bioaccessibility of the micronutrients, according to a harmonized protocol. The two organic residual products had different effect, as the cow dung alone was inefficient to increase iron and zinc contents as well as their bioaccessibility in millet porridges. However, the use of poultry litter alone or in combination with microorganisms increased iron bioaccessibility in cooked cowpea (27%-29%) compared to the non-biofortified counterpart (9%). Surprisingly, bioaccessible β-carotene was significantly higher (4.1%) in sample of mashed OFSP biofortified with the combination of the different agronomic strategies than in the others (1.4%-2.5%). Portions (150 g) of porridge prepared from the three biofortified crops would cover up to 100% of the daily vitamin A requirements of children aged 6-23 months. The use of a combination the most promising varieties of crops, together with the agronomic strategies, would be a complementary approach to sustainability limit micronutrient deficiencies in a context of monotonous diets.

Biofortification: Future Challenges for a Newly Emerging Technology to Improve Nutrition Security Sustainably

Biofortification was coined as a term to define a plant breeding strategy to increase the micronutrient content of staple food crops to reduce the burden of micronutrient deficiencies in low- and middle-income countries. In 2003, the HarvestPlus program, based in the centers comprising the Consultative Group on International Agricultural Research, was initiated to implement the biofortification strategy. This article discusses what has been achieved, what has been learned, and the key challenges to embed biofortification in food systems and to expand its impact. Cost-effectiveness is key to the biofortification strategy. Biofortification piggybacks on the agronomically superior varieties being developed at agricultural research centers. Central plant breeding research discoveries can be spread globally. Farmers have every motivation to adopt the latest high-yielding, high profit crops. High productivity leads to lower food prices. As a consequence, consumers can increase their mineral and vitamin intakes at no additional cost by substituting biofortified staple foods 1-for-1 for nonbiofortified staple foods. After 20 years of investment, biofortified staple food crops are being produced by farmers in over 40 countries and are eaten by hundreds of millions of people. Published nutrition trials have shown nutrient-rich crops to be efficacious. The biofortification strategy is now recognized by the international nutrition community as one effective approach among several interventions needed to reduce micronutrient deficiencies. This is a promising beginning. However, biofortification is still a newly emerging technology. A limitation of biofortification as implemented to date is that densities of single nutrients have been increased in given staple food crops. To reach a higher trajectory, the impacts of biofortification can be multiplied several-fold using genetic engineering and other advanced crop development techniques to combine multiple-nutrient densities with climate-smart traits.

Towards gender-transformative metrics in seed system performance measurement: insights for policy and practice in Sub-Sahara Africa

Context

Food insecurity in Sub-Sahara Africa hinges on addressing salient gender inequities within the seed system. While efficient seed system promises reduced systemic inefficiencies to fast-track seed delivery to the smallholder farmers, a dearth of standardized industry metrices to understand the intersectionality of seed system and gender issues exist. Specifically, metrices on guaranteed seed access, reach, benefit, women's empowerment and ultimate transformation of women, youth and vulnerable people's livelihoods are less understood. The existing metrices are aggregated at very high levels and limit the ability of policymakers and industry stakeholders to effectively address gender-based inequities for an optimized seed system.

Objective

Our objective is to challenge the status quo industry metrics used by seed industry players and apply a gender framework that strikes a balance between the needs of women, youth and vulnerable peoples in the system, vis-a-vis the need of public, private, and civil society actors. Therefore, the study seeks to evaluate how seed system metrics can be effectively tailored to address gender gaps for enhanced agricultural productivity and food security in Sub-Sahara African context. It also refines the proposals of Kennedy and Speilman and introduce gender-specific metrices that may hold promise to address women and youth's challenges within the seed system.

Methods

A systemic review of current industry metrices was conducted and the newly developed reach, benefit, empower and transform (RBET) framework was applied to synthesize the responsiveness of current seed industry indicators on gender issues. Online databases and repositories with key search words that returned 204 results including some gray literature.

Results and conclusion

Using common bean seed system as an illustration, the study found critical gaps in measuring seed industry performance, innovation, structure, seed registration and quality control, intellectual property rights using the reach, benefit, empower and transform approach. Thus, a set of gender responsive indicators was suggested to address gender and inclusive matrices that the seed industry often neglects. Using the reach, benefit, empower and transform approach we have included gender responsive indicators meant to close existing gender gaps. Some of these indicators addressed include women participation, trait preferences, seed packaging sizing, seed system leadership, decision-making capacities, labor intensity/drudgery and use of digital platforms such as point-of-sale tracking systems to reach last mile farmers among others.

Significance

This study uses the newly-developed Reach, Benefit, Empower, and Transform (RBET) Framework together with the already existing Spielman-Kennedy framework. It is timely to inform policymaking process on seed system design, to enhance seed industry performance monitoring, and provide practitioners with the knowledge and missing links in efforts to align the seed system's performance with gender outcomes in a measurable manner.

Strategies and bibliometric analysis of legumes biofortification to address malnutrition

MAIN CONCLUSION

Biofortification of legumes using diverse techniques such as plant breeding, agronomic practices, genetic modification, and nano-technological approaches presents a sustainable strategy to address micronutrient deficiencies of underprivileged populations. The widespread issue of chronic malnutrition, commonly referred to as "hidden hunger," arises from the consumption of poor-quality food, leading to various health and cognitive impairments. Biofortified food crops have been a sustainable solution to address micronutrient deficiencies. This review highlights multiple biofortification techniques, such as plant breeding, agronomic practices, genetic modification, and nano-technological approaches, aimed at enhancing the nutrient content of commonly consumed crops. Emphasizing the biofortification of legumes, this review employs bibliometric analysis to examine research trends from 2000 to 2023. It identifies key authors, influential journals, contributing countries, publication trends, and prevalent keywords in this field. The review highlights the progress in developing biofortified crops and their potential to improve global nutrition and help underprivileged populations.

Unearthing the therapeutic benefits of culinary-medicinal mushrooms for humans: Emerging sustainable bioresources of 21st century

Global interest in mushroom farming techniques has grown in the last few years. Despite not making up a large amount of the human diet at the moment, the nutritional worth of mushrooms has prompted their usage. The three main segments of the global mushroom industry are wild, culinary (edible), and medicinal mushrooms. The quality food that mushrooms provide can be utilized to build agricultural ecosystems that are more sustainable for increasing productivity and enhancing the effectiveness of resource usage. This is mostly because mushrooms can be utilized for the recycling of biomass and remains from crop production. Culinary-medicinal mushrooms are becoming more and more important because of their nutrient density, dietary value, and health advantages. Given its many bioactive components, which include polysaccharides, proteins, vitamins, minerals, dietary fiber, and secondary metabolites, mushrooms have been utilized extensively as health foods. These mushrooms exhibit pharmacological activities and possess prebiotic and antibacterial capabilities. This review provides information on the latest advancements in the sustainable cultivation of mushrooms, particularly with nontraditional substrates, and their potential therapeutic uses. Furthermore, some of the newest developments and difficulties in the production of mushrooms are explored.

Behaviour change communication influences on food consumption behaviours and the demand for diverse nutritious foods in the Makoni District, Zimbabwe

This study evaluated the effectiveness of nutrition behavioural change communication interventions and food consumption behaviours and demand for nutritious foods in Makoni district, Zimbabwe. The study employed an observational and cross-sectional design using mixed-methods. The population was smallholder farmers' households with children six to twenty-four months old. Secondary data was obtained from the main intervention reports. The total sample size of this project comprised of five personnel participating in the implementation of the intervention for key informant interviews; forty participants for the in-depth interviews; and a total of 81 participants for eight focus group discussions. Participants indicated that the Livelihoods and Food Security Programme intervention successfully increased their nutrition knowledge, enhanced their ability to diversify crop production, and improved their access to varied foods, including some new crops. Local markets had little influence on the demand for nutritious foods by the intervention population. The interventions were effective in stimulating demand for diverse and nutritious foods in Makoni District.

Biofortification of Plant- and Animal-Based Foods in Limiting the Problem of Microelement Deficiencies-A Narrative Review

With a burgeoning global population, meeting the demand for increased food production presents challenges, particularly concerning mineral deficiencies in diets. Micronutrient shortages like iron, iodine, zinc, selenium, and magnesium carry severe health implications, especially in developing nations. Biofortification of plants and plant products emerges as a promising remedy to enhance micronutrient levels in food. Utilizing agronomic biofortification, conventional plant breeding, and genetic engineering yields raw materials with heightened micronutrient contents and improved bioavailability. A similar strategy extends to animal-derived foods by fortifying eggs, meat, and dairy products with micronutrients. Employing "dual" biofortification, utilizing previously enriched plant materials as a micronutrient source for livestock, proves an innovative solution. Amid biofortification research, conducting in vitro and in vivo experiments is essential to assess the bioactivity of micronutrients from enriched materials, emphasizing digestibility, bioavailability, and safety. Mineral deficiencies in human diets present a significant health challenge. Biofortification of plants and animal products emerges as a promising approach to alleviate micronutrient deficiencies, necessitating further research into the utilization of biofortified raw materials in the human diet, with a focus on bioavailability, digestibility, and safety.

A systematic review of dietary data collection methodologies for diet diversity indicators

The purpose of the current study was to critically assess the gaps in the existing methodologies of dietary data collection for diet diversity indicators. The study proposed the importance of smartphone application to overcome the drawbacks. The review paper identified and assessed the conventional methodologies used in diet diversity indicators including Minimum Dietary Diversity for Women (MDD-W), Minimum Dietary Diversity of Infant and Young Child Feeding Practices (IYCF-MDD), and Household Dietary Diversity Score (HDDS). The 80 research studies from 38 countries were critically assessed on the basis of their research aim, study design, target audience, dietary data collection methodology, sample size, dietary data type, dietary data collection frequency, and location point of dietary data collection. Results indicated that most studies employed interviewer-administered 24-h recall assessing the dietary diversity. The review paper concluded that smartphone application had potential to overcome the identified limitations of conventional methodologies including recall bias, social-desirability bias, interviewer training, and cost-time constraints.

Dietary Zn deficiency, the current situation and potential solutions

Zinc (Zn) deficiency is a worldwide problem, and this review presents an overview of the magnitude of Zn deficiency with a particular emphasis on present global challenges, current recommendations for Zn intake, and factors that affect dietary requirements. The challenges of monitoring Zn status are clarified together with the discussion of relevant Zn bioaccessibility and bioavailability issues. Modern lifestyle factors that may exacerbate Zn deficiency and new strategies of reducing its effects are presented. Biofortification, as a potentially useful strategy for improving Zn status in sensitive populations, is discussed. The review proposes potential actions that could deliver promising results both in terms of monitoring dietary and physiological Zn status as well as in alleviating dietary Zn deficiency in affected populations.

Genome-wide association analysis of anthracnose resistance in the Yellow Bean Collection of Common Bean

Anthracnose caused by Colletotrichum lindemuthianum is a major disease of common bean (Phaseolus vulgaris) worldwide. Yellow beans are a major market class of common bean especially in eastern and southern Africa. The Yellow Bean Collection (YBC), which is comprised of 255 genotypes, and has not been used previously in genetic studies on anthracnose, is an excellent genetic resource for understanding the extent of anthracnose resistance and its genetic architecture in the yellow bean market class. The objectives of this study were i) evaluate the YBC for resistance to races 5, 19, 39, 51, 81, 183, 1050 and 1105 of C. lindemuthianum. and ii) conduct genome-wide association analysis to identify genomic regions and candidate genes associated with resistance to C. lindemuthianum. The YBC was genotyped with 72,866 SNPs, and genome-wide association analysis was conducted using Mixed Linear Model in TASSEL. Andean and Middle American genotypes with superior levels of resistance to the eight races were identified. YBC278 was the only one among 255 genotypes that was highly resistant to all eight races. Resistance to anthracnose in the YBC was controlled by major-effect loci on chromosomes Pv01, Pv03, Pv04, Pv05 and Pv07. The genomic region on Pv01, which overlapped with the Andean locus Co-1 provided resistance to races 81, 1050 and 1105. Significant SNPs for resistance to race 39 were identified on Pv02. The genomic region on Pv04, which overlapped with known major-effect loci Co-3, Co-15, Co-16, Co-y and Co-z, provided resistance to races 5, 19, 51 and 183. Novel genomic regions for resistance to race 39 were identified on Pv05 and Pv07. Plant resistance genes (R genes) with NB-ARC and LRR domains, which occurred in clusters, were identified as positional candidate genes for genomic regions on Pv02 and Pv04.

Farmers' and millers' experiences and attitudes towards the production and processing of zinc biofortified wheat in Pakistan: a mixed methods study

Background

Zinc biofortified wheat may be a sustainable strategy to increase zinc intake in areas where fortification and dietary diversification are not feasible or are limited by household purchasing power. This convergent mixed methods study aimed to explore the farmers' and millers' experiences and attitudes towards the production and processing of zinc biofortified wheat in Pakistan.

Methods

A telephone survey was conducted with farmers (n = 418) who were provided with Zincol-2016 biofortified wheat seed for the 2019-2020 growing season, as part of a wheat grain micronutrient mapping study across Punjab Province. The survey explored the farmers' experiences of growing Zincol-2016 and whether they opted to grow it again in the subsequent season. Semi-structured focus group discussions were undertaken in a separate group of farmers in Khyber Pakhtunkhwa (KP) province (n = 12) who grew Zincol-2016 for the BiZiFED2 RCT. Millers were also interviewed in KP, both those who had processed Zincol-2016 for the trial (n = 12) and those who had no experience of processing biofortified wheat (n = 12). Survey data were analyzed using descriptive statistics and transcripts of focus groups were analyzed using thematic analysis.

Results

Nearly half of farmers who responded to the survey (47%) re-cultivated Zincol-2016 in the following season. The drivers for Zincol-2016 re-cultivation were seed availability (100%), grain yield and growth resistance (98%), quality of the flour from the previous harvest (97%) and nutritional benefit (94.5%). Discussions with farmers suggested that the main motivators for potential scale-up of biofortified wheat were the perceived quality of the grain, wheat, and flour. Millers saw it as an opportunity to expand their business. Farmers and millers valued the health benefits of the wheat. Challenges for scale-up include the need of additional support to produce it, unfamiliarity with the biofortification process, production costs, and external threats to the supply chain.

Conclusion

Farmers and millers showed a strong implicit preference for Zincol-2016 over alternative varieties. Crop performance and product yield were the most cited motivators for growing Zincol-2016. Farmers and millers are willing to produce and process biofortified wheat if financial and educational support is provided.

Designing nutrition-sensitive agriculture (NSA) interventions with multi-criteria decision analysis (MCDA): a review

Despite the efforts to end malnutrition through intensive agriculture of caloric crops, micronutrient deficiencies and other forms of malnutrition persist in vulnerable communities worldwide. Nutrition-sensitive agriculture (NSA) interventions are recognized as chances to address the causes of malnutrition. In this work, the different types of NSA interventions were explored, as well as the pathways through which they can improve nutrition (e.g., increasing biofortified crops and income generation via agricultural sales for a positive impact on access to nutritious foods, and simultaneously involving nutrition education to improve care practices and eventually nutritional status). Some NSA interventions focus on one pathway. Well-designed interventions, however, should follow multi-pathway approaches targeting the underlying causes of undernutrition within the selected population. The circumstances in which certain indicators should be used to measure the impact of an NSA intervention in each stage of the full pathway were also explained, as well as the need of enhancing the design of such interventions. Multi-criteria decision analysis (MCDA) has been employed to solve agriculture-related issues, but it has not been used to identify the optimal types of NSA interventions, metrics, and indicators based on the context of the community, priorities and objectives of the project managers and designers, etc.

Design and Development of 'Diet DQ Tracker': A Smartphone Application for Augmenting Dietary Assessment

The purpose of the current study was to describe the design, development, and validation of the 'Diet DQ Tracker'. The 'Diet DQ Tracker' is the first self-administered smartphone app designed to collect dietary data for diet diversity indicators. The main objective of the app was to replace the traditional methods of dietary data collection, such as in-person or telephone 24 h recall via pen and paper questionnaire or tablets. The real-time meal recording, extensive food database, and automatic score calculations and visualizations for MDD-W, IYCF-MDD, and HDDS have the potential to overcome the drawbacks of 24 h recalls. Recall depends on respondent memory, food expertise, and time consumption and demands skilled interviewers. Further, SAIN, LIM recommendations in the app prompt users to diversify diets with healthy foods. The pilot study determined the acceptability, feasibility, and relative validity of the 'Diet DQ Tracker' with a 24 h dietary recall. The results demonstrated minimal differences in dietary scores by both methodologies. The app, being convenient, easy to use, less time-consuming, and enjoyable, was preferred by the entire study sample over 24 h recall. The app will be continually updated with foods from different cultures for validating in large-scale studies. The future studies will help to improve the subsequent versions of the app.

Nutritional and Nutraceutical Properties of Selected Pulses to Promote Gluten-Free Food Products

The market for gluten-free products is increasing with an estimated 7.6% annual growth rate from 2020 to 2027. It has been reported that most gluten-free products, such as bread, cookies, and pasta, contain great amounts of simple carbohydrates and are low in fiber and protein, affecting people's health. Pulses such as common beans, chickpeas, lentils, and peas have been studied as an alternative for developing gluten-free products because of their high protein and fiber content. In addition, they contain bioactive compounds with nutraceutical properties, such as phenolics, saponins, dietary fiber, and resistant starch, among others. Most studies carried out with pulses in vitro and in vivo have displayed health benefits, proving that pulse-based food products are better than their counterparts, even those containing wheat, with proper sensory acceptance. This work reviews pulse's nutritional and nutraceutical properties to promote the development and consumption of gluten-free products and improve their formulations to promote people's health.

Genetic studies on iron and zinc concentrations in common bean (Phaseolus vulgaris L.) in Ghana

Iron and zinc deficiencies cause high health risk to young children and expectant mothers in sub Saharan Africa. The development of biofortified common bean (Phaseolus vulgaris L.) varieties could address the acute micronutrient deficiencies with associated improvement in the nutrition and health of women, children and adults. The objective of this study was to determine the mode of gene action and genetic advance in iron and zinc levels in common bean. Field experiment was carried out using six generations of two populations made of crosses between pairs of low iron, low zinc and high iron, moderate zinc genotypes (Cal 96 ˣ RWR 2154; MCR-ISD-672 ˣ RWR 2154). Each generation (P₁, P₂, F₁, F₂, BC₁P₁ and BC₁P₂) was evaluated on the field in a randomized complete block design with three replications. Generation mean analysis were performed for each trait measured in each of the crosses while iron and zinc levels were quantified by x-ray fluorescence. The study showed that both additive and non-additive gene effects were important in determining the expression of high iron and zinc levels. Iron concentration in the common bean seeds ranged from 60.68 to 101.66 ppm while zinc levels ranged from 25.87 to 34.04 ppm. Broad sense heritability estimates of iron and zinc were high in the two crosses (62-82% for Fe and 60-74% for Zn) while narrow sense heritability ranged from low to high (53-75% for Fe and 21-46% for Zn). Heritability and genetic gain were used as selection criteria for iron and zinc, and it was concluded that doing so would be beneficial for future improvement.

Household-Level Coverage of Iron-Biofortified Beans in the Northern Province of Rwanda

Background

Biofortification, the process of enhancing the micronutrient content of staple crops, is a nutrition-sensitive agricultural intervention with the potential to increase micronutrient intakes and improve health outcomes, especially among vulnerable populations. Although data are available on the number of farming households that grow biofortified crops, information on the coverage of biofortified foods in the general population is limited. Such information is critical to assess the performance of biofortification programs and guide decisions related to program implementation while ascertaining progress toward achieving expected impacts.

Objective

This study aimed to assess the household coverage of iron-biofortified beans (IBBs) in rural areas of the Northern Province of Rwanda.

Methods

We applied methods previously used to assess coverage in large-scale food fortification programs to develop coverage indicators for IBBs. These indicators were 1) consumption of beans in any form; 2) awareness of IBBs; 3) availability of IBBs; 4) consumption of IBBs (ever); and 5) consumption of IBBs (current).

Results

Of the 535 households surveyed, 98% consumed beans in any form and 79% were aware of IBBs. Among the 321 households that provided bean samples, only 40% of the samples were biofortified (as determined by a breeding specialist) and only 21% of respondents were able to correctly identify IBBs. Although 52% of households reported to be ever consuming biofortified beans, only 10% of households were currently consuming these beans.

Conclusions

Despite relatively high awareness of IBBs among surveyed households, a few households currently consume IBBs, highlighting the need to explore strategies to promote consumption. More research is also required to investigate factors hindering the consumption of IBBs.

Biofortification to avoid malnutrition in humans in a changing climate: Enhancing micronutrient bioavailability in seed, tuber, and storage roots

Malnutrition results in enormous socio-economic costs to the individual, their community, and the nation's economy. The evidence suggests an overall negative impact of climate change on the agricultural productivity and nutritional quality of food crops. Producing more food with better nutritional quality, which is feasible, should be prioritized in crop improvement programs. Biofortification refers to developing micronutrient -dense cultivars through crossbreeding or genetic engineering. This review provides updates on nutrient acquisition, transport, and storage in plant organs; the cross-talk between macro- and micronutrients transport and signaling; nutrient profiling and spatial and temporal distribution; the putative and functionally characterized genes/single-nucleotide polymorphisms associated with Fe, Zn, and β-carotene; and global efforts to breed nutrient-dense crops and map adoption of such crops globally. This article also includes an overview on the bioavailability, bioaccessibility, and bioactivity of nutrients as well as the molecular basis of nutrient transport and absorption in human. Over 400 minerals (Fe, Zn) and provitamin A-rich cultivars have been released in the Global South. Approximately 4.6 million households currently cultivate Zn-rich rice and wheat, while ~3 million households in sub-Saharan Africa and Latin America benefit from Fe-rich beans, and 2.6 million people in sub-Saharan Africa and Brazil eat provitamin A-rich cassava. Furthermore, nutrient profiles can be improved through genetic engineering in an agronomically acceptable genetic background. The development of "Golden Rice" and provitamin A-rich dessert bananas and subsequent transfer of this trait into locally adapted cultivars are evident, with no significant change in nutritional profile, except for the trait incorporated. A greater understanding of nutrient transport and absorption may lead to the development of diet therapy for the betterment of human health.

Child Health, Agriculture and Integrated Nutrition (CHAIN): protocol for a randomised controlled trial of improved infant and young child feeding in rural Zimbabwe

INTRODUCTION

Over one-quarter of children in sub-Saharan Africa are stunted; however, commercial supplements only partially meet child nutrient requirements, cannot be sustainably produced, and do not resolve physiological barriers to adequate nutrition (eg, inflammation, microbiome dysbiosis and metabolic dysfunction). Redesigning current infant and young child feeding (IYCF) interventions using locally available foods to improve intake, uptake and utilisation of nutrients could ameliorate underlying pathogenic pathways and improve infant growth during the critical period of complementary feeding, to reduce the global burden of stunting.

METHODS AND ANALYSIS

Child Health Agriculture Integrated Nutrition is an open-label, individual household randomised trial comparing the effects of IYCF versus 'IYCF-plus' on nutrient intake during infancy. The IYCF intervention comprises behaviour change modules to promote infant nutrition delivered by community health workers, plus small-quantity lipid-based nutrient supplements from 6 to 12 months of age which previously reduced stunting at 18 months of age by ~20% in rural Zimbabwe. The 'IYCF-plus' intervention provides these components plus powdered NUA-45 biofortified sugar beans, whole egg powder, moringa leaf powder and provitamin A maize. The trial will enrol 192 infants between 5 and 6 months of age in Shurugwi district, Zimbabwe. Research nurses will collect data plus blood, urine and stool samples at baseline (5-6 months of age) and endline (9-11 months of age). The primary outcome is energy intake, measured by multipass 24-hour dietary recall at 9-11 months of age. Secondary outcomes include nutrient intake, anthropometry and haemoglobin concentration. Nested laboratory substudies will evaluate the gut microbiome, environmental enteric dysfunction, metabolic phenotypes and innate immune function. Qualitative substudies will explore the acceptability and feasibility of the IYCF-plus intervention among participants and community stakeholders, and the effects of migration on food production and consumption.

ETHICS AND DISSEMINATION

This trial is registered at ClinicalTrials.gov (NCT04874688) and was approved by the Medical Research Council of Zimbabwe (MRCZ/A/2679) with the final version 1.4 approved on 20 August 2021, following additional amendments. Dissemination of trial results will be conducted through the Community Engagement Advisory Board in the study district and through national-level platforms.

TRIAL REGISTRATION NUMBER

NCT04874688.

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.

Effectiveness of Dietary Interventions to Treat Iron-Deficiency Anemia in Women: A Systematic Review of Randomized Controlled Trials

Iron-deficiency anemia is the most frequent nutritional deficiency, with women of reproductive age being particularly at risk of its development. The aim of the systematic review was to assess the effectiveness of dietary interventions to treat iron-deficiency anemia in women based on the randomized controlled trials. The systematic review was conducted according to the PRISMA guidelines and registered in the PROSPERO database (CRD42021261235). The searching procedure was based on PubMed and Web of Science databases, while it covered records published until June 2021. It included all randomized controlled trials assessing effectiveness of various dietary interventions on treatment of iron-deficiency anemia in women of childbearing age. The total number of 7825 records were screened, while 14 of them were finally included in the systematic review. The studies were screened, included, and reported, and the risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials by two independent researchers. The included studies compared the effectiveness of various dietary interventions with supplementation, placebo, control, or any other dietary intervention, while the assessed dietary interventions were based either on increasing iron supply and/or on increasing its absorption (by increasing vitamin C or vitamin D or decreasing phytate intake). The duration of applied intervention was diversified from 3 months or less, through 4 or 5 months, to half of a year or more. Among the assessed biochemical measures, the following were analyzed in majority of studies: hemoglobin, ferritin, transferrin receptor, hematocrit, and transferrin. The majority of included studies supported the influence of dietary interventions on the treatment of iron-deficiency anemia, as the applied dietary intervention was not effective in only three studies. The majority of included studies were assessed as characterized by medium risk of bias, while the overall risk was high for only four studies, which resulted from the randomization process, deviations from the intended interventions, and selection of the reported result. The majority of included studies were conducted for increasing iron supply and/or increasing vitamin C supply; however, only for the interventions including increasing iron supply and simultaneously increasing its absorption by vitamin C supply were all results confirmed effective. Vitamin D also seems to be an effective dietary treatment, but further studies are necessary to confirm the observations. Considering this fact, dietary interventions recommended for anemic female patients should include increased intake of iron and vitamin C.

The Impact of Consuming Zinc-Biofortified Wheat Flour on Haematological Indices of Zinc and Iron Status in Adolescent Girls in Rural Pakistan: A Cluster-Randomised, Double-Blind, Controlled Effectiveness Trial

Biofortification of wheat is potentially a sustainable strategy to improve zinc intake; however, evidence of its effectiveness is needed. A household-based, double-blind, cluster-randomized controlled trial (RCT) was conducted in rural Pakistan. The primary objective was to examine the effects of consuming zinc-biofortified wheat flour on the zinc status of adolescent girls aged 10−16 years (n = 517). Households received either zinc-biofortified flour or control flour for 25 weeks; blood samples and 24-h dietary recalls were collected for mineral status and zinc intake assessment. Plasma concentrations of zinc (PZC), selenium and copper were measured via inductively coupled plasma mass spectrometry and serum ferritin (SF), transferrin receptor, alpha 1-acid glycoprotein and C-reactive protein by immunoassay. Consumption of the zinc-biofortified flour resulted in a moderate increase in intakes of zinc (1.5 mg/day) and iron (1.2 mg/day). This had no significant effect on PZC (control 641.6 ± 95.3 µg/L vs. intervention 643.8 ± 106.2 µg/L; p = 0.455), however there was an overall reduction in the rate of storage iron deficiency (SF < 15 µg/L; control 11.8% vs. 1.0% intervention). Consumption of zinc-biofortified flour increased zinc intake (21%) but was not associated with an increase in PZC. Establishing a sensitive biomarker of zinc status is an ongoing priority.

Biofortification of Three Cultivated Mushroom Species with Three Iron Salts—Potential for a New Iron-Rich Superfood

Mushrooms fortified with iron (Fe) can offer a promising alternative to counter the worldwide deficiency problem. However, the factors that may influence the efficiency of fortification have not yet been fully investigated. The aim of this study was to compare the effects of three Fe forms (FeCl₃ 6H₂O, FeSO₄ 7H₂O, or FeHBED) in three concentrations (5, 10, or 50 mM) for three mushroom species (Pleurotus eryngii, P. ostreatus, or Pholiota nameko) on their chemical composition, phenolic compounds, and organic acid production. The most effective metal accumulation of all the investigated species was for the 50 mM addition. FeCl₃ 6H₂O was the most favorable additive for P. eryngii and P. nameko (up to 145 and 185% Fe more than in the control, respectively) and FeHBED for P. ostreatus (up to 108% Fe more than in control). Additionally, P. nameko showed the highest Fe accumulation among studied species (89.2 ± 7.51 mg kg⁻¹ DW). The creation of phenolic acids was generally inhibited by Fe salt supplementation. However, an increasing effect on phenolic acid concentration was observed for P. ostreatus cultivated at 5 mM FeCl₃ 6H₂O and for P. eryngii cultivated at 5 mM FeCl₃ 6H₂O and 5 mM FeSO₄ 7H₂O. In the case of organic acids, a similar situation was observed. For P. ostreatus, FeSO₄ 7H₂O and FeHBED salts increased the formation of the determined organic acids in fruiting bodies. P. eryngii and P. nameko were characterized by a much lower content of organic acids in the systems supplemented with Fe. Based on the obtained results, we recommend starting fortification by preliminarily indicating which form of the element is preferred for the species of interest for supplementation. It also seems that using an additive concentration of 50 mM or higher is most effective.

Effect of Drought and Low P on Yield and Nutritional Content in Common Bean

Common bean (Phaseolus vulgaris L.) production in the tropics typically occurs in rainfed systems on marginal lands where yields are low, primarily as a consequence of drought and low phosphorus (P) availability in soil. This study aimed to investigate the physiological and chemical responses of 12 bush bean genotypes for adaptation to individual and combined stress factors of drought and low P availability. Water stress and P deficiency, both individually and combined, decreased seed weight and aboveground biomass by ∼80%. Water deficit and P deficiency decreased photosynthesis and stomatal conductance during plant development. Maximum rates of carboxylation, electron transport, and triose phosphate utilization were superior for two common bean genotypes (SEF60 and NCB226) that are better adapted to combined stress conditions of water deficit and low P compared to the commercial check (DOR390). In response to water deficit treatment, carbon isotope fractionation in the leaf tissue decreased at all developmental stages. Within the soluble leaf fraction, combined water deficit and low P, led to significant changes in the concentration of key nutrients and amino acids, whereas no impact was detected in the seed. Our results suggest that common bean genotypes have a degree of resilience in yield development, expressed in traits such as pod harvest index, and conservation of nutritional content in the seed. Further exploration of the chemical and physiological traits identified here will enhance the resilience of common bean production systems in the tropics.

Current Status and Potential of Biofortification to Enhance Crop Nutritional Quality: An Overview

Around 2 billion people are suffering from chronic malnutrition or “hidden hunger”, which is the result of many diseases and disorders, including cognitive degeneration, stunting growth, and mortality. Thus, biofortification of staple food crops enriched with micronutrients is a more sustainable option for providing nutritional supplements and managing malnutrition in a society. Since 2001, when the concept of biofortification came to light, different research activities have been carried out, like the development of target populations, breeding or genetic engineering, and the release of biofortified cultivars, in addition to conducting nutritional efficacy trials and delivery plan development. Although, being a cost-effective intervention, it still faces many challenges, like easy accessibility of biofortified cultivars, stakeholders’ acceptance, and the availability of biofortified germplasm in the public domain, which varies from region to region. Hence, this review is focused on the recent potential, efforts made to crop biofortification, impacts analysis on human health, cost-effectiveness, and future perspectives to further strengthen biofortification programs. Through regular interventions of sustainable techniques and methodologies, biofortification holds huge potential to solve the malnutrition problem through regular interventions of nutrient-enriched staple food options for billions of people globally.

Bioaccessibility of minerals in combinations of biofortified foods with Fe, Zn and vitamin A

Initiatives to improve the nutritional quality of staple foods, such as beans and cassava by bio fortification should be encouraged as an alternative to overcome the deficiencies of iron and vitamin A. The evaluation of the bio accessibility of the minerals in these foods is also important, since the composition of nutrients does not necessarily correspond to the amount absorbed and metabolized in the body. Thus, the present work aims to evaluate the bio accessibility of iron (Fe) and zinc (Zn) in the presence of β-carotene in combinations of bio fortified food sources of Fe and Zn (cowpea cooked with and without maceration: CM/CW, respectively) and β-carotene (cooked cassava and cassava flour: CC/CF, respectively). The mixtures, after cooking, were analyzed for the centesimal composition and minerals, phytates, the percentage of iron and zinc bio accessibility by in vitro method and molar ratio. The mixtures presented significant amounts of proteins, carbohydrates and fibers. The β-carotene content showed no statistical difference in processing methods. The Fe content showed lower levels in the controls with cassava flour and its bio accessibility was also lower for treatment with cassava flour with CM, while for Zn or higher content it was used for treatment CW/CF, differing only from the treatment CW/CC, although their bio accessibilities were not different, except to iron in CMCC treatment. Both the IP6 fraction and the IP5 fraction did not show a significant difference (p > 0.05) between the treatments, it suggests no interference in bio accessibility. A diet rich in iron and vitamin A in adequate amounts with minimal content of absorption inhibitors can be effective in controlling iron deficiency. Bio fortified mixtures must be encouraged in different forms of consumption.

Effect of agricultural diversification on dietary diversity in rural households with children under 5 years of age in Zambia

Micronutrient deficiencies in low-income countries are associated with the monotonous consumption of nutrient-deficient crops, contributing to childhood stunting with far-reaching socioeconomic consequences. To promote nutrition sensitive agriculture, policy makers in such countries have embarked on policy initiatives that encourage agricultural diversification in smallholder farming systems. This paper investigates the link between agricultural diversification and two key indicators of food and nutrition security among children under 5 years in rural Zambia. Data from the 2015 Rural Agricultural Livelihoods Survey and regression models are used to explain household dietary diversity and months of inadequate household food provisioning among 7934 households. Factors associated with the key outcome variables include land cultivated, household size, total livestock units, household head education, households receiving extension information, and use of productivity-enhancing inputs such as fertilizers. Although the results demonstrate that agricultural diversification is positively associated with the household dietary diversity score, the relationship is not statistically significant. Further, the study findings illustrate that agricultural diversity is negatively associated with months of inadequate household food provisioning but that this relationship is also not statistically significant. The implication for policy is that other interventions such as productivity enhancement and behavioral change communication need to be scaled up.

Do Common Beans (Phaseolus vulgaris L.) Promote Good Health in Humans? A Systematic Review and Meta-Analysis of Clinical and Randomized Controlled Trials

The common bean is a nutrient-dense food empirically known to have beneficial effects on human health. Many studies have looked at the effects of "pulses" on different health issues, providing general overviews of the importance of each pulse in health studies. This study systematically reviews and provides meta-analyses of the effect of bean extract as a supplement or whole bean on four health issues (cardiovascular diseases, diabetes mellitus, obesity, and cancers) from a dissection of clinical and randomized controlled trials using human subjects. A digital search in PubMed and Google ScholarTM resulted in 340 articles, with only 23 peer-reviewed articles matching our inclusion criteria. Findings indicated that common beans reduced LDL cholesterol by 19 percent, risk of cardiovascular disease (CVD) by 11 percent, and coronary heart disease (CHD) by 22 percent. Besides this, we noted variances in the literature on cancer findings, with some authors stating it reduced the proliferation of some kinds of tumor cells and reduced the growth of polyps, while others did not specifically examine cancers but the predisposing factors alone. However, diabetes studies indicated that the postprandial glucose level at the peak of 60 min for common bean consumers was low (mean difference = -2.01; 95% CI [-4.6, -0.63]), but the difference between the treated and control was not significant, and there was a high level of heterogeneity among studies (I2 = 98%). Only obesity studies indicated a significantly high level of weight gain among control groups (mean difference = 1.62; 95% CI [0.37, 2.86]). There is a need for additional clinical trials using a standardized measure to indicate the real effect of the common bean on health.

Iron deficiency anaemia in sub-Saharan Africa: a review of current evidence and primary care recommendations for high-risk groups

The epidemiology of iron deficiency anaemia in sub-Saharan Africa differs from that in other parts of the world. The low-quality diets prevalent in this region are a poor source of iron, the population is frequently exposed to infection, and demographic characteristics result in a greater prevalence of people at high risk of iron deficiency anaemia than in other parts of the world. We herein review the causes, disease burden, and consequences of iron deficiency anaemia in the general population in this region, and current policies and interventions for its control. The current debate is dominated by concerns about the safety of iron interventions, namely regarding its effects on malaria and other infectious diseases. However, universal antenatal iron supplementation and delayed cord clamping are safe interventions and stand out for their potential to improve maternal and infant health. Effective infection control is a precondition to safe and efficacious iron interventions in children. Greater emphasis should be given to approaches aiming to reduce iron loss due to helminth infections and menstruation, alongside interventions to increase iron intake. TRANSLATION: For the French translation of the abstract see Supplementary Materials section.

Iron Bioavailability from Multiple Biofortified Foods Using an In Vitro Digestion, Caco-2 Assay for Optimizing a Cyclical Menu for a Randomized Efficacy Trial

BACKGROUND

Inadequate nutritional status contributes to substantial losses in human health and productivity globally. A multiple biofortified food crop trial targeting iron, zinc, and vitamin A deficiencies among young children and their breastfeeding mothers is being conducted in India.

OBJECTIVE

We sought to determine the relative iron bioavailability from biofortified and conventional crops and crop combinations representative of a cyclical menu using crops targeted for inclusion in the feeding trial.

METHODS

Crops were procured from India, cooked, freeze-dried, and analyzed with an established in vitro digestion/Caco-2 iron bioavailability assay using a fixed sample weight. Crop proportions representative of meals planned for the human study were determined and combined such that samples included either all biofortified or all control crops. Crops were analyzed as single crops (n = 4) or crop combinations (n = 7) by variety (biofortified or control) in triplicate. The primary outcome was iron uptake measured by Caco-2 ferritin production normalized to total Caco-2 protein (nanograms of ferritin/milligrams of cell protein) analyzed for effects of crop variety and crop proportion using generalized linear models.

RESULTS

Biofortified pearl millet alone demonstrated higher iron uptake than conventional varieties (5.01 ± 1.66 vs. 2.17 ± 0.96; P = 0.036). Addition of sweet potato or sweet potato + pulse improved iron uptake for all proportions tested in control varieties and select proportions for biofortified varieties (P ≤ 0.05). Two multiple crop combinations demonstrated modestly higher iron uptake from biofortified crops.

CONCLUSIONS

Optimizing total iron delivery should consider matrix effects, processing, and promoters/inhibitors of iron absorption in addition to total iron concentration. Future directions include evaluating recipes as prepared for consumption and comparison against human iron bioavailability studies.

Redefining Bean Iron Biofortification: A Review of the Evidence for Moving to a High Fe Bioavailability Approach

Iron biofortification of the common bean (Phaseolus vulgaris) commenced in earnest ~18 years ago. Based on knowledge at the time, the biofortification approach for beans was simply to breed for increased Fe concentration based on 3 major assumptions: (1) The average bean Fe concentration is ~50 μg/g; (2) Higher Fe concentration results in more bioavailable Fe delivered for absorption; (3) Breeding for high Fe concentration is a trait that can be achieved through traditional breeding and is sustainable once a high Fe bean sample is released to farmers. Current research indicates that the assumptions of the high Fe breeding approach are not met in countries of East Africa, a major focus area of bean Fe biofortification. Thus, there is a need to redefine bean Fe biofortification. For assumption 1, recent research indicates that the average bean Fe concentration in East Africa is 71 μg/g, thus about 20 μg/g higher than the assumed value. For assumption 2, recent studies demonstrate that for beans higher Fe concentration does not always equate to more Fe absorption. Finally, for assumption 3, studies show a strong environment and genotype by environment effect on Fe concentration, thus making it difficult to develop and sustain high Fe concentrations. This paper provides an examination of the available evidence related to the above assumptions, and offers an alternative approach utilizing tools that focus on Fe bioavailability to redefine Fe biofortification of the common bean.

Prevalence and approaches to manage iron deficiency anemia (IDA)

Iron is a vital micronutrient required for growth and development at all stages of human life. Its deficiency is the primary cause of anemia that poses a significant global health problem and challenge for developing countries. Various risks are involved during iron deficiency anemia (IDA), such as premature delivery, low birth weight, etc. Further, it affects children's cognitive functioning, delays motor development, hampers physical performance and quality of life. It also speeds up the morbidity and mortality rate among women. The major reasons accountable are elevated iron demand in diet, socio-economic status, and disease condition. Various strategies have been adopted to reduce the IDA occurrence, such as iron supplementation, iron fortificants salts, agronomic practices, dietary diversification, biofortification, disease control measures, and nutritional education. Usually, the staple food groups for fortification are considered, but the selection of food fortificants and their combination must be safe for the consumers and not alter the finished product's stability and acceptability. Genetically modified breeding practices also increase the micronutrient levels of cereal crops. Therefore, multiple strategies could be relied on to combat IDA.

The global challenge of hidden hunger: perspectives from the field

The aim of this review paper is to explore the strategies employed to tackle micronutrient deficiencies with illustrations from field-based experience. Hidden hunger is the presence of multiple micronutrient deficiencies (particularly iron, zinc, iodine and vitamin A), which can occur without a deficit in energy intake as a result of consuming an energy-dense, but nutrient-poor diet. It is estimated that it affects more than two billion people worldwide, particularly in low- and middle-income countries where there is a reliance on low-cost food staples and where the diversity of the diet is limited. Finding a way to improve the nutritional quality of diets for the poorest people is central to meeting the UN sustainable development goals particularly sustainable development goal 2: end hunger, achieve food security and improved nutrition and promote sustainable agriculture. As we pass the midpoint of the UN's Decade for Action on Nutrition, it is timely to reflect on progress towards achieving sustainable development goal 2 and the strategies to reduce hidden hunger. Many low- and middle-income countries are falling behind national nutrition targets, and this has been exacerbated by the COVID-19 pandemic as well as other recent shocks to the global food system which have disproportionately impacted the world's most vulnerable communities. Addressing inequalities within the food system must be central to developing a sustainable, cost-effective strategy for improving food quality that delivers benefit to the seldom heard and marginalised communities.

Review of the Micronutrient Situation in Rwanda

BACKGROUND

Rwanda's commitment to reducing malnutrition is evident in their multisectoral nutrition policy and wide array of nutrition partners. However, the prevalence of micronutrient deficiencies and the suitability of current strategies to address existing deficiencies is unclear.

OBJECTIVE

To review the available evidence related to the prevalence of micronutrient deficiencies across the life cycle and strategies in place to address them.

METHODS

We reviewed scientific and grey literature on nutritional problems in Rwanda, emphasizing micronutrient deficiencies and anemia, and current strategies to address micronutrient malnutrition.

RESULTS

Overall, there is scant evidence related to the types and prevalence of micronutrient deficiencies among populations across the life cycle in Rwanda. Existing evidence is primarily limited to outdated or small regional surveys focusing on iron or vitamin A among women and young children. Surveys have assessed the prevalence of anemia and indicate that anemia is very high among young children and moderately high among other age-groups. However, there are limited data on the context-specific causes of anemia in Rwanda across population groups. Current nutrition strategies mainly target women and young children and are primarily designed to reduce vitamin A deficiency and/or anemia caused by micronutrient deficiencies.

CONCLUSIONS

Rwanda has many nutrition programs in place that address micronutrient deficiencies in young children and a few for women of reproductive age. However, gaps exist in knowledge of the extent of different types of micronutrient deficiencies among all populations across the life cycle and whether the delivery of nutrients through current programs is meeting actual needs.

Pulse Probiotic Superfood as Iron Status Improvement Agent in Active Women-A Review

Active women or women of reproductive age (15–49 years old) have a high risk of suffering from anaemia. Anaemia is not solely caused by iron deficiency, however, the approaches to improve iron status in both cases are greatly related. Improving the iron status of active women can be done by dietary intervention with functional food. This review aims to provide insights about the functional food role to increase iron absorption in active women and the potency of pulse probiotic superfood development in dry matrices. Results showed that the beneficial effect of iron status is significantly improved by the synergic work between probiotic and prebiotic. Furthermore, chickpeas and lentils are good sources of prebiotic and the consumption of pulses are related with 21st century people’s intention to eat healthy food. There are wide possibilities to develop functional food products incorporated with probiotics to improve iron status in active woman.

Gene atlas of iron-containing proteins in Arabidopsis thaliana

Iron (Fe) is an essential element for the development and physiology of plants, owing to its presence in numerous proteins involved in central biological processes. Here, we established an exhaustive, manually curated inventory of genes encoding Fe-containing proteins in Arabidopsis thaliana, and summarized their subcellular localization, spatiotemporal expression and evolutionary age. We have currently identified 1068 genes encoding potential Fe-containing proteins, including 204 iron-sulfur (Fe-S) proteins, 446 haem proteins and 330 non-Fe-S/non-haem Fe proteins (updates of this atlas are available at https://conf.arabidopsis.org/display/COM/Atlas+of+Fe+containing+proteins). A fourth class, containing 88 genes for which iron binding is uncertain, is indexed as 'unclear'. The proteins are distributed in diverse subcellular compartments with strong differences per category. Interestingly, analysis of the gene age index showed that most genes were acquired early in plant evolutionary history and have progressively gained regulatory elements, to support the complex organ-specific and development-specific functions necessitated by the emergence of terrestrial plants. With this gene atlas, we provide a valuable and updateable tool for the research community that supports the characterization of the molecular actors and mechanisms important for Fe metabolism in plants. This will also help in selecting relevant targets for breeding or biotechnological approaches aiming at Fe biofortification in crops.

Local Foods Can Increase Adequacy of Nutrients Other than Iron in Young Urban Egyptian Women: Results from Diet Modeling Analyses

BACKGROUND

Nutrition transition and recent changes in lifestyle in Middle Eastern countries have resulted in the double burden of malnutrition. In Egypt, 88% of urban women are overweight or obese and 50% are iron deficient. Their energy, sugar, and sodium intakes are excessive, while intakes of iron, vitamin D, and folate are insufficient.

OBJECTIVE

This study aimed to formulate dietary advice based on locally consumed and affordable foods and determine the need for fortified products to meet the nutrient requirements of urban Egyptian women.

METHODS

Food intakes were assessed using a 4-d food diary collected from 130 urban Egyptian women aged 19-30 y. Food prices were collected from modern and traditional markets to calculate diet cost. Population-based linear and goal programming analyses (Optifood tool) were used to identify "limiting nutrients" and to assess whether locally consumed foods (i.e., consumed by >5% of women) could theoretically improve nutrient adequacy at an affordable cost (i.e., less than or equal to the mean diet cost), while meeting recommendations for SFAs, sugars, and sodium. The potential of hypothetical fortified foods for improving intakes of micronutrients was also assessed.

RESULTS

Iron was the most limiting nutrient. Daily consumption of fruits, vegetables, milk or yogurt, meat/fish/eggs, and tahini (sesame paste) were likely to improve nutrient adequacy for 11 out of 12 micronutrients modeled. Among fortified foods tested, iron-fortified rice, milk, water, bread, or yogurt increased the minimized iron content of the modeled diet from 40% to >60% of the iron recommendation.

CONCLUSIONS

A set of dietary advice based on locally consumed foods, if put into practice, can theoretically meet requirements for most nutrients, except for iron for which adequacy is harder to achieve without fortified products. The acceptability of the dietary changes modeled needs evaluation before promoting them to young Egyptian women.

Effectiveness of Food Fortification in Improving Nutritional Status of Mothers and Children in Indonesia

Food fortification programs have been conducted in several countries to overcome micronutrient deficiency and related problems with various degrees of effectiveness. Available information regarding the success of food fortification programs in some developing countries, including Indonesia, is still limited. Thus, this study conducts a systematic review of the effects of food fortification of mothers and children using biochemical and anthropometric measures focusing on linear growth. Three databases were used in the literature search, namely PubMed, Science Direct and Google Scholar. Fifteen articles were included for analysis from 517 studies found consisting of Indonesian and English articles published from 2000 to June 2020. Fortification of iron, vitamin A, and iodine can increase the level of hemoglobin, serum ferritin, and serum retinol and median urine iodine excretion, especially in toddlers and schoolchildren. However, multinutrient fortification interventions were associated with various effects on hemoglobin, serum ferritin, and serum retinol but a positive association was found with linear growth indicators in the form of body length for age. The effectiveness of food fortification in reducing the prevalence of stunting still needs more and stronger evidence through studies with large sample size and longer duration.

Effects of Dose and Duration of Zinc Interventions on Risk Factors for Type 2 Diabetes and Cardiovascular Disease: A Systematic Review and Meta-Analysis

No meta-analysis has examined the effect of dose and duration of zinc interventions on their impact on risk factors for type 2 diabetes (T2D) or cardiovascular disease (CVD). This study aimed first to compare the effects of zinc interventions dichotomized as low versus high dose (<25 mg/d and ≥25 mg/d, respectively) and short versus long duration (<12 wk and ≥12 wk, respectively) on risk factors for T2D and CVD. Second, it discusses the results from the low-dose and long-duration meta-analyses as a foundation for understanding what impact a zinc-biofortification intervention could have on these risk factors. The PubMed and Cochrane Review databases were searched through January 2020 for full-text, human studies providing zinc supplements (alone) at doses ≤75 mg/d and a placebo. Data on study and sample characteristics and several T2D and CVD risk factors were extracted. There were 1042 and 974 participants receiving zinc and placebo, respectively, from 27 studies. Low-dose zinc supplementation (<25 mg/d) significantly benefited fasting blood glucose, insulin resistance, triglycerides, total cholesterol, and LDL cholesterol. High-dose zinc supplementation (≥25 mg/d) benefited glycated hemoglobin and insulin resistance. Short-duration interventions (<12 wk) benefited fasting blood glucose, insulin resistance, and triglycerides, while long-duration studies (≥12 wk) benefited fasting blood glucose, triglycerides, and total and LDL cholesterol. Effect sizes for low-dose and long-duration interventions were of equal or greater magnitude to those from high-dose or short-duration interventions. Low-dose and long-duration zinc supplementation each improved more risk factors for T2D and CVD than high-dose and short-duration interventions, respectively. It is currently unknown whether low doses of zinc delivered over long durations via a biofortified crop would similarly impact these risk factors. However, this review suggests that low-dose, long-duration zinc intake from supplements, and potentially biofortification, can benefit risk factors for T2D and CVD.

Expanding information on the bioaccessibility and bioavailability of iron and zinc in biofortified cowpea seeds

This work presents new findings on the nutritional quality of recently introduced biofortified and non-biofortified cowpea cultivars as well as some common beans. ICP-MS was used for the measurements. Biofortified cowpea cultivars showed high levels of Fe and Zn, greater than 60 and 40 mg kg^-1 dry weight, respectively. The in vitro digestion protocol enabled simultaneous evaluation of bioaccessibility and bioavailability. Fe levels in cowpea cultivars were ca. 2.5-fold higher than in common beans. Cowpea seeds also had higher Zn levels, reaching 50.1% bioaccessibility and 44.2% bioavailability. Cooking improved the availability of micronutrients in bean seeds. The cooked biofortified Aracê cowpea showed a high Zn bioavailability above 60%. Consumption of 50 g of Aracê would contribute 27% and 48% of the Fe and Zn DRI for 1-3-year-old children. The new cowpea cultivars biofortified are a potential vehicle for improving the Fe and Zn status in groups in which the micronutrient deficiency is prevalent.

Effects of Iron and Zinc Biofortified Foods on Gut Microbiota In Vivo (Gallus gallus): A Systematic Review

Dietary iron and zinc deficiencies are a global health concern. Bacteria that colonize the gastrointestinal tract depend on minerals to maintain their activities; thus, recent evidence suggests that biofortified foods can modulate the host's beneficial bacterial taxa. The current review analyzed the research data that linked between iron and zinc biofortified foods and gut microbiota modulation. The data analysis was based on the PRISMA guidelines and the data search was performed at PubMed, Web of Science, Science Direct, and Scopus databases for experimental studies published from January 2010 until December 2020. The five selected studies were conducted in an experimental in vivo model (Gallus gallus). The identified and discussed research showed positive effects of biofortified foods on the composition and function of the gut microbiota. Further, an increase in short chain fatty acids producing bacterial populations as Lactobacillus and Ruminococcus, and a decrease in potentially pathogenic bacteria as Streptococcus, Escherichia, and Enterobacter was identified due to the consumption of biofortified foods. In conclusion, biofortified foods may contribute to improved gut health without increasing the colonization of pathogenic bacteria. The dietary inclusion of approximately 50% of iron/zinc biofortified foods has a significant beneficial effect on the gut microbiota. Additional studies in humans and animal models are warranted to further establish the suggested effects on the intestinal microbiome. PROSPERO (CRD42020184221).

Iron

Iron deficiency anemia affects approximately one-third of the world's population, and about half the cases are due to iron deficiency. The latest research on iron metabolism published in original articles and systematic reviews is described, and references to recent reviews provided. The topics include dietary sources and bioavailability, iron homeostasis, functions of iron in the body, and biomarkers of status. The consequences of iron deficiency and excess are discussed, with particular focus on vulnerable populations such as pregnant women, infants and the elderly. The newest dietary recommendations, including dietary reference values and food based dietary guidelines, are briefly summarized, followed by the latest developments in food fortification and iron supplementation.

Genome-Wide Association Studies of Mineral Content in Common Bean

Micronutrient malnutrition is one of the main public health problems in many parts of the world. This problem raises the attention of all valuable sources of micronutrients for the human diet, such as common bean (Phaseolus vulgaris L.). In this research, a panel of 174 accessions representing Croatian common bean landraces was phenotyped for seed content of eight nutrients (N, P, K, Ca, Mg, Fe, Zn, and Mn), and genotyped using 6,311 high-quality DArTseq-derived SNP markers. A genome-wide association study (GWAS) was then performed to identify new genetic sources for improving seed mineral content. Twenty-two quantitative trait nucleotides (QTN) associated with seed nitrogen content were discovered on chromosomes Pv01, Pv02, Pv03, Pv05, Pv07, Pv08, and Pv10. Five QTNs were associated with seed phosphorus content, four on chromosome Pv07, and one on Pv08. A single significant QTN was found for seed calcium content on chromosome Pv09 and for seed magnesium content on Pv08. Finally, two QTNs associated with seed zinc content were identified on Pv06 while no QTNs were found to be associated with seed potassium, iron, or manganese content. Our results demonstrate the utility of GWAS for understanding the genetic architecture of seed nutritional traits in common bean and have utility for future enrichment of seed with macro- and micronutrients through genomics-assisted breeding.