Projecting the contribution of pro-vitamin A maize biofortification and other nutrition interventions to the nutritional adequacy and cost of diets in rural Zimbabwe

BACKGROUND

Evidence of the effectiveness of biofortified maize with higher pro-vitamin A (PVA) to address vitamin A deficiency in rural Africa remains scant.

OBJECTIVES

This study projects the impact of adopting PVA maize for a diversity of households in an area typical of rural Zimbabwe, and models the cost and composition of diets adequate in vitamin A.

METHODS

Household-level weighed food records were generated from 30 rural households during a week in April and November 2021. Weekly household intakes were calculated, as well as indicative costs of diets using data from market surveys. The impact of PVA maize adoption was modelled assuming all maize products contained observed vitamin A concentrations. The composition and cost of the least expensive indicative diets adequate in vitamin A were calculated using linear programming.

RESULTS

Very few households would reach adequate intake of vitamin A with the consumption of PVA maize. However, from a current situation of 33%, 50-70% of households were projected to reach at least 50% of their requirements (the target of PVA), even with the modest vitamin A concentrations achieved on-farm (mean of 28.3 μg RAE per 100 g). This proportion would increase if higher concentrations recorded on-station were achieved. The estimated daily costs of current diets (mean ± SD) were USD 1.43 ± 0.59 in the wet season and USD 0.96 ± 0.40 in the dry season. By comparison, optimisation models suggest that diets adequate in vitamin A could be achieved at daily costs of USD 0.97 and USD 0.79 in the wet and dry seasons, respectively.

CONCLUSIONS

The adoption of PVA maize would bring a substantial improvement in vitamin A intake in rural Zimbabwe but should be combined with other interventions (e.g., diet diversification) to fully address vitamin A deficiency.

Mineral supplementation for very preterm infants fed fortified human milk

OBJECTIVES

The safety and feasibility of human milk fortification with bovine colostrum (BC) were investigated in very preterm infants (FortiColos trial, NCT03537365). The BC product contained lower calcium, phosphate, and iron levels compared to the conventional fortifier (CF). We tested whether fortification with BC plus extra phosphate was sufficient to support the infants' mineral status assessed by blood biochemistry.

METHODS

In a randomised controlled trial (FortiColos, NCT03537365), mineral status was compared after fortification with BC versus CF. Blood calcium, phosphate, and haemoglobin were determined before and up to 3 weeks after the start of fortification (at the mean age of 8-9 days). The maximum supplemental doses of calcium, phosphate, and iron given were retrieved from patient medical records. Results were adjusted for gestational age, birth weight, and enteral nutrition with the mother's own milk and/or donor human milk.

RESULTS

Blood values of calcium, phosphate, and haemoglobin were similar between groups. Infants in both groups required supplementation with calcium and phosphate, but infants fed BC required higher maximum doses of phosphate and calcium (p < 0.05) to maintain acceptable blood values. Regardless of fortification groups, the most immature (<29 weeks of gestation) and small for gestational age infants showed a higher risk for requiring additional phosphate (OR: 3.9, p < 0.001; OR: 2.14, p = 0.07, respectively).

CONCLUSIONS

The use of BC as a fortifier for human milk requires additional phosphate and calcium relative to a CF. Regardless of the fortification product, the most immature and small infants require additional mineral supplementation.

Development of fiber-enriched muffins using pomegranate peel powder and its effect on physico-chemical properties and shelf life of the muffins

BACKGROUND

Pomegranate peel is a by-product from the pomegranate processing industries and is a rich source of dietary fibers and bioactive compounds. It has good antioxidant and antimicrobial properties. In the present study, the effects of substitution of refined wheat flour with pomegranate peel powder (PPP) at a rate of 2%, 4%, 6%, 8% and 10% on the physico-chemical and sensorial properties as well as on the oxidative and microbial stability of muffins were investigated.

RESULTS

A significant reduction in specific volume (1.99 to 1.57 cm3  g-1 ), weight loss (11.73 to 10.14 g 100 g-1 ) and an increase in crumb hardness (633.06 to 2311.5 g) of muffins were observed on addition of PPP. Moreover, the nutritional value was improved by a significant increase in the fiber content (4.39 to 10.66%), total phenols (0.443 to 48.53 mg GAE 100 g-1 ), antioxidant activity (75.94% to 99.36%), calcium (200.33 to 294.33 mg 100 g-1 ), potassium (227.33 to 425.33 mg 100 g-1 ) and magnesium (96.33 to 288.33 mg 100 g-1 ). The pasting and rheological properties of muffin batter showed a significant decrease in the final and peak viscosity, as well as increase in storage, loss and complex modulus. The muffin samples were organoleptically acceptable up to a level of 8% PPP. Free fatty acid content, peroxide value and microbial count of the muffin with 8% PPP were significantly lower compared to the control sample and more oxidatively and microbially stable for a storage period of 21 and 28 days at ambient and refrigerated temperatures, respectively.

CONCLUSION

The present study provides the opportunity to use PPP as functional ingredients and natural preservative in the preparation of muffins. © 2023 Society of Chemical Industry.

Consumption of Discretionary Salt and Salt from Bouillon among Households, Women, and Young Children in Northern Region, Ghana: A Mixed-Methods Study with the Condiment Micronutrient Innovation Trial (CoMIT) Project

Background

Information on salt consumption patterns is needed to inform the need for and design of salt reduction strategies.

Objectives

In northern Ghana, this study aimed to estimate household consumption of salt, including salt from bouillon, and compare (estimated) women and children's salt intake to global recommendations; to estimate the proportion of salt consumed from bouillon; and to identify factors, including knowledge, attitudes, and practices, associated with household salt consumption.

Methods

Employing mixed-methods methodology, we conducted a pilot survey (n = 369 households enrolled) and focus group discussions (FGDs; n = 20) in Tolon and Kumbungu districts (14 urban, 14 rural clusters) (clinicaltrials.gov registry: NCT04632771). Households reported purchases of discretionary salt (DS, "table salt") and bouillon cubes. DS and total salt (TS; DS+salt from bouillon) consumption for women (15-49 y) and children (2-5 y) were estimated using the Adult Male Equivalent method and compared with global recommendations (<5 g/d women; <3.75 g/d children). Women's salt intake was also predicted from urinary sodium excretion (INTERSALT equation). Associations between DS and TS consumption, as well as household and women's characteristics, were tested with minimally adjusted and multivariable linear mixed-effects models. Qualitative FGD themes were generated using the Framework Method.

Results

From household purchase data, estimated TS consumption exceeded global recommendations for 44% of children [median: 2.9 (IQR: 1.9, 5.2) g/d] and 60% of women [6.0 (4.0, 10.2) g/d]; 35% of children and 50% of women exceeded recommendations from DS alone. Bouillon contributed <25% of households' TS consumption. Few characteristics were associated with DS or TS consumption. Salient qualitative themes that shaped salt consumption behaviors included salt's ubiquity as a seasoning, key household members' influence on food procurement and preparation, and perceptions about health.

Conclusions

Purchase data suggest salt consumption among women and children exceeds recommendations, even when excluding salt from bouillon; food prepared outside the home likely further contributes. Salt reduction interventions may be warranted in this context.

Low-dose daily folic acid (400 μg) supplementation does not affect regulation of folate transporters found present throughout the terminal ileum and colon of humans: a randomized clinical trial

BACKGROUND

Folic acid supplementation during the periconceptional period reduces the risk of neural tube defects in infants, but concern over chronic folic acid exposure remains. An improved understanding of folate absorption may clarify potential risks. Folate transporters have been characterized in the small intestine, but less so in the colon of healthy, free-living humans. The impact of folic acid fortification or supplementation on regulation of these transporters along the intestinal tract is unknown.

OBJECTIVE

The objective was to characterize expression of folate transporters/receptor (FT/R) and folate hydrolase, glutamate carboxypeptidase II (GCPII), from the terminal ileum and throughout the colon of adults and assess the impact of supplemental folic acid.

METHODS

In this 16-wk open-labeled randomized clinical trial, adults consumed a low folic acid-containing diet, a folate-free multivitamin, and either a 400 μg folic acid supplement or no folic acid supplement. Dietary intakes and blood were assessed at baseline, 8 wk, and 16 wk (time of colonoscopy). Messenger RNA (mRNA) expression and protein expression of FT/R and GCPII were assessed in the terminal ileum, cecum, and ascending and descending colon.

RESULTS

Among 24 randomly assigned subjects, no differences in dietary folate intake or blood folate were observed at baseline. Mean ± SD red blood cell folate at 16 wk was 1765 ± 426 and 911 ± 242 nmol/L in the 400 and 0 μg folic acid group, respectively (P < 0.0001). Reduced folate carrier, proton-coupled folate transporter, and folate-receptor alpha expression were detected in the terminal ileum and colon, as were efflux transporters of breast cancer resistance protein and multidrug resistance protein-3. Other than a higher mRNA expression of FR-alpha and GCPII in the 400 μg supplement group in the ascending colon, no treatment differences were observed (P < 0.02).

CONCLUSIONS

Folate transporters are present throughout the terminal ileum and colon; there is little evidence that a low dose of folic acid supplementation affects colonic absorption. This trial was registered at clinicaltrials.gov as NCT03421483.

Can a Fraction of Flour and Sugar Be Replaced with Fruit By-Product Extracts in a Gluten-Free and Vegan Cookie Recipe?

Certain food by-products, including not-good-for-sale apples and pomegranate peels, are rich in bioactive molecules that can be collected and reused in food formulations. Their extracts, rich in pectin and antioxidant compounds, were obtained using hydrodynamic cavitation (HC), a green, efficient, and scalable extraction technique. The extracts were chemically and physically characterized and used in gluten-free and vegan cookie formulations to replace part of the flour and sugar to study whether they can mimic the role of these ingredients. The amount of flour + sugar removed and replaced with extracts was 5% and 10% of the total. Physical (dimensions, color, hardness, moisture content, water activity), chemical (total phenolic content, DPPH radical-scavenging activity), and sensory characteristics of cookie samples were studied. Cookies supplemented with the apple extract were endowed with similar or better characteristics compared to control cookies: high spread ratio, similar color, and similar sensory characteristics. In contrast, the pomegranate peel extract enriched the cookies in antioxidant molecules but significantly changed their physical and sensory characteristics: high hardness value, different color, and a bitter and astringent taste. HC emerged as a feasible technique to enable the biofortification of consumer products at a real scale with extracts from agri-food by-products.

Enhancement of nutritional quality and shelf life of fish products (powder & chapatti) via fortifying with orange-fleshed sweet potato

Despite its high protein, fat, and mineral contents, fish contains trace amounts of carbohydrates and vitamins, notably vitamin A. The perishable nature of fresh fish makes it challenging to store for a prolonged time, necessitating the use of additives to enhance its shelf life, nutritional, and other quality aspects. Sweet potatoes are the preferred option to blend with fish due to their cost and abundance. This study aims to prepare fortified fish powder and make food products (chapatti) using it. Fish powder and sweet potato powder were prepared by drying them in an oven at 60°C and 45°C, respectively. The two dried samples were then ground and mixed in various ratios, followed by analyzing their nutritional and other parameters using standard methods. Vitamin A and beta-carotene levels were analyzed using HPLC and UV-Vis spectroscopy techniques, respectively. The findings indicated that the outcomes displayed enhanced nutrition and extended storage capacity. The amount of beta-carotene (876.12 ± 14.76 to 3182.4 ± 123.1 μg/100 g) and carbohydrates (4.49 ± 1.02 to 52.31 ± 0.21) increased. The packed fortified flour is safe for human consumption for up to 90 days, as per the International Commission for Microbiological Specifications for Foods. The chapatti made from fortified flour was also deemed acceptable by the panelists.

Fortification of dough with moringa, coriander, and amaranth improves the nutritional composition, health-benefiting properties, and sensory attributes of Nigerian wheat bread

Consumption of bread can be associated with some health issues, which can be improved by fortifying it with plants that are good sources of nutrients and bioactive compounds. This study investigated the effects of fortifying bread with 3 leafy vegetables on the quality of Nigerian wheat bread. Leave powders of coriander, moringa, and amaranths were added to wheat dough at 0% (control), 1%, 3%, 5%, or 7%, and the blends obtained were used to bake vegetable breads, which were then analyzed for proximate, minerals, total phenolics, antioxidant activity, reducing sugars, glycemic index, and sensory evaluation. Results showed that vegetable fortification significantly increased bread ash (from 0.84% in control up to 1.93% in fortified bread), crude fiber (from 1.68% to 3.29%), and nutritionally important minerals Ca, Mg, P, Fe, and Zn (up to 5.2-fold, 5.1-fold, 18.1-fold, 4.1-fold, and 14.0-fold, respectively); it reduced carbohydrates (from 65.65% down to 43.16%), crude lipids (from 2.25% down to 0.44%), and caloric value (from 1239.65 down to 1125.19 kJ/100 g), with little or no effect on proteins and moisture content. The fortification also improved the bioactive properties of the bread, as evidenced by a considerably higher phenolic content (from 0.40 up to 13.95 mg/100 g GAE) and increased antioxidant activities. There was a significant 1.1-to 3.4-fold decrease in the reducing sugars of composite breads with 5% and 7% vegetable powder, and the selected bread formulation with Moringa 7% lowered the glycemic index of rats by 3.5-fold. Fortification did not generally affect the appearance and taste of the breads but decreased other sensory parameters and overall acceptability; the bread sample enriched with 1% amaranth received the highest general acceptance. In conclusion, fortifying wheat bread with the 3 vegetables improves its nutritional quality and can be recommended as a new pathway for the development of more nutritious and healthy bread.

Characterization of Băbească Neagră Grape Pomace and Incorporation into Jelly Candy: Evaluation of Phytochemical, Sensory, and Textural Properties

The influence of particle size intervals (<125 μm, ≥125-<200 μm, and ≥200-<300 μm) of grape pomace (Vitis vinifera var. Băbească Neagră) was analyzed in terms of the proximate composition, functional properties, and physicochemical parameters. The aim was to study the effect of the formulation variables (extract from grape pomace with different particle size intervals and gelatin doses-7, 8.5, and 10 g) on the mechanical properties (hardness, cohesiveness, adhesiveness, springiness, and gumminess), color, and sensorial, microbiological, and phytochemical parameters. The jelly candy formulated with grape pomace extract (<125 μm) and 7 g of gelatin showed the highest total phenolic content (156 mg GAE/g) and antioxidant activity (65.8% inhibition), while grape pomace jellies with a particle size of ≥125-<200 μm and different concentration of gelatin presented the greatest sensory acceptance in terms of sweetness, taste, odor, elasticity, color, and overall acceptability of the resulting jelly. The concluding observation was supported by the microbiological analysis, which also showed that there is no growth in jelly samples except the jelly candies prepared with a ≥200-<300 μm particle size interval of grape pomace extract.

How does Canada's new vitamin D fortification policy affect the high prevalence of inadequate intake of the vitamin?

TAKE-HOME MESSAGE

The 2023 vitamin D fortification policy may significantly reduce inadequacies in non-supplement consumers; however, the policy is far from eliminating population-level vitamin D inadequacies and supplementation should still be encouraged.

Health Benefits of Bread Fortification: A Systematic Review of Clinical Trials according to the PRISMA Statement

Bread is among the most common foods for the world's population. Therefore, it can be fortified to eliminate deficiencies of nutrients or be a carrier of other substances with a nutritional or physiological effect, bringing health benefits to its consumers, thus impacting sustainable health. This systematic review aimed to analyze clinical studies on the effects of bread fortification on human health. The study followed the PRISMA guidelines for transparency and utilized databases Scopus, Embase, PubMed, and Web of Science to search clinical trials focused on the effects of bread fortification on human health over the entire last decade. The methodological quality of selected studies was assessed using the Jadad scale. As a result, twenty-six studies meet the inclusion criteria. Clinical trials have shown health benefits from consuming bread fortified with vitamins (B9, C, D2, D3), minerals (K, P, Ca, Mg, Fe, Zn, Cr, Se), fiber, proteins, and polyphenolic compounds. Conclusions reveal that mandatory fortification aligns with the sustainable development goals. Thus, collaborative partnerships are essential for successful implementation and accessibility, fostering public health advances and progress developing into sustainable health.

An Innovative Method for the Production of Yoghurt Fortified with Walnut Oil Nanocapsules and Characteristics of Functional Properties in Relation to Conventional Yoghurts

Polyunsaturated fatty acids (PUFAs) are crucial nutrients involved in a plethora of metabolic and physiological processes. PUFAs have been extensively researched for their effects on human nutrition and health. The high demand for these fatty acids offers the possibility of adding vegetable oils to dairy products such as yoghurt. The aim of this study was to produce nano/microcapsules comprising walnut oil through exclusively natural ingredients utilised in yoghurt manufacturing. Additionally, the study tested yoghurt supplemented with PUFAs using the acquired nano/microcapsules. Chemical and physiochemical properties, microbiological analysis, rheological measurements, texture analysis, scanning electron microscope (SEM) analysis, ATR-FTIR spectroscopy, and sensory and fatty acids profile analysis were performed. A physico-chemical analysis highlighted the impact of oil addition on fat and dry matter concentration, revealing an increased quantity of said components in yoghurt after oil addition. Based on the identified parameters for potential and active acidity in the yoghurts, normal lactic fermentation was observed. Furthermore, the addition of oil was found to have an impact on the pH of the yoghurt. Microbiological analysis indicated that the incorporation of nano-encapsulated walnut oil did not have any notable effect on the abundance of determined microorganisms in the yoghurt. However, it was observed that the number of Lactobacillus delbrueckii ssp. bulgaricus increased as a result of storage. The incorporation of enclosed oil in yoghurt resulted in negligible alterations in rheological and sensory characteristics when compared with the plain variant. The addition of oil had an effect on most of the analysed fatty acids. Fortified yoghurt shows a more favourable proportion of the fatty acid groups tested (SFA, MUFA, and PUFA) and lower values of fat quality factors (AI and TI).

The potential use of Indian rice flour or husk in fortification of pan bread: assessing bread's quality using sensory, physicochemical, and chemometric methods

Hassawi rice is an Indica variety cultivated in Saudi Arabia with a higher nutritional value than the commercial Basmati rice varieties. The present study has investigated the feasibility of combining Hassawi rice flour (HRF) or husk (HRHF), an abundant byproduct, with wheat flour to produce nutritious economical pan bread. To achieve this aim, the physicochemical properties of HRF and HRHF were assessed using techniques such as UPLC-tandem MS, ICP-OES, and colorimeter. The proximate composition (moisture, crude fiber, and ash) and mineral contents of HRHF are significantly (p < 0.05) higher than HRF. On the other hand, the compounds p-coumaric acid, vanillic acid, γ- and δ-tocotrienols, and γ-oryzanol were unique to HRF. We further determined the changes in sensory, technological, and physicochemical properties of wheat flour bread substituted with 5%, 10%, and 15% of HRF or HRHF. The rheological tests showed that the addition of HRF and HRHF increased dough development and stability time. Further, substituting wheat flour for HRF and HRHF at levels higher than 10% affected sensory attributes, such as color, taste, odor, flavor, and appearance. These changes, however, were not always at a significant level. The causes of the differences in properties between control and fortified bread samples were investigated by chemometric methods. Samples of bread + HRF at 5 and 10% had comparable overall profiles to the control. On the other hand, bread + HRHF samples proved to retain higher concentrations of bioactive molecules compared to the control bread. Our findings shed light on the possible use of rice husk fibers in baking goods, notably pan bread. Furthermore, by integrating rice husk fibers into baked goods, we may boost their health benefits while also contributing to the long-term use of agricultural waste.

Vitamin C fortification: need and recent trends in encapsulation technologies

The multifaceted role of vitamin C in human health intrudes several biochemical functions that are but not limited to antioxidant activity, homoeostasis, amino acid synthesis, collagen synthesis, osteogenesis, neurotransmitter production and several yet to be explored functions. In absence of an innate biosynthetic pathway, humans are obligated to attain vitamin C from dietary sources to maintain its optimal serum level (28 μmol/L). However, a significant amount of naturally occurring vitamin C may deteriorate due to food processing, storage and distribution before reaching to the human gastrointestinal tract, thus limiting or mitigating its disease combating activity. Literature acknowledges the growing prevalence of vitamin C deficiency across the globe irrespective of geographic, economic and population variations. Several tools have been tested to address vitamin C deficiency, which are primarily diet diversification, biofortification, supplementation and food fortification. These strategies inherit their own advantages and limitations. Opportunely, nanotechnology promises an array of delivery systems providing encapsulation, protection and delivery of susceptible compounds against environmental factors. Lack of clear understanding of the suitability of the delivery system for vitamin C encapsulation and fortification; growing prevalence of its deficiency, it is a need of the hour to develop and design vitamin C fortified food ensuring homogeneous distribution, improved stability and enhanced bioavailability. This article is intended to review the importance of vitamin C in human health, its recommended daily allowance, its dietary sources, factors donating to its stability and degradation. The emphasis also given to review the strategies adopted to address vitamin c deficiency, delivery systems adopted for vitamin C encapsulation and fortification.

Global Coverage of Mandatory Large-Scale Food Fortification Programs: A Systematic Review and Meta-Analysis

Food fortification with micronutrients is widely implemented to reduce micronutrient deficiencies and related outcomes. Although many factors affect the success of fortification programs, high population coverage is needed to have a public health impact. We aimed to provide recent global coverage estimates of salt, wheat flour, vegetable oil, maize flour, rice, and sugar among countries with mandatory fortification legislation. The indicators were the proportion of households consuming the: food, fortifiable food (that is, industrially processed), fortified food (to any extent), and adequately fortified food (according to national or international standards). We estimated the number of individuals reached with fortified foods. We systematically retrieved and reviewed all applicable evidence from: published reports and articles from January 2010 to August 2021, survey lists/databases from key organizations, and reports/literature received from key informants. We analyzed data with R statistical package using random-effects meta-analysis models. An estimated 94.4% of households consumed salt, 78.4% consumed fortified salt (4.2 billion people), and 48.6% consumed adequately fortified salt in 64, 84, and 31 countries, respectively. Additionally, 77.4% of households consumed wheat flour, 61.6% consumed fortifiable wheat flour, and 47.1% consumed fortified wheat flour (66.2 million people) in 15, 8, and 10 countries, respectively, and 87.0% consumed vegetable oil, 86.7% consumed fortifiable oil, and 40.1% consumed fortified oil (123.9 million people) in 10, 7, and 5 countries, respectively. Data on adequately fortified wheat flour and vegetable oil and coverage indicators for maize flour, rice, and sugar were limited. There are major data gaps on fortification coverage for most foods except salt. All countries with mandatory fortification programs should generate and use more coverage data to assess program performance and adjust programs as needed to realize their potential to reduce micronutrient deficiencies (PROSPERO CRD42021269364).

Nutritional Description of Processed Foods with Fibre-Related Nutrition Claims in Spain: The BADALI Project

Fibre is one of the most beneficial nutrients for health and is very frequently used in nutrition claims (NCs) to promote foods. These claims may lead consumers to believe that products bearing them are healthy and/or healthier than those without them. The main objective of this work is to address this belief. This is the first exhaustive analysis of seven processed food types with fibre-related NCs (six cereal-based and one plant-based meat analogues) comparing them with those without these claims. The Spanish Food Database, BADALI, was used for this study. Results show that as many as 88.7% of processed foods with fibre-related NCs are classified as 'less healthy' according to the Nutrient Profile Model developed by the Pan American Health Organization (PAHO-NPM). When compared to foods without these NCs, similar results were obtained in the whole sample. Most of the observed divergences when analysing individual critical nutrients by food type indicate a deterioration of the nutritional quality. Foods with fibre-related NCs contained more fibre. The more frequent use of whole grain cereals or other fibre-specific ingredients may contribute to this. Some other nutritionally relevant differences were observed and half of them reflected a deterioration of the nutritional quality. In addition, these foods presented a lower prevalence of the organic version, as well as similar rates of mineral and vitamin fortification. Therefore, processed foods with fibre-related NCs are not healthy, nor present a better nutritional profile than those without.

Nutritional composition and consumer acceptance of tomato paste fortified with palm weevil larvae (Rhynchophorus phoenicis Fabricius) in the Ashanti region, Ghana

Edible insects, such as palm weevil larvae, have been promoted as an alternative source of nutrients in developing countries for their nutritional benefits, cost-effective rearing, and yearly availability. Unfortunately, consumer acceptance remains a barrier to their utilization. A supplemental palm weevil larvae and tomato paste were developed as part of efforts to understand whether incorporating edible insects into staple foods could help overcome this barrier. Palm weevil larvae flour and tomato paste were mixed in three formulations that had 8, 15, and 30% of palm weevil larvae flour. Samples were subjected to proximate and mineral content analyses and sensory evaluation. Among the blends, tomato paste containing 30% palm weevil larvae had the highest protein, fat, and total solids content as compared to unfortified tomato paste. Iron and zinc levels also increased with increasing levels of palm weevil larvae flour. Carbohydrate and crude fiber concentrations of the samples, however, decreased with increasing fortification levels. The overall acceptance and willingness to purchase fortified tomato paste as determined by sensory evaluation was high for all samples and increased with increasing knowledge about palm weevil larvae's nutritional benefits. Overall acceptance and willingness to purchase fortified tomato paste were significantly dependent on the samples' color and consumers' overall liking of the products. Tomato paste fortified with palm weevil larvae can provide a complementary source of iron for Ghanaians.

Including calcium-fortified water or flour in modeled diets based on local foods could improve calcium intake for women, adolescent girls, and young children in Bangladesh, Uganda, and Guatemala

Adequate calcium intake is essential for health, especially for infants, children, adolescents, and women, yet is difficult to achieve with local foods in many low- and middle-income countries. Previous analysis found it was not always possible to identify food-based recommendations (FBRs) that reached the calcium population recommended intake (PRI) for these groups in Bangladesh, Guatemala, and Uganda. We have modeled the potential contribution of calcium-fortified drinking water or wheat flour to FBR sets, to fill the remaining intake gaps. Optimized diets containing fortified products, with calcium-rich local foods, achieved the calcium PRI for all target groups. Combining fortified water or flour with FBRs met dietary intake targets for adolescent girls in all geographies and allowed a reduction from 3-4 to the more feasible 1-2 FBRs. Water with a calcium concentration of 100 mg/L with FBRs was sufficient to meet calcium targets in Uganda, but higher concentrations (400-500 mg/L) were mostly required in Guatemala and Bangladesh. Combining calcium-fortified wheat flour at 400 mg/100 g of flour and the FBR for small fish resulted in diets meeting the calcium PRI in Bangladesh. Calcium-fortified water or flour could improve calcium intake for vulnerable populations, especially when combined with FBRs based on locally available foods.

Development, Analysis, and Sensory Evaluation of Improved Bread Fortified with a Plant-Based Fermented Food Product

In response to the demand for healthier foods in the current market, this study aimed to develop a new bread product using a fermented food product (FFP), a plant-based product composed of soya flour, alfalfa meal, barley sprouts, and viable microorganisms that showed beneficial effects in previous studies. White bread products prepared with three different substitution levels (5, 10, and 15%) of FFP were evaluated for physical characteristics (loaf peak height, length, width), color indices (lightness, redness/greenness, yellowness/blueness), quality properties (loaf mass, volume, specific volume), protein content, crumb digital image analysis, and sensory characteristics. The results revealed that FFP significantly affected all studied parameters, and in most cases, there was a dose-response effect. FFP supplementation affected the nutritional profile and increased the protein content (p < 0.001). The sensory test indicated that consumer acceptance of the studied sensory attributes differed significantly between groups, and bread with high levels of FFP (10 and 15% FFP) was generally more poorly rated than the control (0%) and 5% FFP for most of the variables studied. Despite this, all groups received acceptable scores (overall liking score ≥ 5) from consumers. The sensory analysis concluded that there is a possible niche in the market for these improved versions of bread products.

The Antioxidant Properties of Selected Varieties of Pumpkin Fortified with Iodine in the Form of Potassium Iodide and Potassium Iodate

This study aimed to investigate the use of selected pumpkin varieties as carriers of potassium iodide (KI) and potassium iodate (KIO₃) at different concentrations (2.3, 0.23, and 0.023 mg/100 g). It was hypothesized that the concentrations and form of iodine fortification in pumpkins affect the antioxidant activity of pumpkins. The results showed a high recovery of the introduced iodine in all pumpkin varieties after drying, as well as high iodine stability during storage, especially for KIO₃. However, statistical analysis confirmed a relationship between the forms and concentration of iodine and the ABTS cation radical and the DPPH radical test results. In the systems with iodine concentration at 0.023 and 0.23 mg/100 g, the antioxidant activity did not change. However, for all pumpkin varieties fortified with a KIO₃ concentration at 3.9 mg/100 g (2.3 mg/100 g of iodine), a statistically significant decrease in free-radical scavenging was confirmed. Therefore, for maximum effectiveness in pumpkin's free-radical scavenging indices, it is suggested to introduce iodine in the form of KI and KIO₃, but in controlled concentrations. However, KIO₃ should be added at a maximum amount of 0.39 mg/100 g.

Sweet Wine Production from the Side-Stream of Industrial Corinthian Currant Processing: Product Quality, Antioxidant Capacity, and Volatilome

In the frame of efforts to add value to the Mediterranean currant cultivation and processing sectors, which is essential for their sustainability, sweet wine production is proposed from the finishing side-stream (FSS) of premium quality Corinthian currants, involving complete fermentation using an alcohol-tolerant yeast followed by (i) the addition of FSS to extract sugars or (ii) syrup made from FSS to adjust sweetness. Wine was also made by (iii) ceasing fermentation at the desired sugar level by ethanol addition. The non-fortified wines had 15.2-15.5% ethanol, 115-145 g/L residual sugar, 7.2-7.6 g/L titratable acidity, low volatile acidity (VA; <0.33 g/L), 280-330 mg/L phenolic content (TPC) (as gallic acid), and 23.8-35.6 mg/L antioxidant capacity (AC) (as ascorbic acid). In total, 160 volatiles were identified by SPME GC-MS, including compounds derived from the grapes, the raisin drying, and the fermentation process. The non-fortified wines had better characteristics (mainly VA, AC, and TPC) than the fortified wine, while sweetness adjustment by FSS is the simplest and lowest cost method since it does not involve ethanol or syrup addition. The proposed methods can lead to good quality sweet wines with a characteristic fruity (grape/raisin) flavor that could be commercialized as specialty raisin beverages or liqueurs.

Advances in Low-Lactose/Lactose-Free Dairy Products and Their Production

With increasing health awareness worldwide, lactose intolerance has become a major concern of consumers, creating new market opportunities for low-lactose/lactose-free dairy foods. In recent years, through innovating processes and technologies, dairy manufacturers have significantly improved the variety, and functional and sensory qualities of low-lactose and lactose-free dairy products. Based on this, this paper first covers the pathology and epidemiology of lactose intolerance and market trends. Then, we focus on current advantages and disadvantages of different lactose hydrolysis technologies and improvements in these technologies to enhance nutritional value, and functional, sensory, and quality properties of lactose-free dairy products. We found that more and more cutting-edge technologies are being applied to the production of lactose-free dairy products, and that these technologies greatly improve the quality and production efficiency of lactose-free dairy products. Hopefully, our review can provide a theoretical basis for the marketing expansion and consumption guidance for low-lactose/lactose-free dairy products.

Recent developments and emerging trends in dietary vitamin D sources and biological conversion

This review elaborates on biochemical characteristics, in vivo metabolism, biological conversion through UV irradiation, as well as dietary fortification of vitamin D. Recent innovations in vitamin D utilization, including nanoencapsulation, direct or indirect addition, emulsion, ultrasound, microwave processing, CRISPR-Cas9 genome editing, as well as UV photoconversion, were summarized. Mushrooms, eggs, yeasts, as well as seafood, such as Barramundi and Atlantic salmon, were typical representatives of original natural food materials for vitamin D bioconversion in relevant research. The critical session thereof referred to the 295 nm UV-B irradiation triggering biological fortification of vitamin D₂ and vitamin D₃, which occurred in ergosterol from mushrooms, and cholesterol from egg yolk, respectively. The schematic biosynthesis of vitamin D precursors in yeasts regulated miscellaneous enzymes were clearly demonstrated. These summarized pathways played a role as a theoretical primer for vitamin D bioconversion when the UV irradiation technique is concerned. Besides, tomatoes had become the latest potential vitamin D sources after genetic modification. The safety consideration for vitamin D fortified functional food was discussed either. Further research is required to fill the gap of investigating optimized factors like types of eggs, meat, and grain, boarder range of wavelength, and dosage in UV irradiation. Vitamin D has a great potential market in the field of functional food development.

Volatile Composition of Fortification Grape Spirit and Port Wine: Where Do We Stand?

Port wine's prominence worldwide is unequivocal and the grape spirit, which comprises roughly one fifth of the total volume of this fortified wine, is also a contributor to the recognized quality of this beverage. Nonetheless, information about the influence of the grape spirit on the final aroma of Port wine, as well as its volatile composition, is extremely limited. Moreover, the aroma characteristics of Port wines are modulated mainly by their volatile profiles. Hence, this review presents a detailed overview of the volatile composition of the fortification spirit and Port wine, along with the methodologies employed for their characterization. Moreover, it gives a general overview of the Douro Demarcated Region (Portugal) and the relevance of fortification spirit to the production of Port wine. As far as we know, this review contains the most extensive database on the volatile composition of grape spirit and Port wine, corresponding to 23 and 208 compounds, respectively. To conclude, the global outlook and future challenges are addressed, with the position of the analytical coverage of the chemical data on volatile components discussed as crucial for the innovation centered on consumer preferences.

Formulation of fortified instant weaning food from Musa paradisiaca (banana) and Eleusine coracana

Weaning food is a soft, easily digestible type of food other than breast milk for infants aged 6 to 24 months. The present study was conducted to develop cereal-fruit-based complementary foods for infants and evaluate the nutritional quality of such types of foods. Few researchers have focused on formulating weaning foods from locally available, nutritious, and rich ingredients without nutrient loss to reduce malnutrition and infant morbidity rates. In this study, the formulated infant food was prepared from Musa paradisiaca (Nendran banana) and Eleusine coracana (ragi). Formulated weaning food was analyzed using various standard methods, demonstrating that it could provide adequate nutrients to growing infants for their proper growth and development. The shelf life of the weaning food was also studied for a period of 3 months at ambient conditions in two different packaging materials: aluminum and plastic (low-density polyethylene or LDPE), with the aluminum foil pouch exhibiting the best shelf life. This ready-to-serve food, which is formulated and fortified with natural ingredients containing essential macronutrients and micronutrients, could be regarded as highly effective supplementary food for infants. Furthermore, this development has the potential to introduce an affordable weaning product specifically targeted at low socioeconomic groups.

Effect of iron-fortified jamun leather on the Asunra-induced anemia in Sprague Dawley rats

Introduction

Micronutrients such as minerals and vitamins are required in a minute quantity but play a pivotal role in the functioning of the body. Therefore, deficiency in one of them can lead to lethal health conditions. Iron deficiency anaemia is one of the most common micronutrient deficiencies across the world and is affecting women and children.

Methods

The present study aimed to investigate the anti-anaemic effect of fortified jamun leather on anaemia biomarkers and haematology in anaemic female Sprague Dawley rats. A total of 40 Sprague Dawley rats were used in 4 groups. Iron deficiency anaemia was induced by oral administration of the Asunra drug. The treatments were fed at two dosage levels i.e., 40 and 60% iron-fortified leather. All animals were treated for 60 days and the parameters including biochemical, and histopathology of the kidney and liver were examined.

Results

The experiment's findings showed that the group fed with iron-fortified leather (G₃) succeeded significantly (P < 0.05) in restoring the serum iron (98.68 ± 2.88 μg/dL), haemoglobin (12.41 ± 0.32 g/dL), ferritin (24.54 ± 1.98 ng/mL) and haematocrit levels (39.30 ± 1.66%) at the end of the 60 days period. Additionally, the treated group's mean values for transferrin and total iron binding capacity were lower than those of the anaemic rats, indicating an improvement in iron levels. The microscopic analysis revealed that treatments had no toxic effects on the kidney and liver tissues, except in the diseased group, which had necrosis and irregular cell structure.

Conclusion

Conclusively, iron-fortified jamun leather helped improve iron deficiency biomarkers and imparted a non-toxic effect on tissues in rats.

Global nutritional challenges of reformulated food: A review

Food reformulation, the process of redesigning processed food products to make them healthier, is considered a crucial step in the fight against noncommunicable diseases. The reasons for reformulating food vary, with a common focus on reducing the levels of harmful substances, such as fats, sugars, and salts. Although this topic is broad, this review aims to shed light on the current challenges faced in the reformulation of food and to explore different approaches that can be taken to overcome these challenges. The review highlights the perception of consumer risk, the reasons for reformulating food, and the challenges involved. The review also emphasizes the importance of fortifying artisanal food processing and modifying microbial fermentation in order to meet the nutrient requirements of people in developing countries. The literature suggests that while the traditional reductionist approach remains relevant and yields quicker results, the food matrix approach, which involves engineering food microstructure, is a more complex process that may take longer to implement in developing economies. The findings of the review indicate that food reformulation policies are more likely to succeed if the private sector collaborates with or responds to the government regulatory process, and further research is conducted to establish newly developed reformulation concepts from different countries. In conclusion, food reformulation holds great promise in reducing the burden of noncommunicable diseases and improving the health of people around the world.

The Potential of Food Fortification as an Enabler of More Environmentally Sustainable, Nutritionally Adequate Diets

Policies encouraging shifts towards more plant-based diets can lead to shortfalls in micronutrients typically present in animal products (B-vitamins, vitamin D, calcium, iodine, iron, selenium, zinc, and long-chain omega-3 fatty acids). We modelled the effect of fortifying foods with these critical micronutrients, with the aim of achieving nutrition and sustainability goals, using food consumption data from Dutch adults (19-30 years). Three dietary scenarios were optimized for nutritional adequacy and 2030 greenhouse gas emissions (GHGE-2030) targets, respectively, with the fewest deviations from the baseline diet: (i) the current diet (mainly vitamin A- and D-fortified margarine, iodized bread, and some calcium- and vitamin D-fortified dairy alternatives and iron- and vitamin B12-fortified meat alternatives); (ii) all plant-based alternatives fortified with critical micronutrients; and (iii) fortified bread and oils. Optimizing the current diet for nutrition and GHGE-2030 targets reduced animal-to-plant protein ratios from ~65:35, to 33:67 (women) and 20:80 (men), but required major increases in legumes and plant-based alternatives. When fortifying all plant-based alternatives and, subsequently, bread and oil, smaller dietary changes were needed to achieve nutrition and GHGE-2030 targets. Fortifying food products with critical micronutrients, ideally with complementary education on plant-based foods, can facilitate the transition to healthier and more sustainable diets.

A comparison of the nutritional profile and nutrient density of commercially available plant-based and dairy yogurts in the United States

Introduction

Plant-based yogurts are sustainable alternatives to dairy yogurts, but a nutritional comparison of plant-based yogurts within the context of dairy yogurts has not yet been applied to commercially available products in the United States. Dairy yogurts provide significant dietary nutrients, and substituting plant-based yogurts may have unintended nutritional consequences. The objective of this study was to compare the macronutrient and micronutrient values of commercially available plant-based and dairy yogurts launched between 2016 and 2021.

Methods

Nutritional information for yogurts were collected through Mintel Global New Products Database, and products were categorized according to their primary ingredient. Regular-style yogurts (n = 612) were included in this study: full-fat dairy (n = 159), low and nonfat dairy (n = 303), coconut (n = 61), almond (n = 44), cashew (n = 30), and oat (n = 15). We utilized the Nutrient Rich Foods (NRF) Index, a comprehensive food guidance system that assigns a score based on the nutrient density of individual foods. This allowed us to compare the nutritional density of the yogurts based on nutrients to encourage (protein, fiber, calcium, iron, potassium, vitamin D) and nutrients to limit (saturated fat, total sugar, sodium).

Results

Compared to dairy yogurts, plant-based yogurts contained significantly less total sugar, less sodium, and more fiber. However, plant-based yogurts contained significantly less protein, calcium, and potassium than dairy yogurts. The yogurts were ranked from the highest to lowest nutrient density based on the NRF Index as follows: almond, oat, low and nonfat dairy, full-fat dairy, cashew, and coconut. Almond yogurts scored significantly higher than all other yogurts, indicating the highest nutrient density.

Discussion

The highest NRF scores were awarded to almond and oat yogurts, likely a result of their low levels of total sugar, sodium, and saturated fat. By applying the NRF model to plant-based and dairy yogurts, we have identified opportunities for the food industry to improve the formulation and nutritional composition of plant-based yogurts. In particular, fortification is an opportunity to improve plant-based yogurt nutritional properties.

Production and characterization of cyanocobalamin-enriched tomato (Solanum lycopersicum) fruits grown using hydroponics

BACKGROUND

Vitamin B₁₂ is an essential vitamin that is absent in plant-derived foods such as fruits and vegetables. This can result in an increased risk of developing vitamin B₁₂ deficiency in strict vegetarians (vegans). There are several studies that have aimed to enhance nutrients in food crops. The purpose of the present study was to fortify tomato fruits with vitamin B₁₂ (or cyanocobalamin).

RESULTS

Tomato plants were grown for 70 days in hydroponic culture pots and treated with 5 μm of cyanocobalamin on days 1-24 after the fruiting, and then harvested for tomato fruits. The ripened tomato fruits contained 4.0 × 10^-7  g of cyanocobalamin per 100 g of dry weight and showed a significant increase in glucose and lycopene levels.

CONCLUSION

The present study highlights the use of a cyanocobalamin-supplementation system for the production of B₁₂ fortified tomato fruits that can help prevent B₁₂ deficiency in vegetarians. © 2022 Society of Chemical Industry.

Human Milk Calorie Guide: A Novel Color-Based Tool to Estimate the Calorie Content of Human Milk for Preterm Infants

Fixed-dose fortification of human milk (HM) is insufficient to meet the nutrient requirements of preterm infants. Commercial human milk analyzers (HMA) to individually fortify HM are unavailable in most centers. We describe the development and validation of a bedside color-based tool called the 'human milk calorie guide'(HMCG) for differentiating low-calorie HM using commercial HMA as the gold standard. Mothers of preterm babies (birth weight ≤ 1500 g or gestation ≤ 34 weeks) were enrolled. The final color tool had nine color shades arranged as three rows of three shades each (rows A, B, and C). We hypothesized that calorie values for HM samples would increase with increasing 'yellowness' predictably from row A to C. One hundred thirty-one mother's own milk (MOM) and 136 donor human milk (DHM) samples (total n = 267) were color matched and analyzed for macronutrients. The HMCG tool performed best in DHM samples for predicting lower calories (<55 kcal/dL) (AUC 0.87 for category A DHM) with modest accuracy for >70 kcal/dL (AUC 0.77 for category C DHM). For MOM, its diagnostic performance was poor. The tool showed good inter-rater reliability (Krippendorff's alpha = 0.80). The HMCG was reliable in predicting lower calorie ranges for DHM and has the potential for improving donor HM fortification practices.

Nutritional Description of Organic and Conventional Food Products in Spain: The BADALI Project

Organic food and drink is undoubtedly a growing market. Consumers perceive organic food as healthy, and nutrition claims (NCs) and fortification may add to this perception. Whether this is true is still a matter of controversy, particularly for organic food products. We present here the first comprehensive study of large samples of six specific organic food types, analysing the nutritional quality (nutrient composition and "healthiness") as well as the use of NCs and fortification. In parallel, a comparison with conventional food is also carried out. For this purpose, the Food Database of products in the Spanish market, BADALI, was used. Four cereal-based and two dairy-substitute food types were analysed. Our results show that as many as 81% of organic foods are considered "less healthy" by the Pan American Health Organization Nutrient Profile Model (PAHO-NPM). Organic foods present a slightly improved nutrient profile compared to conventional foods. However, many of the differences, though statistically significant, are nutritionally irrelevant. Organic foods use NCs very frequently, more than conventional foods, with very little micronutrient fortification. The main conclusion of this work is that consumers' perception that organic food products are healthy is unfounded from a nutritional point of view.

Calcium concentration of drinking water to improve calcium intake: A simulation study

The risk of inadequate calcium intake is a worldwide problem. We performed a simulation exercise on the impact, effectiveness, and safety of increasing calcium levels in drinking water using the 2019 Health and Nutrition National Survey of Argentina, which provides water intake and water sources data at the individual level. We simulated the distribution of calcium intake assuming a calcium concentration of 100 mg of calcium per liter of tap water and 400 mg of calcium per liter of bottled water. After the simulation, all population groups had a slightly improved calcium intake. Higher impacts were observed in adults, as reported water intake was higher in adults 19-51 years old. In young adult women, the estimated calcium intake inadequacy decreased from 91.0% to 79.7% when calcium was increased in tap water and to 72.2% when calcium was increased in tap and bottled water. The impact was lower in adolescents and older adults who have higher calcium recommendations and reported lower water intake. Increased calcium concentration of water could improve calcium intake in Argentina, especially in adults as their reported water intake is higher. Combining more than one strategy to improve calcium intake might be required for countries like Argentina with low calcium intake.

New insights of the application of water or ethanol-water plant extract rich in active compounds in food

Plants are recognized as natural sources of antioxidants (e.g., polyphenols, flavonoids, vitamins, and other active compounds) that can be extracted by green solvents like water, ethanol, or their binary mixtures. Plant extracts are becoming more used as food additives in various food systems due to their antioxidant abilities. Their application in food increases the shelf life of products by preventing undesirable changes in nutritional and sensory properties, such as the formation off-flavors in lipid-rich food. This review summarizes the most recent literature about water or ethanol-water plant extracts used as flavors, colorings, and preservatives to fortify food and beverages. This study is performed with particular attention to describing the benefits of plant extract-fortified products such as meat, vegetable oils, biscuits, pastries, some beverages, yogurt, cheese, and other dairy products. Antioxidant-rich plant extracts can positively affect food safety by partially or fully replacing synthetic antioxidants, which have lately been linked to safety and health issues such as toxicological and carcinogenic consequences. On the other hand, the limitations and challenges of using the extract in food should be considered, like stability, level of purity, compatibility with matrix, price, sensory aspects like distinct taste, and others. In the future, continuous development and a tendency to use these natural extracts as food ingredients are expected, as indicated by the number of published works in this area, particularly in the past decade.

Salt-Containing Recipes in Popular Magazines with the Highest Circulation in the United States Do Not Specify Iodized Salt in the Ingredient List

Iodine deficiency is a public health problem in the US, with the iodine status of women of reproductive age decreasing in recent years. This may be attributable to voluntary salt iodization in the US. Magazines, a common source of recipes and nutritional information, may influence salt use and iodine intake. The aim of this study is to assess whether the magazines with the highest circulation in the US include recipes that contain salt and, if so, whether they specify "iodized salt" in the recipes. Recipes in eight of the top ten magazines by circulation in the US were examined. Standardized information was collected on the presence and type of salt in recipes in the last 12 issues reviewed per magazine. About 73% of the 102 issues reviewed contained recipes. A total of 1026 recipes were surveyed for salt; 48% of the recipes listed salt as an ingredient. None of the 493 recipes containing salt specified iodized salt as the type of salt to be used. About half of the recipes in the last 12 issues of popular magazines published in the US included salt in the ingredient list; however, none recommend the use of iodized salt. There is potential for editorial changes among magazines to call for iodized salt in recipes, which may further prevent iodine deficiency in the US.

A Randomized Trial of Quadruple-Fortified Salt for Anemia and Birth Defects Prevention in Southern India: Protocol Design and Methods

Background

Women of reproductive age are at an increased risk of anemia and micronutrient deficiencies. Evidence supports the role of periconceptional nutrition in the development of neural tube defects (NTDs) and other pregnancy complications. Vitamin B12 deficiency is a risk factor for NTDs and may modify folate biomarkers that predict NTD risk at the population level. There is an interest in mandatory fortification with vitamin B12 and folic acid for anemia and birth defect prevention. However, there are limited population-representative data needed to inform policy and guidelines.

Objectives

This randomized trial will be conducted to evaluate the efficacy of quadruple-fortified salt (QFS; iron, iodine, folic acid, vitamin B12) in 1,000 households in Southern India.

Methods

Women 18 to 49 y who are not pregnant or lactating and reside within the catchment area of our community-based research site in Southern India will be screened and invited to participate in the trial. After informed consent, women and their households will be randomized to receive one of the following 4 interventions: 1) double-fortified salt (DFS; iron, iodine), 2) DFS + folic acid (iron, iodine, folic acid), 3) DFS + vitamin B12 (iron, iodine, vitamin B12), or 4) DFS + folic acid and vitamin B12 (QFS; iron, iodine, folic acid, vitamin B12) for 12 mo. Structured interviews will be conducted by trained nurse enumerators to collect sociodemographic, anthropometric, dietary, health, and reproductive history data. Biological samples will be collected at baseline, midpoint, and endpoint. Whole blood will be analyzed for hemoglobin using Coulter Counter. Total vitamin B12 will be measured by chemiluminescence; red blood cell folate and serum folate will be evaluated using the World Health Organization-recommended microbiologic assay.

Conclusions

The results of this randomized trial will help to evaluate the efficacy of QFS to prevent anemia and micronutrient deficiencies. Clinical trial registration numbers: NCT03853304 and Clinical Trial Registry of India REF/2019/03/024479.

Registration number

NCT03853304 and REF/2019/03/024479.

Ferric Pyrophosphate Forms Soluble Iron Coordination Complexes with Zinc Compounds and Solubilizing Agents in Extruded Rice and Predicts Increased Iron Solubility and Bioavailability in Young Women

BACKGROUND

Co-extrusion of ferric pyrophosphate (FePP) with solubilizers, citric acid/trisodium citrate (CA/TSC), or ethylenediaminetetraacetic acid (EDTA) sharply increases iron absorption. Whether this can protect against the inhibition of iron absorption by phytic acid (PA) is unclear. Sodium pyrophosphate (NaPP) may be a new enhancer of iron absorption from FePP.

OBJECTIVES

Our objectives were to 1) investigate the ligand coordination of iron, zinc, and solubilizers in extruded rice and test associations with iron solubility and absorption, 2) assess whether co-extrusion of FePP + CA/TSC rice can protect against inhibition of iron absorption by PA; 3) determine the effect of zinc oxide (ZnO) compared with zinc sulfate (ZnSO4), and 4) quantify iron absorption from FePP + NaPP rice.

METHODS

We produced labeled 57FePP rice cofortified with ZnSO4 and EDTA, CA/TSC or NaPP, and FePP + EDTA rice with ZnO. We used electron paramagnetic resonance (EPR) to characterize iron-ligand complexes. We measured in vitro iron solubility and fractional iron absorption (FIA) in young women (n = 21, age: 22 ± 2 y, BMI: 21.3 ± 1.5 kg/m2 geometric mean plasma ferritin, 28.5 μg/L) compared with ferrous sulfate (58FeSO4). FIA was compared by linear mixed-effect model analysis.

RESULTS

The addition of zinc and solubilizers created new iron coordination complexes of Fe(III) species with a weak ligand field at a high-spin state that correlated with solubility (r2 = 0.50, P = 0.02) and absorption (r2 = 0.72, P = 0.02). Phytic acid reduced FIA from FePP + CA/TSC rice by 50% (P < 0.001), to the same extent as FeSO4. FIA from FePP + EDTA + ZnO and FePP + EDTA + ZnSO4 rice did not significantly differ. Mean FIAs from FePP + EDTA + ZnSO4, FePP + CA/TSC + ZnSO4, and FePP + NaPP + ZnSO4 rice were 9% to 11% and did not significantly differ from each other or from FeSO4.

CONCLUSION

Rice extrusion of FePP with solubilizers resulted in bioavailable iron coordination complexes. In the case of FePP + CA/TSC, PA exerted similar inhibition of FIA as with FeSO4. FePP + NaPP could be a further viable solubilizing agent for rice fortification. This study was registered at clinicaltrials.gov as NCT03703739.

Effect of process parameters on vitamins and sensory acceptability in micronutrient-fortified soymilk prepared by small-scale batch processing

Effects of holding time before cooling, cooling method, and light or dark refrigerated storage on the stability of vitamin A, vitamin C, thiamine, riboflavin, and folate were investigated in fortified and unfortified soymilk. Vitamin C loss (6%) and mild vitamin A isomerization occurred when soymilk was held hot after fortification. Cooling bottled soymilk at ambient temperature or in an ice-water bath did not affect any vitamins. Loss of riboflavin (18%) and vitamin A isomerization occurred during 12 days of light-exposed refrigerated storage, in contrast to no vitamin degradation during dark refrigerated storage. A sensory panel of youth and children indicated no significant preferences between fortified and unfortified soymilk except for color, where the lighter-colored unfortified soymilk was preferred. Acceptable vitamin stability and sensory characteristics can be achieved in fortified soymilk produced in small-scale batch processes with appropriate management of production and storage conditions.

Impact of Starch-Rich Food Matrices on Black Rice Anthocyanin Accessibility and Carbohydrate Digestibility

Anthocyanins reduce starch digestibility via carbohydrase-inhibitory pathways, but food matrix effects during digestion may also influence its enzymatic function. Understanding anthocyanin-food matrix interactions is significant as the efficiency of carbohydrase inhibition relies on anthocyanin accessibility during digestion. Therefore, we aimed to evaluate the influence of food matrices on black rice anthocyanin accessibility in relation to starch digestibility in common settings of anthocyanin consumption-its co-ingestion with food, and consumption of fortified food. Our findings indicate that black rice anthocyanin extracts (BRAE) had reduced intestinal digestibility of bread to a larger extent for the co-digestion of BRAE with bread (39.3%) (4CO), than BRAE-fortified bread (25.9%) (4FO). Overall anthocyanin accessibility was about 5% greater from the co-digestion with bread than fortified bread across all digestion phases. Differences in anthocyanin accessibility were also noted with changes to gastrointestinal pH and food matrix compositions-with up to 10.1% (oral to gastric) and 73.4% (gastric to intestinal) reductions in accessibility with pH changes, and 3.4% greater accessibility in protein matrices than starch matrices. Our findings demonstrate that the modulation of starch digestibility by anthocyanin is a combined result of its accessibility, food matrix composition, and gastrointestinal conditions.

Vitamin D Food Fortification Strategies on Population-Based Dietary Intake Data Using Mixed-Integer Programming

The dietary vitamin D intake of the Danish population is low, and food fortification is a strategy to increase intake. This paper explores the possibility of vitamin D fortification on the current population food intake in Denmark, such that the population receives adequate amounts of vitamin D without having to change current dietary patterns. A mixed-integer programming approach is used to arrive at a solution for the optimal fortification required at each food group level so that the majority of the population receive the minimum intake of average requirement (AR) and do not exceed the tolerable upper intake level (UL). The method shows a significant increase in vitamin D intake compared to the current scenario, keeping a neutral approach towards preferences of one food group over others. The method can also be fine-tuned in different scenarios where certain food group preferences are known, which can be encoded into the model in the form of constraints.

Iron from Co-Encapsulation of Defatted Nannochloropsis Oceanica with Inulin Is Highly Bioavailable and Does Not Impact Wheat Flour Shelf Life or Sensorial Attributes

Defatted green microalgae Nannochloropsis oceanica (DGM) is a rich source of bioavailable iron. However, its use in foods results in unacceptable color and taste development. Therefore, the purpose of this study was to investigate strategies to enhance the use of DGM in foods. DGM and inulin were encapsulated (EC) in an oil-in-water emulsion using high-pressure homogenization. To confirm iron bioavailability, C57BL/6 mice were fed an iron-deficient diet (ID) for 2 weeks. The mice were then fed one of the four diets: ID, ID + DGM (DGM), ID + EC (EC50 or EC100) for 4 weeks. To test the stability of DGM as an iron fortificant at two different fortification rates of 17.5 mg Fe/kg (50%) or 35 mg Fe/kg (100%), whole (DGM50/DGM100), encapsulated (EC50/EC100) and color-masked (CM50/CM100) DGM were added to wheat flour (WF) at two different temperatures: 20 °C and 45 °C and were examined for 30 days. Acceptability studies were conducted to determine sensory differences between rotis (Indian flat bread) prepared from WF/EC50/CM50/EC100. The mice consuming EC50/EC100 diets showed comparable iron status to DGM-fed mice, suggesting that encapsulation did not negatively impact iron bioavailability. Addition of EC to wheat flour resulted in the lowest Fe²⁺ oxidation and color change amongst treatments, when stored for 30 days. There were no differences in the overall liking and product acceptance of rotis amongst treatments at both day 0 and day 21 samples. Our results suggest that EC50 can be effectively used as an iron fortificant in WF to deliver highly bioavailable iron without experiencing any stability or sensory defects, at least until 30 days of storage.

[Iodine intake of two-year-olds and adults in Iceland and estimation of the effect of using iodized salt in breads]

INTRODUCTION

Insufficient iodine status was recently identified in pregnant women in Iceland. Iodine fortification of salt is widely used to decrease the risk of iodine deficiency disorders, but the use of iodized salt has not been recommended in Iceland. The aim was to describe iodine intake among Icelandic adults and two-year-olds and estimate the effect of using iodized salt in bread.

MATERIAL AND METHODS

Iodine intake was assessed using data from the Icelandic National Dietary Survey 2019-2021 (18-80 years, n=822) and a study of two-year-old children (n=124). Data on bread intake was used to estimate expected iodine intake if iodized salt was used in bread. The results are compared with recommended iodine intake (90 µg/day for two-year-olds and 150 µg/day for adults) and upper intake level (200 µg/day and 600 µg/day, respectively).

RESULTS

Average iodine intake was 88 µg/day for children and 134 µg/day for adults. If all types of bread consumed would contain 20 µg of iodine in 100 grams, the average iodine intake would increase to 99 and 153 µg/day, respectively. With higher bread iodine content, >5% of two-year-olds would exceed the upper intake level, while concentration up to 70 µg/100 grams of bread would result in iodine intake below the upper intake level for adults.

CONCLUSION

Use of iodized salt in bread corresponding to 20µg of iodine in 100 grams of bread seems safe for young children in Iceland. However, based on the current dietary habits, adding this amount of iodine to bread would not be sufficient to secure optimal intake of iodine in all adults.

Exploring the Complementarity of Fortification and Dietary Diversification to Combat Micronutrient Deficiencies: A Scoping Review

Achieving a balanced and diverse diet remains a challenge for many people, contributing to an ongoing burden of micronutrient deficiencies, particularly in low-income settings. Fortification or dietary diversification are common food-based approaches. We conducted a scoping review to: 1) find evidence on whether combined food-based strategies are more effective than single strategies, and 2) understand how strategies implemented together could complement each other to achieve optimal nutritional impact on populations. Peer-reviewed articles selected (n = 21) included interventions or observational studies (n = 13) and reviews (n = 8). We found little evidence of an added nutritional impact. On the other hand, it is apparent that fortification and dietary diversification target different types of settings (urban compared with rural) and foods (that is, low priced compared with highly priced). Further research is needed to understand the complementarity of these approaches and establish evidence of the effectiveness of combined strategies to foster policy adoption.

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

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

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

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

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

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

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

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

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

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

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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