Biomedical subjects

M G Venkatesh Mannar

Publications and source records attributed to M G Venkatesh Mannar.

4 recordsLinked to original sources

PubMed2006

Successful food-based programmes, supplementation and fortification.

This review highlights interventions and delivery mechanisms to alleviate macro- and micronutrient deficiencies in preschool children. These deficiencies can be addressed through an integrated combination of improved dietary intake, supplementation, commercial and home-based fortification of complementary foods. Several developed and developing countries have implemented successful approaches to eliminate protein-energy malnutrition and micronutrient deficiencies with sustained impact. These include provision of oral supplements in capsule, tablet or syrup form. Certain micronutrients (eg, vitamin A) can be provided as high-dose supplements twice per year. Most other vitamins and minerals (eg, iron, zinc, iodine) need to be provided in daily doses. Fortified complementary foods provided through public feeding programmes and commercially marketed foods have also made a positive impact. There is growing evidence of the impact of home-based fortification of complementary foods using premixes in single-serving sachets. The fortification of commercially marketed staple foods such as cereal flours, cooking oils and dairy products could have a small but significant impact on preschool children. Cereal flours with iron, folic acid and other nutrients have expanded rapidly, with evidence of impact. A key need is to deliver micronutrients to remote and impoverished populations in an affordable and sustainable manner. Government commitment, clear policy and programme direction, advocacy and communication combined with a strong public-private partnership is essential for successful programmes. Often a period of voluntary fortification needs to be followed by mandatory requirement to ensure full compliance and sustained impact. The review concludes that proven technologies, communications and infrastructure can be harnessed to ensure that the nutrient needs of preschool children are met. When administered systematically with the commitment of and participation by the public and private sectors, most of the major deficiencies can be bridged on a sustained basis, contributing to improved health and well-being of millions of children around the world.

Child Nutrition Disorders↗

PubMed2004

Micronutrient fortification of foods--rationale, application and impact.

Deficiencies in intake of essential vitamins and minerals (commonly referred to as micronutrients) that are essential for efficient energy metabolism and other functions of the human body (commonly termed as micronutrients) are severe and widespread in many parts of the world. They cause an immeasurable burden on individuals, on health services, education systems and families caring for children who are disabled or mentally impaired. Studies by World Bank have shown that countries whose populations suffer from micronutrient deficiencies encounter economic losses as high as 5% of gross domestic product (GDP). The solution to control and prevent micronutrient deficiencies is available and affordable. At a national level, micronutrient malnutrition can be addressed by implementing programmes designed to educate people to diversify their diets (where appropriate foods are available), or by fortifying commonly eaten foods with the missing micronutrients or providing nutrient supplements through targeted distribution programmes. Food fortification is increasingly recognized as an effective means of delivering micronutrients. Fortification of foods can provide meaningful amounts of the nutrient at normal consumption of the food vehicle. Proper choice of fortificant and processing methods could ensure the stability and bioavailability of the nutrient. The level of fortification should take into account variations in food consumption to ensure safety for those at the higher end of the scale and impact for those at the lower end. Fortification needs to be supported by adequate food regulations and labeling, quality assurance and monitoring to ensure compliance and desired impact. In industrialized countries food fortification has played a major role in the substantial reduction and elimination of a number of micronutrient deficiencies. Although a growing number of large scale fortification programmes in different parts of the world are beginning to demonstrate impact at the biochemical level and are leading to the elimination of several nutrient deficiencies, food fortification remains an underutilized opportunity in many developing countries where micronutrient malnutrition remains a public health problem.

Canada↗

PubMed2003

Role of public-private partnership in micronutrient food fortification.

Iron, iodine, and vitamin A deficiencies prevent 30% of the world's population from reaching full physical and mental potential. Fortification of commonly eaten foods with micronutrients offers a cost-effective solution that can reach large populations. Effective and sustainable fortification will be possible only if the public sector (which has the mandate and responsibility to improve the health of the population), the private sector (which has experience and expertise in food production and marketing), and the social sector (which has grass-roots contact with the consumer) collaborate to develop, produce, and promote micronutrient-fortified foods. Food fortification efforts must be integrated within the context of a country's public health and nutrition situation as part of an overall micronutrient strategy that utilizes other interventions as well. Identifying a set of priority actions and initiating a continuous dialogue between the various sectors to catalyze the implementation of schemes that will permanently eliminate micronutrient malnutrition are urgently needed. The partners of such a national alliance must collaborate closely on specific issues relating to the production, promotion, distribution, and consumption of fortified foods. Such collaboration could benefit all sectors: National governments could reap national health, economic, and political benefits; food companies could gain a competitive advantage in an expanding consumer marketplace; the scientific, development, and donor communities could make an impact by achieving global goals for eliminating micronutrient malnutrition; and by demanding fortified foods, consumers empower themselves to achieve their full social and economic potential.

Cost-Benefit Analysis↗

PubMed2002

Iodine stability in salt double-fortified with iron and iodine.

Deficiencies in small quantities of micronutrients, especially iodine and iron, severely affect more than a third of the world's population, resulting in serious public health consequences, especially for women and young children. Salt is an ideal carrier of micronutrients. The double fortification of salt with both iodine and iron is an attractive approach to the reduction of both anemia and iodine-deficiency disorders. Because iodine is unstable under the storage conditions found during the manufacturing, distribution, and sale of salt in most developing countries, the effects of packaging materials and environmental conditions on the stability of salt double-fortified with iron and iodine were investigated. Salt was double-fortified with potassium iodide or potassium iodate and with ferrous sulfate or ferrous fumarate. The effects of stabilizers on the stability of iodine and iron were followed by storing the salt under three conditions that represent the extremes of normal distribution and sale for salt in developing countries: room temperature (25 degrees C) with 50%-70% relative humidity, 40 degrees C with 60% relative humidity, and 40 degrees C with 100% relative humidity. The effects of stabilizers, such as sodium hexametaphosphate (SHMP), calcium carbonate, calcium silicate, and dextrose were investigated. None of the combinations of iron and iodine compounds was stable at elevated temperatures. Essentially all of the iodine was lost over a period of six months. SHMP effectively slowed down the iodine loss, whereas magnesium chloride, a typical hygroscopic impurity, greatly accelerated this process. Calcium carbonate did not have a sparing effect on iodine, despite contrary indications in the literature. Ferrous sulfate-fortified salts generally turned yellow and developed an unpleasant rusty flavor. Salt fortified with ferrous fumarate and potassium, iodide was reasonably stable and maintained its organoleptic properties, making it more likely to be acceptable to consumers. We confirmed that application of the iodine compounds as solutions resulted in a more even distribution of the iodine throughout the sample. The effect of the packaging materials was overshadowed by the other variables. None of the packaging materials was clearly better than any other. This may have been due to the fact that the polymer bags were not heat sealed, and thus some moisture penetration was possible. The results indicate that with careful control of processing, packaging, and storage conditions, a double-fortified salt could be stabilized for the six-month period required for distribution and consumption. Unfortunately, the processing and storage required are difficult to attain under typical conditions in developing countries.

Biological Availability↗