No abstract

OBJECTIVES: We evaluated the possible role of niacin fortification of the US food supply and other concurrent influences in eliminating the nutritional deficiency disease pellagra. METHODS: We traced chronological changes in pellagra mortality and morbidity and compared them with the development of federal regulations, state laws, and other national activities pertaining to the fortification of cereal-grain products with niacin and other B vitamins. We also compared these changes with other concurrent changes that would have affected pellagra mortality or morbidity. RESULTS: The results show the difficulty of evaluating the effectiveness of a single public health initiative such as food fortification without controlled experimental trials. Nonetheless, the results provide support for the belief that food fortification played a significant role in the elimination of pellagra in the United States. CONCLUSIONS: Food fortification that is designed to restore amounts of nutrients lost through grain milling was an effective tool in preventing pellagra, a classical nutritional deficiency disease, during the 1930s and 1940s, when food availability and variety were considerably less than are currently found in the United States.

The effectiveness of EDTA compounds on iron fortificants for potential use in Egyptian balady bread was tested in sixty SpragueDawley weanling male rats by the haemoglobin regeneration efficiency (HRE) method. To confirm HRE-derived findings, eight groups of ten animals were repleted with a modified American Institute of Nutrition (1977; AIN) 76A diet, fortified with ferric phosphate, electrolytic Fe, carbonyl Fe or ferrous sulphate, with and without ascorbic acid. Results without ascorbic acid were comparable to findings of a human study by Forbes et al. (1989). Bioavailability of EDTA-enhanced fortificants, FeSO, + Na,EDTA and NaFe(III)EDTA, was compared with that of FeSO, in six groups of ten animals repleted with a ground Egyptian bread meal or a casein-based AIN diet fortified with one of the three compounds. Addition of either EDTA compound significantly increased bioavailability of Fe in Egyptian balady bread. When present in the less inhibitory casein meal, however, FeSO, + Na,EDTA fortification was significantly less effective than NaFe(1II)EDTA or the reference FeSO,. Results indicate that NaFe(I1I)EDTA may be the fortificant of choice in a mixed diet. Further study of EDTAenhanced Fe fortificants is needed.Iron: EDTA: Bioavailability of iron: Bread: Rat Iron fortification of wheat flour or other cereals is currently being used in many countries as a nutritional strategy. The universal consumption of bread and the usual lower bran content of wheat flour compared with that of other cereals makes flour the food vehicle of choice for Fe fortification throughout the world (Cook & Reusser, 1983), although Fe absorption from flat breads common to the Middle East is suspected to be less than that from American or European breads. The prevalence of Fe deficiency in Egypt makes fortification of wheat flour desirable, as the average annual consumption of wheat flour, i.e. 180 kg/person, provides nearly 50 % of the average daily intake of energy and protein. In Egypt, the addition of Fe to flat-breads is a practical fortification strategy, as this food vehicle is available to even the lowest economic groups.We therefore compared the bioavailability of two EDTA-enhanced Fe compounds, Na,EDTA with ferrous sulphate and NaFe(III)EDTA, with that of a reference, FeSO,, with the goal of determining the most bioavailable form of Fe fortification to use in local balady bread, the more popular of two widely consumed flat breads. The identical fortification compounds were also tested using the American Institute of Nutrition (1977 ; AIN) diet as a food vehicle for comparison with the balady bread. The study was performed as a collateral part of a project sponsored by

Fat substitutes, in theory, may provide special health benefits to certain population segments. The most probable benefits are a reduction in total fat intake and a subsequent reduction in intake of calories from fat. Whether individuals who consume high intakes of fat substitutes that are partially or totally nondigestible also benefit from lower calorie intake on a long-term basis is unknown. It is likely that many individuals will compensate by increasing total food intake to maintain calorie intake. Consumption of fat substitutes presents nutrition problems. Those fat substitutes that are partially or totally nondigested may reduce the bioavailability of other nutrients. Similarly, fat substitutes may have adverse effects on normal gastrointestinal tract function or intestinal tract flora. Unlike other functional food additives, fat substitutes can make up a significant portion of the total diet. For this reason, traditional safety factors cannot be applied. Consequently, more reliance on data from clinical studies involving human subjects and requirements for postmarket surveillance will be necessary as part of the approval process.