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

Abstract

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

Association of soybean-based food with the prevalence of anaemia among reproductive-aged men and women in rural Central Java, Indonesia

“…Whilst iron fortification of wheat flour has been mandatory in Indonesia since 2001 (44) consumption of wheat flour products among adults in our study was very low; the dominant carbohydrate source was white rice (45) . Only recently has iron fortification of rice programs began in Indonesia, but with limited success in increasing serum hemoglobin and ferritin levels (44) .…”

“…Whilst iron fortification of wheat flour has been mandatory in Indonesia since 2001 (44) consumption of wheat flour products among adults in our study was very low; the dominant carbohydrate source was white rice (45) . Only recently has iron fortification of rice programs began in Indonesia, but with limited success in increasing serum hemoglobin and ferritin levels (44) . The added health benefits of soybean should also be mentioned, including a recent study that found that a drink made from soybean protein had anti-inflammatory properties among pregnant women in Malaysia (46) .…”

Nutritional Status of Children Under Five Years in the Work Area of Puskesmas Cipadung

“…The impact of babies with low birth will last from generation to generation; children with LBW will have fewer anthropometric measurements in their development [17]. The continued impact of low birth weight (LBW) can be in the form of failure to thrive, and if a baby is born with LBW, it should be anticipated that it will be challenging to catch up with average early growth and may cause the child to become stunted as one of the risks [18]. Supplementary feeding that does not focus on the frequency, texture, timing of feeding, and diversity can cause stunting in under-five children.…”

Cookies rich in iron (Fe), folic acid, cobalamin (vitamin B12), and antioxidants: a novel functional food potential for adolescent with anemia

“…Therefore, alternative efforts such as food fortification become important to do, especially in snacks that are mostly preferred by teenagers. In addition to promising results in terms of decreasing the problem of micronutrient deficiency (Dewi et al, 2021), fortification in snacks is also potentially effective because adolescents aged 18-25 years tend to consume snacks ≥3 times per day which contributes to 25% recommended dietary allowance (RDA) or average daily dietary intake level (USDA, 2012).…”