Fortification of condiments with micronutrients in public health: from proof of concept to scaling up

Abstract

. The consultation covered aspects related to implementation, monitoring, evaluation, and legal frameworks of fortification programs, as well as food safety and policy coherence for condiment fortification in the context of other public health strategies. This paper introduces the background and rationale of the technical consultation, synopsizes the presentations, and provides a summary of the main considerations proposed by the working groups.

Large-Scale Food Fortification and Biofortification in Low- and Middle-Income Countries: A Review of Programs, Trends, Challenges, and Evidence Gaps

“…Condiments, spices, and seasonings are increasingly being used as vehicles to increase the intake of vitamins and minerals. 29 Mandatory or market-driven condiment fortification with iron has been used with various vehicles such as soy sauce, fish sauce, salt, and bouillon cubes. 12 Until now, most of the experience with fortification of condiments and seasonings has been with NaFe-EDTA added to soy and fish sauces in Southeast Asian countries.…”

“…Other condiments, such as bouillon cubes or curry powders, are now also being fortified with iron and other vitamins and minerals. 29 A recent systematic review has demonstrated that iron fortification of condiments is associated with increased hemoglobin, improved iron status, and reduced anemia across targeted populations. 30…”

The Unfinished Agenda for Food Fortification in Low- and Middle-Income Countries: Quantifying Progress, Gaps and Potential Opportunities

“…In Sub Saharan Africa there are mandatory sugar fortification programs in Malawi, Mozambique, Nigeria, Rwanda, Zambia and Zimbabwe. Fortification of condiments and other flavor enhancers is relatively newer and mostly voluntary, having commenced in the 1980s and expanded rapidly in the West Africa, and South East Asia and Central America [18,19].…”

Current calcium fortification experiences: a review

“…The process of implementation of micronutrient food fortification programs is challenging, as there are several steps involved in the process of monitoring and evaluation. A review of available documents about lessons learned from various micronutrient food fortification programs identified the following challenges and barriers: [64][65][66][67][68][69][70] (1) Lack of qualified personnel and lack of training; (2) Lack of clear guidelines at the country level on implementation, regulatory frameworks, and monitoring and evaluation; (3) Lack of clarity in the structure and roles of government authorities in regulatory monitoring; (4) Lack of enforcement of standards by the regulatory agents or political instability, which may be related to perceived political risk in doing so; • Mandatory fortification of staple foods (salt with iodine, wheat flour and maize meal with iron, zinc, vitamin A, folic acid, and other B-complex vitamins, sugar and oil with vitamin A and skimmed milk powder with vitamins A and D) • Supplementation programs (mega doses of vitamin A to children and iron and folic acid to pregnant women) and biofortification (sweet potato with β-carotene) Philippines…”