Fortification of rice with vitamins and minerals for addressing micronutrient malnutrition

Peña-Rosas, Juan Pablo; Mithra, Prasanna; Unnikrishnan, Bhaskaran; Kumar, Nithin; De-Regil, Luz María; Nair, N. Sreekumaran; Garcı́a-Casal, Marı́a Nieves; Solon, Juan Antonio A.

doi:10.1002/14651858.cd009902.pub2

Cited by 51 publications

(45 citation statements)

References 114 publications

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“…In contrast, a recent systematic review concluded that zinc fortification (single or with multiple micronutrients) increases plasma zinc concentrations ( 52 ). In a recent pooled analysis of 3 postharvest zinc-fortified rice studies, the nonsignificant mean between-group difference was 0.38 μmol/L ( 53 ). Because postharvest zinc fortification shows similar zinc absorption patterns as zinc-biofortified rice ( 10 ), the low amount of zinc provided by the BFR in our study (∼1 mg/d) could have contributed to the lack of effect.…”

Section: Discussionmentioning

confidence: 99%

The effect of zinc-biofortified rice on zinc status of Bangladeshi preschool children: a randomized, double-masked, household-based, controlled trial

Jongstra

Hossain

Galetti

et al. 2022

The American Journal of Clinical Nutrition

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Background Zinc biofortification of rice could sustainably improve zinc status in countries where zinc deficiency is common and rice is a staple, but its efficacy has not been tested. Fatty acid desaturases (FADS) are putative new zinc status biomarkers. Objective Our objective was to test the efficacy of zinc-biofortified rice in preschool-aged children with zinc-deficiency. Our hypothesis was that consumption of zinc-biofortified rice would increase plasma zinc concentration (PZC). Design We conducted a 9-month, double-masked, intervention trial in 12–36 month-old rural Bangladeshi children, most of whem were who were zinc-deficient (PZC < 70 µg/dL) and stunted (n = 520). The children were randomized to receive either control rice (CR) or zinc-biofortified rice (BFR) provided in cooked portions to their households daily, with compliance monitoring. The primary outcome was PZC. Secondary outcomes were zinc deficiency, linear growth, infection-related morbidity, FADS activity indices, intestinal fatty acid binding protein (I-FABP) and fecal calprotectin. We applied sparse serial sampling for midpoint measures and analyzed data by intention-to-treat using mixed-effects models. The trial was registered under NCT03079583. Results At baseline, median (IQR) PZC was 60.4 (56.3–64.3) µg/dL, 78.1% of children were zinc deficient and 59.7% were stunted. Mean ± SD daily zinc intakes from the CR and BFR during the trial were 1.20 ± 0.34 and 2.22 ± 0.47 mg/day, respectively (P < 0.001). There were no significant time-by-treatment effects on PZC, zinc deficiency prevalence, FADS activity, I-FABP or fecal calprotectin (all P > 0.05). There was a time-treatment interaction for height-for-age z scores (P < 0.001) favoring the BFR group. The morbidity longitudinal prevalence ratio (LPR) (95% CI) was 1.08 (1.05,1.12) comparing the BFR and CR groups, due to more upper respiratory tract illness in the BFR group. Conclusions Consumption of zinc-biofortified rice for 9 months providing ∼1 mg of additional zinc daily to Bangladeshi children did not significantly affect PZC, prevalence of zinc deficiency or FADS activity. Clinical Trial Registry: https://clinicaltrials.gov/ct2/show/NCT03079583

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Section: Discussionmentioning

confidence: 99%

The effect of zinc-biofortified rice on zinc status of Bangladeshi preschool children: a randomized, double-masked, household-based, controlled trial

Jongstra

Hossain

Galetti

et al. 2022

The American Journal of Clinical Nutrition

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“…Fortification of wheat flour (49) or rice (50) with Fe alone have little effect on anaemia and probably makes little or no difference in the risk of presenting Fe deficiency, and there is uncertainty that interventions may increase the mean Hb concentrations in the general population of children older than 2 years of age.…”

Section: Discussionmentioning

confidence: 99%

Association between iron supplementation and the presence of diarrhoea in Peruvian children aged 6–59 months: analysis of the database of the Demographic and Family Health Survey in Peru (DHS, Peru), years 2009–2019

Valverde-Bruffau

Steenland

Gonzales

2021

Public Health Nutr.

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Introduction: According to the World Health Organization (WHO), anemia is a severe public health problem when the prevalence is ≥ 40%. In 2019, in Peru, 40.1% of children (age 6 to 35 months) are diagnosed as anemic. This is a concern since, despite the efforts of the governments to reduce the prevalence, the problem has stagnated since 2011. The treatment applied to deal with anemia is iron supplementation. Although iron is essential for cell function, an excess can produce adverse responses, such as gut inflammation affecting microbiota and resulting in diarrheic episodes. Objective: To determine the association between diarrhea and iron supplementation in children with and without anemia, controlling for different socio-demographic variables. Design: We conducted via logistic regression to obtain diarrhea prevalence ratios, adjusted by age, sex, geographic region, water and sanitation service, and rurality. The survey asked for recent episodes of diarrhea during the last 7 days; similarly, after the consumption of iron supplements during the last 12 months before the survey. Setting: Peru Subjects: The Demographic and Health Survey (DHS) is conducted annually at home among 14,202 children on average (2009 – 2019). Results: Iron supplementation in the last seven days (PR=1.09) or the last twelve months (PR=1.19) (p<0.0001) was associated with an increased risk of diarrhea. The same association was observed between iron supplementation and the presence of anemia. Conclusions: Iron supplementation is associated with diarrhea and over-use in children should be avoided.

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“…Rice beverages commercially available in the market mainly consist of water and carbohydrates (including starch, glucose, and maltose), as well as traces of lipids and proteins [5,7,60]. Furthermore, these are not a good source of vitamins and microelements [61][62][63]. Therefore, commercial rice-based beverages are often enriched with B vitamins (e.g., B3 and B12), iron, calcium, and lipid components (e.g., derived from safflower or sunflower oil).…”

Section: Rice and Rice Beveragesmentioning

confidence: 99%

Lactic Acid Bacteria-Fermentable Cereal- and Pseudocereal-Based Beverages

Ziarno

Cichońska

2021

Microorganisms

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Plant beverages are becoming more popular, and fermented cereal- or pseudocereal-based beverages are increasingly used as alternatives for fermented products made from cow milk. This review aimed to describe the basic components of cereal- or pseudocereal-based beverages and determine the feasibility of fermenting them with lactic acid bacteria (LAB) to obtain products with live and active LAB cells and increased dietary value. The technology used for obtaining cereal- or pseudocereal-based milk substitutes primarily involves the extraction of selected plant material, and the obtained beverages differ in their chemical composition and nutritional value (content of proteins, lipids, and carbohydrates, glycemic index, etc.) due to the chemical diversity of the cereal and pseudocereal raw materials and the operations used for their production. Beverages made from cereals or pseudocereals are an excellent matrix for the growth of LAB, and the lactic acid fermentation not only produces desirable changes in the flavor of fermented beverages and the biological availability of nutrients but also contributes to the formation of functional compounds (e.g., B vitamins).

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Fortification of rice with vitamins and minerals for addressing micronutrient malnutrition

Cited by 51 publications

References 114 publications

The effect of zinc-biofortified rice on zinc status of Bangladeshi preschool children: a randomized, double-masked, household-based, controlled trial

The effect of zinc-biofortified rice on zinc status of Bangladeshi preschool children: a randomized, double-masked, household-based, controlled trial

Association between iron supplementation and the presence of diarrhoea in Peruvian children aged 6–59 months: analysis of the database of the Demographic and Family Health Survey in Peru (DHS, Peru), years 2009–2019

Lactic Acid Bacteria-Fermentable Cereal- and Pseudocereal-Based Beverages

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