Micronutrient Fortification of Food: Issues for Asia

Smith, Geoffry

doi:10.3177/jnsv.61.s183

Cited by 9 publications

(5 citation statements)

References 27 publications

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“…Large‐scale, mandatory food fortification has several advantages: it has potential to be a sustainable and cost‐effective intervention, and it requires little or no behavior change on the part of the consumer, as the fortificant is added to a commonly consumed food vehicle (i.e., staple food or condiment). Moreover, food fortification can restore nutrients such as thiamine, riboflavin, and iron lost during processing .…”

Section: Strategies To Improve Thiamine Statusmentioning

confidence: 99%

Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs

Whitfield

Bourassa

Adamolekun

et al. 2018

Annals of the New York Academy of Sciences

231

335

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Thiamine is an essential micronutrient that plays a key role in energy metabolism. Many populations worldwide may be at risk of clinical or subclinical thiamine deficiencies, due to famine, reliance on staple crops with low thiamine content, or food preparation practices, such as milling grains and washing milled rice. Clinical manifestations of thiamine deficiency are variable; this, along with the lack of a readily accessible and widely agreed upon biomarker of thiamine status, complicates efforts to diagnose thiamine deficiency and assess its global prevalence. Strategies to identify regions at risk of thiamine deficiency through proxy measures, such as analysis of food balance sheet data and month-specific infant mortality rates, may be valuable for understanding the scope of thiamine deficiency. Urgent public health responses are warranted in high-risk regions, considering the contribution of thiamine deficiency to infant mortality and research suggesting that even subclinical thiamine deficiency in childhood may have lifelong neurodevelopmental consequences. Food fortification and maternal and/or infant thiamine supplementation have proven effective in raising thiamine status and reducing the incidence of infantile beriberi in regions where thiamine deficiency is prevalent, but trial data are limited. Efforts to determine culturally and environmentally appropriate food vehicles for thiamine fortification are ongoing.

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Section: Strategies To Improve Thiamine Statusmentioning

confidence: 99%

Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs

Whitfield

Bourassa

Adamolekun

et al. 2018

Annals of the New York Academy of Sciences

231

335

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“…Micronutrient supplementation or fortification has been used in recent years instead of pills or capsules in early years to combat anemia or other micronutrient deficiencies in view of the safety of overdose and the sustainability of programs [8–10]. Moreover, micronutrient powders (MNPs), such as Sprinkles [11] and Yingyangbao (YYB, Chinese Child Improvement Program) [10], have been developed as an approach for delivering iron and other micronutrients to young children. MNPs are single-serving packets of vitamins and minerals in powdered form (Sprinkles) or based on soybean or milk powder (YYB) that can be mixed into semisolid food or water before consumption.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of community-based complementary food supplement (Yingyangbao) distribution in children aged 6-23 months in poor areas in China

Wang

Chang²,

Zhao

et al. 2017

PLoS ONE

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BackgroundPoor growth and micronutrient deficiency mainly attack older infants and young children. Some countries have adopted clinically effective measures to combat malnutrition, but the compliance and improvement in efficacy of intervention vehicles in national programs require evaluation.MethodsBaseline and follow-up cross-sectional surveys were conducted before and after a nutrition intervention program in 3 national poverty counties in China. Soybean-based complementary food supplements called Yingyangbao (YYB) in Chinese and training materials on child feeding were distributed to households with children aged 6–23 months for 18 months. Representative children were selected by probability proportional to size sampling methods to assess compliance of YYB and the intervention efficacy. A questionnaire was designed to collect data on basic characteristics of children, breastfeeding, 24-hour dietary intake, and consumption and appetite of YYB. Anthropometrics and hemoglobin were measured in the field, and anemia prevalence was evaluated. Venous blood was drawn from children aged 12–35 months to evaluate micronutrient status. Logistic regression was used to identify the risk factors for children’s anemia.ResultsOf the children involved in the follow-up survey (n = 693), the P50 (P25, P75) intake of YYB was 6.7 (3.5, 7.0) sachets weekly, and 54.7% of the children liked the taste of YYB. Compared with the baseline situation (n = 823), the proportion of children fed a diverse diet and foods rich in iron or vitamin A increased (P < 0.01) in the follow-up study. The prevalence of stunting and underweight decreased (P < 0.05), the prevalence of anemia decreased from 28.0% to 19.9% (P < 0.01), and the prevalence of vitamin B12 deficiency decreased from 26.8% to 15.4% (P < 0.01). For children aged 12–23 months, those who liked YYB and consumed 6 or more sachets of YYB weekly were at lower risk for anemia (OR = 0.34, 95% CI 0.13–0.90, P < 0.05), but the risk of stunting was associated with a non-diverse diet (OR = 1.48, 95% CI 1.06–2.07, P < 0.05).ConclusionThe quality of diet and nutritional status of children aged 6–23 months are significantly improved by the intervention of YYB and nutrition education, and good compliance to YYB contributes to a low risk for anemia.Trial RegistrationChinese Clinical Trial Registry ChiCTR-OOC-16008846

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“…29 To improve the nutrition and health status and the prevalence of IDA among children aged 6-24 months in poor areas, in October 2012, the Chinese government launched a major primary healthcare project to prevent malnutrition and anaemia. [30][31][32] The project provides free, iron-rich nutrition packages to caregivers and promotes scientific knowledge and proper child feeding skills. 20 In 2013, 187 counties in Western China were covered by this project, 33 and between 2012 and 2017, the national anaemia rate decreased from 32.9% to 17.6%.…”

Section: Discussionmentioning

confidence: 99%

Anaemia prevalence and its associated factors in children under 5 years in Western China: a systematic review

Liao

Leng

et al. 2022

bmjpo

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BackgroundIron-deficiency anaemia disproportionately affects children in low-income and middle-income areas; Western China is a prime example. Given the health risks associated with childhood anaemia and the large heterogeneity of published studies on this subject, we conducted a systematic review of the evidence regarding anaemia prevalence and associated factors in children under 5 years in Western China.MethodsWe searched for all relevant studies on the prevalence of iron deficiency anaemia in children under 5 years in Western China, obtaining research between 1 January 2011 and 30 June 2021, in English and Chinese from Medline, Embase, PubMed, Web of Science, CNKI, WanFang Data and VIP. Two reviewers independently screened titles and abstracts; three reviewed full texts of relevant articles for data extraction and performed quality assessments. The median prevalence was calculated on unweighted pooling, stratified by region, sex, age and ethnic group. Associated factors and a linear trend chart were conducted to identify trends and research highlights.ResultsAmong the 55 articles included, most were cross-sectional studies (39, 70.91%). The prevalence of anaemia in children under 5 years in Western China ranged from 3.69% to 75.74% (median 42.54% (IQR 25.62%–52.56%)); the highest levels were in Qinghai province: 59.10%–75.74% (median 67.80% (IQR 64.70%–72.75%)); the highest levels were reported in the subgroup of children aged 6–12 months (median 50.09% (IQR 34.35%–59.04%)). Regional contexts, individual sociodemographic characteristics and feeding behaviours, and nutritional programme interventions were factors associated with anaemia prevalence.ConclusionThe prevalence of anaemia in children under 5 years in Western China is concerningly high. For this multiethnic and economically underdeveloped region, more high-quality and prospective studies are needed to inform evidence based and targeted preventive strategies to decrease the high prevalence of anaemia among young children.

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Micronutrient Fortification of Food: Issues for Asia

Cited by 9 publications

References 27 publications

Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs

Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs

Effectiveness of community-based complementary food supplement (Yingyangbao) distribution in children aged 6-23 months in poor areas in China

Anaemia prevalence and its associated factors in children under 5 years in Western China: a systematic review

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