Vitamin A Fortification of Wheat Flour: Considerations and Current Recommendations

Abstract

Factors to guide a decision to fortify flour with vitamin A include the extent of deficiency, availability of other food vehicle options, the centrality of milling, market reach and population intake distributions of the flour products, the dietary vitamin A intake required, and associated costs. Large gaps persist in knowledge of these factors, which are needed to enable evidence-based fortification in most countries, leaving most decisions to fortify guided by assumptions. Where flour can and should be fortified, guidelines are given for providing nearly 25% of the Recommended Dietary Allowance for vitamin A to vulnerable groups consuming varying ranges of flour products. The costs will vary according to the level of fortification.

Thriving Public—Private Partnership to Fortify Cooking Oil in the West African Economic and Monetary Union (UEMOA) to Control Vitamin A Deficiency: Faire Tache d'Huile en Afrique de l'Ouest

“…At the second Copenhagen Consensus in 2008, an expert panel of eight outstanding economists, including five Nobel laureates, ranked fortification with micronutrients (vitamins and minerals) among the top three international development priorities [15]. A new recommendation for fortification of wheat flour with vitamin A has been accepted [16]. Vegetable oil is, however, recognized as the most suitable vehicle for vitamin A fortification.…”

Vitamin A stability in Nigerian wheat flour and fortification compliance level

“…The stability of vitamin A is affected by physical and chemical factors such as temperature, (water activity (aw) and moisture content), pH, oxygen, light, time, metallic ions, food composition and enzymes (Wirakartakusumah and Hariyadi, 1998;Manan, 1994). It has been reported that once premix is added at intended ratio concentrations to wheat flour, the stability of vitamin A continues to vary according to temperature, humidity, duration of storage, and other conditions of storage (Klemm et al, 2010). The instability might also be due to its chemical structure, having many double bonds susceptible to degradation (Wirakartakusumah and Hariyadi, 1998).…”

“…In South Africa, there is a proven indication of vitamin A source problems where there are two or three different sources using acetate instead of palmitate or using less stabilised forms which are cheaper (DOH/UNICEF, South Africa, 2009). Adjusting for 30 to 50% lost consideration during transportation, distribution, storage and processing of wheat flour and its products according to Klemm et al (2010), it implies that the minimum acceptable range for Nigerian vitamin A content for flour is 15,000 -21,000 IU/kg (4,504.5 -6,306.3 µgRE). Less than half (35.3%) of the flour samples met this range at 1month storage, 23.5% at 2 months storage and none at 3 months storage.…”

“…Encapsulation can only provide additional moisture barrier if the formulation ingredients are stable. The form of vitamin A and premix to be used in fortification should be the highest grade, appropriate for the intended food vehicle, stable under ambient conditions and for the duration of expected use, and introduced into the food supply in accordance with existing industry standards (Klemm et al, 2010). There is a research need to determine the level of encapsulation and ingredients in the Nigerian premix.…”

“…Many countries especially in SubSaharan Africa (SSA) and Asian Countries are mandatorily fortifying wheat flour, maize flour, wheat meal, corn meal, and rice with different micronutrients such as vitamin A, iron, B-complex, zinc, and folate. Currently, 19 lows-and low middle -income countries are fortifying or proposing to fortify wheat flour with vitamin A (Klemm et al, 2010). There has been mandatory vitamin A fortification of wheat and maize flour in USA (1974), Venezuela (1996), Philippines (1996Philippines ( -2000, Egypt (1999), Indonesia (2000), Guatemala (2002), South Africa (2003, Zambia (2003), Nigeria (2004), Morocco (2005) and Ghana (2009).…”