Which Choice of Delivery Model(s) Works Best to Deliver Fortified Foods?

Abstract

Micronutrient deficiencies (MNDs) occur as a result of insufficient intake of minerals and vitamins that are critical for body growth, physical/mental development, and activity. These deficiencies are particularly prevalent in lower-and middle-income countries (LMICs), falling disproportionately on the poorest and most vulnerable segments of the society. Dietary diversity is considered the most effective method in reducing this deficiency but is often a major constraint as most foods rich in micronutrients are also expensive and thereby inaccessible to poorer members of society. In recent years, affordable commodities such as staple foods (e.g., cereals, roots, and tubers) and condiments (e.g., salt and oil) have been targeted as “vehicles” for fortification and biofortification. Despite efforts by many countries to support such initiatives, there have been mixed experiences with delivery and coverage. An important but little understood driver of success and failure for food fortification has been the range of business models and approaches adopted to promote uptake. This review examines the different models used in the delivery of fortified food including complementary foods and biofortified crops. Using a keyword search and pearl growing techniques, the review located 11,897 texts of which 106 were considered relevant. Evidence was found of a range of business forms and models that attempt to optimise uptake, use, and impact of food fortification which are specific to the ‘food vehicle’ and environment. We characterise the current business models and business parameters that drive successful food fortification and we propose an initial structure for understanding different fortification business cases that will offer assistance to future designers and implementors of food fortification programmes.

Multinutrient Biofortification of Maize (Zea mays L.) in Africa: Current Status, Opportunities and Limitations

“…Several interventions have been used to increase dietary intake of nutrients. These include industrial fortification [ 51 ], clinical or pharmaceutical supplementation, dietary diversification [ 12 ] and crop biofortification [ 1 , 52 ]. Crop biofortification is further classified as agronomic and genetic biofortification [ 5 , 53 ].…”

“…It can cause health hazards due to toxicity, especially when food processors exceed the stipulated dose [ 57 ] due to lack of efficient quality monitoring systems, and hence may expose consumers to mineral toxicity [ 40 ]. Another disadvantage of this intervention is that costs incurred by the food processors are included in the price of a commodity and, consequently, the consumer has to bear all these costs [ 51 ]. As a result, fortified foods become more expensive than nonfortified foods.…”

“…The difference in taste of fortified foods can reduce their acceptability by consumers. Relying on fortified foods to curb various nutrient deficiencies has low rural coverage, since the majority of rural people subsist on home-based food products [ 51 , 59 ].…”

Chemical and sensory properties of fruit jams affected by bamboo fiber fortification

“…Food fortification is one of the main strategies identified by the World Health Organization. Staple food (cereals, roots and tubers) same as condiments (salt and oil) is targeted as good food commodities for the fortification, since they are broadly consumed [10].…”

Impact of nutrient supplementation on maternal nutrition and child growth and development in Sub‐Saharan Africa: the case of small‐quantity lipid‐based nutrient supplements

“…Meanwhile, nutrition‐specific interventions such dietary diversification (eg. promoting the consumption of locally available nutrient‐dense food groups), nutrient supplementation, bio‐fortification, and commercial fortification of staple foods may not always yield the desired results in SSA due to a variety of reasons including low affordability, particularly in deprived communities (Lalani, Bechoff, & Bennett, 2019), and low coverage rates of fortified foods (Univ Ghana/GroundWork/Univ Wisconsin‐Madison/KEMRI/UNICEF, 2017). In addition, it is difficult to deliver adequate amounts of iron and zinc in complementary foods for infants without any fortification, even when using a combination of several locally‐available high quality foods (Bose et al, 2019; Osendarp et al, 2016).…”