Fortification of flour is an effective, simple, and inexpensive strategy for supplying vitamins and minerals to the diets of large segments of the world’s population. But it has to be implemented appropriately. Therefore, the millers should be careful to ensure that the precise vitamins are processed correctly, as well as the appropriate premix selection.
The world has taken significant steps towards to end hunger until 2030 globally. However, there is a long way to go to achieve this goal. Flour fortification can be a critical element for the rapid passage of this pathway. Because wheat, corn and rice, which can be fortified with vitamins and minerals, constitute 94 percent of the grain consumed in the world. The fortification of these universally consumed grains offers a unique opportunity to reduce malnutrition, a global problem that affects 2 billion people. For assuring fortification, which is considered as one of the best investments to secure the future of a nation, millers can share responsibility. The millers should be careful to ensure that the precise vitamins are processed correctly, as well as the appropriate premix choice.
An alarming proportion of the world’s population suffers from ‘hidden hunger’, the term used for micronutrient deficiencies because the symptoms often cannot be seen or felt. Deficiencies in micronutrients - small quantities of vitamins and minerals that the body needs for physical and mental development - are widespread affecting more than a third of the world's population. In their absence, individuals and families suffer serious consequences including learning disabilities, impaired work capacity, illness and death. Collectively, the micronutrient deficiencies damage health, cause death, harm reproduction, reduce intelligence, educability and academic achievement, and lower work productivity and occupational choices. Of special concern, micronutrient deficiencies interfere with child growth and development, sometimes permanently.
COVID-19 has serious implications for those most vulnerable to micronutrient malnutrition as well as the essential nutrition services that prevent malnutrition’s debilitating effects. The consequences of micronutrient malnutrition are extensive, including devastating birth defects for babies, impaired brain development in young children, and reduced work capacity among adults that stunts lives and economies. More than ever, food fortification with iron, folic acid, zinc, and other essential nutrients is a life-saving intervention vital to reducing the risk of malnutrition—before, during, and after pandemics. To prevent a rise in malnutrition as a result of the pandemic, countries need to maintain food systems and support large-scale interventions like the fortification of staple foods.
Important micronutrients with public health significance include vitamin A, iron, iodine, B. complex vitamins and zinc. More than two billion people or a third of the world’s population are unable to enjoy their maximum physical and mental potential owing to an inadequate intake of these nutrients. The prevalence of the problem is much higher in developing countries relative to developed countries. Even in developed countries like the USA and Canada, the rates of iron deficiency may reach the levels of public health significance and nearly every country is deficient in folic acid.
Fortification is the process of adding vitamins and/or minerals to foods to increase its overall nutritional content. Fortification when imposed on existing food patterns may not necessitate changes in the customary diet of the population and does not call for individual compliance. It can often be dovetailed into existing food production and distribution systems. For these reasons, fortification can often be implemented and be sustained over a long period of time, making it to be the most cost-effective way to overcome micronutrient malnutrition. Fortification has been recognized by many national governments as an important strategy to help improve the health and nutrition status of millions of people on a continuous and self-sustaining basis.
Cereals are important food vehicles for fortification. Though several foods could be used for carrying micronutrients, wheat flour and maize meal are excellent vehicles because they are staple foods in many parts of the world and key ingredient in so many food preparations. When micronutrient deficiencies are population-wide and result from a combination of low intake and/or low bioavailability, fortification of commonly consumed cereal flours with iron, folic acid and other vitamins offers a number of strategic advantages. In many situations, cereals flours are the best choice for fortification because they are widely and regularly consumed, and mostly processed in centralized facilities with established distribution and marketing capacity. Due to these reasons, grain fortification has played a major role in improving the health of the world populations at large. Currently, over 80 countries now fortify flour.
Advantages of Flour and Maize Meal as Fortification Vehicles
• They are food staples, consumed in significant quantities by all age groups and economic classes at nearly every meal. This makes them ideal vehicles for getting deficient nutrients to the general population.
• Most of the micronutrients being added are naturally present in the whole grain but greatly reduced by the milling refinement process. Many fortification programs simply call for restoring deficit nutrient levels to that contained in the whole grain.
• Fortification at the flour or maize mill is fairly simple and easy to control and regulate.
• The mills producing the bulk of the flour and maize meal are large, modern and centrally located.
• Some micronutrients, like folic acid and other B vitamins, are ideally suited for addition to milled cereals.
• The milling equipment, design and quality control procedures for flour fortification have all been developed and are readily available.
• Fortification of wheat flour and maize meal is an established and proven public health measure with widespread support by the medical and milling communities.
• Cereal fortification is safe because a person cannot eat enough fortified flour or maize meal to exceed the upper safety levels of micronutrient intakes.
• Fortification at the mill is relatively inexpensive and affordable. It will not noticeably impact the cost of the food to the consumer; yet the public will eventually pay for it with a small, overall price increase.
When flour or maize meal is fortified at the mill, it causes all the many products made from that flour at hundreds or thousands of bakeries and food preparation sites to be fortified as well. That makes mill fortification much more efficient than bakery fortification, or even distribution of supplements.
Once the milling infrastructure is in place to fortify flour, it is cost-effective to fortify flour with other nutrients in addition to folic acid. Flour is also routinely fortified with iron, thiamine, riboflavin, and niacin. Some countries also add vitamin D, vitamin B12, vitamin A, and zinc to flour. Many studies have established that fortifying flour with folic acid and iron costs less than 25 US cents per person per year.
The Food Fortification Initiative (FFI)
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- Fortification of Wheat and Maize Flours: Why and how
“It is not enough to simply mandate fortification at a national policy level. Appropriate quality assurance and quality control monitoring must take place within industry at the level of production. Additionally, regulatory bodies need to provide an adequate level of monitoring, support to industry, and enforcement measures if fortification is to be sustained long-term. BioAnalyt has made the process of monitoring fortification and measuring concentrations of various micronutrients in a wide variety of foods easier. In wheat and maize flours, BioAnalyt’s iCheck devices enable the rapid and reliable measurement of iron and vitamin A on-site and without the need for expensive laboratory equipment.”
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- Fortification of flour with vitamin D3: High storage stability, difficult analysis
Vitamin D is playing an increasing role in flour fortification. But whereas the importance of this micronutrient for health is becoming more thoroughly understood all the time, there are still many questions to be answered concerning its practical application in the context of fortification programmes. Mühlenchemie has carried out studies to acquire more information on the storage life of vitamin D in flour. The results indicate that vitamin D3 from the ELCOvit range is highly stable and shows no loss of activity even after twelve months of storage. However, not many laboratories have the expertise necessary for reliable determination of the low percentages present in flour.
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- Flour fortification can prevent some of the world’s most common micronutrient deficiencies
“Food fortification is one of the most cost-effective and sustainable interventions with an unparalleled ability to reach entire populations with essential nutrients, particularly those who might not otherwise have access. The COVID-19 pandemic has further emphasized the value of fortification and the importance of scaling up, so that more people will get the nutrition they need – not just to survive – but to reach their full potential.”
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