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Nutritional and Health-Related Environmental Studies

Food fortification and biofortification to improve micronutrient status during early life

Background

Maternal and child undernutrition is the underlying cause of 3.5 million deaths annually, and 35% of the disease burden in children (Black et al 2008). Undernutrition caused by deficiencies of vitamin A, zinc and iron are of major public health significance in developing countries (The World Bank, 2006). Deficiencies of these micronutrients contribute directly to impaired growth, cognitive development and poor health in children (Bhutta et al 2008). Therefore, effective interventions are urgently needed to reduce the associated disease burden in this vulnerable population group (Bryce et al 2008).

WHO and UNICEF have given high priority to the importance of food-based strategies to control micronutrient deficiencies which include food fortification and biofortification (WHO & UNICEF 2003). Food fortification programmes at the national level generally consist of fortification of a commonly consumed staple food. While this can be an effective strategy for improving micronutrient intake in older children (Lutter et al 2008), a targeted approach is required to meet the specific nutrient needs of younger children. “Home-fortification” is a new food-based approach that consists of providing caretakers with micronutrients in the form of powders or pastes to add directly to complementary foods prepared in the home (Nestel et al 2003). Thus, the micronutrient content of foods that children are accustomed to eating can be increased greatly. Biofortification is another recently introduced food-based strategy that uses conventional breeding techniques to improve the micronutrient quality of staple crops. To date, plant breeders have used selective breeding techniques to increase the provitamin A carotenoid, zinc, and iron levels in several staple food crops. As with food fortification, biofortification of staple crops has the potential to increase the dietary supply of micronutrients. Moreover, biofortification has the potential to reach rural and vulnerable populations who are at highest risk of micronutrient deficiencies (Hotz & McClafferty 2007). In addition, very young children who consume human milk may benefit indirectly from these approaches because of the transfer of certain micronutrients from mother to child through human milk (Canfield et al 2001).

The overall aim of the proposed CRP is to contribute to a better understanding of food fortification and biofortification strategies for improving iron, zinc and vitamin A status in children. Stable isotopes of iron and zinc will be used to collect data on bioavailability of these trace elements from fortified or biofortified foods. Stable isotopes of hydrogen (2H) and carbon (13C) will be used to collect data on the bioavailability and vitamin A activity of provitamin A carotenoids from the labelled foods. Stable isotope-labelled vitamin A will be used to collect data on total body vitamin A pool size. In addition, deuterium oxide will be used to estimate human milk intake in infants, using the “dose-to-mother technique”. Together with information on the vitamin A content of human milk, this technique can be used to collect data on the efficacy of food fortification or biofortification strategies targeted to lactating women for increasing milk vitamin A, and increasing infants’ vitamin A intake from human milk. The outcome of the proposed CRP will contribute to generating new information on the efficacy of food fortification and/or biofortification interventions for improving micronutrient status in children. The results will be of particular relevance to developing countries, where the prevalence of childhood malnutrition is unacceptably high.

Objective

Overall objective

• To contribute to a better understanding of food fortification and biofortification strategies to improve iron, zinc and vitamin A status in children

Specific objectives

• To evaluate the bioavailability of iron, zinc and provitamin A carotenoids from fortified and/or biofortified foods using stable isotope techniques.
• To evaluate the efficacy of food fortification and/or biofortification interventions for improving vitamin A status using stable isotope techniques.
• To evaluate the efficacy of food fortification and/or biofortification interventions targeted to lactating women for increasing the vitamin A content of human milk, and hence infants; vitamin A intake from human milk, using a combination of conventional and stable isotope techniques.
  

Expected research outputs

• New data on the bioavailability of iron, zinc and provitamin A carotenoids from fortified and/or biofortified foods.
• New data on the efficacy of food fortification and/or biofortification interventions for improving the vitamin A status of children.
• New data on the efficacy of food fortification and/or biofortification interventions targeted to lactating women for increasing the vitamin A content of human milk, and infants’ vitamin A intake from human milk.
  

Expected Research Outcomes