Aligning the Epidemiology of Malnutrition with Food Fortification: Grasp Versus Reach
Large-scale food fortification (LSFF) has been recognized as one of the most cost-effective interventions to improve the intake of vitamins and minerals and decrease the burden of micronutrient deficiency. Indeed, the simple addition of micronutrients to staple foods, such as wheat, maize and rice,...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Nutrients |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6643/15/9/2021 |
| _version_ | 1797602022067798016 |
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| author | Megan W. Bourassa Reed Atkin Jonathan Gorstein Saskia Osendarp |
| author_facet | Megan W. Bourassa Reed Atkin Jonathan Gorstein Saskia Osendarp |
| author_sort | Megan W. Bourassa |
| collection | DOAJ |
| description | Large-scale food fortification (LSFF) has been recognized as one of the most cost-effective interventions to improve the intake of vitamins and minerals and decrease the burden of micronutrient deficiency. Indeed, the simple addition of micronutrients to staple foods, such as wheat, maize and rice, or condiments, including salt and bouillon, has tremendous potential to impact malnutrition. However, most LSFF programs have been poorly designed and have not taken into consideration critical inputs, including current levels of nutrient inadequacy and per capita consumption of different food vehicles when deciding which nutrients to add and at what concentrations. LSFF programs, like some other nutrition interventions, also tend to have low coverage and reach and lack monitoring to measure this and course correct. These program design flaws have resulted in limited effectiveness and have made it difficult to determine how best to harmonize LSFF with other interventions to reduce micronutrient deficiencies, including efforts to enhance dietary diversity, biofortification and supplementation. Furthermore, LSFF has often been touted as a population-based intervention, but in fact has heterogenous effects among sub-groups, particularly those with limited access to or inability to afford fortified foods, as well as those with higher physiological requirements, such as pregnant and lactating women. This article focuses on these limitations and the concerted efforts underway to improve the collection, analysis, and use of data to better plan LSFF programs, track implementation, and monitor coverage and impact. This includes a more sophisticated secondary analysis of existing data, innovations to increase the frequency of primary data collection and programmatically relevant visualizations of data of sub-national estimates. These improvements will enable better use of data to target resources and programmatic efforts to reach those who stand to benefit most from fortification. |
| first_indexed | 2024-03-11T04:11:23Z |
| format | Article |
| id | doaj.art-a6db12ac3d504d55909c260fabd190be |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-11T04:11:23Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-a6db12ac3d504d55909c260fabd190be2023-11-17T23:28:04ZengMDPI AGNutrients2072-66432023-04-01159202110.3390/nu15092021Aligning the Epidemiology of Malnutrition with Food Fortification: Grasp Versus ReachMegan W. Bourassa0Reed Atkin1Jonathan Gorstein2Saskia Osendarp3Micronutrient Forum, Washington, DC 20005, USAMicronutrient Forum, Washington, DC 20005, USABill & Melinda Gates Foundation, Seattle, WA 98109, USAMicronutrient Forum, Washington, DC 20005, USALarge-scale food fortification (LSFF) has been recognized as one of the most cost-effective interventions to improve the intake of vitamins and minerals and decrease the burden of micronutrient deficiency. Indeed, the simple addition of micronutrients to staple foods, such as wheat, maize and rice, or condiments, including salt and bouillon, has tremendous potential to impact malnutrition. However, most LSFF programs have been poorly designed and have not taken into consideration critical inputs, including current levels of nutrient inadequacy and per capita consumption of different food vehicles when deciding which nutrients to add and at what concentrations. LSFF programs, like some other nutrition interventions, also tend to have low coverage and reach and lack monitoring to measure this and course correct. These program design flaws have resulted in limited effectiveness and have made it difficult to determine how best to harmonize LSFF with other interventions to reduce micronutrient deficiencies, including efforts to enhance dietary diversity, biofortification and supplementation. Furthermore, LSFF has often been touted as a population-based intervention, but in fact has heterogenous effects among sub-groups, particularly those with limited access to or inability to afford fortified foods, as well as those with higher physiological requirements, such as pregnant and lactating women. This article focuses on these limitations and the concerted efforts underway to improve the collection, analysis, and use of data to better plan LSFF programs, track implementation, and monitor coverage and impact. This includes a more sophisticated secondary analysis of existing data, innovations to increase the frequency of primary data collection and programmatically relevant visualizations of data of sub-national estimates. These improvements will enable better use of data to target resources and programmatic efforts to reach those who stand to benefit most from fortification.https://www.mdpi.com/2072-6643/15/9/2021fortification program designnutrient adequacyepidemiologylarge-scale food fortificationmicronutrients |
| spellingShingle | Megan W. Bourassa Reed Atkin Jonathan Gorstein Saskia Osendarp Aligning the Epidemiology of Malnutrition with Food Fortification: Grasp Versus Reach Nutrients fortification program design nutrient adequacy epidemiology large-scale food fortification micronutrients |
| title | Aligning the Epidemiology of Malnutrition with Food Fortification: Grasp Versus Reach |
| title_full | Aligning the Epidemiology of Malnutrition with Food Fortification: Grasp Versus Reach |
| title_fullStr | Aligning the Epidemiology of Malnutrition with Food Fortification: Grasp Versus Reach |
| title_full_unstemmed | Aligning the Epidemiology of Malnutrition with Food Fortification: Grasp Versus Reach |
| title_short | Aligning the Epidemiology of Malnutrition with Food Fortification: Grasp Versus Reach |
| title_sort | aligning the epidemiology of malnutrition with food fortification grasp versus reach |
| topic | fortification program design nutrient adequacy epidemiology large-scale food fortification micronutrients |
| url | https://www.mdpi.com/2072-6643/15/9/2021 |
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