food processing to challenge malnutrition symposium “food technology for better nutrition”...

Food processing to challenge malnutrition

Food processing to challenge malnutrition

Symposium “food technology for better nutrition”Nutrition Foundation of India

30 Nov – 01 Dec, 2007New Delhi, India

Presenter: Bertrand SalvignolCommodity Quality Control OfficerWorld Food Programme, Bangkok

Symposium “food technology for better nutrition”Nutrition Foundation of India

30 Nov – 01 Dec, 2007New Delhi, India

Presenter: Bertrand SalvignolCommodity Quality Control OfficerWorld Food Programme, Bangkok

Symposium Food Technology for better nutrition. New Delhi, 30 Nov – 01 Dec, 2007

Food processingFood processingDefinition:

Food processing is the set of methods and techniques used to transform raw ingredients into products for consumption by humans or animals … to produce attractive, nutritive, affordable, marketable food products and stabilized for storage over long periods.

Benefits of food processing: Improved food security Creating sustainable livelihoods and economic development Improved bio-availability and digestibility, toxin removal, preservation, flavor

improvement, ease of marketing and distribution. Increased seasonal availability and improved transportation of delicate

perishable foods across long distances. Improved quality of life for people with allergies, diabetics, and others who

cannot consume some common food elements. Enables the addition of extra nutrients (e.g. minerals and vitamins). Increased shelf life, less susceptibility to spoilage than unprocessed foods.


Brief history of food processingBrief history of food processingPrehistoric times: need for preservation techniques Slaughtering, sun drying, salt preservation, fermenting Then cooking: roasting, smoking, oven baking, and steaming

Mesopotamian, Egyptian, Greek, Latin times: … milling, brewing …

Modern history: 1809: Nicholas Appert – Vacuum bottling 1810: Peter Durand - Canning / tinning 1862: Louis Pasteur – Pasteurization 20th century: spray drying, ice drying, extrusion-cooking, freezing,

microwave, continuous treatments …, and addition of preservatives, colorants, enzymes, micro-nutrients, etc


Safe

Well packaged

Easy to transport and to store

Cost-effective

Versatile

Easy to target

Practical, easy to prepare, enabling fuel savings

Culturally acceptable

Legally authorized

And

Nutritious …

Specifications of WFP’s foodSpecifications of WFP’s food


NutritionalNutritional quality of WFP’s foodquality of WFP’s food

Macronutrients and Energy contents: Protein / Fat / kcal Micronutrient contents: % of RNI/RDA covered according to age,

sex, physiological status and programme nutritional objectives Nutrient bio-availability, food digestibility Nutrient density: consistency (special food for young children),

while avoiding displacement of essential nutrients Nutrient availability at beneficiary level: preservation during

storage, preparation, …

… In accordance with the Codex Alimentarius, National

Regulations and WFP specifications.


WFP’s processed foodsWFP’s processed foodsPre-cooking (roasting / extrusion-cooking / IR treatment)• Fortified Blended Foods: Wheat Soya Blend [Indiamix], Corn Soya Blend,

Rice Milk Blend, … (multi-min/vit mix)Milling• Fortified flours: maize meal, wheat flour,

atta (multi-min/vit mix)Baking• Fortified biscuits (multi-min/vit mix)Refining• Fortified oil (Vitamin A, Vitamin D)Grinding / mixing• Fortified salt (Iodine)Steaming / Frying• Fortified noodles (multi-min/vit mix)Roasting / Grinding / Blending• Emergency commodities (Plumpy Nut®, RUTF, RUSF, …)

Practical, Versatile,

Nutritious, cheap (cost-effective), easy to

produce locally, easy to

target, in accordance with WFP policy

Practical, Versatile,

Nutritious, cheap (cost-effective), easy to

produce locally, easy to

target, in accordance with WFP policy


WFP’s food processing activities in Asia(as WFP’s region)

WFP’s food processing activities in Asia(as WFP’s region)

Fortified Blended Foods Fortified Biscuits

Fortified Atta

Fortified Blended Foods (WSB & CSB)

Fortified Biscuits

Fortified Blended FoodsFortified Oil & Ghee

Fortified Biscuits (on going study)

Fortified Coconut Oil

Fortified Blended Foods (RMB, CMB, CSM)

Fortified biscuit

Fortified Noodles (since 2004)Fortified Biscuits

Fortified Blended Foods(January 2006)

...and wheat flour fortification in Afghanistan, and Pakistan, FBF and biscuits production in Pakistan


Why food processing is now focusing on micronutrient

fortification and not on food with protein & energy?

Nutrition Science Pendulum

is Swinging


Proteins (50s-60s)

Quality Quantity

Calories (70s-80s)

Micronutrients (90s)

Enough quantity, Micronutrients, Animal Protein, Energy Density, Fat quality and Active feeding

The food nutrition pendulum(Soekirman 2006, modified from Martorell & Rivera, 2000, Advances in Nutrition Research, 100 yrs PAHO)

Balance Diet

FortificationSupplementation

Ongoing

SupplementationFortification

Milk

SprinklesRUTF / RUSF

(2000’s)


Integrated Approaches to eliminate Integrated Approaches to eliminate

Micronutrient DeficienciesMicronutrient Deficiencies (V.Mannar, MI, 2003)(V.Mannar, MI, 2003)

Rel

ativ

e co

ntr

ibu

tion

of

inte

rven

tion

s to

eli

min

ate

MN

D

Supplementation

Public Health Measures

Fortification

Dietary improvement

2000 2005 2010


WFP policy (Executive Board, May 2004)WFP policy (Executive Board, May 2004)

• Careful attention to be paid to micronutrients in needs assessment and ration planning,

• Programming donor-supplied or internationally procured fortified foods on an increasingly large scale,

• Promotion and use of locally-produced and fortified commodities in at least 13 low income, food deficit countries,

• Advocacy for fortification at national and international policy making levels


• The world’s leading economists ranked the solutions that would offer the biggest bang for the buck, micronutrients came in just near the top.

• It would cost about 25 cents to help each individual suffering from iron deficiencies, yet the benefits in terms of increased productivity, run to as much as $50 per person/year.

• In other words, we could do more than 200 times as much good as we spend.Bjørn Lomborg (director of the Copenhagen Consensus Center) in Foreign Policy, June 2007.

Copenhagen consensusCopenhagen consensus


Controlling and Preventing micronutrient deficienciesControlling and Preventing micronutrient deficiencies

There are two ways to control micronutrient deficiencies:

By reducing the demand for a specific micronutrient

Or

By increasing the supply of micronutrients.


Reducing the demand for micronutrientsReducing the demand for micronutrientsReducing the demand is possible by NON-FOOD

interventions: Improvement of hygiene. Improvement of prophylaxis (e.g. by conventional

immunisation). Improvement of treatment of infectious diseases. De-worming to control anaemia. Malaria control to combat anaemia. Health measures such as sun exposure to protect

against vitamin D deficiency.

WFP in Asia: Collaboration with MOHs, NGOs, UNICEF


Increasing the supply of micronutrientsIncreasing the supply of micronutrients

There are several ways to increase the supply of micronutrients :

Supplementation (including Sprinkle strategies),

Food-based approach (including Fortification of foods),


Increasing the supply of micronutrientsIncreasing the supply of micronutrients

The supplementation approach consists of:

• Distribution of Vitamin A capsules or Iron/Folate tablets; low-cost, successful but not necessarily cost effective approaches.

• New approaches: Sprinkles (also called home-fortification)

Distributing micronutrients often delivers only a few micronutrients, and as they are highly targeted approaches they may reach only a limited population and have low compliance rate.


Increasing the supply of micronutrients Increasing the supply of micronutrients

The food-based approach consists of:

• Increasing the food production by more efficient agricultural practices (e.g. India, Vietnam, China, etc.).

• Increasing the micronutrient content of foods by improving the plant genome (bio-fortification).

• Increasing consumption of specific foods by nutrition education, lowering food prices, improving access to the market, subsidizing foods, and other similar measures.


Increasing the supply of micronutrients Increasing the supply of micronutrients

Fortification approach (included in a food-based approach) refers to the addition of essential micronutrients to food.

• Fortification of food with vitamins and minerals was introduced in the 20’s in western countries (e.g. salt iodisation in Switzerland started in 1923).

• The efficiency of these programmes were extensively analysed and documented. In the USA flour fortification in 1938 reduced mortality due to pellagra from 3,000 per year in 1938 to zero in 1950.

• In the developed countries a wide range of products are fortified with minerals and/or vitamins (e.g. breakfast cereals, oil/margarine, flours, etc.).


Cost of Food FortificationCost of Food Fortification

• Salt: US$ 0.1 / MT

• Wheat Flour: US$ 1 - 4 / MT

• Fortified Biscuits: US$ 9 - 20 / MT

• Fortified Blended Foods: US$ 15 - 17 / MT

The cost includes fortificant cost, investment in new equipment, quality assurance at factory level, monitoring cost at the State Level (e.g. Atta fortification at village level in Gujarat is costing Rp 0.10/kg)


Cost-effectiveness of different interventions(from WHO-FAO, 2006)

Cost-effectiveness of different interventions(from WHO-FAO, 2006)

Fortification is the most cost effective strategy … but does it work?

NB: DALY: cost per disability-adjusted life-year saved. Context: West Africa

Pneumonia manag.

Fe fortif.

Zn suppl.

Oral rehyd.

Water disinfection

Vit. A & Zn fortif.Fe suppl.

0

50

100

150

200

250

Co

st

pe

r D

AL

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ave

d


Evaluation (Efficacy)in controlled conditions

Evaluation (Efficacy)in controlled conditions

Ghana: Comparison of 3 fortified supplement / RCT. “ …All 3 supplements had positive effects on motor milestone acquisition by 12 mo compared with no intervention…”. (Adu-Afarwuah et al, AJCN 2007)

Kenya: Maize meal / RCT. “ … consumption of whole maize flour fortified with NaFeEDTA caused modest, dose-dependent improvements in children’s iron status …” (Andang’o et al, Lancet 2007)

Pakistan: Wheat flour fortification with lysine. These results indicate that lysine fortification of wheat flour can significantly improve sensitive indicators of nutritional status in a population consuming a diet in which 58% to 65% of the protein, depending on age and sex, is supplied by wheat. (Hussain et al. Food Nut Bull 2004)

Vietnam: “… 6-month efficacy trials have established that fortification of fish sauce with iron can significantly improve iron status and reduce anemia and iron deficiency…” (Thuy et al. AJCN 2003).


Indonesia: Home fortification in emergency. “… providing micronutrients [sprinkles] … is feasible. (de Pee et al, Food Nut Bull 2007)

Central America: Sugar fortification in Guatemala and Honduras. “ …prevalence of low plasma retinol decrease over time …”. (ADB, WHO – 2004)

• South Africa: Fortified biscuits. “… fortification of a biscuit … at a level of 50% of the RDA is enough to maintain serum retinol concentrations from day to day …”. (van Stuijvenberg et al. Pub Health Nut 2001)

• Haiti: Donated CSB. “…CSB was key to achieving the recommended iron and zinc densities of complementary foods for children 12 to 23 months of age …” (Ruel et al, Food Nut Bull 2004)

• Morocco: “ … double-blind effectiveness trial in Moroccan schoolchildren has demonstrated that the dual fortification of salt with iron and iodine can improve both iron and iodine status (Zimmermann et al. Eur J Endo 2002)

Evaluation (Effectiveness)in real conditions

Evaluation (Effectiveness)in real conditions


WFP STUDY: Micronutrient losses in FBF at factory and household level (gruel preparation)

• Vitamin A, 5 minutes of boiling reduced the content by about 42% percent, which is in line with 50% retention of vitamin A reported in gruels made from maize meal (Johnson, 2004)

• Vitamin C, 5 minute of boiling, vitamin C content dropped from 348 mg/kg to below the detection limit.

Other WFP studies:

• Retention of micronutrient in biscuits and noodles at factory level in Bangladesh and Indonesia

• Shelf-life study of Rice-Soya-Blend in Thailand

• Digestibility, Energy-density, Destruction of anti-nutritional factors, microbiology, rancidity of Fortified Blended Foods produced by different processes (by Kemin Industry Ltd.)

Product studiesProduct studies


Product study: WFP study of micronutrient losses in atta at mill and household level (roti preparation)

Product study: WFP study of micronutrient losses in atta at mill and household level (roti preparation)

Shelf-life loss Preparation loss Total loss

Vitamin A 7% 27% 34%

Vitamin B1 1% 33% 34%

Vitamin B2 20% 17% 37%

Vitamin B3 3% 5% 8%

Folic Acid 21% 33% 54%

Shelf-life loss Preparation gain Total gain

Iron 1% 25% ± 24%

Zinc 0% 15% ± 15%

Calcium 3% 17% ± 14%

± Most likely due to contaminant sources of minerals, i.e. dirt, cooking utensils, etc.


Achievement in India:Achievement in India:Small-scale atta fortification in Surendranagar district, Gujarat

• Developed appropriate premix composition (diluted) for small-scale fortification, Village Chakkis and Home Chakkis

• Increased nutrition awareness on the importance of fortification with an intensive IEC campaign in 400 villages

• Enhanced the local capacity to produce fortified flour (bajra or wheat) by training 446 Chakki Wallahs on fortification

• Improved access to fortified food for 90% of Gujaratis

• Demonstrated how to maintain the premix pipeline

• Devised a monitoring system for premix and fortified atta

• Provided a replicable model for small-scale atta fortification in Gujarat and India


School feeding

• Fortified biscuits – Distributed to 674,360 school children

– Produced in India and used in WFP operations in Afghanistan

– Efficacy study results: Reduction in anemia status and Improved serum retinol levels

• On-site fortification with micronutrients (new strategy)– Add micronutrients directly to traditional foods cooked in the schools

– Build capacity of 2,400 school cooks to add micronutrients

– Build capacity of 1,200 school teachers to report utilization

– Develop distribution pipeline for micronutrients

– Create nutrition awareness among school staff and parents

Achievement in India:Achievement in India:


INDIAMIX:

• In 2006, WFP distributed 23,555 MT to 1.4 million beneficiaries

• Extruded fortified blended food, produced in 7 factories across India

• Versatile product that can be adapted for different target populations

– Distributed to children, pregnant and lactating women, and adolescent girls thru the ICDS

• Wheat (50%), Soya (25%) Sugar (20%) + Micronutrients

– Distributed to people receiving ART treatment• Wheat (75%), soya (25%) + More Micronutrients

• Indiamix is now distributed by 6 State governments

Improvement for the future:

• Enhance palatability, digestibility, better micronutrient composition and stability, improved product shelf-life, etc.

Achievement in India:Achievement in India:


Future challengesFuture challenges Access to (potable) water

High commodity prices (due to bio-fuels, meat consumption, etc.) “forcing” poor people to subsist on diet consisting of staple foods such as starchy roots and tubers and little else.

Pressure from population growth and poverty

Increased urban population

More targeted interventions (People Living With Hiv/Aids, elderly, etc.)

New pandemics (e.g. Avian Human Influenza)

New food rules and regulations (i.e. local and international)

New technologies (e.g. processing, analytical, etc.)

New products, packaging, etc.

Mainstreaming fortified foods into large scale nutrition-feeding programmes and demand generation at the consumer level

WFP needs to keep up with innovations and to collaborate with organizations (e.g. research institutes, FAO, GAIN, MI, etc.) as well as the private sector (e.g. DSM, Kemin, etc) to propose sustainable, viable, and cost-effective solutions to fight against malnutrition.


Integrated approaches Integrated approaches

A food-based approach is the most sustainable way of meeting the nutritional needs of populations

• It empowers individuals and households to take ultimate responsibility over the quality of their diet through their own production of nutrient-rich foods and informed consumer choices.

• It can address multiple nutrients simultaneously, including dietary energy, protein and various micronutrients, without the risk of antagonistic nutrient interactions or overload.

In the meantime, food technology (incl. fortification processes) must be part of this integrated approach to enhance food nutritional quality, as well as its safety.


Thank youThank you

food processing to challenge malnutrition symposium “food technology for better nutrition”...

Documents

food processing definition

benefits of food processing

improved food security

marketable food products

fortified flours

consistency special

common food elements

new delhi