flour fortification:malnutrition and health effects of whole grains

FLOUR FORTIFICATION : MAL-NUTRITION & HEALTH EFFECTS ON WHOLE GRAINS

Malik Tariq Sarwar Awan, Food Technologist & Consultant,

Chairman Research Wing to Pakistan Flour Mills Association,Editor, Wheat Milling News, PFMA .

Member Pakistan Society of Food Scientists and Technologists


Flour fortification Significance• Fortification involves the addition of nutrients

to foods that are excluded during processing or for any other reason addressing the main health conditions under subject to Mal-Nutrition of masses.

• In other words, the aim of fortification is retaining stability in socio-economic parameters.


• Milling depletes Essential Nutrients from Wheat


MALNUTRITION:

• Deficiency of essential nutrients leading to diseases and mortality.


Malnutrition can take a number of forms:• Stunting• Wasting and • Micronutrient deficiency


• Stunting: is a result of a child having a poor diet – too few calories or too little nutritious food, or both. Stunting refers to a child who is too small for their age because they have not developed properly


• Wasting : results from a severe, and often sudden, lack of food or disease.

• In total, 55.5 million children – around 9% of all children globally – are wasted


• Micronutrient deficiencies : represent a serious risk to a child’s health.

• They account for one-third of all malnutrition-related child deaths, and 10% of all children’s deaths.


Health Effects of Whole Grains:• Heart disease

Studies have consistently found that individuals with three or more servings of whole grain foods per day have a 20 to 30 percent lower risk for atherosclerotic cardiovascular disease compared to individuals with lower intakes of whole grains


Health Effects of Whole Grains:• Cancer

Whole grains appear to be associated with a reduced risk of a number of gastrointestinal cancers as well as several hormone-dependent cancers.

A review of 40 studies on gastrointestinal cancers found a 21 to 43 percent lower cancer risk with high intake of whole grains compared to low intakes.


Health Effects of Whole Grains:• Gastrointestinal health

The effect of promoting normal intestinal regularity makes whole- and high-fiber grain products integral components of diet plans to help alleviate constipation and decrease the risk of developing diverticulosis and diverticulitis.


Health Effects of Whole Grains:• Diabetes

The American Diabetes Association Guidelines for the Prevention and Treatment of Diabetes recognizes the role of whole grains and fiber in reducing the risk of diabetes and maintenance of blood glucose levels.

Major epidemiological studies show a reduced risk of 20 to 30 percent for type 2 diabetes associated with higher intakes of whole grain or cereal fiber


Health Effects of Whole Grains:• Weight management

Studies show that people who include whole grains as part of a healthful diet are less likely to gain weight over time. The mechanisms by which whole grains may support weight management include enhanced satiety to lower energy intake, prolonged gastric emptying to delay the return of hunger, and increased insulin sensitivity to lower insulin demand.

Wheat flour – 67 countries Wheat flour and rice – 3 countries(Nicaragua, Panama, Philippines)

Rice – 1 country(Papua New Guinea)

Wheat flour, maize flour, and rice – 2 countries(Costa Rica and the United States)

Wheat flour and maize flour –12 countries No grain fortification legislation

* Legislation has effect of mandating grain fortification with at least iron or folic acid.Legislation status from the Food Fortification Initiative (www.FFInetwork.org) March 2016

Industrially Milled Flour and RiceFortification Legislation


Fallacies Facts Healthy people do not need to eat fortified flour or bread products.

Everyone in Pakistan should eat fortified flour everyday and for a lifetime as it works as a preventative measure.

The taste and texture of fortified flour is different than unfortified flour.

Fortified flour has the same taste and quality of unfortified flour.

Eating fortified flour puts people at risk for consuming too much iron and making them sick.

No side effects on health have been reported in the studies published on fortified flour. In addition, iron and folic acid do not accumulate in the body. Excess of these nutrients come out in a person’s waste.


Fallacies Facts

Fortified flour can cause obesity. Fortified flour is not cause of obesity than unfortified flour.

Vitamins and minerals in flour decay when bread is baked.

Baking has no effect on the vitamin and mineral content in flour.


Common Concerns:-

1. What do iron and folic acid do for the body?

Iron helps in the production of red blood cells and carries oxygen to the body cells, helps in synthesis of DNA and electron transport. Iron metabolism helps to protect the body against infections and promotes efficient functioning of the brain, aids in physical activity and productivity. It prevents some premature births.

Folic Acid, also known as Vitamin B9, helps to produce and maintain new cells and therefore prevents neural tube defects. It also helps to make normal red blood cells and thus prevents one type of anemia.


Common Concerns:-

2. Who are the most vulnerable to micronutrient deficiencies? Why? Children and women of reproductive age are most vulnerable, but generally everyone needs nutrients for good health. Children need to eat nutritious meals several times a day, because their bodies are growing. Women of reproductive age require extra nutrients during pregnancy and while breastfeeding. These nutrients are needed for the mother’s wellbeing, the development of the fetus during pregnancy, and for the baby during breastfeeding.


Common Concerns:-3. How can you identify flour that is fortified?

Look for fortified flour logo on your bags of flour.

4. What can you say to patients who are upset that fortified flour has increased the price of bread? While fortifying flour has caused a small increase in the price of bread, these added vitamins and minerals in bread helps people to be smarter, stronger, and healthier. Improving nutrition through these added vitamins prevents diseases, strengthens immune systems, and improves productivity. Thus money is saved in lower healthcare costs, and money is made in increased productivity.


Common Concerns:-

5. Fortification v/s Supplements :-

• Fortification is more Effective than Supplementation.

• Fortification does not cause people to consume more than the tolerable upper intake level (UL) of folic acid and iron whereas, Supplements exceeded the Upper Limit (2.7%).

• Folic acid fortification does not cause cancer or mask B12 deficiency whereas, High doses of supplemental folic acid reportedly enhance the inflammatory response in the human colon, which is thought to predispose individuals to colon cancer.


Common Concerns:-

5. Fortification versus Supplements :-

• Fortifying with iron does not contribute to iron overload in beta thalassemia and may contribute slightly to the risk of iron overload in individuals with hemochromatosis. This risk is counterbalanced by the developmental benefits of iron in children.

• Supplements are based on individual health due to which have greater risk for surpassing the UL (Upper Limit) when subjected to masses whereas Fortification is subjected to masses’ health as whole.


Common Concerns:-

6. Enrichment versus fortification:-

• Restoration or enrichment of wheat flour returns nutrients lost in the milling process to their original levels. For iron, this is generally around 35 ppm.

• 25 Iron fortification is the addition of extra iron, usually up to 55–65 ppm, as is practiced in most Latin American countries.


Enhancement done in Wheat Flour by:-• Improvers: increase the speed of the baking

process, strengthen dough.• Reducing agents-break down gluten• Enzymes-supplement inherent enzymes and

minimize variations caused by nature• Emulsifiers-improve loaf volume, crumb structure,

softness• Bleaching agents-enhance whiteness of flour


• Relationship between Mal-nutrition and Socio-economic stability


Business Impact Assessment : New Frontiers for Retailing

• To spur growth, many specialty retailers will follow extension avenues that help maximize customer value and leverage organizational skills.

• Do-it-for-me service and solution offers will surge as retailers strive to capture a share of the growth in spending on services.


Business Impact Assessment : New Frontiers for Retailing

• More retailers will leverage their brand license into the realm of services, making the next concept in their portfolio one that sells services, not products.

• Tools and technology will change the balance of power in retailing, shifting the power to the people. Consumers will have almost perfect information access about products and pricing.


Marketing Strategies for Retail Value Curve

• Air a commercial that educate people on flour fortification.• Have the flour fortification campaign covered by the news.

Have government representatives and the Association for Protection of Consumers Rights representatives speak about the campaign.

• Use a trial run with bakers using fortified flour as a media opportunity to show that fortified flour has the same baking, taste, feel, and smell as unfortified flour. This could also be covered by the news or it could be done on a popular cooking show


Marketing Strategies for Retail Value Curve

• Highlight millers’ commitment to fortifying flour and their social responsibility in a news story.

• Going on a talk show to discuss flour fortification.

• Educate women as they are most likely to purchase flour and handle the family’s healthcare needs.


Commercial Advertisement Video on Fortified Wheat Flour

• Published on Feb 3, 2016https://www.youtube.com/watch?v=_VYNvxX1YoI

• Published on Nov 2, 2015https://www.youtube.com/watch?v=Cma__88WCRU

https://www.youtube.com/watch?v=_VYNvxX1YoI

https://www.youtube.com/watch?v=_VYNvxX1YoI

https://www.youtube.com/watch?v=Cma__88WCRU

https://www.youtube.com/watch?v=Cma__88WCRU

REFERENCES

• http://www.foodinsight.org/Whole_Grains_Fact_Sheet• http://www.ehfg.org/intranet/app/webroot/uploads/presentations/files/

uploads/4316f29e178adeb7774c3cabf728dd.pdf• http://www.ehfg.org/intranet/app/webroot/uploads/presentations/files/

uploads/4316f29e178adeb7774c3cabf728dd.pdf• http://www.who.int/nmh/publications/ncd_report_full_en.pdf• http://www.savethechildren.org.uk• www.FFInetwork.org• http://ffinetwork.org/about/stay_informed/newsletters/images/Armenia_

Comm_Report.pdf

http://www.foodinsight.org/Whole_Grains_Fact_Sheet

http://www.ehfg.org/intranet/app/webroot/uploads/presentations/files/uploads/4316f29e178adeb7774c3cabf728dd.pdf




http://www.who.int/nmh/publications/ncd_report_full_en.pdf

http://www.savethechildren.org.uk/

http://www.ffinetwork.org/

http://ffinetwork.org/about/stay_informed/newsletters/images/Armenia_Comm_Report.pdf

http://ffinetwork.org/about/stay_informed/newsletters/images/Armenia_Comm_Report.pdf

THANK YOU

Malik Tariq Sarwar Awan, Food Technologist & Consultant,

Chairman Research Wing to Pakistan Flour Mills Association,

Editor, Wheat Milling News, PFMA .Member Pakistan Society of Food Scientists and

Technologists

flour fortification:malnutrition and health effects of whole grains

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