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Food processing to

challenge malnutrition

Symposium “food technology for better nutrition”

Nutrition Foundation of India

30 Nov – 01 Dec, 2007

New Delhi, India

Presenter: Bertrand Salvignol

Commodity Quality Control Officer

World Food Programme, Bangkok

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

Food 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 processing

Prehistoric 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 food


Nutritional quality 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 Regulationsand WFP specifications.


WFP’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, …)


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 Oil & Ghee

Fortified Biscuits (on going

study)

Fortified Coconut Oil


(RMB, CMB, CSM)

Fortified biscuit

Fortified Noodles (since 2004)

Fortified Biscuits


(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)

QualityQuantity

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

Sprinkles

RUTF / RUSF

(2000’s)


Integrated Approaches to eliminate

Micronutrient Deficiencies(V.Mannar, MI, 2003)

Rel

ati

ve

con

trib

uti

on

of

inte

rven

tio

ns

to e

lim

ina

te M

ND

Supplementation

Public Health

Measures

Fortification

Dietary improvement

2000 2005 2010


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 consensus


Controlling 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

micronutrients

Reducing 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

micronutrients

There are several ways to increase the supply of micronutrients :

Supplementation (including Sprinkle strategies),

Food-based approach (including Fortification of foods),



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 targetedapproaches they may reach only a limited population and have low compliance rate.



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.



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 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)

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 p

er

DA

LY

saved


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 saltwith iron and iodine can improve both iron and iodine status (Zimmermann et al. Eur J Endo 2002)

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 studies


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:

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



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.



Future 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

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 you

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