Aplicación del perfil de nutrientes de la OPS en productos ultraprocesados, inclusive en alimentos fortificados / Application of PAHO's nutrient profile in ultra-processed products, including fortified foods

Resumen Introducción: en la actualidad se recomienda limitar el consumo de productos ultraprocesados por su alto contenido en azúcar, grasas totales, grasas saturadas, grasas trans y sodio. El etiquetado frontal es una estrategia destinada a fortalecer en el consumidor su capacidad de elegir, pero la estrategia de adición de micronutrientes realizada por la industria alimentaria contribuye a que los consumidores sobrestimen su calidad nutricional. El objetivo de este estudio fue analizar según el modelo del Perfil de Nutrientes (PN) de la Organización Panamericana de la Salud (OPS), un grupo de productos ultraprocesados disponibles en el mercado argentino y aplicar el modelo de forma diferenciada en productos fortificados por la industria alimentaria. Materiales y método: estudio de campo, transversal, descriptivo. Se aplicó el perfil de nutrientes considerando: azúcares libres, grasas totales, grasas saturadas, grasas trans y sodio, en productos fortificados y sin fortificación. Cada una de las categorías generales de alimentos: galletitas dulces, alfajores, chocolates, golosinas, helados, cereales, bebidas, dulces untables, snacks salados y lácteos, fueron divididas en subcategorías, integradas por diferentes productos. Se realizó un análisis estadístico descriptivo por subcategorías. Resultados: la muestra se conformó por 682 productos y todos superaron el punto de corte de al menos un nutriente en cantidad excesiva. El 100% de los productos fortificados (n=146) presentó cantidad excesiva de algún nutriente, el 41,1% tuvo un nutriente en cantidad excesiva y el 50,7% dos nutrientes. 95,7-100% de los productos de los grupos cereales de desayuno, chocolatadas, yogures bebibles y en pote, se categorizaron como con cantidad excesiva de azúcares libres. Conclusiones: todos los productos analizados presentaron al menos un nutriente del PN de referencia, en cantidad excesiva. Los mismos productos tenían adición de vitaminas, minerales o fibra. Se visibiliza la necesidad de realizar estudios que investiguen si esta estrategia induce confusión en el consumidor al momento de elegir.

Abstract Introduction: it is currently recommended to limit the consumption of ultra-processed products because of their high content of sugar, total fats, saturated fats, trans fats and sodium. Front labelling is a strategy aimed at strengthening consumer choice, but the micronutrient addition strategy carried out by the food industry contributes to consumers overestimating their nutritional quality. The objective of this study was to analyze, following the model of the Nutrient Profile (PN) of the Pan American Health Organization (PAHO), a group of ultra-processed products available in the Argentine market and apply the model in a differentiated way in products fortified by the food industry. Materials and method: field study, cross-sectional, descriptive. The nutrient profile was applied considering: free sugars, total fats, saturated fats, trans fats and sodium, both in fortified and unfortified products. Each of the general food categories: sweet cookies, alfajores, chocolates, sweets, ice cream, cereals, beverages, spreadable sweets, salty snacks and dairy products, were divided into subcategories, made up of different products. A descriptive statistical analysis by subcategories was performed. Results: the sample consisted of 682 products and all exceeded the cut-off point of at least one nutrient in excessive quantity. 100% of the fortified products (n=146) had an excessive amount of some nutrient, 41.1% had an excess nutrient and 50.7% two nutrients. 95.7-100% of the products of the breakfast cereals, chocolate, drinking and potted yogurts groups were categorized as having excessive amounts of free sugars. Conclusions: all the products analyzed presented at least one nutrient from the reference NP, in excessive quantity. The same products had added vitamins, minerals or fiber. The need for studies to research whether this strategy induces confusion in the consumer when choosing is made visible.

Large-scale Staple Food Fortification as a Complementary Strategy to Address Vitamin and Mineral Vulnerabilities in India: A Critical Review

The slow improvement in micronutrient malnutrition globally and in India warrants a need for scaling?up scientifically proven, cost?effective public health interventions. The present review discusses the potential of staple food fortification as a complementary strategy to tackle micronutrient deficiencies, while addressing the current concerns raised regarding its implementation. The review indicates the below par status of current strategies like dietary diversity and supplementation to address multiple micronutrients deficiencies in India and the need for complementary strategies to tackle this problem. Based on systematic reviews and meta-analysis, global and national evidence has identified staple food fortification as a proven and recognized cost?effective solution to address micronutrient deficiencies. The Government of India has shown a strong leadership to promote this proven intervention. Further, the paper addresses the concern that large?scale staple food fortification (LSFF) may lead to excessive nutrient intakes when delivered together with other interventions, e.g., supplementation, dietary diversity, among the same populations. A key message that emerges from this review is that LSFF is safe with current dietary intake and deficiencies and low coverage of other interventions. Given the current situation of food and nutrition insecurity which the COVID-19 pandemic has further exacerbated, and the critical role that nutrition plays in building immunity, it is even more important that health and nutrition of the population, especially vulnerable age groups, is not only safeguarded but also strengthened. LSFF should be implemented without any further delay to reach the most vulnerable segments of the population to reduce the dietary nutrient gap and prevent micronutrient deficiencies. Effective monitoring and regular dietary surveys will help ensure these interventions are being deployed correctly.

Contribución de la harina de trigo enriquecida y derivados a los requerimientos de hierro en niños de 6 meses a 7 años / Contribution of enriched wheat flour and flour products to iron requirements in children aged 6 months to 7 year

Introducción. El enriquecimiento de la harina de trigo es una de las estrategias de salud pública recomendadas para prevenir las deficiencias de micronutrientes, entre ellos el hierro. El objetivo de este trabajo fue determinar el contenido de hierro en harina de trigo enriquecida y sus derivados, y la contribución de estos a las recomendaciones nutricionales en niños. Población y métodos. Estudio observacional, analítico, de corte transversal, basado en la metodología de estudio de dieta total. Se analizaron la harina de trigo enriquecida (según la ley 25630) y sus derivados más consumidos. Para seleccionar los alimentos, se realizó un cuestionario de frecuencia de consumo y recordatorio de 24 horas a los padres de niños con edades entre 6 meses y 7 años. Se determinó la concentración de hierro en los alimentos mediante absorción atómica y se evaluó su contribución al requerimiento promedio estimado. Resultados. La harina enriquecida y sus derivados tuvieron la cantidad de hierro esperada, excepto el pan francés y el pan rallado. La contribución a los requerimientos de hierro de los alimentos evaluados fue el 7 % en niños de 6 meses a 1 año, el 81 % en el grupo de 1 a 3 años y el 45 % en los mayores de 4 años. Conclusiones. Excepto el pan francés y el pan rallado, las harinas y sus derivados analizados presentaron el nivel de enriquecimiento esperado. El consumo de estos alimentos no aporta cantidades significativas de hierro en los lactantes, pero sí en los niños mayores de 1 año.

Introduction. Wheat flour enrichment is a public health strategy recommended to prevent micronutrient deficiencies, including iron deficiency. The objective of this study was to determine iron content in enriched wheat flour and flour products and their contribution to nutritional recommendations for children. Population and methods. Observational, analytical, cross-sectional study based on the total diet study method. Enriched wheat flour (as per Law no. 25630) and the most frequently consumed flour products were analyzed. Products were selected using a questionnaire on the frequency of food intake and a 24-hour recall interview with the parents of children aged 6 months to 7 years. Food iron levels were determined based on atomic absorption spectrometry and their contribution to the estimated average requirement was assessed. Results. Enriched flour and flour products showed the expected iron amount, except for French bread and breadcrumbs. The contribution of studied products to iron requirements was 7 % in children aged 6 months to 1 year, 81 % in those aged 1-3 years, and 45 % in those older than 4 years. Conclusions. Except for French bread and breadcrumbs, studied flour and flour products showed the expected enrichment level. The consumption of this type of food does not provide significant amounts of iron to infants, but it does to children older than 1 year.

Country-specific nutrient requirements & recommended dietary allowances for Indians: Current status & future directions

Nutrient requirements and recommended dietary allowances (RDAs) are set and revised periodically by the Indian Council of Medical Research. These are meant to guide the population and provide policy directions regarding nutrient requirements corresponding to a healthy population. This review article provides an overview of the current recommendations (RDA, 2010) and the challenges faced by the committee to contextualize RDA to the Indian scenario which has a background of double burden of malnutrition, diverse dietary habits but predominantly home-based cereal-pulse vegetarian diet with low bioavailability of several nutrients and lower consumption of packaged fortified foods. The need for country-specific requirements and harmonization of methodologies related to nutrient requirements and RDA are also discussed. The recommendations fixed for iron have been provided in detail as an example. The measures to carry forward RDA revisions to ensure its sustainability have been emphasized.

Effect of the Brazilian iron fortification of wheat and corn flour on the nutritional iron status in adolescents, 6 years after its implementation

BACKGROUND: As it is difficult to know the content of iron added in the Brazilian iron fortification of wheat and corn flour, and if the compound has good or poor bioavailability, the objective was to assess the effect of the Brazilian iron fortification program, as it was carried out, on iron nutritional status of adolescents, 6 years after its implementation. METHODS: A cross-sectional retrospective study was conducted with adolescents aged 10 to 17 years, both sexes, treated at a primary health care center. Data were collected from medical records of patients and compared with those of a previous survey conducted at the same center in 2004. Anthropometry, iron biochemical indicators, food intake, pubertal stage, and transferrin saturation were assessed, with pubertal stage and transferrin saturation being the last two variables compared between 2004 and 2010. Mann-Whitney and chi-square tests were also used. RESULTS: In 2010, mean hemoglobin values and serum ferritin levels were within normal ranges for both sexes, and adolescents who consumed diets with low iron bioavailability constituted more than half of the sample (52.7%). In2004, a 10.3 and 18.6% prevalence of iron deficiency was observed, based on low transferrin saturation, in females and males, respectively. It was noted that during the 6-year period, this prevalence decreased significantly, 4 and10.4%. CONCLUSIONS: Anemia and iron deficiency are not prevalent in this population, probably due to the implementation of flour fortification with iron; it is not possible, however, to attribute such a result only to the implementation of this strategy.

Evaluación nutricional y sensorial de un alimento a base de atún y soya enriquecido con vitaminas y minerales / Nutritional and sensorial evaluation of a food with tuna and soya enriched with vitamins and minerals

The objective of this research was to determine the nutritional and sensorial impact of a food with tuna and soya enriched with vitamins and minerals in pre-school children of three communities of Chiapas, Mexico. It is a study of nutritional intervention with a cohorte of six months. The nutritional state of children was determined previuos to the nurishing complement, to the half and at the end of this. The sample was conformed with the children who presented undernourishment problems; they were fed during six months. The level of acceptability of the food was determined with the children in pre-school age of the three communities. Significant evidences (p<0.05) of the high level of acceptability of the food, when comparing the obtained nutritional state at the beginning, half and at the end of the study were detected. Improvement on the health state was observed, when their severe malnutrition normalized.

El objetivo de este estudio fue determinar el impacto nutricional y sensorial de un alimento a base de atún y soya enriquecido con vitaminas y minerales en preescolares de tres comunidades de Chiapas, México. Estudio de intervención nutricional con una cohorte de seis meses. Se determinó el estado nutricional de los niños previo a la alimentación, a la mitad y al final de ésta; la muestra se conformó con los niños que presentaron problemas de desnutrición inicialmente; a los que se les complementó la alimentación durante seis meses. Se determinó el nivel de agrado del producto, con niños de las tres comunidades. Se encontraron evidencias significativas (p<0.05) de un alto nivel de agrado del alimento, al comparar el estado nutricional obtenido al inicio, a la mitad y al final del estudio, se observó mejoras en el estado salud de los niños, al pasar de desnutrición severa o grave a normal.

Mineral Intake in Urban Pregnant Women from Base Diet, Fortified Foods, and Food Supplements: Focus on Calcium, Iron, and Zinc / 生物医学与环境科学（英文）

In the Chinese national nutrition surveys, fortified foods were not investigated separately from the base diet, and the contribution of fortified foods to micronutrients intake is not very clear. This study investigated the diet, including fortified foods and food supplements, of urban pregnant women and analyzed the intake of calcium, iron, and zinc to assess the corresponding contributions of fortified foods, food supplements, and the base diet. The results demonstrated that the base diet was the major source of calcium, iron, and zinc, and was recommended to be the first choice for micronutrients intake. Furthermore, consumption of fortified foods and food supplements offered effective approaches to improve the dietary intake of calcium, iron, and zinc in Chinese urban pregnant women.

Estado nutricional de vitaminas A e D em crianças participantes de programa de suplementação alimentar / Vitamin A and D status among child participants in a food supplementation program / Concentraciones séricas de vitaminas A y D en niños del programa de distribución de leche fortificada

Foram avaliados as concentrações séricas de vitaminas A e D e os fatores associados em crianças beneficiárias de programa de distribuição de leite fortificado, sendo utilizados modelos de regressão linear múltiplos com seleção hierárquica de variáveis independentes (condição sociodemográfica, de saúde, alimentação, amamentação, consumo do leite fortificado, exposição solar, antropometria, retinol e calcidiol séricos). Foram consideradas insuficiência e deficiência de vitamina A e de vitamina D as concentrações séricas < 1,05µmol/L, 0,70µmo/L, 30ng/mL e 20ng/mL, respectivamente. Houve inadequação do consumo alimentar de vitaminas A e D. As prevalências de insuficiência e deficiência de vitamina A e de vitamina D foram 19%, 6%, 82% e 58%, respectivamente. Os fatores associados às menores concentrações séricas de vitamina A foram: amamentação materna exclusiva < 120 dias, ausência de trabalho materno combinada com menor escolaridade materna, maior número de pessoas que consomem leite fortificado no domicílio e menor vitamina D sérica. Para a vitamina D, foram: menor exposição ao sol e menor vitamina A sérica. Ações de educação nutricional são necessárias para melhorar a situação nutricional dessas crianças.

Vitamin A and D serum concentrations and risk factors for their deficiencies were investigated in children participating in a government-sponsored fortified milk program. The study used multivariate linear regression analysis with hierarchical selection of independent variables: socio-demographic conditions, children's health, food consumption, breastfeeding, fortified milk, exposure to sunlight, anthropometric measurements, and serum concentration of retinol and 25(OH)D. Vitamin A and vitamin D insufficiency and deficiency values were defined as < 1.05µmol/L, < 0.7µmol/L, < 30ng/mL, and < 20ng/mL, respectively. Vitamin A and D intake was inadequate. Prevalence rates for vitamin A and vitamin D insufficiency and deficiency were 19%, 6%, 82%, and 58%, respectively. Factors associated with low serum vitamin A were exclusive breastfeeding for less than 120 days, low maternal schooling, maternal unemployment, more consumers of fortified milk in the family, and low serum vitamin D. Factors associated with vitamin D deficiency were low exposure to sunlight and low serum vitamin A. Nutritional education is needed to improve children's nutritional status.

Se evaluaron las concentraciones séricas de vitaminas A y D y factores asociados en niños que se benefician del programa de distribución de leche fortificada. Se utilizaron múltiples modelos de regresión lineal, con una selección jerárquica de las variables independientes (estatus sociodemográfico, salud, alimentación, lactancia materna, consumo de leche fortificada, exposición al sol, medidas antropométricas, retinol y calcidiol séricos). Para la insuficiencia y deficiencia de vitamina A y vitamina D, se adoptaron concentraciones séricas < 1,05µmol/L, < 0,70µmol/L, < 30ng/mL, < 20ng/mL, respectivamente. La inadecuación del consumo de alimentos para vitamina A y vitamina D fue de un 40% y 100%, respectivamente. La prevalencia de insuficiencia y la deficiencia de vitamina A y vitamina D fue de un 19%, 6%, 82% y 58%, respectivamente. Los factores asociados más pequeños de vitamina A sérica fueron: lactancia exclusiva < 120 días, ausencia de empleo de la madre, combinada con una baja educación materna y menor vitamina D sérica. Para la vitamina D fueron: menor exposición al sol y menor vitamina A sérica. Las acciones de educación nutricional son necesarias para mejorar la situación nutricional de estos niños.

Ingestão de folato nos períodos pré e pós-fortificação mandatória: estudo de base populacional em São Paulo, Brasil / Folic acid intake before and after mandatory fortification: a population-based study in São Paulo, Brazil / Ingesta de folatos en la prefortificación o posfortificación: estudio de base poblacional en São Paulo, Brasil

Analisou-se a ingestão de folato nos períodos pré e pós-fortificação. Os dados dietéticos foram coletados por recordatório de 24 horas (R24h) no Inquérito de Saúde de São Paulo (ISA-Capital) em 2003 e 2007/2008, estratificando-se a população segundo fase da vida e sexo. Utilizaram-se os valores de recomendação: necessidade média estimada (EAR) e nível máximo de ingestão tolerada (UL) e o método "EAR como ponto de corte" para estimar a inadequação da ingestão. Houve redução na prevalência de inadequação da ingestão de folato em todos os estratos, com destaque para os adolescentes e adultos do sexo masculino, de 72% para < 1% e de 76% para 6%, mas nas mulheres adultas a inadequação permaneceu elevada (38%). Antes da fortificação, o feijão foi o alimento que mais contribuiu para a ingestão de folato; após, o maior contribuinte passou a ser o pão, porém o feijão permaneceu importante. A fortificação foi bem-sucedida (aumentou a ingestão dentro de níveis seguros), porém, gera preocupação a elevada proporção no grupo alvo, mulheres adultas, que não atingem a recomendação para ingestão de folato.

This study analyzed folic acid intake before and since mandatory fortification. Dietary data were collected by 24-hour recall in a health survey in São Paulo (ISA-Capital) in 2003 and 2007-2008, stratifying the population according to life stage and gender. Estimated average requirement (EAR) and tolerable upper intake level (UL) were used to assess intake. Prevalence of inadequate folic acid intake decreased in all groups, especially adolescents and adult males (72% to < 1% and 76% to 6%, respectively) but remained high in adult women (38%). Beans were the main source of folic acid before fortification. With fortification, bread became the main source, but beans remained important. Fortification was successful (increased intake within safe levels), but it raised concerns about the high proportion in the target group (adult women) who still fail to meet the recommended intake.

Se analizó la ingesta de folato en los periodos de pre- y posfortificación. Los datos dietéticos se recogieron mediante un recordatorio de 24 horas en la Encuesta de Salud de São Paulo (ISA-Capital) en 2003 y 2007/2008, estratificando la población según etapa de la vida y sexo. Se utilizaron los valores de recomendación: necesidad media estimada (EAR) y la ingesta máxima tolerable (UL) y el método "EAR como punto de corte" para estimar la ingesta inadecuada. Se observó una reducción en la prevalencia de ingesta inadecuada de folato en todos los grupos, especialmente en los adolescentes y adultos varones, de un 72% a < 1% y de un 76% a un 6%, no obstante, en las mujeres adultas, la inadecuación seguía siendo alta (38%). Antes de la fortificación, los frijoles son el alimento que más contribuye a la ingesta de folato, después es el pan el que también constituye una fuente de folato, pese a que los frijoles siguen siendo los más importantes. La fortificación fue exitosa (aumento de la ingesta dentro de niveles seguros), sin embargo, se plantea una preocupación por el alto porcentaje del grupo objetivo: mujeres adultas que no cumplen con la recomendación para la ingesta de ácido fólico.

Prevalência e distribuição espacial de defeitos do tubo neural no Estado de São Paulo, Brasil, antes e após a fortificação de farinhas com ácido fólico / Prevalence and spatial distribution of neural tube defects in São Paulo State, Brazil, before and after folic acid flour fortification / Prevalencia y distribución espacial de defectos del tubo neural en el Estado de São Paulo, Brasil, antes y después del enriquecimiento de harinas con ácido fólico

Estudo transversal que analisou prevalência e distribuição espacial de defeitos do tubo neural, antes e após a fortificação das farinhas de trigo e milho com ácido fólico no Estado de São Paulo, Brasil, com uso do Sistema de Informações sobre Nascidos Vivos (SINASC). São apresentadas prevalências segundo características maternas por meio de odds ratio (OR) e intervalos de 95% de confiança (IC95%). Para análise temporal e espacial, foram utilizados, respectivamente, regressão polinomial e mapas com suavização bayesiana empírica. A prevalência diminuiu 35%, de 0,57 para 0,37 por mil nascidos vivos após a fortificação (OR = 0,65; IC95%: 0,59-0,72). Verificou-se redução para mulheres de todas as idades (exceto < 15 anos), com mais de três anos de estudo e sete consultas ou mais de pré-natal. Confirmou-se redução temporal na maior parte do estado, exceto alguns municípios do oeste. Outros aspectos podem ter contribuído para o declínio observado, porém os resultados reiteram a fortificação de farinhas como medida importante para prevenção de defeitos do tubo neural. Outras análises devem ser realizadas para justificar resultado inverso no oeste paulista.

This cross-sectional study analyzed the prevalence and spatial distribution of neural tube defects before and after folic acid flour fortification. The study used the Information System on Live Births (SINASC) and presented prevalence rates according to maternal characteristics with odds ratios (OR) and 95% confidence intervals (95%CI). Polynomial regression was used in time trend analysis and empirical Bayesian smoothed maps for spatial analysis. Total prevalence of neural tube defects decreased by 35%, from 0.57/1,000 to 0.37/1,000 live births after fortification (OR = 0.65; 95%CI: 0.59-0.72). There was a reduction among newborns of mothers with the following characteristics: all age groups (except < 15 years), more than three years of schooling, and seven or more prenatal visits. There was a reduction over time and in most of São Paulo State, except in a few municipalities (counties) located in the western region of the State. Other factors may have contributed to the observed decline, but the results corroborate flour fortification as an important measure to prevent neural tube defects. Further research is needed to elucidate the lack of a decline in neural tube defects in the western part of São Paulo State.

Estudio transversal que analizó la prevalencia y distribución espacial de defectos del tubo neural, antes y después del enriquecimiento de las harinas de trigo y maíz con ácido fólico en el Estado de Sao Paulo, Brasil, con el uso del Sistema de Información sobre Nacidos Vivos (SINASC). Se presentaron prevalencias, según características maternas, mediante odds ratio (OR) e intervalos de un 95% de confianza (IC95%). Para un análisis temporal y espacial, fueron utilizados, respectivamente, regresión polinomial y mapas con suavizamiento bayesiano empírico. La prevalencia disminuyó un 35%, de 0,57 a 0,37 por mil nacidos vivos tras el enriquecimiento (OR = 0,65; IC95%: 0,59-0,72). Se verificó la reducción en mujeres de todas las edades (excepto < 15 años), con más de tres años de estudio y siete consultas o más de carácter prenatal. Se confirmó la reducción temporal en la mayor parte del estado, excepto algunos municipios del oeste. Otros aspectos pueden haber contribuido al declive observado, no obstante, los resultados reiteran el enriquecimiento de harinas como una medida importante para la prevención de defectos en el tubo neural. Otros análisis deben ser realizados para justificar el resultado inverso en el oeste paulista.

Efecto del consumo de harina de maíz fortificada con acido fólico sobre los niveles de folatos sanguíneos en mujeres de edad fértil / Effect of fortified flour consumption on blood folate levels in women of childbearing age

Fortification of foods is now widely used to prevent folate deficiency. Folic acid has been added to corn flour and its efficacy in the prevention of NTD has been proved. The aim of this study was to compare the effect of the intake of fortified corn-flour versus non fortified flour and to folic acid supplement, on blood folate levels in women of childbearing age. Forty-five women were randomized into three groups according to: (A) use of fortified flour (n=18), (B) non-fortified flour (n=17); (C) supplementation with 5 mg of oralfolic acid (n=10). All females answer a dietary and anthropometric questionnaire applied once a month during three months. Blood red cell (IE) and plasmatic (P) folate were measured at the beginning and at the end of the study; also the DNA analysis for the 677T mutation was performed. The corn flour was provided to groups A and B during three months, to be consumed as eight tortillas daily. Group C received 5.0 mg tablet of folic acid (Valdecasas®), once per week, during three months. IE and P folate and hematocrito were significantly increased in women from group C (p<0.05). Only plasmatic folic acid levels were significantly increased in women from groups A and B. Genotype distribution was: 15.6 percent homozygous TT, 42.2 percent C/C and 42.2 percent CT. Weekly administration of 5.0 mg of folic acid is an effective way to increase blood folate levels and shows to be more efficient than fortified corn flour.

La fortificación de alimentos con ácido fólico puede ser efectiva en la prevención de los defectos del tubo neural, aunque no existen estudios que demuestren la eficacia de esta medida en la harina de maíz. El objetivo del estudio fue evaluar el efecto del consumo de harina de maíz vitaminada sobre los niveles de folatos sanguíneos, en comparación con la suplementación oral. Se incluyeron 45 mujeres en edad fértil aleatorizadas en tres grupos; grupo A (n=18) harina vitaminada, grupo B (n=17) harina sin vitaminas, grupo C (n=10) suplemento oral 5.0 mg de ácido fólico una vez por semana, durante tres meses. A las participantes se les aplicó una encuesta nutricional y se les midió por radioinmunoensayo el folato intraeritrocitario (FIE) y plasmático (FP) al inicio y final del estudio y se determinó la presencia del polimorfismo C677T del gen MTHFR. En las mujeres con suplemento oral los niveles FIE y FP y el hematocrito se incrementaron significativamente (p< 0.05), mientras que en los grupos A y B se registró un incremento significativo en los valores de FP pero no IE ni hematocrito. La ingesta de otras fuentes de ácido fólico se incrementó significativamente en los grupos A y B. El 15.6 por ciento de las mujeres fueron homocigotas TT, 42.2 por ciento homocigotas CC y 42.2 por ciento heterocigotas CT. La administración de 5 mg de ácido fólico por semana es una medida más eficiente que la ingesta de harina de maíz vitaminada para elevar los niveles de folatos.

Caracterización del consumo de maíz y fríjol en familias del departamento del Cauca, Colombia / Bean and maize consumption by families in Cauca, Colombia

Objetivo: caracterizar el consumo de maíz y fríjol en las familias de las madres comunitarias del Instituto Colombiano de Bienestar Familiar (ICBF), de los municipios del Cauca. Materiales y métodos: se encuestaron 400 madres comunitarias del ICBF sobre la alimentación en sus propias familias en 12 municipios del Cauca. Resultados: en 100% de las familias caucanas, se reportó un consumo frecuente de maíz y fríjol. El consumo promedio mensual ± DE en kg fue para el maíz blanco 6,5+7,6, el maíz amarillo 5,1+7,0, el fríjol rojo 1,7+1,6, el fríjol blanco 1,1±1,1, el fríjol moteado calima 1,5±1,1, el fríjol moteado cargamanto 1,3±0,7, el fríjol verde 1,4±1,2 y el fríjol de otros tipos 0,8±0,4. Conclusión: el consumo reportado por las familias caucanas muestra que el maíz y el fríjol común hacen parte de su gastronomía. La introducción de cultivos con mayores nutrientes (biofortificados) se facilitaría mediante acciones de educación nutricional, con el fin de incentivar su producción y consumo.

Objective: characterization of maize and bean consumption by families where mothers work with ICBF’s communities in Cauca-Colombia. Materials and methods: mothers (n=400) working with ICBF’s communities in 12 farming municipalities were surveyed about their family’s feeding practices. Results: 100% of mothers interviewed reported frequent consumption of maize and beans. Average ± SD intake kg/ month for white beans was (6,5±7,6), yellow maize (5,1±7,0), red beans(1,7±1,6) white beans (1,1±1,1), mottled calima beans (1,5±1,1), mottled cargamanto (1,3±0,7), green beans (1,4±1,2), and for other kind of beans (0,8±0,4). Conclusion: maize and beans are main components of these communities’ food patterns. Nutrition education activities could help to promote consumption of nutritionally enhanced (biofortified) crops.

Efeito da fortificação semanal do arroz com ferro quelato sobre a freqüência de anemia e concentração de hemoglobina em crianças de creches municipais do Rio de Janeiro, Brasil / Effect of weekly rice fortification with iron on anemia prevalence and hemoglobin concentration among children attending public daycare centers in Rio de Janeiro, Brazil

Trata-se de um ensaio clínico comunitário, duplo-cego, controlado por placebo. Durante 16 semanas, as crianças do grupo intervenção (GI, n = 180) receberam arroz fortificado com ferro, e as do grupo controle (GC, n = 174) receberam arroz com placebo. Considerou-se presença de anemia quando hemoglobina < 11,0g/dL. A comparação da variação média na hemoglobina intergrupos, ajustada por idade e uso de outros suplementos de ferro, foi feita pelo teste t de Student. A concentração de hemoglobina aumentou em ambos os grupos, com incremento médio de 0,42g/dL no GI (11,28±1,23g/dL para 11,75±1,16g/dL; p < 0,001) e de 0,49g/dL no GC (11,06±1,13g/dL para 11,51±1,16g/dL; p < 0,001). A freqüência de anemia reduziu (p < 0,01) em ambos os grupos (37,8 por cento para 23,3 por cento em GI e 45,4 por cento para 33,3 por cento em GC), sem diferença entre os mesmos. As crianças que receberam quantidade total de ferro > 53,76mg pelo arroz fortificado tiveram maior aumento na hemoglobina do que aquelas que receberam quantidades inferiores (0,94g/dL vs. 0,39g/dL; p = 0,03). Sugere-se que esse tipo de intervenção pode ser útil no controle da anemia quando o consumo do alimento fortificado é adequado.

This was a double-blind, placebo-controlled, community-based trial. For 16 weeks, children in the intervention group (n = 180) received iron-fortified rice, while children in the control group (n = 174) received rice with placebo. Anemia was defined as hemoglobin < 11.0g/dL. Student's t-test was used to compare mean variation in hemoglobin between the groups. Hemoglobin concentration improved in both groups, with a mean increase of 0.42g/ dL in the intervention group (11.28±1.23g/dL to 11.75±1.16g/dL, p < 0.001), and 0.49g/dL in controls (11.06±1.13g/dL to 11.51±1.16g/dL, p < 0.001). Anemia decreased (p < 0.01) in both groups (37.8 percent to 23.3 percent in the intervention group and 45.4 percent to 33.3 percent in controls), with no significant difference between the two. Hemoglobin increase was significantly higher in children that received total iron = 53.76mg from fortified rice, compared to those who received less than this cut-off value (0.94g/dl vs. 0.39g/dl, p = 0.03). The findings suggest that this type of intervention can be useful in anemia control as long as fortified food intake is adequate.

DETERMINATION OF VITAMIN D2 IN BABYFOOD (FORTIFIED FOOD) BY TWO STEPS OF HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY / 营养学报

An improved method for the determination of Vitamin D2 in baby food (fortified dried milk) was established by using two steps of high-performance liquid chromatography (HPLC). The sample was directly saponified and extracted with benzene. The extracted unsaponifiable matter was firstly subjected to preparative HPLC using a Nucleosil 5C18 column (reversed-phase type) with acetonitrile-methanol (3:2) as a mobile phase. This first step was for the purpose of clean-up, and a fraction containing Vitamin D2 was collected. The separate fraction was subsequently subjected to analytic HPLC with a Zorbax SIL column (straight-phase type) with isopropanol-hexane (0.8 : 99.2) as a mobile phase. The Vitamin D2 was separated from other contaminants and determined with ultraviolet spectrograph by the peak height estimated. The recovery rate was 84%, standard deviation 12.57 and coefficient of variation 4.57%. The proposed method was rapid, accurate, and suitable for the determination of baby food.

THE EVALUATION OF NUTRITIONAL VALUE OF FOOD FORTIFIED WITH LYSINE, IRON, CALCIUM AND ZINC / 营养学报

The nutritional value of bread fortified with zinc, lysine, iron, and calcium was evaluated by biological method. The amount of the supplemented lysine, iron, calcium and zinc in the experimental diet was 0.3%, 0.008%, 0.3% and 0.008% respectively.32 Wistar rats were devided randomly into 4 groups; the control group was fed with ordinary bread and the other three groups were fed with bread fortified with lysine, Fe and Ca, or Zn or lysine, Ca, Fe and Zn respectively. All the rats in each group took thier respective diet and drank distilled water ad libitum.The results indicated that the body weight of the group fortified with zinc alone was increased more fast at the first two weeks, and then slow down, finally, slower than the control group obviously. The increase of body weight, FE, PER, NPU, BV, weight and length of long bones, iron status in the group fortified with lysine, iron, and Ca combind were better than the control group. The group, however, fortified with lysine, Fe, Ca and Zinc combined was the best among these four groups. It promoted the growth of the rats markedly and did not impede the utilization of iron, calcium and copper as well.