Fortified foods contribute one half of recommended vitamin A intake in poor urban Guatemalan toddlers.

Vitamin A intake from food sources, not including breast milk, was determined from seven consecutive 24-h recalls for 55 children (mean age 20.8 mo, SD 8.9) from two poor communities of Guatemala City. Not including vitamin A derived from fortified sugar or breast milk, the median daily vitamin A intake was 194 retinol equivalents (RE). Including vitamin A derived from fortified sugar but not including that derived from breast milk, the median total vitamin A intake (25th and 75th percentiles) was 338 RE (146 and 617 RE) of which 78% was preformed retinol and 22% provitamin A. More than 90% of total vitamin A intake from non-breast milk food sources was derived from only 10 items; over half came from three fortified foods: fortified sugar, Incaparina and margarine. Sugar samples from 91 households in 1991 had a median of 3.3 RE/g (range, 0.0-29.9 RE/g), <25% of the target level (13-17 RE/g); nevertheless, fortified sugar provided 25% of these children's total vitamin A intake (81 RE/d) from non-breast milk food sources and their intake approached the level recommended by the FAO/WHO (400 RE/d). These results show that fortified foods make an important contribution towards vitamin A intake in this sample of poor urban Guatemalan toddlers.

PIP: Vitamin A intake from food sources was measured in 55 randomly selected toddlers 6-36 months of age (mean age, 20.8 months) from two poor communities in Guatemala City, Guatemala, in 1990. Seven consecutive 24-hour dietary recalls were obtained from mothers. Sugar, coffee, and tortilla accounted for one-third of the 7114 food items reported. Excluding vitamin A derived from breast milk or fortified sugar, the median daily vitamin A intake was 194 retinol equivalents (RE). Including vitamin A derived from fortified sugar but not from breast milk, median total vitamin A intake was 338 RE, of which 78% was preformed retinol and 22% was provitamin A. This figure was 162 RE in breast-fed children and 597 RE in weaned children. Only 10 food items contributed 91% of total vitamin A intake and 55% came from three fortified foods: fortified sugar, Incaparina, and margarine, contributing medians of 81, 94, and 61 RE/g, respectively). The mean retinyl palmitate concentration in sugar samples collected from 91 households in the study communities in 1991 was 3.3 RE/g (less than 25% the stipulated amount) and 24 of these samples did not have detectable vitamin A. Since collection of these sugar samples, the association of sugar manufacturers in Guatemala has strengthened quality control measures. Political will is required, however, to enhance and enforce sugar fortification efforts and protect this vital source of vitamin A.

Preparation effects on tortilla mineral content in Guatemala.

We have previously reported that in Guatemala, the calcium, iron, and zinc contents of tortillas from rural areas are higher that that of tortillas from urban centers. This study examines variation in the calcium, iron, zinc and copper content of tortilla according to the implements used for making tortillas and inquires as to whether preparation effects mediate rural-urban variation in tortilla mineral content. Tortilla samples and information on how the tortillas were prepared were collected from the female heads of a total of 50 households from three rural, two semi-urban and one low income urban community. Samples of lime used for making tortillas were collected from 31 households. To grind masa, a hand mill was found to be used in some rural households whereas a motorized mill predominated in the semi-urban and urban areas. Most women used grinding stones called the "mano y metate" to further refine the texture of the masa. Tortillas prepared with the combined use of the hand mill and "mano y metate" had a significantly (p < 0.05) higher iron content. Use of the "mano y metate" was also associated with a significantly (p < 0.05) higher zinc content. These results suggest that the use of certain grinding implements may mediate rural-urban variation in tortilla iron and zinc content. The cooking surface, pot used for nixtamalization, source of water, and amount of lime used did not significantly account for variation in the content of these minerals.

Preparation effects on tortilla mineral content in Guatemala

We have previously reported that in Guatemala, the calcium, iron, and zinc contents of tortillas from rural areas are higher that that of tortillas from urban centers. This study examines variation in the calcium, iron, zinc and copper content of tortilla according to the implements used for making tortillas and inquires as to whether preparation effects mediate rural-urban variation in tortilla mineral content. Tortilla samples and information on how the tortillas were prepared were collected from the female heads of a total of 50 households from three rural, two semi-urban and one low income urban community. Samples of lime used for making tortillas were collected from 31 households. To grind masa, a hand mill was found to be used in some rural households whereas a motorized mill predominated in the semi-urban and urban areas. Most women used grinding stones called the mano y metate to further refine the texture of the masa. Tortillas prepared with the combined use of the hand mill and mano y metate had a significantly (p < 0.05) higher iron content. Use of the mano y metate was also associated with a significantly (p < 0.05) higher zinc content. These results suggest that the use of certain grinding implements may mediate rural-urban variation in tortilla iron and zinc content. The cooking surface, pot used for nixtamalization, source of water, and amount of lime used did not significantly account for variation in the content of these minerals