Flour fortification: A simple, cost-effective way to address micronutrient deficiencies worldwide

“While hidden hunger continues to be a public health concern worldwide, staple food fortification offers a long-term approach to addressing these widespread micronutrient deficiencies. It has the potential to improve the health and wellbeing of individuals, societies and nations; effectively combating hidden hunger. With the general health of a population rising, economic benefits – including decreasing healthcare costs and unemployment rates – are expected to follow. In the long run, tackling malnutrition can lead to major social returns on investment.”

Arnold Kawuba
EMEA Regional Lead for Partner Engagement
Nutrition Improvement, DSM

The lack of essential vitamins and minerals in individuals’ diets, known as ‘hidden hunger’, is a widespread problem affecting both low-income and high-income nations. Two billion people around the world suffer from hidden hunger and micronutrient deficiencies account for about 7.3% of the global disease burden . This form of malnutrition can lead to serious, long-lasting health issues, including weakened immunity and blindness, and its effects can start early and impede children’s cognitive and physical development. Finding solutions to combat this threat is crucial to not just protect the most vulnerable populations, but to ensure the positive development of societies worldwide. As more people are granted access to nutritious food containing essential micronutrients, economies are also more likely to prosper as healthcare costs decline and children and adults perform better at school and in employment.

To stay healthy, balanced diets are recommended. However, this is not always achievable – especially in countries where people have limited access to affordable food with a high nutritional value. Staple food fortification is a well-established, trusted and proven method of addressing micronutrient deficiencies on a large scale and in a cost-effective way. It involves adding essential vitamins and minerals or replacing micronutrients that may have been lost during food processing.

Alongside gaining access to high-quality premixes, partnering with companies who have a long history of working in the food fortification space, can offer millers the support and know-how they need to successfully implement such interventions. DSM has been promoting and actively engaging in staple food fortification for decades, providing its technical and scientific knowledge and capabilities to its customers, as well as supplying them with high-quality, reliable and traceable micronutrient premixes.
Is wheat flour fortification the way forward?

As one of the most widely produced cereal crops in the world, wheat is a staple part of many everyday food products, including breads, biscuits, pasta and noodles. It makes up a significant percentage of energy intake globally but particularly in Western Asia and the Americas . Due to its broad geographic versatility and availability, wheat flour is considered highly suitable for fortification to deliver micronutrients to large consumer groups. For example, in food applications vitamins are often sensitive to heat, oxidizing and reducing agents, as well as light and other kinds of physical and chemical stress. In wheat flour, however, vitamins are relatively stable, and it also has a high nutrient retention when processed at high temperatures , such as when baked.

In its natural state, wheat is a good source of vitamins B1, B2, B6, E and niacin, as well as iron and zinc. As most of these essential vitamins and minerals are concentrated in the outer layers of the wheat grain, the majority are removed during the milling process. Replacing some of the micronutrients lost through milling is recognized as an effective way to improve the nutritional profile of the food supply and effectively combat hidden hunger. In countries where large numbers of individuals consistently do not consume sufficient quantities of specific vitamins and minerals, the World Health Organization (WHO) recommends not just replacing lost micronutrients, but adding additional ones through fortification. Compulsory wheat flour fortification is becoming increasingly common across the world – 70 countries, including Canada, the US and UK, South Africa, Mexico and the Philippines, currently have policies in place .

Depending on the fortification program, the cost that is passed to the consumer can be as little as USD$ 0.01 per 5 kg flour, meaning fortifying wheat is much less expensive than generally assumed.

For millers, micronutrient premixes represent a cost-effective way to fortify flour. For example, a premix containing iron, folic, acid and several B vitamins usually costs no more than USD$ 3 per metric ton of flour . Overall, the benefits of flour fortification significantly outweigh the investment required. Adding folic acid to the volume of flour consumed in the US each year could, for instance, prevent 767 live births with spina bifida . While the costs of fortifying this amount of flour total just over USD$ 4 million a year, this intervention saves around USD$ 607.3 million a year in healthcare costs . In this case, this represents a return on investment (ROI) of almost USD$ 152 per USD $1 spent.

The do’s and don’ts for flour fortification
The process of flour fortification is simple when approached with the necessary technical know-how and expertise. Instead of adding vitamins and minerals individually, it is typically much more effective to formulate with a premixed blend suitable for flour fortification. This eliminates the need for quality control procedures for raw materials as a dedicated premix supplier will provide an effective quality assurance system. It often lowers the cost of fortification as fewer products have to be purchased, transported and stored, and it also allows for enhanced consistency and homogenous distribution of the micronutrients. This is essential to not only avoid negative impacts on the sensorial characteristics of the final product, but also to ensure the same dosage is added to every batch. Poor mixing could result in some people receiving too few vitamins or minerals to be beneficial for their health, rendering the intervention ineffective. Establishing effective quality control measures are therefore crucial to the success of wheat flour fortification programs.

Looking ahead
While hidden hunger continues to be a public health concern worldwide, staple food fortification offers a long-term approach to addressing these widespread micronutrient deficiencies. It has the potential to improve the health and wellbeing of individuals, societies and nations; effectively combating hidden hunger. With the general health of a population rising, economic benefits – including decreasing healthcare costs and unemployment rates – are expected to follow. In the long run, tackling malnutrition can lead to major social returns on investment.

For further information on effective food fortification, visit www.nutritionimprovement.com or contact
Arnold.Kawuba@dsm.com.

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