Nutrition Improvement Program Click to edit Master title style Vehicles for Fortification, Single vs. Multiple Fortification, Technology and Cost: Fortification of Cereals, Rice, Oil and Sugar Héctor Cori New Delhi, 7 January 2011.

2 Why fortify? The Micronutrient Initiative, *Derives mainly from Vitamin A **Derives mainly from iron nutrition ***Derives mainly from iodine sufficiency Preventing up to four out of ten childhood deaths* Lowering maternal deaths by more than one third** Increasing work capacity up to 20%** Improving population IQ by points***

3 Why staple food fortification affordable easy effective no change of staple food in color or taste. no change in dietary habits

4 Fortification of Cereal Flours

5 Fortification of Sugar

6

7 Fortification of Fats and Oils Dilution BatchBatch Cont. Flow

8 Shellac Coating Natural kernel Extruded Rice fortification technologies

9 Extrusor Fortification of Rice

10 Where is fortification implemented?

11 Food fortification through premixes Heterogeneous System

12 Homogeneous and stable system Premix quality depends on homogeneity

13 Homogeneity depends on equipment Design and construction that guarantees safety and efficiency SOPs for operation and cleaning of each one Preventive maintenance program Optimal mixing time validation

14 Premix Quality depends on Plant Quality

15 Plant quality depends on setup quality

16 Premix quality also relies on plant hygiene Avoid external contamination Avoid cross contamination Ease cleaning Adequate humidity and temperature Clean air Area separation Restricted access Microbiological monitoring

17 Premix quality depends on ingredient quality Physical FormConcentrationDispersibilityEsterificationAntioxidantsExcipients Oil IU/gNon dispersibleAcetateBHA/BHTGelatins Emulsion IU/gDispersiblePalmitateTocopherolStarches Powder IU/gEmulsion OthersGums IU/g No antioxidantsOthers IU/g IU/g IU/g

18 Effectiveness will depend on adequate stable vitamin forms DSM Nutritional Products: Internal trials,

19 Stability will also depend on packaging Hygienic process Protection material Physical Microbiological Humidity Oxygen Exact weighing Labeling Identification Lot Best use before date Others

20 Premix quality is preserved through adequate storage Separate areas Temperature and humidity control Inventory rotation Cleaning and plague control QA approved product entry only Correct labeling

21 Premix quality is guaranteed through Quality Assurance Content control Mixer control Supplier control Auto-inspections Validations Analytical methods Mixing times Homogeneity Counter samples Traceability

22 Premix quality is proved through documentation Internal Manufacturing order Weight control RM addition sequence Equipments used Operations description Annotations Authorizations Analytical controls External Specifications Certificate of analysis Others Composition Sheets Manufacturing principles Specifications and Tests Product Data Sheets Stability data Safety Data Sheets Residual solvents GMO statements BSE statements Order Manual Kosher/Halal certificates

23 Premix quality is certified through external referents ISO norms GMP HACCP Codex Alimentarius Other international directives

24 No compromise on quality Low quality micronutrients are not only deceiving the customers. They deceive the most vulnerable, the malnourished.

25 Avoid Tunnel Vision Nutrition

26 Chances for success are maximized depending on which MNs are used

27 Vitamin A fortification of sugar improves serum iron in preschool children (Guatemala) Mejía, LA, Arroyave, G, 1982.

28 How much do fortificants cost?

29 Estimated Fortificant Costs to Reach Nutritional Goals Through Food Fortification 1: Includes processing and storage overages. Source: Modified from Omar Dary A2Z- 18 Sept. 2007

30 Benefit: Or the costs of malnutrition Based on the UNICEF/MI publication: “Vitamin & Mineral Deficiencies: A global damage assessment report, 2004 Fortification Cost: 100% coverage at 50% daily requirement of A, B1, B2, PP, B12,I + 100% of FA and Fe

31 Effective fortification is affordable, ineffective fortification is expensive.

32 Public Health Benefit as a Function of the Quality of the Program Time Public Health Benefit Minimal Intervention Optimal Intervention

Thank you.