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  1. AU=Luthringer Corey L
  2. AU="Varabyou, Ales"

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  1. Article ; Online: The Potential Contribution of Fortified Maize Flour, Oil, Rice, Salt, and Wheat Flour to Estimated Average Requirements and Tolerable Upper Intake Levels for 15 Nutrients in 153 Countries.

    Pachón, Helena / Reynolds, Bethany / Duong, Michelle / Tsang, Becky L / Childs, Lana / Luthringer, Corey L / Kang, Yunhee / Vasta, Florencia C / Codling, Karen

    Nutrients

    2021  Volume 13, Issue 2

    Abstract: Food fortification is designed to improve the nutritional profile of diets. The purpose of this research was to estimate the potential nutrient contribution of fortified maize flour, oil, rice, salt, and wheat flour in 153 countries, using the national ... ...

    Abstract Food fortification is designed to improve the nutritional profile of diets. The purpose of this research was to estimate the potential nutrient contribution of fortified maize flour, oil, rice, salt, and wheat flour in 153 countries, using the national intake (or availability) of the food and the nutrient levels required for fortification. This was done under two scenarios-maximum, where 100% of the food is assumed to be industrially processed and fortified, and realistic, where the maximum value is adjusted based on the percent of the food that is industrially processed and fortified. Under the maximum scenario, the median Estimated Average Requirements (EARs) met ranged from 22-75% for 14 nutrients (vitamins A, B1, B2, B3, B6, B12, D, E, folic acid and calcium, fluoride, iron, selenium and zinc), and 338% for iodine. In the realistic scenario, the median EARs met were 181% for iodine and <35% for the other nutrients. In both scenarios, the median Tolerable Upper Intake Levels (ULs) met were <55% for all nutrients. Under the realistic scenario, no country exceeded 100% of the UL for any nutrient. Current fortification practices of the five foods of interest have the global potential to contribute up to 15 nutrients to the diets of people, with minimal risk of exceeding ULs.
    MeSH term(s) Eating ; Flour/analysis ; Food, Fortified ; Humans ; Micronutrients/administration & dosage ; Micronutrients/analysis ; No-Observed-Adverse-Effect Level ; Nutritional Requirements ; Oryza ; Plant Oils/analysis ; Sodium Chloride, Dietary/analysis ; Triticum ; Zea mays
    Chemical Substances Micronutrients ; Plant Oils ; Sodium Chloride, Dietary
    Language English
    Publishing date 2021-02-09
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu13020579
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Regulatory Monitoring of Fortified Foods: Identifying Barriers and Good Practices.

    Luthringer, Corey L / Rowe, Laura A / Vossenaar, Marieke / Garrett, Greg S

    Global health, science and practice

    2015  Volume 3, Issue 3, Page(s) 446–461

    Abstract: While fortification of staple foods and condiments has gained enormous global traction, poor performance persists throughout many aspects of implementation, most notably around the critical element of regulatory monitoring, which is essential for ... ...

    Abstract While fortification of staple foods and condiments has gained enormous global traction, poor performance persists throughout many aspects of implementation, most notably around the critical element of regulatory monitoring, which is essential for ensuring foods meet national fortification standards. Where coverage of fortified foods is high, limited nutritional impact of fortification programs largely exists due to regulatory monitoring that insufficiently identifies and holds producers accountable for underfortified products. Based on quality assurance data from 20 national fortification programs in 12 countries, we estimate that less than half of the samples are adequately fortified against relevant national standards. In this paper, we outline key findings from a literature review, key informant interviews with 11 fortification experts, and semi-quantitative surveys with 39 individuals from regulatory agencies and the food fortification industry in 17 countries on the perceived effectiveness of regulatory monitoring systems and barriers to compliance against national fortification standards. Findings highlight that regulatory agencies and industry disagree on the value that enforcement mechanisms have in ensuring compliance against standards. Perceived political risk of enforcement and poorly resourced inspectorate capacity appear to adversely reinforce each other within an environment of unclear legislation to create a major hurdle for improving overall compliance of fortification programs against national standards. Budget constraints affect the ability of regulatory agencies to create a well-trained inspector cadre and improve the detection and enforcement of non-compliant and underfortified products. Recommendations to improve fortification compliance include improving technical capacity; ensuring sustained leadership, accountability, and funding in both the private and the public sectors; and removing political barriers to ensure consistent detection of underfortified products and enforcement of applicable fortification standards. Only by taking concrete steps to improve the entire regulatory system that is built on a cooperative working relationship between regulatory agencies and food producers will a nutrition strategy that uses fortification see its intended health effects.
    MeSH term(s) Food, Fortified/standards ; Food, Fortified/statistics & numerical data ; Guidelines as Topic ; Humans ; Nutrition Policy ; Nutritive Value ; Program Evaluation/statistics & numerical data ; Quality Assurance, Health Care/statistics & numerical data ; World Health Organization
    Language English
    Publishing date 2015-09-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2710875-2
    ISSN 2169-575X ; 2169-575X
    ISSN (online) 2169-575X
    ISSN 2169-575X
    DOI 10.9745/GHSP-D-15-00171
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Review of Grain Fortification Legislation, Standards, and Monitoring Documents.

    Marks, Kristin J / Luthringer, Corey L / Ruth, Laird J / Rowe, Laura A / Khan, Noor A / De-Regil, Luz M / López, Ximena / Pachón, Helena

    Global health, science and practice

    2018  Volume 6, Issue 2, Page(s) 356–371

    Abstract: Objective: Analyze the content of documents used to guide mandatory fortification programs for cereal grains.: Methods: Legislation, standards, and monitoring documents, which are used to mandate, provide specifications for, and confirm fortification, ...

    Abstract Objective: Analyze the content of documents used to guide mandatory fortification programs for cereal grains.
    Methods: Legislation, standards, and monitoring documents, which are used to mandate, provide specifications for, and confirm fortification, respectively, were collected from countries with mandatory wheat flour (n=80), maize flour (n=11), and/or rice (n=6) fortification as of January 31, 2015, yielding 97 possible country-grain combinations (e.g., Philippines-wheat flour, Philippines-rice) for the analysis. After excluding countries with limited or no documentation, 72 reviews were completed, representing 84 country-grain combinations. Based on best practices, a criteria checklist was created with 44 items that should be included in fortification documents. Two reviewers independently scored each available document set for a given country and food vehicle (a country-grain combination) using the checklist, and then reached consensus on the scoring. We calculated the percentage of country-grain combinations containing each checklist item and examined differences in scores by grain, region, and income level.
    Results: Of the 72 country-grain combinations, the majority of documentation came from countries in the Americas (46%) and Africa (32%), and most were from upper and lower middle-income countries (73%). The majority of country-grain combinations had documentation stating the food vehicle(s) to be fortified (97%) and the micronutrients (e.g., iron) (100%), fortificants (e.g., ferrous fumarate) (88%), and fortification levels required (96%). Most (78%) stated that labeling is required to indicate a product is fortified. Many country-grain combinations described systems for external (64%) monitoring, and stated that industry is required to follow quality assurance/quality control (64%), though detailed protocols (33%) and roles and responsibilities (45%) were frequently not described.
    Conclusions: Most country-grain combinations have systems in place for internal, external, and import monitoring. However, documentation of other important items that would influence product compliance to national standard, such as roles and responsibilities between agencies, the cost of regulating fortification, and enforcement strategies, are often lacking. Countries with existing mandatory fortification can improve upon these items in revisions to their documentation while countries that are beginning fortification can use the checklist to assist in developing new policies and programs.
    MeSH term(s) Documentation/statistics & numerical data ; Edible Grain ; Food, Fortified/standards ; Humans ; Legislation, Food ; Mandatory Programs
    Language English
    Publishing date 2018-06-29
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S. ; Review
    ZDB-ID 2710875-2
    ISSN 2169-575X ; 2169-575X
    ISSN (online) 2169-575X
    ISSN 2169-575X
    DOI 10.9745/GHSP-D-17-00427
    Database MEDical Literature Analysis and Retrieval System OnLINE

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