MALNUTRITION: Indioa: Bid to check malnutrition through fortified flour

22 November 2011
The Madhya Pradesh Government is all set to distribute fortified flour from November 22 in a bid to counter malnutrition. There has been a lot of controversy regarding the benefits of enriched flour in relation to those of whole wheat flour. Although enriched flour does contain the similar amounts of vitamins as the unrefined flour products, it does not have the same nutritional benefits of whole wheat flour.

To counter the widespread malnutrition in Madhya Pradesh, the State Government is all set to distribute fortified flour in Madhya Pradesh from November 22. The similar project launched in Rajasthan last year was strongly opposed by the local people stating that despite being nutrients in the flour, the quality is poor.
The Global Alliance for Improved Nutrition (GAIN), which had advocated the campaign in this regard in Rajasthan and Gujarat, would launch a similar drive in Madhya Pradesh too.
The massive food fortification drive claims to bring down high levels of anaemia and Vitamin A deficiency that has been hampering the State's progress and economic growth for several years.
The World Food Programme (WFP) had earlier conducted a similar project on empirical basis in three districts of Madhya Pradesh- Shivpuri, Guna and Sheopur. For the purpose, the WFP is funding local voluntary organisations for fortification of flour and distributing it among the villagers.
Later, the project was withdrawn because the programme could not fulfill the objectives of collecting evidences and data.
However, it has been a debatable issue whether a written consent should be needed from consumers, who are consuming it.
If one goes by the latest human development report of Madhya Pradesh, the state of health in Madhya Pradesh is far from satisfactory. This is reflected from the latest estimate for longevity, measured as life expectancy at birth, which was 59 years for males and 58 years for females.
As per the latest estimate on longevity as quoted in the Human Development Report 2007, the life expectancy for males and females in Madhya Pradesh was the lowest among all the major States in India and a good four to eight years lower than the national average.
State Advisor to Supreme Court Commissioner in Right to Food case Sachin Jain said significantly, there is not a clear situation regarding fortification of flour with iron and folic acid. As per rules, the quantity of iron should be monitored, but it is not being monitored properly at several places and thus negative effects have been witnessed at several places.
In malaria-prone areas, iron fortification needs to be monitored properly because the patients may face problems with the iron fortified flour consumption, he added.
Jain informed that the concept of fortification has been a success only in the States where there is strong network of primary health centres, but in Madhya Pradesh this network is quite poor. "If anybody faces health disorders, he needs to immediately approach primary health centres, thus in the areas where PHCs are available, this has been a success," he informed. The flour fortification project that was launched in Gujarat has been challenged in Supreme Court, he said.
He further said that after fortification, the flour has medicinal components, but globally, natural food is considered as the best food. Thus, the Government should make efforts in making available natural foods to the people, he advised. Jain stated that the interests of MNCs are involved in the project, which need to be checked and the whole process should be in public interest.
General secretary of the Roller Flour Mills Federation of India (RMFI) Veena Sharma told that there has been no incident of ill effects of the fortified flour. She informed that it requires at least four to five months for positive results of the fortification, thus similar time would be required for the ill effects. Thus, the misconceptions if any are plainly on here say, she claimed. Regarding case pending in the Supreme Court against Gujarat Government, Sharma stated that it was regarding no reducing the quantity of grain provided through the PDS in Gujarat.

Difference in amount of fibre
One of the most significant differences is the amount of fibre. During the production of white enriched flour, a lot of the fibre-containing components (the bran and germ) are reduced or removed. Thus, products made from this type of flour contain smaller amounts of fibre than those made with whole wheat flour.
Another concern is the effect on blood sugar levels. Enriched flour products tend to be higher on the Glycemic Index, quickly raising blood sugar levels. In contrast, foods made from whole grains tend to be lower on the Glycemic Index. Because they contain higher amounts of fibre and other complex carbohydrates, they take longer to digest; therefore, sugars enter the bloodstream in a slow and more controlled manner.
However, experts feel that there are more benefits with the fortification of the flour and thus there is no worry to use it.

Vitamin and Mineral Deficiencies
Milk, milk products, fruits, vegetables, egg, fish, and meat are the best sources of micronutrients, ie vitamins and minerals. But in Madhya Pradesh, per-capita consumption of these micronutrient-rich foods across all socio-economic and demographic groups is very low. Hence MP has high levels of micronutrient malnutrition; especially anemia and vitamin A deficiency. According to theNFHS-3, prevalence of anemia is very high amongst all population and socio-economic groups. In MP, 74 per cent of children 6-59 months, 58 per cent women and 25 per cent men are anaemic. Anaemia and vitamin A deficiency are major contributors to the low-vitality and mortality, especially of women and of children under five.
http://www.dailypioneer.com/state-editions/bhopal/22268-bid-to-check-malnutrition-through-fortified-flour.html

MALNUTRITION: Donors have been urged to provide nutritious food aid to help fight malnutrition among children.

A sick and displaced woman watches as her malnourished infant sleeps at a health clinic run by the medical charity Medecins Sans Frontieres (MSF) Holland in Kerfi, a site for thousands of displaced Chadians some 50 kilometres south of the eastern town of Gos Beida, June 10, 2008. MSF have urged donors to provide nutritious food aid to help fight malnutrition among children
By LUCAS BARASA
 October 15 2010
Medicins San Frontieres (Doctors without borders) launched the campaign at a function attended by two MPs and other stakeholders at the Kenyatta International Conference Centre on Thursday evening.
Currently, it said only 1.7 percent of food aid addressed nutrition.
MSF said donors should cease in-kind donations and instead provide cash to finance food aid interventions based on medical needs and at a cheaper cost.
“This is particularly true for the US for whom such a shift could save approximately $600 million-close to double the global amount estimated to focus on malnutrition in any given year,” MSF said in a statement.
It regretted that the current food aid by major donors, Japan, US and Australia lacked necessary vitamins and minerals for children's growth.
The organisation called for the signing of a petition to pressurise the food donors to change their policy and provide adequate food for young children.
It accused the major donors of double standards saying food donated as relief, including maize, was not consumed by children in their countries
http://www.nation.co.ke/News/-/1056/1033366/-/view/printVersion/-/7i959w/-/index.html

MALNUTRITION: Ultra-rice

A simple bowl of white rice sits on a conference table inside the Seattle headquarters of global-health nonprofit PATH.
What looks and tastes like ordinary rice is actually the product of two decades of research and development.
For every 100 grains of rice, the bowl contains one grain of Ultra Rice. It's actually not rice at all, but pasta fortified with vitamins and minerals and squeezed through a rice-shaped mold. The manufactured grains are made from a mixture of rice flour, nutrients and binding agents derived from seaweed.
Originally the creation of father-and-son inventors from Bellingham, Ultra Rice is now being produced and tested around the world as a potential solution to malnutrition. Governments in Brazil and India are serving it in school-lunch programs, and the United Nations' World Food Programme is conducting a trial in Cambodia to see if families find it acceptable.
About 2.5 billion people consume rice as their main source of food. Many of them suffer from deficiencies of iron, folic acid, vitamin A and other essential nutrients.
In India, for example, a national study last year found that more than half of women and 70 percent of children under 5 were anemic. Iron deficiencies can harm brain development and increase the risk of hemorrhaging and death in childbirth.
Adding nutrients to rice can reach millions of people without asking them to change basic shopping, cooking or eating habits, says Dipika Matthias, who directs the Ultra Rice project at PATH in Seattle. In the U.S., products such as flour, milk and salt come fortified with vitamins and minerals.
The challenge: making pasta that smells, tastes and looks like rice, but packs a powerful combination of calcium, zinc, folic acid, thiamin and iron inside, can withstand heat and humidity in storage, and doesn't wash away or break down when cooked.
Customization
Ultra Rice is made by pasta makers then blended with natural rice grains by rice millers, so by the time it gets to consumers, it can be cooked and eaten as usual. The grains are customized to meet the needs of each country — in India that's iron; in Brazil it's a combination of micronutrients.
PATH won an award from The Tech Museum in Silicon Valley last year for its work on Ultra Rice.
It may be a technological wonder, but Ultra Rice has its own set of challenges. The price is 2 to 5 percent higher than traditional rice, and the target population is among the world's poorest, so widespread distribution depends on government support and companies' willingness to limit their profit margins.
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The project dates to 1985, when James Cox and his son R.W. Duffy Cox set out to turn broken grains of rice into a more valuable product by grinding them into flour and extruding them through a pasta machine into rice-shaped kernels.
But it turned out to be more expensive than other rice products on the market and never got off the ground, said Duffy Cox, 45.
Then the U.S. Department of Agriculture saw its potential for nutrition and asked the pair of inventors to come up with a way to fortify the rice with vitamin A. Working at their tiny company, Bon Dente International in Lynden, Whatcom County, they created and patented vitamin-enriched Ultra Rice with a six-month shelf life, then went overseas in search of commercial partners.
Donated patents
They didn't find any they considered suitable. In 1997, the Cox family donated the patents to PATH.
"My father and I had a lot on our plate," Cox said. "We thought it made good sense to put it into hands of people who could do it."
Eleven years later, after further research and refining, the fortified grains made their debut in India under the brand Captain Paushtik Premixed Rice.
PATH partners with local pasta manufacturers to produce the Ultra Rice grains and works with rice millers and government food programs to blend and distribute the fortified product.
It has licensed the technology for free to commercial partners in Brazil, India and Colombia, which are required to make their Ultra Rice grains available to government buyers and consumers at preferential prices.
PATH's Matthias acknowledged the higher cost could deter participation by companies whose margins are already tight. PATH is working with governments to look for incentives such as tax breaks.
"There should be some means to offset incremental cost so rice millers pass on the savings," she said, so that for consumers "ultimately the product is priced the same as traditional rice."
At the same time, she said, momentum is growing in parts of Latin America and Asia to make rice fortification part of the national food policy.
The companies involved see contributing to nutrition as part of their mission, Matthias said. "They can be social entrepreneurs," she said. "They take a hit on margins but enhance their reputation."
In India, PATH launched a pilot program with the Global Alliance for Improved Nutrition (GAIN) and the nonprofit Naandi Foundation in the state of Andhra Pradesh for a government-sponsored Mid-day Meal Scheme.
Swagat Food Products, a pasta manufacturer in West Bengal, produces the fortified rice and will supply it for another program beginning this year in Rajasthan, where the nongovernment organization Akshaya Patra will serve it daily to 185,000 schoolchildren.
In Brazil, Ultra Rice produced by local partner Adorella Alimentos is part of school-lunch programs this year for 100,000 children in three cities. A five-month study of children in Brazil found that eating Ultra Rice rice improved their iron levels at least as well as taking iron drops.
China challenge
In China, the world's biggest producer of rice, PATH explored the market with Longevity Vita Bio-Tech, a company partly owned by the Chinese Center for Disease Control.
The project was put on hold after the extrusion process commonly used in China was found unsuitable for Ultra Rice, Matthias said. The heat used in the Chinese pasta equipment causes the Ultra Rice grains to fall apart. In Brazil and India, the manufacturing is a cold process.
Meanwhile, James Cox died in 1997 after the patents were granted to PATH, leaving his son to continue the Washington company that created technologies from oyster-shucking equipment to methods of eliminating salmonella in eggs. More than a decade after the donation to PATH, Duffy Cox said he hopes Ultra Rice can one day realize its full potential.
Once the benefits to health are demonstrated, it's up to national governments to set the right policies, as it was in the early days of food fortification in the U.S., he said.
"There has to be a meeting of the minds between business and government," he said. "The economics don't make sense until you can do that."
He said he would like to have seen faster progress. "It's been in the mill for a long time," he said. "It's like one of your children. You may not always like where they're at, but you're always vested."
http://seattletimes.nwsource.com/html/localnews/2012441987_ultrarice25.html