Purpose: Anemia in children is a major Public Health problem in developing countries such as Ivory Coast. The fortification of wheat flour with iron and folic acid has been mandated in this country in 2007. To date, there are no studies conducted to assess the effectiveness of these fortification efforts. Therefore, the purpose of this study was to determine if mandated iron and folic acid fortification of wheat flour has reduced the prevalence of anemia in Ivory Coast children. Methods: The study was conducted at the pediatric unit of the university hospital of Treichville, one of the 3 main hospitals of Abidjan, the largest city of Ivory Coast. The medical records of 467 children from 5 to 14 years old were analyzed. The period from January 1st 2004 to December 31st 2006 was considered as pre-fortification period and the period from January 1st 2008 to December 31st 2010 was regarded as the post-fortification period. Data for anemia, hemoglobin, hematocrit, red blood cell count, and MCV were compared between pre- and post-fortification periods. Results: The results showed that there were no statistically significant difference in prevalence of anemia and mean hemoglobin, hematocrit, red blood cells, and MCV between pre and post-fortification periods. Conclusion: The double fortification of wheat flour with folic acid and iron had no significant impact on anemia in Ivorian children. This is perhaps due to the fact that wheat flour is not widely consumed as rice and rice products are more popular in Ivory Coast population. The Ivorian government perhaps should focus efforts on the fortification of these products.

Food fortification and nutrient supplementation are important strategies to address micronutrient deficiencies. Mandatory folic acid fortification was implemented in Canada and the U.S. in 1998 to reduce the incidence of neural tube defects (NTD). However, the actual amount of folic acid added to foods has not been reported in Canada. We analyzed 95 fortified foods and found that there is 50% more folate in foods than that reported in food composition tables, which are primarily based on minimum mandated fortification levels. We then determined if these observed folate overages impacted the prevalence of dietary folate inadequacy or intakes above the Tolerable Upper Intake Level (UL). Using data from the 2004 nationally-representative Canadian Community Health Survey (CCHS) 2.2 (n = 35,107), adjusted for folate overages, we found a low prevalence of folate inadequacy in Canada post-fortification. However, few women 14-50y consumed 400µg/d of synthetic folic acid, an amount associated with maximal protection against an NTD. Conversely, we also showed that use of folic acid-containing supplements led to intakes >UL in the general population. To develop a tool that would help clinicians identify women with red blood cell (RBC) folate concentrations that were not maximally protective against an NTD (<906nmol/L), we used data from the nationally-representative U.S. National Health and Nutrition Examination Survey 2003-2006 to define risk factors of RBC folate <906nmol/L. We found that 35% of American women 19-45y had RBC folate <906nmol/L. Younger age, low dietary folate intake, not consuming supplemental folic acid, smoking, and being African-American were associated with increased risk of RBC folate <906nmol/L. Given our observations of a low prevalence of folate inadequacy and folic acid supplement use leading to intakes >UL, we used CCHS 2.2 data to compare the diets of supplement users and non-users in terms of inadequacy and intakes >UL for other nutrients. We showed that the prevalence of inadequacy was low for most nutrients, and from diet alone, supplement users were not at increased risk of inadequacy compared to non-users. Furthermore, inclusion of supplements led to intakes >UL above 10% for vitamins A, C, niacin, folic acid, and iron, zinc and magnesium.

Food fortification and nutrient supplementation are important strategies to address micronutrient deficiencies. Mandatory folic acid fortification was implemented in Canada and the U.S. in 1998 to reduce the incidence of neural tube defects (NTD). However, the actual amount of folic acid added to foods has not been reported in Canada. We analyzed 95 fortified foods and found that there is 50% more folate in foods than that reported in food composition tables, which are primarily based on minimum mandated fortification levels. We then determined if these observed folate overages impacted the prevalence of dietary folate inadequacy or intakes above the Tolerable Upper Intake Level (UL). Using data from the 2004 nationally-representative Canadian Community Health Survey (CCHS) 2.2 (n = 35,107), adjusted for folate overages, we found a low prevalence of folate inadequacy in Canada post-fortification. However, few women 14-50y consumed 400µg/d of synthetic folic acid, an amount associated with maximal protection against an NTD. Conversely, we also showed that use of folic acid-containing supplements led to intakes >UL in the general population. To develop a tool that would help clinicians identify women with red blood cell (RBC) folate concentrations that were not maximally protective against an NTD (<906nmol/L), we used data from the nationally-representative U.S. National Health and Nutrition Examination Survey 2003-2006 to define risk factors of RBC folate <906nmol/L. We found that 35% of American women 19-45y had RBC folate <906nmol/L. Younger age, low dietary folate intake, not consuming supplemental folic acid, smoking, and being African-American were associated with increased risk of RBC folate <906nmol/L. Given our observations of a low prevalence of folate inadequacy and folic acid supplement use leading to intakes >UL, we used CCHS 2.2 data to compare the diets of supplement users and non-users in terms of inadequacy and intakes >UL for other nutrients. We showed that the prevalence of inadequacy was low for most nutrients, and from diet alone, supplement users were not at increased risk of inadequacy compared to non-users. Furthermore, inclusion of supplements led to intakes >UL above 10% for vitamins A, C, niacin, folic acid, and iron, zinc and magnesium.

The fortification of salt with iron may reduce the prevalence of iron deficiency globally, but fortification is complicated by iron-iodiate interactions. To minimize this interaction, a spray dry microencapsulation system was developed. This study evaluated the creation and use of this system, and produced engineered iron premixes for integration into coarse iodized salt. Bioavailable ferrous fumarate powders were encapsulated to produce small particles (<20μm). Feed systems containing both suspended and dissolved ferrous fumarate were compared to find optimal conditions. The premixes were blended into iodized salt at 1000ppmiron and stored at 40C, ~60%RH. The salt was sampled periodically for 6 months to evaluate iodine stability. All encapsulated samples showed increased stability. The capsules ability to adhere to the salt as well as its colour and apparent bioavailability were evaluated. The evaluated samples indicate that stable double-fortified salt based on inexpensive, coarse, unrefined salt may be obtained economically by this approach.

The fortification of salt with iron may reduce the prevalence of iron deficiency globally, but fortification is complicated by iron-iodiate interactions. To minimize this interaction, a spray dry microencapsulation system was developed. This study evaluated the creation and use of this system, and produced engineered iron premixes for integration into coarse iodized salt. Bioavailable ferrous fumarate powders were encapsulated to produce small particles (<20μm). Feed systems containing both suspended and dissolved ferrous fumarate were compared to find optimal conditions. The premixes were blended into iodized salt at 1000ppmiron and stored at 40C, ~60%RH. The salt was sampled periodically for 6 months to evaluate iodine stability. All encapsulated samples showed increased stability. The capsules ability to adhere to the salt as well as its colour and apparent bioavailability were evaluated. The evaluated samples indicate that stable double-fortified salt based on inexpensive, coarse, unrefined salt may be obtained economically by this approach.

A adição de vitaminas aos produtos industrializados tornou-se prática comum para as indústrias de alimentos e os teores adicionados devem obedecer à legislação brasileira durante toda a vida de prateleira dos produtos. Sabendo da sensibilidade das vitaminas a fatores como oxigênio, luz e calor, é essencial conhecer o comportamento destes compostos no alimento frente aos fatores críticos. Informações confiáveis sobre teores de vitaminas somente podem ser obtidas com métodos analíticos validados. Neste trabalho foi desenvolvido e validado um método de análise para vitaminas B1, B2, B6 e PP em leite em pó/fórmulas infantis, cereais e bebidas instantâneas por cromatografia líquida de alta eficiência com uma única etapa de extração que apresentou recuperações de 90 a 120% dependendo do teor e da matriz analisada. Após a validação do método analítico, foi avaliada a estabilidade das vitaminas em amostras submetidas a diferentes condições de estocagem durante 10 meses. Os resultados mostram que a principal causa de perda das vitaminas B2 e B6 é a exposição à luz, que pode ser agravada pela temperatura e/ou presença de oxigênio no meio, enquanto as vitaminas PP e B1 mostraram-se bem estáveis sob as diferentes condições e no tempo estudado. / Food fortification with vitamins is a very common practice in food industry and the added content must be in compliance with Brazilian Legislation during the whole product shelf life. Due to the vitamins sensibility to light, temperature and oxygen it\'s necessary to know the behavior of these compounds when submitted to these critical conditions. Trustful information about the vitamins content just can be obtained from validated analytical methods. In this work it was developed and validated a HPLC method for determination of vitamins B1, B2, B6 e PP in milk/infant formula, cereals and beverage powders with the same extract which presented recoveries within 90 and 120% depending on the matrix and the vitamins level. After method validation, the vitamins stability in different samples was evaluated during 10 months under different storage conditions. The results showed the high sensitivity of vitamins B2 and B6 to light exposure that can become worse when samples were exposed to high temperature and oxygen. Vitamins PP and B1 had very stable behavior under the studied conditions and for the period of this study.

Abstract The incidence of pre-eclampsia (PE) is 2–7% in different populations and in the worst cases PE may threaten the survival of both mother and newborn; its pathogenesis is not resolved. Field literature today considers PE an angiogenic disorder. Coordinated vascularization is essential for placental development. We wanted to find novel factors in the etiology of PE, and focused our attention on angiogenesis, inherited thrombophilia and folate-homocysteine metabolism. Homocysteine inhibits endothelial cell proliferation, which is closely related to angiogenesis. We performed gene expression profiling of placental tissue using microarray chips, studied the prevalence of factor V Leiden (FVL), prothrombin (F5) G20210A and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism in patients with severe pregnancy complications and normal controls, compared the expression of the placental adiponectin, leptin and their receptor genes and the relationship of each to trophoblast apoptosis and further, studied the effect of folic acid fortified mineral water on plasma homocysteine concentration during pregnancy. Gene expression profiling revealed downregulation of nine and upregulation of four genes. Interestingly, in one PE patient with cord compression during delivery the profile resembled that observed in normals. The expression level of the leptin and the adiponectin receptor 1 (ADIPOR1) genes was significantly higher in PE. No other significant expression changes were observed. The rate of apoptosis was higher in patients with PE. The FVL prevalence was 9.5%, in PE cases and 1.8% in the controls; a difference of 7.7%, (95% CI 2.0–13.4%). No statistical difference was found in other polymorphisms.. Maternal serum folate concentration increased in our intervention group, but decreased in the control group (p &lt; 0.05). The plasma homocysteine concentrations decreased more in the intervention group (p &lt; 0.001). The expression of angiogenesis-related placental genes can be altered in PE and cord compression cases. The activity of adipocytokine genes in PE may mean that they have a role in placental angiogenesis and apoptosis. Women with FVL may have an increased risk of PE. Fortified mineral water will help us to ensure that especially pregnant women achieve adequate folate intake.

A adição de vitaminas aos produtos industrializados tornou-se prática comum para as indústrias de alimentos e os teores adicionados devem obedecer à legislação brasileira durante toda a vida de prateleira dos produtos. Sabendo da sensibilidade das vitaminas a fatores como oxigênio, luz e calor, é essencial conhecer o comportamento destes compostos no alimento frente aos fatores críticos. Informações confiáveis sobre teores de vitaminas somente podem ser obtidas com métodos analíticos validados. Neste trabalho foi desenvolvido e validado um método de análise para vitaminas B1, B2, B6 e PP em leite em pó/fórmulas infantis, cereais e bebidas instantâneas por cromatografia líquida de alta eficiência com uma única etapa de extração que apresentou recuperações de 90 a 120% dependendo do teor e da matriz analisada. Após a validação do método analítico, foi avaliada a estabilidade das vitaminas em amostras submetidas a diferentes condições de estocagem durante 10 meses. Os resultados mostram que a principal causa de perda das vitaminas B2 e B6 é a exposição à luz, que pode ser agravada pela temperatura e/ou presença de oxigênio no meio, enquanto as vitaminas PP e B1 mostraram-se bem estáveis sob as diferentes condições e no tempo estudado. / Food fortification with vitamins is a very common practice in food industry and the added content must be in compliance with Brazilian Legislation during the whole product shelf life. Due to the vitamins sensibility to light, temperature and oxygen it\'s necessary to know the behavior of these compounds when submitted to these critical conditions. Trustful information about the vitamins content just can be obtained from validated analytical methods. In this work it was developed and validated a HPLC method for determination of vitamins B1, B2, B6 e PP in milk/infant formula, cereals and beverage powders with the same extract which presented recoveries within 90 and 120% depending on the matrix and the vitamins level. After method validation, the vitamins stability in different samples was evaluated during 10 months under different storage conditions. The results showed the high sensitivity of vitamins B2 and B6 to light exposure that can become worse when samples were exposed to high temperature and oxygen. Vitamins PP and B1 had very stable behavior under the studied conditions and for the period of this study.

Magister Scientiae (Nutrition Management) - MSc(NM) / Micronutrient deficiencies are of public health concern in South Africa. These deficiencies affect pregnancy outcomes, growth, functional and cognitive development of children and, the health and productivity of women. As an intervention, the South African government implemented the National Food Fortification Programme (NFFP), which was mandated in 2003 and according to which, the staple foods consumed by most of the population e.g. maize meal and wheat flour (and thus bread) are fortified with a premix of thiamin, niacin, riboflavin, vitamin A, folate, vitamin B6, iron and zinc. There is limited data which looks at the contribution fortified staple food to the dietary intakes and measures of nutrient assessment among South African women of reproductive age (WRA).

<p>Kreirana je specijalizovana baza podataka o sadržaju vitamina D koja sadrži 981 analitički podatak prikupljen iz evropskih baza podataka, od čega je 658 (67%) izraženo u formi ukupnog vitamina D. Podaci o svim vitamerima pronađeni su za meso, obogaćene namirnice/formulacije i za ribu, dok su podaci o D3 pronađeni za ribu, meso i mlečne proizvode. Podaci o sadržaju vitamina D, iz srpske baze podataka o sastavu namirnica (BPSN), ažurirani su za ukupno 541 namirnicu, jelo i dijetetski suplement.<br />Da bi se upotpunio kvalitet podataka o vitaminu D u srpskoj BPSN, određen je sadržaj vitamina D u svežim konzumnim koko&scaron;ijim jajima proizvedenim na teritoriji Srbije. Analizirana su jaja iz intenzivne proizvodnje i iz malih domaćinstava. Analize su izvedene u laboratoriji Danskog Tehničkog Univerziteta (DTU) standardizovanom HPLC metodom. Sadržaj vitamina D u jajima iz intenzivne proizvodnje iznosio je 5,78 &mu;g/100g, a u jajima iz slobodnog uzgoja 2,99 &mu;g/100 g. Izračunati prosečni sadržaj vitamina D u svežim jajima iznosio je 4,39 &mu;g/100 g te je ovaj podatak unet u srpsku BPSN.<br />Uobičajeni unos vitamina D analiziran je programom SPADE u populaciji koju su činili ispitanici iz četiri regiona Srbije, ukupno 605 odraslih, od toga 54% žena. Ustanovljeno je da uobičajeni prosečni unos vitamina D iznosi 4&plusmn;1,4 &mu;g/dan, kod mu&scaron;karaca 4,3&plusmn;1,5 &mu;g/dan, a kod žena 3,7&plusmn;1,2 &mu;g/dan, &scaron;to je znatno niže od preporučenih vrednosti od 10 &mu;g/dan za procenjene prosečne potrebe (Estimated Average Requirement-EAR) i 15 &mu;g/dan za adekvatni unos (Adequate Intake &ndash;AI). Čak 95% srpske populacije ne dostiže EAR vrednosti.<br />Analiza ishrane srpske populacije pokazala je da su glavni nutritivni izvori vitamina D jaja, riba, meso i mlečni proizvodi. Konzumacija obogaćenih namirnica vitaminom D (obogaćenih i biljnih mleka, kakao praha, obogaćenih sokova, margarina i instant žitarica) identifikovana je kod trideset petoro ispitanika. Prateći kriterijume za odabir adekvatnih namirnica za obogaćivanje, a za potrebe dizajniranja prediktivnog modela, odabrano je 70 namirnica koje su sortirane u sedam karakterističnih grupa: beli hleb, mleko, jogurt, sir, pavlaka, jaja i paradajz pire.<br />Prediktivni model obogaćivanja namirnica baziran je na matematičkoj formuli kojom se izračunava količina vitamina D (fc) koju treba dodati određenoj namirnici, odnosno grupi namirnica. Izračunata količina zavisi od tri faktora:<br />- prosečne konzumacije date namirnice, ili grupe, u gramima na n-tom percentilu populacije,<br />- njenog (njihovog) procentualnog udela u dnevnom energetskom unosu,<br />- unosa vitamina D (u &mu;g/dan) na n-tom percentilu.<br />Odabrano je sedam scenarija koji su simulirani da bi se validirala efektivnost &bdquo;dodavanja&ldquo; vitamina D radi dostizanja preporučenih nutritivnih vrednosti. U optimalnom scenariju, AI je dostignut na 65. percentilu populacije, a unos vitamina D na 95. percentilu populacije bio je ispod 25 &mu;g/dan. U maksimalnom scenariju, 50% populacije bilo je između AI i gornjeg tolerisanog nivoa nutritivnog unosa (Upper Tolerable Intake Level-UL), pri čemu niko nije dostigao UL vrednosti. Na ovaj način definisane su optimalne i maksimalne količine vitamina D koje se mogu dodati odabranim namirnicama da bi se zadovoljile potrebe, odnosno korigovao unos vitamina D kod srpske populacije.</p> / <p>A specialized database on the content of vitamin D was created with 981 analytical data on vitamin D content obtained from European databases, of which 658 (67%) were expressed as total vitamin D. The data (for all vitamins) were mainly found for meat, enriched foods/formulations and fish, while D3 data was identified for fish, meat and dairy products. Updating data on vitamin D content in Serbian food composition database (FCDB) was done in 541 foods, dishes and dietary supplements. To enhance the quality of data in Serbian FCDB, content of vitamin D in fresh eggs from the farm and domestic production on the territory of Serbia has been determined. Analysis was performed in Danish Technical University-DTU, Denmark, using standardized HPLC method. Eggs from the farm contained 5.78 &mu;g vitamin D/100 g, while domestic eggs were 2.99 &mu;g vitamin D/100 g, and the average vitamin D content in fresh eggs - 4.39 &mu;g/100 g which value was inserted into Serbian FCDB. The usual dietary intake of vitamin D was analyzed using the SPADE program in the survey covering 605 adult respondents from four regions of Serbia, of which 54% were women. The average intake of vitamin D was found to be 4&plusmn;1.4&mu;g/day, which is 4.3&plusmn;1.5 &mu;g/day for men and 3.7&plusmn;1.2 &mu;g/day for women, and is significantly lower than the recommended Estimated Average Requirement (EAR) values (10 &mu;g/day) and Adequate Intake (AI) values (15 &mu;g/day). As many as 95% of Serbian population are not reaching the EAR values. Nutritional analysis of Serbian diet has shown that the main sources of vitamin D are eggs, fish, meat and dairy products. Consumption of vitamin D-fortified foods (fortified and plant milk, cocoa powder, fortified juices, margarine, and instant cereals) was identified in 35 subjects. Following the criteria for selecting adequate foods for fortification, for the needs of designing the model, 70 foods were selected that were sorted into 7 characteristic food groups: white bread, milk, yoghurt, cheese, sour cream, eggs and tomato puree.<br />The prediction model of food fortification is based on a mathematical formula that calculates the amount of vitamin D (fc) to be added to a particular food group in accordance with:<br />- the amount of consumption of that food vector and<br />- the percentage factor in the total energy intake of the considered foods (food vectors) in the observed population,<br />- the intake of vitamin D on n-th percentile.<br />Seven scenarios were simulated to validate the effect of addition of vitamin D toward reaching the given reference values. In the optimal scenario, AI was reached at the 65th percentile of the population, and vitamin D intake at 95th percentile was below 25 &mu;g/day. In the maximum scenario, 50% of the population was between AI and Upper Tolerable Intake Level (UL), while none has reached UL values. This defines the ranges of optimal and maximum values of vitamin D that, by being added to the chosen food-vectors, can help in reaching vitamin D requirements of Serbian population.</p>