Considerations for Rice (Oryzasativa) Fortification with Essential Micronutrients in Public Health Intervention

Am Mujibul Haq,Asm Giasuddin,Khadija Akther Jhuma,Md Sabir Hossain

doi:10.3329/bjms.v19i2.44994

Abstract

Background and Rationale: Fortification of staple foods and commonly used condiments with vitamins and minerals has been considered one of the most cost-effective interventions to prevent and control micronutrient deficiencies. Because of its wide local consumption, acceptability, reach, and quantum of consumption, rice (Oryzasativa) far exceeds the requirements of a staple food vehicle that can be considered for fortification purposes at a population-level intervention. The World Health Organization (WHO) has the mandate to develop evidenceinformed guidelines for the fortification of staple foods as a public health intervention, including rice fortification with micronutrients. The WHO, in collaboration with the Global Alliance for Improved Nutrition (GAIN), convened a consultation on “Technical Considerations for Rice Fortification in Public Health” in Geneva, Switzerland in 2012 to provide technical inputs to the guideline development process, particularly with reference to feasibility and implementability. Conclusion: The industrial and regulatory technical considerations in rice fortification, as well as the considerations for implementing it as a public health strategy and assuring equitable access and universal coverage and priority research areas for the forthcoming years were reviewed in this article based on WHO consultation Bangladesh Journal of Medical Science Vol.19(2) 2020 p.189-193

Highlights

Background and RationaleFortification of staple foods and commonly used condiments with vitamins and minerals has been considered one of the most cost-effective interventions to prevent and control micronutrient deficiencies
Strategies for behavior change communication can help to (1) understand knowledge of and attitudes toward fortification of this staple food from different quarters involved in the fortification program, from consumers; (2) identify crucial success factors and opportunities for the program; (3) choose best appropriate delivery channels according to target groups; (4) generate demand from different sectors; and (5) communicate other nutritional aspects related to rice fortification, e.g. household storing and use of rice
The key areas of research priorities for implementation to scaling up of rice fortification as a public health strategy were identified as the following: (i) stability of different micronutrients and compounds in different cooking processes that are context specific; (ii) relative bioavailability among different chemical forms of various micronutrients that can be used in rice fortification, including nutrient-nutrient interactions; (iii) acceptability of changes, if any, in organoleptic characteristics with different micronutrient combinations on different fortified rice preparations and cooking methods; (iv) effects of different phytate contents on the absorption of iron from the premix formulation; (v) most appropriate delivery platforms for reaching the intended target population; and (vi) effectiveness of different methods of fortification for rice in different contexts.[11,15,17]

Summary

Introduction

Background and RationaleFortification of staple foods and commonly used condiments with vitamins and minerals has been considered one of the most cost-effective interventions to prevent and control micronutrient deficiencies. While different approaches can be used to estimate safe and efficacious amounts of key fortificants in rice and considerations in relation to stability, bioavailability, cost and diet given, proposed the use of WHO/FAO food fortification guidelines to decide which micronutrients to add and at what level.

Results

Conclusion