The technology for fortifying sugar with vitamin A was developed in Guatemala in the mid-1970s, and the Guatemalan government enacted legislation to make fortification mandatory in June 1974. This action was copied by other Central American governments. The fortification programme in Guatemala developed in two stages. In the first (1975–77), the fortification programme was evaluated four times at six-month intervals and was shown to be effective. The sugar industry was responsible for carrying out the programme, but the programme was suspended, mainly because of economic arguments. After 10 years of effort, the programme was restarted in 1989. At this time the programme was combined with an initial mass distribution of vitamin A capsules to pre-school children, which began the first successful social mobilization effort in the area. The programme was evaluated for six months and was shown to be effective in improving the vitamin A status of the Guatemalan population. This sec- ond stage has been active continuously since 1989. With improvements in the technology of fortification, new approaches have been tested, and now it is possible to obtain an excellent sugar doubly fortified with vitamin A and iron, using new iron products of high bioavailability that do not alter the organoleptic characteristics of the sugar and do not produce unwanted colour changes during processing. To avoid the rancidity of premixes, new processes of dry mixing have been developed in which no oil is used, This opens a real possibility for the fortification of sugar with other nutrients. Sugar fortified with vitamin A, iron, and zinc, either alone or in any combination, is commercially available in Brazil, where, under the guidance of the Latin American Centre of Nutrition and Metabolic Studies (CELANEM), the procedures have been developed using iron amino acid chelated minerals.
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