Fortification Strategies Research Articles

Spray Encapsulation of Iron in Chitosan Biopolymer for Tea Fortification

Aim. Tea was studied as a carrier for iron in a fortification strategy to reduce iron deficiency. Iron forms insoluble coloured complexes with tea polyphenols which lower consumer acceptability. Complexation of iron by polyphenols and quinones derived from tea inhibits iron absorption in the first segment of the small intestine. Spray-dried chitosan-iron microcapsules were prepared to prevent iron-polyphenol interaction before the beverage is consumed. A competing chelating agent (EDTA) or antioxidant (sodium ascorbate) was added to prevent interactions and help improve iron bioavailability. Methods. The effect of concentration of chitosan (0.2–1.5%w/w), iron loading (10–60% w/w FeSO4), addition of secondary coatings on particle morphology, surface iron exposure and release, and bioaccessibility were evaluated. Tea-containing chitosan microcapsules and chelating agents to enable iron absorption were evaluated for sensory acceptability. Results. The iron release profile at pH 1 and pH 7 exhibited reverse enteric behaviour of non-cross-linked chitosan microcapsules. Increasing the iron content leads to more iron exposure on the surface due to a high core to coat ratio. Cross-linked chitosan effectively encapsulated iron, and its release in tea was inhibited, as indicated by lower delta E values in comparison with untreated tea and positive sensory testing scores. The use of maltodextrin as secondary coating slightly improved the spray process and produced larger particles, with less exposed iron on the surface. However, it did not improve the colour performance in milk tea. Conclusions. Tea fortified with encapsulated iron and a chelating agent providing 40% of the daily iron requirement of an adult, prepared in a traditional South Asian manner, i.e., with milk and water, resulted in tea with acceptable colour and taste. However, further research is required to develop an encapsulation formulation for stable iron encapsulation in hot tea and exploration of equivalent plant-based chitosan sources to address concerns of consumers with dietary restrictions.

Trends in Micronutrient Interventions, Anemia, and Iron Deficiency among Women and Children in Guatemala, 2009–2019

BackgroundFood fortification and micronutrient supplementation are public health strategies to improve micronutrient status in Guatemala; their population effectiveness has not been evaluated in recent years. ObjectiveWe evaluated trends in food fortification, micronutrient supplementation, anemia, and iron deficiency among nonpregnant women aged 15–49 y [women of reproductive age (WRA)] and children 6–59 aged mo [preschool age children (PSC)]. MethodNationally representative serial cross-sectional surveys were used to assess changes in hemoglobin, anemia, ferritin, iron deficiency, iron deficiency anemia, and self-reported consumption of fortifiable foods and micronutrient supplements during 2008/2009, 2013, 2015, 2016, 2017/2018, and 2018/2019. Predictors of hemoglobin and ferritin were assessed using generalized linear mixed models adjusted for survey year as random effects, and the consumption of fortifiable foods, supplements, and other potential confounders were fixed effects. ResultsMultiple micronutrient powder consumption among PSC during the previous 3 mo was 53.3% (95% CI: 49.4, 57.2) in 2013 and 33.6% (28.8, 38.4) in 2018/2019. Anemia among PSC was 11.3% (8.0, 14.5) in 2008/2009 and 6.1% (3.6, 8.6) in 2018/2019. Anemia among WRA was 10.7% (7.2, 14.2) in 2008/2009 and 3.9% (2.7, 5.2) in 2018/2019. Iron deficiency among PSC was 15.5% (12.1, 19.0) in 2008/2009 and 10.9% (7.4, 14.5) in 2016 (lowest), but 17.1 (13.3, 21.0) in 2017/2018 (highest). Iron deficiency among WRA was 14.9% (11.6, 18.2) in 2008/2009, 13.8% (11.8, 15.8) in 2013 (lowest), and 18.9% (16.3, 21.6) in 2017/2018 (highest). Wheat flour/bread consumption was positively associated with hemoglobin among PSC, and sugar consumption was positively associated with hemoglobin among WRA. The reported consumption of fortifiable foods was not associated with ferritin among PSC or WRA. ConclusionsGuatemala has implemented multiple food fortification strategies, and anemia has declined. Increases in iron deficiency in 2017–2019 warrant further attention. Secular trends toward poverty alleviation, education, and development might be responsible for changes not explained by the micronutrient interventions evaluated.

Compositional analysis of phytochemicals and polysaccharides from Senegalese plant ingredients: Adansonia digitata (baobab), Moringa oleifera (moringa) and Hibsicus sabdariffa (hibiscus)

Certain indigenous African plant materials, including Adansonia digitata (baobab), Moringa oleifera (moringa), and Hibiscus sabdariffa (hibiscus) could be leveraged in food-to-food fortification strategies due to their high content of nutrients, dietary fiber, and phenolic compounds. However, more studies are needed to understand the nutritional composition of commercially available food ingredients. The objective of this study was to examine the phytochemical and polysaccharide compositions of commercially available baobab, moringa, and hibiscus ingredients from Senegal. Characterization of carotenoids, tocopherols, phenolic compounds, monosaccharide composition, and glycosyl linkage was carried out. We observed that moringa contained the greatest content of carotenoids and tocopherols. Moringa also contained significant amounts of the flavonols quercetin 3-O-glucoside and quercetin 3-O-rutinoside, while baobab had greater concentrations of flavan-3-ols. Substantial content of anthocyanins was observed for hibiscus, but not moringa or baobab. The predominant monosaccharide in baobab was xylose, while hibiscus was a combination of xylose, galactose, and glucose. The primary monosaccharides in moringa were galactose and glucose. Based on our glycosyl linkage analysis, (1 → 2)- and (1 → 2,4)-linked rhamnose were attributed to rhamnogalacturonan-I, while (1 → 4)-linked glucose and (Terminal →)-linked xylose were attributed to xyloglucans. The phytochemical and polysaccharide characterization of baobab, moringa, and hibiscus suggested that delivery of micronutrients, such as iron and carotenoids, could be impacted when applied as functional food ingredients.

Encapsulation of atomized erythrocytes in liposomes as source of heme iron for oral supplementation strategies

AbstractThis work aimed to develop and characterize liposomes of atomized bovine erythrocytes (ABE‐liposomes) for potential use as a heme iron supplement or to fortify food with heme iron. Soy lecithin (SL) and Tween 80 (T80) were chosen to prepare empty liposomes (8 types), and ABE‐liposomes (16 types) by a rotary‐evaporated film method. Variables of interest for our study were: ABE concentration, proportion of SL:T80 and ultrasonic bath time. ABE‐liposomes were characterized according to appearance, color, morphology, Fourier transform infrared spectroscopy (FTIR), size, zeta potential, total iron content, encapsulation efficiency (EE) and in vitro iron release under gastrointestinal conditions. ABE‐liposomes presented a brown color and spherical shape. Hydrogen bridges were the main interactions in ABE‐liposomes. Their size ranged from 379 to 964 nm, the zeta potential from −56 to −74 mV, the iron concentration range was 0.8–9.0 mg/100 mL, and EE ranged from 29% to 48%. Ultrasonic bath time was the most important variable on the reduction of ABE‐liposomes' size and EE. Under in vitro gastrointestinal conditions, iron release from ABE‐liposomes occurred mainly at the intestinal level. In conclusion, ABE‐liposomes were effectively developed, which could become a complement for supplementation or food fortification strategies with nonheme for the prevention of iron deficiency anemia.Practical ApplicationsIn this study atomized bovine erythrocytes (ABE)‐liposomes were developed, due to the: (1) lack of supplements or products to fortify foods based on heme iron, (2) higher bioavailability of heme iron than nonheme iron, especially when working with ABE, and (3) ABE is a low value‐added product that is generated in slaughter plants and in turn is an excellent source of underutilized heme iron. In this study it was possible to develop ABE‐liposomes, where ABE was encapsulated inside liposomes, obtaining a product that could be used as a complement in iron supplementation strategies or food fortification to prevent or treat iron deficiency or iron deficiency anemia, especially in developing countries that have low consumption of heme iron.

The Effects of Latitude and Temperate Weather on Vitamin D Deficiency and Women's Reproductive Health: A Scoping Review.

We conducted a scoping review to analyze the effects and implications of vitamin D deficiency on female reproductive health during the last decade, considering temperate planetary zones and climate change impacts. We used a qualitative methodology for a panoramic database review of PubMed, Web of Science, and Scopus covering articles from the last decade focused on populations living at latitudes higher than 40°N and 40° S. As descriptors, we used the phrases climate change, cholecalciferol or vitamin d3, pregnancy, and woman health and the Boolean operators AND and OR. We excluded letters to the editor, reviews, protocols, and clinical trials without human participants, as well as duplicate articles. We included 35 studies in English, the majority of which were from North America or Europe. No studies were found from the Southern Hemisphere or having any direct relation with climate change, although studies demonstrated that latitude and environmental factors affected vitamin D deficiency, which had an impact on pregnant women and their children. Supplementation guidelines were not well developed, and there was a lack of studies among at-risk groups of women (eg, darker skin, higher latitudes, immigrants) across the life span. Vitamin D deficiency is a global environmental problem that affects female reproductive health and depends on multiple environmental factors and human behavior. Therefore, we recommend consideration of environmental and sociocultural factors in public policy and clinical research and more research on the effectiveness of supplementation and fortification strategies. Health care professionals working in reproductive health need to generate actions for detection of, education on, and prevention of vitamin D deficiency among women across their life spans, considering the multicausality of the phenomenon, which includes environmental and climate factors in population health.

Exclusive Human Milk Diet for Extremely Premature Infants: A Novel Fortification Strategy That Enhances the Bioactive Properties of Fresh, Frozen, and Pasteurized Milk Specimens

Background: Human milk (HM) fortification has been recommended for the nutritional optimization of very low-birthweight infants. This study analyzed the bioactive components of HM and evaluated fortification choices that could accentuate or attenuate the concentration of such components, with special reference to human milk-derived fortifier (HMDF) offered to extremely premature infants as an exclusive human milk diet. Materials and Methods: An observational feasibility study analyzed the biochemical and immunochemical characteristics of mothers' own milk (MOM), both fresh and frozen, and pasteurized banked donor human milk (DHM), each supplemented with either HMDF or cow's milk-derived fortifier (CMDF). Gestation-specific specimens were analyzed for macronutrients, pH, total solids, antioxidant activity (AA), α-lactalbumin, lactoferrin, lysozyme, and α- and β-caseins. Data were analyzed for variance applying general linear model and Tukey's test for pairwise comparison. Results: DHM exhibited significantly lower (p < 0.05) lactoferrin and α-lactalbumin concentrations than fresh and frozen MOM. HMDF reinstated lactoferrin and α-lactalbumin and exhibited higher protein, fat, and total solids (p < 0.05) in comparison to unfortified and CMDF-supplemented specimens. HMDF had the highest (p < 0.05) AA, suggesting the potential capability of HMDF to enhance oxidative scavenging. Conclusion: DHM, compared with MOM, has reduced bioactive properties, and CMDF conferred the least additional bioactive components. Reinstatement and further enhancement of bioactivity, which has been attenuated through pasteurization of DHM, is demonstrated through HMDF supplementation. Freshly expressed MOM fortified with HMDF and given early, enterally, and exclusively (3E) appears an optimal nutritional choice for extremely premature infants.

Entrepreneur-led food fortification: A complementary approach for nutritious diets in developing countries

Small and micro food enterprises are critical implementation partners for fortification strategies that address the widespread micronutrient deficiencies in low-income countries. This paper describes the concept and practice of Entrepreneur-led Food Fortification (ElFF). It draws on the experience of a consortium of US and African food and nutrition R&D organizations, partnering with African small-scale food processors. ElFF can address major challenges faced by such enterprises by providing convincing value propositions, product distribution and marketing, and achieving business scale and nutritional impact. Through the example of entrepreneur-led production of food-to-food fortified grain-based instant porridge flour, we illustrate a framework for successful implementation of ElFF both in local markets and potential links to government nutrition strategies to address micronutrient deficiencies.

Can consumption of local micronutrient- and absorption enhancer-rich plant foods together with starchy staples improve bioavailable iron and zinc in diets of at-risk African populations?

Iron and zinc deficiencies remain prevalent in developing countries, often due to monotonous starchy diets that are low in bioavailable minerals. This review addresses the question as to whether consumption of starchy staple foods in Africa together with micronutrient-dense and absorption enhancer-rich plant foods can enhance iron and zinc bioavailability in the diets of at-risk populations. While green leafy vegetables (GLVs) fortification of starchy staples can improve mineral contents, especially iron, it may not improve bioavailable iron and zinc, due to GLVs’ high contents of mineral absorption inhibitors, notably polyphenols, phytate and calcium. Fruits, although low in minerals, could improve bioavailable iron and zinc in the staples because of their high ascorbic and citric acid and/or β-carotene contents, which can form soluble chelates with the minerals. More human studies are needed to establish whether such a technology or fortification strategy can improve bioavailable iron and zinc in African-type plant-based diets.

Iodine Deficiency and Iodine Prophylaxis: An Overview and Update.

The thyroid gland requires iodine to synthesize thyroid hormones, and iodine deficiency results in the inadequate production of thyroxine and related thyroid, metabolic, developmental, and reproductive disorders. Iodine requirements are higher in infants, children, and during pregnancy and lactation than in adult men and non-pregnant women. Iodine is available in a wide range of foods and water and is susceptible to almost complete gastric and duodenal absorption as an iodide ion. A healthy diet usually provides a daily iodine consumption not exceeding 50% of the recommended intake. Iodine supplementation is usually necessary to prevent iodine deficiency disorders (IDDs), especially in endemic areas. The community-based strategy of iodine fortification in salt has eradicated IDDs, such as endemic goiter and cretinism, in countries providing adequate measures of iodine prophylaxis over several decades in the 20th century. Iodized salt is the cornerstone of iodine prophylaxis in endemic areas, and the continuous monitoring of community iodine intake and its related clinical outcomes is essential. Despite the relevant improvement in clinical outcomes, subclinical iodine deficiency persists even in Western Europe, especially among girls and women, being an issue in certain physiological conditions, such as pregnancy and lactation, and in people consuming unbalanced vegetable-based or salt-restricted diets. Detailed strategies to implement iodine intake (supplementation) could be considered for specific population groups when iodized salt alone is insufficient to provide adequate requirements.

Vitamin D Food Fortification Strategies on Population-Based Dietary Intake Data Using Mixed-Integer Programming.

The dietary vitamin D intake of the Danish population is low, and food fortification is a strategy to increase intake. This paper explores the possibility of vitamin D fortification on the current population food intake in Denmark, such that the population receives adequate amounts of vitamin D without having to change current dietary patterns. A mixed-integer programming approach is used to arrive at a solution for the optimal fortification required at each food group level so that the majority of the population receive the minimum intake of average requirement (AR) and do not exceed the tolerable upper intake level (UL). The method shows a significant increase in vitamin D intake compared to the current scenario, keeping a neutral approach towards preferences of one food group over others. The method can also be fine-tuned in different scenarios where certain food group preferences are known, which can be encoded into the model in the form of constraints.

Enhancing micronutrient absorption through simultaneous fortification and phytic acid degradation.

Phytic acid (PA), an endogenous antinutrient in cereals and legumes, hinders mineral absorption by forming less bioavailable, stable PA-mineral complexes. For individual micronutrients, the PA-to-mineral molar ratio below the critical level ensures better bioavailability and is achieved by adding minerals or removing PA from cereals and pulses. Although several PA reduction and fortification strategies are available, the inability to completely eradicate or degrade PA using available techniques always subdues fortification's impact by hindering fortified micronutrient absorption. The bioavailability of micronutrients could be increased through simultaneous PA degradation and fortification. Following primary PA reduction of the raw material, the fortification step should also incorporate additional essential control stages to further PA inactivation, improving micronutrient absorption. In this review, the chemistry of PA interaction with metal ions, associated controlling parameters, and its impact on PA reduction during fortification is also evaluated, and further suggestions were made for the fortification's success.

Functional microorganisms in Baijiu Daqu: Research progress and fortification strategy for application.

Daqu is a saccharifying and fermenting starter in the production of Chinese Baijiu; its quality directly affects the quality of Baijiu. The production of Daqu is highly environment-dependent, and after long-term natural domestication, it is rich in a wide variety of microorganisms with a stable composition, which provide complex and diverse enzymes and flavor (precursor) substances and microbiota for Jiupei (Fermented grains) fermentation. However, inoculation with a relatively stable microbial community can lead to a certain upper limit or deficiencies of the physicochemical properties (e.g., saccharification capacity, esterification capacity) of the Daqu and affect the functional expression and aroma formation of the Daqu. Targeted improvement of this problem can be proposed by selecting functional microorganisms to fortify the production of Daqu. This review introduced the isolation, screening, identification and functional characteristics of culture-dependent functional microorganisms in Baijiu-brewing, the core functional microbiota community of Daqu, and the related research progress of functional microorganisms fortified Daqu, and summarized the fortifying strategies of functional microorganisms, aiming to further deepen the application of functional microorganisms fortification in Daqu fermentation and provide ideas for the flavor regulation and quality control of Baijiu.

Mechanism of Enhancing Pyrazines in Daqu via Inoculating Bacillus licheniformis with Strains Specificity.

Despite the importance of pyrazines in Baijiu flavor, inoculating functional strains to increase the contents of pyrazine in Daqu and how those interact with endogenic communities is not well characterized. The effects of inoculating Bacillus licheniformis with similar metabolic capacity on pyrazine and community structure were assessed in the Daqu complex system and compared with traditional Daqu. The fortification strategy increased the volatile metabolite content of Daqu by 52.40% and the pyrazine content by 655.99%. Meanwhile, results revealed that the pyrazine content in Daqu inoculated isolate J-49 was 2.35-7.41 times higher than isolate J-41. Both isolates have the almost same capability of 2,3-butanediol, a key precursor of pyrazine, in pure cultured systems. Since the membrane fatty acids of isolate J-49 contain unsaturated fatty acids, it enhances the response-ability to withstand complex environmental pressure, resulting in higher pyrazine content. PICRUSt2 suggested that the increase in pyrazine was related to the enzyme expression of nitrogen metabolism significantly increasing, which led to the enrichment of NH4+ and 2,3-butanediol (which increased by 615.89%). These results based on multi-dimensional approaches revealed the effect of functional bacteria enhancement on the attribution of Daqu, laid a methodological foundation regulating the microbial community structure and enhanced the target products by functional strains.

Postnatal growth and body composition in extremely low birth weight infants fed with individually adjusted fortified human milk: a cohort study

This cohort study aimed to evaluate the impact of an individualised nutritional care approach combining standardised fortification with adjustable fortification on postnatal growth and body composition in extremely low birth weight (ELBW) infants. We included ELBW infants admitted to a neonatal intensive care unit and still hospitalised at 35 weeks postmenstrual age (PMA). The fortification of human milk was standardised (multicomponent fortifier) between 70 mL/kg/day and full enteral feeding, and then individualised using adjustable fortification. When weight gain was below 20 g/kg/day, protein or energy was added when serum urea was below or above 3.5 mmol/L, respectively. Postnatal growth failure (PNGF) was defined as being small for gestational age at discharge and/or when the Z-score loss between birth and discharge was higher than 1. Body composition was assessed between 35 and 41 weeks of PMA. Among the 310 ELBW infants included, the gestational age of birth was 26.7 ± 1.8 weeks, and the birth weight was 800 ± 128 g. The mean Z-score difference between birth and discharge was moderately negative for the weight (−0.32), more strongly negative for length (−1.21), and almost nil for head circumference (+ 0.03). Only 27% of infants presented PNGF. At discharge, fat mass was 19.8 ± 3.6%. Multivariable analysis showed that the proportion of preterm formula received and gestational age at birth were independently associated with the percentage of fat mass. Conclusion: The individualised nutritional care approach applied herein prevented postnatal weight loss in most infants, limited length growth deficit, and supported excellent head circumference growth.What is Known:• At least half of extremely low birth weight infants are small for gestational age at discharge and postnatal growth deficit has been associated with impaired neurocognitive and renal development.• Human milk is the main milk used in neonatology and, although fortification of human milk is a standard of care, there is no consensus regarding the optimal fortification strategy to be adopted.What is New:• Using an approach combining standardised fortification followed by individualised adjustable fortification limited postnatal growth deficit for body weight and head circumference. Postnatal growth failure is not a fatality in extremely low birth weight infants.• Each additional gestational age week at birth resulted in a decrease in fat mass percentage at discharge, which was higher than in foetuses of the same gestational age, likely representing a necessary adaptation to extra-uterine life.

Enhanced stability and clinical absorption of a form of encapsulated vitamin A for food fortification

Food fortification is an effective strategy to address vitamin A (VitA) deficiency, which is the leading cause of childhood blindness and drastically increases mortality from severe infections. However, VitA food fortification remains challenging due to significant degradation during storage and cooking. We utilized an FDA-approved, thermostable, and pH-responsive basic methacrylate copolymer (BMC) to encapsulate and stabilize VitA in microparticles (MPs). Encapsulation of VitA in VitA-BMC MPs greatly improved stability during simulated cooking conditions and long-term storage. VitA absorption was nine times greater from cooked MPs than from cooked free VitA in rats. In a randomized controlled cross-over study in healthy premenopausal women, VitA was readily released from MPs after consumption and had a similar absorption profile to free VitA. This VitA encapsulation technology will enable global food fortification strategies toward eliminating VitA deficiency.

A Data Driven Approach to Identify Safe and Adequate Schemes for Vitamin D Fortification

Food fortification is a strategy to increase low vitamin D intake. In order to avoid the intake of a population exceeding the upper tolerable intake level, the right choice of food groups to fortify is of crucial importance. An automated fortification tool was developed based on dietary intake data from the Danish National Survey of Dietary Habits and Physical Activity 2011-2013 (DANSDA), taking into account the energy contribution of the fortified food. The fortification of food group is a variant in the linear modelling, where the optimization ensures the lowest possible variation in deviation of the calculated intake and the target intake. The resulting tool demonstrated that the lowest limit of fortification, where the model works, is 12 µg/10 MJ, when fortification of any food group is allowed. The tool also demonstrated that, by increasing the allowed upper level of fortification from 12 µg/10 MJ up to 30 µg/10 MJ, the food groups selected for fortification and the level of fortification in those food groups may change. Specifically, fewer food groups seem to be needed as the upper level of fortification is increased. The optimized scenarios, using the food groups, including milk, cheese, cereals, fats, and juice, were tested on dietary-survey data and demonstrated that all the projected scenarios manage to lift the median vitamin D intake to the targeted intake safely. A data-driven approach was used to develop a simple, fast, and automated fortification tool to test different vitamin D food fortification strategies.

Polyphenols for Livestock Feed: Sustainable Perspectives for Animal Husbandry?

There is growing interest in specialized metabolites for fortification strategies in feed and/or as an antioxidant, anti-inflammatory and antimicrobial alternative for the containment of disorders/pathologies that can also badly impact human nutrition. In this context, the improvement of the diet of ruminant species with polyphenols and the influence of these compounds on animal performance, biohydrogenation processes, methanogenesis, and quality and quantity of milk have been extensively investigated through in vitro and in vivo studies. Often conflicting results emerge from a review of the literature of recent years. However, the data suggest pursuing a deepening of the role of phenols and polyphenols in ruminant feeding, paying greater attention to the chemistry of the single compound or to that of the mixture of compounds more commonly used for investigative purposes.

Association of Human Milk Fortifier and Feeding Intolerance in Preterm Infants: A Cohort Study about Fortification Strategies in Southwest China.

The present strategy of administering human milk fortifier (HMF) in southwest China (swC) is mainly based on European and American populations' guidelines. Additionally, some southwest Chinese preterm infants have been observed to develop feeding intolerance (FI) after administration of HMF. In order to develop adapted southwest Chinese guidelines for the administration of HMF to preterm infants and improve fortification strategies, a retrospective cohort study was performed to explore the association of the use of HMF and FI. To explore the association between HMF and FI in preterm infants and provide recommendations for its use in swC. This cohort study included 298 preterm infants from West China Second University Hospital. Maternal and infant clinical data were collected from electronic patient records. The infant cohort was divided into two groups based on the use/nonuse of HMF. The association between HMF and FI was evaluated using multivariate analysis. Nonlinear relationships and threshold effects were evaluated using generalized additive models and two-piecewise linear regression models. The multivariate analysis confirmed that there is no significant association between HMF use and FI, but significant risk factors for FI include early HMF initiation (p = 0.02), full-strength HMF initiation (p = 0.04), and fast HMF supplementation rates (p = 0.004). Through smooth curve fitting and threshold effect analysis, we found that two inflection points, an initial concentration of HMF &gt; 24 mg/mL and a HMF supplementation rate &gt; 12.5 mg/mL/d, significantly increased FI risk. Routine HMF fortification can be safely used in preterm infants with gestational age &lt; 32 wk or birth weight &lt; 1500 g in swC, and we advise initiating fortification when enteral milk intake reaches 100 mL/kg/day, with an HMF concentration of 1:50 and if tolerated, increase to 1:25 more than 38 h. The recommended HMF supplementation rate differs from current guidelines and provides evidence for developing southwest Chinese guidelines. A prospective trial is needed in order to validate this proposal.

Nanotech-based Food: An Initiative for Alternative Pharmaceuticals.

Nanotechnology opens many avenues in the food sector and offers applications associated with food production, processing, cultivation, and packaging. Nanofood employs nanotechniques like nano-encapsulation to conjugate various phytochemicals, antioxidants, probiotics, minerals, vitamins, etc., into nanovehicles. Food fortification strategies are implemented to incorporate nano-processed substances. Nanofood is mostly used for improving health and as a supplementation in various diseases ranging from liver diseases to neurodegenerative disorders. Here, we focus on recent studies that exhibit comparable results for nanofood and conventional medicines, subsiding the limitations of traditional therapies. Nanofood holds the potential for the management of various health problems and can be used as an alternative to medicine in clinical conditions, like cancers and inflammatory bowel disease. With further advances in nanotechnology and expansion in the scope of the current nanofood industry, in addition to proper regulations set in place, nanofood may offer a wide variety of advantages in terms of safety, long-term stability, etc.

An exact method for binary fortification games

A fortification game (FG) is a three-level, two-player hierarchical game, also known as defender-attacker-defender game, in which at the uppermost level, the defender selects some assets to be protected from potential malicious attacks. At the middle level, the attacker solves an interdiction game by depreciating unprotected assets, i.e., reducing the values of such assets for the defender, while at the innermost level the defender solves a recourse problem over the surviving or partially damaged assets. Fortification games have applications in various important areas, such as military operations, design of survivable networks, protection of facilities or power grid protection. In this work, we present an exact solution algorithm for FGs, in which the recourse problems correspond to (possibly NP-hard) combinatorial optimization problems. The algorithm is based on a new generic mixed-integer linear programming reformulation in the natural space of fortification variables. Our new model makes use of fortification cuts that measure the contribution of a given fortification strategy to the objective function value. These cuts are generated when needed by solving separation problems, which correspond to (modified) middle-level interdiction games. We design a branch-and-cut-based solution algorithm based on fortification cuts, their strengthened versions and other speed-up techniques. We present a computational study using the knapsack fortification game and the shortest path fortification game. For the latter one, we include a comparison with a state-of-the-art solution method from the literature. Our algorithm outperforms this method and allows us to solve previously unsolved instances with up to 330 386 nodes and 1 202 458 arcs to optimality.