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Food Research International 44 (2011) 652659

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Food Research International

j o r n a l h o ! e " a # e $ % % %& e l s e v i e r& c o ! ' l o c a t e ' ( o o d r e s


)icron trient (orti*cation o( %heat +o r$ Recent develo"!ent and strate#ies

Saeed ,-htar a.. Fa/ir )& ,nj ! b. )& ,-bar ,nj ! a
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De"art!ent o( Food and 0ortic lt ral Sciences. 1niversit2 Colle#e o( ,#ric lt re. 3ah addin 4a-ari2a 1niversit2. ) ltan. 5a-istan 6ational Instit te o( Food Science and 7echnolo#2. 1niversit2 o( ,#ric lt re. Faisalabad. 5a-istan

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a b s t r a c t
De*ciencies o( iron. <inc and vita!in , have been a (oc s o( the #overn!ents and %orld or#ani<ations (or decades and e=tensive e((orts are bein# !ade to address this !aln trition& 3ein# a "o" lar and !ost co!!on dietar2 sta"le o( the "o" lation livin# in s b>continent and develo"in# co ntries. %heat +o r (:F) has #ained a si#ni*cant attention as a s itable vehicle (or !icron trient (orti*cation& Forti*cation o( %heat +o r has been established as an a""ro"riate strate#2 to c rtail !icron trient de*ciencies es"eciall2 in the develo"in# econo!ies& ?=tent o( the "revalence o( !icron trient de*ciencies. their conse/ ences. selection o( a s itable vehicle. choice o( (orti*cants and their levels and stora#e stabilit2. acce"tabilit2 and bioavailabilit2 o( iron and <inc (orti*ed :F are the -e2 "oints o( disc ssion in the c rrent revie%& 7his revie% ( rther hi#hli#hts ! lti(aceted iss es "ertainin# to the a""ro"riateness and s itabilit2 o( (orti*cation over other intervention strate#ies. ecolo#ical needs and (orti*cation s ccess stories and advanta#es o( si!"l2 addin# (orti*cants to +o r to !eet n tritional re/ ire!ents o( v lnerable #ro "s& 7he a thors have atte!"ted to enco!"ass the s bject !atter based on their research endeavors !ade in this direction& @ 2011 ?lsevier Atd& ,ll ri#hts reserved&

,rticle histor2$ Received 9 8 l2 2010 ,cce"ted 21 Dece!ber 2010 9e2%ords$ )icron trient (orti*cation :heat +o r Iron 4inc ;ita!in ,

Contents 1& 2& Introd ction & & & & & & & & & & & & & & & & & & & & & & & & & Food (orti*cation$ recent develo"!ent and strate#ies & & & & & & 2&1& )icron trients de*cienciesC "revalence and conse/ ences 2&2& Interventions strate#ies & & & & & & & & & & & & & & & & 2&B& Aevels o( +o r (orti*cation & & & & & & & & & & & & & & & 2&4& Iron (orti*cants & & & & & & & & & & & & & & & & & & & & 2&5& 4inc (orti*cants & & & & & & & & & & & & & & & & & & & & 2&6& ;ita!in , (orti*cants & & & & & & & & & & & & & & & & & 2&D& Stora#e stabilit2 o( (orti*ed +o rs & & & & & & & & & & & & 2&E& ,cce"tabilit2 o( (orti*ed %heat +o r & & & & & & & & & & 2&9& 3ioavailabilit2 o( (orti*ed %heat +o r & & & & & & & & & & 2&10& :heat +o r (orti*cation ecolo#ical st dies & & & & & & B& Concl sion & & & & & & & & & & & & & & & & & & & & & & & & & & Re(erences & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & 652 65B 65B 654 654 654 655 655 655 656 656 65D 65D 65E

1& Introd ction 6 tritional de*ciencies. a serio s #lobal health "roble!. are %ides"read in develo"in# co ntries o%in# to escalatin# "o" lation. navailabilit2 o( reso rces and indeed lac- o( le#islation and

Corres"ondin# a thor& 7el&$ F 92 BBB 6106099C (a=$ F 92 61 921009E& ?>!ail address$ saeedb< G2ahoo&co! (S& ,-htar)&

#overn!ental control (,# a2o H 3a-er. 2005)& )oreover. tendenc2 to de"end "on one or !ore (ood co!"onents that lti!atel2 leads to lo%er inta-e o( !icron trients has co!e o t o%in# to ind striali<a> tion and chan#in# li(est2le (;isioli H 0a#en. 200D)& Iron. <inc. iodine and vita!in , are the !ost chronic (or!s o( !icron trient a(+ictions. %hile the "revalence o( (olate de*cienc2 is tho #ht to be o( si#ni*cant i!"ortance. altho #h the e=tent o( its "revalence has not 2et been established (9enned2. 6antel. 3ro %er. H 9o-. 2006C van>den 3riel. Che n#. 4e%ari. H 9han. 200DC :elch H Iraha!. 1999)& Reliance o(

096B>9969'J see (ront !atter @ 2011 ?lsevier Atd& ,ll ri#hts reserved& doi$10&1016'j&(oodres&2010&12&0BB

S& ,-htar et al& ' Food Research International 44 (2011) 652K659


co!! nities on "lant based diets and lo% "er ca"ita cons !"tion o( !eat and !eat "rod cts see! to be one o( the si#ni*cant reasons to boost the "revalence o( these n tritional de*ciencies in the develo"in# co ntries& Children and %o!en o( child bearin# a#e are the !ost v lnerable se#!ent (Ran !. 2001C :0L. 1992)& ,!on# ! lti"le strate#ies to control !icron trients de*ciencies i&e& dietar2 !odi*cations. s ""le!entation and (ood (orti*cation. the latter see!s to be the !ost "ractical and lon#>ter! a""roach (:in#er. 9Mni#. H 0o se. 200E)& 5revio s e="eriences have sho%n that this strate#2 is technolo#icall2 and econo!icall2 e((ective (or increasin# !icron trient inta-es in "o" lations (Aot*. )annar. )er=. 6aber>van den. H 0e vel. 1996)& In order to !a-e an2 (orti*cation "ro#ra! a s ccess. it is i!"ortant that the "h2sicoche!ical chan#es. ta-in# "lace in the vehicle and the end "rod ct. as a res lt o( (orti*cation are to be care( ll2 !onitored& ) lti"le (orti*cation o( %hole %heat +o r %ith novel iron and <inc so rces is #ainin# "o" larit2 to overco!e !icron trient !aln trition in the develo"in# co ntries& ,lbeit. s ch addition ind ced a sli#ht deteriorative e((ect on che!ical co!"osition o( %hole %heat +o r& )ar#inal chan#es in / alit2 o( the +o rs !a2 be co!"ro!ised %ith #reater health bene*ts o( addin# !icron trients to +o r& 7hese di((erences !a2 be ne#lected in vie% o( the "otential health and econo!ic bene*ts o( ! lti"le (orti*cation (,-htar. ,nj !. Reh!an. ) nir. H Far<ana. 200E)& Selection o( a""ro"riate (orti*cant and vehicle is the !ost i!"ortant co!"onent to !a-e an2 (orti*cation "ro#ra! a s ccess& International or#ani<ations li-e :0L'?)RL. 1S,ID. S1S7,I6. and )I are activel2 en#a#ed to establish # idelines (or vita!in and !ineral (orti*cation o( dietar2 sta"les e&#& %heat +o r (FFI. 200E)& 7he objectives o( the "resent revie% are to s"otli#ht the ! lti(aceted technical iss es "ertainin# to %heat +o r (orti*cation& ,tte!"ts have been !ade to detail the "revalence o( the !icron > trients de*ciencies. its health and econo!ic conse/ ences. choice o( s itable (orti*cants and their levels. selection o( an a""ro"riate vehicle. stora#e stabilit2. acce"tabilit2 and bioavailabilit2 o( (orti*ed +o rs and #lobal trends and e="eriences %ith res"ect to +o r (orti*cation& 2& Food (orti*cation$ recent develo"!ent and strate#ies 2&1& )icron trients de*cienciesC "revalence and conse/ ences )icron trient !aln trition a((ects !ore than hal( o( the %orld "o" lation. "artic larl2 in develo"in# co ntries ()a2er. 5(ei((er. H 3e2er. 200E)& Red ction in !icron trient de*ciencies can contrib te si#ni*cantl2 to i!"roved health. "rod ctivit2 and %ell>bein# o( h !ans& ;ita!in ,. iron. <inc and iodine de*ciencies are #lobal "roble!s. a((ectin# at least B0N o( the %orld "o" lation& 7he !ani(estations o( s ch !icron trients de*ciencies are vita!in , de*cienc2 s2ndro!e. ane!ia and #oiter& )oreover. these are the !ost i!"ortant ris- (actors (or illness and death. a((ectin# t%o billion "eo"le ()Oller H 9ra%in-el. 2005)& 7hese de*ciencies also lead to the "heno!enon o( nder%ei#ht that acco nts (or B&D !illion deaths ann all2& ,!on# these. iron de*cienc2 ane!ia (ID,) alone is associated %ith a""ro=i!atel2 E61.000 deaths. a""ro=i!atel2 B5

!illion disabilit2>adj sted li(e 2ears lost. and billions o( dollars in indirect costs ann all2 (Stolt<( s. ) llan2. H 3lac-. 200B)& 5h2tic acid is #enerall2 re#arded as the "ri!ar2 stora#e (or! o( both "hos"hate and inositol in seeds& 5h2tic acid "hos"hor s constit tes the !ajor "ortion o( total "hos"hor s in several seeds and #rain& It acco nts (or 50E0N o( the total "hos"hor s in di((erent cereals& 5h2tate is one o( the !ajor inhibitin# (actors (or <inc and iron absor"tion& :hen "h2tate is h2drol2<ed d rin# (ood "rocessin#. the !ineral availabilit2 is increased (0idve#i H Aas<tit2. 2002C Aonnerdal. 2000C Sandber#. 1991)& 7he a!o nt o( "h2tic acid. and the total 4n content have a !ajor i!"act on the a!o nt o( 4n absorbed (ro! (oods& Si!ilarl2. nder nor!al "h2siolo#ical conditions. iron absor"> tion is closel2 related to the content o( "h2tate in bread (3r ne. Rossander>0 lten. 0allber#. Ileer ". H Sandber#. 1992)& 7he conse/ ences o( iron de*cienc2 ane!ia are red ced "s2cho> !otor and !ental develo"!ent in in(ants. adverse "re#nanc2 o tco!e. "re!at re deliver2 and decreased i!! ne ( nction& F rther. individ als %ith ID, re/ ire #reater o=2#en cons !"tion to !aintain bod2 te!"erat re d rin# cold e="os re leadin# to ne#ative caloric balance (, -ett. 5ar-s. Scott. H :harton. 19E6C :alter. De,ndraca. Chad d. H 5erales. 19E6)& Ai-e%ise. <inc de*cienc2 is a serio s #lobal iss e "artic larl2 in the develo"in# co ntries& 7he (ood s ""l2 o( nearl2 50N o( the #lobal "o" lation is lo% in absorbable <inc beca se o( li!ited availabilit2 o( ani!al "rod cts (3ro%n. : ehler. H 5eerson. 2001C Co sins. 1996C Falch - H ;allee. 199B)& In(ants and 2o n# children are believed to be at #reatest ris- o( dietar2 <inc ins (*cienc2. as are "re#nant and lactatin# %o!en. adolescents. and the elderl2 (3ro%n. :essells. H 0ess. 200DC Iibson. 1994)& De*cienc2 o( <inc also leads to #ro%th retardation. increased s sce"tibilit2 to co#nitive i!"air!ent and diarrhea (7able 1)& Ao% ser !>4n concentration d rin# "re#nanc2 co ld be a si#ni*cant "redictor o( lo% birth %ei#ht and increased riso( "reter! deliver2 in "oorer rban %o!en (Irace2. 1999C 6e##ers et al&. 1990C 5rasad. 200BC :alter et al&. 19E6)& ;ita!in , de*cienc2 (;,D) is %ides"read in lo% inco!e co ntries and is one o( the serio s n trition threats& Develo"in# co ntries are !ore v lnerable to ;,D as co!"ared to develo"ed nations and nearl2 hal( o( all the vita!in , de*ciencies occ r in So th and So th ?ast ,sia and ,(rica (3h tta. 200E)& :o!en. bein# the !ost s sce"tible #ro " are in+ enced b2 ;,D d rin# "re#nanc2 and lactation (4i!!er!ann et al&. 2006)& ?radication o( ;,D calls (or an i!!ediate action since it a""ears to be a !ajor ris- (actor (or both !aternal and child !ortalit2& 7he e((orts %ere directed in the "ast to "rotect vita!in , in di((erent (ood s2ste!s (Aoveda2 H Sin#h. 200E)& It is i!"erative to address these !alno rish!ents be(ore the2 co ld "la2 havoc %ith h !an health& In a recent st d2. (orti*cation o( %heat +o r %ith vita!in , has been stron#l2 reco!!ended as a strate#2 to "revent or control vita!in , de*cienc2 in lo%>inco!e co ntries %here nder n trition and "overt2 coe=ist (9le!! et al&. 2010)& )icron trients de*ciencies can be overco!e b2 ado"tin# ! lti(ario s strate#ies (,d >,(ar% ah et al&. 200E)& In a recent st d2 cond cted a!on# ?thio"ian %o!en (0aidar. 2010). the a thor de!onstrated that iron and (olic acid %ere the

7able 1 ?sti!ated n !ber and "ercenta#e o( "ersons and %o!en %ho had access to (orti*ed %heat +o r and o( ne%borns %hose !others had access to (orti*ed +o rs d rin# "re#nanc2 %orld%ide. 2004200D& So rce$ )aberl2 et al&. 200E& Cate#or2 7otal "o" lation 6.512.E22 b 2.142.225 c 1BB.E04

2004 6o&a (N) 1.2D1.B6B (19&5) 410.091 (19&1) 2D.052 (20&2)

200D 6o&a (N) 1.E10.659 (2D&E) 5DD.461 (2D) 41.060 (B0&D)

Chan#e (ro! 2004 to 200D 6o&a (N) 5B9.29D (E&B) 16D.BD0 (D&E) 1400.D (10&5)

7otal "ersons :o!en a#ed 1560 2ears 6e%borns %hose !others had access
a b c

In tho sands. calc lated (ro! data (ro! the Flo r Forti*cation Initiative. available at htt"$''%%%&s"h&e!or2&ed '%heat+o r& In tho sands. !id>2006 esti!ate& (ro! the 1S Central Intelli#ence ,#enc2. available at htt"$''%%%&cia& #ov& In tho sandsC (ro! the 1nited 6ations International ChildrenPs ?!er#enc2 F nd (16IC?F) birth rate esti!ates. available at htt"$''%%%& nice(&or#&

7able 2 5rovisional reco!!endations (or levels o( n trients to add to (orti*ed +o r based on t2"e o( +o r and (orti*cant. as %ell as "er ca"ita +o r inta-e& 6 trient 72"e o( +o r (e=traction) Ao% Forti*cant 5er ca"ita %heat availabilit2 (#'da2) ("ro=2 (or %heat +o r inta-e) b D5 6aFe?D7, c S l(ate'F !arate ?lectrol2tic "o%der 6aFe?D7, 4inc L=ide 4inc L=ide

D5149 40 ""! 60 ""! d 6R 40 ""! 55 ""! 100 ""!

150B00 20 B0 60 20 ""! ""! ""! ""!

6 B00 15 20 40 15


0i#h 4inc
a e

40 ""! 60 ""! d 6R 40 ""! 95 ""! 100 ""!

""! ""! ""! ""!

Ao% 0i#h

40 ""! E0 ""!

B0 ""! D0 ""!

5er ca"ita cons !"tion o( b D5 #'da2 does not allo% (or addition o( s (*cient level o( (orti*cant to cover !icron trients (or %o!en o( childbearin# a#e& Forti*cation o( additional (ood vehicles sho ld also be considered& b Fe% co ntries have "er ca"ita cons !"tion o( 6 B00 #'da2&
c d e

Ferro s ( !arate is the "re(erred co!"o nd (or !ai<e +o r& 6R Q not reco!!ended beca se the ver2 hi#h levels o( electrol2tic iron needed %o ld ne#ativel2 a((ect sensor2 "ro"erties o( (orti*ed +o r& 7hese are the reco!!ended a!o nts o( <inc (orti*cation ass !in# 5 !# <inc inta-e and no additional "h2tate inta-e (ro! other dietar2 so rces&

"rinci"al !icron trient de*ciencies %hich s ##ested the "resence o( de*ciencies o( ! lti"le !icron trients& 2&2& Interventions strate#ies Food based strate#ies are !ost e((ective and s stainable a""roach to co!bat !icron trients de*ciencies& 7hree !ajor strate#ies have been in "lace to address the iss e i&e& (ood diversi*cation. s ""le> !entation and (ood (orti*cation (3loe! et al&. 19E9C Cha-arvart2. 2000C Filtea H 7o!-ins. 1999)& 0o%ever. s ccess o( s ch strate#ies re/ ires thoro #h -no%led#e o( n trients so rces and their accessi> bilit2'bioavailabilit2 to h !ans (9han et al&. 200D)& Food diversi*cation involves cons !"tion o( variet2 o( (oods to cover n trient re/ ire!ents& Co!! nities livin# in develo"in# %orld rel2 on territorial s"eci*c so rces o( (oods o(ten de*cient in so!e !inor constit ents& In s ch conditions. it see!s / ite rational to add so!e other (ood co!"onents to brin# balance in n trientsP inta-e (Iraebner. Si/ eira. ,rr da. H de So <a. 2004)& Contraril2. e((ective> ness o( s ""le!entation "ro#ra!s de"ends on the level o( covera#e and co!"liance& Iron s ""le!entation in the (or! o( tablets and s2r "s has not been s ccess( l in develo"in# co ntries (3einner H Aa!o nier. 200B)& 4inc s ""le!entation is e((ective in red cin# the !orbidit2 and !ortalit2 d e to in(ectio s diseases (3ro%n. AR"e< de Ro!aSa. ,rsena lt. 5eerson. H 5enn2. 200D)& In co!"arison. (ood (orti*cation is !ore econo!ical. +e=ible and sociall2 acce"table to i!"rove n trition in a n !ber o( develo"ed co ntries (7able 2) e&#& (orti*cation o( !il-. !ar#arine and cereals has #reatl2 red ced the occ rrence o( de*ciencies (:ahl/vist. 200E)& Ideall2. the (ood cons !ed b2 !ost o( the "o" lation se#!ents sho ld be chosen as a vehicle& In the co ntries %here %heat is the sta"le diet o( !asses. e!"hasis has been laid do%n to (orti(2 the %heat +o r %ith ! lti"le !icron trients in order to enhance the inta-e and to overco!e the de*ciencies& 2&B& Aevels o( +o r (orti*cation 7he selection and levels o( a""ro"riate (orti*cant is one o( the !ost i!"ortant (actors %hile addressin# the s ccess o( %heat +o r (orti*cation e&#& se o( a""ro"riate levels o( the !ost bioavailable (or!s o( iron can i!"rove the iron stat s o( "o" lations %ith ver2 little ris- o( adverse e((ects& ?(*cac2 st dies indicate that dail2 cons !"tion o( D&1 !# (erro s s l(ate (e/ ivalent to D&1 !# (erro s ( !arate. 4&6 !# 6aFe?D7, or 10 !# electrol2tic iron) thro #h (orti*ed +o r "rod cts %ill i!"rove iron stat s (or %o!en o( childbearin# a#e& 0o%ever. addition o( sodi ! iron ?D7, (6aFe?D7,) in +o r %ith hi#h e=traction 2ield co ld bene*t in enhancin# the levels o( iron (FFI. 200E)& 7he level o( iron addition in cereal (oods (%heat +o r. !ai<e !eal and %hite rice) sho ld be (ro! 25 ""! to E0 ""! de"endin# on the

severit2 o( need (or additional iron %ithin the "o" lation and the cons !"tion o( the cereal (Ran !. 1999)& Flo r can be (orti*ed %ith at least 100 !# <inc'- +o r %itho t adverse e((ects on the sensor2 "ro"erties or acce"tabilit2 o( <inc> (orti*ed +o r "rod cts (,rredondo. )artTne<. 6USe<. R <. H Llivares. 2006)& ,nother st d2 (Ran !. 2001) de!onstrated that even lo%er levels aro nd 20 to B0 ""! o( <inc addition %o ld be bene*cial in !eetin# dietar2 re/ ire!ents& Dail2 inta-e o( 100 # o( cereal enriched %ith 20 ""! <inc. children %o ld receive 20N o( their dail2 <inc re/ ire!ents (7able B)& ;ita!in , co ld also be added to batter at di((erent doses "rovidin# 50N o( RD, that is considered (easible (3 tt. ,rshad. ,la!. H 6adee!. 200D)& 2&4& Iron (orti*cants , s ccess( l (ood (orti*cation "ro#ra! incl des the se o( sol ble iron s ch as (erro s s l(ate. the addition o( ascorbic acid as an absor"tion enhancer or the se o( 6aFe?D7, to overco!e the ne#ative e((ect o( "h2tic acid& 3etter absorbed alternative co!"o nds (or cereal (orti*cation incl de enca"s lated (erro s s l(ate and 6aFe?D7, (,-htar et al&. 2010C 0 rrell. 2002)& ,ccordin# to the reco!!endations o( FFI (200E). 6aFe?D7,. (erro s s l(ate and
7able B Iron so rces sed in (ood (orti*cation& Iron so rce Fe (N) ,vera#e R3 Rats Freel2 %ater sol ble Ferro s s l(ate D 02L Ferro s #l conate Ferro s lactate 106 Ferric a!!& citrate Ferro s a!!& s l(ate Ferric choline citrate Slo%l2 sol ble Dried (erro s Ferric #l2c& "hos"hate Ferric citrate Ferric s l(ate 5oorl2 Ferro Ferro Ferro Ferro sol ble s ( !arate s s ccinate s tartrate s citrate 0 !an

20 12 19 1E 14 10

100 9D

100 E9

10D 99 102

BB 15 1D 22

100 9B DB EB

100 B1 B4

BB B5 22 24

95 119 DD D6

101 12B 62 D4

,l!ost insol ble Ferric "2ro"hos"ahte Ferric ortho"hos"hate Red ced iron Relative bioavailabilit2&

25 2E 9D

45 DB2 ED6

B1 1B90

7able 4 Characteristics o( vario s <inc (orti*cation co!"o nds& So rce$ ,sh H ,sh. 1995& Co!"o nd 4n 4n 4n 4n 4n 4n 4n 4n 4n acetate chloride citrate #l conate lactate o=ide stearate s l(ate anh2& s l(ate D 02L Color :hite :hite :hite :hite :hite :hite'#re2 :hite Colorless Colorless 7aste Ldo r Sli#htl2 acidic Ldo rless 02L sol ble (20 WC) F F Sli#ht F Sli#ht F F Sol ble in ,lcohol ,lcohol ,cids'al-alis ,cids



Ldo rless Faint Ldo rless Ldo rless

(erro s ( !arate are to be "re(erred (or %heat and !ai<e +o r (orti*cation (or "o" lations %here +o r cons !"tion is relativel2 hi#her than electrol2tic iron "o%der& 7he val able "ro"erties o( 6aFe?D7, as an iron (orti*cant have been described in the literat re (or abo t 25 2ears& 7he e(*cac2 o( 6aFe?D7, (or i!"rovin# iron stat s has been de!onstrated in several co!! nit2 trials (;iteri et al&. 1995)& :hen !i=ed %ith (ood at (orti*cation levels. the iron in 6aFe?D7, absorbed better than other non>he!e (or!s o( iron& )oreover. it has the advanta#e in enhancin# the total non>he!e iron "ool (3allot. )c5hail. 3oth%ell. Iillool2. H )a2et. 19E9)& ,dditionall2. it is not sensitive to !an2 (ood iron inhibitors& It is "artic larl2 o( interests in "o" lations %hose sta"le (oods are cereal or le# !e based& F rther!ore. d e to its better absor"tion ca"acit2 and che!ical stabilit2. it does not ca se (at to beco!e rancid& 7here(ore. it is s itable (or se as (orti*cant in %heat +o r (;iteri et al&. 1995)& :hen the diet contains inhibitors. iron in 6aFe?D7, is t%o to three ti!es !ore available than (erro s salts& 0o%ever. iron absor"tion (ro! 6aFe?D7, is si!ilar to that (or (erro s s l(ate in (oods that contain s bstantial a!o nts o( ascorbic acid or !eat (Candela. Ca!acho. H )artine<>7orres. 19E4)& In I ate!ala. Fe %as tested as a s #ar (orti*cant (;iteri et al&. 1995) at a concentration o( 1 # 6aFe?D7,'- s #ar and (orti*cation increased iron stores si#ni*cantl2& It also s ccess( ll2 i!"roved he!o#lobin concentrations %hen incor"orated as a (orti*cant into c rr2 "o%der in So th ,(rica and into *sh sa ce in 7hailand %itho t havin# detri!ental e((ects on h !an health (3allot et al&. 19E9)& 6aFe?D7, added to lo%>bioavailabilit2 diets !i#ht increase <inc absor"tion and "rovides iron %ith hi#h bioavailabilit2 as %ell (Davidsson. Di!itrio . 3o2. :alc<2-. H 0 rrell. 2002C Davidsson. 9asten!a2er. H 0 rrell. 1994)& )oreover. it also i!"roved <inc blood levels act all2 a(ter B0 !onths (ollo%in# the cons !"tion o( iron> ?D7, (orti*ed s #ar in I ate!ala (;iteri et al&. 1995)& 7he concern raised re#ardin# the cons !"tion o( 6aFe?D7, based on the consens s that dietar2 ?D7, levels are hi#h is in develo"ed nations d e to tili<ation o( ?D7,. 6a?D7, and Ca6a?D7, as "reservatives& 0o%ever. acce"table dail2 inta-e (,DI) o( ?D7, is 150 !#'"erson'da2 or 2&5 !#'-'da2& In 1992. the !ean overall e="os re to ?D7, in the 1nited States %as 15 !#'"erson'da2. %hich s ##ested that the se o( 6aFe?D7, as a (orti*cant !i#ht be "ossible in the 1nited States and es"eciall2 in develo"in# co ntries %here s al inta-es are lo%er (I6,CI. 199B)& ?le!ental iron is sed to (orti(2 brea-(ast cereals and has been (o nd to have e=cellent stabilit2 d rin# "rocessin# and stora#e& Red ced iron is #enerall2 the "re(erable (or! in +o r %hen lon# shel( li(e is desired (L)6I. 1996)& 2&5& 4inc (orti*cants Serio s concern arises as to the need o( <inc (orti*cation es"eciall2 in those "o" lation #ro "s in develo"in# co ntries %hose diets

contain co!"le= s bstances that li!it the bioavailabilit2 o( <inc& Several <inc salts are available (or (ood (orti*cation ran#in# in sol bilit2 (ro! ver2 sol ble (s l(ate and chloride). (reel2 sol ble (acetate) to al!ost insol ble (carbonate and o=ide) (0enderson et al&. 1995C 5rasad. 1991)& 4inc o=ide is the !ost co!!onl2 sed <inc so rce (or the (orti*cation o( cereal based (oods (ollo%ed b2 <inc s l(ate and to a ver2 li!ited e=tent <inc #l conate& 4inc s l(ate is s"eci*ed (or se in the corn so2 blend& I!"ortance o( <inc n trition is increasin#l2 nderstood and International 4inc 6 trition Cons ltative Iro " (I46CI) has develo"ed # idance on intervention "ro#ra!s (7able 4) (,sh H ,sh. 1995)& 2&6& ;ita!in , (orti*cants 7he !ost i!"ortant co!!ercial (or!s o( vita!in , are retin2l acetate and retin2l "al!itate& 7hese " re che!icals have "ri!aril2 been added to (oods as i!"rovers and colorants. b t (oods can also carr2 the! to increase vita!in , inta-e o( the "o" lations (Aot* et al&. 1996)& Criteria (or assessin# the " blic health severit2 o( vita!in , de*cienc2 have been %ell de*ned (or vario s a#e #ro "s (So!!er H Davidson. 2002C :0L. 1996) (7able 5)& 2&D& Stora#e stabilit2 o( (orti*ed +o rs 7he stabilit2 o( the !icron trient in the carrier is considered one o( the -e2 (actors to%ard the s ccess o( an2 (orti*cation "ro#ra!. as (orti*ed +o rs !a2 nder#o "h2sicoche!ical chan#es d rin# stora#e and "rocessin#& ?="os re o( the (orti*cants to an2 o( the "h2sical and che!ical (actors incl din# heat. !oist re. air. or li#ht and acid or al-aline environ!ents d rin# (ood "rocessin#. "ac-a#in#. distrib tion or stora#e a((ects its stabilit2& Factor a((ectin# the choice o( the (or!s o( iron to se incl de bioavailabilit2. ( nctional and stabilit2 "ro"erties. co!!ercial availabilit2 o( (ood #rade !aterials and cost & 1n(ort natel2 the (or!s that sho% the #reatest ( nctional stabilit2 are o(ten less absorbable %hile those (or!s that sho% the #reatest bioavailabilit2 have #reatest "otential (or da!a#in# "rod ct / alit2 ()ehansho H )annar. 1999)&
7able 5 Criteria (or assessin# the " blic health severit2 o( vita!in , de*cienc2& So rce$ :0L. 1996C So!!er H Davidson. 2002& Indicator 5o" lation #ro " 5revalence indicatin# a " blic health "roble! (N o( the "o" lation) 65 61 6 0&5 10

6i#ht blindness 6i#ht blindness 3itotPs s"ots Ser ! retinol b 0&D V!ol'l (b 20 V#'dl)&

5re#nant %o!en Children 24D1 !onths Children 24D1 !onths Children 6D1 !onths

7he stabilit2 o( the vita!ins re!ained #ood d rin# stora#e o( (orti*ed cereals as %ell as in bread& )ar#inal di((erence in "ro=i!ate co!"osition o( (orti*ed %heat +o r %as observed d rin# stora#e (or 60 da2s (,-htar. ,nj !. Reh!an. H ) nir. 2009C R bin. ?!isi. H Scal"i. 19DD)& )ineral (orti*cation has sho%n to i!"art inhibitor2 e((ect on !o ld #ro%th d rin# stora#e in (orti*ed +o r (or 60 da2s (,-htar et al&. 200E)& 0o%ever. addition o( !inerals to (oods that contain (at s ch as !il-. !ar#arine and %heat +o r can also ca se o((> +avor d e to li"id o=idation and th s shortenin# the shel(>li(e o( certain "rod cts& Iron is a "ro>o=idant and is involved in !ajor +avor chan#es in (orti*ed (oods. es"eciall2 those that re/ ire lon#er shel(> li(e incl din# %heat and corn +o r& Iron !a2 also catal2<e the o=idation o( vita!ins , and C& Aon#>ter! stora#e o( iron>(orti*ed +o r be2ond 60 da2s can adversel2 a((ect the sensor2 characteristics o( nleavened +at bread (3ovell>3enja!in. ;iteri. H ,llen. 2000C L)6I. 1996C Sahib. 0a!id. Salee!. H ,2esha. 200D)&

7able 6 Relative bioavailabilit2 o( iron co!"o nds sed in (ood (orti*cation& So rce$ 0 rrell. 2002& Iron co!"o nd Ferro s s l(ate Ferro s ( !arate Ferro s saccharate Ferric "2ro"hos"hate Ferric ortho"hos"hate ?le!ental iron R3 Q relative bioavailabilit2& R3 100 100 D4 21D4 25B1 590 Forti*ed Foods In(ant (or! las In(ant cereal Drin- "o%ders In(ant cereal. rice In(ant cereals :heat +o r

2&9& 3ioavailabilit2 o( (orti*ed %heat +o r In the di#estive environ!ent o( the sto!ach. !ost o( the iron is released (ro! the iron co!"le=es in (ood (aided b2 the acidic "0 and di#estive "rocesses) and enters the co!!on non>he!e iron "ool (Forth H R !!el. 19DB)& 7he entr2 o( ele!ental iron and iron (orti*cants into the co!!on iron "ool is li!ited b2 their sol bilit2& 7he co!!on "ool o( (erro s and (erric iron. and li#ands s ch as "h2tate. tannins. ascorbate. o=alate. etc&. leave the sto!ach and enter the intestine %here the "0 is abo t D or E. %hich (avors the re> (or!ation o( co!"le=es& It is at this "oint that there is a co!"etition bet%een the di((erent li#ands to (or! co!"le=es %ith iron. and the i!"act o( inhibitors is rein(orced& Iron bioavailabilit2 is. there(ore. deter!ined b2 the de#ree o( the a(*nit2 o( each li#and (or iron and the sol bilit2 o( the iron>li#and co!"le= (7able 6)& 7he stren#th o( the bond %ith %hich the li#and co!"le=es iron !a2 contrib te to either enhance!ent or inhibition o( iron absor"tion& I( iron and <inc are to be "rovided to#ether. it is i!"ortant to deter!ine %hether. and i( so. ho% the2 interact biolo#icall2 beca se the2 have che!icall2 si!ilar absor"tion and trans"ort !echanis!s and have been tho #ht to co!"ete (or absor"tive "ath%a2s& 7he interaction bet%een <inc and iron is "ri!aril2 anta#onistic& ?=tre!e levels o( dietar2 <inc i!"air iron !etabolis! directl2 or indirectl2 e&#& the direct interaction bet%een <inc and iron in the intestine both in the l !en at so!e intracell lar location distal to the site o( the re# lation o( iron absor"tion (Aonnerdal. 2002C Sandstro!. 2001)& , "revio s st d2 de!onstrated lo% bioavailabilit2 o( <inc (ro! 4nL %ith re#ard to other dietar2 so rces and %as "rone to anta#onistic reactions %ith other n trients (Darnton 0ill. )ora. :einstein. :ilb r. H 6al bola. 1999)& 0o%ever. several other researchers con*r!ed that 4nL and 4nSL4 are e/ all2 %ell absorbed %hen added as (orti*cants (0er!an et al&. 2002)& 6o ne#ative overall e((ect o( 6aFe?D7, cons !"tion on the !etabolis! o( <inc %as observed thro #h e="eri!entation& 0o%ever. iron !i#ht have a ne#ative e((ect on <inc absor"tion as lon# as #iven in a/ eo s sol tions %hile no e((ect is observed %hen <inc is added to !eals& 7he "ossibilit2 that ?D7, co ld enhance <inc absor"tion in other diet t2"es re/ ires ( rther investi#ation (3r ne et al&. 1992C Davidsson et al&. 1994C Sandber#. 1991)&7he lo%er bioavailabilit2 o( ele!ental iron as co!"ared to 6aFe?D7, has been con*r!ed in !an2 st dies (;iteri et al&. 1995)& 7here %as no di((erence in <inc absor"tion (ro! 4nL and 4nSL4 %hen added as (orti*cants to !ai<e tortillas& 7he addition o( ?D7, %ith <inc o=ide or the se o( "re>chelated sodi !<inc ?D7, as (orti*cants did not res lt in hi#her <inc absor"tion (ro! the test !eal& 3ioavailabilit2 o( 4n>s l(ate and 4n>o=ide in rats sho%ed no di((erences (0ot< et al&. 2005)& ,%areness o( these interactions. co!bined %ith a balanced eval ation o( the dietar2 inta-e o( the "o" lation %ith re#ard to absor"tion "ro!otin# and inhibitin# s bstances and the ris- (or ! lti"le de*ciencies. co ld lead to !ore e((ective strate#ies to i!"rove !icron trient stat s (Sandstro!. 2001)& S (*cient literat re is available to s ""ort a ne#ative e((ect o( <inc on iron absor"tion

2&E& ,cce"tabilit2 o( (orti*ed %heat +o r Lne o( the !ajor "roble!s in iron (orti*cation has been the develo"!ent o( nacce"table color chan#es in (orti*ed (oods& Fe?D7, is a "ale 2ello% %ater>sol ble "o%der %ith a hi#h stabilit2 constant and does not ca se a !ajor "roble! and can serve as a vehicle (or (orti*cation& 0o%ever. one o( the disadvanta#es (or addin# Fe?D7,>(orti*ed s #ar to tea is characteristic blac-ish discoloration& )an2 iron co!"o nds are colored and cannot be sed to (orti(2 li#ht>colored (oods& 0o%ever. the catal2tic e((ect o( iron on (at o=idation in cereal d rin# stora#e is the !ajor "roble!& ,s in the case o( "rod ct discoloration. %ater>sol ble co!"o nds s ch as (erro s s l(ate "ro!ote (at o=idation and red ce "rod ct shel( li(e (0 rrell et al&. 19E9)& Food (orti*cation %ith 4n has not been re"orted to "rovo-e nacce"table or#anole"tic chan#es in the "rod cts. "robabl2 o%in# to the relativel2 lo% level o( (orti*cation and the li!ited n !ber o( (ood ite!s c rrentl2 (orti*ed %ith 4n& 7h s. nless or#anole"tic "roble!s are observed in s"eci*c "rod cts. the "ri!ar2 choice o( 4n (orti*cant sho ld be a sol ble 4n co!"o nd (Cl2desdale. 1991C Davidsson. 19E5C 0 rrell et al&. 19E9)& ,ddition o( retin2l acetate and retin2l "al!itate as vita!in , salts is e((ective and hold ba-in# and stora#e stabilit2 as re"orted b2 3 tt et al&. 200D& 7he2 also stated that the addition o( vita!in , salts did not alter the sensorial attrib tes o( coo-ies& Cl2desdale (1991) stated that or#anole"tic "roble!s related to <inc (orti*cation o( (ood have not been re"orted and do not see! to be a !ajor concern& 3ovell>3enja!in et al& (2000) de!onstrated that sensor2 testin# %as an i!"ortant ste" in deter!inin# %hether a novel iron (orti*cant co ld be sed to (orti(2 a !ai<e diet a(ter learnin# that the novel iron (orti*cant %as better absorbed (ro! a !ai<e "orrid#e than (erro s s l(ate& :alter. Aeenhardt. Co dra2. and Re!es2 (2002) e=a!ined the sensor2 / alities or acce"tabilit2 o( cereal "rod cts (orti*ed %ith iron or <inc (orti*cants& 7he2 noted that the level o( (orti*cation a((ected the acce"tabilit2 o( noodles !ade (ro! %heat +o r (orti*ed %ith iron and <inc& 6oodles %ith a hi#h level o( (orti*cation (100 !#'- +o r) %ere in #eneral li-ed less than those %ith a lo%er level o( (orti*cation (60 !#'- +o r)& ,!on# noodles (orti*ed %ith hi#h levels o( <inc. <inc o=ide received si#ni*cantl2 lo%er hedonic scores than <inc s l(ate& ,t lo%er levels o( (orti*cation. ho%ever. the onl2 di((erence (o nd %as that noodles (orti*ed %ith <inc o=ide #ot lo%er scores (or te=t re& ,nother sensor2 (,-htar H ,nj !. 200D) st d2 o( the !ineral (orti*ed cha"attis revealed that the +o r (orti*ed %ith 6aFe?D7, in co!bination %ith 4nSL4 or 4nL. stored is the better choice (or or#anole"ticall2 acce"table !ineral (orti*ed cha"attis&

%hen s ""lied in the diet to#ether& 7race ele!ent interactions are #enerall2 anta#onistic and %hen t%o che!icall2 si!ilar ions are "resent in the intestinal l !en. the one havin# #reater ratio tends to e=cl de the other (Solo!ons H R <. 199D)& ,nother st d2 con*r!ed that the in#estion o( e=cess a!o nts o( <inc has been (o nd to ind ce ane!ia and de"ress tiss e iron levels in rats and chic-s (3a( ndo. 3a-er. H Fit<#erald. 19E4) b t this interaction has received little attention in h !ans& 4nSL4 and 4nL var2 in their sol bilit2 ran#in# (ro! ver2 sol ble to al!ost insol ble (0enderson et al&. 1995)& 4inc !a2 red ce the bene*cial e((ect o( iron stat s. b t this ne#ative interaction does not a""ear to be #reat eno #h to disco ra#e joint s ""le!entation& ?ven in the "resence o( <inc. the bene*t o( iron s ""le!entation on iron indicators %as si#ni*cant and i!"ortant& Iron does not a""ear to have a ne#ative e((ect on ser ! <inc concentrationsC i( there is an e((ect. it is s!all (:al-er. 9ordas. Stolt<( s. H 3lac-. 2005)& ?vidence s ##ests that there are no clinicall2 i!"ortant adverse e((ects o( <inc (orti*cation on iron or co""er stat sC / estions re!ain abo t the "otential e((ects o( <inc (orti*cation on other !inerals (,rredondo et al&. 2006)& Iron and <inc a""ear to be hi#hl2 bioavailable (ro! (oods !ade (ro! (orti*ed +o r. b t <inc s l(ate co>(orti*cation !a2 have a detri!ental e((ect on iron absor"tion& Co> (orti*cation o( iron>(orti*ed +o r %ith <inc s l(ate. b t not <inc o=ide. decreases iron absor"tion in Indonesian children (0er!an et al&. 2002)& 0i#her iron absor"tion %as observed in diet #ro "s (ed 6aFe?D7,. alone and %ith 4nL& Si!ilarl2. in#estion o( 4nSL4 !ani(ested the hi#hest absor"tion o( <inc %hen #iven alone and'or %ith ?I and 6aFe?D7, (,-htar et al&. 2010)& 2&10& :heat +o r (orti*cation X ecolo#ical st dies 7he cereals are considered to be the best vehicle (or (orti*cation in develo"in# co ntries. beca se Y 95N o( the "o" lation cons !es cereals as dietar2 sta"le& 7he2 are relativel2 ine="ensive. #ro%n and cons !ed %orld%ide b2 all econo!ic classes& ,""ro=i!atel2. 600 !illion !etric tons o( %heat and !ai<e +o rs are co!!erciall2 !illed ann all2 and cons !ed as vario s +o r "rod cts in nearl2 ever2 nation o( the %orld (FFI. 200E)& :heat +o r is a sta"le (ood o( the "o" lation in the Indian s b>continent and it "rovides !ore than *(t2 "ercent o( the total ener#2 inta-e& Si!ilarl2. in co ntries li-e S2ria. ,l#eria. 7 r-e2 and Iran. %heat cons !"tion is abo t hal( the total caloric inta-e and ran#es " to 600 # a da2& :heat +o r (orti*cation %as started in the 1940s b2 the 1nited States and Canada& Aater in 1950s. Chile started (orti(2in# %heat +o r. %hile d rin# the 1960s. so!e Aatin ,!erican co ntries "assed le#islation enco ra#in# (orti*cation o( (oods& Conse/ entl2. addition o( iron and 3 vita!ins be#an on a vol ntar2 basis b2 so!e !illers (0ertra!"(. 2002)& Several other co ntries in )iddle ?ast and 6orth ,(rica are i!"le!entin# +o r (orti*cation "ro#ra!s (or %heat and corn +o r %ith iron and other !icron trients& Central ,sian Co ntries i&e& ,<erbaijan. 9a<a-hstan. 92r#2< Re" blic. )on#olia. 7aji-istan. and 1<be-istan have started +o r (orti*cation (:0L. 1999)& ;ietna!. 7hailand. the 5eo"lePs Re" blic o( China. 5a-istan. and Indonesia also si#ned the consens s state!ent on %heat +o r (orti*cation& 7hese co ntries %ere o( the vie% that addition o( !icron trients to +o r is an e(*cacio s !ethod to red ce the "revalence o( the -e2 de*ciencies es"eciall2 iron (,D3. 2001)& 8ordan also initiated +o r (orti*cation "ro#ra! to bene*t a lar#er sector o( the "o" lation ()ehansho H )annar. 1999C L)6I. 1996C Ran !. 199D)& 7hese develo"!ents in the do!ain o( (orti*cation led to increase in %orld%ide "ercenta#e o( %heat>+o r (orti*cation (ro! 1EN in 2004 to 2DN in 200D& 7he esti!ated n !ber o( "ersons %ith access to (orti*ed %heat +o r increased b2 a""ro=i!atel2 540 !illion. and the ann al n !ber o( ne%borns %hose !others had access to (orti*ed

%heat +o r d rin# "re#nanc2 increased b2 a""ro=i!atel2 14 !illion& 7he n !ber o( co ntries %ith !andator2 %heat +o r (orti*cation "ro#ra!s rose (ro! BB in 2004 to 54 in 200D (CDC5. 200EC )aberl2 et al&. 200E)& In s"ite o( these s ccesses. !ore than t%o>thirds o( the %orldPs "o" lation still lac-s access to (orti*ed %heat +o r and its bene*ts. incl din# !illions o( %o!en o( childbearin# a#e. ho%ever. re# lar access o( the "o" lation to (orti*ed +o r !a2 be e((ective in red cin# the b rden o( !icron trients de*ciencies (FFI. 200E)& St dies in I ate!ala and 7hailand have sho%n that villa#e>level (orti*cation can be o"erationall2 (easible& Chile has an iron de*cienc2 "revalence o( less than 1N %hich !ost observers attrib te to a stron# +o r (orti*cation "ro#ra! ()ehansho H )annar. 1999C L)6I. 1996) )ai<e +o r (orti*cation %ith iron and vita!in , has !ani(ested a stron# "ositive e((ect on the iron stat s o( the "o" lation in ;ene< ela (3eth. Flores. Dar2. H )artorell. 200DC Aa2risse et al&. 1996)& Forti*cation o( +o r and other cereal "rod cts %ith vita!in , and other !icron trients is #ainin# attention beca se o( hi#h covera#e o( "o" lation in !an2 co ntries (:0L. 1999)& ;ita!in , (orti*ed cereal "rod cts can be e((ective to red ce the ;,D !enace (Ran !. 2001)& Dail2 cons !"tion o( vita!in , (orti*ed %heat +o r b n i!"roved the vita!in , stat s si#ni*cantl2 in s bjects %ith !ar#inal to lo% initial ser ! retinol concentrations (Solon. Fernande<. Aatha!. H 5o"-in. 19D9)& In another intervention st d2 in r ral So th ,(rica. "rovision o( vita!in , (orti*ed bisc its (or si=t2 %ee-s i!"roved the ser ! retinol level si#ni*cantl2 (8inabhai et al&. 2001)& 0o%ever. there is little e="erience in develo"in# co ntries %ith (orti*cation %ith <inc (Ran !. 199D)& S!all>scale e(*cac2 trials indicate that <inc (orti*cation can increase total dail2 <inc cons !"> tion and the a!o nt o( absorbed <inc. both in children and ad lts (3ro%n. AR"e< de Ro!aSa. et al&. 200D)& 4inc s ""le!entation de!onstrated red ctions in the incidences o( diarrhea. "ne !onia and !alaria. the !ost co!!on ca ses o( death in children in develo"in# co ntries& 7h s a correction o( <inc de*cienc2 is also li-el2 to have a #reat i!"act on the health o( a lar#e "o" lation in the develo"in# %orld (Irace2. 1999C 6e##ers et al&. 1990C 5rasad. 200B)& 5ro#ra!s are contin in# to e="and covera#e o( %heat>+o r (orti*cation as a strate#2 to increase !icron trient cons !"tion (:0L. 1999)& 0o%ever. it is ti!e to (oc s on ! lti"le !icron trient (orti*cation as sin#le !icron trient addition to an a""ro"riate (ood vehicle is a less co!!on a""roach in (ood (orti*cation "ro#ra!s& 7he ! lti"le (orti*cation o( (oods is a "ossible !ean o( addressin# de*ciencies o( t%o or !ore !icron trients at the sa!e ti!e in a cost> e((ective !anner (Darnton 0ill et al&. 1999C Aot* et al&. 1996)& B& Concl sion 7he conse/ ences o( !icron trient de*cienc2 are adverse and lead to health and econo!ic disaster in the v lnerable "o" lation in develo"in# co ntries& ,lbeit. eli!ination o( !icron trient de*cienc2 has al%a2s been on the "riorit2 a#enda o( the international or#ani<ations. it still re!ains a !ajor iss e and e=ists in its a""rehensive sha"e in the develo"in# co ntries& Correct esti!ation o( "revalence o( !icron trient de*cienc2 in the re#ion. "olic2 decisions and their i!"le!entation. choice o( !ineral (orti*cants. levels o( (orti*cation. selection o( s itable vehicle and (easibilit2 st dies are so!e o( the -e2 / estions to be addressed (or a s ccess( l (orti*cation "ro#ra!& :heat +o r see!s to be a "otential vehicle (or (orti*cation %ith !inerals as co!"ared to !an2 other vehicles in Indian s bcontinent o%in# to its hi#h cons !"tion& 0o%ever. the at!os"heric conditions and lac- o( !odern stora#e (acilities (or (orti*ed +o rs indeed %o ld de!and an ade/ ate consideration to over"o%er stabilit2 and acce"tabilit2 iss es& 3ioavailabilit2 o( !ineral (orti*ed +o r has lon# been debated and hi#hli#hts the (act that se o( novel iron so rces e&#& 6aFe?D7, in the "resence o( "h2tic acid in %heat +o r co ld be a better choice (or (orti*cation&

,D3 (2001)& Consens s state!ent on sheat +o r (orti*cation develo"ed at the Re#ional :or-sho" on +o r and coo-in# oil (orti*cation )anila 5hili""ines& & ,d >,(ar% ah. S&. Aarte2. ,&. 3ro%n. 9& 0&. 4lot-in. S&. 3riend. ,&. H De%e2. 9& I& (200E)& 0o!e (orti*cation o( co!"le!entar2 (oods %ith !icron trient s ""le!ents is %ell acce"ted and has "ositive e((ects on in(ant iron stat s in Ihana& 7he ,!erican 8o rnal o( Clinical 6 trition. ED(4). 9299BE& ,# a2o. ;& )&. H 3a-er. S& 9& (2005)& ;ita!in , de*cienc2 and child s rvival in s b> Saharan ,(rica$ , rea""raisal o( challen#es and o""ort nities& Food and 6 trition 3 lletin. 26(4). B4EB55& ,-htar. S&. H ,nj !. F& )& (200D)& Sensor2 characteristics o( %hole %heat !ineral (orti*ed cha"attis& 5a-istan 8o rnal o( 6 trition. 6. 6E16E6& ,-htar. S&. ,nj !. F& )&. Reh!an. S& 1&. H ) nir. ,& S& (2009)& ?((ect o( !ineral (orti*cation on rheolo#ical "ro"erties o( %heat +o r& 8o rnal o( 7e=t re St dies. 40. 5260& ,-htar. S&. ,nj !. F& )&. Reh!an. S& 1&. ) nir. ,& S&. H Far<ana. 9& (200E)& ?((ect o( (orti*cation on "h2sico>che!ical and !icrobiolo#ical stabilit2 o( %hole %heat +o r& Food Che!istr2. 110. 11B119& ,-htar. S&. Reh!an. 4& 1&. ,nj !. F& )&. ,li. 4&. H 6isar. ,& (2010)& 3ioavailabilit2 o( iron and <inc (orti*ed %hole %heat +o r in rats& 5a-istan 8o rnal o( 4olo#2. 4B. DD1DD9& ,rredondo. )&. )artTne<. R&. 6USe<. )& 7&. R <. )&. H Llivares. )& (2006)& Inhibition o( iron and co""er "ta-e b2 iron. co""er and <inc& 3iolo#ical Research. B9. 95 102& ,sh. )&. H ,sh. I& (1995)& 0and boo- o( (ood additives& 3roo-*eld$ Io%er 5 blishin# Atd& ;7& , -ett. )& ,&. 5ar-s. Z& ,&. Scott. 5& 0&. H :harton. 3& ,& (19E6)& 7reat!ent %ith iron increases %ei#ht #ain and "s2cho!otor develo"!ent& ,rchives o( Disease in Childhood. 61. E49E5D& 3a( ndo. 9& :&. 3a-er. D& 0&. H Fit<#erald. 5& R& (19E4)& 7he iron<inc interrelationshi" in the chic- as in+ enced b2 ?i!eria acerv lina in(ection& 7he 8o rnal o( 6 trition. 114. 1B061B12& 3allot. D& ?&. )c5hail. ,& 5&. 3oth%ell. 7& 0&. Iillool2. )&. H )a2et. F& I& (19E9)& Forti*cation o( c rr2 "o%der %ith 6aFe(III)?D7, in an iron>de*cient "o" lation$ Re"ort o( a controlled iron (orti*cation trial& 7he ,!erican 8o rnal o( Clinical 6 trition. 49. 162169& 3einner. )& ,&. H Aa!o nier. 8& ,& (200B)& Recent e="erience %ith (orti*cation o( (oods and bevera#es %ith iron (or the control o( iron>de*cienc2 ane!ia in 3ra<ilian children& Food and 6 trition 3 lletin. 24(B). 26E2D4& 3eth. I& 9&. Flores. R&. Dar2. L&. H )artorell. R& (200D)& :heat +o r (orti*cation is nli-el2 to bene*t the neediest in I ate!ala& 7he 8o rnal o( 6 trition. 1BD. 101D1022& 3h tta. 4& ,& (200E)& )icron trient needs o( !alno rished children& C rrent L"inion in Clinical 6 trition and )etabolic Care. 11. B09B14& 3loe!. )& :&. :edel. )&. ?##er. R& 8&. S"ee-. ,& 8&. Schrijver. 8&. Sao%a-ontha. S&. et al& (19E9)& Iron !etabolis! and vita!in , de*cienc2 in children in 6ortheast 7hailand& 7he ,!erican 8o rnal o( Clinical 6 trition. 50. BB2BBE& 3ovell>3enja!in. ,& C&. ;iteri. F& ?&. H ,llen. A& 0& (2000)& Iron absor"tion (ro! (erro s b2s#l2cinate and (erric tris#l2cinate in %hole !ai<e is re# lated b2 iron stat s& 7he ,!erican 8o rnal o( Clinical 6 trition. D1. 156B1569& 3ro%n. 9& 0&. AR"e< de Ro!aSa. D&. ,rsena lt. 8& ?&. 5eerson. 8& )&. H 5enn2. )& ?& (200D)& Co!"arison o( the e((ects o( <inc delivered in a (orti*ed (ood or a li/ id s ""le!ent on the #ro%th. !orbidit2. and "las!a <inc concentrations o( 2o n# 5er vian children& 7he ,!erican 8o rnal o( Clinical 6 trition. E5. 5BE54D& 3ro%n. 9& 0&. :essells. 9& R&. H 0ess. S& Z& (200D)& 4inc bioavailabilit2 (ro! <inc> (orti*ed (oods& International 8o rnal (or ;ita!in and 6 trition Research. DD. 1D41E1& 3ro%n. 9& 0&. : ehler. S& ?&. H 5eerson. 8& )& (2001)& 7he i!"ortance o( <inc in h !an n trition and esti!ation o( #lobal "revalence o( <inc de*cienc2& Food and 6 trition 3 lletin. 22. 11B125& 3r ne. )&. Rossander>0 lten. A&. 0allber#. A&. Ileer ". ,&. H Sandber#. ,& S& (1992)& Iron absor"tion (ro! bread in h !ans$ Inhibitin# e((ects o( cereal *ber. "h2tate and inositol "hos"hates %ith di((erent n !bers o( "hos"hate #ro "s& 7he 8o rnal o( 6 trition. 122. 442449& 3 tt. )& S&. ,rshad. )& 1&. ,la!. )& S&. H 6adee!. )& 7& (200D)& 3ioavailabilit2 and stora#e stabilit2 o( vita!in , (orti*cant (retin2l acetate) in (orti*ed coo-ies& Food Research International. 40. 12121219& Candela. ?&. Ca!acho. )& ;&. H )artine<>7orres. C& (19E4)& Iron absor"tion b2 h !ans and s%ine (ro! Fe(III)?D7,& F rther st dies& 7he 8o rnal o( 6 trition. 114. 22042211& CDC5 (200E)& 7rends in %heat>+o r (orti*cation %ith (olic acid and iron. %orld%ide. 2004 and 200D& )orbidit2 and )ortalit2 :ee-l2 Re"ort. 5D. E10& Cha-arvart2. I& (2000)& Food based strate#ies to control vita!in , de*cienc2& Food and 6 trition 3 lletin. 21. 1B514B& Cl2desdale. F& )& (1991)& )ineral additives& In 8& C& 3a ern(eind. 5& ,& Aachance. H C& 7& 7r !b ll (?ds&). 6 trient addition to (ood. n tritional. technolo#ical and re# lator2 as"ects (""& ED10D)& 6e% Zor-$ Food and 6 trition 5ress Inc& Co sins. R& 8& (1996)& 4inc& In ?& ?& 4ie#ler. H A& 8& Filer (?ds&). 5resent -no%led#e in n trition (""& 29BB06)& :ashin#ton DC$ IASI 5ress& Darnton 0ill. I&. )ora. 8& L&. :einstein. 0&. :ilb r. S&. H 6al bola. 5& R& (1999)& Iron and (olate (orti*cation in the ,!ericas to "revent and control !icron trient !aln trition$ ,n anal2sis& 6 trition Revie%s. 5D. 25B1& Davidsson. A& (19E5)& 4inc& In R& 0 rrell (?d&). )ineral Forti*cation o( Foods (""& 1EE1E9)& 19$ Aeatherhead 5 b& Davidsson. A&. Di!itrio . 7&. 3o2. ?&. :alc<2-. 7&. H 0 rrell. R& F& (2002)& Iron

bioavailabilit2 (ro! iron>(orti*ed I ate!alan !eals based on corn tortillas and blac- bean "aste& 7he ,!erican 8o rnal o( Clinical 6 trition. D5. 5B55B9& Davidsson. A&. 9asten!a2er. 5&. H 0 rrell. R& F& (1994)& Sodi ! iron ?D7, [6aFe(III) ?D7,\ as a (ood (orti*cant$ 7he e((ect on the absor"tion and retention o( <inc and calci ! in %o!en& 7he ,!erican 8o rnal o( Clinical 6 trition. 60. 2B12BD&

Falch -. 9& 0&. H ;allee. 3& A& (199B)& 7he bioche!ical basis o( <inc "h2siolo#2& 5h2siolo#ical Revie%s. DB. D911E& FFI (200E)& Second technical %or-sho" on %heat +o r (orti*cation$ 5ractical reco!!en> dations (or 6ational ,""lication S !!ar2 Re"ort. Stone )o ntain. Ieor#ia. 1S,& Filtea . S& )&. H 7o!-ins. ,& )& (1999)& 5ro!otin# vita!in , stat s in lo% inco!e co ntries& Aancet. B5B. 145E1459& Forth. :&. H R !!el. :& (19DB)& Iron absor"tion& 5h2siolo#ical Revie%s. 5B. D2499B& Iibson. R& S& (1994)& 4inc n trition in develo"in# co ntries& 6 trition Research Revie%s. D. 1511DB& Irace2. )& (1999)& 6 tritional e((ects and !ana#e!ent o( diarrhoea in in(anc2& ,cta 5aediatrica. EE. 110126& Iraebner. I& 7&. Si/ eira. ?& )& ,&. ,rr da. S& F&. H de So <a. ?& )& 7& (2004)& Carotenoids (ro! native 3ra<ilian dar- #reen ve#etables are bioavailable$ , st d2 in rats& 6 trition Research Revie%s. 24. 6D16D9& 0aidar. 8& (2010)& 5revalence o( ,nae!ia. De*ciencies o( iron and (olic acid and their deter!inants in ?thio"ian %o!en& 8o rnal o( 0ealth 5o" lation and 6 trition. 2E. B59B6E& 0enderson. A& )&. 3re%er. I& 8&. Dress!an. 8& 3&. S%idan. S& 4&. D Ross. D& 8&. ,dair. C& 0&. et al& (1995)& ?((ect o( intra#astric "0 on the absor"tion o( oral <inc acetate and <inc o=ide in the 2o n# health vol nteers& 8o rnal o( 5arenteral and ?nteral 6 trition. 19. B9BB9D& 0er!an. S&. Iri(*n. I& 8&. S %arti. S&. ?rna%ati. F&. 5er!aesih. D&. H 5a!b di. D& (2002)& Co(orti*cation o( iron>(orti*ed +o r %ith <inc s l(ate. b t not <inc o=ide. decreases iron absor"tion in Indonesian children& 7he ,!erican 8o rnal o( Clinical 6 trition. D6. E1BE1D& 0ertra!"(. ?& (2002)& Iron (orti*cation in the ,!ericas& 6 trition Revie%s. 60. 2225& 0idve#i. )&. H Aas<tit2. R& (2002)& 5h2tic acid content o( cereals and le# !es and interaction %ith "roteins& 5eriodica 5ol2technica Ser& Che!& ?n#&. 46. 5964& 0ot<. C&. De0aene. 8&. :oodho se. A&. ;illal"ando. S&. Rivera. 8& ,&. H 9in#. 8& C& (2005)& 4inc absor"tion (ro! <inc o=ide. <inc s l"hate. <inc o=ide F ?D7,. or sodi !<inc ?D7, does not di((er %hen added as (orti*cants to !ai<e tortillas& 7he 8o rnal o( 6 trition. 1B5. 11021105& 0 rrell (2002)& Forti*cation$ Lverco!in# technical and "ractical barriers& 7he 8o rnal o( 6 trition. 1B2. E06E12& 0 rrell. R& F&. F rniss. D& ?&. 3 rri. 8&. :hita-er. 5&. A2nch. S& R&. H Coo-. 8& D& (19E9)& Iron (orti*cation o( in(ant cereals. a "ro"osal (or the se o( (erro s ( !arate or (erro s s ccinate& 7he ,!erican 8o rnal o( Clinical 6 trition. 49. 12D412E2& I6,CI (199B)& Iron ?D7, (or (ood (orti*cation& International 6 tritional ,nae!ia Cons ltative Iro "& :ashin#ton DC$ 7he 6 trition Fo ndation'IASI& 8inabhai. C& C&. 7a2lor. )&. Co tso dis. ,&. Coovadia. 0& )&. 7o!-ins. ,& )&. H S llivan9. R& (2001)& , rando!i<ed controlled trial o( the e((ect o( anti>hel!inthic treat!ent and !icron trient (orti*cation on health stat s and school "er(or!ance o( r ral "ri!ar2 school children& ,nnals o( 7ro"ical 5aediatrics. 21. B19BBB& 9enned2. I&. 6antel. I&. 3ro %er. I& D&. H 9o-. F& 8& (2006)& Does livin# in an rban environ!ent con(er advanta#es (or childhood n tritional stat s] ,nal2sis o( dis"arities in n tritional stat s b2 %ealth and residence in ,n#ola. Central ,(rican Re" blic and Sene#al& 5 blic 0ealth 6 trition. 9. 1ED19B& 9han. 6& C&. )ai. A& 3&. )inh. 6& D&. Do. 7& 7&. 9hoi. 0& 0&. :est. C& ?&. et al& (200D)& Inta-es o( retinol and carotenoids and its deter!inin# (actors in the Red River Delta "o" lation o( northern ;ietna!& ? ro"ean 8o rnal o( Clinical 6 trition. 62. E10E16& 9le!!. R& D& :&. 9eith. 5& :&. 8r&. ,!anda. C& 5&. ^ entin. 8&. 5hili". R&. 5eter. R&. et al& (2010)& ;ita!in , (orti*cation o( %heat +o r$ Considerations and c rrent reco!!endations& Food and 6 trition 3 lletin. B1. S4DS61& Aa2risse. )&. Chaves. 8& F&. )ende<>Castellano. 0&. 3osch. ;&. 7ro""er. ?&. 3astardo. 3&. et al& (1996)& ?arl2 res"onse to the i!"act o( iron (orti*cation in the ;ene< elan "o" lation& 7he ,!erican 8o rnal o( Clinical 6 trition. 64. 90B90D& Aonnerdal. 3& (2000)& Dietar2 (actors in+ encin# <inc absor"tion& 7he 8o rnal o( 6 trition. 1B0. 1BDE1BEB& Aonnerdal. 3& (2002)& 5h2tic acid trace ele!ent (4n. C . )n) interactions& International 8o rnal o( Food Science H 7echnolo#2. BD. D49D5E& Aot*. )&. )annar. )& I& ;&. )er=. R& 0&. 6aber>van den. H 0e vel. 5& (1996)& )icron trient (orti*cation o( (oods$ C rrent "ractices. research and o""ort nities& 7he )icron trient Initiative.Ltta%a. International ,#ric lt re Centre. :a#enin#en& Aoveda2. S& )&. H Sin#h. 0& (200E)& Recent advances in technolo#ies (or vita!in , "rotection in (oods& 7rends in Food Science and 7echnolo#2. 19. 65D66E& )aberl2. I&. Ir !!er>Stra%n. A&. 8e((erds. )& ?&. 5ena>Rosas. 8& 5&. Serd la. )& 9&. 72ler. ;& ^&. et al& (200E)& 7rends in %heat>+o r (orti*cation %ith (olic acid and iron %orld%ide. 2004 and 200D& )orbidit2 and )ortalit2 :ee-l2 Re"ort. 5D& )a2er. 8& ?&. 5(ei((er. :& 0&. H 3e2er. 5& (200E)& 3io(orti*ed cro"s to alleviate !icron trient !aln trition& C rrent L"inion in 5lant 3iolo#2. 11. 1661D0& )ehansho. 0&. H )annar. )& I& ;& (1999)& )ineral (orti*cation in develo"in# co ntries& In R& 0 rrell (?d&). 7he !ineral (orti*cation o( (oods (""& 21B214)& 19$ Aeatherhead 5 b& )Oller. L&. H 9ra%in-el. )& (2005)& )aln trition and health in develo"in# co ntries& Canadian )edical ,ssociation 8o rnal. 1DB. 2D92E6& 6e##ers. Z& 0&. C tter. I& R&. ,cton. R& 7&. ,lvare<. 8& L&. 3onner. 8& A&. Ioldenber#. R& A&. et al& (1990)& , "ositive association bet%een !aternal ser ! <inc concentration and birth %ei#ht& 7he ,!erican 8o rnal o( Clinical 6 trition. 51. 6DE6E4& L)6I (1996)& )andator2 (ood enrich!ent& 6 trivie% S ""le!ent. the Roche'1S,ID Forti*cation 3asics series. and L)6I'1S,ID " blication& 5rasad. ,& S& (1991)& Discover2 o( h !an <inc de*cienc2 and st dies in e="eri!ental h !an !odel& ,!erican 8o rnal o( 6 trition. 5B. 40B412& 5rasad. ,& S& (200B)& 4inc de*cienc2 has been -no%n o( (or 40 2ears b t i#nored b2

#lobal health or#anisations& 3ritish )edical 8o rnal. B26. 409410& Ran !. 5& (199D)& L""ort nities (or %heat +o r (orti*cation& Food (orti*cation to end !icron trient !aln trition (""& 5E)& Canada$ S2!"osi ! re"ort&

Ran !. 5& (1999)& Iron (orti*cation o( cereals& In R& 0 rrell (?d&). )ineral (orti*cation o( (oods (""& 251)& 19$ Aeatherhead 5 b& Ran !. 5& (2001)& 4inc enrich!ent o( cereal sta"les& Food and 6 trition 3 lletin. 22& R bin. S& 0&. ?!isi. ,&. H Scal"i. A& (19DD)& )icron trient addition to cereal #rain "rod cts& Cereal Che!istr2. 54. E9590B& Sahib. ,&. 0a!id. 1& S&. Salee!. 1&. H ,2esha. R& (200D)& Co!"arative st dies on stora#e stabilit2 o( (erro s iron in %hole %heat +o r and +at bread (naan)& International 8o rnal o( Food Science and 6 trition. 5E. 5462& Sandber#. ,& S& (1991)& 7he e((ect o( (ood "rocessin# on "h2tate h2drol2sis and availabilit2 o( iron and <inc& ,dvances in ?="eri!ental )edicine and 3iolo#2. 2E9. 49950E& Sandstro!. 3& (2001)& )icron trient interactions$ ?((ects on absor"tion and bioavail> abilit2& 7he 3ritish 8o rnal o( 6 trition. E5. 1E11E5& Solo!ons. 6&. H R <. )& (199D)& 4inc and iron interaction$ Conce"ts and "ers"ectives in the develo"in# %orld& 6 trition Research Revie%s. 1D. 1DD1E5& Solon. F&. Fernande<. 7& A&. Aatha!. )& C&. H 5o"-in. 3& )& (19D9)& ,n eval ation o( strate#ies to control vita!in , de*cienc2 in the 5hili""ines& ,!erican 8o rnal o( Che!ical 6 trition. B2. 1445145B& So!!er. ,&. H Davidson. F& R& (2002)& ,ssess!ent and control o( vita!in , de*cienc2$ 7he ,nnec2 ,ccords& 7he 8o rnal o( 6 trition. 1B2. 2E452E50& Stolt<( s. R& 8&. ) llan2. A&. H 3lac-. R& ?& (200B)& Iron de*cienc2 anae!ia in co!"arative / anti*cation o( health ris-s$ 7he #lobal b rden o( disease d e to 25 selected !ajor ris(actors& Ca!brid#e. 19$ 0arvard 1niversit2 5ress& van>den 3riel. 7&. Che n#. ?&. 4e%ari. 8&. H 9han. R& (200D)& Forti(2in# (ood in the *eld to boost n trition$ Case st dies (ro! ,(#hanistan. ,n#ola. and 4a!bia& Food and 6 trition 3 lletin. 2E. B5BB64& ;isioli. F&. H 0a#en. 7& )& (200D)& 6 tritional strate#ies (or health2 cardiovasc lar a#in#$ Foc s on !icron trients& 5har!ace tical Research. 55. 199206& ;iteri. F& ?&. ,lvare<. ?&. 3atres. R&. 7or n. 3&. 5ineda. L&. )ejia. A& ,&. et al& (1995)& Forti*cation o( s #ar %ith iron sodi ! eth2lenedia!inetetracetate (Fe6a?D7,)

i!"roves iron stat s in se!ir ral I ate!alan "o" lations& 7he ,!erican 8o rnal o( Clinical 6 trition. 61. 15B116B& :ahl/vist. )& A& (200E)& 6ational (ood (orti*cation$ , dialo# e %ith re(erence to ,sia$ 5olic2 in evol tion& ,sia 5aci*c 8o rnal o( Clinical 6 trition. 1D. 2429& :al-er. C& F&. 9ordas. 9&. Stolt<( s. R& 8&. H 3lac-. R& ?& (2005)& Interactive e((ects o( iron and <inc on bioche!ical and ( nctional o tco!es in s ""le!entation trials& 7he ,!erican 8o rnal o( Clinical 6 trition. E2. 512& :alter. De,ndraca. I&. Chad d. 5&. H 5erales. C& I& (19E6)& Iron de*cienc2 ane!ia$ ,dverse e((ects on in(ant "s2cho!otor& Develo"!ent 5ediatrics. E4. D1D& :alter. A&. Aeenhardt. F&. Co dra2. C&. H Re!es2. C& (2002)& )inerals and "h2tic acid interactions$ Is it a real "roble! (or h !an n trition] International 8o rnal o( Food Science H 7echnolo#2. BD. D2DDB9& :elch. R& )&. H Iraha!. R& D& (1999)& , ne% "aradi#! (or %orld a#ric lt re$ )eetin# h !an needs "rod ctive. s stainable. n tritio s& Field Cro"s Research. 60. 110& :0L (1992)& 6ational strate#ies (or overco!in# !icron trients !aln trition& :orld 0ealth ,sse!bl2 5rovisional ,#enda Ite! 21 Ieneva& S%it<erland& :0L (1996)& Indicators (or assessin# vita!in , de*cienc2 and their a""lication in !onitorin# and eval atin# intervention "ro#ra!!es& Ieneva$ :orld 0ealth Lr#ani<ation. (:0L'617'96&10& :0L (1999)& Forti*cation o( +o r to control iron de*ciencies in the )iddle ?ast and 6orth ,(rica& Re"ort o( a joint :0L'16IC?F')I'IASI %or-sho" (""& 1B16)&& :in#er. R& 8&. 9Mni#. 8&. H 0o se. D& ,& (200E)& 7echnolo#ical iss es associated %ith iodine (orti*cation o( (oods& 7rends in Food Science and 7echnolo#2. 19. 94101& 4i!!er!ann. )& 3&. 3iebin#er. R&. Rohner. F&. Dib. ,&. 4eder. C&. 0 rrell. R& F&. et al& (2006)& ;ita!in , s ""le!entation in children %ith "oor vita!in , and iron stat s increases er2thro"oietin and he!o#lobin concentrations %itho t chan#in# total bod2 iron& ,!erian 8o rnal o( Clinical 6 trition. E4. 5E05E6&