TY - JOUR
T1 - The Potential for Bouillon Fortification to Reduce Dietary Micronutrient Inadequacy
T2 - Modeling Analyses Using National Survey Data from Cameroon, Ghana, and Haiti
AU - Engle-Stone, Reina
AU - Kumordzie, Sika M.
AU - Luo, Hanqi
AU - Wessells, Kimberly Ryan
AU - Adu-Afarwuah, Seth
AU - Njebayi, Alex
AU - Teta, Ismael
AU - Régis, Yves Laurent
AU - Gyimah, Emmanuel
AU - Vosti, Stephen A.
AU - Adams, Katherine P.
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2024/11
Y1 - 2024/11
N2 - Background: Bouillon is commonly consumed in some countries where micronutrient deficiencies are prevalent, but it has not been widely adopted as a micronutrient fortification vehicle. Objectives: We modeled the potential impacts of bouillon fortification on dietary micronutrient adequacy to inform future discussions around bouillon fortification programs. Methods: We analyzed the dietary intake of women of reproductive age (WRA) and 1- to 5-y-old children from a national dietary survey in Cameroon, and “apparent intake” (using the nutrient density approach) of WRA, children, and men from 3 household surveys in Cameroon, Ghana, and Haiti. We examined (apparent) intake of bouillon and simulated the impacts of bouillon fortification with varying levels of vitamin A, folic acid, vitamin B12, iron, and zinc on inadequate intake (below the estimated average requirement) and intake above the tolerable upper intake level (UL). Scenarios accounted for current mandatory fortification programs and different assumptions about iron absorption from bouillon. Results: Bouillon was consumed by >67% of households in Ghana and >90% in Haiti and Cameroon. Median (apparent) consumption ranged from 1.6 to 2.1 g/d for WRA, 0.7 to 1.0 g/d for children, and 1.8 to 2.2 g/d for men. Bouillon fortification at the highest micronutrient concentration modeled was predicted to reduce dietary inadequacy by 21–52 percentage points (pp) for vitamin A; 3–47pp for folic acid, and 4–90pp for vitamin B12, depending on the country and population group. In contrast, predicted impacts for iron were modest (2–17pp reduction) but would increase if absorption of iron from bouillon were enhanced. Simulated zinc fortification reduced inadequacy by 12–50pp, but zinc intake above the UL exceeded 10% among children in almost all scenarios. Conclusions: Modeling indicates that bouillon fortification could improve dietary micronutrient adequacy beyond existing fortification programs. Further work is needed to identify fortification levels that meet criteria for nutritional benefit, technical and commercial feasibility, affordability, and cost-effectiveness.
AB - Background: Bouillon is commonly consumed in some countries where micronutrient deficiencies are prevalent, but it has not been widely adopted as a micronutrient fortification vehicle. Objectives: We modeled the potential impacts of bouillon fortification on dietary micronutrient adequacy to inform future discussions around bouillon fortification programs. Methods: We analyzed the dietary intake of women of reproductive age (WRA) and 1- to 5-y-old children from a national dietary survey in Cameroon, and “apparent intake” (using the nutrient density approach) of WRA, children, and men from 3 household surveys in Cameroon, Ghana, and Haiti. We examined (apparent) intake of bouillon and simulated the impacts of bouillon fortification with varying levels of vitamin A, folic acid, vitamin B12, iron, and zinc on inadequate intake (below the estimated average requirement) and intake above the tolerable upper intake level (UL). Scenarios accounted for current mandatory fortification programs and different assumptions about iron absorption from bouillon. Results: Bouillon was consumed by >67% of households in Ghana and >90% in Haiti and Cameroon. Median (apparent) consumption ranged from 1.6 to 2.1 g/d for WRA, 0.7 to 1.0 g/d for children, and 1.8 to 2.2 g/d for men. Bouillon fortification at the highest micronutrient concentration modeled was predicted to reduce dietary inadequacy by 21–52 percentage points (pp) for vitamin A; 3–47pp for folic acid, and 4–90pp for vitamin B12, depending on the country and population group. In contrast, predicted impacts for iron were modest (2–17pp reduction) but would increase if absorption of iron from bouillon were enhanced. Simulated zinc fortification reduced inadequacy by 12–50pp, but zinc intake above the UL exceeded 10% among children in almost all scenarios. Conclusions: Modeling indicates that bouillon fortification could improve dietary micronutrient adequacy beyond existing fortification programs. Further work is needed to identify fortification levels that meet criteria for nutritional benefit, technical and commercial feasibility, affordability, and cost-effectiveness.
KW - bouillon
KW - dietary adequacy
KW - fortification
KW - micronutrient
KW - modeling
UR - http://www.scopus.com/inward/record.url?scp=85209148892&partnerID=8YFLogxK
U2 - 10.1016/j.cdnut.2024.104485
DO - 10.1016/j.cdnut.2024.104485
M3 - Article
AN - SCOPUS:85209148892
SN - 2475-2991
VL - 8
JO - Current Developments in Nutrition
JF - Current Developments in Nutrition
IS - 11
M1 - 104485
ER -