By Eman Saleem
Malnutrition is a condition that arises when a person’s diet lacks essential nutrients such as proteins, vitamins, or minerals, or when it includes excessive harmful substances like sugary drinks and fast food. It can result from undernutrition, overnutrition, or micronutrient deficiencies. Malnutrition occurs for various reasons, including poor diet, insufficient food intake, digestive problems, increased nutrient requirements during pregnancy, childhood, or adolescence, inadequate breastfeeding practices, and social and economic factors such as poverty and food insecurity. Mental health conditions, such as depression or anxiety, and certain medical conditions, like kidney disease or cancer, can also contribute to malnutrition.Fortified foods play a crucial role in tackling malnutrition by providing essential micronutrients that may be missing from an individual’s diet. Nutritional deficiencies occur when the body’s requirements for basic nutrients are not met, compromising health and well-being. The global hunger crisis worsened in 2021, with an alarming 828 million people affected, marking a distressing increase of 46 million from the previous year and a sharp rise of 150 million compared to pre-pandemic levels in 2020.In Pakistan, the 2018 National Nutrition Survey was the largest of its kind, offering valuable insights into the country’s nutritional challenges. This survey marked the fifth since 1965 and was the first to provide district-representative data. It included a focus on adolescents and a dedicated component on water consumption. The survey was conducted across the provinces of Punjab, Sindh, Balochistan, and Khyber Pakhtunkhwa (KP), involving 76,742 children aged 0-59 months, 145,847 adolescents aged 10-19 years, and 145,324 women of reproductive age (WRA) aged 15-45 years. Participants were selected from 115,600 households to assess various health indicators. Blood samples from 31,828 women and children were collected for biochemical analysis, and 31,828 water samples were taken to evaluate water quality and detect contaminants like coliform and E. coli.
Large-scale food fortification (LSFF) has emerged as a highly effective strategy to enhance vitamin and mineral intake, addressing widespread micronutrient deficiencies. Staples such as wheat, maize, rice, condiments, and edible oils are fortified with essential micronutrients. For instance, folic acid fortification helps prevent anemia, with reductions ranging from 15% to 58%. A meta-analysis revealed that universal salt iodization (USI) is highly effective in reducing the risk of goiter, with a remarkable 74% decrease in its occurrence.Fortified foods are enriched with added micronutrients such as iron, zinc, vitamin D, and B vitamins, which help prevent deficiencies leading to malnutrition. These foods, especially those targeted at children and pregnant women, support healthy growth and development by providing essential nutrients. They also address “hidden hunger,” a term for micronutrient deficiencies that may not be immediately apparent but can significantly impact health.
Fortified foods offer a range of health benefits beyond preventing micronutrient deficiencies. Foods enriched with calcium and vitamin D are essential for maintaining strong bones and preventing conditions like osteoporosis. Iron-fortified cereals or grains help prevent anemia and iron deficiency, while vitamin D-enriched almond milk or dairy products support bone and immune function. Iodized salt helps prevent iodine deficiency and thyroid problems, and folic acid-fortified foods prevent birth defects and support healthy pregnancy.The enhanced fortification of sugar with vitamin A has yielded remarkable benefits, including a substantial increase in vitamin A intake among women of reproductive age, surpassing 235% of their daily needs. Concurrently, vitamin A deficiency has decreased significantly among children aged 12-59 months, and treatment of related eye disorders has been notably effective. Fortifying staple foods with vitamin D helps prevent nutritional rickets, and foods fortified with zinc can improve serum zinc status. Wheat flour fortified with folic acid is beneficial in preventing malnutrition and reducing the risk of neural tube defects, while increasing erythrocyte or plasma folate concentrations.Essential nutrients like iron, zinc, copper, iodine, selenium, and various vitamins are fortified in beverages and foods for pregnant and lactating women, with levels ranging from 50% to 100% of the recommended daily intake. These fortified foods aim to reduce the risk of pre-eclampsia and maternal mortality while addressing micronutrient deficiencies like anemia and iron deficiency. Moreover, omega-3 polyunsaturated fatty acids (PUFAs) have demonstrated anti-tumor effects by reducing Cox-2 and PGE-2 levels, highlighting their potential in preventing tumor progression.Fortified foods are particularly beneficial for women, children, and the elderly who require additional nutrients for growth and maintenance. They reduce the risk of health diseases like scurvy and rickets, which are linked to micronutrient deficiencies. These foods enhance cognitive function and boost the immune system by providing vitamins C, D, and E, reducing the risk of illnesses and infections.
Fortified foods are a powerful tool in combating malnutrition, addressing both under nutrition and over nutrition. By incorporating fortified foods into their diets, individuals can improve their overall health and well-being, prevent a range of health problems, and reduce the risk of chronic diseases. As the global population continues to grow, the importance of fortified foods in ensuring optimal nutrition will only increase.Fortified foods are a practical and effective solution for enhancing nutritional intake, especially in regions where malnutrition is prevalent. By continuing to develop and implement food fortification programs, we can make significant strides in reducing malnutrition and improving public health worldwide. The success of these programs relies on collaboration between governments, non-governmental organizations, and the private sector to ensure that fortified foods are accessible and affordable for all.
By Eman Saleem, B.S. Food Science and Technology
