Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.
Centre of Excellence in Women and Child Health and Institute for Global Health & Development, Aga Khan University, Karachi, Pakistan.
Curr Opin Clin Nutr Metab Care. 2021 May 1;24(3):271-275. doi: 10.1097/MCO.0000000000000745.
Undernutrition, including micronutrient deficiencies, continues to plague children across the world, particularly in low and middle-income countries (LMICs). The situation has worsened alongside the SARS-CoV-2 pandemic because of major systemic disruptions to food supply, healthcare, and employment. Large-scale food fortification (LSFF) is a potential strategy for improving micronutrient intakes through the addition of vitamins and minerals to staple foods and improving the nutritional status of populations at large.
Current evidence unquestionably supports the use of LSFF to improve micronutrient status. Evidence syntheses have also demonstrated impact on some functional outcomes, including anemia, wasting, underweight, and neural tube defects, that underpin poor health and development. Importantly, many of these effects have also been reflected in effectiveness studies that examine LSFF in real-world situations as opposed to under-controlled environments. However, programmatic challenges must be addressed in LMICs in order for LSFF efforts to reach their full potential.
LSFF is an important strategy that has the potential to improve the health and nutrition of entire populations of vulnerable children. Now more than ever, existing programs should be strengthened and new programs implemented in areas with widespread undernutrition and micronutrient deficiencies.
全世界的儿童，尤其是中低收入国家（LMICs）的儿童仍然存在营养不良问题，包括微量营养素缺乏。由于食品供应、医疗保健和就业的重大系统性中断，这一情况在 SARS-CoV-2 大流行期间恶化了。大规模食品强化（LSFF）是一种通过向主食中添加维生素和矿物质来改善微量营养素摄入并提高人群营养状况的潜在策略。
目前的证据无疑支持使用 LSFF 来改善微量营养素状况。证据综合也表明了其对一些功能结果的影响，包括贫血、消瘦、体重不足和神经管缺陷，这些结果是健康和发育不良的基础。重要的是，这些效果中的许多也反映在有效性研究中，这些研究考察了现实环境中 LSFF 的情况，而不是在受控制的环境中。然而，为了使 LSFF 发挥其全部潜力，必须在 LMICs 中解决方案性挑战。
LSFF 是一种重要的策略，有潜力改善弱势儿童的整体健康和营养状况。现在比以往任何时候都更需要加强现有计划，并在广泛存在营养不良和微量营养素缺乏的地区实施新的计划。
