Engle-Stone Reina, Kumordzie Sika M, Luo Hanqi, Wessells Kimberly Ryan, Adu-Afarwuah Seth, Njebayi Alex, Teta Ismael, Régis Yves-Laurent, Gyimah Emmanuel, Vosti Stephen A, Adams Katherine P
Department of Nutrition, University of California, Davis, California, United States.
Institute for Global Nutrition, University of California, Davis, California, United States.
Curr Dev Nutr. 2024 Oct 18;8(11):104485. doi: 10.1016/j.cdnut.2024.104485. eCollection 2024 Nov.
Bouillon is commonly consumed in some countries where micronutrient deficiencies are prevalent, but it has not been widely adopted as a micronutrient fortification vehicle.
We modeled the potential impacts of bouillon fortification on dietary micronutrient adequacy to inform future discussions around bouillon fortification programs.
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.
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.
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.
在一些微量营养素缺乏普遍存在的国家，肉汤是常见的食物，但它尚未被广泛用作微量营养素强化载体。
我们模拟了肉汤强化对膳食微量营养素充足性的潜在影响，为未来围绕肉汤强化计划的讨论提供信息。
我们分析了喀麦隆一项全国膳食调查中育龄妇女（WRA）和1至5岁儿童的膳食摄入量，以及喀麦隆、加纳和海地3项家庭调查中WRA、儿童和男性的“表观摄入量”（使用营养密度法）。我们研究了肉汤的（表观）摄入量，并模拟了用不同水平的维生素A、叶酸、维生素B12、铁和锌强化肉汤对摄入量不足（低于估计平均需求量）和超过可耐受最高摄入量水平（UL）的影响。情景考虑了当前的强制性强化计划以及关于肉汤中铁吸收的不同假设。
加纳超过67%的家庭、海地和喀麦隆超过90%的家庭食用肉汤。WRA的中位数（表观）消费量为1.6至2.1克/天，儿童为0.7至1.0克/天，男性为1.8至2.2克/天。根据国家和人群组的不同，在模拟的最高微量营养素浓度下强化肉汤预计可使维生素A的膳食摄入量不足降低21至52个百分点（pp）；叶酸降低3至47pp，维生素B12降低4至90pp。相比之下，预计铁的影响较小（降低2至17pp），但如果肉汤中铁的吸收增强，影响会增加。模拟的锌强化使摄入量不足降低了12至50pp，但在几乎所有情景中，儿童中锌摄入量超过UL的比例都超过了10%。
模型表明，肉汤强化可以改善膳食微量营养素充足性，超出现有强化计划。需要进一步开展工作，以确定符合营养效益、技术和商业可行性、可承受性以及成本效益标准的强化水平。
