Author: Supplefer

COMPLEMENTARY FOOD SUPPLEMENTS TO ACHIEVE MICRONUTRIENT ADEQUACY FOR INFANTS AND YOUNG CHILDREN
P. Nestel; A. Briend; B. de Benoist; E. Decker; E. Ferguson; O. Fontaine; A. Micardi; R. Nalubola

Many children in developing countries survive on a nutritionally inadequate diet. Dietary inadequacies during the complementary feeding period can be prevented by using complementary food supplements (CFSs) such as water dispersible or crushable micronutrient tablets, micronutrient sprinkles added to food just before feeding, or fortified spreads added to food just before feeding or fed as a snacks. A meeting was convened to discuss technical and operational issues related to the development of these new approaches and to identify knowledge gaps. The technical issues covered: what micronutrients to include, tolerable upper intake limits, bioavailability, micronutrient and macronutrient stability, package systems and amounts, encapsulation technologies, methods to limit or eliminate allergens, bacterial and chemical contamination, interactions between CFSs and complementary foods, and flavoring …

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In an effort to improve compliance to prevent iron deficiency anemia and other
micronutrient deficiencies, an alternate micronutrient delivery system for infants and
toddlers has been suggested by our group. This system involves a novel packaging method
and source of iron that is relatively inexpensive to manufacture and distribute. Essentially,
lipid encapsulated iron (soy-lipid) in powder form is packaged into individual sachets as a
single daily dose. Parents can be easily instructed to mix the contents of one sachet per
day into a bowl of any infant weaning food. Encapsulation of the iron source, ferrous fumarate,
prevents the iron from interacting with the food thereby preventing unacceptable organoleptic effects
associated with iron supplementation such as metallic-aftertaste and change of color, smell or texture
to foods. In vitro dissolution studies have demonstrated that the lipid encapsulate will
dissolve in the low pH of the stomach leaving the iron available for absorption. …

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Introduction

Humanitarian efforts are underway in the Asian
countries affected by the massive earthquake and resulting tsunamis that
devastated the region on December 26, 2004.  Relief operations initiated by international
and regional groups are acting urgently to prevent further tragedy and loss of
life of the hundreds and thousands of survivors that will be vulnerable to the
next wave of infectious disease and malnutrition.  The World Food Program of the United Nations
has endorsed an emergency approach to provide supplementation with
micronutrients in disaster situations as a cost-effective way to save lives and
prevent disease where food is limited and sanitation poor.  Supplementation with micronutrients (SUM)
offers a unique set of advantages as a first-line response in emergency aid:
(1) high impact, (2) low cost, (3) minimum storage needs, (4) little if no
preparation, (5) easily transportable and (6) a gateway to communities and
individuals for assessment and implementation …

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Vitamin C (Ascorbic Acid):

Function

Vitamin C is involved in the formation of collagen, tissue repair, and wound healing. It also is involved in the synthesis of several hormones and reactions. Ascorbic acid solublizes copper and iron, putting them in a form that can be more easily absorbed in the body. It may also play a role in membrane permeability, leukocyte function, and prevention of histamine accumulation in the body.

Physiology

Absorption of vitamin C occurs in the small intestine. Ascorbic acid is water-soluble and is easily excreted in urine. It is stored in large quantities in the retina, adrenal and pituitary glands, kidney, pancreas, spleen and liver. It is also present in tissues such as the testes, ovaries, lungs, platelets, leukocytes, erythrocytes and plasma.

Food Sources

Food sources richest in vitamin C include black currants, citrus fruits, other fruit and raw vegetables. Prolonged heating or aging can significantly reduce …

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B12 is required for folate metabolism, cell division and replication. It is also involved in the metabolism of certain amino and fatty acids.

Physiology

A glycoprotein called “intrinsic factor” must be present in the gastrointestinal tract in order for B12 absorption to take place. Instrinsic factor is secreted from cells lining the stomach. It then forms a complex with B12, carrying it to the small intestine where B12 is absorbed. In the small intestine, B12 can also be synthesized by bacteria. In the blood, B12 is present as methylcobalamin II, where it circulates bound to a protein called transcobalamin II. In the body, B12 is stored in the liver as adenosylcobalamin and circulates through the biliary system. Very small amounts are lost in the feces or urine and therefore deficiency takes a long time to develop.

Food Sources

Cobalamin is found almost exclusively in foods of animal origin. These include …

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COMPARISON OF DOSING FREQUENCY AND SAFETY OF MICRONUTRIENT SPRINKLES ON IRON STATUS IN PRESCHOOL CHILDREN IN NORTHERN CHINA. M Chan, S Zlotkin, SA Yin, W Sharieff, C Schauer: The Hospital for Sick Children, Research Institute, Canada; Departments of Paediatrics, Nutritional Sciences, and Centre for International Health, University of Toronto; Institute of Nutrition and Food Hygiene, Chinese Academy of Preventive Medicine, Beijing, China.

Adherence to iron supplementation has been disappointing in unsupervised settings. Evidence suggests that in supervised settings, such as in schools, intermittent dosing may be as efficacious as daily dosing. Sprinkles containing iron and other micronutrients can easily be added to school meals. Aims: (1) To determine whether Sprinkles given once/week would yield similar increases in hemoglobin (Hb) and ferritin (Fn) as Sprinkles given 5-days/week; (2) To explore whether a 30mg Fe dose would be safe to administer to preschool children. Methods: A 3-arm RCT using cluster randomization was …

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PROCESS EVALUATION OF THE DISTRIBUTION OF MICRONUTRIENT SPRINKLES IN OVER 10,000 MONGOLIAN INFANTS USING A NON-GOVERNMENTAL ORGANIZATION (NGO) PROGRAM MODEL.

C. Schauer, S. Zlotkin1, M. Nyamsuren, C.R. Hubbell, M. Chan, O. Purevsuren, C. MacDonald, N. Klaas: The Hospital for Sick Children, Research Institute, Canada; Departments of Paediatrics, Nutritional Sciences, and Centre for International Health, University of Toronto; World Vision Mongolia; World Vision Canada.

Background Economic instability and severe winters have resulted in food shortages across Mongolia. As a result, micronutrient deficiencies (iron and vitamin D) are common among children. ‘Sprinkles’ containing iron and other micronutrients (including Vitamin D) were developed as an inexpensive micronutrient supplement. Objectives 1. To determine the prevalence of anemia and rickets in children <5 years. 2. To develop an NGO distribution model to deliver Sprinkles to infants 6-36 mo. and achieve 80% coverage. 3. To monitor and evaluate process and biological outcome indicators. Methods A cross-sectional …

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How to Use Sprinkles

->Tear open the top of the package

-> Poor contents of the package into the complementary food after it has been cooked and is no longer steaming hot

-> Mix Sprinkles with an amount of food that the child can consume at a time

–>Mix the food well after you have added the package of Sprinkles

->Give one full package each day at any mealtime

->Do not share the food with Sprinkles with others because the child will not get enough…

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Sprinkles are sachets (like small packets of sugar) containing a blend of micronutrients in powder form, which are
easily sprinkled onto foods prepared in the home. Any homemade food can be instantly fortified by adding Sprinkles. Coating of
the iron prevents changes to the taste, colour or texture of the food to which Sprinkles are added. Sprinkles were developed by the Sprinkles Global Health Initiative to prevent and treat micronutrient deficiencies among young children and other vulnerable groups at risk.…

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