Grape pomace and pecan shell fortified bread: The effect of dietary fiber-phenolic compounds interaction on the in vitro accessibility of phenolic compounds and in vitro glycemic index.

Grape pomace (GP) and pecan shell (PS) are two by-products rich in phenolic compounds (PC), and dietary fiber (DF) that may be considered for the development of functional baked foods. In this study, four formulations with different GP:PS ratios (F1(8%:5%), F2(5%:5%), F3(5%:2%), F4(0%:5%), and control bread (CB)) were elaborated and characterized (physiochemical and phytochemical content). Also, their inner structure (SEM), changes in their FTIR functional group's vibrations, and the bioaccessibility of PC and sugars, including an in vitro glycemic index, were analyzed. Results showed that all GP:PS formulations had higher mineral, protein, DF (total, soluble, and insoluble), and PC content than CB. Additionally, PC and non-starch polysaccharides affected gluten and starch absorbance and pores distribution. In vitro digestion model showed a reduction in the glycemic index for all formulations, compared to CB. These findings highlight the possible health benefits of by-products and their interactions in baked goods.

Peptidomic profile of human milk as influenced by fortification with different protein sources: An in vitro dynamic digestion simulation.

Fortification of human milk (HM) is often necessary to meet the nutritional requirements of preterm infants. The present experiment aimed to establish whether the supplementation of HM with either an experimental donkey milk-derived fortifier containing whole donkey milk proteins, or with a commercial bovine milk-derived fortifier containing hydrolyzed bovine whey proteins, affects peptide release differently during digestion. The experiment was conducted using an in vitro dynamic system designed to simulate the preterm infant's digestion followed by digesta analysis by means of LC-MS-MS. The different fortifiers did not appear to influence the cumulative intensity of HM peptides. Fortification had a differential impact on the release of either donkey or bovine bioactive peptides. Donkey milk peptides showed antioxidant/ACE inhibitory activities, while bovine peptides showed opioid, dipeptil- and propyl endo- peptidase inhibitory and antimicrobial activity. A slight delay in peptide release from human lactoferrin and α-lactalbumin was observed when HM was supplemented with donkey milk-derived fortifier.

Folate fortification for spina bifida: preventing neural tube defects.

Neural tube defects (NTDs), such as spina bifida and anencephaly, are severe congenital anomalies affecting the development of the brain and spine. These conditions are often linked to folic acid deficiency during early pregnancy, a modifiable risk factor. While high-income countries have implemented mandatory folic acid fortification in staple foods, resulting in significant reductions in NTD prevalence, low- and middle-income countries (LMICs) continue to experience disproportionately high rates of these birth defects. Folic acid supplementation and fortification are proven interventions for preventing NTDs, but many LMICs face political, financial, and logistical barriers to implementing these programs. This paper highlights the importance of mandatory folic acid fortification as a cost-effective public health intervention and advocates for its expansion in LMICs. It reviews the successes of fortification programs in high-income countries, explores alternative food vehicles like rice for regions with different dietary staples, and discusses the potential of multi-nutrient fortification strategies. Additionally, this paper emphasizes the need for global collaboration, enhanced monitoring and evaluation, and public health education campaigns to ensure that women of reproductive age, especially in LMICs, receive adequate folic acid. By addressing these challenges, the global health community can significantly reduce the incidence of NTDs, improve maternal and child health, and promote health equity worldwide. The time to act is now, as the benefits of folic acid fortification far outweigh the costs of inaction.

Strategies and bibliometric analysis of legumes biofortification to address malnutrition.

MAIN CONCLUSION: Biofortification of legumes using diverse techniques such as plant breeding, agronomic practices, genetic modification, and nano-technological approaches presents a sustainable strategy to address micronutrient deficiencies of underprivileged populations. The widespread issue of chronic malnutrition, commonly referred to as "hidden hunger," arises from the consumption of poor-quality food, leading to various health and cognitive impairments. Biofortified food crops have been a sustainable solution to address micronutrient deficiencies. This review highlights multiple biofortification techniques, such as plant breeding, agronomic practices, genetic modification, and nano-technological approaches, aimed at enhancing the nutrient content of commonly consumed crops. Emphasizing the biofortification of legumes, this review employs bibliometric analysis to examine research trends from 2000 to 2023. It identifies key authors, influential journals, contributing countries, publication trends, and prevalent keywords in this field. The review highlights the progress in developing biofortified crops and their potential to improve global nutrition and help underprivileged populations.

Co-fermentation improves the functional properties and nutritional quality of infant complementary food products.

Food-to-food fortification and fermentation are effective strategies to enhance the product functionality and nutrient density of infant complementary foods. However, their effectiveness hinges on a deep understanding of ingredient combinations. Our research focused on the physicochemical and techno-functional aspects of sorghum-baobab blends, comparing two processes: 'co-ferment-cook' and 'ferment-cook-fortify'. The results show that both techniques improved the water absorption capacity by 17-20% and the water solubility index increased by over 100% while maintaining a comparable nutritional composition and energy density. The calculated energy density (2048.8-2345 kJ day-1) was sufficient for both blends for infants 6-11 months old with an average breast milk intake. Viscosity, another crucial factor for complementary feeding, improved significantly (P < 0.05) after co-ferment-cook compared to ferment-cook-fortify reaching a value suitable for children older than 18 months. Starch digestibility increased with co-ferment-cook, while protein digestion increased with fortified non-fermented foods. In conclusion, our findings emphasize that combining fermentation and fortification processing steps is optimal for balancing the nutritional and techno-functional properties of sorghum porridges for infant complementary foods. Processing parameters must be optimized to reach the viscosity suitable for complementary feeding at the assigned soluble solid contents for the age group 6-24 months.

Bouillon fortification as a strategy to address inequities in micronutrient adequacy of diets in Nigeria.

Bouillon is a widely consumed condiment in many West African countries, including Nigeria. Although Nigeria has mandatory fortification standards for multiple food vehicles, bouillon fortification could help address remaining gaps in micronutrient intake. Using household food consumption data, we used the nutrient density method to model the additional contribution of bouillon fortified with vitamin A (40-250 µg/g bouillon), folic acid (20-120 µg/g), vitamin B12 (0.2-2 µg/g), iron (0.6-5 mg/g), and zinc (0.6-5 mg/g) for meeting micronutrient requirements of women of reproductive age (WRA) and children aged 6-59 months. Accounting for existing fortification programs, our results showed that, except for iron, the prevalence of inadequacy was substantially higher among WRA and children living in poorer and rural households. Given the ubiquity of bouillon consumption, bouillon fortification has the potential to virtually eliminate vitamin A, folate, and vitamin B12 inadequacy, reduce the prevalence of zinc inadequacy by over 20 percentage points, and improve equity in the micronutrient adequacy of diets across socioeconomic strata and urban and rural residence. Our results also suggested that designing a bouillon fortification program would require careful planning to balance reductions in inadequacy with the risk of high intakes. This evidence provides important input into decisions around bouillon fortification in Nigeria.

School feeding for improving child nutrition in conflict-affected settings: Feasibility and cost efficiency of alternative models in Yemen.

School feeding programs can support children's nutrition, health, and education in emergencies. This study assessed the feasibility, trade-offs, cost efficiency, and perceived benefits of school feeding modalities operating in urban Yemen. It draws on primary data from a qualitative evaluation with 21 school feeding implementers and 88 beneficiaries conducted in Feb-Mar 2023, and secondary data from a desk review of published and program literature on school feeding operations. Results showed that school feeding provided students with on average 18%, 40%, and 66% of daily energy, protein, and micronutrient requirements, respectively. Models including fortified snacks were 3-11 times more cost-efficient in terms of nutrient delivery. The most prominent strength of the models examined were the perceived benefits on child, family, and financial outcomes. Among the main weaknesses was the poor nutritional quality of the meal, which in turn emerged as a primary opportunity to improve school feeding through hybrid models providing a combination of fortified snacks and healthy meals. Other weaknesses such as poor water, sanitation, and hygiene infrastructure, and desired improvements such as the school kitchen and canteen, require considerable investments. Hybrid models are cost-efficient, acceptable, and feasible in Yemen and can serve the diet and nutrition needs of school-aged children.

Adjusted versus Targeted Fortification in Extremely Low Birth Weight Preterm Infants: Fortin Study-A Randomized Clinical Trial.

Fortified human milk is the first choice for preterm infants. Although individualized fortification is recommended, the optimal method for this population remains uncertain. We conducted a comparative study assessing the growth effects of adjusted (AF) and targeted fortification (TF) in extremely low birth weight (ELBW) infants. This single-center, randomized, controlled clinical trial was conducted at a tertiary neonatal unit in Spain. Eligible participants were premature infants with a birthweight of <1000 g exclusively fed with human milk. A total of 38 patients were enrolled, 15 of them randomized to AF group and 23 to TF group. AF was based on blood urea nitrogen (BUN) concentration and TF on human milk analysis. The primary outcome was weight gain velocity (g/kg/day). No significant differences were found in weight gain velocity at 28 days, at 36 weeks of postmenstrual age, at discharge, nor during the intervention. Protein intake was significantly higher in the AF group (5.02 g/kg/day vs. 4.48 g/kg/day, p = 0.001). No differences were found in the lipid, carbohydrate, and energy intake; in the weight z score change between the different time points; nor in the length and head circumference growth. Both AF and TF are comparable methods of fortification and provide the appropriate growth rate in ELBW infants.

Effects of Replacing Cow's Milk with Plant-Based Beverages on Potential Nutrient Intake in Sustainable Healthy Dietary Patterns: A Case Study.

More consumers are replacing cow's milk (CM) with plant-based drinks (PBD), but data indicating the nutritional impact are limited. This theoretical study aims to assess the effect of substituting CM with PBD sold in Italy on nutrient intake within two dietary patterns: one aligned with the EAT-Lancet Commission reference diet adapted to Italian food habits (EAT-IT) and another one in line with the Italian Dietary Guidelines (IDG). Nutrition information from 368 PBD were collected and categorized according to their descriptive name and their fortification or not with calcium (Ca- and nCa-fortified). The substitution of CM with each PBD category in both dietary patterns was conducted, and an analysis of nutrient content and adequacy was performed. Substituting CM with all PBD resulted in reduced protein intake, except for nCa-fortified soy drinks, decreased saturated fat and vitamins B2 and B12, and increased fiber intake. Replacing CM with nCa-fortified PBD within both diets decreased Ca intake. Following the substitution of CM with Ca-fortified PBD, variations in vitamin D intake depended on the PBD category. The main risk of nutritional inadequacy was observed in Ca and vitamin D levels, which may even be amplified considering the different bioavailability based on the source of nutrients. This study highlighted the important role of CM in meeting calcium requirements and the potential unintended consequences of substituting CM with PBD without considering their nutritional differences.

Future development trend of food-borne delivery systems of functional substances for precision nutrition.

BACKGROUND: Precision nutrition, a personalized nutritional supplementation model, is widely acknowledged for its significant impact on human health. Nevertheless, challenges persist in the advancement of precision nutrition, including consumer dietary behaviors, nutrient absorption, and utilization. Thus, the exploration of effective strategies to enhance the efficacy of precision nutrition and maximize its potential benefits in dietary interventions and disease management is imperative. SCOPE AND APPROACH: The primary objective of this comprehensive review is to synthesize and assess the latest technical approaches and future prospects for achieving precision nutrition, while also addressing the existing constraints in this field. The role of delivery systems is pivotal in the realization of precision nutrition goals. This paper outlines the potential applications of delivery systems in precision nutrition and highlights key considerations for their design and implementation. Additionally, the review offers insights into the evolving trends in delivery systems for precision nutrition, particularly in the realms of nutritional fortification, specialized diets, and disease prevention. KEY FINDINGS AND CONCLUSIONS: By leveraging computer data collection, omics, and metabolomics analyses, this review scrutinizes the lifestyles, dietary patterns, and health statuses of diverse organisms. Subsequently, tailored nutrient supplementation programs are devised based on individual organism profiles. The utilization of delivery systems enhances the bioavailability of functional compounds and enables targeted delivery to specific body regions, thereby catering to the distinct nutritional requirements and disease prevention needs of consumers, with a particular emphasis on special populations and dietary preferences.

Different polysaccharide-enhanced probiotic and polyphenol dual-functional factor co-encapsulated microcapsules demonstrate acute colitis alleviation efficacy and food fortification.

Probiotics and polyphenols have multiple bioactivities, and developing co-encapsulated microcapsules (CM) is a novel strategy to enhance their nutritional diversity. However, the development of CMs is challenged by complicated processing, single types, and unclear in vivo effects and applications. In this study, the co-microencapsulations of polyphenol and probiotic were constructed using pectin, alginate (WGCA@LK), and Fu brick tea polysaccharides (WGCF@LK), respectively, with chitosan-whey isolate proteins by layer-by-layer coacervation reaction, and their protective effects, in vivo effectiveness, and application potential were evaluated. WGCA@LK improved the encapsulation rate of polyphenols (42.41 %), and remained high viability of probiotics after passing through gastric acidic environment (8.79 ± 0.04 log CFU/g) and storage for 4 weeks (4.59 ± 0.06 log CFU/g). WGCF@LK exhibited the highest total antioxidant activity (19.40 ± 0.25 µmol/mL) and its prebiotic activity removed the restriction on probiotic growth. WGCA@LK showed strong in vitro colonic adhesion, but WGCF@LK promoted in vivo retention of probiotics at 48 h. WGCF@LK showed excellent anti-inflammatory effects and alleviated symptoms of acute colitis in mice. These findings provide unique insights into the fortification of probiotic-polyphenol CMs by different polysaccharides and the development of novel health foods with rich functional hierarchies and superior therapeutic effects.

Decreased formulation pH and protein preheating treatment enhance the interaction, storage stability, and bioaccessibility of caseinate-bound lutein/zeaxanthin.

Heat treatment and pH are crucial factors in the formulation and processing of food and beverages; thus, a thorough understanding of the impact of these factors on the interactions between bioactive constituents and proteins is essential to developing effective protein-based delivery systems. This study explores the influences of pH (ranged from 1.5 to 7.5) and preheating treatment on the characteristics of caseinates-lutein (LU)/zeaxanthin (ZX) complexes and evaluates the potential application of caseinates as protective carriers in xanthophyll-fortified beverages. The properties and interactions of caseinates and two xanthophylls were systematically investigated utilizing a range of spectroscopic techniques, including ultraviolet-visible (UV-Vis) spectroscopy, dynamic light scattering (DLS), fluorescence spectroscopy, and Fourier transform infrared (FTIR) spectroscopy. Caseinates were bound to LU/ZX with a binding constant of the order 105 M-1. Furthermore, ZX exhibited a higher affinity for caseinates than LU. In particular, the decreased pH level of complex formulation and the preheating of caseinates at 85 °C strengthened the binding affinity between LU/ZX and caseinates. The caseinate-LU/ZX complexes effectively improved the chemical stability of LU/ZX and achieved a bioaccessibility rate of over 70 %. This study provides a guide for developing commercially available xanthophyll-fortified beverages and further expanding the application of caseinates as encapsulation carriers for extremely hydrophobic nutrients in the food industry.

Effect of Arthrospira platensis (Spirulina) Fortification on Physicochemical, Nutritional, Bioactive, Textural, and Sensory Properties of Vegan Basil Pesto.

The high protein content of several microalgae species makes them an excellent addition to various food products, increasing their nutritional value. In this study, vegan basil pesto was designed and enriched with 1% and 2% Arthrospira platensis (spirulina). The pesto obtained was characterized by increased protein content (up to 40% more) and had a rich mineral composition, including up to three times more iron and 25% more calcium, among others. The increase of spirulina addition in the pesto also increased the content of polyphenols (up to 50% more) and flavonoids (up to 39% more). The fortified products had higher antioxidant activity against ABTS (up to 484.56 ± 2.16 µM Trolox/g) and DPPH (up to 392.41 ± 13.58 µM Trolox/g). The addition of spirulina will affect the hardness of the sauce, while in the other texture parameters (adhesiveness, springiness, and cohesion), there were no significant differences between the control and spirulina-fortified pesto. Although the pesto with spirulina was significantly darker in color (ΔE 8.83 and 12.05), consumers still rated it highly. All quality parameters of pesto with a 1% spirulina addition were rated the highest, contributing to the highest overall rating of the product (4.56). An increase in spirulina addition to 2% resulted in a decrease in the overall pesto rating (4.01), but still remains a good result compared to the control (4.22).

An Electrolytic Elemental Iron Powder Effectively Regenerates Hemoglobin in Anemic Rats and Is Relatively Well Absorbed When Compared to Ferrous Sulfate Monohydrate.

Elemental iron powders are used as food fortificants to reduce the incidence of iron deficiency anemia. However, many commercially available iron powders are relatively untested in vivo. The purpose of this study was to determine the hemoglobin regeneration efficiency (HRE) and relative iron bioavailability (RBV) of an electrolytic elemental iron powder (EIP), by treating anemic rats with 14 d iron repletion diets fortified with four different concentrations (12, 24, 36, or 48 mg iron/kg diet) of EIP and bakery-grade ferrous sulfate monohydrate (FS; FeSO4•H2O), or no added iron (control); n = 9-12/group. The HRE of FS was significantly higher (p ≤ 0.05) than EIP at each concentration of dietary iron tested. For EIP, the HREs (ratios) of diets containing 12, 24, 36, and 48 mg iron/kg were 0.356, 0.205, 0.197, and 0.163, respectively. For both EIP and FS, HRE was inversely associated with increasing dietary iron. The RBVs (%) of iron from EIP in diets at 12, 24, 36, and 48 mg iron/kg as compared to FS were 64.5, 59.1, 50.6, and 54.3%, respectively. Overall, findings show that at the concentrations of iron tested, EIP has RBVs greater than 50% and is an effective fortification agent to replenish hemoglobin and correct iron deficiency anemia.

Neurosurgical Advocacy in the Prevention of Neural Tube Defects: Impacting Global Fortification Policies Through Leadership, Collaboration, and Stakeholder Engagement.

The G4 Alliance and its member organizations formed a delegation that participated in the 76th World Health Assembly (WHA) in 2023, which unanimously adopted the resolution to address micronutrient deficiencies through safe, effective food fortification to prevent congenital disorders such as spina bifida and anencephaly, the first neurosurgery-led resolution since the founding of the World Health Organization. The WHA included other resolutions and side events by the G4 Alliance and other organizations relevant to neurosurgery. An opportunity exists for neurosurgeons to harness the momentum from this resolution to promote initiatives to prevent neurosurgical disease or expand access to neurosurgical care.

Bibliometric Analysis and a Call for Increased Rigor in Citing Scientific Literature: Folic Acid Fortification and Neural Tube Defect Risk as an Example.

The health benefits of vitamin B9 (folate) are well documented, particularly in regard to neural tube defects during pregnancy; however, much remains to be learned regarding the health effects and risks of consuming folic acid supplements and foods fortified with folic acid. In 2020, our laboratory conducted a population-based analysis of the Food Fortification Initiative (FFI) dataset to determine the strength of the evidence regarding the prevalence of neural tube defects (NTD) at the national level in response to mandatory fortification of cereal grains with folic acid. We found a very weak correlation between the prevalence of NTDs and the level of folic acid fortification irrespective of the cereal grain fortified (wheat, maize, or rice). We found a strong linear relationship between reduced NTDs and higher socioeconomic status (SES). Our paper incited a debate on the proper statistics to employ for population-level data. Subsequently, there has been a large number of erroneous citations to our original work. The objective here was to conduct a bibliometric analysis to quantitate the accuracy of citations to Murphy and Westmark's publication entitled, "Folic Acid Fortification and Neural Tube Defect Risk: Analysis of the Food Fortification Initiative Dataset". We found a 70% inaccuracy rate. These findings highlight the dire need for increased rigor in citing scientific literature, particularly in regard to biomedical research that directly impacts public health policy.

Salt Reduction and Iodine Fortification Policies Are Compatible: Perspectives for Public Health Advocacy.

Cardiovascular diseases account for almost 18 million deaths annually, the most of all non-communicable diseases. The reduction of dietary salt consumption is a modifiable risk factor. The WHO recommends a daily sodium intake of <2000 mg but average consumption exceeds this in many countries globally. Strategies proposed to aid effective salt reduction policy include product reformulation, front of pack labelling, behavioural change campaigns and establishing a low-sodium-supportive environment. Yet, salt for household and processed food use is, in countries wholly or partially adopting a universal salt iodisation policy, the principal vehicle for population-wide iodine fortification. With salt reduction policies in place, there is concern that iodine deficiency disorders may re-emerge. Recognising the urgency to tackle the rising prevalence of NCDs yet not risk the re-emergence and detrimental effect of inadequate iodine intakes, this review lays out the feasibility of integrating both salt reduction and salt iodine fortification strategies. Reducing the burden of health risks associated with an excessive sodium intake or inadequate iodine through population-tailored, cost-effective strategies involving salt is both feasible and achievable, and represents an opportunity to improve outcomes in public health.

Orally self-disintegrating milk protein puffs enriched with food by-products for the elderly.

Supercritical fluid extrusion (SCFX) processing was used to develop milk protein-based orally self-disintegrating puffs enriched with fruit and dairy by-products, designed specifically to cater to the needs of elderly population having swallowing issues and lactose intolerance. Lactose hydrolyzed skim milk powder (LHSMP) was also added in the formulation to mitigate lactose intolerance while LHSMP was also exploited as a precursor for the polymerization of galactose and lactose to generate galacto-oligosaccharides (GOS) in the puffs. This study for the first time took advantage of the unique features of SCFX processing for in-process GOS formation and enrichment of puffs, achieving GOS contents up to 0.48 g/30 g serving of puffs, thereby making them nutritionally superior and functionally attractive snacks. The estimated nutritional profile revealed that SCFX puffs contained higher levels of protein (16.3 g/30 g), fiber (1.6 g/30 g), phenolics and other valuable nutrients compared to the starch-rich, disintegrating Market Baby puffs.

Yogurt fortified with various protein hydrolysates: Texture and functional properties.

This work evaluated the impact of incorporating 1% of commercial protein hydrolysates [rice protein hydrolysate (RPH), pea protein hydrolysate (PPH), and casein hydrolysate (CH)] on the functional, microstructure, and texture properties of set yogurt. Yogurt prepared with RPH exhibited the highest viability number of Streptococcus thermophilus. The addition of three hydrolysate types to yogurt revealed significant increases in the antioxidant and ACE-inhibitory activities, where the highest values were noted for the yogurt prepared with RPH. RPH exhibited no differences in texture properties (firmness, consistency, and cohesiveness) to control yogurt. These results were confirmed by scanning electron microscope examination. RPH and control yogurts showed compacted and dense structures accompanied by small pores, whereas CH and PPH yogurt structures were characterized by coarse networks with large voids. Furthermore, there was no significant impact of adding protein hydrolysates on the overall acceptability of yogurt as indicated by a sensory panel.

Comparing Nutrient Profiles of Meat and Fish with Plant-Based Alternatives: Analysis of Nutrients, Ingredients, and Fortification Patterns.

Nutrient quality of plant-based meat and fish alternative (MFA) products has been reported as variable. The present objective was to compare the nutrient density of raw meat and fish with MFA products and to examine MFA ingredients and fortification patterns. Nutrient composition data for raw beef, pork, and chicken (n = 450) came from the USDA Standard Reference Legacy Reselase (SR28) nutrient composition database (n = 450). Data for plant-based meat alternatives (n = 118) came from the USDA Branded Food Products Database (BFPDB). Data for fish and seafood (n = 68) and alternatives (n = 12) came from the Danish Frida Database and Mintel (n = 503). Analyses compared macronutrient content and selected micronutrients per 100 g and percentage of US Daily Values. Nutrient density scores were based on the NRF5.3 algorithm. NRF5.3 scores were significantly lower for MFA products as compared to meat or fish. Saturated fat content was lower, but the mean MFA sodium content was 660 mg/100 g compared to 60 mg/100 g for beef. Mean protein content (17 g) was lower than for beef and pork (20 g). A search of ingredient lists found that fortification with most nutrients associated with animal source proteins (such as B vitamins, vitamin D, iodine, zinc, and omega-3 EPA and DHA) was minimal. Plant-based MFA products would benefit from nutrient standards and fortification guidelines to ensure that these products are not nutritionally inferior to the originals.