Stakeholder's Perceptions of Mexico's Federal Corn Flour Fortification Program: A Qualitative Study.

BACKGROUND: In Mexico, the fortification of corn and wheat flours with iron, zinc, and folic acid and the restoration of B-vitamins is a mandatory program. However, the monitoring and evaluation (M&E) of this fortification process is not well understood. Thus, the purpose of the study was to understand the M&E of the food fortification program in Mexico, with an emphasis on technology research and development. METHODS: Open-ended exploratory interviews were conducted with food technology representatives (n = 9), food science academic faculty (n = 1), president of a private tortilla-making federation (n = 1), and representatives of the federal monitoring agency (n = 2). Interviews were transcribed and themes were identified using the content analysis methodology. Inter-rater reliability was assessed by calculating an intraclass correlation coefficient (ICC) between the raters (n = 3). RESULTS: A total of 49 codes were identified that resulted in three overarching themes, manufacturing/processing, monitoring logistics, and nutrition. Overall, there is a need for more robust internal and external M&E with Mexico's fortification program to improve the manufacturing/processing of fortifying the tortillas, the monitoring of this fortification program, and the impact the fortified tortillas have on the nutritional status of the Mexican population. The overall ICC was 0.87. CONCLUSIONS: The present study can be used to gain insight into Mexico's fortification program and to inform food fortification policymakers of best practices.

Iron Fortification of Spiced Vinegar in the Philippines.

Despite existent fortification initiatives in the Philippines, approximately 50% of the population still suffers from iron deficiency anemia (IDA), mainly in rural areas. Fortification of staple foods has been proved successful in China and Vietnam. Coconut spiced vinegar (SV) is an inexpensive, widely available, and culturally acceptable condiment in Filipino households; however, no technical evidence exists on its potential as fortification vehicle. This study aimed to physicochemically characterize and evaluate the consumer acceptability of SV fortified with ferrous sulfate (FS), ferrous fumarate (FF), or sodium iron ethylenediaminetetraacetate (NaFeEDTA) at 0.2 mg Fe/mL. Iron fortificants were added directly to SV, vortexed, and stored for analysis. A nonfortified SV served as a control. Physicochemical analyses (pH, titratable acidity, color, turbidity, and iron recovery) were conducted from 0 to 6 months postfortification. Consumer acceptability (9-point hedonic scale: color, appearance, aroma, sourness, and overall acceptability) was conducted using 1-month fortified vinegar in 96 students and 27 women. Iron recovery of fortified samples was high and similar (>97%) after 3 days of fortification and remained >87% at 6 months postfortification. All samples had minimum acidity of 5.31% and pH between 3.12 and 3.3. Color difference against the control followed the next order: SV-NaFeEDTA < SV-FS = SV-FF. Among students, acceptability of SV-FS and SV-FF were lower than the control and SV-NaFeEDTA for all attributes (P < 0.05) except aroma. In women, overall acceptability and aroma were not different among samples (P > 0.05). Overall, SV-NaFeEDTA had similar acceptability to the control, and was the most accepted fortified vinegar. SV-NaFeEDTA shows potential (in terms of physicochemical stability and consumer acceptability) to be used as an iron-delivery vehicle to address IDA. PRACTICAL APPLICATION: The present study addresses the technical and organoleptic challenges of fortifying Filipino spiced vinegar with three iron sources. About 50% of the Filipino population (especially women and children) still suffers from iron deficiency, thus, more effective ways to deliver iron are needed. If successful, our study could pose as the base milestone for implementing mass iron fortification of spiced vinegar, given its frequent consumption and reach of all socioeconomic pockets of the Filipino population. Our aim is to improve the overall nutritional health of at-risk populations, and our study is one step closer to achieve this goal.