(Sponsor) by Mr Bruno Kistner, Director of the Nutrition improvement

Welcome to the
Nutrition Improvement Program
1

The Global Pyramid
Wealthy
0.8 billion
Malnourished:
2 billion
Emerging
Middle Class
1.5 billion
Low Income Markets
Base of Pyramid
4 billion
Hungry/starving:
100 million
(People who would
not survive without
aid = WFP target
group)
2

3
Invisible

Malnutrition
Malnutrition caused by
deficiencies of vitamins and
minerals is also known as
“hidden hunger”, because most
of the people affected by it do
not show the physical
symptoms usually associated
with hunger and malnutrition.
4

What micronutrient deficiency causes in 12 months
• 1 million children to die before the age of five
• 50,000 women to die during or soon after childbirth
• 19 million infants to be born with impaired mental capacity
• 100,000 infants to be born with preventable physical defects
• Global cost of malnutrition $19 billion in lost adult work
performance and related health expenditure
Source: GAIN
5

Food fortification to fight malnutrition
Food Fortification is the deliberate addition of
essential micronutrients into a food.
Probably no other technology available today
offers as large an opportunity to improve lives
and accelerate development at such low cost and
in such a short time.
Source: Enriching Lives, The World Bank
6

Why staple food fortification
• affordable
• easy
• effective
• no change of staple food in color or
taste.
• no change in dietary habits
7

Effective fortification is affordable,
ineffective fortification is expensive.
8

1. No compromise on effectiveness
We have a very firm
position that a food
fortification program
must have a multinutrient
approach, because
malnourished people do
not lack single
micronutrients.
9

2. No compromise on quality
Low quality micronutrients
are not only deceiving the
customers.
They deceive the most
vulnerable,
the malnourished.
10

3. Monitoring
Successful food fortification programs require regular
monitoring by the authorities to ensure effectiveness.
11

We are partners in the emerging global ‘hidden
hunger domain’
AIM, Amsterdam Initiative against Malnutrition
Project Laserbeam
12

13
Africa

Africa: Some projects we support with technical and
scientific know-how
• Ghana: Flour fortification
• Zambia: Maize meal fortification, sugar fortification
• Sudan, Malawi, Zambia, Kenya, South Africa and Nigeria: Sugar
fortification
• Nigeria and Kenya: flour, edible oil and pasta fortification
• Namibia, Mozambique and Kenya: Technical and scientific
support of government to develop mandatory fortification
programs
14

Wheat flour fortification worldwide
Wheat Flour Fortification
Initiatives (3)
Mandatory (29)
Not enforced (2)
Targeted (2)
Voluntary (19)
15

USA: Cereal fortification with niacin eliminated
pellagra
3500
3000
Number of deaths
2500
2000
1500
1000
500
0
38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53
Year
D. Miller, 1955
16

Venezuela: Fortification of wheat and corn flour
reduces iron deficiency and anemia
in children of lower socio-economic groups
in children of lower socio-economic groups
40
37
35
30
Cases in %
25
20
15
10
15
19
10
1992
1994
5
0
Iron deficiency
Anemia
M. layrisse et al. Am J Clin
Nutr. 1996; 64:903-7.
17

Costa Rica
In Costa Rica, it is mandatory to fortify sugar with vitamin A;
wheat and maize flours with vitamins B1, B2, niacin, iron and
folic acid; rice with vitamins E, B1, B12, folic acid, niacin, zinc
and selenium; and milk with vitamin A, folic acid and iron.
The Ministry of Health of Costa Rica
recently published the results of a
survey on the effects of its measures
to improve the nutritional status of
the population from 1996 to 2008.
The rate of anemia among
preschool children has dropped
some 70 percent.
18

Costa Rica, massive reduction of vitamin A deficiency
in preschool children
The survey showed that sugar and
milk fortification has clearly helped
reduce vitamin A deficiency in
preschool children: 67.1 percent
have normal levels of vitamin A, 30.1
percent are marginally deficient and
only 2.8 percent demonstrate a more
severe deficiency. The effect of
fortification programs is reflected in a
more than threefold reduction of
vitamin A deficiency from 1996 to
2008/2009.
10
9
8
7
6
5
4
3
2
1
0
8.7%
2.8%
1996 2008/9
19

South Africa
Since 2003 the fortification of wheat flour
and maize meal with essential
micronutrients is mandatory.
DSM‘s contribution was the management
and continuous, intensive collaboration
and cooperation with all the stakeholders
over a 5-6 year period.
20