CHOOSING A SUITABLE VEHICLE FOR FOOD FORTIFICATION: WHAT ARE THE CRITERIA

Micronutrients are required in trace amounts for a sustainable healthy life. Yet, micronutrient deficiency (MND) is quite prevalent globally with women at child-bearing ages and children under 5 yrs at the highest risk. Among the micronutrients, deficiencies of iron, iodine, folate, zinc and vitamin A are more prevalent than the others (1). Countless reports from almost all countries of the world, including Iran, indicate a remarkably high prevalence of vitamin D deficiency (VDD) in almost all population subgroups (2-4). There are several community-based strategies to combat MND including nutrition education and dietary diversification, economic growth and poverty eradication, direct supplementation of the vulnerable subpopulations and fortification among others (5). Though integrated approach is the preferred strategy and is recommended (5), food fortification has the advantage over other strategies that is cost-effective, sustainable and faster to implement and take a response (6). To implement a mass fortification program, sufficient and convincible evidence-based data on the prevalence of MND in the target population and the necessity of nutritional intervention with the focus on food fortification must be gathered and translated in an understandable language to the policy-makers (7, 8). Data on dietary supplement use in the target population could especially be beneficial (9). Notwithstanding, the success of a fortification program depends on many factors one of which is undoubtedly selection of a suitable food vehicle. This involves gathering reliable data on food consumption pattern to have a good estimation of the percent of the population who will be placed under the supportive fortification program umbrella (10). Indeed, the selection of a suitable vehicle is a process based on several steps (11):• The fortified food must be easily accessible as well as affordable for the target population• The fortified food must be consumed on a daily basis in predictable amounts• The process of fortification must be cost-effective and economically feasible• The added micronutrient should not change organoleptic properties of the fortified food• The stability (during processing and storage) and bioavailability of the added micronutrient in a fortified food must be determined using laboratory as well as clinical efficacy studies• The amount of the added micronutrient should be sufficient to remarkably reduce the prevalence of (and preferably eradicate) micronutrient deficiency in the target population while there is no risk of toxicity• A well designed and effective quality control platform is highly needed In this presentation, the problem of vitamin D deficiency in Iran and the steps taken thus far to select a suitable vehicle as well as the related challenges will be discussed as an example. Finally, concluding remarks for the future studies will be proposed