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This section is designed as an easy means to download SUSTAIN reports
and other documents. All documents are in the Adobe .PDF (Portable Document
Format) and require the Adobe Acrobat Reader for viewing and printing.
Most new computers come with Acrobat pre-installed, but you can download
a free copy from Adobe's website (www.adobe.com).
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Research Protocol Summary: SUSTAIN Evaluation
of the Bioavailability of Elemental Iron Powders used for Food Fortification
(Initiated in 2001)
This document summarizes research methodologies that SUSTAIN is using
to evaluate elemental iron powders used for food fortification. Iron deficiency
anemia (IDA) is the most prevalent nutritional disorder in the world and
has far-reaching consequences. IDA is so widespread, affecting literally
millions of people, that public health resources alone cannot address
the problem. Programs designed to fortify staple foods with iron are being
introduced in many developing countries with elemental iron powders used
as the most common iron fortificants; however little is known about the
extent to which iron powders are absorbed by the body. To address these
concerns, SUSTAIN has launched a comprehensive evaluation of each of the
iron powder fortificants in use today. Initially, a series of screening
tests will be run to indicate the most promising powders for subsequent
evaluation in human trials in mildly iron deficient individuals. Results
from the screening studies are expected in 2002; results from the human
trials are expected the following year.
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Guidelines for Iron Fortification of
Cereal Food Staples (May 2001)
The following are recommended guidelines for the type and levels of iron
to add to cereal food staples. They have beebn written with the goal of
optimizing bioavailability, cost-effectiveness, and consumer acceptance
of the fortified product, and have been reviewed and endorsed by a panel
of leading experts in the field. It is important to note that these guidelines
should be considered interim and may change, as more information becomes
available on the bioavailability of elemental iron powders.
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Summary of Monterrey Workshop: Evaluating
the Usefulness of Elemental Iron Powders (September 2000)
Elemental iron powders are the most commonly used iron fortificants worldwide,
but confusion exists over the extent to which these fortificants are absorbed
by the body. Bioavailability studies on elemental iron powders over the
last 45 years have yielded hightly variable results, from 5% to 145% relative
bioavailability in compaison to the standard, ferrous sulfate. To help
improve our understading of elemental iron's value as a fortificant, SUSTAIN
convened a panel of world-renowned research scientists, physicians and
industry specialists to review and evaluate past research. The meeting
was held in Monterrey Mexico in September 2000 at the Monterrey Institute
of Tehcnology and Higher Education (ITESM). The following document summarizes
key findings and recommendations resulting from the Monterrey meeting.
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Micronutrient Compliance Review of Fortified
PL 480 Commodities (October, 2001)
This report by SUSTAIN for USAID reviews compliance by cereal processing
plants with the new micronutrient standards on fortified PL480 commodities
that resulted from the Micronutrient Assessment Project (MAP study). SUSTAIN
found that the industry had made great strides in implementing systems
up-grades to comply with the new specifications. But the report also notes
a number of areas that still need improvement, and suggests strengthening
USDA's Total Quality Systems Audit (TQSA) program. Specific recommendations
are made for systemizing assurances of product quality. For example, plant
sampling procedures and laboratory measures used to test for compliance
could be standardized, and fortificant suppliers regularly audited.
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Final Report of the Micronutrient Assessment
Project (1999)
The Micronutrient Assessment Project (MAP), a three-year scientific study
on three continents, was launched in 1996 to determine if adequate and
uniform levels of micronutrients were reaching developing country recipients
of U.S. P.L. 480 food aid commodities. The MAP investigated the stability
(from U.S. manufacturer to overseas consumer) and uniformity in the manufacturing
process of key micronutrients added to processed Title II food commodities.
It was found that the amounts of vitamins A and C actually delivered to
food aid recipients was well below expectations due to 1} serious shortcomings
in the fortification and uniformity of some P.L. 480 processed and blended
cereals at U.S. production facilities and 2} significant losses of vitamins
during the cooking of the foods by recipients. Recommendations were made
to strengthen minimum standards, improve monitoring and enforcement, and
enhance the uniformity and quality of micronutrient fortified commodities.
The study was conducted by SUSTAIN, with support from the U.S. Agency
for International Development.
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Storage, Sensory and Bioavailability Evaluation
of Iron Fortified Corn Masa Flour: SUSTAIN Final Report (August, 2000)
The recent development of industrially produced corn masa flour (CMF)
and its increasing popularity in Mexico and Central America has created
the opportunity to improve the nutritional status of millions of people
vulnerable to iron deficiency anemia (IDA) by using CMF as a fortification
vehicle. Overall success of Fe fortification programs depends on several
factors, including fortificant bioavailability and product acceptability
by consumers. In 1998 SUSTAIN commissioned a three-part study to help
identify a viable iron fortificant for use in fortifying corn masa flour,
one that does not adversely affect the product, and that is readily absorbed
by the body. This report presents the research findings. Ferrous fumarate,
though it is not optimal in all respects, emerges as the most promising
iron compound for CMF fortification based on the combined results of storage,
sensory and bioavailability tests.
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Fortification of Corn Masa Flour with Iron
and/or Other Nutrients: A Literature and Industry Experience Review
(December, 1997)
Tortillas are a major food staple in Central American countries, particularly
in rural populations. Corn masa flour (CMF), a timesaving alternative
to the labor-intensive process of making tortilla dough from raw ingredients,
provides a convenient and newly available vehicle for enrichment. This
document provides a thorough review of literature and industry experience
with CMF fortification, revealing that our current knowledge and technology
for this is very limited. Recommended are quality and bioavailability
studies of CMF tortillas and other CMF products fortified with selected
iron compounds.
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SUSTAIN Forum on Iron Fortification, Forum
Proceedings (June, 1998)
Held in Atlanta (1998) during the IFT Annual Meeting, SUSTAIN' Forum on
Iron Fortification presented the current state of our understanding of
iron fortification as a means to reduce IDA in developing countries. The
forum also served as an opportunity to discuss encouraging scientific
advancements in the field, risk factors, and relevant regulatory issues.
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Vitamin A Fortification of P.L. 480 Vegetable
Oil Report (Fall, 1998)
Fortification of P.L. 480 vegetable oil, which reaches approximately 20
million recipients in over 40 developing countries, would be an effective
way to deliver vitamin A to deficient populations. This paper provides
information on the technical and biological aspects of fortifying vegetable
oil with vitamin A and recommends the appropriate form and level of fortification.
Based on this report, and at the request of USAID/FFP, the Kansas City
Commodity Office amended Announcement VO-6 to require vitamin A fortification
(in the recommended form of retinol palmitate) of vegetable oil purchased
for foreign food assistance programs.
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Results report on the Vitamin C Pilot Program
(September, 1997)
The Vitamin C Pilot Program, initiated in March 1996, was designed to
explore the advisability and cost-effectiveness of scaling up vitamin
C fortification of food
aid commodities. Findings indicated that problems exist with the uniformity
of fortification in corn soy blend; however, the amount of vitamin C in
blended foods was found to be generally stable during shipping, transport
and storage. Financial analyses indicate that scaling up vitamin C fortification
while maintaining present costs would significantly reduce the numbers
currently benefiting from food aid. The report includes information requested
by the Committee on International Nutrition on: the worldwide prevalence
of scurvy; and on vitamin C and iron uptakes in refugee camps and in targeted
beneficiary households in Title II development programs.
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Food Technology and Enterprise Project
(FY 92-00)
This final report describes short- and long-term activities
undertaken by the Food Technology and Enterprise - SUSTAIN Project under
Cooperative Agreement DAN-A-00-91-00066-00 during the fiscal years of
1992-2000. It also suggests what steps USAID might take to build on Project
SUSTAIN's work to improve the quality and micronutrient content of PL
480 Food Aid Commodities and of local food products worldwide.
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