Guidelines on food fortification with micronutrients - Nutritotal

1. MICRONUTRIENT MALNUTRITION: A PUBLIC HEALTH PROBLEMVitamin B 3 Insufficient data on marginal deficiency Low intakes of animal and dairy Severe deficiency results in pellagra, which(niacin) Severe deficiency (pellagra) still products is characterized by:common in Africa, China and India High consumption of refined — dermatitis (symmetrical pigmented rashand recently reported among cereals on skin areas exposed to sunlight);displaced populations (south-eastern Maize-based diets (not lime — digestive mucosa disorders (diarrhoeaAfrica) and in famine situations treated) and vomiting);— neurological symptoms, depressionand loss of memoryVitamin B6 Insufficient data, but recent reports from Low intakes of animal products Symptoms are non-specific and may include:Egypt and Indonesia suggest High consumption of refined — neurological disorders withdeficiency is likely to be widespread cereals convulsions;in developing countries Chronic alcoholism — dermatitis (stomatitis and cheilosis)Rather uncommon in isolation, being Anaemia (possibly)typically associated with deficiencies Deficiency is a risk factor for elevatedin the other B vitamins plasma homocysteineVitamin C Insufficient data on moderate Low intakes of fresh vitamin Severe deficiency results in scurvy with(ascorbic acid) deficiencies C-rich fruits and vegetables haemorrhagic syndrome (i.e. bleedingSevere deficiency (scurvy) regularly Prolonged cooking gums, joint and muscle pain, peripheralreported in famine situations (e.g. oedema)east Africa) and among displaced Anaemiapeople dependent on food aid forlong periods (e.g. east Africa, Nepal)Vitamin D Insufficient data, but likely to be Low exposure to ultra-violet Severe forms result in rickets in children andcommon in both industrialized and radiation from the sun osteomalacia in adultsdeveloping countries Wearing excess clothingHigher at more northerly and southerly Having darkly pigmented skinlatitudes where daylight hours arelimited during the winter months9