Elements of a National Food- Fortification Program for Bangladesh

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Section 5: Elements of a National Food-Fortification ProgramAlthough roller mills represent theonly practical means of introducing flourfortification on a sustainable basis, it mustbe recognized that this will initially limitrural access to the fortified product, sincemost rural consumers obtain their flourthrough chakki mills. In the longer run,as the economy develops further and astransportation improves, it is likely thatBangladesh will follow the same pattern thathas been observed in other countries: rollermill production will expand and account foran increasing share of the rural market. Asthat occurs, fortified flour will further extendinto rural areas.ConsumptionThe bulk of sugar consumed in Bangladeshis imported in an already refined form, thusplacing severe limitations on the amountof sugar available for fortification. Localproduction is only about 20-25 percent of totalsugar consumption, equivalent to less than2g/day/person. Moreover, per capita sugarconsumption in rural areas — where mostof the vulnerable groups can be found — ismuch lower than in urban areas. Increasedcompetition between sugar and gur (molasses)in recent years has put additional pressure onper capita sugar consumption in rural areas.A Voluntary, not Mandatory, ProgramThe number of mills, their size, and the extentto which flour milling is centralized willdetermine whether a mandatory or voluntaryprogram is the better option. The structure ofthe milling industry in Bangladesh suggeststhat a mandatory flour-fortification programwill not be realistic for two reasons. First, thesmaller mills, especially those located in ruralareas, typically will lack the capital resourcesneeded to participate in the fortificationprogram. Second, implementation of a qualitycontrolsystem will not be possible when mostparticipants consist of a large number of smallmills scattered throughout the country.CostAt about Tk630, or $10.8 per MT, the costof sugar fortification is more than twice ashigh as that for wheat flour and nearly threetimes as high as for oil. The additional costassociated with fortification would lead to anincrease of over 2 percent in the retail price ofsugar. Assuming fortification costs are passedon to consumers, this increase may placefortified sugar at a disadvantage relative tothe imported unfortified product. Only a shiftin demand for local sugar — stimulated, forinstance, by a strong promotion and healtheducationcampaign — would enable fortifiedsugarproduction to compete with unfortifiedprivate-sector imports.SugarThe case for sugar fortification in Bangladeshis based on two major arguments, the firstbeing that the country has only 15 sugarfactories, which would make programcoordination and quality-control systems easyto implement. The second argument is that theBSFIC, a state-owned company, operates allthose factories.However, strong evidence presented inthis study suggests that sugar fortificationin Bangladesh is not recommended. Thisconclusion is supported by a combinationof very low per capita consumption andrelatively high fortification costs.Fortification FormulationTable 5.1 describes the fortificationformulation and micronutrient supply foroil and wheat flour in Bangladesh. Fortifiedat a minimum vitamin A level of 20mg/kg,oil would supply about 52 percent of EAR— an amount expected to have a significantbiological impact.Based on the formulation described in table5.1, fortification of maida would supply about20 percent of EAR for vitamin A, iron, folate,B-12, B-1, B-2, B-6, niacin, and zinc.16MOST The USAID Micronutrient Program
Section 5: Elements of a National Food-Fortification ProgramTable 5.1: Fortification Formulation and Micronutrient Supply for Wheat Flour (Maida) and Oilin BangladeshNutrient Form Minimum Level ofAddition (mg/kg) *Wheat FlourPackaging and LabelingPackaging and product labeling playan important role in fortification, assome micronutrient additives degrade withexposure to heat, light, and other factorssuch as excessive moisture (in wheat flour,for example). Vitamins are affected by bothheat and excessive moisture, while mineralstend to be affected to a lesser extent. 7 Certainpackaging and labeling guidelines shouldtherefore be followed for each productconsidered for fortification.OilInterviews with producers indicate that about85 percent of oil produced in Bangladesh issold in large tin cans, with the remaindersold in smaller plastic bottles. Processingplants have mechanical packaging machinesthat affix their own labels and promotionalinformation on each can or bottle. Down themarketing chain, oil in tin cans is sold toretailers and small vendors, who then resell insmaller quantities to consumers from stalls attraditional markets throughout the country.While fortified oil sold in tin cans is notlikely to lose any of its micronutrient content,the shelf life of vitamin A in oil sold intransparent plastic bottles will be adverselyaffected by exposure to light. An importantstep in the oil-fortification program willbe to replace the transparent plastic bottlewith a more-opaque container to protect themicronutrient content.Wheat FlourOverage (%) **% EAR in UsualConsumption ***Vitamin A SD250 2 50 16Iron Ferrous fumerate 45 5 20Folate Folic acid 2 50 23B-12 B-12 — 0.01% 0.010 30 18B-1 Thiamin mononitrate 6 40 18B-2 Riboflavin 4 30 16B-6 Pyridoxin 5 20 19Niacin Niacinamide 40 10 16Zinc Zinc oxide 20 5 19OilVitamin A Vitamin A oily 1.7mIU/g 20 5 52Notes:* Selected (1) to provide at least 20 percent EAR from 50g/day/person of wheat flour consumption, (2) to becompatible with the sensorial properties of the product, and (3) to be safe for those who consume large amounts ofthe product.** The additional amount over the minimum level to compensate for losses in production, storage, and transportation.*** 40g/day for wheat flour and 13g/day for oil; values for families, adult male.Wheat flour in Bangladesh normally has amoisture content of 13–16 percent. At theselevels, significant loss of micronutrientswould be expected to occur if fortified flourwere stored for several months. Since flourin Bangladesh is rarely stored for more thana few weeks, micronutrient loss due to thepresence of moisture is not expected to occur.If mills were to produce dryer flour, withmoisture content of 10 percent or less, itwould be possible to store flour for longerperiods of time, provided the low moisturelevels could be maintained. For thesepurposes, it would be preferable to pack the7 Sensitivity of vitamins and minerals to heat, light and similar factors are a few of the underlying reasons for selecting the overage figuresin table 5. 1.Elements of a National Food-fortification Program for Bangladesh17
Page 1 and 2: Elements of a National Food-Fortifi
Page 3 and 4: Elements of a National Food-Fortifi
Page 5 and 6: Table of Contents and AcronymsTable
Page 7 and 8: Table of Contents and AcronymsAcron
Page 9 and 10: SummaryElements of a National Food-
Page 11 and 12: Section 1: IntroductionSection 1: I
Page 13 and 14: Section 2: Nature of the Micronutri
Page 15 and 16: Section 2: Nature of the Micronutri
Page 17 and 18: Section 3: Potential Food-Fortifica
Page 19 and 20: Section 3: Potential Food-Fortifica
Page 21 and 22: Section 4: Cost Analysis of Food Fo
Page 23 and 24: Section 4: Cost Analysis of Food Fo
Page 25: Section 5: Elements of a National F
Page 29 and 30: ReferencesReferencesBangladesh Bure
Page 31 and 32: Annex TablesAnnex B: Estimated Cost
Page 34: Bangladesh has the necessary human

Elements of a National Food- Fortification Program for Bangladesh

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