How can fish sauce be vitamin A fortified?

Answer 1

The Use of NaFeEDTA-Fortified Fish Sauce Is an Effective Tool for Controlling Iron Deficiency in Women of Childbearing Age in Rural Vietnam1,2
Iron deficiency (ID)4 is the most common nutritional deficiency disorder worldwide, affecting an estimated 3.5 billion individuals (1). The risk is highest for children and women of childbearing age. There are major health consequences including lower birth weight in infants born to women suffering from iron deficiency during pregnancy, impaired psychomotor development in infancy with effects on later cognitive function, an increased prevalence and duration of upper respiratory infections in children, and reduced physical work performance at all ages (2–5).

Iron deficiency is particularly prevalent in Vietnam and other developing countries in which cereal staples, rich in inhibitors of iron absorption such as phytates, are the major energy source. Food fortification is considered to be the most cost-effective strategy for combating nutritional iron deficiency in population groups that buy one or more commonly eaten food items (6). It is an attractive strategy because consumer compliance is ensured; it can be both inexpensive to initiate and sustainable (6). However, it depends greatly on the selection of a suitable food vehicle. The ideal vehicle is a dietary item that is consumed daily in relatively consistent quantities by the individuals at greatest risk for nutritional iron deficiency. It must also be feasible to add sufficient bioavailable iron to the vehicle without changing its storage properties or the color and taste of meals in which it is eaten. Fish sauce is a suitable vehicle in Vietnam. It is a traditional condiment that is consumed daily with most meals in all regions. Fish sauce can be fortified with NaFeEDTA. It does not oxidize the lipids or precipitate the peptides in the sauce and remains stable for at least 12 mo if protected from light (7). No degradation of NaFeEDTA was observed after storage in Vietnamese fish sauce for 364 d if the fish sauce was protected from direct exposure to natural or artificial sunlight. Furthermore, we demonstrated recently (8) that monitored consumption of NaFeEDTA-fortified fish sauce [10 mL containing 0.18 mmol (10 mg) Fe/d] for 6 d/wk for 6 mo was highly efficacious in correcting iron deficiency in a group of women of childbearing age who suffered from iron deficiency anemia (IDA).

The present study was designed to evaluate the effectiveness of supplying NaFeEDTA-fortified fish sauce [9 mmol (500 mg)/Fe/L] at the household level for reducing the prevalence of nutritional iron deficiency. Although the fish sauce was provided for the whole household, iron status was assessed only in women of childbearing age. Women and children are most likely to benefit from mass fortification. However, parents in this community were not willing to allow their children to participate in the study protocol that required blood samples to be obtained.

Regular consumption of NaFeEDTA-fortified fish sauce improves iron status and reduces the prevalence of anemia in anemic Vietnamese women1,2,3
Fish sauce is consumed daily by a large proportion of the Vietnamese population and could therefore be a potentially useful food vehicle for iron-fortification programs.

Micronutrient malnutrition—"the hidden hunger"—includes deficiency disorders of iron, vitamin A, and iodine and represents widespread nutritional problems in resource-poor areas. The consequences of these deficiency disorders on health and economic development are major public health concerns in many countries.

Iron deficiency (ID) in its most severe form results in anemia, and a recent review (1) concluded that iron deficiency anemia (IDA) is associated with impaired child development and decreased work productivity. Although estimates of the magnitude of this public health problem vary widely (1) and accurate prevalence data are often missing, it can be assumed that a significant proportion of children and women of childbearing age in many developing countries are anemic and that ID is a major factor in the etiology of anemia. For example, recent data from Cote d’Ivoire showed that 42–46% of schoolchildren and adult women were anemic and that IDA accounted for 50% of the anemia cases (2). In preschool children, the prevalence of anemia was 50% and IDA represented 80% of all anemia cases.

In Vietnam, detailed information about the etiology of anemia is not available. The 1995 National Anemia and Nutrition Risk Factor Survey reported a high prevalence (40–50%) of anemia in young children and adult women, including both pregnant and nonpregnant women. Insufficient iron intake and low iron bioavailability were identified as important factors in the etiology of anemia although other important contributing factors such as hookworm infection, which increases iron losses, were also highlighted (3). A more recent Nutrition Risk Factor Survey, based on data collected in 2000, showed that the prevalence of anemia had decreased to 34% in young children and to 25% in women. However, anemia remains a significant public health problem in Vietnam (HH Khoi, NC Khan, and LB Mai, unpublished observations, 2001), and strategies for combating anemia, ID, and IDA are needed in large segments of vulnerable population groups.

Food fortification is often suggested as one of the most cost-effective and sustainable strategies for increasing iron intake in the general population (4,5). The food vehicle that is the most commonly fortified with iron is cereal. However, condiments have been proposed as alternative vehicles for iron-fortification programs, particularly in countries where rice is the staple food, because rice grains are difficult to fortify. Fish sauce was suggested as a potentially useful vehicle for iron fortification in Vietnam because > 80% of the population consumes fish sauce regularly (Khoi et al, unpublished observations, 2001). The aim of the present study was to evaluate the efficacy of iron-fortified fish sauce in improving iron status and reducing the prevalence of anemia in adult, nonpregnant anemic Vietnamese women.

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Answer 2

They can fortify any food these days. The companies that make them use vitamins as additives in all their products.