Mohamed Dahir Abdi ( Bsc, Mph Nutrion)

1. EFFECT OF FOOD FORTIFICATION ON
PREGNANCY OUTCOME
Q.14

2. // ASSIGNMENT //
• Department:- Mph nutrition
• Title course
• Nutritional Assessment
• Name:- Mohamed dahir Abdi
• ID no 4033/12
• good luck Dr. Kadir Teji

3. FOOD FORTIFICATION
• Food fortification is the process of adding nutrients into foodstuff that do not already contain them. For
example, milk is often fortified with additional vitamin D, to boost its nutritional value. The aim of fortification is
to help people remedy their nutritional deficiencies.
• Has been shown to be an impactful approach to improve micronutrient status and related functional outcomes
for some nutrients in some food vehicles, but there are still calls to strengthen the evidence base, particularly
with programmatic evidence. The primary objectives of this chapter are to review methodologies used to date
to evaluate the impact of food fortification programs in populations, discuss the strengths and limitations of
these methodologies and resulting evidence, and provide recommendations on how such methodologies
could be improved.

4. • The majority of the evidence for food fortification programs has been generated using observational
methodologies (ecological, repeat cross-sectional, and cohort designs). While such methods can be
cost-efficient and less complex than experimental impact evaluation designs, they present important
limitations for attribution and for assessing impact on functional outcomes. Using impact pathways
to guide evaluations and prioritizing impact assessment in programs with appropriate design (i.e., in
populations with potential to respond and appropriate food vehicles/ fortificants) and implementation
(i.e., compliance monitoring and enforcement, high coverage in populations with potential to
respond) could substantially increase the quality of evidence for food fortification. Food fortification
has become an increasingly significant strategy to address gaps in micronutrient intakes in
populations with measurable impact in both industrialized and developing countries. While the
positive impacts are well recognized there are new concerns in some countries that excessive
fortification of foods, outdated nutritional labeling rules and misleading marketing tactics used by
food manufacturers may result in young children consuming harmful amounts of some vitamins and
minerals.

5. • Food fortification is one of the strategies that has been used safely and effectively to prevent
micronutrient deficiencies and has been practiced in developed countries for well over a century
now. In the early 20th century, salt iodization began in Switzerland; vitamin A-fortified margarine
was introduced in Denmark in 1918; and in the 1930s, vitamin A-fortified milk and iron and B
complex flour was introduced in a number of developed countries. These fortification strategies are
now almost universal in the developed world and increasingly deployed in many middle-income
countries. Relatively few of these programs have been adequately evaluated to assess their impact
on population health

6. DEVELOPING COUNTRY
• In developing countries, micronutrient deficiencies are common during pregnancy, and around 50%
of pregnant women are anemic. Severely anemic women are at increased risk of death in
pregnancy: 13% of maternal deaths in Asia and 4% in Africa are directly caused by anemia
(UNICEF, 2009). Anemia contributes to the over 30% of deaths that are due to hemorrhage.
• An assessment of micronutrient status among pregnant women in Nepal found that only 4% had no
micronutrient deficiency and almost 18% had five or more deficiencies (Jiang al et. 2005). Nearly
one‐third (32%) of the women were deficient in riboflavin, 40% had vitamin B6 deficiency and 28%
had vitamin B12 deficiency

7. BENEFITS OF FOOD FORTIFICATION
• Food fortification can help in stopping many neural tube defects. These are birth defects associated with the spine or brain.
• This process can also help prevent many deficiencies like iron deficiencies in kids and vitamin D deficiencies in women.
• This is an excellent way of ensuring that a country has a healthier population as a large section of the population makes use of
foods that have been fortified.
• Most food fortification processes don’t pose a health risk to people as the quantities are quite small and the fortification process
is regulated by prescribed standards.
• An overdose of nutrients is not very likely as regulations control how much fortification is to be done and quality checks are
regularly done.
• People who are consuming fortified foods don’t need to change their food habits or patterns.
• Most societies and cultures have no objection to the food fortification process.
• One of the biggest benefits of food fortification is that it doesn’t change the taste, the feel or the look of the foods in most cases.

8. • The process of food fortification is a quick one. You can get it done in short order.
• Even the results of food fortification are visible within a few months of fortified foods as the people with a deficiency get
to see improvement in their health.
• Thanks to the latest technological innovations, the food fortification process has become quite cost effective as well.
• According to a consensus, every one rupee spent on fortification leads to 9 rupees in benefits to the economy.
• Food fortification is a boon for kids, pregnant women and older adults as these groups are usually more vulnerable to
vitamin deficiencies.
• People who follow special diets like vegans practicing veganism can benefit if they have foods that are fortified with
vitamin B-12.

9. PREGNANCY OUTCOME
• Pregnancy outcome is the final result of a fertilization event. Types of pregnancy outcomes include live birth (full term or preterm
birth), stillbirth, spontaneous abortion, and induced abortion.
• That woman of childbearing potential should maintain good nutritional status through a lifestyle that optimizes maternal health
and reduces the risk of birth defects, suboptimal fetal growth and development, and chronic health problems in their children.
The key components of a health-promoting lifestyle during pregnancy include appropriate weight gain; consumption of a variety
of foods in accordance with the Food Guide Pyramid; appropriate and timely vitamin and mineral supplementation; avoidance of
alcohol, tobacco, and other harmful substances; and safe food-handling. Prenatal weight gain within the Institute of Medicine
(IOM) recommended ranges is associated with better pregnancy outcomes. The total energy needs during pregnancy range
between 2,500 to 2,700 kcal a day for most women, but prepreg Nancy body mass index, rate of weight gain, maternal age, and
physiological appetite must be considered in tailoring this recommendation to the individual. The consumption of more food to
meet energy needs and the increased absorption and efficiency of nutrient utilization that occurs in pregnancy are generally
adequate to meet the needs for most nutrients. However, vitamin and mineral supplementation is appropriate for some nutrients
and situations.
•

10. EFFECT OF PREGNANCY OUT COME
• This statement also includes recommendations pertaining to use of alcohol, tobacco, caffeine,
street drugs, and other substances during pregnancy; food safety; and management of common
complaints during pregnancy and specific health problems. In particular for medical nutrition
therapy, pregnant women with inappropriate weight gain, hyper emesis, poor dietary patterns,
phenylketonuria (PKU), certain chronic health problems, or a history of substance abuse should be
referred to qualified dietetics professional.
• smoking cigarettes
• using illegal drugs
• drinking alcohol
• poor dietary patterns, tobacco, caffeine,

11. CONCLUSIONS
• Food fortification is an essential element in nutrition strategies to alleviate micronutrient deficiencies. It is a dynamic
area developing in response to the needs of population groups and global industries. Efforts should continue to
develop new systems of delivering micronutrients to target populations through appropriate fortification procedures.
To facilitate this, those involved in the establishment of food fortification programmed must have ready access to
information concerning fortification techniques and procedures being used all over the world. A multi-disciplinary
approach is essential for successful fortification, with active collaboration with all parties involved. Adequate
monitoring of food fortification is essential and should include both monitoring of critical control points in the
production and distribution of fortified foods and the strict monitoring of micronutrient status for target populations.
• From a business perspective, fortification can also make for more marketable products. However, blending nutrients
is a science involving consideration of many factors. Good practice calls for high quality nutritional blends that
address these issues and gain consumer confidence in the product and in the role that nutrition can play in improving
health and fighting disease.
•

12. RECOMMENDATION
• Food fortification is the process of adding one or more essential nutrients to the food to make sure
that there is no deficiency of any nutrient. Though there is no doubt that there are immense benefits of
food fortification, the process is not always harmless. Read on to know what are the benefits of food
fortification and how can you make the most of it as a consumer.