Consumption of rice, acceptability and sensory qualities of fortified rice amongst consumers of social safety net rice in Nepal

English version

Autoři: Anjana Rai ^aff001; Macha Raja Maharjan ^aff001; Helen A. Harris Fry ^aff002; Parbati K. Chhetri ^aff001; Purna Chandra Wasti ^aff003; Naomi M. Saville ^aff001
Působiště autorů: Nutrition Section, UN World Food Programme Nepal, Kathmandu, Nepal ^aff001; Department of Population Health, London School of Hygiene & Tropical Medicine, London, England, United Kingdom ^aff002; Department of Food Technology and Quality Control, Ministry of Agriculture and Livestock Development, Kathmandu, Nepal ^aff003; Institute for Global Health, University College London, London, England, United Kingdom ^aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222903

Souhrn

Introduction

Micronutrient deficiencies are prevalent in Nepal where starchy foods constitute a large proportion of diets and consumption of micronutrient-rich foods is inadequate. We conducted a study to determine whether rice would be an appropriate vehicle for micronutrient fortification in Nepal.

Materials and methods

In Bajura in remote rural Nepal, we conducted a household survey to characterize rice intakes in 195 households, and a double-blinded acceptability test with 177 social safety net rice consumers ≥18 years of age. Of these, 168 tasted fortified and unfortified rice to assess whether respondents could differentiate between fortified and non-fortified rice and their sensory properties. Rice was fortified by blending hot extruded kernels containing 6 micronutrients together with non-fortified rice at a 1:99 ratio. We used binomial tests to assess whether participants could correctly differentiate fortified rice, from non-fortified rice and paired t-tests to compare scores for sensory qualities of cooked fortified and non-fortified rice. We used multiple regression to test associations between per capita consumption and age, gender, wealth and food security.

Results

Per capita consumption of rice (median 216g/day, IQR 144.0, 288.0) did not vary by wealth but was +52.08g, (95% CI 10.43, 93.72) higher amongst moderately to severely food insecure households compared with food secure / mildly food insecure. Most respondents could not differentiate fortified rice from non-fortified rice: 37.5% identified uncooked fortified rice and 39.3% cooked rice, which was not different from the 33% expected by chance (p = 0.22 and p = 0.09 respectively). The sensory qualities of fortified rice were acceptable (scoring 3.9 out of 5) and did not differ from non-fortified rice (p>0.05).

Conclusion

A rice fortification programme implemented through the Nepal Food Corporation’s social safety nets has potential because purchase and consumption of rice is high and fortified rice is acceptable among consumers in remote food insecure areas of Nepal.

Klíčová slova:

Rice – Diet – Food – Surveys – Livestock – Food consumption – Nepal – Cereal crops

Zdroje

1. Torheim LE, Ferguson EL, Penrose K, Arimond M. Women in Resource-Poor Settings Are at Risk of Inadequate Intakes of Multiple Micronutrients–4. The Journal of nutrition. 2010;140(11):2051S–8S. doi: 10.3945/jn.110.123463 20881075

2. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The lancet. 2013;382(9890):427–51.

3. Rao S, Yajnik CS, Kanade A, Fall CH, Margetts BM, Jackson AA, et al. Intake of micronutrient-rich foods in rural Indian mothers is associated with the size of their babies at birth: Pune Maternal Nutrition Study. J Nutr. 2001;131(4):1217–24. Epub 2001/04/04. doi: 10.1093/jn/131.4.1217 11285330.

4. Zerfu TA, Umeta M, Baye K. Dietary diversity during pregnancy is associated with reduced risk of maternal anemia, preterm delivery, and low birth weight in a prospective cohort study in rural Ethiopia. The American Journal of Clinical Nutrition. 2016. doi: 10.3945/ajcn.115.116798 27169832

5. Black RE, Allen LH, Bhutta ZA, Caulfield LE, De Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. The lancet. 2008;371(9608):243–60.

6. Perignon M, Fiorentino M, Kuong K, Burja K, Parker M, Sisokhom S, et al. Stunting, poor iron status and parasite infection are significant risk factors for lower cognitive performance in Cambodian school-aged children. PLoS One. 2014;9(11):e112605. doi: 10.1371/journal.pone.0112605 25405764

7. Arsenault JE, Yakes EA, Islam MM, Hossain MB, Ahmed T, Hotz C, et al. Very low adequacy of micronutrient intakes by young children and women in rural Bangladesh is primarily explained by low food intake and limited diversity. J Nutr. 2013;143(2):197–203. Epub 2012/12/21. doi: 10.3945/jn.112.169524 23256144.

8. Busert LK, Neuman M, Rehfuess EA, Dulal S, Harthan J, Chaube SS, et al. Dietary Diversity Is Positively Associated with Deviation from Expected Height in Rural Nepal. J Nutr. 2016;146(7):1387–93. Epub 2016/06/17. doi: 10.3945/jn.115.220137 27306894

9. IHME. Institute for Health Metrics and Evaluation; [cited 2018]. http://www.healthdata.org/nepal.

10. MoH, ERA N, ICF. Nepal Demographic and Health Survey 2016. Kathmandu, Nepal: Ministry of Health, Nepal; 2017.

11. UNICEF. Improving child nutrition: The achievable imperative for global progress. New York: United Nations Children’s Fund, 2013.

12. Parajuli RP, Umezaki M, Watanabe C. Diet among people in the Terai region of Nepal, an area of micronutrient deficiency. J Biosoc Sci. 2012;44(4):401–15. Epub 2012/03/20. doi: 10.1017/S0021932012000065 22424573.

13. Henjum S, Torheim LE, Thorne-Lyman AL, Chandyo R, Fawzi WW, Shrestha PS, et al. Low dietary diversity and micronutrient adequacy among lactating women in a peri-urban area of Nepal. Public health nutrition. 2015;18(17):3201–10. doi: 10.1017/S1368980015000671 25824344

14. Sudo N, Sekiyama M, Maharjan M, Ohtsuka R. Gender differences in dietary intake among adults of Hindu communities in lowland Nepal: assessment of portion sizes and food consumption frequencies. Eur J Clin Nutr. 2006;60(4):469–77. Epub 2006/01/05. doi: 10.1038/sj.ejcn.1602339 16391580.

15. Angeles-Agdeppa I, Paulino LS, Ramos AC, Etorma UM, Cavalli-Sforza T, Milani S. Government-industry partnership in weekly iron-folic acid supplementation for women of reproductive age in the Philippines: impact on iron status. Nutrition reviews. 2005;63(suppl_2):S116–S25.

16. Piccoli NB, Grede N, de Pee S, Singhkumarwong A, Roks E, Moench-Pfanner R, et al. Rice fortification: its potential for improving micronutrient intake and steps required for implementation at scale. Food and nutrition bulletin. 2012;33(4_suppl3):S360–S72.

17. Muthayya S, Hall J, Bagriansky J, Sugimoto J, Gundry D, Matthias D, et al. Rice fortification: an emerging opportunity to contribute to the elimination of vitamin and mineral deficiency worldwide. Food Nutr Bull. 2012;33(4):296–307. Epub 2013/02/22. doi: 10.1177/156482651203300410 23424896.

18. Central Bureau of Statistics. Annual Household Survey 2014/15. Kathmandu, Nepal: Central Bureau of Statistics, Nepal and UNDP, 2016.

19. Alavi S, Bugusu B, Cramer G, Dary O, Lee T-C, Martin L, et al. Rice fortification in developing countries: a critical review of the technical and economic feasibility. Institute of Food Technologists, Washington DC. 2008.

20. Muthayya S, Sugimoto JD, Montgomery S, Maberly GF. An overview of global rice production, supply, trade, and consumption. Annals of the new york Academy of Sciences. 2014;1324(1):7–14.

21. WFP, Gov of Nepal. Landscape Analysis for Rice Fortification in Nepal. Kathmandu, Nepal: WFP and Government of Nepal, 2018.

22. Della Lucia CM, Rodrigues KCC, Rodrigues VCC, Santos LLM, Cardoso LM, Martino HSD, et al. Diet Quality and Adequacy of Nutrients in Preschool Children: Should Rice Fortified with Micronutrients Be Included in School Meals? Nutrients. 2016;8(5):296.

23. Beinner MA, Velasquez-Meléndez G, Pessoa MC, Greiner T. Iron-Fortified Rice Is As Efficacious As Supplemental Iron Drops in Infants and Young Children. The Journal of Nutrition. 2010;140(1):49–53. doi: 10.3945/jn.109.112623 19889805

24. Angeles-Agdeppa Capanzana, Barba Florentino, Takanashi. Efficacy of iron-fortified rice in reducing anemia among schoolchildren in the Philippines. International journal for vitamin and nutrition research. 2008;78(2):74–86.

25. Hotz C, Porcayo M, Onofre G, Garcia-Guerra A, Elliott T, Jankowski S, et al. Efficacy of iron-fortified Ultra Rice in improving the iron status of women in Mexico. Food Nutr Bull. 2008;29(2):140–9. Epub 2008/08/13. doi: 10.1177/156482650802900208 18693478.

26. Fiorentino M, Perignon M, Kuong K, Burja K, Kong K, Parker M, et al. Rice fortified with iron in school meals improves cognitive performance in Cambodian school children. European Journal of Nutrition & Food Safety. 2015:769–70.

27. Perignon M, Fiorentino M, Kuong K, Chamnan C, Parker M, Burja K, et al. Multi-micronutrient fortified rice improved vitamin A status of Cambodian school children. European Journal of Nutrition & Food Safety. 2015:832–3.

28. Ara G, Khanam M, Rahman AS, Islam Z, Farhad S, Sanin KI, et al. Effectiveness of micronutrient-fortified rice consumption on anaemia and zinc status among vulnerable women in Bangladesh. PloS one. 2019;14(1):e0210501. doi: 10.1371/journal.pone.0210501 30629717

29. Tacsan L, Fabrizio C, Smit J. Rice Fortification in Costa Rica: Case study. Scaling up rice fortifiction in Asia: WFP and Sight and Life; 2015.

30. Montgomery S, Rosenweig J, Smit J. Technology for rice fortification. Scaling up rice fortification in Asia. Germany: Sight for life on behalf of the World Food Programme; 2015. p. 57–62.

31. Yusufali R, Ghoos K, Rosenzweig J. Landscape Analysis for Rice Fortification. Scaling up Rice Fortification in Asia. 2014:43.

32. de Pee S, Fabrizio C, Rosenweig J. Overview of evidence and recommendations for effective large-scale rice fortification. Scaling up rice fortification in Latin America and the Caribbean. Germany: Sight for Life on behalf of the World Food Programme; 2017.

33. WFP Nepal. The Food Security Atlas of Nepal. Kathmandu: WFP, 2010.

34. Central Bureau of Statistics. Population census 2001 of Nepal. His Majesty’s Government N, editor. Kathmandu2001.

35. Khanh Van T, Burja K, Thuy Nga T, Kong K, Berger J, Gardner M, et al. Organoleptic qualities and acceptability of fortified rice in two Southeast Asian countries. Ann N Y Acad Sci. 2014;1324(1):48–54.

36. Saville NM, Shrestha BP, Style S, Harris-Fry H, Beard BJ, Sen A, et al. Impact on birth weight and child growth of Participatory Learning and Action women’s groups with and without transfers of food or cash during pregnancy: Findings of the low birth weight South Asia cluster-randomised controlled trial (LBWSAT) in Nepal. PLOS ONE. 2018;13(5):e0194064. doi: 10.1371/journal.pone.0194064 29742136

37. Saville NM, Shrestha BP, Style S, Harris-Fry H, Beard BJ, Sengupta A, et al. Protocol of the Low Birth Weight South Asia Trial (LBWSAT), a cluster-randomised controlled trial testing impact on birth weight and infant nutrition of Participatory Learning and Action through women’s groups, with and without unconditional transfers of fortified food or cash during pregnancy in Nepal. BMC Pregnancy Childbirth. 2016;16(1):320. Epub 2016/10/23. doi: 10.1186/s12884-016-1102-x 27769191

38. Harris-Fry H, Paudel P, Karn M, Mishra N, Thakur J, Paudel V, et al. Development and validation of a photographic food atlas for portion size assessment in the southern plains of Nepal. Public Health Nutr. 2016;19(14):2495–507. Epub 2016/03/22. doi: 10.1017/S1368980016000537 26996822.

39. Bowman SA, Martin CL, Friday JE, Moshfegh AJ, Lin B-H, Wells HF. Methodology and User Guide for The Food Intakes Converted to Retail Commodities Databases: CSFII 1994–1996 and 1998 NHANES 1999–2000 WWEIA, NHANES 2001–2002. US Department of Agriculture, Agricultural Research Service, Beltsville, MD, and US Department of Agriculture, Economic Research Service, Washington, DC. 2011.

40. Coates J, Swindale A, Bilinsky P. Household Food Insecurity Access Scale (HFIAS) for measurement of food access: indicator guide. Washington, DC: Food and Nutrition Technical Assistance Project, Academy for Educational Development. 2007;34.

41. Bilinsky P, Swindale A. Months of adequate household food provisioning (MAHFP) for measurement of household food access: indicator guide: Food and Nutritional Technical Assistance Project, Academy for Educational …; 2007.

42. FAO, FHI360. Minimum Dietary Diversity for Women: A Guide for Measurement. Rome: FAO. Rome: FAO, 2016.

43. Swindale A, Bilinsky P. Household Dietary Diversity Score (HDDS) for measurement of household food access: indicator guide (v.2). Washington DC: Food and Nutrition Technical Assistance (FANTA) project: Academy for Educational Development, 2006.

44. Wiesmann D, Bassett L, Benson T, Hoddinott J. Validation of the World Food Programme s Food Consumption Score and Alternative Indicators of Household Food Security. Intl Food Policy Res Inst, 2009.

45. WFP. Emergency Food Security Assessment Handbook World Food Programme; 2009.

46. Watts BM, Ylimaki G, Jeffery L, Elias LG. Basic sensory methods for food evaluation: IDRC, Ottawa, ON, CA; 1989.

47. Moretti D, Zimmermann MB, Muthayya S, Thankachan P, Lee T-C, Kurpad AV, et al. Extruded rice fortified with micronized ground ferric pyrophosphate reduces iron deficiency in Indian schoolchildren: a double-blind randomized controlled trial. The American Journal of Clinical Nutrition. 2006;84(4):822–9. doi: 10.1093/ajcn/84.4.822 17023709

48. Campbell RK, Talegawkar SA, Christian P, LeClerq SC, Khatry SK, Wu LS, et al. Seasonal dietary intakes and socioeconomic status among women in the Terai of Nepal. Journal of health, population, and nutrition. 2014;32(2):198–216. Epub 2014/08/01. 25076658

49. Harris-Fry HA, Paudel P, Shrestha N, Harrisson T, Beard BJ, Jha S, et al. Status and determinants of intra-household food allocation in rural Nepal. Eur J Clin Nutr. 2018;72(11):1524–36. Epub 2018/01/24. doi: 10.1038/s41430-017-0063-0 29358603

50. Laillou A, Berger J, Le BM, Pham VT, Le TH, Nguyen CK, et al. Improvement of the Vietnamese diet for women of reproductive age by micronutrient fortification of staples foods and condiments. PLoS One. 2012;7(11):e50538. Epub 2012/12/12. doi: 10.1371/journal.pone.0050538 23226308

51. Sudo N, Sekiyama M, Maharjan M, Ohtsuka R. Gender differences in dietary intake among adults of Hindu communities in lowland Nepal: assessment of portion sizes and food consumption frequencies. European journal of clinical nutrition. 2006;60(4):469. doi: 10.1038/sj.ejcn.1602339 16391580

52. Radhika MS, Nair KM, Kumar RH, Rao MV, Ravinder P, Reddy CG, et al. Micronized ferric pyrophosphate supplied through extruded rice kernels improves body iron stores in children: a double-blind, randomized, placebo-controlled midday meal feeding trial in Indian schoolchildren. The American Journal of Clinical Nutrition. 2011;94(5):1202–10. doi: 10.3945/ajcn.110.007179 21940595

53. Chakraborty B, Akter F. Acceptability of fortified rice by participants of Government social safety net programmes. Dhaka, Bangladesh: 2014.

54. Moretti D, Lee TC, Zimmermann MB, Nuessli J, Hurrell RF. Development and evaluation of iron‐fortified extruded rice grains. Journal of food science. 2005;70(5):S330–S6.

55. Beinner MA, Soares ADN, Barros ALA, Monteiro MAM. Sensory evaluation of rice fortified with iron. Food Science and Technology. 2010;30(2):516–9.