Finding the way to a permanent nutrition solution

Fortification of staple foods

Supplementation is often followed by fortification of staple foods and should substitute supplementation over time. This intervention entails adding Vitamin A to one or more widely consumed staple foods. Fortification is justified when widespread or blanket coverage is desired.This implies that VAD is extensive and not limited to specific groups or isolated communities. Coverage can include whole country or a region.

Fortification does not require people to change their dietary habits. Thus, the target population continues to eat the fortified food as a vehicle. The Vitamin A added provides low but constant amounts, so there is little risk that intake become undesirably high.

A large proportion of the population should consume the food vehicle, especially those at major risk of VAD. There should be little day-to-day and inter-individual variation in the amount of the food vehicle (staple) consumed. The food vehicle should go through central processing where Vitamin A can be added under controlled conditions. Rice, shorgum, maize, roots or tubers are the major source of energy in many countries, but these foods lack Vitamin A. In theory, these staple foods could be perceived as appropriate due to their widespread use.

However, they are usually processed and cooked at home, thus making it impractical or impossible to fortify them centrally under controlled conditions. Hence, the most common vehicles for food fortification are wheat flour, sugar, vegetable oil and salt. These staple foods are normally produced in large factories.

Nutrition education and home gardening

The permanent and logical solution to eliminating Vitamin A deficiency should be through modifications in patterns of food production, consumption and distribution. These can be done through the application of agricultural or horticultural and educational alleviation strategies. This is a long-term part of the strategy and should be started along with the interventions mentioned above.