Countering malnutrition: Experts tout benefits of proteins, micronutrient supplements and food fortification

20 Jul 2023 --- Addressing malnutrition is a pressing global concern, as UN agencies recently warned that the goal to end world hunger by 2030 is out of reach. More people are suffering from malnutrition due to the COVID-19 pandemic, climate shocks and conflicts, such as the Ukraine war. 

Nutrition Insight speaks with professionals from Fonterra, Lubrizol Nutraceuticals, Lactalis Ingredients and dsm-firmenich on the impact of malnutrition and different products that can help eradicate the problem. 

“Malnutrition is a complex health concern that results from insufficient food intake or utilization of nutrients. It is a global problem affecting more than one billion people,” says Victoria Lam, general manager of marketing, active living at Fonterra. 

“Malnutrition has many negative impacts on the human body, such as loss of muscle mass and impaired muscle function, reduced immune function and psychological impairment. These effects significantly impair quality of life and ultimately mortality.” 

Andrea Salvador, from Lubrizol Nutraceuticals’ marketing department, observes that micronutrient deficiencies are highest in low-income countries where the diversity of nutritious foods is limited. But, “it can affect the whole world, for instance, women of reproductive age who have increased iron requirements.”

“The principal consequence is the effect on the function and recovery of every organ system. It even affects the immune system, slowing down its responses and can have psychosocial effects, for instance, anxiety or depression.” 

Protein is a crucial macronutrient deficit to address in malnutrition products (Image credit: Lactalis Ingredients).Malnutrition risk populations
Lam explains that individuals with certain medical conditions, lower socioeconomic status and older age groups are at the highest risk of malnutrition. “Nutritional screening followed by individualized nutritional support is used to tackle this condition, usually with a strong focus on increasing protein and total energy intake.” 

Elodie Macariou, senior product manager at Lactalis Ingredients, adds: “The primary issues in malnutrition often include inadequate intake of essential nutrients, especially among vulnerable populations such as children, pregnant women and the elderly. Their diets may lack key nutrients like protein, vitamins and minerals.” 

She notes that different ingredients can help address these issues, depending on the population’s needs. “If we look at senior populations, protein-enriched products are often proposed to combat undernutrition and sarcopenia.” 

“If we now turn our attention to children, nutritional supplements or therapeutic foods can be given depending on the degree of malnutrition. Dairy ingredients like milk powder, whey protein and dairy-based fortifiers are commonly used to address these issues. These nutrient-dense ingredients can help enhance the nutritional profile of various food products.” 

Power of protein 
Regarding malnutrition, protein is the most important macronutrient deficit to address, emphasizes Fonterra’s Lam. 

“This is because of the diverse and critical role that protein plays. If we exclude water weight, the human body is primarily composed of protein – which is a major component of muscle, bone, organs, skin, nails and our hormonal system.” 

Lam adds that dairy proteins such as whey protein are excellent sources of proteins with many benefits for patients, such as high levels of essential amino acids that the body cannot produce on its own. 

“For some nutritional product formulations, the natural micronutrient levels of our ingredients can also provide benefits, for example, vitamin Bs or minerals like calcium and phosphorus.” 

Lam explains that Fonterra offers specialized protein ingredients with characteristics that enable them to be used in formulations that can be particularly difficult to manufacture – especially when creating palatable consumer products. 

“Typical examples would be extremely high protein beverages such as oral nutritional supplements (ONS), which require proteins that can withstand harsh heat treatments, maintain stability over long shelf life and also deliver on taste and texture and not be gritty or thick. This negative sensory experience is often the biggest barrier to high protein ONS.”

Macariou cautions that malnutrition is not only a question of nutrient deficiency, “it can also be a question of imbalance, sometimes with excess.” 

She adds that Prolacta, a high-quality protein by Lactalis Ingredients, addresses this issue in the infant population by providing the proper intake of amino acids. “Prolacta’s high content of alpha-lactalbumin and tryptophan permits a lower total protein content in baby milk formula,” she explains. 

Iron deficiency is a crucial challenge in malnutrition (Image credit: Lubrizol Nutraceuticals).Targeting micronutrient deficiencies 
The inadequate intake of essential nutrients required for proper growth, development and overall health is a significant issue, says Yannick Foing, the global director for nutrition improvement at DSM-Firmenich.

“A key contributor to this is hidden hunger, a deficiency in essential vitamins and minerals that can occur due to energy-rich but nutrient-poor diets, which affects more than three billion people.” 

He continues: “Micronutrient deficiencies have severe consequences, including birth defects, blindness, reduced growth, cognitive impairment, decreased school productivity and even death.” 

However, there are proven cost-effective solutions that could be scaled up to help close the micronutrient gap, emphasizes Foing. These include “promoting dietary diversity and agricultural productivity, as well as staple food fortification, like fortified rice, flour, oil and salt, micronutrient powders and emergency foods.” 

Iron deficiency is one of the crucial challenges of malnutrition in this field, according to Lubrizol Ingredient’s Salvador. 

“This element is vital for producing red blood cells, which are the ones that transport oxygen through our cells. This type of malnutrition affects billions of people worldwide and remains the leading cause of anemia with significant negative impacts on health.” 

Salvador notes that iron supplements have been designed as a solution for anemia iron deficiency. “However, due to its high reactivity, some formulation challenges are associated with iron, such as an unpleasant metallic taste, hardened texture and changing color. It also leads to undesirable side effects for the consumers such as stomach upset after gastrointestinal digestion.” 

Future food fortification
DSM-Firmenich’s Foing notes that fortification of staple foods is a proven and cost-effective intervention to increase the intake of micronutrients across general populations. “Fortified rice kernels, in particular, represent a significant opportunity to improve micronutrient status worldwide.” 

He explains that although 3.5 billion people consume rice globally, less than 5% of all rice supplies are fortified. 

Fortifying staple foods can increase the intake of micronutrients (Image credit: Lactalis Ingredients).Foing expects this number to increase substantially due to “advancements in technology, growing evidence of fortified rice’s benefits and an increase in support from governments and non-governmental organizations.” 

“Rice brand owners can use fortification to differentiate their products by providing more nutritious rice that meets consumers’ needs, strengthening their position in the market.” 

Foing sees several challenges in the food fortification space, as local authorities may not be willing to adopt fortification measures, or food importers may bring non-fortified products to the market. 

“Regulations must be strictly implemented to ensure that the industry fortifies staple foods with the recommended levels of micronutrients.” 

Salvador adds that iron fortification of F&B, such as fruit juice, dairy and plant-based milk, is a common strategy to combat iron deficiency worldwide.

“It is crucial for countries who cannot afford to pay for supplements but can also be an important contribution to the whole world. Vehicles with iron can be added to staple foods, for instance, wheat, maize and rice.” 

However, she cautions that fortification programs lack quality assurance systems. “These programs have a limited impact because of the use of elemental iron powders with uncertain bioavailability. For these reasons, supplementation is the most effective way to combat malnutrition nowadays.”

Opportunities for new nutraceuticals 
There is a growing need in the market to provide nutraceutical products that can help address malnutrition, Salvador observes. “These include more traditional applications such as tablets, capsules, chewable and effervescent tablets, but also liquid supplement applications such as syrups, shots, gels and drops.” 

There is a growing need to provide nutraceutical products that can help address malnutrition.Lam stresses that premium quality proteins with the proper functionality are needed to enable the creation of different product formats and formulations. 

“Consumers and patients who require malnutrition products still value variety in their diets,” she continues. “They don’t want to drink the same ONS every day, so having a choice of dietary supplementation can significantly impact their recovery, compliance to treatment regimes and quality of life.” 

Lam cautions that these end products must meet strict regulatory requirements regarding levels of vitamins and minerals for fully fortified products while allowing for a broad spectrum of protein content and caloric density.

Macariou from Lactalis Ingredients sees an opportunity in the growing global demand for nutritious and functional food products. “Suppliers can contribute to improving the nutritional value of various food items by providing high-quality dairy ingredients.”

She also sees challenges, such as ensuring affordability, addressing specific dietary needs of diverse populations and maintaining consistent quality and safety standards across the supply chain. 

“There are also technical challenges when incorporating proteins into nutrient-dense products that undergo heat treatments. Heat treatments, such as UHT processing or sterilization, can affect the functionality and stability of proteins, leading to issues like denaturation.” 

By Jolanda van Hal