Earlier this year, global campaign accelerator Changing Markets Foundation co-published a report with Proyecto AliMente calling out failings in Mexico's mandatory flour fortification program, suggesting just 7% of flour products were adequately fortified.
Since 2008, the national standard NOM 247-SSA-1-2008 in Mexico means all flour manufacturers must fortify wheat and nixtamalized maize flours with iron, zinc, folic acid, and vitamins B1, B2 and B3. Mexico's Federal Commission for the Protection Against Sanitary Risks (COFEPRIS) is responsible for verifying compliance.
Changing Markets and Proyecto AliMente presented findings from the report to Mexico's new government in the hope existing regulations could be strengthened and regular inspections and sanctions for noncompliance introduced.
Speaking to NutraIngredients-LATAM, ConMéxico's nutrition advisor Laura Miranda said that, so far, COFEPRIS had not pronounced any noncompliance of flour fortification in Mexico. Moving forward, she said it would be important the government improved the efficacy of current programs in place aimed at combating malnutrition.
Tackling anemia – the 'serious public health problem'
According to Mexico's 2012 National Health and Nutrition Survey (ENSANUT), anemia in Mexican children decreased steadily between 1999 and 2012 but progress had been slow and less than anticipated.
Miranda said it was therefore necessary to “re-analyze targeted interventions in children with greater vulnerability” to combat anemia.
Similarly, the older population of adults 60+ years also had to be closely considered, she said, as “no progress has been shown in the past six years” to reduce anemia levels.
“Despite the improvement in the prevalence of anemia in women of reproductive age, the prevalence observed in the pregnant as well as in adults of 60 years or more of both sexes continue to represent a serious public health problem in Mexico.”
A report from Sight and Life Foundation and World Food Programme highlighted anemia as the most important health problem among women of reproductive age and children in Latin America, with a moderate prevalence among Mexican children of 20-40%. Prevalence of childhood anemia across the wider Latin America and Caribbean region was 28.56%, according to review published earlier this year.
Strengthening programs that already exist
Miranda said it was important to continue intervention efforts that provided “new options” for Mexicans to encourage a shift towards a high-iron diet and ensure wider availability and improved access to enriched foods and iron supplements. And these efforts, she said, had to stretch beyond flour fortification.
“It is important to notice that the interventions for the vulnerable population are not based in who needs more fortified flours. This is because flours are not the only source of iron and folic acid – there are other sources of these nutrients like the milk from the federal health program LICONSA,” she said.
LICONSA – a parastatal milk company subsidized by the federal government of Mexico – was created as part of a series of social support programs in the country over 50 years ago to industrialize and commercialize premium grade milk at very low costs to contribute to the nutrition of disadvantaged and vulnerable Mexicans.
“The government needs to work harder to strengthen actions with the programs that already exist to combat malnutrition,” Miranda said.
Market-driven fortification a plus
The private sector also had a role to play and were already engaged in voluntary fortification of food and beverage products with necessary nutrients, she said. At the end of 2017, ConMéxico members had fortified more than 1,480 products with vitamins and 1,300 with minerals according to the requirements of the Mexican population, she said.
Alice Delemare, campaign advisor at Changing Markets Foundation, said: “Where market-driven fortification is concerned, there is both a moral responsibility and a clear business case for food companies to be part of the solution to tackle global nutritional challenges.
“With two billion people in the world suffering from a lack of vitamins and minerals in their diet, it is no longer good enough for food companies to say their products are not harmful. To gain market share in the future, companies will need to go above and beyond to show their foods are nutritionally beneficial.”