Southeast Asia IAOM District Conference and Expo

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08 October 2013 - 10 October 2013


Location: InterContinental Hotel, Ho Chi Minh City, Vietnam

Region: Asia


Thirty-one people attended a special session for industry leaders in Viet Nam prior to the Southeast Asia International Association of Operative Millers (IAOM) District Conference and Expo held in Ho Chi Minh City. A policy paper for Viet Nam indicated that fortifying wheat flour would be a good economic investment for the country. This session explained what a mandatory flour fortification policy would mean for flour millers.

During the IAOM main event, Lena Kampehl from Muehlenchemie gave an excellent presentation on technical concerns related to flour fortification in South East Asia. We had a booth at the meeting's expo that allowed participants to taste test bread made with fortified and unfortified flour. None of the participants could tell any difference in the two products. We appreciate bakers from Interflour Viet Nam providing the bread samples.

The Vietnamese government has allowed flour millers to add nutrients to their products since 2010, but very little flour is being voluntarily fortified. The nutrient most frequently added to wheat flour is iron. When people do not have enough iron, they are less productive. Children need iron to full develop their cognitive ability and succeed in school. Yet the 2009-2011 General Nutrition Survey in Viet Nam showed that 30% of children less than 5 years of age had iron deficiency anemia.

Folic acid is also routinely added to wheat flour. Folic acid is a B vitamin that helps prevent serious birth defects called neural tube defects. The most common of these is spina bifida in which the baby’s spine does not form correctly and leads to paralysis. Folic acid deficiency can also lead to anemia.

Viet Nam does not have a national system to count how many pregnancies are affected by these birth defects. Based on hospital records, however, it appears that 3,000 to 4,000 children are born with spina bifida in Vietnam every year. This figure does not include pregnancies that are terminated when a neural tube defect is diagnosed in prenatal screening.

Surgical treatment is available for children born with spina bifida, depending on the severity of the birth defect. Yet about half of the children born with a neural tube defect in Viet Nam will die in infancy, according to a flour fortification report to the Vietnamese National Institute of Nutrition.

Other vitamins and minerals being considered for wheat flour fortification in Viet Nam are zinc, thiamine (vitamin B1), and vitamin B12. Zinc helps children develop, strengthens immune systems and lessens complications from diarrhea. Thiamine prevents the nervous system disease called beriberi. Vitamin B12 maintains functions of the brain and nervous system.

One reason mandatory fortification is successful is that people get additional nutrition through the foods they are already eating. They do not have to change their eating patterns or shopping habits to enjoy the benefits.

With that in mind, it would seem that rice rather than wheat flour should be fortified in Viet Nam as rice is the main food eaten in the country. Guidelines for fortifying rice are still being developed, however, and currently only five countries mandate it. Fortification is also most feasible in industrial settings. In Viet Nam, most rice is milled in small, village facilities where fortification is not yet practical.

On the other hand, Viet Nam has 19 industrial wheat flour mills which could easily begin fortification. Also, wheat flour consumption is increasing in Viet Nam. Data from the US Department of Agriculture shows that wheat consumption in Viet Nam has more than doubled in the past 10 years. This is consistent with information from the Food and Agriculture Organization of the United Nations. The increase is partly due to the growing popularity of instant noodles, which showed a 24% increase in consumption in Viet Nam between 2008 and 2012, according to the World Instant Noodle Association.

Some programs distribute vitamin and mineral supplements to individuals who are most at risk of having nutritional deficiencies. For example, Handicap International Vietnam has projects in Khanh Hoa and Thua Thien to encourage women to take folic acid supplements before they become pregnant. The success of these programs depends on people following the directions to take the supplement.

“Since the consequences of vitamin and mineral deficiencies can be devastating, we encourage countries to consider multiple approaches to improving nutrition,” said Annoek van den Wijngaart, the Flour Fortification Initiative Associate Executive Officer in Asia. “In Vietnam, the current opportunities include wheat flour and salt fortification as well as supplement programs. In the future, rice fortification may also be considered.”