Location: Obesity and Metabolism Research Unit
Title: Considerations in developing lipid-based nutrient supplements for prevention of undernutrition: experience from the International Lipid-Based Nutrient Supplements (iLiNS) Authors
|Arimond, Mary -|
|Zeilani, Mamane -|
|Jungjohann, Svenja -|
|Brown, Kenneth -|
|Ashorn, Per -|
|Dewey, Kathryn -|
Submitted to: Maternal and Child Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: June 27, 2013
Publication Date: N/A
Interpretive Summary: The approach for setting nutrient levels for pregnant and lactating women was slightly different in that the iLiNS formulation was influenced by a recent study showing better results with an antenatal supplement providing micronutrients (except iron) at twice the RDA/RNI (Kaestel et al. 2005). Our supplements do the same, with several exceptions due to considerations of safety (vitamin A, folic acid and iron) or feasibility (vitamin C) or in harmony with a newer recommendation (iodine). We also provide additional micronutrients not found in the UNIMMAP supplements as well as EFA. Our summary of considerations related to safety of ingredients and products – while not unique to LNS – highlights the many challenges faced by producers. Available international standards provide a framework. Finally, iLiNS Project researchers and partners now have experience with several different packaging options for LNS.We hope that the discussion of the advantages and disadvantages of the two main options (cups and sachets) can inform choices made by others.
Technical Abstract: The International Lipid-Based Nutrient Supplements (iLiNS) Project began in 2009 with the goal of contributing to the evidence base regarding the potential of lipid-based nutrient supplements (LNS) to prevent undernutrition in vulnerable populations. The first project objective was the development of acceptable LNS products for infants 6–24 months and for pregnant and lactating women, for use in studies in three countries (Burkina Faso, Ghana and Malawi). This paper shares the rationale for a series of decisions in supplement formulation and design, including those related to ration size, ingredients, nutrient content, safety and quality, and packaging. Most iLiNS supplements have a daily ration size of 20 g and are intended for home fortification of local diets. For infants, this ration size is designed to avoid displacement of breast milk and to allow for dietary diversity including any locally available and accessible nutrient-dense foods. Selection of ingredients depends on acceptability of flavour, micronutrient, anti-nutrient and essential fatty acid contents. The nutrient content of LNS designed to prevent undernutrition reflects the likelihood that in many resource-poor settings, diets of the most nutritionally vulnerable individuals (infants, young children, and pregnant and lactating women) are likely to be deficient in multiple micronutrients and, possibly, in essential fatty acids. During ingredient procurement and LNS production, safety and quality control procedures are required to prevent contamination with toxins or pathogens and to ensure that the product remains stable and palatable over time. Packaging design decisions must include consideration of product protection, stability, convenience and portion control.