Miller Magazine Issue: 124 April 2020

54 COVER STORY MILLER / APRIL 2020 termines if we speak of hot or warm extrusion and has an influence on the rice starch gelatinization and thus firmness of the produced fortified kernels. Rice fortified by hot extrusion enjoys widespread consumer acceptance, as it looks, cooks and tastes the same as its non-fortified counterpart — allowing it to be easily and seamlessly introduced into people’s diets. While the spe- cific costs of fortified rice depend on several factors, such as the scale of the operation and the blending ratio of for- tified to non-fortified kernels — rice fortification costs are small compared to the wide-reaching benefits. The cost impact is around 0.5 to 3%, yet such strategies could be a gamechanger for reducing malnutrition globally at both a population and individual level. The World Health Organization recommends fortifying rice as a public health strategy with a range of micronutrients, including iron, folic acid and vitamin A. 14 It is currently mandatory to fortify rice in a range of countries, including Costa Rica, Nicaragua, Panama, Papua New Guinea, Peru, the Philippines and some parts of the US. 15 SUPPORTING BRIGHTER FUTURES Implementing staple food fortification programs has the potential to not only protect the most vulnerable popula- tions, but also benefit societies as a whole. Beside nation- al fortification programs, targeted nutrition interventions, such as school feeding programs and workforce nutrition programs, are also proving to be effective. 1. School feeding programs (SFPs) One way of reducing the risk of malnourishment or ad- dressing existing malnutrition in children is through school feeding programs. Traditionally, SFPs have focused on chil- dren consuming enough calories and not going to school hungry. However, the importance of providing children with nutritious meals, which comprise nutrient-dense foods that are high in vitamins and minerals, is becoming increasingly recognized as an effective way to ensure these programs meet their objectives and are successful. Hidden hunger can affect overall health and development, learning and cognitive function, as well as productivity and performance later in life. Local studies in Ethiopia, for example, indicate that 31% of school children are under- nourished, out of which 19.6% are stunted, 15.9% are underweight and 14% are considered wasted. 16,17 Further studies report that 47.4% of preschool-aged children and 25.4% of school-aged children suffer from anemia, or vita- min B12 deficiency, as a result of inadequate micronutrient intake. 18 Anemia in children can contribute to a higher risk of disease and infection, poor cognitive development, im- paired physical growth, poor school performance and work capacity, which, in turn, can limit social and economic de- velopment. 19,20 Evidence suggests that SFPs that provide