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Considerations in developing lipid-based nutrient supplements for prevention of undernutrition: experience from the International Lipid-Based nutrient supplements (iLiNS) Project.
Maternal and Child Nutrition. 2015 Dec; 11(Suppl 4):31-61.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.
Infant and young child nutrition, including the nutritional value and safety of products specifically intended for infant and young child feeding and the status of compliance with and implementation of the International Code of Marketing of Breast-milk Substitutes: report by the Director-General.
Geneva, Switzerland, WHO, March 1983. 39 p.This report to the Health Assembly is presented in 3 parts: Part I--a summary of the present global nutritional situation with particular reference to infants and young children--is based on an initial reading of the results of national surveillance and monitoring activities in over 50 countries. Part II has been prepared in accordance with resolution WHA34.23 which requested the Director-General to report to the Assembly on steps taken to assess the changes that occur with time and under various climatic conditions in the quality, nutritional value and safety of products specifically intended for infant and young child feeding. Part III, in accordance with resolution WHA34.22, summarizes information provided by Member States on action being taken to give effect to the International Code of Marketing of Breast-milk Substitutes. It should be read in conjunction with section VI of the Director-General's progress report which informed the 35th World Health Assembly of action taken by WHO and its Member States in the field of infant and young child feeding. In light of the information on the implementation of the Code contained in these 2 reports, and in the absence of any suggestions from Member States for change, the Director-General considers that it would be premature, at this time, to propose any revision of the text of the Code, either its form or content. The Health Assembly's attention will be drawn, in future biennial progress reports on infant and young child feeding, to any development which may have a bearing on the International Code, in accordance with its Article 11.7 and resolution WHA33.32.