ENHANCING THE NUTRIENT BIOAVAILABILITY OF AID PRODUCTS

A Report from the Food Aid Quality Review

PREPARED BY:

Michael Joseph Sajid Alavi Quentin Johnson Shelley Walton Patrick Webb

JANUARY 2019 This report was produced for the United States Agency for International Development (USAID). It was prepared under the terms of contract AID-OAA-C-16-00020 awarded to the Friedman School of Science and Policy at Tufts University.

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Recommended citation:

Joseph, Michael; Alavi, Sajid; Johnson, Quentin; Walton, Shelley; and Webb, Patrick. 2019. Enhancing the Nutrient Bioavailability of Food Aid Products, Report to USAID, Boston, MA: Tufts University.

This document may be reproduced without written permission by including a full citation of the source.

For correspondence, contact: This report is made possible by the generous support of the American people through the Patrick Webb support of the Office of Food for Peace (FFP) Friedman School of Nutrition Science & Policy of the Bureau for Democracy, Conflict and Tufts University Humanitarian Assistance (DCHA), under 150 Harrison Avenue terms of Contract No. AID-OAA-C-16- 00020, managed by Tufts University. The Boston, MA 02111 contents are the responsibility of Tufts [email protected] University and its partners in the Food Aid Quality Review Phase III (FAQR Phase III) and Sajid Alavi do not necessarily reflect the views of the Department of Grain Science and Industry United States Agency for International Kansas State University Development (USAID) or the United States 1301 Mid Campus Drive Government. Manhattan, KS 66506 [email protected]

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ACRONYMS

ACF Action Against ARA Arachidonic acid ARF Amylase-rich flour BHA Butylated hydroxyanisole BHT Butylated hydroxytoluene Ca Calcium cP centi Poise CSB Corn-soy blend CSB+ Corn-soy blend Plus (also, CSB++) CSWB Corn-soy-whey blend DCHA Bureau of Democracy, Conflict and Humanitarian Assistance DHA Docosahexaenoic acid DP Diastatic power DWG Defatted and toasted wheat germ E Energy EAA Essential EPA Eicosapentaenoic acid FAO Food and Agriculture Organization (of the United Nations) FAQR Food Aid Quality Review FBF Fortified blended food FFP Office of Food for Peace (USAID) FOS Fructo-oligosaccharide GI Gastrointestinal g/L Gram per liter GOS Galacto-oligosaccharides HCl Hydrochloride HEBs High-energy biscuits HMO Human milk oligosaccharide HSCAS Hydrated sodium calcium aluminosilicate IVPD In vitro protein digestibility K Potassium lc Long-chain LNS -based nutrient supplement LOS Lactulose MAM Moderate-acute Mg Magnesium MUAC Mid-upper arm circumference NDO Non-digestible oligosaccharide NPU Net protein utilization P Phosphrous PDX Polydextrose PG Propyl gallate PUFA Polyunsaturated fatty acid RUSF Ready-to-use supplementary food

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RUTF Ready-to-use therapeutic food RVA Rapid visco analyzer SAM Severe-acute malnutrition sc Short-chain SCFA Short-chain fatty acid SC Plus Super Cereal Plus SNFP Specialized nutritious food product SPI Soy-protein isolate TBHQ Tert-Butylhydoxyquinone USAID United States Agency for International Development USD United States dollar USDA United States Department of Agriculture WHO World Health Organization WPC Whey-protein concentrate w.r.t. With respect to w/v Weight/volume

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TABLE OF CONTENTS

ACRONYMS...... 3 1. EXECUTIVE SUMMARY ...... 6 II. INTRODUCTION ...... 7 III. METHODS ...... 9 IV. CHALLENGES IN IMPROVING BIOAVAILABILITY OF NUTRIENTS IN FOOD AID PRODUCTS...... 9 V. RECOMMENDATIONS ...... 16 1. Toasted and Defatted Wheat