Micronutrient status in Southeast Asia - Opportunities for the Food and Beverage industry

By YASHNA HARJANI, Nutrition Director, VeVeva Nutrition Pte Ltd

Micronutrient deficiencies affect over 2 billion people globally, especially women of the reproductive age, infants, young children, and the elderly. This is a concern, as even mild micronutrient deficiencies adversely impact growth, mental and cognitive development, immune function, overall health, school performance, working capacity, economic productivity in the general population; and overall quality of life in the elderly.

(Photo credit: Hui Sang I Unspash) 

In Southeast Asia (SEA), micronutrient deficiencies continue to be a public health problem. The challenge, however, is that deficiency data is either limited or outdated, and in the case of the elderly, they have not been prioritised in national nutrition surveys. But based on the information we have on hand today, following is an update on the nutrients of concern:

Protein  While protein intake is adequate in Singapore and Thailand, deficiency is a concern in children in Malaysia, Indonesia and Vietnam. The elderly population across the region is likely to be deficient in protein, as protein requirement increases and food intake decreases with age.

Vitamin A  As a bulk of the SEA population does not meet the recommended level of vitamin A, deficiency is a concern. Women in their reproductive years, children, a small percentage of adults and the elderly are affected.  

B Vitamins  A high percentage of the population in SEA, especially women in their reproductive years, children and the elderly, do not meet the daily requirement of some B vitamins. Inadequate intake of folate (young women, infants, children), thiamine (infants, children), niacin (children) and vitamin B12 (elderly, young women, children, vegans) is a concern.

Vitamin C  Inadequate intake of vitamin C is a concern across SEA, especially among pregnant and lactating women, and children.

Vitamin D   Despite abundant sunlight in many parts of SEA, vitamin D deficiency is rampant across the population, as it cannot be obtained solely from dietary sources, and pollution and busy lifestyles which limit exposure to sunlight, interfere with natural vitamin D production. Pregnant and lactating women, children and the elderly are at high risk of deficiency.

Vitamin E  Pregnant and lactating women are likely to be deficient.

Iron  Moderate-to-high levels of iron-deficiency has been reported in SEA. More women than men, pregnant and lactating women, infants, pre-school and older children, especially older girls, do not meet the recommended level of iron.

Zinc  Zinc deficiency is a concern in young women in their reproductive years, children, adolescents, some adults, and the elderly.

Calcium  Inadequate calcium intake is a concern in SEA and it impacts young women in their reproductive years, pregnant and lactating women, some adults, children and the elderly.

Potassium  Pregnant and lactating women are less likely to meet the requirement for potassium.

Iodine Iodine deficiency is prevalent in some parts of SEA, and leads to iodine deficiency disorders (IDD) such as goitre, cretinism, and impaired cognitive development. Lack of iodized salt consumption and low seafood intake are the primary causes of IDD in the region.

Opportunities for food and beverage industry

Clearly, deficiency is a concern. It may be severe in some parts of SEA and moderate in the emerging and developing parts of SEA, but the fact is, that it exists. Deficiency, combined with heightened consumer awareness of the importance of a healthy diet and the role of vitamins and minerals in supporting immune health, in the post pandemic era, indicates a demand for products fortified with immune-boosting nutrients and functional ingredients.,

Manufacturers have stepped up to this demand, by trying to understand consumer dietary and nutrient gaps, emerging consumer health concerns and lifestyle needs, to build the next generation of holistic functional food and beverage solutions. However, there is more the food industry  can do, to alleviate and or prevent micronutrient deficiencies in the region, such as:  

Mass fortification to alleviate severe deficiencies

Fortifying staples and commonly used food like flour, salt, noodles, yogurt, soy sauce can help mitigate large scale deficiency, for e.g., vitamin A, vitamin D, iron and zinc. The food industry can support mandated mass fortification by collaborating with NGOs and public health agencies on nationwide nutrient deficiency data gathering, to identify the extent of deficiency, and the populations that need to be targeted with fortified food. This can help governments define, evaluate and refine mass fortification interventions.

Low-cost product development, packaging, distribution and promotion guidance for these foods, can help ensure successful launch and sustainability of these interventions in the marketplace.   

Pregnant woman and child (Photo credit: Matilda Wormwood) 

Fortification to address deficiencies in vulnerable populations

Fortification to address nutrient gaps in vulnerable populations is another important intervention that could be considered. Food targeting young women and infants, can help ensure healthy growth and development of infants; those targeting children and adolescents, can help them grow to their full potential and set them on a path to a long and healthy life; and food for the elderly, can help ensure better physical and mental health, mobility and quality of life.

The key here is to find the right food vehicle, combination of nutrients that are compatible and bioavailable nutrients. Assessing bioavailability is important, to ensure the product delivers credible levels of nutrients. Promoting extent of and adverse impact of deficiency, and benefit of each nutrient is important too, to encourage daily consumption of these food by the target population.

Prioritising inclusion of nutrients of concern in functional food and beverages

As consumer interests in health and well-being are on the rise, especially in light of the recent COVID-19 pandemic, innovative fortified nutritional products that address key consumer health concerns are required. Immune health, heart health, gut health, eye health, brain or cognitive health, and mobility are adult consumer concerns. For parents, their greatest concerns for their children are immunity, energy levels and eye health.

From a solution perspective, all food or beverage products will have to be fortified with a bundle of compatible bioavailable nutrients and beneficial functional ingredients at an efficacious level. For example, to develop and maintain a strong immune system, the product could be fortified with protein, vitamins A, B6, C, D and E, as well as probiotics, prebiotics and or curcumin that could also be added to improve product functionality. To alleviate nutrition deficiencies, fortification with key nutrients of concern should be considered first that is, protein and vitamins A, C, D and E.

Consumers are also looking for lifestyle-linked food and beverage solutions. Hence, fortified food and beverages that support major consumers’ lifestyle trends are required too. Hectic stressful lifestyles require products that can boost energy levels and alleviate tiredness. A food or beverage fortified with calcium, magnesium, phosphorous, manganese, iron; and vitamins B1, B2, B3, B5, B6, B12 and C can help boost energy metabolism. Folate, magnesium, iron, and vitamins B2, B3, B5, B6, B12, and C play an important function in reducing fatigue and tiredness. In addition, to beat the damage caused by stress, the formulation could also include antioxidant nutrients like vitamins C and E, zinc and selenium.

Cost, technical feasibility and bioavailability of nutrients may require elimination of certain nutrients from fortified formulations. To support alleviation of deficiency, food manufacturers could make a conscious decision to include nutrients of concern first such as calcium iron, zinc; vitamins B1, B3, B12, C, E and folate.

Aging is another issue of concern for many consumers, with both men and women wanting to look younger and stay healthy, active and mobile, as they are likely to be living longer. Antioxidant vitamins C and E, zinc and selenium, nutrients that help maintain normal skin health, and vitamins B2 and B3 can be added into formulations to help people look younger. Here again, it is important to ensure that nutrients of concern, that is, vitamins C, E, B3 and zinc are included in the formulation.

Fortification to prevent deficiencies in certain groups of consumers

As overweight and obesity is a concern in SEA, many individuals are constantly on a weight loss or weight maintenance diet. Supplementary food or beverages developed for weight loss or weight management must provide at least a third of all essential vitamins and minerals, to prevent micronutrient deficiencies.

Emerging vegan and vegetarian consumers are also likely to fall short of protein, vitamins B12, iron, zinc and calcium, and products targeted at them should be fortified with these nutrients.

Future outlook

As consumers become more health-conscious and adopt healthier lifestyles, we are seeing a correspondingly increased preference for fortified food and beverages that address health concerns and support changing lifestyles. With this trend, the vitamin fortified and mineral enriched food and beverage market in SEA will continue to grow in the coming years. In fact, it is likely to evolve to a whole new level with personalized nutrition. With artificial intelligence and new age apps, it will soon be possible for the food industry to understand nutrient gaps and excesses of consumers, group consumers with similar gap and excess profiles together and create unique product solutions for each consumer group.  

The advancement of eCommerce business in sales and marketing will also enable food manufacturers to focus more on their product development and identify their market differentiation, such as vitamin D for immunity and bone health in young families; and immunity, bone and cardiovascular health in the elderly. You can also expect more partnerships among the food industry to leverage synergies and new technologies, to expand market reach.

Overall, SEA presents huge opportunities for growth of fortified functional food and beverages, and companies that can best align their strategies with consumer preferences and market trends are likely to succeed. And with a little bit of focus on the nutrients of concern, micronutrient deficiencies can be eliminated and or even prevented in the region.