It is clear that the escalating epidemic of insulin resistance and type 2 diabetes has reached a crisis level in the United States, that overweight and obesity are drivers, and that diets and the food system have major roles. It is also clear that nutrition and medical research point to increased healthful fruit and vegetable intake as a key part of any strategy to manage the crisis. But although increasing healthful intake entails both expanding production of fruits and vegetables and improving their healthful characteristics, horticulture has generally been sidelined or taken for granted when strategies are envisioned. This article makes the case that horticulture research and practice can and should be equal partners with nutrition and medicine in the pressing search for effective crisis-management strategies. To do so, it first "runs the numbers" for the scale of the crisis, for trends in fruit and vegetable intake and production, for the scant federal support for horticultural crop production and research, and for horticulture research's high return on investment. The article then sketches a roadmap to integrate horticulture research and community outreach with nutrition and healthcare, stressing new opportunities. The goal is a US food system that i) makes healthful fruits and vegetables accessible, affordable, and appealing for all and ii) complements a healthcare system spanning patient-based to population-based nutrition.

Chronic kidney disease (CKD) impairs the activation of vitamin D, leading to deficiencies that exacerbate disease progression and metabolic complications. This pilot study investigated the effects of consuming almond milk fortified with vitamin D3 nanoparticles on 25(OH)D3 among adults with advanced stages of CKD. A 21-day, double-blind randomized controlled pilot study was conducted. Participants (n = 18) were randomly assigned to consume 4 oz (118 ml) of almond milk daily with 4000 IU of vitamin D3 dispersed in soy protein nanoparticles (intervention group), or almond milk without vitamin D (control group). The primary outcome was the change in serum 25(OH)D3 levels, while secondary outcomes included changes in serum calcium and parathyroid hormone (PTH). From baseline to end of intervention, there was a significant decrease in serum 25(OH)D3 in the control group (49.2 ± 23.3 nmol/L to 44.5 ± 25.6 nmol/L; p < 0.05). In the intervention group, there was a significant increase in 25(OH)D3 (33.0 ± 15.8 nmol/L to 36.4 ± 15.8 nmol/L; p < 0.05). A significant time × treatment interaction (p < 0.01) was observed, with the intervention group showing a marked increase in serum 25(OH)D3. No differences between groups were observed in serum calcium and PTH. The consumption of almond milk fortified with vitamin D3 dispersed in soy protein nanoparticles increased 25(OH)D3 in adults with advanced stages of CKD over 21-days. Future research should explore the metabolism and long-term efficacy of nanoparticle-based delivery of vitamin D3 in larger, more diverse populations.

Objective: The objective of the study is to investigate the response of nutritional supplement (LNS-PLW) on appetite score, energy intake, insulin and glucose levels in preeclamptic women. Design and participiants: Sixty under-weight preeclamptic primigravida were divided into two groups randomly and provided LNS-PLW/placebo in the fasted state. Blood samples were collected at fasting state, after 30 min of supplementation, ‘ad libitum buffet’ breakfast and lunch for glucose and insulin levels. Results: Total energy intake was higher significantly in the LNS-PLW group, although during breakfast it was significantly reduced. The insulin and glucose concentration was significantly increased after 30 min of supplementation in the LNS-PLW group. Conclusion: Intake of the LNS-PLW by preeclamptic women had short-term suppression on subsequent meal but improved total energy intake during trial.

BACKGROUND:Adults with chronic kidney disease (CKD) have different protein requirements than the general population. Limited protein-rich baked snack options are available for CKD adults. The purpose of this proof of concept study was to develop two protein-rich baked snacks made with whey protein isolate and soy protein isolate and to evaluate their quality characteristics and sensory perceptions for adults with CKD. METHODS:A control formulation was obtained from the American Association of Cereal Chemists to develop three formulations-dried milk (control), whey protein isolate and soy protein isolate at an unbaked weight of 30 g. Product quality characteristics included moisture content, water activity, shape and size, and texture profile. For the sensory perception, healthy adults (n = 101) and adults with CKD (n = 57) completed a 9-point hedonic scale for appearance, flavor, texture, and overall acceptability. RESULTS:Protein content for the whey protein isolate and soy protein isolate reached 20% total weight. Despite containing similar moisture, both formulations were harder than the control (p < 0.001). Healthy participants preferred the whey protein isolate-based snack over the soy protein isolate-based snack for all attributes (p < 0.05). Differences in the same attributes were not perceived among CKD participants (p > 0.05). Open-ended responses from both healthy and CKD participants indicated that the soy protein isolate formulation was softer and sweeter compared to the whey protein isolate formulation. CONCLUSION:Overall, adults with CKD preferred both the whey protein isolate-and soy protein isolate-formulated snacks. These protein-rich baked snacks can be further modified to serve as an alternative snack choice for adults with CKD and used in future clinical trials.

Women sustain household health by operationalizing and maximizing nutrition through food preparation. Thus, information and the women's knowledge on nutrient adequacy of meals prepared at home is crucial for the design, implementation and performance of nutrition interventions. However, there is limited evidence on the adequacy of homemade complementary meals for children below two years in Tanzania. This study aimed to assess the dietary quality of the prepared complementary foods provided to infants and children. A cross-sectional survey was used to collect demographic and nutritional information. A total of 119 breastfeeding children aged 6 to 22 months were recruited. The dietary intake patterns were assessed using a seven-day food frequency questionnaire, and a 3-day 24 h recall. The dietary diversity score and Food consumption score evaluated dietary patterns. Food consumed by 27 children in a day (24 h) was weighed and recorded and samples were collected for nutrient analysis. Nutrient adequacy ratios were obtained by comparing FAO/WHO recommended intakes. Results revealed that 15% of the children had poor food consumption patterns. The median dietary diversity score of the children was four out of eight food groups. For most households, median adequacy ratios for energy, fat and micronutrient contributed from complementary foods were less than one. Although breastfeeding was present and supported at home, the nutrient densities of complementary meals were inadequate to achieve the WHO/FAO recommended nutrient intakes. Promotion of community food fortification and diversification programs, along with nutrition education, health and sanitation are necessary as they can improve the intake of critical micronutrients and nutrition status.

Unpredictable chronic mild stress (UCMS) leads to variable metabolic effects. Oxidative stress (OS) of adipose tissue (AT) and mitochondrial energy homeostasis is little investigated. This work studied the effects of UCMS on OS and the antioxidant/redox status in AT and mitochondrial energy homeostasis in rats. Twenty-four male Wistar rats (180-220 g) were divided into two equal groups; the normal control (NC) group and the UCMS group which were exposed to various stresses for 28 days. An indirect calorimetry machine was used to measure volumes of respiratory gases (VO2 & VCO2 ), total energy expenditure (TEE), and food intake (FI). The AT depots were collected, weighed, and used for measuring activities and gene expression of key antioxidant enzymes (GPx1, SOD, CAT, GR, GCL, and GS), OS marker levels including superoxide anion (SA), peroxynitrite radical (PON), nitric oxide (NO), hydrogen peroxide (H2 O2 ), lipid peroxides (LPO), t-protein carbonyl content (PCC), and reduced/oxidized glutathione levels (GSH, GSSG). Additionally, AT mitochondrial fractions were used to determine the activities of the tricarboxylic acid cycle (TCA) cycle enzymes (CS, α-KGDH, ICDH, SDH, MDH), respiratory chain complexes I-III, II-III, IV, the nicotinamide coenzymes NAD+ , NADH, and ATP/ADP levels. Compared with the NC group, the UCMS group showed very significantly increased OS marker levels, lowered antioxidant enzyme activities and gene expression, as well as lowered TCA cycle and respiratory chain activity and NAD+ , NADH, and ATP levels (p < .001 for all comparisons). Besides, the UCMS group had lowered TEE and insignificant FI and weight gain. In conclusion, AT of the UCMS-subjected rats showed a state of disturbed redox balance linked to disrupted energy homeostasis producing augmentation of AT.

Introduction:One key approach to achieve zero hunger in Sub-Saharan Africa (SSA) is to develop sustainable, affordable, and green technologies to process nutritious food products from locally available sources. Soybeans are an inexpensive source of high-quality protein that may help reduce undernutrition, but it is underutilized for human consumption. This research evaluated the feasibility of a low-cost method developed initially at the United States Department of Agriculture to produce soy protein concentrate (SPC) from mechanically pressed soy cake and thus create a more valuable ingredient to improve protein intake in SSA.Methods:The method was initially tested in the bench scale to assess process parameters. Raw ingredients comprised defatted soy flour (DSF), defatted toasted soy flour (DTSF), low-fat soy flour 1 (LFSF1; 8% oil), and LFSF2 (13% oil). Flours were mixed with water (1:10 w/v) at two temperatures (22 or 60°C) for two durations (30 or 60 min). After centrifugation, supernatants were decanted, and pellets were dried at 60°C for 2.5 h. Larger batches (350 g) of LFSF1 were used to examine the scalability of this method. At this level, protein, oil, crude fiber, ash, and phytic acid contents were measured. Thiobarbituric acid reactive substances (TBARS), hexanal concentration and peroxide value were measured in SPC and oil to evaluate oxidative status. Amino acid profiles, in vitro protein digestibility, and protein digestibility corrected amino acid score (PDCAAS) were determined to assess protein quality.Results:Bench scale results showed accumulation of protein (1.5-fold higher) and reduction of oxidative markers and phytic acid to almost half their initial values. Similarly, the large-scale production trials showed high batch-to-batch replicability and 1.3-fold protein increase from initial material (48%). The SPC also showed reductions in peroxide value (53%), TBARS (75%), and hexanal (32%) from the starting material. SPC's in vitro protein digestibility was higher than the starting material.Conclusion:The proposed low-resource method results in an SPC with improved nutritional quality, higher oxidative stability, and lower antinutrient content, which enhances its use in food-to-food fortification for human consumption and is thus amenable to address protein quantity and quality gaps among vulnerable populations in SSA.

A case study in the U.S. Midwest explored factors likely to be limiting organic maize, aka corn seed quality and quantity. We sought to learn about the influence of the regulatory loophole which allows use of conventionally produced, untreated, non-GMO seed for organic production when an organic equivalent is unavailable and, the organic sectors' concerns about access to quality seed, and seed price. Two farmer focus groups, a workshop with seed producers, a survey of merchants of organic maize seed, and a research project advisory board suggested that the degree of concern about the loophole and seed quality varied according to participants' priorities. Farmers equate seed quality with agronomic traits impacting grain yield and crop establishment (vigor, emergence and tolerance to cultivation). Traits influencing grain quality or composition for specific uses, and the ability to satisfy consumer wants were more important to buyers. Seed price was of greater concern to farmers and buyers catering to commodity markets than to producers and buyers serving de-commodified markets. Producers that prized yield most highly were less concerned about the loophole or interested in participatory on-farm breeding and testing networks than farmers catering to specialty markets. Despite interest, little information about nutritional quality, rhizosphere function, and ecosystem service provision is circulated outside of academic groups. A workshop with leaders in the organic seed improvement industry and advisory board input identified the inability of inbred lines to withstand weed, pest, and disease pressure as the main bottleneck increasing costs and limiting investment in organic seed improvement. The cost differential between organic-and conventional non-treated seed, and competition from organic grain imports, were believed to be limiting the price of certified seed, thus making it difficult to garner investment and innovation needed to develop desired agronomic, environmental, or grain-quality traits. An audit of seed sales reported by >90% of U.S. vendors of certified seed found that the volume of organic seed being sold may account for as much as 75% of organic maize acreage planted in the U.S. Costs of non-treated seed sourced through the loophole are 40-100% less than certified seed. With 75% of U.S. organic corn being produced using certified organic seed, we conclude that the loophole is not altering seed quality by undercutting organic seed sales. Substantially higher costs of organic seed production and challenges associated with organic seed production appear to be the most likely barriers to maize seed improvement for the organic sector.

The study assessed the nutrient value and desirability of eight improved soybean varieties, for use in soymilk, tofu and as an ingredient to enhance staple foods. The soymilk, tofu, and soybean residue (okara) yields were determined across all varieties. The okara was subsequently used in composite with cassava, as a recipe refinement of gari, a popular cassava-based ready-to-eat food. Multiple composite ratios were compared against a control of 100% cassava gari; 80% cassava: 20% okara, 70% cassava: 30% okara, and 50% cassava: 50% okara. The soymilk and tofu from the various varieties and okara enriched-gari were also evaluated for proximate and sensory qualities ( n = 50) using standard protocols. No differences ( p > 0.05) existed among soybean varieties in terms of soymilk ( p = 0.55; 13.0–14.1 L), tofu ( p = 0.05; 0.12–0.15 kg/L) or okara ( p = 0.08; 3.17–3.97 kg) yields. The proximate parameters evaluated for soymilk did not vary significantly ( p > 0.05) among varieties. However, for total solids (3.33–7.93°Brix; p < 0.01) there were significant differences. Generally, there was an increasing trend in the crude protein, moisture, crude fat and total ash contents for the okara-enriched gari as the okara inclusion increased from 20 to 50%. Thus, the crude protein content of the 50% okara-enriched gari, the formulation with the highest okara incorporation was almost 11-times higher than the 100% cassava gari. The swelling capacity of the okara-enriched gari ranged from 3.29–5.47 and for water holding capacity 439.7–482.1%. The okara-enriched gari was equally preferred by consumers, except for colour which consumers were mostly indifferent towards. The 50%-okara enriched gari composite was compared equally with 100% cassava gari control. The sensory data showed that the “Favour” soybean variety was desirable for soymilk production while Salintuya 1 was desirable for tofu production. Recipe refinements using the desired varieties and compositing okara with cassava may help fill the protein gap among the vulnerable group in Ghana by improving the protein quality of ready-to-eat foods such as gari.

Food fortification in low-income settings is limited due to the lack of simple quality control sensing tools. In this study, we field validated a paper-based, smartphone-assisted colorimetric assay (Nu3Px) for the determination of iron in fortified flours against the gold standard method, atomic emission spectrometry (AES). Samples from commercial brands (n = 6) were collected from supermarkets, convenience stores, and directly from companies in Mexico and characterized using both Nu3Px and AES. Nu3Px’s final error parameters were quantified (n = 45) via method validation final experiments (replication and comparison of methods experiment). Qualitative pilot testing was conducted, assessing Nu3Px’s accept/reject batch decision making (accept ≥ 40 μg Fe/g flour; reject < 40 μg Fe/g flour) against Mexico’s fortification policy. A modified user-centered design process was followed to develop and evaluate an alternative sampling procedure using affordable tools. Variation of iron content in Mexican corn flours ranged from 23% to 39%. Nu3Px’s random error was 12%, and its bias was 1.79 ± 9.99 μg Fe/g flour. Nu3Px had a true mean difference from AES equal to 0 and similar variances. AES and Nu3Px made similar classifications based on Mexico’s policy. Using simple, affordable tools for sampling resulted in similar output to the traditional sampling preparation (r = 0.952, p = 0.01). The affordable sample preparation kit has similar precision to using analytical tools. The sample preparation kit coupled with the smartphone app and paper-based assay measure iron within the performance parameters required for the application to corn flour fortification programs, such as in the case of Mexico.

At specific vibration frequencies like ones generated by insects such as caterpillar chewing and bee's buzz-pollination turn on the plants secondary metabolism and their respective pathways gets activated. Thus, studies report that vibrations and sound waves applied to plants improves their fitness performance. Commonly, acoustic treatments for plants have used arbitrarily random frequencies. In this work, a group of signals obtained from hydric-stressed plants was recorded as vibrational patterns using a laser vibrometer. These vibration-signals were classified as representative of each condition and then externally applied as Acoustic Emission Patterns (AEP). The present research hypothesized that specific vibration frequencies could "emulate" a plant signal through mechanical energy based on tplant's ability to recognize vibration pattern similarity to a hydric status. This investigation aimed to apply the AEP's as characteristic vibrations classified as Low hydric stress (LHS), medium hydric stress (MHS), and high hydric stress (HHS) to evaluate their effect on healthy-well watered plants at two developmental stages. In the vegetative stage, the gene expression related to antioxidant and hydric stress responses was assessed. The LHS, MHS, and HHS acoustic treatments up-regulated the peroxidase (Pod) (~2.8, 1.9, and 3.6-fold change, respectively). The superoxide dismutase (Mn-sod) and phenylalanine ammonia-lyase (Pal) genes were up-regulated by HHS (~0.23 and ~0.55-fold change, respectively) and, the chalcone synthase (Chs) gene was induced by MHS (~0.63-fold-change). At the fructification stage, the MHS treatment induced a significant increase in Capsaicin content (5.88-fold change), probably through the at3and kas gene activation. Findings are correlated for a better understanding of plant responses to different multi frequency-signals tones from vibrations with potential for agricultural applications.

The oxidative stability of pretreated full-fat soybean flour (FFSF) was evaluated under commercial (Experiment I) and accelerated conditions (Experiment II). In Experiment I, soybeans were pretreated using germination, soaking (24 h), or roasting (110–120 °C), and the dried, milled FFSF was stored for 120 days under commercial storage conditions in two cities in Ghana. Acid value (AV) and peroxide value (PV) were determined. The proximate and sensory quality of Tuo Zaafi, a maize-only dish in northern Ghana enriched with 10–30% of the pretreated FFSF, was assessed. Before storage, all samples had similar PV (1.907–4.305 mEq/kg oil); however, the AV of the germinated sample was higher than that of the unprocessed samples (10.83 vs. 3.13 mgKOH/g oil; p < 0.001). After storage, although AV fluctuated, the PV was similar (2.39–3.74 mEq/kg oil; p = 1.00). Storage location showed no significant differences in terms of AV (4.96–4.97 mgKOH/g oil; p = 0.994), unlike PV (2.07–3.55 mEq/kg oil; p < 0.001). Increasing the levels of the pretreated FFSF in Tuo Zaafi resulted in lower consumer preference scores for all sensory attributes. In Experiment II, FFSF samples (dehulled and nondehulled) prepared from germination, soaking (18 h and 24 h) and roasting were evaluated under accelerated conditions (AC) of controlled temperature (45 ± 0.1 °C) and relative humidity (81 ± 1%) for AV, PV, p-anisidine value (pAV), lipoxygenase activity (LOX), color, and moisture. Pretreatment, condition, time, and their interaction affected the oxidative stability of all FFSF samples (p < 0.001). Roasted samples showed the highest increase in AV and pAV in both storage conditions (p < 0.05). Under room temperature conditions (RTC), the roasted and germinated samples had lower LOX activity (p < 0.05) at the end of storage time compared to that of the controls. In conclusion, germination and soaking reduced oxidation of FFSF, while roasting promotes it, despite its common use.

The high consumption of sugar-added food products by children has stimulated research on formulations using ingredients such as mango bagasse (MB), which deliver health-associated components. This research aimed to characterize, perform a sensory evaluation, and assess the probiotic effect in vitro of MB-added gum confections (1:4 and 1:5 water:MB). The 1:4 formulation displayed the highest acceptance by 51 children from a primary school in Ciudad Juárez (Mexico). This formulation contained a high fiber content (10.50%) and phenolic compounds (mainly mangiferin and (+)-catechin), and it allowed L. plantarum, L. reuteri, L. helveticus, and L. rhamnosus GG growth. The results suggest that MB-confections are fiber- and polyphenol-rich products with a sensory profile accepted by children and prebiotic effects.

Vitamin D deficiency is a global issue which has been exacerbated by the COVID-19 pandemic-related lockdowns. Fortification of food staples with vitamin D provides a solution to alleviate this problem. This research explored the use of pea protein nanoemulsion (PPN) to improve the stability of vitamin D in various food products. PPN was created using a pH-shifting and ultrasonication combined method. The physicochemical properties were studied, including particle size, foaming ability, water holding capacity, antioxidant activity, and total phenolic contents. The fortification of several food formulations (non-fat cow milk, canned orange juice, orange juice powder, banana milk, and infant formula) with vitamin D–PPN was investigated and compared to raw untreated pea protein (UPP) regarding their color, viscosity, moisture content, chemical composition, vitamin D stability, antioxidant activity, and morphology. Finally, a sensory evaluation (quantitative descriptive analysis, and consumer testing) was conducted. The results show that PPN with a size of 21.8 nm protected the vitamin D in all tested products. PPN may serve as a potential carrier and stabilizer of vitamin D in food products with minimum effects on the taste and color. Hence, PPN may serve as a green and safe method for food fortification during the COVID-19 pandemic.

Valid and reliable questionnaires are necessary to improve the existence and quality of nutrition information, which determines interventions in low-resource settings, especially among decision makers and change agents. The present study evaluated the internal consistency and test-retest reliability of the data collected among 255 head teachers from schools in Mukono and Wakiso districts in Uganda using a general nutrition knowledge questionnaire (GNKQ) earlier developed. Cronbach alpha (α) was used to determine internal consistency. Pearson's correlation coefficient (r) and intraclass correlation coefficient were used to measure test-retest dependability on scores (ICC2,1). Overall internal consistency on 94 items was α = 0.89 at time one and 0.92 at time two. All items yielded data with a satisfactory internal consistency (α > 0.7). Two domains, Expert advice (ICC = 0.64) and Selecting food (ICC = 0.41), were determined to have insufficient test-retest reliability (r < 0.7 and ICC = 0.7), and their items were removed from the next analyses. The remaining nutrition knowledge topics with adequate test-retest reliability were food groupings (ICC = 0.9), nutrition and sickness (ICC = 0.91), and food fortification (ICC = 0.95). According to the findings, the prototype nutrition knowledge questionnaire had acceptable internal consistency and test-retest reliability. These findings indicate that the previously established questionnaire can be used to assess general nutrition knowledge among head teachers. To boost generalizability, future studies could use the questionnaire on a different group of adults.

Cryptosporidium parvum is a protozoan parasite that infects intestinal epithelial cells causing malabsorption and severe diarrhea. The monoterpene thymol has been reported to have antifungal and antibacterial properties but less is known about the antiparasitic effect of this compound. Terpenes are sometimes unsuitable for therapeutic and food applications because of their instability. Esterification of terpenes eliminates this disadvantage. The present study evaluates the effects of thymol (Th) and a thymol ester, thymol octanoate (TO), against C. parvum infectivity in vitro. The cytotoxicity IC50 value for TO after 24 h of treatment was 309.6 μg/mL, significantly higher than that of Th (122.5 μg/mL) in a human adenocarcinoma cell line (HCT-8). In the same way, following 48 h of treatment, the cytotoxicity IC50 value for TO was significantly higher (139 μg/mL) than that of Th (75.5 μg/mL). These results indicate that esterification significantly reduces Th cytotoxicity. Dose-dependent effects were observed for TO and Th when both parasite invasion and parasite growth assays were evaluated. When evaluated for their activity against C. parvum growth cultured in vitro in HCT-8 cells, the anti-cryptosporidial IC50 values were 35.5 and 7.5 μg/mL, for TO and Th, respectively. Together, these findings indicate that esterified thymol has anti-cryptosporidial effect comparable with its parental compound thymol, but with improved safety margins in mammalian cells and better physicochemical properties that could make it more suitable for diverse applications as an antiparasitic agent.

Iron fortification of staple foods is a common practice around the world to reduce the prevalence of iron-deficiency anemia. More recently, fortified condiments, including salts, sauces, and powders, have been tested in various efficacy trials. However, there is limited information on how nutritional, environmental, and experimental factors affect their efficacy and effectiveness. The purpose of the present work was to systematically review performance factors affecting the efficacy of condiment fortification trials. Three databases were searched using a standardized keyword search and included based on four-point inclusion criteria. Studies were evaluated against a quality assessment tool and effect sizes were calculated. Studies were ranked as low or high performing, based on whether or not they significantly improved iron-deficiency outcomes (hemoglobin, anemia prevalence, and ferritin levels). Of the 955 retrieved studies, 23 were included-of which, nine performed poorly, eight performed highly, and six were classified as neither because they did not meet the criteria of assessing the three iron outcomes. Results showed that unsuccessful trials did not consider environmental factors such as parasitic infections, nutritional factors such as micronutrient deficiencies other than iron, consumer acceptability of the product or experimental factors such as monitoring and adherence to the trials. Two common performing factors identified among those studies performing highly vs. those that did not were the control of sensory changes and monitoring of consumption compliance (i.e., dose delivery). The present work can be used as decision-making support for nutrition policy makers when determining the appropriate implementation of condiment fortification programs.

BACKGROUND:In Mexico, the fortification of corn and wheat flours with iron, zinc, and folic acid and the restoration of B-vitamins is a mandatory program. However, the monitoring and evaluation (M&E) of this fortification process is not well understood. Thus, the purpose of the study was to understand the M&E of the food fortification program in Mexico, with an emphasis on technology research and development.METHODS:Open-ended exploratory interviews were conducted with food technology representatives (n = 9), food science academic faculty (n = 1), president of a private tortilla-making federation (n = 1), and representatives of the federal monitoring agency (n = 2). Interviews were transcribed and themes were identified using the content analysis methodology. Inter-rater reliability was assessed by calculating an intraclass correlation coefficient (ICC) between the raters (n = 3).RESULTS:A total of 49 codes were identified that resulted in three overarching themes, manufacturing/processing, monitoring logistics, and nutrition. Overall, there is a need for more robust internal and external M&E with Mexico's fortification program to improve the manufacturing/processing of fortifying the tortillas, the monitoring of this fortification program, and the impact the fortified tortillas have on the nutritional status of the Mexican population. The overall ICC was 0.87.CONCLUSIONS:The present study can be used to gain insight into Mexico's fortification program and to inform food fortification policymakers of best practices.

Food fortification programs and food companies in low-income settings, such as in the case of Mexico, lack the ability to monitor the micronutrients added to staples entering local markets. The purpose of the present work is to validate a user-friendly sampling kit and quantify the final error parameters of a paper-based, smartphone-assisted sensor (Nu3px) for the determination of iron in corn flours within the context of Mexico's food fortification program. Corn flour samples (n = 45) from local brands (n = 6) were collected from supermarkets, convenience stores, and directly from companies in the States of Querétaro, Cuautitlán, Saltillo, and Cuetzalan, Mexico. Iron content was analyzed using atomic emission spectroscopy (AES) and Nu3px. The final error parameters were quantified via method validation final experiments, i.e., replication and comparison of methods experiments. Qualitative categorization of samples (i.e., accept/reject batch) was applied to evaluate Nu3px's against Mexico's fortification policy (cutoff = 40 μg Fe/g flour). A user-centered design process was applied to develop and evaluate a sampling kit consisting of low-cost measuring utensils. Iron content in fortified Mexican corn flours varied widely (23–39%). Nu3px's random error was 12% (replication experiment, n = 5) and its bias was 1.79 ± 9.99 μg Fe/g flour (comparison of methods experiment, n = 45). The true mean difference between Nu3px and AES was zero (p > 0.05) and both methods had similar variance (F = 2.40; P > 0.05). AES and Nu3px classified the iron content above/below the cutoff in the same way (100% match, Χ2 = 16.41, P = 0.01). The affordable and user-friendly sampling kit added some random error, but the mean difference was equal to zero (P > 0.05). Both sampling procedures were correlated (r = 0.952, P = 0.01). An affordable, user-friendly, and equipment-free sample preparation kit for corn flour samples showed similar precision to using analytical tools. The sample preparation kit along with the paper-based, smartphone-assisted assay measure iron within the performance parameters required for its application to monitor batch quality in the corn flour fortification program in Mexico. Fulbright Garcia-Robles Fellowship, 2019.