Food therapy
KO Isaac discusses how fortified food products can be
transformed into theraupetic nutrition
With therapeutic intervention
through pharmaceuticals being
increasingly stretched and focused
at the invading pathogen or disease, health
care experts as well as patients the world over
have been concerned about how to make the
host or patient stronger and contribute to
fight the disease. This is seen rather starkly in
the case of HIV and its opportunistic
affiliates like pneumonia, tuberculosis and
bronchial infections and various bacterial
infestations like septicemia etc., where the
host, namely the human being, has no ability
to withstand any additional infection. In
another category, with India targeted to have
over 66 million Type II diabetics in the next
10 years, there is an incumbent need for
health care professionals to support patients
through nutritional intervention. This is to
either enhance supportive therapy in the
form of products like Methycobalamin for
prevention and treatment of Diabetic
neuropathy or combinations of Carotenoids
for prevention of either age-related or
diabetic macular degeneration. Food,
therefore becomes an excellent 'delivery
mechanism' for specific supplementation
necessary for supportive therapies.
However any attempt at creating
'therapeutic nutrition' must also focus at the
don'ts associated with tackling disease. For
example, sugared products must be replaced
with low calorie sweeteners like sucralose for
diabetics. For cardiology patients, saturated
fats need to be dispensed with. Therefore for
target populations like pregnant or lactating
mothers, diabetics, cardio-vascular patients,
geriatrics, convalescence etc., the
requirements of therapeutic intervention
through nutrition are significantly different.
Food fortification is a nutritional
intervention, the success of which is measured
by whether or not the nutrition and health
status of the targeted population and their
ability to fight disease has been improved.
Therefore, several important aspects should
be carefully assessed in the development of a
food-fortification.
Processing techniques for
fortified food
Each type of fortification in a product needs
to be understood thoroughly in terms of
interaction among the added nutrients and
the nutrients that are originally present in the
food. Stability of nutrient content includes
application of protective coatings for the
individual nutrient, addition of antioxidants,
control of temperature, moisture and pH and
protection from air, light and incompatible
metals during processing and storage. The
knowledge of these factors clubbed with a detailed understanding of the production
parameters is essential. Thus it is necessary to
know that oil soluble vitamin E molecules of
400 to 1000 nanometres, when cut down to
only 10 nanometres in diameter, make them
thermodynamically stable and unlikely to rise
and cloud a beverage; the concentration of
sugar in syrup or sodium metabisulphite
solution (equivalent to 1000 ppm), salt in
brine is usually 15 g/l etc.
Similarly, good knowledge of production
processes like pulper-finishers for sieving and
separating seeds, skins etc., from the pulp;
extraction of juice from fruit using a fruit
press or fruit mill or by steaming the fruit;
that acidic fruits require relatively mild
heating conditions for pasteurisation (for
example, 90-100°C for 10-20 minutes) to
destroy yeasts and moulds, whereas less
acidic vegetables require more severe heat
sterilisation to destroy food poisoning
bacteria etc., is crucial to create products in
this category. Knowledge of the method of
fortification into the product and subjecting
it to suitable processing would ensure that
the fortification eventually delivers the
effective resultant values to the consumer.
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