Can Fortified Beverages Contribute to

Nutrition Improvement in Low- and

Medium-Income Countries?
Presentation for

2nd Asia Food and Beverage Summit

7-8 November 2016, Jakarta
Presenter

Regina Moench-Pfanner, PhD

ibn360 Pte Ltd, Singapore
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CORE MESSAGES
New Norm of Malnutrition
Nutrition and health statistics in Asia still need improvement
A holistic understanding of how people get and consume
energy (calories) and nutrients in the present environment must
inform solutions to improve nutrition and health
Collaborations are needed to lower the barriers for lowest
income populations to obtain a nutritionally complete diet
As part of a fast-growing segment of the F&B market, fortified
functional beverages could potentially play an important role in
improving nutrition among malnourished low- and middleincome populations

GLOBAL NUTRITION REPORT

Every country has a nutrition

problem
- Overnutrition
- Undernutrition
- Micronutrient deficiencies
- Non-communicable diseases

New Norm of Malnutrition

SCALE OF MALNUTRITION IN 2016

Source: IFPR. 2016. Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030. Washington, DC.

DOUBLE BURDEN OF MALNUTRITION PREVALENCE OF WASTING AND OVERWEIGHT

IN CHILDREN UNDER FIVE IN ASEAN

Source: ASEAN/UNICEF/WHO (2016). Regional Report on Nutrition Security in ASEAN,

Volume 2. Bangkok; UNICEF

PREVALENCE OF DIABETES AT A GLANCE

SEA SEA:
Bangladesh,

Bhutan, India,
Maldives, Mauritius, Nepal, Sri
Lanka

Source: International Diabetes Federation, IDF Diabetes Atlas. http://www.idf.org/sites/default/files/Atlas-poster-2014_EN.pdf

GLOBAL HIDDEN HUNGER: FACTS AND

FIGURES

Source:
World: Global Hidden Hunger Map (as of 28 Jan 2010) [Internet]. Sight and Life; 28 Jan 2010. Available from: http://reliefweb.int/map/world/worldglobal-hidden-hunger-map-28-jan-2010

What can industry do in response to these nutrition

and health trends?

THE HEALTH SIGNIFICANCE OF VITAMINS

AND MINERALS (MICRONUTRIENTS)

Micro
Nutrients

needed in small amounts

vitamins and minerals are needed by the body to perform hundreds of roles
body cannot manufacture on its own in sufficient amounts
must be consumed

Some of the roles of micronutrients

 Supplementation
Home fortification
Biofortification
Food fortification
Dietary diversification

Market

Targeted health interventions

Public
Health

STRATEGIES ADDRESSING THE PROBLEM OF

VITAMIN AND MINERAL DEFICIENCIES HIDDEN
HUNGER

KEY PLAYERS AND THEIR ROLES IN

NUTRITION IMPROVEMENT

Labelling
Enforcement
Regulations
Incentives
Education

Holding
industry &
government
accountable

Consensus
to provide
nutritious
foods

Research
Knowledge
Advocacy

Innovation
Social marketing
Financial
sustainability

Education
Nutrition awareness
Participation

USE OF PROCESSED FOODS IN PUBLIC HEALTH

Food Fortification
Addressing wide-spread deficiencies in vitamins and minerals
by enriching commonly consumed and accessible staple foods
in a cost efficient way

Over 80 countries have mandatory law in place to fortify wheat

flour; most countries have universal salt iodization; rice
fortification efforts underway in several countries;

FORTIFICATION HISTORY
In 1940s 50s: Elimination of
multiple nutrient
deficiencies, e.g. B-vitamin
deficiencies in USA, Canada

1920

1930

1940

In 2000s: Emphasis on
effectiveness to show health
impacts, with high cost-benefit ratio
(MDGs, Copenhagen Consensus)

1950

Early 1920s programs

Elimination of single
endemic nutrient
deficiency, ex. Goiter in
Switzerland

1960

1970

1980

1990

2000

2010

In 1960-90s: Early
industry voluntary
fortification

NUTRITION IN TRANSITION

A holistic understanding of
how people get and
consume food and nutrients
in the present environment
must inform solutions to
improve nutrition and health

DEMOGRAPHIC TRENDS 1950 - 2050

10

Population (billion)

Total population - world

Total population - more developed
regions

Total population - less developed

regions
4

Rural population - less developed

regions
Urban population - less developed
regions

0
1950

1970

2011

2030

2050

Source: United Nations, World Urbanization Prospects, The 2011 Revision

http://esa.un.org/unup/pdf/WUP2011_Highlights.pdf

BASE OF THE PYRAMID MARKET POTENTIAL

1 Billion
>$60/day

2 Billion
$10-60/day

Purchasing
Power:
$12.5 Trillion

3 Billion
$1-10/day

$5 Trillion

1 Billion
<$1/day

Humanitarian

Fairly urban, extremely

competitive, well-served

Changing
food
consumption,
under-served,
informal
economy,
inefficient and
little
competition

Base of
Pyramid
(BoP)

BOP SPENDS US$ 2.3 TRILLION A YEAR ON

FOOD & BEVERAGES

Source: Time Magazine, February 28, 2011

ASIA PROJECTED TO BE LEADING MARKET

FOR BEVERAGES BY 2021

Source:
http://www.beveragedaily.com/Mark
ets/Unprecedented-growth-for-Asiabeverage-market-globalconsumption-data

What can industry do in response to these nutrition

and health trends?

As part of a fast-growing segment of the F&B

market, fortified functional beverages could
potentially play an important role in improving
nutrition among malnourished low- and middleincome populations

KEY PLAYERS AND THEIR ROLES IN

NUTRITION IMPROVEMENT

Labelling
Enforcement
Regulations
Incentives
Education

Holding
industry &
government
accountable

Consensus
to provide
nutritious
foods

Research
Knowledge
Advocacy

Innovation
Social marketing
Financial
sustainability

Education
Nutrition awareness
Participation

KEY PLAYERS AND THEIR ROLES IN

NUTRITION IMPROVEMENT

Innovation
Social
marketing
Financial
sustainability

Labelling
Enforcement
Regulations
Incentives
Education

Holding
industry &
government
accountable

Consensus
to provide
nutritious
foods

Research
Knowledge
Advocacy

Education
Nutrition awareness
Participation

EVIDENCE BASE (1)

The future of functional

beverages depends on the
unequivocal demonstration of
their efficacy in promoting health.
Thus, a joint venture between
food producers and researchers
is advisable, as a tool to provide
scientific evidence of many
health claims, as well as a way to
find successful strategies to
improve the appeal of functional
beverages.

EVIDENCE BASE (2)

Multi-micronutrient fortified
beverage interventions highly
effective at reducing anemia
and iron deficiency
Strong public health rationale
for use in countries with high
prevalence
Further research needed on
impact of fortified beverages
with other nutrients or on
other outcomes (i.e. other
nutrients, physical
performance, etc.)

ADDITIONAL RESEARCH PRIORITIES

- Product R&D to determine optimal vehicle(s) and nutrient

formulations to achieve health-promoting functional
beverage profiles, while reducing undesirable ingredients,
such as sugar, salt, unhealthy fats, etc.
- Market research to identify most suitable products to reach
nutritionally-underserved population groups and define
affordable price points to encourage uptake
- Packaging R&D to develop innovative and intuitive visual
cues on serving/portion sizes as well as
nutrition/educational information

OBJECTIONS TO SUGAR SWEETENED

BEVERAGES (SSBS)

Soft
drinks

Sweetened
milk, tea or
coffee drinks

Sweetened fruit
or vegetable drinks

Sports & energy drinks

Unsweetened milk (dairy or

otherwise), tea or coffee drinks

Unsweetened 100% fruit or

vegetable drinks

Plain water

SSBs: Relative risk of

excessive calorie intake or
other negative effects on
health if over-consumed

CHANGING BEVERAGE FORMULATION?

GETTING BEYOND THE OBJECTIONS WHAT

WOULD AN IDEAL FORMULATION/ PRODUCT
LOOK LIKE? (1)

Fortified Food/Beverage hybrid of dietary diversity and

supplementation approaches
Besides being affordable, ideal products would:
- Provide adequate quantities of nutrient-dense calories
- Contain limited or non-existent amounts of unhealthy
ingredients, i.e. sugar, salt, trans/saturated fats, etc.
- Maintain/deliver an appealing sensory experience
(sight, smell, taste, texture/viscosity)
- Possess reasonably good handling and storage
characteristics, i.e. shelf life, packaging, etc.

GETTING BEYOND THE OBJECTIONS WHAT

WOULD AN IDEAL FORMULATION/PRODUCT
LOOK LIKE? (2)

- Provide easy-to-understand visual cues on

serving/portion sizes (if containing more than 1
serving/portion) packaging innovation needed
- Provide adequate information/education on the
nutritional content, particularly key macro- and
micronutrients meet or exceed labeling requirements
- (Bonus) Include labeling that enables consumers,
regulators, NGOs or industry watchdogs to verify
origin and other supply chain characteristics for
traceability/transparency and proof of sustainability

CORE MESSAGE FOR ACTION

Given the scale of beverage consumption and private

sectors influence on dietary intake, the private sector
needs to be co-opted into creating solutions for
reducing double burden of malnutrition

Expand the circles of (existing) collaborations to be

inclusive of all relevant actors and sectors across the
nutrition improvement value chain

Q&A

Information & correspondence:

Regina Moench-Pfanner, PhD

Chief Executive Officer, Ibn 360 Pte Ltd

3 Pickering Street, #02-36 Nankin Row,
China Square Central, Singapore 048660
m +65 8387 2535 t +65 6327 8824 f +65 6223 7314
regina@ibn-360.com www.ibn-360.com
@Moenchpfanner

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