This report contains the results of the USAID Vitamin C Pilot Program for use by USAID in consultation with the National Academy of Sciences to determine appropriate vitamin C fortification levels in food commodities used in U.S. food aid programs.

Contents

• COMMITTEE ON INTERNATIONAL NUTRITION—VITAMIN C IN FOOD AID COMMODITIES
• FOOD AND NUTRITION BOARD
• BOARD ON INTERNATIONAL HEALTH
• Preface
• Executive Summary
• 1. Introduction
  • The Committee's Task
  • The Study Process
• 2. Vitamin C: Needs and Functions
  • Prevalence of Scurvy
  • Vitamin C Requirements
  • Other Functions of Vitamin C
  • Vitamin C and Iron Absorption
• 3. Cost-Effectiveness Analysis
  • Effectiveness
  • Cost
  • Cost-Effectiveness Estimate
• 4. Results of the Vitamin C Pilot Program
  • Summary of the Pilot Program
  • Major Findings of the Pilot Program
• 5. Critique of the Pilot Program
  • Uniformity of Blended Commodities
  • Capability of the Production Process to Meet Product Specifications
  • Stability of Vitamin C During Transport and Storage
  • Vitamin C Cooking Losses
• 6. Conclusions and Recommendations
  • Conclusions
  • Recommendations
• References
• Appendix A Legislative Language for Increased Vitamin C Fortification
• Appendix B SUSTAIN Report Executive Summary
• Appendix C Letter from the United Nations World Food Programme
• Appendix D Biographical Sketches

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

Support for this project was provided by the Office of Health and Nutrition, United States Agency for International Development, Cooperative Agreement No. DPE-5951-A-00-0035-00. The opinions expressed in this report are those of the Committee on International Nutrition and do not necessarily reflect the views of the sponsor.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.