Special Article - Protein Diet
Austin J Nutri Food Sci. 2018; 6(2): 1103.
Are There Organoleptic Differences between Micronutrients Fortified Pure Natural Milk and Fortified Constituted Milk?
Van TK¹*, Thuc VTM², Nga TT¹, Tu NS¹ and Tu NTN¹
¹National Institute of Nutrition, Vietnam
²Department of Immunology, Otorhinolaryngology Hospital, Vietnam
*Corresponding author: Van TK, National Institute of Nutrition, 48 Tang Bat Ho, Hanoi, Vietnam
Received: April 02, 2018; Accepted: April 25, 2018; Published: May 02, 2018
Abstract
Introduction: The school age (6-11) is an important stage and a nutritionally vulnerable age group. Sensory acceptance for fortified micronutrients milk is required to expand the milk program to improve nutrition for school children on a nationwide scale.
Objective: Assessing organoleptic acceptance of fortified micronutrients milk in primary school children in PhuBinh district, Thai Nguyen province, and a rural district in the Northern mountain of Vietnam.
Method: Fortified micronutrients milk formula was developed base on the World Health Organization (WHO) recommendations. Children were chosen from the subjects that participated in the effectiveness study of fortified micronutrients 100% natural milk and fortified micronutrients constituted milk to involve in the sensory acceptance research using the hedonic scale (9 points).
Results: Dietary intake in the research met the recommended dietary allowances for varying age groups of energy from 6.6% to 10.7%, of protein from 10.8% to 21.6%, of vitamin A from 19% to 25.3%, of vitamin D approximately 12.7%, of water-soluble vitamins from 13% to 36%, of iron from 15% to 30.9%, zinc from 16.7% to 30% and other minerals from 10.1% to 36%. Chi-square test gave a p-value<0.0001, showing a significant difference in the result of organoleptic acceptance ranging from terrible to great. The number of acceptance was much higher than that of unacceptance. Fisher extract test gave a p-value>0.05, showing no significant difference between the group of fortified micronutrients 100% pure natural milk and that of the fortified constituted milk for the score of larger than 5 among all organoleptic qualities including color, taste, smell, flavorful and overall acceptance.
Conclusion: fortified micronutrients 100% pure natural milk and that of constituted milk can be used for school children in Vietnam under the standpoint of sensory acceptance.
Keywords: Fortified micronutrients milk; Micronutrients; Organoleptic acceptance
Introduction
Stunting is common in developing countries, resulting in high mortality rate and diseases [1]. Micronutrient Deficiency (MD) is one of the main reasons for the current state of stunting [2]. MD has led to children unable to develop both the mentality and physicality to its optimal; iron, zinc and iodine when are deficient have negative effects on the development of children [3]. Therefore, intervention to improve the MD status is essential in developing countries including Vietnam. The Copenhagen Consensus of 2012 has recognized the big effects of these interventions and has deemed them imperious with high cost-effective values in improving public health of developing and affected countries [4].
The reason for MD is the dietary intake unable to provide necessary micronutrients for body demands [5,6]. In the same subject group, it is more common to see multiple micronutrients deficiency than a single vitamin or mineral [7-9]. MD, especially vitamin A, iron, zinc and iodine, is a public health problem in Vietnam with children as the main target. In Vietnamese dietary intake, average iron intake is 6.5mg/day, reaching only 73% of the Recommended Dietary Allowances (RDA) [10,11]. Vitamin A meets 65% of the RDA. In the North, Central Highlands and Central Vietnam, retinol vitamin A reach 34%, 36% and 42% of the RDA, respectively [10]. According to the national nutrition survey in 2010, in groups of Vitamin D and/or Calcium rich foods, fish and tofu consumption in children is 11% while all dairy products is 19% daily. This shows that, the average vitamin D and calcium consumption of children under the age of 5 is approximately 0.5μg/person/day and 256.8 mg/person/ day, respectively. These consumptions only provide 60.3% average calcium requirements and 10.6% average Vitamin D requirements for children between the age of 1 and 3 [10].
Pre-puberty and puberty is an important stage in developing a child’s physicality, requiring focus both in nutrients intake and exercises [12]. Nutrients supplementation is essential to prevent and control MD in the diets of this age. “School milk” is one of the strategic programs with the aim to improve nutrition status for children aged 6 to 12. Fortifying micronutrients in milk is thus a tool to provide more micronutrients in diet to meet the children’s RDA and is one of the sustainable and cost effective interventions. Vietnam has already implemented food fortification programs for years; milk is food vehicle with advantages of fortifying micronutrients for school age children. The program is supported by the government and society nationwide. Furthermore, micronutrients such as iron, Vitamin A, zinc and Vitamin B groups can also be fortified to milk. There are several studies showing sensory acceptability and effectiveness of single micronutrient fortified milk (iron, zinc) in improving nutritional status. However, there is not study on the organoleptic acceptability of multi-micronutrients fortified milk.
Vietnam is a country with milk consumption remaining low (around 19%). In order to increase this rate, and improve effectiveness of multi micronutrients fortified milk for school age children, sensory acceptability of micronutrient fortified milk requires to be studied carefully before producing nationwide. Therefore, the aim of the research is to assess the sensory acceptability and acceptance to micronutrient fortified milk. The result of this research is the basis to create micronutrients fortified milk with the formula and sensory appropriate for different age groups, allowing the development of the program on a nationwide scale.
Methods and Subjects
Prospective study is conducted to evaluate organoleptic characteristics together with the effectiveness study.
Research product
Milk used in research are provided by Vinamilk Corp. consist of 100% natural milk which is branded 100% natural milk and constituted milk which is branded ADM gold. Micronutrients fortified formula for both types of milk were designed based on recommendations of the WHO [7] and Nutritional Requirements for Vietnamese people to increase micronutrients for children age 2 to 12. All products have labels with the formula imprinted and legalized on the market based on Vietnam Food Administration and the Ministry of Health.
Research subjects
Children were chosen from 2094 subjects from 6 primary school of 5 communities of PhuBinh District Thai Nguyen Province. These children consumed milk based on effectiveness study of fortified micronutrient pure 100% milk and that of constituted milk.
Research design
Children participated in the research were chosen from 2 groups of the effectiveness study of fortified micronutrient milk and the micronutrients status of which one group drink 100% pure fortified micronutrient milk (100% pure milk) and another drinks fortified micronutrient constituted milk (ADM Gold).
Children participating in the research drink 2 boxes of milk 180 ml each day and drink designated type of milk for that research group. Time of consumption is around 9:00 a.m. and 3:00 p.m. Teachers distributed the milk and checked whether it was fully consumed, recorded the amount of milk consumed and medical record (if present) of children in the process of research.
Analysis of main nutrients level includes lipid, protein, carbohydrate and calcium to ensure those in both milks are similar. The formula for micronutrients fortification of both milks is also similar.
After 6 months of intervention, organoleptic study was implemented for approximately 20% of the research subjects and 360 children from two genders and aged from 1 grade to 4 grade were chosen in the two groups. The group of 100% pure milk had 188 children and the group of ADM Gold milk had 172.
Criteria for organoleptic assessment
Children participating in the organoleptic assessment were asked their feeling about criteria of color, smell, taste, flavorful and overall acceptance of fortified micronutrients milks and rated each criteria following the Hedonic scale from 1 (terrible) to 9 (great). Points from 6-9 is consider sensory acceptance, 5 is neutral and 1 to 4 is sensory unacceptance (Figure 1).
Figure 1: Hedonic scale.
Organoleptic study was conducted inside rooms at school. Researchers who were trained at National Institute of Nutrition (NIN) carried out the assessment.
Statistics analysis
Data of organoleptic assessment were checked for normality using the Shaprio-Wolk test and it did not follow the normal distribution.
Differences in proportion of acceptance and unacceptance of organoleptic characteristics were done using Chi-square test. p – value of 0.01 was used as the baseline for significant difference. Fisher extract test was used to assess the difference between the two groups. Data was analyzed using PASW statistics software 20.0 (SPSS Inc., U.S.A).
Results
Nutritional value of fortified micronutrients milk
Following the Vietnamese RDA, portions of 2 180 ml milk cartons daily meet the RDA of different age groups of energy from 6.6% to 10.7%, of protein 10.8% to 21.6%, of vitamin A from 19% to 25.3%, of vitamin D approximately 12.7%, of minerals from water from 13% to 36%, and minerals from iron from 15% to 10.9%, zinc from 16.7% to 30% and other minerals from 10.1% to 36 % (Table 1 & Figures 1-5).
Ingredient
Nutritional value of a 180ml carton of milk
Ingredient
Nutritional value of a 180ml carton of milk
Vitamin A
114μg
Lipid
6.1g
Vitamin D
1.9μg
Protein
5.4g
Vitamin E
1.2mg
Carbohydrate
8.1g
Vitamin K
4.68μg
Calcium
216mg
Vitamin C
12mg
Iron
2.7mg
Vitamin B1
180μg
Zinc
2.25mg
Vitamin B2
250μg
Copper
130
Vitamin B3
2mg
Selen
6μg
Acid Pantothenic
0.52mg
Iodine
27μg
Vitamin B6
150μg
Magnesium
21.24mg
Acid Folic
54μg
Lysine
450mg
Vitamin B12
0.3μg
Taurine
12.6mg
Biotin
3.6μg
Table 1: Nutritional values of fortified micronutrients milk for both types.
Characteristics of children participating organoleptic assessment
Number of children participating in organoleptic assessment of 100% pure milk with micronutrients fortification is 188 with 96 males and 92 females. Number of children participating in organoleptic assessment of ADM Gold milk with micronutrients fortification is 172 with 89 males and 83 females. Children are mainly in 2nd, 3rd and 4th grade in primary school that is also in intervention research. There are 11 1st grades participating in the research. This is the smallest grade in primary school so only few are selected (Tables 2 & 3).
Figure 2: Level of energy and main nutrients in a carton of fortified
micronutrients milk 180 ml compared to RDA of children in different age
groups.
Figure 3: Level of fat soluble vitamins level in a carton of fortified micronutrients
milk 180 ml comparedto RDA of children in different age groups.
Figure 4: Level of water soluble vitamins in a carton of fortified micronutrients
milk 180 ml compared to RDA of children in different age groups.
Figure 5: Level of mineralsin a carton of fortified micronutrients milk 180 ml
compared to RDA of children in different age groups.
Characteristics
100% pure
ADM Gold
N
%
N
%
Male
96
26,6
89
24,7
Female
92
25,6
83
23,1
Total
188
52,2
172
47,8
1st grade
6
1,6
5
1,4
2nd grade
65
18,1
63
17,5
3rd grade
57
15,8
54
15,0
4th grade
60
16,7
50
13,9
Total
188
52,2
172
47,8
Table 2: A few characteristics of children participating in research.
COLOR
100% pure
ADM Gold
N
Percent
P*
N
Percent
P*
Neutral
2
1.1
<0.0001
5
2.9
<0.0001
Positive
186
98.9
167
97.1
Negative
0
0
0
0
Total
188
100
172
100
SMELL
Neutral
5
2.7
<0.0001
1
0.6
<0.0001
Positive
182
96.8
168
97.7
Negative
1
0.5
3
1.7
Total
188
100
TASTE
Neutral
2
1.1
<0.0001
4
2.3
<0.0001
Positive
185
98.4
168
97.7
Negative
1
0.5
0
0
Total
188
100
172
172
FLAVOR
Neutral
0
0
1
0.6
<0.0001
Positive
186
98.9
<0.0001
168
97.7
Negative
2
1.1
3
1.7
Total
188
100
172
100
OVERALL ACCEPTANCE
Neutral
0
0
3
1.7
<0.0001
Positive
187
99.5
<0.0001
167
97.1
Negative
1
0.5
2
1.2
Total
188
100
172
100
Table 3: Organoleptic acceptance of two types of milk in school children.
Chi-square test, p-value<0.0001 show a significant difference in the scale. As shown in the table, acceptance is significant larger than un acceptance.
In 360 kids participating in the event of 6 months of using micronutrients-increased milk, most provide a positive to very positive answer to all senses, including color, taste, and smell, flavorful and overall acceptance. Very few dislike and strongly disliked the product (p-value<0.0001). Overall acceptance showed that very few children from both groups had signs of sensory unacceptance to the products (0.5% and 1.2% respectively), while 99.5% of the children were positive with 100% pure milk and 97.1% was positive with processed milk. There are 1.7% of the children remained neutral to the products (Table 4).
COLOR
N
%
P*
100% pure
186
52.7
>0.05
ADM Gold
167
47.3
Total
353
100
SMELL
100% pure
182
52.0
>0.05
ADM Gold
168
48.0
Total
350
97.2
TASTE
100% pure
185
52.4
>0.05
ADM Gold
168
47.6
Total
353
98.1
FLAVOR
100% pure
186
52.5
>0.05
ADM Gold
168
47.5
Total
354
98.3
OVERALL ACCEPTANCE
100% pure
187
52.8
>0.05
ADM Gold
167
47.2
Total
354
98.3
Table 4: Organoleptic difference between the two products.
Fisher extract test provided a p-value >0.05 showing that there is no significant difference between the two types of milk with both being over 5 on the Hedonic scale.
Discussion
This research shows that the two commonly used milk in Vietnam including 100% pure with sugar and constituted milk with sugar when fortified with micronutrients have good acceptability among primary school children. Even though there have been organoleptic studies done on fortified micronutrients milk, most of these studies were conducted on one type of milk either pure natural liquid milk (UHT milk) or powdered milk. This organoleptic research was conducted on two types of liquid milks including pure natural milk and constituted milk and compared organoleptic qualities of these both groups. Another difference is that while other researches focus on one or several micronutrients such as iron, zinc, magnesium [13] or fortified iron [14] or fortified vitamin A and D, this research conducted on 13 different vitamins and minerals. Fortified micronutrients formula applied the WHO recommendation for home fortification of children age 6-month to 12 years (micronutrients powder). This is the first time milk was fortified with such an amount of micronutrients. An outstanding aspect of the organoleptic study on different concentrations of fortified micronutrients to satisfy different RDA is that variability’s in organoleptic acceptance only presented when minerals such as iron, magnesium and zinc reached 75% of the RDA, not when they were at 50% of RDA. Following Vietnamese regulations, fortified vitamin and minerals should reach approximately 30% of the RDA. This research confirmed that fortified dose also will affect organoleptic acceptance of the product.
An advantage of this research is the formula for fortified vitamins and minerals is developed based on the WHO recommendation for micronutrient home fortification children and guidelines for food fortification [7,15]. This research was also done on a large sample size of rural part of Vietnamese mountainous area, where children do not have regular access to the product. Therefore, when organoleptic acceptance is high, it will be more probable to integrate the programs into every day school meals using fortified micronutrients milk in Vietnam.
In conclusion, our research showed that fortified micronutrients 100% pure natural milk and that of constituted milk are feasible for usage for Vietnamese school children under the aspect of organoleptic acceptance to fortified micronutrients milk. However, more detail information should be provided to the parents and teachers of the students, explaining organoleptic acceptance of the product as well as research results about the effectiveness of the product consumption for general nutrition status and micronutrients status to ensure that children can consume fortified micronutrients milk regularly in a long-term period.
Acknowledgement
The research was supported by the National Institute of Nutrition and authorities of PhuBinh district, Thai Nguyen province, Vietnam. Funding and research products were provided by the Vinamilk Company. The authors alone are responsible for the views expressed in this article; they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated or the decisions, policies, or views of the Vinamilk Company. The opinions expressed in this publication are those of the authors and are not attributable to the sponsors or support agencies. TKV, VTMT, TTN, NST were involved in designing and conducting the study in Vietnam. Data analysis was done by TKV and NTNT. The manuscript was written by TKV, VTMT, and NTNT with contributions from all authors.
References
- World Health Organization. WHA Global Nutrition Targets 2025: Stunting Policy Brief. Geneva. 2014.
- World Health Organization, Child hood Stunting: Context, Causes and Consequences. WHO Conceptual Framework. 2013.
- Rivera JA, Hotz C, GonzáÍez-CossiŽo T, Neufeld L, García-Guerra A. The Effect of Micronutrient Deficiencies on Child Growth: A Review of Results from Community-Based Supplementation Trials. J Nutr. 2003; 133: 4010S-4020S.
- Copenhagen Consensus. 2018.
- Ochola S, Masibo PK. Dietary intake of schoolchildren and adolescents in developing countries. Ann Nutr Metab. 2014; 64: 24-40.
- Marion Fiorentino, Edwige Landais, Guillaume Bastard, Alicia Carriquiry, Frank T. Wieringa, Jacques Berger. Nutrient Intake Is Insufficient among Senegalese Urban School Children and Adolescents: Results from Two 24 h Recalls in State Primary Schools in Dakar. Nutrients. 2016; 8: 650.
- World Health Organization. WHO guideline: Use of multiple micronutrient powders for point-of-use fortification of foods consumed by infants and young children aged 6-23 months and children aged 2-12 years. Geneva: World Health Organization. 2016.
- Dapi LN, Hörnell A, Janlert U, Stenlund H, Larsson C. Energy and nutrient intakes in relation to sex and socio-economic status among school adolescents in urban Cameroon, Africa. Public Health Nutr. 2011; 14: 904-913.
- Abdul AR, Buxton C, Kwara L, Mensah-Homiah J, Armar-Klemesu M, Brouwer ID. School feeding contributes to micronutrient adequacy of Ghanaian schoolchildren. Br J Nutr. 2014; 112: 1019-1033.
- Vi?n Dinh du?ng, T?ng di?u tra Dinh du?ng 2009 - 2010. Nhà xu?t b?n Y h?c. 2010.
- Le Nguyen BK, Le Thi H, Nguyen Do VA, Tr?n Thúy N, Nguyen Huu C, Thanh Do T, et al. Double burden of undernutrition and overnutrition in Vietnam in 2011: results of the SEANUTS study in 0•5-11-year-old children. Br J Nutr. 2013; 110: 45-56.
- Matthiew CH Jukes, Lesley J Drake, Donald AP Bundy. School health, nutrition and education for all: leveling the playing field. Wallingford: CABI Publishing. 2007.
- Abdulghani AH, Prakash S, Ali MY, Deeth HC. Sensory evaluation and storage stability of UHT milk fortified with iron, magnesium and zinc. Dairy Science and Technology. 2015; 95: 33-46.
- Osman AK, al-Othaimeen A, Experience with ferrous bis-glycine chelate as an iron fortificant in milk. Int J Vitam Nutr Res. 2002; 72: 257-263.
- World Health Organization, Food and Agriculture Orgnization of the United Nations, Guidelines on food fortification with micronutrients. World Health Organization publication. 2006.
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