Fortification games

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Excluding Off-topic Review Activity. Loading reviews There are no more reviews that match the filters set above. Each sachet costs approximately USD 0. A recent Cochrane review has established that MNPs are effective in reducing anemia and iron deficiency for children 6—24 months [ 30 ].

Malnutrition in all its forms affects millions of women worldwide, but women in LMICs are particularly vulnerable to deficiencies in essential vitamins and minerals such as iron, folic acid, zinc and iodine due to poor quality diets.

These nutritional deficiencies not only affect their health but also that of their children. Latest estimates reveal that million women of reproductive age are too thin and million women are anemic, two conditions that are linked to the birth of 20 million low birth weight LBW babies annually [ 34 ]. Maternal micronutrient supplements MMS are a safe and cost-effective solution to improve the nutritional status of pregnant women in LMICs [ 35 ].

According to WHO mortality data, around 0. A recent analysis of 50 studies in LMICs has shown that fortification with iodine, folic acid, vitamin A and iron have led to dramatic reductions in serious disease [ 36 ]. A review attempted to estimate the real-world impact of industrial food fortification on health and nutrition outcomes in LMICs, and found that it had a positive impact on some health outcomes, including goiter, anemia, and NTD prevalence [ 36 ].

Figure 1 shows the potential benefits of food fortification across the life cycle. Potential benefits of food fortification across the life cycle. World Food Programme and Sight and Life : Numerous country-level studies on the impact of food fortification on micronutrient status have shown very positive results.

Not only did the vitamin A status of all beneficiaries improve and vitamin A deficiency dropped significantly, but so the vitamin A content of breast milk of lactating mothers also increased.

In Costa Rica, an evaluation of the impact of iron fortification on anemia prevalence found a significant decrease at the national level in the prevalence of anemia among children aged 1—7 years and women of reproductive age. Despite the enormous benefits of food fortification strategies on nutritional status, some studies have identified opposite results in terms of no impact of food fortification programs and of guaranteeing safe upper limits.

For example, a study conducted among Brazilian children under the age of six found no effect of iron-fortified flour on anemia prevalence. The study consisted of four population-based surveys conducted over a four-year period, and it measured dietary intake and hemoglobin levels.

The findings showed an unexpected increase in anemia among children. Despite the average intake of fortified flour detected by the study amounting to g per day, the poor diets quality of children with low bioavailability of iron compromised the benefits of fortified flour [ 41 ]. There are also ongoing debates globally and in some countries regarding the performance and safety of fortification efforts whether or not the consumption of micronutrient fortified foods may cause adverse health effects due to the accumulation of these nutrients in the human body.

The WHO proposed a methodology for calculating and defining the safe upper limit in the Guidelines on Food Fortification with Micronutrients, which vary depending on the local context.

However, challenges can arise in case of large consumption of the fortified food among the same population and utilization of multiple food vehicles [ 41 ]. In Guatemala it was shown that the consumption of wheat flour fortified with acid folic varied massively among people from different socioeconomic status women from wealthy groups consumed 15 times more than women from no wealthy groups rising concerns on the safe limits [ 43 ]. In Cameroon, the consumption of multiple Vitamin A fortified vehicles such as sugar or wheat flour with edible oil resulted in a possible excess of UL among children.

This was the case in urban settings due to the high consumption of such foods [ 44 ]. While some evidence suggests that while multiple exposures of micronutrients including fortified foods for a long period of time may result in adverse effects, when properly regulated, fortification carries a minimal risk of toxicity [ 45 ]. For example, Vitamin A fortification safety is often cited as a concern in food fortification programs, but a recent review indicated that the risk of excessive vitamin A consumption from fortified foods in women and young children is likely negligible [ 46 ].

Food fortification is a cost-effective strategy to improve the nutrition status of populations [ 47 , 48 , 49 ], and it associated with high economic benefits [ 50 , 51 , 52 , 53 ].

Reviews such as the Copenhagen Consensus have consistently ranked micronutrients as the most cost-effective development intervention and provides significant returns for a low cost [ 11 ]. For example, iodizing salt can cost as little as USD 0. Lifetime costs for these two fortified commodities are less than USD 15 per person and can provide a return on investment of more than USD 26 in increased productivity and health care savings; and every dollar spent on fortification results in USD 9 in benefits to the economy [ 10 ].

A feasibility and cost-effectiveness study in the Philippines using fortified powdered milk to increase micronutrient intake amongst children found it as a cost-effective tool for addressing iron deficiency [ 54 ]. The results indicated that for iron deficiency, food fortification was the most cost-effective method with a cost of USD 66 per disability adjusted life years DALY , whereas supplementation and dietary diversification had estimated costs of USD and per DALY, respectively.

In the case of biofortification, the estimated health benefit-to-cost ratio was USD 17 of benefits for every USD 1 invested [ 11 ]. Despite the enormous economic potential of food fortification, several barriers are not conducive to creating an enabling environment for global food fortification scale-up. These constraints include low private-public partnership and lack of national regulations on food fortification. The authors identified engagement with Small and Medium Enterprise as a bottleneck to expanding food fortification programs, as well as their low technological and economic capacity; lack of regulations and food laws were also cited as barriers [ 47 ].

For example, despite mandatory salt iodization in the Philippines, more than two-thirds of the salt is imported and not fortified due to low production capacity. Furthermore, the national production of salt is carried out by producers without a license, thereby avoiding any official controls; and the absence of high-quality laboratories prevent control and monitoring to assess the quality of fortified food [ 55 ].

Luthringer et al. The paper emphasized conflicts and best practices for governments and the food industry in LMICs. Key aspects of successful fortification strategies include partnership between Governments and food industries and developing the economic and human capacities of small industries [ 56 ]. As such, combatting hunger and malnutrition in many countries is more than a moral duty but is a legally binding part of national law under human rights obligation.

Unfortunately, guaranteeing the right to food and nutrition is a complex and often overwhelming challenge in many LMICs. Particularly in the context of the COVID pandemic in which mandatory lockdowns and economic slowdowns are leading to increases in food insecurity and malnutrition.

Therefore, food fortification can be a crucial intervention to decrease the risk of malnutrition—before, during, and after pandemic. The Sustainable Development Goals SDGs and the Agenda for Sustainable Development Agenda aim to achieve a world free of hunger and malnutrition in all its forms, and to use data and global partnerships to realize the goals. Food fortification is a key element to strengthen the public and private partnership with beneficial multi-sectoral impacts on society.

While private sector partners from the food industry are the main actors within food fortification programs, governments and civil society also have a role to play. Civil society in particular can help improve accountability and commitment to standards, etc. Finally, food fortification, when combined with social safety net programs SSNP , such as school feeding programs, distributions to the poor or to vulnerable groups, food for work programs, and food aid during emergency situations, have been effective tools to deliver fortified food to vulnerable people but also disseminate information on diets [ 59 ].

In doing so, they found that by substituting wheat grain for fortified wheat flour dramatically increased the intake of micronutrients among its SSNP beneficiaries, and that it was a very cost-effective approach [ 60 ]. A challenge for school feeding and other SSNP programs is their long-term effectiveness. Another challenge emerged during the recent lock-downs due to the COVID pandemics when SMEs faced increased difficulties to access to the vitamins and mineral premix for the fortification procedures, particularly from the international premix supply [ 62 ].

Sight and Life is a global humanitarian organization that works to end malnutrition in all its forms. The projects are grounded in evidence and build strategic and long-lasting partnerships to implement sustainable solutions to improve the lives of those in most need, and include several projects focused on food fortification.

Sight and Life works as a catalyst in bringing key stakeholders together to address multidisciplinary challenges related to food fortification strategies. The following section will highlight some of key lessons learned from Sight and Life projects and its partners.

Micronutrient deficiencies are common among women and children in the Indian state of Andhra Pradesh. Among the various staples available in Andhra Pradesh, rice is the most effective vehicle to reach the poorest and only one of two staples, which when fortified well, can carry a range of minerals and vitamins.

The Food Safety and Standards Authority of India FSSAI developed specifications for fortified rice after expert consultations which included strong clinical evidence from leading academic institutions in India.

To strengthen these programs, Sight and Life , in collaboration with Tata Trust and the local Government, has instituted a promising, cost-effective blending process known as continuous blending. Next, note that interdiction problems can be extended to a three-stage problem in which the operator fortifies the network by increasing capacities, reducing flow costs, or defending network elements from the interdictor before the interdictor takes action.

We devote one section to ongoing research in this area and conclude by discussing areas for future research. Algorithms for network interdiction and fortification games. Cole ; Lim, Churlzu. N2 - This chapter explores models and algorithms applied to a class of Stackelberg games on networks.

AB - This chapter explores models and algorithms applied to a class of Stackelberg games on networks. Overview Fingerprint. View Community Hub.

About This Game Fortified is an explosive strategy shooter where players will defend the Earth against a menacing Martian invasion in the s. Protect the city by building a network of defensive structures, commanding an army, and jumping into battle against dangerous sky scraping attackers.

Fight for Earth alone or with up to four players for the ultimate co-op defense experience. Genre-Bending Gameplay — Fortified combines third-person shooter, real-time strategy, and tower defense mechanics in an exciting new way!

Retro Sci-Fi Flare — Go back in time and experience an alternate history, where planet Earth is assaulted by an unstoppable Martian menace.

Construct the Ultimate Defense — Players will fortify their base by strategically building a network of defensive structures to thwart the oncoming waves of mechanical invaders.

Pulp Inspired Character Classes — Fortified features four classes based on prominent pulp character archetypes, including a jetpack piloting heroine, a shotgun wielding space cowboy, a secret government agent, and a battle hardened Marine captain. Fortified offers diverse co-op gameplay that requires team coordination and strategy. See all. Customer reviews. Overall Reviews:. Recent Reviews:. Review Type. All 1, Positive 1, Negative All 1, Steam Purchasers Other 1,