Fortified bouillon cubes are seen as a way to curb malnutrition in Africa

IBADAN, Nigeria (AP) — In her cramped, dimly lit kitchen, Idowu Bello leans over a gas cooker while stirring a pot of eba, the thick starchy West African staple made from cassava root. Kidney problems and chronic exhaustion forced the 56-year-old Nigerian woman to retire from teaching, and she switches between cooking with gas or over a wood fire depending on the fuel she can afford.

Financial constraints also limit the food Bello has on hand even though doctors have recommended a nutrient-rich diet both to improve her weakening health and to help her teenage daughter, Fatima, grow. Along with eba, on the menu today is melon soup with ponmo, an inexpensive condiment made from dried cowhide.

“Fish, meat, eggs, fruits, vegetables and even milk are costly these days,” Bello, 56, said, her lean face etched with worry.

If public health advocates and the Nigerian government have their way, malnourished households in the West African nation soon will have a simple ingredient available to improve their intake of key vitamins and minerals. Government regulators on Tuesday are launching a code of standards for adding iron, zinc, folic acid and vitamin B12 to bouillon cubes at minimum levels recommended by experts.

While the standards will be voluntary for manufacturers for now, their adoption could help accelerate progress against diets deficient in essential micronutrients, or what is known in nutrition and public health circles as “hidden hunger.” Fortified bouillon cubes could avert up to 16.6 million cases of anemia and up to 11,000 deaths from neural tube defects in Nigeria, according to a new report from the Bill & Melinda Gates Foundation.

“Regardless of economic situation or income level, everyone uses seasoning cubes,” Bello said as she unwrapped and dropped one in her melon soup.

Making do with smaller portions and less nutritious foods is common among many Nigerian households, according to a recent government survey on dietary intake and micronutrients. The survey estimated that 79% of Nigerian households are food insecure.

The climate crisis, which has seen extreme heat and unpredictable rainfall patterns hobble agriculture in Africa's troubled Sahel region, will worsen the problem, with several million children expected to experience growth problems due to malnutrition between now and 2050, according to the Gates Foundation report released Tuesday.

“Farmlands are destroyed, you have a shortage of food, the system is strained, leading to inflation making it difficult for the people to access foods, including animal-based proteins,” Augustine Okoruwa, a regional program manager at Helen Keller Intl, said, highlighting the link between malnutrition and climate change.

Dietary deficiencies of the micronutrients the government wants added to bouillon cubes already have caused a public health crisis in Nigeria, including a high prevalence of anemia in women of child-bearing age, neural tube defects in newborn babies and stunted growth among children, according to Okoruwa.

Helen Keller Intl, a New York-based nonprofit that works to address the causes of blindness and malnutrition, has partnered with the Gates Foundation and businesses and government agencies in Africa to promote food fortification.

In Nigeria, recent economic policies such as the cancellation of gasoline subsidies are driving the country’s worst cost-of-living crisis in generations, further deepening food hardship for the low-income earners who form the majority of the country’s working population.

Globally, nearly 3 billion people are unable to access healthy diets, 71% of them in developing countries, according to the World Health Organization.

The large-scale production of fortified foods would unlock a new way to “increase micronutrients in the food staples of low-income countries to create resilience for vulnerable families,” the Gates Foundation said.

Bouillon cubes — those small blocks of evaporated meat or vegetable extracts and seasonings that typically are used to flavor soups and stews — are widely consumed in many African countries, nearing 100% household penetration in countries like Nigeria, Senegal, Ivory Coast, and Cameroon, according to a study by Helen Keller Intl.

That makes the cubes the “most cost-effective way” to add minerals and vitamins to the diets of millions of people, Okoruwa said.

No Nigerian manufacturers already include the four micronutrients at the recommended levels, but there is industry interest.

Sweet Nutrition, located in Ota, near Lagos in Nigeria's southwest, started adding iron to some of its products in 2017. Marketing manager Roop Kumar told The Associated Press it was a “voluntary exercise” to contribute to public health.

“But we are taking trials and looking at further fortification” with the launch of the new regulatory framework, Kumar said.

Although NASCON Allied Industries, a Nigerian company that produces table salt and seasoning cubes, currently does not make products with any of the four micronutrients, quality control manager Josephine Afolayan said fortification is a priority.

“If we’re successful, that would mean that the fortified bouillon seasoning cubes in so many Nigerian dishes would also contribute to improving the micronutrient content of the dishes in my country,” Ladidi Bako-Aiyegbusi, the director of nutrition at Nigeria’s Ministry of Health and Social Welfare, wrote in the Gates Foundation report.

The Associated Press receives financial support for news coverage in Africa from the Bill & Melinda Gates Foundation and for news coverage of women in the workforce and in statehouses from Melinda French Gates’ organization, Pivotal Ventures.

Despite the promise of enriching a product that most people have in their pantries, some challenges need to be addressed. One is the “campaign of calumny” in a region where science-led interventions in the food sector have sometimes faced resistance from interest groups, Okoruwa said.

Educating people about the benefits of fortified products may help counter any possible disinformation campaign, said Yunusa Mohammed, the head of the food group at the Standards Organization of Nigeria, the government regulator for consumer products.

There is also the need to make fortified cubes affordable for struggling households like Bello's, where a pile of firewood she uses to cook outdoors on an open flame is stacked against a wall.

“What we can do is to influence the government and industry on rebates on the importation of raw materials as a public health intervention,” Mohammed said.

Food fortification is not new in Nigeria. Most of the salt consumed in the country is iodized, and products such as wheat flour, cooking oil and sugar are fortified with vitamin A by law. But the requirement for adding the four vitamins and minerals to bouillon is the most comprehensive fortification regulation to date.

Although Nigerian companies do not have to enrich their seasoning cubes yet, experts think setting standards that producers must follow if they choose to will make a difference.

A working group involving representatives from companies, regulatory agencies, research groups and development organizations is in place to accelerate voluntary compliance.

“Ultimately, we will make the bouillon fortification mandatory after seeing the acceptance of the voluntary regulations in the industry,” Mohammed said.

The Associated Press’ climate and environmental coverage receives financial support from multiple private foundations. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

Dr Augustine Okoruwa, a nutrition expert at Hellen Keller International, speaks during in an interview with The Associated Press in Ota, Nigeria, Thursday, Sept. 12, 2024. (AP Photo/Sunday Alamba)

Workers package bouillon cubes at the Sweet Nutrition factory in Ota, Nigeria, Thursday, Sept. 12, 2024. (AP Photo/Sunday Alamba)

A worker checks bouillon cubes ahead of packaging at the Sweet Nutrition factory in Ota, Nigeria, Thursday, Sept. 12, 2024. (AP Photo/Sunday Alamba)

Workers collect bouillon cubes packages at the Sweet Nutrition factory in Otta, Nigeria, Thursday, Sept. 12, 2024. (AP Photo/Sunday Alamba)

Idowu Bello, 56, buys cowhide to prepare a pot of soup in Ibadan, Nigeria, Friday, Sept. 13, 2024. (AP Photo/Sunday Alamba)

Idowu Bello, 56, buys onions to prepare a pot of soup at a market in Ibadan, Nigeria, Friday, Sept. 13, 2024. (AP Photo/Sunday Alamba)

Idowu Bello, 56, poses for a photograph inside her house in Ibadan, Nigeria, Friday, Sept. 13, 2024. (AP Photo/Sunday Alamba)

Idowu Bello, 56, prepares a meal in her kitchen in Ibadan, Nigeria, Friday, Sept. 13, 2024. (AP Photo/Sunday Alamba)

ANAHEIM, Calif. (AP) — Eric Wagaman scored with one out in the 13th inning when Jordyn Adams' grounder deflected off the glove of third baseman Miguel Vargas, and the Los Angeles Angels dealt the Chicago White Sox their 117th loss, rallying for a 4-3 victory on Wednesday.

Instead of winning consecutive series for the first time in four months, the White Sox tied the 1916 Philadelphia Athletics for the third most losses since 1900.

Chicago (36-117) needs to go 7-2 in its final nine games to avoid the post-1900 record of 120 losses by the 1962 expansion New York Mets. The 2003 Detroit Tigers hold the American League mark with 119 losses.

It doesn't get easier for the White Sox, who begin a three-game series at San Diego on Friday. The Padres hold the first NL wild card spot but have closed within 3 1/2 games of the slumping Los Angeles Dodgers in the NL West.

“We get the same question every day, we're focused on one series at a time and one game at a time. Everything else is irrelevant right now,” interim manager Grady Sizemore said. “It's going to be a hard series (in San Diego). They're playing for something and we have to play our best ball to have a chance.”

After the series in San Diego, the White Sox close the season with a six-game homestand against the Angels (Sept. 24-26) and Detroit Tigers (Sept. 27-29).

The Angels had the bases loaded in the 10th and 12th innings, but were finally able to walk it off in the 13th.

“We had opportunities throughout the game to do something, we just couldn’t stretch that run, especially in extra innings. But we kept going and finally caught a break,” Angels manager Ron Washington said.

Wagaman was the automatic runner on second base and advanced to third on Logan O'Hoppe's ground ball to right field. With the infield drawn in, Adams hit a sharp grounder off Jairo Iriarte (0-1) that Vargas wasn't able to field cleanly, giving the Angels their fifth walk off victory of the season.

“I was just trying to put it in play and give the runner at third a chance to score,” Adams said.

The White Sox had the bases loaded with two out in the 13th, but José Quijada (2-0) struck out Yoán Moncada to end the frame. It was Moncada's his first big league at-bat since April 9. He was activated from the 60-day injured list on Monday after missing five months because of a left adductor strain.

The game went into extra innings tied at one. Each team scored in the 10th as Chicago’s Korey Lee scored on Vargas’ sacrifice fly and Los Angeles’ Gustavo Campero had an RBI base hit.

The teams again traded runs in the 11th on RBI singles by the White Sox Andrew Benintendi and Wagaman.

Andrew Vaughn led off the fourth inning with his team-tying 19th home run. The designated hitter — who is 7 for 20 with two homers during a five-game hitting streak — drove an elevated, inside sinker from Halos starter Jack Kochanowicz into the bullpens in left field as he went deep for the second time in the series.

The White Sox have hit nine home runs over the last five games after recording just six in the previous 13 contests.

The Angels evened it in the eighth when Taylor Ward's line drive went off the glove of White Sox shortstop Nicky Lopez and into left field to drive in Zach Neto.

TRAINER’S ROOM

Angels: OF Mickey Moniak (left hand) did not start for the third straight day, but came in as a pinch runner in the 11th inning.

UP NEXT

White Sox: LHP Garrett Crochet (6-12, 3.78 ERA) takes the mound on Friday to start a three-game series at San Diego.

Angels: Head to Houston for a four-game weekend series. LHP José Suarez (1-2, 6.80) makes his second start of the season on Thursday.

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Chicago White Sox relief pitcher Prelander Berroa leaves the mound during the sixth inning of a baseball game against the Los Angeles Angels in Anaheim, Calif., Wednesday, Sept. 18, 2024. (AP Photo/Ashley Landis)

Los Angeles Angels starting pitcher Jack Kochanowicz throws during the first inning of a baseball game against the Chicago White Sox in Anaheim, Calif., Wednesday, Sept. 18, 2024. (AP Photo/Ashley Landis)

Los Angeles Angels shortstop Jack López applies sunscreen before a baseball game against the Chicago White Sox in Anaheim, Calif., Wednesday, Sept. 18, 2024. (AP Photo/Ashley Landis)

Los Angeles Angels third baseman Eric Wagaman applies sunscreen before a baseball game against the Chicago White Sox in Anaheim, Calif., Wednesday, Sept. 18, 2024. (AP Photo/Ashley Landis)

Chicago White Sox first base coach/outfield coach Jason Bourgeois (38) is reflected in the glasses of third baseman Bryan Ramos in the dugout during the sixth inning of a baseball game Los Angeles Angels in Anaheim, Calif., Wednesday, Sept. 18, 2024. (AP Photo/Ashley Landis)

Los Angeles Angels shortstop Jack López throws to first to out Chicago White Sox's Lenyn Sosa during the fourth inning of a baseball game in Anaheim, Calif., Wednesday, Sept. 18, 2024. (AP Photo/Ashley Landis)

Chicago White Sox first baseman Gavin Sheets (32) tags out Los Angeles Angels' Jordyn Adams (39) at first base during the third inning of a baseball game in Anaheim, Calif., Wednesday, Sept. 18, 2024. (AP Photo/Ashley Landis)

Chicago White Sox designated hitter Andrew Vaughn celebrates in the dugout after hitting a home run during the fourth inning of a baseball game against the Los Angeles Angels in Anaheim, Calif., Wednesday, Sept. 18, 2024. (AP Photo/Ashley Landis)

Los Angeles Angels' Eric Wagaman (34) scores off of a walk-off single hit by Jordyn Adams during the thirteenth inning of a baseball game against the Chicago White Sox in Anaheim, Calif., Wednesday, Sept. 18, 2024. The Angels won 4-3. (AP Photo/Ashley Landis)

Los Angeles Angels' Jordyn Adams (39) celebrates after a walk-off single during the thirteenth inning to win 4-3 over the Chicago White Sox in a baseball game in Anaheim, Calif., Wednesday, Sept. 18, 2024. (AP Photo/Ashley Landis)

Los Angeles Angels' Jordyn Adams is doused after a walk-off single to win 4-3 against the Chicago White Sox in a baseball game in Anaheim, Calif., Wednesday, Sept. 18, 2024. (AP Photo/Ashley Landis)