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Focus on bio-availability and not just label claims to make people nutrient replete: Ashoka fellow

By Stephen Daniells , 09-Jan-2014

The food and nutrition industries should be focusing on bioavailablity and bioefficacy of nutrients, and not just on big numbers on product labels, says a leading social entrepreneur who has spent over a decade boosting the nutritional status of the severely malnourished across Africa.

Basil Kransdorff is a social entrepreneur, CEO of e’Pap, and an Ashoka fellow since 2011. For over 13 years he has been focused on achieving a condition of ‘nutrient repleteness’, using his e’Pap porridge product to boost the nutritional status of extremely malnourished people. The lessons he’s learned have implications for all of nutrition, health and sustainable development of economies across the world. 

“Helping people to become “nutrient replete” requires a basic understanding of the biology of human beings,” he said.

“What’s important in our self created objective is not just what’s on the label but more important, what gets biologically  absorbed by the body,” he said. “With our initial formulation objective of helping to create a “nutrient replete human being, we had to understand bio-availability, bio-efficacy, and nutrient interactions (the mineral wheel). That’s how e’Pap was born.

“Because we were social entrepreneurs trying to find a solution to many challenges in poor communities, experts in the field openly and at no cost shared ‘cutting edge’ knowledge with us. We had access to some of the best brains in the world, including people who were experts on food fortification. It was an amazing experience that helped get us up to speed ‘overnight’. Because we were dealing with such malnourished people, the impact is very visual and dramatic. This has helped us overcome the many frustrations we have experienced trying to change entrenched paradigms.”

“We learnt very quickly that the form of the nutrients is a key issue if you want to help create a nutrient-replete human being. Only in a nutrient replete state will the body become physiologically functional where the body can perform optimally as the sports industry have well understood for many years. In this condition the body can better manage health challenges with or without drug interventions.

“This is missed by all mainstream supplementation products that use low level absorption chemical isolate forms of nutrients. People often wrongly think that if you’re iron deficient then just throw some iron into your mouth and somehow it will address the deficiency. It does not work like that because “part solutions” are about as useful as a bucket of water in helping to stop your house from burning down.”

Getting to the most vulnerable

Basil Kransdorff, social entrepreneur, CEO of e’Pap, and Ashoka fellow

The flagship e’Pap product is like a pre-cooked porridge. The line has also been extended with an e’Spread peanut butter, an e’Soup (an instant soup), and an e’Drink. All the line extensions are based on the same technology approach that is used for the porridge.

Kransdorff said that they have kept their technology proprietary, and it’s all focused on the preservation of nutrients and their bio-efficacy. “Our technology goes right through from affordability to how we source, how we process, how we cook, how we mix, and how we package, and then to how we distribute. We are not a typical food company that distributes via retail. We distribute through community networks which means impact and word of mouth drive the distribution”.

e’Pap is not an NGO, but social entrepreneur enterprise. It has a limited amount of resources that are generated from what it sells. “The bulk of e’Pap gets sold to faith-based or community based organizations,” he said. “They’ve been amazing because they actually work in communities and they’ve seen the impact.

“We use local distribution structures to get into the community. Even though we’re using state-of-the-art technology it’s cheaper than Coca-Cola at about US$0.15 cents a meal portion.

“e’Pap is affordable to the poorest where the issue is about poor people and community-based programs  reassigning their priorities based on impact. It is this that really drives the distribution of e’Pap,” he said.

Selecting suppliers

By making nutrient repleteness the key formulation objective it becomes ‘quite simple’ to select ingredients and their suppliers, he said.

“We select technologies that are backed up by scientific outcome based research by going for those that are what we call a ‘mimic food state form’,” he explained. “Our underlying understanding is that the best way to get a nutrient into the body is in the form of a food, Nutrients in a food are “complexed” with protein and peptides and all sorts of molecules that the body can better manage. Nutrients in a food state form are self-regulating and do not have many of the problems that nutrients in a chemical form have when fortifying a very dense food product.

“Selenium rich nuts are an excellent example of the principle that highlights - it is not possible to get selenium poisoning from eating kilograms of brazil nuts. RDA levels of selenium are set at very low levels when using a chemical form of selenium. But if you purchase inorganic selenium in bulk it will have a skull and cross bones on the packaging.

“With refined chemical nutrient forms, nutrient interactions, blocking, unabsorbed liberation via urine and feces means low biological absorption. The result is expensive urine and part solutions with little impact in a focus of an objective of ‘nutrient repleteness’.  Because chemical forms of nutrients can be seen by the body as foreign objects, the bodies defense organs will filter them out and could cause toxic build-up.

“Iron overload is well understood when using chemical isolate forms of iron which results in only two possible outcomes – either too much iron must be added which will cause taste profile changes and toxic outcomes or too little iron is added which results in a part solution that does not address the problem.”

e’Pap gets it mineral ingredients from Utah-based Albion. Max Motyka from Albion Minerals told us that the company has been working with Kransdorff for about 10 years via their local distributors INS.

“The e’Pap program is about a maize porridge with soy protein, minerals and vitamins,” explained Motyka. “The minerals are all chelates with amino acids from Albion, predominantly zinc and iron, which are badly needed by developing children for their immune system and brain development.”

So what is it about Albion’s ingredients? “What Albion did in the 1990s was absolutely revolutionary,” said Kransdorff. “They went right back to the fundamentals and developed a unique piece of technology that mimicked nature. When Albion was putting that work together 20 years ago they were creating a revolution.

“Albion really deserves a Nobel Prize,” he added. “Those guys worked out the technology years ago, but they’ve never had their recognition in mainstream interventions in spite of extensive scientific evidence of its effectiveness. Albion has played a critical role in what e’Pap has done. It’s not the whole part but it’s a major part.”

e’Pap also uses technologies developed by the GROW Company who have developed technologies that bond vitamins into a food state form thus further enhancing the formulation objective of ‘nutrient repleteness’, he added.

Going global

In terms of what e’Pap has achieved, Kransdorff said it was difficult to specify, but over the past 12 or 13 years he estimated they must have moved over 150 million food portions of e’Pap – all through what we call – word of mouth marketing.

“And remember that we haven’t had any major support from governments or large International NGO’s,” he said. “The World Food Program and Unicef, WHO among many other international organizations have ignored the impact e’Pap has been making on the ground across Africa for over 13 years. But we’ll get there; mainstream interventions cannot continue to ignore the impact. 'Walking the talk' helping to make communities’ nutrient replete is going to have huge implications for human health, education, early childhood and sustainable development and of course poor malnourished communities.

“Poverty is not a sin,” he said. “Allowing poor communities to continue to be malnourished and dysfunctional so that they cannot take responsibility for their own challenges is a 'crime against humanity' especially when there are affordable solutions available to address the issue. ”

The impact of e’Pap was recognized by the American organization Ashoka , a global network of about 3,000 social entrepreneurs in 70 countries putting their system changing ideas into practice on a global scale.

“Ashoka has moved us above the bureaucrats and really helped international decision makers see the impact e’Pap is making. Because of that, he has had a huge amount of interest from across the World.”

Indeed, he’s currently in the process of registering e’Pap with the FDA so that he is able to export e’Pap into the USA.

“There’s a huge market in the US, because of the drop in nutrient content in food of up to 75% over the past 100 years which means - everybody’s got the problem,” he said. The issue, now called ‘hidden hunger’, is linked to many health challenges including TB, obesity, depression, stunted births, diabetes’, ADD [attention deficit disorder], and even violence in schools. 

“The American Health System model which tries to address the consequence of our compromised food chain, will in the future not be affordable. You cannot continue trying to address the consequences; you have to go back to basics and actually fix the cause, a compromised food chain.

“Modern agricultural science has figured out how to grow much more food, but it has lost the plot on an important issue that has fallen through the cracks.  The consequence of this “modern revolution” is the decrease in nutrient content of food on such a dramatic scale, the result is - we are all “starving to death” even if we have full stomachs.”

Goals

Kransdorff’s short-term goal is to get as much product on the ground as possible, because it has such a great impact on people’s lives. He has concluded that the best way to change the present “ineffective approach” is to let poor communities themselves tell the experts what works. Longer-term, he’s seeking the right partner to help them globalize.

“What’s tragic is that a product like e’Pap has been shown that it can help solve many serious problems facing the world and yet it is a challenge to engage main stream ‘experts’” he said. 

“It’s not just about e’Pap though; it’s about getting people to understand the value of effective nutrition that results in nutrient repleteness and prioritizing such an approach in all human activities and challenges.”

While mainstream political mindsets may have all bought into the idea that nutrition is a high priority (just look at the involvement of the Clintons in the 1,000 Days to Scale Up Nutrition program, for example ), the problem from Kransdorff’s perspective is that “main stream decision makers” have not yet understood that the key issue is about - how much is biologically absorbed. Scaling up “part solutions” because of low bioavailability, will not bring the impact needed, especially in highly malnourished communities.

“Clinical evidence is often confusing. One week there is a new study that says supplements work, and the next week is a study that says supplements don’t work."

“Clinical evidence is often confusing. One week there is a new study that says supplements work, and the next week is a study that says supplements don’t work. We speculate that the reason for this confusion is that either clinical studies are measuring the wrong outcomes like BMI (Body Mass Index) as a measure of nutrient status or not taking into account the use of low bio-available nutrients that might be causing the anomalies.  Few studies are looking at relating the impact of outcomes to what’s being absorbed.

"If I read a clinical investigation that has low absorption chemical isolate nutrients and I see a positive impact, then I know that I can make even more positive outcome using high bio-available nutrients that result in nutrient repleteness. If I see a negative impact, I don’t disregard the research; perhaps the outcome was as a result of the researchers using low bio-efficacy nutrients at such a low levels that it’s not addressing the body’s daily requirements for the body to operate optimally.

“The resulting confusion is part of a bigger problem as to why we are wasting millions of dollars of resources on ineffective nutrition interventions and why we are not getting the outcomes necessary to ‘make poverty history”.  

“Mainstream decision makers are rightly confused,” he said. “They require scientific evidence to make better decision and so continue to do what is called ‘common practice’.  Decision makers need to understand the importance of nutrient form and the lack of impact and confusion part solutions’ create. What is required is research focused on creating new measurements that can better articulate ‘nutrient repleteness’. This will better explain our understandings which are supported by communities using e’Pap across Africa.  It will stop wasteful expenditure on part solutions that are not effective.  Decision makers will be able to make better decisions based on a cost dose response impact focused on an objective of ‘nutrient repleteness’ that will create real change as communities become nutrient replete.

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