The Lowly Tortilla Gets a Boost

At just 1 month old, Maria Isabel Esquivel is chubby, smiling and alert, and her older brother and sisters now run with bounding strides through the family’s tiny cornfield in this dirt-poor Indian village.

The vigor of the Esquivel children brings to life the startling statistics that are emerging from several ambitious nutrition projects in the Mexican countryside.

The goal is nothing short of transforming the humble tortilla, Mexico’s corn-based staple food, into a protein-fortified “supertortilla” that would give a nutritional boost to the nearly 20 million Mexicans who live in extreme poverty.

The tortilla, Mexico’s equivalent of bread, has long been a symbol of Mexican cuisine and culture. This is the cradle of corn itself, first cultivated by the ancestors of the Aztecs about 6,000 years ago and revered as a sacred source of life.

But the tortilla is richer in tradition than nutrition. And the hard fact is that the poorer the modern-day Mexican, the greater his survival depends on the unleavened corn disks--often accompanied only by a scoop of refried beans.

The tortilla, wrote pioneer Mexican nutritionist Salvador Zubiran, “has been the luck and the disgrace of Mexicans: the luck because it has given us daily sustenance, and the disgrace because its nutritional deficiencies have limited the development of much of the population.”

Now, however, a flurry of initiatives at the federal and state level intends to make the tortilla a means to deliver better nutrition to the very poorest, whose levels of malnutrition rank among the worst in the hemisphere.

“Few countries in the world have such a wonderful vehicle to deliver improved nutrition to the families that most need it,” said Felipe de Jesus Preciado, a federal congressman who has proposed that both cornmeal and traditional corn dough be fortified. “The poorest families in Mexico get 70% of their nutrition from tortillas. So enriched tortillas are the perfect vehicle to reach the poor.”

A substantial first step--an agreement by the nation’s cornmeal makers to add vitamins and minerals to tortilla cornmeal--took effect in March. The major cornmeal manufacturers are now adding a blend of six vitamins and minerals to all commercially sold tortilla cornmeal, the base for about half the tortillas eaten in Mexico. (The rest are made from traditional nixtamal dough, which is harder to enrich than dry cornmeal powder. In one project in rural Mexico, some participants said they made a mix of the two types to retain the traditional flavor.)

But the real opportunity, nutritionists argue, is to enrich tortillas with protein, not just vitamins, by adding protein-rich soy--ideally in all tortillas sold commercially, but at least in targeted poverty relief programs for the poorest Mexicans.

Otomi Indian families in San Ildefonso, a collection of villages in the central state of Queretaro, are the guinea pigs for the most extensive protein-enrichment project, carried out by the respected government-run National Nutrition Institute. And they have no doubt about the benefits.

“Before, my children fainted in school for lack of energy,” said Juana Quirino, a 42-year-old mother of six. “Now, they have gained weight, and they’re stronger.”

In one rocky village called Yosphi, 125 Otomi families were given twice-monthly supplies of ordinary cornmeal over three years to make their daily supply of tortillas. In the adjacent village of El Rincon, half a mile away across a deep canyon, 115 families were given cornmeal rations fortified with protein-rich soy.

The participants’ health was closely monitored by teams of doctors and social workers until the project concluded last month.

The results, to be published within a few weeks, are “very, very impressive,” in the words of project leader Dr. Adolfo Chavez, head of the institute’s applied nutrition department. “The malnutrition dropped by half, and very rapidly.”

Fortified Staple Food Boosts Kids’ Weight

Children ages 1 to 5 in El Rincon who consumed the protein-fortified tortillas gained an average of 10.6 pounds over the three years of the test, more than double the 4-pound gain for children who ate unfortified tortillas, according to a first draft of the report. Weight and height gains are key nutrition measures.

Another indicator: Pregnant women in El Rincon gained significantly more weight than those in Yosphi across the valley, and their babies’ birth weight averaged 6.84 pounds against 5.98 pounds in Yosphi.

Children who were not eating the enriched tortillas got sick twice as often as their counterparts in El Rincon, Chavez noted. Further, the length of illness and the time needed for full recovery were longer in Yosphi.

In addition, mental and motor-function tests measuring spatial perception, hand-eye coordination and attention capacity also showed better results in those who had consumed the soy-enriched tortillas.

As a final test, and to meet what Chavez called an ethical obligation, the institute also gave residents of Yosphi fortified cornmeal during the final year of the study. In the final six months, the doctor said, the Yosphi children and mothers began to demonstrate the same gains shown by residents of El Rincon.

“The results are definitive in the consistency of changes encountered in every key area. Height, birth weight, immunity, and physical and mental capacity all are substantially improved with protein enrichment,” the study concludes.

Using plainer language, the people of San Ildefonso agree.

“All of our five children are stronger, and we are too,” said Francisco Esquivel, whose family in El Rincon has eaten the fortified tortillas throughout the three-year test period. “Our first child was born malnourished, but Maria Isabel weighed 3.5 kilograms [7.7 pounds] when she was born. And she is happier, she has more energy, and she is more awake.”

Family of Seven Shares Single Room

The Esquivels are typical of the poorest rural Mexicans. Francisco said he earns about 250 pesos ($27) per week fashioning traditional clay pots and ornaments. He has just over half an acre of ground on the edge of the canyon to grow corn for tortillas and a bit of beans. The seven family members share the single concrete-floored room in their low-ceilinged stone house.

They eat meat only once or twice a month, Francisco said, and when they can afford it, a bit of soup, rice and grilled nopal cactus. They hardly ever eat fresh vegetables.

“The weight of the children has gone up steadily over the past three years, and it is healthy weight,” the father said. “With this, the children all win. It gives them a chance to go forward.”

The United Nations Children’s Fund, which is helping to pay for several rural tortilla-enrichment initiatives, has declared the initial results positive.

Dr. Rafael Camacho, a senior advisor in the Health Ministry who helped broker the national vitamin-enrichment agreement, said Mexico’s three major cornmeal manufacturers have all begun adding the agreed vitamins and minerals: thiamine, riboflavin, niacin, folic acid, iron and zinc.

But it is uncertain whether Mexico will quickly move beyond vitamin enrichment, which is common for foodstuffs in developed countries, and adopt the protein-fortified tortillas.

Camacho noted that the vitamin and mineral additives are inexpensive, at about three-tenths of a cent per pound, but that the soy-based protein enrichment is substantially more costly. Adding 6% soy to cornmeal increases the cost by about 10%, which, he says, consumers and producers will resist.

Camacho argued that whereas vitamin and mineral enrichment benefits everyone, only poorer Mexicans suffer from protein deficiencies, so it would make sense to reach them through focused poverty programs.

Project leader Chavez estimated that it would cost the government no more than $85 million per year to enrich tortillas with protein for 8 million extremely malnourished Mexicans who live in 10 critical zones. That cost, he noted, would still be far less than the $2 billion in subsidies that once kept tortillas cheap for all Mexicans, regardless of their income.

Chavez is convinced that poor people can and will pay the extra 1.5 cents per pound for enriched tortilla meal as they get to know the benefits.

In addition to the Queretaro program, state governments have begun distributing protein-enriched tortillas in pilot poverty-relief projects in the states of Guanajuato, San Luis Potosi, Jalisco and Zacatecas.

Dr. Guillermo Arteaga, a senior researcher for Grupo Maseca, the nation’s largest cornmeal producer, which helped sponsor the Queretaro and Guanajuato pilot projects, said the results are most positive in areas where tortilla consumption forms the largest part of the diet.

“In San Ildefonso in Queretaro, the tortilla is the food. They eat tortillas morning, noon and night. In other communities where the diet is more varied, the impact is not as pronounced,” Arteaga said. “But even in Guanajuato, people’s weight is starting to go up, and it’s not due to water or fat but to improved muscle mass.”

Tortillas remain relatively cheap, starting at about 15 cents a pound, and per capita consumption averages two-thirds of a pound per day.

In the Queretaro test, villagers were found to get between 76% and 80% of their daily energy intake from tortillas. Farmer Eliseo Esteban de Jesus, 41, said he and his wife each eat 10 to 15 tortillas a day. On bad days, he said, they flavor the tortillas with nothing more than salt.

Yet even if all cornmeal were protein-enriched, that would fortify only about half the tortillas now consumed in Mexico. The rest are made by the traditional nixtamal method, in which corn kernels are ground up with lime and turned directly into a damp dough.

It is easier and cheaper to add soy protein to dry cornmeal flour than to the nixtamal dough. And because the nixtamal tortillas are produced by a highly fragmented industry, numbering about 47,000 storefront factories throughout the country, it would be harder to implement and monitor a protein-enrichment program.

Traditional nixtamal millers, who liken themselves to neighborhood bread bakers defending the consumer against mass-produced white bread, oppose any mandatory enrichment schemes without government help.

The lifting of subsidies and price controls for the entire tortilla industry in January, which heightened competition and tightened margins, makes the nixtamal producers even more nervous about any imposed costs that might put them at a disadvantage.

Still, proponents say the steady gain in market share for cornmeal makes an enrichment program easier to manage because only three companies--Grupo Maseca, Grupo Minsa and Agroinsa--control all production. Furthermore, scientists have improved the taste of soy additives so that they no longer cause unpalatable taste changes.

Technically, it is feasible to enrich nixtamal tortillas too, said industry leader Sergio Celorio, a sometime inventor who has patented methods to fortify tortilla dough with soy protein. But he says the government should assist small millers in paying the technology costs or else the nixtamal industry will be unable to compete against the three big cornmeal companies.

And the Health Ministry’s Camacho cautioned against the notion that a supertortilla could magically solve nutrition problems that have deep structural roots in poverty and lack of opportunity.

While he sees useful roles for targeted protein-enriched tortilla programs, “no one should mythologize the tortilla. . . . Nutrition is not solved through one food alone--it is a matter of achieving the proper mix of foods.”

In San Ildefonso, no one complained about the switch to dry cornmeal to make their tortillas.

Above a rocky ravine, Fernando Perez Ventura was working his tiny cornfield while his wife, Maria Miguel Benito, embroidered Otomi designs on a cloth napkin and their four children played nearby. The family has been in the enriched-tortilla program from the outset.

“God has been punishing us with hunger,” Benito said, “and it was a great gift to get this help. It would be great for all Mexicans.”