Flour enrichment and iron-deficiency anemia in the Kyrgyz Republic

Abstract

Introduction. Poor nutrition is the main cause of nutrition-associated diseases, including iron-deficiency anemia (IDA). An enrichment of basic foods is the one of the most effective preventive measures among the population, especially women and children. Materials and methods. A survey of 2,218 respondents was conducted to identify public awareness and consumption of enriched flour, of which 1,442 (65%) were women and 776 (35%) were men. The enrichment quality of 408 flour samples was determined according to GOST 26928-86. An epidemiological analysis of the long-term follow up on the prevalence and incidence rates was carried out for the period 2009-2019. Results. According to the results of the survey, 5.7% of respondents did not know what the term “enriched flour” means, 68.3% consider it “safe flour enriched with vitamins and minerals”. The media were the main sources of information on enriched flour. The majority (30.9%) of the respondents noted the improvement of physical and mental development among the beneficial properties of enriched flour. According to the results of the analysis, 77.4% of Orion brand flour were found to have an underestimated iron content compared with the requirements of the Technical Regulation of the Kyrgyz Republic “On the safety of fortified flour”, 54.8% of Rola flour, 44.7% of Aliya flour. A retrospective analysis of the long-term trend in IDA for the period from 2010 to 2018 revealed a significant decline in the trend by 44.8% (in 2010 - 2373.3 per 100 thousand people, in 2018 - 1311.0 per 100 thousand people) among adults and adolescents, and among children from 0 to 14 years of age by 18.4%. Limitations. The study has potential limitations due to the lack of a comparative analysis of the incidence of iron-deficiency anemia in the population using enriched flour and without, and that not all brands of flour produced domestically and imported were subjected to a full study. Conclusion. The enrichment of flour with micro-elements is one of the ways to provide functional nutrition. Flour fortification can contribute to strengthening the health of the nation by providing essential vitamins and minerals that are lacking in daily nutrition.