The Use of Iron-fortified Wheat Flour to Reduce Anemia Among the Estate Population in Sri Lanka

Abstract

The use of flour fortified with 66 mg/kg of electrolytic or reduced iron to reduce the prevalence of anemia was determined in a two-year, double-blind, controlled trial. The trial was conducted in Sri Lanka among preschoolers between 9 and 71 months old, primary schoolers 6 to 11 years old, and nonpregnant women. At baseline, 18.4% of the preschoolers had low hemoglobin (Hb) concentrations. Neither electrolytic nor reduced iron had an effect on Hb concentration among preschoolers. Only 7% of the primary schoolers were anemic at the start of the trial and, again, fortification had no effect on Hb concentration. Twenty-nine percent of women had a low Hb at outset and there was no evidence that fortification had an effect on Hb in this group. The findings from this study suggest that fortification of flour with electrolytic iron or reduced iron was not beneficial in reducing anemia in this population. This was probably due to the low prevalence of anemia and low bioavailability of the fortificant iron. Fortification with either iron fortificant was acceptable.

Flour fortification with iron has no impact on anaemia in urban Brazilian children

“…Although evaluations in Guatemala (26) and Sri Lanka (27) showed that flour fortification has little impact on anaemia, in Venezuela compulsory fortification of corn and wheat flours seems to have restored the Fe status of adolescents of low socio-economic status (28) .…”

Alimentos sujeitos à fortificação compulsória com ferro: um estudo com gestantes

“…Para que um alimento possa ser um veículo potencial de fortificação, deve ser de baixo custo 7 , de alto consumo pela população-alvo 7,8 e ter um consumo padrão constante com baixo risco de excesso 7 .…”

Effectiveness of fortification of corn flour-derived products with hydrogen-reduced elemental iron on iron-deficiency anaemia in children and adolescents in southern Brazil

“…On the basis of the change in body Fe stores during a 35-week study in Thai women, Zimmermann et al (19) verified that the relative efficacy of the electrolytic and H 2 -reduced Fe compared with FeSO 4 (12 mg Fe/d) was 77 % and 49 %, respectively. Nevertheless, two other studies using electrolytic Fe did not find improvement of Fe status (20,21) .…”