The Usefulness of Elemental Iron for Cereal Flour Fortification: a Sustain Task Force Report

Hurrell, Richard F.; Bothwell, T. H.; Cook, James D.; Dary, Omar; Davidsson, Lena; Fairweather‐Tait, Susan J.; Hallberg, Leif; Lynch, Shaina M.; Rosado, Jorge L.; Walter, Tomás; Whittaker, Paul

doi:10.1301/002966402320964061

Cited by 101 publications

(88 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Ferrous sulfate is the most bioavailable Fe source, but it still has low absorption. Due to the sensory effects in many food vehicles that it produces (17) , it is usually less used (18) . Fe bioavailability, which is a key factor in fortification programmes, depends on the nature and level of the Fe compound added to the food, the amount of fortified foods consumed, the Fe status of the consumer, and the presence of inhibitors and enhancers of Fe absorption in the overall diet (11) .…”

Section: Discussionmentioning

confidence: 99%

An evaluation of the effectiveness of the flour iron fortification programme in Brazil

Santos

Nilson

Verly

et al. 2014

Public Health Nutr.

View full text Add to dashboard Cite

Objective: The present communication reports a strategy to calculate the intake of Fe based on data available for folic acid and evaluate the programme of flour fortification in Brazil. Design: Cross-sectional study conducted in Brazil during 2008 and 2009. A 2 d dietary record of individuals was used. The usual intake of folic acid by sex and age group was estimated using the National Cancer Institute method. The quantity of folic acid and Fe established by mandatory food fortification in Brazil was used, and based on that quantity we calculated the amount of flour consumed and the intake of Fe from fortification and Fe from food. Then, the absorption of each nutrient was calculated. Setting: Brazilian households (n 16 764). Subjects: Individuals (men and women, n 34 003, aged 10 to 60 + years) from a Brazilian nationwide survey. Results: Mean intake and absorption of Fe from fortification (electrolytic Fe) was low in men and women. Conclusions: The impact from the consumption of fortified products is small in relation to Fe intake in Brazil. The strategy proposed to estimate Fe intake from the fortification programme indicates that the amount of flour intake observed in Brazil does not justify the current ranges of mandatory flour fortification and the form of Fe that is mainly used (electrolytic Fe).

show abstract

Section: Discussionmentioning

confidence: 99%

An evaluation of the effectiveness of the flour iron fortification programme in Brazil

Santos

Nilson

Verly

et al. 2014

Public Health Nutr.

View full text Add to dashboard Cite

show abstract

“…Furthermore, our results imply that the most successful and thus qualitatively best course of action for combating iron deficiency is to combine fully available iron fortifiers with dietary modifications aimed at improving iron bioavailability. Even though this has been suggested earlier on by both WHO and the SUSTAIN Task Force, it derives from a primarily theoretical reasoning basis (WHO, 2001;Hurrell et al, 2002;). The important difference of this present paper is that it adds a quantitative dimension to these predictions.…”

Section: Discussionmentioning

confidence: 97%

“…A more realistic bioavailability figure would be B50%, or less (Hallberg et al, 1986;Hurrell et al, 2002;Walter et al, 2004;Hoppe et al, 2006). This more realistic figure would lead to an even more pronounced inability to reach the iron requirement.…”

Section: Discussionmentioning

confidence: 99%

The importance of bioavailability of dietary iron in relation to the expected effect from iron fortification

2007

View full text Add to dashboard Cite

Background:The most common method of combating iron deficiency is iron fortification, especially in developing countries. However, few studies have shown a significant effect on iron status following iron fortification of low bioavailability diets. Objective: To investigate how iron fortification and dietary modifications affect iron absorption and rates of changes in iron stores. Methods: Research has made it possible to predict both iron absorption and the effects of iron fortification and diet modifications on iron stores using recently developed algorithms. Iron absorption and rate of change in iron stores were calculated from nine diets representing a broad range of iron bioavailability and iron contents. The calculations were related to the main target group for iron fortification, that is, women of reproductive age having empty stores but normal haemoglobin concentrations. Results: As the only measure, iron fortification has practically no effect on iron status if the original diet has low bioavailability. However, after dietary modifications such a diet shows a positive effect on iron stores. The combined action of fortification (6 mg/day) and modest bioavailability changes in a low bioavailability diet results approximately in 40 and 70% greater increases in iron stores than through iron fortification or dietary modification alone. Conclusions: It is difficult to achieve good effects on iron status from iron fortification as the only measure if the diet has low bioavailability. Both dietary modifications as well as iron fortification are required to improve effectively the iron status of a population.

show abstract

“…However, an expert panel (18) reporting on the usefulness of elemental Fe powders for food fortification concluded that electrolytic Fe was the only Fe powder to be recommended. 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.…”

Section: Discussionmentioning

confidence: 99%

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

Miglioranza

Breganó

Dichi

et al. 2009

Public Health Nutr.

View full text Add to dashboard Cite

Objective: To find the ideal combination of Fe fortifier and its food vehicle is an essential measure in developing countries. However, its cost also plays an important role. In the present study, the effect on blood parameter values of corn flour-derived products fortified with powdered elemental Fe in the form of H 2 -reduced Fe was investigated in children and adolescents. Methods: One hundred and sixty-two individuals (eighty-six boys and seventy-six girls) from public educational centres in Londrina, Paraná (southern Brazil) participated in the study. Fe-deficiency anaemia (IDA) was defined when Hb and serum ferritin values fell below 12 g/dl and 20 mg/l, respectively; Fe deficiency (ID) was considered when serum ferritin was below 20 mg/l. Results: The prevalence of ID and IDA decreased from 18?0 % and 14?9 %, values found at the beginning of the study, to respectively 5?6 % and 1?2 % after 6 months. Changes from altered to normal values occurred more often than normal to altered values with transferrin saturation (14?2 % v. 6?8 %; P , 0?04) and ferritin (12?4 % v. 0 %; P , 0?001). Hb, transferrin saturation and ferritin showed differences between normal and altered parameters after 6 months (P , 0?001). Conclusion: A pronounced reduction in the prevalence of ID and IDA was observed in children and adolescents following 6 months' ingestion of corn flour-derived products enriched with elemental Fe.

show abstract

The Usefulness of Elemental Iron for Cereal Flour Fortification: a Sustain Task Force Report

Cited by 101 publications

References 33 publications

An evaluation of the effectiveness of the flour iron fortification programme in Brazil

An evaluation of the effectiveness of the flour iron fortification programme in Brazil

The importance of bioavailability of dietary iron in relation to the expected effect from iron fortification

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

Contact Info

Product

Resources

About