Wheat flour fortification with iron for reducing anaemia and improving iron status in populations

Field, Martha S.; Mithra, Prasanna; Estevez, Diana; Peña-Rosas, Juan Pablo

doi:10.1002/14651858.cd011302.pub2

Cited by 22 publications

(12 citation statements)

References 138 publications

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“…However, certain fortification approaches, such as iron fortification of staple foods like flour, provided mixed results. For example, Field et al (2020) found that fortifying wheat flour with iron had little or no effect on anemia [ 14 ] and had little to no impact on iron deficiency compared to unfortified wheat flour; and that the addition of other micronutrients also had little impact on iron deficiency and hemoglobin concentrations compared to wheat flour alone [ 15 ]. Similarly, Pachon et al (2015) found limited evidence to support the reduction of anemia with large-scale flour fortification [ 16 ].…”

Section: What Is Food Fortification?mentioning

confidence: 99%

Food Fortification: The Advantages, Disadvantages and Lessons from Sight and Life Programs

et al. 2021

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Deficiencies in one or more micronutrients such as iron, zinc, and vitamin A are widespread in low- and middle-income countries and compromise the physical and cognitive capacity of millions of people. Food fortification is a cost-effective strategy with demonstrated health, economic and social benefits. Despite ongoing debates globally and in some countries regarding the performance and safety of food fortification, the practice offers significant benefits across each of the main vehicles for food fortification (large-scale food fortification, biofortification and point-of-use or home fortification) ranging from reducing the prevalence of nutritional deficiencies and economic benefits to societies and economies. Using Sight and Life’s global and national experiences in implementing food fortification efforts, we demonstrate how different programs in LMICs have successfully addressed challenges with food fortification and in doing so, find that these efforts are most successful when partnerships are formed that include the public and private sector as well as other parties that can provide support in key areas such as advocacy, management, capacity building, implementation and regulatory monitoring.

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Section: What Is Food Fortification?mentioning

confidence: 99%

Food Fortification: The Advantages, Disadvantages and Lessons from Sight and Life Programs

et al. 2021

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“…Fortification of wheat flour (49) or rice (50) with Fe alone have little effect on anaemia and probably makes little or no difference in the risk of presenting Fe deficiency, and there is uncertainty that interventions may increase the mean Hb concentrations in the general population of children older than 2 years of age.…”

Section: Discussionmentioning

confidence: 99%

Association between iron supplementation and the presence of diarrhoea in Peruvian children aged 6–59 months: analysis of the database of the Demographic and Family Health Survey in Peru (DHS, Peru), years 2009–2019

Valverde-Bruffau

Steenland

Gonzales

2021

Public Health Nutr.

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Introduction: According to the World Health Organization (WHO), anemia is a severe public health problem when the prevalence is ≥ 40%. In 2019, in Peru, 40.1% of children (age 6 to 35 months) are diagnosed as anemic. This is a concern since, despite the efforts of the governments to reduce the prevalence, the problem has stagnated since 2011. The treatment applied to deal with anemia is iron supplementation. Although iron is essential for cell function, an excess can produce adverse responses, such as gut inflammation affecting microbiota and resulting in diarrheic episodes. Objective: To determine the association between diarrhea and iron supplementation in children with and without anemia, controlling for different socio-demographic variables. Design: We conducted via logistic regression to obtain diarrhea prevalence ratios, adjusted by age, sex, geographic region, water and sanitation service, and rurality. The survey asked for recent episodes of diarrhea during the last 7 days; similarly, after the consumption of iron supplements during the last 12 months before the survey. Setting: Peru Subjects: The Demographic and Health Survey (DHS) is conducted annually at home among 14,202 children on average (2009 – 2019). Results: Iron supplementation in the last seven days (PR=1.09) or the last twelve months (PR=1.19) (p<0.0001) was associated with an increased risk of diarrhea. The same association was observed between iron supplementation and the presence of anemia. Conclusions: Iron supplementation is associated with diarrhea and over-use in children should be avoided.

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“…As of 1 year old, children are incorporated into the family diet and studied foods cover a greater proportion of iron requirements. 4 The impact of wheat flour enrichment with iron on the prevalence of anemia has proven to be positive in some studies, 3,5,22,23 although others have not corroborated such improvement. 24,25 A study carried out by our task force in 2004 26 in the province of Buenos Aires showed that the prevalence of anemia decreased over 1 year from 55 % to 39 % in children younger than 2 years as a result of the synergistic effect of delivering foods containing micronutrients and the enactment of the law establishing flour enrichment.…”

Section: Discussionmentioning

confidence: 99%

“…In Argentina, anemia is prevalent in children younger than 2 years, but it also affects children younger than 6 years. [3][4][5] S p e c i f i c a l l y , i t h a s b e e n demonstrated that wheat flour enrichment with iron is an adequate vehicle in countries where flour is regularly consumed. More than 80 countries have passed some type of legislation aimed at wheat flour fortification with iron.…”

Section: Introductionmentioning

confidence: 99%

Contribution of enriched wheat flour and flour products to iron requirements in children aged 6 months to 7 years

2021

Arch Argent Pediat

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Introduction. Wheat flour enrichment is a public health strategy recommended to prevent micronutrient deficiencies, including iron deficiency. The objective of this study was to determine iron content in enriched wheat flour and flour products and their contribution to nutritional recommendations for children. Population and methods. Observational, analytical, cross-sectional study based on the total diet study method. Enriched wheat flour (as per Law no. 25630) and the most frequently consumed flour products were analyzed. Products were selected using a questionnaire on the frequency of food intake and a 24-hour recall interview with the parents of children aged 6 months to 7 years. Food iron levels were determined based on atomic absorption spectrometry and their contribution to the estimated average requirement was assessed. Results. Enriched flour and flour products showed the expected iron amount, except for French bread and breadcrumbs. The contribution of studied products to iron requirements was 7 % in children aged 6 months to 1 year, 81 % in those aged 1-3 years, and 45 % in those older than 4 years. Conclusions. Except for French bread and breadcrumbs, studied flour and flour products showed the expected enrichment level. The consumption of this type of food does not provide significant amounts of iron to infants, but it does to children older than 1 year.

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Wheat flour fortification with iron for reducing anaemia and improving iron status in populations

Cited by 22 publications

References 138 publications

Food Fortification: The Advantages, Disadvantages and Lessons from Sight and Life Programs

Food Fortification: The Advantages, Disadvantages and Lessons from Sight and Life Programs

Association between iron supplementation and the presence of diarrhoea in Peruvian children aged 6–59 months: analysis of the database of the Demographic and Family Health Survey in Peru (DHS, Peru), years 2009–2019

Contribution of enriched wheat flour and flour products to iron requirements in children aged 6 months to 7 years

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