Researchers at Emory’s Rollins School of Public Health analyzed an in-depth report (published and unpublished) of national and sub-national programs to fortify flour with iron. The reports were from 13 countries: Azerbaijan, Brazil, China, Fiji, India, Iran, Kazakhstan, Mongolia, Nepal, Sri Lanka, Tajikistan, Uzbekistan, and Venezuela. The reviewed reports all compared data collected before fortification with data collected at least 12 months after fortification began. Fortification was for wheat flour alone or in combination with maize flour.
Led by Dr. Helena Pachón, research assistant professor in the Hubert Department of Global Health at the Rollins School of Public Health and senior nutrition scientist for the Food Fortification Initiative (FFI), this first systematic review of the effectiveness of flour fortification on iron and anemia outcomes offered three recommendations for improving national fortification programs that included:
The complete paper is available in the October 3 edition of Nutrition Reviews .
One objective of the systematic review was to identify differences between programs that did and did not follow WHO recommendations for flour fortification. The WHO recommendations are based on the per capita intake as well as the type of flour being fortified.
“The fact that most of these programs were not aligned with WHO recommendations is understandable because they all began before the WHO recommendations were published in 2009,” noted Pachón. “We suggest that new fortification programs should be designed to follow WHO recommendations and that existing standards be amended to follow WHO recommendations as needed.”
Co-authors of the paper are affiliated with the Global Alliance for Improved Nutrition (GAIN) and the U.S. Centers for Disease Control and Prevention (CDC) International Micronutrient Malnutrition Prevention and Control (IMMPaCt) program.