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Systematic Review and Meta-Analysis of the Effect of Iron-Fortified Flour on Iron Status of Populations Worldwide Publisher Pubmed



Sadighi J1 ; Nedjat S2 ; Rostami R1
Authors
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Authors Affiliations
  1. 1. Health Metrics Research Center, Institute for Health Sciences Research, ACECR, Tehran, Iran
  2. 2. Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran

Source: Public Health Nutrition Published:2019


Abstract

Assess the effectiveness of iron-fortified flour on iron status.Design: Systematic review and meta-analysis.Setting: Argentina, Australia, Azerbaijan, Bangladesh, Brazil, Cameroon, Chile, China, Costa Rica, Cote d'Ivoire, Denmark, India, Iran, Jordan, Kazakhstan, Kenya, Kuwait, Mongolia, Morocco, Norway, South Africa, Sri Lanka, Tajikistan, Thailand, UK, USA, Uzbekistan, Venezuela, Vietnam, and Zambia.Participants: Fifty-two articles (ninety-four trials) were examined. The main target groups were women, children, and infants/toddlers. The effects of different types of iron-fortified flour (wheat, maize, rice, soy, and beans) on iron status were examined.Results: A random effects analysis of before-after studies showed that iron-fortified flour led to significant increases of mean haemoglobin level (3·360 g/l; 95 % CI: 0·980, 5·730) and mean serum ferritin level (4·518 g/l; 95 % CI: 2·367, 6·669); significant decreases of anaemia (-6·7 %; 95 % CI: -9·8 %, -3·6 %) and iron deficiency (ID) (-10·4 %; 95 % CI: -14·3 %, -6·5 %); but had no significant effect on iron deficiency anaemia (IDA). A random effects analysis of controlled trials indicated that iron-fortified flour led to significant increases of mean haemoglobin level (2·630 g/l; 95 % CI: 1·310, 3·950) and mean ferritin level (8·544 g/l; 95 % CI: 6·767, 10·320); and significant decreases of anaemia (-8·1 %; 95 % CI: -11·7 %, -4·4 %), ID (-12·0 %; 95 % CI: -18·9 %, -5·1 %), and IDA (-20·9 %; 95 % CI: -38·4 %, -3·4 %).Conclusions: Flour fortification with iron is an effective public health strategy that improves iron status of populations worldwide. © The Authors 2019.