Document Detail

Revised recommendations for iron fortification of wheat flour and an evaluation of the expected impact of current national wheat flour fortification programs.
MedLine Citation:
PMID:  20629349     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Iron fortification of wheat flour is widely used as a strategy to combat iron deficiency. OBJECTIVE: To review recent efficacy studies and update the guidelines for the iron fortification of wheat flour. METHODS: Efficacy studies with a variety of iron-fortified foods were reviewed to determine the minimum daily amounts of additional iron that have been shown to meaningfully improve iron status in children, adolescents, and women of reproductive age. Recommendations were computed by determining the fortification levels needed to provide these additional quantities of iron each day in three different wheat flour consumption patterns. Current wheat flour iron fortification programs in 78 countries were evaluated. RESULTS: When average daily consumption of low-extraction (< or = 0.8% ash) wheat flour is 150 to 300 g, it is recommended to add 20 ppm iron as NaFeEDTA, or 30 ppm as dried ferrous sulfate or ferrous fumarate. If sensory changes or cost limits the use of these compounds, electrolytic iron at 60 ppm is the second choice. Corresponding fortification levels were calculated for wheat flour intakes of < 150 g/day and > 300 g/day. Electrolytic iron is not recommended for flour intakes of < 150 g/day. Encapsulated ferrous sulfate or fumarate can be added at the same concentrations as the non-encapsulated compounds. For high-extraction wheat flour (> 0.8% ash), NaFeEDTA is the only iron compound recommended. Only nine national programs (Argentina, Chile, Egypt, Iran, Jordan, Lebanon, Syria, Turkmenistan, and Uruguay) were judged likely to have a significant positive impact on iron status if coverage is optimized. Most countries use non-recommended, low-bioavailability, atomized, reduced or hydrogen-reduced iron powders. CONCLUSION: Most current iron fortification programs are likely to be ineffective. Legislation needs updating in many countries so that flour is fortified with adequate levels of the recommended iron compounds.
Richard Hurrell; Peter Ranum; Saskia de Pee; Ralf Biebinger; Lena Hulthen; Quentin Johnson; Sean Lynch
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Food and nutrition bulletin     Volume:  31     ISSN:  0379-5721     ISO Abbreviation:  Food Nutr Bull     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-07-15     Completed Date:  2010-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906418     Medline TA:  Food Nutr Bull     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  S7-21     Citation Subset:  IM    
Swiss Federal Institute of Technology (ETH), Institute of Food Science and Nutrition, ETH Zentrum, LFV D20, Schmelzbergstrasse 7, 8092 Zürich, Switzerland.
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MeSH Terms
Anemia, Iron-Deficiency / prevention & control
Evaluation Studies as Topic
Flour / analysis*
Food, Fortified / standards*
Guidelines as Topic
Iron / administration & dosage*,  chemistry,  deficiency
Iron Compounds / administration & dosage,  pharmacokinetics
Nutrition Policy / trends*
Nutritional Status
Young Adult
Reg. No./Substance:
0/Iron Compounds; 7439-89-6/Iron

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