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Meta-Analysis
. 2019 Dec;22(18):3465-3484.
doi: 10.1017/S1368980019002179. Epub 2019 Sep 5.

Systematic review and meta-analysis of the effect of iron-fortified flour on iron status of populations worldwide

Jila Sadighi  1 , Saharnaz Nedjat  2 , Rahele Rostami  1
Affiliations
Meta-Analysis

Systematic review and meta-analysis of the effect of iron-fortified flour on iron status of populations worldwide

Jila Sadighi et al. Public Health Nutr. 2019 Dec.

Abstract

Objective: 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, Côte 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 µg/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 µg/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.

Keywords: Fortified flour; Iron status; Meta-analysis; Systematic review.

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Figures

Fig. 1
Fig. 1
Flow diagram of article selection process
See this image and copyright information in PMC

References

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