Flour fortification efficiency at the flour mill

The article discusses the process of flour fortification with vitamin and mineral complexes. The ways of implementation and expansion of the fortified flour production program are analyzed and indicated. The analysis conducted by the authors showed the effectiveness of introducing premixes into flour precisely at a flour mill.

Awareness and factors associated with reported intake of folic acid-fortified flour among women of reproductive age in Ifakara, Morogoro region, Tanzania: a cross-sectional study

Background Folic acid fortification of staple foods has been in place in many countries for over two decades. Studies have shown that folic acid fortification can significantly reduce incidence of neural tube defects. Tanzania adopted a mandatory fortification policy for commercially-produced wheat and maize flour in 2011. We determined factors influencing intake of folic acid-fortified flour among women of reproductive age (WRA). Methods We conducted a cross-sectional study among WRA during March–April 2017 in Ifakara Town Council, Morogoro region. Multistage cluster sampling was used to select study participants. We used a questionnaire to capture information on demographics, awareness of folic acid, awareness of existence of folic acid fortified flour in community and intake of folic acid fortified flour. Intake was defined as reported consumption of folic acid fortified flour products at least once within 7 days before interview. Univariate, bivariate, and multivariable logistic analyses were done to evaluate factors associated with intake of folic acid fortified flour. Results The median age of the 698 participating WRA was 30 years (range: 18–49). Awareness of folic acid and folic acid fortified flour was 6.9% (95% CI: 5.2–9.0%) and 7.5% (95% CI: 5.7–9.6%), respectively. Consumption of folic acid fortified flour was 63.3% (95% CI: 59.7–66.8%). Independent factors associated with intake included being employed (aOR = 1.91; 95% CI: 1.19–3.06), having no children (nulliparity) (aOR = 2.59; 95% CI: 1.36–4.95) or having 1–4 children (aOR = 1.98; 95% CI: 1.17–3.33) (vs. 5 or more children), and folic acid awareness (aOR = 2.53; 95% CI: 1.30–4.92). Conclusion Folic acid fortified flour was used by most respondents in our study despite low awareness of existence of folic acid fortified flour in the community. Being employed, having fewer than five children, and folic acid awareness were independent factors associated with intake. We recommend scaling up of mandatory flour fortification program and doing further studies on blood folate level among women of reproductive age in Ifakara to assess fortification program effectiveness.

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

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.

Stability of Vitamin A in Nigerian Retailed Biscuits

Vitamin A deficiency is a major public health problem affecting poor populations in developing countries. Biscuits baked with Nigerian vitamin A fortified flour (30 IU/g) have been consumed by pre-school children. This study aims at determining vitamin A content and stability in retailed biscuits at point of consumption. Pre-tested, semi-structured, interviewer-administered questionnaire was used to collect biscuit consumption pattern of pre-school children (n=1600). Out of 18 brands of biscuits reported, eight cartons of 8 commonly consumed brands were purchased from major markets in Lagos. Vitamin A (retinol) stability was determined by storing biscuit samples for 30 days. Pre- and post-storage retinol analyses were carried out using high performance liquid chromatography. Vitamin A stability was calculated as percentage of initial vitamin A biscuit values. Crunchiness and packaging of biscuit samples were also assessed. Data were analysed using descriptive and T-test at p<0.05. At pre-storage level, 62.5 % and 37.5 % samples had vitamin A and zero contents respectively. At post-storage, 25% had vitamin A content while 75% had zero content. Pre- and post-storage vitamin A content of samples was 5.2±4.9 IU/g and 1.9±1.8 IU/g. Mean vitamin A stability and loss in retailed biscuits at 2 months was 16.8% and 83.2% respectively. A significant difference was found in vitamin A content and stability of biscuits at pre- and post-storage levels. Biscuits lost crunchiness at post-storage level. Vitamin A content of retailed biscuit samples was below 30 IU/g resulting in very low stability. Use of fortified quality raw materials and compliance are essential.

Brazilians’ experiences with iron fortification: evidence of effectiveness for reducing inadequate iron intakes with fortified flour policy

ObjectiveTo assess Fe intake, calculate the prevalence of inadequate Fe intake and identify food contributors to Fe intake during 2003 and 2008 in a population-based study, reflecting before and after the mandatory fortification of flour with Fe.DesignTwo cross-sectional population-based studies conducted in 2003 and 2008. Dietary intake was evaluated by 24 h recall and the Software for Intake Distribution Estimation (PC-SIDE) was used to estimate within-person variance and prevalence of inadequate Fe intake. The statistical analysis was conducted considering the complex survey design.SettingSão Paulo, Brazil.SubjectsAdolescents, adults and elderly adults of both sexes, interviewed in 2003 (n 2386) and 2008 (n 1661).ResultsThe Fe intake mean increased in all populations in the post-fortification period. A reduction of over 90 % was observed in the prevalence of inadequate Fe intake among men for all age groups analysed. When evaluating women, despite the substantial reduction (over 63 %), prevalence of inadequate Fe intake remained high (34 %) in those aged 19–50 years. Major food contributors to Fe intake before fortification were beans, beef, vegetables and dairy. There was an alteration in the contributors in the post-fortification period, with bread, beef, beans and biscuits as main contributors.ConclusionsThe mandatory fortification with Fe significantly furthered the reduction in the prevalence of inadequacy, except among women of reproductive age, and changed the main contributors to this nutrient in the studied population. Therefore, monitoring of Fe addition in flour is essential to assess compliance to the fortified flour policy and to guarantee a safe Fe intake for all the population.