Abstract
Iron deficiency anemia is the most prevalent nutritional deficiency in the world and food fortification is a cost-effective approach to combat it. This paper reviews the food fortification process with micronutrients, with special emphasis on iron and the most critical steps and common difficulties found when implementing a program. The first step is to measure the magnitude of the problem and the groups affected by iron deficiency and anemia, to determine if there is a need for fortification. Then the adequate iron compound and vehicle should be selected, to obtain a bioavailable form of iron in a frequently consumed food item without changing the taste, appearance or cooking characteristics of the final food item or complete meals containing it, to assure the acceptance by consumers. Before implementation, bioavailability studies are in order for the fortified food item and for complete meals especially typical or traditional meals, followed by field studies and pilot tests. Once implemented, the program should be monitored and evaluated continuously, and the impact on health assessed periodically to give the program the flexibility for continuation made changes or finalization when necessary. Other key elements for successful implementation of food fortification programs include the presence of a viable food industry; available channels for food marketing and distribution; a health care system to identify and monitor micronutrient malnutrition in the population; institutions for education, treatment and evaluation of the impact of the program; and continuous and effective input into the planning, implementation, monitoring and evaluation of the intervention to ensure sustainability of the intervention.
Highlights
Anemia constitutes the most prevalent nutritional deficiency worldwide, especially in children and women in childbearing age
The first one is to measure the magnitude of the problem and the groups affected by iron deficiency and anemia, to determine if there is a need for fortification
NaFeEDTA is recommended for the mass fortification of high-phytate cereal flours and for sauces with high peptide content and ferrous bisglycinate, micronized ferric pyrophosphate and ferric ammonium citrate have been used to fortify liquid milk and dairy products, [21] [22]
Summary
Anemia constitutes the most prevalent nutritional deficiency worldwide, especially in children and women in childbearing age. Anemia due to iron deficiency is highly prevalent in developing countries, in Asia, Africa and South America, and is caused by poor dietary iron content and availability for absorption, together with increased requirements (during growth and pregnancy) and losses (especially due to intestinal parasitic infection and menstruation). Iron deficiency anemia is associated with poor physical and work performance, cognitive development and increased risk of maternal and perinatal mortality, low size or weight at birth. Food fortification is probably the most cost-effective approach and has been proved to have an important impact on anemia prevalence in complete populations especially in the most affected age groups [8] is not free of multiple steps and bottle necks. This paper reviews the food fortification process with iron and the most critical steps and common difficulties found when implementing a program
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