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Wheat flour fortification and human health

Code: 9781801461023
Helena Pachón, Food Fortification Initiative and Emory University, USA

Chapter synopsis: Using varied study designs (none of which can confirm causality), investigators assessed the health impact of wheat flour fortification after it was implemented at large scale in countries. Folic acid was the most studied nutrient and the most studied outcomes were neural tube defects, cancer, folate status, folate deficiency, anemia, iron deficiency, iron status, hemoglobin and iron-deficiency anemia (IDA). For all of these outcomes except IDA, the majority of studies showed improvements after fortification. For some of the outcomes (cancer, anemia, hemoglobin, folate deficiency), there were studies that indicated health outcomes worsened after fortification. The discrepant results for cancer may be due to years since fortification initiated and sample size differences. The preponderance of the evidence suggests that wheat flour fortification improves many health outcomes. Because fortification may also be associated with negative health outcomes such as cancer, health monitoring should continue to assess these outcomes in countries with fortification.

DOI: 10.19103/AS.2021.0087.23

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Table of contents 1 Introduction 2 Status of wheat flour fortification 3 How the human health impact of wheat flour fortification is measured 4 Examples of health outcomes associated with wheat flour fortification that have been studied 5 Additional considerations when assessing the health impact of wheat flour fortification 6 Health impact results observed from wheat flour fortification studies 7 Summary 8 Future trends in research 9 Where to look for further information 10 References

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