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Nutritional Anemia Reductions Due to Food Fortification Among Women of Childbearing Age: A Literature Review and Bayesian Meta‐Analysis
Journal article   Open access   Peer reviewed

Nutritional Anemia Reductions Due to Food Fortification Among Women of Childbearing Age: A Literature Review and Bayesian Meta‐Analysis

Andrea D. Dorbu, Hannah B. Waddel, Manpreet K. Chadha, Daniel López de Romaña, Mandana Arabi, Reneé H. Moore, Christina Mehta and Helena Pachón
Maternal and child nutrition, pe13801
03 Feb 2025
PMID: 39899434
url
https://doi.org/10.1111/mcn.13801View
Published, Version of Record (VoR) Open CC BY-NC-ND V4.0

Abstract

fortification hemoglobin maize flour oil rice wheat flour Anemia
Food fortification can deliver essential micronutrients to populations at a large scale, thereby reducing nutritional anemia. This study aimed to review and meta‐analyze the literature on the impact of wheat flour, maize flour, rice, and oil (singly or combined) fortification on women's (10–49 years) hemoglobin and anemia. A search of 17 databases yielded 2284 results. Longitudinal, pre‐post cross‐sectional, efficacy, and effectiveness studies were included. Primary outcomes were changes in hemoglobin concentration and anemia prevalence. Studies were synthesized using arm‐based network meta‐analysis. In women who consumed fortified rice, hemoglobin mean change was 3.24 g/L (95% credibility interval (CrI) 0.9, 5.98), higher than for women in the control, with a 99.1% probability that the true mean difference was > 0. Hemoglobin was 2.08 g/L (95% CrI −0.76, 4.35) higher in women who consumed wheat flour versus control, with a 93.5% probability that the true mean difference was > 0. After rice fortification, anemia prevalence in women was 1.38 percentage points (95% CrI −106.6, 99.2) lower than for control women, with a 51.2% probability that the true mean difference was < 0. Wheat flour fortification decreased anemia prevalence by 1.84 percentage points (95% CrI −93.4, 92.4) with a 52.72% probability that the true mean difference was < 0. The treatment effects of fortified maize flour and fortified oil could not be calculated due to the absence of control arms compared to the intervention arms. Fortified rice and wheat flour appear likely to modestly increase hemoglobin and may also reduce anemia in women of childbearing age. There was a high probability of increasing hemoglobin concentration if rice or wheat flour are fortified independently, and if maize flour, rice, oil, and wheat flour are fortified with iron alone regardless of women's ages and fortification duration. Fortification of maize flour, rice, oil, and wheat flour with folic acid alone or a combination of multiple micronutrients had a moderate probability of increasing hemoglobin concentration. There was a moderate probability of reducing anemia prevalence when maize flour, rice, oil, and wheat flour were fortified with iron alone or with folic acid alone.

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#3 Good Health and Well-Being

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Collaboration types
International collaboration
Web of Science research areas
Nutrition & Dietetics
Pediatrics
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