Evidence map›Paper›PMID 26433017›Full record

SynthesisNutrition reviews2015

Evidence of the effectiveness of flour fortification programs on iron status and anemia: a systematic review.

Helena Pachón, Rebecca Spohrer, Zuguo Mei, Mary K Serdula

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Nutrition reviews, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 8 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Helena PachónH. Pachón is with the Food Fortification Initiative, Atlanta, Georgia, USA, and the Hubert Department of Global Health, Emory University, Atlanta, Georgia, USA. R. Spohrer is with the Global Alliance for Improved Nutrition, Geneva, Switzerland. Z. Mei and M.K. Serdula are with the US Centers for Disease Control and Prevention, Atlanta, Georgia, USA. helena.pachon@emory.edu.
Rebecca SpohrerH. Pachón is with the Food Fortification Initiative, Atlanta, Georgia, USA, and the Hubert Department of Global Health, Emory University, Atlanta, Georgia, USA. R. Spohrer is with the Global Alliance for Improved Nutrition, Geneva, Switzerland. Z. Mei and M.K. Serdula are with the US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Zuguo MeiH. Pachón is with the Food Fortification Initiative, Atlanta, Georgia, USA, and the Hubert Department of Global Health, Emory University, Atlanta, Georgia, USA. R. Spohrer is with the Global Alliance for Improved Nutrition, Geneva, Switzerland. Z. Mei and M.K. Serdula are with the US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Mary K SerdulaH. Pachón is with the Food Fortification Initiative, Atlanta, Georgia, USA, and the Hubert Department of Global Health, Emory University, Atlanta, Georgia, USA. R. Spohrer is with the Global Alliance for Improved Nutrition, Geneva, Switzerland. Z. Mei and M.K. Serdula are with the US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

contextMore than 80 countries fortify flour, yet the public health impact of this intervention on iron and anemia outcomes has not been reviewed.

objectiveThe objective of this systematic review was to review published and gray literature pertaining to the impact of flour fortification on iron and anemia. DATA SOURCES: A systematic review was conducted by searching 17 databases and appealing for unpublished reports, yielding 1881 documents. STUDY SELECTION: Only studies of government-supported, widely implemented fortification programs in which anemia or iron status was measured prior to and ≥12 months after initiation of fortification were included. DATA EXTRACTION: Details about the design, coverage, compliance with national standards, and evaluation (e.g., anemia prevalence before and after fortification) of flour fortification programs were extracted from the reports. DATA SYNTHESIS: Thirteen studies describing 26 subgroups (n = 14 for children ≤15 y, n = 12 for women of reproductive age) were included. During the period from pre- to postfortification (and as difference-in-difference for those studies that included a control group), there were statistically significant decreases in the prevalence of anemia in 4 of 13 subgroups of children and in 4 of 12 subgroups of women of reproductive age as well as significant decreases in the prevalence of low ferritin in 1 of 6 subgroups of children and in 3 of 3 subgroups of women of reproductive age.

conclusions. Evidence of the effectiveness of flour fortification for reducing the prevalence of anemia is limited; however, evidence of effectiveness for reducing the prevalence of low ferritin in women is more consistent.

Indexed as

FlourFood, FortifiedIronAdultAnemia, Iron-DeficiencyChildDatabases, FactualFemaleFerritinsGlobal HealthHumansMalePrevalenceFerritinsIronenrichmentferritinhemoglobinmaize flourwheat flour

Identifiers

PMID26433017
PMCPMC9052958

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.