{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:01:05Z","timestamp":1790996465517,"version":"4.1.0"},"reference-count":80,"publisher":"Cambridge University Press (CUP)","issue":"18","license":[{"start":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T00:00:00Z","timestamp":1567641600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"},{"start":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T00:00:00Z","timestamp":1567641600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1368980019002179_as1\"><jats:title>Objective:<\/jats:title><jats:p>Assess the effectiveness of iron-fortified flour on iron status.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980019002179_as2\"><jats:title>Design:<\/jats:title><jats:p>Systematic review and meta-analysis.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980019002179_as3\"><jats:title>Setting:<\/jats:title><jats:p>Argentina, Australia, Azerbaijan, Bangladesh, Brazil, Cameroon, Chile, China, Costa Rica, C\u00f4te d\u2019Ivoire, Denmark, India, Iran, Jordan, Kazakhstan, Kenya, Kuwait, Mongolia, Morocco, Norway, South Africa, Sri Lanka, Tajikistan, Thailand, UK, USA, Uzbekistan, Venezuela, Vietnam, and Zambia.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980019002179_as4\"><jats:title>Participants:<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980019002179_as5\"><jats:title>Results:<\/jats:title><jats:p>A random effects analysis of before\u2013after studies showed that iron-fortified flour led to significant increases of mean haemoglobin level (3\u00b7360\u00a0g\/l; 95 % CI: 0\u00b7980, 5\u00b7730) and mean serum ferritin level (4\u00b7518 \u00b5g\/l; 95 % CI: 2\u00b7367, 6\u00b7669); significant decreases of anaemia (\u22126\u00b77 %; 95 % CI: \u22129\u00b78 %, \u22123\u00b76 %) and iron deficiency (ID) (\u221210\u00b74 %; 95 % CI: \u221214\u00b73 %, \u22126\u00b75 %); 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\u00b7630\u00a0g\/l; 95 % CI: 1\u00b7310, 3\u00b7950) and mean ferritin level (8\u00b7544 \u00b5g\/l; 95 % CI: 6\u00b7767, 10\u00b7320); and significant decreases of anaemia (\u22128\u00b71 %; 95 % CI: \u221211\u00b77 %, \u22124\u00b74 %), ID (\u221212\u00b70 %; 95 % CI: \u221218\u00b79 %, \u22125\u00b71 %), and IDA (\u221220\u00b79 %; 95 % CI: \u221238\u00b74 %, \u22123\u00b74 %).<\/jats:p><\/jats:sec><jats:sec id=\"S1368980019002179_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>Flour fortification with iron is an effective public health strategy that improves iron status of populations worldwide.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1368980019002179","type":"journal-article","created":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T09:11:54Z","timestamp":1567674714000},"page":"3465-3484","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":35,"title":["Systematic review and meta-analysis of the effect of iron-fortified flour on iron status of populations worldwide"],"prefix":"10.1017","volume":"22","author":[{"given":"Jila","family":"Sadighi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saharnaz","family":"Nedjat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahele","family":"Rostami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2019,9,5]]},"reference":[{"key":"S1368980019002179_ref45","doi-asserted-by":"publisher","DOI":"10.3945\/jn.111.155135"},{"key":"S1368980019002179_ref60","doi-asserted-by":"publisher","DOI":"10.1177\/156482650802900402"},{"key":"S1368980019002179_ref16","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980012003047"},{"key":"S1368980019002179_ref28","first-page":"48","article-title":"The use of sweet rolls fortified with iron bis-glycinate chelate in the prevention of iron deficiency anemia in preschool children","volume":"51","author":"Giorgini","year":"2001","journal-title":"Arch Latinoam Nutr"},{"key":"S1368980019002179_ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcs.2005.04.001"},{"key":"S1368980019002179_ref69","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1093\/ajcn\/82.6.1276","article-title":"Comparison of the efficacy of wheat-based snacks fortified with ferrous sulfate, electrolytic iron, or hydrogen-reduced elemental iron: randomized, double-blind, controlled trial in Thai women","volume":"82","author":"Zimmermann","year":"2005","journal-title":"Am J Clin Nutr"},{"key":"S1368980019002179_ref39","doi-asserted-by":"publisher","DOI":"10.1177\/156482650202300414"},{"key":"S1368980019002179_ref62","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1079\/PHN2001179","article-title":"Long-term evaluation of a micronutrient-fortified biscuit used for addressing micronutrient deficiencies in primary school children","volume":"4","author":"van Stuijvenberg","year":"2001","journal-title":"Public Health Nutr"},{"key":"S1368980019002179_ref48","doi-asserted-by":"publisher","DOI":"10.3945\/jn.108.099754"},{"key":"S1368980019002179_ref9","unstructured":"9. 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