{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:22:01Z","timestamp":1790893321290,"version":"4.1.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"4_suppl3","license":[{"start":{"date-parts":[[2012,12,1]],"date-time":"2012-12-01T00:00:00Z","timestamp":1354320000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Food Nutr Bull"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Micronutrient deficiencies, especially iron-deficiency anemia, are a public health problem in Egypt, where anemia rates almost doubled in the years from 2000 to 2005. In 2008, the Government of Egypt began implementation of a 5-year national program to fortify with iron and folic acid the wheat flour used in baking subsidized baladi bread, the staple food consumed by a majority of low-income groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To project the achievements of this national Wheat Flour Fortification Program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This paper describes the program, estimates the production of fortified flour and consumption of fortified bread, and identifies program challenges and sustainability issues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Through the national Wheat Flour Fortification Program, ferrous sulfate and folic acid are now added to all wheat flour produced under the national Food Subsidy Program. Up to 50 million Egyptians nationwide are now consuming quality-assured fortified baladi bread on a daily basis. In 2011, 6.5 million MT of fortified wheat flour was produced by 143 participating public- and private-sector mills. Political changes in Egypt in 2011 did not seem to affect the program; the new leadership in the Ministry of Supply and Internal Trade remains committed to fortification of wheat flour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The daily intake of approximately 12 mg of iron and 600 \u03bcg of folic acid through the consumption of baladi bread suggests that the impact of the program on the prevention and reduction of iron and folate deficiencies among the Egyptian population could be significant; the results of an end-line survey are pending.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15648265120334s302","type":"journal-article","created":{"date-parts":[[2015,11,25]],"date-time":"2015-11-25T15:56:01Z","timestamp":1448466961000},"page":"S260-S271","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":35,"title":["Fortifying\n                    <i>baladi<\/i>\n                    Bread in Egypt: Reaching More than 50 Million People through the Subsidy Program"],"prefix":"10.1177","volume":"33","author":[{"given":"Nadine","family":"Elhakim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Laillou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwar","family":"El Nakeeb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rukia","family":"Yacoub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdy","family":"Shehata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2012,12,15]]},"reference":[{"key":"bibr1-15648265120334S302","first-page":"337","volume":"12","author":"Galal O","year":"2003","journal-title":"Asia Pac J Clin Nutr"},{"key":"bibr2-15648265120334S302","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.2009.00158.x"},{"key":"bibr3-15648265120334S302","volume-title":"Guidelines on food fortification with micronutrients","author":"Allen L","year":"2006"},{"key":"bibr4-15648265120334S302","volume-title":"Egypt National Food and Nutrition Strategy (2007\u20132017)","author":"Ministry of Health and Population\/National Nutrition Institute of the Government of Egypt","year":"2006"},{"key":"bibr5-15648265120334S302","volume-title":"Egypt Demographic and Health Survey 2005","author":"El-Zanaty F","year":"2006"},{"key":"bibr6-15648265120334S302","volume-title":"Baseline survey data on iron deficiency anemia in Egypt","author":"National Nutrition Institute of the Government of Egypt\/World Food Programme","year":"2010"},{"key":"bibr7-15648265120334S302","first-page":"1740","volume":"10","author":"Austin AM","year":"2011","journal-title":"Matern Child Nutr"},{"key":"bibr8-15648265120334S302","unstructured":"Flour Fortification Initiative Egypt. Wheat facts. Available at: http:\/\/www.sph.emory.edu\/wheatflour\/IEMT\/IEMT_files\/Country_summaries\/egypt.pdf. Accessed 18 July 2012."},{"key":"bibr9-15648265120334S302","volume-title":"Analysis of consumer profiles and behavior patterns of food subsidy recipients: an approach to targeting","author":"World Food Programme\/Cairo Demographic Centre","year":"2010"},{"key":"bibr10-15648265120334S302","doi-asserted-by":"publisher","DOI":"10.1177\/15648265100311S102"},{"key":"bibr11-15648265120334S302","unstructured":"Johnson Q, Mannar V, Ranum P. Fortification handbook: vitamin and mineral fortification of wheat flour and maize meal. 2004. Available at: http:\/\/www.sph.emory.edu\/wheatflour\/KEYDOCS\/MI_Fort_handbook.pdf. Accessed 18 July 2012."},{"key":"bibr12-15648265120334S302","unstructured":"National Nutrition Institute of the Government of Egypt. Available at: http:\/\/www.nni.org.eg\/Html\/Bread_Ar.html. Accessed 18 July 2012."},{"key":"bibr13-15648265120334S302","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/82.6.1276"},{"key":"bibr14-15648265120334S302","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.110.004549"},{"key":"bibr15-15648265120334S302","unstructured":"Food and Agriculture Organization\/World Health Organization. Combined compendium of food additive specifications. 2010. Available at: http:\/\/www.fao.org\/ag\/agn\/jecfa-additives\/search.html. Accessed 18 July 2012."},{"key":"bibr16-15648265120334S302","unstructured":"Food and Agriculture Organization\/World Health Organization. Codex Alimentarius. Available at: http:\/\/www.codexalimentarius.org. Accessed 18 July 2012."},{"key":"bibr17-15648265120334S302","volume-title":"Egypt loses LE 6.1 billion due to malnutrition","year":"2010"},{"key":"bibr18-15648265120334S302","volume-title":"Bread fortification saves the economy LE 650 million per year","year":"2010"},{"key":"bibr19-15648265120334S302","volume-title":"Flour fortification in Beheira Governorate","year":"2010"},{"key":"bibr20-15648265120334S302","volume-title":"Launch of the flour fortification program in Sharkeya governorate (in Arabic)","year":"2008"},{"key":"bibr21-15648265120334S302","volume-title":"Failure of Ministry of Health is behind the delay in bread fortification (in Arabic)","year":"2008"},{"key":"bibr22-15648265120334S302","volume-title":"A new mill in Sharkeya for production of fortified flour with iron and folic acid (in Arabic)","year":"2008"},{"key":"bibr23-15648265120334S302","volume-title":"The \u201ciron\u201d loaf on Egyptian dining tables today","year":"2007"},{"key":"bibr24-15648265120334S302","volume-title":"The iron loaf on Egyptian dining tables with no prior notice","year":"2007"},{"key":"bibr25-15648265120334S302","volume-title":"Practical and impartial view of the program to fortify baladi bread with iron (in Arabic)","author":"Gohar A","year":"2007"},{"key":"bibr26-15648265120334S302","unstructured":"UNICEF\/World Health Organization\/United Nations University. Iron deficiency anemia: assessment, prevention, and control. A guide for programme managers. 2001. Available at: http:\/\/whqlibdoc.who.int\/hq\/2001\/WHO_NHD_01.3.pdf. Accessed 18 July 2012."},{"key":"bibr27-15648265120334S302","volume-title":"Scaling up nutrition: what it will cost. A report of the International Bank for Reconstruction and Development","author":"Horton S","year":"2010"},{"key":"bibr28-15648265120334S302","volume-title":"Economic benefits of flour fortification in Egypt: applying global evidence to the national environment. World Food Programme Consultant Report","author":"Bagriansky J","year":"2010"},{"key":"bibr29-15648265120334S302","volume-title":"National survey for assessment of vitamin A status in Egypt","author":"Moussa W","year":"1995"},{"key":"bibr30-15648265120334S302","volume-title":"National survey for the determination of BMD among adolescents and adults","author":"Hassan H","year":"2004"},{"key":"bibr31-15648265120334S302","volume-title":"Egypt Demographic and Health Survey 2008","author":"El-Zanaty F","year":"2009"},{"key":"bibr32-15648265120334S302","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-59745-464-3_13"},{"key":"bibr33-15648265120334S302","first-page":"133","volume-title":"Nutritional anemia","author":"West K","year":"2007"},{"key":"bibr34-15648265120334S302","doi-asserted-by":"publisher","DOI":"10.1177\/156482651203300303"},{"key":"bibr35-15648265120334S302","volume-title":"Focusing on anemia: towards an integrated approach for effective anemia control","author":"World Health Organization\/UNICEF","year":"2004"}],"container-title":["Food and Nutrition Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15648265120334S302","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15648265120334S302","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:16:55Z","timestamp":1777443415000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15648265120334S302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,12]]},"references-count":35,"journal-issue":{"issue":"4_suppl3","published-print":{"date-parts":[[2012,12]]}},"alternative-id":["10.1177\/15648265120334S302"],"URL":"https:\/\/doi.org\/10.1177\/15648265120334s302","relation":{},"ISSN":["0379-5721","1564-8265"],"issn-type":[{"value":"0379-5721","type":"print"},{"value":"1564-8265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,12]]}}}