Consumption of Fortified Wheat Flour and Associations with Anemia and Low Serum Ferritin in Colombia.

• Type of Material: Article
• Authors: Amy Fothergill, Emory University.; Zulma YF Centeno, Universidad Nacional de Colombia, Observatorio de Soberanía y Seguridad Alimentaria y Nutricional-OBSSAN, Bogotá, Colombia.; Paul René Ocampo Téllez, Universidad Nacional de Colombia. Bogotá, Colombia.; Helena Pachón, Emory University
• Language: English
• Date: 2019
• Publisher: PERSPECTIVAS EN NUTRICIÓN HUMANA
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 Universidad de Antioquia
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.17533/udea.penh.v21n2a03
• Title of Journal or Parent Work: Perspect Nutr Hum
• Volume: 21
• Issue: 2
• Start Page: 159
• End Page: 171
• Grant/Funding Information: Funding for this research was provided solely by way of salary support.; Research reported in this publication was supported by the National Institutes of Health under award 5 T32 HD087137 (Amy Fothergill).; Helena Pachón’s time was supported by an agreement between the United States Centers for Disease Control and Prevention (CDC), McKing Consulting Corporation, and Emory University.
• Keywords: effectiveness; enrichment; evaluation; wheat flour; Ferritin; hemoglobin; fortification

Abstract

BACKGROUND: Colombia's mandatory wheat flour fortification program has yet to be evaluated. OBJECTIVE: Examine associations between consumption of fortified wheat flour and low serum ferritin (LSF) and anemia prevalence. MATERIALS AND METHODS: A secondary analysis of the 2005 national nutrition survey (ENSIN) was completed for 3988 children 2-4 y, 5669 children 5-12 y and 2053 non-pregnant women 13-49 y. The relationship between consumption (quartiles) of wheat flour containing food (WFCF) and LSF and anemia was examined using chi-square analyses and logistic regression models. RESULTS: In unadjusted analyses, the prevalence of LSF was similar across all quartiles of WFCF consumption in all age groups. The highest prevalence of anemia was observed in the lowest WFCF consumption quartiles in all age groups, but was not significantly different in non-pregnant women 13-49 y. In adjusted models this relationship between WFCF and anemia remained for children 2-4 y when comparing the highest WFCF intake quartile with the lowest quartile (OR: 0.7, 95 % Cl: 0.6-0.9). No association between WFCF and LSF was observed in adjusted (or unadjusted) models. CONCLUSIONS: In Colombia, consumption of wheat flour containing foods is associated with lower levels of anemia in pre-school children.