Objective:Evaluate the impact of the wheat flour fortification program in Colombia by examining the relationship between consumption of fortified wheat flour and two outcomes: iron deficiency (ID) and anemia prevalence.
Methods:The 2005 national nutrition survey (ENSIN) was analyzed for 3988 children 2-4 y, 5669 children 5-12 y and 2053 non-pregnant women 13-49 y. ID was defined as serum ferritin <12 µg/L, among those with C-reactive protein <1.2 mg/dL. Anemia was defined as altitude-adjusted hemoglobin <11 g/dL in children 2-4 y, and < 12 g/dL in children 5-12 y and non-pregnant women. Daily intake (g/d) of wheat flour containing foods (WFCF), determined from a 24-h recall and divided into quartiles, was used as a proxy for wheat flour consumption. The relationship between WFCF quartiles and ID and anemia was examined using chi-square analyses and logistic regression models.
Results:WFCF consumption varied significantly between socioeconomic strata in all age groups. The highest prevalence of ID and anemia was observed in the lowest WFCF consumption quartile for all age groups (e.g. 8.7% versus 3.5% ID in lowest versus highest WFCF intake quartile, respectively, in non-pregnant women). In models controlling for animal source food and supplement intake in the previous 24 h and socioeconomic status, this relationship between WFCF and anemia remained and was statistically significant for children 2-4 y and 5-12 y when comparing the highest WFCF intake quartile with the lowest quartile.
Conclusion:In Colombia, consumption of wheat flour containing foods is associated with positive health outcomes. In children, lower anemia prevalence was observed in higher consumption groups.