Effect of the Brazilian iron fortification of wheat and corn flour on the nutritional iron status in adolescents, 6 years after its implementation

Abstract

Background: As it is difficult to know the content of iron added in the Brazilian iron fortification of wheat and corn flour, and if the compound has good or poor bioavailability, the objective was to assess the effect of the Brazilian iron fortification program, as it was carried out, on iron nutritional status of adolescents, 6 years after its implementation. Methods: A cross-sectional retrospective study was conducted with adolescents aged 10 to 17 years, both sexes, treated at a primary health care center. Data were collected from medical records of patients and compared with those of a previous survey conducted at the same center in 2004. Anthropometry, iron biochemical indicators, food intake, pubertal stage, and transferrin saturation were assessed, with pubertal stage and transferrin saturation being the last two variables compared between 2004 and 2010. Mann-Whitney and chi-square tests were also used. Results: In 2010, mean hemoglobin values and serum ferritin levels were within normal ranges for both sexes, and adolescents who consumed diets with low iron bioavailability constituted more than half of the sample (52.7%). In 2004, a 10.3 and 18.6% prevalence of iron deficiency was observed, based on low transferrin saturation, in females and males, respectively. It was noted that during the 6-year period, this prevalence decreased significantly, 4 and 10.4%. Conclusions: Anemia and iron deficiency are not prevalent in this population, probably due to the implementation of flour fortification with iron; it is not possible, however, to attribute such a result only to the implementation of this strategy.

Prevalence of iron deficiency anemia in Brazilian women of childbearing age: a systematic review with meta-analysis

“…Of these, 237 were selected for full-text reading. Finally, 91 studies were included for the qualitative synthesis and 83 for the meta-analysis ( Américo & Ferraz, 2011 ; Araf et al, 2010 ; Araújo, 2012 ; Araújo et al, 2013 ; Arruda, 1990 ; Arruda, 1997 ; Bagni, Luiz & Da Veiga, 2013 ; Batista Filho & Romani, 2002 ; Bezerra et al, 2018 ; Borges et al, 2016 ; Bresan et al, 2018 ; Bresani et al, 2007 ; Carvalho et al, 2017 ; Cavalcanti et al, 2014 ; Cavalcanti, Diniz & Arruda, 2019 ; Cintra, 2018 ; Clemente, 2019 ; Coelho, 2011 ; Côrtes, 2006 ; Da Costa et al, 2013 ; Da Silva, 2015 ; Dal Pizzol, Giugliani & Mengue, 2009 ; Dani et al, 2008 ; De Camargo et al, 2013 ; De Carli et al, 2018 ; De Castro et al, 2019 ; De França, 2006 ; De Oliveira, De Barros & Ferreira, 2015 ; De Sá et al, 2015 ; De Souza, 2011 ; Dell Agnolo, 2009 ; Deméio, Teles-Santos & Dos Santos, 2017 ; Dos Santos et al, 2020 ; Dos Santos et al, 2018 ; Einloft et al, 2010 ; Fabian et al, 2007 ; Fávaro, 2011 ; Ferreira et al, 1998 ; Ferreira et al, 2007 ; Ferreira, Moura & Cabral Júnior, 2008 ; Ferreira, 2016 ; Frota, 2013 ; Fujimori, Szarfarc & De Oliveira, 1996 ; Fujimori et al, 1999 ; Fujimori et al, 2011 ; Guerra et al, 1990 ; Hirata et al, 2017 ; Instituto Nacional de Alimentação e Nutrição, 1998 ; Leite, 1998 ; Lerner, 1994 ; Lopes et ...…”

Anemia ferropriva entre adolescentes participantes do programa Bolsa Família: Análise à luz das condicionalidades de saúde

“…A literatura, no entanto, ainda é escassa no que diz respeito a estudos de base populacional e multicêntricos que tiveram como objetivo avaliar a anemia ferropriva entre adolescentes no Brasil. A maior parte dos estudos foi conduzida com um número pequeno de indivíduos [14][15][16][17] .…”

“…A prevalência de anemia ferropriva encontrada no presente estudo (26%) é classificada como um problema de saúde pública de grau moderado segundo a OMS 3 , e a maior parte dos adolescentes anêmicos apresentou níveis de hemoglobina que correspondem à anemia ferropriva de grau moderado ou grave. Estes resultados são superiores aos de outros estudos conduzidos no Brasil, nos últimos cinco anos, que observaram prevalências de anemia ferropriva entre 1% e 22,8%, em ambos os sexos, com maior prevalência de anemia de grau leve [14][15][16][17] . Cabe destacar que a utilização de diferentes técnicas para coleta dos testes pode ocasionar variações nos valores de hemoglobina, no entanto a utilização do hemoglobinômetro portátil, utilizado no presente estudo, é validada para pesquisas de campo 18 .…”