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Flour Fortification Database : 

Flour Fortification Database Jacquelyn Nystrom Graduate Research Assistant Rollins School of Public Health

Overview : 

Overview Purpose of presentation: to present 5 spreadsheets of current data on factors affecting world-wide flour fortification: Sheet 1: Wheat consumption/ production situation Sheet 2: World Fortification Status Sheet 3: Anemia Prevalence By Country Sheet 4: Milling Infrastructure By Country and Region Sheet 5: Calculated Potential Reduction in Anemia Cases due Flour Fortification

Wheat Consumption and Production – Sheet 1: 

Wheat Consumption and Production – Sheet 1 Purpose of spreadsheet 1: to document baseline global wheat consumption and production trends. Categories: wheat consumed, wheat consumed per capita, and wheat produced. Also, lists countries that fortify wheat with any fortificant.

Wheat Consumption vs Flour Consumption - Sheet 1 : 

Wheat Consumption vs Flour Consumption - Sheet 1 Wheat consumption and flour consumption differ due to extraction rates: MI and FAO. Ex: Argentina

Validity and Reliability of Consumption/Production Data : 

Validity and Reliability of Consumption/Production Data FAO compared to USDA and the International Grains Council. In comparing FAO to IGC, the average difference between the two for wheat consumption data was -161,167 metric tons. This average difference is 2% of the mean wheat consumption of the 48 countries compared.

Status of Fortification with Iron and Folic Acid : 

Status of Fortification with Iron and Folic Acid 65 million metric tons of wheat were fortified with iron and folic acid in 2000. This amounts to 15% of all wheat consumed. 1.7 million tons fortified with iron, not folic acid. Number calculated based on presence of a national mandatory fortification program or voluntary program with known compliance.

Non-fortifying Countries Consuming Over 20 kg wheat/capita/year : 

Non-fortifying Countries Consuming Over 20 kg wheat/capita/year Consuming 20 kg/capita corresponds to 1.5-2% drop in anemia prevalence per country. Europe: 38 countries Africa: 26 countries S East Asia: 3 countries N and S Asia: 7 countries South Pacific: 6 countries Middle East: 9 countries

Fortificants, Fortification LevelsSheet 2 : 

Fortificants, Fortification Levels Sheet 2 Sheet details which countries fortify with which nutrients. Provides background data for percent of wheat fortified with iron and folic acid listed on sheet one. Note column N, which lists whether a national fortification program is voluntary (V), mandatory (M), pending (P), level0added (LA), or required for certain region or states (R). Sources: Peter Ranum and the MI LAC report were primary sources.

Anemia Data Sheet 3 : 

Anemia Data Sheet 3 Shows national anemia prevalence rates for pregnant women, children 6 – 59 months, and women of child bearing age. Two primary data sources: John Mason of Tulane University, and UNICEF. The data for women of child bearing age was used in our benefit calculations.

Milling Data By RegionSheet 4: 

Milling Data By Region Sheet 4 Primary purpose: milling infrastructure data can enable selection of nations for UFF activity. The number of roller mills/country, and the capacity of those mills. Assumption: mills with a capacity of 50 MT/24 hours can easily be enabled to fortify. Data Sources: MI Reports, USDA Attache reports, and proprietary sources from private wheat selling/milling businesses.

Milling Data by RegionSheet 4 : 

Milling Data by Region Sheet 4 Secondary Purpose: Obtain contact names and addresses of individual mills to prepare for a future miller survey. Survey: ability of a mill to fortify (ash content, current use of flour improvers) willingness to fortify Future activities targeted at millers will be informed by responses to questionnaire. Confidentiality Statement

Summary of Milling Infrastructure Data: 

Summary of Milling Infrastructure Data Most Surveyed areas: East and South East Asia Latin America Caribbean Middle East and North Africa West Africa Characteristics of Areas of high fortification potential: low number of large mills/country. Such high potential areas include: East and Southeast Asia, West Africa, and certain countries in the Middle East.

The Benefit of Flour Fortification: 

The Benefit of Flour Fortification Calculated first: the decrease in prevalence of anemia among women of child bearing age caused by fortification of wheat at the level of 60 ppm elemental iron. Calculated second: decrease in number of cases of anemia among women of child bearing age. Total: 46 million, 8.7% of total cases N= 82 countries

Conclusion: 

Conclusion 89 countries in the world consume over 20 kg/capita/year and do not currently fortify their flour. Areas with prime milling infrastructures include East and Southeast Asia, West Africa, and certain countries in the Middle East. Fortification with 60 ppm elemental iron could lower the number of women in the world with iron-deficiency anemia by 46 million.