Zinc fortification of cereal flours: current recommendations and research needs.
BACKGROUND
Zinc fortification is recommended as an appropriate strategy to enhance population zinc status, but guidelines are needed on the appropriate types and levels of zinc fortification of cereal flours for mass fortification programs.


OBJECTIVE
To review available information on the scientific rationale, efficacy, and effectiveness of zinc fortification programs, and to develop guidelines on appropriate levels of fortification of cereal flours, based on simulations of the amount of zinc absorbed under different dietary conditions and information on possible adverse effects.


METHODS
Systematic review of scientific literature and application of an existing prediction equation to estimate zinc absorption.


RESULTS
Previously completed research demonstrates that zinc intake and absorption are increased when zinc-fortified foods are consumed, but little information is, as yet, available on the biologic impact of large-scale fortification programs. Studies suggest that there are no disadvantages of the recommended ranges of zinc fortification with regard to the sensory properties of zinc-fortified foods, and most research indicates that there are no adverse effects of zinc fortification on the utilization of other minerals.


CONCLUSIONS
Zinc fortification of cereal flour is a safe and appropriate strategy for enhancing the zinc status of population subgroups who consume adequate amounts of fortified cereal flour, although additional information is needed to confirm the efficacy and effectiveness of large-scale zinc fortification programs to control zinc deficiency. The appropriate level of fortification depends on the population subgroup, their usual amount of flour intake, the degree of milling and fermentation that is practiced, and the usual intakes of zinc and phytate from other food sources. Fortification recommendations are presented for different dietary scenarios.
Brown
Kenneth H
KH
Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, One Shields Ave., Davis, CA 95616, USA. khbrown@ucdavis.edu
Hambidge
K Michael
KM
Ranum
Peter
P
D004032:Diet; D002523:Edible Grain; D005069:Evaluation Studies as Topic; D005260:Female; D005433:Flour / Q000032:analysis*; D005511:Food Handling; D005527:Food, Fortified / Q000009:adverse effects / Q000592:standards*; D017408:Guidelines as Topic; D006801:Humans; D007408:Intestinal Absorption; D008297:Male; D008903:Minerals / Q000378:metabolism; D018673:Nutrition Policy; D010833:Phytic Acid / Q000008:administration & dosage; D012677:Sensation; D014908:Triticum; D015032:Zinc / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry / Q000378:metabolism
D008903:Minerals; D010833:Phytic Acid; D015032:Zinc