title: Effect of iron-fortified foods on hematologic and biological outcomes: systematic review of randomized controlled trials.
abstract: BACKGROUND
  The utility of iron fortification of food to improve iron deficiency, anemia, and biological outcomes is not proven unequivocally.
  
  
  OBJECTIVE
  The objectives were to evaluate 1) the effect of iron fortification on hemoglobin and serum ferritin and the prevalence of iron deficiency and anemia, 2) the possible predictors of a positive hemoglobin response, 3) the effect of iron fortification on zinc and iron status, and 4) the effect of iron-fortified foods on mental and motor development, anthropometric measures, and infections.
  
  
  METHODS
  Randomized and pseudorandomized controlled trials that included food fortification or biofortification with iron were included.
  
  
  RESULTS
  Data from 60 trials showed that iron fortification of foods resulted in a significant increase in hemoglobin (0.42 g/dL; 95% CI: 0.28, 0.56; P < 0.001) and serum ferritin (1.36 μg/L; 95% CI: 1.23, 1.52; P < 0.001), a reduced risk of anemia (RR: 0.59; 95% CI: 0.48, 0.71; P < 0.001) and iron deficiency (RR: 0.48; 95% CI: 0.38, 0.62; P < 0.001), improvement in other indicators of iron nutriture, and no effect on serum zinc concentrations, infections, physical growth, and mental and motor development. Significant heterogeneity was observed for most of the evaluated outcomes. Sensitivity analyses and meta-regression for hemoglobin suggested a higher response with lower trial quality (suboptimal allocation concealment and blinding), use of condiments, and sodium iron edetate and a lower response when adults were included.
  
  
  CONCLUSIONS
  Consumption of iron-fortified foods results in an improvement in hemoglobin, serum ferritin, and iron nutriture and a reduced risk of remaining anemic and iron deficient.
authors: S.L. Jain Hospital, Delhi, India.
authors: Tarun
authors: T
authors: Gera
authors: Harshpal Singh
authors: HS
authors: Sachdev
authors: Erick
authors: E
authors: Boy
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000178:diet therapy / Q000453:epidemiology*; D004492:Edetic Acid / Q000008:administration & dosage; D005290:Ferric Compounds / Q000008:administration & dosage; D005293:Ferritins / Q000097:blood; D005527:Food, Fortified / Q000032:analysis*; D006454:Hemoglobins; D006801:Humans; D019266:Iron, Dietary / Q000008:administration & dosage*; D009752:Nutritional Status; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D015032:Zinc / Q000097:blood
chemical_list: D005290:Ferric Compounds; D006454:Hemoglobins; D019266:Iron, Dietary; D005293:Ferritins; D004492:Edetic Acid; D015032:Zinc; C019179:Fe(III)-EDTA