title: Micronutrient Fortified Condiments and Noodles to Reduce Anemia in Children and Adults--A Literature Review and Meta-Analysis.
abstract: Micronutrient deficiencies impose a considerable burden of disease on many middle and low income countries. Several strategies have been shown to be effective in improving micronutrient deficiencies. However, the impact of fortified condiments as well as fortified noodles is less well documented. We aimed to investigate existing evidence on the impact of micronutrient fortified condiments and noodles on hemoglobin, anemia, and functional outcomes in children and adults (age: 5 to 50 years). We conducted a literature review in electronic databases. In addition, we screened the homepages of relevant organizations and journals. We included randomized controlled trials (RCT). Of 1046 retrieved studies, 14 RCT provided data for the meta-analysis. Micronutrient fortification of condiments and noodles increased hemoglobin concentrations by 0.74 g/dL (95%-confidence intervals (95%-CI): 0.56 to 0.93; 12 studies) and 0.3 g/dL (95%-CI: 0.12 to 0.48; 1 study), respectively. Micronutrient fortification also led to a reduced risk of having anemia (risk ratio 0.59 (95%-CI 0.44 to 0.80)). Ferritin concentrations increased with fortified condiments. Functional outcomes were rarely assessed and showed mixed results. The use of micronutrient fortified condiments can be a strategy to reduce anemia in children and adults due to micronutrient deficiencies. The effect of fortified noodles seems to be smaller.
authors.affiliation: Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur 8401, Switzerland. sascha.hess@zhaw.ch.
authors.forename: Sascha
authors.initials: S
authors.lastname: Hess
authors.affiliation: Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur 8401, Switzerland. tecklin@web.de.
authors.forename: Linda
authors.initials: L
authors.lastname: Tecklenburg
authors.affiliation: Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur 8401, Switzerland. klaus.eichler@zhaw.ch.
authors.forename: Klaus
authors.initials: K
authors.lastname: Eichler
mesh_terms: D000740:Anemia; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000178:diet therapy* / Q000209:etiology; D003212:Condiments; D005293:Ferritins / Q000097:blood; D005433:Flour; D005527:Food, Fortified; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000494:pharmacology / Q000627:therapeutic use*; D000090463:Iron Deficiencies; D019266:Iron, Dietary / Q000494:pharmacology / Q000627:therapeutic use*; D018977:Micronutrients; D014131:Trace Elements / Q000172:deficiency / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D006454:Hemoglobins; D019266:Iron, Dietary; D018977:Micronutrients; D014131:Trace Elements; D005293:Ferritins; D007501:Iron
keywords: condiments; fortification; iron; meta-analysis; micronutrients; noodles; review