Consumption of Fortified Wheat Flour and Associations with Anemia and Low Serum Ferritin in Colombia

Perspect Nutr Hum. 2019 Jul-Dec;21(2):159-171. doi: 10.17533/udea.penh.v21n2a03. Epub 2019 Nov 14.

Abstract

Background: Colombia's mandatory wheat flour fortification program has yet to be evaluated.

Objective: Examine associations between consumption of fortified wheat flour and low serum ferritin (LSF) and anemia prevalence.

Materials and methods: A secondary analysis of the 2005 national nutrition survey (ENSIN) was completed for 3988 children 2-4 y, 5669 children 5-12 y and 2053 non-pregnant women 13-49 y. The relationship between consumption (quartiles) of wheat flour containing food (WFCF) and LSF and anemia was examined using chi-square analyses and logistic regression models.

Results: In unadjusted analyses, the prevalence of LSF was similar across all quartiles of WFCF consumption in all age groups. The highest prevalence of anemia was observed in the lowest WFCF consumption quartiles in all age groups, but was not significantly different in non-pregnant women 13-49 y. In adjusted models this relationship between WFCF and anemia remained for children 2-4 y when comparing the highest WFCF intake quartile with the lowest quartile (OR: 0.7, 95 % Cl: 0.6-0.9). No association between WFCF and LSF was observed in adjusted (or unadjusted) models.

Conclusions: In Colombia, consumption of wheat flour containing foods is associated with lower levels of anemia in pre-school children.

Antecedentes: la fortificación obligatoria de harina de trigo en Colombia no se ha evaluado.

Objetivo: examinar las asociaciones entre el consumo de harina y ferritina sérica baja (BSF) y la prevalencia de anemia.

Materiales y métodos: se completó un análisis secundario de la Encuesta Nacional de la Situacion Nutricional de 2005 (ENSIN) para 3988 niños de 2–4 años, 5669 escolares de 5–12 años y 2053 mujeres no embarazadas de 13–49 años, Se examino la relacion entre el consumo (cuartiles) de alimentos que contenían harina (ACHT) y la BSF y la anemia mediante análisis de ji al cuadrado y modelos ae regresión logística.

Resultados: en modelos ajustados, controlando por el estado socioeconomico, alimentos de origen animal y la ingesta de suplementos en las 24 horas anteriores, existía relacion entre ACHT y la anemia en los preescolares. al comparar el cuartil más alto del consumo de ACHT con el cuartil más bajo (OR: 0.7: IC 95 %: 0,6–0,9). No se observó asociación entre ACHT y BFS en modelos ajustados.

Conclusiones: en Colombia, el consumo de alimentos que contienen harina de trigo se asocia con niveles más bajos de anemia en preescolares.

Keywords: Ferritin; effectiveness; enrichment; evaluation; fortification; hemoglobin; wheat flour.