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Food-Based Approaches for Combating Iron Deficiency

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Nutritional Anemia

Part of the book series: Nutrition and Health ((NH))

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Abstract

This chapter reviews the evidence behind the most widely implemented food-based strategies for the reduction and prevention of iron deficiency and iron deficiency anemia. Specifically, it considers the impact of industrial food fortification, home fortification, and nutrition-sensitive agricultural programs, such as biofortification and homestead food production, on the iron status and health of vulnerable population groups, mainly women and young children living in low- and middle-income countries. The efficacy of fortification programs—both industrial and home fortification—has been rigorously tested in numerous contexts and populations; yet, effectiveness evidence in real-world settings remains limited. In short, home fortification is a widely used, efficacious approach to improve nutrition status and reduce iron deficiency anemia in infants and young children and industrial fortification has shown to significantly improve iron status among children older than 5 years of age and non-pregnant women of reproductive age. Iron fortification is not efficacious for pregnant women, for whom general standards of care (e.g., supplementation) should be maintained where iron deficiency is a public health concern. In terms of agricultural programs aimed at combating iron deficiency, biofortification is the most promising solution with the strongest evidence base. Randomized controlled trials show that daily consumption of iron-biofortified foods can significantly improve iron status in non-pregnant, non-lactating women and adolescent boys and girls, as well as functional indicators causally associated with iron deficiency. The impact of other nutrition-sensitive agricultural programs on iron deficiency is still unclear. There is a need for more controlled studies that include specific markers of iron status, not just anemia, to better evaluate their effect. For sustained impact, food-based strategies should be designed, implemented, monitored, and evaluated according to international guidelines. They should measure and report on iron-specific biomarkers and inflammation and screen for iron replete and malaria-endemic populations to assure safety before scaling up. Ultimately, the reduction and prevention of iron deficiency depends on multiple, sustained, and coordinated efforts across sectors. Food-based interventions that improve access to nutrient-rich foods and enhance dietary diversification should be prioritized to ensure safe and sustainable progress in combatting iron deficiency globally.

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Notes

  1. 1.

    Assuming 7% bioavailability and after accounting for processing losses and other inhibitory effects

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Acknowledgement

We sincerely thank Dr. Jere D. Haas for his contribution as an editorial reviewer.

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Authors and Affiliations

  1. HarvestPlus, International Food Policy Research Institute (IFPRI), Washington, DC, USA

    Kristina D. Michaux, Jennifer K. Foley & Erick Boy

  2. Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada

    Kristina D. Michaux

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  1. Kristina D. Michaux
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  2. Jennifer K. Foley
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  3. Erick Boy
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Correspondence to Erick Boy .

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Editors and Affiliations

  1. Human Nutrition, The University of British Columbia, Vancouver, BC, Canada

    Crystal D. Karakochuk

  2. Institute of Food Nutrition and Health, ETH Zurich, Zürich, Zürich, Switzerland

    Michael B. Zimmermann

  3. Department of Health, University of Applied Sciences of South Switzerland (SUPSI) and Swiss Distance University of Applied Sciences (FFHS), Zürich, Zürich, Switzerland

    Diego Moretti

  4. International Health, Sight and Life Foundation and Johns Hopkins School of Public Health, Basel, Switzerland

    Klaus Kraemer

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Michaux, K.D., Foley, J.K., Boy, E. (2022). Food-Based Approaches for Combating Iron Deficiency. In: Karakochuk, C.D., Zimmermann, M.B., Moretti, D., Kraemer, K. (eds) Nutritional Anemia. Nutrition and Health. Springer, Cham. https://doi.org/10.1007/978-3-031-14521-6_25

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