Staple Food Fortification with Iron: a Multifactorial Decision

Iron deficiency is not restricted to infants and pregnant women; it also affects school‐age children, adolescents, elders, and even adult males in developing countries, including those of Latin America. Therefore, interventions with extensive coverage are suitable to prevent and to control this deficiency. Fortification of staple foods is an adequate strategy to provide additional iron to populations. However, unlike fortification with vitamin A, iodine, and B vitamins, food fortification with iron has not been very successful. Iron is a reactive compound, whose level in foods is limited because iron causes negative changes in the original properties of the food that is being fortified. This feature combined with the low absorption of iron compounds used for fortification ‐ usually not higher than 10% ‐ makes prevention of iron deficiency through food fortification of very few commodities a great challenge. This review will cover several factors that need to be taken into consideration to plan, understand, evaluate, and make a decision about fortification of staple foods with iron. Included is a discussion regarding bioavailability, technologic compatibility, and cost effectiveness. To conclude, the review mentions additional advantages of fortifying staple foods with iron and the indispensable need to combine this strategy with other interventions. All of these factors must be considered before launching a field efficacy trial, which should be the ultimate proof for a decision made wisely and with possibilities of success.