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Evaluating the effectiveness and risks of bread fortification programs in the middle eastern region

A comprehensive review

Bibliographic Data

ID22083644
AuthorsSafa Abdul Majeed, Safa Majeed (0009-0004-6966-9914, Qatar University), Suad Said (Qatar University), Dana Ahmad Hassan, Dana Hassan (Qatar University), Faaiza Sadiq (Qatar University), Maryam Alhosani (Qatar University), Ayoub Al‐Jawaldeh (0000-0001-7387-8277, World Health Organization Regional Office for the Eastern Mediterranean), Tahra El-Obeid, Tahra Elobeid (0000-0003-1448-9815, Qatar University), Reema Tayyem (0000-0003-1640-0511, Qatar University, corresponding author)
Year2025
Volume13
Pages1530380-1530380
Publication date2025-03-11
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1530380
PMID40135160
OpenAlexW4408324119
LanguageEN
References cited66

Fortification of staple foods such as bread has been implemented as a public health strategy to address nutrient deficiencies. Currently, 11 out of 22 Middle Eastern countries have mandatory wheat flour fortification, primarily with iron and folic acid, while others have voluntary initiatives. Despite progress in bread fortification efforts across the Middle East the long-term effectiveness and safety of these programs remain unclear. We assess the historical context, existing policies, and standards of fortification, focusing on public health outcomes, implementation challenges, and potential risks. A comprehensive search in PubMed, MEDLINE, Cochrane, and ProQuest databases, and relevant studies from the inception of the fortification efforts till 2024 were selected. Our search included Bread or flour fortification and their effectiveness and potential risks specific to Middle Eastern Regions. Findings from the literature indicate that fortification was effective in combating micronutrient deficiencies without causing the harmful effects of overload. However, ongoing research is needed to monitor potential risks, such as micronutrient overload. Most studies are concentrated in Egypt and Iran, with limited data from Saudi Arabia, Turkey, and Jordan, and a notable absence of research from other Middle Eastern countries. This highlights the need for further studies across a wider range of countries to provide a more comprehensive understanding of the regional impact and effectiveness of fortification policies. Addressing the challenges of inadequate coverage, compliance issues, and infrastructure limitations could provide a more comprehensive understanding of the region’s fortification policies and their effectiveness

Business · Economic growth · Economics · Environmental health · Food fortification · Fortification · Geography · Micronutrient · Middle East · Political science · Population · Public health · Folate and B Vitamins Research · Iron Metabolism and Disorders · Medicine · Nutrition and Health in Aging

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