Miller Magazine Issue 146 February 2022

62 COVER STORY MILLER / FEBRUARY 2022 consume rice but the consumption of wheat is significant and growing. Maize is the main staple in Central America, Mexico and sub Sahara Africa. The Middle East, North America, coun- tries in the former Soviet Union and Europe consume mostly wheat. Wheat is an important cereal crop and together with maize and rice account for 94% of total cereal consumption worldwide. Fortification of industrially processed wheat flour, when appro- priately implemented, is an effective, simple, and inexpensive strategy for supplying vitamins and minerals to the diets of large segments of the world’s population. Fortification has been recognized by many national gov- ernments as an important strategy to help improve the health and nutrition status of millions of people on a continuous and self-sustaining basis. The work productivity and learning ability of the nation as well as the cognitive capacity of the next gener- ation could substantially be improved through fortification. When micronutrient deficiencies are population-wide and re- sult from a combination of low intake and/or low bioavailability, fortification of commonly consumed cereal flours with iron, folic acid and other vitamins offers a number of strategic advantages. In many situations, cereals flours are the best choice for fortifi- cation because they are widely and regularly consumed, and mostly processed in centralized facilities with established dis- tribution and marketing capacity. Due to these reasons, cereal fortification has played a major role in improving the health of the world populations at large. Globally, 91 countries have leg- islation to mandate fortification of at least one industrially milled cereal grain. Flour fortification should be considered when industrially pro- duced flour is regularly consumed by large population groups in a country. Decisions about which nutrients to add and the appropriate amounts to add should be based on a number of factors including i) the nutritional needs and deficiencies of the population; ii) the usual consumption profile of “fortifiable” flour (i.e. the total estimated amount of flour milled by industrial roller mills, produced domestically or imported, which could in prin- ciple be fortified); iii) sensory and physical effects of the added nutrients on flour and flour products; iv) fortification of other food vehicles; and v) costs. Wheat and maize flour fortification is a preventive food-based approach to improve micronutrient status of populations over time that can be integrated with other interventions in the efforts to reduce vitamin and mineral deficiencies when identified as public health problems. However, fortification of other appropri- ate food vehicles with the same and/or other nutrients should also be considered when feasible. Wheat and maize flour for- tification programmes could be expected to be most effective in achieving a public health impact if mandated at the national Source: Food Fortification Initiative