ATLANTA, GEORGIA, U.S. — The Flour Fortification Institute (FFI) is marking 10 years since its launch, FFI said on Oct. 23.
A “Policy Planning Forum” on Oct. 24, 2002, led to creation of the FFI as a network of partners working together to make fortification standard practice in industrial mills.
In the past decade, the number of countries requiring wheat flour fortification with at least iron or folic acid has more than doubled from 33 to 75, and the proportion of industrially milled flour being fortified has risen from 18% to 30%.
Fortification adds vitamins and minerals to flour as it is milled. Seventy countries with fortification requirements include both iron and folic acid in wheat flour. Many countries include zinc plus other B vitamins; some include vitamin A and vitamin D as well, FFI said.
The combined population of the 75 countries requiring wheat flour fortification now is 2.09 billion. Women and children who consume foods made with fortified flour are the primary beneficiaries.
Studies of flour fortification’s effect among specific populations in China, Iran, Venezuela, Fiji and Oman have each shown an improvement in iron status. Because iron deficiency usually has no visible symptoms, it is considered “hidden hunger.” A more tangible measure of fortification’s success is the reduction in neural tube defects, such as spina bifida and anencephaly, when flour is fortified with folic acid, a B vitamin.
By 2008 it was estimated that 22,000 neural tube defects a year are prevented annually due to flour being fortified with folic acid. That is an average of 60 birth defects prevented worldwide every day. In addition, eight sub-national studies showed an overall reduction of 46% in these birth defects after fortification began.
The 2002 “Policy Planning Forum” was in Mauritius in conjunction with a meeting of the Association of Operative Millers. The forum was initiated by Glen Maberly who was then a professor at Emory University in Atlanta, Georgia, U.S. It was co-hosted by the Micronutrient Initiative based in Canada and the U.S. Centers for Disease Control and Prevention (CDC).
By 2003, the Association of Operative Millers was renamed the International Association of Operative Millers (IAOM). In May that year, the IAOM board of directors passed a resolution in support of flour fortification worldwide. By June, partners had grown to include the Australian Wheat Board, U.S. Wheat Associates, American Ingredients Company, the Wheat Foods Council, the United Nations Children’s Fund (UNICEF), the Global Alliance for Improved Nutrition (GAIN), and the Fleishman Hillard public relations agency among others.
As fortifying flour with folic acid to prevent birth defects has proven effective, civic groups focused on birth defect prevention have joined the partnership. Organizers have agreed for FFI to remain a network to support national partnerships rather than to become a traditional organization.
“We refer to flour fortification as a ‘public-private-civic sector investment’ because successful fortification requires each of these groups to work together for the well-being of people,” said Scott J. Montgomery who became the FFI director in 2011 after 30 years experience in the private sector.
One of the eight Millennium Development Goals adapted in 2000 is to develop a global partnership for development.
“The FFI experience as a network of partners committed to a common mission indicates that developing global partnerships could very well lead to the accomplishment of the remaining goals,” Montgomery said.
FFI has historically focused on wheat flour. Plans are underway for the emphasis to expand to include maize and rice fortification. These three cereal crops are the most commonly consumed grains worldwide, and the fortification of each represents tremendous opportunities to improve global health.
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