广泛实施微量营养素食品强化,以减少微量营养素缺乏和相关结果。尽管许多因素影响防御工事计划的成功,需要高人口覆盖率才能产生公共卫生影响。我们的目标是提供最近的全球盐覆盖率估计,小麦粉,植物油,玉米粉,大米,和糖在有强制性强化立法的国家中。指标是消费食品的家庭比例,可强化的食物(即,工业加工),强化食品(在任何程度上),和足够强化食品(根据国家或国际标准)。我们估计了使用强化食品的人数。我们系统地检索和审查了所有适用的证据:2010年1月至2021年8月发表的报告和文章,主要组织的调查清单/数据库,以及从主要线人收到的报告/文献。我们使用随机效应元分析模型用R统计包分析数据。估计有94.4%的家庭食用盐,78.4%的人消耗了强化盐(42亿人),在64、84和31个国家中,48.6%的人摄入了足够的强化盐,分别。此外,77.4%的家庭消费小麦粉,消耗61.6%的可强化小麦粉,在15、8和10个国家/地区,47.1%的人消费了强化小麦粉(6620万人),分别,消耗植物油的87.0%,消耗86.7%的强油,在10、7和5个国家中,40.1%的强化石油消费量(1.239亿人),分别。关于充分强化的小麦粉和植物油的数据以及玉米粉的覆盖率指标,大米,糖是有限的。除盐外,大多数食品的强化覆盖率存在重大数据空白。所有具有强制性强化计划的国家都应生成和使用更多的覆盖率数据来评估计划绩效,并根据需要调整计划,以实现其减少微量营养素缺乏的潜力(PROSPEROCRD42021269364)。
Food fortification with micronutrients is widely implemented to reduce micronutrient deficiencies and related outcomes. Although many factors affect the success of fortification programs, high population coverage is needed to have a public health impact. We aimed to provide recent global coverage estimates of
salt, wheat flour, vegetable oil, maize flour, rice, and sugar among countries with mandatory fortification legislation. The indicators were the proportion of households consuming the: food, fortifiable food (that is, industrially processed), fortified food (to any extent), and adequately fortified food (according to national or international standards). We estimated the number of individuals reached with fortified foods. We systematically retrieved and reviewed all applicable evidence from: published reports and articles from January 2010 to August 2021, survey lists/databases from key organizations, and reports/literature received from key informants. We analyzed data with R statistical package using random-effects meta-analysis models. An estimated 94.4% of households consumed
salt, 78.4% consumed fortified
salt (4.2 billion people), and 48.6% consumed adequately fortified
salt in 64, 84, and 31 countries, respectively. Additionally, 77.4% of households consumed wheat flour, 61.6% consumed fortifiable wheat flour, and 47.1% consumed fortified wheat flour (66.2 million people) in 15, 8, and 10 countries, respectively, and 87.0% consumed vegetable oil, 86.7% consumed fortifiable oil, and 40.1% consumed fortified oil (123.9 million people) in 10, 7, and 5 countries, respectively. Data on adequately fortified wheat flour and vegetable oil and coverage indicators for maize flour, rice, and sugar were limited. There are major data gaps on fortification coverage for most foods except
salt. All countries with mandatory fortification programs should generate and use more coverage data to assess program performance and adjust programs as needed to realize their potential to reduce micronutrient deficiencies (PROSPERO CRD42021269364).