Flour Fortification Initiative
The Flour Fortification Initiative is currently celebrating the 15-year history of fortifying flour with folic acid to prevent birth defects. In 1996, Oman was the first country to achieve national scale flour fortification with folic acid to prevent neural tube defects (NTDs). The United States and Canada began adding folic acid to flour in 1996, but it took these larger countries longer to reach national coverage. Fortification is now mandatory practice in 57 countries and voluntary in many others. Three key results are:
- World-wide, at least 22,000 fatal or disabling birth defects such as spina bifida are prevented annually. That’s 60 babies a day.
- Countries around the world report 30% to 70% declines in NTDs after fortification begins.
- Countries save millions of dollars in healthcare cost when spina bifida is prevented.
The Flour Fortification Initiative (FFI) is a network of partners working together to make flour fortification a standard practice worldwide so that people receive essential nutrients through staple food products. The World Health Organization (WHO) has issued a consensus statement endorsing fortification of flour with iron, folic acid, vitamin B 12, vitamin A, and zinc.1 Flour fortification allows these vitamins and minerals to be included in bread, noodles, and other wheat or maize products offering a cost-efficient strategy for addressing nutrient deficiencies.
Start Date: 2004
The CDC supports the FFI through the following activities:
- Funding the global secretariat.
- Providing technical assistance in scientific issues related to flour fortification. For example, through the IMMPaCt program, provided support to the 2nd Technical Workshop on Wheat Fortification.
- Serving as a member of the FFI Executive Management Team to provide strategic direction for the initiative.
Since 2004, the FFI has helped increase the amount of fortified flour produced by roller mills from 18% to 30%.2 Additionally, the number of countries with documented national regulations for mandatory wheat flour fortification has increased from 33 to 63.2 As a result, in 2007 nearly 2 billion people had potential access to fortified flour; that number is 540 million more people than had access in 2004.2
The FFI is working to increase the amount of wheat flour fortified by roller mills to 80% by 2015, the same year as the target date for achieving the United Nations Millennium Development Goals.2 At that time, the FFI will reassess its goals and determine the next steps for making flour fortification a standard practice worldwide.
The CDC plans to continue its current activities in support of the FFI.
The FFI partners include individuals, private organizations, public entities, academic institutions and civic groups.
For More Information
For more information about the initiative, see Flour Fortification Initiative.
Trends in Wheat-Flour Fortification with Folic Acid and Iron --- Worldwide, 2004 and 2007
MMWR January 11, 2008 / 57(01);8—10
- Recommendations on Wheat and Maize Flour Fortification
Meeting Report: Interim Consensus Statement - http://www.who.int/nutrition/publications/micronutrients/wheat_maize_fort.pdf [PDF–104k]
- FFI: Map of Global Progress - http://www.sph.emory.edu/wheatflour/globalmap.php