Fortifying Foods with NaFeEDTA: A Game-Changer in the Fight Against Anaemia?

Fortifying everyday foods with iron could be a powerful tool to combat anaemia—but how effective is it? A new meta-analysis by Fortify Health explores the impact of NaFeEDTA (sodium iron ethylenediaminetetraacetate) fortification on iron levels and anaemia prevalence. NaFeEDTA is a highly bioavailable form of iron that binds to a compound (EDTA) to improve iron absorption, especially in diets rich in grains and legumes, where natural inhibitors can block iron uptake. The findings suggest that adding NaFeEDTA to staples like wheat flour and rice significantly improves iron absorption and reduces the risk of anaemia.

What did the research find?

The meta-analysis findings from the seven selected studies reveal that fortifying foods with NaFeEDTA leads to an average increase of 3.93 g/L in haemoglobin levels. Haemoglobin, the crucial component in red blood cells responsible for carrying oxygen, when available in sufficient levels, means better energy and overall well-being for those consuming fortified foods. This increase suggests that fortified foods could boost the iron status of those who consume them regularly.

Furthermore, our analysis indicates a significant 16% reduction in the risk of anaemia. This suggests that by fortifying staple foods with NaFeEDTA, we could see a substantial decrease in the number of people affected by anaemia, which can lead to fatigue, weakness, and other health problems. The research also found that a weekly intake of at least 20 mg of NaFeEDTA is essential for effective results in reducing anaemia. Lower amounts appear less impactful in reducing anaemia. 

How was this research conducted? 
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The Fortify Health team followed a structured methodology for this meta-analysis, which included five stages :

• ●Literature Search: Relevant studies on NaFeEDTA fortification were identified through searches of major scientific databases.
• ●Study Selection: The identified studies were assessed against predefined inclusion criteria, focusing on randomised controlled trials (RCTs) that examined the impact of NaFeEDTA on anaemia and haemoglobin levels.
• ● Data Extraction: Information from the included studies was systematically extracted by multiple researchers to ensure accuracy.
• ●Data Analysis: Statistical methods were used to synthesise the data from the different studies and to calculate overall estimates of the effect of NaFeEDTA fortification.
• ●Bias Assessment: The quality of the included studies was evaluated to identify potential sources of bias that could affect the reliability of the findings. 

This meta-analysis was undertaken to provide more specific evidence on the effectiveness of NaFeEDTA, as previous broader analyses may have included studies with different iron fortificants and varying methodologies. Understanding the impact of NaFeEDTA is important for informing public health interventions aimed at reducing iron deficiency.

Why does NaFeEDTA work so well?

The meta-analysis highlights NaFeEDTA as a particularly effective fortificant. But why is that?

• ● Bioavailability: NaFeEDTA is highly bioavailable, meaning that it is easily absorbed by the body. This is crucial because some iron compounds are poorly absorbed, rendering them less effective for fortification. NaFeEDTA actively facilitates the absorption of iron by preventing phytic acid from inhibiting iron absorption.
• ●Sensory Changes: NaFeEDTA offers advantages over other iron compounds by minimising undesirable changes in the taste, colour, and texture of fortified foods.
• ●Reduced Inhibition: Certain food components (such as phytic acid in wheat) can inhibit iron absorption. NaFeEDTA helps to overcome this inhibition, ensuring that more iron is absorbed. 

While the results of this meta-analysis are encouraging, the researchers note some areas for future research. Many of the included studies focused on children, and further research involving adults and pregnant women would be valuable.  Additionally, investigating the long-term effects of NaFeEDTA fortification and exploring optimal dosages for various populations could provide further insights. Examining the application of NaFeEDTA fortification in a wider variety of staple foods beyond wheat and rice may also be beneficial. 

In conclusion, this meta-analysis suggests that fortifying staple foods with NaFeEDTA can lead to improvements in haemoglobin levels and a reduction in anaemia prevalence. These findings contribute to the evidence base for using food fortification as a public health strategy to address iron deficiency. 

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