Fortified wheat flour

Studies in people

• Benefit

  Vitamin and mineral shortfalls²

  Fortified wheat flour adds vitamins and minerals that many people, especially children and women, do not get enough of.

• Benefit

  Iron levels in the blood³

  Eating iron-fortified wheat flour raised iron levels and lowered anaemia in people across many countries.

• Benefit

  Iron and anaemia⁴

  Fortified wheat flour may lower anaemia risk, but scientists do not yet know whether it helps other health outcomes.

• Benefit

  Calcium intake shortfall⁵

  Adding calcium to wheat flour could cut low calcium intake, especially in younger adults, the study found.

• Benefit

  Birth defects in babies⁷

  In Chile, adding folic acid to wheat flour cut serious birth defects of the brain and spine by about half.

• Open question

  Immune function in women⁸

  In women with low iron, fortified wheat flour with iron and prebiotics changed levels of immune proteins called immunoglobulins.

• Benefit

  Vitamin and mineral levels in women and children⁹

  In women and children in Cameroon, iron, zinc, folate and vitamin B-12 levels rose after wheat flour was fortified.

• Benefit

  Cleft lip and palate¹⁰

  In Chile, fewer babies were hospitalized for cleft lip and palate after folic acid was added to wheat flour.

• Open question

  Poorly absorbed iron¹²

  Fortified wheat flour adds iron, but most countries use forms the body absorbs poorly, so many programs may not help.

• Benefit

  Iron levels in women¹⁴

  Women who ate more iron-fortified wheat flour were less likely to be low in iron.

• Benefit

  Anemia in pregnancy¹⁵

  In Brazilian pregnant women, anemia fell from 25% to 20% after fortified wheat flour, but stayed common in the North and Northeast.

• Benefit

  Child growth and immunity¹⁶

  In families eating lysine-fortified wheat flour, children grew taller and heavier and family immune markers improved.

• Benefit

  Vitamin A levels in children¹⁷

  In children with low vitamin A, eating vitamin A-fortified wheat flour buns improved their vitamin A levels.

• Benefit

  Folate intake in women¹⁹

  Fortified wheat flour helped women in Brazil reach the recommended daily amount of folate, though cooking may reduce it.

• No harm found

  Anemia in women and children²⁰

  In Sri Lankan women and children, flour fortified with electrolytic or reduced iron did not reduce anemia.

• Benefit

  Blood iron levels in women²¹

  Women who ate iron-fortified wheat flour for four months had higher hemoglobin levels.

• Concern

  Iron levels in men²²

  In nonanemic men, eating iron-fortified flour for 16 months raised iron levels and lowered antioxidant protection.

• Open question

  Anemia and folate levels²³

  Fortified wheat flour did not lower anemia risk in women, though extra folic acid from it was linked to fewer folate deficiencies.

• Benefit

  Diarrhea in women²⁴

  In women eating lysine-fortified wheat flour, diarrhea episodes dropped, but scientists do not yet know if this holds up.

• Benefit

  Anaemia in young children²⁵

  Anaemia in Jordanian pre-school children dropped after wheat flour was fortified with multiple micronutrients.

• Open question

  Blood antioxidant balance²⁶

  In men, eight months of eating iron-fortified bread changed some blood markers of oxidative stress, but women showed no change.

How it’s made and used

• Birth defects and nutrition gaps⁶

  Fortified wheat flour carries folic acid and iron, but most people worldwide still cannot get it.

• Nutrient retention in noodles¹¹

  Instant noodles made with fortified wheat flour keep most added vitamins and minerals, though thiamin is lost.

• Iron levels in the body¹³

  In people, electrolytic iron powder added to flour is absorbed about half as well as ferrous sulfate.

• Consumer awareness of fortification¹⁸

  In a study of 300 households, richer people knew more about fortified wheat flour than poorer people did.

The signal at the top counts the findings in people and in animal and lab studies. A concern in studies of people outranks animal and lab studies, and “No concerns” needs at least one finding in people. When most findings in people point one way, the page leans that way (“Mostly”), and every finding is still shown. Findings whose study type is not stated are shown but not counted. This page is a reference, not medical advice. It describes what regulators and published research say. Talk to a doctor or dietitian about your own diet.