Iron-fortified wheat flour and hemoglobin in Pakistani women
What it found
In 280 women of reproductive age in Mansehra, Pakistan, eating iron-fortified wheat flour for 120 days raised average hemoglobin from 10.20 g/dL to 11.85 g/dL.
Severe anemia fell from 16.7 percent of the women to none.
What they found
Studies in people
Hemoglobin rose
Average hemoglobin among the 280 women went from 10.20 g/dL at the start to 11.85 g/dL after 120 days of eating iron-fortified wheat flour. The authors say this rise was significant.
Severe anemia disappeared
At the start, 16.7 percent of the women had severe anemia. After 120 days, none of them did.
Moderate anemia share
Moderate anemia was found in 63.0 percent of the women at the start and 67.5 percent at the end. The authors explain this rise by women who had severe anemia moving into the moderate group as their hemoglobin improved.
Normal hemoglobin share
The share of women with normal hemoglobin rose from 20.0 percent at the start to 32.5 percent at the end of the study.
Other findings
Iron eaten from flour
The women ate on average 343.5 g of wheat flour a day, which supplied 28.4 mg of iron. The recommended daily iron intake for Pakistani women of childbearing age is 30 mg a day.
Other foods eaten
Rice was the second staple at 115.7 g a day, and tea intake was high at 410.4 mL a day. Meat, eggs, milk and leafy vegetables were eaten in small amounts.
What the authors conclude
“The study concluded that the consumption of iron-fortified wheat flour could be an effective strategy to combat the problem of iron deficiency in Pakistan.”
Also in their conclusions
- They conclude that iron-fortified wheat flour improved mean hemoglobin levels among women of reproductive age.
- They say wheat flour fortification is a cost-effective intervention to combat iron deficiency among women of reproductive age, especially in a developing country such as Pakistan.
- They note that the iron-fortified wheat flour provided amounts of iron quite near the recommended daily allowance.
How it was done
Iron deficiency is the biggest micronutrient problem worldwide, and fortifying staple foods like wheat flour is seen as one of the most effective ways to tackle it. The authors wanted to test what iron-fortified wheat flour did to hemoglobin levels in women of reproductive age in Mansehra, Pakistan.
They recruited 280 women aged 15 to 49 from four Union Councils in Mansehra district, Pakistan, after 7 of the original 287 dropped out. The women ate iron-fortified wheat flour for 120 days, and their hemoglobin was measured at the start and at the end. A 24-hour dietary recall was also taken to see what foods they ate.
What it can’t tell you
- The study did not include a comparison group that ate unfortified flour, so it cannot prove the flour alone caused the hemoglobin rise.
- The women were also eating other foods during the 120 days, and those foods could have played a part.
- The results are from one district in Pakistan and may not apply to other populations.
Who paid
- Authors work at
- Ibadat International University, Pakistan; Quaid-i-Azam University, Pakistan; Health Services Academy, Pakistan
The paper
- Title
- Effect of Iron-fortified Wheat Flour on Hemoglobin Levels among Women of Reproductive Age Group in Mansehra, KPK, Pakistan
- Type
- Study
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Anis RA, Anees M, Zafar S, et al (2023). Effect of Iron-fortified Wheat Flour on Hemoglobin Levels among Women of Reproductive Age Group in Mansehra, KPK, Pakistan. Cellular and molecular biology (Noisy-le-Grand, France). doi:10.14715/cmb/2023.69.2.5Free full textPubMed 37224051DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error