SUSTAIN
Micronutrient Fortification  
The Monterrey Workshop--A Giant Step Towards Clarification

Iron deficiency anemia poses a serious public health problem in developing countries, one that is often addressed by fortifying staple foods with iron. However, success depends on adding effective iron fortificants to cereal-based staplesóiron forms that are readily absorbed during digestion and that improve iron status. Elemental iron powders are the most commonly used iron fortificants worldwide, but little was known about the extent to which they impacted iron status before SUSTAINís initiative (launched in 2001 and completed in 2006) to rigorously evaluate all commercially available elemental iron products. Studies conducted over the previous 45 years had reported highly variable results, from 5% to 145% relative bioavailability in comparison with the standard, ferrous sulfate. This confusion impeded regional initiatives to fortify food staples in many regions of the world.

To help accelerate progress toward effective fortification programs in the developing world, SUSTAIN convened a panel of world-renowned research scientists, physicians and industry specialists to review and attempt to interpret the decades of conflicting bioavailability data. The meeting was held in Monterrey Mexico in September 2000.

Participants identified a number of problems with previous research on elemental iron powders that led to inconsistent, incomplete and confusing information on their bioavailabilities. Many of the powders evaluated either were not identified or had little relevance to commercial products actually used to enrich foods. Workshop participants urged that more and better data be generated by research on a standardized suite of samples from the iron powder industry. This recommendation resulted in SUSTAINís Elemental Iron Studies Project and task force report. To read about the project click here.

To provide interim guidance for program planners and industry on the selection and use of iron fortificants, SUSTAIN published a set of "Guidelines for Iron Fortification of Cereal Food Staples". These incorporated recommendations from the Monterrey Workshop and expert consensus on the best currently available information on this important subject.



Project related publications include: