Osler M, Milman N, Heitmann B L
Department of Medicine C, Glostrup University Hospital, 2600 Glostrup, Denmark.
Prev Med. 1999 Jul;29(1):32-6. doi: 10.1006/pmed.1999.0499.
Health authorities recommend that populations consume a diet providing sufficient iron, and in order to prevent iron deficiency, a number of countries have fortified certain foods with iron. In Denmark, flour was fortified with iron from 1954 until 1987, at which time the mandatory fortification was stopped. This study examines the effect of iron fortification on iron status by comparing the intake of iron with serum ferritin over time and in relation to the removal of flour fortification.
In a cohort of 238 Danish men and women, at baseline ages 35-65 years, dietary intake and serum ferritin were measured, first in 1987/1988 and again in 1993/1994.
In 1987/1988 the fortification may have supplied up to 25% of total iron intake, and without this enrichment some 35% of the men and 73% of the women may have had iron intakes lower than 10 mg/day. Assuming that no flour was enriched, iron intake was constant during the 6-year study period. Despite this, after flour fortification was stopped in 1987, serum ferritin increased among both men and postmenopausal women.
Considering that mandatory iron fortification of flour affects the entire population, including subjects who are at risk for chronic diseases because of too-high iron stores, the decision to stop the mandatory fortification in Denmark seems to have been well-founded.
卫生当局建议民众摄入富含足够铁元素的饮食，为预防缺铁，一些国家对某些食品进行了铁强化。在丹麦，从1954年至1987年对面粉进行了铁强化，1987年停止了强制强化。本研究通过比较不同时间的铁摄入量与血清铁蛋白水平，并结合面粉强化措施的取消，来研究铁强化对铁状况的影响。
选取238名年龄在35 - 65岁的丹麦男性和女性组成队列，在1987/1988年首次测量其饮食摄入量和血清铁蛋白，1993/1994年再次测量。
1987/1988年，强化措施可能提供了高达总铁摄入量25%的铁，若没有这种强化，约35%的男性和73%的女性铁摄入量可能低于10毫克/天。假设没有面粉进行强化，在为期6年的研究期间铁摄入量保持恒定。尽管如此，1987年面粉强化停止后，男性和绝经后女性的血清铁蛋白均有所增加。
考虑到对面粉进行强制性铁强化会影响全体人群，包括因铁储存过高而有患慢性病风险的人群，丹麦停止强制性强化的决定似乎是有充分依据的。
