Department of Dietetics and Nutrition, Stempel School of Public Health, Florida International University, Miami, Florida.
Effective Care Research Unit, Eastern Cape Department of Health, Universities of the Witwatersrand and Fort Hare, East London, South Africa.
Ann N Y Acad Sci. 2021 Jan;1484(1):55-73. doi: 10.1111/nyas.14481. Epub 2020 Sep 18.
Low dietary calcium is very common in many populations, contributing to nutritional rickets/osteomalacia in children/adults and increasing the risk of several health problems. Calcium is a nutrient of concern as the recommended nutrient requirements are difficult to meet in the absence of dairy products. The provision of culturally acceptable calcium-fortified foods may improve calcium intake when it is a feasible and cost-effective strategy in a particular setting. This landscape review was conducted in 2019 and describes current calcium fortification efforts and lessons learned from these experiences. Worldwide, the United Kingdom is the only country where calcium fortification of wheat flour is mandatory. It is estimated that this fortified staple ingredient contributes to 13-14% of calcium intake of the British population. Other items voluntary fortified with calcium include maize flour, rice, and water. Current calcium fortification programs may lack qualified personnel/training, clear guidelines on implementation, regulation, monitoring/evaluation, and functional indicators. Also, the cost of calcium premix is high and the target groups may be hard to reach. There is a lack of rigorous evaluation, particularly in settings with multiple micronutrient programs implemented simultaneously, with low quality of the evidence. Further research is needed to assess the impact of calcium fortification programs.
在许多人群中，低膳食钙非常普遍，导致儿童/成人营养性佝偻病/骨软化症，并增加了多种健康问题的风险。钙是一种受关注的营养素，因为在缺乏乳制品的情况下，很难满足推荐的营养素需求。在特定环境下，如果提供文化上可接受的强化钙食品可能会改善钙的摄入量，这是一种可行且具有成本效益的策略。本景观综述于 2019 年进行，描述了目前的钙强化工作以及从这些经验中吸取的教训。在全球范围内，英国是唯一强制对小麦粉进行钙强化的国家。据估计，这种强化主食成分占英国人口钙摄入量的 13-14%。其他自愿添加钙的物品包括玉米粉、大米和水。目前的钙强化计划可能缺乏合格的人员/培训、关于实施、监管、监测/评估以及功能指标的明确指导方针。此外，钙预混料的成本很高，目标群体可能难以触及。由于缺乏同时实施多种微量营养素方案的严格评估，证据质量也较低。需要进一步研究来评估钙强化计划的影响。
