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Evidence found and GRADE certainty

26 questions · 26 findings · 3 reviews · Public Health · Headline outcomes only

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No studies found 1 · 3.8%GRADE not reported 0 · 0%Very low 15 · 57.7%Low 10 · 38.5%Moderate 0 · 0%High 0 · 0%

Wheat flour or wheat flour products fortified with folic acid plus other vitamins and minerals vs unfortified wheat flours or wheat flour products (not containing folic acid nor any other vitamins and minerals)

Spina bifida · health: non‐randomised studies

It is very uncertain whether wheat flour or wheat flour products fortified with folic acid plus… changes spina bifida compared with unfortified wheat flours or wheat flour products (not containing… (very low certainty).

1 finding from 1 review

Wheat flour or wheat flour products fortified with folic acid plus other vitamins and minerals vs unfortified wheat flours or wheat flour products (not containing folic acid nor any other vitamins and minerals)

Encephalocoele · health: non‐randomised studies

It is very uncertain whether wheat flour or wheat flour products fortified with folic acid plus… changes encephalocoele compared with unfortified wheat flours or wheat flour products (not containing… (very low certainty).

1 finding from 1 review

Wheat flour or wheat flour products fortified with folic acid plus other vitamins and minerals vs unfortified wheat flours or wheat flour products (not containing folic acid nor any other vitamins and minerals)

Fatal anencephaly · health: non‐randomised studies

It is very uncertain whether wheat flour or wheat flour products fortified with folic acid plus… changes fatal anencephaly compared with unfortified wheat flours or wheat flour products (not containing… (very low certainty).

1 finding from 1 review

Wheat flour or wheat flour products fortified with folic acid plus other vitamins and minerals vs unfortified wheat flours or wheat flour products (not containing folic acid nor any other vitamins and minerals)

Folate concentration Serum folate levels, measured between 6 and 12 months after entry to the study · health: non‐randomised studies
1 finding from 1 review

Wheat flour or wheat flour products fortified with folic acid plus other vitamins and minerals vs unfortified wheat flours or wheat flour products (not containing folic acid nor any other vitamins and minerals)

Anaemia · health: non‐randomised studies

It is very uncertain whether wheat flour or wheat flour products fortified with folic acid plus… changes anaemia compared with unfortified wheat flours or wheat flour products (not containing… (very low certainty).

1 finding from 1 review

Wheat flour or wheat flour products fortified with folic acid plus other vitamins and minerals vs unfortified wheat flours or wheat flour products (not containing folic acid nor any other vitamins and minerals)

Anaemia · health outcomes

Wheat flour or wheat flour products fortified with folic acid plus… showed no clear difference in anaemia compared with unfortified wheat flours or wheat flour products (not containing… (low certainty).

1 finding from 1 review

Wheat flour or wheat flour products fortified with folic acid plus other vitamins and minerals vs unfortified wheat flours or wheat flour products (not containing folic acid nor any other vitamins and minerals)

Neural tube defects (All) · health: non‐randomised studies

It is very uncertain whether wheat flour or wheat flour products fortified with folic acid plus… changes neural tube defects (spina bifida, encephalocoele, anencephaly‐fatal… compared with unfortified wheat flours or wheat flour products (not containing… (very low certainty).

1 finding from 1 review

Provision of maize flour or maize flour products fortified with iron plus other vitamins and minerals vs unfortified maize flours or maize flour products

Anaemia · general population older than 2 years of age (including pregnant women), in Kenya and Mexico

It is very uncertain whether provision of maize flour or maize flour products fortified with iron… changes anaemia (defined as haemoglobin (Hb) below WHO cut‐off, adjusted for… compared with unfortified maize flours or maize flour products (very low certainty).

1 finding from 1 review

Provision of maize flour or maize flour products fortified with iron plus other vitamins and minerals vs unfortified maize flours or maize flour products

Iron deficiency (as defined by study authors, based on a biomarker of iron status) · general population older than 2 years of age (including pregnant women), in Kenya and Mexico

It is very uncertain whether provision of maize flour or maize flour products fortified with iron… changes iron deficiency (as defined by trialists, based on a biomarker of… compared with unfortified maize flours or maize flour products (very low certainty).

1 finding from 1 review

Provision of maize flour or maize flour products fortified with iron plus other vitamins and minerals vs unfortified maize flours or maize flour products

Any adverse effects (including constipation, nausea, vomiting, heartburn or diarrhoea, as measured by trialists) · general population older than 2 years of age (including pregnant women), in Kenya and Mexico

The review found no eligible studies for this question.

1 finding from 1 review

Rice fortified with iron alone or in combination with other micronutrients vs unfortified rice (no micronutrients added)

Anaemia · general population of all age groups (including pregnant women) from any country, over two years of age

Rice fortified with iron alone or in combination with other… may leads to lower anaemia (defined as haemoglobin below the WHO cut‐off, adjusted for… compared with unfortified rice (no micronutrients added) (low certainty).

1 finding from 1 review

Rice fortified with iron alone or in combination with other micronutrients vs unfortified rice (no micronutrients added)

Iron deficiency (as defined by study authors, based on a biomarker of iron status) · general population of all age groups (including pregnant women) from any country, over two years of age

Rice fortified with iron alone or in combination with other… may leads to lower iron deficiency (as defined by study authors, based on a biomarker… compared with unfortified rice (no micronutrients added) (low certainty).

1 finding from 1 review