Cochrane · systematic review · CD012150
Fortification of wheat and maize flour with folic acid for population health outcomes
Centeno Tablante, E, Pachón, H, Guetterman, HM, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
Public HealthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
14
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 12 · 85.7%Low 2 · 14.3%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Maize flour or maize flour products fortified with folic acid alone versus no intervention for population health outcomes
Population: health outcomes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Erythrocyte concentrations Maize flour or maize flour products fortified with folic acid alone vs no intervention | no estimate extracted | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision |
Serum folate concentrations Maize flour or maize flour products fortified with folic acid alone vs no intervention | no estimate extracted | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision |
Maize flour or maize flour products fortified with folic acid plus other vitamins and minerals versus unfortified maize flours or maize flour products (not containing folic acid nor any other vitamins and minerals) for population health outcomes
Population: health outcomes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Erythrocyte folate concentrations (nmol/L) Maize flour or maize flour products fortified with folic acid plus other vitamins and minerals vs unfortified maize flours or maize flour products (not containing folic acid nor any other vitamins and minerals) | no estimate extracted | 1 study · 35 participants | Very low Downgraded: risk of bias, imprecision |
Serum folate concentrations (nmol/L) Maize flour or maize flour products fortified with folic acid plus other vitamins and minerals vs unfortified maize flours or maize flour products (not containing folic acid nor any other vitamins and minerals) | no estimate extracted | 1 study · 35 participants | Very low Downgraded: risk of bias, imprecision |
Wheat flour or wheat flour products fortified with folic acid alone versus unfortified wheat flours or wheat flour products (not containing folic acid nor any other vitamins and minerals) for population health outcomes
Population: health outcomes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Erythrocyte folate concentrations (nmol/L) Wheat flour or wheat flour products fortified with folic acid alone vs unfortified wheat flours or wheat flour products (not containing folic acid nor any other vitamins and minerals) | no estimate extracted | 1 study · 30 participants | Very low Downgraded: imprecision |
Plasma folate concentrations (nmol/L) Wheat flour or wheat flour products fortified with folic acid alone vs unfortified wheat flours or wheat flour products (not containing folic acid nor any other vitamins and minerals) | no estimate extracted | 1 study · 30 participants | Very low Downgraded: imprecision |
Wheat flour or wheat flour products fortified with folic acid plus other vitamins and minerals versus unfortified wheat flours or wheat flour products (not containing folic acid nor any other vitamins and minerals) for population health outcomes
Population: health outcomes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Anaemia 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) | RR 1.07 [0.74, 1.55] | 1 study · 334 participants | Low Downgraded: imprecision |
Haemoglobin concentrations 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) | no estimate extracted | 1 study · 334 participants | Low Downgraded: imprecision |
Wheat flour or wheat flour products fortified with folic acid plus other vitamins and minerals compared to unfortified wheat flours or wheat flour products (not containing folic acid nor any other vitamins and minerals) for population health: non‐randomised studies
Population: health: non‐randomised studies
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Neural tube defects (spina bifida, encephalocoele, anencephaly‐fatal and non‐fatal) 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) | RR 0.32 [0.21, 0.48] | 8037 participants | Very low Downgraded: risk of bias |
Spina bifida 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) | RR 0.29 [0.16, 0.56] | 8037 participants | Very low Downgraded: risk of bias |
Encephalocoele 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) | RR 0.26 [0.13, 0.56] | 8037 participants | Very low Downgraded: risk of bias |
Fatal anencephaly 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) | RR 0.47 [0.21, 1.07] | 8037 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Serum folate concentrations (nmol/L) 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) | no estimate extracted | 657 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Anaemia 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) | RR 0.87 [0.68, 1.11] | 657 participants | Very low Downgraded: risk of bias, imprecision, indirectness |