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Related Experiment Video

Updated: May 13, 2026

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A simulation study to improve calcium intake through wheat flour fortification.

Gabriela Cormick1,2,3, Iris B Romero3, María B Puchulu3,4

  • 1Centro de Investigaciones en Epidemiología y Salud Pública (CIESP - IECS), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.

Public Health Nutrition
|June 2, 2024
PubMed
Summary

Fortifying wheat flour with calcium can significantly reduce low calcium intake in Argentinian populations, particularly in younger age groups. This strategy shows promise for improving public health, with minimal risk of exceeding upper intake levels.

Keywords:
CalciumFlourFortificationInadequate intakeMicronutrient

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Area of Science:

  • Nutrition Science
  • Public Health
  • Food Fortification

Background:

  • Low calcium intake is a significant public health concern, especially in populations with high wheat flour consumption.
  • Wheat flour is a widely consumed staple food, making it a suitable vehicle for nutrient fortification.

Purpose of the Study:

  • To simulate the effectiveness and safety of fortifying wheat flour with varying levels of calcium (200, 400, and 500 mg per 100 g).
  • To assess the potential impact on calcium intake and the prevalence of low calcium intake across different age groups in Argentina.

Main Methods:

  • Secondary analysis of cross-sectional data from the National Health and Nutrition Survey of Argentina (ENNyS 2018-2019).
  • Utilized the Iowa State University Intake Modelling, Assessment and Planning Program for dietary intake simulations.
  • Included a large, diverse participant pool (21,358) encompassing children, adolescents, and adults from urban areas.

Main Results:

  • Wheat flour consumption was widespread across all age groups.
  • A 500 mg/100 g calcium fortification level could decrease low calcium intake by over 40 percentage points in individuals aged 4 to 70 years.
  • The prevalence of low calcium intake remained high (above 65%) in older age groups.
  • Risk of exceeding the upper intake level was minimal (<1.5%) across all simulated scenarios.

Conclusions:

  • Calcium fortification of wheat flour is a viable strategy to improve calcium intake in Argentina.
  • Further subnational simulations are recommended to identify specific populations needing targeted interventions.
  • The findings support advocating for wheat flour fortification as a public health measure.