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Mandatory fortification of wheat flour in Indonesia has been a significant public health initiative since its implementation in 1998. Over the past two decades, the Indonesian government has continuously refined the program to enhance its effectiveness, particularly by adjusting the standards for added micronutrients. One of the key changes occurred with the release of SNI number 3751:2018, where the type of iron fortificant was updated from Fe-elemental to Ferro sulfate, Ferro Fumarate, or Sodium Ferri-EDTA. This change aimed to improve the bioavailability and efficacy of iron fortification (BSN 2018). Despite the longstanding implementation of mandatory wheat flour fortification and periodic adjustments to fortification standards, comprehensive research evaluating its effectiveness on a national scale has been limited. Specifically, there is a lack of studies that consider different economic strata (income quintiles), age groups, and rural-urban areas. The most recent and comprehensive food consumption data available is from the SKMI 2014 survey. Recognizing the need for detailed evaluation, the Indonesian Nutrition Foundation for Food Fortification (KFI) conducted a study using SKMI 2014 data. The study aimed to analyze the contribution of wheat flour and its processed products to the intake of key micronutrients such as iron (Fe), zinc (Zn), and vitamin B9. The findings of this study have been published in the Jurnal Ilmu Gizi dan Dietetik. This research provides valuable insights into the nutritional impact of wheat flour fortification in Indonesia and highlights areas for potential improvement and further investigation.
ABSTRACT The mandatory wheat flour fortification program in Indonesia aims to reduce the prevalence of iron deficiency anemia (IDA). However, the effectiveness of this program is rarely evaluated. This study analyses the contribution of consumption of wheat flour and processed food to intake of Fe, Zn, and vitamin B9 (folate) using data from the 2014 Indonesian Food Consumption Survey (SKMI). The study used a cross-sectional research design and included a large sample of 145,360 individuals. The results clearly show that the average wheat flour consumption of the Indonesian population is below the recommended consumption level of 75 g/cap/day for a successful food fortification program, with an average of only 43.17±72.78 g/cap/day. In particular, only- a small portion of the Indonesian population, ranging from 10-30%, consumes wheat flour above the recommended level. Consumption of wheat flour of 75 g or more per capita per day contributes to the Recommended Daily Allowance (RDA) for iron, zinc, and folate intake, providing 20.35±11.96% of the RDA for iron, 57.52±32.73% of the RDA for zinc, and 12.01±6.45% of the RDA for folate. Regular monitoring of wheat flour consumption is needed to assess the impact of flour fortification in reducing micronutrient deficiencies in Indonesia. The Indonesian Food Consumption Survey (SKMI) needs to be conducted now and periodically in the future to continue to monitor the developments in wheat flour consumption and its contribution in overcoming the IDA problem, as a basis for improving policies to address the problem of Iron Deficiency Anemia (IDA) in Indonesia.
Keywords: anemia, fortification, micronutrient, wheat flour