In many parts of the world where iron deficiency anemia poses a major public health problem, both governments and industry have recognized the potential benefits of fortifying staple foods with iron. However, initiatives to do so have been hampered by questions and conflicting data on the efficacy of various iron compounds and of elemental iron powders, the fortificants favored and most used by industry. To help clarify these issues, SUSTAIN drafted and published a set of "Guidelines for Iron Fortification of Cereal Food Staples." The Guidelines are designed as an interim tool to help program planners select and use optimal iron fortificants for specific public health programs. They reflect a consensus among leading public and private sector experts, including participants at the Monterrey Workshop, on what can be deduced from past experience with iron metabolism and fortification; and on reviews of the best information currently available, including SUSTAIN's own research.

Key recommendations from the Guidelines address the two major elements of any fortification strategy: selecting an appropriate iron fortificant; and determining optimal addition levels. The Iron Guidelines have been widely disseminated and used to select iron compounds, levels and other product characteristics for national fortification legislation as well as voluntary fortification initiatives worldwide. Industries expressed considerable appreciation for the Guidelines as a clear, if interim, standard on a complex issue. The Guidelines have also served as communication and marketing tools, simplifying information sharing on iron fortification among governments, donors, food processors and premix suppliers. Finally, the Guidelines offer a baseline of information from which to identify research needs.