Given the high prevalence of iron deficiency anemia in developing countries and the limited access to meat products among poor populations, finding an effective iron fortificant for cereal-based staples is a matter of some urgency. Elemental iron powders are the most commonly used iron fortificants worldwide, but little is known about the extent to which they are absorbed by the body. Studies conducted over the last 45 years have reported highly variable results, from 5% to 145% relative bioavailability in comparison with the standard, ferrous sulfate. This confusion has impeded regional initiatives to fortify food staples (such as corn masa flour) with iron in Mexico and Central America.

To help address this issue and accelerate progress toward food fortification standards and legislation in the region, SUSTAIN convened a panel of world-renowned research scientists, physicians and industry specialists to review and attempt to interpret decades of conflicting bioavailability data.
The meeting was held in Monterrey Mexico in September 2000.

Participants in the Monterrey workshop identified a number of problems with previous research on elemental iron powders that had led to inconsistent, incomplete and confusing information on their bioavailabilities. Nevertheless, workshop participants were able to recommend one of the available powders for use in fortification programs on an interim basis. They urged that more and better data be generated by research on a standardized suite of samples from the iron powder industry; and they suggested that the bioavailability of these powders be evaluated through in-vivo studies with mildly iron-deficient volunteers. (pdf version)

These consensus points, which were supported broadly by the scientific community, were welcome to industry as a first step toward clarification. To provide guidance for program planners and industry on the selection and use of iron fortificants, SUSTAIN published a set of "Guidelines for Iron Fortification of Cereal Food Staples". These incorporated recommendations from the Monterrey Workshop and expert consensus on the best currently available information on this important subject. (see complete Guidelines pdf)