XML Print


1- Student Research Committee, Department of Environmental Health Engineering, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran.
2- Department of Food Safety and Hygiene, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran.
3- Department of Environmental Health Engineering, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran.
Abstract:   (415 Views)
Bread is a staple food and a major energy source for many populations, especially in developing countries. However, traditional bread often lacks essential micronutrients, contributing to widespread malnutrition. Fortified bread, enriched with key nutrients such as iron, folic acid, vitamin D, calcium, iodine, and dietary fiber, represents an effective strategy to combat micronutrient deficiencies and improve public health outcomes. These nutrients support critical functions such as anemia prevention, immune health, bone integrity, and fetal development. Fortified bread is particularly beneficial for vulnerable populations, including children, pregnant women, and the elderly. Despite its benefits, several challenges hinder its widespread adoption. These include sensory alterations such as changes in taste and texture, increased production costs, regulatory complexity, and limited consumer awareness or acceptance. Addressing these barriers requires coordinated efforts in food technology, education, and policy support. Overall, bread fortification presents a practical and sustainable solution to enhance nutritional status and reduce the burden of diet-related diseases globally.
     
Type of Study: Review Article | Subject: Food Safety and Hygiene
Received: 2026/01/5 | Accepted: 2026/03/8

References
1. Abdul Majeed, S., Said, S., Hassan, D. A., Sadiq, F., Alhosani, M., Al-Jawaldeh, A., . . . & Tayyem, R. (2025). Evaluating the effectiveness and risks of bread fortification programs in the middle eastern region: A comprehensive review. Frontiers in Public Health, 13, 1530380. [Crossref]
2. Alahmari, L. A. (2024). Dietary fiber influence on overall health, with an emphasis on CVD, diabetes, obesity, colon cancer, and inflammation. Frontiers in Nutrition, 11, 1510564. [Crossref]
3. Alina, V. R., Carmen, M. C., Sevastita, M., Andruţa, M., Vlad, M., Ramona, S., . . . & Mihaela, M. (2019). Food fortification through innovative technologies. In T. E. Coldea, Food engineering (pp. 1-25). IntechOpen.
4. Almoumen, A., Mohamed, H., Subash, A., Al-Marzouqi, A. H., Ayyash, M., Al Dhaheri, A. S., & Kamal-Eldin, A. (2025). Fortifying bread rolls with date fruit fiber: Effects on dietary fiber, antioxidant capacity, mineral content, and glycemic response. NFS Journal, 39, 100229. [Crossref]
5. Benítez, V., Esteban, R. M., Moniz, E., Casado, N., Aguilera, Y., & Mollá, E. (2018). Breads fortified with wholegrain cereals and seeds as source of antioxidant dietary fibre and other bioactive compounds. Journal of Cereal Science, 82, 113-120. [Crossref]
6. Berner, L. A., Keast, D. R., Bailey, R. L., & Dwyer, J. T. (2014). Fortified foods are major contributors to nutrient intakes in diets of US children and adolescents. Journal of the Academy of Nutrition and Dietetics, 114(7), 1009-1022. [Crossref]
7. Bredariol, P., & Vanin, F. M. (2022). Bread baking review: Insight into technological aspects in order to preserve nutrition. Food Reviews International, 38(sup1), 651-668. [Crossref]
8. Cappelli, A., & Cini, E. (2021). Challenges and opportunities in wheat flour, pasta, bread, and bakery product production chains: A systematic review of innovations and improvement strategies to increase sustainability, productivity, and product quality. Sustainability, 13(5), 2608. [Crossref]
9. Castillo-Lancellotti, C., Tur, J. A., & Uauy, R. (2013). Impact of folic acid fortification of flour on neural tube defects: A systematic review. Public Health Nutrition, 16(5), 901-911. [Crossref]
10. Cencic, A., & Chingwaru, W. (2010). The role of functional foods, nutraceuticals, and food supplements in intestinal health. Nutrients, 2(6), 611-625. [Crossref]
11. Chamandoost, S., Naderi, M., Afshar, H., & Kamali, K. (2015). Amount of baking soda and salt in bakeries of Zanjan City in 2011-2012. Journal of Human Environment and Health Promotion, 1(1), 54-62. [Crossref]
12. Chilek, T. Z. T., Kairuaman, N. A., Ahmad, F., Wahab, R. A., Zamri, A. I., & Mahmood, A. (2018). Development of white bread fortified with calcium derived from Eggshell powder. Malaysian Applied Biology, 47(6), 29-39.
13. Crider, K. S., Bailey, L. B., & Berry, R. J. (2011). Folic acid food fortification-its history, effect, concerns, and future directions. Nutrients, 3(3), 370-384. [Crossref]
14. Diego Quintaes, K., Barberá, R., & Cilla, A. (2017). Iron bioavailability in iron-fortified cereal foods: The contribution of in vitro studies. Critical Reviews in Food Science and Nutrition, 57(10), 2028-2041. [Crossref]
15. Dwyer, J. T., Wiemer, K. L., Dary, O., Keen, C. L., King, J. C., Miller, K. B., . . . & Gaine, P. C. (2015). Fortification and health: Challenges and opportunities. Advances in Nutrition, 6(1), 124-131. [Crossref]
16. El Hoss, K., Salla, M., Khaled, S., Krayem, M., Hassan, H. F., & El Khatib, S. (2024). Vitamin D fortification in lebanese bread: Impact on sensory attributes, consumer perception and public acceptance. Applied Food Research, 4(2), 100502. [Crossref]
17. Feizollahi, E., Hadian, Z., & Honarvar, Z. (2018). Food fortification with omega-3 fatty acids; Microencapsulation as an addition method. Current Nutrition & Food Science, 14(2), 90-103. [Crossref]
18. Gargano, D., Appanna, R., Santonicola, A., De Bartolomeis, F., Stellato, C., Cianferoni, A., . . . & Iovino, P. (2021). Food allergy and intolerance: A narrative review on nutritional concerns. Nutrients, 13(5), 1638. [Crossref]
19. Gómez, M., Gutkoski, L. C., & Bravo‐Núñez, Á. (2020). Understanding whole‐wheat flour and its effect in breads: A review. Comprehensive Reviews in Food Science and Food Safety, 19(6), 3241-3265. [Crossref]
20. Horton, S., & Venkatesh-Mannar, M. (2018). Economics of food fortification. In M. G. Venkatesh Mannar, & R. F. Hurrell, Food fortification in a globalized world (pp. 299-304). Elsevier. [Crossref]
21. Iossifidis, S., Vaiou, M., Challa, A., Migdanis, A., Migdanis, I., Moula, A. I., . . . & Varitimidis, S. E. (2021). Use of fortified bread for addressing vitamin D deficiency. Advances in Experimental Medicine and Biology, 1337, 371-378. [Crossref]
22. Joshi, S., Tabassum, N., Mobeen, A., & Bora, J. (2024). Micronutrients. In M. G. Venkatesh Mannar, & R. F. Hurrell, Food fortification (pp. 33-54). CRC Press. [Crossref]
23. Kaczmarczyk, M. M., Miller, M. J., & Freund, G. G. (2012). The health benefits of dietary fiber: Beyond the usual suspects of type 2 diabetes mellitus, cardiovascular disease and colon cancer. Metabolism, 61(8), 1058-1066. [Crossref]
24. Kiani, A. K., Dhuli, K., Donato, K., Aquilanti, B., Velluti, V., Matera, G., . . . & Bertelli, M. (2022). Main nutritional deficiencies. Journal of Preventive Medicine and Hygiene, 63(2 Suppl 3), E93-E101.
25. Köken, G. N., Derbent, A. U., Erol, O., Saygın, N., Ayık, H., & Karaca, M. (2013). Awareness and use of folic acid among reproductive age and pregnant women. Journal of the Turkish German Gynecological Association, 14(2), 87. [Crossref]
26. Korzeniowska, M., Wojdylo, A., & Barrachina, A. A. C. (2017). Advances in food fortification with vitamins and co-vitamins. In A. Saeid, Food biofortification technologies (pp. 61-96). CRC Press. [Crossref]
27. Longoria-García, S., Cruz-Hernández, M., Flores-Verástegui, M., Contreras-Esquivel, J., Montañez-Sáenz, J., & Belmares-Cerda, R. (2018). Potential functional bakery products as delivery systems for prebiotics and probiotics health enhancers. Journal of Food Science and Technology, 55, 833-845. [Crossref]
28. Man, Y., Xu, T., Adhikari, B., Zhou, C., Wang, Y., & Wang, B. (2022). Iron supplementation and iron-fortified foods: A review. Critical Reviews in Food Science and Nutrition, 62(16), 4504-4525. [Crossref]
29. Marone, P. A. (2016). Food safety and regulatory concerns. In A. T. Dossey, J. A. Morales-Ramos, & M. Guadalupe Rojas, Insects as sustainable food ingredients (pp. 203-221). Elsevier. [Crossref]
30. Mesta-Corral, M., Gómez-García, R., Balagurusamy, N., Torres-León, C., & Hernández-Almanza, A. Y. (2024). Technological and nutritional aspects of bread production: An overview of current status and future challenges. Foods, 13(13), 2062. [Crossref]
31. Milanesi, A., & Brent, G. A. (2017). Iodine and thyroid hormone synthesis, metabolism, and action. In J. F. Collins, Molecular, genetic, and nutritional aspects of major and trace minerals (pp. 143-150). Elsevier. [Crossref]
32. Mohammadi-Nasrabadi, F., Ghodsi, D., Haghighian-Roudsari, A., Esfarjani, F., Khoshfetrat, M. R., Houshialsadat, Z., . . . & Majdzadeh, R. (2023). Economic sanctions affecting household food and nutrition security and policies to cope with them: A systematic review. International Journal of Health Policy and Management, 12, 7362. [Crossref]
33. Mollakhalili-Meybodi, N., Sheidaei, Z., Khorshidian, N., Nematollahi, A., & Khanniri, E. (2023). Sensory attributes of wheat bread: A review of influential factors. Journal of Food Measurement and Characterization, 17(3), 2172-2181. [Crossref]
34. Murphy, S. P., Yates, A. A., Atkinson, S. A., Barr, S. I., & Dwyer, J. (2016). History of nutrition: The long road leading to the dietary reference intakes for the United States and Canada. Advances in Nutrition, 7(1), 157-168. [Crossref]
35. Nikooyeh, B., Neyestani, T. R., Zahedirad, M., Mohammadi, M., Hosseini, S. H., Abdollahi, Z., . . . & Kalayi, A. (2016). Vitamin D-fortified bread is as effective as supplement in improving vitamin D status: A randomized clinical trial. The Journal of Clinical Endocrinology & Metabolism, 101(6), 2511-2519. [Crossref]
36. Oldewage-Theron, W. H., & Egal, A. (2012). Impact of nutrition education on nutrition knowledge of public school educators in South Africa: A pilot study. Health SA Gesondheid, 17(1), 1-8. [Crossref]
37. Patel, S. (2015). Cereal bran fortified-functional foods for obesity and diabetes management: Triumphs, hurdles and possibilities. Journal of Functional Foods, 14, 255-269. [Crossref]
38. Pellegrino, L., Marangoni, F., Muscogiuri, G., D’Incecco, P., Duval, G. T., Annweiler, C., & Colao, A. (2021). Vitamin D fortification of consumption cow’s milk: Health, nutritional and technological aspects. A multidisciplinary lecture of the recent scientific evidence. Molecules, 26(17), 5289. [Crossref]
39. Piskin, E., Cianciosi, D., Gulec, S., Tomas, M., & Capanoglu, E. (2022). Iron absorption: Factors, limitations, and improvement methods. ACS Omega, 7(24), 20441-20456. [Crossref]
40. Polzonetti, V., Pucciarelli, S., Vincenzetti, S., & Polidori, P. (2020). Dietary intake of vitamin D from dairy products reduces the risk of osteoporosis. Nutrients, 12(6), 1743. [Crossref]
41. Redfern, K. M., Hollands, H. J., Welch, C. R., Pinkney, J. H., & Rees, G. A. (2022). Dietary Intakes of folate, vitamin D and iodine during the first trimester of pregnancy and the association between supplement use and demographic characteristics amongst white caucasian women living with obesity in the UK. Nutrients, 14(23), 5135. [Crossref]
42. Saing, S., Haywood, P., van der Linden, N., Manipis, K., Meshcheriakova, E., & Goodall, S. (2019). Real-world cost effectiveness of mandatory folic acid fortification of bread-making flour in Australia. Applied Health Economics and Health Policy, 17, 243-254. [Crossref]
43. Shegelman, I., Vasilev, A., Shtykov, A., Sukhanov, Y., Galaktionov, O., & Kuznetsov, A. (2019). Food fortification-problems and solutions. Eurasian Journal of Biosciences, 13(2), 1089.
44. Shlobin, N. A., LoPresti, M. A., Du, R. Y., & Lam, S. (2020). Folate fortification and supplementation in prevention of folate-sensitive neural tube defects: A systematic review of policy. Journal of Neurosurgery: Pediatrics, 27(3), 294-310. [Crossref]
45. Soliman, S. A., Mahmoud, M. H. M., Abd El-Latif, B. M., Bahlol, H. E., & Abou El-Azm, H. A. (2012). Production of balady bread by using some improvers. Moshtohor and Hurghada, 15(24), 1-29.
46. Vandevijvere, S., Mourri, A. B., Amsalkhir, S., Avni, F., Van Oyen, H., & Moreno-Reyes, R. (2012). Fortification of bread with iodized salt corrected iodine deficiency in school-aged children, but not in their mothers: A national cross-sectional survey in Belgium. Thyroid, 22(10), 1046-1053. [Crossref]
47. Weegels, P. L. (2019). The future of bread in view of its contribution to nutrient intake as a starchy staple food. Plant Foods for Human Nutrition, 74(1), 1-9. [Crossref]
48. Xing, Q., Kyriakopoulou, K., Zhang, L., Boom, R. M., & Schutyser, M. A. (2021). Protein fortification of wheat bread using dry fractionated chickpea protein-enriched fraction or its sourdough. Lwt, 142, 110931. [Crossref]
49. Yang, Z., & Huffman, S. L. (2011). Review of fortified food and beverage products for pregnant and lactating women and their impact on nutritional status. Maternal & Child Nutrition, 7, 19-43. [Crossref]
50. Zimmermann, M. B., & Windhab, E. J. (2009). Encapsulation of iron and other micronutrients for food fortification. In N. J. Zuidam, & V. Nedovic, Encapsulation technologies for active food ingredients and food processing (pp. 187-209). Springer. [Crossref]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 The Author(s)

© 2026 CC BY-NC 4.0 | Journal of Human Environment and Health Promotion

Designed & Developed by : Yektaweb