OBJECTIVETo assess the effect of sodium iron ethylenediaminetetraacetate (NaFeEDTA)-fortified soy sauce on anemia prevalence in the Chinese population.

METHODSA systematic review was performed to identify potential studies by searching the electronic databases of PubMed, Cochrane Library, WHO Library, HighWire, CNKI, and other sources. The selection criteria included randomized controlled trials that compared the efficacy of NaFeEDTA-fortified soy sauce with that of non-fortified soy sauce. Anemia rates and hemoglobin levels were the outcomes of interest. Inclusion decisions, quality assessment, and data extraction were performed by two reviewers independently. A total of 16 studies met the inclusion criteria for anemia rate analysis, of which 12 studies met the inclusion criteria for hemoglobin analysis. All included studies assessed the effect of NaFeEDTA-fortified soy sauce on anemia rates and hemoglobin concentrations.

RESULTSAfter the intervention, the hemoglobin concentration increased and anemia rates decreased significantly as compared with the non-fortified soy sauce groups. For anemia rates, data from 16 studies could be pooled, and the pooled estimate odds ratio was 0.25 (95% CI 0.19-0.35). For hemoglobin concentrations, data from 12 studies could be pooled, and the pooled weighted mean difference was 8.81 g/L (95% CI 5.96-11.67).

CONCLUSIONNaFeEDTA-fortified soy sauce has a positive effect on anemia control and prevention in the at-risk population.

Age Factors ; Anemia, Iron-Deficiency ; epidemiology ; prevention & control ; China ; epidemiology ; Edetic Acid ; Ferric Compounds ; Food, Fortified ; Hematocrit ; Humans ; Prevalence ; Randomized Controlled Trials as Topic ; Soy Foods

The epidemiology of foodborne diseases is changing. While in manydeveloping nations the efficient treatment of diarrhoeal diseases through oral rehydration has probably led to the prevention of many food related deaths, the underlying problems have not been solved. In these countries, the disease incidence of food-and waterborne disease is still increasing, and now data from other parts of the world indicate that new foodborne pathogens have emerged as important public health problems. Over the last two decades, bacterial infections caused by Campylobacter and enterohaemorrhagic Escherichia coli have emerged, well-recognized pathogens, such as Salmonella enteritidis, have increased dramatically in disease incidence and important foodborne pathogens have become increasingly resistant to antimicrobial agents. The future strategy for prevention of foodborne disease should be founded in scientifically based evaluations of the whole food production chain ‘from farm to table’, including a description of the most important (risk) factors. Epidemiological studies of outbreaks as well as sporadic cases should be aimed at a better understanding of these factors. In terms of public health importance of the problem, the focus should be on the size of the problem, and the potential for improvement. The indications are that both in developed and developing countries there is significant potential for an improvement of the situation. With this aim in mind, international effort should focus on scientific assessments of the potential for risk reduction under different regional conditions.