Low dietary calcium is very common in many populations, contributing to nutritional rickets/osteomalacia in children/adults and increasing the risk of several health problems. Calcium is a nutrient of concern as the recommended nutrient requirements are difficult to meet in the absence of dairy products. The provision of culturally acceptable calcium‐fortified foods may improve calcium intake when it is a feasible and cost‐effective strategy in a particular setting. This landscape review was conducted in 2019 and describes current calcium fortification efforts and lessons learned from these experiences. Worldwide, the United Kingdom is the only country where calcium fortification of wheat flour is mandatory. It is estimated that this fortified staple ingredient contributes to 13–14% of calcium intake of the British population. Other items voluntary fortified with calcium include maize flour, rice, and water. Current calcium fortification programs may lack qualified personnel/training, clear guidelines on implementation, regulation, monitoring/evaluation, and functional indicators. Also, the cost of calcium premix is high and the target groups may be hard to reach. There is a lack of rigorous evaluation, particularly in settings with multiple micronutrient programs implemented simultaneously, with low quality of the evidence. Further research is needed to assess the impact of calcium fortification programs.

中文翻译：

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当前的钙强化经验：回顾

膳食钙含量低在许多人群中非常常见，会导致儿童/成人营养性佝偻病/骨软化症，并增加多种健康问题的风险。钙是一种令人担忧的营养素，因为在没有乳制品的情况下很难满足推荐的营养需求。当在特定环境下提供可行且具有成本效益的策略时，提供文化上可接受的钙强化食品可能会改善钙的摄入量。本景观回顾于 2019 年进行，描述了当前的钙强化工作以及从这些经验中吸取的教训。在世界范围内，英国是唯一一个强制对小麦粉进行钙强化的国家。据估计，这种强化主食成分占英国人口钙摄入量的 13-14%。其他自愿强化钙的物品包括玉米粉、大米和水。目前的钙强化计划可能缺乏合格的人员/培训、明确的实施指南、监管、监测/评估和功能指标。此外，钙预混剂的成本较高，且目标群体可能难以接触到。缺乏严格的评估，特别是在同时实施多个微量营养素计划的环境中，证据质量较低。需要进一步的研究来评估钙强化计划的影响。