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Article
June 24, 1974

Bureaucratic Clout, and a Parable: The Iron-Enrichment-Now Brouhaha

JAMA. 1974;228(13):1651-1652. doi:10.1001/jama.1974.03230380019013
Abstract

IN THIS modern world of mass medicine, physicians may become too greatly concerned with the welfare of individuals. We do sometimes find ourselves at cross-purposes with bureaucrats, nutritionists, and others who apply medical care with a broad brush or spray gun. Some of us have been dismayed at the collaboration of the Food and Drug Administration (FDA) with the milling and baking industries and a coterie of nutritionists to increase by some 300% of the present requirement the amount of iron required to be added to flour and bread in the United States. The basis for this benevolence is the Ten-State Nutrition Survey performed six years ago on the poorest segments of the population. The nutritional situation was bad enough, but the data were manipulated to suggest a national catastrophe, especially in the area of anemia. In women, for example, any hemoglobin value that fell not outside the normal range,

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