scholarly journals The Efficacy of Consuming Iron-Fortified Lentils on Body Iron (Fe) Status in Bangladeshi Adolescent Girls: A Sustainable, Food-Based Solution to Iron Deficiency

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 700-700
Author(s):  
Fakir Yunus ◽  
Chowdhury Jalal ◽  
Anupom Das ◽  
Kaosar Afsana ◽  
Rajib Podder ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Adolescent Girls ◽  
Iron Status ◽  
Controlled Trial ◽  
Health Concern ◽  
Community Based ◽  
Double Blind ◽  
Sustainable Food ◽  
Funding Sources ◽  
Cluster Randomized

Abstract Objectives Iron deficiency (ID) and iron deficiency anaemia (IDA) remain a public health concern among women and girls globally, and have numerous impacts on health, nutrition and socioeconomic status. Our objective was to investigate the efficacy of consuming iron-fortified lentils on iron status among rural Bangladeshi adolescent girls. Methods In this community-based, double-blind, cluster-randomized controlled trial, girls (13.5 ± 2.0 years) were randomly assigned to three groups that received 1)cooked iron-fortified lentils (160 ppm Fe NaFeEDTA per kg of lentils); 2)cooked non-iron-fortified lentils; or 3)no lentils (usual intake group). We served 200 g of cooked lentils using a local daal recipe on five days/week, for 4 months. Iron status (sFer, sTfR, and Hgb) was assessed at baseline, 2 and 4 months. All analyses were adjusted for inflammation. Results There were no differences in baseline iron status among the three groups. sFer significantly increased by 21.9% (+5.7 μg/L, p < 0.001; 95% CI: 1.7, 9.5 μg/L) from baseline to 4 months in the iron-fortified lentil group, compared to a decline in sFer observed in the non-iron fortified lentil (53.3 vs. 38.6 μg/L, p < 0.01) and no lentil groups (53.6 vs. 39.5 μg/L, p < 0.01). Examining overall changes in iron status over 4 months, we observed maintenance in the iron-fortified group from baseline, compared to a decline in the other groups. Conclusions We observed improvement in and maintenance of iron status in a population vulnerable to ID and IDA who consumed iron-fortified lentils for 4 months. Additionally, girls who consumed iron-fortified lentils had a 60% lower chance of developing clinical and subclinical ID (sFer < 15, 15–30 μg/L), and a 70% lower chance of developing sub-clinical IDA (sFer 15–30 μg/L + Hgb < 12 g/dL) compared to those who did not. Funding Sources Global Institute for Food Security.

scholarly journals A Community Trial Examining the Effectiveness of Iron-fortified Lentils to Improve Iron Status Among Bangladeshi Adolescent Girls: Results from a Baseline Survey (P10-099-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Fakir Yunus ◽  
Anupom Das ◽  
Chowdhury Jalal ◽  
Kaosar Afsana ◽  
Rajib Podder ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Adolescent Girls ◽  
Iron Status ◽  
Controlled Trial ◽  
Baseline Data ◽  
Health Concern ◽  
Baseline Survey ◽  
Double Blind ◽  
Status Survey

Abstract Objectives Despite all efforts, iron deficiency (ID) and iron deficiency anaemia (IDA) among adolescent girls remains a public health concern for Bangladesh. The objective of the current analysis was to examine baseline data from an effectiveness trial with the aim to compare prevalence of anemia, ID and IDA with Bangladesh's National Micronutrients Status Survey 2011–12. Methods A community-based, double-blind, cluster randomized controlled trial is being conducted among n = 1260 Bangladeshi adolescent girls (10–17 years). Treatment groups include: 1) Fe-fortified lentils; 2) unfortified lentils and 3) usual intake (no intervention). Within the lentil groups, participants are being served 250 g cooked lentils with half a cup of cooked rice 5 days/week for 85 feeding days. All Fe-fortification and processing of lentils were carried out at the University of Saskatchewan. Anemia, ID and IDA were defined according to WHO (2011) cut-off values. Results At baseline, age of participants was 13.5 ± 2.0 years; BMI 18.2 ± 3.0 kg/m2 (or 38th percentile BMI-for-age); hemoglobin 12.4 ± 1.1 g/dL, serum ferritin 54.2 ± 36.3 ng/mL, sTfR 3.7 ± 2.6 µg/mL, and CRP 1.2 ± 3.9 mg/L. 26.6% girls were clinically anemic (non-pregnant-Hb <12 g/dl), 19.9% of those were mildly anemic (non-pregnant-Hb: 11–11.9 g/dl), 5.9% were moderately anemic (non-pregnant-Hb: 8.0–10.9 g/dl) anemic, and 0.8% were severely anemic (<8.0 g/dL). We found 9.2% of girls were ID (serum ferritin <15 µg/l). Conclusions One-fourth of rural Bangladeshi adolescent girls were anemic, and one-tenth were ID. This shows that rural anemia prevalence has increased ∼8.5% (26.6% vs 18.1%), ID has slightly increased (9.2% vs 10.0%) and IDA has increased (6.1% vs 1.8%) over the 7 years since the Bangladesh National Micronutrients Status Survey 2011–12. We can conclude from these baseline data that Bangladesh has made poor progress in reducing adolescent girls’ anemia with public policy efforts. Funding Sources Global Institute for Food Security; Nutrition International.

scholarly journals Effect of an Iron-Fortified Complementary Food on Anemia and Nutritional Status of Infants Aged 6–18 Months in Ghana (P10-103-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Frederick Vuvor ◽  
Sir Paul ◽  
Richard Ansong ◽  
Rose Otema Baah ◽  
Daniel Amo Annor ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Complementary Food ◽  
Health Concern ◽  
Deficiency Anemia ◽  
Controlled Study ◽  
Socioeconomic Background ◽  
Double Blind ◽  
Funding Sources ◽  
Significant Difference ◽  
Cluster Randomized

Abstract Objectives Anemia remains widely prevalent in Ghana, affecting about 75% of children aged 6–23 months, with iron deficiency a common cause. The objective of this study was to assess the effect of a micronutrient-fortified complementary food on hemoglobin, anemia prevalence, and growth of infants in the La Nkwantanang Municipality of the Greater Accra Region, Ghana. Methods In this double-blind, cluster-randomized, controlled study, infants (aged 6–18 months) received either micronutrient-fortified infant cereal with iron (3.75 mg iron as ferrous fumarate/50 g cereal: INT, n = 107) or the same cereal without iron (CTL; n = 101) to complement other family foods and breast milk for a 6 month period. Recommended cereal intake differed by age (50 g/day for ages 6–8mo, 75 g/d for ages 9–11mo, and 100 g/d for ages 12–18mo). Hemoglobin (Hb), weight, height, and mid-upper arm circumference were assessed at baseline and every 2 months for 8 months. Infants’ usual dietary intake was assessed using questionnaires. Differences between groups were analyzed using ANCOVA, adjusted for potential confounders such as child's age, socioeconomic background of caregivers, worm infestation, and malaria. Results There were no significant differences between groups in maternal/household characteristics or infant baseline anthropometry. At 6 months, adjusted mean ± SE Hb change from baseline in CTL and INT was 1.16 ± 0.21 and 1.97 ± 0.19 g/dL, respectively (P < 0.01 for each); the increase over time was significantly larger in INT vs. CTL (0.68 ± 0.30 g/dL; P = 0.02). Similar results were found in unadjusted models. Hb levels declined slightly in both groups in the 2 month period after the intervention but remained higher in INT (Figure). Prevalence of anemia declined in both groups (CTL: 89.1% to 62.8%, INT: 84.1% to 42.8%); the magnitude of decrease was 57% greater in INT. There was no significant difference between groups in length gain (CTL: 6.24 ± 0.28, INT: 5.62 ± 0.27 cm; P = 0.21) or weight gain (CTL: 1.03 ± 0.24, INT: 1.31 ± 0.24 kg; P = 0.41). Conclusions Iron-fortified infant cereal consumed for 6 months promoted greater reductions in iron-deficiency anemia in infants aged 6–18 months, which is a public health concern in Ghana and most developing countries. Funding Sources This study was sponsored by Nestlé Company Limited (Ghana) in collaboration with the University of Ghana School of Biological Sciences. Supporting Tables, Images and/or Graphs

scholarly journals Consumption of a Double-Fortified Salt Affects Perceptual, Attentional, and Mnemonic Functioning in Women in a Randomized Controlled Trial in India

2017 ◽  
Vol 147 (12) ◽  
pp. 2297-2308 ◽  
Author(s):  
Michael J Wenger ◽  
Laura E Murray-Kolb ◽  
Julie EH Nevins ◽  
Sudha Venkatramanan ◽  
Gregory A Reinhart ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Status ◽  
Controlled Trial ◽  
Reproductive Age ◽  
Deficiency Anemia ◽  
Control Group ◽  
Attention And Memory ◽  
Double Blind ◽  
Iron Deficient ◽  
Mnemonic Function

Abstract Background: Iron deficiency and iron deficiency anemia have been shown to have negative effects on aspects of perception, attention, and memory. Objective: The purpose of this investigation was to assess the extent to which increases in dietary iron consumption are related to improvements in behavioral measures of perceptual, attentional, and mnemonic function. Methods: Women were selected from a randomized, double-blind, controlled food-fortification trial involving ad libitum consumption of either a double-fortified salt (DFS) containing 47 mg potassium iodate/kg and 3.3 mg microencapsulated ferrous fumarate/g (1.1 mg elemental Fe/g) or a control iodized salt. Participants' blood iron status (primary outcomes) and cognitive functioning (secondary outcomes) were assessed at baseline and after 10 mo at endline. The study was performed on a tea plantation in the Darjeeling district of India. Participants (n = 126; 66% iron deficient and 49% anemic at baseline) were otherwise healthy women of reproductive age, 18–55 y. Results: Significant improvements were documented for iron status and for perceptual, attentional, and mnemonic function in the DFS group (percentage of variance accounted for: 16.5%) compared with the control group. In addition, the amount of change in perceptual and cognitive performance was significantly (P < 0.05) related to the amount of change in blood iron markers (mean percentage of variance accounted for: 16.0%) and baseline concentrations of blood iron markers (mean percentage of variance accounted for: 25.0%). Overall, there was evidence that the strongest effects of change in iron status were obtained for perceptual and low-level attentional function. Conclusion: DFS produced measurable and significant improvements in the perceptual, attentional, and mnemonic performance of Indian female tea pickers of reproductive age. This trial was registered at clinicaltrials.gov as NCT01032005.

scholarly journals Safe and effective delivery of supplemental iron to healthy older adults: The double-blind, randomized, placebo-controlled trial protocol of the Safe Iron Study

2019 ◽  
Vol 3 ◽  
pp. 1510
Author(s):  
Erin D. Lewis ◽  
Dayong Wu ◽  
Joel B. Mason ◽  
Athar H. Chishti ◽  
John M. Leong ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Adverse Effects ◽  
Phase I ◽  
Ex Vivo ◽  
Iron Status ◽  
Controlled Trial ◽  
Double Blind ◽  
Sulfate Heptahydrate ◽  
Bacterial Proliferation ◽  
Forms Of Iron

The forms of iron currently available to correct iron deficiency have adverse effects, including infectious diarrhea, increased susceptibility to malaria, inflammation and detrimental changes to the gut microbiome. These adverse effects limit their use such that the growing burden of iron deficiency has not abated in recent decades. Here, we summarize the protocol of the “Safe Iron Study”, the first clinical study examining the safety and efficacy of novel forms of iron in healthy, iron-replete adults. The Safe Iron Study is a double-blind, randomized, placebo-controlled trial conducted in Boston, MA, USA. This study compares ferrous sulfate heptahydrate (FeSO4·H2O) with two novel forms of iron supplements (iron hydroxide adipate tartrate (IHAT) and organic fungal iron metabolite (Aspiron™ Natural Koji Iron)). In Phase I, we will compare each source of iron administrated at a low dose (60 mg Fe/day). We will also determine the effect of FeSO4 co-administrated with a multiple micronutrient powder and weekly administration of FeSO4. The forms of iron found to produce no adverse effects or adverse effects no greater than FeSO4 in Phase I, Phase II will evaluate a higher, i.e., a therapeutic dose (120 mg Fe/day). The primary outcomes of this study include ex vivo malaria (Plasmodium falciparum) infectivity of host erythrocytes, ex vivo bacterial proliferation (of selected species) in presence of host plasma and intestinal inflammation assessed by fecal calprotectin. This study will test the hypotheses that the novel forms of iron, administered at equivalent doses to FeSO4, will produce similar increases in iron status in iron-replete subjects, yet lower increases in ex vivo malaria infectivity, ex vivo bacterial proliferation, gut inflammation. Ultimately, this study seeks to contribute to development of safe and effective forms of supplemental iron to address the global burden of iron deficiency and anemia. Registration: ClinicalTrials.gov identifier: NCT03212677; registered: 11 July 2017.

scholarly journals Reducing Iron Content in Infant Formula from 8 to 2 mg/L Does Not Increase the Risk of Iron Deficiency at 4 or 6 Months of Age: A Randomized Controlled Trial

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 3
Author(s):  
Maria Björmsjö ◽  
Olle Hernell ◽  
Bo Lönnerdal ◽  
Staffan K. Berglund
Keyword(s):  
Breast Milk ◽  
Iron Deficiency ◽  
Infant Formula ◽  
Iron Content ◽  
Iron Status ◽  
Controlled Trial ◽  
Bovine Lactoferrin ◽  
High Concentration ◽  
Double Blind ◽  
Term Infants

Many infant formulas are fortified with iron at 8–14 mg/L whereas breast milk contains about 0.3 mg/L. Another major difference between breast milk and infant formula is its high concentration of lactoferrin, a bioactive iron-binding protein. The aim of the present study was to investigate how reducing the iron content and adding bovine lactoferrin to infant formula affects iron status, health and development. Swedish healthy full-term formula-fed infants (n = 180) were randomized in a double-blind controlled trial. From 6 weeks to 6 months of age, 72 infants received low-iron formula (2 mg/L) fortified with bovine lactoferrin (1.0 g/L) (Lf+), 72 received low-iron formula un-fortified with lactoferrin (Lf−) and 36 received standard formula with 8 mg of iron/L and no lactoferrin fortification as controls (CF). Iron status and prevalence of iron deficiency (ID) were assessed at 4 and 6 months. All iron status indicators were unaffected by lactoferrin. At 4 and 6 months, the geometric means of ferritin for the combined low-iron groups compared to the CF-group were 67.7 vs. 88.7 and 39.5 vs. 50.9 µg/L, respectively (p = 0.054 and p = 0.056). No significant differences were found for other iron status indicators. In the low-iron group only one infant (0.7%) at 4 months and none at 6 months developed ID. Conclusion: Iron fortification of 2 mg/L is an adequate level during the first half of infancy for healthy term infants in a well-nourished population. Adding lactoferrin does not affect iron status.

scholarly journals Safe and effective delivery of supplemental iron to healthy older adults: The double-blind, randomized, placebo-controlled trial protocol of the Safe Iron Study

2021 ◽  
Vol 3 ◽  
pp. 1510
Author(s):  
Erin D. Lewis ◽  
Dayong Wu ◽  
Joel B. Mason ◽  
Athar H. Chishti ◽  
John M. Leong ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Adverse Effects ◽  
Phase I ◽  
Ex Vivo ◽  
Iron Status ◽  
Controlled Trial ◽  
Double Blind ◽  
Sulfate Heptahydrate ◽  
Bacterial Proliferation ◽  
Forms Of Iron

The forms of iron currently available to correct iron deficiency have adverse effects, including infectious diarrhea, increased susceptibility to malaria, inflammation and detrimental changes to the gut microbiome. These adverse effects limit their use such that the growing burden of iron deficiency has not abated in recent decades. Here, we summarize the protocol of the “Safe Iron Study”, the first clinical study examining the safety and efficacy of novel forms of iron in healthy, iron-replete adults. The Safe Iron Study is a double-blind, randomized, placebo-controlled trial conducted in Boston, MA, USA. This study compares ferrous sulfate heptahydrate (FeSO4·H2O) with two novel forms of iron supplements (iron hydroxide adipate tartrate (IHAT) and organic fungal iron metabolite (Aspiron™ Natural Koji Iron)). In Phase I, we will compare each source of iron administrated at a low dose (60 mg Fe/day). We will also determine the effect of FeSO4 co-administrated with a multiple micronutrient powder and weekly administration of FeSO4. The forms of iron found to produce no adverse effects, or adverse effects no greater than FeSO4 in Phase I, Phase II will evaluate a higher, i.e., a therapeutic dose (120 mg Fe/day). The primary outcomes of this study include ex vivo malaria (Plasmodium falciparum) infectivity of host erythrocytes, ex vivo bacterial proliferation (of selected species) in presence of host plasma and intestinal inflammation assessed by fecal calprotectin. This study will test the hypotheses that the novel forms of iron, administered at equivalent doses to FeSO4, will produce similar increases in iron status in iron-replete subjects, yet lower increases in ex vivo malaria infectivity, ex vivo bacterial proliferation, gut inflammation. Ultimately, this study seeks to contribute to development of safe and effective forms of supplemental iron to address the global burden of iron deficiency and anemia. Registration: ClinicalTrials.gov identifier: NCT03212677; registered: 11 July 2017.

Study to Evaluate Efficacy of Vajravatakmaņdura in Iron Deficiency Anemia in Adolescent Girls: A Randomized Controlled Trial

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Rashmi Pareek Ayatullah Hosne Asif ◽  
Nisha Kumari Ojha
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Adolescent Girls ◽  
Controlled Trial ◽  
Control Programme ◽  
Deficiency Anemia ◽  
Group A ◽  
The Government ◽  
Trial Drug ◽  
And Control

Background: Anemia in adolescent girls possess greatest burden on their health as it leads to poor cognitive development, poor reproductive health and if not treated may lead to intrauterine growth retardation in their developing fetus. The prevalence of anemia among adolescent is 27% in developing country and 6% in developed country. The Government of India has launched National Anemia Control Programme, to prevent and control anaemia in children and adolescents. But the problem is still persisting because of many issues like - poor palatability, intolerance to the drug used, poor absorption of the drugs used, constipation, discoloration of stool, unpleasant odor and taste etc. result in poor compliance and therefore non adherence to the therapy which finally results in poor improvement. By looking at the magnitude of the problem, an Ayurveda drug Vajravatakmandura has been selected for the study and the present study was undertaken to evaluate the efficacy of the trial drug in iron deficiency anemia in adolescent girls. Material and methods: 100 subjects satisfying inclusion and exclusion criteria were selected and were randomly divided in two groups. In group A, the trial drug Vajravatakmaņdura was administered and in group B, IFA tablets were given for two month of duration with follow up at every fortnight. Result: Both the trial and control groups showed extremely significant result over subjective parameters. Trial drug Vajravatakmaņdura in group A was found more effective over the subjective parameters - weakness, palpitation, pallor and loss of appetite with % gain of 39.77%, 39.39%, 39.17%, 38.09% respectively. Statistical analysis between before and after treatment findings of objective parameters, extremely significant (P less than 0.0001) improvement was found in both groups in all parameters, except for RBC count in group A, which was significant. No adverse effects were reported during entire period of study by any of the patients in trial group treated with trial drug. Conclusion: The trial drug “Vajravatakmandura” is effective, safe and palatable for the management of iron deficiency anemia in adolescent girls.

‘No one ever asked us’: a feasibility study assessing the co-creation of a physical activity programme with adolescent girls

2019 ◽  
Vol 27 (3) ◽  
pp. 34-43
Author(s):  
Méabh Corr ◽  
Elaine Murtagh
Keyword(s):  
Physical Activity ◽  
Data Collection ◽  
Behaviour Change ◽  
Adolescent Girls ◽  
Retention Rate ◽  
Controlled Trial ◽  
Activity Level ◽  
Health Concern ◽  
Post Intervention ◽  
Behaviour Change Wheel

Background: Globally, the poor activity level of adolescent girls is a public health concern. Little research has involved adolescents in the design of interventions. This study assessed the feasibility of involving girls in the co-creation of an activity programme. Methods: Thirty-one students (15–17 years old) were recruited from a post-primary school. The Behaviour Change Wheel guided intervention design, providing insights into participants’ capability, opportunity and motivation for change. Step counts and self-reported physical activity levels were recorded pre- and post-intervention. Feasibility benchmarks assessed recruitment, data collection, acceptability and adherence. Results: Activity and educational sessions were delivered for six weeks during physical education class. Average attendance was 87% (benchmark = 80%). Eligibility was 61% (benchmark = 60%). There was a 100% retention rate (benchmark = 90%). All participants ( n = 31) completed baseline measures and 71% ( n = 22) completed post-measures. 54% ( n = 17) of students completed pedometer measurements, with 32% ( n = 10) having complete data. Average daily steps were 13,121 pre-intervention and 14,128 post-intervention ( p > 0.05). Data collection was feasible, receiving a mean score > 4/5 (benchmark > 3.5/5). Conclusions: The Behaviour Change Wheel can be used to co-create an activity programme with adolescent girls. Predetermined benchmarks, except for pedometer recordings, were reached or exceeded, providing evidence for the need of a randomised controlled trial to test effectiveness.

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