Fortification of drinking water with iron has previously demonstrated effectiveness in increasing iron supplies. This simple strategy was confirmed in the present study. The present study also demonstrated that for populations receiving an abundant supply of non-heme iron, it is possible to control anemia in a simple, safe, and inexpensive manner by adding ascorbic acid to drinking water.
Iron deficiency and iron-deficiency anemia are common in the developing world. We evaluated the feasibility of iron fortification of domestic drinking water to prevent and control iron deficiency and iron-deficiency anemia. Twenty-one families representing 88 persons, including children, were selected to participate in this study. Twelve families added an iron solution plus ascorbic acid to their domestic drinking water over a four months period and nine families added a placebo. Blood samples were collected, before and after the four months, for hemoglobin and serum ferritin measurements. Iron-fortified drinking water increased hemoglobin (children 10.9 ±1.1 g/dl to 11.
Anemia and iron deficiency should receive special attention considering their high prevalence and serious consequences. For prevention, globally it is recommended to increase dietary iron intake, iron fortification of industrialized foods, and medical iron supplementation.
Food fortification for the prevention of iron deficiency in developing countries should consider carriers locally available and consumed daily, requiring limited infrastructure and technology. Drinking water is the iron carrier we have been working for years for the prevention of iron deficiency and anemia in small children in Brazil. It was shown that studies with iron-fortified drinking water were proved to be effective on children's anemia prevention. Water is found everywhere, consumed daily by everyone may be easily fortified with simple technology, is low priced and was effective on the prevention of children's anemia. Fortification of drinking water with iron was locally implemented with the direct participation of the government and community. Government authorities, health personnel and population were part of the project and responsible for its community implementation. The mayor/municipality permitted and supported the proposal to supply it to children at their day-care centers. To keep the children drinking water iron fortified supply an officially authorized legislation was also approved.
OBJETIVOS: Com a finalidade de preparar um programa municipal de fortificação da água de beber com ferro, foi realizado levantamento antropométrico e do estado nutricional de ferro das crianças institucionalizadas nas cinco creches de período integral da cidade de Jardinópolis, São Paulo. MÉTODOS: Em estudo transversal, foram avaliadas 184 crianças com idades entre 12 e 59,9 meses, no período entre 1º e 31 de agosto de 2006. De cada criança, foram obtidos dados pessoais, peso, estatura e colhida amostra de sangue para dosagem de hemoglobina, volume corpuscular médio (VCM), índice de saturação da transferrina (IST) e o red cell distribution width (RDW). RESULTADOS: A prevalência global de anemia foi de 29,3% e a média de hemoglobina de 11,5g/dL. Deficiência de ferro foi observada em 75% das crianças. As prevalências de deficit (escore Z <-2) para os indicadores peso para idade, estatura para idade e peso para estatura foram de respectivamente 1,6%, 0,5% e 4,3%. A prevalência de obesidade (escore Z de peso para estatura >2) foi de 2,2%. CONCLUSÕES: Apesar de inferior a outros estudos brasileiros, a prevalência de anemia mostrou-se elevada. A antropometria mostrou que a oferta de macronutrientes está bastante próxima do ideal, mas a elevada prevalência de crianças deficientes em ferro indica a necessidade da adoção de medidas para aprimorar a oferta de ferro.
Water fortification is efficient in controlling iron deficiency and anemia. Iron stores' recovery depends on a more effective offer of iron. Water fortification must be preceded by a careful assessment of the previous nutritional status.
Results demonstrate that beta-carotene added to soybean oil used in the preparation of rice is absorbed, heated or not, and could be a practical source of provitamin A. Developing countries looking for strategies to increase vitamin A intake could use fortification of vegetable oils with synthetic beta-carotene as a simple method.
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