Efeito da fortificação semanal do arroz com ferro quelato sobre a freqüência de anemia e concentração de hemoglobina em crianças de creches municipais do Rio de Janeiro, Brasil

Abstract

Trata-se de um ensaio clínico comunitário, duplo-cego, controlado por placebo. Durante 16 semanas, as crianças do grupo intervenção (GI, n = 180) receberam arroz fortificado com ferro, e as do grupo controle (GC, n = 174) receberam arroz com placebo. Considerou-se presença de anemia quando hemoglobina < 11,0g/dL. A comparação da variação média na hemoglobina intergrupos, ajustada por idade e uso de outros suplementos de ferro, foi feita pelo teste t de Student. A concentração de hemoglobina aumentou em ambos os grupos, com incremento médio de 0,42g/dL no GI (11,28±1,23g/dL para 11,75±1,16g/dL; p < 0,001) e de 0,49g/dL no GC (11,06±1,13g/dL para 11,51±1,16g/dL; p < 0,001). A freqüência de anemia reduziu (p < 0,01) em ambos os grupos (37,8% para 23,3% em GI e 45,4% para 33,3% em GC), sem diferença entre os mesmos. As crianças que receberam quantidade total de ferro > 53,76mg pelo arroz fortificado tiveram maior aumento na hemoglobina do que aquelas que receberam quantidades inferiores (0,94g/dL vs. 0,39g/dL; p = 0,03). Sugere-se que esse tipo de intervenção pode ser útil no controle da anemia quando o consumo do alimento fortificado é adequado.

Anemia em gestantes brasileiras antes e após a fortificação das farinhas com ferro

“…The minimum sample size for each group in each study site was calculated using the formula n=Zα 2 Hb level data referred to the test performed at the time of the woman's fi rst prenatal care visit. This was true also for women who began prenatal care during the second or third trimesters.…”

“…Although a number of quasi-experimental studies carried out in Brazil have provided evidence of the effi cacy of fl our fortifi cation in controlling anemia in children, 2,4,9,12,17,22 only very few studies evaluate the impact of nutritional programs in the fi eld.…”

Multidimensional approach to iron de ciency anemia in infants younger than two years old in Northeast Argentina. 2004-2005

“…Other authors who assessed food consumption in infant populations who have a high prevalence of anemia showed that children who had fortified food had a lower prevalence of anemia. [16][17][18][19]26 Once again, this underscores the importance of feeding in this age group.…”

“…This evidences the beneficial effects of food assistance programs on infant health, already demonstrated in other studies conducted in Latin America. [16][17][18][19] However, it is worth noting that, in Argentina, following the 2001 economic crisis, traditional food policies (e.g., programs that distributed bags or boxes of groceries among households) were concurrent with the implementation of the food fortification law (Law no. 25630), 20 which established mandatory wheat flour fortification with iron and folic acid.…”

Iron Food Fortification for the Control of Childhood Anemia in Brazil

“…It was observed an increase in hemoglobin concentration in both groups, with the reduction in the prevalence of anemia in the intervention group was 37.8% to 23.3% and for the control group was 45.4% for 33, 3%, with no difference in reduction between the groups. According to the authors, the total amount of iron available was not sufficient to achieve more significant results in the intervention group, after four months of study (Bagni et al, 2009). The other study was conducted with families in the metropolitan area of Belo Horizonte.…”