Efficacy of iron-supplement bars to reduce anemia in urban Indian women: a cluster-randomized controlled trial ,

Abstract

India's high prevalence of iron-deficiency anemia has largely been attributed to the local diet consisting of nonheme iron, which has lower absorption than that of heme iron. We assessed the efficacy of the consumption of iron-supplement bars in raising hemoglobin concentrations and hematocrit percentages in anemic (hemoglobin concentration <12 g/dL) Indian women of reproductive age. The Let's be Well Red study was a 90-d, pair-matched, cluster-randomized controlled trial. A total of 361 nonpregnant women (age 18-35 y) were recruited from 10 sites within Mumbai and Navi Mumbai, India. All participants received anemia education and a complete blood count (CBC). Random assignment of anemic participants to intervention and control arms occurred within 5 matched site-pairs. Intervention participants received 1 iron-supplement bar (containing 14 mg Fe)/d for 90 d, whereas control subjects received nothing. CBC tests were given at days 15, 45, and 90. Primary outcomes were 90-d changes from baseline in hemoglobin concentrations and hematocrit percentages. Linear mixed models and generalized estimating equations were used to model continuous and binary outcomes, respectively. Of 179 anemic participants, 136 (76.0%) completed all follow-up assessments (65 intervention and 71 control participants). Baseline characteristics were comparable by arm. Mean hemoglobin and hematocrit increases after 90 d were greater for intervention than for control participants [1.4 g/dL (95% CI: 1.3, 1.6 g/dL) and 2.7% (95% CI: 2.2%, 3.2%), respectively]. The anemia prevalence at 90 d was lower for intervention (29.2%) than for control participants (98.6%) (OR: 0.007; 95% CI: 0.001, 0.04). The daily consumption of an iron-supplement bar leads to increased hemoglobin concentrations and hematocrit percentages and to a lower anemia prevalence in the target population with no reported side effects. This intervention is an attractive option to combat anemia in India. This trial was registered at clinicaltrials.gov as NCT02032615.

Effectiveness of Dietary Interventions to Treat Iron-Deficiency Anemia in Women: A Systematic Review of Randomized Controlled Trials

“…The general characteristics of the randomized controlled trials included in the systematic review [25][26][27][28][29][30][31][32][33][34][35][36][37][38] is presented in Table 3. The included randomized controlled trials presented the effectiveness of the dietary intervention assessed within the study and were compared with the effectiveness of supplementation [25,26,35], placebo [25,27,32,33], control [25,26,28,34,35,37,38], or other dietary approach [29][30][31]36]. The studies were conducted mainly in samples of young women [30,[32][33][34][36][37][38] or young to middle-aged women [25][26][27][28][29]31], while one study was conducted in a group of adolescent girls [35]…”

“…The included randomized controlled trials presented the effectiveness of the dietary intervention assessed within the study and were compared with the effectiveness of supplementation [25,26,35], placebo [25,27,32,33], control [25,26,28,34,35,37,38], or other dietary approach [29][30][31]36]. The studies were conducted mainly in samples of young women [30,[32][33][34][36][37][38] or young to middle-aged women [25][26][27][28][29]31], while one study was conducted in a group of adolescent girls [35]. The studied individuals were described as those with iron deficiency/anemia [25][26][27]35,38] or low iron stores [28][29][30][31][32][33][34]36,37].…”

“…The studies were conducted mainly in samples of young women [30,[32][33][34][36][37][38] or young to middle-aged women [25][26][27][28][29]31], while one study was conducted in a group of adolescent girls [35]. The studied individuals were described as those with iron deficiency/anemia [25][26][27]35,38] or low iron stores [28][29][30][31][32][33][34]36,37]. The studies were conducted mainly in developed countries, such as Spain [33][34][35], Denmark [28,29], the United States of America [36], Australia [26], or New Zealand [25,31], but also in India [35,38], Mexico [27], and Rwanda [37].…”

“…The studied individuals were described as those with iron deficiency/anemia [25][26][27]35,38] or low iron stores [28][29][30][31][32][33][34]36,37]. The studies were conducted mainly in developed countries, such as Spain [33][34][35], Denmark [28,29], the United States of America [36], Australia [26], or New Zealand [25,31], but also in India [35,38], Mexico [27], and Rwanda [37].…”

Terapi Pemberian Besi pada Penderita Anemia Defisiensi Besi

“…Terdapat empat garam besi yang dapat diberikan secara oral yaitu sulfat, glukonat, fumarat, dan suksinat. Dosis pemberian besi tersebut sesuai dengan penelitian yang telah dilakukan oleh Mehta et al 13 yang menggunakan suplemen zat besi (mengandung 14 mg Fe)/hari selama 90 hari, dengan hasil hemoglobin dan hematokrit meningkat setelah 90 hari lebih besar untuk peserta intervensi dibandingkan untuk peserta kontrol. Menurut Das et al, 12 pemberian terapi besi secara oral 100 mg/tablet sulfat besi sebanyak 2 kali sehari selama 1 bulan.…”