Domestic Drinking Water—An Effective Way to Prevent Anemia among Low Socioeconomic Families in Brazil

Abstract

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.

Randomized Controlled Trial of Iron-Fortified Drinking Water in Preschool Children

“…This is different from that observed by other authors who do not report changes in taste with doses $10 mg Fe/L, which may be a limiting factor for children's adherence [10,12]. Improvement in Hb levels in group C is in agreement with previous studies that used fortified drinking water with 10 mg Fe/ L doses; however, these studies used iron associated with ascorbic acid [11][12][13][14]. Studies evaluating the use of 5 and 7.5 mg are not available in the literature.…”

“…Children with hemoglobin $9.5-11.0 g/dL, despite presenting some degree of anemia, were not excluded, as drinking-water fortification has been shown in previously published studies [10][11][12][13][14] to be an effective form of treatment for moderate anemia.…”

“…None of the studies were double-blind or randomized, and only 2 had a placebo control group [11,14]. Four of these studies describe the fortification of water with ascorbic acid [11][12][13][14]. The quantity of iron used in these studies was also different-20 mg Fe/L in one study [10], 12 mg Fe/L in another study [12], and 10 mg Fe/L in the other 3 studies [11,13,14].…”

“…In 5 studies published starting from 1994 [10][11][12][13][14], the authors describe improvement in nutritional status in terms of iron, when a single concentration of iron was used. None of the studies were double-blind or randomized, and only 2 had a placebo control group [11,14]. Four of these studies describe the fortification of water with ascorbic acid [11][12][13][14].…”

“…Four of these studies describe the fortification of water with ascorbic acid [11][12][13][14]. The quantity of iron used in these studies was also different-20 mg Fe/L in one study [10], 12 mg Fe/L in another study [12], and 10 mg Fe/L in the other 3 studies [11,13,14]. Despite the fact that these studies were technically well designed and significant results were obtained, a randomized, double-blind study with a placebo control is needed that will evaluate the addition of different concentrations of iron to water to achieve optimal adherence, without other products that could enhance absorption.…”