Effectiveness of fortification of corn flour-derived products with hydrogen-reduced elemental iron on iron-deficiency anaemia in children and adolescents in southern Brazil

Miglioranza, Lucia H. S.; Breganó, José Wander; Dichi, Isaías; Matsuo, Tiemi; Dichi, Jane Bandeira; Barbosa, Décio Sabbatini

doi:10.1017/s1368980008003704

Cited by 10 publications

(8 citation statements)

References 28 publications

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“…Of these, 121 [25-145] studies were on infants and children and 79 [146-224] were on women, while one study had both women and children as their study population [33] (Figure 2). Furthermore 125 [25-28,30,32-39,41-44,47,48,51,53],[54,56,59,60,62,63,65-73,75-77],[81-83,85,86,88-90,92,93,95-104,107-109],[111-117,119-127,129,130,132-136,139-144,223,225-228] of these trials were RCTs; the rest were quasi-experimental [46,55,61,74,78,87,91] and before-after studies [29,31,40,45,49,50,52,57],[58,79,80,84,94,95,105,131],[137,138,149,150,153,157,159-169,172],[174,177,181,183-186,189-191,193,195-…”

Section: Resultsmentioning

confidence: 99%

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Micronutrient fortification of food and its impact on woman and child health: a systematic review

2013

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BackgroundVitamins and minerals are essential for growth and metabolism. The World Health Organization estimates that more than 2 billion people are deficient in key vitamins and minerals. Groups most vulnerable to these micronutrient deficiencies are pregnant and lactating women and young children, given their increased demands. Food fortification is one of the strategies that has been used safely and effectively to prevent vitamin and mineral deficiencies.MethodsA comprehensive search was done to identify all available evidence for the impact of fortification interventions. Studies were included if food was fortified with a single, dual or multiple micronutrients and impact of fortification was analyzed on the health outcomes and relevant biochemical indicators of women and children. We performed a meta-analysis of outcomes using Review Manager Software version 5.1.ResultsOur systematic review identified 201 studies that we reviewed for outcomes of relevance. Fortification for children showed significant impacts on increasing serum micronutrient concentrations. Hematologic markers also improved, including hemoglobin concentrations, which showed a significant rise when food was fortified with vitamin A, iron and multiple micronutrients. Fortification with zinc had no significant adverse impact on hemoglobin levels. Multiple micronutrient fortification showed non-significant impacts on height for age, weight for age and weight for height Z-scores, although they showed positive trends. The results for fortification in women showed that calcium and vitamin D fortification had significant impacts in the post-menopausal age group. Iron fortification led to a significant increase in serum ferritin and hemoglobin levels in women of reproductive age and pregnant women. Folate fortification significantly reduced the incidence of congenital abnormalities like neural tube defects without increasing the incidence of twinning. The number of studies pooled for zinc and multiple micronutrients for women were few, though the evidence suggested benefit. There was a dearth of evidence for the impact of fortification strategies on morbidity and mortality outcomes in women and children.ConclusionFortification is potentially an effective strategy but evidence from the developing world is scarce. Programs need to assess the direct impact of fortification on morbidity and mortality.

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Section: Resultsmentioning

confidence: 99%

“…A total of 41 [25,26,28,30-32,35,39,48,49],[54,56,57,65,70,77,80,81],[83,85,88,89,97,99,101,104],[106-108,112-114,116,120,124,126],[127,129,135,136,139] studies reported outcomes for impact of iron fortification. Four of the studies were before-after studies and the rest were RCTs.…”

Section: Resultsmentioning

confidence: 99%

Micronutrient fortification of food and its impact on woman and child health: a systematic review

2013

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“…Nutrients are often added in combinations, but nutritional improvements can be achieved using single nutrients. For example, maize flour fortified with powdered iron (as Fe(II)) decreased iron deficiency and iron‐related anemia in Brazilian children and adolescents in 6 mo (Miglioranza and others 2009). Adding folic acid to U.S. maize flour at 140 μg/100 g, effectively increased Mexican American women's intake by 20%.…”

Section: Current Trends In Improving Nutritional Quality Of Maizementioning

confidence: 99%

Maize: A Paramount Staple Crop in the Context of Global Nutrition

Nuss¹,

Tanumihardjo²

2010

Comp Rev Food Sci Food Safe

508

350

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The maize plant (Zea mays), characterized by an erect green stalk, is one of the 3 great grain crops of the world. Its kernels, like other seeds, are storage organs that contain essential components for plant growth and reproduction. Many of these kernel constituents, including starch, protein, and some micronutrients, are also required for human health. For this reason, and others, maize has become highly integrated into global agriculture, human diet, and cultural traditions. The nutritional quality and integrity of maize kernels are influenced by many factors including genetic background, environment, and kernel processing. Cooking procedures, including nixtamalization and fermentation, can increase accessibility of micronutrients such as niacin. However, man cannot live on maize alone. For one‐third of the world's population, namely in sub‐Saharan Africa, Southeast Asia, and Latin America, humans subsist on maize as a staple food but malnutrition pervades. Strategies to further improve kernel macronutrient and micronutrient quality and quantities are under intense investigation. The 2 most common routes to enhance grain nutritional value are exogenous and endogenous fortification. Although exogenous fortification, such as addition of multivitamin premixes to maize flour, has been successful, endogenous fortification, also known as “biofortification,” may provide a more sustainable and practical solution for chronically undernourished communities. Recent accomplishments, such as low‐phytate, high‐lysine, and multivitamin maize varieties, have been created using novel genetic and agronomic approaches. Investigational studies related to biofortified maize are currently underway to determine nutrient absorption and efficacy related to human health improvement.

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“…Özellikle çocukluk döneminde geliflme ve büyümeye olumsuz etkiler yapt›¤› iyi bilinmektedir (2)(3)(4). Bu olumsuz etkilerden korunmak için 4 ay-1 yafl aras› bebeklere koruyucu dozda demir verilmesi gerekti¤i önerilmektedir (5).…”

Section: Giriflunclassified

“…Baz› çal›flmalarda ise koruyucu demir verilmesinin alt›nc› aydan bafllanarak dokuzuncu aya kadar devam edilmesi gerekti¤i belirtilmektedir (18 Bizim çal›flmam›z dördüncü ay sonras›nda koruyucu doz demir verilmesi gerekti¤i tezini desteklemektedir. Ayr›ca Amerikan Çocuk Akademisi de bebeklere dördüncü aydan itibaren 1 mg/kg/gün demir deste¤i verilmesini önermektedir (2)(3)(4). Ancak ebeveynler demir ilac›n› vermeyi ya unutmakta, ya önemsememekte ya da her gün vermek aile için s›k›nt› verebilmektedir.…”

Section: Tart›flmaunclassified

Daily and every other day use of iron prophylaxis in the first year of life

Arıca¹,

Arıca²,

Tutanç³

et al. 2010

tpa

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K Ko or ru uy yu uc cu u d de em mi ir r d do oz zu un nu un n h ha ay ya at t› ›n n i il lk k y y› ›l l› ›n nd da a g gü ün nl lü ük k v ve e g gü ün na afl fl› ›r r› › k ku ul ll la an n› ›m m› › D Da ai il ly y a an nd d e ev ve er ry y o ot th he er r d da ay y u us se e o of f i ir ro on n p pr ro op ph hy yl la ax xi is s i in n t th he e f fi ir rs st t y ye ea ar r o of f l li if fe e V Ve ef fi ik k A Ar r› ›c ca a, , S Se eç çi il l A Ar r› ›c ca a* *, , M Mu ur ra at t T Tu ut ta an nç ç, , S Se ed da at t M Mo ot to or r* ** *, , H Ha at ti ic ce e O On nu ur r* ** ** *, , M Mu ur ra at t D Do o¤ ¤a an n* ** ** ** * S Su um mm ma ar ry yAim: In countries like Turkey where iron deficiency anemia (IDA) is common, it was that iron prophylaxis can be used every other day as intermittent because it would show the same effect and easier for compliance. Material and Method: Two groups of infants born healthy, breastfed exclusively for the first six months and given 400 IU vitamin D were included in the study. In the fourth month of their life, infants started to take iron (Fe +2) 1 mg/kg/day and the second group 2 mg/kg/48 h In use of daily 1 mg/kg/day dose as of the fourth month till the first year 75 patients (the first group), in use of 2 mg/kg/48 h 80 patients (the second group) were involved in our study group. 34 infants (the third group) who did not start to take iron prophylaxis or use any was taken in our study as a control group. Results: It was found out that in the first group 14 infants (18.6%) developed iron deficiency (ID), 3 infants (4%) iron deficiency anemia (IDA), in the second group 16 infants (20%) developed ID and 4 infants (5%) IDA, in the third group, namely in the control group 12 infants (35,3%) developed ID and 10 infants (29.4%) IDA. In comparison of the control group with the first and second groups, IDA portion was less in iron prophylaxis groups, this value was found statistically reliable (p=0.001). When the first and second groups were compared with one another, a statistical difference could not be found between ID/IDA proportions. Because ID and IDA were encountered in both prophylaxis groups it was assumed that iron prophylaxis given just during the first year of life should also be given afterwards. Conclusions:There is no statistical difference between the first and second prophylaxis groups, thus, it was considered that instead of daily use, taking iron every other day would be more effective when it was given in a proper dose. (

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Effectiveness of fortification of corn flour-derived products with hydrogen-reduced elemental iron on iron-deficiency anaemia in children and adolescents in southern Brazil

Cited by 10 publications

References 28 publications

Micronutrient fortification of food and its impact on woman and child health: a systematic review

Micronutrient fortification of food and its impact on woman and child health: a systematic review

Maize: A Paramount Staple Crop in the Context of Global Nutrition

Daily and every other day use of iron prophylaxis in the first year of life

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