Fortification of sugar with iron sodium ethylenediaminotetraacetate (FeNaEDTA) improves iron status in semirural Guatemalan populations

Abstract

A 32-mo-long, double-blind field study involving one highland control community receiving only vitamin A-fortified sugar and three vitamin A- and FeNaEDTA-sugar-fortified communities, two in the lowlands and one in the highlands of Guatemala, was undertaken to test the effectiveness of this approach in controlling iron deficiency. The communities' population ranged between 1200 and 17000. Sugar fortified with 1 g FeNaEDTA and 15 mg retinol as retinyl palmitate/kg was stable, did not segregate, and was well accepted by the communities. The impact of fortification on iron nutrition was estimated at 8, 20, and 32 mo of intervention. All pregnant women and subjects with severe anemia received supplements or treatment and were excluded from the analysis. Iron stores in the fortified communities increased significantly except for women 18-48 y of age in one lowland community and > 49 y in the highland community. Iron stores in the control community remained unchanged except for a rise among adult males.

The importance of bioavailability of dietary iron in relation to the expected effect from iron fortification

“…On the other hand, successful iron fortification interventions have been conducted in Morocco (Zimmermann et al, 2004), Vietnam (Thuy et al, 2003;Van Thuy et al, 2005), Chile (Hertrampf et al, 1990;Walter et al, 1993), Ghana (Lartey et al, 1999), Venezuela (Layrisse et al, 1996), Guatemala (Viteri et al, 1995) and India (Ballot et al, 1989). However, with a few exceptions the majority of these successful interventions have actually also included encapsulation (Zimmermann et al, 2004) or dietary bioavailability improvements, in the form of ethylenediamine tetraacetic acid (EDTA) (Ballot et al, 1989;Viteri et al, 1995;Thuy et al, 2003;Van Thuy et al, 2005), fish powder (Lartey et al, 1999) or/and ascorbic acid (Hertrampf et al, 1990;Walter et al, 1993) as well. This makes the interpretation of the effects of the iron fortification alone difficult.…”

Efeito da fortificação de alimentos com ferro sobre anemia em crianças: um estudo de revisão

“…Dos 11 estudos internacionais 20,21,22,23,24,25,26,27,28,29,30 incluídos nesta revisão, nove foram randomizados 20,21,22,23,25,27,28,29,30 , um do tipo quase-experimental e outro uma avaliação transversal. Dos dez nacionais 31,32,33,34,35,36,37,38,39,40 , nove foram do tipo antes e depois e apenas um foi randomizado 39 .…”

“…No Chile, Hertrampf et al 20 20 Hertrampf et al 21 Olivares et al 22 Walter et al 23 Walter et al 24 Viteri et al 25 Layrisse et al 26 Leite em pó 22 estudaram o efeito sobre o status de ferro da utilização de biscoitos produzidos com farinha de trigo fortificada com 6% de concentrado de hemoglobina bovina. Inicialmente, 427 escolares de seis a doze anos de duas escolas situadas em comunidades de baixa renda em Santiago, no Chile, foram incluídos no estudo.…”

“…Apesar da baixa prevalência de anemia em ambos os grupos, houve diferença significativa na concentração de hemoglobina e ferritina sérica, favorecendo as crianças que consumiram biscoitos fortificados após três anos de intervenção. Na Guatemala, Viteri et al 25 conduziram um estudo controlado, randomizado, duplo cego, envolvendo quatro comunidades semi-rurais de baixa renda. Uma comunidade recebeu açúcar fortificado com vitamina A (comunidade contro-le) e três receberam açúcar fortificado com vitamina A e ferro (etileno diamino tetra acetato -EDTA de ferro e sódio, na quantidade de 1g/kg de açúcar).…”

Effects of Iron Supplementation on Auditory Brainstem Response in Marginally LBW Infants

“…It is also chemically stable, which allows for long storage of foods. Condiments such as curry powder in South Africa have been successfully fortified with iron-EDTA, as has sugar in Guatemala (110). However, additional information is needed on its efficacy and safety before it can be recommended.…”