Haematological response to haem iron or ferrous sulphate mixed with refried black beans in moderately anaemic Guatemalan pre-school children

Abstract

Objective: Combating iron deficiency in toddlers with iron-fortified food has proved difficult in countries with phytate-rich diets. For this purpose, a new haem iron preparation was developed. The study compared changes in iron status after administration of refried beans with beans fortified with a haem iron preparation or ferrous sulphate (FeSO 4 ). Design: In a masked, stratified-randomised intervention trial, children received five 156-g cans of refried black beans per week for 10 consecutive weeks. The beans-only (control), FeSO 4 and haem iron groups were offered a cumulative dose of 155 mg, 1625 mg and 1700 mg of iron from the bean intervention, respectively. Haemoglobin (Hb) and ferritin concentrations were determined at baseline and after 5 and 10 weeks. Compliance was examined weekly.

Efficacy and safety of twice-weekly administration of three RDAs of iron and folic acid with and without complement of 14 essential micronutrients at one or two RDAs: a placebo-controlled intervention trial in anemic Cambodian infants 6 to 24 months of age

“…Implications in this study come as a further reminder in a growing chain of evidence in young children around the world that much less than 100% of anemia is attributable to iron deficiency or responsive to iron administration (Allen et al, 2000;Asobayire et al, 2001;Verhoef et al, 2001;Zlotkin et al, 2001;Schümann et al, 2005). In accordance with earlier experiences (Allen et al, 2000;Zlotkin et al, Figure 4 Differences in prevalence between iron-deficiency anemia (IDA) and non-iron-deficiency anemia (non-IDA) between baseline and study end: Each column represents the percentage of nonanemic children (black), children with IDA (hatched) and with non-IDA (white).…”

“…Sample size estimation was based on our results of earlier studies of children of comparable age from Guatemala City (Dewey et al, 1997;Schümann et al, 2005). We argued that sample sizes of 30 and 100 children per cohort would suffice to detect a difference in hemoglobin increases of 12.5 or 5%, respectively, at a significance level of 5% with a power of 80% (two-sided testing).…”

“…Iron and multi-micronutrient supplementation in Cambodian infants K Schümann et al 2001; Schümann et al, 2005), non-IDA did not respond markedly to iron supplementation. The entire lack of any response of non-IDA prevalence to the four-weekly RDAs of vitamin B12 and riboflavin, and the two-weekly RDAs of vitamin A provided by the FeMMN seems to suggest that micronutrients deficiency may not be the cause of non-IDA.…”

“…Moreover, iron in complementary foods to which most infants are weaned has a poor biological availability (Dallman et al, 1981;Brown et al, 1998). However, there is increased awareness that a large fraction of anemias in children is not related to iron-deficiency (Allen et al, 2000;Asobayire et al, 2001;Zlotkin et al, 2001;Schümann et al, 2005), but possibly to deficiencies in other micronutrients, such as folate (Institute of Medicine, 1998), vitamins B12 (Herbert, 1973), B2 (Powers, 2003), vitamin A (Semba and Bloem 2002) or copper (Hoffman et al, 1988). Moreover, there are adverse consequences for infant development from iron-deficiency anemia, such as cognitive deficits and a compromised host-defense immunity (Chandra and Kumari, 1994;Bhaskaram, 2002;Algarin et al, 2003;Failla, 2003).…”

Effectiveness of antioxidants in preventing oxidation of palm oil enriched with heme iron: A model for iron fortification in baked products

“…Among the different iron compounds that can be used, heme iron has a particularly high bioavailability, which is higher than that of inorganic iron mainly because the inhibition of heme iron absorption by food ligands is low [2], and also their absorption process is different [3]. As a result, trials have taken place to fortify different foods such as biscuits [4,5], cookie fillings [6], weaning foods [7], flour [8], and black beans [9] with heme iron.…”