Iron biofortification interventions to improve iron status and functional outcomes

Abstract

This analysis was conducted to evaluate the evidence of the efficacy of iron biofortification interventions on iron status and functional outcomes. Iron deficiency is a major public health problem worldwide, with a disproportionate impact on women and young children, particularly those living in resource-limited settings. Biofortification, or the enhancing of micronutrient content in staple crops, is a promising and sustainable agriculture-based approach to improve nutritional status. Previous randomised efficacy trials and meta-analyses have demonstrated that iron-biofortification interventions improved iron biomarkers; however, no systematic reviews to date have examined the efficacy of biofortification interventions on health outcomes. We conducted a systematic review of the efficacy of iron-biofortified staple crops on iron status and functional outcomes: cognitive function (e.g. attention, memory) and physical performance. Five studies from three randomised efficacy trials (i.e. rice, pearl millet, beans) conducted in the Philippines, India and Rwanda were identified for inclusion in this review. Iron status (Hb, serum ferritin, soluble transferrin receptor, total body iron, α-1-acid glycoprotein) was measured at baseline and endline in each trial; two studies reported cognitive outcomes, and no studies reported other functional outcomes. Meta-analyses were conducted using DerSimonian and Laird random-effects methods. Iron-biofortified crop interventions significantly improved cognitive performance in attention and memory domains, compared with conventional crops. There were no significant effects on categorical outcomes such as iron deficiency or anaemia. Further studies are needed to determine the efficacy of iron-biofortified staple crops on human health, including additional functional outcomes and other high-risk populations.

Iron, Zinc and Phytic Acid Retention of Biofortified, Low Phytic Acid, and Conventional Bean Varieties When Preparing Common Household Recipes

“…Studies conducted to date on the iron bioaccessibility and bioavailability from (iron biofortified) beans have been using Caco-2 cell models, in vitro digestion models [15][16][17][18][19][20][21], poultry studies [16,[20][21][22][23][24], and human feeding trials [25][26][27][28]. These studies show the influence of specific polyphenols on iron bio-accessibility and bioavailability depending on the type of bean.…”

Can Improved Legume Varieties Optimize Iron Status in Low- and Middle-Income Countries? A Systematic Review

“…More specifically, comparison of improved beans alongside other improved grains (e.g. pearl millet and rice) suggests strong evidence on the efficacy of improved beans in repletion, maintenance of iron status and some functional outcomes [49].…”

Scaling Up Delivery of Biofortified Staple Food Crops Globally: Paths to Nourishing Millions

“…7,9,10 Over 15 years of peer-reviewed efficacy and effectiveness research has shown that biofortified foods measurably improve micronutrient intake, nutritional status, and health outcomes causally associated with vitamin A, iron, and zinc when eaten as a main portion of the diet. [11][12][13][14][15][16][17][18] For example, consumption of provitamin A-biofortified maize significantly improved pupillary responsiveness and provitamin A-orange sweet potato (OSP) reduced the prevalence and duration of diarrhea episodes 16,18 ; iron-biofortified beans and pearl millet significantly improved cognitive function 15,19 ; and zinc-biofortified wheat significantly reduced reported maternal and child morbidity. 20 Through daily consumption of biofortified foods, 25% to 100% of the Estimated Average Requirements (EAR) of vitamin A, iron, or zinc can be met for young children (1-6 years) old and nonpregnant, nonlactating women of reproductive age (WRA; 15-49 years old).…”