Randomized Placebo-Controlled Trial of Guava Juice as a Source of Ascorbic Acid to Reduce Iron Deficiency in Tarahumara Indigenous Schoolchildren of Northern Mexico

Monárrez‐Espino, Joel; López-Alarcón, Mardia; Greiner, Ted

doi:10.1080/07315724.2011.10719960

Cited by 21 publications

(18 citation statements)

References 51 publications

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“…Intakes of ascorbic acid in the form of guava and other locally grown seasonal fruit have been shown to be high among nonanemic Tanzanian schoolchildren aged 7-12 y on the basis of FFQs (52). A recent study reported that the consumption of guava juice showed only marginal beneficial effects on hemoglobin and ferritin concentrations in iron-deficient anemic children (53). Our results are in agreement with the above literature.…”

Section: Discussionsupporting

confidence: 92%

Inclusion of Guava Enhances Non-Heme Iron Bioavailability but Not Fractional Zinc Absorption from a Rice-Based Meal in Adolescents

Nair

Brahmam

Radhika

et al. 2013

The Journal of Nutrition

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Assessing the bioavailability of non-heme iron and zinc is essential for recommending diets that meet the increased growth-related demand for these nutrients. We studied the bioavailability of iron and zinc from a rice-based meal in 16 adolescent boys and girls, 13-15 y of age, from 2 government-run residential schools. Participants were given a standardized rice meal (regular) and the same meal with 100 g of guava fruit (modified) with (57)Fe on 2 consecutive days. A single oral dose of (58)Fe in orange juice was given at a separate time as a reference dose. Zinc absorption was assessed by using (70)Zn, administered intravenously, and (67)Zn given orally with meals. The mean hemoglobin concentration was similar in girls (129 ± 7.8 g/L) and boys (126 ± 7.1 g/L). There were no sex differences in the indicators of iron and zinc status except for a higher hepcidin concentration in boys (P < 0.05). The regular and modified meals were similar in total iron (10-13 mg/meal) and zinc (2.7 mg/meal) content. The molar ratio of iron to phytic acid was >1:1, but the modified diet had 20 times greater ascorbic acid content. The absorption of (57)Fe from the modified meal, compared with regular meal, was significantly (P < 0.05) greater in both girls (23.9 ± 11.2 vs. 9.7 ± 6.5%) and boys (19.2 ± 8.4 vs. 8.6 ± 4.1%). Fractional zinc absorption was similar between the regular and modified meals in both sexes. Hepcidin was found to be a significant predictor of iron absorption (standardized β = -0.63, P = 0.001, R(2) = 0.40) from the reference dose. There was no significant effect of sex on iron and zinc bioavailability from meals. We conclude that simultaneous ingestion of guava fruit with a habitual rice-based meal enhances iron bioavailability in adolescents.

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Section: Discussionsupporting

confidence: 92%

Inclusion of Guava Enhances Non-Heme Iron Bioavailability but Not Fractional Zinc Absorption from a Rice-Based Meal in Adolescents

Nair

Brahmam

Radhika

et al. 2013

The Journal of Nutrition

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“…The effect of vitamin C from natural dietary sources on the iron status is not widely covered in the literature and previous papers have limitations in study design, including intervention dose, sample size, or subject category . In addition, there are no studies (as far as we are aware) testing the impact of long‐term regular consumption of vitamin C–rich fruits with a supplementary nutrition meal program on preschoolers.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, we considered an intercluster correlation of 0.01 ( n = 10 in each AWC), 95% confidence interval, 80% power, and 20% attrition to achieve the required sample size. Earlier studies reported a change in hemoglobin (Hb) by 0.4–1.0 g/dL with a sample size ranging from n = 89 to 95. In the present study, a subsample of 80 per group was computed for assessing the impact of the intervention on iron biomarkers based on changes in hemoglobin (Hb) of 0.8 g/dL and a standard deviation of 1.5 g/dL.…”

Section: Methodsmentioning

confidence: 99%

“…Vitamin C reduces dietary ferric iron (Fe 3+ ) to ferrous (Fe 2+ ), which enhances absorption of nonheme iron . Other studies have shown mixed results when used for improving iron status . Increasing nonheme iron absorption by increasing intake of vitamin C–containing food is called a food‐based approach to ameliorating iron deficiency.…”

Section: Introductionmentioning

confidence: 99%

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A food synergy approach in a national program to improve the micronutrient status of preschoolers: a randomized control trial protocol

Choudhury

Nair

Balakrishna

et al. 2018

Annals of the New York Academy of Sciences

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Iron deficiency anemia (IDA) is a significant public health issue in India affecting nearly all vulnerable segments of the population. Causes of IDA include low consumption of iron-rich foods combined with poor iron bioavailability of nonheme iron sources. To date, interventions aimed at correcting IDA focus on increasing iron intake through iron supplementation or fortification strategies. In contrast, dietary diversification is a long-term sustainable approach to improve bioavailable iron intake. In this context, the inclusion of vitamin C-rich fruits in the regular diet has proven to improve iron absorption, but the effect on iron status is inconclusive. Considering the ongoing national program for preschoolers in India, we designed a cluster randomized controlled trial (RCT) to test the hypothesis that inclusion of vitamin C-rich fruit in a regular meal would improve iron absorption and lead to better child iron and micronutrient status, cognitive development, gut health, and growth while reducing morbidity. This paper illustrates a context-specific framework and activities to design and functionalize an open-label, three-arm cluster RCT to test a specific hypothesis. The results of this designed trial should generate evidence to inform policy on the effect of a food-based intervention on iron status.

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“…In Mexico, en experiment of the provision of guava juice containing of 200 mg AA led to an increase in levels of 0.64 mg/dl. 7 In Indonesia, guava juice research has been carried out to increase Hemoglobin levels and the results show an increase in Hemoglobin levels. 8,9 This study aims to assess the effect of the provision of guava juice containing AA of 200mg/100 grams and Fe tablets 2 times a day on the increase in hemoglobin levels in third trimester pregnant women..…”

mentioning

confidence: 99%

The effect of guava juice toward haemoglobin levels in pregnant women

Wahyuntari¹,

Wahtini²

2020

Int J Res Med Sci

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Background: The prevalence of anemia among pregnant women is 33-75% in developing countries. Iron deficiency is a common cause of anaemia. Absorption of iron can be achieved by increasing the content of diets containing vitamin C or ascorbic acid (AA) such as those in vegetables and fruit. The purpose of this study was to assess the effect of guava juice on the haemoglobin levels of pregnant women.Methods: The study was conducted using quasi-experiment. Sample was determined by the consecutive sampling method. 29 respondents were selected from each group. Both groups were given iron supplements of 2x1 for 2 weeks, while the control group besides receiving iron supplement therapy also consumed 200 ml/day guava juice for 2 weeks, with the inclusion criteria of third trimester pregnant women, anemia, no pregnancy complications and willing to be a respondent by signing an informed consent. Exclusion criteria not having a routine ANC at the Kalasan primary Health. Data collection was conducted using demographic data questionnaire, Observation Sheet of the provision of Fe tablets and guava juice and the measurement of hemoglobin levels with a hemocue.Results: There was an increase in Haemoglobin levels in the group given iron supplement therapy and consumption of 200 ml guava juice/day for 2 weeks with a p value of <0.05.Conclusions: Consumption of guava juice of 200 ml/day for 2 weeks increases the haemoglobin in pregnant women with anemia.

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Randomized Placebo-Controlled Trial of Guava Juice as a Source of Ascorbic Acid to Reduce Iron Deficiency in Tarahumara Indigenous Schoolchildren of Northern Mexico

Abstract: Guava juice providing 200 mg AA at one meal on each school day had a marginal effect on Hb and PF concentrations in children consuming high-phytate diets fortified with iron.

Cited by 21 publications

References 51 publications

Inclusion of Guava Enhances Non-Heme Iron Bioavailability but Not Fractional Zinc Absorption from a Rice-Based Meal in Adolescents

Inclusion of Guava Enhances Non-Heme Iron Bioavailability but Not Fractional Zinc Absorption from a Rice-Based Meal in Adolescents

A food synergy approach in a national program to improve the micronutrient status of preschoolers: a randomized control trial protocol

The effect of guava juice toward haemoglobin levels in pregnant women

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