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Iron fortification of whole wheat flour reduces iron deficiency and iron deficiency anemia and increases body iron stores in Indian school-aged children.
J Nutr. 2012 Nov; 142(11):1997-2003.JN

Abstract

Wheat is the primary staple food for nearly one-third of the world's population. NaFeEDTA is the only iron (Fe) compound suitable for fortifying high extraction flours. We tested the hypothesis that NaFeEDTA-fortified, whole wheat flour reduces Fe deficiency (ID) and improves body Fe stores (BIS) and cognitive performance in Indian children. In a randomized, double-blind, controlled, school feeding trial, 6- to 15-y-old, Fe-depleted children (n = 401) were randomly assigned to either a daily wheat-based lunch meal fortified with 6 mg of Fe as NaFeEDTA or an otherwise identical unfortified control meal. Hemoglobin (Hb) and Fe status were measured at baseline, 3.5 mo, and 7 mo. Cognitive performance was evaluated at baseline and 7 mo in children (n = 170) at one of the study sites. After 7 mo, the prevalence of ID and ID anemia in the treatment group significantly decreased from 62 to 21% and 18 to 9%, respectively. There was a time x treatment interaction for Hb, serum ferritin, transferrin receptor, zinc protoporphyrin, and BIS (all P < 0.0001). Changes in BIS differed between the groups; it increased in the treatment group (0.04 ± 0.04 mmol/kg body weight) and decreased in the control group (-0.02 ± 0.04 mmol/kg body weight) (P < 0.0001). In sensory tests, NaFeEDTA-fortified flour could not be differentiated from unfortified flour. There were no significant differences in cognitive performance tests between the groups. NaFeEDTA-fortified wheat flour markedly improved BIS and reduced ID in Fe-depleted children. It may be recommended for wider use in national school feeding programs.

Authors+Show Affiliations

Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India. sumi.muthayya@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23014487

Citation

Muthayya, Sumithra, et al. "Iron Fortification of Whole Wheat Flour Reduces Iron Deficiency and Iron Deficiency Anemia and Increases Body Iron Stores in Indian School-aged Children." The Journal of Nutrition, vol. 142, no. 11, 2012, pp. 1997-2003.
Muthayya S, Thankachan P, Hirve S, et al. Iron fortification of whole wheat flour reduces iron deficiency and iron deficiency anemia and increases body iron stores in Indian school-aged children. J Nutr. 2012;142(11):1997-2003.
Muthayya, S., Thankachan, P., Hirve, S., Amalrajan, V., Thomas, T., Lubree, H., Agarwal, D., Srinivasan, K., Hurrell, R. F., Yajnik, C. S., & Kurpad, A. V. (2012). Iron fortification of whole wheat flour reduces iron deficiency and iron deficiency anemia and increases body iron stores in Indian school-aged children. The Journal of Nutrition, 142(11), 1997-2003. https://doi.org/10.3945/jn.111.155135
Muthayya S, et al. Iron Fortification of Whole Wheat Flour Reduces Iron Deficiency and Iron Deficiency Anemia and Increases Body Iron Stores in Indian School-aged Children. J Nutr. 2012;142(11):1997-2003. PubMed PMID: 23014487.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Iron fortification of whole wheat flour reduces iron deficiency and iron deficiency anemia and increases body iron stores in Indian school-aged children. AU - Muthayya,Sumithra, AU - Thankachan,Prashanth, AU - Hirve,Siddhivinayak, AU - Amalrajan,Vani, AU - Thomas,Tinku, AU - Lubree,Himangi, AU - Agarwal,Dhiraj, AU - Srinivasan,Krishnamachari, AU - Hurrell,Richard F, AU - Yajnik,Chittaranjan S, AU - Kurpad,Anura V, Y1 - 2012/09/26/ PY - 2012/9/28/entrez PY - 2012/9/28/pubmed PY - 2013/1/3/medline SP - 1997 EP - 2003 JF - The Journal of nutrition JO - J Nutr VL - 142 IS - 11 N2 - Wheat is the primary staple food for nearly one-third of the world's population. NaFeEDTA is the only iron (Fe) compound suitable for fortifying high extraction flours. We tested the hypothesis that NaFeEDTA-fortified, whole wheat flour reduces Fe deficiency (ID) and improves body Fe stores (BIS) and cognitive performance in Indian children. In a randomized, double-blind, controlled, school feeding trial, 6- to 15-y-old, Fe-depleted children (n = 401) were randomly assigned to either a daily wheat-based lunch meal fortified with 6 mg of Fe as NaFeEDTA or an otherwise identical unfortified control meal. Hemoglobin (Hb) and Fe status were measured at baseline, 3.5 mo, and 7 mo. Cognitive performance was evaluated at baseline and 7 mo in children (n = 170) at one of the study sites. After 7 mo, the prevalence of ID and ID anemia in the treatment group significantly decreased from 62 to 21% and 18 to 9%, respectively. There was a time x treatment interaction for Hb, serum ferritin, transferrin receptor, zinc protoporphyrin, and BIS (all P < 0.0001). Changes in BIS differed between the groups; it increased in the treatment group (0.04 ± 0.04 mmol/kg body weight) and decreased in the control group (-0.02 ± 0.04 mmol/kg body weight) (P < 0.0001). In sensory tests, NaFeEDTA-fortified flour could not be differentiated from unfortified flour. There were no significant differences in cognitive performance tests between the groups. NaFeEDTA-fortified wheat flour markedly improved BIS and reduced ID in Fe-depleted children. It may be recommended for wider use in national school feeding programs. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/23014487/Iron_fortification_of_whole_wheat_flour_reduces_iron_deficiency_and_iron_deficiency_anemia_and_increases_body_iron_stores_in_Indian_school_aged_children_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.3945/jn.111.155135 DB - PRIME DP - Unbound Medicine ER -