Efficacy of Iron-Fortified Rice in Reducing Anemia Among Schoolchildren in the Philippines
Iron deficiency anemia (IDA) in the Philippines is a serious public health problem. Fortifying rice offers a great opportunity to control IDA. However, information on other types of fortificants that can be used is scarce.
To compare the effects of two types of iron fortificants in rice in improving the hematological status of schoolchildren. Design: 180 randomly selected 6-to 9-year-old anemic children were randomly allocated to three groups in a double-blinded manner: One group received iron-enriched rice (IER) with extruded iron premix rice (IPR) using ferrous sulfate as fortificant (ExFeSO4); the second group received IER with extruded IPR using micronized dispersible ferric pyrophosphate (ExFeP80); and the third group received non-fortified rice (Control). These were administered daily for 5 days a week for 6 months. Blood samples were collected at baseline after 3 and 6 months.
At baseline, one child in the ExFeP80 group was suffering from IDA; at 3 months, no IDA was found in any groups; while at 6 months, one child in the ExFeP80 developed IDA. The baseline prevalence of anemia in all groups, which was 100%, was significantly reduced to 51%, 54%, and 63% in the ExFeSO4, ExFeP80 and Control groups respectively. After 6 months, further significant reductions were observed in the ExFeSO4 (38%) and ExFeP80 (33%) but remained at 63% in the Control group. Greater, significant increases were also observed in plasma ferritin in the fortified groups than in the Control group from baseline to 6 months. The predictors of change in hemoglobin (Hb) and plasma ferritin were group allocation and basal values.
The consumption of rice fortified with FeP80 using extrusion technology has similar effects as that of FeSO4 in reducing the prevalence of IDA among schoolchildren.
Available from: Mario V Capanzana
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ABSTRACT: Rice, the staple food of the Philippines, is an appropriate vehicle for iron fortification to combat the high prevalence of iron-deficiency anemia. A previous study among schoolchildren supplemented with iron-fortified rice showed a significant reduction in the rate of iron-deficiency anemia from 100% to 33%.
To document the processes involved in commercializing iron-fortified rice and to determine its effects on anemia prevalence.
This study was conducted on 766 mothers and their children aged 6 to 9 years in Orion, Bataan. Soliciting political support, networking with local organizations, market surveys, and social marketing activities were conducted. The iron content of iron-fortified rice was tested for each production run. Hemoglobin measurements were performed on the mothers and children at baseline and endline.
A municipal ordinance to sell iron-fortified rice was issued, while the local federation provided funds to kick off the sale of iron-fortified rice. Sales of iron-fortified rice were highest when the rice was sold at Php 27 (Php 1 = US$0.025) per kilogram and lowest when the price was Php 37 per kilogram or greater. The municipal ordinance was not strictly enforced because of the global rice crisis. Social marketing activities encouraged families to buy iron-fortified rice. The iron content of the iron-rice premix was within the set specification limits of 600 to 760 mg of iron per 100 g of premix, while the iron-fortified rice was within 3 to 3.8 mg of iron and 1 to 2 mg (BC No. 2009-010) per 100 g of raw and cooked fortified rice, respectively. The decrease in the rate of anemia was significant among children (from 17.5% to 12.8%) but not among mothers (from 13.0% to 12.5%) after 9 months of study implementation.
Strong political support and intensive social marketing activities are crucial inputs in commercializing iron-fortified rice. Keeping the cost affordable and maintaining the commitment of identified partners were the key factors for providing a continuous supply of iron-fortified rice. Commercializing iron-fortified rice can be considered as one of the strategies for decreasing anemia prevalence.
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ABSTRACT: Food fortification is advocated to tackle iron deficiency in anemic populations. Our objective was to evaluate the impact
of iron-fortified rice (Ultrarice®) weekly on hemoglobin and anemia levels compared with standard rice (control). This cluster-randomized study deals with infants
(10–23 months) from two public child day care centers in Brazil, n = 216, in an 18 week intervention. The intervention group received individual portions of fortified rice (50 g) provided
56.4 mg elemental/Fe. For intervention center: baseline mean hemoglobin was 11.44 ± 1.07 g/dl, and after intervention 11.67 ± 0.96 g/dl,
p < 0.029; for control: baseline mean hemoglobin value was 11.35 ± 4.01 g/dl, and after intervention 11.36 ± 2.10 g/dl, p = 0.986. Anemia prevalence for intervention center was 31.25% at baseline, and 18.75% at end of study, p = 0.045; for control 43.50% were anemic at baseline, and 37.1% at the end of study, p = 0.22. Number Needed to Treat was 7. Iron-fortified rice was effective in increasing hemoglobin levels and reducing anemia
Available from: Jp Pena-Rosas
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