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Heme Iron Concentrate and Iron Sulfate Added to Chocolate Biscuits: Effects on Hematological Indices of Mexican Schoolchildren.

Journal of the American College of Nutrition
August 1, 2016
Adrián Guillermo Quintero-Gutiérrez et al. (4 authors)
Journal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to compare the effectiveness of two iron fortification methods (heme iron concentrate and iron sulfate) in chocolate biscuits on improving hemoglobin and iron status in preschool children.

Results Summary

Both heme iron concentrate and iron sulfate significantly increased hemoglobin levels and other hematological indices, with no significant difference between the two forms. The fortified chocolate biscuits were more effective than the control group in improving hemoglobin levels.

Population

Preschool children (aged 3-6 years) from rural communities.

Effective Dosage

Not specified (consumed fortified biscuits for 72 days).

Duration

72 days (10 weeks).

Interactions

None mentioned.

Extracted Claims (13)
InterventionDirectionEndpointPopulationDosageImpactClaim #
iron-fortified chocolate biscuits
increase
hemoglobin levels
preschool children from rural communities
+1.1 ± 0.2 g/dL
adjusted effect ... was higher than the control group
#1
fortified biscuits with heme iron concentrate
no change
hemoglobin levels
preschool children from rural communities
+1.9 ± 0.2 g/dL
no difference was found between consumers of fortified biscuits with heme iron concentrate or iron sulfate
#2
fortified biscuits with iron sulfate
no change
hemoglobin levels
preschool children from rural communities
+2.0 ± 0.2 g/dL
no difference was found between consumers of fortified biscuits with heme iron concentrate or iron sulfate
#3
iron-fortified chocolate biscuits
increase
mean corpuscular volume
preschool children from rural communities
+2.2 ± 1.0 f/dL
increased significantly
#4
iron-fortified chocolate biscuits
increase
red blood cells
preschool children from rural communities
+0.30 ± 0.37 M/μL
increased significantly
#5
iron-fortified chocolate biscuits
increase
mean corpuscular hemoglobin
preschool children from rural communities
+1.8 ± 1.74 pg
increased significantly
#6
iron-fortified chocolate biscuits
increase
hemoglobin
preschool children from rural communities
+1.68 ± 0.91 g/dL
increased significantly
#7
iron-fortified chocolate biscuits
increase
hematocrit
preschool children from rural communities
+3.43% ± 3.03%
increased significantly
#8
iron-fortified chocolate biscuits
increase
plasma ferritin
preschool children from rural communities
+18.38 ± 22.1 μg/L
increased significantly
#9
iron-fortified chocolate biscuits
increase
mean corpuscular hemoglobin concentrations
preschool children from rural communities
+1.27 ± 2.25 g/dL
increased
#10
heme iron concentrate
increase
Hb levels and hematological indices
preschool children
-
were equally effective in increasing
#11
iron sulfate
increase
Hb levels and hematological indices
preschool children
-
were equally effective in increasing
#12
Processed foods
decrease
anemia
preschool children
-
were shown to be an effective, valuable, and admissible intervention to prevent
#13
Abstract

OBJECTIVE: Food fortification is one of the most effective strategies for increasing iron intake in the population. A simple blind trial was conducted to compare the effect of 2 forms of iron fortification and assess the changes in hemoglobin and iron status indices among preschool children from rural communities. METHODS: Hemoglobin was evaluated in 47 children aged 3-6 years old. For 72 days (10-week period), children ate Nito biscuits. Thirteen pupils with elevated hemoglobin levels were assigned to the biscuit control group, and pupils with hemoglobin equal to 13.5 mg/dL or less were randomly allocated to consume fortified biscuits with a heme iron concentrate (n = 15) or iron sulfate (n = 19). Changes in hemoglobin, plasma ferritin, and other hematological indices were evaluated with analysis of variance (ANOVA) for repeated measurements. RESULTS: Except mean corpuscular hemoglobin concentrations (+1.27 ± 2.25 g/dL), hematological indices increased significantly across the study: Mean corpuscular volume (+2.2 ± 1.0 f/dL), red blood cells (+0.30 ± 0.37 M/μL), mean corpuscular hemoglobin (+1.8 ± 1.74 pg), hemoglobin (+1.68 ± 0.91 g/dL), hematocrit (+3.43% ± 3.03%), and plasma ferritin (+18.38 ± 22.1 μg/L) were all p < 0.05. After 10 weeks, the adjusted effect of the iron-fortified chocolate biscuits in the hemoglobin levels was higher than the control group (+1.1 ± 0.2 g/dL) but no difference was found between consumers of fortified biscuits with heme iron concentrate or iron sulfate (+1.9 ± 0.2 g/dL and +2.0 ± 0.2 g/dL, respectively). CONCLUSION: Heme iron concentrate and iron sulfate were equally effective in increasing Hb levels and hematological indices. Processed foods were shown to be an effective, valuable, and admissible intervention to prevent anemia in preschool children.

Medical Subject Headings (MeSH)
Anemia, Iron-DeficiencyChildChild, PreschoolChocolateErythrocyte IndicesFemaleFerritinsFerrous CompoundsFood, FortifiedHematocritHemeHemoglobinsHumansIronIron, DietaryMaleMexicoNutritional StatusRural Population
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality75/10
Citation Metrics
Total Citations5
Citations/Year0.6
Relative Citation Ratio0.27
NIH Percentile14%
Research Impact Scores
APT Score0.25
Weight Score1.62
Normalized Score0.69
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