Consumption of Iron-Fortified Lentils Is Protective against Declining Iron Status among Adolescent Girls in Bangladesh: Evidence from a Community-Based Double-Blind, Cluster-Randomized Controlled Trial.
Study Goal
The researchers aimed to determine whether iron-fortified lentils (IFLs) could improve body iron status in adolescent girls in rural Bangladesh, specifically by mitigating declines in serum ferritin and total body iron levels.
Results Summary
The study found that the IFL group had a significantly reduced decline in serum ferritin and total body iron levels compared to the non-fortified lentils and control groups, with a 57% reduced risk of developing clinical iron deficiency. However, all groups experienced some decline in iron status over time.
Population
Rural Bangladeshi adolescent girls aged 10-17 years (n = 1195).
Effective Dosage
200 g cooked IFLs or non-iron-fortified lentils (NIFLs) 5 days a week, providing ~8.625 mg Fe per serving (IFL) or 2.625 mg Fe (NIFL).
Duration
85 feeding days (approximately 17 weeks).
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
iron-fortified lentils (IFLs) | decrease | serum ferritin (sFer) | rural Bangladeshi adolescent girls | -7.2 μg/L | exhibited a significantly reduced decline | #1 |
iron-fortified lentils (IFLs) | decrease | total body iron (TBI) | rural Bangladeshi adolescent girls | -0.48 mg/kg | exhibited a significantly reduced decline | #2 |
noniron-fortified lentils (NIFLs) | decrease | serum ferritin (sFer) | rural Bangladeshi adolescent girls | -14.3 μg/L | decline | #3 |
noniron-fortified lentils (NIFLs) | decrease | total body iron (TBI) | rural Bangladeshi adolescent girls | -1.36 mg/kg | decline | #4 |
usual dietary intake (control group) | decrease | serum ferritin (sFer) | rural Bangladeshi adolescent girls | -12.8 μg/L | decline | #5 |
usual dietary intake (control group) | decrease | total body iron (TBI) | rural Bangladeshi adolescent girls | -1.33 mg/kg | decline | #6 |
iron-fortified lentils (IFLs) | decrease | clinical iron deficiency (sFer <15 μg/L) | rural Bangladeshi adolescent girls | 57% | had a reduced risk | #7 |
BACKGROUND: In many low-income countries, iron deficiency (ID) and its anemia (IDA) pose significant health challenges, particularly among females and girls. Finding sustainable and effective solutions to address this issue is critical. OBJECTIVES: This study aimed to evaluate the efficacy of incorporating iron-fortified lentils (IFLs) into the diets of rural Bangladeshi adolescent girls on their body iron (Fe) status. METHODS: A community-based, double-blind, cluster-randomized controlled trial involved n = 1195 girls aged 10-17 y. A total of 48 adolescent clubs (n = ∼27 girls each) were randomized into 3 groups: 1) 200 g cooked IFLs, 2) 200 g cooked noniron-fortified lentils (NIFLs), and 3) a control group with no lentils (usual dietary intake). The intervention, administered 5 days a week for 85 feeding days, provided ∼8.625 mg Fe from each serving of IFLs and 2.625 mg from NIFLs. Blood samples collected at baseline, midpoint (42 feeding days), and endpoint (85 feeding days) assessed key Fe and inflammation biomarkers. Statistical analyses were filtered for inflammation. RESULTS: Although all groups experienced a decline in Fe status over time, the IFL group exhibited a significantly reduced decline in serum ferritin (sFer -7.2 μg/L), and total body iron (TBI -0.48 mg/kg) level compared with NIFL (sFer -14.3 μg/L and TBI -1.36 mg/kg) and usual intake group (sFer -12.8 μg/L and TBI -1.33 mg/kg). Additionally, those in the IFL group had a 57% reduced risk of developing clinical ID (sFer <15 μg/L) compared with the usual intake group. CONCLUSIONS: Our findings suggest that incorporating IFLs into the diet can help mitigate a decline in sFer, indicating a positive impact on the body Fe status of adolescent girls. This research underscores the potential role of fortified foods in addressing ID and IDA in vulnerable populations, emphasizing the significance of food-based interventions in public health. TRIAL REGISTRATION NUMBER: This trial was registered at the clinicaltrials.gov on May 24, 2018 (https://clinicaltrials.gov/study/NCT03516734?locStr=Bangladesh&country=Bangladesh&distance=50&cond=Anemia&intr=Iron%20fortified%20lentils&rank=1) as NCT03516734.