The effects of iron-fortified lentils on the iron (fe) status of adolescent girls in Bangladesh: a double-blind, community-based, cluster-randomized controlled trial
Date
2020-09-21
Authors
Journal Title
Journal ISSN
Volume Title
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ORCID
https://orcid.org/0000-0002-0614-000X
Type
Thesis
Degree Level
Doctoral
Abstract
This research aimed to investigate if consuming iron-fortified lentils could improve the body iron status of non-pregnant adolescents in rural Bangladesh. A four-month experimental study was carried out with n=1195 Bangladeshi adolescent girls aged 10–17 years, who were randomly assigned to one of three groups. One group consumed cooked iron-fortified lentils (~ 200 g/day, five days per week for 85 feeding days), the second group consumed a similar amount of non-iron-fortified lentils, and the third group was provided no lentils. The lentil recipe (daal) was selected based on cultural preferences. Body iron stores before and after the intervention were measured to determine the differences between and within groups over the four month study. In the group that consumed the iron-fortified lentils, there was a positive effect on body iron status. In this group, serum ferritin was maintained, whereas it declined in both the non-iron-fortified lentil group and the no-intervention group. Girls in the iron-fortified lentil group had higher iron stores compared to girls in the non-iron-fortified lentil and no-intervention groups. No difference in body iron stores was observed between or within these last two groups. Girls who consumed iron-fortified lentils were also less likely to have low hemoglobin levels compared to those in the other groups. However, there was little difference between or within groups in hemoglobin levels, as opposed to body iron stores. This is likely because increased iron stores in non-iron-depleted individuals would have little influence on hemoglobin, but iron stores in iron-depleted individuals who move to the non-depleted population could elevate hemoglobin. As for anemia prevalence (%), we observed no noticeable increase in anemia prevalence in the iron-fortified lentil group compared to the other two groups, in which there was a significant increase in anemia prevalence during the study. Thus, although there were clear differences in iron stores, these did not impact hemoglobin and anemia status. Further analysis of iron-depleted populations across the three groups revealed that iron stores increased substantially in the iron-fortified group between the beginning and end of the study. These results suggest that the iron-depleted population had the most potential to benefit from consuming iron-fortified lentils to resolve their iron deficiency, both clinically and sub-clinically.
Description
Keywords
Fortification, Micronutrient deficiency, Nutrition, Food-based approach.
Citation
Degree
Doctor of Philosophy (Ph.D.)
Department
Pharmacy and Nutrition
Program
Nutrition