Efficacy of twice-weekly multiple micronutrient supplementation for improving the hemoglobin and micronutrient status of anemic adolescent schoolgirls in Bangladesh

Ahmed, Faruk; Khan, Mohammad Rezwan; Akhtaruzzaman, Mohammad; Karim, Rezaul; Marks, Geoffrey C.; Banu, C.; Nahar, Badrun; Williams, Gail

doi:10.1093/ajcn/82.4.829

Cited by 45 publications

(42 citation statements)

References 20 publications

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“…The study was carried out between March and May 2003 during screening for anaemia for an intervention trial that examined the efficacy of multiple micronutrient supplementation (Ahmed et al, 2005). After obtaining the girls' and their parents' written consent, 1800 eligible girls of grades VIII-X in the selected schools participated in the initial screening for anaemia; 570 of them were identified as anaemic (Hb) concentration o120 g/l) using a B-Haemoglobin Analyzer (HemoCue, Angelholm, Sweden) on a finger prick blood sample.…”

Section: Subjectsmentioning

confidence: 99%

“…Details of blood collection, processing and analytical procedures for serum ferritin, red blood cell (RBC) folic acid, erythrocyte glutathione reductase activity coefficient (EGRAC, an indicator of riboflavin status), plasma vitamin C, serum vitamins A and B 12 have been described elsewhere (Ahmed et al, 2005). The number of samples varied for each of the biochemical variables because some were lost during analysis.…”

Section: Biochemical and Haematological Measuresmentioning

confidence: 99%

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The coexistence of other micronutrient deficiencies in anaemic adolescent schoolgirls in rural Bangladesh

et al. 2007

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Objective: To investigate the prevalence of selected micronutrient deficiencies amongst anaemic adolescent schoolgirls in rural Bangladesh and to examine their relationship with haemoglobin (Hb) levels. Design: A cross-sectional study. Setting: Girls' high schools in rural areas of Dhaka District in Bangladesh. Subjects and methods: Three hundred and ten anaemic adolescent girls aged 14-18 years from eight schools participated in the study. Information on personal characteristics and food habits were collected by interview. Parents were asked about their socio-economic conditions. Anthropometric data and blood samples were collected following the interview. Results: Twenty-eight per cent of the girls had depleted iron stores (serum ferritin o12.0 mg/l), 25% had folic acid deficiency (red blood cell folic acid o317 nmol/l), 89% had vitamin B 2 (erythrocyte glutathione reductase activity coefficient X1.4) and 7% had vitamin B 12 deficiencies (serum vitamin B 12 o150 pmol/l). Although the prevalence of vitamins A and C deficiency was very low, a significant proportion had low vitamin A (serum retinol between 0.70 and o1.05 mmol/l) and vitamin C status (plasma ascorbic acid between 11.4-23.0 mmol/l). Frequency of consumption of meat, serum ferritin and vitamin B 2 status were found to be strongly related to Hb by multiple regression analysis. For 1 mg/l change in serum ferritin, there was a 0.13 g/l change in Hb when adjusted for other factors. Conclusions: There is coexistence of micronutrient deficiencies among anaemic adolescent girls in rural Bangladesh, although they do not suffer from energy deficiency. Of all micronutrients, only iron and vitamin B 2 concentrations were found to be related to the Hb concentration.

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Section: Subjectsmentioning

confidence: 99%

Section: Biochemical and Haematological Measuresmentioning

confidence: 99%

The coexistence of other micronutrient deficiencies in anaemic adolescent schoolgirls in rural Bangladesh

et al. 2007

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“…11 Namun, peningkatan Hb subjek penelitian ini masih lebih rendah dibandingkan dengan studi eksperimental yang menmpergunakan suplementasi besi, yaitu 0,08-1,12 g/dL. 6,9,12 Evaluasi program suplementasi besi para siswi SMP dan SMK di Kota Bekasi memperlihatkan perbaikan status anemia. Kadar Hb rata-rata sebelum suplementasi 12,4 g/dL dan setelah itu menurun menjadi 12,3 g/dL.…”

Section: Pembahasanunclassified

“…4 Pada kebanyakan studi eksperimental yang lainnya, status besi awal berpengaruh pada perubahan nilai hemoglobin dan feritin serum. 6,12,13 Pada penelitian ini fortifikasi cookies hanya sedikit meningkatkan kadar Hb siswi remaja. Hal ini kemungkinan disebabkan karena retensi vitamin fortifikan di dalam proses pembuatan cookies yang ternyata rendah, sehingga dosis tidak sesuai dengan desain awal.…”

Section: Pembahasanunclassified

Efikasi Fortifikasi Cookies Ubi Jalar untuk Perbaikan Status Anemia Siswi Sekolah

Briawan¹,

Sulaeman²,

Syamsir³

et al. 2013

mkb

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AbstrakSelain suplementasi tablet besi, fortifikasi pangan lokal diperlukan sebagai alternatif program untuk perbaikan status besi. Tujuan penelitian ialah menguji efikasi fortififikasi cookies ubi jalar untuk peningkatan hemoglobin (Hb) pada siswi sekolah. Studi dilakukan dengan desain pre-post intervention study, yang melibatkan 74 siswi SMK Pelita Kabupaten Bogor. Studi dilaksanakan pada bulan Mei-Juli 2012. Cookies ubi jalar difortifikasi dengan 10,5 mg vitamin A, 42 µg vitamin B12, 1,25 g vitamin C, 2 mg asam folat, dan besi fumarat 150 mg per 100 g. Cookies sebanyak 40 g diberikan seminggu tiga kali selama dua bulan. Hasil penelitian menunjukkan kadar Hb rata-rata sebelum intervensi 13,4±1,4 g/dL. Setelah intervensi, terdapat perubahan kadar Hb 0,4±1,6 g/dL dan sebanyak 65,2% subjek mengalami kenaikan Hb. Kenaikan Hb ini tidak memengaruhi prevalensi anemia yang sedikit meningkat dari 10,8% menjadi 18,8% dan secara statistik tidak nyata (p>0,05). Simpulan, intervensi fortifikasi cookies ubi jalar selama dua bulan tidak menurunkan prevalensi anemia pada anak sekolah. Disarankan studi berikutnya untuk menambah waktu intervensi dan menggunakan indikator status besi lainnya. [MKB. 2013;45(4):206-12] Kata kunci: Anemia, cookies, fortifikasi, siswi, ubi jalar Efficacy of Fortified Sweet Potato Cookies for Improving Anemia Status in Female Students AbstractLocal food fortification for improving iron status is one of the alternative programs in addition to iron tablet supplementation. The objective of this study was to analyze the efficacy of fortified sweet potato cookies for improving hemoglobin (Hb) concentrations in female students. The pre-post intervention study was applied to 74 female students of SMK Pelita in Bogor District. The study was conducted from May to July 2012. The sweet potato cookies used were fortified with 10.5 mg vitamin A, 42 µg vitamin B12, 1.25 g vitamin C, 2 mg folic acid, and 150 mg iron fumarate per 100 g cookies. Subjects received 40 g cookies three times a week for two months. The average Hb concentration before intervention was 13.4±1.4 g/dL. After intervention, there was an increase in hemoglobin concentration (mean 0.4±1.6 g/dL). About 65.2% subjects experienced increase in their Hb concentration. However, after the intervention the anemia prevalence slightly increased from 10.8% to 18.8% although this increase is not statistically significant (p>0.05). In conclusion, fortified sweet potato cookies intervention for two months does not reduce anemia prevalence in female students. Further studies are required by extending intervention times and applying other indicators of iron status. [MKB. 2013;45(4):206-12]

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“…Multiple factors, including the continuing inadequate intake or low bioavailability of dietary Fe (Thankachan et al, 2007) and the presence of concurrent micronutrient deficiencies (Ahmed et al, 2005) and intestinal parasitic infections (Boccio, 2003), have been implicated in the continuing high prevalence of iron deficiency (ID) and IDA. Additional reasons may be poor compliance to long-term supplementation programs, along with logistic problems with the continuous supply of supplements.…”

Section: Introductionmentioning

confidence: 99%

A mathematical model for the hemoglobin response to iron intake, based on iron absorption measurements from habitually consumed Indian meals

et al. 2011

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Background/Objectives: The prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) is high in India and appear unchanging over decades. To understand the persistence of these disorders, it is critical to measure iron (Fe) absorption from cereal-based Indian meals, its modulation by ID and the time-course of the response of hemoglobin (Hb) to Fe intake. Subjests/Methods: Fe absorption from rice-based meals was measured by the erythrocyte incorporation of the stable isotope label at 14 days in IDA (N ¼ 15) and Fe replete (IR) women (N ¼ 15). Hb level was used as surrogate for Fe status, and a response curve for Fe absorption versus the Hb level for a rice-based meal was constructed from measured data. This relationship was used as input for a mathematical model that examined the Hb response to different Fe intakes in normal and anemic women. Results: The mean fractional Fe absorption from a rice-based meal in IR and IDA women was 2.7% and 8.3%, respectively. The model predicted that Fe intakes between 20 and 55 mg/day in low-bioavailability diets would result in stable, non-anemic levels of Hb in women over a 1-year period.Conclusion: This mathematical model suggests that with a Fe intake of 20-30 mg/day and a dietary bioavailability of 3-5%, Hb concentration would hover around 12 g/dl with a variability of 0.5 g/dl in pre-menopausal adult women.

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Efficacy of twice-weekly multiple micronutrient supplementation for improving the hemoglobin and micronutrient status of anemic adolescent schoolgirls in Bangladesh

Cited by 45 publications

References 20 publications

The coexistence of other micronutrient deficiencies in anaemic adolescent schoolgirls in rural Bangladesh

The coexistence of other micronutrient deficiencies in anaemic adolescent schoolgirls in rural Bangladesh

Efikasi Fortifikasi Cookies Ubi Jalar untuk Perbaikan Status Anemia Siswi Sekolah

A mathematical model for the hemoglobin response to iron intake, based on iron absorption measurements from habitually consumed Indian meals

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