The effects of fortification through an added enhancer vitamin C beverage or NaFeEDTA alone or in combination with a multiple micronutrient snack daily in improving iron and micronutrient status of young women in south India: A randomized controlled study
Poor dietary iron intake, decreased iron absorption and multiple micronutrient (MMN) deficiencies (Fe, folate vitamins C, B2 and B12) have been implicated in the etiology of anaemia. This study evaluated the efficacy of a vitamin C beverage or a snack fortified with iron alone or iron in combination with MMN provided for 6 months (6 days/week) at lunch in reducing the prevalence of iron deficiency anemia (IDA) and improvement of MMN status in young women. Iron depleted (ID) women (n=500) were randomized into four arms which received either; iron- fortified snack (7 mg iron as Na Fe EDTA), iron-fortified-MMN snack (7 mg NaFeEDTA , 50 mcg folate, 0.50mcg B12, 0.70mg B2), vitamin C beverage (40 mg) alone or a placebo. At the end of 6 months, there was a significant reduction in prevalence of IDA in iron- fortified, iron-fortified-MMN and vitamin C groups but the prevalence at that point was significantly lower only for the iron-fortified group when compared to the other two groups. The concentrations of hemoglobin and serum ferritin were significantly higher in the iron-fortified and iron-fortified-MMN groups when compared to the other groups (P<0.001). Red cell folate and vitamin B12 levels improved significantly in the iron-fortified-MMN alone. Iron and vitamin C fortification reduced the prevalence of IDA with the greatest effect being observed for the iron-fortified group.