India has the highest rate of iron deficiency anemia, which has been suggested to be the result of a poor diet. Consuming iron supplement bars daily can increase hemoglobin concentrations to help lower the prevalence of anemia in India without a risk of side effects.
India has the highest rates of iron deficiency anemia (IDA) worldwide and affects approximately 70% of children, 55% of women during their reproductive age and 85% of pregnant women. This issue has been attributed to having a poor availability of iron due to food consumption of the local diet. Iron sources include non-heme inorganic iron sources such as grains, plants, vegetables, cereals, lentils and iron supplements (iron pills and iron- fortified foods). Where the Recommended Daily Allowance for iron (Fe) is 15-18 mg/d for women aged 14-50 years old, a typical Indian woman consumes only 9.5 mg Fe/d. Moreover, the cost of meat in addition to vegetarianism in certain parts of India is a contributing factor to this issue.
A new study, published in The American Journal of Clinical Nutrition, examines the efficacy of iron supplement bars in raising hemoglobin concentrations and hematocrit (red blood cell concentration) percentages in anemic women in India at the reproductive age. Mehta et al. conducted a 90 day, cluster-randomized control trial in Mumbai and Navi Mumbai, India. 361 non-pregnant women between the ages of 18-35 years were recruited and received information sessions regarding anemia and a complete blood count (CBC). However, over the period of the study, out of the 361 participants, only 179 women were eligible to take part in the study. The participants were divided into two groups, intervention, and control. The intervention participants received one iron supplement bar which contained 14 mg Fe/d for 90 days and the control group did not receive anything. CBC tests were taken at 15-, 45- and 90-day intervals. Linear mixed models and generalized equations were used to model continuous outcomes.
Mehta et al. concluded that there was a positive correlation between the iron supplement bars and hemoglobin levels increasing. By the 15th day of the study, the odds of being anemic were already lower in this group. Moreover, 93.1% of the women in the intervention arm (compared to 34.6% of women in the control arm) displayed positive increases in hemoglobin within the 90-day period. Also, after the consumption of iron supplement bars for 90 days, 70.8% of the anemic women in the intervention arm had normal hemoglobin concentrations of 12.0 g/dL and were no longer anemic. The results also showed that 82.1% of the women in the treatment arm reached normal hematocrit percentages.
Even though iron bar supplements have proven to be a useful source to Indian women to raise their hemoglobin levels and help with their anemia, two limitations were still present in this study. Firstly, the participants were recruited from 10 sites (clusters), therefore, it cannot be used to fully represent each state of India as each state’s diet, socioeconomic status and lifestyle are very different. Due to this, the amount of iron supplement bars used in this study should be altered based on each individual. The second limitation was that a lack of blinding in this experiment could have led to some bias in the study.
IDA is a social, political and health problem for women worldwide and especially women in India. Therefore, the results from this study act as an important factor in helping to reduce high prevalence rates in India, especially amongst pregnant women and children living in vulnerable populations, by offering iron supplement bars as a solution.
Written By: Seema N. Goolie, BSc